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The reduction of sugar and energy (calories) in the diet has been a long‐standing challenge for the food industry, not only to support individuals actively seeking to limit their sugar and energy (calorie) intake but also as a response to public health policy initiatives, such as sugar taxes for the food industry and government reformulation programmes. In recent years, responding to this challenge has become more difficult for food manufacturers and formulators, as consumers are increasingly seeking products formulated using a limited range of natural, clean‐label ingredients. Zero‐calorie high‐potency sweeteners with improved taste performance are a partial solution, but a greater challenge is the replacement of the bulking, browning and other properties that sucrose, glucose and fructose provide in many solid food products. This article describes advances in high‐potency sweeteners and in bulk, low‐calorie sugar replacement ingredients that can offer effective solutions to the challenges encountered in developing great‐tasting, sugar‐ and calorie‐reduced food products for today's consumers. [ABSTRACT FROM AUTHOR]

Background The reported risk of depression in patients with hypomagnesaemia is controversial. Aim The objective of this meta-analysis was to assess the association between depression and hypomagnesaemia. Methods A literature search was performed using MEDLINE, EMBASE, Cochrane Database and from inception through October 2014. Studies that reported odds ratios, relative risks or hazard ratios comparing the risk of depression in patients with hypomagnesaemia were included. Pooled risk ratios ( RR) and 95% confidence interval ( CI) were calculated using a random-effect, generic inverse variance method. Results Six observational studies (three cohort studies, two cross-sectional studies and a case-control study) with a total of 19 137 patients were identified and included in the data analysis. The pooled RR of depression in patients with hypomagnesaemia was 1.34 (95% CI, 1.01-1.79, I2 = 33%). The association between depression and hypomagnesaemia was marginally insignificant after the sensitivity analysis including only cohort and case-control studies, with a pooled RR of 1.38 (95% CI, 0.92-2.07, I2 = 24%). Conclusion Our study demonstrates a potential association between hypomagnesaemia and depression. Further studies assessing the benefits of treatment of hypomagnesaemia in patients with depression are needed. [ABSTRACT FROM AUTHOR]

Pathogens that infect and/or are transmitted by mosquitoes typically are exposed to the body cavity, and to haemocytes circulating therein, during development or dissemination. Aedes aegypti haemocytes produce a range of immune response-related gene products, and an endpoint response of phagocytosis and/or melanization that is temporally and structurally distinct for the invading pathogen. Expressed sequence tags were generated from haemocyte libraries and then used to design oligonucleotide microarrays. Arrays were screened with haemocyte material collected 1-, 8- and 24-h post-inoculation with Escherichia coli or Micrococcus luteus bacteria. Data from these studies support the discovery of novel immune response-activated genes, provide an expanded understanding of antimicrobial peptide biology and highlight the coordination of immune factors that leads to an endpoint response. [ABSTRACT FROM AUTHOR]

Over the past decade, on-line databases have become increasingly popular among health care professionals. As a group, these 'end-users' report utilizing databases to keep abreast of medical progress, to conduct research and to address specific patient care issues. Throughout the literature, medical professionals ('content experts') have proved to be less effective searchers than librarians ('search experts'). The potential implications of this discrepancy are worrysome. For any given clinical scenario, for example, published reports may reach contradictory conclusions. A poorly skilled searcher may not retrieve enough articles to appreciate this fact. Optimizing searching skills is therefore a worthwhile goal. As a first step, many medical schools introduce students to on-line databases, most notably MEDLINE. Residency is an ideal time to continue this training. A recognized obstacle to provide residents with formal MEDLINE instruction is time constraint. We therefore conducted this study to ascertain the impact an individual 1-hour tutorial session would have on MEDLINE utilization among obstetrics and gynecology residents training at an academic medical centre. Outcome measures included MEDLINE search frequency, duration, recall, precision and searcher satisfaction. Search recall measures the searcher's ability to retrieve articles deemed relevant to the question at hand. Search precision gauges the searchers' ability to eliminate irrelevant articles. Although the sessions were well received, we were unable to demonstrate an improvement in the outcome measures analysed. Further research is therefore indicated so that cost-effective educational strategies can be recommended for wide-scale use. [ABSTRACT FROM AUTHOR]

Thirteen per cent of all corneas harvested by the Eye Bank of South Australia during 1986 were discarded because storage time in McCarey-Kaufman medium exceeded four days. We have therefore examined the suitability of the Dutch method of long-term corneal storage for our purposes. Twenty-two human corneas that had been discarded from the Eye Bank were assessed using the trypan blue-sucrose staining technique, and then placed into long-term storage for 15 to 17 days. They were then reassessed by vital dye staining before permanent flat-mounts were prepared for silver staining of the endothelium. A good correlation (albeit subjective) was found between the non-destructive and destructive techniques of endothelial cell assessment. Those corneas that failed to survive organ culture storage were easily detected. The Dutch system of corneal preservation and post-storage assessment seems well-suited to Australian eye-banking. [ABSTRACT FROM AUTHOR]

BSTRACT. This research examines the impact of high rates of interest upon the least cost system design for urban drainage systems when water quality is a critical parameter. Results of examination of twelve alternative system designs in a case study watershed indicate the least cost study design is highly sensitive to the rate of interest, but not sensitive to the water quality parameters. When the high rates of interest currently prevalent are introduced into the model those systems which contain open channel collection components are selected as the least cost system. At low rates of interest pipeline collection components are selected as the least cost system. Holding pond components of system design are cost effective at several levels of water quality. They are neutral to the rate of interest so they are incorporated in least cost systems at all the levels of interest rates. The results of the study indicate that at the current high rates of interest open channel collection systems and holding ponds are cost effective system components to achieve selected levels of water quality in urban drainage system design. [ABSTRACT FROM AUTHOR]

Thermal evolution modeling based on the geometry of the Scotian Basin, eastern Canada, and analysis of the shear resistance associated with lithospheric faulting are used to investigate the initiation of subduction at passive margins. Previous studies have demonstrated the difficulty of subduction initiation at mature passive margins. However, unique features along a passive margin may facilitate subduction initiation. Subduction may initiate along a part of the margin (1) by extensional or strike-slip deformation rather than shortening, (2) by deformation of the weaker continental lithosphere rather than oceanic lithosphere, (3) by heating and weakening of oceanic lithosphere due to lateral heat transfer from adjacent continental lithosphere, and (4) by heating and weakening of the lithosphere due to the passage of a mantle plume beneath the margin. The values of shear resistance under these conditions are still higher than those calculated for ridge push, indicating that subduction initiation at passive margins is difficult even with these weakening mechanisms. However, pulses of compression associated with plate reorganization may be enough to trigger subduction at such passive margins. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between PaCO2 levels in ventilated very preterm infants and (i) the incidence of severe intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL); and (ii) bronchopulmonary dysplasia (BPD).Methods: A retrospective cohort analysis of preterm infants comparing PaCO2 levels with the incidence of severe IVH/PVL and BPD was carried out on patients born at less than 29 weeks gestation from 1992 to 1994 and admitted to the tertiary neonatal intensive care unit at the King Edward Memorial Hospital (314 infants). During the first 96 h, PaCO2 levels were examined including lowest and highest PaCO2 levels, mean PaCO2 levels and duration of hypocarbia both pre- and post-surfactant administration.Results: Of the 314 infants, there were 40 early neonatal deaths (less than 48 h) who were not included in the analysis. Of the 274 surviving infants, 72 (26%) infants had severe IVH. Infants whose PaCO2 fell below 30 mmHg at any stage in the first 48 h of life had an increased risk of severe IVH or PVL (odds ratio 2.38; 95% CI 1.27-4.49; P = 0.007). Of the 265 survivors to 36 weeks corrected gestational age, 134 (51%) had BPD. Infants with at least three PaCO2 values less than 30 mmHg in the first 24 h of life had an increased risk of BPD (odds ratio 2.21; 95% CI 1.05-4.57; P = 0.036).Conclusions: The risk of severe IVH/PVL was significantly increased by hypocarbia. There was also an association between hypocarbia and BPD, particularly when hypocarbia was prolonged. These findings suggest that avoidance of hypocarbia may reduce the incidence of severe IVH/PVL and BPD in preterm infants. [ABSTRACT FROM AUTHOR]

Objective: To ascertain whether the incidence of clonidine poisoning in children has increased given the probable increase in clonidine use for treatment of childhood behavioural disorders.Methods: Cases of clonidine poisoning requiring hospital admission between 1985-95 inclusive were reviewed and demographic data pertinent to each admission were recorded. A literature review was also performed, with particular emphasis on incidence, clinical presentation and management of clonidine poisoning.Results: There were 14 cases of clonidine poisoning during the specified period eight cases presenting in the last 2 years. These eight children or their siblings had been prescribed clonidine for behavioural disorders. The most common signs at presentation were alteration of conscious state (71%) and bradycardia (50%). Nine children were given activated charcoal while seven cases underwent gastric lavage or induced emesis. Although six children were admitted to intensive care, length of hospital stay was less than 24 h in all cases and all had a favourable outcome.Conclusion: We concluded that the incidence of clonidine poisoning had increased over the specified period and that, based on our results, this was likely to be due to an increase in clonidine use in childhood behavioural disorders. Based on our data and that from literature review it was evident that there are inconsistencies in the management of clonidine poisoning and that safety measures, namely packaging and education, are inadequate given the increasing profile of clonidine use. [ABSTRACT FROM AUTHOR]

Summary Five healthy standard donkeys were subjected to exercise tests on a treadmill before and after conditioning. After the pre-conditioning trial, the donkeys worked 3 days/week for 60 min pulling a cart at increasing trot duration and 2 days/week for 20 min in a round pen for the 28 day conditioning period. During the trial, donkeys worked at 1.5-2 m/s on an 11% grade for a distance of 1830 m. Heart rate, respiratory rate and body temperature were recorded before, 10 min into exercise, immediately following and 1, 5, 10, 20, 30, and 60 min after exercise. Arterial samples for blood gas measurements and venous samples for measurement of lactate [La [ABSTRACT FROM AUTHOR]

Background Outcomes for pediatric cardiac surgery are commonly reported from international databases compiled from voluntary data submissions. Surgical outcomes for all children in a country or region are less commonly reported. We aimed to describe the bi-national population-based outcome for children undergoing cardiac surgery in Australia and New Zealand and determine whether the Risk Adjustment for Congenital Heart Surgery ( RACHS ) classification could be used to create a model that accurately predicts in-hospital mortality in this population. Methods and Results The study was conducted in all children's hospitals performing cardiac surgery in Australia and New Zealand between January 2007 and December 2015. The performance of the original RACHS -1 model was assessed and compared with an alternative RACHS - ANZ (Australia and New Zealand) model, developed balancing discrimination with parsimonious variable selection. A total of 14 324 hospital admissions were analyzed. The overall hospital mortality was 2.3%, ranging from 0.5% for RACHS category 1 procedures, to 17.0% for RACHS category 5 or 6 procedures. The original RACHS -1 model was poorly calibrated with death overpredicted (1161 deaths predicted, 289 deaths observed). The RACHS - ANZ model had better performance in this population with excellent discrimination (Az- ROC of 0.830) and acceptable Hosmer and Lemeshow goodness-of-fit ( P=0.216). Conclusions The original RACHS -1 model overpredicts mortality in children undergoing heart surgery in the current era. The RACHS - ANZ model requires only 3 risk variables in addition to the RACHS procedure category, can be applied to a wider range of patients than RACHS -1, and is suitable to use to monitor regional pediatric cardiac surgery outcomes.

We measured the impact of pharmaceutical care on outcomes of antihypertensive therapy for patients with elevated baseline blood pressures who were attending an urban university-affiliated internal medicine clinic. The intervention group received education about hypertension, drug and nondrug management, and assistance to enhance compliance. The pharmacist made recommendations to physicians regarding pharmacotherapy. The control group received no such education, and interventions relating to pharmacotherapy were only physician initiated. Over an average follow-up of 5 months, significant-decreases in mean blood pressures were noted for the intervention group from baseline to final assessment (156.5/144.5 mm Hg systolic, p = 0.001; 91.6/86.9 mm Hg diastolic, p = 0.01), with insignificant changes in mean pressures in the control group (153.7/151.0 mm Hg systolic, p = 0.48; 90.4/87.8 mm Hg diastolic, p = 0.29). Comparing the groups, the change in diastolic pressures was insignificant (4.7 vs 2.6 mm Hg intervention vs control, p = 0.49), but the change in systolic pressure was more impressive (12.0 vs 2.7 mm Hg, respectively, p = 0.05). There was no significant difference in SF-36 Health Survey scores between groups. A significant decrease (p = 0.03) in the SF-36 physical functioning domain was seen in the intervention group, but no other significant changes in health-related quality of life scores. Pharmaceutical care contributed to improved blood pressure control in these patients.