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BackgroundSleep-disordered breathing (SDB) in pregnancy is associated with adverse maternal outcomes. The relationship between SDB and infant birthweight is unclear. This study's primary aim is to determine if objectively measured SDB in pregnancy is associated with infant birthweight.MethodsWe measured SDB objectively in early (6-15 weeks' gestation) and mid (22-31 weeks' gestation) pregnancy in a large cohort of nulliparous women. SDB was defined as an Apnea-Hypopnea Index ≥5 and in secondary analyses we also examined measures of nocturnal hypoxemia. We used a modified Poisson regression approach to estimate relative risks (RR) of large-for-gestational-age (LGA: >90th percentile for gestational age) and small-for-gestational-age (SGA

Histone modifications alter numerous cornerstone processes in eukaryotes, including metabolism, physiology, and immunity. Numerous bacterial pathogens can alter expression of host-derived sirtuins to deacetylate histones in order to promote infection, yet, a bacterial-derived sirtuin has yet to be investigated to deacetylate host histones. Using Campylobacter jejuni, the leading cause of bacterial-derived gastroenteritis, we found a secreted sirtuin, SliP, which binds to and deacetylates neutrophil histones. We found neutrophil activation and extrusion of neutrophil extracellular traps was SliP dependent, whereby sliP mutants are unable to activate neutrophils or promote NETosis. Leveraging the mouse model of campylobacteriosis, we further demonstrate the sliP mutant can efficiently infect IL-10-/- mice, but induction of proinflammatory cytokine production and gastrointestinal pathology is SliP-dependent. In conclusion, we investigate a unique bacterial effector which targets host histones and is responsible for the inflammatory response and tissue pathology observed during campylobacteriosis.HighlightsC. jejuni encodes a secreted effector, SliP, which functions as a canonical sirtuinSliP binds to and deacetylates neutrophil histone H3 during bacterial infectionC. jejuni-induced neutrophil activation and NETosis are SliP-dependentInflammation and tissue pathology during C. jejuni infection is SliP-dependent

With the advent of technologies such as ion array detectors and high energy permanent magnet materials, there is renewed interest in the unique focusing properties of the cycloidal mass analyzer and its ability to enable small, high-resolution, and high-sensitivity instruments. However, most literature dealing with the design of cycloidal mass analyzers assumes a single channel detector because at the time of those publications, compatible multichannel detectors were not available. This manuscript introduces and discusses considerations and a procedure for designing cycloidal mass analyzers coupled with focal plane ion array detectors. To arrive at a set of relevant design considerations, we first review the unique focusing properties of the cycloidal mass analyzer and then present calculations detailing how the dimensions and position of the focal plane array detector relative to the ion source determine the possible mass ranges and resolutions of a cycloidal mass analyzer. We present derivations and calculations used to determine the volume of homogeneous electric and magnetic fields needed to contain the ion trajectories and explore the relationship between electric and magnetic field homogeneity on resolving power using finite element analysis (FEA) simulations. A set of equations relating the electric field homogeneity to the geometry of the electric sector electrodes was developed by fitting homogeneity values from 78 different FEA models. Finally, a sequence of steps is suggested for designing a cycloidal mass analyzer employing an array detector.

ObjectivesAgitation, defined as excessive psychomotor activity leading to aggressive or violent behaviour, is prevalent in the emergency department (ED) due to rising behavioural-related visits. Experts recommend use of verbal de-escalation and avoidance of physical restraint to manage agitation. However, bedside applications of these recommendations may be limited by system challenges in emergency care. This qualitative study aims to use a systems-based approach, which considers the larger context and system of healthcare delivery, to identify sociotechnical, structural, and process-related factors leading to agitation events and physical restraint use in the ED.DesignQualitative study using a grounded theory approach to triangulate interviews of patients who have been physically restrained with direct observations of agitation events.SettingTwo EDs in the Northeast USA, one at a tertiary care academic centre and the other at a community-based teaching hospital.ParticipantsWe recruited 25 individuals who experienced physical restraint during an ED visit. In addition, we performed 95 observations of clinical encounters of agitation events on unique patients. Patients represented both behavioural (psychiatric, alcohol/drug use) and non-behavioural (medical, trauma) chief complaints.ResultsThree primary themes with implications for systems-based practice of agitation events in the ED emerged: (1) pathways within health and social systems; (2) interpersonal contexts as reflections of systemic stressors on behavioural emergency care and (3) systems-based and patient-oriented strategies and solutions.ConclusionsAgitation events represented manifestations of patients’ structural barriers to care from socioeconomic inequities and high burden of emotional and physical trauma as well as staff members’ simultaneous exposure to external stressors from social and healthcare systems. Potential long-term solutions may include care approaches that recognise agitated patients’ exposure to psychological trauma, improved coordination within the mental health emergency care network, and optimisation of physical environment conditions and organisational culture.

Objective To assess knowledge, attitudes, and perceived barriers (KAP) regarding e-cigarette use counselling among adolescent healthcare clinical staff in an urban system, and to compare results between providers and rooming staff. Methods Primary care clinical staff (n = 169) completed an anonymous survey. Descriptive statistics and Chi-square tests were used to summarize data and compare KAP between medical providers and rooming staff. Results Staff wanted to learn more about e-cigarettes (87.6%). The most common knowledge deficits were how to use the 5As + 5Rs model for tobacco cessation counselling (66.7%) and the chemical content of e-liquids (55.4%), with no differences across groups. Overall, 58% of providers expressed confidence in their ability to talk with adolescent patients about e-cigarette use. The most common barriers to counselling were low knowledge about e-cigarettes (74.0%) and how to refer adolescent patients for cessation support (43.8%). Conclusions Provider and rooming staff expressed similar educational needs surrounding e-cigarettes, counselling, and treatment for adolescent patients. Clinical staff expressed confidence in their ability to affect change. There were no differences in the identified knowledge gaps or barriers to care between rooming staff and providers, suggesting that the same educational format can be used to target both groups.

The effect of docosahexaenoic acid (DHA, 22:6 n-3)-rich microalgae and methionine (Met) supplementation on production performance, incidence of breast muscle white striping (WS), and pathology, lipid profile, and meat quality aspects in broiler chickens was investigated. The hypothesis tested was that feeding Met and n-3 fatty acid (FA)-rich diet enhances muscle n-3 FA content and meat quality while attenuating breast muscle WS and myopathy in broiler chickens. One hundred and forty four (n = 144) 10-day-old Cornish cross chicks were fed a corn-soybean meal-based diet containing 0% microalgae (control), 2% microalgae (diet 1), and diet 1 + 100% more National Research Council requirement of Met (diet 2) up to day 42 of growth. All diets were isocaloric and isonitrogenous. The chicks were kept in 6 pens with 8 chicks per replicate pen. Feed consumption and feed efficiency were calculated on day 21 and 42. On day 43, 3 chicks per pen (n = 18/treatment) were euthanized. The breast muscle (pectoralis major) was visually scored for muscle WS (1 = no striping, 2 = mild, 3 = severe) and was subjected to histopathology. Breast muscle lipid profile (total lipids, FA composition, cholesterol, lipid oxidation products), quality (moisture, color, drip loss, shear force, cook loss, pH), and chemical characterization (protein, minerals) were recorded. A one-way analysis of variance was carried out with diet as the main factor and significance was set at P < 0.05. The incidence of muscle WS was lower (P < 0.02) for control vs. diet 2 and a trend for reduction in WS was observed in birds fed diet 1 vs. control (P = 0.09). Histopathological changes consisted of floccular or vacuolar degeneration, fibrosis, lipidosis, interstitial inflammation, and lysis of fibers, and were minimal in diet 2 when compared to control (P < 0.05). The total lipid content was lowest in birds fed diet 1 (P < 0.05). Total n-3 and total long chain (≥20C) n-3 FA were highest in the breast muscle of diet 2 birds (P < 0.05). Muscle drip loss and shear force were highest in diet 2 (P < 0.05). Meat color (a∗, redness) was reduced (P < 0.05) and a trend for reduction in b∗ (yellowness) was observed in diet 2 (P = 0.07). No effect of diet on body weight gain, feed efficiency, breast muscle yield, pH, moisture, lipid oxidation products, cook loss, minerals (Ca, P, Mg, Na), cholesterol, or protein content was observed (P > 0.05). The results demonstrated a significant effect of DHA-rich microalgae along with Met supplementation in reducing the incidence of breast muscle striping and myopathy, while enriching meat with n-3 FA. However, inclusion of Met in microalgae-based diets could influence meat tenderness and color.

HighlightsNitrous oxide and methane emissions were measured from a commercial beef feedyard following large rainfall events.Nitrous oxide emissions dropped below detection levels for ten days following a 77 mm rainfall event.Daily N2O and CH4 emissions followed a diel pattern, peaking at manure temperatures of 36°C to 38°C.Results will be used to refine empirical models for predicting GHG emissions from open-lot feedyards.Abstract. More than six million beef cattle are fed annually in feedyards on the semiarid Southern Great Plains (SGP). Manure deposited on the open-lot pen surfaces contributes to greenhouse gas (GHG) emissions. Nitrous oxide (N2O) and methane (CH4) are GHGs linked to climate change, and both have global warming potentials greater than carbon dioxide (CO2). Two sampling campaigns were conducted in 2019 to quantify N2O and CH4 emissions from open-lot pen surfaces. The occurrence of large, unforecast rainfall events during both campaigns provided an opportunity to compare GHG emissions from the dry manure before rainfall and from the wetted pen surface for one to two weeks following precipitation. Temporal variability was quantified by continuous sampling using six to eight automated flux chambers, a multiplexer system, and real-time analyzers. Spatial variability was quantified using a recirculating portable chamber on a 5 × 8 grid. Nitrous oxide emissions dropped below detection levels for ten days after the precipitation event. Nitrous oxide emissions were related to nitrification or other aerobic processes. Methane emissions dropped below detection levels for five days after the precipitation event and then increased to pre-rainfall levels by day 8. When present, N2O and CH4 emissions followed a diel pattern, with the highest emissions occurring during the afternoon when manure pack temperatures at the 25 mm depth were 36°C to 38°C and ambient temperatures were 31°C to 32°C. Average CH4 emissions from the feedyard pen surface were 96-fold lower than estimated enteric CH4 emissions. The results of this field research will be used to refine empirical models for predicting annual N2O and CH4 emissions from open-lot beef cattle feedyards on the semiarid SGP. Keywords: Beef cattle, Flux chamber, Greenhouse gas, Manure, Nitrous oxide, Rainfall.

HighlightsOpen-lot beef cattle feedyards are a source of greenhouse gas emissions.Pen surface methane emissions were quantified during the cool and warm seasons.Methane was generated in the lower anaerobic layers of the manure pack.Methane emissions decreased after rainfall due to methane oxidation or blocking of pore space.Pen surface methane emissions accounted for 2eq.Abstract. Texas is one of the top beef-producing states, where annually more than five million beef cattle are finished in large feedyards on earthen-surfaced pens. Manure deposited on open-lot pen surfaces can contribute to greenhouse gas (GHG) emissions such as methane (CH4). Two week-long sampling campaigns were conducted in April (cool season) and August (warm season) to quantify CH4 emissions from the feedyard pen surface. Emissions were monitored before and after 12.7 mm simulated rainfall events. Temporal and spatial variabilities in emissions were quantified using automated recirculating flux chambers, a multiplexer system, and a real-time CH4 analyzer. During the cool season, mean CH4 flux was 1.09 (SD ±2.39) and 0.12 (±0.25) g animal-1 d-1 before and after rainfall, respectively. During the warm season, mean CH4 flux was 0.65 (±1.01) and 0.26 (±0.44) g animal-1 d-1 before and after rainfall, respectively. This suggested that CH4 was produced in the lower, anaerobic layer of the manure pack and CH4 emissions were inhibited following rainfall, most likely due to microbial oxidation of CH4 in the upper layers through methanotrophy or from slowing of diffusion by blocking the manure pore space. The overall mean pen surface CH4 flux was 0.53 g animal-1 d-1. This flux accounted for a small percentage (

HighlightsLab-scale beef manure bedded packs were constructed to evaluate the temperature effect on gaseous emissions.Temperature had a tendency to increase ammonia, hydrogen sulfide, and greenhouse gases in the headspace above bedded packs over time.Abstract. Throughout the Upper Midwest, producers have observed increased land and fertilizer prices, resulting in increased popularity of confinement feeding facilities such as mono-slope and hoop barns with bedded packs. Environmental and public pressure has been placed on the agriculture community to reduce ammonia (NH3), hydrogen sulfide (H2S), and greenhouse gas (GHG) emissions from concentrated animal feeding operations (CAFOs). This study was conducted to determine the effects of bedding material (corn stover (CS), bean stover (BS), wheat straw (WS), or pine wood chips (PC)) and ambient temperature (15°C (COOL) or 30°C (HOT)) on NH3, CH4, CO2, N2O, and H2S flux in air samples collected in the headspace above lab-scale bedded packs. All bedded packs were housed at 18°C for an initial three weeks before being placed in their respective environmental chambers at 15°C or 30°C for the remainder of the 6-week study period. Significant two-way interactions of bedding material by temperature for NH3 flux were observed (p = 0.0094). Ammonia flux was greater at higher temperature, while CS bedding had the lowest NH3 emissions compared to the other bedding materials. A significant two-way interaction of bedding material by temperature for H2S flux was observed (p < 0.0001), with significantly greater H2S produced in the headspace of COOL-BS packs compared to all other treatments. Additionally, a significant (p = 0.0357) two-way interaction of temperature by age of the bedded pack was observed for H2S flux. Hydrogen sulfide flux appeared to be influenced by low bedded pack pH to a greater extent than by increase in temperature. Greenhouse gas emissions tended to be higher from bedded packs in HOT treatments. A significant (p = 0.0422) interaction among bedding material, temperature, and age of the bedded pack was observed for CH4. Significantly greater CH4 flux was observed in the headspace above HOT-BS and HOT-CS at week 6 compared to all other treatments. A significant two-way interaction of bedding material by temperature was observed for CO2 flux (p = 0.0189). The largest CO2 levels were observed above WS bedding material regardless of temperature. Nitrous oxide flux decreased over the 6-week study for all bedded packs, while WS and PC bedded packs produced the greatest N2O flux. The results indicate that feedlot operators maintaining bedded pack facilities will have the greatest reduction in NH3 emissions when using CS bedding, regardless of ambient temperature. To reduce CH4 emissions, producers should avoid allowing BS and CS bedded packs that are maintained for longer than six weeks in HOT (30°C) temperatures; frequent cleaning during summer months is recommended. Based on the CO2 equivalents of CH4 and N2O, producers should consider PC as an option to reduce GHG emissions. Keywords: Ammonia, Bedding age, Bedding type, Beef, Carbon dioxide, Greenhouse gas, Hydrogen sulfide, Methane, Nitrous oxide, Temperature.

HighlightsAromatic compounds generated 72.6% of the total odor activity values (OAVs) over time.Cold treatments had significantly lower total OAVs than hot treatments regardless of the age of the bedded pack.Abstract. Beef cattle producers are beginning to raise cattle in confinement facilities such as slatted-floor barns, hoop barns, and mono-slope facilities. Hoop and mono-slope facilities typically use bedding packs as part of their manure management system, with crop residues being the most commonly used bedding material. This study was conducted to determine the effects of bedding material, i.e., corn stover (CS), bean stover (BS), wheat straw (WS), or pine wood chips (PC), and environmental ambient temperature, i.e., cold (15°C) or hot (30°C), on the concentrations of odorous volatile organic compounds (VOCs) in air samples collected in the headspace above lab-scale bedded packs over a 42-day period. Total aromatic compounds, sulfide compounds, straight-chain fatty acids (SCFAs), and branched-chain fatty acids (BCFAs) were measured and used to calculate total odor activity values (OAVs) for each bedding and temperature effect. No significant three-way interactions for bedding material × ambient temperature × age of bedded pack were observed. Significant bedding material × ambient temperature interactions were observed for total aromatic compounds and total sulfide compounds (p = 0.0455 and p = 0.0083, respectively). The concentration of total aromatic compounds was greater for all hot treatments compared to cold treatments, with hot-CS and hot-WS bedding types (389.83 and 365.5 ng L-1, respectively) significantly (p < 0.05) greater than all other bedding types, while total aromatic compounds were lowest (87.09 ng L-1) for BS across cold treatments. Total sulfide compounds from cold-PC (51.69 ng L-1) were significantly (p = 0.0143) greater than all other treatments. Within hot treatments, total sulfide compounds were similar across all bedding materials. Total SCFAs for both cold and hot treatments decreased significantly from weeks 4 to 6. Total SCFA concentrations within weeks were significantly (p < 0.0001) greater for WS and CS compared to BS and PC but similar across bedding materials at week 6. Total BCFA concentrations from bedded packs containing CS and WS were significantly (p < 0.0001) higher at week 4 compared to concentrations from bedded packs containing BS or PC. As bedded packs aged, total BCFA concentrations for all bedding materials were similar at week 6. Total OAVs decreased over time for both hot and cold treatments, although cold treatments had significantly (p < 0.0001) lower total OAVs regardless of the age of the bedded pack. Aromatic compounds generated 72.6% of the total OAV over the 42-day study. Bedding types BS and PC had the lowest total OAVs across all weeks. The results indicate that feedlot operators maintaining bedded pack facilities will achieve the greatest overall odor reduction when using BS or PC bedding material, no matter the ambient temperature. Keywords: Bedding, Beef, Odor, Volatile organic compounds.

Human capital is undoubtedly one of the main engines of any successful business, and there is nothing more critical to the overall health of a business than ensuring health and safety of its people. Employers are uniquely positioned to improve health and safety through the workplace, yet many organisations struggle to decode the right formula for impactful initiatives and measuring success. It is particularly timely, as the ‘new normal’ of work has pushed workforce well-being up to the top of the priority list. Evidence supports that a healthy and safe workforce can provide a competitive business advantage by positively impacting productivity, business output, sustainability and corporate brand and reputation. The article shares insights into the evolving well-being risk, social profile and medical trends globally with country-specific highlights. We delve into the survey findings on employer and employee perspective of well-being and expectation on the solutions that can support in ensuring overall well-being.

OBJECTIVE To characterize stillbirths associated with pregestational diabetes and gestational diabetes mellitus (GDM) in a large, prospective, U.S. case-control study. METHODS A secondary analysis of stillbirths among patients enrolled in a prospective; multisite; geographically, racially, and ethnically diverse case-control study in the United States was performed. Singleton gestations with complete information regarding diabetes status and with a complete postmortem evaluation were included. A standard evaluation protocol for stillbirth cases included postmortem evaluation, placental pathology, clinical testing as performed at the discretion of the health care professional, and a recommended panel of tests. A potential cause of death was assigned to stillbirth cases using a standardized classification tool. Demographic and delivery characteristics among women with pregestational diabetes and GDM were compared with characteristics of women with no diabetes in pairwise comparisons using χ or two-sample t tests as appropriate. Sensitivity analysis was performed excluding pregnancies with genetic conditions or major fetal malformations. RESULTS Of 455 stillbirth cases included in the primary analysis, women with stillbirth and diabetes were more likely to be older than 35 years and have a higher body mass index. They were also more likely to have a gestational hypertensive disorder than women without diabetes (28% vs 9.1%; P

Successful de novo protein design ideally targets specific folding kinetics, stability thermodynamics, and biochemical functionality, and the simultaneous achievement of all these criteria in a single step design is challenging. Protein design is potentially simplified by separating the problem into two steps: (a) an initial design of a protein "scaffold" having appropriate folding kinetics and stability thermodynamics, followed by (b) appropriate functional mutation-possibly involving insertion of a peptide functional "cassette." This stepwise approach can also separate the orthogonal effects of the "stability/function" and "foldability/function" tradeoffs commonly observed in protein design. If the scaffold is a protein architecture having an exact rotational symmetry, then there is the potential for redundant folding nuclei and multiple equivalent sites of functionalization; thereby enabling broader functional adaptation. We describe such a "scaffold" and functional "cassette" design strategy applied to a β-trefoil threefold symmetric architecture and a heparin ligand functionality. The results support the availability of redundant folding nuclei within this symmetric architecture, and also identify a minimal peptide cassette conferring heparin affinity. The results also identify an energy barrier of destabilization that switches the protein folding pathway from monomeric to trimeric, thereby identifying another potential advantage of symmetric protein architecture in de novo design.