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Fluid foods are typically heat-treated to eliminate pathogens and reduce microbial counts. Coupling thermosonication with heat may reduce the microbial load in fluid foods and enhance the product quality during storage. This study evaluated the effect of thermosonication along with heat in a laboratory-scale continuous system, on the survival of Geobacillus stearothermophilus in milk, at two different settings (setting 1: 27.7 s total heating time with or without 11.9 s of sonication; setting 2: 20.3 s total heating time with or without 7.1 s of sonication). This study also investigated the effect of thermosonication along with heat on indigenous microbiota in raw milk; and milk quality was assessed by pH, free fatty acid (FFA) content, and casein/total protein (CN/TP) content during storage at the two different settings. Overall, thermosonication with heat resulted in higher log reductions for G. stearothermophilus; but, the reduction was not significant overall. Thermosonication with heat significantly decreased the indigenous microbiota in milk as compared to heat alone at both settings. Longer residence times (setting 1) had significantly higher log reductions at week 0, and treatment samples had significantly higher reductions than control during storage time at both the settings. Treatment samples at setting 1 had significantly higher pH and CN/TP, and lower FFA content at week 4, as compared to the control. Thermosonication using practical residence times along with heat may reduce milk microbiota. Results from this study need to be verified in a scale-up study employing pasteurization conditions. [ABSTRACT FROM AUTHOR]

125I-BSA injected intravenously into lactating mice persisted in the circulation for 4 h, entered the mammary gland, and was transferred to the neonate via the milk. When injected with anti-BSA antibodies, it was rapidly cleared from the circulation. Although animals receiving anti-BSA antibodies transferred more radioactivity to the neonate via the milk, the radioactivity was not TCA- precipitable or bound to staphylococcal protein A, nor was it immunoreactive. These findings suggest that circulating maternal antibody can limit the transfer of specific protein antigen from mother to newborn. [ABSTRACT FROM AUTHOR]

Introduction: Medication-assisted treatment (MAT) is a combination of behavioural therapy and medications to assist with recovery and has been administered to individuals with alcohol and opioid withdrawal symptoms. Military veterans seeking MAT could have barriers preventing them from receiving the care they desire. The present study sought to compare outcomes in individuals who received MAT or those who participated in self-help groups for opioid or alcohol use disorder. In addition, the present study sought to compare outcomes between veterans and non-military-connected individuals., Methods: We used the 2015-2017 United States Treatment Episode Data Set Discharges data from the Substance Abuse and Mental Health Services Administration. The data set included 138 594 unique discharges. A multinomial logistic regression model was used to examine differences in substance use outcomes for veterans/non-veterans in MAT and a self-help group., Results: Fewer veterans (2.58%) than non-veterans (4.28%) reported usage of MAT. Fewer veterans (38.94%) than non-veterans (40.17%) reported signing up for a self-help group. Finally, those who participated in MAT and a self-help group had a better outcome (66.64%)-defined as no substance use at discharge-than those who only received MAT (43.02%) and those who did not participate in MAT or self-help groups (34.84%)., Conclusions: Recommendations for future research on MAT and implementation for the veteran population would benefit the literature base., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Genetic and phenotypic performance of U.S. Holstein embryo-split and nuclear-transfer clones was documented for yield and fitness traits. For cows, mean genetic superiority based on pedigree was 186 kg of milk, 9 kg of fat, and 7 kg of protein for embryo-split clones and 165, 10, and 8 kg, respectively, for nuclear-transfer clones compared with the population for the same birth year; pedigree advantage for male clones generally was slightly greater. Estimates of genetic merit that considered a clone's own performance as well as pedigree merit were slightly lower for embryo-split cows than for their full siblings for yield but not for milk composition (fat and protein percentages), mastitis resistance (somatic cell score), longevity (productive life), or cow fertility (daughter pregnancy rate); no corresponding genetic differences were found for nuclear-transfer cows or for cloned bulls regardless of clone type. For bulls, estimated genetic merit based on daughter yield was more similar for clone pairs with apparent identical genotype than for pairs from the same biotechnology but nonidentical as confirmed by blood typing. Yield deviations were lower for clones than for their full siblings. Milk composition (total solids, fat, fatty acid profile, lactose, and protein) also was compared for nuclear-transfer clones (Brown Swiss, Holstein, and Holstein-Jersey cross) with non-cloned cows and literature values; no differences were found for gross chemical composition of milk. No obvious differences were evident between cloned and non-cloned animals or for the milk that they produced.

Objective: To determine the frequency with which solitary blood culture samples were submitted to laboratories serving small hospitals and to ascertain whether certain hospital practices relating to the performance of blood cultures were associated with lower solitary blood culture rates (SBCRs)., Design: Participants in the College of American Pathologists Q-Probes laboratory quality improvement program collected data prospectively on the numbers of solitary blood culture sets from adult patients submitted to their laboratories and answered questions about their institutions' practice characteristics relating to the collection of blood culture specimens., Setting and Participants: Three hundred thirty-three public and private institutions with a median occupied bed size of 57. Participants were located in the United States (n = 329), Canada (n = 3), and Australia (n = 1)., Main Outcome Measure: The solitary blood culture rate was defined as the number of instances in which only 1 blood culture venipuncture was performed on an individual patient during a 24-hour period divided by the total number of blood culture venipunctures that were performed during the study period., Results: Participants submitted data on 132 778 adult patient blood culture sets. The SBCRs were 3.4% or less in the top-performing 10% of participating institutions (90th percentile and above), 12.7% in the midrange of participating institutions (50th percentile), and 42.5% or more in the bottom-performing 10% of participating institutions (10th percentile and below). In half the participating institutions, the SBCRs for inpatients were 8.3% or less and for outpatients, 22% or less. Solitary blood culture rates were lower for institutions in which phlebotomists rather than nonphlebotomists routinely collected blood culture specimens, in which internal policies required drawing at least 2 blood culture sets, in which hospital personnel contacted clinicians when their laboratories received requests for solitary blood culture sets, and in which quality control programs monitored SBCRs routinely., Conclusions: Hospitals can achieve SBCRs under 5%. Those hospitals with particularly high SBCRs may lower their rates by altering certain institutional practices.

In developing muscle, synapse elimination reduces the number of motor axons that innervate each postsynaptic cell. This loss of connections is thought to be a consequence of axon branch trimming. However, branch retraction has not been observed directly, and many questions remain, such as: do all motor axons retract branches, are eliminated branches withdrawn synchronously, and are withdrawing branches localized to particular regions? To address these questions, we used transgenic mice that express fluorescent proteins in small subsets of motor axons, providing a unique opportunity to reconstruct complete axonal arbors and identify all the postsynaptic targets. We found that, during early postnatal development, each motor axon loses terminal branches, but retracting branches withdraw asynchronously and without obvious spatial bias, suggesting that local interactions at each neuromuscular junction regulate synapse elimination.

Objectives: To compare how frequently institutions monitor glycohemoglobin in diabetic patients, the level of glycemic control achieved and to identify institutional factors associated with higher rates of monitoring and lower glycohemoglobin levels., Methods: A total of 212 institutions retrospectively abstracted laboratory and outpatient records of up to 30 diabetic patients who had initial glycohemoglobin monitoring performed in their laboratories. Data from a cohort of 5586 diabetic patients and 17 365 assays were analyzed., Results: Overall, 31.3% of patients underwent glycohemoglobin monitoring at least quarterly, the frequency recommended by the American Diabetes Association (ADA) to stabilize patients at target hemoglobin A(1c) (HbA(1c)) levels. A total of 64.9% of patients were monitored at least semiannually, the ADA recommendation for patients with stable diabetes in glycemic control (final HbA(1c) level <7%). When we compared the top and bottom deciles of the 212 institutions, there was more than an eightfold difference in the proportion of patients monitored at least quarterly and more than a twofold difference in the proportion of patients monitored at least semiannually. Glycemic control was assessed by examining the value of the last glycohemoglobin determination on record after at least 8 months of management. For all 5586 diabetic patients, the median value of the last HbA(1c) assay was 7.4%. Comparing the top and bottom deciles, there was almost a fourfold difference among institutions in the proportion of diabetic patients in glycemic control. The use of reminders to order glycohemoglobin monitoring was associated with higher rates of semiannual monitoring (P <.05) and tighter glycemic control (P <.05). In addition, patients who were monitored more frequently experienced glycohemoglobin reductions of greater magnitude (P <.001). The presence of diabetes clinics and the use of rapid methods for testing glycohemoglobin were not associated with monitoring frequency or glycohemoglobin levels., Conclusions: There is wide interinstitutional variation in the frequency with which diabetic patients are monitored and the level of glycemic control achieved. The use of prompting systems to remind providers to order glycohemoglobin monitoring was associated with more frequent monitoring and superior glycemic control.

This paper specifies an econometric model to forecast State government expenditure on recognised public hospitals in Victoria. The OECD's recent cross-country econometric work exploring factors affecting health spending was instructive. The model found that Victorian Gross State Product, population aged under 4 years, the mix of public and private patients in public hospitals, introduction of casemix funding and funding cuts, the proportion of public beds to total beds in Victoria and technology significantly impacted on expenditure. The model may have application internationally for forecasting health costs, particularly in short and medium-term budgetary cycles.

The lessons learned in industry can be applied to anaesthetic departments. Progress and development are part of improving quality, and evidence is emerging that improved quality can reduce costs. Improving quality requires anaesthetic departments to develop a clear customer focus. Education, training, research and quality improvement are essential components of a quality anaesthetic department. Some of the cost reductions are achieved by development of partnerships with customers and suppliers. The emphasis is likely to shift from cost reduction to quality improvement and anaesthetic departments should anticipate this change.

The Victorian Department of Human Services has developed a classification and funding model for non-admitted radiation oncology patients. Agencies were previously funded on an historical cost input basis. For 1996-97, payments were made according to the new Non-admitted Radiation Oncology Classification System and include four key components. Fixed grants are based on Weighted Radiation Therapy Services targets for megavoltage courses, planning procedures (dosimetry and simulation) and consultations. The additional throughput pool covers additional Weighted Radiation Therapy Services once targets are reached, with access conditional on the utilisation of a minimum number of megavoltage fields by each hospital. Block grants cover specialised treatments, such as brachytherapy, allied health payments and other support services. Compensation grants were available to bring payments up to the level of the previous year. There is potential to provide incentives to promote best practice in Australia through linking appropriate practice to funding models. Key Australian and international developments should be monitored, including economic evaluation studies, classification and funding models, and the deliberations of the American College of Radiology, the American Society for Therapeutic Radiology and Oncology, the Trans-Tasman Radiation Oncology Group and the Council of Oncology Societies of Australia. National impact on clinical practice guidelines in Australia can be achieved through the Quality of Care and Health Outcomes Committee of the National Health and Medical Research Council.

Background: Epidemiologic data on the possible benefit of eating fish to reduce the risk of coronary heart disease have been inconsistent. We used data from the Chicago Western Electric Study to examine the relation between base-line fish consumption and the 30-year risk of death from coronary heart disease., Methods: The study participants were 1822 men who were 40 to 55 years old and free of cardiovascular disease at base line. Fish consumption, as determined from a detailed dietary history, was stratified (0, 1 to 17, 18 to 34, and > or = 35 g per day). Mortality from coronary heart disease, ascertained from death certificates, was classified as death from myocardial infarction (sudden or nonsudden) or death from other coronary causes., Results: During 47,153 person-years of follow-up, there were 430 deaths from coronary heart disease; 293 were due to myocardial infarctions (196 were sudden, 94 were nonsudden, and 3 were not classifiable). Cox proportional-hazards regression showed that for men who consumed 35 g or more of fish daily as compared with those who consumed none, the relative risks of death from coronary heart disease and from sudden or nonsudden myocardial infarction were 0.62 (95 percent confidence interval, 0.40 to 0.94) and 0.56 (95 percent confidence interval, 0.33 to 0.93), respectively, with a graded relation between the relative risks and the strata of fish consumption (P for trend = 0.04 and 0.02, respectively). These findings were accounted for by the relation of fish consumption to nonsudden death from myocardial infarction (relative risk, 0.33; 95 percent confidence interval, 0.12 to 0.91; P for trend= 0.007)., Conclusions: These data show an inverse association between fish consumption and death from coronary heart disease, especially nonsudden death from myocardial infarction.

Covalently immobilized biotin was used as a biospecific adsorbant to investigate the application of streptavidin as an affinity domain for simultaneous purification and immobilization of recombinant proteins. A streptavidin-beta-galactosidase fusion protein was constructed and tested as a model system. The gene for streptavidin from Streptomyces avidinii was modified by polymerase chain reaction to mutate the stop codon and to facilitate cloning into an Escherichia coli expression vector yielding a versatile plasmid with 37 unique restriction enzyme sites at the 3' end. E. coli beta-galactosidase was cloned in-frame to the streptavidin gene. Analysis of lysates of induced recombinant E. coli cells by SDS-PAGE and Western blots indicated that the 133.6-kDa fusion protein was expressed. Sulfosuccinimidyl-6-(biotinamido) hexanoate was covalently immobilized on 3-aminopropyl-controled-pore glass beads. Exposure of recombinant cell lysates to this support indicated that streptavidin-beta-galactosidase was bioselectively adsorbed. The resulting biocatalyst contained 300 mg protein per gram of beads and exhibited a specific activity of 306 betamol/min per milligram protein with o-nitrophenyl-beta-D-galactopyranoside as substrate corresponding to approximately 50% of that observed for commercially pure E. coli beta-galactosidase.

Increased vascular permeability, one of the characteristic features of immediate hypersensitivity (Type I), is mediated through a variety of compounds, including histamine and platelet-activating factor (PAF), a phospholipid inflammatory mediator. The effects on vascular permeability of histamine, PAF, and ethanol, the solvent for PAF, were compared in the guinea pig conjunctiva. Permeability at 30 min was investigated by evaluation of conjunctival edema and Evans blue extravasation (clinically estimated and colorimetrically measured). Doses of PAF from 1 to 10 nmol produced an increase in vascular permeability, with a peak effect at 10 nmol. Ethanol had no effect on vascular permeability below 40 X 10(3) nmol; above this concentration, however, permeability increased, reaching a maximum at 175 X 10(3) nmol. At low doses of PAF and ethanol, the effects were additive, whereas at 20-80 nmol of PAF with high concentrations of ethanol there was no additive effect of PAF, producing a decrease in the net effect of PAF. Histamine increased vascular permeability, with a minimum effect at 10 nmol and a maximum effect at 450 nmol. The slopes of the dose-response curves for all three compounds were linear and parallel, with statistically different potencies. The potencies for each compound were identical by all three methods of evaluation. Therefore, we conclude that PAF is a potential mediator in hypersensitivity reaction in the guinea pig conjunctiva, and that its effect is similar to but much more potent than that of histamine or ethanol. Since ethanol alone has a significant effect on vascular permeability, studies on PAF effects using control solutions without ethanol may be difficult to interpret.

A recent study showed that after feeding 125I-labelled proteins or free 125I to mice, as much as 40% of total radioactivity in the circulation precipitated upon mixing whole blood with 10% trichloroacetic acid. We examined this potential limitation to the use of radiolabelled tracers for studies on intestinal digestion of proteins and protein uptake, and identified its mechanism. BALB/c mice were gavage-fed or injected intravenously (i.v.) with Na125I. Blood obtained at 15 min was added directly to 10% trichloroacetic acid (TCA) or was processed to obtain serum or plasma. On mixing with 10% TCA, 25-33% of the radioactivity in whole blood was precipitated; less than 2% of the radioactivity in plasma or serum was precipitated. In vitro studies identified hemoglobin as the primary carrier protein participating in this reaction. If hemoglobin was replaced by methemoglobin or cyanomethemoglobin, then the reaction with 125I did not occur, suggesting that iron in the heme group may be the site for 125I binding and that iron must be in its reduced or ferrous form (Fe2+). The administration of non-radioactive NaI in vivo or its addition to reaction mixtures in vitro completely inhibited the precipitation of 125I by hemoglobin in the presence of TCA. Thus the addition of non-radioactive iodide to TCA stock solutions may effectively prevent non-specific binding of 125I to free hemoglobin released unintentionally during venipuncture or at other stages of blood processing.