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B lines in lung ultrasound are useful to diagnose heart failure in adults. This study was to done to correlate lung ultrasound score with heart failure severity in CHD.
Material and methods:
Fifty infants with left to right shunt underwent Ross scoring, measurement of NT pro BNP and lung ultrasound. Lung was divided into 14 zones (7 on each side); each zone was scored as: No B lines = 0, less than 3 B lines = 1, 3-7 B lines = 2, > 7 /or confluent B lines = 3. Total score was calculated by adding all scores. A modified ultrasound score was calculated by excluding scores of 1. Relationship between ultrasound scores and heart failure was assessed. Receiver operator curve (ROC) was generated to find a cut-off of ultrasound score to detect moderate or severe heart failure.
Results:
No correlation was found between either total or modified lung ultrasound score with the modified Ross score or NT pro BNP. A cut-off of total lung ultrasound score of 11 gave an accuracy of 68% with area under the curve (AUC) of 0.64 to detect moderate or severe heart failure.
Conclusion:
Utility of lung ultrasound in detecting severity of heart failure in infants with left to right shunts is limited at present due to its low accuracy and lack of standardised method of scoring.
Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease globally(1) whereby there is a loss of dopaminergic neurons in the brain and a deficiency of dopamine. PD is characterised by dyskinesia, rigidity, tremor and postural instability, and non-motor symptoms which include neuropsychiatric, sleep and autonomic dysfunction which often occur before motor symptoms(2). Several of these motor and non-motor symptoms can adversely affect nutritional status(3) and a significant number of people with PD are at risk of malnutrition(4). Observational studies have examined the relationship between dietary intake, symptoms and disease progression yet there is a lack of randomised controlled trials of dietary interventions. This presentation will examine the evidence base and suggest future directions for nutrition research in this important area.
Persistent pulmonary hypertension of the newborn is a serious disease with significant morbidity and mortality. Magnesium sulphate has been proposed as a potential treatment for persistent pulmonary hypertension of the newborn, but its efficacy remains unclear. The article aims to evaluate the effects of magnesium sulphate on persistent pulmonary hypertension of the newborn.
Methods:
A comprehensive search of PubMed, Web of Science, Embase, and Cochrane Library was conducted to identify relevant studies. The primary outcomes were pulmonary artery pressure and oxygenation index, while secondary outcomes included mean blood pressure, alveolar-arterial oxygen difference, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and arterial oxygen saturation. Statistical analysis was performed by Cochrane Review Manager 5.3.
Results:
The study analysed twelve studies involving 380 patients. Results indicated that magnesium sulphate treatment significantly reduced pulmonary artery pressure levels (MD −24.96, 95% CI −28.19 to −21.73, P < 0.0001) and mean blood pressure (MD −3.11, 95% CI −3.91 to −2.32, P < 0.0001) compared to pretreatment. Additionally, it led to a notable decrease in oxygenation index (P < 0.00001) and alveolar-arterial oxygen difference (P < 0.0001), while increasing PaO2 (P < 0.0001) and arterial oxygen saturation (P < 0.001). However, there was no significant effect on PaCO2 levels compared to pretreatment.
Conclusion:
Magnesium sulphate is a valuable therapy for persistent pulmonary hypertension of the newborn. It markedly reduced pulmonary artery pressure, alveolar-arterial oxygen difference, and oxygenation index, while enhancing PaO2, and arterial oxygen saturation, with no impact on PaCO2 levels. Magnesium sulphate may also reduce mean blood pressure following a 2-hour treatment. Additional studies are necessary to further clarify its efficacy and potential side effects.
Registration:
This study was registered with PROSPERO (CRD42024578092).
Phytophagous insects are influenced by various abiotic factors, with temperature being a key determinant. We hypothesised that fluctuating thermal conditions would enhance antioxidant enzyme activity and nutrient assimilation in these insects. We investigated superoxide dismutase, catalase, and lipid peroxidation activity, as well as glucose and triglyceride assimilation in Parthenium beetles, Zygogramma bicolorata Pallister (Coleoptera: Chrysomelidae), under repeated exposure to short-duration heat (42 ± 2 °C) and cold (10 ± 2 °C), and optimal (27 ± 2 °C) temperatures, along with post-stress recovery. Results revealed that superoxide dismutase, catalase, and lipid peroxidation activity were highest under the heat stress and lowest under the cold stress conditions. Upon returning to optimal conditions, adults previously exposed to thermal stress showed reduced superoxide dismutase and catalase activity and elevated lipid peroxidation product levels compared to those reared continuously at optimal temperatures. Glucose assimilation was highest under cold stress, whereas triglyceride assimilation peaked under optimal temperatures. After stress conditions ended, glucose assimilation decreased in beetles across all temperature groups, whereas triglyceride assimilation increased in adults that had been maintained at optimal temperatures. Adult mortality peaked under heat stress, with male beetles showing higher mortality rates than females did. Moreover, male beetles exhibited higher enzyme activity, whereas female beetles assimilated more glucose and triglycerides, suggesting greater thermal-stress tolerance in the females. These findings imply that female Parthenium beetles are more resilient to thermal stress and are therefore more effective for use in Parthenium (Asteraceae) biocontrol.
The estimated global preterm birth rate in 2020(1) was more than 10% of livebirths or 13.4 million infants. Despite the importance of neonatal nutrition in optimising growth, neurodevelopment, and later metabolic disease risk, there is inconsistency in nutrition recommendations for preterm infants(2). Incomplete or inconsistent reporting of outcomes in nutrition intervention studies is part of the reason for the lack of consensus on optimal nutrition. To reduce uncertainty in measuring or reporting nutritional intake and growth outcomes in preterm studies, a consensus process is needed to identify relevant measures for patients, parents/caregivers, researchers, and health professionals. We aimed to develop a minimum reporting set (MRS) for measures of nutritional intake and growth in preterm nutrition studies. We collaborated with a group of international researchers from 13 countries and registered this study at the COMET initiative (registration number 3185). The target population was individuals born preterm at any gestational age and study location whose nutritional intake was assessed before first hospital discharge and whose growth was assessed at any age. Measures reported in preterm nutrition studies were systematically reviewed and used to develop the real-time Delphi survey(3) using Surveylet (Calibrum) software, including 13 questions about nutritional intake and 14 about growth outcomes. We used a snowball process to recruit participants from the consumer, healthcare provider, and researcher stakeholder groups with expertise in preterm infants, nutrition, and growth to rate the importance of each measure on a 9-point Likert scale. Participants initially rated the survey items without seeing other participants’ responses, saved and refreshed the page to see the anonymous responses of other participants, and had the option to change their rating and provide reasons for their answers. Participants’ final scores for each item will be used to identify the consensus criteria for that item(3). To date, we have recruited 246 participants from 31 countries across 5 continents, including 58 (24%) consumers, 156 (63%) healthcare professionals, and 26 (11%) researchers. Preliminary findings indicate that 12 measures of nutritional intake and 4 of growth have met the criteria for inclusion in the MRS. However, participant recruitment and survey responses are ongoing. A final consensus meeting is planned for November 2024 to confirm the MRS.
The effect of Stokes number on turbulence modulation in particle-laden channel flow is investigated through four-way coupled point-particle direct numerical simulations, with the mass loading fixed at 0.6 and the friction Stokes number $St^+$ varying from 3 to 300. A full transition pathway is observed, from a drag-enhanced to a drag-reduced regime, eventually approaching the single-phase state as $St^+$ increases towards 300. A set of transport equations for the particle phase is derived analytically to characterise the interphase coupling, within the framework of the point-based statistical description of particle-laden turbulence. By virtue of this, two dominant mechanisms are identified and quantitatively characterised: a positive, particle-induced extra transport that decreases monotonically with increasing $St^+$, and a negative, particle-induced extra dissipation that varies non-monotonically with $St^+$. The coupling of these two mechanisms leads to a direct contribution of the particle phase to the shear stress balance, the turbulent kinetic energy budgets and the Reynolds stress budgets. Consequently, as $St^+$ increases, the self-sustaining cycle of near-wall turbulence transitions from being augmented to being suppressed and, eventually, returns to the single-phase state. This gives rise to an indirect effect, manifested as a non-monotonic modulation of Reynolds shear stress and turbulence production rate. Taken together, complex interplays between particle-modified turbulent transport, particle-induced extra transport and extra dissipation are analysed and summarised, providing a holistic physical picture composed of consistent interpretations of turbulence modulation induced by small heavy particles.
As many as 1 in 12 people in residential care are likely to have a pressure injury at any time(1). Our pragmatic intervention, consented by both patients and their Enduring Power of Attorney, provided 20g whey protein concentrate (WPC) in 200ml whole milk to be consumed by the resident in the morning with breakfast or morning tea, to compensate for the likely lowest protein meal of the day(2), and increase total protein intake. WPC has a number of beneficial substances that support wound healing, such as arginine, and glutamine(3), plus the branch chain amino acids(4). The intervention was uncomplicated, well tolerated and resulted in wound healing, as evidenced by the pictures of the three initial cases. We need further trials to show that this is better than usual interventions. However, we believe this is a useful protocol to address a recognised problem of poor protein intake for those who need extra to heal wounds
The objective of the food safety system is to provide safe and suitable food in New Zealand(1). This is of particular importance for our youngest members– infants and young children. During the first 2000 days of life, food and nutrition have crucial roles. Nutrient requirements are high, and children often have an increased vulnerability to hazards associated with chemical and microbiological contamination. Foods targeted to this age group typically have strict regulations, as the quality and safety of foods for infants and young children is of great concern to caregivers, public health authorities and regulatory bodies worldwide. The recent First Foods New Zealand Study (FFNZ) and Young Foods New Zealand (YFNZ) Study have provided important data into what, and how, we feed our infants and young children under four years of age(2). Insights from the dietary intakes and health of 925 infants and young children from these studies are being used by NZFS to inform its work on food monitoring surveillance and food policy. Currently New Zealand Food Safety (NZFS) is conducting the 2024 New Zealand Total Diet Study (NZTDS) (Infants and Toddlers)(3). The NZTDS is a food monitoring and surveillance programme which aims to evaluate the risk to New Zealanders from exposure to certain chemicals such as agricultural chemicals, contaminants (including from food packaging), and nutrients. The 2024 NZTDS will, for the first time, focus exclusively on infants and young children. The FFNZ and YFNZ studies informed the selection of 117 foods to be tested from four New Zealand regions throughout 2024/2025. The dietary intake data will then be used to estimate the dietary exposure to each of the 362 chemicals analysed. This monitoring programme informs policy decision-making and food standard setting and provides assurance on the safety of our food supply. Concerns around the nutrient quality and labelling of some commercial products for infants and young children have been identified in Australia and New Zealand. Within the joint food regulatory system, consultation is underway to consider regulatory and non-regulatory options for improving commercial foods for infants and young children(4). This presentation will discuss NZFS’s role in monitoring foods and diets of infants and young children in Aotearoa New Zealand, the importance of, and application of evidence to inform policy, food safety, and potential regulatory and non-regulatory options to ensure that the food safety system continues to deliver safe and suitable food in New Zealand.
New Zealand and Australian governments rely heavily on voluntary industry initiatives to improve population nutrition, such as voluntary front-of-pack nutrition labelling (Health Star Rating [HSR]), industry-led food advertising standards, and optional food reformulation programmes. Research in both countries has shown that food companies vary considerably in their policies and practices on nutrition(1). We aimed to determine if a tailored nutrition support programme for food companies improved their nutrition policies and practices compared with control companies who were not offered the programme. REFORM was a 24-month, two-country, cluster-randomised controlled trial. 132 major packaged food/drink manufacturers (n=96) and fast-food companies (n=36) were randomly assigned (2:1 ratio) to receive a 12-month tailored support programme or to the control group (no intervention). The intervention group was offered a programme designed and delivered by public health academics comprising regular meetings, tailored company reports, and recommendations and resources to improve product composition (e.g., reducing nutrients of concern through reformulation), nutrition labelling (e.g., adoption of HSR labels), marketing to children (reducing the exposure of children to unhealthy products and brands) and improved nutrition policy and corporate sustainability reporting. The primary outcome was the nutrient profile (measured using HSR) of company food and drink products at 24 months. Secondary outcomes were the nutrient content (energy, sodium, total sugar, and saturated fat) of company products, display of HSR labels on packaged products, company nutrition-related policies and commitments, and engagement with the intervention. Eighty-eight eligible intervention companies (9,235 products at baseline) were invited to participate, of whom 21 accepted and were enrolled in the REFORM programme (delivered between September 2021 and December 2022). Forty-four companies (3,551 products at baseline) were randomised to the control arm. At 24 months, the model-adjusted mean HSR of intervention company products was 2.58 compared to 2.68 for control companies, with no significant difference between groups (mean difference -0.10, 95% CI -0.40 to 0.21, p-value 0.53). A per protocol analysis of intervention companies who enrolled in the programme compared to control companies with no major protocol violation also found no significant difference (2.93 vs 2.64, mean difference 0.29, 95% CI -0.13 to 0.72, p-value 0.18). We found no significant differences between the intervention and control groups in any secondary outcome, except in total sugar (g/100g) where the sugar content of intervention company products was higher than that of control companies (12.32 vs 6.98, mean difference 5.34, 95% CI 1.73 to 8.96, p-value 0.004). The per-protocol analysis for sugar did not show a significant difference (10.47 vs 7.44, mean difference 3.03, 95% CI -0.48 to 6.53, p-value 0.09).In conclusion, a 12-month tailored nutrition support for food companies did not improve the nutrient profile of company products.
For which choices of $X,Y,Z\in \{\Sigma ^1_1,\Pi ^1_1\}$ does no sufficiently strong X-sound and Y-definable extension theory prove its own Z-soundness? We give a complete answer, thereby delimiting the generalizations of Gödel’s second incompleteness theorem that hold within second-order arithmetic.
Understanding the process of seeking long-term care (LTC) in old age helps identify what contributes to delays and inequalities in accessing it. Current research highlights the roles of individual and policy factors, but pays little attention to how these factors interact. This qualitative study aims to fill this gap by identifying facilitating factors and mechanisms in the initial approaches to LTC policies. It examines care-seeking in two towns in northern Italy, where a demand-based approach, high fragmentation and poor coordination pose significant challenges. In a bottom-up approach to policy implementation, the experiences and perspectives of both care-seekers and professionals are integrated. Indeed, the data collection (April 2023–May 2024) triangulates 100+ hours of participant observation and semi-structured or vignette-based interviews. The study finds that care-seeking entails three interrelated steps: recognising care needs, being willing to receive LTC, and reaching an entry point. At each stage, three mechanisms operate at intrapersonal and interpersonal levels and can be promoted by LTC policies to facilitate care-seeking, especially for those experiencing barriers. The mechanisms are (1) taking the initiative to raise awareness of care needs and share information about available solutions; (2) fostering trust between professionals and care-seekers, who often rely on confidential relationships to discuss care arrangements; and (3) combining primary information with tailored guidance on the local offer, enabling care-seekers to make informed decisions. The findings provide actionable insights into policies and practices that facilitate care-seeking, and offer a conceptual framework that explains the driving factors behind this process and its mechanisms.
Metacercariae of Diplostomum spp. are widespread fish parasites. In this study we obtained the first data on infection of Bullhead Cottus koshewnikowi with these larvae in five rivers of northern Europe (Finland and Russia) using molecular and morphological description. Three Diplostomum spp. were revealed in the eyes of bullheads. Diplostomum spathaceum and D. mergi Lineage 3 sensu Georgieva et al. (2013) were found in the lens, while Diplostomum sp. Lineage 6 sensu Blasco-Costa et al. (2014) was found in the retina. We obtained molecular data on these three species and provided morphological characteristics of the latter two species. Partial sequences of the cytochrome c oxidase subunit 1 (cox1) and ITS1-5.8S-ITS2 were amplified for 20 isolates. Using molecular data, we ascertained the species identification and obtained new information on the life cycles of D. mergi Lineage 3 and Diplostomum sp. Lineage 6. Partial cox1 sequences were used to assess the haplotype diversity of D. mergi Lineage 3 and Diplostomum sp. Lineage 6 in the study area. Discriminant analysis showed that D. mergi Lineage 3 was morphometrically close both to the species of the lens complex (D. mergi Lineage 2, D. mergi, D. nordmanni, and D. parviventosum) and to the species from the retina (D. pungiti, D. volvens). Dimensions of Diplostomum gobiorum lay far outside the confidence interval of D. mergi Lineage 3. Our molecular and morphological data and the new information about the hosts and the distribution of these parasites are a crucial step towards elucidating the diversity and life cycles of these important parasites. The data on the infection of bullheads in the River Utsjoki (a tributary of the River Teno, Finland) with metacercariae of Diplostomum spp. offer some insights into the relationships between the introduced host and the native parasites. Infection of bullheads, which are considered invasive in the Teno River system, with metacercariae of Diplostomum spp. may lead to increased infection levels in resident fish.
Gut health is a 50-billion-dollar (US) industry that is forecast to continue growing. This growth is attributed to our increased understanding and interest in the gut microbiome and its association with many chronic diseases, mental health and gut and autoimmune disorders. In 2024, “dysbiosis”, “gut microbiome” and “gut probiotics” were some of the most commonly google searched words but, what constitutes “good gut health”? There is no exact definition but in clinical practice we may use symptoms as a proxy for gut health, for example normal gastrointestinal function and the absence of chronic gastrointestinal symptoms that negatively impact on our quality of life. Consumer research found that consumers regard gut health as well-being and are interested in latest science but that does not inform their purchasing behaviours(1). Interestingly, symptoms of suboptimal gut health, which may include abdominal bloating, diarrhoea, constipation, excessive flatulence, were most likely to influence consumer behaviours.1 In this presentation, I review the latest scientific evidence about foods and dietary patterns that are associated with markers of gut health. I also provide examples of how we can practically educate and advise New Zealanders on implementation of dietary changes that may support sustainable gut health.
This Research Communication presents a cross-sectional study to compare the prevalence of contagious, environmental, opportunistic and other intramammary infection pathogens in mountain dairy herds. In the Italian Apennine mountains, areas where dairy farming is thriving are interspersed among areas where only a few dairy herds remain. The disappearance of some dairy farms relates to the reduction of agricultural and veterinary services in a process that can jeopardize dairy herd profitability. Sixteen herds were screened for intramammary infection (IMI) pathogens. Antimicrobial susceptibility testing of mastitis pathogens was performed, and data on antimicrobial use was collected from the herd treatment registry. The prevalence of contagious IMI pathogens was significantly higher in areas where dairy farming is reducing, whereas environmental and opportunistic infections were more abundant in herds in thriving areas where farmers had a more consistent relationship with veterinarians. Antimicrobial resistance levels were low throughout all areas and did not relate to antimicrobial use, although it was significantly higher in areas where dairy herds were thriving.
Cardiometabolic diseases, including type 2 diabetes (T2DM) and cardiovascular disease (CVD), are common. Approximately one in three deaths annually are caused by CVD in Aotearoa New Zealand (AoNZ)(1). The Mediterranean dietary pattern is associated with a reduced risk of cardiometabolic disease in epidemiological and interventional studies(2,3). However, implementing the Mediterranean diet into non-Mediterranean populations can be challenging(4). Some of these challeanges include facilitating consumption of unfamiliar foods and the cultural and social context of food consumption. AoNZ produces a rich source of high-quality foods consistent with a Mediterranean dietary pattern. He Rourou Whai Painga is collaborative project combining contributions from food industry partners into a Mediterranean Diet pattern and providing foods, recipes and other support to whole household/whānau. The aim was to test if a New Zealand food-based Mediterranean diet (NZMedDiet) with behavioural intervention improves cardiometabolic health and wellbeing in individuals at risk. This presentation will review the background to the research, the process of forming a collaboration between researchers and the food industry, the design and implementation of a complex study design (see protocol paper)(5), with results from the initial randomised controlled trial. We conducted several pilot studies(6,7,8) to inform the final design of the research, which was a combination of two randomised controlled trials (RCT 1 and 2) and a longitudinal cohort study. RCT-1 compared 12-weeks of the NZMedDiet to usual diet in participants with increased cardiometabolic risk (metabolic syndrome severity score (MetSSS) >0.35). The intervention group were provided with food and recipes to meet 75% of their energy requirements, supported by a behavioural intervention to improve adherence. The primary outcome measure was MetSSS after 12 weeks. Two hundred individuals with mean (SD) age 49.9 (10.9)yrs with 62% women were enrolled with their household/whānau. After 12 weeks, the mean (SD) MetSSS was 1.0 (0.7) in the control (n = 98) and 0.8 (0.5) in the intervention (n = 102) group; estimated difference (95% CI) of -0.05 (-0.16 to 0.06), p=0.35. A Mediterranean diet score (PyrMDS) was greater in the intervention group 1.6 (1.1 to 2.1), p<0.001, consistent with a change to a more Mediterranean dietary pattern. Weight reduced in the NZMedDiet group compared with control (-1.9 kg (-2.0 to -0.34)), p=0.006 and wellbeing, assessed by the SF-36 quality of life questionnaire, improved across all domains p<0.001. In participants with increased cardiometabolic risk, food provision with a Mediterranean dietary pattern and a behavioural intervention did not improve a metabolic risk score but was associated with reduced weight and improved quality of life.
Masters athletes tend to have higher intakes of calcium, magnesium, iron, and zinc when compared to Australian national population data from similar age groups(1). However, little is known about the diets of New Zealand Olympians as they get older. This study aimed to describe the micronutrient intakes of New Zealand Olympic and Commonwealth Games athletes over the age of 60 years and make comparisons with National Nutrition Survey data. Thirty-three individuals (mean age 76±8 years, n=27 male) who had represented New Zealand at an Olympic or Commonwealth Games participated in this study. Dietary intake was assessed using three 24-h diet recalls. The first recall was conducted face to face in the participant’s home and the second and third were completed over a voice or video call on non-consecutive days following this. All recalls were performed using a multiple-pass technique and entered into FoodWorks dietary analysis software (Version 9, Xyris Software Ltd., Brisbane, Australia). Mean intakes across the three recalls were used to represent the intake of each individual.This study was approved by the University of Otago Ethics Committee (Health; H23/054, April 2023).The mean intakes of iron (males 13.3±5.1 mg, females 9.9±1.9 mg) and zinc (males 10.7±4.0 mg, females 9.6±1.9 mg) in Olympians were similar to those reported in those over 70 y in the 2008/09 New Zealand Adult Nutrition Survey, but more than 60% of Olympians had intakes below the estimated average requirements for these nutrients. Intakes of calcium (males 1048±474 mg, females 810±139 mg) and selenium (males 66.7±49.1 µg, females 48.4±17.7 µg) were higher in Olympians when compared to the 2008/09 New Zealand Adult Nutrition Survey data, however 39% and 61% of Olympians still had intakes below the estimated average requirements, respectively. While this group of older New Zealand Olympians did have higher intakes of some nutrients than a representative sample of their peers, a marked number are still at risk of inadequate intakes and may benefit from a nutrition intervention to improve the overall quality and adequacy of their diet.
Fossil crinoids from the Ordovician–Silurian boundary interval (~ 443.8 million years) are known from relatively few locations worldwide due to a near-global unconformity that formed from eustatic sea-level fall. This rock record bias has severely hindered study of the timing, magnitude, biogeographic signature, and extinction mechanisms of the Late Ordovician mass extinction (LOME). Crinoids underwent a significant faunal transition between the Late Ordovician and early Silurian that resulted in major shifts between dominant clades, but the driving mechanisms and precise timing of this transition remain unclear. Anticosti Island (Québec, Canada) preserves one of the few Late Ordovician–early Silurian successions of highly fossiliferous, shallow-water rocks that includes the Ordovician–Silurian boundary, making fossils from this region instrumental for better understanding the LOME and Ordovician–Silurian crinoid faunal turnover.
Here we report on a new flexible crinoid, Anticosticrinus natiscotecensis n. gen. n. sp., from the Ordovician–Silurian boundary of Anticosti Island. Phylogenetic analysis of Middle Ordovician–early Silurian flexibles recovers Anticosticrinus natiscotecensis n. gen. n. sp. as a member of family Anisocrinidae. We quantified stratigraphic age uncertainty of A. natiscotecensis using a Bayesian approach for estimating tip-occurrence times in a phylogenetic context. Although results do not provide unequivocal support for the specimen’s precise stratigraphic age, the maximum a posteriori estimate indicates a late Hirnantian age. Regardless of its true age, recognition of Anticosticrinus natiscotecensis provides additional data for evaluating the timing of extinction in flexible crinoids, their diversification and increasing dominance during the Silurian, and crinoid faunal turnover between the Ordovician and Silurian.