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Cocoa-derived flavanols (CDF) may act as prebiotics. However, evidence is inconsistent, and the duration and dose of CDF intake needed to elicit any prebiotic effect are undefined. This randomized, double-blind, crossover study determined the effects of short-term, high-dose dietary supplementation with CDF versus matched placebo on gut microbiota composition in 8 healthy adults. A single faecal sample was collected 8 d after supplementation with 900 mg/d CDF or placebo. Gut microbiota composition and Bifidobacterium spp. and Lactobacillus spp. abundance were measured as secondary outcomes by 16S ribosomal ribonucleic acid (rRNA) amplicon sequencing and quantitative polymerase chain reaction, respectively. No between-treatment differences in the relative or absolute abundance of Bifidobacterium spp. (Cohen’s d = 0.89, P = 0.22) or Lactobacillus spp. (Cohen’s d = 0.42, P = 0.65) were detected. Shannon diversity (Cohen’s d = 0.38, P = 0.04) and overall community richness (Cohen’s d = 0.34, P = 0.06) were lower following CDF supplementation versus placebo, but no between-treatment differences in β-diversity or taxa relative abundances were observed. Findings are not consistent with a clear prebiotic effect of this short-term, high-dose CDF supplementation strategy relative to placebo.
Developing effective enrichments is important for improving pig (Sus scrofa) welfare as it increases species-specific behaviours, decreases abnormal behaviours, and increases time active. However, few enrichments are available for sows in farrowing crates. Pigs are often observed to scratch, or rub against objects, however enrichments designed to provide a scratching outlet have never been tested in sows. We examined the behaviour and welfare of sows in farrowing crates when they were presented with one of two types of scratchpad enrichment. Sows (n = 18) of parities two (P2) and three (P3) were housed for 25 days and assigned no enrichment (Control) or a scratch-pad made of plastic mats (Plastic) or coir fibre mats (Fibre). Parity two Plastic sows scratched for a longer total duration than P2 and P3 Fibre sows, P3 Plastic sows, and P2 Control sows. Parity two Plastic sows also displayed scratching bouts more frequently than all except P3 Control sows. There were no body lesion differences between treatments. Abnormal behaviour and proportion of time spent in different postures also did not differ between treatments. Plastic scratch-pads may be a suitable enrichment for farrowing crates as they increased the natural behaviour of scratching. More research is needed to refine the scratch-pad design and measure motivation before it can be concluded that scratch-pads are a successful enrichment that should be implemented on-farm.
The purpose of this study was to evaluate whether linear and non-linear measures of heart rate variability (HRV) could be used as indicators of piglet castration pain. Thirty piglets were allocated to 1 of 4 treatments: i) sham castrated HRV (SHRV; n = 8); ii) surgical castrated HRV (CHRV; n = 7); iii) sham castrated blood collection (SBC; n = 7); or iv) surgical castrated blood collection (CBC; n = 8). Piglets in the SHRV and CHRV treatment groups underwent a 1-h HRV and postural behaviour evaluation on day-1, day 0 (castration treatment), day 1 and day 3 of the experimental procedure. Piglets in the SBC and CBC groups underwent blood collection for serum cortisol analysis at -0.5, 1, 2, 3, 24, 48 and 72 h relative to castration treatment. Castrated piglets (CHRV) exhibited greater low to high frequency ratio, lower sample entropy and greater percent determinism compared to SHRV piglets, indicating greater pain-related stress due to the surgical castration procedure. Serum cortisol was greater in CBC pigs at 1 h post-castration compared to SBC piglets. No effect of treatment was found for amount of time spent lying post-castration. In conclusion, surgically castrated pigs exhibited greater pain-related stress than their sham castrated counterparts. Additionally, non-linear HRV measures seem to complement traditional linear HRV measures and may be valuable for assessing pain-related stress in future studies investigating swine welfare.
Energy deficit is common during prolonged periods of strenuous physical activity and limited sleep, but the extent to which appetite suppression contributes is unclear. The aim of this randomised crossover study was to determine the effects of energy balance on appetite and physiological mediators of appetite during a 72-h period of high physical activity energy expenditure (about 9·6 MJ/d (2300 kcal/d)) and limited sleep designed to simulate military operations (SUSOPS). Ten men consumed an energy-balanced diet while sedentary for 1 d (REST) followed by energy-balanced (BAL) and energy-deficient (DEF) controlled diets during SUSOPS. Appetite ratings, gastric emptying time (GET) and appetite-mediating hormone concentrations were measured. Energy balance was positive during BAL (18 (sd 20) %) and negative during DEF (–43 (sd 9) %). Relative to REST, hunger, desire to eat and prospective consumption ratings were all higher during DEF (26 (sd 40) %, 56 (sd 71) %, 28 (sd 34) %, respectively) and lower during BAL (–55 (sd 25) %, −52 (sd 27) %, −54 (sd 21) %, respectively; Pcondition < 0·05). Fullness ratings did not differ from REST during DEF, but were 65 (sd 61) % higher during BAL (Pcondition < 0·05). Regression analyses predicted hunger and prospective consumption would be reduced and fullness increased if energy balance was maintained during SUSOPS, and energy deficits of ≥25 % would be required to elicit increases in appetite. Between-condition differences in GET and appetite-mediating hormones identified slowed gastric emptying, increased anorexigenic hormone concentrations and decreased fasting acylated ghrelin concentrations as potential mechanisms of appetite suppression. Findings suggest that physiological responses that suppress appetite may deter energy balance from being achieved during prolonged periods of strenuous activity and limited sleep.
Rural Long-term Care (LTC) providers face unique challenges when planning, preparing for, and responding to disasters. We sought to better understand challenges and identify best practices for LTC in rural areas.
Methods:
Case studies including key informant interviews and site visits were conducted with LTC staff and emergency planning, preparedness, and response partners in three rural communities. Themes were identified across sites using inductive coding.
Results:
Communication across disaster phases continues to be a challenge for LTC providers in rural communities for all disaster types. Communication challenges limit LTC providers’ ability to address patient needs during emergencies and limit the resilience of providers and patients to future disasters. Limited coordination among local leadership and LTC providers prevents dissemination of information, resources, and services, and slows response and recovery time. Including LTC providers as stakeholders in planning and exercises may improve communication and coordination.
Conclusion:
More than two decades into efforts to increase preparedness of health care systems to all hazards, rural LTC facilities still face challenges related to communication and coordination. Agencies at the federal, state, and local level should include input from rural LTC stakeholders to address gaps in communication and coordination and increase their disaster resilience.
Heart rate variability (HRV) is a proxy measure of autonomic function and can be used as an indicator of swine stress. While traditional linear measures are used to distinguish between stressed and unstressed treatments, inclusion of nonlinear HRV measures that evaluate data structure and organization shows promise for improving HRV interpretation. The objective of this study was to evaluate the inclusion of nonlinear HRV measures in response to an acute heat episode. Twenty 12- to 14-week-old growing pigs were individually housed for 7 days and acclimated to thermoneutral conditions (20.35°C ± 0.01°C; 67.6% ± 0.2% RH) before undergoing one of the two treatments: (1) thermoneutral control (TN; n = 10 pigs) or (2) acute heat stress (HS; n = 10 pigs; 32.6°C ± 0.1°C; 26.2% ± 0.1% RH). In Phase 1 of the experimental procedure (P1; 60 min), pigs underwent a baseline HRV measurement period in thermoneutral conditions before treatment [Phase 2; P2; 60 min once gastrointestinal temperature (Tg) reached 40.6°C], where HS pigs were exposed to heated conditions and TN pigs remained in thermoneutral conditions. After P2, all pigs were moved back to thermoneutral conditions (Phase 3; P3; 60 min). During each phase, Tg data were collected every 5 min and behavioural data were collected to evaluate the amount of time each pig spent in an active posture. Additionally, linear (time and frequency domain) and nonlinear [sample entropy (SampEn), de-trended fluctuation analysis, percentage recurrence, percentage determinism (%DET), mean diagonal line length in a recurrence plot] HRV measures were quantified. Heat stressed pigs exhibited greater Tg (P = 0.002) and spent less time in an active posture compared to TN pigs during P2 (P = 0.0003). Additionally, low frequency to high frequency ratio was greater in HS pigs during P3 compared to TN pigs (P = 0.02). SampEn was reduced in HS pigs during P2 (P = 0.01) and P3 (P = 0.03) compared to TN pigs. Heat stressed pigs exhibited greater %DET during P3 (P = 0.03) and tended to have greater %DET (P = 0.09) during P2 than TN pigs. No differences between treatments were detected for the remaining HRV measures. In conclusion, linear HRV measures were largely unchanged during P2. However, changes to SampEn and %DET suggest increased heat stress as a result of the acute heat episode. Future work should continue to evaluate the benefits of including nonlinear HRV measures in HRV analysis of swine heat stress.
The objective of this study was to provide real-world clinical laboratory-based data to supplement Centers for Disease Control and Prevention (CDC) reporting of Q fever. We analysed titre results of specimens submitted to a large US clinical laboratory for Coxiella burnetii IgG antibody testing from 2010 through 2016. Presumptive Q fever was defined as acute (phase II IgG titre ⩾1:128, phase I titre <1:1024) or chronic (phase I IgG titre ⩾1:1024), based on the results from a single serum specimen. During 2010–2016, an average of 328 presumptive acute Q fever cases were identified at Quest each year, nearly three times the annual average reported to the CDC (122). During the same period, the number of chronic cases identified annually at Quest Diagnostics (34) was similar to that reported to the CDC (29). These findings suggest that CDC data may underestimate the incidence of acute Q fever.
What is the experience of a racial subaltern on becoming an employee of a postcolonial state? Latin America has undertaken widespread multicultural state reform, often in response to pressure from nation-wide social movements and transnational human rights activism. This provides us with a window into ways in which subaltern individuals negotiate their place in a historically exclusionary state with norms of whiteness, European codes, and literal and metaphoric distance from marginal populations. Previous research has emphasized the cooptation of subaltern actors by neoliberal postcolonial states, but we argue that a close reading of subaltern accounts yields important insights into their experiences of ambivalence, ambiguity, and agency. Neoliberal state restructuring entrained a parallel, and in many cases interconnected process that generated ambivalence among civil servants. We draw on interviews with state employees associated with multicultural educational reforms in Chile to document the registers through which indigenous subalterns position themselves regarding the politics of interculturalism and the costs of serving the state.
The study of extremal problems related to independent sets in hypergraphs is a problem that has generated much interest. There are a variety of types of independent sets in hypergraphs depending on the number of vertices from an independent set allowed in an edge. We say that a subset of vertices is j-independent if its intersection with any edge has size strictly less than j. The Kruskal–Katona theorem implies that in an r-uniform hypergraph with a fixed size and order, the hypergraph with the most r-independent sets is the lexicographic hypergraph. In this paper, we use a hypergraph regularity lemma, along with a technique developed by Loh, Pikhurko and Sudakov, to give an asymptotically best possible upper bound on the number of j-independent sets in an r-uniform hypergraph.
Dubhashi, Jonasson and Ranjan Dubhashi, Jonasson and Ranjan (2007) study the negative dependence properties of Srinivasan's sampling processes (SSPs), random processes which sample sets of a fixed size with prescribed marginals. In particular they prove that linear SSPs have conditional negative association, by using the Feder–Mihail theorem and a coupling argument. We consider a broader class of SSPs that we call tournament SSPs (TSSPs). These have a tree-like structure and we prove that they have conditional negative association. Our approach is completely different from that of Dubhashi, Jonasson and Ranjan. We give an abstract characterization of TSSPs, and use this to deduce that certain conditioned TSSPs are themselves TSSPs. We show that TSSPs have negative association, and hence conditional negative association. We also give an example of an SSP that does not have negative association.
The general bacterial flora of 38 Tasmanian SIDS infants was examined together with faecal flora of 134 comparison infants ranging in age from birth to 6 months. The microflora of all specimens received was investigated with special emphasis on the toxigenic Escherichia coli (TEC). Samples were examined for verocytotoxigenic E. coli, free faecal verocytotoxin (FVT), heat labile toxin (LT) and heat stable toxin (ST) producers with the use of a Vero cell assay and commercial kits. The findings of this study revealed a high isolation rate (39%) of TEC from SIDS infants as compared to 1.5% from the healthy comparison infants. Atypical E. coli strains were also identified during the study, including E. coli A–D. An analysis of the same specimens for rotaviral and adenoviral antigens indicated that 30% of the SIDS cases were positive as compared to 20% in the comparison group.
1. A fresh emulsion of tubercle bacilli in salt solution when used as the antigen will give about 90 % of positive results in cases of pulmonary tuberculosis, whilst in healthy persons the result is negative.
2. In cases suspected of pulmonary tuberculosis, the results of this test conform closely to those given by a combination of the opsonic index test with injections of tuberculin, and so may be of value in diagnosis.
3. Diseases other than tuberculosis have always been negative, but only a small number of such cases have been examined.
4. An emulsion of tubercle bacilli when used as an antigen must be freshly prepared immediately before use, and should be made from a young subculture.
5. Owing to the differences in complements, they should always be titrated in the presence of the antigen, and probably also in the presence of both antigen and normal serum.
6. Exercise does not seem to affect the result of the reaction in any way, but a course of tuberculin treatment leads to an increase in the complement-fixing bodies of the serum in some cases.
We consider the performance of a simple greedy matching algorithm MINGREEDY when applied to random cubic graphs. We show that if λn is the expected number of vertices not matched by MINGREEDY, there are positive constants c1 and c2 such that C1n1/5 ≤ λn ≤ C2n1/5 log n.
Background and objective The intubating laryngeal mask (intubating laryngeal mask airway) was designed to facilitate blind intubation. Its value as an adjunct to fibreoptic laryngoscopy has not been evaluated. This study compares the intubating laryngeal mask airway with the standard laryngeal mask airway as conduits for fibreoptic laryngoscopy.
Methods The fibreoptic view of the laryngeal inlet was graded via both devices in 60 anaesthetized patients. The fibreoptic view through the intubating laryngeal mask airway was assessed after the central epiglottic elevator bar had been lifted out of the field of vision by an 8-mm Euromedical® tracheal tube, which was inserted to a depth of 18 cm. The fibreoptic view from the aperture bars of the laryngeal mask was recorded.
Results The vocal cords were viewed less frequently through the intubating laryngeal mask airway (52%) than through the laryngeal mask airway (92%) [difference = 40% (95% CI = 26% to 54%), P < 0.0001].
Conclusion The view of the laryngeal inlet is better through the laryngeal mask airway than through a tracheal tube inserted to 18 cm in the intubating laryngeal mask.
We present a rare case of an intra-parenchymal thyroid epidermal cyst presenting with a left recurrent laryngeal nerve palsy. There was a complete recovery of the nerve function following surgical excision of the lesion. Theories of aetio-pathogenesis of the cyst and underlying mechanisms responsible for the nerve paralysis are explored.
Considering manufacturing expertise during the early stages of design can be of great benefit. Such information can greatly improve not only the quality of a design, but it can also ensure the generation of an easily manufactured design. This, in turn, can lower the final cost of the designed product. By evaluating how easily an evolving conceptual design can be made, potential hazards can be avoided before any detailed design efforts commence. The conceptual manufacturing planning requisite to such an evaluation is the focus of this paper. A domain-independent strategy for conceptual manufacturing planning is presented. A task-structure analysis of this strategy shows its domain independence. A specific implementation of this strategy for polymer composites manufacturing planning (Socharis) is discussed. The high-level implementation details of Socharis are presented as instantiations of the conceptual manufacturing planning strategy. Finally, the validity of the planning strategy and the utility of Socharis are assessed.
We approach sphere of influence graphs (SIGs) from a probabilistic perspective. Ordinary SIGs were first introduced by Toussaint as a type of proximity graph for use in pattern recognition, computer vision and other low-level vision tasks. A random sphere of influence graph (RSIG) is constructed as follows. Consider n points uniformly and independently distributed within the unit square in d dimensions. Around each point,Xi, draw an open ball (‘sphere of influence’) with radius equal to the distance to Xi's nearest neighbour. Finally, draw an edge between two points if their spheres of influence intersect. Asymptotically exact values for the expected number of edges in a RSIG are determined for all values of d; previously, just upper and lower bounds were known for this quantity. A modification of the Azuma-Hoeffding exponential inequality is employed to exhibit the sharp concentration of the number of edges around its expected value.