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Ventilator-associated pneumonia (VAP) is a well-established cause of morbidity in critically ill patients. Current VAP criteria exclude patients on extracorporeal membrane oxygenation (ECMO). This retrospective analysis tests the validity of VAP in this population, as well as a new proposed diagnostic criterion for ECMO-associated pneumonia.
The objective of the study was to assess the concordance and ranking ability of a non-quantitative 33-item dietary screener developed to assess the diet of young adults in Norway, ‘MyFoodMonth 1.1’, compared to a semi-quantitative food frequency questionnaire (FFQ). Data were collected in a cross-sectional dietary survey evaluating the diets of students at the University of Agder, in southern Norway. The students were asked to complete both a dietary screener and an FFQ. Data collection was carried out from September to December 2020. Participants were first-year university students aged ≥18 years familiar with Scandinavian language. Almost half of the eligible sample (n 344) was excluded due to not completing the FFQ, compared to 1⋅7 % not completing the dietary screener, resulting in 172 (66 % female) participants with a median age of 21 years. For most items of the dietary screener (n 27/33, 82 %), all aspects of diet quality and components of the Diet Quality Score showed moderate-to-strong concordance with the FFQ evaluated using Kendall's tau-b analyses (t > 0⋅31), supported by visual inspection of box and whisker plots and descriptive ranking ability in a cross-tabulation. There was little evidence to suggest that concordance was dependent on sex. The concordance and ranking ability of ‘MyFoodMonth 1.1’ is considered satisfactory compared to a semi-quantitative FFQ. This rapid dietary assessment instrument presents a valuable addition to traditional instruments and a possible solution to recruit hard-to-reach parts of the population.
Emerging evidence suggests that parents’ nutritional status before and at the time of conception influences the lifelong physical and mental health of their child. Yet little is known about the relationship between diet in adolescence and the health of the next generation at birth. This study examined data from Norwegian cohorts to assess the relationship between dietary patterns in adolescence and neonatal outcomes. Data from adolescents who participated in the Nord-Trøndelag Health Study (Young-HUNT) were merged with birth data for their offspring through the Medical Birth Registry of Norway. Young-HUNT1 collected data from 8980 adolescents between 1995 and 1997. Linear regression was used to assess associations between adolescents’ diet and later neonatal outcomes of their offspring adjusting for sociodemographic factors. Analyses were replicated with data from the Young-HUNT3 cohort (dietary data collected from 2006 to 2008) and combined with Young-HUNT1 for pooled analyses. In Young-HUNT1, there was evidence of associations between dietary choices, meal patterns, and neonatal outcomes, these were similar in the pooled analyses but were attenuated to the point of nonsignificance in the smaller Young-HUNT3 cohort. Overall, energy-dense food products were associated with a small detrimental impact on some neonatal outcomes, whereas healthier food choices appeared protective. Our study suggests that there are causal links between consumption of healthy and unhealthy food and meal patterns in adolescence with neonatal outcomes for offspring some years later. The effects seen are small and will require even larger studies with more state-of-the-art dietary assessment to estimate these robustly.
The development of nutritional strategies to improve microbial homeostasis and gut health of piglets post-weaning is required to mitigate the high prevalence of post-weaning diarrhea and subsequent growth checks typically observed during the weaning transition. Therefore the objective of this study was to determine the effect of supplementing piglet creep and nursery feed with a yeast-derived mannan-rich fraction (MRF) on piglet growth performance, cecal microbial profiles, and jejunal morphology and gene expression. Ten litters of piglets (n=106) were selected on postnatal day (PND) 7 and assigned to diets with or without MRF (800 mg/kg) until weaning (n=5 litters/treatment; initial weight 3.0±0.1 kg). On PND 21, 4 piglets per litter (n=40) were selected and weaned into the nursery where they remained on their respective diets until PND 42. A two-phase feeding program was used to meet nutrient requirements, and pigs were switched from phase 1 to phase 2 on PND 28. Feed intake and piglet weights were recorded on PND 7, 14, 21, 28, 35 and 42. On PND 28 and 42, ten piglets per treatment were euthanized to collect intestinal tissue and digesta. Piglets supplemented with MRF had 21.5% greater (P<0.05) average daily feed intake between PND 14-21. However, MRF supplementation did not affect piglet growth performance compared to control. On PND 28, jejunal villus height was 16.8% greater (P<0.05) in piglets consuming MRF supplemented diets. Overall microbial community structure in cecal digesta on PND 28 tended to differ in pigs supplemented with MRF (P=0.076; analysis of similarities (ANOSIM)) with increased (P<0.05) relative abundance of Paraprevotellaceae genera YRC22 and CF231, and reduced (P<0.05) relative abundance of Sutterella and Prevotella. Campylobacter also tended to reduce (P<0.10) in MRF supplemented piglets. On PND 28 differential gene expression in jejunal tissue signified an overall effect of supplementing MRF to piglets. Downstream analysis of gene expression data revealed piglets supplemented with MRF had enriched biological pathways involved in intestinal development, function and immunity, supporting the observed improvement in jejunal villus architecture on PND 28. On PND 42 there was no effect of MRF supplementation on jejunal morphology or overall cecal microbial community structure. In conclusion, supplementing Actigen™, a MRF, to piglets altered cecal microbial community structure and improved jejunal morphology early post-weaning on PND 28, which is supported by enrichment of intestinal development pathways.
The rising prevalence of overweight and obesity is a worldwide public health challenge. Pregnancy and beyond is a potentially important window for future weight gain in women. We investigated associations between maternal adherence to the New Nordic diet (NND) during pregnancy and maternal BMI trajectories from delivery to 8 years post delivery. Data are from the Norwegian Mother and Child Cohort. Pregnant women from all of Norway were recruited between 1999 and 2008, and 55 056 are included in the present analysis. A previously constructed diet score, NND, was used to assess adherence to the diet. The score favours intake of Nordic fruits, root vegetables, cabbages, potatoes, oatmeal porridge, whole grains, wild fish, game, berries, milk and water. Linear spline multi-level models were used to estimate the association. We found that women with higher adherence to the NND pattern during pregnancy had on average lower post-partum BMI trajectories and slightly less weight gain up to 8 years post delivery compared with the lower NND adherers. These associations remained after adjustment for physical activity, education, maternal age, smoking and parity (mean diff at delivery (high v. low adherers): −0·3 kg/m2; 95 % CI −0·4, −0·2; mean diff at 8 years: −0·5 kg/m2; 95 % CI −0·6, −0·4), and were not explained by differences in energy intake or by exclusive breast-feeding duration. Similar patterns of associations were seen with trajectories of overweight/obesity as the outcome. In conclusion, our findings suggest that the NND may have beneficial properties to long-term weight regulation among women post-partum.
The newer cyanide antidote, hydroxocobalamin, due to its pigmentation, has been found to cause interferences in some laboratory assays. Co-oximetry may also be affected by hydroxocobalamin, leading to false elevations in hemoglobin concentration, methemoglobin, carboxyhemoglobin, and false decreases in oxyhemoglobin. The Masimo Radical-7 is a medical device that performs noninvasive oximetry and estimates hemoglobin (Hb) concentration and percent carboxyhemoglobin (COHb), methemoglobin (MetHb), and oxyhemoglobin saturation (O2Hb).
Study Objectives
The study sought to determine the effect of hydroxocobalamin on noninvasive measurement of hemoglobin indices using the Masimo Radical-7 monitor.
Methods
Seven asymptomatic volunteers who were unexposed to cyanide had baseline heart rate (HR), blood pressure (BP), and oximeter measurements recorded followed by an infusion of five grams of hydroxocobalamin over 15 minutes. The above parameters were subsequently recorded at: 5, 10, 15, 30 and 60 minutes post infusion. Data were analyzed by calculating the area under the curve (AUC) for each variable and comparing the results to expected values by paired t tests. Expected AUC values were calculated by extrapolating baseline values across the entire time period.
Results
The mean differences from baseline values with 95% confidence intervals and t tests of mean difference were: SBP: 11 mm Hg (95% CI, 0-22; P = .051); HR: -9 (95% CI, -15 to -3; P = .01); Hb: -0.1 (95% CI, -0.7 to 0.4; P = .57); O2Hb: 0 g/dL (95% CI, -1 to 1; P = .41); COHb: -1 (95% CI, -3 to 1; P = .25); MetHb: -0.2 (95% CI, -0.3 to 0; P = .03).
Discussion
After infusion of hydroxocobalamin there was a significant elevation of systolic blood pressure and decrease in heart rate. There were no significant differences in Hb, O2Hb, and COHb. Although percent methemoglobin concentrations were statistically lower, the authors feel this difference is of trivial clinical significance.
Conclusion
The administration of hydroxocobalamin does not significantly impact noninvasive oximetry.
CashinB, MatlockA, KangC, ReynoldsP, WillsB. Effect of Hydroxocobalamin on Surface Oximetry in Nonexposed Humans. Prehosp Disaster Med. 2013;28(4):1-3.
The study of both neutral and ionised gas in young radio sources is providing key information on the effect the radio plasma has on the ISM of these objects. We present results obtained for the compact radio sources PKS 1549–79, 4C 12.50 and PKS 1814–63 and for the intermediate-size radio galaxy 3C 459. At least in the first two, low ionisation optical emission lines and HI absorption appear to be associated with the extended, but relatively quiescent, dusty cocoon surrounding the nucleus. The [OIII] lines are, on the other hand, mostly associated with the region of interaction between the radio plasma and the ISM, indicating a fast outflow from the centre. A case of fast outflow (up to ∼1000 km s-1) is also observed in HI in the radio source 4C 12.50. As the radio source evolves, any obscuring material along the radio axis is swept aside until, eventually, cavities (of the same kind as observed e.g. in Cygnus A) are hollowed out on either side of the nucleus. We may witness this phase in the evolution of a radio source in the radio galaxy 3C 459.
Timing measurements of periodic X-ray pulses from two ultrashort-period double degenerate binaries, RX J1914+24 and RX J0806+15, show that the rates of change of their orbital periods are consistent with gravitational radiation losses. This contradicts the predictions of models which invoke mass transfer between the two white dwarfs. The X-ray emission is, therefore, unlikely to be powered by accretion processes. The unipolar inductor model explains the source of X-ray emission as electrical dissipation at the base of a flux tube, which connects the magnetic white dwarf to its companion. This model is most consistent with the observed X-ray pulse properties. A similar current system exists in the Jupiter–Io system, where a mildly relativistic electron current produces an auroral footprint at the base of the Io flux tube and highly polarized beamed radio emission by means of the electron cyclotron maser mechanism. Detection of radio emission from RX J1914+24 and RX J0806+15 would thus provide further support for the unipolar inductor model. We present theoretical predictions, based on a loss-cone-driven electron cyclotron maser model, of radio fluxes from systems with parameters similar to RX J1914+24 and RX J0806+15.
Lower birthweight, and rapid childhood weight gain predict elevated cardiovascular risk factors in children. We examined associations between serial, detailed, anthropometric measurements from birth to 9.5 years of age and cardiovascular risk markers in Indian children. Children (n = 663) born at the Holdsworth Memorial Hospital, Mysore, India were measured at birth and 6–12 monthly thereafter. At 9.5 years, 539 (255 boys) underwent a 2-h oral glucose tolerance test, and blood pressure (BP) and fasting lipid concentrations were measured. Insulin resistance was calculated using the HOMA equation. These outcomes were examined in relation to birth measurements and changes in measurements (growth) during infancy (0–2 years), 2–5 years and 5–9.5 years using conditional s.d. scores. Larger current weight, height and skinfold thickness were associated with higher risk markers at 9.5 years (P < 0.05). Lower weight, smaller length and mid-arm circumference at birth were associated with higher fasting glucose concentrations at 9.5 years (P ⩽ 0.01). After adjusting for current weight/height, there were inverse associations between birthweight and/or length and insulin concentrations, HOMA, systolic and diastolic BP and plasma triglycerides (P < 0.05). Increases in conditional weight and height between 0–2, 2–5 and 5–9.5 years were associated with higher insulin concentrations, HOMA and systolic BP. In conclusion, in 9–10-year-old Indian children, as in other studies, cardiovascular risk factors were highest in children who were light or short at birth but heavy or tall at 9 years. Greater infant and childhood weight and height gain were associated with higher risk markers.
Foetal development may permanently affect muscle function. Indian newborns have a low mean birthweight, predominantly due to low lean tissue and muscle mass. We aimed to examine the relationship of birthweight, and arm muscle area (AMA) at birth and post-natal growth to handgrip strength in Indian children. Grip strength was measured in 574 children aged 9 years, who had detailed anthropometry at birth and every 6–12 months post-natally. Mean (standard deviation (s.d.)) birthweight was 2863 (446) g. At 9 years, the children were short (mean height s.d. −0.6) and light (mean weight s.d. −1.1) compared with the World Health Organization growth reference. Mean (s.d.) grip strength was 12.7 (2.2) kg (boys) and 11.0 (2.0) kg (girls). Weight, length and AMA at birth, but not skinfold measurements at birth, were positively related to 9-year grip strength (β = 0.40 kg/s.d. increase in birthweight, P < 0.001; and β = 0.41 kg/s.d. increase in AMA, P < 0.001). Grip strength was positively related to 9-year height, body mass index and AMA and to gains in these measurements from birth to 2 years, 2–5 years and 5–9 years (P < 0.001 for all). The associations between birth size and grip strength were attenuated but remained statistically significant for AMA after adjusting for 9-year size. We conclude that larger overall size and muscle mass at birth are associated with greater muscle strength in childhood, and that this is mediated mainly through greater post-natal size. Poorer muscle development in utero is associated with reduced childhood muscle strength.
X-Ray Absorption Spectroscopy (XAS) and Photoelectron Spectroscopy (PES) have been performed upon highly radioactive samples, particularly Plutonium, at the Advanced Light Source in Berkeley, CA, USA. First results from alpha and delta Plutonium are reported as well as a detailed analysis of sample quality.
For large numbers of marker loci in a genomic scan for disease loci, we propose a novel 2-stage approach for linkage or association analysis. The two stages are (1) selection of a subset of markers that are ‘important’ for the trait studied, and (2) modelling interactions among markers and between markers and trait. Here we focus on stage 1 and develop a selection method based on a 2-level nested bootstrap procedure. The method is applied to single nucleotide polymorphisms (SNPs) data in a cohort study of heart disease patients. Out of the 89 original SNPs the method selects 11 markers as being ‘important’. Conventional backward stepwise logistic regression on the 89 SNPs selects 7 markers, which are a subset of the 11 markers chosen by our method.
A new radio image of the core of the starburst galaxy M82 is presented. A pair of probable galactic chimneys are evident. Such structures have been conjectured to result when a giant shell of ionized gas breaks out of the dense plane of a galaxy and ejects hot gas into the halo. In M 82, the starburst activity drives a galactic superwind and theoretical models of this process require a knowledge of the kinematics of the hot gas in the core of the galaxy. The results presented here imply that the ejection of material into the base of the superwind does not occur smoothly over the starburst region; instead, very localised venting of the hot gas appears to be taking place.
With the advent of new multijunction thin film solar cells, amorphous silicon photovoltaic technology is undergoing a commercial revival with about 30 megawatts of annual capacity coming on-line in the next year. These new a−Si multijunction modules should exhibit stabilized conversion efficiencies on the order of 8%, and efficiencies over 10% may be obtained in the next several years. The improved performance results from the development of amorphous and microcrystalline silicon alloy films with improved optoelectronic properties and from the development of more efficient device structures. Moreover, the manufacturing costs for these multijunction modules using the new large-scale plants should be on the order of $1 per peak watt. These modules may find widespread use in solar farms, photovoltaic roofing, as well as in traditional remote applications.
The aim of this study was to determine the degree to which the epidermis and oral epithelium of species other than man express cytokeratin (CK) intermediate filaments, which are markers of epithelial differentiation. Fixed, wax-embedded samples of skin, buccal mucosa and gingiva from rhesus monkey, marmoset, cow, sheep, pig, ferret, hamster, axolotl and trout were tested for CK expression using a panel of antihuman CK antibodies and an immunoperoxidase procedure. Human skin and oral mucosa were also stained to act as positive control. The results showed that antihuman CK antibodies stained animal tissues, but the patterns of staining were not always identical to the established human CK profile. Of particular interest was the expression of CK18, typically only detected in ‘simple’ epithelium in man, in bovine, ferret and hamster stratified epithelium from different sites. However, there was evidence of variable anti-CK antibody cross-reactivity, both as a result of intrinsic variations in CK polypeptide structure and as artifacts of fixation. We conclude that some CK are conserved between species, but that biological variables, for example local functional requirements, and technical factors affect the results. These considerations need to be borne in mind in animal studies of epithelial differentiation employing CK immunohistochemistry. Biochemical characterisation is ultimately necessary to determine specific differences between human and animal CK.
Some of the significant steps in technological development for large-scale commercialization of amorphous silicon (a-Si:H) based multijunction photovoltaic modules are presented. These developments are establishing a high quality baseline process for manufacturing large-area ( ˜ 8 ft2) a-Si:H/a-SiGe:H tandem junction modules with improved stabilized conversion efficiency, throughput, yield, and reduced materials usage.
Some of the significant steps in technological development for large-scale commercialization of amorphous silicon (a-Si:H) based multijunction photovoltaic modules are presented. These developments are establishing a high quality baseline process for manufacturing large-area ( ∼ 8 ft2) a-Si:H/a-SiGe:H tandem junction modules with improved stabilized conversion efficiency, throughput, yield, and reduced materials usage.
We report the results of computer simulations of phase transitions in noble-gas clusters. The calculations were performed on a MasPar MP-l massively parallel computer with 8,192 processing elements (PE's). We discuss the efficient implementation of molecular dynamics algorithms for small clusters on this type of architecture. The simulations are based on a classical Lennard-Jones pair potential and follow the temporal evolution of the system by numerically integrating Newton's equations of motion using the Gear algorithm. Because the number of particles is much smaller than the number of PE's, optimal partitioning of the processing element array is an essential and non-trivial task.