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The aim of this study was to assess the associations of intake of different types of meat with semen parameters and reproductive hormones in healthy young men. This cross-sectional study included 206 men, 18–23 years, from Southern Spain. All men completed a validated FFQ, underwent a physical examination, and provided blood and semen samples. Multivariable linear regression was used to evaluate the associations between meat intake with semen quality parameters and reproductive hormones. Total meat intake was unrelated to semen quality or reproductive hormone levels. When subgroups of meat were separately considered, however, shellfish intake was positively related to progressive motility. The adjusted percentages of progressively motile spermatozoa for men in increasing quartiles of shellfish intake were 45·2, 42·0, 49·4 and 53·2 % with a significant linear trend across quartiles (Ptrend≤0·001). In contrast, men who consumed organ meats had significantly lower progressive sperm motility (51·5 v. 42·8 %; P = 0·001) and higher luteinising hormone levels (4·0 v. 4·6 IU/l; P = 0·03) compared with men who did not consume organ meats. Intake of shellfish and organ meats was low in this population, however. Given the scarcity of data on the relation between specific types of meat with semen quality and reproductive hormone levels, additional research is needed to confirm or refute these findings.
Based on the vulnerability–stress model, we aimed to (1) determine new onset of depression in individuals who had not shown evidence of depression at baseline (5 years earlier) and (2) identify social, psychological, behavioral, and somatic predictors.
Longitudinal data of N = 10 036 participants (40–79 years) were evaluated who had no evidence of depression at baseline based on Patient Health Questionnaire (PHQ-9), no history of depression, or intake of antidepressants. Multivariate logistic regression models were used to predict the onset of depression.
Prevalence of new cases of depression was 4.4%. Higher rates of women (5.1%) than men (3.8%) were due to their excess incidence <60 years of age. Regression analyses revealed significant social, psychological, behavioral, and somatic predictors: loneliness [odds ratio (OR) 2.01; 95% confidence interval (CI) 1.48–2.71], generalized anxiety (OR 2.65; 1.79–3.85), social phobia (OR 1.87; 1.34–2.57), panic (OR 1.67; 1.01–2.64), type D personality (OR 1.85; 1.47–2.32), smoking (OR 1.35; 1.05–1.71), and comorbid cancer (OR 1.58; 1.09–2.24). Protective factors were age (OR 0.88; 0.83–0.93) and social support (OR 0.93; 0.90–0.95). Stratified by sex, cancer was predictive for women; for men smoking and life events. Entered additionally, the PHQ-9 baseline score was strongly predictive (OR 1.40; 1.34–1.47), generalized anxiety became only marginally, and panic was no longer predictive. Other predictors remained significant, albeit weaker.
Psychobiological vulnerability, stress, and illness-related factors were predictive of new onset of depression, whereas social support was protective. Baseline subclinical depression was an additional risk weakening the relationship between anxiety and depression by taking their overlap into account. Vulnerability factors differed between men and women.
Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.
To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRS
American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011–2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.
Of 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
The primary outcome of interest was 30-day SSI rate.
A total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23–2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09–1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06–2.53; P=.02), and longer duration of procedure were associated with development of SSI.
Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes.
The objective of this study was to evaluate the effects of the energy restriction of gestation of adult ewes from day 45 to day 115 on lamb live performance parameters, carcass and meat traits. In experiment I, dietary energy was restricted at 70% of the metabolizable energy (ME) requirements, after which ewes were re-fed ad libitum until lambing. In experiment II, dietary energy was restricted at 60% of the ME requirements, and ewes were re-fed to ME requirements until lambing. All ewes grazed together from the end of the restriction periods to weaning. Lambs were weaned and lot fed until slaughter. Feed intake, weight gain and feed efficiency were recorded, and body fat thickness and ribeye area (REA) were measured in the longissimus thoracis muscle. After slaughter, carcass weight and yield, fat depth, carcass and leg length, and frenched rack and leg weights and yields were determined. Muscle fiber type composition, Warner-Bratzler shear force, pH and color were determined in the longissimus lumborum muscle. In experiment I, energy restriction followed by ad libitum feeding affected lamb birth weight (P<0.05); however, no effects (P>0.05) were observed on later BW, REA, BF or carcass traits. Lambs born to non-restricted-fed ewes had higher (P<0.05) weight and yield of the frenched rack cut and their meat tended (P=0.11) to be tender compared with that of lambs from restricted ewes. The percentage of oxidative muscle fibers was lower for lambs born to non-restricted ewes (P<0.05); however, no effects of ewe treatment were observed on other muscle fiber types. For experiment II, energy restriction followed by ME requirements feeding, affected (P<0.01) pre-weaning live weight gain, weaning and final weights. Lambs from restricted ewes had higher (P<0.05) feed intake as % of leg weight and a trend to be less efficient (P=0.16) than lambs from unrestricted dams. Ribeye area and BF were not influenced by treatment. Treatment significantly affected slaughter weight, but had no effects on carcass yield and traits or on meat traits. The results obtained in both experiments indicate submitting ewes to energy restriction during gestation affects the performance of their progeny but the final outcome would depend on the ewe’s re-feeding level during late gestation and the capacity of the offspring to compensate the in utero restriction after birth.
Guidelines for the severity classification and treatment of Clostridium difficile infection (CDI) were published by Infectious Diseases Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) in 2010; however, compliance and efficacy of these guidelines has not been widely investigated. This present study assessed compliance with guidelines and its effect on CDI patient outcomes as compared with before these recommendations. A retrospective study included all adult inpatients with an initial episode of CDI treated in a single academic center from January 2009 to August 2014. Patients after guideline publication were compared with patients treated in 2009–2010. Demographic, clinical, and laboratory data were collected to stratify for disease severity. Outcome measures included compliance with guidelines, mortality, length of stay (LOS), and surgical intervention for CDI. A total of 1021 patients with CDI were included. Based upon the 2010 guidelines, 42 (28·8%) of 146 patients treated in 2009 would have been considered undertreated, and treatment progressively improved over time, as inadequate treatment decreased to 10·0% (15/148 patients) in 2014 (P = 0·0005). Overall, patient outcomes with guideline-adherent treatment decreased CDI attributable mortality twofold (P = 0·006) and CDI-related LOS by 1·9 days (P = 0·0009) when compared with undertreated patients. Compliance with IDSA/SHEA guidelines was associated with a decreased risk of mortality and LOS in hospitalized patients with CDI.
Low resting respiratory sinus arrhythmia (RSA), and to a lesser extent excessive RSA reactivity to emotion evocation, are observed in many psychiatric disorders characterized by emotion dysregulation, including syndromes spanning the internalizing and externalizing spectra, and other conditions such as nonsuicidal self-injury. Nevertheless, some inconsistencies exist. For example, null outcomes in studies of RSA–emotion dysregulation relations are sometimes observed among younger participants. Such findings may derive from use of age inappropriate frequency bands in calculating RSA. We combine data from five published samples (N = 559) spanning ages 4 to 17 years, and reanalyze RSA data using age-appropriate respiratory frequencies. Misspecifying respiratory frequencies results in overestimates of resting RSA and underestimates of RSA reactivity, particularly among young children. Underestimates of developmental shifts in RSA and RSA reactivity from preschool to adolescence were also observed. Although correlational analyses revealed weak negative associations between resting RSA and aggression, those with clinical levels of externalizing exhibited lower resting RSA than their peers. No associations between RSA reactivity and externalizing were observed. Results confirm that age-corrected frequency bands should be used when estimating RSA, and that literature-wide overestimates of resting RSA, underestimates of RSA reactivity, and underestimates of developmental shifts in RSA and RSA reactivity may exist.
The study aims to assess whether supplementation with the probiotic Lactobacillus rhamnosus HN001 (HN001) can reduce the prevalence of gestational diabetes mellitus (GDM). A double-blind, randomised, placebo-controlled parallel trial was conducted in New Zealand (NZ) (Wellington and Auckland). Pregnant women with a personal or partner history of atopic disease were randomised at 14–16 weeks’ gestation to receive HN001 (6×109 colony-forming units) (n 212) or placebo (n 211) daily. GDM at 24–30 weeks was assessed using the definition of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) (fasting plasma glucose ≥5·1 mmol/l, or 1 h post 75 g glucose level at ≥10 mmol/l or at 2 h ≥8·5 mmol/l) and NZ definition (fasting plasma glucose ≥5·5 mmol/l or 2 h post 75 g glucose at ≥9 mmol/l). All analyses were intention-to-treat. A total of 184 (87 %) women took HN001 and 189 (90 %) women took placebo. There was a trend towards lower relative rates (RR) of GDM (IADPSG definition) in the HN001 group, 0·59 (95 % CI 0·32, 1·08) (P=0·08). HN001 was associated with lower rates of GDM in women aged ≥35 years (RR 0·31; 95 % CI 0·12, 0·81, P=0·009) and women with a history of GDM (RR 0·00; 95 % CI 0·00, 0·66, P=0·004). These rates did not differ significantly from those of women without these characteristics. Using the NZ definition, GDM prevalence was significantly lower in the HN001 group, 2·1 % (95 % CI 0·6, 5·2), v. 6·5 % (95 % CI 3·5, 10·9) in the placebo group (P=0·03). HN001 supplementation from 14 to 16 weeks’ gestation may reduce GDM prevalence, particularly among older women and those with previous GDM.
We conducted a prospective cohort study between 1 January 2010 and 31 December 2012 at five adult and paediatric academic medical centres to identify factors associated with persistent methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Adults and children presenting to ambulatory settings with a MRSA skin and soft tissue infection (i.e. index cases), along with household members, performed self-sampling for MRSA colonisation every 2 weeks for 6 months. Clearance of colonisation was defined as two consecutive negative sampling periods. Subjects without clearance by the end of the study were considered persistently colonised and compared with those who cleared colonisation. Of 243 index cases, 48 (19·8%) had persistent colonisation and 110 (45·3%) cleared colonisation without recurrence. Persistent colonisation was associated with white race (odds ratio (OR), 4·90; 95% confidence interval (CI), 1·38–17·40), prior MRSA infection (OR 3·59; 95% CI 1·05–12·35), colonisation of multiple sites (OR 32·7; 95% CI 6·7–159·3). Conversely, subjects with persistent colonisation were less likely to have been treated with clindamycin (OR 0·28; 95% CI 0·08–0·99). Colonisation at multiple sites is a risk factor for persistent colonisation and may require more targeted decolonisation efforts. The specific effect of clindamycin on MRSA colonisation needs to be elucidated.
A megaslump at Batagaika, in northern Yakutia, exposes a remarkable stratigraphic sequence of permafrost deposits ~50–80 m thick. To determine their potential for answering key questions about Quaternary environmental and climatic change in northeast Siberia, we carried out a reconnaissance study of their cryostratigraphy and paleoecology, supported by four rangefinder 14C ages. The sequence includes two ice complexes separated by a unit of fine sand containing narrow syngenetic ice wedges and multiple paleosols. Overall, the sequence developed as permafrost grew syngenetically through an eolian sand sheet aggrading on a hillslope. Wood remains occur in two forest beds, each associated with a reddened weathering horizon. The lower bed contains high amounts of Larix pollen (>20%), plus small amounts of Picea and Pinus pumila, and is attributed to interglacial conditions. Pollen from the overlying sequence is dominated by herbaceous taxa (~70%–80%) attributed to an open tundra landscape during interstadial climatic conditions. Of three hypothetical age schemes considered, we tentatively attribute much of the Batagaika sequence to Marine Oxygen Isotope Stage (MIS) 3. The upper and lower forest beds may represent a mid–MIS 3 optimum and MIS 5, respectively, although we cannot discount alternative attributions to MIS 5 and 7.
SnO2 doped with Sb and Nb has been investigated for its use as catalyst support materials replacing carbon to enhance PEM fuel cells stability. Nanostructured powders of various doping levels were prepared by flame spray pyrolysis (FSP). The specific requirements of surface area >50 m2g-1 and electronic conductivity >0.01 Scm-1 were obtained, and pore sizes ranging mainly from 10 to 100 nm. Pt particles (9-20 wt.% in loading targeted) of ∼1 nm well dispersed in Sb-doped SnO2 was prepared by a one-step FSP procedure providing microstructures of high interest for further investigations as cathode in PEM fuel cells.
To determine the impact of total household decolonization with intranasal mupirocin and chlorhexidine gluconate body wash on recurrent methicillin-resistant Staphylococcus aureus (MRSA) infection among subjects with MRSA skin and soft-tissue infection.
Three-arm nonmasked randomized controlled trial.
Five academic medical centers in Southeastern Pennsylvania.
Adults and children presenting to ambulatory care settings with community-onset MRSA skin and soft-tissue infection (ie, index cases) and their household members.
Enrolled households were randomized to 1 of 3 intervention groups: (1) education on routine hygiene measures, (2) education plus decolonization without reminders (intranasal mupirocin ointment twice daily for 7 days and chlorhexidine gluconate on the first and last day), or (3) education plus decolonization with reminders, where subjects received daily telephone call or text message reminders.
MAIN OUTCOME MEASURES
Owing to small numbers of recurrent infections, this analysis focused on time to clearance of colonization in the index case.
Of 223 households, 73 were randomized to education-only, 76 to decolonization without reminders, 74 to decolonization with reminders. There was no significant difference in time to clearance of colonization between the education-only and decolonization groups (log-rank P=.768). In secondary analyses, compliance with decolonization was associated with decreased time to clearance (P=.018).
Total household decolonization did not result in decreased time to clearance of MRSA colonization among adults and children with MRSA skin and soft-tissue infection. However, subjects who were compliant with the protocol had more rapid clearance
Properties of the microwave emission from HR1099 are examined in an attempt to determine whether the emission arises as gyro-synchrotron radiation from mildly relativistic electrons trapped in magnetic fields above starspots on the active K subgiant component. It is shown that radio curves do not exhibit a systematic variation in phase with the rotation rate, as one might expect for emission from a source situated above a long-lived starspot. However, there is some evidence that the radio flaring occurs at two preferred longitude zones. Whether these zones agree with starspot locations remains to be determined by light curve modelling. What we can say with confidence is that the measured spectral index of the microwave emission does not fit a simple gyro-synchrotron source model, such as that proposed to explain the observed reversal with frequency of the sense of circular polarization.
This roundtable celebrates the twentieth anniversary of Stephen Skowronek’s Building a New American State: The Expansion of National Administrative Capacities, 1877–1920 (1982). Skowronek’s book introduced scholars to the emerging field of historical institutionalism, offering an interdisciplinary approach to analyzing government and public policy. Tackling three different policy areas, the book offered a pathbreaking examination of institutional development and a treatment of political actors that moved beyond standard accounts of elites who responded only to societal or corporate demands. Building a New American State demonstrated how politics could be understood only historically, since current conditions were layered over preexisting institutions. Through this book, Skowronek became one of those rare authors able to influence scholarship in several academic fields. The theoretical and substantive insights of his book influenced the first and second generations of scholars who built the field of American Political Development, using historical data to examine how institutions structured politics over long periods of time and how policies reconfigured politics. This roundtable explores how this classic book affected the study of government in the disciplines of political science, history, and sociology. The authors discuss ways each discipline developed a distinct version of American Political Development. The roundtable also explores how the interdisciplinary project of historical institutionalism has evolved since the early 1980s and new directions in which the field might go.
The claim that contemporary historical scholarship has ignored the twentieth-century U.S. Congress is a great understatement. During the past two decades, most social and cultural historians minimized the study of government institutions, policy makers, and policies. They characterized these aspects of American history as elitist, irrelevant, and even illegitimate (Leff 1995; Leuchtenburg 1986).The ultimate villain in this scholarly narrative was Congress, considered to be an insulated haven for white male elites who sub-vert the democratic process in favor of vested interest groups.When Congress appeared in a few academic books, it was treated as an archaic institution that functions as either a road block or a rubber stamp to proposals that emanate from the executive branch or from mass social movements.Those interested in the modern history of Congress can turn only to the work of journalists such as John Jacobs (1995) and Richard Cohen (1999) who rely on political biography in attempts to understand the institution’s past.
Congressional scholars have a unique opportunity to reconnect the histories of American state and society, a task central to the new generation of political historians. As MarkLeff (1995:852) recently argued, social and political historians have come to realize that they “ignored the other at their peril” and that “interaction was the only way to interrogate power—how it was structured and changed, where it was contested, how it was exerted, what its impact was, and what assumptions shaped the discourse that framed it” (see also Gillon 1997).To accomplish the challenge of integrating social and political history, congressional historians will have to examine how the institution’s development related to external forces. Much of what has been written about Congress thus far remains insular.
A handful of books published in the past two decades suggest how integration can be accomplished. In Sectionalism and American Political Development 1880–1980, Richard Bensel (1984) situates the internal development of Congress within the larger context of sectional tensions between the “industrial northern core” and the “underdeveloped southern and western periphery.” He pays close attention to key policy decisions and the ongoing struggle between decentralized committee and centralized partisan power to show the influence of sectionalism.
Over the past decade, epigenetic analyses have made important contributions to our understanding of healthy development and a wide variety of adverse conditions such as cancer and psychopathology. There is increasing evidence that DNA methylation is a mechanism by which environmental factors influence gene transcription and, ultimately, phenotype. However, differentiating the effects of the environment from those of genetics on DNA methylation profiles remains a significant challenge. Monozygotic (MZ) twin study designs are unique in their ability to control for genetic differences because each pair of MZ twins shares essentially the same genetic sequence with the exception of a small number of de novo mutations and copy number variations. Thus, differences within twin pairs in gene expression and phenotype, including behavior, can be attributed in the majority of cases to environmental effects rather than genetic influence. In this article, we review the literature showing how MZ twin designs can be used to study basic epigenetic principles, contributing to understanding the role of early in utero and postnatal environmental factors on the development of psychopathology. We also highlight the importance of initiating longitudinal and experimental studies with MZ twins during pregnancy. This approach is especially important to identify: (1) critical time periods during which the early environment can impact brain and mental health development, and (2) the specific mechanisms through which early environmental effects may be mediated. These studies may inform the optimum timing and design for early preventive interventions aimed at reducing risk for psychopathology.