An investigation into the nutritional status of patients receiving an Enhanced Recovery After Surgery (ERAS) protocol versus standard care following Oesophagectomy

Enhanced Recovery After Surgery (ERAS) protocols have been effectively expanded to various surgical specialities including oesophagectomy. Despite nutrition being a key component, actual nutrition outcomes and specific guidelines are lacking. This cohort comparison study aims to compare nutritional status and adherence during implementation of a standardised post-operative nutritional support protocol, as part of ERAS, compared to those who received usual care.Two groups of patients undergoing resection of oesophageal cancer were studied. Group 1 (n = 17) underwent oesophagectomy between Oct 2014 and Nov 2016 during implementation of an ERAS protocol. Patients in group 2 (n = 16) underwent oesophagectomy between Jan 2011 and Dec 2012 prior to the implementation of ERAS. Demographic, nutritional status, dietary intake and adherence data were collected. Ordinal data was analysed using independent t tests, and categorical data using chi-square tests.There was no significant difference in nutrition status, dietary intake or length of stay following implementation of an ERAS protocol. Malnutrition remained prevalent in both groups at day 42 post surgery (n = 10, 83% usual care; and n = 9, 60% ERAS). A significant difference was demonstrated in adherence with earlier initiation of oral free fluids (p

Absorbed dose measurements and predictions on LDEF

The overall radiation environment of the Long Duration Exposure Facility (LDEF) was determined in part through the use of thermoluminescent detectors (TLD's) which were included in several experiments. The results given are from four experiments (A0015 Biostack, M0004 Fiber Optics Data Link, P0004 Seeds in Space, and P0006 Linear Energy Transfer Spectrum Measurement) and represent a large fraction of existing absorbed dose data. The TLD's were located on the leading and the trailing edges and the Earth end of the spacecraft under various shielding depths (0.48 to 15.4 g/sq cm). The measured absorbed doses were found to reflect both directional dependence of incident trapped protons and shielding. At the leading edge, doses ranged from 2.10 to 2.58 Gy under shielding of 2.90 to 1.37 g/sq cm Al equivalent (M0004). At the trailing edge, doses varied from 3.04 to 4.49 Gy under shielding of 11.7 to 3.85 g/sq cm (A0015), doses varied from 2.91 to 6.64 Gy under shielding of 11.1 to 0.48 g/sq cm (P0004), and a dose range of 2.66 to 6.48 Gy was measured under shielding of 15.4 to 0.48 g/sq cm (P0006). At the Earth end of the spacecraft, doses from 2.41 to 3.93 Gy were found under shielding of 10.0 to 1.66 g/sq cm (A0015). The effect of the trapped proton anisotropy was such that the western side of LDEF received more than 2 times the dose of the eastern side at shielding depths of approximately 1 g/sq cm. Calculations utilizing a directional model of trapped proton spectra predict smaller doses than those measured, being about 50 percent of measured values at the trailing edge and Earth end, and about 80 percent near the leading edge

Dialectica Categories for the Lambek Calculus

We revisit the old work of de Paiva on the models of the Lambek Calculus in dialectica models making sure that the syntactic details that were sketchy on the first version got completed and verified. We extend the Lambek Calculus with a \kappa modality, inspired by Yetter's work, which makes the calculus commutative. Then we add the of-course modality !, as Girard did, to re-introduce weakening and contraction for all formulas and get back the full power of intuitionistic and classical logic. We also present the categorical semantics, proved sound and complete. Finally we show the traditional properties of type systems, like subject reduction, the Church-Rosser theorem and normalization for the calculi of extended modalities, which we did not have before

Information-theoretic significance of the Wigner distribution

A coarse grained Wigner distribution p_{W}(x,u) obeying positivity derives out of information-theoretic considerations. Let p(x,u) be the unknown joint PDF (probability density function) on position- and momentum fluctuations x,u for a pure state particle. Suppose that the phase part Psi(x,z) of its Fourier transform F.T.[p(x,u)]=|Z(x,z)|exp[iPsi(x,z)] is constructed as a hologram. (Such a hologram is often used in heterodyne interferometry.) Consider a particle randomly illuminating this phase hologram. Let its two position coordinates be measured. Require that the measurements contain an extreme amount of Fisher information about true position, through variation of the phase function Psi(x,z). The extremum solution gives an output PDF p(x,u) that is the convolution of the Wigner p_{W}(x,u) with an instrument function defining uncertainty in either position x or momentum u. The convolution arises naturally out of the approach, and is one-dimensional, in comparison with the two-dimensional convolutions usually proposed for coarse graining purposes. The output obeys positivity, as required of a PDF, if the one-dimensional instrument function is sufficiently wide. The result holds for a large class of systems: those whose amplitudes a(x) are the same at their boundaries (Examples: states a(x) with positive parity; with periodic boundary conditions; free particle trapped in a box).Comment: pdf version has 16 pages. No figures. Accepted for publ. in PR

Influence of characters of ear and kernel upon the germination of maize

Approved, M. MillerTypescriptM.A. University of Missouri 1912A great amount of literature has been published upon the selection of types of seed corn which will produce the best yield of grain. It is the general opinion of most agriculturists that there are certain physical and chemical characteristics of the ear and kernel which have a marked influence upon the yield. This is so universal that we have score cards which set forth the ideal type of ear and give certain values to the different characters. In general, the score cards are alike and all agree upon the characters which are desirable. They set forth a very similar type of ideal ear. No doubt the ear with the score card characters and type approaches that type of ideal ear which is the highest producer, but the question arises as to: How far should we carry on the selection for these characters? Is the extreme perfection the best or is it possible to carry the selection for a character beyond the point of best production and thereby decrease instead of increase the yield

Drosophila nuclear lamin precursor Dm0 is translated from either of two developmentally regulated mRNA species apparently encoded by a single gene.

A cDNA clone encoding a portion of Drosophila nuclear lamins Dm1 and Dm2 has been identified by screening a lambda-gt11 cDNA expression library using Drosophila lamin-specific monoclonal antibodies. Two different developmentally regulated mRNA species were identified by Northern blot analysis using the initial cDNA as a probe, and full-length cDNA clones, apparently corresponding to each message, have been isolated. In vitro transcription of both full-length cDNA clones in a pT7 transcription vector followed by in vitro translation in wheat germ lysate suggests that both clones encode lamin Dm0, the polypeptide precursor of lamins Dm1 and Dm2. Nucleotide sequence analyses confirm the impression that both cDNA clones code for the identical polypeptide, which is highly homologous with human lamins A and C as well as with mammalian intermediate filament proteins. The two clones differ in their 3'-untranslated regions. In situ hybridization of lamin cDNA clones to Drosophila polytene chromosomes shows only a single locus of hybridization at or near position 25F on the left arm of chromosome 2. Southern blot analyses of genomic DNA are consistent with the notion that a single or only a few highly similar genes encoding Drosophila nuclear lamin Dm0 exist in the genome

Breakfast glycaemic index and exercise: combined effects on adolescents' cognition

The aim of the present study was to examine the combined effects of breakfast glycaemic index (GI) and a mid-morning bout of exercise on adolescents’ cognitive function. Participants were randomly allocated to a high or low GI breakfast group in a mixed research design, where each participant completed two experimental trials (exercise and resting). Forty-two adolescents (12.4±0.5 years old), undertook a bout of exercise (ten repeats of level one of the multi-stage fitness test; exercise trial) or continued to rest (resting trial) following consumption of either a high or low GI breakfast. A battery of cognitive function tests (visual search test, Stroop test and Sternberg paradigm) was completed 30 min before and 45 min following the exercise. Average heart rate during exercise was 170±15 beats.min-1. On the complex level of the Stroop test, response times improved across the morning following the low GI breakfast on both the exercise and resting trials, though the improvement was greatest on the exercise trial. However, response times only improved on the resting trial following the high GI breakfast (p = 0.012). On the 5 letter level of the Sternberg paradigm, response times improved across the morning following the low GI breakfast (regardless of exercise) and only on the exercise trial following the high GI breakfast (p = 0.019). The findings of the present study suggest that the combined effects of breakfast GI and exercise in adolescents depend upon the component of cognitive function examined. A low GI breakfast and mid-morning bout of exercise were individually beneficial for response times on the Sternberg paradigm, whereas they conferred additional benefits for response times on the Stroop test