Growth performance, hematology and immunological parameters of rainbow trout, Oncorhynchus mykiss, fed with diets containing different levels of vitamin E and folic acid

This study was conducted to evaluate the effects of dietary levels of vitamins E (25, 30 and 35 mg kg^-1), Folic Acid (1.5, 2 and 2.5 mg kg^-1) and their combination on the growth performance, hematological and immunological parameters of rainbow trout, Oncorhynchus mykiss. Each diet was fed to rainbow trout in triplicate to apparent satiation four times daily for 8 weeks. At the end of the feeding trial, the final body weight (FBW), total length (TL), feed conversion ratio (FCR), specific growth rate (SGR) and survival rate were significantly affected by treatments and the fish fed with the diet containing 35 mg kg^-1 vitamin E plus 2.5 mg kg^-1 of folic acid had higher values than those fish fed with the other diets. The results also indicated that hematocrit (Ht), mean corpuscular volume (MCV) mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) were significantly influenced by the treatments. Lysozyme and immunoglobulin (IgM) concentrations were significantly influenced by the dietary treatments, fish fed with the diet supplemented with 30 mg kg^-1 of vitamin E plus 2 mg kg^-1 of folic acid and unsupplemented diet had higher concentrations than those fish fed with the other diets. The findings of this study suggested that trout requires 35 mg kg^-1 vitamin E and 2.5 mg kg^-1 folic acid for it’s normal growth and physiology

Effect of dietary estradiol-17β on growth performance, body composition and blood indices in Stellate sturgeon, Acipenser stellatus

This study was investigated the effects of dietary estradiol-17β (E2) on growth, body composition and blood indices in Acipenser stellatus. Fish (40.9 ± 1.1 g average initial weight; n = 60 per group) were fed with three different diets containing 0 (control), 25 and 50 mg kg-1 dietary estradiol contents to apparent satiation for seven months. The results suggested that growth rate were decreased as the E2 level was increased. No significant difference was observed in condition factor among dietary treatments. The highest survival rate was observed in fish fed control diet, but was not significantly different among the treatments (P>0.05). Body composition did not show significant changes among dietary treatments. Number of white blood cells and red blood cells, hemoglobin and hematocrit values were significantly decreased as the E2 levels were raised (P<0.05). Plasma biochemical parameters including glucose, total protein, cholesterol, triglyceride, calcium, and phosphorus levels were dose dependent with the lowest levels in control with the highest levels in fish treated with 50 mg E2. The results of the present study revealed growth suppression of dietary E2 and changes of blood indices with providing some basic information on the effect of estrogen hormone on physiology of sturgeon

Safety and efficacy of endoscopic submucosal dissection for rectal neoplasia: a multicenter North American experience.

Background and aims  Rectal lesions traditionally represent the first lesions approached during endoscopic submucosal dissection (ESD) training in the West. We evaluated the safety and efficacy of rectal ESD in North America. Methods  This is a multicenter retrospective analysis of rectal ESD between January 2010 and September 2018 in 15 centers. End points included: rates of en bloc resection, R0 resection, adverse events, comparison of pre- and post-ESD histology, and factors associated with failed resection. Results  In total, 171 patients (median age 63 years; 56 % men) underwent rectal ESD (median size 43 mm). En bloc resection was achieved in 141 cases (82.5 %; 95 %CI 76.8-88.2), including 24 of 27 (88.9 %) with prior failed endoscopic mucosal resection (EMR). R0 resection rate was 74.9 % (95 %CI 68.4-81.4). Post-ESD bleeding and perforation occurred in 4 (2.3 %) and 7 (4.1 %), respectively. Covert submucosal invasive cancer (SMIC) was identified in 8.6 % of post-ESD specimens. There was one case (1/120; 0.8 %) of recurrence at a median follow-up of 31 weeks; IQR: 19-76 weeks). Older age and higher body mass index (BMI) were predictors of failed R0 resection, whereas submucosal fibrosis was associated with a higher likelihood of both failed en bloc and R0 resection. Conclusion  Rectal ESD in North America is safe and is associated with high en bloc and R0 resection rates. The presence of submucosal fibrosis was the main predictor of failed en bloc and R0 resection. ESD can be considered for select rectal lesions, and serves not only to establish a definitive tissue diagnosis but also to provide curative resection for lesions with covert advanced disease

Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry.

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291

BRAIN Initiative: Cutting-Edge Tools and Resources for the Community.

The overarching goal of the NIH BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative is to advance the understanding of healthy and diseased brain circuit function through technological innovation. Core principles for this goal include the validation and dissemination of the myriad innovative technologies, tools, methods, and resources emerging from BRAIN-funded research. Innovators, BRAIN funding agencies, and non-Federal partners are working together to develop strategies for making these products usable, available, and accessible to the scientific community. Here, we describe several early strategies for supporting the dissemination of BRAIN technologies. We aim to invigorate a dialogue with the neuroscience research and funding community, interdisciplinary collaborators, and trainees about the existing and future opportunities for cultivating groundbreaking research products into mature, integrated, and adaptable research systems. Along with the accompanying Society for Neuroscience 2019 Mini-Symposium, "BRAIN Initiative: Cutting-Edge Tools and Resources for the Community," we spotlight the work of several BRAIN investigator teams who are making progress toward providing tools, technologies, and services for the neuroscience community. These tools access neural circuits at multiple levels of analysis, from subcellular composition to brain-wide network connectivity, including the following: integrated systems for EM- and florescence-based connectomics, advances in immunolabeling capabilities, and resources for recording and analyzing functional connectivity. Investigators describe how the resources they provide to the community will contribute to achieving the goals of the NIH BRAIN Initiative. Finally, in addition to celebrating the contributions of these BRAIN-funded investigators, the Mini-Symposium will illustrate the broader diversity of BRAIN Initiative investments in cutting-edge technologies and resources

Exposure of Nonbreeding Migratory Shorebirds to Cholinesterase Inhibiting Contaminants in the Western Hemisphere

Migratory shorebirds frequently forage and roost in agricultural habitats, where they may be exposed to cholinesterase-inhibiting pesticides. Exposure to organophosphorus and carbamate compounds, common anti-cholinesterases, can cause sublethal effects, even death. To evaluate exposure of migratory shorebirds to organophosphorus and carbamates, we sampled birds stopping over during migration in North America and wintering in South America. We compared plasma Cholinesterase activities and body masses of individuals captured at sites with no known sources of organophosphorus or carbamates to those captured in agricultural areas where agrochemicals were recommended for control of crop pests. In South America, plasma acetylcholinesterase and butyrylcholinesterase activity in Buff-breasted Sandpipers was lower at agricultural sites than at reference sites, indicating exposure to organophosphorus and carbamates. Results of plasma Cholinesterase reactivation assays and foot-wash analyses were inconclusive. A meta-analysis of six species revealed no widespread effect of agricultural chemicals on Cholinesterase activity. However, four of six species were negative for acetylcholinesterase and one of six for butyrylcholinesterase, indicating negative effects of pesticides on Cholinesterase activity in a subset of shorebirds. Exposure to Cholinesterase inhibitors can decrease body mass, but comparisons between treatments and hemispheres suggest that agrochemicals did not affect migratory shorebirds' body mass. Our study, one of the first to estimate of shorebirds' exposure to cholinesterase-inhibiting pesticides, suggests that shorebirds are being exposed to cholinesterase-inhibiting pesticides at specific sites in the winter range but not at migratory stopover sites. Future research should examine potential behavioral effects of exposure and identify other potential sites and levels of exposure.Instituto de Recursos BiológicosFil: Strum, Khara M. Kansas State University. Division of Biology; Estados UnidosFil: Hooper, Michael J. Texas Tech University. Institute of Environmental and Human Health; Estados UnidosFil: Johnson, Kevin A. Southern Illinois University. Department of Chemistry and Environmental Sciences; Estados UnidosFil: Lanctot, Richard B. United State Fish and Wildlife Service. Migratory Bird Management; Estados UnidosFil: Zaccagnini, Maria Elena. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Recursos Biológicos; ArgentinaFil: Sandercock, Brett K. Kansas State University. Division of Biology; Estados Unido

SUPRA-CLAVICULAR BRACHIAL PLEXUS BLOCK: ULTRA-SONOGRAPHY GUIDED TECHNIQUE OFFER ADVANTAGE OVER PERIPHERAL NERVE STIMULATOR GUIDED TECHNIQUE

Introduction: Brachial Plexus block is an excellent anaesthetic option of upper limb surgery. The age old “Blind Paresthesia” technique and Peripheral Nerve Stimulation (PNS) may require multiple trial and error, not only increases block performance time and delays onset of anaesthesia, but also carries risk of damage to nerves or surrounding. Use of ultrasound to perform peripheral nerve block is a relatively new technique that is rapidly gaining popularity. Methodology: This study was conducted among 60 patients suffering from chronic renal failure with ASA III scheduled for the creation of arterio-venous fistula which needed brachial plexus block. In one group (n=30) ultrasonography (USG) guided technique was used and in second group (n=30) Peripheral Nerve Stimulation (PNS) guided technique was used. Various parameters including procedure time, onset time for sensory block, duration of sensory block, onset time for motor block, duration of motor block, time to achieve complete block etc were observed. Results: Overall success rate was higher in USG guided group as compared to PNS guided group, which was statistically significant (p <0.05). Time to perform the block was significantly shorter in USG guided group (p <0.05). Onset time for sensory block, onset time for motor block & time to achieve a complete block was also shorter in USG guided group (p value <0.05). Duration of sensory & motor block was significantly prolonged in USG guided group (p <0.05) Conclusion: Ultrasonography guided supraclavicular brachial plexus block is quick to perform, offers improved safety & accuracy in identifying the position of the nerves to be blocked & of the structures

KNOWLEDGE ABOUT ANESTHESIA AND PERCEPTION ABOUT ANESTHESIOLOGISTS AMONG PATIENTS AT A RURAL TERTIARY CARE HOSPITAL: A CROSS SECTIONAL SURVEY

Background: Our patients are not well aware of the role of anesthetist and especially their knowledge is very poor regarding anesthetist commitments within and outside the operation theatre. The present study was conducted to know the awareness and knowledge of the patients about anesthesia and anesthetist. Methodology: The present study was a cross sectional study conducted using predesigned questionnaire containing questions related to the awareness and knowledge of anesthesia among the patients coming for a pre-anesthesia check-up after taking their voluntary informed consent. Results: Only 22% of the cases know correctly that anesthetist is the person who will resuscitate the patients if any mishap occurs in operation theatre. It was observed that 63% of the cases feel that the role of the anesthetist in operation theatre is to put the patient to sleep. The knowledge about the types of anesthesia was present among 170 (56.7%) of the participants. 52% believe that the role of anesthetist is equivalent to that of the surgeon. Significant association was observed between educational status and perception about the anesthetist as a doctor (p<0.05), equivalent role of anesthetist and surgeon (p<0.05) and the knowledge about anesthetist as a person who gives anesthesia (p<0.05). Conclusion: The available data suggest that specialty of anesthesia has not done all that it can to educate the patients in particular and the public at large about the role of anesthesiologist

The relationship between wasting and stunting: a retrospective cohort analysis of longitudinal data in Gambian children from 1976 to 2016

Background: The etiologic relationship between wasting and stunting is poorly understood, largely because of a lack of high-quality longitudinal data from children at risk of undernutrition. Objectives: The aim of this study was to describe the interrelationships between wasting and stunting in children aged <2 y. Methods: This study involved a retrospective cohort analysis, based on growth-monitoring records spanning 4 decades from clinics in rural Gambia. Anthropometric data collected at scheduled infant welfare clinics were converted to z scores, comprising 64,342 observations on 5160 subjects (median: 12 observations per individual). Children were defined as "wasted" if they had a weight-for-length z score <-2 against the WHO reference and "stunted" if they had a length-for-age z score <-2. Results: Levels of wasting and stunting were high in this population, peaking at approximately (girls-boys) 12-18% at 10-12 months (wasted) and 37-39% at 24 mo of age (stunted). Infants born at the start of the annual wet season (July-October) showed early growth faltering in weight-for-length z score, putting them at increased risk of subsequent stunting. Using time-lagged observations, being wasted was predictive of stunting (OR: 3.2; 95% CI: 2.7, 3.9), even after accounting for current stunting. Boys were more likely to be wasted, stunted, and concurrently wasted and stunted than girls, as well as being more susceptible to seasonally driven growth deficits. Conclusions: We provide evidence that stunting is in part a biological response to previous episodes of being wasted. This finding suggests that stunting may represent a deleterious form of adaptation to more overt undernutrition (wasting). This is important from a policy perspective as it suggests we are failing to recognize the importance of wasting simply because it tends to be more acute and treatable. These data suggest that stunted children are not just short children but are children who earlier were more seriously malnourished and who are survivors of a composite process