Local Anaesthetic Flush Reduces Postoperative Pain and Haematoma Formation After Great Saphenous Vein Stripping—A Randomised Controlled Trial

AbstractObjectivesTo observe the effect of local anaesthetic flush through the great saphenous vein (GSV) tunnel on postoperative pain and haematoma formation following saphenous vein stripping operations.DesignProspective, double-blind, randomised, control trial.MethodsOne hundred patients were randomized to receive 20ml of local anaesthetic (bupivacaine 0.25%+adrenaline) or saline control flush through the GSV tunnel after stripping in a double-blind study. Visual analogue pain scores were used to measure postoperative pain daily for the 1st week, then at 3 weeks and 6 weeks. Patients were examined during the 1st, 3rd and 6th week for haematoma formation.ResultsIn the control group the median postoperative pain score was 4 (range 0–7) in the immediate postoperative period compared to a median of 1 (range 0–4) in the LA group (p<0.001). The median pain score on day-4 was 4 (range 1–6) (control) vs. 1 (range 0–3) (LA group) (p<0.001, Mann–Whitney Utest) and on day-6 it was 1 (range 0–5) (control) vs. 0 (range 0–5) (LA group) (p<0.001, Mann–Whitney). Twelve patients (24%) developed a haematoma in the GSV tunnel in the control group compared to three patients (6%) in the LA group (p=0.007).ConclusionFlushing of the GSV tunnel with bupivacaine plus adrenaline significantly reduces postoperative pain and haematoma formation in patients undergoing GSV stripping for varicose veins

Perceptions and experiences of appetite awareness training among African-American women who binge eat

Introduction: Binge eating may contribute to the prevalence of obesity in African-American women. Yet, there has been scant intervention research on the treatment of binge eating in this population. We tested the feasibility of an appetite awareness training (AAT) intervention in a sample of African-American women with binge and overeating behaviors. Participants who completed AAT were recruited to participate in focus groups to elicit information about their perceptions and experiences with this intervention to inform the design of future interventions to treat binge eating and obesity in African-American women. Methods: African-American women, aged 18–70 years, who had completed an 8-week randomized AAT intervention, were invited to attend a focus group discussion. Session content was recorded and transcribed. Data were analyzed by use of open coding. Themes were identified that described their perceptions and experiences of participating in the intervention. Results: Seventeen women participated in three focus group discussions. Pertinent themes identified included: paying attention to internal cues of hunger and satiety, influence of culture on eating patterns, breaking patterns of disordered eating, and perceptions about weight. Overall, participants were satisfied with their experience of AAT, and reported they found it valuable to learn about listening to biological signals of hunger and satiety and to learn specific strategies to reduce maladaptive eating patterns. Conclusion: AAT was acceptable and provided helpful eating behavior instruction to African-American women with reported binge and overeating behaviors. Future research should examine the potential of AAT to improve weight management in this underserved population. Level of evidence: Level V, qualitative descriptive study

The Use of mHealth to Deliver Tailored Messages Reduces Reported Energy and Fat Intake.

Evidence supports the role of feedback in reinforcing motivation for behavior change. Feedback that provides reinforcement has the potential to increase dietary self-monitoring and enhance attainment of recommended dietary intake. The aim of this study was to examine the impact of daily feedback (DFB) messages, delivered remotely, on changes in dietary intake. This was a secondary analysis of the Self- Monitoring And Recording using Technology (SMART) Trial, a single-center, 24-month randomized clinical trial of behavioral treatment for weight loss. Participants included 210 obese adults (mean body mass index, 34.0 kg/m2) who were randomized to either a paper diary (PD), personal digital assistant (PDA), or PDA plus daily tailored feedback messages (PDA + FB). To determine the role of daily tailored feedback in dietary intake, we compared the self-monitoring with DFB group (DFB group; n = 70) with the self-monitoring without DFB group (no-DFB group, n = 140). All participants received a standard behavioral intervention for weight loss. Self-reported changes in dietary intake were compared between the DFB and no-DFB groups and were measured at baseline and at 6, 12, 18, and 24 months. Linear mixed modeling was used to examine percentage changes in dietary intake from baseline. Compared with the no-DFB group, the DFB group achieved a larger reduction in energy (−22.8% vs −14.0%; P = .02) and saturated fat (−11.3% vs −0.5%; P = .03) intake and a trend toward a greater decrease in total fat intake (−10.4% vs −4.7%; P = .09). There were significant improvements over time in carbohydrate intake and total fat intake for both groups (P values < .05). Daily tailored feedback messages designed to target energy and fat intake and delivered remotely in real time using mobile devices may play an important role in the reduction of energy and fat intake

The protein-protein interactions required for assembly of the Tn3 resolution synapse

The site‐specific recombinase Tn3 resolvase initiates DNA strand exchange when two res recombination sites and six resolvase dimers interact to form a synapse. The detailed architecture of this intricate recombination machine remains unclear. We have clarified which of the potential dimer‐dimer interactions are required for synapsis and recombination, using a novel complementation strategy that exploits a previously uncharacterized resolvase from Bartonella bacilliformis (“Bart”). Tn3 and Bart resolvases recognize different DNA motifs, via diverged C‐terminal domains (CTDs). They also differ substantially at N‐terminal domain (NTD) surfaces involved in dimerization and synapse assembly. We designed NTD‐CTD hybrid proteins, and hybrid res sites containing both Tn3 and Bart dimer binding sites. Using these components in in vivo assays, we demonstrate that productive synapsis requires a specific “R ” interface involving resolvase NTDs at all three dimer‐binding sites in res . Synapses containing mixtures of wild‐type Tn3 and Bart resolvase NTD dimers are recombination‐defective, but activity can be restored by replacing patches of Tn3 resolvase R interface residues with Bart residues, or vice versa . We conclude that the Tn3 /Bart family synapse is assembled exclusively by R interactions between resolvase dimers, except for the one special dimer‐dimer interaction required for catalysis

Seasonal speedup of a Greenland marine-terminating outlet glacier forced by surface melt-induced changes in subglacial hydrology

We present subdaily ice flow measurements at four GPS sites between 36 and 72 km from the margin of a marine-terminating Greenland outlet glacier spanning the 2009 melt season. Our data show that >35 km from the margin, seasonal and shorter–time scale ice flow variations are controlled by surface melt–induced changes in subglacial hydrology. Following the onset of melting at each site, ice motion increased above background for up to 2 months with resultant up-glacier migration of both the onset and peak of acceleration. Later in our survey, ice flow at all sites decreased to below background. Multiple 1 to 15 day speedups increased ice motion by up to 40% above background. These events were typically accompanied by uplift and coincided with enhanced surface melt or lake drainage. Our results indicate that the subglacial drainage system evolved through the season with efficient drainage extending to at least 48 km inland during the melt season. While we can explain our observations with reference to evolution of the glacier drainage system, the net effect of the summer speed variations on annual motion is small (∼1%). This, in part, is because the speedups are compensated for by slowdowns beneath background associated with the establishment of an efficient subglacial drainage system. In addition, the speedups are less pronounced in comparison to land-terminating systems. Our results reveal similarities between the inland ice flow response of Greenland marine- and land-terminating outlet glaciers

The contribution of extra‐pair paternity to the variation in lifetime and age‐specific male reproductive success in a socially monogamous species

In socially monogamous species, extra-pair paternity (EPP) is predicted to increase variance in male reproductive success (RS) beyond that resulting from genetic monogamy, thus, increasing the “opportunity for selection” (maximum strength of selection that can act on traits). This prediction is challenging to investigate in wild populations because lifetime reproduction data are often incomplete. Moreover, age-specific variances in reproduction have been rarely quantified. We analyzed 21 years of near-complete social and genetic reproduction data from an insular population of Seychelles warblers (Acrocephalus sechellensis). We quantified EPP's contribution to lifetime and age-specific opportunities for selection in males. We compared the variance in male genetic RS versus social (“apparent”) RS (RSap) to assess if EPP increased the opportunity for selection over that resulting from genetic monogamy. Despite not causing a statistically significant excess (19%) of the former over the latter, EPP contributed substantially (27%) to the variance in lifetime RS, similarly to within-pair paternity (WPP, 39%) and to the positive WPP-EPP covariance (34%). Partitioning the opportunity for selection into age-specific (co)variance components, showed that EPP also provided a substantial contribution at most ages, varying with age. Therefore, despite possibly not playing the main role in shaping sexual selection in Seychelles warblers, EPP provided a substantial contribution to the lifetime and age-specific opportunity for selection, which can influence evolutionary processes in age-structured populations

A theoretical and empirical investigation of nutritional label use

Due in part to increasing diet-related health problems caused, among others, by obesity, nutritional labelling has been considered important, mainly because it can provide consumers with information that can be used to make informed and healthier food choices. Several studies have focused on the empirical perspective of nutritional label use. None of these studies, however, have focused on developing a theoretical economic model that would adequately describe nutritional label use based on a utility theoretic framework. We attempt to fill this void by developing a simple theoretical model of nutritional label use, incorporating the time a consumer spends reading labels as part of the food choice process. The demand equations of the model are then empirically tested. Results suggest the significant role of several variables that flow directly from the model which, to our knowledge, have not been used in any previous empirical work

New Physics Effects on Higgs Production at γγ\gamma \gamma Colliders

We study heavy physics effects on the Higgs production in $\gamma \gamma$ fusion using the effective Lagrangian approach. We find that the effects coming from new physics may enhance the standard model predictions for the number of events expected in the final states $\bar bb$, $WW$, and $ZZ$ up to one order of magnitude, whereas the corresponding number of events for the final state $\bar tt$ may be enhanced up to two orders of magnitude.Comment: Latex, 6 pages, 4 eps figures, to appear in the Proceedings of the V Mexican Workshop of Particles and Fields, Puebla, Mexico, October 199

Nutrient deficiencies in apple plants (Pyrus malus L.)

O ensaio foi conduzido com macieiras 'Ohio Beauty' com 1 ano, cultivadas em vaso para se verificar sintomas e níveis de deficiências de N, P, K, Ca, Mg, S e B. Conclui - se que: os níveis de nutrientes em folhas sadias e com sintomas de deficiência são: N -2,22 e 1,53%, P - 0,17 e 0,05%; K - 1,32 e 0,22%, Ca - 0,9¹* e 0,52%, Mg - 0,37 60,06%, S - 0,18 e 0,08%, B - 62 e 2k ppm. Os níveis de deficiência em folhas,a fome oculta" são: N - 1,74%, P - 0,07%, K - 0,30%, Ca - 0,65%, Mg - 0,09%, S - 0,09%, B-33ppm.A trial was carried out with one year old 'Ohio Beauty apples (grafted on 'Doucin'), grown on sand cu1ture, receining nutrient solutions lacking the following nutrients at the time: N, P, K, Ca, Mg, S, and B. The main conclusions are as follows: as the adequate and inadequate levels from leaf analysis were, respectively: N -2.22 and 1.53%, P - 0,17 and 0.05%, K - 1.32 and 0.33%; Ca -0.9.4 and 0.52%, Mg - 0.37 and 0.06%; S -0.18 and 0.08%; B -62 and 2k ppm

Plasma and rectal mucosal oxylipin levels during aspirin and eicosapentaenoic acid treatment in the seAFOod polyp prevention trial

Background Aspirin and eicosapentaenoic acid (EPA) have colorectal polyp prevention activity, alone and in combination. This study measured levels of plasma and rectal mucosal oxylipins in participants of the seAFOod 2 × 2 factorial, randomised, placebo-controlled trial, who received aspirin 300 mg daily and EPA 2000 mg free fatty acid, alone and in combination, for 12 months. Methods Resolvin (Rv) E1, 15-epi-lipoxin (LX) A4 and respective precursors 18-HEPE and 15-HETE (with chiral separation) were measured by ultra-high performance liquid chromatography-tandem mass spectrometry in plasma taken at baseline, 6 months and 12 months, as well as rectal mucosa obtained at trial exit colonoscopy at 12 months, in 401 trial participants. Results Despite detection of S- and R- enantiomers of 18-HEPE and 15-HETE in ng/ml concentrations, RvE1 or 15‑epi-LXA4 were not detected above a limit of detection of 20 pg/ml in plasma or rectal mucosa, even in individuals randomised to both aspirin and EPA. We have confirmed in a large clinical trial cohort that prolonged (12 months) treatment with EPA is associated with increased plasma 18-HEPE concentrations (median [inter-quartile range] total 18-HEPE 0.51 [0.21–1.95] ng/ml at baseline versus 0.95 [0.46–4.06] ng/ml at 6 months [P<0.0001] in those randomised to EPA alone), which correlate strongly with respective rectal mucosal 18-HEPE levels (r = 0.82; P<0.001), but which do not predict polyp prevention efficacy by EPA or aspirin. Conclusion Analysis of seAFOod trial plasma and rectal mucosal samples has not provided evidence of synthesis of the EPA-derived specialised pro-resolving mediator RvE1 or aspirin-trigged lipoxin 15‑epi-LXA4. We cannot rule out degradation of individual oxylipins during sample collection and storage but readily measurable precursor oxylipins argues against widespread degradation