The Emergent Vinifera Wine Industry in North Carolina: A Descriptive Overview

The North Carolina (NC) wine industry has grown rapidly over the past decade and is expected to grow even more as the worldwide wine consumption and export of wines rises. In the United States, the wine market has grown by 13.7 percent since 2002 in volume and by more than 15 percent in dollars as wine has progressed from being a beverage of an elite segment of the market to becoming a mainline beverage, taking its place alongside beer and liquor (MKF Research LLC, 2007; Oches, 2009). The Piedmont Triad Region is uniquely positioned to increase its presence in this industry. Of the 80 wineries in NC that are currently open to the public, nearly half are located in the Piedmont Triad Region. However, growing grapes and making wine is a long term commitment to a community, both financially and physically. The MKF Research report states that the capital-intensive nature of the winery and vineyard sectors is often underestimated, with new entrants to the industry at times unprepared for the extended cash requirements. In addition, only a few local institutions are familiar with the unique needs of the winemaking business. In order to address factors that will impede growth in this nascent industry, it is important to identify the state of the industry and obtain management perspectives on the needs and challenges facing their operations. This study provides information that would help gain a better understanding of the business issues and needs related to the wine and grape industry in North Carolina. Data for this study was drawn from a census of 34 wine producers located in the Yadkin, Swan Creek, and the Haw River valley regions of North Carolina. Descriptive statistics using frequencies and means is used to provide a demographic overview of the industry and to identify the factors that wine producers perceive to be important in affecting their profitability. Results from the study shows that most of the wineries share some common traits: they are small, relatively new to the wine and grape industry and grow grapes other than the traditional native Muscadine grape. Primarily, a majority of the wineries are family-based entrepreneurial businesses that have to behave like mini-conglomerates. These findings are consistent with a study conducted by Taplin and Breckenridge (2008).Profitability Constraints, Financial Management, Marketing, Distribution, Agribusiness, Community/Rural/Urban Development, Farm Management,

Surgical Management of Inguinal Hernias at Bugando Medical Centre in Northwestern Tanzania: Our Experiences in a Resource-Limited Setting.

Inguinal hernia repair remains the commonest operation performed by general surgeons all over the world. There is paucity of published data on surgical management of inguinal hernias in our environment. This study is intended to describe our own experiences in the surgical management of inguinal hernias and compare our results with that reported in literature. A descriptive prospective study was conducted at Bugando Medical Centre in northwestern Tanzania. Ethical approval to conduct the study was obtained from relevant authorities before the commencement of the study. Statistical data analysis was done using SPSS software version 17.0. A total of 452 patients with inguinal hernias were enrolled in the study. The median age of patients was 36 years (range 3 months to 78 years). Males outnumbered females by a ratio of 36.7:1. This gender deference was statistically significant (P=0.003). Most patients (44.7%) presented late (more than five years of onset of hernia). Inguinoscrotal hernia (66.8%) was the commonest presentation. At presentation, 208 (46.0%) patients had reducible hernia, 110 (24.3%) had irreducible hernia, 84 (18.6%) and 50(11.1%) patients had obstructed and strangulated hernias respectively. The majority of patients (53.1%) had right sided inguinal hernia with a right-to-left ratio of 2.1: 1. Ninety-two (20.4%) patients had bilateral inguinal hernias. 296 (65.5%) patients had indirect hernia, 102 (22.6%) had direct hernia and 54 (11.9%) had both indirect and direct types (pantaloon hernia). All patients in this study underwent open herniorrhaphy. The majority of patients (61.5%) underwent elective herniorrhaphy under spinal anaesthesia (69.2%). Local anaesthesia was used in only 1.1% of cases. Bowel resection was required in 15.9% of patients. Modified Bassini's repair (79.9%) was the most common technique of posterior wall repair of the inguinal canal. Lichtenstein mesh repair was used in only one (0.2%) patient. Complication rate was 12.4% and it was significantly higher in emergency herniorrhaphy than in elective herniorrhaphy (P=0.002). The median length of hospital stay was 8 days and it was significantly longer in patients with advanced age, delayed admission, concomitant medical illness, high ASA class, the need for bowel resection and in those with surgical repair performed under general anesthesia (P<0.001). Mortality rate was 9.7%. Longer duration of symptoms, late hospitalization, coexisting disease, high ASA class, delayed operation, the need for bowel resection and presence of complications were found to be predictors of mortality (P<0.001). Inguinal hernias continue to be a source of morbidity and mortality in our centre. Early presentation and elective repair of inguinal hernias is pivotal in order to eliminate the morbidity and mortality associated with this very common problem

Secondary bacterial infections of buruli ulcer lesions before and after chemotherapy with streptomycin and rifampicin

Buruli ulcer (BU), caused by Mycobacterium ulcerans is a chronic necrotizing skin disease. It usually starts with a subcutaneous nodule or plaque containing large clusters of extracellular acid-fast bacilli. Surrounding tissue is destroyed by the cytotoxic macrolide toxin mycolactone produced by microcolonies of M. ulcerans. Skin covering the destroyed subcutaneous fat and soft tissue may eventually break down leading to the formation of large ulcers that progress, if untreated, over months and years. Here we have analyzed the bacterial flora of BU lesions of three different groups of patients before, during and after daily treatment with streptomycin and rifampicin for eight weeks (SR8) and determined drug resistance of the bacteria isolated from the lesions. Before SR8 treatment, more than 60% of the examined BU lesions were infected with other bacteria, with Staphylococcus aureus and Pseudomonas aeruginosa being the most prominent ones. During treatment, 65% of all lesions were still infected, mainly with P. aeruginosa. After completion of SR8 treatment, still more than 75% of lesions clinically suspected to be infected were microbiologically confirmed as infected, mainly with P. aeruginosa or Proteus miriabilis. Drug susceptibility tests revealed especially for S. aureus a high frequency of resistance to the first line drugs used in Ghana. Our results show that secondary infection of BU lesions is common. This could lead to delayed healing and should therefore be further investigated

D 5.5.2. Report on near-market consumer testing of new improved products and substitutes in Africa. Project AFTER “African Food Tradition rEvisited by Research”

In this deliverable, the reengineered products relating to groups 1 to 3 are tested by consumers in Africa in order to test whether the acceptance meets consumer needs. The summaries are by group. These products were widely different and tested in differing cultures and situations. A common feature, however, is that all products are already commonly consumed by the communities and accepted, particularly with respect to the baseline products. Some products were found to be more acceptable (Gowe and Akpan in Benin, Kenkey in Ghana, Kong and Lanhouin in Senegal, Bissap and Baobab in Senegal), some of similar acceptance (Kitoza in Madagascar) and some were less acceptable (Kishk Sa'eedi in Egypt and Jaabi in Cameroon). Ways forward are discussed in all cases. Group 1: The reengineered group 1 products had mixed acceptance to consumers. Ones that were highly accepted were the reengineered Akpan which was highly accepted regardless of age, gender, socio- professional category and possessions (goods) and the majority (84.9%) expressed an interest for purchasing the reengineered Akpan and the reengineered gowe (n=100 consumers) in Benin, which was strongly accepted and more so than the traditional gowe. However, the reengineered Kenkey in Ghana while being comparable acceptance to the traditional white kenkey this would only meet a niche market. However, for the reengineered Kishk Sa'eedi, it was less acceptable and the difference was due to sour taste and spicy flavour. Group 2:The group 2 products had mixed acceptance among consumers. In the case of Kong in and Lanhouin in Senegal, the reengineered products had improved acceptance while for kitoza in Madagascar, there was no improvement in acceptance apart from those in terms of quality and safety. More specifically, Kong made using liquid smoke novel technique (RLK) had by far the highest acceptance and could easily be integrated as part of the Senegalese cuisine. This shows that there is a potential for RLK on the Senegalese market. Two types of reengineered Lanhouin types (Lanhouin dry powder, Lanhouin dry fillet) were greatly acceptable and the powdered form more than the fillet. In the case of Kitoza, consumer acceptance studies showed that there was no significant difference between all samples tested. Group 3: Group 3 reengineered products had mixed acceptance among consumers. Re-engineered bissap (hibiscus drinks) in Senegal were positively appreciated by consumers in Senegal and better accepted than the traditional commercial infusion used as baseline comparison. However, the new drinks were not perceivably different from the baseline drink to consumers concerning both the traditional character and the nutritional and healthy attributes. The reengineered baobab drinks were positively appreciated by consumers in Senegal and significantly better appreciated than the traditional commercial ones earlier tested. Jaabi (Ziziphus mauritiana). The result is the proposition of a reengineered Yaabande presenting fine texture well appreciated by consumers. However, particle size was critical and this needed to be lower than 125μm. Due to this limit, processors have adopted the manual production of flour of particle size 250μm>Ø>125μm, which is less tiresome, though it appears in second rank in the preference of consumers. The detailed methodology for each product is given for Groups I, II and III respectively. Common to all of the methodologies is the Ethical assessment and consent which is listed as follows: Ethical assessment and consent. The studies have been assessed and approved by the University of Greenwich Research Ethics Committee and the Ethics Committee at CIRAD. Consent was sought from sensory panellists and from adult consumers participating in this study. Enumerators informed participants about the study and explained that their participation was entirely voluntary, that they could stop the interview at any point and that the responses would be anonymous

Impact of Vitamin D Supplementation on Arterial Vasomotion, Stiffness and Endothelial Biomarkers in Chronic Kidney Disease Patients

Background: Cardiovascular events are frequent and vascular endothelial function is abnormal in patients with chronic kidney disease (CKD). We demonstrated endothelial dysfunction with vitamin D deficiency in CKD patients; however the impact of cholecalciferol supplementation on vascular stiffness and vasomotor function, endothelial and bone biomarkers in CKD patients with low 25-hydroxy vitamin D [25(OH)D] is unknown, which this study investigated. Methods: We assessed non-diabetic patients with CKD stage 3/4, age 17–80 years and serum 25(OH)D ,75 nmol/L. Brachial artery Flow Mediated Dilation (FMD), Pulse Wave Velocity (PWV), Augmentation Index (AI) and circulating blood biomarkers were evaluated at baseline and at 16 weeks. Oral 300,000 units cholecalciferol was administered at baseline and 8-weeks. Results: Clinical characteristics of 26 patients were: age 50614 (mean61SD) years, eGFR 41611 ml/min/1.73 m2, males 73%, dyslipidaemia 36%, smokers 23% and hypertensives 87%. At 16-week serum 25(OH)D and calcium increased (43616 to 84629 nmol/L, p,0.001 and 2.3760.09 to 2.4260.09 mmol/L; p = 0.004, respectively) and parathyroid hormone decreased (10.868.6 to 7.464.4; p = 0.001). FMD improved from 3.163.3% to 6.163.7%, p = 0.001. Endothelial biomarker concentrations decreased: E-Selectin from 566662123 to 525662058 pg/mL; p = 0.032, ICAM-1, 3.4560.01 to 3.1061.04 ng/mL; p = 0.038 and VCAM-1, 54633 to 42633 ng/mL; p = 0.006. eGFR, BP, PWV, AI, hsCRP, von Willebrand factor and Fibroblast Growth Factor-23, remained unchanged. Conclusion: This study demonstrates for the first time improvement of endothelial vasomotor and secretory functions with vitamin D in CKD patients without significant adverse effects on arterial stiffness, serum calcium or FGF-23. Trial Registration: ClinicalTrials.gov NCT0200571

Genetic Diversity of PCR-Positive, Culture-Negative and Culture-Positive Mycobacterium ulcerans Isolated from Buruli Ulcer Patients in Ghana.

Culture of Mycobacterium ulcerans from Buruli ulcer patients has very low sensitivity. Thus confirmation of M. ulcerans infection is primarily based on PCR directed against IS2404. In this study we compare the genotypes obtained by variable number of tandem repeat analysis of DNA from IS2404-PCR positive cultures with that obtained from IS2404 positive, culture-negative tissue. A significantly greater genetic heterogeneity was found among culture-negative samples compared with that found in cultured strains but a single genotype is over-represented in both sample sets. This study provides evidence that both the focal location of bacteria in a lesion as well as differences in the ability to culture a particular genotype may underlie the low sensitivity of culture. Though preliminary, data from this work also suggests that mycobacteria previously associated with fish disease (M. pseudoshottsii) may be pathogenic for humans

Plasma zinc concentrations are depressed during the acute phase response in children with falciparum malaria

Plasma concentrations of some micronutrients are altered in the setting of acute infectious or inflammatory stress. Previous studies have provided conflicting evidence concerning the extent and direction of changes in plasma zinc concentrations during the acute phase response. We carried out an observational cohort study in 689 children enrolled in a randomized trial of zinc supplementation during acute falciparum malaria in order to evaluate the relation between plasma zinc concentration and the acute phase response. Plasma zinc was measured by atomic absorption spectrophotometry. On admission, 70% of all subjects had low plasma zinc (\u3c9.2 μmol/L). Multivariate analysis of predictors of admission plasma zinc showed that admission C-reactive protein (CRP), parasite density, and study site were the most important predictors. Predictors of changes in plasma zinc from admission to 72 h included baseline CRP, change in CRP, treatment group, study site, and baseline zinc concentration. In children with acute malaria infection, baseline plasma zinc concentrations were very low and were inversely correlated with CRP (r = -0.24, P \u3c 0.0001) and the degree of parasitemia (r = -0.19, P \u3c 0.0001). Even when CRP and time were taken into account, zinc supplementation increased plasma zinc concentration from admission to 72 h. When available, plasma zinc concentrations should be interpreted with concurrent measures of the acute phase response such as CRP. In children whose age, diet, and/or nutritional status place them at risk of zinc deficiency, those with low plasma zinc levels should be supplemented with oral zinc and followed for clinical and/or biochemical response. © 2005 American Society for Nutritional Sciences

Discovery of Sexual Dimorphisms in Metabolic and Genetic Biomarkers

Metabolomic profiling and the integration of whole-genome genetic association data has proven to be a powerful tool to comprehensively explore gene regulatory networks and to investigate the effects of genetic variation at the molecular level. Serum metabolite concentrations allow a direct readout of biological processes, and association of specific metabolomic signatures with complex diseases such as Alzheimer's disease and cardiovascular and metabolic disorders has been shown. There are well-known correlations between sex and the incidence, prevalence, age of onset, symptoms, and severity of a disease, as well as the reaction to drugs. However, most of the studies published so far did not consider the role of sexual dimorphism and did not analyse their data stratified by gender. This study investigated sex-specific differences of serum metabolite concentrations and their underlying genetic determination. For discovery and replication we used more than 3,300 independent individuals from KORA F3 and F4 with metabolite measurements of 131 metabolites, including amino acids, phosphatidylcholines, sphingomyelins, acylcarnitines, and C6-sugars. A linear regression approach revealed significant concentration differences between males and females for 102 out of 131 metabolites (p-values<3.8 x 10(-4); Bonferroni-corrected threshold). Sex-specific genome-wide association studies (GWAS) showed genome-wide significant differences in beta-estimates for SNPs in the CPS1 locus (carbamoyl-phosphate synthase 1, significance level: p<3.8 x 10(-10); Bonferroni-corrected threshold) for glycine. We showed that the metabolite profiles of males and females are significantly different and, furthermore, that specific genetic variants in metabolism-related genes depict sexual dimorphism. Our study provides new important insights into sex-specific differences of cell regulatory processes and underscores that studies should consider sex-specific effects in design and interpretation

International financial reporting standards adoption and accounting quality: Evidence from Ghanaian listed firms

The adoption of International Financial Reporting Standards (IFRS) by Ghanaian listed firms form the basis of higher accounting quality and reliability of accounting information from IFRS application. Existing literature suggests that the adoption affects the level of accounting quality. The aim of this paper is to examine whether the shift to IFRS minimises weaknesses in Ghana National Accounting Standards (GNAS) in measuring accounting quality. The paper employs research design metrics of discretional accruals, accrual quality, earnings smoothness, small loss avoidance and price-earnings to compute accounting quality of Ghana Stock Exchange (GSE) firms. The results suggest that accounting quality has improved after the shift to IFRS. This research fills the gap in Ghana level, given that there was no such study. Also, this study gives evidence of improvement in the information environment of GSE capital market after the shift in terms of information quality and accounting comparability.info:eu-repo/semantics/acceptedVersio