Novel High-Molecular Weight Fucosylated Milk Oligosaccharides Identified in Dairy Streams

peer-reviewedOligosaccharides are the third largest component in human milk. This abundance is remarkable because oligosaccharides are not digestible by the newborn, and yet they have been conserved and amplified during evolution. In addition to encouraging the growth of a protective microbiota dominated by bifidobacteria, oligosaccharides have anti-infective activity, preventing pathogens from binding to intestinal cells. Although it would be advantageous adding these valuable molecules to infant milk formula, the technologies to reproduce the variety and complexity of human milk oligosaccharides by enzymatic/organic synthesis are not yet mature. Consequently, there is an enormous interest in alternative sources of these valuable oligosaccharides. Recent research has demonstrated that bovine milk and whey permeate also contain oligosaccharides. Thus, a thorough characterization of oligosaccharides in bovine dairy streams is an important step towards fully assessing their specific functionalities. In this study, bovine milk oligosaccharides (BMOs) were concentrated by membrane filtration from a readily available dairy stream called “mother liquor”, and analyzed by high accuracy MALDI FT-ICR mass spectrometry. The combination of HPLC and accurate mass spectrometry allowed the identification of ideal processing conditions leading to the production of Kg amount of BMO enriched powders. Among the BMOs identified, 18 have high-molecular weight and corresponded in size to the most abundant oligosaccharides present in human milk. Notably 6 oligosaccharides contained fucose, a sugar monomer that is highly abundant in human milk, but is rarely observed in bovine milk. This work shows that dairy streams represent a potential source of complex milk oligosaccharides for commercial development of unique dairy ingredients in functional foods that reproduce the benefits of human milk.This project was supported by the University of California Discovery Program (05GEB01NHB), the National Institute of Environmental Health Sciences (P42ES004699), the National Institutes of Health award R01AT00707, the California Dairy Research Foundation (08 GEB-04 NH) and the CHARGE study (P01 ES11269). The authors acknowledge financial support from the Irish Department of Agriculture, Fisheries and Food through the Food Institutional Research Measure (FIRM–05/R&D/TD/368)

Effects of Smoking on Outcomes of Thyroid Eye Disease Treated with Teprotumumab: A Retrospective Cohort Study

Introduction. Smoking has been demonstrated to worsen the disease process and conventional treatment outcomes of thyroid eye disease. However, the effects of smoking on outcomes of thyroid eye disease treated with the novel therapeutic teprotumumab are currently unknown. Our study compares response to teprotumumab treatment between smokers and non-smokers with thyroid eye disease.   Methods. We conducted a single-center, retrospective cohort study. Inclusion criteria were patients diagnosed with thyroid eye disease who had started or completed therapy with teprotumumab at the time of our data collection. Main outcome measures included reduction in clinical activity score, diplopia, and proptosis. Results. We found that all smokers had type 2 thyroid eye disease prior to treatment and demonstrated less improvement in diplopia, proptosis, and overall clinical activity score compared to non-smokers with thyroid eye disease. There was no significant difference between smokers and non-smokers in baseline variables (sex, TSH, T4, T3, number of infusions completed). Data analysis revealed statistically significant difference in proptosis reduction between non-smokers and smokers. Conclusions. Smoking is a modifiable risk factor which portends a worse response to treatment of thyroid eye disease with teprotumumab

Temperature requirement for the efficient application of condensed phosphate to Pacific shrimp (Pandalus jordani)

Treatment of round shrimp (3 days post-catch) in 6% condensed phosphate solution at temperatures ranging from 39 (3.9°C) to 86°F (30°C) reduced meat yield derived by mechanical peeling from 30.0 to 16.4% (wet wt.) according to the linear function y = -.2787 x + 42.7262 (P>.005). Condensed phosphate treatment at ambient potable water temperature 62°F (16.7°C) increased the meat yield over a respective water treatment control from 21.2 to 27.1% (wet wt.); refrigeration of the condensed phosphate solution to 39°F (3.9°C) raised yield to 30.0%. Elevated solution temperatures accelerated proteolytic attack degrading musculature proteins to a degree that precluded their interaction with condensed phosphate in a manner that would effectively retard heat solubilization during cooking. Condensed phosphate interacted with meat proteins more readily at high temperatures, but not in a manner which conserved yield. Exposure of round shrimp to condensed phosphate treatment temperatures greater than 62°F (16.7°C) markedly reduced cooked meat quality. Loss of more hydrated and less pigmented unformed connective tissue through cooking concentrated meat pigment, increased the force required to shear and reduced meat moisture content. Flavor panel scores for texture, flavor and over-all desirability were significantly reduced. The advantage of reducing condensed phosphate pretreatment temperature from ambient potable water (62-66°F; 16.7-18°C) to 38-40°F (3.3-4.4°C) was shown to range from 1.2 to 4.8 percentage points in yield from 2 and 8 day post-catch shrimp, respectively. A similar more accentuated advantage of condensed phosphate over a water pretreatment by post-catch storage was observed (from 4.2 to 6.0 percentage points) at 62-66°F (16.7-18.9°C). Meat quality was not markedly affected by the type of treatment solution or temperature regime (38-40 and 62-66°F). Application of yield conserving procedures (low temperature pretreatment; condensed phosphate application) increased cooked meat quality decline with respect to post-catch storage. Conserving the degraded meat fraction somewhat reduced sensory acceptability

Predicting hospital aggression in secure psychiatric care

Risk assessment instruments have become a preferred means for predicting future aggression, claiming to predict long-term aggression risk. We investigate the predictive value over 12 months and 4 years of two commonly applied instruments (HCR-20, VRAG) in a secure psychiatric population with personality disorder. Focus was on aggression in hospital. The actuarial risk assessment (VRAG) was generally performing better than the structured risk assessment (HCR-20), although neither approach performed particularly well overall. Any value in their predictive potential appeared focused on the longer time period under study (4 years) and was specific to certain types of aggression. The value of these instruments for assessing aggression in hospital among personality-disordered patients in a high secure psychiatric setting is considered

Recreational ketamine-related deaths notified to the National Programme on Substance Abuse Deaths, England, 1997-2019

© 2021 The Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: Ketamine is a phencyclidine derivative with dissociative anaesthetic properties. Increasing numbers of individuals in England take ketamine recreationally. Information on deaths arising from such use in England is presented. Methods: Cases were extracted on 31 January 2020 from the National Programme on Substance Abuse Deaths database, based on text searches of the cause of death, coroner’s verdict and positive toxicology results for the terms ‘ketamine’ or ‘norketamine’. Findings: During 1997–2005, there were <5 deaths p.a. in which ketamine was implicated. Numbers increased until 2009 (21), plateauing until 2016; thereafter, deaths have risen to about 30 p.a. Decedents’ characteristics (N = 283): male 84.1%, mean age 31.2 (SD 10.0) years, employed 56.5%, drug use history 79.6% and living with others 60.3%. Ketamine was detected with other substances in most cases. Main (74.6%) underlying cause of death was accidental poisoning. Ketamine may have impaired judgement in other cases. Conclusions: Although controlled, recreational ketamine use and related fatalities continue to increase. Consumers need to be more aware of the potentially fatal risks they face.Peer reviewedFinal Published versio

Teachers’ perspectives on communication in the context of supervising learners during telehealth encounters

Background: The COVID-19 pandemic has led to increased use of telehealth for healthcare visits. Telehealth visits have created new communication challenges for clinician-patient encounters and for interactions between health professional learners and clinical teachers, known as preceptors. Little research has explored how teachers can effectively supervise and explicitly emphasize communication skills during telehealth visits. Aim: This study’s purpose was to explore clinical preceptors’ perspectives on effective approaches in precepting telehealth visits with medical residents and students. Methods: An online survey elicited comments from clinical preceptors from two United States medical schools on effective telehealth teaching practices. Thematic analysis identified salient perspectives and overall guidance on precepting telehealth encounters. Results: Survey participants reported varying levels of experience with precepting telehealth visits. Main areas identified as important for effectively supervising telehealth encounters and facilitating effective communication included explicit preparation for preceptors, learners and patients and using educational opportunities, especially observation, during the telehealth encounter. Discussion: This study identifies strategies for maximizing effective communication between preceptors, learners, and patients during supervised telehealth visits. Participants identified potential educational advantages of supervising telehealth visits. Conclusions: Clinical teachers can reinforce effective telehealth communication skills with learner led telehealth patient encounters

El desarrollo socioemocional en niños con discapacidad auditiva en escuelas regulares inclusivas

El desarrollo de un niño con discapacidad auditiva no es solo físico y cognitivo, para entenderlo en su totalidad es necesario conocer su desarrollo social y emocional para que los padres y la escuela tengan herramientas que les permitan brindar un abordaje oportuno, en función a lo descrito se desarrolla el presente estudio denominado El desarrollo socioemocional en niños con discapacidad auditiva en escuelas regulares inclusivas con el objetivo de conocer los aspectos socioemocionales y sus implicaciones en las personas con discapacidad auditiva, explorando la influencia de las familias y el papel fundamental que tienen las escuelas regulares, donde se realizó un análisis bibliográfico y documental, mediante la revisión de diferentes documentos físicos y virtuales obteniendo información de las variables, llegando a la conclusión que el desarrollo socioemocional en una persona con discapacidad auditiva se inicia en la infancia, donde la familia y la escuela juegan un papel importante; la familia, es el primer soporte emocional mediante la afectividad y la comunicación de sus miembros, y la escuela refuerza el desenvolvimiento social, el autoconcepto que va formando de sí mismo. El trabajo conjunto del binomio (escuela - familia) conlleva a una mejor adaptación en la escuela.Trabajo académic