Effect of beverage glucose and sodium content on fluid delivery

<p>Abstract</p> <p>Background</p> <p>Rapid fluid delivery from ingested beverages is the goal of oral rehydration solutions (ORS) and sports drinks.</p> <p>Objective</p> <p>The aim of the present study was to investigate the effects of increasing carbohydrate and sodium content upon fluid delivery using a deuterium oxide (D₂O) tracer.</p> <p>Design</p> <p>Twenty healthy male subjects were divided into two groups of 10, the first group was a carbohydrate group (CHO) and the second a sodium group (Na). The CHO group ingested four different drinks with a stepped increase of 3% glucose from 0% to 9% while sodium concentration was 20 mmol/L. The Na group ingested four drinks with a stepped increase of 20 mmol/L from 0 mmol/L to 60 mmol/l while glucose concentration was 6%. All beverages contained 3 g of D₂O. Subjects remained seated for two hours after ingestion of the experimental beverage, with blood taken every 5 min in the first hour and every 10 min in the second hour.</p> <p>Results</p> <p>Including 3% glucose in the beverage led to a significantly greater AUC 60 min (19640 ± 1252 δ‰ vs. VSMOW.60 min) than all trials. No carbohydrate (18381 ± 1198 δ‰ vs. VSMOW.60 min) had a greater AUC 60 min than a 6% (16088 ± 1359 δ‰ vs. VSMOW.60 min) and 9% beverage (13134 ± 1115 δ‰ vs. VSMOW.60 min); the 6% beverage had a significantly greater AUC 60 min than the 9% beverage. There was no difference in fluid delivery between the different sodium beverages.</p> <p>Conclusion</p> <p>In conclusion the present study showed that when carbohydrate concentration in an ingested beverage was increased above 6% fluid delivery was compromised. However, increasing the amount of sodium (0–60 mmol/L) in a 6% glucose beverage did not lead to increases in fluid delivery.</p

Reading the Radical American Periodical

This special issue probes our definitions and understandings of both the ‘radical’ and the ‘American’ in North American print and periodical culture. As many of the subsequent papers demonstrate, notions of radicalism as expressed in American periodicals often necessitate(d) looking beyond the nation state. Similarly, this issue highlights the fluidity of ‘radicalism’ as a temporal and technological concept; relatable not only to literary content, but also to graphic design, editorial control, foreign language use, subscription policies, and other aspects of production, dissemination and reception. Thematically and conceptually diverse, the articles collated here provide a judicious intervention into the developing field of periodical studies

Molecular dynamics study of accelerated ion-induced shock waves in biological media

We present a molecular dynamics study of the effects of carbon- and iron-ion induced shock waves in DNA duplexes in liquid water. We use the CHARMM force field implemented within the MBN Explorer simulation package to optimize and equilibrate DNA duplexes in liquid water boxes of different sizes and shapes. The translational and vibrational degrees of freedom of water molecules are excited according to the energy deposited by the ions and the subsequent shock waves in liquid water are simulated. The pressure waves generated are studied and compared with an analytical hydrodynamics model which serves as a benchmark for evaluating the suitability of the simulation boxes. The energy deposition in the DNA backbone bonds is also monitored as an estimation of biological damage, something which is not possible with the analytical model

Simulation of the ion-induced shock waves effects on the transport of chemically reactive species in ion tracks

Abstract: The passage of energetic ions through tissue initiates a series of physico-chemical events which leads to biodamage. The study of such ion-induced biodamage using a multiscale approach to the physics of radiation damage with ions has led to the prediction of shock waves being initiated by concentrated energy deposition along the ion track. In this work the radial energy deposition around carbon ion paths, calculated solving diffusion equations, is augmented with the inclusion of more energetic δ-electrons. The radial profiles of energy deposition and the induced concentrations of free radicals are used to simulate the shock waves by means of reactive classical molecular dynamics, which predict a characteristic distribution of reactive chemical species which may have an as yet unrecognised contribution to the nascent biodamage. The paper also suggests some experimental methods by which such a shock wave may be detected and the predictions of these simulations verified

Fe XVII X-ray Line Ratios for Accurate Astrophysical Plasma Diagnostics

New laboratory measurements using an Electron Beam Ion Trap (EBIT) and an x-ray microcalorimeter are presented for the n=3 to n=2 Fe XVII emission lines in the 15 {\AA} to 17 {\AA} range, along with new theoretical predictions for a variety of electron energy distributions. This work improves upon our earlier work on these lines by providing measurements at more electron impact energies (seven values from 846 to 1185 eV), performing an in situ determination of the x-ray window transmission, taking steps to minimize the ion impurity concentrations, correcting the electron energies for space charge shifts, and estimating the residual electron energy uncertainties. The results for the 3C/3D and 3s/3C line ratios are generally in agreement with the closest theory to within 10%, and in agreement with previous measurements from an independent group to within 20%. Better consistency between the two experimental groups is obtained at the lowest electron energies by using theory to interpolate, taking into account the significantly different electron energy distributions. Evidence for resonance collision effects in the spectra is discussed. Renormalized values for the absolute cross sections of the 3C and 3D lines are obtained by combining previously published results, and shown to be in agreement with the predictions of converged R-matrix theory. This work establishes consistency between results from independent laboratories and improves the reliability of these lines for astrophysical diagnostics. Factors that should be taken into account for accurate diagnostics are discussed, including electron energy distribution, polarization, absorption/scattering, and line blends.Comment: 29 pages, including 7 figure

Isotope shift in the dielectronic recombination of three-electron ^{A}Nd^{57+}

Isotope shifts in dielectronic recombination spectra were studied for Li-like ^{A}Nd^{57+} ions with A=142 and A=150. From the displacement of resonance positions energy shifts \delta E^{142,150}(2s-2p_1/2)= 40.2(3)(6) meV (stat)(sys)) and \delta E^{142,150}(2s-2p_3/2) = 42.3(12)(20) meV of 2s-2p_j transitions were deduced. An evaluation of these values within a full QED treatment yields a change in the mean-square charge radius of ^{142,150}\delta = -1.36(1)(3) fm^2. The approach is conceptually new and combines the advantage of a simple atomic structure with high sensitivity to nuclear size.Comment: 10 pages, 3 figures, accepted for publication in Physical Review Letter

Assertive outreach treatment versus care as usual for the treatment of high-need, high-cost alcohol related frequent attenders: study protocol for a randomised controlled trial

Background: Alcohol-related hospital admissions have doubled in the last ten years to >1.2m per year in England. High-need, high-cost (HNHC) alcohol-related frequent attenders (ARFA) are a relatively small subgroup of patients, having multiple admissions or attendances from alcohol during a short time period. This trial aims to test the effectiveness of an assertive outreach treatment (AOT) approach in improving clinical outcomes for ARFA, and reducing resource use in the acute setting. Methods: One hundred and sixty ARFA patients will be recruited and following baseline assessment, randomly assigned to AOT plus care as usual (CAU) or CAU alone in equal numbers. Baseline assessment includes alcohol consumption and related problems, physical and mental health comorbidity and health and social care service use in the previous 6 months using standard validated tools, plus a measure of resource use. Follow-up assessments at 6 and 12months after randomization includes the same tools as baseline plus standard measure of patient satisfaction. Outcomes for CAU+AOT and CAU at 6 and 12months will be compared, controlling for pre-specified baseline measures. Primary outcome will be percentage of days abstinent at 12months. Secondary outcomes include emergency department (ED) attendance, number and length of hospital admissions, alcohol consumption, alcohol-related problems, other health service use, mental and physical comorbidity 6 and 12months post intervention. Health economic analysis will estimate the economic impact of AOT from health, social care and societal perspectives and explore cost-effectiveness in terms of quality adjusted life years and alcohol consumption at 12-month follow-up. Discussion: AOT models piloted with alcohol dependent patients have demonstrated significant reductions in alcohol consumption and use of unplanned National Health Service (NHS) care, with increased engagement with alcohol treatment services, compared with patients receiving CAU. While AOT interventions are costlier per case than current standard care in the UK, the rationale for targeting HNHC ARFAs is because of their disproportionate contribution to overall alcohol burden on the NHS. No previous studies have evaluated the clinical and costeffectiveness of AOT for HNHC ARFAs: this randomized controlled trial (RCT) targeting ARFAs across five South London NHS Trusts is the first. Trial registration: International standard randomized controlled trial number (ISRCTN) registry: ISRCTN67000214, retrospectively registered 26/11/2016

SH3 interactome conserves general function over specific form

Src homology 3 (SH3) domains bind peptides to mediate protein–protein interactions that assemble and regulate dynamic biological processes. We surveyed the repertoire of SH3 binding specificity using peptide phage display in a metazoan, the worm Caenorhabditis elegans, and discovered that it structurally mirrors that of the budding yeast Saccharomyces cerevisiae. We then mapped the worm SH3 interactome using stringent yeast two-hybrid and compared it with the equivalent map for yeast. We found that the worm SH3 interactome resembles the analogous yeast network because it is significantly enriched for proteins with roles in endocytosis. Nevertheless, orthologous SH3 domain-mediated interactions are highly rewired. Our results suggest a model of network evolution where general function of the SH3 domain network is conserved over its specific form

Clinical outcomes resulting from telemedicine interventions: a systematic review

BACKGROUND: The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. METHODS: Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis). All included articles were abstracted and graded for quality and direction of the evidence. RESULTS: A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. CONCLUSIONS: Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

BACKGROUND: Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. METHODS: A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. RESULTS: According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering telehealth within the broader organisation of health care services in remote and rural regions. CONCLUSION: This study identified core elements that should be considered when implementing telehealth applications with the purpose of supporting medical practice in rural and remote regions. Decision-makers need to be aware of the specific conditions that could influence telehealth integration into clinical practices and health care organisations. Thus, strategies addressing the identified conditions for telehealth success would facilitate the optimal implementation of this technology