The Failure of Anthropometry as a Nutritional Assessment Tool

Anthropometric measurements are commonly used to assess body composition changes and adequacy of nutritional support in the hospitalized patient. To test their utility as nutritional assessment tools in the intensive care unit (ICU) patient, body weight, triceps skinfold (TSF), mid-arm muscle circumference (MAMC). and fluid balance and intake were collected on 21 critically ill patients during their ICU stay. Correlations were sought between adequacy of nutritional support and changes over time in weight. MAMC, fluid balance, and TSF. A significant change over time in mean body weight (p \u3c 0.0001) was seen, reflecting a mean weight loss despite a positive cumulative fluid balance of almost 20 L by day 14 for all patients (p \u3c 0.0001). There was a significant change over time in the mean fractional intake of required calories ranging from 41.7% on observation day 1 to a peak of 84.0% on day 22 (p \u3c 0.001). TSF and MAMC could not be obtained on a large percentage of ICU patients due to severe edema including the mid-upper arm. Obtained measurements showed no change over the study period in TSF (p = 0.24) and MAMC (p = 0.71) despite significant changes in weight (p \u3c 0.0001). caloric intake (p = 0.0001). and cumulative fluid balance (p = 0.0001). From these data it appears that anthropometric indices of TSF and MAMC are unrelated to nutritional intake and weight in ICU patients and are therefore not of use in the nutritional assessment of this population

Multiple Function Intubation Apparatus and Method

An apparatus and its method of use are provided allowing lavage, sump and enteral feeding operations with only one intubation. The apparatus includes a first tube having two distinct passageways. One of these passageways completely contains a second, feeding tube during intubation. Once the first tube is in place in the patient, the second tube is extended from the first tube so as to enter the stomach. The extension of the second tube opens ports in the first passageway of the first tube, thereby allowing sump or lavage treatment with the second passageway of the first tube serving as an air vent. A constriction in the end of the first passageway engages a band on the proximal end of the second tube to keep the tubes together. Once gastric emptying of the patient resumes, the second tube immediately moves into the duodenum then into the jejunum past the Ligament of Treitz and the first tube is withdrawn from the patient while maintaining the second tube in position for enteral feeding through feeding ports in its distal end

Informal “Seed” Systems and the Management of Gene Flow in Traditional Agroecosystems: The Case of Cassava in Cauca, Colombia

Our ability to manage gene flow within traditional agroecosystems and their repercussions requires understanding the biology of crops, including farming practices' role in crop ecology. That these practices' effects on crop population genetics have not been quantified bespeaks lack of an appropriate analytical framework. We use a model that construes seed-management practices as part of a crop's demography to describe the dynamics of cassava (Manihot esculenta Crantz) in Cauca, Colombia. We quantify several management practices for cassava—the first estimates of their kind for a vegetatively-propagated crop—describe their demographic repercussions, and compare them to those of maize, a sexually-reproduced grain crop. We discuss the implications for gene flow, the conservation of cassava diversity, and the biosafety of vegetatively-propagated crops in centers of diversity. Cassava populations are surprisingly open and dynamic: farmers exchange germplasm across localities, particularly improved varieties, and distribute it among neighbors at extremely high rates vis-à-vis maize. This implies that a large portion of cassava populations consists of non-local germplasm, often grown in mixed stands with local varieties. Gene flow from this germplasm into local seed banks and gene pools via pollen has been documented, but its extent remains uncertain. In sum, cassava's biology and vegetative propagation might facilitate pre-release confinement of genetically-modified varieties, as expected, but simultaneously contribute to their diffusion across traditional agroecosystems if released. Genetically-modified cassava is unlikely to displace landraces or compromise their diversity; but rapid diffusion of improved germplasm and subsequent incorporation into cassava landraces, seed banks or wild populations could obstruct the tracking and eradication of deleterious transgenes. Attempts to regulate traditional farming practices to reduce the risks could compromise cassava populations' adaptive potential and ultimately prove ineffectual