Hospital transfers of nursing home residents with advanced dementia.

To describe diagnoses and factors associated with hospital transfer in nursing home (NH) residents with advanced dementia. Prospective cohort study. Twenty-two Boston, Massachusetts-area NHs. Three hundred twenty-three NH residents with advanced dementia. Data were collected quarterly for up to 18 months. Data regarding transfers were collected with regard to hospitalization or emergency department (ED) visit, diagnosis, and duration of inpatient admission. Information on the occurrence of any acute medical event (pneumonia, febrile episode, or other acute illness) in the prior 90 days was obtained quarterly. Logistic regression conducted at the level of the acute medical event identified characteristics associated with hospital transfer. The entire cohort experienced 74 hospitalizations and 60 ED visits. Suspected infections were the most common reason for hospitalization (44, 59%), most frequently attributable to a respiratory source (30, 41%). Feeding tube-related complications accounted for 47% of ED visits. In adjusted analysis conducted on acute medical events, younger resident age, event type (pneumonia or other event vs febrile episode), chronic obstructive pulmonary disease, and the lack of a do-not-hospitalize (DNH) order (adjusted odds ratio = 5.22, 95% confidence interval = 2.31-11.79) were associated with hospital transfer. The majority of hospitalizations of NH residents with advanced dementia were due to infections and thus were potentially avoidable, because infections are often treatable in the NH. Feeding tube-related complications accounted for almost half of all ED visits, representing a common but underrecognized burden of this intervention. Advance care planning in the form of a DNH order was the only identified modifiable factor associated with avoiding hospitalization

Effect of oilseed type on milk fatty acid composition of individual cows, and also bulk tank milk fatty acid composition from commercial farms

Supplementing dairy cow diets with oilseed preparations has been shown to replace milk saturated fatty acids (SFA) with mono- and/or polyunsaturated fatty acids (MUFA, PUFA), which may reduce risk factors associated with cardio-metabolic diseases in humans consuming milk and dairy products. Previous studies demonstrating this are largely detailed, highly controlled experiments involving small numbers of animals, but in order to transfer this feeding strategy to commercial situations further studies are required involving whole herds varying in management practices. In experiment 1, three oilseed supplements (extruded linseed (EL), calcium salts of palm and linseed oil (CPLO) and milled rapeseed (MR)) were included in grass silage-based diets formulated to provide cows with ~350 g oil/day, and compared with a negative control (Control) diet containing no supplemental fat, and a positive control diet containing 350 g/cow per day oil as calcium salt of palm oil distillate (CPO). Diets were fed for 28-day periods in a 5×4 Latin Square design, and milk production, composition and fatty acid (FA) profile were analysed at the end of each period. Compared with Control, all lipid supplemented diets decreased milk fat SFA concentration by an average of 3.5 g/100 g FA, by replacement with both cis- and trans-MUFA/PUFA. Compared with CPO, only CPLO and MR resulted in lower milk SFA concentrations. In experiment 2, 24 commercial dairy farms (average herd size±SEM 191±19.3) from the south west of the United Kingdom were recruited and for a 1 month period asked to supplement their herd diets with either CPO, EL, CPLO or MR at the same inclusion level as the first study. Bulk tank milk was analysed weekly to determine FA concentration by Fourier Transform mid-IR spectroscopy prediction. After 4 weeks, EL, CPLO and MR all decreased herd milk SFA and increased MUFA to a similar extent (average −3.4 and +2.4 g/100 g FA, respectively) when compared with CPO. Differing responses observed between experiments 1 and 2 may be due in part to variations in farm management conditions (including basal diet) in experiment 2. This study demonstrates the importance of applying experimental research into commercial practice where variations in background conditions can augment different effects to those obtained under controlled conditions

Copper Oxide Nanoparticle Diameter Mediates Serum-Sensitive Toxicity in BEAS-2B Cells

Copper oxide (CuO) nanoparticles (NPs) are abundant in manufacturing processes, but they are an airway irritant. In vitro pulmonary toxicity of CuO NPs has been modeled using cell lines such as human bronchial epithelial cell line BEAS-2B. In 2D in vitro culture, BEAS-2B undergoes squamous differentiation due to the presence of serum. Differentiation is part of the repair process of lung cells in vivo that helps to preserve the epithelial lining of the respiratory tract. Herein, the effects of serum on the hydrodynamic diameter, cellular viability, cellular differentiation, and cellular uptake of 5 and 35 nm CuO NPs are investigated, and the mean cell area is used as the differentiation marker for BEAS-2B cells. The results demonstrate that the hydrodynamic diameter decreases with the addition of serum to the culture medium. Serum also increases the mean cell area, and only affects dose-dependent cytotoxicity of 35 nm CuO NPs, while simultaneously having no effect on intracellular Cu2+. This study presents evidence that both NP size and the presence of serum in culture media influence the relative viability of BEAS-2B cells following CuO NP exposure and highlights a critical need for carefully designed experiments and accurately reported conditions

Effects of forage type and extruded linseed supplementation on methane production and milk fatty acid composition of lactating dairy cows

Replacing dietary grass silage (GS) with maize silage (MS) and dietary fat supplements may reduce milk concentration of specific saturated fatty acids (SFA) and can reduce methane production by dairy cows. The present study investigated the effect of feeding an extruded linseed supplement on milk fatty acid (FA) composition and methane production of lactating dairy cows, and whether basal forage type, in diets formulated for similar neutral detergent fiber and starch, altered the response to the extruded linseed supplement. Four mid-lactation Holstein-Friesian cows were fed diets as total mixed rations, containing either high proportions of MS or GS, both with or without extruded linseed supplement, in a 4 × 4 Latin square design experiment with 28-d periods. Diets contained 500 g of forage/kg of dry matter (DM) containing MS and GS in proportions (DM basis) of either 75:25 or 25:75 for high MS or high GS diets, respectively. Extruded linseed supplement (275 g/kg ether extract, DM basis) was included in treatment diets at 50 g/kg of DM. Milk yields, DM intake, milk composition, and methane production were measured at the end of each experimental period when cows were housed in respiration chambers. Whereas DM intake was higher for the MS-based diet, forage type and extruded linseed had no significant effect on milk yield, milk fat, protein, or lactose concentration, methane production, or methane per kilogram of DM intake or milk yield. Total milk fat SFA concentrations were lower with MS compared with GS-based diets (65.4 vs. 68.4 g/100 g of FA, respectively) and with extruded linseed compared with no extruded linseed (65.2 vs. 68.6 g/100 g of FA, respectively), and these effects were additive. Concentrations of total trans FA were higher with MS compared with GS-based diets (7.0 vs. 5.4 g/100 g of FA, respectively) and when extruded linseed was fed (6.8 vs. 5.6 g/100 g of FA, respectively). Total n-3 FA were higher when extruded linseed was fed compared with no extruded linseed (1.2 vs. 0.8 g/100 g of FA, respectively), whereas total n-6 polyunsaturated FA were higher when feeding MS compared with GS (2.5 vs. 2.1 g/100 g of FA, respectively). Feeding extruded linseed and MS both provided potentially beneficial decreases in SFA concentration of milk, and no significant interactions were found between extruded linseed supplementation and forage type. However, both MS and extruded linseed increased trans FA concentration in milk fat. Neither MS nor extruded linseed had significant effects on methane production or yield, but the amounts of supplemental lipid provided by extruded linseed were relatively small

You\u27re So Gay! : Do Different Forms of Bullying Matter for Adolescent Males?

This study examined effects of adolescent males\u27 perceptions of being bullied because of verbal taunts related to gender nonconformity (i.e., They say I\u27m gay ). Participants included 251 ninth- (n = 77), tenth- (n = 96), and eleventh- (n = 78) grade students in a private, all-male college preparatory school. Participants were divided into two groups based on whether they were bullied by being called gay. Out of the 251 participants, 121 (48%) reported having been bullied and 127 (50%) stated that they had not been bullied during the past year (2% did not report). Of the 121 participants who had been bullied, 32 (26%) reported that they had been bullied because others called them gay (Group 1) and 89 (74%) reported that they had been bullied for other reasons, exclusive of being called gay (Group 2). Consistent with predictions, the boys who were bullied because they were called gay experienced greater psychological distress, greater verbal and physical bullying, and more negative perceptions of their school experiences than boys who were bullied for other reasons. Implications for school-based intervention services for bullying are discussed

Differential effects of oilseed supplements on methane production and milk fatty acid concentrations in dairy cows

It is known that supplementing dairy cow diets with full-fat oilseeds can be used as a strategy to mitigate methane emissions, through their action on rumen fermentation. However, direct comparisons of the effect of different oil sources are very few, as are studies implementing supplementation levels that reflect what is commonly fed on commercial farms. The objective was to investigate the effect of feeding different forms of supplemental plant oils on both methane emissions and milk fatty acid (FA) profile. Four multiparous, Holstein-Friesian cows in mid-lactation were randomly allocated to one of four treatment diets in a 4 x 4 Latin square design with 28-day periods. Diets were fed as a TMR with a 50:50 forage:concentrate ratio (dry matter, DM basis) with the forage consisting of 75:25 maize silage:grass silage (DM). Dietary treatments were a control diet containing no supplemental fat, and three treatment diets containing extruded linseed (EL), calcium salts of palm and linseed oil (CPLO) or milled rapeseed (MR) formulated to provide each cow with an estimated 500 g additional oil/d (22 g oil/kg diet DM). Dry matter intake (DMI), milk yield, milk composition and methane production were measured at the end of each experimental period when cows were housed in respiration chambers for 4 days. There was no effect of treatment diet on DMI or milk protein or lactose concentration, but oilseed-based supplements increased milk yield compared with the control diet and milk fat concentration relative to control was reduced by 4 g/kg by supplemental EL. Feeding CPLO reduced methane production, and both linseed-based supplements decreased methane yield (by 1.8 L/kg DMI) and intensity (by 2.7 L/kg milk yield) compared with the control diet, but feeding MR had no effect on methane emission. All the fat supplements decreased milk total saturated fatty acid (SFA) concentration compared with the control, and SFA were replaced with mainly cis-9 18:1 but also trans FA (and in the case of EL and CPLO there were increases in polyunsaturated FA concentration). Supplementing dairy cow diets with these oilseed-based preparations affected milk FA profile and increased milk yield. However, only the linseed-based supplements reduced methane production, yield, or intensity, whilst feeding MR had no effect

Gender differences in injuries sustained during United States Marine Corps training

Aim: To investigate gender-specific differences in injuries in United States Marine Corps (USMC) trainees.Design: Retrospective cohort study.Method: Point-of-care injury data for USMC recruits (females=94; males=681) completing training were drawn from the Marine Corps Recruit Depot San Diego sports medicine injury database and analysed descriptively. The male: female incidence rate ratio (IRR) was calculated.Results: Male trainees suffered more injuries (male=268; 39%; female n=22; 23%; IRR=1.68 (95% CI 1.33 to 2.1)). Sprains and strains were the leading nature of injury (female=41%; male=25%) followed by pain(female=23%; male=22%). The leading type of injury was ‘new overuse injuries’ for both genders (54% each). Female trainees experienced more acute injuries (36% versus 26%). While female (55%) and male (58%)rates of ‘moderate’ injuries were similar, female trainees experienced more ‘mild’ injuries (36% versus 25%). The knee (female=27%: male=23%) and lower leg (female=23%: male=21%) were the leading injury sites. All injuries were to the lower limbs in female trainees; male trainees also reported injuries to the upper limb (12%) and trunk (8%).Conclusion: Female trainees experienced fewer injuries than male trainees, with more being mild. Both genders had similar natures of injuries in similar body sites except that male trainees reported some upper body and trunk injuries.</div

Rola zarejestrowanej objętości wyrzutu płynu mózgowo-rdzeniowego w przewidywaniu wyniku w zmodyfikowanej skali Rankina przy wypisie ze szpitala u pacjentów z krwawieniami podpajęczynówkowymi (DROPSS)

Introduction. External ventricular drain (EVD) placement is common among aneurysmal subarachnoid hemorrhage (aSAH). Draining cerebrospinal fluid (CSF) from the EVD is also common, yet little is known about how much to drain, the length of time to drain, or how drainage impacts patient outcomes. Aim. The purpose of this study is to correlate amount of CSF drainage to patient outcomes, via modified Rankin Score (mRS). Material and Methods. This retrospective review of data located in a local hospital-based registry and electronic medical record. A linear mixed effects model was constructed to examine CSF drainage volume as a predictor of mRS at discharge. Results. Data from 82 patients was included in this analysis. There was no statistically significant relationship between CSF totals and mRS at hospital discharge (p = 0.3614, r² = 0.01). After controlling for age, Hunt and Hess score, and subject as random effect, there was still no significant relationship between CSF drained and mRS score at hospital discharge (p = .9042). Conclusions. There is no correlation between the total volume of CSF drained and mRS at discharge. Future research should explore CSF drainage documentation practices. (JNNN 2022;11(2):43–48) Key Words: acute care, aneurysmal subarachnoid hemorrhage, cerebrospinal fluid, external ventricular drain, patient outcomesWstęp. Założenie drenu komorowego zewnętrznego (EVD) jest powszechne w przypadku tętniakowatego krwotoku podpajęczynówkowego (aSAH). Drenaż płynu mózgowo-rdzeniowego (cerebrospinal fluid, CSF) z EVD jest również powszechny, jednak niewiele wiadomo na temat ilości płynu, czasu trwania drenażu i wpływu drenażu na wyniki leczenia. Cel. Celem tego badania jest korelacja ilości drenażu płynu mózgowo-rdzeniowego z wynikami leczenia pacjentów w zmodyfikowanej skali Rankina (modified Rankin Score, mRS). Materiał i metody. Retrospektywny przegląd danych znajdujących się w lokalnym rejestrze szpitalnym i elektronicznej dokumentacji medycznej. W celu zbadania objętości drenażu płynu mózgowo-rdzeniowego jako predyktora mRS przy wypisie ze szpitala skonstruowano liniowy model efektów mieszanych. Wyniki. Do analizy włączono dane od 82 pacjentów. Nie stwierdzono istotnej statystycznie zależności między całkowitą objętością płynu mózgowo-rdzeniowego a mRS przy wypisie ze szpitala (p = 0,3614, r² = 0,01). Po uwzględnieniu wieku, punktacji w skali Hunta i Hessa oraz podmiotu jako efektu losowego, nadal nie było istotnej zależności między odsączonym płynem mózgowo-rdzeniowym a wynikiem mRS przy wypisie ze szpitala (p = .9042). Wnioski. Nie ma korelacji między całkowitą objętością zdrenowanego płynu mózgowo-rdzeniowego a mRS przy wypisie ze szpitala. W przyszłych badaniach należy przeanalizować sposób prowadzenia dokumentacji drenażu płynu mózgowo-rdzeniowego. (PNN 2022;11(2):43–48)

Monte Carlo study of the Widom-Rowlinson fluid using cluster methods

The Widom-Rowlinson model of a fluid mixture is studied using a new cluster algorithm that is a generalization of the invaded cluster algorithm previously applied to Potts models. Our estimate of the critical exponents for the two-component fluid are consistent with the Ising universality class in two and three dimensions. We also present results for the three-component fluid.Comment: 13 pages RevTex and 2 Postscript figure

Correspondence

quantification, real-time PCR, rumen, stearic acid producers