Protein Intake, IGF-1 Concentrations, and Growth in the Second Year of Life in Children Receiving Growing Up Milk – Lite (GUMLi) or Cow's Milk (CM) Intervention

The relationship of protein intake with insulin-like growth factor 1 (IGF-1) concentrations in well-nourished children during the second year of life is poorly understood. The aim of this study was to explore the effect of a reduced-protein Growing Up Milk Lite (GUMLi) or unfortified cow's milk (CM) on protein intake, growth, and plasma IGF-1 at 2 y. An exploratory analysis of a sub-sample of Auckland-based children (n = 79) in the GUMLi trial (a double-blind, randomised control trial, N = 160) completed in Auckland and Brisbane (2015–2017) was conducted. One-year old children were randomised to receive a reduced-protein GUMLi (1.7 g protein/100 mL) or a non-fortified CM (3.1 g protein/100 mL) for 12 months. Blood sampling and anthropometric measurements were made at 1 and 2 y. Diet was assessed using a validated food frequency questionnaire. Total protein intake (g/d) from all cow's milk sources was 4.6 g (95% CI: −6.7, −2.4; p < 0.005) lower in the GUMLi group after 12 months of the intervention, with a significant group-by-time interaction (p = 0.005). Length-for-age (LAZ) and weight-for-length (WLZ) z-scores did not differ between groups, however, mean body fat % (BF%) was 3.2% (95%CI: −6.2, −0.3; p = 0.032) lower in the GUMLi group at 2 y. There was no difference between the intervention groups in relation to IGF-1 and IGF-BP3 (p = 0.894 and 0.698, respectively), with no group-by-sex interaction. After combining the groups, IGF-1 concentration at 2 y was positively correlated with parameters of growth (all p < 0.05), total cow's milk intake (p = 0.032) after adjusting for sex, breastfeeding status, and gestation. Randomisation to a reduced protein GUMLi resulted in small reduction in %BF and lower total protein intakes but had no effect on growth. Plasma IGF-1 concentrations were independently associated with total protein intake from cow's milk at 2 y, highlighting a potential area of the diet to target when designing future protein-related nutrition interventions.Clinical Trial Registration: Australian New Zealand Clinical Trials Registry number: ACTRN12614000918628. Date registered: 27/08/2014

Management of Children With Chronic Wet Cough and Protracted Bacterial Bronchitis CHEST Guideline and Expert Panel Report

BACKGROUND: Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged METHODS: We used the CHEST expert cough panel\u27s protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation). Data from the systematic reviews in conjunction with patients\u27 values and preferences and the clinical context were used to form recommendations. Delphi methodology was used to obtain consensus for the recommendations/suggestions made. RESULTS: Combining data from the systematic reviews, we found high-quality evidence in children aged 4 weeks\u27 duration) wet/productive cough that using appropriate antibiotics improves cough resolution, and further investigations (eg, flexible bronchoscopy, chest CT scans, immunity tests) should be undertaken when specific cough pointers (eg, digital clubbing) are present. When the wet cough does not improve following 4 weeks of antibiotic treatment, there is moderate-quality evidence that further investigations should be considered to look for an underlying disease. New recommendations include the recognition of the clinical diagnostic entity of protracted bacterial bronchitis. CONCLUSIONS: Compared with the 2006 Cough Guidelines, there is now high-quality evidence for some, but not all, aspects of the management of chronic wet cough in specialist settings. However, further studies (particularly in primary health) are required

Evaluation of X-ray/EUV Nanolithography Facility at AS Through Wavefront Propagation Simulations

Synchrotron light sources can provide the required spatial coherence, stability and control that is required to support the development of advanced lithography at the extreme ultraviolet and soft X-ray wavelengths that are relevant to current and future fabricating technologies. Here we present an evaluation of the optical performance of the soft X-ray (SXR) beamline of the Australian Synchrotron (AS) and its suitability for developing interference lithography using radiation in the 91.8 eV (13.5 nm) to 300 eV (4.13 nm) range. A comprehensive physical optics model of the APPLE-II undulator source and SXR beamline was constructed to simulate the properties of the illumination at the proposed location of a photomask, as a function of photon energy, collimation, and monochromator parameters. The model is validated using a combination of experimental measurements of the photon intensity distribution of the undulator harmonics. We show that the undulator harmonics intensity ratio can be accurately measured using an imaging detector and controlled using beamline optics. Finally, we evaluate photomask geometric constraints and achievable performance for the limiting case of fully spatially coherent illumination.Comment: 21 pages, 7 figures, 3 tables. Preprint: submitted to Journal of Synchrotron Radiation 16/11/2

Confirmation of co-denitrification in grazed grassland

peer-reviewedPasture-based livestock systems are often associated with losses of reactive forms of nitrogen (N) to the environment. Research has focused on losses to air and water due to the health, economic and environmental impacts of reactive N. Di-nitrogen (N2) emissions are still poorly characterized, both in terms of the processes involved and their magnitude, due to financial and methodological constraints. Relatively few studies have focused on quantifying N2 losses in vivo and fewer still have examined the relative contribution of the different N2 emission processes, particularly in grazed pastures. We used a combination of a high 15N isotopic enrichment of applied N with a high precision of determination of 15N isotopic enrichment by isotope-ratio mass spectrometry to measure N2 emissions in the field. We report that 55.8 g N m−2 (95%, CI 38 to 77 g m−2) was emitted as N2 by the process of co-denitrification in pastoral soils over 123 days following urine deposition (100 g N m−2), compared to only 1.1 g N m−2 (0.4 to 2.8 g m−2) from denitrification. This study provides strong evidence for co-denitrification as a major N2 production pathway, which has significant implications for understanding the N budgets of pastoral ecosystems.The authors are grateful for the funding that was provided through the Research Stimulus Fund Program administered by the Department of Agriculture & Food under the National Development Plan 2007–2013 RSF 07536. The first author is grateful for the funding provided by Teagasc through the Walsh Fellowship Scheme

The cessation in pregnancy incentives trial (CPIT): study protocol for a randomized controlled trial

Background: Seventy percent of women in Scotland have at least one baby, making pregnancy an opportunity to help most young women quit smoking before their own health is irreparably compromised. By quitting during pregnancy their infants will be protected from miscarriage and still birth as well as low birth weight, asthma, attention deficit disorder and adult cardiovascular disease. In the UK, the NICE guidelines: 'How to stop smoking in pregnancy and following childbirth' (June 2010) highlighted that little evidence exists in the literature to confirm the efficacy of financial incentives to help pregnant smokers to quit. Its first research recommendation was to determine: Within a UK context, are incentives an acceptable, effective and cost-effective way to help pregnant women who smoke to quit? <p/>Design and Methods: This study is a phase II exploratory individually randomised controlled trial comparing standard care for pregnant smokers with standard care plus the additional offer of financial voucher incentives to engage with specialist cessation services and/or to quit smoking during pregnancy. Participants (n=600) will be pregnant smokers identified at maternity booking who when contacted by specialist cessation services agree to having their details passed to the NHS Smokefree Pregnancy Study Helpline to discuss the trial. The NHS Smokefree Pregnancy Study Helpline will be responsible for telephone consent and follow-up in late pregnancy. The primary outcome will be self reported smoking in late pregnancy verified by cotinine measurement. An economic evaluation will refine cost data collection and assess potential cost-effectiveness while qualitative research interviews with clients and health professionals will assess the level of acceptance of this form of incentive payment. Research questions What is the likely therapeutic efficacy? Are incentives potentially cost-effective? Is individual randomisation an efficient trial design without introducing outcome bias? Can incentives be introduced in a way that is feasible and acceptable? <p/>Discussion: This phase II trial will establish a workable design to reduce the risks associated with a future definitive phase III multicentre randomised controlled trial and establish a framework to assess the costs and benefits of financial incentives to help pregnant smokers to quit

End-user acceptability of personal protective equipment disinfection for potential reuse: a survey of health-care workers in Aotearoa New Zealand

Background The COVID-19 pandemic has highlighted personal protective equipment (PPE) supply, distribution, and disposal issues worldwide. Calls to conserve PPE stocks and increase supply resulted in the rapid development of potential disinfection methods, with the possibility of improvements in medical waste reduction. However, how receptive health-care workers are to PPE reuse remains unknown. We aimed to examine the views of health-care workers who used PPE during the first COVID-19 wave in Aotearoa New Zealand, in relation to acceptability of PPE disinfection and reuse. Methods In this multi-methods survey, health-care workers in New Zealand, were invited via a multimodal recruitment strategy to complete a survey regarding use of PPE during the first COVID-19 wave. Gender question options were male, female, gender diverse, or prefer not to say. Demographic differences in self-reported PPE reuse and acceptability were examined. The survey included closed (single-response, multi-response, ranking, and Likert-scale questions) and open-text questions. Any open-text comments were analysed with thematic analysis. The survey was built and deployed using Qualtrics software. Findings 1411 health-care workers completed the survey between Oct 7 and Nov 30, 2020. 1397 participants had gender data available (1140 [82%] female and 257 [18%] male) and 995 (74%) of 1347 were of New Zealand European ethnicity. PPE reuse was common and reported by 628 (45%) of the 1411 participants, with 396 (63%) of the 628 reporting reusing PPE multiple times in 1 day. Acceptability of the concept of PPE disinfection for potential reuse was high overall (1196 [85%] of 1411) but varied depending on the type of PPE. Thematic analysis confirmed that PPE reuse was already occurring and respondents recognised the potential benefits of reduced medical wastage and increased PPE supply. Important caveats for consideration included the availability of scientific evidence, level of negotiated risk, and trust in the organisation undertaking PPE disinfection, with clear communication about decontamination processes being crucial to acceptability. Interpretation PPE reuse occurred frequently during the first wave of COVID-19 in New Zealand. Although support for the disinfection of PPE for reuse was high, the success of any future programmes to reuse PPE will require meaningful engagement and clear communication with health-care workers. Further research into PPE disinfection safety and logistics is warranted, alongside the development of standard operating procedures and clearly communicated policies for the end user, should this more sustainable health-care practice be planned for adoption in certain settings. Funding New Zealand Ministry of Business, Innovation and Employment (COVID-19 Innovation Acceleration Fund) and the Medical Assurance Society Foundation

An Overview of the Performance of the Chandra X-Ray Observatory

The Chandra X-ray Observatory is the X-ray component of NASA's Great Observatory Program which includes the recently launched Spitzer Infrared Telescope, the Hubble Space Telescope (HST) for observations in the visible, and the Compton Gamma-Ray Observatory (CGRO) which, after providing years of useful data has reentered the atmosphere. All these facilities provide, or provided, scientific data to the international astronomical community in response to peer-reviewed proposals for their use. The Chandra X-ray Observatory was the result of the efforts of many academic, commercial, and government organizations primarily in the United States but also in Europe. NASA's Marshall Space Flight Center (MSFC) manages the Project and provides Project Science; Northrop Grumman Space Technology (NGST -- formerly TRW) served as prime contractor responsible for providing the spacecraft, the telescope, and assembling and testing the Observatory; and the Smithsonian Astrophysical Observatory (SAO) provides technical support and is responsible for ground operations including the Chandra X-ray Center (CXC). Telescope and instrument teams at SAO, the Massachusetts Institute of Technology (MIT), the Pennsylvania State University (PSU), the Space Research Institute of the Netherlands (SRON), the Max-Planck Institut fur extraterrestrische Physik (MPE), and the University of Kiel also provide technical support to the Chandra Project. We present here a detailed description of the hardware, its on-orbit performance, and a brief overview of some of the remarkable discoveries that illustrate that performance.Comment: 71 pages, 66 Figures, accepted for Experimental Astronom

Confirmation of co-denitrification in grazed grassland

Pasture-based livestock systems are often associated with losses of reactive forms of nitrogen (N) to the environment. Research has focused on losses to air and water due to the health, economic and environmental impacts of reactive N. Di-nitrogen (N₂) emissions are still poorly characterized, both in terms of the processes involved and their magnitude, due to financial and methodological constraints. Relatively few studies have focused on quantifying N₂ losses in vivo and fewer still have examined the relative contribution of the different N₂ emission processes, particularly in grazed pastures. We used a combination of a high ¹⁵N isotopic enrichment of applied N with a high precision of determination of ¹⁵N isotopic enrichment by isotope-ratio mass spectrometry to measure N₂ emissions in the field. We report that 55.8 g N m⁻² (95%, CI 38 to 77 g m⁻²) was emitted as N₂ by the process of co-denitrification in pastoral soils over 123 days following urine deposition (100 g N m⁻²), compared to only 1.1 g N m⁻² (0.4 to 2.8 g m⁻²) from denitrification. This study provides strong evidence for co-denitrification as a major N₂ production pathway, which has significant implications for understanding the N budgets of pastoral ecosystems