Communication with the elderly patient

Communication with the elderly patien

Herd diagnosis of low pathogen diarrhoea in growing pigs – a pilot study

BACKGROUND: The major indication for antibiotic use in Danish pigs is treatment of intestinal diseases post weaning. Clinical decisions on antibiotic batch medication are often based on inspection of diarrhoeic pools on the pen floor. In some of these treated diarrhoea outbreaks, intestinal pathogens can only be demonstrated in a small number of pigs within the treated group (low pathogen diarrhoea). Termination of antibiotic batch medication in herds suffering from such diarrhoea could potentially reduce the consumption of antibiotics in the pig industry. The objective of the present pilot study was to suggest criteria for herd diagnosis of low pathogen diarrhoea in growing pigs. Data previously collected from 20 Danish herds were used to create a case series of clinical diarrhoea outbreaks normally subjected to antibiotic treatment. In the present study, these diarrhoea outbreaks were classified as low pathogen (<15% of the pigs having bacterial intestinal disease) (n =5 outbreaks) or high pathogen (≥15% of the pigs having bacterial intestinal disease) (n =15 outbreaks). Based on the case series, different diagnostic procedures were explored, and criteria for herd diagnosis of low pathogen diarrhoea were suggested. The effect of sampling variation was explored by simulation. RESULTS: The diagnostic procedure with the highest combined herd-level sensitivity and specificity was qPCR testing of a pooled sample containing 20 randomly selected faecal samples. The criteria for a positive test result (high pathogen diarrhoea outbreak) were an average of 1.5 diarrhoeic faecal pools on the floor of each pen in the room under investigation and a pathogenic bacterial load ≥35,000 per gram in the faecal pool tested by qPCR. The bacterial load was the sum of Lawsonia intracellularis, Brachyspira pilosicoli and Escherichia coli F4 and F18 bacteria per gram faeces. The herd-diagnostic performance was (herd-level) diagnostic sensitivity =0.99, diagnostic specificity =0.80, positive predictive value =0.94 and negative predictive value =0.96. CONCLUSIONS: The pilot study suggests criteria for herd diagnosis of low pathogen diarrhoea in growing pigs. The suggested criteria should now be evaluated, and the effect of terminating antibiotic batch medication in herds identified as suffering from low pathogen diarrhoea should be explored. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/2046-0481-67-24) contains supplementary material, which is available to authorized users

Higher intake of fish and fat is associated with lower plasma s-adenosylhomocysteine: a cross-sectional study

The final publication is available at Elsevier via https://doi.org/10.1016/j.nutres.2017.09.008 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Several B-vitamins act as co-factors in one-carbon metabolism, a pathway that plays a central role in several chronic diseases. However, there is a lack of knowledge of how diet affects markers in one-carbon metabolism. The aim of this study was to explore dietary patterns and components associated with one-carbon metabolites. We hypothesized that intake of whole-grains and fish would be associated with lower Hcy, and higher SAM:SAH ratio due to their nutrient content. We assessed dietary information using a four-day dietary record in 118 men and women with features of the metabolic syndrome. In addition we assessed whole-blood fatty acid composition and plasma alkylresorcinols. Plasma s-adenosylmethionine (SAM), s-adenosylhomocysteine (SAH), homocysteine (Hcy) and vitamin B12 was included as one-carbon metabolism markers. We used principal component analysis (PCA) to explore dietary patterns and multiple linear regression models to examine associations between dietary factors and one-carbon metabolites. PCA separated subjects based on prudent and unhealthy dietary patterns, but the dietary pattern score was not related to the one-carbon metabolites. Whole grain intake was found to be inversely associated to plasma Hcy (?4.7% (?9.3; 0.0), P=.05) and total grain intake tended to be positively associated with SAM and SAH (2.4% (?0.5; 5.5), P=.08; 5.8% (?0.2; 12.1), P=.06, respectively, per SD increase in cereal intake). Fish intake was inversely associated with plasma Hcy and SAH concentrations (?5.4% (?9.7; ?0.8), P=.02 and ?7.0% (?12.1; ?1.5), P=.01, respectively) and positively associated with the SAM:SAH ratio (6.2% (1.6; 11.0), P=.008). In conclusion, intake and fish and whole-grain appear to be associated with a beneficial one-carbon metabolism profile. This indicates that dietary components could play a role in regulation of one-carbon metabolism with a potential impact on disease prevention.Innovation Fund Denmark, grant no. 0603-00487B (11-116163). MV Lind partly supported by an unrestricted grant from Cereal Partners Worldwide a joint venture between Nestlé SA and General Mills Ltd

Complementary shifts in photoreceptor spectral tuning unlock the full adaptive potential of ultraviolet vision in birds

Color vision in birds is mediated by four types of cone photoreceptors whose maximal sensitivities (λmax) are evenly spaced across the light spectrum. In the course of avian evolution, the λmax of the most shortwave-sensitive cone, SWS1, has switched between violet (λmax > 400 nm) and ultraviolet (λmax < 380 nm) multiple times. This shift of the SWS1 opsin is accompanied by a corresponding short-wavelength shift in the spectrally adjacent SWS2 cone. Here, we show that SWS2 cone spectral tuning is mediated by modulating the ratio of two apocarotenoids, galloxanthin and 11',12'-dihydrogalloxanthin, which act as intracellular spectral filters in this cell type. We propose an enzymatic pathway that mediates the differential production of these apocarotenoids in the avian retina, and we use color vision modeling to demonstrate how correlated evolution of spectral tuning is necessary to achieve even sampling of the light spectrum and thereby maintain near-optimal color discrimination

The K2-HERMES Survey: Age and Metallicity of the Thick Disc

Asteroseismology is a promising tool to study Galactic structure and evolution because it can probe the ages of stars. Earlier attempts comparing seismic data from the {\it Kepler} satellite with predictions from Galaxy models found that the models predicted more low-mass stars compared to the observed distribution of masses. It was unclear if the mismatch was due to inaccuracies in the Galactic models, or the unknown aspects of the selection function of the stars. Using new data from the K2 mission, which has a well-defined selection function, we find that an old metal-poor thick disc, as used in previous Galactic models, is incompatible with the asteroseismic information. We show that spectroscopic measurements of [Fe/H] and [$\alpha$/Fe] elemental abundances from the GALAH survey indicate a mean metallicity of $\log (Z/Z_{\odot})=-0.16$ for the thick disc. Here $Z$ is the effective solar-scaled metallicity, which is a function of [Fe/H] and [$\alpha$/Fe]. With the revised disc metallicities, for the first time, the theoretically predicted distribution of seismic masses show excellent agreement with the observed distribution of masses. This provides an indirect verification of the asteroseismic mass scaling relation is good to within five percent. Using an importance-sampling framework that takes the selection function into account, we fit a population synthesis model of the Galaxy to the observed seismic and spectroscopic data. Assuming the asteroseismic scaling relations are correct, we estimate the mean age of the thick disc to be about 10 Gyr, in agreement with the traditional idea of an old $\alpha$-enhanced thick disc.Comment: 21 pages, submitted to MNRA

The GALAH survey: Milky Way disc metallicity and alpha-abundance trends in combined APOGEE-GALAH catalogues

GALAH and APOGEE are two high resolution multi object spectroscopic surveys that provide fundamental stellar parameters and multiple elemental abundance estimates for $>$ 400,000 stars in the Milky Way. They are complimentary in both sky coverage and wavelength regime. Thus combining the two surveys will provide us a large sample to investigate the disc metallicity and alpha abundance trends. We use the Cannon data-driven approach selecting training sets from among $\sim$20,000 stars in common for the two surveys to predict the GALAH scaled stellar parameters from APOGEE spectra as well as APOGEE scaled stellar parameters from GALAH spectra. We provide two combined catalogues with GALAH scaled and APOGEE scaled stellar parameters each having $\sim$500,000 stars after quality cuts. With $\sim$470,000 stars that are common in both these catalogues, we compare the GALAH scaled and APOGEE scaled metallicity distribution functions (MDF), radial and vertical metallicity gradients as well as the variation of [$\alpha$/Fe] vs [Fe/H] trends along and away from the Galactic mid plane. We find mean metallicities of APOGEE scaled sample to be higher compared to that for the GALAH scaled sample. We find similar [$\alpha$/Fe] vs [Fe/H] trends using both samples consistent with previous observational as well as simulation based studies. Radial and vertical metallicity gradients derived using the two survey scaled samples are consistent except in the inner and outer Galactocentric radius bins. Our gradient estimates in the solar neighborhood are also consistent with previous studies and are backed by larger sample size compared to previous works.Comment: 21 pages, 19 figures, submitted to MNRA