Nutritional parameters predicting postoperative infections

Thirteen nutritional parameters viz body mass index (BMI), mid arm circumference (MAC), mid calf circumference (MCC), triceps skin fold thickness (TST), abdominal skin fold thickness (ASFT), abdominal girth at umbilicus (AG U), haemoglobin (Hb), total leucocytes count (WBC), absolute lymphocyte count (ALC), serum proteins (Prot.), serum albumin (AIb), serum total iron binding capacity (TIBC) and serum iron (Fe) were estimated in 52 (36 male and 16 female) consecutive patients admitted to a surgical service at the Abbasi Shaheed Hospital, Karachi. Nine males and one female developed surgical infections whilst the wounds of 27 males and 15 females healed by primary intent. There was a significant difference in the values of BMI, MCC, ASFT, Prot., and AIb between the patients with infected and clean wounds. Whilst MCC was significantly dif­ferent, MAC was not as good a differentiator. Whilst Prot. and AIb were lower in the infected group, BMI, MCC, TST, ASFT were higher in the patients whose wounds healed by primary inten

Testing novel miniature NIR spectrometers for wearable broadband NIRS devices

The feasibility of new-generation miniature spectrometers for use in portable broadband NIRS (bNIRS) devices was explored in this investigation. The study outlines tests of varying integration time between 1000 ms, 500 ms and 250 ms and source-detector separations between 2 cm, 3cm and 4 cm, and their effect on the received signal through MEDPHOT tissue-mimicking phantoms, A2, B2, B3 and D7, using the Oceans Optics HL-2000-HP tungsten halogen lamp as a broadband light source. The spectra and SNR were then compared to two gold-standard bNIRS systems. It is found that two of the spectrometers give respectable SNR values for the detection range of 600 - 1000 nm in all regimes except when saturated or using phantom D7. It is demonstrated that these two devices can appropriately be used for source-detector separations of 3 cm and 4 cm at 500 ms and 1000 ms integration times, to determine absorption changes in tissue and thus chromophore concentrations. To use them for 2 cm separations, an additional attenuation component will be required

Bio-Dodecanedioic Acid (DDDA) Production

The demand for dodecanedioic acid (DDDA) is steadily increasing each year with demand expected to exceed 90.4 kilotons per month in 2023.1.1 DDDA is an intermediate chemical used in a variety of end products. Thus, the increase in DDDA demand can largely be attributed to increasing demand for manufacturing nylon, paints, adhesives, and powder coatings. Regionally, Asia Pacific has been observing the fastest growth of all regions at over 6% CAGR.1.2 The robust manufacturing base for nylon, along with a growing automotive industry in India and China, will propel DDDA growth into the next decade. The current synthesis process for DDDA relies on a multi step butadiene process. This pathway has large price volatility and supply/demand imbalances due to using a petrochemical feedstock. This proposed process outlines a biologically-sourced alternative to conventional DDDA production, and would be located in Malaysia to access regional organic feedstocks. The proposed DDDA plant is designed to produce 14,000 metric tons per year of DDDA using palm oil, and would be strategically located near rapidly expanding Asia Pacific markets. This project has an estimated IRR of 24.12%, ROI of 18.20%, and a NPV of approximately $54.1 MM

Objective understanding of front-of-package nutrition labels: An international comparative experimental study across 12 countries

Front-of-Package labels (FoPLs) are efficient tools for increasing consumers’ awareness of foods’ nutritional quality and encouraging healthier choices. A label’s design is likely to influence its effectiveness; however, few studies have compared the ability of different FoPLs to facilitate a consumer understanding of foods’ nutritional quality, especially across sociocultural contexts. This study aimed to assess consumers’ ability to understand five FoPLs [Health Star Rating system (HSR), Multiple Traffic Lights (MTL), Nutri-Score, Reference Intakes (RIs), and Warning symbol] in 12 different countries. In 2018, approximately 1000 participants per country were recruited and asked to rank three sets of label-free products (one set of three pizzas, one set of three cakes, and one set of three breakfast cereals) according to their nutritional quality, via an online survey. Participants were subsequently randomised to one of five FoPL conditions and were again asked to rank the same sets of products, this time with a FoPL displayed on pack. Changes in a participants’ ability to correctly rank products across the two tasks were assessed by FoPL using ordinal logistic regression. In all 12 countries and for all three food categories, the Nutri-Score performed best, followed by the MTL, HSR, Warning symbol, and RIs

The prevalence of silent kidney stones: An ultrasonographic screening study

Objective: Silent and not yet discovered stones of the upper urinary tract are potentially dangerous, since in due course they may cause infection, obstruction and renal damage. The aim of this study was to determine the prevalence of such silent kidney stones in a representative Pakistani population of Karachi. Subjects and Methods: We studied 201 consecutive subjects at our hospital who underwent additional kidney screening whilst undergoing abdominal ultrasound. All these subjects did not have a history or symptoms of urolithiasis. Results: We found silent kidney stones in 3% of subjects. All stone bearers were males. Most stones were in the left kidney. Notably, multiple stones and stones of a considerable size went unnoticed. Conclusion: In addition to the usual figures of incidence and prevalence of stone disease drawn from patient data, there is a prevalence of 3% silent stones that may only be discovered incidentally or by screening. This is true for a “stone country” like Pakistan. Figures for other regions have yet to be determined. Due to socioeconomic reasons, we believe that a general kidney screening for urolithiasis is, however, not indicated, at least in our countr

Role of estrogens in the secondary hormonal manipulation of hormone refractory prostate cancer

Objective: To evaluate the role of Estrogens (Honvan) in the secondary hormonal manipulation of patients with hormone refractory prostate cancer (HRCP). Methods: Twelve patients diagnosed as hormone refractory prostate cancer received intravenous estrogens for six days (Fosfestrol, a synthetic phosphorylated estrogen derivative), followed by a maintenance oral dose of 120 mg thrice daily as second line hormonal treatment. During the treatment they were given deep venous thrombosis prophylaxis. Their stage at initial presentation, primary treatment, mode of androgen ablation, prostate specific antigen (PSA) level, duration of remission prior of HRPC status, PSA doubling time before and after estrogen treatment were recorded. The morbidity and mortality of the treatment was also recorded. A drop in PSA of \u3e 50% was classified as major responder. The drop of \u3c 50% was defined as minor responders. Treatment failure was defined as a rise in PSA \u3e the level prior to the start of treatment. Results: The mean age at diagnosis of prostate cancer was 66.6 + 5.4 years (range 57-73). At the time of initial diagnosis only 3 patients (25%) had localized disease and 9 (75%) had metastatic prostate cancer. Six patients each opted for surgical or medical castration (LHRH analogs) as the mode of androgen ablation. The mean initial PSA at diagnosis was 340 + 728.1 ng/ml (range 4.1-2375, Median 94). After development of HRPC, six patients (50%) had major response, four (33%) had minor response to estrogen administration. Two patients (17%) did not respond to estrogens. The mean PSA before receiving Fosfestrol was 60.5 + 82 ng/ml (range 0.013-246). The PSA (nadir) after treatment was 24.3 + 33.2 ng/ml (range 0.9-81.3). One patient developed gynaecomastia and one had congestive cardiac failure. Two patients died of non cancer related deaths and one patient died of cancer related death. Conclusion: Synthetic estrogens are well tolerated, in-expensive agents and could be considered for palliative use against hormone resistant prostate cancer (JPMA 54:445;2004)

Translational Epidemiology In Psychiatry: Linking Population To Clinical And Basic Sciences

Translational research generally refers to the application of knowledge generated by advances in basic sciences research translated into new approaches for diagnosis, prevention, and treatment of disease. This direction is called bench-to-bedside. Psychiatry has similarly emphasized the basic sciences as the starting point of translational research. This article introduces the term translational epidemiology for psychiatry research as a bidirectional concept in which the knowledge generated from the bedside or the population can also be translated to the benches of laboratory science. Epidemiologic studies are primarily observational but can generate representative samples, novel designs, and hypotheses that can be translated into more tractable experimental approaches in the clinical and basic sciences. This bedside-to-bench concept has not been explicated in psychiatry, although there are an increasing number of examples in the research literature. This article describes selected epidemiologic designs, providing examples and opportunities for translational research from community surveys and prospective, birth cohort, and family-based designs. Rapid developments in informatics, emphases on large sample collection for genetic and biomarker studies, and interest in personalized medicine—which requires information on relative and absolute risk factors—make this topic timely. The approach described has implications for providing fresh metaphors to communicate complex issues in interdisciplinary collaborations and for training in epidemiology and other sciences in psychiatry. Translational research generally refers to the application of knowledge generated by advances in basic sciences research translated into new approaches for prevention, diagnosis, and treatment of disease, followed by the introduction of innovations into clinical practice and health policy. This direction is called bench-to-bedside. Translational research has received increasing priority in recent years, by means of the National Institutes of Health's Road Map Plan, newly launched scientific journals (eg, http:// www.sciencetranslationalmedicine.org), new career programs, and the Clinical and Translational Science Award program. This emphasis is not just within the United States: the British Medical Research Council in 2007 established new translational medicine centers, one of which is devoted to translational epidemiology, and translational research has served as a centerpiece of the European Commission health budget. Psychiatry has similarly emphasized the basic sciences as the starting point of translational research. Wang et al, in an explicit application of translation research to psychiatry, applied the Institute of Medicine's recommendations for translational research to schizophrenia and other psychotic disorders. They describe the application of 2 translational blocks. The first block, called T1, translates discoveries from the basic sciences into new diagnostic and preventive interventions, including early identification of high-risk individuals and new methods for testing interventions. In the second block, called T2, resulting clinical developments are received in clinical practice in comparative effectiveness studies, bridging the gap between diagnosis and actual treatment, providing health education, and changing prescribing practices. Within this bench-to-bedside framework, Wang et al argue, clinical epidemiology has played an important role in the design of clinical trials, prevention, health education, and service delivery. The purpose of this article is to expand the term translational epidemiology into psychiatric research as a bidirectional concept in which the bedside, ie, the population, can also be translated into the benches of laboratory science. This approach uses epidemiologic designs and findings to facilitate or to partner with basic science research. We will apply this concept of translational epidemiology to psychiatry and demonstrate that the representative samples, novel designs, and hypotheses offered by epidemiology can be translated into more tractable experimental approaches in the clinical and basic sciences. Because the validity, interpretation, and generalizability of findings vary by design, we provide a brief overview of core epidemiologic designs and provide illustrations of translational applications with each design. The discussion of design is not intended as a substitute for an exhaustive review of epidemiologic design, for which we direct the reader to one of many excellent textbooks. We also do not intend to appropriate bedside-to-bench as a novel direction. There are a number of classic examples in medicine, such as the epidemiologic observation of the relationship between smoking and lung cancer, which led to animal studies demonstrating the carcinogenic effect of nicotine and other cigarette toxins. This approach does not contradict the literature on bench-to-bedside translation; rather, it is complementary and iterative. The use of epidemiology in bedside-to-bench translational research in psychiatry has not been fully explicated, even though a number of studies appearing in the psychiatric literature have indirectly used epidemiologic designs. It is useful to make this idea explicit because epidemiology can provide hypotheses, designs, and samples for basic research, and the failure to avail oneself of these resources can lead to lost opportunities. Furthermore, different epidemiologic designs answer different questions, and inappropriate designs or inferences, particularly generalization of findings across designs, can confound results

Vibrational contribution to the thermodynamics of nanosized precipitates: vacancy-copper clusters in bcc-Fe

Within the harmonic approximation, the effects of lattice vibration on the thermodynamics of nano-sized coherent clusters in bcc-Fe consisting of vacancies and/or copper are investigated. A combination of on-lattice simulated annealing based on Metropolis Monte Carlo simulations and off-lattice relaxation by Molecular Dynamics is applied to obtain the most stable cluster configurations at T = 0 K. The most recent interatomic potential built within the framework of the embedded atom method for the Fe-Cu system is used. The vibrational part of the total free energy of defect clusters in bcc-Fe is calculated using their phonon density of states. The total free energy of pure bcc-Fe and fcc-Cu as well as the total formation free energy and the total binding free energy of the vacancy-copper clusters are determined for finite temperatures. Our results are compared with the available data from previous investigations performed using empirical many-body interatomic potentials and first-principle methods. For further applications in rate theory and object kinetic Monte Carlo simulations, the vibrational effects evaluated in the present study are included in the previously derived analytical fits based on the classical capillary model.Comment: 6 figure

Effects of Serotonin Transporter Gene Variation on Impulsivity Mediated by Default Mode Network: A Family Study of Depression

Serotonergic neurotransmission, potentially through effects on the brain’s default mode network (DMN), may regulate aspects of attention including impulse control. Indeed, genetic variants of the serotonin transporter (5-HTT) have been implicated in impulsivity and related psychopathology. Yet it remains unclear the mechanism by which the 5-HTT genetic variants contribute to individual variability in impulse control. Here, we tested whether DMN connectivity mediates an association between the 5-HTT genetic variants and impulsivity. Participants (N = 92) were from a family cohort study of depression in which we have previously shown a broad distribution of 5-HTT variants. We genotyped for 5-HTTLPR and rs25531 (stratified by transcriptional efficiency: 8 low/low, 53 low/high, and 31 high/high), estimated DMN structural connectivity using diffusion probabilistic tractography, and assessed behavioral measures of impulsivity (from 12 low/low, 48 low/high, and 31 high/high) using the Continuous Performance Task. We found that low transcriptional efficiency genotypes were associated with decreased connection strength between the posterior DMN and the superior frontal gyrus (SFG). Path modeling demonstrated that decreased DMN–SFG connectivity mediated the association between low-efficiency genotypes and increased impulsivity. Taken together, this study suggests a gene-brain-behavior pathway that perhaps underlies the role of the serotonergic neuromodulation in impulse control

Risks For Major Depression: Searching For Stable Traits

In this issue of Biological Psychiatry, Scifo et al. follow a reasonable clinical and epidemiologic classification to separate biological traits and states. They base their hypothesis on existing strong findings that patients often have lifelong recurring episodes of major depression of increasing severity, shorter remission periods, and reduced therapeutic response. Based on these observations, they reason that patients with differing clinical courses (single episodes, single episodes in remission, recurrent episodes, recurrent episodes in remission, and control subjects) should show differing biological traits and states. Applying mass spectrometry–based proteomics to postmortem tissue, they tested 3630 proteins within the subgenual anterior cingulate cortex, a region previously implicated in the modulation of negative mood and found to be responsive to deep brain stimulation in patients with treatment-refractory depression. They identified 98 proteins whose expression was associated with major depressive disorder (MDD). Much to their surprise, they found weak evidence of proteomic differences as a function of depressive state. Instead, they found persistent effects of MDD independent of episode or remission, demographic characteristics, or other clinical measures of severity. They concluded that these proteomic differences did not predict state differences, but may have predicted traits. These depression effects were detected in a host of proteomic measures that certainly will guide numerous other investigations