Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants.

BACKGROUND: The age at which allergenic foods should be introduced into the diet of breast-fed infants is uncertain. We evaluated whether the early introduction of allergenic foods in the diet of breast-fed infants would protect against the development of food allergy. METHODS: We recruited, from the general population, 1303 exclusively breast-fed infants who were 3 months of age and randomly assigned them to the early introduction of six allergenic foods (peanut, cooked egg, cow's milk, sesame, whitefish, and wheat; early-introduction group) or to the current practice recommended in the United Kingdom of exclusive breast-feeding to approximately 6 months of age (standard-introduction group). The primary outcome was food allergy to one or more of the six foods between 1 year and 3 years of age. RESULTS: In the intention-to-treat analysis, food allergy to one or more of the six intervention foods developed in 7.1% of the participants in the standard-introduction group (42 of 595 participants) and in 5.6% of those in the early-introduction group (32 of 567) (P=0.32). In the per-protocol analysis, the prevalence of any food allergy was significantly lower in the early-introduction group than in the standard-introduction group (2.4% vs. 7.3%, P=0.01), as was the prevalence of peanut allergy (0% vs. 2.5%, P=0.003) and egg allergy (1.4% vs. 5.5%, P=0.009); there were no significant effects with respect to milk, sesame, fish, or wheat. The consumption of 2 g per week of peanut or egg-white protein was associated with a significantly lower prevalence of these respective allergies than was less consumption. The early introduction of all six foods was not easily achieved but was safe. CONCLUSIONS: The trial did not show the efficacy of early introduction of allergenic foods in an intention-to-treat analysis. Further analysis raised the question of whether the prevention of food allergy by means of early introduction of multiple allergenic foods was dose-dependent. (Funded by the Food Standards Agency and others; EAT Current Controlled Trials number, ISRCTN14254740.)

T1 and FLAIR signal intensities are related to tau pathology in dominantly inherited Alzheimer disease

Carriers of mutations responsible for dominantly inherited Alzheimer disease provide a unique opportunity to study potential imaging biomarkers. Biomarkers based on routinely acquired clinical MR images, could supplement the extant invasive or logistically challenging) biomarker studies. We used 1104 longitudinal MR, 324 amyloid beta, and 87 tau positron emission tomography imaging sessions from 525 participants enrolled in the Dominantly Inherited Alzheimer Network Observational Study to extract novel imaging metrics representing the mean (μ) and standard deviation (σ) of standardized image intensities of T1-weighted and Fluid attenuated inversion recovery (FLAIR) MR scans. There was an exponential decrease in FLAIR-μ in mutation carriers and an increase in FLAIR and T1 signal heterogeneity (T1-σ and FLAIR-σ) as participants approached the symptom onset in both supramarginal, the right postcentral and right superior temporal gyri as well as both caudate nuclei, putamina, thalami, and amygdalae. After controlling for the effect of regional atrophy, FLAIR-μ decreased and T1-σ and FLAIR-σ increased with increasing amyloid beta and tau deposition in numerous cortical regions. In symptomatic mutation carriers and independent of the effect of regional atrophy, tau pathology demonstrated a stronger relationship with image intensity metrics, compared with amyloid pathology. We propose novel MR imaging intensity-based metrics using standard clinical T1 and FLAIR images which strongly associates with the progression of pathology in dominantly inherited Alzheimer disease. We suggest that tau pathology may be a key driver of the observed changes in this cohort of patients

Role of Position 627 of PB2 and the Multibasic Cleavage Site of the Hemagglutinin in the Virulence of H5N1 Avian Influenza Virus in Chickens and Ducks

Highly pathogenic H5N1 avian influenza viruses have caused major disease outbreaks in domestic and free-living birds with transmission to humans resulting in 59% mortality amongst 564 cases. The mutation of the amino acid at position 627 of the viral polymerase basic-2 protein (PB2) from glutamic acid (E) in avian isolates to lysine (K) in human isolates is frequently found, but it is not known if this change affects the fitness and pathogenicity of the virus in birds. We show here that horizontal transmission of A/Vietnam/1203/2004 H5N1 (VN/1203) virus in chickens and ducks was not affected by the change of K to E at PB2-627. All chickens died between 21 to 48 hours post infection (pi), while 70% of the ducks survived infection. Virus replication was detected in chickens within 12 hours pi and reached peak titers in spleen, lung and brain between 18 to 24 hours for both viruses. Viral antigen in chickens was predominantly in the endothelium, while in ducks it was present in multiple cell types, including neurons, myocardium, skeletal muscle and connective tissues. Virus replicated to a high titer in chicken thrombocytes and caused upregulation of TLR3 and several cell adhesion molecules, which may explain the rapid virus dissemination and location of viral antigen in endothelium. Virus replication in ducks reached peak values between 2 and 4 days pi in spleen, lung and brain tissues and in contrast to infection in chickens, thrombocytes were not involved. In addition, infection of chickens with low pathogenic VN/1203 caused neuropathology, with E at position PB2-627 causing significantly higher infection rates than K, indicating that it enhances virulence in chickens

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Tuning the structural and magnetocaloric properties of Gd5Si2Ge2 with Nd substitution

Structural and magnetocaloric properties of Nd substituted Gd5-xNdxSi2Ge2 with x = 0.05, 0.1, and 0.2 have been investigated. The composition with x = 0.05 crystallizes in monoclinic Gd5Si2Ge2 structure with P112(1)/a space group and undergoes a first order phase transition with a Curie temperature of 275 K. With increase in Nd content to x = 0.1, the compound is found to stabilize in orthorhombic Gd5Si4 phase with Pnma space group. The compounds with x = 0.1 and 0.2 undergoes a second order magnetic transition at 300K and 293 K, respectively. Temperature variation of maximum entropy change for Gd5-xNdxSi2Ge2 alloys with x = 0.05, 0.1, and 0.2 are 7.9, 3.7, and 3.2 J/kg K, respectively, for a field change of 20 kOe, and 12.8, 7.6, and 7.2 J/kg K, respectively, for 50 kOe. A large relative cooling power of 295, 205, and 188 J/kg are obtained for x = 0.05, 0.1, and 0.2, respectively, fulfilling the required criteria for a potential magnetic refrigerant in the room temperature regime. (C) 2015 AIP Publishing LLC

Magnetocaloric properties, exchange bias, and critical behavior of Ge substituted Ni50Mn36Sn14 Heusler alloys

The effect of Ge substitution on the magnetic, magnetocaloric, and exchange bias properties of Heusler alloy system Ni50Mn36Sn14-xGex (x = 1, 2) has been investigated. With the increase of Ge content, the cell volume decreases due to the smaller Ge radius and the martensitic transition temperature increases, while the Curie temperature of the austenite phase shows a small decrease. Metamagnetic behavior is observed in the low temperature magnetization isotherms for x = 1, whereas it is less pronounced in x = 2. The maximum magnetic entropy changes associated with the martensitic transition are 7.8 J/kg K and 2.3 J/kg K for x = 1 and 2, respectively, for a field change of 5 T. Relative cooling power is found to be more in the vicinity of the Curie temperature of the austenite phase, compared to that at the martensitic transition temperature in both x = 1 and 2. At low temperatures, both the samples exhibit exchange bias effect, with x = 2 showing higher value of exchange bias field. This is ascribed to the coexistence of ferromagnetic and antiferromagnetic interactions in these alloys. Further, the critical behavior of the austenite phase of both the alloys is studied and the values of the critical exponents are found to be different from the mean field values, which is attributed to the magnetic inhomogeneity originated due to Ge substitution. (C) 2015 AIP Publishing LLC

Co-existence of magnetocaloric effect and magnetoresistance in Co substituted La0.67Sr0.33MnO3 at room temperature

Magnetization (M), Magnetocaloric effect (MCE), and Magnetoresistance (MR) in Co substituted La0.67Sr0.33Mn1-xCoxO3 (x = 0.03, 0.05, and 0.1) samples have been investigated. All the studied samples were crystallized into a single phase rhombohedral structure with R (3) over barc space group. The Curie temperature (T-C) is found to decrease with the increase of Co content and for the composition x = 0.1, a cluster glass-like nature is observed. Temperature variation of magnetic entropy change (Delta S-M) shows a positive peak at TC for the composition x = 0.1 with Delta S-M = 3.1 J/kg K and relative cooling power, RCP = 155 J/kg at a magnetic field of 50 kOe. Again, the critical analysis of the paramagnetic to ferromagnetic transition and the scaling behaviour of field dependence of MCE for x = 0.1 composition is also reported. Furthermore, the temperature dependence of electrical resistivity under the magnetic fields up to 50 kOe is reported along with the values of 20% enhancement in MR at room temperature for the Co substituted samples. (C) 2013 AIP Publishing LLC

Phase transformations, inverse magnetocaloric effect and critical behavior of Ni50Mn36Sn14-xSix Heusler alloys

The magnetic, magnetocaloric and critical behavior properties are systematically investigated for the Heusler alloy system Ni50Mn36Sn14-xSix (x = 1, 2 and 3). For all the samples both the normal and inverse magnetocaloric effects (MCE) are observed. The magnetic entropy change and relative cooling power are evaluated near the structural phase transformation and magnetic transition regions under an applied magnetic field of 50 kOe. The maximum magnetic entropy change associated with the martensitic transition are 3.4 J kg (-1) K-1, 2.5 J kg(-1) K-1 and 1.3 J kg(-1) K-1 for x = 1, 2 and 3 respectively. The entropy change for x = 1, 2 and 3 alloys near the Curie temperature of the austenite phase is found to be -2.8 J kg(-1) K-1, -2.7 J kg(-1) K-1 and -2.3 J kg(-1) K-1 respectively. Relative cooling power is calculated in the vicinity of the Curie temperature of the austenite phase, as well as in the martensitic transition temperature regime. The critical parameters (beta, gamma and delta) of the samples were determined from the static magnetic data at the second-order ferromagnetic-paramagnetic transition region using the field dependence of magnetic entropy change. (C) 2016 Elsevier Ltd. All rights reserved