Post-Discharge Nutrition Care Instructions for Malnourished Adults

Malnutrition remains an insidious yet common ailment among hospitalized adults, with prevalence estimates ranging from 4-45%. Multiple studies confirm the adverse effects of malnutrition, which include prolonged length of stay, readmissions, higher hospitalization costs, and mortality. Malnutrition is frequently associated with chronic disease. For nutrition interventions to be successful, they must continue to support the long-term nutritional needs of patients beyond the hospital stay. Few studies, however, examine the receipt of recommendations for oral nutrition supplementation (ONS) or basic nutrition care instructions at the time of discharge. There is a need to better understand what post-discharge nutrition care instructions are documented in the electronic medical record (EMR) and how they are communicated to patients once they leave the hospital. This study sought to describe the malnourished adult patient population and the standard of nutrition-focused discharge care they receive at Christiana Hospital in Newark, DE. The investigation revealed that a majority of these patients received inappropriate or inadequate nutrition care instructions at time of discharge. Preliminary survey data suggest that some patients may be unaware of their malnutrition diagnosis, and may receive care instructions that are never documented. Clinician education and redesign of nutrition care options in the EMR may aid in the provision of discharge instructions to treat and prevent malnutrition after patients leave the hospital

An economic analysis of Jara and Colombo lemon production in Bangladesh

The study was conducted in two districts namely Sylhet and Narsingdi to investigate the production technology of Jara and Colombolemon growers, estimate profitability and identify the constraints of Jara and Colombolemon. A total sample of 120 farmers taking 60 for Jara lemon from Sylhet and 60 for Colombolemon from Narsingdi was selected randomly for the study. Data were collected through face to face interview method by using structured questionnaire during April–May, 2016. Cost return analysis revealed that Jara and Colombolemon cultivation were profitable in the study areas. Jara lemon cultivation highest cost was estimated Tk. 413575/ha in (11–15)th year garden and lowest cost was Tk. 365777/ha in 2nd year garden. Gross return was highest in 5th year garden (Tk.1995750/ha) and lowest Tk. 975600/ha in (11–15)th year garden. The benefit cost ratio at 6.5% rate of interest was 2.85and IRR 78%. Colombo lemon cultivation highest cost was estimated Tk. 316505/ha in 4th year garden and lowest cost was Tk. 257543/ha in (11–15)th year garden. Gross return was highest Tk. 841522 in 5th year garden and lowest Tk. 413616/ha in (11–15)th year garden. The benefit cost ratio at 6.5% rate of interest was 1.81 and IRR 65%. Lack of improved production technology, poor quality saplings, insect/pest infestation, adulteration of fertilizer and insecticides and less number of export buyers were found major constraints both Jara andColombo lemon production

Genetic Diversity Analysis of Ginger (Zingiber officinale Roscoe.) Genotypes Using RAPD Markers

Ginger (Zingiber officinale Roscoe.) is an important spice crop in Bangladesh as well as in all over the world for its economical and medicinal values. A measure of the existing genetic diversity is essential for planning a meaningful breeding strategy. Moreover, assessment and characterization of genetic diversity of the available germplasm is important to know the source of gene for particular trait of interest. The present investigation was undertaken to assess the genetic diversity among eight ginger genotypes using RAPD markers. A total of 16 distinct DNA fragments ranging from 100–1000 bp were amplified by using three selected primers of which 10 (62.50%) were polymorphic. BARI ada-1 was more homogenous than others and Syedpuri was found less homogenous showing the low intra-variety similarity value (75.56). the genotype ‘Syedpuri’ was found as more diversified from the viewpoint of lowest intra-variety similarity index value, highest gene diversity, proportion of polymorphic loci and highest level of genetic variation. The cluster analysis indicated that the eight genotypes were grouped into two major clusters. ‘Indian’ alone formed the first major cluster while the second major cluster had seven genotypes and was divided into two minor clusters. China and Sherpuri genotype pair were very close to each other with the lowest genetic distance (0.03). On the other hand, Indian and Syedpuri pair was more distant to each other with the highest genetic distance (0.55). RAPD analysis revealed a considerable level of polymorphism among the studied genotypes. The genetic variation thus detected has significance for ginger improvement programs

Relationships of Polychlorinated Biphenyls and Dichlorodiphenyldichloroethylene (p,p’-DDE) with Testosterone Levels in Adolescent Males

Background: Concern persists over endocrine-disrupting effects of persistent organic pollutants (POPs) on human growth and sexual maturation. Potential effects of toxicant exposures on testosterone levels during puberty are not well characterized. Objectives: In this study we evaluated the relationship between toxicants [polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (p,p´-DDE), hexachlorobenzene (HCB), and lead] and testosterone levels among 127 Akwesasne Mohawk males 10 to \u3c 17 years of age with documented toxicant exposures. Methods: Data were collected between February 1996 and January 2000. Fasting blood specimens were collected before breakfast by trained Akwesasne Mohawk staff. Multivariable regression models were used to estimates associations between toxicants and serum testosterone, adjusted for other toxicants, Tanner stage, and potential confounders. Results: The sum of 16 PCB congeners (Σ16PCBs) that were detected in ≥ 50% of the population was significantly and negatively associated with serum testosterone levels, such that a 10% change in exposure was associated with a 5.6% decrease in testosterone (95% CI: –10.8, –0.5%). Of the 16 congeners, the more persistent ones (Σ8PerPCBs) were related to testosterone, whereas the less persistent ones, possibly reflecting more recent exposure, were not. When PCB congeners were subgrouped, the association was significant for the sum of eight more persistent PCBs (5.7% decrease; 95% CI: –11, –0.4%), and stronger than the sum of six less persistent congeners (3.1% decrease; 95% CI: –7.2, 0.9%). p,p´-DDE was positively but not significantly associated with serum testosterone (5.2% increase with a 10% increase in exposure; 95% CI: –0.5, 10.9%). Neither lead nor HCB was significantly associated with testosterone levels. Conclusions: Exposure to PCBs, particularly the more highly persistent congeners, may negatively influence testosterone levels among adolescent males. The positive relationship between p,p´-DDE and testosterone indicates that not all POPs act similarly

Comparative Population Genetics of the Immunity Gene, Relish: Is Adaptive Evolution Idiosyncratic?

The frequency of adaptive evolution acting on common loci in distant lineages remains an outstanding question in evolutionary biology. We asked whether the immunity factor, Relish, a gene with a history of directional selection in Drosophila simulans, shows evidence of a similar selective history in other Drosophila species. We found only weak evidence of recurrent adaptive protein evolution at the Relish locus in three sister species pairs, suggesting that this key component of the insect immune system has an idiosyncratic evolutionary history in Drosophila

Efficient Gene Targeting by Homologous Recombination in Rat Embryonic Stem Cells

The rat is the preferred experimental animal in many biological studies. With the recent derivation of authentic rat embryonic stem (ES) cells it is now feasible to apply state-of-the art genetic engineering in this species using homologous recombination. To establish whether rat ES cells are amenable to in vivo recombination, we tested targeted disruption of the hypoxanthine phosphoribosyltransferase (hprt) locus in ES cells derived from both inbred and outbred strains of rats. Targeting vectors that replace exons 7 and 8 of the hprt gene with neomycinR/thymidine kinase selection cassettes were electroporated into male Fisher F344 and Sprague Dawley rat ES cells. Approximately 2% of the G418 resistant colonies also tolerated selection with 6-thioguanine, indicating inactivation of the hprt gene. PCR and Southern blot analysis confirmed correct site-specific targeting of the hprt locus in these clones. Embryoid body and monolayer differentiation of targeted cell lines established that they retained differentiation potential following targeting and selection. This report demonstrates that gene modification via homologous recombination in rat ES cells is efficient, and should facilitate implementation of targeted, genetic manipulation in the rat

Increased Recruitment but Impaired Function of Leukocytes during Inflammation in Mouse Models of Type 1 and Type 2 Diabetes

BACKGROUND: Patients suffering from diabetes show defective bacterial clearance. This study investigates the effects of elevated plasma glucose levels during diabetes on leukocyte recruitment and function in established models of inflammation. METHODOLOGY/PRINCIPAL FINDINGS: Diabetes was induced in C57Bl/6 mice by intravenous alloxan (causing severe hyperglycemia), or by high fat diet (moderate hyperglycemia). Leukocyte recruitment was studied in anaesthetized mice using intravital microscopy of exposed cremaster muscles, where numbers of rolling, adherent and emigrated leukocytes were quantified before and during exposure to the inflammatory chemokine MIP-2 (0.5 nM). During basal conditions, prior to addition of chemokine, the adherent and emigrated leukocytes were increased in both alloxan- (62±18% and 85±21%, respectively) and high fat diet-induced (77±25% and 86±17%, respectively) diabetes compared to control mice. MIP-2 induced leukocyte emigration in all groups, albeit significantly more cells emigrated in alloxan-treated mice (15.3±1.0) compared to control (8.0±1.1) mice. Bacterial clearance was followed for 10 days after subcutaneous injection of bioluminescent S. aureus using non-invasive IVIS imaging, and the inflammatory response was assessed by Myeloperoxidase-ELISA and confocal imaging. The phagocytic ability of leukocytes was assessed using LPS-coated fluorescent beads and flow cytometry. Despite efficient leukocyte recruitment, alloxan-treated mice demonstrated an impaired ability to clear bacterial infection, which we found correlated to a 50% decreased phagocytic ability of leukocytes in diabetic mice. CONCLUSIONS/SIGNIFICANCE: These results indicate that reduced ability to clear bacterial infections observed during experimentally induced diabetes is not due to reduced leukocyte recruitment since sustained hyperglycemia results in increased levels of adherent and emigrated leukocytes in mouse models of type 1 and type 2 diabetes. Instead, decreased phagocytic ability observed for leukocytes isolated from diabetic mice might account for the impaired bacterial clearance

Associations between Polycyclic Aromatic Hydrocarbon–Related Exposures and p53 Mutations in Breast Tumors

Background: Previous studies have suggested that polycyclic aromatic hydrocarbons (PAHs) may be associated with breast cancer. However, the carcinogenicity of PAHs on the human breast remains unclear. Certain carcinogens may be associated with specific mutation patterns in the p53 tumor suppressor gene, thereby contributing information about disease etiology. Objectives: We hypothesized that associations of PAH-related exposures with breast cancer would differ according to tumor p53 mutation status, effect, type, and number. Methods: We examined this possibility in a population-based case–control study using polytomous logistic regression. As previously reported, 151 p53 mutations among 859 tumors were identified using Surveyor nuclease and confirmed by sequencing. Results: We found that participants with p53 mutations were less likely to be exposed to PAHs (assessed by smoking status in 859 cases and 1,556 controls, grilled/smoked meat intake in 822 cases and 1,475 controls, and PAH–DNA adducts in peripheral mononuclear cells in 487 cases and 941 controls) than participants without p53 mutations. For example, active and passive smoking was associated with p53 mutation–negative [odds ratio (OR) = 1.55; 95% confidence interval (CI), 1.11–2.15] but not p53 mutation–positive (OR = 0.77; 95% CI, 0.43–1.38) cancer (ratio of the ORs = 0.50, p < 0.05). However, frameshift mutations, mutation number, G:C→A:T transitions at CpG sites, and insertions/deletions were consistently elevated among exposed subjects. Conclusions: These findings suggest that PAHs may be associated with specific breast tumor p53 mutation subgroups rather than with overall p53 mutations and may also be related to breast cancer through mechanisms other than p53 mutation

Identification and Visualization of CD8+ T Cell Mediated IFN-γ Signaling in Target Cells during an Antiviral Immune Response in the Brain

CD8+ T cells infiltrate the brain during an anti-viral immune response. Within the brain CD8+ T cells recognize cells expressing target antigens, become activated, and secrete IFNγ. However, there are no methods to recognize individual cells that respond to IFNγ. Using a model that studies the effects of the systemic anti-adenoviral immune response upon brain cells infected with an adenoviral vector in mice, we describe a method that identifies individual cells that respond to IFNγ. To identify individual mouse brain cells that respond to IFNγ we constructed a series of adenoviral vectors that contain a transcriptional response element that is selectively activated by IFNγ signaling, the gamma-activated site (GAS) promoter element; the GAS element drives expression of a transgene, Cre recombinase (Ad-GAS-Cre). Upon binding of IFNγ to its receptor, the intracellular signaling cascade activates the GAS promoter, which drives expression of the transgene Cre recombinase. We demonstrate that upon activation of a systemic immune response against adenovirus, CD8+ T cells infiltrate the brain, interact with target cells, and cause an increase in the number of cells expressing Cre recombinase. This method can be used to identify, study, and eventually determine the long term fate of infected brain cells that are specifically targeted by IFNγ. The significance of this method is that it will allow to characterize the networks in the brain that respond to the specific secretion of IFNγ by anti-viral CD8+ T cells that infiltrate the brain. This will allow novel insights into the cellular and molecular responses underlying brain immune responses