The use of chemical analyses in predicting nutritive value of forages as measured by an in vitro and a nylon bag method

Thirty-seven forages, used in previous performance trials, were analyzed for in vitro dry matter disappearance (IDMD), nylon bag dry matter disappearance (NDMD), and chemical constituents. The forages were grouped into the following classifications for comparisons: 1) grain silages, 2) legumes, 3) orchardgrass hay, 4) summer and annual hays, and 5) wheat silage. In some analyses legume silages and hays were separated. The IDMD and NDMD techniques were compared as methods of predicting nutritive value„ Correlation and regression analyses were performed both across species and within classifications to evaluate chemical components as predictors of IDMD and NDMD. A correlation coefficient of 0.85 (P \u3c 0.01) was obtained when IDMD and NDMD were correlated across species. The NDMD method tended to yield higher values than the IDMD procedure. The mean dry matter disappearance values for the two methods were 74.8 and 64.9. The higher values obtained using the NDMD method along with the inaccuracies involved in handling the nylon bags, would suggest the in vitro proce-dure to be the method of choice. Correlation coefficients were utilized to express the relation-ship between chemical components and digestibility estimates. Although the correlations of IDMD and NDMD with crude protein, CWC, hemicellulose, estimated cell wall digestibility and calculated digestible dry matter were highly significant, the magnitudes of these correlations were low and of little predictive value. Lignin gave the larger correlations (r = -0.57 to -0.85) when compared to IDMD within classifications. Several combinations of the predictors (lignin, ADF, CWC, and crude protein) were evaluated for their accuracy in predicting IDMD and NDMD. Multiple correlation coefficients were calculated, and the combination of CWC, ADF, and lignin appeared to be the most accurate in predicting IDMD or NDMD. The multiple regression equation developed from all 37 samples using a stepwise regression analysis was as follows: IDMD = 52.38 + 0.70 crude protein - 0.71 lignin + 0.15 cell contents. The coefficient of multiple determination for this equation was 0.58

Perioperative celecoxib administration for pain management after total knee arthroplasty – A randomized, controlled study

<p>Abstract</p> <p>Background</p> <p>Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty.</p> <p>Methods</p> <p>This was a prospective, randomized, observer-blind control study. Eighty patients that underwent total knee arthroplasty were randomized into two groups of 40 each. The study group received a single 400 mg dose of celecoxib, one hour before surgery, and 200 mg of celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA) morphine. The control group received only PCA morphine for postoperative pain management. Visual analog scale (VAS) pain scores, active range of motion (ROM), total opioid use and postoperative nausea/vomiting were analyzed.</p> <p>Results</p> <p>Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. Resting VAS pain scores improved significantly in the celecoxib group, compared with controls, at 48 hrs (2.13 ± 1.68 vs. 3.43 ± 1.50, p = 0.03) and 72 hrs (1.78 ± 1.66 vs. 3.17 ± 2.01, p = 0.02) after surgery. Active ROM also increased significantly in the patients that received celecoxib, especially in the first 72 hrs [40.8° ± 17.3° vs. 25.8° ± 11.5°, p = 0.01 (day 1); 60.7° ± 18.1° vs. 45.0° ± 17.3°, p = 0.004 (day 2); 77.7° ± 15.1° vs. 64.3° ± 16.9°, p = 0.004 (day 3)]. Opioid requirements decreased about 40% (p = 0.03) in the celecoxib group. Although patients suffering from post-operative nausea/vomiting decreased from 43% in control group to 28% in celecoxib group, this was not significant (p = 0.57). There were no differences in blood loss (intra- and postoperative) between the groups. Celecoxib resulted in no significant increase in the need for blood transfusions.</p> <p>Conclusion</p> <p>Perioperative celecoxib significantly improved postoperative resting pain scores at 48 and 72 hrs, opioid consumption, and active ROM in the first three days after total knee arthroplasty, without increasing the risks of bleeding.</p> <p>Trial registration</p> <p>Clinicaltrials.gov NCT00598234</p

The Strategies to Reduce Injuries and Develop Confidence in Elders Intervention: Falls Risk Factor Assessment and Management, Patient Engagement, and Nurse Co‐management

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141587/1/jgs15121.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141587/2/jgs15121_am.pd

Not seeing the forest for the trees: Generalised linear model out-performs random forest in species distribution modelling for Southeast Asian felids

Species Distribution Models (SDMs) are a powerful tool to derive habitat suitability predictions relating species occurrence data with habitat features. Two of the most frequently applied algorithms to model species-habitat relationships are Generalised Linear Models (GLM) and Random Forest (RF). The former is a parametric regression model providing functional models with direct interpretability. The latter is a machine learning non-parametric algorithm, more tolerant than other approaches in its assumptions, which has often been shown to outperform parametric algorithms. Other approaches have been developed to produce robust SDMs, like training data bootstrapping and spatial scale optimisation. Using felid presence-absence data from three study regions in Southeast Asia (mainland, Borneo and Sumatra), we tested the performances of SDMs by implementing four modelling frameworks: GLM and RF with bootstrapped and non-bootstrapped training data. With Mantel and ANOVA tests we explored how the four combinations of algorithms and bootstrapping influenced SDMs and their predictive performances. Additionally, we tested how scale-optimisation responded to species' size, taxonomic associations (species and genus), study area and algorithm. We found that choice of algorithm had strong effect in determining the differences between SDMs' spatial predictions, while bootstrapping had no effect. Additionally, algorithm followed by study area and species, were the main factors driving differences in the spatial scales identified. SDMs trained with GLM showed higher predictive performance, however, ANOVA tests revealed that algorithm had significant effect only in explaining the variance observed in sensitivity and specificity and, when interacting with bootstrapping, in Percent Correctly Classified (PCC). Bootstrapping significantly explained the variance in specificity, PCC and True Skills Statistics (TSS). Our results suggest that there are systematic differences in the scales identified and in the predictions produced by GLM vs. RF, but that neither approach was consistently better than the other. The divergent predictions and inconsistent predictive abilities suggest that analysts should not assume machine learning is inherently superior and should test multiple methods. Our results have strong implications for SDM development, revealing the inconsistencies introduced by the choice of algorithm on scale optimisation, with GLM selecting broader scales than RF

Heterodinuclear ruthenium(II)-cobalt(III) complexes as models for a new approach to selective cancer treatment

Heterodinuclear ruthenium(ii)-cobalt(iii) complexes have been prepared as part of investigations into a new approach to selective cancer treatment. A cobalt(iii) centre bearing amine ligands, which serve as models for cytotoxic nitrogen mustard ligands, is connected by a bridging ligand to a ruthenium(ii)-polypyridyl moiety. Upon excitation of the ruthenium centre by visible light, electron transfer to the cobalt(iii) centre results in reduction to cobalt(ii) and consequent release of its ligands. We have synthesised several such structures and demonstrated their ability to release ligands upon excitation of the ruthenium centre by visible light

Consumer Response to Drug Risk Information:The Role of Positive Affect

Risk disclosure is an essential element of the marketing of prescription drugs and other medical products. This study examines how consumers respond to verbal information about the frequency and severity of medical-product risks and how media-induced affect can moderate such responses. The study finds that consumers tend to overestimate the actual likelihood of adverse events described with words such as “common” or “rare” (compared with the probabilities such terms are typically intended to convey) and that consumers tend to give little weight to such probability language when forming product use intentions. However, consumers in positive media-induced moods seem to engage in more nuanced evaluation of product risk information, weighing both frequency and severity information and using such information to make inferences about other product attributes (e.g., product efficacy). These findings suggest that medical marketers and regulators need to devise more effective means of communicating risk probability to consumers and that positive mood induction (e.g., by placing advertisements in upbeat media environments) can enhance consumers' ability to process product risk information

Article on vitamin A suppressing skin cancer. Clinical Trials Safety and Efficacy of Dose-Intensive Oral Vitamin A in Subjects with Sun-Damaged Skin

ABSTRACT Purpose: Previously, we reported the results of a Phase III, placebo-controlled trial in 2,297 randomized participants with moderately severe actinic keratoses wherein 25,000 IU/day vitamin A caused a 32% risk reduction in squamous cell skin cancers. We hypothesized that dose escalation of vitamin A to 50,000 or 75,000 IU/day would be both safe and more efficacious in skin cancer chemoprevention. Experimental Design: One hundred and twenty-nine participants with severely sun-damaged skin on their lateral forearms were randomized to receive placebo or 25,000, 50,000, or 75,000 IU/day vitamin A for 12 months. The primary study end points were the clinical and laboratory safety of vitamin A, and the secondary end points included quantitative, karyometric image analysis and assessment of retinoid and rexinoid receptors in sun-damaged skin. Results: There were no significant differences in expected clinical and laboratory toxicities between the groups of participants randomized to placebo, 25,000 IU/day, 50,000 IU/day, and 75,000 IU/day. Karyometric features were computed from the basal cell layer of skin biopsies, and a total of 22,600 nuclei from 113 participants were examined, showing statistically significant, dose-response effects for vitamin A at the 25,000 and 50,000 IU/day doses. These karyometric changes correlated with increases in retinoic acid receptor , retinoic acid receptor ß, and retinoid X receptor at the 50,000 IU/day vitamin A dose. Conclusions: The vitamin A doses of 50,000 and 75,000 IU/day for 1 year proved safe and equally more efficacious than the 25,000 IU/day dose and can be recommended for future skin cancer chemoprevention studies

A classification system to guide physical therapy management in Huntington’s disease: a case series

Background and Purpose: Individuals with Huntington’s disease (HD), a rare neurological disease, experience impairments in mobility and cognition throughout their disease course. The Medical Research Council Framework (MRC) provides a framework that can be applied to the development and evaluation of complex interventions, such as those provided by physical therapists. Treatment-based classifications, based on expert consensus and available literature are helpful in guiding physical therapy management across the stages of HD and contributing to the development and further evaluation of well-defined complex interventions in this highly variable and complex neurodegenerative disease. The purpose of this case series was to illustrate the use of these classifications in the management of two individuals with late-stage HD. Case Description: Two females, ages 40 and 55, with late-stage HD participated in this study. Both experienced progressive declines in ambulatory function and balance as well as falls or fear of falling. Both individuals received daily care in the home for ADLs. Intervention: Physical Therapy Treatment based classifications for HD guided the interventions and outcomes. Eight weeks of in-home balance training, strength training, task-specific practice of functional activities including transfers and walking tasks, and family/carer education was provided. Outcomes: Both individuals demonstrated improvements that met or exceeded the established minimal detectible change (MDC) values for gait speed and Timed Up and Go performance. Both also demonstrated improvements on Berg Balance Scale and Physical Performance Test performance, with one of the two exceeding the established MDCs for both tests. Reductions in fall risk were evident in both cases. Discussion: These cases provide proof-of-principle to support usage of Treatment Based Classifications for physical therapy management for individuals with HD. Traditional classification of early-, mid-, and late-stage disease progression may not reflect patients’ true capabilities; those with late-stage HD may be as responsive to interventions as those at an earlier disease stage