Delirium: assessment and treatment of patients with cancer PART 2

Delirium at the end of life may present significant ethical dilemmas in clinical practice: whether to simply treat it in order to maximise symptom relief, with the resulting side effect being palliative sedation, or to attempt to reverse delirium and risk prolonging suffering. Determining whether the delirium can be reversed involves comprehensive assessment using established tools, which may or may not provide the answer to the question posed. This article examines the evidence surrounding several assessment tools that have been suggested as effective in identifying delirium, and the consequences of various approaches to the management of delirium in a patient with a cancer diagnosis. It also considers the impact delirium may have on the health professional and those close to the patient.N/

Final Design of Secondary Refrigeration System and Wind Tunnel

The goal of the secondary refrigeration system project was to design and build a secondary refrigeration loop to interface with an existing primary refrigeration loop for the testing and research of microencapsulated phase change material, as well as an educational tool for students interested in refrigeration. The aim of this report is to discuss and explain the final version of the design, the testing methods, results, conclusion, and any future recommendations. The wind tunnel is operational, reaching an average maximum air velocity close to what the group had aimed for. The heaters were able to heat the air to the desired range. Piping and most components and instrumentation have been connected and mounted. LabVIEW has been set up to read the outputs of the instruments. Unfortunately, the steam generator has not been mounted and the system has not been charged due to time constraints. Since much time was spent fixing the primary loop to an operational state, it is recommended that future groups working on the existing refrigeration loops ensure that they are working prior to the start of a new project. Overall, the client who requested this system is satisfied with the outcome, despite not meeting certain design criteria

Influence of lipid content on pork sensory quality within pH classification

The objective of this project was to determine the contribution of lipid content to textural and sensory properties of fresh pork within defined pH classifications. Pigs (n = 1,535; from 248 sires and 836 dams) from the 1991, 1992, and 1994 National Barrow Show Sire Progeny Test were used in this study. The test included purebred Berkshire (107), Chester White (113), Duroc (249), Hampshire (220), Landrace (165), Poland China (101), Spotted (181), and Yorkshire (399) barrows (901) and gilts (634). Diets were uniform across breeds within test. The halothane (Hal 1843) genotype (1346 NN and 189 Nn) was determined. Pigs were slaughtered at 105 kg of BW, and samples of the LM were obtained from each carcass at the 10th rib. Star probe, sensory traits, and lipid content were determined on the LM from each pig. A pH classification of LM was assigned as follows: class A, \u3e5.95, n = 186; class B, ≥5.80 to 5.95, n = 236; class C, ≥5.65 to 5.80, n = 467; class D, ≥5.50 to 5.65, n = 441; class E, \u3c5.50, n = 205. Data were analyzed using a mixed linear model including pH classification, test, sex, halothane genotype, breed, and breed × sex interaction as fixed effects, with sire and dam within breed included as random effects. Correlations were determined within pH class. Lipid content was a significant source of variation for models predicting star probe values in class C and D and for chewiness in class B, C, and D. Increasing lipid content tended to increase sensory tenderness in pH class D. Sensory tenderness was not affected by lipid content in pH class A, B, or E. Lipid content was not a significant source of variation for juiciness scores within any pH class. Intramuscular lipid is correlated with sensory texture traits primarily in classes C and D. Within class C and D, correlations indicate that increasing lipid content is associated with high sensory tenderness, low sensory chewiness, and low star probe values. It is concluded that lipid content is a small source of variation in texture and tenderness of pork loin with pH between 5.80 and 5.50, but not at a greater or lesser pH

Impact of Mycoplasma hyopneumoniae and Lawsonia intracellularis on the performance of pigs divergently selected for feed efficiency

Feed efficiency (FE) is a valuable trait, yet how genetic selection for enhanced FE affects other processes such as response to disease is unknown. Disease from endemic respiratory and enteric pathogens such as Mycoplasma hyopneumoniae (Mh) and Lawsonia intracellularis (LI) are common in swine production. Therefore, the aim of this study was to examine if pigs selected for high versus low FE based on residual feed intake (RFI) respond differently to a dual respiratory and enteric challenge. Pigs selected for low RFI (LRFI, high feed efficiency) pigs are considered more FE compared to their high RFI (HRFI, low feed efficiency) selected counterparts. Using a 2 x 2 factorial design, 25 littermate pairs from the HRFI and 25 littermate pairs from the LRFI line (barrows, 50 ± 7 kg BW) were selected, with one pig from each pair assigned to individual pens in either the challenge or the non-challenge (control) rooms (n = 25 barrows per line/challenge). On days post inoculation (dpi) 0, the challenged pigs were inoculated with LI and Mh (MhLI). Feed intake, body weight, fecal swabs, and serum samples were collected and recorded weekly for 42 days. On dpi -2 and 47, 14 littermate pairs (n=7 barrows per line/challenge) were utilized for initial and final body composition scans using dual X-ray absorptiometry to calculate longitudinal whole body tissue accretion rates for lean, protein, fat, and bone mineral content. Serum antibody levels and fecal shedding of LI were used to confirm infection. Control pigs remained negative by all measures during the 6 week trial and MhLI inoculated pigs were confirmed positive via serological antibody responses by dpi 14 for LI and Mh. There were no interactions between RFI line and challenge status for any overall performance parameter (P \u3e 0.05). The six week MhLI challenge resulted in a 17% reduction in ADG, a 12% reduction in ADFI, and a 7% reduction in G:F versus controls (P \u3c 0.05). In addition, compared to the control pigs, MhLI challenge reduced lean, protein, and lipid accretion rates by 16% (P \u3c 0.05). Genetic selection for high FE resulted in decreased ADFI and increased G:F (P \u3c 0.01), but did not impact ADG or tissue accretion versus low FE pigs. Collectively, these results demonstrate that a dual enteric and respiratory pathogen challenge reduced ADG, ADFI, G:F and tissue accretion in growing pigs. Further, there was no evidence that selection for enhanced FE based on RFI index affects response to disease

Effects of breed, sex, and halothane genotype on fatty acid composition of pork longissimus muscle

The objective of this study was to estimate the effects of breed, sex, and halothane genotype on fatty acid composition and several fatty acid indices of lipid extracted from porcine LM. Purebred Yorkshire (n = 436), Duroc (n = 353), Hampshire (n = 218), Spotted (n = 187), Chester White (n = 173), Poland China (n = 124), Berkshire (n = 256), and Landrace (n = 187) pigs (n = 1,934; 1,128 barrows and 806 gilts) from 1991, 1992, 1994, and 2001 National Barrow Show Sire Progeny Tests were used. Pigs were classified as the HAL-1843 normal (NN) genotype (n = 1,718) or the HAL-1843 carrier (Nn) genotype (n = 216). For statistical analysis, a mixed model was used that included fixed effects of breed, sex, halothane genotype, test, slaughter date, interaction of breed × sex, and random effects of sire and dam within breed. Breed significantly affected the concentration of individual fatty acids, total lipid content, and the values of several fatty acid indices of LM. Duroc pigs had the greatest (P\u3c 0.01) content of total SFA. Total MUFA concentration in Poland China pigs was greater (P \u3c 0.05) than in all other breeds except the Spotted (P\u3e 0.05). The concentrations of total PUFA were greater (P \u3c 0.01) in Hampshire, Landrace, and Yorkshire pigs compared with those of other breeds. Significant sex differences for individual fatty acids were detected. Compared with gilts, barrows had greater (P \u3c 0.01) concentrations of SFA and MUFA but lower (P \u3c 0.01) total PUFA. Halothane genotype was a significant source of variation for the percentages of some fatty acids. Pigs with the carrier (Nn) genotype had lower concentrations of SFA (P \u3c 0.05) and MUFA (P \u3c 0.01) but a greater concentration of PUFA (P \u3c 0.01) compared with NN pigs. There were significant negative correlations between total lipid content and individual PUFA and significant positive correlations between lipid concentration and most individual SFA and MUFA. In conclusion, the results suggest that breed and sex are important sources of variation for fatty acid composition of LM

Role of diestrus progesterone on endometrial function and conceptus development in cattle

Abstract Successful growth and development of the post-hatching blastocyst and pregnancy establishment are a result of the interaction between a competent embryo and a receptive uterine environment. Progesterone (P4) plays a key role in reproductive events associated with establishment and maintenance of pregnancy through its action on the uterine endometrium. Elevated concentrations of circulating P4 in the immediate post-conception period have been associated with an advancement of conceptus elongation, an increase in interferon-tau production and higher pregnancy rates in cattle. The potential beneficial effects of exogenous P4 supplementation on fertility have been acknowledged for a long time but results of supplementation have been inconsistent and may be related to the strategy used to achieve high P4 endogenous concentrations in the animal. This review summarizes recent data highlighting the role of progesterone in regulating uterine function and embryo development in cattle

Diabetes and disordered eating behaviours in a community-based sample of australian adolescents

Background:People with diabetes have been shown to be at risk for disordered eating compared to their non-diabetic peers. However, the majority of studies have been conducted in relatively small samples drawn from clinical diabetes settings or registries. Community-based samples are required to better understand disordered eating behaviours in this population. In a large community-based population sample of Australian adolescents, this study aimed to (1) investigate disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers and (2) test associations between disordered eating behaviours and insulin restriction.Methods:Secondary school students (n = 4854; mean (SD) age 14.4 (1.6) years; 47% boys) completed an online survey, including self-reported presence of diabetes, demographics, weight status, substance use, insulin restriction and disordered eating behaviours. Clinically meaningful cut-offs for disordered eating behaviours were generated for analysis.Results:Disordered eating behaviours, specifically self-induced vomiting (diabetes 19.2%, no diabetes 3.3%; p p p p Conclusion:There was a high rate of disordered eating behaviours in adolescents with diabetes compared to their peers without diabetes. The findings of this study may have the potential to inform future health promotion, prevention, and early intervention approaches for those with comorbid diabetes and disordered eating behaviours. Future longitudinal studies are required to evaluate disordered eating behaviours in those with diabetes over time in community-based samples

Sexually dimorphic gene expression in bovine conceptuses at the initiation of implantation

In cattle, maternal recognition of pregnancy occurs on Day 16 via secretion of interferon tau (IFNT) by the conceptus. The endometrium can distinguish between embryos with different developmental competencies. In eutherian mammals, X-chromosome inactivation (XCI) is required to ensure an equal transcriptional level of most X-linked genes for both male and female embryos in adult tissues, but this process is markedly different in cattle than mice. We examined how sexual dimorphism affected conceptus transcript abundance and amino acid composition as well as the endometrial transcriptome during the peri-implantation period of pregnancy. Of the 5132 genes that were differentially expressed on Day 19 in male compared to female conceptuses, 2.7% were located on the X-chromosome. Concentrations of specific amino acids were higher in the uterine luminal fluid of male compared to female conceptuses, while female conceptuses had higher transcript abundance of specific amino acid transporters (SLC6A19 and SLC1A35). Of note, the endometrial transcriptome was not different in cattle gestating a male or a female conceptus. These data support the hypothesis that, far from being a blastocyst specific phenomenon, XCI is incomplete before and during implantation in cattle. Despite differences in transcript abundance and amino acid utilization in male versus female conceptuses, the sex of the conceptus itself does not elicit a different transcriptomic response in the endometrium

Micron-sized Spinel Crystals In High Level Waste Glass Compositions: Determination Of Crystal Size And Crystal Fraction

The compositions utilized for immobilization of high-level nuclear wastes (HLW) are controlled using glass property models to avoid the deleterious effects of crystallization in the high-level waste (HLW) vitrification melters. The type and size of the crystals that precipitate during melter operations (typically at 1150 °C) and idling (∼1000 °C) are significantly impacted by glass composition and thermal history. This study was conducted to measure the impact of melt composition and heat treatment temperature on crystal size and fraction. A matrix of 31 multi-component glasses canvasing the expected Hanford HLW compositional space was developed and the glasses fabricated, and heat treated at 850, 900, and 950 °C. The crystal amounts, as determined by X-ray diffraction, varied from 0.2 to 41.0 wt.%. Spinel concentrations ranged from 0.0 to 13.8 wt.%. One glass of the matrix did not precipitate spinel and contained 0.2 wt.% RuO2, which was assumed to be undissolved from the melting process. All compositions contained crystals in the as-quenched glass. All of the spinel-based crystals present in the glasses were less than 10 μm in diameter, as determined by scanning electron microscopy with image analysis. Composition and temperature dependent models were generated using the resulting data and the best model fit was obtained by only considering spinel concentrations (R2 = 0.87). Two glasses were unable to be characterized because of an inability to process the glass under the conditions of this study. Those glasses were utilized to give insight into a potential multi-component constraint to aid in future statistical composition designs