Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme A qualitative study

Introduction Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. Methods Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. Results In total, 19 liver transplant recipients participated in the study (25-68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) 'broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) 'impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) 'adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) 'increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. Discussion A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations

The Hunt for Red 'Microba: Identification of Microorganisms involved in 'Red Heat' Contamination of Salt-Cured Hides

Content: “Red heat” is an industry term that describes the appearance of mostly red-pink coloured macroscopic microbial colonies on salt-cured hides and skins. Red heat-affected stock is undesirable as the resultant leather often shows obvious defects; but why this contamination is only superficial in other instances remains unclear. Previous work has focused on pigmented halophiles (‘salt-loving’ microbes) isolated from curing salts as the primary culprit. However, the identity of causative agents remains unspecified. Also, the involvement of non-pigmented microbes, and of microbes native to hides and skins, could be better understood. Thus, an investigation of the microbial communities that inhabit untreated bovine hide, curing salt, unaffected salt-cured bovine hide, and red heat-affected cured hide is proposed to uncover the microbial agents responsible for this contamination. This project aims to define these microbial communities using both a culture-dependent and –independent approach. Methods of microbe identification focus on marker gene amplification and sequencing. This is in contrast to earlier work which was restricted solely to phenotypic analyses. The 16S ribosomal RNA gene marker is used to identify members of Bacteria and Archaea, while the 18S and ITS2 regions of the fungal ribosomal RNA operon are targeted to detect fungi. Metagenomic amplicon sequencing using the Illumina MiSeq platform employs these same markers to determine taxonomic composition and relative abundance. Preliminary results from culturing identified different dominant species in curing salts screened for microbial growth. In agreement with earlier culture-based studies, these isolates were mostly pigmented, highly salt-tolerant members of the halophilic archaea of family Halobacteriaceae, as determined by marker gene sequencing. However, in agreement with more recent work within food preservation technology, nonpigmented isolates of halophilic archaea of genus Natrinema and bacterial genus Chromohalobacter were also found. It was also revealed that non-pigmented, quick-growing, salt-tolerant, proteolytic microbes were easily cultured from red heat-affected hide, most of the isolates were identified by marker gene sequencing as bacterial Pseudomonas halophila or Salicola. To determine red heat-causing microbes, future work involves the screening of isolates for extracellular enzyme activity; the most likely cause of red heat-associated damage. Sterile-salted hide samples will be inoculated with selected individual and combinations of isolates, and then further examined using confocal microscopy to check for reproducibility of red heat-associated damage. Take-Away: Different microbial species are found in different curing salts. Not all microbes involved in 'red heat' contamination are pigmented. The purpose is the possibility to overcome all the restrictions connected with the pin-wheel machine, the improvement of actual EN ISO methods of leather measurement and a better instrument to define tolerances considering the couple leather-machine

A new taeniolabidoid multituberculate (Mammalia) from the middle Puercan of the Nacimiento Formation, New Mexico, and a revision of taeniolabidoid systematics and phylogeny

Multituberculates were amongst the most abundant and taxonomically diverse mammals of the late Mesozoic and the Paleocene, reaching their zenith in diversity and body size in the Paleocene. Taeniolabidoidea, the topic of this paper, includes the largest known multituberculates, which possess highly complex cheek teeth adapted for herbivory. A new specimen from the early Paleocene (middle Puercan; biochron Pu2) of the Nacimiento Formation, New Mexico represents a new large-bodied taeniolabidoid genus and species, Kimbetopsalis simmonsae. A phylogenetic analysis to examine the relationships within Taeniolabidoidea that includes new information from Kimbetopsalis gen. et sp. nov. and gen. nov. and from new specimens of Catopsalis fissidens, first described here, and data from all other described North American and Asian taeniolabidoids. This analysis indicates that Catopsalis is nonmonophyletic and justifies our transfer of the basal-most taeniolabidoid ‘Catopsalis’ joyneri to a new genus, Valenopsalis. Kimbetopsalis and Taeniolabis form a clade (Taeniolabididae), as do the Asian Lambdopsalis, Sphenopsalis, and possibly also Prionessus (Lambdopsalidae). Taeniolabidoids underwent a modest taxonomic radiation during the early Paleocene of North America and underwent a dramatic increase in body size, with Taeniolabis taoensis possibly exceeding 100 kg. Taeniolabidoids appear to have gone extinct in North America by the late Paleocene but the appearance of lambdopsalids in the late Paleocene of Asia suggests that they dispersed from North America in the early to middle Paleocene

Dynamics Explorer 1: Energetic Ion Composition Spectrometer (EICS)

The Energetic Ion Composition Spectrometer (EICS) experiment was selected as part of the Dynamics Explorer (DE) Program. One of the primary goals of the DE program was to investigate in detail the plasma physics processes responsible for energizing thermal (approximately 1 eV) ionospheric ions and transporting them to the earth's plasma sheet and distant polar cap. The results of the EICS data analysis (including support of other investigators) and of the archiving efforts supported by this contract are summarized in this document. Also reported are some aspects of our operational support activities

pH-Dependent Metal Ion Toxicity Influences the Antibacterial Activity of Two Natural Mineral Mixtures

Recent studies have demonstrated that several mineral products sold for medicinal purposes demonstrate antimicrobial activity, but little is known about the physicochemical properties involved in antibacterial activity. or other sequestered metal cations, in mineral toxicity. This conclusion was supported by NMR relaxation data, which indicated that BY07 and CB07 leachates contained higher concentrations of chemically accessible metal ions than leachates from non-bactericidal mineral samples.We conclude that the acidic environment of the hydrated minerals significantly contributes to antibacterial activity by increasing the availability and toxicity of metal ions. These findings provide impetus for further investigation of the physiological effects of mineral products and their applications in complementary antibacterial therapies

The InfraRed Imaging Spectrograph (IRIS) for TMT: photometric precision and ghost analysis

The InfraRed Imaging Spectrograph (IRIS) is a first-light instrument for the Thirty Meter Telescope (TMT) that will be used to sample the corrected adaptive optics field by NFIRAOS with a near-infrared (0.8 - 2.4 $\mu$m) imaging camera and Integral Field Spectrograph (IFS). In order to understand the science case specifications of the IRIS instrument, we use the IRIS data simulator to characterize photometric precision and accuracy of the IRIS imager. We present the results of investigation into the effects of potential ghosting in the IRIS optical design. Each source in the IRIS imager field of view results in ghost images on the detector from IRIS's wedge filters, entrance window, and Atmospheric Dispersion Corrector (ADC) prism. We incorporated each of these ghosts into the IRIS simulator by simulating an appropriate magnitude point source at a specified pixel distance, and for the case of the extended ghosts redistributing flux evenly over the area specified by IRIS's optical design. We simulate the ghosting impact on the photometric capabilities, and found that ghosts generally contribute negligible effects on the flux counts for point sources except for extreme cases where ghosts coalign with a star of $\Delta$m$>$2 fainter than the ghost source. Lastly, we explore the photometric precision and accuracy for single sources and crowded field photometry on the IRIS imager.Comment: SPIE 2018, 14 pages, 14 figures, 4 tables, Proceedings of SPIE 10702-373, Ground-based and Airborne Instrumentation for Astronomy VII, 10702A7 (16 July 2018

Pilot Convective Weather Decision Making in En Route Airspace

The present research investigates characteristics exhibited in pilot convective weather decision making in en route airspace. In a part-task study, pilots performed weather avoidance under various encounter scenarios. Results showed that the margins of safety that pilots maintain from storms are as fluid as deviation decisions themselves

Assessment of aortic regurgitation by transesophageal color Doppler imaging of the vena contracta: validation against an intraoperative aortic flow probe

AbstractOBJECTIVESThis study was performed to validate the accuracy of color flow vena contracta (VC) measurements of aortic regurgitation (AR) severity by comparing them to simultaneous intraoperative flow probe measurements of regurgitant fraction (RgF) and regurgitant volume (RgV).BACKGROUNDColor Doppler imaging of the vena contracta has emerged as a simple and reliable measure of the severity of valvular regurgitation. This study evaluated the accuracy of VC imaging of AR by transesophageal echocardiography (TEE).METHODSA transit-time flow probe was placed on the ascending aorta during cardiac surgery in 24 patients with AR. The flow probe was used to measure RgF and RgV simultaneously during VC imaging by TEE. Flow probe and VC imaging were interpreted separately and in blinded fashion.RESULTSA good correlation was found between VC width and RgF (r = 0.85) and RgV (r = 0.79). All six patients with VC width >6 mm had a RgF >0.50. All 18 patients with VC width <5 mm had a RgF <0.50. Vena contracta area also correlated well with both RgF (r = 0.81) and RgV (r = 0.84). All six patients with VC area >7.5 mm2had a RgF >0.50, and all 18 patients with a VC area <7.5 mm2had a RgF <0.50. In a subset of nine patients who underwent afterload manipulation to increase diastolic blood pressure, RgV increased significantly (34 ± 26 ml to 41 ± 27 ml, p = 0.042) while VC width remained unchanged (5.4 ± 2.8 mm to 5.4 ± 2.8 mm, p = 0.41).CONCLUSIONSVena contracta imaging by TEE color flow mapping is an accurate marker of AR severity. Vena contracta width and VC area correlate well with RgF and RgV obtained by intraoperative flow probe. Vena contracta width appears to be less afterload-dependent than RgV