Nutrition and Indirect Calorimetry

Nutrition support is important in the care of patients with both acute and chronic illness. Optimizing nutritional support for the critically ill and patients with acute and chronic respiratory disorders has been shown to shorten length of stay, shorten duration of mechanical ventilation, lower health-care costs and reduce morbidity and mortality while improving functional quality of life. Nutritional requirements are difficult to predict in patients diagnosed with cancer due to their disease processes, altered inflammatory responses and metabolic rates among many other variables. Often predictive equations are used to estimate energy requirements and the average dietary energy intake needed to maintain energy balance. Energy requirements can be estimated through the use of over 200 predictive equations. Utilization of indirect calorimetry as the ‘gold standard’ for measuring resting metabolic rate (RMR) and resting energy expenditure (REE) can provide support in all states of health and disease. This chapter will identify and discuss the role of indirect calorimetry, examine the reasons why indirect calorimetry is more reliable than predictive equations in determining a patient’s calorie requirement, and when it is most applicable to incorporate indirect calorimetry measurements in the care of cancer patients

Substance Use Disorder Treatment in the Time of COVID

Primary care clinicians face many challenges when addressing the complex needs of patients with chronic pain, substance use disorders or both. Over the last 10 months, the SARS-CoVID-2 pandemic has both increased and changed the challenges that healthcare providers face. Massachusetts Consultation Service for the Treatment of Addiction and Pain (MCSTAP) is a free service that helps doctors and other clinicians meet these challenges by increasing their capacity for, and comfort in, using evidence-based practices to screen, diagnose, treat and manage the care of these patients. MCSTAP provides on-demand physician consultation on safe prescribing and managing the care of patients with chronic pain and/or SUD. Join us for a webinar to learn about the innovative services that MCSTAP provides. Christopher Shanahan MD MPH FACP will share his knowledge about why and experience about how MCSTAP was created. You will learn about how SARS-CoVID-2 pandemic has changed SUD treatment and prescribing protocols. Currently, the SARS-CoVID-2 pandemic has presented serious and life-threatening challenges to both patients and to their clinicians. After attending this webinar, participants will: Understand the bidirectional relationship of SARS-Cov-2 pandemic & the epidemic U.S. Substance Use on identification & treatment of physical, mental health & Substance Use Disorders (SUD) e.g. opioid crisis Describe components & impact of Social Determinants of Health (SDOH) on care of individuals with SUD & impact on the risk for & clinical outcomes of SARS-CoV-2 infection Employ Intersectionality to identify/analyze key areas of need & potential for high impact & then develop/implement evidence-based & innovative solutions

Downregulation of barley ferulate 5-hydroxylase dramatically alters straw lignin structure without impact on mechanical properties

Barley is a major cereal crop for temperate climates, and a diploid genetic model for polyploid wheat. Cereal straw biomass is an attractive source of feedstock for green technologies but lignin, a key determinant of feedstock recalcitrance, complicates bio-conversion processes. However, manipulating lignin content to improve the conversion process could negatively affect agronomic traits. An alternative approach is to manipulate lignin composition which influences the physical and chemical properties of straw. This study validates the function of a barley ferulate 5-hydroxylase gene and demonstrates that its downregulation using the RNA-interference approach substantially impacts lignin composition. We identified five barley genes having putative ferulate 5-hydroxylase activity. Downregulation of HvF5H1 substantially reduced the lignin syringyl/guaiacyl (S/G) ratio in straw while the lignin content, straw mechanical properties, plant growth habit, and grain characteristics all remained unaffected. Metabolic profiling revealed significant changes in the abundance of 173 features in the HvF5H1-RNAi lines. The drastic changes in the lignin polymer of transgenic lines highlight the plasticity of barley lignification processes and the associated potential for manipulating and improving lignocellulosic biomass as a feedstock for green technologies. On the other hand, our results highlight some differences between the lignin biosynthetic pathway in barley, a temperate climate grass, and the warm climate grass, rice, and underscore potential diversity in the lignin biosynthetic pathways in grasses

RNAi-suppression of barley caffeic acid O-methyltransferase modifies lignin despite redundancy in the gene family

Caffeic acid O-methyltransferase (COMT), the lignin biosynthesis gene modified in many brown-midrib high-digestibility mutants of maize and sorghum, was targeted for downregulation in the small grain temperate cereal, barley (Hordeum vulgare), to improve straw properties. Phylogenetic and expression analyses identified the barley COMT orthologue(s) expressed in stems, defining a larger gene family than in brachypodium or rice with three COMT genes expressed in lignifying tissues. RNAi significantly reduced stem COMT protein and enzyme activity, and modestly reduced stem lignin content while dramatically changing lignin structure. Lignin syringyl-to-guaiacyl ratio was reduced by ~50%, the 5-hydroxyguaiacyl (5-OH-G) unit incorporated into lignin at 10--15-fold higher levels than normal, and the amount of p-coumaric acid ester-linked to cell walls was reduced by ~50%. No brown-midrib phenotype was observed in any RNAi line despite significant COMT suppression and altered lignin. The novel COMT gene family structure in barley highlights the dynamic nature of grass genomes. Redundancy in barley COMTs may explain the absence of brown-midrib mutants in barley and wheat. The barley COMT RNAi lines nevertheless have the potential to be exploited for bioenergy applications and as animal feed

Decreased Serologic Response in Vaccinated Military Recruits during 2011 Correspond to Genetic Drift in Concurrent Circulating Pandemic A/H1N1 Viruses

Population-based febrile respiratory illness surveillance conducted by the Department of Defense contributes to an estimate of vaccine effectiveness. Between January and March 2011, 64 cases of 2009 A/H1N1 (pH1N1), including one fatality, were confirmed in immunized recruits at Fort Jackson, South Carolina, suggesting insufficient efficacy for the pH1N1 component of the live attenuated influenza vaccine (LAIV).To test serologic protection, serum samples were collected at least 30 days post-vaccination from recruits at Fort Jackson (LAIV), Parris Island (LAIV and trivalent inactivated vaccine [TIV]) at Cape May, New Jersey (TIV) and responses measured against pre-vaccination sera. A subset of 78 LAIV and 64 TIV sera pairs from recruits who reported neither influenza vaccination in the prior year nor fever during training were tested by microneutralization (MN) and hemagglutination inhibition (HI) assays. MN results demonstrated that seroconversion in paired sera was greater in those who received TIV versus LAIV (74% and 37%). Additionally, the fold change associated with TIV vaccination was significantly different between circulating (2011) versus the vaccine strain (2009) of pH1N1 viruses (ANOVA p value = 0.0006). HI analyses revealed similar trends. Surface plasmon resonance (SPR) analysis revealed that the quantity, IgG/IgM ratios, and affinity of anti-HA antibodies were significantly greater in TIV vaccinees. Finally, sequence analysis of the HA1 gene in concurrent circulating 2011 pH1N1 isolates from Fort Jackson exhibited modest amino acid divergence from the vaccine strain.Among military recruits in 2011, serum antibody response differed by vaccine type (LAIV vs. TIV) and pH1N1 virus year (2009 vs. 2011). We hypothesize that antigen drift in circulating pH1N1 viruses contributed to reduce vaccine effectiveness at Fort Jackson. Our findings have wider implications regarding vaccine protection from circulating pH1N1 viruses in 2011-2012

Striking the right balance in right whale conservation

Author Posting. © The Authors, 2009. This article is posted here by permission of NRC Research Press for personal use, not for redistribution. The definitive version was published in Canadian Journal of Fisheries and Aquatic Sciences 66 (2009): 1399-1403, doi:10.1139/F09-115.Despite many years of study and protection, the North Atlantic right whale (Eubalaena glacialis) remains on the brink of extinction. There is a crucial gap in our understanding of their habitat use in the migratory corridor along the eastern seaboard of the United States. Here, we characterize habitat suitability in migrating right whales in relation to depth, distance to shore, and the recently enacted ship speed regulations near major ports. We find that the range of suitable habitat exceeds previous estimates and that, as compared with the enacted 20 nautical mile buffer, the originally proposed 30 nautical mile buffer would protect more habitat for this critically endangered species.This work was supported in part by SERDP/DoD grant W912HQ-04-C-0011 to A.J. Read and P.N. Halpin as well as a James B. Duke Fellowship and a Harvey L. Smith Dissertation Year Fellowship to R.S. Schick

Nonlinear Measures for Characterizing Rough Surface Morphologies

We develop a new approach to characterizing the morphology of rough surfaces based on the analysis of the scaling properties of contour loops, i.e. loops of constant height. Given a height profile of the surface we perform independent measurements of the fractal dimension of contour loops, and the exponent that characterizes their size distribution. Scaling formulas are derived and used to relate these two geometrical exponents to the roughness exponent of a self-affine surface, thus providing independent measurements of this important quantity. Furthermore, we define the scale dependent curvature and demonstrate that by measuring its third moment departures of the height fluctuations from Gaussian behavior can be ascertained. These nonlinear measures are used to characterize the morphology of computer generated Gaussian rough surfaces, surfaces obtained in numerical simulations of a simple growth model, and surfaces observed by scanning-tunneling-microscopes. For experimentally realized surfaces the self-affine scaling is cut off by a correlation length, and we generalize our theory of contour loops to take this into account.Comment: 39 pages and 18 figures included; comments to [email protected]

Antibodies to Henipavirus or Henipa-Like Viruses in Domestic Pigs in Ghana, West Africa

Henipaviruses, Hendra virus (HeV) and Nipah virus (NiV), have Pteropid bats as their known natural reservoirs. Antibodies against henipaviruses have been found in Eidolon helvum, an old world fruit bat species, and henipavirus-like nucleic acid has been detected in faecal samples from E. helvum in Ghana. The initial outbreak of NiV in Malaysia led to over 265 human encephalitis cases, including 105 deaths, with infected pigs acting as amplifier hosts for NiV during the outbreak. We detected non-neutralizing antibodies against viruses of the genus Henipavirus in approximately 5% of pig sera (N = 97) tested in Ghana, but not in a small sample of other domestic species sampled under a E. helvum roost. Although we did not detect neutralizing antibody, our results suggest prior exposure of the Ghana pig population to henipavirus(es). Because a wide diversity of henipavirus-like nucleic acid sequences have been found in Ghanaian E. helvum, we hypothesise that these pigs might have been infected by henipavirus(es) sufficiently divergent enough from HeVor NiV to produce cross-reactive, but not cross-neutralizing antibodies to HeV or NiV

Henipavirus Neutralising Antibodies in an Isolated Island Population of African Fruit Bats

Isolated islands provide valuable opportunities to study the persistence of viruses in wildlife populations, including population size thresholds such as the critical community size. The straw-coloured fruit bat, Eidolon helvum, has been identified as a reservoir for henipaviruses (serological evidence) and Lagos bat virus (LBV; virus isolation and serological evidence) in continental Africa. Here, we sampled from a remote population of E. helvum annobonensis fruit bats on Annobón island in the Gulf of Guinea to investigate whether antibodies to these viruses also exist in this isolated subspecies. Henipavirus serological analyses (Luminex multiplexed binding and inhibition assays, virus neutralisation tests and western blots) and lyssavirus serological analyses (LBV: modified Fluorescent Antibody Virus Neutralisation test, LBV and Mokola virus: lentivirus pseudovirus neutralisation assay) were undertaken on 73 and 70 samples respectively. Given the isolation of fruit bats on Annobón and their lack of connectivity with other populations, it was expected that the population size on the island would be too small to allow persistence of viruses that are thought to cause acute and immunising infections. However, the presence of antibodies against henipaviruses was detected using the Luminex binding assay and confirmed using alternative assays. Neutralising antibodies to LBV were detected in one bat using both assays. We demonstrate clear evidence for exposure of multiple individuals to henipaviruses in this remote population of E. helvum annobonensis fruit bats on Annobón island. The situation is less clear for LBV. Seroprevalences to henipaviruses and LBV in Annobón are notably different to those in E. helvum in continental locations studied using the same sampling techniques and assays. Whilst cross-sectional serological studies in wildlife populations cannot provide details on viral dynamics within populations, valuable information on the presence or absence of viruses may be obtained and utilised for informing future studies