Feeding volume advancement in preterm neonates: A level 4 neonatal intensive care unit quality improvement initiative

INTRODUCTION

Because of provider variability in feeding guideline application, a quality improvement (QI) initiative was begun to better standardize feeding initiation and advancement for preterm infants. Our specific, measurable, achievable, relevant, and timely aims included decreasing the time to reach full feeds by 35% and reducing the duration of central lines by 30% over 12 months in infants born between 25 and 30 weeks' gestation or with birth weight between 600 and 1250 g.

METHODS

Registered dietitians tracked central line days, parenteral nutrition (PN), enteral nutrition, fortification, guideline adherence, anthropometrics, necrotizing enterocolitis (NEC) cases, and central line-associated bloodstream infections (CLABSIs). QI progress charts were reviewed monthly.

RESULTS

Mean central line days decreased from 7.3 to 5.8. Days of PN decreased from 6.7 to 5.1. The day of life that enteral feeds were started decreased from 1.1 to 0.5. The number of days between starting enteral feeds and adding fortification decreased from 3.4 to 2.3 days. Full enteral feeds were achieved on average 2 days earlier. Birth weight was regained at around 10.2 days of life before the guideline was implemented and at a mean of 9.6 days after the guideline. There was no increase in cases of CLABSI or diagnoses of NEC.

CONCLUSION

After implementation of this feeding QI initiative at a level 4 neonatal intensive care unit, central line duration and PN use were decreased and infants reached full enteral feeds earlier without changes in cases of NEC, CLABSI, or time to regain birth weight.

Nuclear shell-model simulation in digital quantum computers

The nuclear shell model is one of the prime many-body methods to study the structure of atomic nuclei, but it is hampered by an exponential scaling on the basis size as the number of particles increases. We present a shell-model quantum circuit design strategy to find nuclear ground states by exploiting an adaptive variational quantum eigensolver algorithm. Our circuit implementation is in excellent agreement with classical shell-model simulations for a dozen of light and medium-mass nuclei, including neon and calcium isotopes. We quantify the circuit depth, width and number of gates to encode realistic shell-model wavefunctions. Our strategy also addresses explicitly energy measurements and the required number of circuits to perform them. Our simulated circuits approach the benchmark results exponentially with a polynomial scaling in quantum resources for each nucleus. This work paves the way for quantum computing shell-model studies across the nuclear chart and our quantum resource quantification may be used in configuration-interaction calculations of other fermionic systems.

Association between coffee consumption and total dietary caffeine intake with cognitive functioning: cross-sectional assessment in an elderly Mediterranean population

PURPOSE

Coffee is rich in compounds such as polyphenols, caffeine, diterpenes, melanoidins and trigonelline, which can stimulate brain activity. Therefore, the possible association of coffee consumption with cognition is of considerable research interest. In this paper, we assess the association of coffee consumption and total dietary caffeine intake with the risk of poor cognitive functioning in a population of elderly overweight/obese adults with metabolic syndrome (MetS).

METHODS

PREDIMED-plus study participants who completed the Mini-Mental State Examination test (MMSE) (n = 6427; mean age = 65 ± 5 years) or a battery of neuropsychological tests were included in this cross-sectional analysis. Coffee consumption and total dietary caffeine intake were assessed at baseline using a food frequency questionnaire. Logistic regression models were fitted to evaluate the association between total, caffeinated and decaffeinated coffee consumption or total dietary caffeine intake and cognitive impairment.

RESULTS

Total coffee consumers and caffeinated coffee consumers had better cognitive functioning than non-consumers when measured by the MMSE and after adjusting for potential confounders (OR 0.63; 95% CI 0.44-0.90 and OR 0.56; 95% CI 0.38-0.83, respectively). Results were similar when cognitive performance was measured using the Clock Drawing Test (CDT) and Trail Making Test B (TMT-B). These associations were not observed for decaffeinated coffee consumption. Participants in the highest tertile of total dietary caffeine intake had lower odds of poor cognitive functioning than those in the reference tertile when screened by the MMSE (OR 0.64; 95% CI 0.47-0.87) or other neurophysiological tests evaluating a variety of cognitive domains (i.e., CDT and TMT-A).

CONCLUSIONS

Coffee consumption and total dietary caffeine intake were associated with better cognitive functioning as measured by various neuropsychological tests in a Mediterranean cohort of elderly individuals with MetS.

TRIAL REGISTRATION

ISRCTN89898870. Registration date: July 24, 2014.

Peroxynitrite-Induced Intracellular Ca2+ Depression in Cardiac Myocytes: Role of Sarco/Endoplasmic Reticulum Ca2+ Pump

Several studies have shown that peroxynitrite (ONOO-), formed upon the reaction of •NO and O2-, is increased in many cardiovascular diseases and is detrimental to myocardial function. Proteins associated with Ca2+ homeostasis regulation in the heart may be involved in these effects. Thus, the aim of this study was to elucidate the mechanisms associated with ONOO--induced effects. We evaluated [Ca2+]i regulation, sarco/endoplasmic reticulum Ca2+- binding proteins, and phosphorylation levels of the ryanodine receptor in isolated rat myocytes. Electrical field-induced intracellular Ca2+ transients and contractions were recorded simultaneously. Myocytes superfused with 3-morpholinosydnonimine N-ethylcarbamide (SIN-1), an ONOO- donor, decreased the amplitude of Ca2+ transients and contraction in a dose-response (1-200 μM) manner. Similarly, SIN-1 increased half-time decay in a concentration-dependent manner. Co-infusion of the ONOO- donor with FeTMPyP (1 μM), an ONOO- decomposition catalyst, inhibited the effects induced by ONOO-. Impaired sarcoplasmic reticulum Ca2+ uptake caused by ONOO- (SIN-1 200 μM) was confirmed by a reduction of caffeine-evoked Ca2+ release along with prolongation of the half-time decay. Surprisingly, ONOO- induced a spontaneous Ca2+ transient that started at the beginning of the relaxation phase and was inhibited by tetracaine. Also, reduced phosphorylation at the ryanodine receptor 2 (RyR2)-Ser-2814 site was observed. In conclusion, deficient sarco/endoplasmic reticulum Ca2+-ATPase-mediated Ca2+ uptake concomitant with augmented Ca2+ release by RyR2 in myocytes may be associated with modification of myocyte Ca2+ handling by ONOO-. Thus, development of cardiac failure in diabetes, nephropathy, or hypertension may be related with elevated ONOO- in cardiac tissue.

Bone marrow characterization in COPD: a multi-level network analysis

Background

Bone marrow (BM) produces hematopoietic and progenitor cells that contribute to distant organ inflammation and repair. Chronic obstructive pulmonary disease (COPD) is characterized by defective lung repair. Yet, BM composition has not been previously characterized in COPD patients.

Methods

In this prospective and controlled study, BM was obtained by sternum fine-needle aspiration in 35 COPD patients and 25 healthy controls (10 smokers and 15 never-smokers). BM cell count and immunophenotype were determined by microscopy and flow cytometry, respectively. Circulating inflammatory (C-reactive protein, IL-6, IL-8) and repair markers (HGF, IGF, TGF-β, VEGF) were quantified by ELISA. Results were integrated by multi-level network correlation analysis.

Results

We found that: (1) there were no major significant pair wise differences between COPD patients and controls in the BM structural characteristics; (2) multi-level network analysis including patients and controls identifies a relation between immunity, repair and lung function not previously described, that remains in the COPD network but is absent in controls; and (3) this novel network identifies eosinophils as a potential mediator relating immunity and repair, particularly in patients with emphysema.

Conclusions

Overall, these results suggest that BM is activated in COPD with impaired repair capacity in patients with more emphysema and/or higher circulating eosinophils.

Electronic supplementary material

The online version of this article (10.1186/s12931-018-0824-x) contains supplementary material, which is available to authorized users.

Pairing and Short-Range Correlations in Nuclear Systems

The structure and density dependence of the pairing gap in infinite matter is relevant for astrophysical phenomena and provides a starting point for the discussion of pairing properties in nuclear structure. Short-range correlations can significantly deplete the available single-particle strength around the Fermi surface and thus provide a reduction mechanism of the pairing gap. Here, we study this effect in the singlet and triplet channels of both neutron matter and symmetric nuclear matter. Our calculations use phase-shift equivalent interactions and chiral two-body and three-body interactions as a starting point. We find an unambiguous reduction of the gap in all channels with very small dependence on the NN force in the singlet neutron matter and the triplet nuclear matter channel. In the latter channel, SRC alone provide a 50% reduction of the pairing gap.

Incidence of respiratory viral infection in infants with respiratory symptoms evaluated for late-onset sepsis

OBJECTIVE

To determine the frequency, etiology and impact of respiratory viral infection (RVI) on infants evaluated for late-onset sepsis (LOS), defined as sepsis occurring >72 h of life, in the neonatal intensive care unit.

STUDY DESIGN

Prospective observational study conducted from 6 March 2014 to 3 May 2016 on infants evaluated for LOS. PCR viral panel performed on nasopharyngeal specimens among infants with clinical suspicion for RVI. Sequence analysis was performed to determine viral subtypes. Fisher's exact or χ² tests were done to determine the impact of RVI.

RESULTS

During the 26-month study, there were 357 blood cultures obtained for LOS evaluations, 29 (8%) had a respiratory virus detected. Only 88 (25%) of infants evaluated for LOS also had clinical suspicion for a respiratory viral infection. RSV (14 of 29; 48%) was the predominant virus detected. Almost all infants (13 of 14; 93%) with RSV required increased respiratory support. Antimicrobial therapy was withheld or discontinued on most infants with a virus detected (18 of 29; 62%) and in the majority where there was no confirmed bacterial co-infection (18 of 20; 90%).

CONCLUSION

The incidence of RVI in infants being evaluated for LOS is about 8%. RVI should be considered in LOS evaluation to prevent unnecessary antibiotic therapy.

Role of adenylyl cyclase in reduced β-adrenoceptor-mediated vasorelaxation during maturation

Beta-adrenergic receptor (βAR)-dependent blood vessel relaxation is impaired in older animals and G protein activation has been suggested as the causative mechanism. Here, we investigated the role of βAR subtypes (β1AR, β2AR, and β3AR) and cAMP in maturation-dependent vasorelaxation impairment. Aortic rings from 15 Sprague-Dawley male rats (3 or 9 weeks old) were harvested and left intact or denuded of the endothelium. Vascular relaxation in aortic rings from younger and older groups was compared in the presence of βAR subtype agonists and antagonists along with cAMP and cGMP antagonists. Isolated aortic rings were used to evaluate relaxation responses, protein expression was evaluated by western blot or real time PCR, and metabolites were measured by ELISA. Expression of βAR subtypes and adenylyl cyclase was assessed, and cAMP activity was measured in vascular tissue from both groups. Isoproterenol- and BRL744-dependent relaxation in aortic rings with and without endothelium from 9-week-old rats was impaired compared with younger rats. The β1AR antagonist CGP20712A (10^-7 M) did not affect isoproterenol or BRL744-dependent relaxation in arteries from either group. The β2AR antagonist ICI-118,551 (10^-7 M) inhibited isoproterenol-dependent aortic relaxation in both groups. The β3AR antagonist SR59230A (10^-7 M) inhibited isoproterenol- and BRL744-dependent aortic ring relaxation in younger but not in older rats. All βAR subtypes were expressed in both groups, although β3AR expression was lower in the older group. Adenylyl cyclase (SQ 22536) or protein kinase A (H89) inhibitors prevented isoproterenol-induced relaxation in younger but not in older rats. Production of cAMP was reduced in the older group. Adenylyl cyclase III and RyR3 protein expression was higher in the younger group. In conclusion, altered expression of β3AR and adenylyl cyclase III may be responsible for reduced cAMP production in the older group.

Organ Donation: What Are the Opinions of Nursing Students at the University of Bialystok in Poland?

BACKGROUND

Nursing students, as future professionals, have an enormous impact on the opinion of the rest of the population on topics of organ donation and transplantation (ODT). The objective of this study was to analyze the attitudes of nursing students at the University of Bialystok toward ODT, and to determine the factors that affect ithemt.

METHODS

Academic year 2011-2012.

STUDY POPULATION

nursing students at the University of Bialystok. Type of sampling: sampling points during 5 compulsory-attendance nursing courses with >80% fulfillment. Measuring instrument: validated questionnaire (PCID-ODT Rios) filled out anonymously and self-administered.

RESULTS

Completion rate of 90% (331/367): 58% (n = 191) in favor, 35% (n = 118) undecided, and 7% (n = 22) against. The most important variables were: being in the 1st year (odds ratio [OR], 4.444; 95% confidence interval [CI], 11.627-1.700; P = .002); not knowing any donor (OR, 12.048; 95% CI, 55.555-2.57; P = .018); being in favor of organ donation by a relative (OR, 6.25; 95% CI, 14.705-2.666; P < .001); discussing the topic with friends (OR, 2,785; 95% CI, 5.347-1.447; P = .002); not worried about the possible mutilation of the body after donation (OR, 3.039; 95% CI, 5.882-1.569; P = .001); favorable attitude toward ODT of mother (OR, 3.676 (0.881-1.814; P < .001); accepting other treatment options, such as inhumation (OR, 3.436; 95% CI, 7.092-1.655; P = .001); accepting autopsy after death (OR, 2.141; 95% CI, 4.065-1.126; P = .020); and professing the Catholic religion (OR, 3.436; 95% CI, 8.333-1.410; P = .007).

CONCLUSIONS

More than 42% of the nursing students were not in favor of organ donation, their attitudes influenced by various psychosocial factors.

Knowledge of the Concept of Encephalic Death: Is This an Obstacle in the Acceptance of Donation and Transplantation of Organs Among Students of Nursing at the Medical University of Warsaw in Poland?

BACKGROUND

The knowledge and acceptance of the concept of brain death among future health professionals is essential. The objective of this study was to analyze the knowledge of the concept of brain death among nursing students at the Medical University of Warsaw and determine the factors that affect it.

METHODS

Academic year 2011-2012, nursing students of the University of Poland. Sampling points in 5 compulsory-attendance nursing courses with a completion rate >80%. Validated questionnaire (PCID-DTO Rios), anonymous and self-administered.

RESULTS

The completion rate was 96% (793/828); 71% (n = 561) knew the concept of brain death, 22% (n = 178) did not know it, and 7% (n = 54) did not know that it implies the death of the patient. Variables related to the correct knowledge: 1) to be studying in 4th year compared with 1st year (85% vs 60%; P ≤ .001); 2) discuss the subject with family (76% vs 61%; P ≤ .001); 3) discuss with friends (73% vs 63%; P = .009); and 4) having a favorable attitude toward organ donation (74% vs 65%; P = .011). In the multivariate analysis, the variables that remained independent were studying in 4th year (odds ratio [OR], 3.809; 95% confidence interval [CI], 2.006-5.823; P ≤ .001) and discussed with family concerning donation and transplantation (OR, 1.718; 95% CI, 1.241-2.381; P ≤ .001).

CONCLUSIONS

One-third of the nursing students were unfamiliar with the concept of brain death.

Donate a Piece of Liver: Is This an Option Accepted by Future Nurses of Pomeranian Medical University in Poland?

BACKGROUND

Liver transplantation from living donors (LLD) has become a viable and important source of liver grafts. The objective of this study was to analyze the attitude of nursing students at the Pomeranian Medical University in Poland on donation of live liver, and to determine the factors that affect it.

METHODS

Academic year 2011-2012, nursing students at a university in Poland, sampling points in 5 compulsory-attendance nursing courses with a completion rate of 80%, validated questionnaire (PCID-DVH Rios) filled out anonymously and self-administered.

RESULTS

The completion rate was 89% (227/254). Of the 227 students surveyed, 92% (n = 209) were in favor, 6% (n = 14) undecided, and 2% (n = 4) against. When the LLD is not related, 44% (n = 100) of respondents would be in favor. With a positive attitude toward this type of donation, we associated the following variables: 1) age, with the youngest showing a more favorable attitude (P = .006); 2) attitude in favor of living kidney donation (98% vs 85%; odds ratio, 4.950; 95% confidence interval, 9.259-2.652; P = .002); 3) attitude in favor of accepting a family LLD (96% vs 81%; P = .003); 4) discussing donation and transplantation with family (95% vs 87%; P = .043).

CONCLUSIONS

Ninety-two percent of nursing students at the Pomeranian Medical University in Poland were in favor of live organ donation, an attitude conditioned by various psychosocial factors.

Synthesis of CuNP-Modified Carbon Electrodes Obtained by Pyrolysis of Paper

A one-step approach for the synthesis and integration of copper nanoparticles (CuNPs) onto paper-based carbon electrodes is herein reported. The method is based on the pyrolysis (1000 °C under a mixture of 95% Ar / 5% H₂ for 1 hour) of paper strips modified with a saturated solution of CuSO₄ and yields to the formation of abundant CuNPs on the surface of carbonized cellulose fibers. The resulting substrates were characterized by a combination of scanning electron microscopy, EDX, Raman spectroscopy as well as electrical and electrochemical techniques. Their potential application, as working electrodes for nonenzymatic amperometric determination of glucose, was then demonstrated (linear response up to 3 mM and a sensitivity of 460 ± 8 μA·cm^-2·mM^-1). Besides being a simple and inexpensive process for the development of electrochemically-active substrates, this approach opens new possibilities for the in-situ synthesis of metallic nanoparticles without the traditional requirements of solutions and adjuvants.

Development and Characterization of Carbon Based Electrodes from Pyrolyzed Paper for Biosensing Applications

This article details the study of electrochemical behavior of new carbon electrodes based on pyrolysis of different paper sources to be used in biosensor applications. The resistivity of the pyrolyzed papers was initially used as screening parameters to select the best three paper samples (imaging card paper, multipurpose printing paper, and 3MM chromatography paper) and assemble working electrodes that were further characterized by a combination of microscopy, electrochemistry, and spectroscopy. Although slight differences in performance were observed, all carbon substrates fabricated from pyrolysis of paper allowed the development of competitive biosensors for uric acid. The presented results demonstrate the potential of these electrodes for sensing applications and highlight the potential advantages of 3MM chromatography paper as a substrate to fabricate electrodes by pyrolysis.

Opinion of Nursing Students of the University of Bydgoszcz in Poland About the Transplantation of Living Liver Donors

INTRODUCTION

Liver transplantation from living liver donation (LLD) has become an important source of liver grafts.

MATERIAL AND METHOD

We studied the 2011-2012 academic year attitude of nursing students from a university in Poland. The sampling points were compulsory attendance in the 5 nursing courses. The validated questionnaire was Project Collaborative International Donor-Living Liver Donation Rios. The questionnaire was completed anonymously and was self-administered.

RESULTS

The completion rate was 89% (440 of 495); 91% (n = 398) were in favor of the related LLD, 8% (n = 37) were undecided, and 1% (n = 5) were against. When the attitude toward LLD is not related, 40% (n = 177) of respondents were in favor. The favorable attitude was associated with the following: consideration of the needs of organs for transplantations are covered (P ≤ .001); attitude in favor toward organ donation and transplantation (ODT) (P = .001); attitude in favor toward LLD (P = .007); attitude in favor of the acceptance of a LLD by a family member (P = .001); discussion of ODT with the family (P ≤ .001); being in favor of donating organs of a relative (P ≤ .001); and being Catholic (P = .003). After multivariate analysis, we observed the following significant correlations: the thought that the needs of transplantation organs are covered (odds ratio [OR] = 4.608; P = .020); being ready to accept a liver from a LLD (OR = 3.125; P = .038); discussion with the family about the subject of donation and transplantation (OR = 3.215; P = .003); and not belonging to any doctrine or religious belief (OR = 11.363; P = .039).

CONCLUSIONS

In this study 91% of nursing students were in favor of living organ donation.

B Cell-Activating Factor. An Orchestrator of Lymphoid Follicles in Severe Chronic Obstructive Pulmonary Disease

RATIONALE

Patients with chronic obstructive pulmonary disease (COPD) have increased pulmonary lymphoid follicle (LF) counts. B cell-activating factor of tumor necrosis factor family (BAFF) regulates B cells in health, but its role in COPD pathogenesis is unclear.

OBJECTIVES

To determine whether BAFF expression in pulmonary LFs correlates with COPD severity, LF size or number, and/or readouts of B-cell function in LFs.

METHODS

We correlated BAFF immunostaining in LFs in lung explants or biopsies from nonsmoking control subjects (NSC), smokers without COPD (SC), and patients with COPD with the number and size of LFs, and LF B-cell apoptosis, activation, and proliferation. We analyzed serum BAFF levels and BAFF expression in B cells in blood and bronchoalveolar lavage samples from the same subject groups. We assessed whether: (1) cigarette smoke extract (CSE) increases B-cell BAFF expression and (2) recombinant BAFF (rBAFF) rescues B cells from CSE-induced apoptosis by inhibiting activation of nuclear factor-κB (NF-κB).

MEASUREMENTS AND MAIN RESULTS

Patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage IV COPD had increased numbers and larger pulmonary LFs than patients with GOLD stages I-II COPD and SC. We identified two main types of pulmonary LFs: (1) type A, the predominant type in GOLD stages I-II COPD and SC, characterized by abundant apoptotic but few BAFF-positive cells (mostly B cells); and (2) type B, the main type in GOLD stage IV COPD, characterized by abundant BAFF-positive cells but few apoptotic cells (mostly B cells). BAFF levels were also higher in blood and bronchoalveolar lavage B cells in patients with COPD versus NSC and SC. Surprisingly, rBAFF blocked CSE-induced B-cell apoptosis by inhibiting CSE-induced NF-κB activation.

CONCLUSIONS

Our data support the hypothesis that B-cell BAFF expression creates a self-perpetuating loop contributing to COPD progression by promoting pulmonary B-cell survival and LF expansion.

Structure-function relationship in COPD revisited: an in vivo microscopy view

BACKGROUND

Fibred confocal fluorescence microscopy (FCFM) is a novel technology that allows the in vivo assessment and quantification during bronchoscopy of the bronchial wall elastic fibre pattern, alveolar and vessel diameters and thickness of the elastic fibre in the alveolar wall.

AIMS

To relate these structural characteristics with lung function parameters in healthy subjects, smokers with normal spirometry and patients with chronic obstructive pulmonary disease (COPD).

METHODS

We performed FCFM in 20 never smokers, 20 smokers with normal spirometry and 23 patients with COPD who required bronchoscopy for clinical reasons. The bronchial wall elastic fibre pattern was classified as lamellar, loose and mixed pattern, and later confirmed pathologically. Airspace dimensions and extra-alveolar vessel diameters were measured. Lung function measurements and pulmonary CT scans were obtained in all participants.

RESULTS

Patients with COPD were characterised by a significantly higher prevalence of loose fibre bronchial deposition pattern and larger alveolar diameter which correlated inversely with several lung function parameters (forced expiratory volume in 1 s (FEV1) , FEV1/forced vital capacity ratio, maximum expiratory flow, carbon monoxide transfer factor and carbon monoxide transfer coefficient; p<0.05). Increased alveolar macrophages were demonstrated in active smokers with or without COPD.

CONCLUSIONS

This is the first FCFM study to describe in vivo microscopic changes in the airways and alveoli of patients with COPD that are related to lung function impairment. These findings open the possibility of assessing the in vivo effects of therapeutic interventions for COPD in future studies.

Complete and repeatable inactivation of HIV-1 viral particles in suspension using a photo-labeled non-nucleoside reverse transcriptase inhibitor

A method is described for achieving repeatable, complete inactivation of HIV, based on photo-inactivation of HIV reverse transcriptase (RT) with a non-nucleoside reverse transcriptase inhibitor (NNRTI), photoactive 4-[[4-[(4-azido-2,6-dimethylphenyl) amino]-2-pyrimidinyl]amino]benzonitrile (PA-DAPYa). These results show that PA-DAPYa inactivated completely a suspension of cell-free HIV-1 viral particles in a dose and time-dependent manner. Using an ELISA assay for p24, it is demonstrated that a 500nM concentration of PA-DAPYa is able to inactivate 500 TCID50 of HIV viral particles in suspension when irradiated with non-microbicidal wavelength UV light for 30min. No active p24 was detected on days 7, 14, and 21 days after culturing the inactivated HIV in peripheral blood mononuclear cells (PBMCs). Several batches of large quantities of HIV viral particles were demonstrated to be inactivated completely and repeatedly by this method. Therefore, a reliable method has been developed to inactivate HIV viral particles in a reproducible manner using an optimal concentration of PA-DAPYa and duration of UV exposure time of the treated particles. The inactivation of viral particles in suspension allows for large-scale production of an injectable formulation of inactivated HIV viral particles for vaccine development which should preserve the conformational and antigenic integrity of viral surface proteins.

Charge radius isotope shift across the N=126 shell gap

We revisit the problem of the kink in the charge radius shift of neutron-rich even isotopes near the N=126 shell closure. We show that the ability of a Skyrme force to reproduce the isotope shift is determined by the occupation of the neutron 1i(11/2) orbital beyond N=126 and the corresponding change it causes to deeply-bound protons orbitals with a principal quantum number of 1. Given the observed position of the single-particle energies, one must either ensure occupation is allowed through correlations, or not demand that the single-particle energies agree with experimental values at the mean-field level.

Pesticide residue levels in green beans cultivated in Souss Masa valley (Morocco) after multiple applications of bifenthrin and λ-cyhalothrin

Dissipation of bifenthrin and λ-cyhalothrin pyrethroid insecticides, under environmental conditions, was evaluated on green beans grown in experimental greenhouses (Souss Massa valley, Morocco). Pesticide residues were determined by gas chromatography with micro electron-capture detector (GC-μECD) after dichloromethane extraction and cleanup on florisil phase cartridges. In the case of field experiments, a random block scheme was employed. Each block contained 25 plants in a single row and tests were carried out in triplicates applying pesticides at the recommended doses by the manufacturers. Fruit samples were periodically taken until the end of the preharvest interval (p.i.). The results obtained showed that the p.i of bifenthrin in green bean were 4 days in the winter and 3.5 days in the spring, whereas that for λ-cyhalothrin 8 days was found in the winter and 7.5 days in the spring. Consequently, it is possible to consider the European Union maximum residue limit (EU MRL) values compatible with the proper agricultural practices used for growing green bean in the plastic greenhouse of Souss Massa valley in South Morocco. Bifenthrin had a degradation of first-order kinetics, whereas that of levels for λ-cyhalothrin residue can not be interpreted by the use of a first order model.

Low-dose theophylline enhances the anti-inflammatory effects of steroids during exacerbations of COPD

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is characterised by an abnormal inflammatory response mainly to cigarette smoke that flares up during exacerbations of the disease (ECOPD). Reduced activity of histone deacetylases (HDAC) contributes to enhanced inflammation in stable COPD. It was hypothesised that HDAC activity is further reduced during ECOPD and that theophylline, an HDAC activator, potentiates the anti-inflammatory effect of steroids in these patients. A study was performed to investigate HDAC activity during ECOPD and the effects of theophylline on the anti-inflammatory effects of steroids in a randomised single-blind controlled study.

METHODS

35 patients hospitalised with ECOPD and treated according to international guidelines (including systemic steroids) were randomised to receive or not to receive low-dose oral theophylline (100 mg twice daily). Before treatment and 3 months after discharge, HDAC and nuclear factor-kappaB (NF-kappaB) activity in sputum macrophages, the concentration of nitric oxide in exhaled air (eNO) and total antioxidant status (TAS), tumour necrosis factor alpha (TNFalpha), interleukin (IL)-6 and IL8 levels in sputum supernatants were measured.

RESULTS

Patients receiving standard therapy showed decreased NF-kappaB activity, eNO concentration and sputum levels of TNFalpha, IL6 and IL8, as well as increased TAS during recovery of ECOPD, but HDAC activity did not change. The addition of low-dose theophylline increased HDAC activity and further reduced IL8 and TNFalpha concentrations.

CONCLUSIONS

During ECOPD, low-dose theophylline increases HDAC activity and improves the anti-inflammatory effects of steroids.

TRIAL REGISTRATION NUMBER

NCT00671151.

Supercritical fluid extraction as an on-line clean-up technique for rapid amperometric screening and alternative liquid chromatography for confirmation of paraquat and diquat in olive oil samples

A rapid and simple method for the direct screening of paraquat (PQ) and diquat (DQ) in olive oil samples is proposed. The sample screening method involves supercritical fluid extraction (SFE) (clean-up followed by the extraction of the analytes) followed by continuous flow electrochemical detection. Those samples for which the total concentration is close to or above the threshold limit established by the Columbian Society for Social Protection (0.05 microg g(-1)) are subsequently analyzed by liquid chromatography (LC) with diode array detection (DAD). This confirmation method allows the determination of PQ and DQ in the range between 0.04 and 1.0 microg g(-1), with average relative standard deviations lower than 3.5%, and 0.003 and 0.002 microg g(-1) detection limits for PQ and DQ, respectively. The proposed arrangement opens up interesting prospects for the direct determination of polar pesticides in complex samples with a good throughput and a high level of automation.

Method of determination of nitrosamines in sausages by CO2 supercritical fluid extraction (SFE) and micellar electrokinetic chromatography (MEKC)

In this paper, the use of supercritical fluid extraction (SFE) and micellar electrokinetic capillary chromatography (MEKC) is proposed for the complete analysis of volatile nitrosamines in sausages. The extraction fluid used was CO2 and variables such as density, temperature of thimbles, extraction time, modifier, fluid flow, and kind of traps were investigated. Several experiments were carried out to obtain the most favorable conditions for analysis of volatile nitrosamines in sausages. The recoveries ranged from 21 to 82% for the five nitrosamines studied. The optimal condition of extraction was 0.2 g of sample fortified with 10 mg/kg, using dynamic extraction during 20 min and with adsorbent Florisil in the trap. The solvent selected for the elution of the analytes was methanol.

Subcellular distribution of theEntamoeba histolytica140 kDa FN-binding molecule during host-parasite interaction

Entamoeba histolyticatrophozoites recovered from the host-parasite interface during abscess development obtain different stimuli compared with long-term cultured cells. In order to have a better understanding about the mechanisms in which the 140 kDa fibronectin (FN)-binding molecule (EhFNR) is involved during the invasive process, we decided to compare the regulation process of this molecule among long-term cultured trophozoites, FN-stimulated trophozoites, and trophozoites recently recovered from a liver abscess. A cDNA clone (5A) containing a fragment of theEhFNR that shows identity to the C-terminal region of the intermediate galactose lectin subunit Igl, was selected with a mAb (3C10). Identity ofEhFNR with Igl was confirmed by immunoprecipitation with 3C10 and EH3015 (against the Gal/GalNAc intermediate subunit) mAbs. The 3C10 mAb was used as a tool to explore the modulation of the amoebic receptor (EhFNR). Our results showed specific regulation of theEhFNR in FN-interacted amoebas, as well as in trophozoites recovered at different stages of abscess development. This regulation involved mobilization of the receptor molecule from internal vesicles to the plasma membrane. Therefore, we suggest that in the host-parasite interface, theEhFNR (Igl) plays an important role in the adhesion process during abscess development.

The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants

OBJECTIVE

To determine whether extremely low birth weight infants (ELBW) transfused at lower hemoglobin thresholds versus higher thresholds have different rates of survival or morbidity at discharge.

STUDY DESIGN

Infants weighing <1000 g birth weight were randomly assigned within 48 hours of birth to a transfusion algorithm of either low or high hemoglobin transfusion thresholds. The composite primary outcome was death before home discharge or survival with any of either severe retinopathy, bronchopulmonary dysplasia, or brain injury on cranial ultrasound. Morbidity outcomes were assessed, blinded to allocation.

RESULTS

Four hundred fifty-one infants were randomly assigned to low (n = 223) or high (n = 228) hemoglobin thresholds. Groups were similar, with mean birth weight of 770 g and gestational age of 26 weeks. Fewer infants received one or more transfusions in the low threshold group (89% low versus 95% high, P = .037). Rates of the primary outcome were 74.0% in the low threshold group and 69.7% in the high (P = .25; risk difference, 2.7%; 95% CI -3.7% to 9.2%). There were no statistically significant differences between groups in any secondary outcome.

CONCLUSIONS

In extremely low birth weight infants, maintaining a higher hemoglobin level results in more infants receiving transfusions but confers little evidence of benefit.

Aromatase inhibitor (AI)-associated arthralgia (A) and bone pain (BP): Frequency and characterization in clinical practice

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Background: Prior studies of AI have identified A and/or BP as side effects. Reported incidences have varied from 4% (IMPACT) to 35.6% (ATAC). In order to determine the frequency of A or BP in clinical practice, we reviewed a consecutive series of patients (PTs) receiving AI in community cancer centers. Methods: The charts of consecutive PTs receiving AI were reviewed, and PTs were interviewed regarding the occurrence of A or BP (ABP), severity, whether ABP was worse than before AI therapy, preexisting co-morbidities, type of therapy for ABP, and pain characterization. Results: 56 PTs were receiving AI. The type of AI used was anastrazole in 44 PTs, letrozole in 10 PTs, and exemestane in 2 PTs. The age range was 45 to 89 years. All PTs had breast cancer. The duration AI usage was 1 to 44 mo. Worsening of ABP compared to pretreatment ABP was reported in 34 PTs (61%). In 11 Pts (20%), severity was sufficient and control poor enough to result in discontinuation of AI at a median of 2 mo of AI therapy. The median severity of ABP, when present, was 7.5 on a 10 point pain scale. The character of the ABP was continuous in 20 (59%) and intermittent in 14 (41%), affected central/axial bones in 20 (36%), and peripheral bones in 35 (64%). Coexisting conditions possibly contributing to worsening of ABP occurred in 36%, consisting of degenerative joint disease 10, fibromyalgia 1, osteoporosis 4, and degenerative disc disease 1. Therapy associated with amelioration of symptoms included acetaminophen in 26%, NSAIDs in 45%, mild opiates in 11%, strong opiates in 5%, and glucosamine in 13%. The occurrence of ABP was not associated with age (68% in PTs less than 60 versus 57% in PTs over 60). The occurrence of ABP was not associated with duration of use of AI (50% of 16 Pts on AI for 3–6 mo, 75% for 7–12 mo, and 56% for over 12 mo). Conclusions: The occurrence of AI associated ABP is higher in a non-clinical trial population of PTs than reported in most clinical trials. This side effect is severe enough to cause discontinuation of needed AI therapy in 20%. Further studies are warranted to determine the mechanism of AI associated ABP, and optimal therapy. It is reasonable to consider glucosamine as well as standard analgesics in controlling this syndrome.

No significant financial relationships to disclose.

Frequency analysis of air and skin temperature in neonates in servo-controlled incubators

OBJECTIVE

To test a new system designed for digital recording of skin and air temperature, thereby allowing analysis of cyclic changes in temperature in neonates in servo-controlled incubators.

METHODS

Analysis of cyclic changes of serial skin and air temperature in asymptomatic infants in servo-controlled incubators adjusting heat output to the patient's temperature.

RESULTS

In nine asymptomatic neonates ranging from 25 to 40 weeks of gestational age, analysis showed peaks of coherence (squared correlation) between skin and air temperature measurements at periods ranging between 1.5 and 3 h.

CONCLUSION

We have established a new system to study cyclic changes in skin and air temperature in neonates in servo-controlled incubators. The analysis of this pilot study suggests that the most important changes in skin and air temperature in asymptomatic neonates occur at a periodicity of 1.5 to 3 h, which is similar to that previously described for neonatal temperature. Additional data are required to determine whether this new system may be useful in neonatal care.