Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

Plasma and rectal mucosal oxylipin levels during aspirin and eicosapentaenoic acid treatment in the seAFOod polyp prevention trial

BACKGROUND

Aspirin and eicosapentaenoic acid (EPA) have colorectal polyp prevention activity, alone and in combination. This study measured levels of plasma and rectal mucosal oxylipins in participants of the seAFOod 2 × 2 factorial, randomised, placebo-controlled trial, who received aspirin 300 mg daily and EPA 2000 mg free fatty acid, alone and in combination, for 12 months.

METHODS

Resolvin (Rv) E1, 15-epi-lipoxin (LX) A₄ and respective precursors 18-HEPE and 15-HETE (with chiral separation) were measured by ultra-high performance liquid chromatography-tandem mass spectrometry in plasma taken at baseline, 6 months and 12 months, as well as rectal mucosa obtained at trial exit colonoscopy at 12 months, in 401 trial participants.

RESULTS

Despite detection of S- and R- enantiomers of 18-HEPE and 15-HETE in ng/ml concentrations, RvE1 or 15‑epi-LXA₄ were not detected above a limit of detection of 20 pg/ml in plasma or rectal mucosa, even in individuals randomised to both aspirin and EPA. We have confirmed in a large clinical trial cohort that prolonged (12 months) treatment with EPA is associated with increased plasma 18-HEPE concentrations (median [inter-quartile range] total 18-HEPE 0.51 [0.21-1.95] ng/ml at baseline versus 0.95 [0.46-4.06] ng/ml at 6 months [P<0.0001] in those randomised to EPA alone), which correlate strongly with respective rectal mucosal 18-HEPE levels (r = 0.82; P<0.001), but which do not predict polyp prevention efficacy by EPA or aspirin.

CONCLUSION

Analysis of seAFOod trial plasma and rectal mucosal samples has not provided evidence of synthesis of the EPA-derived specialised pro-resolving mediator RvE1 or aspirin-trigged lipoxin 15‑epi-LXA₄. We cannot rule out degradation of individual oxylipins during sample collection and storage but readily measurable precursor oxylipins argues against widespread degradation.

Occurrence of microplastics in wild oysters (Crassostrea tulipa) from the Gulf of Guinea and their potential human exposure

The high dependence on plastics in Ghana has resulted in the generation of large quantities of plastic waste which are poorly managed and improperly disposed into the aquatic environments. This study assessed the spatial distribution and abundance of microplastics in mangrove oysters (Crassostrea tulipa): a major fishery resource of commercial importance in Ghana. The results showed that 84.0% of all individuals examined had ingested microplastics. A total of 276 microplastic items were recovered from the 120 individual oysters. Densu (100%) and Volta (93%), two estuaries situated in urban areas, had a greater incidence of microplastics than Whin (77%) and Nakwa (66%), estuaries situated in peri-urban and rural settlements, respectively. The mean microplastic abundance ranged from 1.4 to 3.4 items/individual and 0.34 to 1.7 items/g tissue wet weight. Fiber accounted for 69% of microplastic shapes, followed by fragments (27%) and films (4%). Polymer analysis showed polyethylene (PE), polypropylene (PP) and polystyrene (PS) as the most common types in oysters. The estimated microplastic intake per capita per year was one magnitude higher than the mean for other countries. This high rate of human exposure to microplastics requires an eminent policy formulation to guide the use, management and disposal of plastic waste in Ghana.

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

Comparison of Dietary Intake in UK Adults Aged 50 to 75 Years During the 2020 UK Covid-19 Lockdown Compared to their 2019 Intakes

The lockdown restrictions imposed as a result of COVID-19 impacted on many areas of daily life including dietary behaviours. A cohort of middle-older age adults (n=17), who had previously provided 3-day food diaries in May 2019 were asked to record their 3 day dietary intake in May 2020 when the UK was under lockdown restrictions. Mean (SD) energy intakes were significantly higher by ~750kilojoules in 2020 (8587kJ (1466.9)) compared to 2019 (7837 kJ (1388.9)). This energy increase is equivalent to ~170kcal; approximately 2 slices of bread. Furthermore, recorded meat/meat products, riboflavin, vitamin B6/B12 and iron intakes were all greater in 2020. No other dietary differences were observed between the two timepoints. This was a small, homogenous but well controlled sample, who exhibited a relatively stable diet during lockdown compared with pre-pandemic intakes 12 months earlier. It can be concluded that there was little evidence of food insecurity in this cohort.

Characterizing the optical response of ultra-low-noise far-infrared 60-110 μm transition edge sensors

Far-infrared Transition Edge Sensors (TESs) are being developed for the SAFARI grating spectrometer on the cooled-aperture space telescope SPICA. In support of this work, we have devised a cryogenic (90 mK) test facility for carrying out precision optical measurements on ultra-low-noise TESs. Although our facility is suitable for the whole of the SAFARI wavelength range, 34 µm-230 µm, we focus on a representative set of measurements at 60 µm-110 µm using a device having a noise equivalent power of 0.32 aW Hz^-1/2. The system is able to perform a range of measurements: (i) dark electrical characterization, (ii) optical efficiency with respect to a partially coherent beam having a modal composition identical to that of an ideal imaging telescope, (iii) optical saturation and dynamic range, (iv) fast optical transient response to a modulated thermal source, and (v) optical transient response in the presence of high-level background loading. We describe dark measurements to determine the operating characteristics of a TES and then compare the predicted optical behavior with the measured optical behavior. By comparing electrical and optical transient responses, we were able to observe thermalization in the device. We comment on the challenge of eliminating stray light.

Investigating the nutritional advice and support given to colorectal cancer survivors in the UK: is it fit for purpose and does it address their needs?

BACKGROUND

The present study assessed the quantity and quality of nutritional advice and support given to colorectal cancer survivors in the UK.

METHODS

A descriptive cross-sectional survey was completed by 75 colorectal cancer survivors recruited through social media and bowel cancer support groups in the UK. The survey consisted of open-ended and closed questions that aimed to explore the nutritional needs, nutritional advice given and other sources of information accessed by colorectal cancer survivors.

RESULTS

Sixty-nine percent of respondents reported that they did not receive any nutritional advice or support from their healthcare team throughout diagnosis, treatment and post-treatment. Colorectal cancer survivors accessed nutritional advice from a variety of sources, mainly cancer charity websites. Respondents expressed their desire for individualised advice relating to their nutritional problems.

CONCLUSIONS

The results obtained in the present study indicate that a high proportion of colorectal cancer patients are not receiving the nutritional support that they need to overcome nutritional difficulties. There is an urgent need to improve clinical practice to ensure colorectal patients receive nutritional advice that is both consistent between healthcare professionals and personalised throughout each stage of diagnosis, treatment and post-treatment.

Fucosyltransferase gene expression in goat endometrium during the estrous cycle and early pregnancy

Regulation of the expression of the alpha(1,2)fucosyltransferase (FUT) genes and their enzymatic products, including the H-type 1 antigen (HT1), on the luminal surface of the uterus is believed to be critical for establishment of pregnancy in mammals. The FUT1 gene is a marker for conception rates in dairy cows and HT1 is a marker for uterine receptivity in rodents. To determine the spatiotemporal expression patterns of FUT1 and FUT2 genes in goats, endometrial tissues were obtained on six days spanning the estrous cycle (Days 5, 11, 13, 15, 17 and 19) and seven days spanning early pregnancy (Days 5, 11, 13, 15, 17, 19 and 25). In all data, we found no effect of status (cyclic or pregnant; P > 0.1) and pooled data where appropriate. We cloned FUT1 cDNA from goat endometrium and made probes from it for Northern and slot blot analyses. The analyses indicated that FUT1 gene expression was high until Day 13, and then declined. In situ hybridization revealed a change in the cell-specificity of FUT1 gene expression over the estrous cycle and early pregnancy. In situ hybridization signal intensity scores indicated that FUT1 expression by uterine epithelium was high on Day 5, moderate on Day 11, and minimal on subsequent days. In situ hybridization signals in uterine glandular epithelial cells remained high from Day 5 to Day 13, with weaker signals thereafter. Quantitative reverse transcription-PCR (RT-qPCR) assays were used for quantitation of FUT1 and FUT2 mRNAs. Quantitative RT-qPCR data were generated from endometrium collected from cyclic and pregnant animals on Days 5, 11 and 17. Relative levels of FUT1 mRNA were high on Days 5 and 11, but then fell 5-fold by Day 17 (P < 0.01). FUT2 mRNA concentrations were below the accurate detectable limit of the assay. High levels of HT1 were observed on the apical surface of uterine luminal epithelia on Days 5, 15, 17 and 19, with much lower levels on Days 11 and 13. Thus, data suggests that FUT1 is the primary enzyme responsible for the high levels of HT1 antigen present on the uterine luminal epithelium between Days 5 and 11 of the estrous cycle and early pregnancy. But changes in the expression of the FUT1 gene does not directly correlate to HT1 staining, which increased from Day 13-15. Future studies are required to understand the regulation of the HT1 antigen on the luminal surface of endometrium.

A Comparison of Food Portion Size Estimation by Older Adults, Young Adults and Nutritionists

OBJECTIVES

To investigate the ability of older adults, younger adults and nutritionists to assess portion size using traditional methods versus a computer-based method. This was to inform the development of a novel dietary assessment method for older adults "The NANA system".

DESIGN

Older and younger adults assessed the portion size of self-served portions of foods from a buffet style set up using traditional and computerised portion size assessment aids. Nutritionists assessed the portion size of foods from digital photographs using computerised portion size aids. These estimates were compared to known weights of foods using univariate analyses of covariance (ANCOVA).

SETTING

The University of Sheffield, United Kingdom.

SUBJECTS

Forty older adults (aged 65 years and over), 41 younger adults (aged between 18 and 40 years) and 25 nutritionists.

RESULTS

There was little difference in the abilities of older and younger adults to assess portion size using both assessment aids with the exception of small pieces morphology. Even though the methods were not directly comparable among the test groups, there was less variability in portion size estimates made by the nutritionists.

CONCLUSION

Older adults and younger adults are similar in their ability to assess food portion size and demonstrate wide variability of estimation compared to the ability of nutritionists to estimate portion size from photographs. The results suggest that the use of photographs of meals consumed for portion size assessment by a nutritionist may improve the accuracy of dietary assessment. Improved portion size assessment aids are required for all age groups.

Using the NANA toolkit at home to predict older adults' future depression

BACKGROUND

Depression is currently underdiagnosed among older adults. As part of the Novel Assessment of Nutrition and Aging (NANA) validation study, 40 older adults self-reported their mood using a touchscreen computer over three, one-week periods. Here, we demonstrate the potential of these data to predict future depression status.

METHODS

We analysed data from the NANA validation study using a machine learning approach. We applied the least absolute shrinkage and selection operator with a logistic model to averages of six measures of mood, with depression status according to the Geriatric Depression Scale 10 weeks later as the outcome variable. We tested multiple values of the selection parameter in order to produce a model with low deviance. We used a cross-validation framework to avoid overspecialisation, and receiver operating characteristic (ROC) curve analysis to determine the quality of the fitted model.

RESULTS

The model we report contained coefficients for two variables: sadness and tiredness, as well as a constant. The cross-validated area under the ROC curve for this model was 0.88 (CI: 0.69-0.97).

LIMITATIONS

While results are based on a small sample, the methodology for the selection of variables appears suitable for the problem at hand, suggesting promise for a wider study and ultimate deployment with older adults at increased risk of depression.

CONCLUSIONS

We have identified self-reported scales of sadness and tiredness as sensitive measures which have the potential to predict future depression status in older adults, partially addressing the problem of underdiagnosis.

Validation of the NANA (Novel Assessment of Nutrition and Ageing) touch screen system for use at home by older adults

Prospective measurement of nutrition, cognition, and physical activity in later life would facilitate early detection of detrimental change and early intervention but is hard to achieve in community settings. Technology can simplify the task and facilitate daily data collection. The Novel Assessment of Nutrition and Ageing (NANA) toolkit was developed to provide a holistic picture of an individual's function including diet, cognition and activity levels. This study aimed to validate the NANA toolkit for data collection in the community. Forty participants aged 65 years and over trialled the NANA toolkit in their homes for three 7-day periods at four-week intervals. Data collected using the NANA toolkit were compared with standard measures of diet (four-day food diary), cognitive ability (processing speed) and physical activity (self-report). Bland-Altman analysis of dietary intake (energy, carbohydrates, protein fat) found a good relationship with the food diary and cognitive processing speed and physical activity (hours) were significantly correlated with their standard counterparts. The NANA toolkit enables daily reporting of data that would otherwise be collected sporadically while reducing demands on participants; older adults can complete the daily reporting at home without a researcher being present; and it enables prospective investigation of several domains at once.

Probiotic supplement consumption alters cytokine production from peripheral blood mononuclear cells: a preliminary study using healthy individuals

The objective of this study was to examine the effect of daily probiotic supplementation upon the immune profile of healthy participants by the assessment of ex vivo cytokine production. Twenty healthy adult volunteers received a multi-strain probiotic supplement consisting of two strains of Lactobacillus acidophilus (CUL60 and CUL21), Bifidobacterium lactis (CUL34) and Bifidobacterium bifidum (CUL20) and fructooligosaccharide for 12 weeks. Blood samples were collected at baseline, 6 and 12 weeks. Peripheral blood mononuclear cells (PBMCs) were isolated and cultured ex vivo in the presence or absence of lipopolysaccharide and cytokine production was assessed. Postintervention, a significant decrease in the production of interleukin-6 and interleukin-1β was apparent when PBMCs were incubated in the presence of lipopolysaccharide, whilst a significant increase in IL-10 and transforning growth factor-β production was seen when the cells were incubated without an additional stimulus. This preliminary study demonstrates the potential of a multi-strain probiotic supplement to alter the immune response as demonstrated by changes in ex vivo cytokine production. Such results demonstrate the potential benefit of probiotic supplementation for healthy individuals and warrants further investigation.

Raman backscatter as a remote laser power sensor in high-energy-density plasmas

Stimulated Raman backscatter is used as a remote sensor to quantify the instantaneous laser power after transfer from outer to inner cones that cross in a National Ignition Facility (NIF) gas-filled hohlraum plasma. By matching stimulated Raman backscatter between a shot reducing outer versus a shot reducing inner power we infer that about half of the incident outer-cone power is transferred to inner cones, for the specific time and wavelength configuration studied. This is the first instantaneous nondisruptive measure of power transfer in an indirect drive NIF experiment using optical measurements.

Kinetic theory and Vlasov simulation of nonlinear ion-acoustic waves in multi-ion species plasmas

The theory of damping and nonlinear frequency shifts from particles resonant with ion-acoustic waves (IAWs) is presented for multi-ion species plasma and compared to driven wave Vlasov simulations. Two distinct IAW modes may be supported in multi-ion species plasmas, broadly classified as fast and slow by their phase velocity relative to the constituent ion thermal velocities. In current fusion-relevant long pulse experiments, the ion to electron temperature ratio, T(i)/T(e), is expected to reach a level such that the least damped and thus more readily driven mode is the slow mode, with both linear and nonlinear properties that are shown to differ significantly from the fast mode. The lighter ion species of the slow mode is found to make no significant contribution to the IAW frequency shift despite typically being the dominant contributor to the Landau damping.

Stochastic ion heating from many overlapping laser beams in fusion plasmas

In this Letter, we show through numerical simulations and analytical results that overlapping multiple (N) laser beams in plasmas can lead to strong stochastic ion heating from many (~N(2)) electrostatic perturbations driven by beat waves between pairs of laser beams. For conditions typical of inertial-confinement-fusion experiment conditions, hundreds of such beat waves are driven in mm(3)-scale plasmas, leading to ion heating rates of several keV/ns. This mechanism saturates cross-beam energy transfer, with a reduction of linear gains by a factor ~4-5 and can strongly modify the overall hydrodynamics evolution of such laser-plasma systems.

Three-wavelength scheme to optimize hohlraum coupling on the National Ignition Facility

By using three tunable wavelengths on different cones of laser beams on the National Ignition Facility, numerical simulations show that the energy transfer between beams can be tuned to redistribute the energy within the cones of beams most prone to backscatter instabilities. These radiative hydrodynamics and laser-plasma interaction simulations have been tested against large-scale hohlraum experiments with two tunable wavelengths and reproduce the hohlraum energetics and symmetry. Using a third wavelength provides a greater level of control of the laser energy distribution and coupling in the hohlraum, and could significantly reduce stimulated Raman scattering losses and increase the hohlraum radiation drive while maintaining a good implosion symmetry.

Demonstration of ignition radiation temperatures in indirect-drive inertial confinement fusion hohlraums

We demonstrate the hohlraum radiation temperature and symmetry required for ignition-scale inertial confinement fusion capsule implosions. Cryogenic gas-filled hohlraums with 2.2 mm-diameter capsules are heated with unprecedented laser energies of 1.2 MJ delivered by 192 ultraviolet laser beams on the National Ignition Facility. Laser backscatter measurements show that these hohlraums absorb 87% to 91% of the incident laser power resulting in peak radiation temperatures of T(RAD)=300 eV and a symmetric implosion to a 100 μm diameter hot core.

Observation of high soft x-ray drive in large-scale hohlraums at the National Ignition Facility

The first soft x-ray radiation flux measurements from hohlraums using both a 96 and a 192 beam configuration at the National Ignition Facility have shown high x-ray conversion efficiencies of ∼85%-90%. These experiments employed gold vacuum hohlraums, 6.4 mm long and 3.55 mm in diameter, heated with laser energies between 150-635 kJ. The hohlraums reached radiation temperatures of up to 340 eV. These hohlraums for the first time reached coronal plasma conditions sufficient for two-electron processes and coronal heat conduction to be important for determining the radiation drive.

The first measurements of soft x-ray flux from ignition scale Hohlraums at the National Ignition Facility using DANTE (invited)

The first 96 and 192 beam vacuum Hohlraum target experiments have been fielded at the National Ignition Facility demonstrating radiation temperatures up to 340 eV and fluxes of 20 TW/sr as viewed by DANTE representing an ∼20 times flux increase over NOVA/Omega scale Hohlraums. The vacuum Hohlraums were irradiated with 2 ns square laser pulses with energies between 150 and 635 kJ. They produced nearly Planckian spectra with about 30±10% more flux than predicted by the preshot radiation hydrodynamic simulations. To validate these results, careful verification of all component calibrations, cable deconvolution, and software analysis routines has been conducted. In addition, a half Hohlraum experiment was conducted using a single 2 ns long axial quad with an irradiance of ∼2×10(15) W/cm(2) for comparison with NIF Early Light experiments completed in 2004. We have also completed a conversion efficiency test using a 128-beam nearly uniformly illuminated gold sphere with intensities kept low (at 1×10(14) W/cm(2) over 5 ns) to avoid sensitivity to modeling uncertainties for nonlocal heat conduction and nonlinear absorption mechanisms, to compare with similar intensity, 3 ns OMEGA sphere results. The 2004 and 2009 NIF half-Hohlraums agreed to 10% in flux, but more importantly, the 2006 OMEGA Au Sphere, the 2009 NIF Au sphere, and the calculated Au conversion efficiency agree to ±5% in flux, which is estimated to be the absolute calibration accuracy of the DANTEs. Hence we conclude that the 30±10% higher than expected radiation fluxes from the 96 and 192 beam vacuum Hohlraums are attributable to differences in physics of the larger Hohlraums.

Tuning the implosion symmetry of ICF targets via controlled crossed-beam energy transfer

Radiative hydrodynamics simulations of ignition experiments show that energy transfer between crossing laser beams allows tuning of the implosion symmetry. A new full-scale, three-dimensional quantitative model has been developed for crossed-beam energy transfer, allowing calculations of the propagation and coupling of multiple laser beams and their associated plasma waves in ignition hohlraums. This model has been implemented in a radiative-hydrodynamics code, demonstrating control of the implosion symmetry by a wavelength separation between cones of laser beams.

Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study

BACKGROUND

The efficacy of probiotics in alleviating the symptoms of irritable bowel syndrome (IBS) appears to be both strain- and dose-related.

AIM

To investigate the effect of LAB4, a multistrain probiotic preparation on symptoms of IBS. This probiotic preparation has not previously been assessed in IBS.

METHODS

Fifty-two participants with IBS, as defined by the Rome II criteria, participated in this double blind, randomized, placebo-controlled study. Participants were randomized to receive either a probiotic preparation comprising two strains of Lactobacillus acidophilus CUL60 (NCIMB 30157) and CUL21 (NCIMB 30156), Bifidobacterium lactis CUL34 (NCIMB 30172) and Bifidobacterium bifidum CUL20 (NCIMB 30153) at a total of 2.5 × 10(10) cfu/capsule or a placebo for 8 weeks. Participants reported their IBS symptoms using a questionnaire fortnightly during the intervention and at 2 weeks post-intervention.

RESULTS

A significantly greater improvement in the Symptom Severity Score of IBS and in scores for quality of life, days with pain and satisfaction with bowel habit was observed over the 8-week intervention period in the volunteers receiving the probiotic preparation than in the placebo group.

CONCLUSION

LAB4 multistrain probiotic supplement may benefit subjects with IBS.

Using a short-pulse diffraction-limited laser beam to probe filamentation of a random phase plate smoothed beam

A short pulse (few picoseconds) laser probe provides high temporal resolution measurements to elucidate details of fast dynamic phenomena not observable with typical longer laser pulse probes and gated diagnostics. Such a short pulse laser probe (SPLP) has been used to measure filamentation of a random phase plate (RPP) smoothed laser beam in a gas-jet plasma. The plasma index of refraction due to driven density and temperature fluctuations by the RPP beam perturbs the phase front of a SPLP propagating at a 90 degree angle with respect to the RPP interaction beam. The density and temperature fluctuations are quasistatic on the time scale of the SPLP (approximately 2 ps). The transmitted near-field intensity distribution from the SPLP provides a measure of the phase front perturbation. At low plasma densities, the transmitted intensity pattern is asymmetric with striations across the entire probe beam in the direction of the RPP smoothed beam. As the plasma density increases, the striations break up into smaller sizes along the direction of the RPP beam propagation. The breakup of the intensity pattern is consistent with self-focusing of the RPP smoothed interaction beam. Simulations of the experiment using the wave propagation code, PF3D, are in qualitative agreement demonstrating that the asymmetric striations can be attributed to the RPP driven density fluctuations. Quantification of the beam breakup measured by the transmitted SPLP could lead to a new method for measuring self-focusing of lasers in underdense plasmas.

Creation of hot radiation environments in laser-driven targets

A hot radiation environment, produced by maximizing laser-energy deposition into a small, high- "can," is a platform being developed for investigations of material properties under extreme conditions. In such small targets, almost doubling the laser energy results in only an incremental increase in the x-radiation flux, and almost no increase in the maximum achieved radiation temperature. That most of this additional laser energy is not deposited within the target is a direct consequence of laser-plasma interactions (LPI) outside of the target, which result in high-angle beams never entering the target late in the laser pulse. Accounting for these processes in the modeling results in quantitative agreement for the first time with experiments using very small cans. These findings have provided the scientific foundation for modifying the target geometry to mitigate the LPI and to achieve higher radiation temperatures.

Methylation of the ESR1 CpG island in the colorectal mucosa is an 'all or nothing' process in healthy human colon, and is accelerated by dietary folate supplementation in the mouse

ESR1 is frequently silenced by CGI (CpG island) methylation, both in human colorectal tumours and, in an age-dependent manner, in healthy mucosa. It is not clear, however, whether methylation of individual cytosines occurs randomly within the epithelial genome, or preferentially within individual cells as an 'all-or-nothing' phenomenon. CGI methylation can be quantified in human DNA residues recovered from faecal samples. We used bisulphite genomic sequencing of human DNA from this source and from a colorectal cancer cell line (SW48) to show that the ESR1 CGI is methylated in an allele-specific manner. This provides support for the 'all or none' mechanism for methylation of this gene, and shows how age-dependent methylation of the ESR1 CGI leads rapidly to silencing of the gene within the cells, and hence the colonic crypt within which it occurs. Preliminary studies with a rodent model suggest the rate of age-dependent methylation of ESR1 is modifiable by dietary folate.

DNA mismatch repair status may influence anti-neoplastic effects of butyrate

HNPCC (hereditary non-polyposis colon cancer) is an autosomal-dominant disorder characterized by early-onset CRC (colorectal cancer). HNPCC is most often associated with mutations in the MMR (mismatch repair) genes hMLH1, hMSH2, hMSH6 or hPMS2. The mutator phenotype of a defective MMR system is MSI (microsatellite instability), which also occurs in approx. 15-25% of sporadic CRC cases, where it is associated with the hypermethylation of the promoter region of hMLH1. Dietary factors, including excessive alcohol consumption, ingestion of red meat and low folate intake, may increase the risk of MSI high tumour development. In contrast, aspirin may suppress MSI in MMR-deficient CRC cell lines. Butyrate, a short-chain-fatty-acid end product of carbohydrate fermentation in the colon, shares a number of anti-neoplastic properties with aspirin, including inhibiting proliferation and inducing apoptosis of CRC cells. Recent in vitro studies suggest that physiological concentrations of butyrate (0.5-2 mM) may have more potent anti-neoplastic effects in CRC cell lines deficient in MMR, but mechanisms for such a differential response remain to be established.

Folate and DNA methylation during in utero development and aging

DNA methylation is one of several epigenetic mechanisms that play a regulatory role in genome programming and imprinting during embryogenesis. Aberrant DNA methylation has been implicated in the pathogenesis of a number of diseases associated with aging, including cancer and cardiovascular and neurological diseases. Evidence is accumulating that dietary factors in utero modulate disease risk in later life. Although folic acid is a key component of DNA methylation, the impact of folic acid availability in utero on DNA methylation patterns and disease risk in adulthood is at present poorly characterized. This review describes the relationship between folic acid and DNA methylation, and the association between DNA methylation during in utero development and aging.

Differential distribution of parvalbumin immunoreactive neurons in the striatum of cocaine sensitized rats

Intermittent administration of psychostimulants such as cocaine and amphetamine can result in behavioral sensitization, which is believed to model the onset of drug addiction, as well as possible neural adaptations that lead to addictive behaviors. The dorsal striatum and the nucleus accumbens (NAc) have been shown to play an integral role in this phenomenon. However, these structures comprise a complex neuroanatomical organization, and few studies have correlated anatomical differentiation within these brain regions with functional (i.e. behavioral) outcome, particularly after psychostimulant exposure. Parvalbumin (PV)-containing GABAergic interneurons are a key neuronal cell population that can significantly regulate input-output functions in these brain regions. The present study quantified parvalbumin-immunoreactive cells in subterritories of the striatum and NAc in animals behaviorally sensitized to cocaine. Rats received a sensitization-inducing regimen of cocaine (twice-daily injections of 15 mg/kg i.p. for 5 consecutive days). Two or 14 days following the last injection, rats were given a challenge injection of cocaine (15 mg/kg i.p.), and killed 2 h later. Sections through the striatum (including the NAc) were processed for parvalbumin immunoreactivity, and the number of immunoreactive neurons was quantified. Repeated cocaine administration resulted in robust sensitization that correlated with transient increases in the number of PV immunoreactive neurons in the ventrolateral, dorsolateral and dorsomedial striatum. After a 2-week withdrawal period, sensitized animals showed a significant decrease in the number of PV+ neurons in the ventrolateral shell of the NAc and dorsomedial striatum, and no significant difference in any other area examined. These data suggest a dichotomous role for PV interneurons in different subterritories of the striatum and NAc during the short-term (induction) vs. long-term (expression) phases of cocaine sensitization.

Observation of the parametric two-ion decay instability with thomson scattering

We present the first direct experimental observation of the parametric two-ion decay instability of ion-acoustic waves driven by a high intensity (5 x 10(15) W cm(-2)) laser beam in a laser produced high-Z plasma. Using two separate Thomson scattering diagnostics simultaneously, we directly measure the scattering from thermal ion-acoustic fluctuations, the primary ion waves that are driven to large amplitudes by the high intensity beam, and the two-ion decay products. The decay products are shown to be present only where the interaction takes place and their k spectrum is broad.

Investigation of the onset and development of forward scattering in an underdense plasma

We investigate the distortion of a spatial intensity modulation imposed on a 527 nm f/10 probe beam as it transmits through an underdense plasma characterized with Thomson scattering. Combining the measurements with full wave simulations of beam propagation through the entire plasma show that the key features of the data can be reproduced using the Kaiser thermal transport model.

Observation of saturation of energy transfer between copropagating beams in a flowing plasma

Experiments demonstrate energy and power transfer between copropagating, same frequency, beams crossing at a small angle in a plasma with a Mach 1 flow. The process is interpreted as amplification of the low intensity probe beam by the stimulated scatter of the high intensity pump beam. The observed probe amplification increases slowly with pump intensity and decreases with probe intensity, indicative of saturation limiting the energy and power transfer due to ion-wave nonlinearities and localized pump depletion. The results are consistent with numerical modeling including ion-wave nonlinearities.

Anomalous absorption of high-energy green laser light in high- z plasmas

We observe strong anomalous absorption of green laser light in mm-scale high-temperature gold plasmas. Both the laser light absorption and the resulting increase of the electron temperature, which was measured independently with Thomson scattering, have been successfully modeled by including enhanced collisions due to heat-flux driven ion acoustic fluctuations. Calculations that include only inverse bremsstrahlung significantly underestimate the experimental laser absorption and the electron temperature.

Detection of red reflex asymmetry by pediatric residents using the Brückner reflex versus the MTI photoscreener

OBJECTIVE

To compare the ability of pediatric residents to differentiate an asymmetric from a symmetric red reflex in patients with anisometropia and microstrabismus using the Brückner reflex and the Medical Technology Innovations (MTI) photoscreener.

METHODS

A prospective, masked, case-control study was performed. Twelve pediatric residents evaluated 10 study patients and 6 control subjects in a masked manner in 2 separate sessions, using the Brückner reflex or the MTI photoscreener, evaluating for asymmetric (abnormal) or symmetric (normal) red reflexes between the 2 eyes. Each study patient had asymmetric red reflexes and the amblyogenic risk factor of anisometropia or microstrabismus. Each control subject had symmetric red reflexes.

RESULTS

The pediatric residents had a mean correct score of 82% (69%-100%) using the MTI photoscreener versus a mean correct score of 65% (44%-81%) using the Brückner reflex (McNemar test: alpha < 0.01). The sensitivity of the MTI photoscreener evaluation was 89% in comparison to 61% for the Brückner reflex. The specificities for the MTI photoscreener versus the Brückner reflex were similar at 69% and 71%, respectively.

CONCLUSIONS

Pediatric residents were better at detecting asymmetric red reflexes in patients with anisometropia and microstrabismus when evaluating MTI photoscreener photographs than when evaluating the red reflexes by the Brückner reflex. The MTI photoscreener may be a more sensitive method than the Brückner reflex to screen for the common amblyogenic risk factors of anisometropia and microstrabismus by easier detection of red reflex asymmetry.

Neurons of origin of the neurotensinergic plexus enmeshing the ventral tegmental area in rat: retrograde labeling and in situ hybridization combined

The morphological and physiological substrates that underlie the mutual regulatory interactions of neurotensin and dopamine in the rat mesotelencephalic projections and related structures remain to be fully described. A salient candidate for neurotensinergic effects on the mesotelencephalic dopamine projection is the dense plexus of neurotensin immunoreactive axons that enmeshes the ventral tegmental area and substantia nigra, but the locations of the neurons that give rise to this plexus have not been identified and its systemic context remains obscure. To address this, Fluoro-Gold and the cholera toxin beta subunit, retrogradely transported axonal tracers, were injected into the ventral tegmental area of rats and the brains were processed to demonstrate neurons that contained both retrograde tracer immunoreactivity and a probe against neurotensin/neuromedin N messenger RNA. Substantial numbers of double-labeled neurons were observed in the rostral part of the lateral septum, and in a region centered on the shared boundaries of the bed nucleus of stria terminalis, ventromedial ventral pallidum, diagonal band of Broca, lateral preoptic area and rostral lateral hypothalamus. A few double-labeled neurons were also observed in the dorsal raphe nucleus and adjacent periaqueductal gray. Despite the administration of haloperidol and D-amphetamine to elicit and enhance neurotensin/neuromedin N messenger RNA expression in striatum, including the nucleus accumbens and olfactory tubercle, no double-labeled neurons were observed there. These results identify a novel brain substrate for control of midbrain dopamine levels, which affect reward mechanisms and motivation.

Ventral mesopontine projections of the caudomedial shell of the nucleus accumbens and extended amygdala in the rat: double dissociation by organization and development

The shell of the nucleus accumbens and central division of the extended amygdala are telencephalic structures that influence motor activity and lately have been regarded by some as components of a single functional-anatomic continuum. Each has a highly differentiated internal organization and output system and distinct pharmacologic responses however, and it is thus likely that each subserves distinct contributions to behavior. In this investigation, nucleus accumbens and extended amygdala outputs were compared by using retrograde tracing in adult and postnatal rats. Fluoro-Gold, when injected into the ventral tegmental area, produced substantial retrograde labeling in the adult nucleus accumbens shell, but only trivial amounts in the central division of the extended amygdala. Injection sites in the lateral mesopontine tegmentum produced robust labeling in the central extended amygdala but little in the nucleus accumbens. The projections of extended amygdala were substantially developed by postnatal day 1, whereas those of the caudomedial shell of the nucleus accumbens only reached the ventral tegmental area by approximately postnatal day 6. Few neurons projecting from the caudomedial shell of the accumbens to the ventral tegmental area were observed even at postnatal day 21. In consideration of the reported importance of the nucleus accumbens, particularly the caudomedial shell, in neural processing related to reward and motivation and the central nervous system response to antipsychotic drugs, it may be important to determine whether processes occurring during the protracted postnatal development of the caudomedial shell are vulnerable to destructive circumstances, such as drug intoxication, maternal separation, or social isolation.

Liquid lung ventilation reduces neutrophil sequestration in a neonatal swine model of cardiopulmonary bypass

OBJECTIVE

Liquid lung ventilation has been demonstrated to improve cardiorespiratory function after cardiopulmonary bypass. We hypothesized that liquid lung ventilation (LLV) would decrease the pulmonary inflammatory response after cardiopulmonary bypass (CPB).

DESIGN

Prospective, randomized, experimental, controlled, nonblinded study.

SETTING

Animal research laboratory at a university setting.

SUBJECTS

A total of 24 neonatal piglets.

INTERVENTIONS

After intubation with a cuffed endotracheal tube, swine were conventionally ventilated. After surgical cannulation, each piglet was placed on conventional nonpulsatile CPB and cooled to 18 degrees C (64.4 degrees F). Subsequently, the animals were exposed to 90 mins of low-flow CPB (35 mL/kg/min). Animals were rewarmed to 37 degrees C (98.6 degrees F), removed from CPB, and ventilated for 90 min. Ten animals received conventional gas ventilation only (control), seven received initiation of LLV before CPB (prevention), and seven received initiation of LLV during the rewarming phase of CPB (treatment). After the animals were killed, the lungs were removed en bloc. The left lobe was dissected and formalin-fixed at 20 cm H2O overnight, followed by paraffin embedding. Sections were taken from the paraffin-embedded lungs. Neutrophil accumulation and lung injury were assessed by histochemical staining with leukocyte esterase and morphometrics, respectively. One hundred microscopic images were digitized from each tissue sample for lung morphometrics, and neutrophil counts were obtained from every fifth image.

MEASUREMENTS AND MAIN RESULTS

Lung tissue sections showed a significantly lower number of neutrophils per alveolar area in the prevention and treatment groups than in the control group (control 681 +/- 65, prevention 380 +/- 49, treatment 412 +/- 101 neutrophils per alveolar area [cells/mm2]; p <.05 for both prevention and treatment compared with control). There were no differences in lung injury as assessed with morphometrics or hemodynamic measurements between any of the three groups.

CONCLUSIONS

The data suggest that LLV reduces the CPB-induced neutrophil sequestration in the pulmonary parenchyma independent of its effects on the circulatory physiology or evidence of early lung injury.

Backscatter reduction using combined spatial, temporal, and polarization beam smoothing in a long-scale-length laser plasma

Spatial, temporal, and polarization smoothing schemes are combined for the first time to reduce to a few percent the total stimulated backscatter of a NIF-like probe laser beam (2x10(15) W/cm (2), 351 nm, f/8) in a long-scale-length laser plasma. Combining temporal and polarization smoothing reduces simulated Brillouin scattering and simulated Raman scattering (SRS) up to an order of magnitude although neither smoothing scheme by itself is uniformly effective. The results agree with trends observed in simulations performed with the laser-plasma interaction code F3D simulations [R. L. Berger et al., Phys. Plasma 6, 1043 (1999)].

Thomson scattering measurements of saturated ion waves in laser fusion plasmas

We have measured the characteristics of saturated ion-acoustic waves in inertial confinement fusion plasmas. A 263-nm probe laser has been applied to simultaneous Thomson scatter on both ion-acoustic waves excited by thermal electrostatic fluctuations and by stimulated Brillouin scattering of a kilojoule laser beam of varying intensity. The Thomson scattering spectra show saturated ion-wave amplitudes for intensities above 5x10(14) W cm(-2) consistent with three dimensional nonlinear wave modeling.

On the altered expression of tyrosine hydroxylase and calbindin-D 28kD immunoreactivities and viability of neurons in the ventral tegmental area of Tsai following injections of 6-hydroxydopamine in the medial forebrain bundle in the rat

Calbindin-D 28kD is a calcium binding protein reported to protect neurons from degeneration by buffering intracellular calcium. It is expressed in midbrain dopaminergic neurons reported to be relatively resistant to degeneration in Parkinson's disease and certain of its animal models. Lesions of the nigrostriatal pathway produced in rats following injection of 6-hydroxydopamine result in a neurochemical profile similar to that seen in patients with Parkinson's disease. In the present study, brains were processed to exhibit tyrosine hydroxylase- and calbindin-D 28kD immunoreactivities in sections through the ventral mesencephalon at 3, 7, 10, 14 and 21 days after 6-hydroxydopamine had been injected into the medial forebrain bundle. Numbers of ventral mesencephalic calbindin-D 28kD immunoreactive neurons were significantly reduced ipsilateral to the lesions at 3 days post-lesion and, following slight recovery, remained significantly depleted through post-lesion day 21. The densities of calbindin-D 28kD and tyrosine hydroxylase immunoreactive neurons were different only at the 3 day post-lesion time point, when the apparent loss of calbindin-D 28 kD immunoreactive profiles was significantly greater. A lesion-induced increase in the proportion of neurons exhibiting both calbindin-D 28kD and tyrosine hydroxylase immunoreactivities, expected if calbindin-D 28kD is neuroprotective, was observed in the substantia nigra, pars compacta, but not in the ventral tegmental area. It is concluded that, while the observed losses of tyrosine hydroxylase and calbindin-D 28kD immunoreactivities do not necessarily reflect neuronal degeneration, they are not consistent with CB confering a neuroprotective advantage in the ventral tegmental area following 6-OHDA lesions as administered in this study.

Acute lung injury and acute respiratory distress syndrome after pulmonary resection

BACKGROUND

In this study we investigate the frequency and mortality of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) after pulmonary resection.

METHODS

Patients that underwent pulmonary resection at the Royal Brompton Hospital between 1991 and 1997 were included. The case notes of all patients developing postoperative complications were retrospectively reviewed.

RESULTS

The overall combined frequency of ALI and ARDS was 3.9%. The frequency was higher in patients over 60 years of age, males and those undergoing resection for lung cancer. ALI/ARDS caused 72.5% of the total mortality after resection in this series.

CONCLUSIONS

In our experience ALI and ARDS are major causes of mortality after lung resection.

Lung injury following pulmonary resection in the isolated, blood-perfused rat lung

Lung resection may be complicated by postpneumonectomy pulmonary oedema. Oxidant generation following surgery-induced ischaemia-reperfusion may be responsible. This hypothesis was tested utilizing isolated, in situ, blood perfused rodent lungs subjected to continuous perfusion (control subjects); one lung ventilation followed by pneumonectomy (group 1); or one lung ventilation followed by reinflation of the collapsed lung (group 2). In control subjects, no significant changes in markers of oxidant damage, oxygenation, pulmonary artery pressure or extravascular albumin extravasation were detected. In group 1 lungs, hydroxyl radical-like damage was detected in association with impaired oxygenation (p<0.05), and increased pulmonary artery pressure and extravascular albumin accumulation in both lungs. In group 2, there was evidence of hydroxyl radical-like damage, and a fall in oxygenation (p<0.05) occurred during one lung ventilation. There was a transient rise in pulmonary artery pressure following lung reinflation and extra vascular albumin accumulation was significantly increased in both lungs (right>left, p<0.05). Both changes were attenuated (p<0.05) following treatment with the reactive oxygen species (ROS) scavenger superoxide dismutase (group 2a) and the nitric oxide synthase inhibitor N(G)-nitro-L-arginine methyl ester (group 2b). Hydroxyl radical-like damage was undetectable following nitric oxide synthase inhibition. Oxidant stress may contribute to the pathologies seen in this model of lung injury.

Perforin-dependent nuclear entry of granzyme B precedes apoptosis, and is not a consequence of nuclear membrane dysfunction

Killer lymphocytes utilize the synergy of a membranolytic protein, perforin, and the serine protease granzyme B (grB) to induce target cell apoptosis, however the mechanism of this synergy remains incompletely defined. We have previously shown that perforin specifically induces the redistribution of cytoplasmic grB into the nucleus of dying cells, however a causal role for nuclear targeting of grB in cell death has not been demonstrated. In the present study, we used confocal laser scanning microscopy (CLSM) to determine whether the nuclear accumulation of fluoresceinated (FITC-) grB precedes or is a consequence of apoptosis. Two distinct and mutually exclusive cellular responses were observed in FDC-P1 cells: (i) up to 50% of the cells rapidly accumulated FITC-grB in the nucleus (maximal at 7 min; t1/2 of 2 min) and underwent apoptosis; (ii) the remaining cells took up FITC-grB only into the cytoplasm, and escaped apoptosis. Under these conditions, DNA fragmentation was not observed for at least 13 min, indicating nuclear accumulation of grB preceded the execution phase of apoptosis. Furthermore, nuclear import of grB proceeded through an intact nuclear membrane, as the nuclei of cells whose cytoplasm was pre-loaded with 70 kDa FITC-dextran excluded dextran for up to 90 min while still undergoing apoptosis in response to perforin and grB. These findings indicated that perforin-induced nuclear accumulation of grB precedes apoptosis, and is not a by-product of caspase-induced nuclear membrane degradation. The cell membrane lesions formed by perforin in these experiments were not large enough to permit a 13 kDa protein (yeast cdk p13suc) access into the cytoplasm, but an 8 kDa protein (bacterial azurin) was able to equilibrate between the cytosol and the exterior. Therefore, transmembrane pores large enough to allow passive diffusion of grB (32 kDa) into the cell are not necessary for apoptosis. Rather, a perforin-dependent signal results in a redistribution of grB from the cytoplasm to the nucleus, where it may contribute to the nuclear changes associated with apoptosis.

Postoperative lung injury and oxidative damage in patients undergoing pulmonary resection

Postpneumonectomy pulmonary oedema (PPO) complicates a significant number of thoracic surgical procedures involving lung resection and in its extreme form is indistinguishable from the acute respiratory distress syndrome. This study investigated the possibility that ischaemia-reperfusion (I-R) injury contributes to PPO via the production of damaging reactive oxygen species. In a prospective, observational, comparative study, patients undergoing pneumonectomy, lobectomy, or wedge resection or open lung biopsy were investigated for perioperative changes in lung function indicative of lung injury and changes in plasma indices of oxidative damage. Significant percentage perioperative falls in plasma protein thiol levels (-17.9+/-7.0% for pneumonectomy, -24.3+/-5.5% for two-lobe lobectomy and -10.2+/-2.2% for one-lobe lobectomy, p<0.05) and rises in plasma protein carbonyl levels (26.2+/-10.5% for pneumonectomy, p<0.05, 9.8+/-7.0% for two-lobe lobectomy and 5.0+/-2.7% for one-lobe lobectomy) were identified, but not in patients undergoing biopsy or wedge resection. Plasma myeloperoxidase levels rose in all groups, but not significantly. The carbon monoxide transfer coefficient (K(CO)) fell significantly in patients undergoing lobectomy (p<0.05) but not in those undergoing wedge resection, lung biopsy or pneumonectomy. Changes in markers of oxidative protein damage occurred in patients undergoing lung resection, although the gas transfer coefficient fell significantly only following lobectomy. Oxidative damage occurs during pulmonary resection, although associated effects on gas exchange are seen only after lobectomy.

Sexual coercion, domestic violence, and negotiating condom use among low-income African American women

Coercion to engage in unwanted sex places women at risk for human immunodeficiency virus (HIV) infection. A survey of 125 women living in low-income housing developments in Fulton County, Georgia, showed that 53 (42%) women had engaged in unwanted sex because a male partner threatened to use force or used force to obtain sexual access. Women who had been sexually coerced were more likely to have used marijuana and crack cocaine and to have abused alcohol. Coerced women were more likely to have been physically abused by a domestic partner. These women were also more likely to perceive that requesting male partners to use condoms would create a potentially violent situation. These results suggest that women experience an interactive constellation of social problems that create risks for HIV infection and, therefore, that efforts to prevent HIV infection among women will require multifaceted intervention strategies to reach both men and women at risk.

It's like a regular part of gay life: repeat HIV antibody testing among gay and bisexual men

HIV antibody testing is a critical facet of national AIDS prevention strategies and increasing numbers of persons are tested each year. Research has shown that a significant number of men who have sex with men are repeatedly tested for HIV antibodies, and many are tested regularly every 6 months. This study investigated the prevalence of repeat testing (having been tested three or more time) and regular testing (having been tested three or more times and getting tested every 6 months), and their association to testing attitudes and sexual behaviors. We found that 66% of 253 HIV seronegative gay and bisexual men surveyed at a large gay pride festival had been repeatedly tested, and 47% were tested regularly. Repeat testing was associated with knowing people with HIV or AIDS, whereas regular testing was associated with younger age and not being in an exclusive sexual relationship. Both repeat and regular testers held more positive health-related attitudes about testing than nonrepeat and nonregularly tested men, respectively. Contrary to previous research, repeat testing was not associated with unprotected anal intercourse or unprotected oral sex. However, both repeat and regular testing were positively related to condom use during anal intercourse as well as having multiple protected anal intercourse partners. We therefore conclude that both repeat testing and higher rates of condom use reflect positive health attitudes and that repeat testing may function to meet the needs of some men who have sex with men.

An investigation into the reversibility of the morphological and cytokinetic changes seen in the small intestine of riboflavin deficient rats

BACKGROUND

Impaired iron handling in riboflavin deficiency is thought to be partially a result of significant morphological and cytokinetic changes within the small intestine.

AIMS

The aim of the study was to find out if the responses of the rat small intestine to riboflavin deficiency induced at weaning could be reversed upon repletion.

SUBJECTS

48 female weanling Wistar rats were used for the purpose of the study.

METHODS

Rats were fed a riboflavin deficient diet or a complete control diet for a period of five weeks followed by a repletion period of up to three weeks. Rats were killed on day 0, 2, 7, or 21 of repletion. The duodenum was removed and fixed for subsequent analysis.

RESULTS

Five weeks of riboflavin deficiency significantly changed the morphology and cytokinetics of the duodenum; the changes were not reversed within the 21 day repletion period despite biochemical evidence for a correction of the deficiency.

CONCLUSIONS

The results show that the small intestine cannot readily recover from a period of riboflavin deficiency induced at weaning, supporting the notion that the weaning period is a critical time for gastrointestinal development and highlighting the importance of adequate nutrition during infancy.