Knowledge, attitudes and practices among healthcare professionals regarding complementary alternative medicine use by patients with hypertension and type 2 diabetes mellitus in Western Jamaica.

OBJECTIVES: This study investigated the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) regarding CAM use for Hypertension (HTN) and Type 2 Diabetes Mellitus (T2DM) among patients in western Jamaica, and to determine HCPs' perceptions of the need for training on CAM. DESIGN: A cross-sectional study was conducted from May to August 2019. SETTING: HCPs serving patients with HTN and T2DM in chronic disease clinics in western Jamaica completed a self-administered questionnaire that provided data on their sociodemographic characteristics, training, and KAP of CAM. MAIN OUTCOME MEASURE: The data identified factors associated with discussion and recommendation of CAM to patients and personal use of CAM by HCPs. RESULTS: Type of profession (physicians vs nurses OR = 2.17; 95 % CI = 1.07-4.42 and pharmacists vs nurses OR = 8.67; 95 % CI = 2.83-26.57) was significantly associated with discussion of CAM. Training on CAM was significantly associated with discussion (OR = 2.36; 95 % CI = 1.26-4.42), recommendation (OR = 2.72; 95 % CI = 1.36-5.42), and personal use of CAM (OR = 2.90; 95 % CI = 1.69-4.97). Dieticians and nutritionists had 4.56 higher odds of personal use of CAM (95 % CI = 1.16-17.86), and personal use of CAM was significantly associated with discussion (OR = 8.94; 95 % CI = 4.76-16.80) and recommendation (OR = 7.17; 95 % CI = 3.54-14.51) of CAM. The majority of HCPs (70-89 %) agreed that there is a need to include CAM in professional training programs. CONCLUSION: The results of this study can be used to guide development of programs for training HCPs on knowledge and safe use of CAM so that they can better serve their patients.

Developing a novel oral vitamin D3 intake bioassay to re-evaluate the vitamin D3 requirement for modern broiler chickens.

The present study was conducted to develop a non-traditional vitamin D3 (D3) intake bioassay with the objective of increasing the precision of D3 delivery to the chickens. For this purpose, newly hatched chickens (5 birds per cage) were allocated in battery brooders and randomly distributed into 8 treatments and 6 replicates per treatment. A basal corn-soy diet devoid of D3 containing calculated calcium and non-phytate phosphorus concentrations of 0.90 and 0.45%, respectively, was fed throughout a 21-D period. The first 9 D of the study served to deplete the maternal stores of D3 followed by a 12-h fasting period. From day 10 to the end of the trial, the birds were gavaged with graded levels of D3 obtained from a highly purified pharmaceutical grade D3 standard (99.8%) purchased from Sigma-Aldrich and dissolved in corn oil. Daily gavage treatments were based on estimated intake of 0, 50, 100, 200, 400, 800, 1,600, and 3,200 IU D3/kg of feed consumed over the last 12 D of the study. Precise cholecalciferol intake per kg of diet was adjusted based on actual daily feed intake per pen of birds. Performance data were evaluated from day 10 to 21. Percent tibia bone ash (TBA), tibia breaking strength (TBS), total mineral content, and total bone mineral density were obtained at day 21. The D3 treatments improved (P < 0.05) weight gain and feed efficiency. There was no linear or quadratic effect for any of the productivity performance variables. Graded levels of D3 improved (P < 0.05) TBA and TBS. Both were linearly increased (P < 0.05) in response to graded levels of D3. A quadratic response was observed for TBS only. Under the conditions of the present experiment and the average of 3 regression models, the D3 requirement for starter broilers was estimated at 285 IU D3/kg of feed when bone mineralization responses (TBA and TBS) were used as criteria to estimate the requirement.

Evaluation of high dietary phytase supplementation on performance, bone mineralization, and apparent ileal digestible energy of growing broilers.

The present study was conducted to evaluate four commercially available phytase sources supplemented at regular (R) and super-dose (S) levels on live performance, bone mineralization, and apparent ileal digestible energy. Broiler chickens were allocated in stainless steel battery brooders (six birds per cage and eight pen replicates per treatment). A basal diet formulated to contain 0.2% non-phytate phosphorus (NPP) and 0.7% Ca was subdivided to create 11 dietary treatments: (1) basal diet was kept as the negative control (NC); (2) NC + limestone and monoclacium phosphate to create positive controls 1 and 2 formulated to yield 0.3% and 0.4% NPP; (3) NC + phytase A (250 and 1,500 FTU/kg); (4) NC + phytase B (500 and 1,500 FTU/kg); (5) NC + phytase C (500 and 1,000 FTU/kg); (6) NC + phytase D (1,000 and 2,000 FYT/kg). Performance was evaluated on d 7, 14, and 22. Tibia bone ash, tibia breaking strength, bone mineral content, and bone mineral density were evaluated on d 22. Apparent energy digestibility was evaluated on d 24. At d 7, phytases A and C supplemented at S level improved (P < 0.05) body weight and weight gain when compared to the NC. At d 14 and 22, all phytase sources improved (P < 0.05) body weight, weight gain, and bone mineralization when compared to the chicks under the NC diet. Overall, phytase supplementation at S level improved 17% apparent ileal digestibility at 24 d. Throughout the grow out period, phytase super-dose yield (P < 0.05) better performance, bone characteristics, and energy digestibility than the regular dietary level. In conclusion, all phytase sources were able to compensate the phosphorus deficiency and promote performance and bone mineralization. High levels of phytase showed a higher response when compared to the lower levels of supplementation.

Saline-push improves rubidium-82 PET image quality.

INTRODUCTION: Rubidium-82 (82Rb) PET is used widely for myocardial perfusion imaging. The purpose of this study was to investigate if an additional saline-push following the 82Rb elution improves PET image quality. METHODS: 82Rb PET scans were acquired with and without 26 mL saline-push in six patients as part of a clinical quality improvement program. Dynamic images were analyzed to measure the total activity delivered to the superior vena cava (SVC) and retained in the left ventricle (LV) myocardium. Tracer uptake images were used to measure blood background coefficient-of-variation (COV), myocardium-to-blood signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) to assess image quality. RESULTS: Similar eluted activity was measured with/without the saline-push (830 vs 795 MBq; P = 0.24). The activity delivered to the heart and retained in the myocardium was consistently increased more than twofold (SVC: + 114% and LV: + 104%; P < 0.001) with the saline-push. Image quality was improved in all patients, with lower background noise (COV: - 19%), higher SNR (+ 24%) and CNR (+ 27%) (all P ≤ 0.01). CONCLUSIONS: The saline-push used to flush 82Rb activity out of the infuser tubing, patient injection and intravenous access lines consistently increased the activity delivered to the heart by twofold. This technique is recommended to maximize image quality with 82Rb PET.

Hydrogen Atom Abstraction by Permanganate: Oxidations of Arylalkanes in Organic Solvents.

Oxidations of arylalkanes by (n)()Bu(4)NMnO(4) have been studied in toluene solvent: toluene, ethylbenzene, diphenylmethane, triphenylmethane, 9,10-dihydroanthracene, xanthene, and fluorene. Toluene is oxidized to benzoic acid and a small amount of benzaldehyde; other substrates give oxygenated and/or dehydrogenated products. The manganese product of all of the reactions is colloidal MnO(2). The kinetics of the reactions, monitored by UV/vis spectrometry, show that the initial reactions are first order in the concentrations of both (n)()Bu(4)NMnO(4) and substrate. No induction periods are observed. The same rate constants for toluene oxidation are observed in neat toluene and in o-dichlorobenzene solvent, within experimental errors. The presence of O(2) increases the rate of (n)()Bu(4)NMnO(4) disappearance. The reactions of toluene and dihydroanthracene exhibit primary isotope effects: k(C)()7(H)()8/k(C)()7(D)()8 = 6 (+/-1) at 45 degrees C and k(C)()14(H)()12/k(C)()14(D)()12 = 3.0 (+/-0.6) at 25 degrees C. The rates of oxidation of substituted toluenes show only small substituent effects. In the reactions of dihydroanthracene and fluorene, the MnO(2) product is consumed in a subsequent reaction that appears to form a charge-transfer complex. The rate-limiting step in all of the reactions is hydrogen atom transfer from the substrate to a permanganate oxo group. The enthalpies of activation for the different substrates are directly proportional to the DeltaH degrees for the hydrogen atom transfer step, as is typical of organic radical reactions. The ability of permanganate to abstract a hydrogen atom is explained on the basis of its ability to form an 80 +/- 3 kcal/mol bond to H(*), as calculated from a thermochemical cycle. (This bond strength is slightly lower than given in earlier calculations.) Rates of H(*) abstraction by (n)()Bu(4)NMnO(4) correlate with rates of abstraction by oxygen radicals.