Performances of local poultry breed fed black soldier fly larvae reared on horse manure.

In poultry, feed based on maggots, like larvae of black soldier fly (Hermetia illucens) is an attractive option to substitute current ingredients which are expensive and often in direct or indirect competition with human food. Little information is currently available on the utility of these larvae in poultry feed, so goals of this study were to determine whether larvae could be reared on horse manure under traditional farming conditions and to evaluate the growth performances of a local poultry fed these larvae and the fatty acids profiles of their meat. After freezing and thawing, larvae were introduced in the feed of Ardennaise chickens between 30 and 80 days of age. Birds in the control group received a commercial standard feed, while those in the treatment group received the same commercial feed in which 8% was substituted with whole fresh larvae corresponding to 2% on a dry matter basis. Means ± standard errors of larval length and weight were 20.67 ± 2.21 mm and 0.14 ± 0.02 g, respectively. Mean larval percentages of dry matter and of substances extractable in diethyl ether were 24.6% and 23.1%, respectively. Larval fatty acids profiles were predominantly composed of lauric acid (28.1%) and palmitic acid (22.0%). Least squares means of weekly weights of chicken, adjusted for the effects of sex, replication and initial weights, were significantly higher (P < 0.05) by 77.03 ± 53.37 g in larvae-fed than in control chickens. All other measurements were not statistically different between larvae-fed and control chicken, including fatty acid profiles, protein content and ω6/ω3 ratio.

Hospital Choice for Cataract Treatments: The Winner Takes Most.

BACKGROUND: Transparency in quality of care is an increasingly important issue in healthcare. In many international healthcare systems, transparency in quality is crucial for health insurers when purchasing care on behalf of their consumers, for providers to improve the quality of care (if necessary), and for consumers to choose their provider in case treatment is needed. Conscious consumer choices incentivize healthcare providers to deliver better quality of care. This paper studies the impact of quality on patient volume and hospital choice, and more specifically whether high quality providers are able to attract more patients. METHODS: The dataset covers the period 2006-2011 and includes all patients who underwent a cataract treatment in the Netherlands. We first estimate the impact of quality on volume using a simple ordinary least squares (OLS), second we use a mixed logit to determine how patients make trade-offs between quality, distance and waiting time in provider choice. RESULTS: At the aggregate-level we find that, a one-point quality increase, on a scale of one to a hundred, raises patient volume for the average hospital by 2-4 percent. This effect is mainly driven by the hospital with the highest quality score: the effect halves after excluding this hospital from the dataset. Also at the individual-level, all else being equal, patients have a stronger preference for the hospital with the highest quality score, and appear indifferent between the remaining hospitals. CONCLUSION: Our results suggest that the top performing hospital is able to attract significantly more patients than the remaining hospitals. We find some evidence that a small share of consumers may respond to quality differences, thereby contributing to incentives for providers to invest in quality and for insurers to take quality into account in the purchasing strategy.

Platypnea-Orthodeoxia Syndrome: A Case of Chronic Paroxysmal Hypoxemia.

A 75-year-old man with chronic (30-year) unexplained paroxysmal hypoxemia presented with postural hypoxemia and desaturation consistent with a clinical manifestation of platypnea-orthodeoxia syndrome. His history included a lack of significant past pulmonary disease, yet with intermittent need for oxygen supplementation. On admission he was found to have an interatrial shunt through a patent foramen ovale. Device closure by percutaneous catheterization led to sustained resolution of symptoms. Platypnea-orthodeoxia syndrome is a rare but important consideration in the differential diagnosis of hypoxemia, as it represents a potentially curable cause of hypoxemia, with missed diagnosis leading to possible patient morbidity if untreated. Even more importantly, an astute and careful history and physical examination are integral to the diagnosis of this rare but likely under-recognized syndrome.

The dimensional structure of cycling mood disorders.

This study examines whether mood disorders differ fundamentally in terms of phase duration. Most clinically significant mood disorders are recurrent and cyclical. The phase duration of these cycles is part of the diagnostic criteria. Specifically, we determined whether a dimensional or taxonic latent structure better captures cycling mood disorders. 319 patients recruited from 5 psychiatrists and a psychoeducational program completed three questionnaires assessing aspects of mood cycling. These were the Affective Lability Scale-Short Form (ALS-SF), Mood Disorders Questionnaire (MDQ), and the Eysenck Neuroticism scale. Patient scores on these instruments were submitted to three taxometric procedures (MAMBAC, MAXEIG, and L-Mode). Comparison curve fit indices (CCFIs) were calculated to distinguish taxonic versus dimensional latent structure. In addition, graphs were produced for each procedure and compared with those of categorical or dimensional prototypes. The CCFIs of the three procedures ranged from 0.25 to 0.27, consistent with dimensional structure. The graphs closely resembled dimensional prototypes. Mood instability and other types of cycling moods probably conform to a dimensional latent structure. Patients with disorders featuring mood cycling might benefit from common treatments.

Pricing behaviour of nonprofit insurers in a weakly competitive social health insurance market.

In this paper we examine the pricing behaviour of nonprofit health insurers in the Dutch social health insurance market. Since for-profit insurers were not allowed in this market, potential spillover effects from the presence of for-profit insurers on the behaviour of nonprofit insurers were absent. Using a panel data set for all health insurers operating in the Dutch social health insurance market over the period 1996-2004, we estimate a premium model to determine which factors explain the price setting behaviour of nonprofit health insurers. We find that financial stability rather than profit maximisation offers the best explanation for health plan pricing behaviour. In the presence of weak price competition, health insurers did not set premiums to maximize profits. Nevertheless, our findings suggest that regulations on financial reserves are needed to restrict premiums.

Treatment for depression and change in mood instability.

BACKGROUND: Mood varies along at least 2 dimensions, severity and instability (MI). Compared with severity, there is little research on the treatment of MI. We assessed changes in MI with community psychiatric treatment, in patients with depression and mood swings. METHOD: Diagnoses were obtained with the MINI. Thirty-four patients completed the Mood Disorders Questionnaire, the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-T). MI was calculated from visual analogue scales (VAS) ratings for depression and anxiety. The VAS was rated twice a day for a week. The BDI, STAI-T and VAS were repeated after 3-6 months of treatment. RESULTS: Patients improved with treatment on depression (BDI) and anxiety (STAI-T) severity but not on MI. However, change in MI predicted change in depression severity (BDI). LIMITATIONS: The sample size was relatively small and information on treatment was limited. There was no control group. Studies of longer duration and with more comprehensive treatment might be necessary to show changes in MI. CONCLUSIONS: MI does not respond consistently within 3-6 months to common effective psychiatric treatments for depression and anxiety. Improved treatment of MI could result in improved treatment for major depression.

A mathematical study of the differential effects of two SERCA isoforms on Ca2+ oscillations in pancreatic islets.

Cytosolic Ca2+ dynamics are important in the regulation of insulin secretion from the pancreatic beta-cells within islets of Langerhans. These dynamics are sculpted by the endoplasmic reticulum (ER), which takes up Ca2+ when cytosolic levels are high and releases it when cytosolic levels are low. Calcium uptake into the ER is through sarcoendoplasmic reticulum Ca2+-ATPases, or SERCA pumps. Two SERCA isoforms are expressed in the beta-cell: the high Ca2+ affinity SERCA2b pump and the low affinity SERCA3 pump. Recent experiments with islets from SERCA3 knockout mice have shown that the cytosolic Ca2+ oscillations from the knockout islets are characteristically different from those of wild type islets. While the wild type islets often exhibit compound Ca2+ oscillations, composed of fast oscillations superimposed on much slower oscillations, the knockout islets rarely exhibit compound oscillations, but produce slow (single component) oscillations instead. Using mathematical modeling, we provide an explanation for this difference. We also investigate the effect that SERCA2b inhibition has on the model beta-cell. Unlike SERCA3 inhibition, we demonstrate that SERCA2b inhibition has no long-term effect on cytosolic Ca2+ oscillations unless a store-operated current is activated.

Role of cytokines (TNF-alpha, IL-1beta and KC) in the pathogenesis of CPT-11-induced intestinal mucositis in mice: effect of pentoxifylline and thalidomide.

INTRODUCTION: Irinotecan (CPT-11) is an inhibitor of DNA topoisomerase I and is clinically effective against several cancers. A major toxic effect of CPT-11 is delayed diarrhea; however, the exact mechanism by which the drug induces diarrhea has not been established. PURPOSE: Elucidate the mechanisms of induction of delayed diarrhea and determine the effects of the cytokine production inhibitor pentoxifylline (PTX) and thalidomide (TLD) in the experimental model of intestinal mucositis, induced by CPT-11. MATERIALS AND METHODS: Intestinal mucositis was induced in male Swiss mice by intraperitoneal administration of CPT-11 (75 mg/kg) daily for 4 days. Animals received subcutaneous PTX (1.7, 5 and 15 mg/kg) or TLD (15, 30, 60 mg/kg) or 0.5 ml of saline daily for 5 and 7 days, starting 1 day before the first CPT-11 injection. The incidence of delayed diarrhea was monitored by scores and the animals were sacrificed on the 5th and 7th experimental day for histological analysis, immunohistochemistry for TNF-alpha and assay of myeloperoxidase (MPO) activity, tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and KC ELISA. RESULTS: CPT-11 caused significant diarrhea, histopathological alterations (inflammatory cell infiltration, loss of crypt architecture and villus shortening) and increased intestinal tissue MPO activity, TNF-alpha, IL-1beta and KC level and TNF-alpha immuno-staining. PTX inhibited delayed diarrhea of mice submitted to intestinal mucositis and reduced histopathological damage, intestinal MPO activity, tissue level of TNF-alpha, IL-1beta and KC and TNF-alpha immuno-staining. TLD significantly reduced the lesions induced by CPT-11 in intestinal mucosa, decreased MPO activity, TNF-alpha tissue level and TNF-alpha immuno-staining, but did not reduce the severity of diarrhea. CONCLUSION: These results suggest an important role of TNF-alpha, IL-1beta and KC in the pathogenesis of intestinal mucositis induced by CPT-11.

Comportamientos sexuales de adolescentes y jóvenes adultos en comunidades de Honduras / Adolescents youngsters Sexual behaviorus in communities in Honduras

OBJETIVOS. En Honduras, con altas tasas de infecciones de transmisión sexual y VIH/sida y violencia, resulta urgente conocer los comportamientos relacionados con las prácticas sexuales de los adolescentes y adultos. MATERIAL Y MÉTODOS. Este estudio, ha pretendido recoger a través de una etnografía las principales manifestaciones de la sexualidad de los/las jóvenes en comunidades de obreros/as del Distrito Central, Valle de Sula y costa atlántica del país. RESULTADOS. Se encontró que las conductas sexuales se conforman y se refuerzan dentro y a partir de grupos primarios. La formación que reciben niños y adolescentes enfatiza en que la niña aprenda a ser complaciente, obediente, sumisa, pasiva y cariñosa; el niño a ser rebelde, voluntarioso, agresivo, con la convicción de que ser hombre es mejor que ser mujer. El doble y contradictorio proceso de socialización se traduce en æÉxito inmediato, sexo temprano. Ambos aprenden a mentir desde muy temprano, rasgo potenciado por la extendida indolencia ante los fenómenos sociales, políticos y culturales. Un importante vacío detectado es la ignorancia acerca de la sexualidad y el desconocimiento sobre su propio organismo. CONCLUSIONES. Es necesario vigilar los comportamientos condicionantes de epidemias como sida y violencia, aplicar sistemas de consejería para atender a los niños y jóvenes, y lograr acuerdos básicos entre los grupos que establecen políticas de educación y conducen procesos de persuasión dirigidos a jóvenes y adultos...

Valproic acid enhances axonal regeneration and recovery of motor function after sciatic nerve axotomy in adult rats.

It has recently been demonstrated that valproic acid (VPA) robustly promotes neurite outgrowth, activates the extracellular signal regulated kinase pathway, and increases growth cone-associated protein 43 and bcl-2 levels in cultured human neuroblastoma SH-SY5Y cells. We hypothesized that VPA could also enhance peripheral nerve regeneration in adult animals. To test this hypothesis, we examined the effects of VPA (300 mg/kg daily for 16 weeks) on sciatic axonal regeneration following single or conditional axotomies in rats. The results showed that in VPA-treated rats there was a significant increase in the total numbers of regenerated myelinated nerve fibers and reinnervated muscle fibers in comparison with those rats not treated with VPA. As measured by sciatic function index and toe spread index, the motor function of the reinnervated hind limbs of rats receiving single axotomy without VPA treatment significantly improved at week 8 and reached plateau levels at about week 11, whereas the motor function of the reinnervated hind limbs of rats receiving single axotomy plus VPA and rats receiving conditional axotomy with or without VPA treatment significantly improved at week 4 and reached plateau levels at about week 8; there was no significant difference of the motor function among the three later groups. The results demonstrated that VPA is able to enhance sciatic nerve regeneration and recovery of motor function in adult rats, suggesting the potential clinical application of VPA for the treatment of peripheral nerve injury in humans.

Response of patients with panic disorder and symptoms of hypomania to cognitive behavior therapy for panic.

OBJECTIVES: The purpose of this cohort study was to determine in patients with Panic Disorder (PD): (1). the prevalence of subsyndromal symptoms of hypomania, and (2). whether subsyndromal hypomania symptoms affect the outcome of cognitive behavior therapy (CBT) for panic. METHODS: Using the Diagnostic Interview Schedule, and DSM-III-R criteria we identified 18 individuals with a history of symptoms of hypomania among 56 patients with PD. Patients were treated in an open CBT group program. They were assessed before treatment and 6 and 12 months later. We used the Brief Symptom Inventory (BSI), the Perceived Stress Scale (PSS), the Pearlin-Schooler Mastery Scale (PMS), and the Social Adjustment Scale (SAS) at all assessments. RESULTS: The total group significantly improved on all measures. The Clinically Significant Change was 71.4% and the Reliable Change Index 48.2%. Between 6 and 12 months, there was a trend for the hypomania symptom subgroup (PH) to continue to improve on the BSI Depression Scale, the Perceived Stress Scale, the Pearlin-Schooler Mastery Scale, and the Social Adjustment Scale but to lose gains on the BSI Phobic Anxiety and Somatization subscales compared with the group without symptoms of hypomania (PNH). CONCLUSIONS: Thirty-two percent of patients with PD had symptoms of hypomania. With CBT for panic, patients with PD and symptoms of hypomania improve as much as those without hypomania symptoms. The presence or absence of symptoms of hypomania might help explain the inconsistent effects of depression and personality disorders on the treatment of PD.

Excision of a conjugative transposon in vitro by the Int and Xis proteins of Tn916.

The roles of purified Int and Xis proteins of the conjugative transposon Tn 916 in excision of a deletion derivative of the closely related element Tn 1545 were investigated. At a low salt concentration (37.5 mM NaCl), Int alone was able to promote limited excision to produce a covalently closed circular form of the transposon, showing that Tn 916 Int can catalyze both DNA cleavage and strand exchange. This reaction was stimulated by Xis. At higher salt concentrations (150 mM NaCl), excision by Int alone was reduced to barely detectable levels and Xis was required for excision. The low salt, Xis-stimulated reaction was approximately 8-fold more efficient than the high salt, Xis-dependent reaction. These results reflect in vivo requirements for Int and Xis in excision.

DNA binding by the Xis protein of the conjugative transposon Tn916.

We purified the Xis protein of the conjugative transposon Tn916 and showed by nuclease protection experiments that Xis bound specifically to sites close to each end of Tn916. These specific binding sites are close to, and in the same relative orientation to, binding sites for the N-terminal domain of Tn916 integrase protein. These results suggest that Xis is involved in the formation of nucleoprotein structures at the ends of Tn916 that help to correctly align the ends so that excision can occur.