In vivo assessment of an industrial waste product as a feed additive in dairy cows: Effects of larch (Larix decidua L.) sawdust on blood parameters and milk composition.

When larch (Larix spp.) is processed in the wood industry, the sawdust is currently disposed of as waste or used as combustible material, even though it is rich in biologically active compounds. In this study the effect of larch sawdust supplementation on blood parameters as well as milk composition was examined in healthy mid-lactating dairy cows. Twenty-four multiparous Italian Friesian dairy cows were assigned to groups receiving either 300 g/day/cow of larch sawdust or a control diet, and treatments were continued for a 20 day period. Milk parameters were unaffected by treatment. A lower plasma total protein concentration was observed and can be attributed to a decrease in globulin concentration. A lower plasma urea concentration was also detected in the larch group. Moreover, biomarkers of liver function were influenced by the treatment. Total bilirubin was lower in larch-treated animals, and cholesterol tended to be lower. In addition, an interaction between day and treatment was observed for very low density lipoprotein. The concentration of other parameters, including reactive oxygen metabolites, superoxide dismutase, glutathione peroxidase and nitrotyrosine, did not differ between treatments. The observed benefits, together with the good palatability, make larch sawdust a promising candidate for the development of beneficial feed supplements for livestock. Further studies will be useful, particularly to evaluate its efficacy in different health conditions.

The effects of gait strategy on metabolic rate and indicators of stability during downhill walking.

When walking at a given speed, humans often appear to prefer gait patterns that minimize metabolic rate, thereby maximizing metabolic economy. However, recent experiments have demonstrated that humans do not maximize economy when walking downhill. The purpose of this study was to investigate whether this non-metabolically optimal behavior is the result of a trade-off between metabolic economy and gait stability. We hypothesized that humans have the ability to modulate their gait strategy to increase either metabolic economy or stability, but that increase in one measure will be accompanied by decrease in the other. Subjects walked downhill using gait strategies ranging from risky to conservative, which were either prescribed by verbal instructions or induced by the threat of perturbations. We quantified spatiotemporal gait characteristics, metabolic rate and several indicators of stability previously associated with fall risk: stride period variability; step width variability; Lyapunov exponents; Floquet multipliers; and stride period fractal index. When subjects walked using conservative gait strategies, stride periods and lengths decreased, metabolic rate increased, and anteroposterior maximum Lyapunov exponents increased, which has previously been interpreted as an indicator of decreased stability. These results do not provide clear support for the proposed trade-off between economy and stability, particularly when stability is approximated using complex metrics. However, several gait pattern changes previously linked to increased fall risk were observed when our healthy subjects walked with a conservative strategy, suggesting that these changes may be a response to, rather than a cause of, increased fall risk.

ECG-gated 99mTc single-photon emission CT for assessment of right ventricular structure and function: is the information provided similar to echocardiography?

STUDY OBJECTIVE: (99m)Tc single-photon emission CT (SPECT) and ECG-gated SPECT can visualize well the right ventricle (RV) in most patients, but their utility for assessment of the RV has not been formally evaluated. We examined whether (99m)Tc SPECT/ECG-gated SPECT provide similar information to transthoracic two-dimensional Doppler echocardiography (2D-ECHO) regarding RV cavity size, wall thickness, and systolic function. DESIGN: Retrospective analysis. SETTING: A major university teaching hospital. PATIENTS: A consecutive series of 194 patients with good quality stress SPECT and 2D-ECHO studies performed within 1 day of each other and no significant interim cardiac events. MEASUREMENTS AND RESULTS: RV size and function were visually assessed by SPECT/ECG-gated SPECT and 2D-ECHO. RV wall thickness was visually assessed by SPECT and measured in mm in end-diastole by 2D-ECHO. Of 142 patients with normal RV cavity size by SPECT, 134 patients (94%) had normal RV cavity size by 2D-ECHO. However, of 52 patients with RV dilation by SPECT, only 9 patients (17%) had RV dilation by 2D-ECHO. A perfusion abnormality in the right coronary artery territory was significantly associated with RV dilation by SPECT (p < 0.005) and 2D-ECHO (p < 0.05). Among 150 patients with ECG-gated SPECT, only 2 patients had abnormal RV systolic function, as compared with 18 patients by 2D-ECHO. RV wall thickness measurements by SPECT and 2D-ECHO did not correlate. CONCLUSIONS: For normal interpretations regarding RV cavity size, wall thickness, and systolic function, there is good agreement between (99m)Tc stress SPECT/ECG-gated SPECT and 2D-ECHO. However, there is poor overall agreement between gated SPECT/ECG-gated SPECT and 2D-ECHO regarding the presence of RV dilation, hypertrophy, and systolic dysfunction.

Posttraumatic concerns: a patient-centered approach to outcome assessment after traumatic physical injury.

BACKGROUND: Approximately 2.5 million Americans are admitted to the hospital after traumatic physical injury each year. Few investigations have elicited patients' perspectives regarding posttraumatic outcomes. OBJECTIVE: To identify and categorize physically injured trauma survivors' posttraumatic concerns. RESEARCH DESIGN: Prospective longitudinal investigation; trauma survivors were interviewed during the post-injury hospitalization and again 1, 4, and 12 months after the trauma. SUBJECTS: Ninety-seven, randomly selected, English speaking, hospitalized survivors of motor vehicle-crashes or assaults. MEASURES: At the end of each interview patients were asked, "Of all the things that have happened to you since you were injured, what concerns you the most?" Using an iterative process and working by consensus, investigators categorized patient concerns in content domains. Concern domains were then compared with established measures of posttraumatic stress disorder (PTSD) symptoms and limitations in physical functioning. RESULTS: Seven categories of posttraumatic concerns were identified. During the course of the year, 73% of patients expressed physical health concerns, 58% psychological concerns, 53% work and finance concerns, 40% social concerns, 10% legal concerns, 10% medical concerns, and 20% uncodable concerns. Rater agreement on concern categorization was substantial (kappa = 0.72). The mean number of concerns expressed per patient gradually decreased over time (1 month mean = 1.51; 12 month mean = 1.26) and resembled the trajectories of PTSD symptoms and functional limitations. CONCLUSIONS: The concerns of physically injured trauma survivors are readily elicited and followed up during the course of the year after injury. Open-ended inquiry regarding posttraumatic concerns may complement standardized outcome assessments by identifying and contextualizing the outcomes of greatest importance to patients.

Determination of the presence of antioxidants deriving from sage and oregano extracts added to animal fat by means of assessment of the radical scavenging capacity by photochemiluminescence analysis.

Herbs and their extracts with antioxidant capacity could be used directly as stabilisers of fat and indirectly as feed additives, in order to improve quality and shelf-life of meat and fat-containing food. In this work a sensitive analytical method is proposed for determination of the antioxidant activity measured by photochemiluminescence (PCL) in lard stabilised with extracts of sage (Salvia officinalis L.) or oreganum (Origanum vulgare L.). A prior step of purification of fat samples is required, in order to separate and concentrate the phenolics from lipidic substances. The method was validated by determination of recovery rate and repeatability. In addition fat samples originating from pigs fed with feed additives of Salviae folium or Origani herba were analysed to investigate the supposed antioxidative effects, that could increase the shelf-life of meat products. In contrast with lard mixed with extracts of sage or oregano, back fat samples originating from pigs fed with feed additives of the same herbs didn't show a higher antioxidant activity than the control group. On the one hand it seems possible to keep perishable fat-containing food longer by an addition of an extract of sage or oregano due to their antioxidative properties, on the other hand administration of feed additives of dried herbs to pigs had no effect on quality and shelf-life of fat obtained from these animals.

[Multidisciplinary treatment program for chronic low back pain, part 1. Overview]. / Das Göttinger Rücken Intensiv Programm (GRIP)--ein multimodales Behandlungsprogramm für Patienten mit chronischen Rückenschmerzen, Teil 1 Ergebnisse im Uberblick.

UNLABELLED: A multimodal treatment program is presented in cases of functional restoration for chronic low back pain. The study comprises four parts. Part I gives an overview of the different results of the study. Part II focuses on the medical and functional examination in comparison with persons who do not suffer from back pain. Part III describes psychosocial aspects (depression, complaints, ways of coping, disability) and psychotherapy. In part IV prognostic factors and their reliability for predicting treatment outcome (return to work, pain intensity, self-assessment of success by patients) are examined. In addition the relevant effects of the program on social and health care systems are also addressed. PROBLEM: The incidence of low back pain is continuously increasing, causing tremendous costs for the health insurance system. Therefore effective treatment methods are needed that take into account somatic, psychological and social factors. Chronic low back pain is conceptualized as a complex phenomenon including biological, social and psychological aspects, all of which should be addressed in a treatment program. A multimodal treatment program for chronic low back pain is presented, in which physical activity and cooperation of the patient are the primary targets. Therapeutic aims focus less on pain reduction and emphasize instead pain control, individual responsibility of the patient, and early reintegration into the working environment. The specific goals of the program are to increase the physical abilities of the patients (i. e., flexibility, strength and endurance), to increase patients' knowledge and the use of body mechanics and back protection techniques, to decrease medication-intake, to decrease dependency on the medical community, to improve patients' own positive coping skills and levels of emotional control, to increase the patient's activity level at home and to facilitate a return to work. METHODS: A total of 90 disabled patients with chronic low back pain were admitted to an 8-week program of functional restoration and behavioral support. The program consisted of a pre-program (3 weeks: education, stretching and calisthenic exercises) and an intensive treatment period (aerobics, functional strength and endurance exercises, back exercises, cognitive behavioral group therapy, relaxation training, socioeconomic and vocational counseling) which took place for 5 weeks, 7 h a day, on an outpatient basis. Apart from a medical examination and a personal interview, the patients' physical impairment, pain descriptions, and psychological distress (according to different criteria for evaluation) were also measured. This includes variables such as depression, psychovegetative complaints, quality of life and workplace satisfaction, disability, and coping with disease. Measurements were repeated at the end of the 8-week program, and after 6 and 12 months. RESULTS: In total 84 patients (94 %) were examined following treatment. There was a statistically significant improvement in flexibility, strength, lifting capacity, and endurance measurements ( p < 0.001) at the end of the treatment. In addition, significant reductions in pain, disability, depression, and psychovegetative signs were demonstrated ( p < 0.001). There was a decreased use of medical treatment for back pain following the program, with 42 % of the patients refraining from the intake of analgesics, followed by a significant reduction in physiotherapy and the consultation of physicians. Assessment of the patients' reported increased activity levels at home also supported findings that statistical improvements were significant. Sixty-three percent of the patients were found to have returned to active, productive work following discharge from the program. Most of the improvements remained stable at the 6- and 12-month follow-up examinations. CONCLUSION: The results demonstrate the effectiveness of the multimodal program of functional restoration, not only concerning positive changes in somatic, psychological and physical variables, but also with respect to the number of patients who returned to work. Our methods are also compared with the discrepant results of multimodal treatment in the United States and Scandinavia.

Lives of women and men active in the social protests of the 1960s: a longitudinal study.

This study found that 46 of 116 children from the R. R. Sears, E. E. Maccoby, and H. Levin (1957) child-rearing study classified at age 31 as participants in the protest movements of the 1960s came more often from middle-class families and attained higher educational levels than their counterparts who did not participate in the protests. In midlife, activists remained more rebellious and altruistic than their peers of equivalent education. Sixties activists did better in grade school and had positive permissive parents at age 5. Parenting style was associated with doing well in school only in girls. As adults, female activists were less involved in family life and had better jobs than their peers. Male activists did less well occupationally and were less happy than their male peers or the female activists.

Rapid estimation of hospitalization charges from a brief medical record review. Evaluation of a multivariate prediction model.

In settings where an itemized hospital bill is not generated, estimation of hospitalization charges for research or administrative purposes can be a laborious task. This article examines the extent to which the number of hospital days spent outside an intensive care unit (ICU), number of days in an ICU, number of laboratory tests performed, number of x-rays, and number of surgeries can be used in a multiple regression equation to impute inpatient charges for a sample of 103 hospitalizations at a Veterans Administration hospital. These predictor variables, all of which are readily ascertained in a brief medical record review, accounted for about 97% of the variance in imputed hospital charges. The bootstrap method was applied for validation of the prediction equation. Application of the method described here may be of value to researchers concerned with hospital charge estimation in non-fee-for-service settings.