Quantification of North American and European Crataegus flavonoids by nuclear magnetic resonance spectrometry.

Crataegus (Rosaceae; hawthorn), are small trees that grow in the Northern Hemisphere. Plant materials of Crataegus show promising benefits in adjunctive treatment of cardiovascular disorders, primarily attributed to flavonoids and other phenolic derivatives. 1H NMR was used in quantification of four flavonoids (naringenin, hyperoside, rutin, and vitexin-2″-O-rhamnoside) and chlorogenic acid in leaf extracts of four Crataegus species. The data were validated by comparison to HPLC-DAD. Vitexin and its derivatives were significantly more concentrated in the European (C. monogyna and C. laevigata) leaves and rutin significantly more concentrated in the North American (C. douglasii and C. okanaganensis) leaves. The concentrations of rutin and naringenin reported in this study are the highest reported for Crataegus. This work represents the first quantitative report of flavonoids in the North American hawthorns C. douglasii and C. okanaganensis and a direct comparison with the common European species.

Culture Vitamins - an Arts on Prescription project in Denmark.

AIMS: Four Arts on Prescription (AoP) projects are piloting in Denmark between 2016 and 2019. One of the local authorities delivering the project is Aalborg. The AoP project 'Culture Vitamins' runs for 10 weeks and offers a variety of cultural activities averaging 2.5 workshops per week for participants with mild to moderate depression, stress or anxiety. The study aims to evaluate and explore the potential mental health wellbeing benefits for the participants. METHOD: A qualitative approach with semi-structured interviews was used and included seven participants who were referred to the project by the local job centre. A thematic approach was applied to analyse the data and a theoretical lens of Salutogenesis was employed to explore the findings. FINDINGS: The findings associated with mental health and the themes that emerged from the data described the participants' subjective experiences and were (1) positive changes, (2) overcoming challenges and being in the 'space' and (3) moving from self-critical to self-caring. The reported mental health benefits were increased energy level, increased self-esteem, more joy in life, less panic attacks, increased motivation, a better understanding of own needs, an increased level of self-care and, in addition, some of the participants said that they felt more aligned to the labour market. CONCLUSIONS: The AoP project offered value and meaning for the participants and can be seen as a motivating tool that created access to new experiences and understandings by means of arts engagement. The 'Culture Vitamins' project can be regarded as a catalyst for connecting with inner resources and unlocking some of the barriers that mental ill health has created. The experience has shifted the participants' experience of themselves in the world and initiated their motivation for the future. The 'Culture Vitamins' project offered a positive contribution to public health challenges associated with stress, anxiety and depression of individuals.

Single-Lab Validation for Determination of Kavalactones and Flavokavains in Piper methysticum (Kava).

Piper methysticum (Kava) is a plant whose roots are used in the preparation of traditional beverages with spiritual, medicinal, and social importance for the Pacific Islanders. Kava is also sold as a herbal supplement or recreational beverage consumed for its mild inebriating effect in Europe and North America. With an ongoing interest in the safety and quality of kava products, it is necessary to develop a validated method for determination of kava chemical composition to ensure confidence in quality assessment. Thus, an high-performance liquid chromatography with ultraviolet detection (HPLC-UV) method was developed, optimized, and validated for determining six major kavalactones and three flavokavains in kava raw materials and finished products based on AOAC single-laboratory validation guidelines. This is the first fully validated analytical method for measuring kavalactones and flavokavains in a single run. The separation of the analytes was achieved in 10 min with an Agilent Poroshell C18 column using gradient separation. The sample was extracted with methanol first and then acetone. The signals were detected at 240 nm and 355 nm. The limit of quantification was under 1.2 µg/mL (0.3 mg/g) for kavalactones and under 0.35 µg/mL (0.01 mg/g) for flavokavains. The Horwitz ratio values described ranged from 0.3 to 1.82. The spike recovery experiments showed an accuracy between 92 and 105% for all analytes. The results of the study demonstrate that the method is fit for the purpose of determining methysticin, dihydromethysticin, kavain, dihydrokavain, yangonin, desmethoxyyangonin, flavokavain A, flavokavain B, and flavokavain C in kava raw material and finished products (dry-filled capsule, liquid phytocaps, and tincture).

The use of arts interventions for mental health and wellbeing in health settings.

AIMS: This literature review aims to illustrate the variety and multitude of studies showing that participation in arts activities and clinical arts interventions can be beneficial for citizens with mental and physical health problems. The article is focused on mental health benefits because this is an emerging field in the Nordic countries where evidence is demanded from national health agencies that face an increasing number of citizens with poor mental health and a need for non-medical interventions and programmes. METHODS: A total of 20 articles of interest were drawn from a wider literature review. Studies were identified through the search engines: Cochrane Library, Primo, Ebscohost, ProQuest, Web of Science, CINAHL, PsycINFO, PubMed and Design and Applied Arts Index. Search words included the following: arts engagement + health/hospital/recovery, arts + hospital/evidence/wellbeing, evidence-based health practice, participatory arts for wellbeing, health + poetry/literature/dance/singing/music/community arts, arts health cost-effectiveness and creative art or creative activity + health/hospital/recovery/mental health. The inclusion criteria for studies were (1) peer review and (2) empirical data. RESULTS: The studies document that participation in activities in a spectrum from clinical arts interventions to non-clinical participatory arts programmes is beneficial and an effective way of using engagement in the arts to promote holistic approaches with health benefits. Engagement in specially designed arts activities or arts therapies can reduce physical symptoms and improve mental health issues. CONCLUSION: Based on the growing evidence of the arts as a tool for enhancing mental health wellbeing, and in line with the global challenges in health, we suggest that participatory arts activities and clinical arts interventions are made more widely available in health and social settings. It is well-documented that such activities can be used as non-medical interventions to promote public health and wellbeing.

A randomised study of tailored toxicity-based dosage of fluorouracil-epirubicin-cyclophosphamide chemotherapy for early breast cancer (SBG 2000-1).

STUDY AIM: Retrospective studies have demonstrated a worse outcome in breast cancer patients not developing leukopenia during adjuvant chemotherapy. The SBG 2000-1 is the first randomised trial designed to compare individually dosed chemotherapy without G-CSF support based on grade of toxicity to standard-dosed chemotherapy based on body surface area (BSA). METHODS: Patients with early breast cancer were included and received the first cycle of standard FEC (fluorouracil 600 mg/m2, epirubicin 60 mg/m2, cyclophosphamide 600 mg/m2). Patients with nadir leukopenia grade 0-2 after first cycle were randomised between either 6 additional courses of tailored FEC with increased doses (E 75-90 mg/m2, C 900-1200 mg/m2) or fixed treatment with 6 standard FEC. Patients with grade 3-4 leukopenia were registered and treated with 6 standard FEC. Primary end-point was distant disease-free survival (DDFS). RESULTS: The study enrolled 1535 patients, of which 1052 patients were randomised to tailored FEC (N = 524) or standard FEC (N = 528), whereas 401 patients with leukopenia grade 3-4 continued standard FEC and formed the registered cohort. Dose escalation did not statistically significantly improve 10-year DDFS (79% and 77%, HR 0.87, CI 0.67-1.14, P = 0.32) or OS (82% and 78%, respectively, HR 0.89, CI 0.57-1.16, P = 0.38). Corresponding estimates for the registered group of patients were DDFS 79% and OS 82%, respectively. CONCLUSIONS: The SBG 2000-1 study failed to show a statistically significant improvement of escalated and tailored-dosed chemotherapy compared with standard BSA-based chemotherapy in patients with low haematological toxicity, although all efficacy parameters showed a numerical advantage for tailored treatment.

Mindfulness-based cognitive therapy (MBCT) is cost-effective compared to a wait-list control for persistent pain in women treated for primary breast cancer-Results from a randomized controlled trial.

OBJECTIVE: To investigate the cost-effectiveness of mindfulness-based cognitive therapy (MBCT) compared to a wait-list control group for pain in women treated for breast cancer. METHODS: A total of 129 women were randomly allocated to MBCT or a wait-list control group. The primary outcome was the minimal clinically important difference (MCID) on pain intensity (≥2 point reduction on an 11-point Numeric Rating Scale). Analyses were conducted from the health care system perspective and included data on health care utilization and pain medication retrieved from national registries for the period from baseline (T1) to 6 months postintervention (T4). Bootstrap simulations were used to estimate confidence intervals for the incremental cost and effect measures, and cost-effectiveness acceptability curves. In sensitivity analyses, we replaced dropouts with last-observation-carried-forward and tested consequences of higher costs of the intervention. RESULTS: The intervention cost was 240€ per participant. The average total cost from T1 to T4 in the MBCT group was 1706€ compared with 2436€ in the control group (mean difference: 729€, P = .07). More women in the MBCT group (N:19/36; 52.8%) than in the control group (N:14/48; 29.2%) achieved an MCID in pain intensity (OR=2.71, P = .03). The MBCT was cost-effective with a probability of 85% with a value of an additional women achieving MCID set to zero remained cost-effective with a probability of 70% to 82% when smaller effect and higher MBCT costs were assumed. CONCLUSIONS: Our results suggest that MBCT is a cost-effective pain intervention for women treated for breast cancer. Future studies could include utility measures, indirect costs, and active control groups to increase the generalizability and pragmatic value of the results.

A botanical, phytochemical and ethnomedicinal review of the genus Mitragyna korth: Implications for products sold as kratom.

ETHNOPHARMACOLOGICAL RELEVANCE: The genus Mitragyna (Rubiacaeae) has been traditionally used in parts of Africa, Asia and Oceania. In recent years, there has been increased interest in species of Mitragyna with the introduction of products to western markets and regulatory uncertainty. AIM OF THE STUDY: This paper reviewed the traditional ethnomedicinal uses of leaves for species belonging to the genus Mitragyna with reference to the botany and known chemistry in order to highlight areas of interest for products currently being sold as kratom. MATERIALS AND METHODS: A literature search was conducted using Web of Science, Google Scholar, the Royal Museum for Central Africa, Internet Archive, Hathi Trust, and Biodiversity Heritage Library search engines in the spring of 2015, fall of 2016 and winter of 2017 to document uses of bark, leaf and root material. RESULTS: Leaves of M. speciosa (kratom) had the most common documented ethnomedicinal uses as an opium substitute or remedy for addiction. Other species of Mitragyna were reportedly used for treating pain, however the mode of preparation was most often cited as topical application. Other uses of Mitragyna included treatment of fever, skin infections, and as a mild anxiolytic. CONCLUSIONS: Mitragyna species have been used medicinally in various parts of the world and that there is significant traditional evidence of use. Modern products that include formulations as topical application of liniments, balms or tinctures may provide effective alternatives for treatment of certain types of pains. Future research is required to establish safety and toxicology limits, medicinal chemistry parameters and the potential for different physiological responses among varying genetic populations to support regulatory requirements for Mitragyna spp.

Clinical and psychological moderators of the effect of mindfulness-based cognitive therapy on persistent pain in women treated for primary breast cancer - explorative analyses from a randomized controlled trial.

BACKGROUND: Mindfulness-based intervention has been found efficacious in reducing persistent pain in women treated for breast cancer. Little, however, is known about possible moderators of the effect. We explored clinical and psychological moderators of the effect on pain intensity previously found in a randomized controlled trial of mindfulness-based cognitive therapy (MBCT) with women treated for breast cancer with persistent pain. MATERIAL AND METHODS: A total of 129 women treated for breast cancer reporting persistent pain were randomized to MBCT or a wait-list control. The primary outcome of pain intensity (11-point numeric rating scale) was measured at baseline, post-intervention, three, and six months follow-up. Proposed clinical moderators included age, axillary lymph node dissection (ALND), radiotherapy, and endocrine treatment. Psychological moderators included psychological distress [the Hospital Anxiety and Depression Scale (HADS)], the adult attachment dimensions anxiety and avoidance [the Experiences in Close Relationships Short Form (the ECR-SF)], and alexithymia [the Toronto Alexithymia Scale (TAS-20)]. Multi-level models were used to test moderation effects over time, i.e. time × group × moderator. RESULTS: Only attachment avoidance (p = 0.03, d = 0.36) emerged as a statistically significant moderator. Higher levels of attachment avoidance predicted a larger effect of MBCT in reducing pain intensity compared with lower levels attachment avoidance. None of the remaining psychological or clinical moderators reached statistical significance. However, based on the effect size, radiotherapy (p = 0.075, d = 0.49) was indicated as a possible clinical moderator of the effect, with radiotherapy being associated with a smaller effect of MBCT on pain intensity over time compared with no radiotherapy. CONCLUSION: Attachment avoidance, and potentially radiotherapy, may be clinically relevant factors for identifying the patients who may benefit most from MBCT as a pain intervention. Due to the exploratory nature of the analyses, the results should be considered preliminary.

Single-Laboratory Validation for the Determination of Flavonoids in Hawthorn Leaves and Finished Products by LC-UV.

Suitably validated analytical methods that can be used to quantify medicinally active phytochemicals in natural health products are required by regulators, manufacturers, and consumers. Hawthorn (Crataegus) is a botanical ingredient in natural health products used for the treatment of cardiovascular disorders. A method for the quantitation of vitexin-2″-O- rhamnoside, vitexin, isovitexin, rutin, and hyperoside in hawthorn leaf and flower raw materials and finished products was optimized and validated according to AOAC International guidelines. A two-level partial factorial study was used to guide the optimization of the sample preparation. The optimal conditions were found to be a 60-minute extraction using 50 : 48 : 2 methanol : water : acetic acid followed by a 25-minute separation using a reversed-phased liquid chromatography column with ultraviolet absorbance detection. The single-laboratory validation study evaluated method selectivity, accuracy, repeatability, linearity, limit of quantitation, and limit of detection. Individual flavonoid content ranged from 0.05 mg/g to 17.5 mg/g in solid dosage forms and raw materials. Repeatability ranged from 0.7 to 11.7 % relative standard deviation corresponding to HorRat ranges from 0.2 to 1.6. Calibration curves for each flavonoid were linear within the analytical ranges with correlation coefficients greater than 99.9 %. Herein is the first report of a validated method that is fit for the purpose of quantifying five major phytochemical marker compounds in both raw materials and finished products made from North American (Crataegus douglasii) and European (Crataegus monogyna and Crataegus laevigata) hawthorn species. The method includes optimized extraction of samples without a prolonged drying process and reduced liquid chromatography separation time.

Arthropod Pests and Predators Associated With Bittersweet Nightshade, a Noncrop Host of the Potato Psyllid (Hemiptera: Triozidae).

Bittersweet nightshade (Solanum dulcamara L.) is a key noncrop host of the potato psyllid (Bactericera cockerelli Sulc), proposed to be a source of the psyllids that colonize potato (Solanum tuberosum L.) fields in the northwestern United States. Here, we describe the broader community of arthropod potato pests, and also predatory arthropods, found in bittersweet nightshade patches. Over 2 yr, we sampled arthropods in patches of this weed spanning the potato-growing region of eastern Washington State. The potato psyllid was the most abundant potato pest that we found, with reproduction of these herbivores recorded throughout much of the growing season where this was measured. Aphid, beetle, and thrips pests of potato also were collected on bittersweet nightshade. In addition to these herbivores, we found a diverse community of >40 predatory arthropod taxa. Spiders, primarily in the Families Dictynidae and Philodromidae, made up 70% of all generalist predator individuals collected. Other generalist predators included multiple species of predatory mites, bugs, and beetles. The coccinellid beetle Stethorus punctillum (Weise) was observed eating psyllid eggs, while the parasitoid wasp Tamarixia triozae (Burks) was observed parasitizing potato psyllid nymphs. Overall, our survey verified the role of bittersweet nightshade as a potato psyllid host, while suggesting that other potato pests also use these plants. At the same time, we found that bittersweet nightshade patches were associated with species-rich communities of natural enemies. Additional work is needed to directly demonstrate movement of pests, and perhaps also predators, from bittersweet nightshade to potato fields.

Treatment of adult patients with schizophrenia and complex mental health needs: a national clinical guideline

BACKGROUND AND AIM: The Danish Health and Medicines Authority assembled a group of experts to develop a national clinical guideline for patients with schizophrenia and complex mental health needs. Within this context, ten explicit review questions were formulated, covering several identified key issues. METHODS: Systematic literature searches were performed stepwise for each review question to identify relevant guidelines, systematic reviews/meta-analyses, and randomized controlled trials. The quality of the body of evidence for each review question was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Clinical recommendations were developed on the basis of the evidence, assessment of the risk-benefit ratio, and perceived patient preferences. RESULTS: Based on the identified evidence, a guideline development group (GDG) recommended that the following interventions should be offered routinely: antipsychotic maintenance therapy, family intervention and assertive community treatment. The following interventions should be considered: long-acting injectable antipsychotics, neurocognitive training, social cognitive training, cognitive behavioural therapy for persistent positive and/or negative symptoms, and the combination of cognitive behavioural therapy and motivational interviewing for cannabis and/or central stimulant abuse. SSRI or SNRI add-on treatment for persistent negative symptoms should be used only cautiously. Where no evidence was available, the GDG agreed on a good practice recommendation. CONCLUSIONS: The implementation of this guideline in daily clinical practice can facilitate good treatment outcomes within the population of patients with schizophrenia and complex mental health needs. The guideline does not cover all available interventions and should be used in conjunction with other relevant guidelines.(AU)

Thalamic post-inhibitory bursting occurs in patients with organic dystonia more often than controls.

We now test the hypothesis that post-inhibitory bursting in the human pallidal receiving nucleus of the thalamus (ventral oral) mediates inhibitory pallido-thalamic transmission during dystonia. We have compared thalamic single neuron activity in nine patients with organic dystonia to that in a patient with psychogenic dystonia (Psyd) and in healthy waking monkeys. In organic dystonia, EMG power is commonly concentrated at the lowest frequency of the smoothed autopower spectrum (0.39Hz). Therefore, segments of spike trains with a signal-to-noise ratio ≥2 at 0.39Hz were termed dystonia frequency (DF) segments, which occurred more commonly during dystonia related to movement. Those with a SNR<2 were termed non-dystonia frequency (nDF) segments, which were associated with spontaneous dystonia. We concentrated on nDF activity since neuronal activity in our controls was measured at rest. Neuronal spike trains were categorized into those with post-inhibitory bursts (G, grouped), with single spikes (NG, non-grouped), or with both single spikes and bursts (I, intermediate). nDF spike trains in ventral oral had more G category firing in dystonia than in controls. The burst rate and the pre-burst silent period in nDF firing of organic dystonia were consistently greater than those of both the monkeys and the patient with Psyd. The distribution of the pre-burst silent period was bimodal with a longer mode of approximately GABAb (gamma amino butyric acid receptor-type b) duration. These results demonstrate distinct differences of post-inhibitory bursting in organic dystonia versus controls. The presence of inhibitory events consistent with GABAb duration suggests interventions for treatment of dystonia.

The haematocrit--an important factor causing impaired haemostasis in patients with cyanotic congenital heart disease.

BACKGROUND: Patients with cyanotic congenital heart disease(CCHD) have haemostatic abnormalities, which result in an increased risk of bleeding. The cause is unknown, but recent studies have indicated that an elevated haematocrit, which is present in cyanotic patients, could be an important factor. The aim of this study was to characterize the haemostatic profile, examine how changes in haematocrit affect the haemostatic profile, and whether a haematocrit reduction could terminate bleeding in CCHD patients. METHODS: This was a prospective, multicenter study. The haemostatic profile consisting of haematocrit, platelet count and thrombelastography(TEG) was characterized in ninety-eight CCHD patients. To evaluate the influence of haematocrit on the haemostatic profile, 21 of the patients underwent phlebotomy and 16 patients received treatment with an iron supplement. Furthermore ten patients with haemoptysis underwent phlebotomy. The haemostatic profile was reevaluated after interventions. RESULTS: TEG revealed that patients with CCHD and elevated haematocrit were hypocoagulable due to reduced clot formation and strength. Furthermore a positive correlation between elevated haematocrit and hypocoagulability was present. Interventions such as phlebotomy and treatment with supplemental iron causing significant haematocrit changes confirmed the correlation between haematocrit and the haemostatic profile. Finally a haematocrit reduction by phlebotomy successfully terminated haemoptysis in ten CCHD patients. CONCLUSION: Patients with CCHD and elevated haematocrit are hypocoagulable. The hypocoagulable haemostatic profile is positively correlated to increasing haematocrit. An intervention, which increases or decreases haematocrit, changes the haemostatic profile. A haematocrit reduction seems to improve the haemostatic profile, and may thereby terminate bleeding. However, these results warrant further studies.

Effects of feeding finisher pigs with chicory or lupine feed for one week or two weeks before slaughter with respect to levels of Bifidobacteria and Campylobacter.

This study aimed to assess whether inclusion of chicory or lupine (prebiotics) in the diet of pre-slaughter pigs for just 1 or 2 weeks could change the composition of their intestinal microbiota, stimulate the growth of bifidobacteria and help to lower the amount of thermoplilic Campylobacter spp. (mainly Campylobacter jejuni and Campylobacter coli), which are a major cause of food-borne infections in humans. A total of 48 pigs that had an initial live weight of 90 kg were fed with either a lupine (organic concentrate with 25% blue lupine seeds), chicory (organic concentrate with 10% dried chicory roots) or control (100% organic concentrate) diet for 1 week (24 pigs) or 2 weeks (24 pigs) before slaughter. The Campylobacter spp. level in rectal faecal samples after 0, 1 and 2 weeks of feeding and in the luminal content from ileum, caecum and colon at slaughter was determined by direct plating on modified charcoal-cefoperazone-deoxycholate agar plates. DNA extracted from the luminal content of distal ileum and caecum was used for terminal restriction fragment length polymorphism (T-RFLP) analysis of the composition of intestinal microbiota and for measuring the amount of bifidobacterial and total bacterial DNA by quantitative real-time PCR (qPCR). Campylobacter spp. were excreted by all pigs and present in the luminal content from distal ileum to midway colon with particularly high numbers in the caecum, but the excretion was reduced by 10-fold in pigs fed lupines for 1 week as compared with control- and chicory-fed pigs (mean log(10) 2.9 v. 4.1 CFU/g; P < 0.05). The qPCR analysis showed that feeding with lupines resulted in higher levels of bifidobacteria in caecum as compared with the other diets (P < 0.05). T-RFLP analysis showed that four of the most abundant bacteria with terminal restriction fragment values >5% relative to the intensity of total abundance differed between the feed treatments (P < 0.05). Therefore, this study showed that even a short-term alternative feeding strategy with prebiotics in the diet of pre-slaughter pigs elicited changes in the composition of the intestinal microbiota, where lupine increased the level of bifidobacteria in caecum and reduced the Campylobacter spp. excretion level after 1 week.

Mice over-expressing salmon calcitonin have strongly attenuated osteoarthritic histopathological changes after destabilization of the medial meniscus.

OBJECTIVE: Calcitonin is well-known for its inhibitory actions on bone-resorbing osteoclasts and recently potential beneficial effects on cartilage were shown. We investigated effects of salmon calcitonin (sCT) on the articular cartilage and bone, after destabilization of the medial meniscus (DMM) in normal and sCT over-expressing mice. DESIGN: Bone phenotype of transgenic (TG) C57Bl/6 mice over-expressing sCT at 6 months and 12 months was investigated by (1) serum osteocalcin and urinary deoxypyridinoline and (2) dynamic and normal histomorphometry of vertebrae bodies. In subsequent evaluation of cartilage and subchondral bone changes, 44 10-week old TG or wild-type (WT) mice were randomized into four groups and subjected to DMM or sham-operations. After 7 weeks animals were sacrificed, and knee joints were isolated for histological analysis. RESULTS: Trabecular bone volume (BV/TV) increased 150% after 6 months and 300% after 12 months in sCT-expressing mice when compared to WT controls (P<0.05). Osteoblast number, bone formation rate and osteocalcin measurements were not affected in TG mice over-expressing sCT. In WT animals, a 5-fold increase in the quantitative erosion index was observed after DMM, and the semi-quantitative OARSI score showed over 400% (P<0.001) increase, compared to sham-operated WT mice. DMM-operated TG mice were protected against cartilage erosion and showed a 65% and 64% (P<0.001) reduction, respectively, for the two histopathological evaluation methods. CONCLUSIONS: sCT over-expressing mice had higher bone volume, and were protected against cartilage erosion. These data suggest that increased levels of sCT may hamper the pathogenesis of osteoarthritis (OA). However more studies are necessary to confirm these preliminary results.

Spatial and temporal dynamics of potato tuberworm (Lepidoptera: Gelechiidae) in the Columbia Basin of the Pacific Northwest.

A landscape-scale study from 2004 to 2006 investigated the spatial and temporal dynamics of a new pest to the Columbia Basin of the Pacific Northwest, the potato tuberworm, Phthorimaea operculella (Zeller). Male P. operculella were monitored in spring, summer, and fall each year with a pheromone-baited trapping network in Oregon and Washington. The objectives of the study were to (1) describe the temporal and spatial dynamics of the recent outbreak of P. operculella in the region and (2) examine the relationship of the spatial and temporal distribution of the outbreak and weather (air temperature, precipitation, and dew point) and geographic variables (elevation and latitude). Weather data during the P. operculella outbreak were compared with a reference period (1993-1999) that occurred before the outbreak. The outbreak in 2004, which caused the first widespread tuber damage in the region, was positively associated with warmer temperatures in the preceding fall and in the spring, summer, and fall of the growing season. October and November 2003 and March 2004 were also drier than the reference period. However, the winter of 2003/2004 was colder than the reference period and thus mild winter conditions did not explain the outbreak. The importance of environmental variables on the seasonal spatial distribution of the pest each year was examined using nonparametric multiplicative regression. Locations with higher spring, summer, or fall temperatures were associated with increased trapping rates in most seasons. Elevation and latitude seemed to play a constraining role, because low trapping rates of P. operculella were associated with higher elevations and latitudes.

[MRSA--current aspects of resistance, pathology, epidemiology and therapy]. / MRSA--aktuelle Aspekte der Resistenzentwicklung, Pathomechanismen, Epidemiologie und Therapie.

The Methicillin-resistant Staphylococcus aureus (MRSA) is a Staphylococcus aureus (S. aureus) resistant against all kinds of beta-lactam antibiotics. Moreover, resistances against other antibiotics have gradually started to develop. In the last decades, MRSA started as a serious problem only in hospitals, but in recent years it also rose as an alarming community pathogen. In addition to the resistances against Penicillin which emerged in the 1940s. with the use of beta-lactamase proof antibiotics in the 1960s, the resistance of S. aureus against Methicillin started to develop. According to the kind of resistance, the genotype, the time of infection and the origin of the infection, MRSA infections are classified as hospital-associated (HA-MRSA) and community-associated (cMRSA). On the one hand, this differentiation results in distinct strategies of calculated therapy against each class of MRSA. On the other hand, it is important in order to identify relevant judicious aspects of transmission.

Development of a recommended food intake pattern for healthy Danish adolescents consistent with the Danish dietary guidelines, nutrient recommendations and national food preferences.

BACKGROUND: Danish adolescents have poor dietary habits compared to current recommendations. The present study aimed to develop a recommended food intake pattern for adolescents consistent with Danish Dietary Guidelines (DDG), Nordic Nutrition Recommendations (NNR) and dietary preferences. METHODS: The nutrient content of a food intake pattern consistent with DDG was calculated using dietary intake data from a random sample of 11-15-year-old boys (n = 85) and girls (n = 70). A recommended food intake pattern was modelled to meet NNR. The discretionary energy allowance was calculated as the difference between the total energy level and the energy needed to meet recommended nutrient needs. The flexibility of the recommended food intake pattern was tested against various energy requirements and with the inclusion of basic foods with higher sugar and/or fat content. RESULTS: The developed food intake pattern meets all nutrient goals except for vitamin D. At low energy requirements, the intake of iron and selenium is of concern. To fulfil nutrient recommendations, half of the bread/cereals and vegetables consumed should be fibre-rich, and fats should be of plant origin. CONCLUSIONS: The recommended food intake pattern meets most nutrient recommendations and makes it possible to advise on discretionary energy.