A complex and demanding situation - Midwifery preceptors and midwifery students' experiences of teaching and learning prevention of severe perineal trauma.

BACKGROUND: Many high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described. AIM: To describe midwifery preceptors and midwifery students' experiences' of teaching and learning how to manage the second stage of labour, with the specific aim of preventing severe perineal trauma. METHODS: A qualitative study with focus group discussions and individual in depth-interviews with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed by qualitative content analysis. RESULTS: "A complex and demanding situation with mutual need for feedback, reflection and safety" was the overall theme describing the conditions. Three sub-themes were identified. "Adapting to a unique situation" refers to the difficulty of teaching and learning the aspects needed to prevent severe perineal trauma, and to provide care during this stage. "Hindering and limiting circumstances" describes teaching strategies that were perceived negatively, and how midwifery students tried to adapt to the preceptors rather than the birthing women. "A trustful and communicative relationship" describes the importance of the relationship between the student and the preceptor, where communication was a central, but not obvious part. CONCLUSION: An increased awareness among preceptors is needed to optimize teaching strategies, enabling the students to focus on learning the art of the second stage of labour; supporting the woman, preventing severe perineal trauma and ensuring the safety of the unborn baby. Future research should address how existing prevention models can include training to increase preceptors' confidence in teaching.

Curcumin loaded Ag-TiO2-halloysite nanotubes platform for combined chemo-photodynamic therapy treatment of cancer cells.

The use of naturally occurring anticancer materials in combination with doped metal oxide has emerged as one of the most promising ways for improving anticancer treatment efficacy. In this study, the anticancer potential of curcumin-loaded Ag-TiO2-halloysite nanotubes (curcumin-loaded Ag-TiO2-HNTs) was examined. Ag-TiO2-HNTs with different wt% of Ag-TiO2 were synthesized and characterized using XRD, TGA, FT-IR, UV-Vis spectroscopy, and SEM-EDX. The XRD results revealed the presence of crystalline TiO2. However, the presence of Ag was detected through the SEM-EDX analysis. Cyclic voltammetry measurements suggested the enhancement of the release of ROS from TiO2 upon deposition with Ag. FT-IR and TGA analysis confirmed the successful loading of curcumin inside the nanotubes of the halloysite. In vitro drug released studies revealed the release of approximately 80-99% curcumin within 48 hours. Kinetic model studies revealed that the release of curcumin from HNT and Ag-TiO2-HNT followed the first-order and Higuchi models, respectively. The light irradiated curcumin-loaded Ag-TiO2-HNTs samples exhibited considerable anticancer potential as compared to the free curcumin, irradiated Ag-TiO2 NPs samples, and unirradiated curcumin loaded Ag-TiO2-HNTs samples. The obtained results revealed that combined chemo- and photodynamic therapy using curcumin-loaded Ag-TiO2-HNTs nanomaterial has the potential as an effective anticancer treatment method.

Waste to resource: use of water treatment residual for increased maize productivity and micronutrient content.

Soil degradation, which is linked to poor nutrient management, remains a major constraint to sustained crop production in smallholder urban agriculture (UA) in sub-Saharan Africa (SSA). While organic nutrient resources are often used in UA to complement mineral fertilizers in soil fertility management, they are usually scarce and of poor quality to provide optimum nutrients for crop uptake. Alternative soil nutrient management options are required. This study, therefore, evaluates the short-term benefits of applying an aluminium-based water treatment residual (Al-WTR), in combination with compost and inorganic P fertilizer, on soil chemical properties, and maize (Zea mays L.) productivity and nutrient uptake. An eight-week greenhouse experiment was established with 12 treatments consisting of soil, Al-WTR and compost (with or without P fertilizer). The co-amendment (10% Al-WTR + 10% compost) produced maize shoot biomass of 3.92 ± 0.16 g at 5 weeks after emergence, significantly (p < 0.05) out-yielding the unamended control which yielded 1.33 ± 0.17 g. The addition of P fertilizer to the co-amendment further increased maize shoot yield by about twofold (7.23 ± 0.07 g). The co-amendment (10% Al-WTR + 10% C) with P increased maize uptake of zinc (Zn), copper (Cu) and manganese (Mn), compared with 10% C + P. Overall, the results demonstrate that combining Al-WTR, compost and P fertilizer increases maize productivity and micronutrient uptake in comparison with single amendments of compost and fertilizer. The enhanced micronutrient uptake can potentially improve maize grain quality, and subsequently human nutrition for the urban population of SSA, partly addressing the UN's Sustainable Development Goal number 3 of improving diets.

Thermal burns of the spectacle associated with supplementary heating in native New Zealand geckos.

Case history: Gradual onset of ocular opacity was observed in three gold-striped geckos (Woodworthia chrysosiretica), and five Pacific geckos (Dactylocnemis pacificus) held in two adjacent terrariums in a zoological institution located in the North Island of New Zealand. Ultraviolet light and heat had been provided for the previous 3-4 years by a fluorescent bulb, but in the last 4 weeks of winter a ceramic heat bulb had been added, situated 10 cm above the upper mesh of the cageClinical findings: All eight geckos presented with mostly bilateral lesions of varying severity confined to the central or upper quadrant of the spectacles. These lesions ranged from variable areas of opacity within the stroma of the spectacle to similarly distributed ulcers of the surface epithelium of both spectacles. The spectacle lesions in the Pacific geckos responded well to treatment with topical combined antimicrobial therapy, within 18-29 days. The gold-striped geckos suffered complications including dysecdysis, severe spectacle ulceration and perforation, mycotic spectaculitis, and widespread mycotic dermatitis resulting in death or leading to euthanasia.Pathological findings: In the three gold-striped geckos, there were extensive areas of deep ulceration and replacement of the spectacle with a thick serocellular crust containing large numbers of fungal elements. The affected areas of the stroma were expanded by large deposits of proteinaceous and mucinous material, pyknotic cellular debris and moderate numbers of heterophils and macrophages as well as infiltrating fungal hyphae.Diagnosis: Mycotic spectaculitis with ulceration and perforation, and disseminated mycotic dermatitis likely secondary to thermal burns.Clinical relevance: This is the first report of thermal burns of the spectacle in any reptile. There was species variation in the burn severity with gold-striped geckos showing more severe lesions, possibly due to a mix of behavioural and anatomical factors. The thermal burns to the spectacles in three cases were complicated by delayed healing, perforation, dysecdysis and severe mycotic infection.

Sexuality issues in gynaecological oncology patients: post treatment symptoms and therapeutic options.

BACKGROUND/AIM: According to recent studies up to 80% of patients would like to receive more information about how cancer treatments can affect their sexual functioning. Moreover, 75 % of them would not feel comfortable being the first to bring up the subject. Our Gynaecological Advice Clinic was established in 2006 at the Christie Hospital and offers support to cancer patients who face sexuality issues. A previous evaluation established that the service sees approximately, 200 patients per year. The aims of this study are to evaluate the service by collecting data relating to levels of attendance, type and amount of clinical activity and to explore further patients' experiences and management. METHODS: This is a retrospective study which was carried out in 2012-2013. Different models are used to evaluate our patients including history taking integrated therapy model, consultations to understand the normal anatomy and physiology with the use of diagrams and photographs, psycho-education and the international classification "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (DSMV). The treatment options advised include medications such as hormone replacement treatment, testosterone, antidepressant, local oestrogen, tibolone, aqueous cream, lubrication to introitus, diprobase, dermal cream and advice for massage to areas of discomfort. Moreover, the use of vaginal dilators, the role of pelvic floor exercises, vulval care and self examination are explained. The team works closely with the psycho-oncology department. The most frequently discussed topics that were covered during the consultation are analysed. RESULTS: 41 outpatient clinics were held between 2012 and 2013. 194 patients attended those clinics during the study period. Single and not group therapy was offered to all the participants. 216 patients were offered appointments while 194 patients actually attended (90%). Patients' age ranged from 24 to 91 years with a mean age of 59 years. 45% had endometrial and 32% cervical cancer, 18% vulval cancer, 4 % ovarian cancer. 74% attended on their own while 18% with their partners and 8% with another family member or friend. 98% of the patients had confidence/trust in the healthcare professional. 95% felt involved with treatment decisions. 82% reported completely understanding information about side-effects. 16% were unaware of who to contact once they had completed treatment. 8% were attending for on-going help with psycho-sexual concerns following completion of treatment. CONCLUSION: The clinic was positively evaluated by patients, they had a high level of trust in the nurses running the service and they found it beneficial. Consultations were generally lasting 20-30 min and most patients reported this was an appropriate length. It once again highlights that although the service was set-up to address psycho-sexual concerns, in reality it dealt with a variety of other patient concerns. Due to the success of the clinic, the service has expanded and we are now supporting patients from other tumour groups such as colorectal, urology and plastic surgery.

Multivitamin and mineral use and breast cancer mortality in older women with invasive breast cancer in the women's health initiative.

Multivitamin use is common in the United States. It is not known whether multivitamins with minerals supplements (MVM) used by women already diagnosed with invasive breast cancer would affect their breast cancer mortality risk. To determine prospectively the effects of MVM use on breast cancer mortality in postmenopausal women diagnosed with invasive breast cancer, a prospective cohort study was conducted of 7,728 women aged 50-79 at enrollment in the women's health initiative (WHI) in 40 clinical sites across the United States diagnosed with incident invasive breast cancer during WHI and followed for a mean of 7.1 years after breast cancer diagnosis. Use of MVM supplements was assessed at WHI baseline visit and at visit closest to breast cancer diagnosis, obtained from vitamin pill bottles brought to clinic visit. Outcome was breast cancer mortality. Hazard ratios and 95 % confidence intervals (CIs) for breast cancer mortality comparing MVM users to non-users were estimated using Cox proportional hazard regression models. Analyses using propensity to take MVM were done to adjust for potential differences in characteristics of MVM users versus non-users. At baseline, 37.8 % of women reported MVM use. After mean post-diagnosis follow-up of 7.1 ± 4.1 (SD) years, there were 518 (6.7 %) deaths from breast cancer. In adjusted analyses, breast cancer mortality was 30 % lower in MVM users as compared to non-users (HR = 0.70; 95 % CI 0.55, 0.91). This association was highly robust and persisted after multiple adjustments for potential confounding variables and in propensity score matched analysis (HR = 0.76; 95 % CI 0.60-0.96). Postmenopausal women with invasive breast cancer using MVM had lower breast cancer mortality than non-users. The results suggest a possible role for daily MVM use in attenuating breast cancer mortality in women with invasive breast cancer but the findings require confirmation.

Effects of feeding corn modified wet distillers grain plus solubles co-ensiled with chopped whole plant corn on heifer growth performance and diet digestibility in beef cattle.

Two experiments were conducted to evaluate the effect of feeding corn modified wet distillers grain plus solubles (MWDGS; 48% DM) co-ensiled with chopped whole plant corn (WC) on growth performance, dietary intake, and nutrient digestibility of beef cattle. In Exp. 1, 96 Angus-crossed heifers (2 yr old; 522 ± 49.1 kg BW; 5.3 ± 0.1 BCS) were stratified and blocked according to BW and stratified by BCS in each block in a randomized complete block design (24 pens; 4 heifers/pen; 6 treatment replications). Groups were assigned to 1 of 4 dietary treatments for a 62 d trial. Treatments were 1) corn silage (CS) and soybean meal (CON), 2) MWDGS co-ensiled with chopped whole plant corn (WC; CO-EN), 3) CS mixed with MWDGS at feeding (CS+WDG), and 4) CS mixed with dry distillers grain plus solubles (DDGS) at feeding (CS+DDG). In Exp. 2, 4 crossbred beef steers (initial BW = 278 ± 18 kg) fitted with permanent ruminal cannulas were used in a balanced 4 × 4 Latin square to test the effects of feeding MWDGS co-ensiled with WC on DM intake, ruminal fermentation characteristics, and total tract digestibility. There were four 14-d periods, with 10 d for diet adaptation and 4 d for samples collection. Orthogonal contrasts were used and compared CON vs. diets containing distillers grains (DGD), CO-EN vs. diets where distillers grains were mixed at feeding (MIX), and CS+WDG vs. CS+DDG. In Exp. 1, the CON fed heifers resulted in greater G:F (P = 0.04) compared with those fed DGD. However, ADG (P = 0.03), final BW (P = 0.04), and BW gain (P = 0.03) were greatest for DGD diets compared with CON and greatest (P = 0.04) for CO-EN when compared with MIX. Apart from a slightly greater acetate concentration (P = 0.05), which resulted in a greater acetate to propionate ratio (P = 0.03) for the CON diet compared with DGD, no important differences were observed on intake, diet digestibility, or fermentation characteristics when comparing the CON treatment with DGD or when comparing CS+WDG with CS+DDG. However, the CO-EN diet resulted in decreased DMI (P = 0.05) and consequently decreased OM (P = 0.05), N (P = 0.04), and NDF (P = 0.02) intakes compared with MIX. Data from these studies suggest that MWDGS co-ensiled with WC can successfully replace traditional corn-based diets supplemented with soybean meal and corn silage diets supplemented with distillers grains without compromising digestibility and growth performance in pregnant heifers.

Effects of feeding corn modified wet distillers grain plus solubles co-ensiled with direct-cut forage on feedlot performance, carcass characteristics, and diet digestibility of finishing steers.

Two experiments were conducted to evaluate the effects of feeding corn modified wet distillers grain plus solubles (MWDGS) co-ensiled with direct-cut forage (DC) to beef steers, on feedlot performance and total tract digestibility. In Exp. 1, sixty-four crossbred Angus steers (n = 64; 329 ± 43 kg) were blocked by BW and randomly assigned to 1 of 4 dietary treatments: 1) corn-silage and soybean meal (CON), 2) DC co-ensiled with MWDGS (CO-EN), 3) haylage mixed with MWDGS at feeding (H+WDG), and 4) haylage mixed with dry distillers grains plus solubles at feeding (H+DDG). Steers were harvested when they reached an endpoint of 1.1 cm of 12th-rib back fat. In Exp. 2, four ruminally cannulated beef steers (initial BW = 556 ± 31 kg) were used in a 4 × 4 Latin square to evaluate digestibility of diets used in Exp. 1. Experimental periods were 14 d in length with 10 d for diet adaptation and 4 d for sample collection. Three linear orthogonal contrasts were used to compare effects of 1) CON vs. diets containing distillers grains (DGD), 2) CO-EN vs. diets where distillers grains were mixed at feeding (MIX), and 3) H+WDG vs. H+DDG. In Exp. 1, DMI was less (P < 0.001) for steers fed CON compared with those fed DGD and greatest (P < 0.001) for steers fed CO-EN compared with MIX. Corn-silage- and soybean-meal-fed steers had more days on feed than those fed DGD (P = 0.001). Body weight gain (P = 0.02) was greater for CO-EN compared with MIX. Fat thickness at the 12th and 13th ribs was greater (P = 0.03) for DGD steers compared with CON steers. Hot carcass weight was greater (P = 0.03) for steers fed CO-EN compared with those fed MIX. Steers fed CON resulted in greater marbling scores (P = 0.01) compared DGD-fed steers. Longissimus muscle area was greater (P = 0.01) for CON-fed steers compared with all other treatments. In Exp. 2, no differences (P > 0.10) in DM, OM, or N intakes were observed. Apparent total tract DM (P = 0.01) and N (P = 0.02) digestibility were greatest in steers fed CON compared with all others. Steers fed DGD had less (P = 0.02) rumen NH(3) concentrations compared with CON. The CON diet resulted in greater molar concentrations of VFA (P = 0.03) and decreased acetate to propionate ratio (P = 0.03) compared with all DGD. These data suggest that feeding MWDGS co-ensiled with direct-cut forage results in reduced diet digestibility but equal or greater feedlot performance and similar carcass and characteristics when compared with a corn diet supplemented with soybean meal and diets where MWDGS and DDGS were added at the mixer.

Treatment and secondary prevention effects of the probiotics Lactobacillus paracasei or Bifidobacterium lactis on early infant eczema: randomized controlled trial with follow-up until age 3 years.

BACKGROUND: Allergic disease has been associated with altered intestinal microbiota. Therefore, probiotics have been suggested as a potential treatment for eczema. OBJECTIVE: We investigated whether dietary supplementation of infants with eczema at age 3-6 months with Lactobacillus paracasei CNCM I-2116 or Bifidobacterium lactis CNCM I-3446 had a treatment effect or altered allergic disease progression. METHODS: Primary outcome included eczema severity (SCORing Atopic Dermatitis, SCORAD) 3 months post-randomization. Secondary: SCORAD (other visits); infant dermatitis quality of life (IDQoL); gastrointestinal permeability; urinary eosinophilic protein X; allergen-sensitization; allergic symptoms (age 12, 18, 36 months). A total of 208 infants aged 3-6 months with physician-diagnosed eczema were recruited; 137/208 (SCORAD ≥ 10, consuming ≥ 200 mL standard formula/day) were randomized to daily supplements containing L. paracasei or B. lactis or placebo for a 3-month period, while receiving extensively hydrolysed whey-formula (dairy-free diet). There were two open observational groups, one group exclusively breastfed (n = 22) and the other, standard formula-fed (n = 49). TRIAL NUMBER: ISRCTN41490500. RESULTS: Eczema severity decreased significantly over time in all groups. No significant difference was observed between randomized groups after 12-week treatment-period (SCORAD-score pre-/post-intervention: B. lactis 25.9 [95% CI: 22.8-29.2] to 12.8 [9.4-16.6]; L. paracasei 25.4 [22.1-29] to 12.5 [9.2-16.4]; placebo 26.9 [23.4-30.6] to 11.8 [9.6-14.3]; P = 0.7). Results were similar when analysis was controlled for allergen-sensitization, or when only sensitized infants were analysed. No differences were found for secondary outcomes. No difference was observed in SCORAD-score between randomized and observational groups. CONCLUSION AND CLINICAL RELEVANCE: We found no benefit from supplementation with B. lactis or L. paracasei in the treatment of eczema, when given as an adjunct to basic topical treatment, and no effect on the progression of allergic disease from age 1 to 3 years.

Effect of lauric acid and coconut oil on ruminal fermentation, digestion, ammonia losses from manure, and milk fatty acid composition in lactating cows.

This experiment (replicated 3 x 3 Latin square design) was conducted to investigate the effects of lauric acid (LA) or coconut oil (CO) on ruminal fermentation, nutrient digestibility, ammonia losses from manure, and milk fatty acid (FA) composition in lactating cows. Treatments consisted of intraruminal doses of 240 g of stearic acid/d (SA; control), 240 g of LA/d, or 530 g of CO/d administered once daily, before feeding. Between periods, cows were inoculated with ruminal contents from donor cows and allowed a 7-d recovery period. Treatment did not affect dry matter intake, milk yield, or milk composition. Ruminal pH was slightly increased by CO compared with the other treatments, whereas LA and CO decreased ruminal ammonia concentration compared with SA. Both LA and CO decreased protozoal counts by 80% or more compared with SA. Methane production rate in the rumen was reduced by CO compared with LA and SA, with no differences between LA and SA. Treatments had no effect on total tract apparent dry matter, organic matter, N, and neutral detergent fiber digestibility coefficients or on cumulative (15 d) in vitro ammonia losses from manure. Compared with SA, LA and CO increased milk fat 12:0, cis-9 12:1, and trans-9 12:1 content and decreased 6:0, 8:0, 10:0, cis-9 10:1, 16:0, 18:0, cis 18:1, total 18:2, 18:3 n-3 and total polyunsaturated FA concentrations. Administration of LA and 14:0 (as CO) in the rumen were apparently transferred into milk fat with a mean efficiency of 18 and 15%, respectively. In conclusion, current data confirmed that LA and CO exhibit strong antiprotozoal activity when dosed intraruminally, an effect that is accompanied by decreases in ammonia concentration and, for CO, lowered methane production. Administration of LA and CO in the rumen also altered milk FA composition.

Effects of suburban land use on phosphorus fractions and speciation in the Upper Peruque Creek, Eastern Missouri.

This field study was conducted to explore the spatial and seasonal changes in total phosphorus and fraction distribution in relation to land uses. Water samples were collected biweekly at four sampling locations, which represented different potential phosphorus sources along the Upper Peruque Creek in Eastern Missouri. Total phosphorus concentrations of > 0.8 mg/L appeared sporadically at site 2, downstream of a small community, with an average of 0.82 +/- 0.14 mg/L in fall. Particulate phosphorus accounted for approximately 80% of total phosphorus at all sampling sites, except for site 2, where approximately 50 to 75% of dissolved phosphorus was often observed. Approximately 71 and 85% of total phosphorus in the sediment was in the form of iron (III) phosphate at the headwaters and downstream sites, respectively; 29 and 15% was in the form of phytic acid at the two sites. Land uses affect the total phosphorus concentration and alternate phosphorus fraction and speciation in the creek.

Osteopenia of prematurity: a national survey and review of practice.

UNLABELLED: Premature infants are at significant risk of reduced bone mineral content (BMC) and subsequent osteopenia. There are currently no standard practices regarding screening, investigation or treatment of this condition. We present a case report and findings of a national survey of 36 level 2 and 3 neonatal units (72% response rate). The findings showed widely disparate practice regarding screening, prevention and treatment. We summarize the tests currently available for osteopenia and suggest guidelines for management of the at risk group. CONCLUSION: Our survey confirms inconsistent practices regarding management of infants at risk of osteopenia of prematurity. Investigations and treatments available are summarized together with a guideline for management of this susceptible group of infants.

Anastomotic leaks: what is the best diagnostic imaging study?

PURPOSE: Postoperative anastomotic leaks are one of the most devastating consequences of colorectal surgery. Diagnostic imaging for upper gastrointestinal anastomotic leaks has been evaluated and reported on extensively. No study has compared the utility and effectiveness of CT scans and water-soluble enemas for the identification of postoperative lower gastrointestinal anastomotic leaks. The present study was designed to evaluate and compare these two common radiographic imaging modalities in detecting lower gastrointestinal anastomotic leaks. METHODS: A retrospective chart review was performed that identified 36 patients during a seven-year period who underwent reoperative surgery for a lower gastrointestinal anastomotic leak. Patient's imaging studies were classified as positive if extravasation of contrast material was demonstrated. When negative, a study was retrospectively reviewed in an attempt to identify findings suggestive of an anastomotic leak. RESULTS: There were 36 patients identified with a postoperative lower gastrointestinal leak requiring surgical intervention. There were 28 of 36 patients (78 percent) re-explored on the basis of a radiologic study demonstrating an anastomotic leak. A total of 27 CT scans were performed, of which 4 (14.8 percent) were considered positive for an anastomotic leak. On review of the remaining negative CT scans, nine (33.3 percent) were considered descriptive positive with a large amount of fluid or air in the peritoneal cavity but without obvious extravasation of contrast. Eighteen patients were evaluated with a water-soluble enema and 15 (83.3 percent) demonstrated extravasation of contrast material. In the 26 patients with a distal anastomotic leak, 17 water-soluble enemas were performed, with 15 (88 percent) demonstrating a leak. In contrast, only 2 of 17 (12 percent) CT scans were positive in this group of patients (P < 0.001). There were ten patients who initially had a CT scan followed by a water-soluble enema. Of these patients, eight of nine (88 percent) initially had a negative CT scan but were considered to be clinically suspicious of having an anastomotic leak and subsequently had a leak demonstrated on a water-soluble enema. CONCLUSIONS: Early intervention in patients who develop an anastomotic leak can be shown to improve the ultimate outcome, especially with respect to mortality. It is usually necessary to obtain objective tests of anastomotic integrity because of the nonspecificity of clinical signs. Our study supported the superiority of water-soluble enema to CT imaging in patients in whom both modalities were used. This difference was most pronounced for distal anastomotic leaks, whereas no radiologic imaging study proved effective in evaluating proximal anastomoses.

Effects of pasteurization of potato slurry by-product fed in corn-or barley-based beef finishing diets.

Pasteurization of vegetable by-products such as potato slurry (PS) before feeding may be necessary to prevent the spread of pathogens and beef carcass blemishes. We hypothesized that pasteurization would increase ruminal fermentability of PS starch. Four ruminally cannulated crossbred beef steers (initial BW = 432) were used in a 4 x 4 Latin square experiment with a 2 x 2 factorial arrangement of treatments to examine the main effects and interactions of pasteurization (54.4 degrees C for 2 h) of PS and grain type (GT; dry-rolled corn and barley) on ruminal and total tract digestion of beef finishing diets. Diets contained 7% alfalfa hay and 14% PS (DM basis) and were fed ad libitum three times daily. Corn-based diets had 71.7% corn, whereas barley-based diets had 60% barley and 11.7% corn. Pasteurization resulted in greater (P = 0.004) soluble, rapidly degradable starch (34.3 vs. 26.7% for pasteurized and nonpasteurized PS, respectively). Ruminal fluid pH was more acidic (P < 0.07) for corn-based diets than for barley-based diets (P = 0.07) at 0200 and 2100 (sample time x GT; P < 0.05). Ruminal fluid pH was more acidic (P = 0.06) at 1400 for corn-based diets containing pasteurized PS compared with other dietary treatments (sample time x pasteurization x GT; P = 0.04). Minimum and maximum ruminal pH were greater (P < 0.10) for barley-based diets than for corn-based diets. Ruminal fluid pH was < 6.0 for a greater (P = 0.04) proportion of the day for corn-based compared with barley-based diets. In vitro incubation measurements revealed that pasteurization of PS resulted in lower (P = 0.06) ruminal fluid ammonia N concentration. Ruminal fluid ammonia N concentration was lower (P = 0.11) for barley-based diets than for corn-based diets. Steers fed barley-based diets had greater (P = 0.02) DMI and lesser (P < 0.05) total tract digestibility of DM and ADF compared with steers fed corn diets. Pasteurization increased (P = 0.10) total tract starch digestibility. Results indicate pasteurization increased rapidly degradable starch, ruminal starch fermentability, and total tract starch digestibility of PS. Grain type interacted with pasteurization such that feeding corn-based diets containing pasteurized PS resulted in periodic reductions in ruminal pH. Feeding management may be more critical when feeding pasteurized PS in beef finishing diets.

Growth, carcass characteristics, muscle conjugated linoleic acid (CLA) content, and response to intravenous glucose challenge in high percentage Wagyu, Wagyu x Limousin, and Limousin steers fed sunflower oil-containing diet.

The effect of breed and diet on insulin response to glucose challenge and its relation to intramuscular fat deposition was determined in 36 steers with 12 each of greater than 87% Wagyu (referred to as Wagyu), Wagyu x Limousin, and Limousin breeds. Weaned steers were blocked by weight into heavy, medium, and light calves and placed in six pens with two pens per weight type and with two steers of each breed per pen. Three pens with steers from each weightclass were fed backgrounding and finishing diets for 259 d, while the other three pens were fed the same diets where 6% of the barley grain was replaced with sunflower oil. Prior to initiation of the finishing phase of the study the intravenous glucose tolerance test (VGTIT) was conducted in all steers. Once steers were judged as carrying adequate 12th-rib fat, based on weight and days on feed, they were harvested and graded and samples of the longissimus muscle were procured for determination of fat content and fatty acid composition. Dietary oil improved (P = 0.011; 0.06) ADG and feed conversion efficiency of steers during the latter part of backgrounding and only ADG during early part ofthe finishing period. Generally percent kidney, pelvic, and heart fat was the only adiposity assessment increased (P = 0.003) by dietary oil. The IVGTT results indicated that insulin response to intravenous glucose was lower in Limousin steers than in Wagyu steers. Dietary oil decreased (P = 0.052) fasting plasma insulin concentration in Wagyu steers compared with Limousin steers. The correlation coefficients among the IVGTT measures and intramuscular fat content or marbling score were less than 0.4, and only a negative trend existed between fasting insulin and USDA marbling scores. However, the carcasses of the Wagyu steers graded US Choice, and 66% of the Wagyu carcasses graded US Prime, which were substantially better than the quality grades obtained for the carcasses from the other breed types. Dietary oil did not affect muscle fat content but increased (P = 0.01) conjugated linoleic acid (CLA) concentrations by 339%. Results indicated that IVGTT measures were not appropriate indices of marbling potential in cattle and that dietary oil can enhance CLA content of beef.

The effect of oilseeds in diets of lactating cows on milk production and methane emissions.

Thirty-six lactating multiparous Holstein cows were assigned to diets that contained 2.3, 4.0, and 5.6% fat for an entire lactation to determine the effect of oilseeds on milk composition, production, and methane emissions. The diets were formulated so that whole cottonseeds and canola oilseeds provided equal amounts of added fat. Methane emissions were measured every 3 mo from two replicates of four cows per treatment using a room tracer approach. Dry matter intakes and yields of milk and FCM were greater for cows fed the diets containing oilseeds. Although the concentration of protein in milk was reduced, yields of both protein and fat tended to be increased by the addition of fat. Within the milk fat, the concentrations of C10, C12, C14:0, and C16:0 were reduced and concentrations of C18, C18:1, and trans-C18:1 were increased in response to dietary oilseeds. In serum, urea-N was increased by the dietary oilseeds. Supplementation of diets with oilseeds did not affect methane emissions but tended to increase the efficiency of milk produced per unit of methane emitted. A 1.7% addition of fat to the control diet from a combination of oilseed types increased yields of milk without reducing methane emission rates. The strategy of using unsaturated fats from oilseeds to substantially reduce methane emissions was ineffective, although yield of milk was increased.

Risk factors for male breast cancer in Canada, 1994-1998.

Relatively little attention has been paid to the aetiology of male breast cancer and the current understanding of female breast cancer, primarily related to reproductive events, cannot be readily transferred to understanding the cancer in males. However, since male breast cancer occurs in the absence of factors related to childbearing and menstruation, its aetiology may provide special insights into the causes of breast cancer in women. We examined lifestyle risk factors for male breast cancer as part of a Canadian, multi-site, population-based, case-control study. Eighty-one newly diagnosed, histologically confirmed cases and 1905 male controls aged 42-74 were analysed using unconditional logistic regression. Increased risks were found for men with a mother or sister with breast cancer (adjusted odds ratio (OR) 3.65, 95% confidence interval (95% CI) 1.62-8.19). Higher physical activity levels (moderate, and strenuous recreational plus occupational) were associated with a decreased risk of male breast cancer (highest quartile, adjusted OR 0.48, 95% CI 0.26-0.91). Similarly, higher risks were associated with higher weight 2 years before interview (2.19, 95% CI 1.08-4.43), maximum weight (OR 2.66) and higher body mass index (OR 1.60). Higher vegetable consumption and coffee consumption were associated with decreased risk, whereas higher beta-carotene, vitamin E and calcium supplementation were associated with statistically significant increased risk. The small number of cases and multiple comparisons preclude strong conclusions, but our study is consistent with studies suggesting obesity and family history increase risk, and physical activity decreases risk of breast cancer.

Risk factors for kidney stones in older women in the southern United States.

BACKGROUND: The occurrence of kidney stones is disproportionate in the southern region of the United States. Risk factors for the occurrence of kidney stones in this geographic area have not been reported previously. METHODS: The Women's Health Initiative (WHI) is an ongoing multicenter clinical investigation of strategies for the prevention of common causes of morbidity and mortality among postmenopausal women. A case-control ancillary study was conducted on 27,410 (white or black) women enrolled in the 9 southern WHI clinical centers. There were 1,179 cases (4.3%) of kidney stones at the baseline evaluation. Risk factors for stone formation were assessed in cases versus age- and race-matched control subjects. RESULTS: Risk factors (univariate) included low dietary potassium (2,404 versus 2,500 mg/day, P = 0.006), magnesium (243 versus 253 mg/day, P = 0.003) and oxalate (330 versus 345 mg/day, P = 0.02) intake, as well as increased body mass index (28.5 versus 27.7 kg/m2, P = 0.001) and a history of hypertension (42% versus 34%, P = 0.001). A slightly lower dietary calcium intake (683 versus 711 mg/day, P = 0.04) was noted in case subjects versus control subjects, but interpretation was confounded by the study of prevalent rather than incident cases. Supplemental calcium intake >500 mg/day was inversely associated with stone occurrence. CONCLUSION: Multivariate risk factors for the occurrence of kidney stones in postmenopausal women include a history of hypertension, a low dietary intake of magnesium, and low use of calcium supplements.

Up-regulated expression of the phosphodiesterase nucleotide pyrophosphatase family member PC-1 is a marker and pathogenic factor for knee meniscal cartilage matrix calcification.

OBJECTIVE: Elevated cartilage inorganic pyrophosphate (PPi) production and PPi-generating nucleoside triphosphate pyrophosphohydrolase (NTPPPH) activity are strongly linked with aging-related cartilage calcification in meniscal and articular cartilages. We hypothesized that there were divergent relationships of 3 NTPPPH isozymes with cartilage matrix calcification and sought to identify them. METHODS: We studied knee medial meniscal expression in situ of 3 NTPPPH isozymes of the phosphodiesterase nucleotide pyrophosphatase (PDNP) family: plasma cell membrane glycoprotein 1 (PC-1, or PDNP1), autotaxin (ATX, or PDNP2), and B10/PDNP3. We also used complementary DNA transfection to assess differential functions in matrix calcification of each NTPPPH isozyme in vitro in meniscal cells. RESULTS: We observed diffuse cell-associated ATX and B10/PDNP3 expression in central (chondrocytic) and, to a lesser degree, peripheral (fibroblastic) regions of normal, degenerative uncalcified, and degenerative calcified menisci. In contrast, PC-1 expression was only robust at sites of apoptotic cells and calcification in central regions of degenerative menisci. Only PC-1 was abundant at the perimeter of meniscal cells and in association with meniscal cell-derived matrix vesicles (MVs). Because each PDNP-family isozyme was expressed by cells near calcifications, we transfected the isozymes in nonadherent knee meniscal cells cultured with ascorbic acid, beta-glycerophosphate, and dexamethasone supplementation to stimulate them to calcify the matrix. PC-1, but not ATX or B10/PDNP3, consistently promoted increased MV NTPPPH, MV-associated PPi, and extracellular PPi. PC-1 also increased matrix calcification (with hydroxyapatite crystals) by meniscal cells. ATX uniquely induced alkaline phosphatase activity, but promoted only moderately increased matrix calcification. CONCLUSION: We identified divergent effects of 3 PDNP-family NTPPPH isozymes on meniscal cell matrix calcification. Increased expression of PC-1 is both a marker and a potential pathogenic factor for knee meniscal cartilage matrix calcification.