A systematic review and meta-analysis of the effects of community use of oral nutritional supplements on clinical outcomes.

The impact of oral nutritional supplements (ONS) on patients with complications (disease related morbidity) requires further exploration. This systematic review included 44 randomised controlled trials (RCT) (29 RCT surgical, 15 RCT medical patients) examining the effect of ONS in community settings on the incidence of complications (n = 716, mean age 67 years, range 35-87). ONS (mean intake 588 kcal/day, range 125-1750; protein 22 g/day, range 0-54; mean energy from protein 22 %, range 0-54) were prescribed for a mean 74 days, range 5-365. Most RCT (77 %) reported fewer complications in the ONS group versus control. Meta-analysis (39 RCT) showed ONS consumption reduced complications including infections, pressure ulcers, wound and fracture healing (OR 0.68, 95 % CI 0.59,0.79; p<0.001). Results showed reductions when ONS were used in hospital and community settings (OR 0.72, 95 % CI 0.59,0.87; p = 0.001) or just in the community (OR 0.65, 95 % CI 0.52, 0.80; p<0.001). Reductions in complications were only seen with high ONS adherence ≥ 80 % (OR 0.63, 95 % CI 0.48,0.83; p = 0.001) and ready-to-drink ONS (OR 0.69, 95 % CI 0.60,0.81; p<0.001). This systematic review and meta-analysis show community-based use of ONS in addition to the diet substantially reduces the incidence of complications. The diversity of ONS, patient populations and complication outcomes within the trials included in this review mean further research is warranted.

Biological therapy prior to repeat ileocolic resection in Crohn's disease can reduce the postoperative complication rate.

BACKGROUND: The aim of this study was to assess the effect of preoperative biologic therapy on the surgical outcome of Crohn's disease (CD) patients undergoing repeat ileocolic resection. METHODS: This was a retrospective analysis of all CD patients who underwent repeat ileocolic resection at Cleveland Clinic Florida between January 2011 and April 2021. Patients were divided into two groups: treatment biologic therapy prior to surgery and controls. RESULTS: Sixty-five patients (31males, median age 54 [range 23-82] years) were included in the study. Twenty nine (44.6%) were treated with biologic therapy prior to repeat ileocolic resection. No demographic differences were found between the biologic therapy and control groups. In addition, no differences were found in mean time from index ileocolic resection (p = 0.9), indication for surgery (p = 0.11), and preoperative albumin (p = 0.69). The majority of patients (57; 87.7%) were operated on laparoscopically, and mean overall operation time was 225 (SD 49.27) min. Overall, the postoperative complication rate was 43.1% (28 patients) and median length of stay was 5 (range 2-21) days. Postoperative complications were more common in the control group, compared to the biologic therapy group (55.6 vs 27.5%; p = 0.04). Conversion rate (35.7 vs 20.7%; p = 0.24), operation time (223 vs 219 min; p = 0.75), length of stay (5.2 vs 5.9 days; p = 0.4), and readmission (16.6 vs 11.1%; p = 0.72) were similar between the two groups. Multivariate analysis of risk factors for postoperative complications showed that biologic treatment was correlated with a lower risk (HR -0.28, CI 95% -0.5596 to -0.01898, p = 0.03). CONCLUSIONS: Patients treated with biologic therapy for CD who underwent repeat ileocolic resection had fewer postoperative complications.

Effect of varying prepartum dietary cation-anion difference and calcium concentration on postpartum mineral and metabolite status and milk production of multiparous cows.

Eighty-two multiparous Holstein cows were enrolled 28 d before expected calving and assigned to 1 of 4 dietary treatments in a randomized block design experiment with a 2 × 2 factorial arrangement of treatments to determine the effect of feeding a neutral or acidogenic diet varying in Ca concentration on prepartum and postpartum intake, blood mineral and metabolite concentrations, and postpartum milk production. Prepartum diets were formulated to provide a dietary cation-anion difference (DCAD) of -21 (negative, NEG) or -2 (neutral, NEU) mEq/100 g of dry matter with either 1.3% or 1.8% Ca. After calving, cows remained on trial through 63 d in milk (DIM) and were fed a common lactation diet. Urine pH was lower for NEG compared with NEU and tended to be lower for 1.8% Ca compared with 1.3% Ca. Fractional excretion of Ca and Mg in urine was greater for NEG than for NEU. Prepartum plasma bicarbonate was lower and P was higher for NEG compared with NEU. Prepartum plasma P and blood urea nitrogen to creatinine ratio was higher for 1.3% compared with 1.8% Ca. Postpartum, concentrations of plasma total protein, albumin, blood urea nitrogen, Mg, and ionized Mg (iMg) were higher and Na was lower for NEU compared with NEG. An interaction of DCAD and Ca was observed for plasma creatinine, which was highest for cows fed NEU and 1.3% Ca compared with all other treatments. Interactions of DCAD and DIM were observed for plasma bicarbonate and iMg. Bicarbonate was higher at 3 DIM and lower at 14 DIM for NEU compared with NEG. Concentrations of iMg were higher at 1, 2, and 14 DIM for NEU compared with NEG. Interactions of Ca and DIM were observed for plasma Ca, Cl, and anion gap. Compared with cows fed 1.5% Ca, those fed 1.3% Ca had lower Ca and anion gap and higher Cl at 1 DIM and lower Cl and higher anion gap at 14 DIM. No differences were observed in body weight or body condition score due to DCAD or Ca. Prepartum dry matter intake (DMI) was lower for NEG compared with NEU and lower for 1.8% compared with 1.3% Ca. Postpartum DMI was not different among treatments. An interaction was observed for DCAD and DIM due to higher milk yield after 45 DIM for NEG compared with NEU. No differences were observed in milk component percentage or yield among treatments. There was an interaction of DIM and Ca for milk urea concentrations, which were higher at 5 wk and lower at 6 wk for 1.3% Ca compared with 1.8% Ca. These results suggest that feeding NEG prepartum alters plasma and urine mineral concentrations compared with feeding NEU and supports increased milk yield after 45 DIM. Feeding 1.8% Ca prepartum only improved plasma Ca at 1 DIM. Feeding either NEG or 1.8% Ca reduced DMI prepartum compared with NEU or 1.3% Ca.

Short communication: Blood mineral and gas concentrations of calves born to cows fed prepartum diets differing in dietary cation-anion difference and calcium concentration.

Eighty-two multiparous Holstein cows were fed diets differing in dietary cation-anion difference (DCAD) and Ca concentrations in a randomized block design experiment beginning 4 wk before anticipated calving to determine the effects on colostrum yield and quality and acid-base balance and mineral status of newborn calves. Treatments were arranged as a 2 × 2 factorial to provide 2 DCAD [-22 mEq/100 g of dry matter (NEG) or -3 mEq/100 g of dry matter (NEU)] and 2 supplemental Ca concentrations (1.3 or 1.8% of dry matter). After calving, cows were milked within 2 to 8 h and colostrum yield was recorded. Calves were fed 200 g of IgG of a commercial colostrum replacer within 4 h of birth. No differences were observed in birth weight or dystocia score among treatments, which averaged 42.7 kg and 1.12, respectively. Colostrum yield was not different among treatments and averaged 8.75 kg. Colostrum quality, as measured using a Brix refractometer, was not affected by DCAD but was higher for 1.3% compared with 1.8% Ca: 21.58% and 19.87%, respectively. Colostrum IgG concentrations were higher for NEG compared with NEU and for 1.3% compared with 1.8% Ca. No differences were observed in concentrations of serum IgG, Ca, P, K, Cl, anion gap, or whole-blood pH, partial pressure of O2, or SO2 of calves among treatments. Serum Mg and lactate concentrations were higher and CO2 tended to be lower for calves born to cows fed 1.3% compared with 1.8% Ca. Interactions of DCAD and Ca were observed for serum Na and Cl, which were higher for NEU-1.3% Ca and NEG-1.8% Ca compared with NEU-1.8% Ca and NEG-1.3% Ca. Whole-blood partial pressure of CO2, and HCO3 exhibited an interaction of DCAD and Ca and tended to be lower for NEU-1.3% Ca and NEG-1.8% Ca compared with NEU-1.8% Ca and NEG-1.3% Ca. Results of this trial indicate that feeding prepartum diets with 1.8% compared with 1.3% supplemental Ca reduced colostrum quality and serum concentrations of Mg and lactate in calves immediately after birth. Feeding NEG supported higher colostrum IgG concentrations. Blood mineral concentrations and blood gas balance tended to differ, but the effects were not consistent across DCAD and Ca.

Therapeutic targeting of membrane-associated GRP78 in leukemia and lymphoma: preclinical efficacy in vitro and formal toxicity study of BMTP-78 in rodents and primates.

Translation of drug candidates into clinical settings requires demonstration of preclinical efficacy and formal toxicology analysis for filling an Investigational New Drug (IND) application with the US Food and Drug Administration (FDA). Here, we investigate the membrane-associated glucose response protein 78 (GRP78) as a therapeutic target in leukemia and lymphoma. We evaluated the efficacy of the GRP78-targeted proapoptotic drug bone metastasis targeting peptidomimetic 78 (BMTP-78), a member of the D(KLAKLAK)2-containing class of agents. BMTP-78 was validated in cells from patients with acute myeloid leukemia and in a panel of human leukemia and lymphoma cell lines, where it induced dose-dependent cytotoxicity in all samples tested. Based on the in vitro efficacy of BMTP-78, we performed formal good laboratory practice toxicology studies in both rodents (mice and rats) and nonhuman primates (cynomolgus and rhesus monkeys). These analyses represent required steps towards an IND application of BMTP-78 for theranostic first-in-human clinical trials.

An early modern human presence in Sumatra 73,000-63,000 years ago.

Genetic evidence for anatomically modern humans (AMH) out of Africa before 75 thousand years ago (ka) and in island southeast Asia (ISEA) before 60 ka (93-61 ka) predates accepted archaeological records of occupation in the region. Claims that AMH arrived in ISEA before 60 ka (ref. 4) have been supported only by equivocal or non-skeletal evidence. AMH evidence from this period is rare and lacks robust chronologies owing to a lack of direct dating applications, poor preservation and/or excavation strategies and questionable taxonomic identifications. Lida Ajer is a Sumatran Pleistocene cave with a rich rainforest fauna associated with fossil human teeth. The importance of the site is unclear owing to unsupported taxonomic identification of these fossils and uncertainties regarding the age of the deposit, therefore it is rarely considered in models of human dispersal. Here we reinvestigate Lida Ajer to identify the teeth confidently and establish a robust chronology using an integrated dating approach. Using enamel-dentine junction morphology, enamel thickness and comparative morphology, we show that the teeth are unequivocally AMH. Luminescence and uranium-series techniques applied to bone-bearing sediments and speleothems, and coupled uranium-series and electron spin resonance dating of mammalian teeth, place modern humans in Sumatra between 73 and 63 ka. This age is consistent with biostratigraphic estimations, palaeoclimate and sea-level reconstructions, and genetic evidence for a pre-60 ka arrival of AMH into ISEA. Lida Ajer represents, to our knowledge, the earliest evidence of rainforest occupation by AMH, and underscores the importance of reassessing the timing and environmental context of the dispersal of modern humans out of Africa.

Validation of a laboratory-developed test of human sperm capacitation.

Sperm must undergo capacitation to become fertilization competent. Here we validated that monosialotetrahexosylganglioside (GM1 ) localization patterns, which were assessed in the Cap-Score™ Sperm Function Test, reflect a capacitated state in human sperm. First, we defined patterns representing sperm that do or do not respond to stimuli for capacitation. Sperm with "capacitated" patterns had exposed acrosomal carbohydrates and underwent acrosome exocytosis in response to calcium ionophore (A23187). Precision was evaluated by percent change of the Cap-Score measured for 50, 100, 150, and 200 sperm. Changes of 11%, 6%, and 5% were observed (n ≥ 23); therefore, we counted ≥150 sperm per condition. Variance within and between readers was evaluated using 20 stitched image files generated from unique ejaculates. Two trained readers randomly resampled each image 20 times, reporting an average standard deviation of 3 Cap-Score units and coefficient of variation of 13% when rescoring samples, with no difference between readers. Semen liquefaction times ≤2 hr and mechanical liquefaction with Pasteur or wide-orifice transfer pipettes did not alter Cap-Score values. However, liquefaction with chymotrypsin (p = 0.002) and bromelain (p = 0.049) reduced response to capacitating stimuli and induced membrane damage, while counterintuitively improving sperm motility. Together, these data validate the Cap-Score assay for the intended purpose of providing information on sperm capacitation and male fertility. In addition to its clinical utility as a diagnostic tool, this test of sperm function can reveal the impact of common practices of semen handling on the ability of sperm to respond to capacitation stimuli.

Effects of Supplementing Holstein Heifers with Dietary Melatonin during Late Gestation on Growth and Cardiovascular Measurements of their Offspring.

The objective was to examine the effects of supplementing dams with dietary melatonin during late gestation on offspring growth and cardiovascular measurements. On day 190 of gestation, heifers (n = 20) were blocked by body weight and randomly assigned to one of two dietary treatments consisting of 20 mg of dietary melatonin per day [melatonin (MEL)] or no melatonin supplementation [control (CON)]. Dietary treatments were terminated on day 262 of gestation. At birth, calves were separated from their dams with no further treatments. Calf (n = 18) blood pressure, cortisol, nitrites and total antioxidant capacity were collected on weeks 0, 1, 2, 3 and 4 of age. Calf hepatic portal blood flow and concentrations of insulin-like growth factor 1 were determined on weeks 0 and 4 of age. Calf body weight, abdominal girth, hip height and wither height increased (p < 0.05) with age. An age by treatment interaction (p < 0.01) was observed for calf body weight, which was increased at weeks 8 and 9 of age in calves born to MEL heifers compared to calves born to CON heifers. Pulse pressure, mean arterial pressure, absolute hepatic portal blood flow and blood flow relative to calf body weight were not different (p > 0.05) between treatments. A main effect of calf age (p < 0.05) was observed for concentrations of insulin-like growth factor 1, which was decreased at week 4 compared to week 0. An age by treatment interaction (p < 0.05) was observed for cortisol, which was decreased at week 2 in calves from MEL-treated dams compared to calves from CON-treated dams. Early post-natal growth was altered in offspring born to dams supplemented with dietary melatonin. This could lead to further foetal programming implications in conjunction with post-natal development.

Multivalent linkers for improved covalent binding of oligonucleotides to dye-doped silica nanoparticles.

This paper describes the fabrication of oligonucleotide-coated Cy5-doped silica nanoparticles using a combination of multivalent linkers and their use in surface-based DNA sandwich hybridization assays. Dipodal silane is introduced as a means to fabricate amine-coated silica nanoparticles and its advantages compared to monopodal silanes are discussed. The use of dipodal silane in conjunction with three different polymer linkers (oxidized dextran, linear and 8-arm polyethylene glycol (PEG)) to immobilize single-stranded DNA to Cy5-doped nanoparticles is investigated and dynamic light scattering measurements and Fourier transform infrared spectroscopy are used to follow the progression of the functionalization of the nanoparticles. We observe a significant improvement in the binding stability of the single-stranded DNA when the dipodal silane and 8-arm PEG are used in combination, when compared to alternative conjugation strategies. Both 8mer and 22mer oligonucleotides are securely conjugated to the high-brightness nanoparticles and their availability to hybridize with a complementary strand is confirmed using solution-based DNA hybridization experiments. In addition, a full surface-based sandwich assay demonstrates the potential these nanoparticles have in the detection of less than 500 femtomolar of a DNA analogue of micro RNA, miR-451.

Effects of a silica-based feed supplement on performance, health, and litter quality of growing turkeys.

Poor litter quality is a potential challenge to footpad health as well as the primary cause of ammonia volatilization. High ambient ammonia concentration is one of the most significant factors negatively affecting poultry production today. Some minerals have been reported to reduce ammonia release from poultry litter. Silicon dioxide, a highly pure and natural mineral, shows promise in decreasing ammonia volatilization and improving litter quality. The objective of the current study was to investigate the effects of feed-borne silicon dioxide on litter quality and how this impacts bird performance, general health and footpad health throughout a 12-wk posthatching turkey study. Supplementing the diet with silicon dioxide was found to significantly improve turkey BW gain and the efficiency of feed conversion. The severity of footpad dermatitis was monitored throughout the experimental period but no significant effect of diet was seen. The feeding of silicon dioxide reduced litter pH which decreased the conversion of NH4⁺ to NH3 thereby reducing nitrogen losses from litter. It was concluded that, under our study conditions, the feeding of 0.02% silicon dioxide offers potential economic benefits to turkey producers.

Persistent hindlimb inflammation induces changes in activation properties of hyperpolarization-activated current (Ih) in rat C-fiber nociceptors in vivo.

A hallmark of chronic inflammation is hypersensitivity to noxious and innocuous stimuli. This inflammatory pain hypersensitivity results partly from hyperexcitability of nociceptive dorsal root ganglion (DRG) neurons innervating inflamed tissue, although the underlying ionic mechanisms are not fully understood. However, we have previously shown that the nociceptor hyperexcitability is associated with increased expression of hyperpolarization-activated cyclic nucleotide-gated channel 2 (HCN2) protein and hyperpolarization-activated current (Ih) in C-nociceptors. Here we used in vivo voltage-clamp and current-clamp recordings, in deeply anesthetized rats, to determine whether activation properties of Ih in these C-nociceptors also change following persistent (not acute) hindlimb inflammation induced by complete Freund's adjuvant (CFA). Recordings were made from lumbar (L4/L5) C-nociceptive DRG neurons. Behavioral sensory testing was performed 5-7days after CFA treatment, and all the CFA-treated group showed significant behavioral signs of mechanical and heat hypersensitivity, but not spontaneous pain. Compared with control, C-nociceptors recorded 5-7days after CFA showed: (a) a significant increase in the incidence of spontaneous activity (from ∼5% to 26%) albeit at low rate (0.14±0.08Hz (Mean±SEM); range, 0.01-0.29Hz), (b) a significant increase in the percentage of neurons expressing Ih (from 35%, n=43-84%, n=50) based on the presence of voltage "sag" of >10%, and (c) a significant increase in the conductance (Gh) of the somatic channels conducting Ih along with the corresponding Ih,Ih, activation rate, but not voltage dependence, in C-nociceptors. Given that activation of Ih depolarizes the neuronal membrane toward the threshold of action potential generation, these changes in Ih kinetics in CFA C-nociceptors may contribute to their hyperexcitability and thus to pain hypersensitivity associated with persistent inflammation.

Oral immunostimulation of the oyster Ostrea edulis: Impacts on the parasite Bonamia ostreae.

Bioactive compounds were orally administered to the native European oyster Ostrea edulis to evaluate the immune response and the progression of infection of the protozoan parasite Bonamia ostreae. The immunostimulants lipopolysaccharide and zymosan directly administrated to the water column induced an increase in lysozyme activity and the percentage of granulocytes in naïve oysters over a period of 7 days. In another set of experiments, zymosan and curdlan were microencapsulated in alginate and also administered to the water column to naïve and B. ostreae infected O. edulis. Oyster mortality, prevalence and intensity of infection and several immune parameters were evaluated up to 28 days post-administration. Lysozyme activity, nitric oxide production and the expression of galectin, lysozyme and superoxide dismutase increased after 24 h in both infected and uninfected oysters. Zymosan immunostimulated oysters displayed a decrease in the prevalence of B. ostreae infection not attributed to mortalities but which could be associated to the enhanced ability of immunostimulants to evoke an enhanced immune response in the oysters and reduce infection.

Taurolidine locks significantly reduce the incidence of catheter-related blood stream infections in high-risk patients on home parenteral nutrition.

Emerging evidence suggests taurolidine reduces the risk of repeated episodes of catheter related blood stream infections (CRBSI) in a subgroup of patients receiving home parenteral nutrition (HPN). We defined 3 indications where taurolidine could be considered and retrospectively analysed data from patients who were treated over a 10 year period to examine the validity of these criteria. Twenty-two patients were identified from a total HPN population of 81, representing 33.2 years of experience. The overall CRBSI rate pre- and post-taurolidine usage was reduced from 5.71 to 0.99 infections per 1000 patient parenteral nutrition days (P-value <0.0001), with reductions identified in each smaller subgroup, confirming previous reports of a significant reduction in infections when taurolidine is used as secondary prophylaxis and providing initial data suggesting the benefit of its use as primary prophylaxis.

Short communication: norbixin and bixin partitioning in Cheddar cheese and whey.

The Cheddar cheese colorant annatto is present in whey and must be removed by bleaching. Chemical bleaching negatively affects the flavor of dried whey ingredients, which has established a need for a better understanding of the primary colorant in annatto, norbixin, along with cheese color alternatives. The objective of this study was to determine norbixin partitioning in cheese and whey from full-fat and fat-free Cheddar cheese and to determine the viability of bixin, the nonpolar form of norbixin, as an alternative Cheddar cheese colorant. Full-fat and fat-free Cheddar cheeses and wheys were manufactured from colored pasteurized milk. Three norbixin (4% wt/vol) levels (7.5, 15, and 30 mL of annatto/454 kg of milk) were used for full-fat Cheddar cheese manufacture, and 1 norbixin level was evaluated in fat-free Cheddar cheese (15 mL of annatto/454 kg of milk). For bixin incorporation, pasteurized whole milk was cooled to 55 °C, and then 60 mL of bixin/454 kg of milk (3.8% wt/vol bixin) was added and the milk homogenized (single stage, 8 MPa). Milk with no colorant and milk with norbixin at 15 mL/454 kg of milk were processed analogously as controls. No difference was found between the norbixin partition levels of full-fat and fat-free cheese and whey (cheese mean: 79%, whey: 11.2%). In contrast to norbixin recovery (9.3% in whey, 80% in cheese), 1.3% of added bixin to cheese milk was recovered in the homogenized, unseparated cheese whey, concurrent with higher recoveries of bixin in cheese (94.5%). These results indicate that fat content has no effect on norbixin binding or entrapment in Cheddar cheese and that bixin may be a viable alternative colorant to norbixin in the dairy industry.

The influence of bleaching agent and temperature on bleaching efficacy and volatile components of fluid whey and whey retentate.

Fluid whey or retentate are often bleached to remove residual annatto Cheddar cheese colorant, and this process causes off-flavors in dried whey proteins. This study determined the impact of temperature and bleaching agent on bleaching efficacy and volatile components in fluid whey and fluid whey retentate. Freshly manufactured liquid whey (6.7% solids) or concentrated whey protein (retentate) (12% solids, 80% protein) were bleached using benzoyl peroxide (BP) at 100 mg/kg (w/w) or hydrogen peroxide (HP) at 250 mg/kg (w/w) at 5 °C for 16 h or 50 °CC for 1 h. Unbleached controls were subjected to a similar temperature profile. The experiment was replicated three times. Annatto destruction (bleaching efficacy) among treatments was compared, and volatile compounds were extracted and separated using solid phase microextraction gas chromatography mass spectrometry (SPME GC-MS). Bleaching efficacy of BP was higher than HP (P < 0.05) for fluid whey at both 5 and 50 °C. HP bleaching efficacy was increased in retentate compared to liquid whey (P < 0.05). In whey retentate, there was no difference between bleaching with HP or BP at 50 or 5 °C (P > 0.05). Retentate bleached with HP at either temperature had higher relative abundances of pentanal, hexanal, heptanal, and octanal than BP bleached retentate (P < 0.05). Liquid wheys generally had lower concentrations of selected volatiles compared to retentates. These results suggest that the highest bleaching efficacy (within the parameters evaluated) in liquid whey is achieved using BP at 5 or 50 °C and at 50 °C with HP or BP in whey protein retentate.

In vitro comparison of two different methods of cell washing.

The storage of red blood cells (RBC) results in increased concentrations of plasma free hemoglobin, potassium, glucose, and lactate, among other undesirable substances. These concentrations continue to increase as RBC products age and can cause deleterious effects to the patient. In the setting of cardiac surgery, the autotransfusion devices are routinely used to wash blood that is shed from the surgical site. These devices could also be used to wash stored RBC units obtained from the blood bank. The objective of this study was to compare the product created by washing a unit of RBCs with the AutoLog autotransfusion device in the operating room to the washed products from a standard cell washer in the blood bank. Eleven outdated RBC units (stored for >42 days at 4 °C) were split in half. One half was washed using the Medtronic AutoLog device; the other half was washed using the blood bank's Cobe 2991 Cell Processor. Analytes were measured on samples from the unwashed parent unit and from the washed daughter units. The parameters measured included hematocrit, free hemoglobin, lactate, lactate dehydrogenase (LDH), potassium, glucose, and pH. When compared to the original untreated RBCs, the glucose, lactate, and potassium levels were decreased when washed in an autotranfusion device. Additionally, the free hemoglobin and LDH levels were significantly lower with the Medtronic Autolog cell saver than in the COBE 2991 Cell Processor. Washing the RBC donor units in an autotransfusion device prior to transfusion can effectively attenuate the increases seen in glucose, potassium, free hemoglobin, and LDH associated with RBC storage lesion.

Alternative bleaching methods for Cheddar cheese whey.

UNLABELLED: Residual annatto colorant (norbixin) in fluid Cheddar cheese whey can be bleached. The 2 approved chemical bleaching agents for whey, hydrogen peroxide (HP) and benzoyl peroxide (BP), negatively impact the flavor of dried whey protein. The objective of this study was to evaluate alternative methods for bleaching liquid whey: ultraviolet radiation (UV), acid-activated bentonite (BT), and ozone (OZ). Colored Cheddar cheese whey was manufactured followed by pasteurization and fat separation. Liquid whey was subjected to one of 5 treatments: control (CT) (no bleaching; 50 °C, 1 h), HP (250 mg/kg; 50 °C, 1 h), UV (1 min exposure; 50 °C), BT (0.5% w/w; 50 °C, 1 h), or OZ (2.2g/h, 50 °C, 1 h). The treated whey was then ultrafiltered, diafiltered, and spray-dried to 80% whey protein concentrate (WPC80). The entire experiment was replicated 3 times. Color (norbixin extraction and measurement), descriptive sensory, and instrumental volatile analyses were conducted on WPC80. Norbixin elimination was 28%, 79%, 39%, and 15% for HP, BT, UV, and OZ treatments, respectively. WPC80 from bleached whey, regardless of bleaching agent, had lower sweet aromatic and cooked/milky flavors compared to unbleached CT (P < 0.05). The HP and BT WPC80 had higher fatty flavor compared to the CT WPC80 (P < 0.05), and the UV and OZ WPC80 had distinct mushroom/burnt and animal flavors. Volatile compound results were consistent with sensory results and confirmed higher relative abundances of volatile aldehydes in UV, HP, and OZ WPC80 compared to CT and BT WPC80. Based on bleaching efficacy and flavor, BT may be an alternative to chemical bleaching of fluid whey. PRACTICAL APPLICATION: The 2 approved chemical bleaching agents for whey, hydrogen peroxide (HP) and benzoyl peroxide (BP), negatively impact flavor of dried whey protein, and restrictions on these agents are increasing. This study evaluated 3 alternatives to chemical bleaching of fluid whey: UV radiation, ozone, and bentonite.

Evaluation of a holistic cardiac rehabilitation in the reduction of biopsychosocial risk factors among patients with coronary heart disease.

The purpose of this pilot study is to evaluate the effectiveness of the Lifestyle Change Program (LSCP). LSCP was a holistic cardiac rehabilitation (CR) intervention focusing on several psychosocial and biological predictors of coronary heart disease including depression, hostility, low social support, high perceived stress, low spirituality, low life satisfaction, overall health status and cholesterol levels. Utilising a quasi-experimental design, overall health scores of LSCP patients were compared with those of a control group. To assess differences within-and between- groups, two (programme type) × 2 (age) × 2 (gender) × 2 (time) mixed design ANOVAs were used. Within-group relationships for psychosocial assessments and cholesterol levels were analysed using paired-samples t-tests. Results suggest that there were no significant differences between the LSCP group and the control group with regard to overall health status. However, the LSCP participants reported significantly lower levels of depression and perceived stress, as well as significantly higher levels of life satisfaction and spirituality upon programme completion. In addition, lipid panels changed significantly: A significant decrease in total cholesterol, low-density lipoproteins and triglycerides, as well as a significant increase in high-density lipoproteins. These trends suggest that holistic CR may be effective at reducing biopsychosocial risk factors for future cardiac events. Future studies, utilising an experimental design, are necessary to determine whether holistic programmes are more effective than traditional programmes in the reduction of cardiac risk factors.

Dietary supplementation with short-chain fructo-oligosaccharides improves insulin sensitivity in obese horses.

Obesity and insulin resistance are risk factors for laminitis in horses and ponies, and diet can play an important role in modulating these risk factors. Dietary supplementation with prebiotic fibers, such as short-chain fructo-oligosaccharides (scFOS), has resulted in improvement of insulin sensitivity in obese dogs and rodents. Thus, we hypothesized that scFOS may reduce insulin resistance in obese horses and designed a study to evaluate the effect of dietary supplementation with scFOS on insulin sensitivity. Eight mature Arabian geldings (BW = 523.0 ± 56.5 kg) with an average BCS of 8 were included in a crossover study. In each period, 4 horses were provided 45 g/d per horse of maltodextrin (control) and 4 horses received the same amount of scFOS for 6 wk, with a 3-wk washout between periods. Resting plasma concentrations of glucose, insulin, triglycerides, and leptin were measured. Minimal model analysis of a frequently sampled intravenous glucose tolerance test was used to evaluate insulin sensitivity, glucose effectiveness, acute insulin response to glucose, and disposition index. Without affecting BW and BCS, dietary supplementation with scFOS increased (P < 0.05) insulin sensitivity and reduced (P < 0.05) acute insulin response to glucose in comparison with maltodextrin but did not alter (P > 0.05) glucose effectiveness and disposition index. Resting serum insulin concentration also was reduced (P < 0.05) by scFOS supplementation but not by maltodextrin (P > 0.05). There was no effect (P > 0.05) of scFOS supplementation on plasma glucose or serum triglyceride and leptin concentrations. This study demonstrated that scFOS can moderately improve insulin sensitivity of obese horses, a finding that has potential relevance to the dietary management of obese, insulin-resistant horses at increased risk for laminitis.

Thromboprophylaxis following major skeletal trauma: a systematic review.

PURPOSE: Venous thromboembolic disease following skeletal polytrauma is a major issue for trauma surgeons, but there is no consensus of opinion regarding the optimal form of prophylaxis. The purpose of this paper was to compare the incidence of venous thromboembolic events (VTE) after major skeletal trauma managed with different prophylactic methods and their combinations. METHODS: A search of AMED, CINAHL, Cochrane Library, EMBASE and MEDLINE databases was performed from their inception to July 2010. A search of unpublished literature databases was undertaken. All randomised controlled trials assessing the incidence of VTE events between two or more forms of thromboprophylaxis for patient following major skeletal trauma were included. Two reviewers independently identified all eligible articles, extracted the data, and critically appraised all included publications using the Critical Appraisal Skills Programme tool. RESULTS: A total of 11 papers were identified. The findings of this study suggest that low molecular weight heparin (LMWH) may be superior to low dose heparin (LDH), and that LMWH should be used in addition to mechanical prophylaxis measures in patients following major skeletal trauma. There is limited evidence for the use of electrostimulation. There appeared to be no significant difference between the use of LDH compared to calf compression devices. However, the evidence-base was insufficient in both size and methodological quality. CONCLUSIONS: There is currently insufficient research to be able to inform trauma surgeons as to the optimal method of thromboprophylaxis for patients following major skeletal trauma.