Exotic Dark Matter Search with the Majorana Demonstrator.

With excellent energy resolution and ultralow-level radiogenic backgrounds, the high-purity germanium detectors in the Majorana Demonstrator enable searches for several classes of exotic dark matter (DM) models. In this work, we report new experimental limits on keV-scale sterile neutrino DM via the transition magnetic moment from conversion to active neutrinos ν_{s}→ν_{a}. We report new limits on fermionic dark matter absorption (χ+A→ν+A) and sub-GeV DM-nucleus 3→2 scattering (χ+χ+A→ϕ+A), and new exclusion limits for bosonic dark matter (axionlike particles and dark photons). These searches utilize the (1-100)-keV low-energy region of a 37.5-kg y exposure collected by the Demonstrator between May 2016 and November 2019 using a set of ^{76}Ge-enriched detectors whose surface exposure time was carefully controlled, resulting in extremely low levels of cosmogenic activation.

Assessment of meat quality attributes of four commercial broiler strains processed at various market weights.

As the demand for poultry meat continues to rise, industry production is constantly challenged with obtaining consumer needs. Integrators have answered this increasing demand by improving the growth rate of broilers allowing for increased production efficiently. The resulting broiler produces higher yields and a larger quantity of fresh poultry to satisfy consumer needs. However, this increase in efficiency has cost integrators as new quality issues continue to manifest through global production. Therefore, the objective of the current experiment was to evaluate the effect of genetic strain (standard and high yielding) and target weight on meat quality attributes such as pH, water holding capacity (WHC), and tenderness, alongside meat quality defects such as breast and tender myopathies. In the current study, 1,800 broilers from 4 commercial strains (2 high breast yielding (HY) and 2 standard yielding (SY) were raised sex separate to evaluate meat quality trends over time at 6 previously defined market weights. Birds were processed at weights ranging from 2,043 to 4,313 g in 454 g increments. HY strains produced higher breast and tender yields than those of SY strains (P < 0.05). There was an increase in breast and tender yield as target weight increased (P < 0.05) for both HY and SY strains. Differences were observed between strains for all fillet dimensions (P < 0.05); however, these measurements increased as target weight increased as expected. Woody breast (WB) had a higher severity (P < 0.05) in HY strains over SY strains, for both males and females. Differences were observed in white striping (WS; P < 0.05) for females in both strains, but no differences were observed in males. A main effect of target was noticed for both WB and WS (P < 0.05), expressing increased severity as target weight increased. Shear values were influenced more by target weight (P < 0.05), but inconsistent differences were observed between HY and SY groups. Meullenet-Owens Razor Shear (MORS) energy values increased slightly as target weights increased (P < 0.05) from 2,951 to 4,313 g in both males and females, but differences were minor and inconsistent with the smaller carcass weights. The MORS peak counts generally increased as target weight increased for both sexes. While strain had minimal effects on meat quality attributes, processing weight had a greater influence on quality, specifically muscle myopathies, WHC, and shear properties.

Meat quality attributes of male and female broilers from 4 commercial strains processed for 2 market programs.

In recent times, meat quality has become a key aspect of poultry production. In the current study, 2,400 sex separate broilers from 4 commercial strains were placed in 6 replications to evaluate various meat quality characteristics when grown to 2 market weights. Broilers were fed 1 of 2 diets with varying degrees of amino acid inclusion to evaluate meat quality of broiler raised on varying planes of nutrition. Birds were processed to meet 2 specified target weights (2.5 and 3.8 kg) representing small bird and big bird debone markets in the United States, respectively. Birds were processed using commercial methods, deboned at 3-h postmortem, and meat quality was assessed. Myopathies (woody breast, white striping, spaghetti meat, along with tenderloin quality), fillet dimensions, color, water-holding capacity (e.g., drip loss, cook loss), and Meullenet Owens Razor Shear was determined. Data were analyzed using the Mixed Model platform of JMP Pro 15.2 (SAS Institute, Cary, NC). Diet had no effect (P > 0.05) on the key quality responses; data were then pooled resulting in main effects of sex, strain, and target weight (noted as carcass size). On the day of processing, high yielding (HY) strains produced higher breast and tender yields (P < 0.05) when compared to standard yielding (SY) strains. In addition, and as expected, females exhibited higher breast and tender yields (P < 0.05) than males. However, males had significantly thicker (P < 0.05) and longer (P < 0.05) fillets, higher incidences (P < 0.05) of white striping, and higher (P < 0.05) cook loss when compared to females. Differences were also observed in tenderness as SY strain A produced the lowest shear values, whereas SY strain B produced the highest shear values across parameters (P < 0.05). SY strains in the small bird (SB) market performed better than SY strains in the big bird (BB) market as indicated by lower incidences of breast and tender myopathies white striping, woody breast, spaghetti meat, woody-like tender, and tender feathering and improved quality attributes (P < 0.05). Similar trends were observed (P < 0.05) in HY strains as SB carcasses produced a better overall product than BB. Differences in carcass size directly impacted quality (P < 0.05) as SB markets showed improvements in most parameters assessed, but broilers representing BB markets had greater breast yield. Although strain had minimal impacts on quality measures, carcass size, and sex had a greater impact on muscle myopathies, water-holding capacity, and shear properties.

Final Result of the Majorana Demonstrator's Search for Neutrinoless Double-ß Decay in

The Majorana Demonstrator searched for neutrinoless double-ß decay (0νßß) of ^{76}Ge using modular arrays of high-purity Ge detectors operated in vacuum cryostats in a low-background shield. The arrays operated with up to 40.4 kg of detectors (27.2 kg enriched to ∼88% in ^{76}Ge). From these measurements, the Demonstrator has accumulated 64.5 kg yr of enriched active exposure. With a world-leading energy resolution of 2.52 keV FWHM at the 2039 keV Q_{ßß} (0.12%), we set a half-life limit of 0νßß in ^{76}Ge at T_{1/2}>8.3×10^{25} yr (90% C.L.). This provides a range of upper limits on m_{ßß} of (113-269) meV (90% C.L.), depending on the choice of nuclear matrix elements.

Characterization of growth patterns and carcass characteristics of male and female broilers from four commercial strains fed high or low density diets.

Over the last few decades, the poultry industry has seen the emergence of various market segments that are beneficial for rearing various flock sizes. Two concurrent experiments consisting of 1,200 broilers each were conducted to evaluate the effects of broiler size and diet on the performance of four commercially available broiler strains, including 2 standard yielding (SY) and 2 high yielding (HY) strains. Within each experiment (Experiment 1: males, Experiment 2: females), a small bird (38 and 40 d processing) and big bird (47 and 54 d processing) debone market were targeted to give variable carcass size. Two polyphasic diets were fed based on varying of amino acid densities. The low-density diet (L) consisted of 1.20, 1.10, 1.00, and 0.96% digestible Lys and the high-density diet (H) consisted of 1.32, 1.21, 1.10, and 1.06% across the 4-phases, respectively, with similar essential amino acid to digestible Lys ratios between the L and H diets in each phase. Weekly BW, BW gain, feed intake, and feed conversion ratio were assessed, as well as processing yields during both experiments. Broilers fed the H diets responded better than those fed the L diets, regardless of sex, with increased BW and decreased FCR (P < 0.05). Male HY strains provided the highest carcass yields (P < 0.05) compared to SY strains, with no differences observed in females (P > 0.05). High density diets (Diet H) also produced increases in carcass, breast, and tender yield (P < 0.05) for males, but that trend was not present in carcass yield for females (P < 0.05). Overall, strain impacted performance traits and carcass yields. Therefore, the use of specific strains and amino acid density for various market segments is beneficial for integrators to maximize return.

Search for Solar Axions via Axion-Photon Coupling with the Majorana Demonstrator.

Axions were originally proposed to explain the strong-CP problem in QCD. Through axion-photon coupling, the Sun could be a major source of axions, which could be measured in solid state detection experiments with enhancements due to coherent Primakoff-Bragg scattering. The Majorana Demonstrator experiment has searched for solar axions with a set of ^{76}Ge-enriched high purity germanium detectors using a 33 kg-yr exposure collected between January, 2017 and November, 2019. A temporal-energy analysis gives a new limit on the axion-photon coupling as g_{aγ}<1.45×10^{-9} GeV^{-1} (95% confidence level) for axions with mass up to 100 eV/c^{2}. This improves laboratory-based limits between about 1 eV/c^{2} and 100 eV/c^{2}.

Measuring school level attributable risk to support school-based HPV vaccination programs.

BACKGROUND: In Australia in 2017, 89% of 15-year-old females and 86% of 15-year-old males had received at least one dose of the HPV vaccine. However, considerable variation in HPV vaccination initiation (dose one) across schools remains. It is important to understand the school-level characteristics most strongly associated with low initiation and their contribution to the overall between-school variation. METHODS: A population-based ecological analysis was conducted using school-level data for 2016 on all adolescent students eligible for HPV vaccination in three Australian jurisdictions. We conducted logistic regression to determine school-level factors associated with lower HPV vaccination initiation (< 75% dose 1 uptake) and estimated the population attributable risk (PAR) and the proportion of schools with the factor (school-level prevalence). RESULTS: The factors most strongly associated with lower initiation, and their prevalence were; small schools (OR = 9.3, 95%CI = 6.1-14.1; 33% of schools), special education schools (OR = 5.6,95%CI = 3.7-8.5; 8% of schools), higher Indigenous enrolments (OR = 2.7,95% CI:1.9-3.7; 31% of schools), lower attendance rates (OR = 2.6,95%CI = 1.7-3.7; 35% of schools), remote location (OR = 2.6,95%CI = 1.6-4.3; 6% of schools,) and lower socioeconomic area (OR = 1.8,95% CI = 1.3-2.5; 33% of schools). The highest PARs were small schools (PAR = 79%, 95%CI:76-82), higher Indigenous enrolments (PAR = 38%, 95%CI: 31-44) and lower attendance rate (PAR = 37%, 95%CI: 29-46). CONCLUSION: This analysis suggests that initiatives to support schools that are smaller, with a higher proportion of Indigenous adolescents and lower attendance rates may contribute most to reducing the variation of HPV vaccination uptake observed at a school-level in these jurisdictions. Estimating population-level coverage at the school-level is useful to guide policy and prioritise resourcing to support school-based vaccination programs.

A comparison of formic acid or monoglycerides to formaldehyde on production efficiency, nutrient absorption, and meat yield and quality of Cobb 700 broilers.

After being banned by the European Commission in 2018, the use of formaldehyde as a feed amendment in the United States has come into question. Therefore, this study was conducted to explore alternatives to formaldehyde, such as formic acid and monoglycerides, and their effects on poultry production. In total, 1,728 Cobb 700 broilers were randomly assigned to 96-floor pens on day of hatch (18 birds/pen). Using a randomized complete block design (4 blocks), treatments were assigned to pens with blocking based on location within the barn, with the eastern half of the barn designated for digestibility and the western half designated for production (per experiment: 8 control pens and 10 pens per treatment). All diets were based on a negative control (NC), basal diet. Dietary treatments consisted of: NC, NC + 0.25% formalin (F), NC + 0.25 and 0.50% Amasil NA (AML and AMH; 61% formic acid and 20.5% Na-formate), and NC + SILO Health 104L (SILO; mixture of monoglycerides; 0.5% from 0 to 14 d, 0.4% from 14 to 28 d, and 0.2% from 28 to 42 d). Water and feed were provided ad libitum. Performance data were collected during feed changes on d 0, 14, 28, and 42, with digestibility data collected at d 14 (2 per pen) and carcass quality (6 per pen) assessed at d 46 with a randomly selected group of broilers. A one-way ANOVA followed by Dunnett's multiple comparison, where treatments were evaluated against F were conducted using JMP 14.0 (P ≤ 0.05). Main effect of treatment was significant for performance, nutrient digestibility, and carcass quality. Differences in body weight and ADG were observed from d 14 to d 28, resulting in a trending improvement in lysine digestibility on d 14 and carcass quality on d 46 of birds fed AML and AMH in comparison to those fed F (P < 0.05). Whereas birds fed SILO had reduced digestibility of methionine on d 14 and a decrease in meat quality on d 46 in comparison to those fed F (P < 0.05). Therefore, Amasil NA at 0.25 or 0.50% may be an effective alternative to formaldehyde as a feed amendment for poultry production.

Differences in school factors associated with adolescent HPV vaccination initiation and completion coverage in three Australian states.

BACKGROUND: Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake. METHODS: Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage. RESULTS: Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates. CONCLUSION: This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.

A multigenomic liquid biopsy biomarker for neuroendocrine tumor disease outperforms CgA and has surgical and clinical utility.

BACKGROUND: Biomarkers are key tools in cancer management. In neuroendocrine tumors (NETs), Chromogranin A (CgA) was considered acceptable as a biomarker. We compared the clinical efficacy of a multigenomic blood biomarker (NETest) to CgA over a 5-year period. PATIENTS AND METHODS: An observational, prospective, cross-sectional, multicenter, multinational, comparative cohort assessment. Cohort 1: NETest evaluation in NETs (n = 1684) and cancers, benign diseases, controls (n = 731). Cohort 2: (n = 1270): matched analysis of NETest/CgA in a sub-cohort of NETs (n = 922) versus other diseases and controls (n = 348). Disease status was assessed by response evaluation criteria in solid tumors (RECIST). NETest measurement: qPCR [upper limit of normal (ULN: 20)], CgA (EuroDiagnostica, ULN: 108 ng/ml). STATISTICS: Mann-Whitney U-test, AUROC, chi-square and McNemar' test. RESULTS: Cohort 1: NETest diagnostic accuracy was 91% (P < 0.0001) and identified pheochromocytomas (98%), small intestine (94%), pancreas (91%), lung (88%), gastric (80%) and appendix (79%). NETest reflected grading: G1: 40 ± 1, G2 (50 ± 1) and G3 (52 ± 1). Locoregional disease levels were lower (38 ± 1) than metastatic (52 ± 1, P < 0.0001). NETest accurately stratified RECIST-assessed disease extent: no disease (21 ± 1), stable (43 ± 2), progressive (62 ± 2) (P < 0.0001). NETest concordance with imaging (CT/MRI/68Ga-SSA-PET) 91%. Presurgery, all NETs (n = 153) were positive (100%). After palliative R1/R2 surgery (n = 51) all (100%) remained elevated. After curative R0-surgery (n = 102), NETest levels were normal in 81 (70%) with no recurrence at 2 years. In the 31 (30%) with elevated levels, 25 (81%) recurred within 2 years. Cohort #2: NETest diagnostic accuracy was 87% and CgA 54% (P < 0.0001). NETest was more accurate than CgA for grading (chi-square = 7.7, OR = 18.5) and metastatic identification (chi-square = 180, OR = 8.4). NETest identified progressive disease (95%) versus CgA (57%, P < 0.0001). Imaging concordance for NETest was 91% versus CgA (46%) (P < 0.0001). Recurrence prediction after surgery was NETest-positive in >94% versus CgA 11%. CONCLUSION: NETest accurately diagnoses NETs and is an effective surrogate marker for imaging, grade, metastases and disease status compared to CgA. A multigenomic liquid biopsy is an accurate biomarker of NET disease.

Progress of amino acid nutrition for diet protein reduction in poultry.

There is growing interest among nutritionists in feeding reduced protein diets to broiler chickens. Although nearly a century of research has been conducted providing biochemical insights on the impact of reduced protein diets for broilers, practical limitation still exists. The present review was written to provide insights on further reducing dietary protein in broilers. To construct this review, eighty-nine peer reviewed manuscripts in the area of amino acid nutrition in poultry were critiqued. Hence, nutritional research areas of low protein diets, threonine, glycine, valine, isoleucine, leucine, phenylalanine, histidine, and glutamine have been assessed and combined in this text, thus providing concepts into reduced protein diets for broilers. In addition, linkages between the cited work and least cost formation ingredient and nutrient matrix considerations are provided. In conclusion, practical applications in feeding reduced protein diets to broilers are advancing, but more work is warranted.

Normal head and neck lymph nodes in the paediatric population.

AIM: To determine the normal range of head and neck lymph nodes in a paediatric population. MATERIALS AND METHODS: A retrospective review was undertaken of 200 brain magnetic resonance imaging (MRI) examinations in patients aged between 5 months to 16 years. Exclusion criteria included possible causes for lymphadenopathy. Studies were reported previously as normal. Eight regions were assessed for the presence of nodes, short and long axis of the largest node measured, and the ratio was calculated. RESULTS: Most commonly identifiable nodes were the deep cervical, submandibular, and posterior cervical in 100%, 99.5%, and 92.5% of studies. In the long axis, the three largest were the submandibular, deep, and posterior cervical with mean values of 19.7, 18.1, and 15.4 mm, respectively. For the S/L ratio, the three with the most oval shape were the pre-auricular, occipital, and submental with ratios of 0.64, 0.63, and 0.6, respectively. A positive correlation between the occipital and deep cervical lymph node groups with age was found to be stronger than the rest of localisations. CONCLUSION: This study characterises the normal distribution, size, and shape of head and neck lymph nodes in a healthy paediatric population, demonstrating that rounder and larger lymph nodes may be a normal finding, depending on their location and patient age.

Dietary branched-chain amino acid assessment in broilers from 22 to 35 days of age.

BACKGROUND: Valine and isoleucine are similar in chemical structure and their limitation in broiler chicken diets. To evaluate their limitation and interactive effects, multivariate assessment nutrition studies for the branched-chain amino acids (BCAA) are needed. A three level (- 1, 0, + 1), three-factor Box-Behnken design study was conducted to assess dietary BCAA ratios to lysine of 65, 75, and 85 for valine, 58, 66, and 74 for isoleucine, and 110, 130, and 150 for leucine in male and female Lohman Indian River broilers from 22 to 35 d of age. RESULTS: Live performance of male broilers was not affected by BCAA level. However, male broilers fed increasing isoleucine had improved (P = 0.07) carcass yield as leucine and valine were reduced. Female broilers had improved body weight gain (P = 0.05) and feed conversion (P = 0.003) when leucine and isoleucine were at their lowest levels, independent of valine, but increasing leucine impaired live performance and warranted concomitant increases in isoleucine to restore responses. Increasing dietary isoleucine and valine in female broilers increased breast meat yield (P = 0.05), but increasing leucine tended to diminish the response. CONCLUSION: The female Lohman Indian River broiler is more sensitive to BCAA diet manipulation than males. Specifically, as dietary leucine is increased in female broilers, dietary isoleucine increases were needed to offset the negative effects. Both increases in dietary valine and isoleucine improved breast meat yield in female broilers, but only when birds were fed the lowest dietary leucine.

Involvement of the Spinal Cord in Primary Mitochondrial Disorders: A Neuroimaging Mimicker of Inflammation and Ischemia in Children.

BACKGROUND AND PURPOSE: Little is known about imaging features of spinal cord lesions in mitochondrial disorders. The aim of this research was to assess the frequency, imaging features, and pathogenic variants causing primary mitochondrial disease in children with spinal cord lesions. MATERIALS AND METHODS: This retrospective analysis included patients seen at Children's Hospital of Philadelphia between 2000 and 2019 who had a confirmed diagnosis of a primary (genetic-based) mitochondrial disease and available MR imaging of the spine. The MR imaging included at least both sagittal and axial fast spin-echo T2-weighted images. Spine images were independently reviewed by 2 neuroradiologists. Location and imaging features of spinal cord lesions were correlated and tested using the Fisher exact test. RESULTS: Of 119 children with primary mitochondrial disease in whom MR imaging was available, only 33 of 119 (28%) had available spine imaging for reanalysis. Nineteen of these 33 individuals (58%) had evidence of spinal cord lesions. Two main patterns of spinal cord lesions were identified: group A (12/19; 63%) had white ± gray matter involvement, and group B (7/19; 37%) had isolated gray matter involvement. Group A spinal cord lesions were similar to those seen in patients with neuromyelitis optica spectrum disorder, multiple sclerosis, anti-myelin oligodendrocyte glycoprotein-IgG antibody disease, and leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation. Group B patients had spinal cord findings similar to those that occur with ischemia and viral infections. Significant associations were seen between the pattern of lesions (group A versus group B) and the location of lesions in cervical versus thoracolumbar segments, respectively (P < .01). CONCLUSIONS: Spinal cord lesions are frequently observed in children with primary mitochondrial disease and may mimic more common causes such as demyelination and ischemia.

Effect of pullet body weight and hen dietary amino acid treatments on their progeny fed high and low amino acid diets.

Four studies were conducted on Cobb 700 broilers to evaluate the dietary protein and any maternal effects on live production and processing parameters. Day-old Cobb 700 broiler breeder pullets were reared to conform to 2 different BW curves (control BW and increased BW) with 8 replicate pens per treatment. Birds were fed common diets from 1 d of age until first egg (24 wk). At 24 wk, 12 pens of each pullet treatment were given different amino acid (AA) diets (low = 14% CP, high = 15% CP). The performance of female and male progeny from 32 and 45 wk hens were evaluated on low AA and high AA density diets. The 4 progeny trial designs were identical factorial 2 × 2 × 2 designs, with 2 pullet BW curves (control BW and increased BW), 2 dam CP diet levels (low and high), and 2 progeny CP diets (low and high), with 6 replicates each containing 18 birds, for a total of 108 broiler progeny per treatment. Broiler chickens on the higher AA density feed exhibited consistent improvement in mid-growth BW and FCR and white meat yield percentage. Some maternal effects were noted, including increased carcass yield in female broilers from 32 wk old hens. There were 3-way interactions of pullet BW × hen dietary AA × progeny dietary AA treatments for female progeny carcass yield (from 32-week-old hens) and male tender yield (from 45-week-old hens). There were 2-way interactions of pullet BW x hen dietary AA treatments effect on female and male progeny drumstick yield from 32-week-old hens, pullet BW × progeny dietary AA treatments effect on male 27 d BW from 32-week-old hens, and hen dietary AA × progeny dietary AA treatments effect on male thigh yield from 45-week-old hen. The epigenetic effects of maternal pullet BW and dietary AA treatments were seen in processing yields suggesting, the need of dietary CP changes of the progeny.

Predictors of 1-year survival in South African transcatheter aortic valve implant candidates.

BACKGROUND: Transcatheter aortic valve implantation (TAVI) has undergone rapid expansion internationally over the past 15 years. In view of resource constraints in developing countries, a major challenge in applying this technology lies in identifying patients most likely to benefit. The development of a risk prediction model for TAVI has proved elusive, with a reported area under the curve (AUC) of 0.6 - 0.65. The available models were developed in a First-World setting and may not be applicable to South Africa (SA). OBJECTIVES: To evaluate novel indicators and to develop a TAVI risk prediction model unique to the SA context. The current work represents the important initial steps of derivation cohort risk model development and internal validation. METHODS: Seven-year experience with 244 successive TAVI implants in three centres in Western Cape Province, SA, was used to derive risk parameters. All outcomes are reported in accordance with the Valve Academic Research Consortium definitions. Multiple preprocedural variables were assessed for their impact on 1-year survival using univariate and multivariate models. RESULTS: Factors found not to correlate with 1-year survival included age, renal function and aortic valve gradients. The commonly used surgical risk prediction models (Society of Thoracic Surgeons score and EuroSCORE) showed no correlation with outcomes. Factors found to correlate best with 1-year survival on multivariate analysis were preprocedural body mass index (BMI) (favouring higher BMI), preprocedural left ventricular end-diastolic dimension (LVED) and ejection fraction (EF) (favouring smaller LVED and higher EF), absence of atrial fibrillation, and three novel parameters: independent living, ability to drive a car, and independent food acquisition/cooking. Discriminant analysis of these factors yielded an AUC of 0.8 (95% confidence interval 0.7 - 0.9) to predict 1-year survival, with resubstitution sensitivities and specificities of 72% and 71%, respectively. CONCLUSIONS: Apart from existing predictors, we identified three novel risk predictors (independent living, ability to drive a car, and independent food acquisition/cooking) for 1-year survival in TAVI candidates. These novel parameters performed well in this early evaluation, with an AUC for predicting 1-year survival higher than the AUCs for many of the internationally derived parameters. The parameters are inexpensive and easy to obtain at the initial patient visit. If validated prospectively in external cohorts, they may be applicable to other resource-constrained environments.

Determining the 4th limiting amino acid in low crude protein diets for male and female Cobb MV × 500 broilers.

1. Four experiments were conducted to determine the 4th limiting amino acid (AA) in maize-soybean meal-based diets. 2. Deletion assay methodology was used to quantify performance and carcase trait responses to potential deficiencies in essential and conditionally essential AA caused by reductions in dietary crude protein of maize-soybean meal-based diets from 202.9 to 186.5 g/kg. 3. The deletion of Val, Phe and Gly + Pro resulted in negative effects on live performance and carcase traits for male broilers, whereas AA deletion only affected wing weights for females with no response on live performance. 4. Further experimentation could not duplicate a response to Phe or Pro in male broilers. 5. Valine was identified as the potential 4th limiting AA in maize-soybean meal-based diets and was not found to be co-limiting with Ile.

Impact of implementing an online interactive educational tool for future HIV "cure" research in an HIV clinic waiting room in Cape Town, South Africa.

Access to antiretroviral treatment (ART) in South Africa is suboptimal and erratic. For those on treatment, compliance remains a significant challenge. Interruptions to ART have negative implications for the individual and the epidemic. ART is therefore not a sustainable solution and there is an urgent need for a cure. As HIV cure research expands globally, the need to engage community members about cure is becoming a priority. It is vital that potential trial participants understand basic HIV cure research concepts. An online interactive educational tool was co-created with HIV stakeholders to engage and inform HIV research trial participants. The study was conducted with patients at the FAMCRU HIV clinic at Tygerberg Hospital in Cape Town, South Africa. The educational tool comprises two modules that provide information on HIV prevention, treatment and cure research. Participants completed a questionnaire before and after interacting with the programme. There was a significant increase in knowledge scores of participants demonstrated after using the tool. The interactive tool was successful in increasing participants' knowledge of HIV prevention, treatment and cure research.

Pre-frailty factors in community-dwelling 40-75 year olds: opportunities for successful ageing.

BACKGROUND: There is little known about pre-frailty attributes or when changes which contribute to frailty might be detectable and amenable to change. This study explores pre-frailty and frailty in independent community-dwelling adults aged 40-75 years. METHODS: Participants were recruited through local council networks, a national bank and one university in Adelaide, Australia. Fried frailty phenotype scores were calculated from measures of unintentional weight loss, exhaustion, low physical activity levels, poor hand grip strength and slow walking speed. Participants were identified as not frail (no phenotypes), pre-frail (one or two phenotypes) or frail (three or more phenotypes). Factor analysis was applied to binary forms of 25 published frailty measures Differences were tested in mean factor scores between the three Fried frailty phenotypes and ROC curves estimated predictive capacity of factors. RESULTS: Of 656 participants (67% female; mean age 59.9 years, SD 10.6) 59.2% were classified as not frail, 39.0% pre-frail and 1.8% frail. There were no gender or age differences. Seven frailty factors were identified, incorporating all 25 frailty measures. Factors 1 and 7 significantly predicted progression from not-frail to pre-frail (Factor 1 AUC 0.64 (95%CI 0.60-0.68, combined dynamic trunk stability and lower limb functional strength, balance, foot sensation, hearing, lean muscle mass and low BMI; Factor 7 AUC 0.55 (95%CI 0.52-0.59) comprising continence and nutrition. Factors 3 and 4 significantly predicted progression from pre-frail to frail (Factor 3 AUC 0.65 (95% CI 0.59-0.70)), combining living alone, sleep quality, depression and anxiety, and lung function; Factor 4 AUC 0.60 (95%CI 0.54-0.66) comprising perceived exertion on exercise, and falls history. CONCLUSIONS: This research identified pre-frailty and frailty states in people aged in their 40s and 50s. Pre-frailty in body systems performance can be detected by a range of mutable measures, and interventions to prevent progression to frailty could be commenced from the fourth decade of life.

Neurodevelopmental and behavioural outcomes of HIV-exposed uninfected and HIV-unexposed children at 2-3 years of age in Cape Town, South Africa.

Successful vertical HIV transmission prevention programmes (VTP) have resulted in an expanding population of HIV-exposed uninfected (HEU) infants whose growth, health and neurodevelopmental outcomes could have consequences for future resource allocation. We compared neurodevelopmental and behavioural outcomes in a prospective cohort of 2-3 year old HEU and HIV-unexposed uninfected (HU) children.Women living with and without HIV and their infants were enrolled within three days of birth from a low-risk midwife obstetric unit in Cape Town, South Africa during 2012 and 2013, under WHO Option A VTP guidelines. HIV-uninfected children aged 30-42 months were assessed using the Bayley scales of Infant Development-Third edition (BSID) and Strengths and Difficulties questionnaire (SDQ).Thirty-two HEU and 27 HU children (mean birth weight 3048g vs 3096g) were assessed. HEU children performed as well as HU children on BSID cognitive, language and motor domains. Mean scores fell within the low average range. Mothers of HEU children reported fewer conduct problems but stunting was associated with increased total difficulties on the SDQ.HEU and HU children's performance on the BSID was similar. In this low-risk cohort, HIV exposure did not confer additional risk. Stunting was associated with increased behavioural problems irrespective of HIV exposure.