Edad retiniana como biomarcador predictivo del grado de retinopatía diabética / Retinal age as a predictive biomarker of the diabetic retinopathy grade

Objetivo Aplicar técnicas de inteligencia artificial, mediante algoritmos de aprendizaje profundo, para el desarrollo y optimización de un sistema de predicción de la edad de una persona con base en una retinografía color, y estudiar una posible relación entre la evolución de la retinopatía diabética (RD) y un envejecimiento prematuro de la retina. Métodos Se entrenó una red convolucional para calcular la edad de una persona con base en una retinografía. Dicho entrenamiento fue realizado sobre un conjunto de retinografías de pacientes con diabetes previamente dividido en 3 subconjuntos (entrenamiento, validación y test). La diferencia entre la edad cronológica del paciente y la edad biológica de la retina se definió como gap de edad retiniano. Resultados Se utilizó un conjunto de 98.400 imágenes para la fase de entrenamiento, 1.000 imágenes para la fase de validación y 13.544 para la fase de test. El gap retiniano de los pacientes sin RD fue de 0,609 años y el de los pacientes con RD de 1,905 años (p<0,001), siendo la distribución por grado de RD de: RD leve 1,541 años; RD moderada 3,017 años; RD severa 3,117 años, y RD proliferativa 8,583 años. Conclusiones El gap de edad retiniano muestra una diferencia en positivo de media entre las personas diabéticas con RD frente a las que no tienen RD, y además aumenta progresivamente, de acuerdo con el grado de RD. Estos resultados podrían indicar la existencia de una relación entre la evolución de la enfermedad y un envejecimiento prematuro de la retina (AU)

Objective To apply artificial intelligence techniques, through deep learning algorithms, for the development and optimization of a system for predicting the age of a person based on a color retinography, and to study a possible relationship between the evolution of retinopathy diabetes (RD) and premature aging of the retina. Methods A convolutional network was trained to calculate the age of a person based on a retinography. Said training was carried out on a set of retinographies of patients with diabetes previously divided into 3 subsets (training, validation and test). The difference between the chronological age of the patient and the biological age of the retina was defined as the retinal age gap. Results A set of 98,400 images was used for the training phase, 1000 images for the validation phase and 13,544 for the test phase. The retinal gap of the patients without RD was 0.609 years and that of the patients with RD was 1905 years (p<0.001), with the distribution by degree of RD being: mild RD 1541 years; moderate RD 3017 years; RD severe 3117 years, and proliferative RD 8583 years. Conclusions The retinal age gap shows a positive mean difference between diabetics with RD versus those without RD, and it increases progressively, according to the degree of RD. These results could indicate the existence of a relationship between the evolution of the disease and premature aging of the retina (AU)

Retinal age as a predictive biomarker of the diabetic retinopathy grade.

OBJECTIVE: To apply artificial intelligence (AI) techniques, through deep learning algorithms, for the development and optimization of a system for predicting the age of a person based on a color retinography and to study a possible relationship between the evolution of retinopathy diabetes and premature ageing of the retina. METHODS: A convolutional network was trained to calculate the age of a person based on a retinography. Said training was carried out on a set of retinographies of patients with diabetes previously divided into three subsets (training, validation and test). The difference between the chronological age of the patient and the biological age of the retina was defined as the retinal age gap. RESULTS: A set of 98,400 images was used for the training phase, 1000 images for the validation phase and 13,544 for the test phase. The retinal gap of the patients without DR was 0.609 years and that of the patients with DR was 1905 years (p < 0.001), with the distribution by degree of DR being: mild DR: 1541 years, moderate DR: 3017 years, DR severe: 3117 years and proliferative DR: 8583 years. CONCLUSIONS: The retinal age gap shows a positive mean difference between diabetics with DR versus those without DR, and it increases progressively, according to the degree of DR. These results could indicate the existence of a relationship between the evolution of the disease and premature ageing of the retina.

Rapid Communication: 16S ribosomal ribonucleic acid characterization of liver abscesses in feedlot cattle from three states in the United States.

Liver abscesses are a major economic burden to beef producers. Although a few causative organisms have been cultured from purulent material, the full polymicrobial diversity of liver abscesses has not been reported. The objective of this study was to characterize purulent material collected from liver abscess in beef cattle produced in different production systems in 3 cattle producing states in the United States using 16S rRNA gene sequencing. Differences between purulent material microbial communities among geographic region of feeding and application of a common antimicrobial were also investigated. Cattle included in the study were fed in California (dairy type) and Colorado and Texas (both beef type). Liver abscesses from a cross section of feedlots, geographic areas, and tylosin phosphate-administered groups were collected at harvest; DNA from 34 liver abscess samples was extracted; and the V4 region of the 16S rRNA gene was amplified and sequenced. Sequences were classified into 5 phyla, 13 classes, and 17 orders in the domain Bacteria. The phyla identified included Bacteroidetes (35.2% of reads), Proteobacteria (28.6%), Fusobacteria (18.2%), Firmicutes (12.4%), and Actinobacteria (5.5%). Sequences matching the genera and , which have previously been identified as causative agents in liver abscesses, were both present in the abscess bacterial communities at a relative abundance of 15.1 and 3.2%, respectively, of the overall relative abundance. Furthermore, 3 of the most common phyla were Gram-negative bacteria. An analysis-of-similarities test was conducted on Euclidean distances to assess differences between cattle treated and not treated with tylosin as well as to assess differences between geographic regions. Geographical region and treatment with tylosin did affect the microbiome ( = 0.002 and = 0.026 respectively); however, a more robust sample scheme is needed to explore these differences. To our knowledge, this is the first publication describing the complex community of liver purulent material using next generation sequencing in cattle. These data provide a framework for research on a more targeted approach to liver abscess prevention and treatment.

National Beef Quality Audit - 2016: Survey of carcass characteristics through instrument grading assessments.

The instrument grading assessment portion of the National Beef Quality Audit (NBQA) - 2016 allows the unique opportunity to evaluate beef carcass traits over the course of a year. One week of instrument grading data was collected each month from 5 beef processing corporations encompassing 18 facilities from January 2016 through December 2016 ( = 4,544,635 carcasses). Mean USDA yield grade (YG) was 3.1 with 1.37 cm fat thickness (FT), 88.9 cm LM area, 393.6 kg HCW, and 2.1% KPH. Frequency distribution of USDA YG was 9.5% YG 1, 34.6% YG 2, 38.8% YG 3, 14.6% YG 4, and 2.5% YG 5. Increases in HCW and FT since the NBQA-2011 were major contributors to differences in mean YG and the (numerically) increased frequency of YG 3, 4, and 5 carcasses found in the current audit. Mean marbling score was Small, and the distribution of USDA quality grades was 4.2% Prime, 71.4% Choice, 21.7% Select, and 2.7% other. Frequency of carcasses grading Prime on Monday (6.43%) was numerically higher than the average frequency of carcasses grading Prime overall (4.2%). Monthly HCW means were 397.6 kg in January, 397.2 kg in February, 396.5 kg in March, 389.3 kg in April, 384.8 kg in May, 385.0 kg in June, 386.1 kg in July, 394.1 kg in August, 399.1 kg in September, 403.9 kg in October, 406.5 kg in November, and 401.9 kg in December. Monthly mean marbling scores were Small in January, Small in February, Small in March, Small in April, Small in May, Small in June, Small in July, Small in August, Small in September, Small in October, Small in November, and Small in December. Both mean HCW and mean marbling score declined in the months of May and June. The month with the greatest numerical frequency of dark cutters was October (0.74%). Comparison of overall data from in-plant carcass and instrument grading assessments revealed close alignment of information, especially for YG (3.1 for in-plant assessment versus 3.1 for instrument grading) and marbling (Small for in-plant assessment versus Small for instrument grading). These findings allow the beef industry access to the greatest volume of beef value-determining characteristics for the U.S. fed steer and heifer population than ever reported, resulting in potentially more precise targeting of future quality and consistency efforts.

National Beef Quality Audit-2016: In-plant survey of carcass characteristics related to quality, quantity, and value of fed steers and heifers.

The National Beef Quality Audit (NBQA)-2016 used in-plant cooler assessments to benchmark the current status of the fed steer and heifer beef industry in the United States. In-plant cooler assessments ( = 9,106 carcasses) were conducted at 30 facilities, where approximately 10% of a single day's production were evaluated for USDA quality grade (QG) and yield grade (YG) factors. Frequencies of evaluated traits were 66.5% steer and 33.4% heifer sex classes and 82.9% native, 15.9% dairy-type, and 1.2% estimated breed types. Mean USDA YG factors were 1.42 cm for adjusted fat thickness, 89.5 cm for LM area, 390.3 kg for HCW, and 1.9% for KPH. Mean USDA YG was 3.1, with a frequency distribution of 9.6% YG 1, 36.7% YG 2, 39.2% YG 3, 12.0% YG 4, and 2.5% YG 5. Mean USDA QG traits were Small for marbling score, A for overall maturity, A55 for lean maturity, and A for skeletal maturity. Mean USDA QG was Select with a frequency distribution of QG of 3.8% Prime, 67.3% Choice, 23.2% Select, and 5.6% lower score. Lower score included dark cutter (1.9%), blood splash (0.1%), and hard bone, which are USDA overall maturity scores of C or older (1.8%). Marbling score distributions were 0.85% Slightly Abundant or greater, 7.63% Moderate, 23.54% Modest, 39.63% Small, 23.62% Slight, and 0.83% Traces or less. Carcasses that were Choice or Select and USDA YG 2 or 3 accounted for 70.7% of the carcasses evaluated. Compared with the previous NBQA, we found a numerical increase in mean USDA YG, USDA QG, adjusted fat thickness, HCW, LM area, and marbling score with an increase in dairy-type carcasses and percentage of carcasses grading USDA Prime and Choice as well as frequency of USDA YG 4 and 5. The findings from this study will be used by all segments of the industry to understand and improve the quality of fed steer and heifer beef that is being produced.

Risk of End-Stage Renal Disease in HIV-Positive Potential Live Kidney Donors.

New federal regulations allow HIV-positive individuals to be live kidney donors; however, potential candidacy for donation is poorly understood given the increased risk of end-stage renal disease (ESRD) associated with HIV infection. To better understand this risk, we compared the incidence of ESRD among 41 968 HIV-positive participants of North America AIDS Cohort Collaboration on Research and Design followed for a median of 5 years with the incidence of ESRD among comparable HIV-negative participants of National Health and Nutrition Examination III followed for a median of 14 years. We used risk associations from multivariable Cox proportional hazards regression to derive cumulative incidence estimates for selected HIV-positive scenarios (no history of diabetes, hypertension, AIDS, or hepatitis C virus coinfection) and compared these estimates with those from similarly selected HIV-negative scenarios. For 40-year-old HIV-positive individuals with health characteristics that were similar to those of age-matched kidney donors, viral load <400 copies/mL, and CD4+ count ≥500 cells/µL, the 9-year cumulative incidence of ESRD was higher than that of their HIV-negative peers, yet still low: 2.5 versus 1.1 per 10 000 among white women, 3.0 versus 1.3 per 10 000 among white men, 13.2 versus 3.6 per 10 000 among black women, and 15.8 versus 4.4 per 10 000 among black men. HIV-positive individuals with no comorbidities and well-controlled disease may be considered low-risk kidney donor candidates.

National Beef Quality Audit-2016: Transportation, mobility, and harvest-floor assessments of targeted characteristics that affect quality and value of cattle, carcasses, and by-products.

The National Beef Quality Audit-2016 (NBQA-2016) was conducted to assess current transportation, mobility, and quality characteristics of U.S. fed steers and heifers. Data were collected at 17 beef processing facilities between March and November 2016. About 8,000 live cattle were evaluated for transportation and mobility, and about 25,000 carcasses were evaluated on the slaughter floor. Cattle were in transit to the slaughter facility for a mean duration of 2.7 h from a mean distance of 218.5 km using trailers with dimensions ranging from 17.84 m2 to 59.09 m2. Area allotted per animal averaged 1.13 m2 and ranged from 0.85 m2 to 2.28 m2. A total of 96.8% of cattle received a mobility score of 1 (walks easily, no apparent lameness). Identification types (35.1% had multiple) were lot visual tags (61.5%), individual tags (55.0%), electronic tags (16.9%), metal-clip tags (9.2%), bar-coded tags (0.05%), wattles (0.01%), and other (2.6%). Cattle were black-hided (57.8%), Holstein (20.4%), red-hided (10.5%), yellow-hided (4.8%), gray-hided (2.9%), brown-hided (1.3%), and white-hided (1.1%). Unbranded hides were observed on 74.3% of cattle; 18.6% had brands located on the butt, 6.3% on the side, and 1.3% on the shoulder (values exceed 100% due to multiple brands). For hide-on carcasses, 37.7% displayed no mud or manure; specific locations for mud or manure were legs (40.8%), belly (33.0%), tail region (15.5%), side (6.8%), and top-line (3.9%). Cattle without horns represented 83.3% of the sample, and cattle that did have horns measured: < 2.54 cm (5.5%), 2.54 to 12.7 cm (8.3%), and > 12.7 cm (2.9%). Carcasses without bruises represented 61.1% of those sampled, whereas 28.2% had 1, 8.2% had 2, 2.1% had 3, and 0.3% had 4 bruises. Of those carcasses with a bruise, the bruise was located on the loin (29.7%), round (27.8%), chuck (16.4%), rib (14.4%), and brisket/plate/flank (11.6%). Frequencies of offal condemnations were livers (30.8%), lungs (18.2%), viscera (16.3%), hearts (11.1%), heads (2.7%), and tongues (2.0%). Compared to NBQA-2011, fewer cattle were identified for traceability, fewer were black-hided, a greater number were Holstein cattle, more with no brand and no horns, fewer without bruises, more liver, lung, and viscera condemnations, and fewer heads and tongues were condemned. The NBQA remains an influential survey for the U.S. beef industry to provide benchmarks and strategic plans for continued improvement of beef quality and consistency.

National Beef Quality Audit-2016: Phase 1, Face-to-face interviews.

The National Beef Quality Audit (NBQA) is conducted every 5 yr and was most recently again conducted in 2016. Face-to-face interviews gauged progress in quality associated with live cattle production using procedures first utilized in NBQA 2011. The 2016 NBQA was the first in which interviews concerning fed steers and heifers were combined with an audit of market cow and bull beef. Face-to-face interviews were designed to illicit definitions for beef quality, estimate willingness to pay (WTP) for quality attributes, establish relative importance rankings for important quality factors, and assess images, strengths, weaknesses, potential threats, and shifting trends in the beef industry since the 2011 audit. Individuals making purchasing decisions in 5 market sectors of the steer/heifer and cow/bull beef supply chain were interviewed, including packers (n = 36), retailers (including large and small supermarket companies and warehouse food sales companies; n = 35), food service operators (including quick-serve, full-service, and institutional establishments; n = 29), further processors (n = 64), and peripherally-related government and trade organizations (GTO; n = 30). Face-to-face interviews were conducted between January and November of 2016 using a designed dynamic routing system. Definitions (as described by interviewees) for 7 pre-determined quality factors, including: (1) How and where the cattle were raised, (2) Lean, fat, and bone, (3) Weight and size, (4) Visual characteristics, (5) Food safety, (6) Eating satisfaction, and (7) Cattle genetics were recorded verbatim and categorized into similar responses for analysis. Compared to NBQA-2011, a higher percentage of companies were willing to pay premiums for guaranteed quality attributes, but overall were willing to pay lower average premiums than the companies interviewed in 2011. Food safety had the highest share of preference among all interviewees, generating a double-digit advantage over any other quality factor. The 2 beef industries have an overall positive image among interviewees, and despite lingering weaknesses, product quality continued to be at the forefront of the strengths category for both steer and heifer beef and market cow and bull beef.

National Beef Quality Audit-2016: Transportation, mobility, live cattle, and carcass assessments of targeted producer-related characteristics that affect value of market cows and bulls, their carcasses, and associated by-products.

The National Beef Quality Audit-2016 marks the fourth iteration in a series assessing the quality of live beef and dairy cows and bulls and their carcass counterparts. The objective was to determine the incidence of producer-related defects, and report cattle and carcass traits associated with producer management. Conducted from March through December of 2016, trailers (n = 154), live animals (n = 5,470), hide-on carcasses (n = 5,278), and hide-off hot carcasses (n = 5,510) were surveyed in 18 commercial packing facilities throughout the United States. Cattle were allowed 2.3 m2 of trailer space on average during transit indicating some haulers are adhering to industry handling guidelines for trailer space requirements. Of the mixed gender loads arriving at processing facilities, cows and bulls were not segregated on 64.4% of the trailers surveyed. When assessed for mobility, the greatest majority of cattle surveyed were sound. Since the inception of the quality audit series, beef cows have shown substantial improvements in muscle. Today over 90.0% of dairy cows are too light muscled. The mean body condition score for beef animals was 4.7 and for dairy cows and bulls was 2.6 and 3.3, respectively. Dairy cattle were lighter muscled, yet fatter than the dairy cattle surveyed in 2007. Of cattle surveyed, most did not have horns, nor any visible live animal defects. Unbranded hides were observed on 77.3% of cattle. Carcass bruising was seen on 64.1% of cow carcasses and 42.9% of bull carcasses. However, over half of all bruises were identified to only be minor in severity. Nearly all cattle (98.4%) were free of visible injection-site lesions. Current results suggest improvements have been made in cattle and meat quality in the cow and bull sector. Furthermore, the results provide guidance for continued educational and research efforts for improving market cow and bull beef quality.

Antimicrobial susceptibility and internalization of Salmonella Typhimurium in vacuum-tumbled marinated beef products.

As the incidence of multidrug resistance (MDR) Salmonella enterica serotype Typhimurium is increasing, data regarding the antimicrobial interventions and pathogen internalization in marinated meat products are important. This study evaluated the antimicrobial intervention and internalization of Salm. Typhimurium in marinated beef sirloin steaks. Beef bottom sirloin flaps (IMPS #185A; USDA Select) inoculated (108  log10  CFU ml-1 ) with Salm. Typhimurium were sprayed (lactic acid (4%) and buffered vinegar (2%)) prior to vacuum-tumbled marination (0·35% sodium chloride and 0·45% sodium tripolyphosphate) for 30 min. Pathogen presence after antimicrobial spray, vacuum-tumbled marination, and translocation was determined by direct plating on Xylose Lysine Deoxycholate (XLD) agar with tryptic soy agar (TSA) overlay. The data imply varied internalization and antimicrobial susceptibility pattern of Salm. Typhimurium in marinated meat. Lactic acid (4%) spray (P < 0·0001) and buffered vinegar (2%; P < 0·0001) reduced surface populations of Salm. Typhimurium on inoculated beef sirloin flaps prior to vacuum marination. However, lactic acid treated sirloin flaps had greater reductions (~2 log10  CFU cm-2 ) than buffered vinegar when compared with control prior to vacuum marination. However, the translocation of Salm. Typhimurium following vacuum marination was not influenced (P < 0·333) by the application of a surface organic acid spray prior to marination. SIGNIFICANCE AND IMPACT OF THE STUDY: As detailed in the Federal Register FSIS final rule (9 CFR part 317), vacuum-marinated, vacuum-tumbled meat products are not designated as 'mechanically tenderized'. As such, the internalization and potential survival of Salmonella spp. in marinated beef products is a major concern. These results highlight the internalization of pathogens in vacuum-tumbled meat products and emphasize the importance of considering these products as nonintact. Similarly, these data confirm the efficacy and utility of interventions prior to vacuum-tumbled marination. Further research is needed to identify additional strategies to mitigate internalization and translocation of pathogens into vacuum-marinated meat products.

Induction of labour at term with oral misoprostol versus a Foley catheter (PROBAAT-II): a multicentre randomised controlled non-inferiority trial.

BACKGROUND: Labour is induced in 20-30% of all pregnancies. In women with an unfavourable cervix, both oral misoprostol and Foley catheter are equally effective compared with dinoprostone in establishing vaginal birth, but each has a better safety profile. We did a trial to directly compare oral misoprostol with Foley catheter alone. METHODS: We did an open-label randomised non-inferiority trial in 29 hospitals in the Netherlands. Women with a term singleton pregnancy in cephalic presentation, an unfavourable cervix, intact membranes, and without a previous caesarean section who were scheduled for induction of labour were randomly allocated to cervical ripening with 50 µg oral misoprostol once every 4 h or to a 30 mL transcervical Foley catheter. The primary outcome was a composite of asphyxia (pH ≤7·05 or 5-min Apgar score <7) or post-partum haemorrhage (≥1000 mL). The non-inferiority margin was 5%. The trial is registered with the Netherlands Trial Register, NTR3466. FINDINGS: Between July, 2012, and October, 2013, we randomly assigned 932 women to oral misoprostol and 927 women to Foley catheter. The composite primary outcome occurred in 113 (12·2%) of 924 participants in the misoprostol group versus 106 (11·5%) of 921 in the Foley catheter group (adjusted relative risk 1·06, 90% CI 0·86-1·31). Caesarean section occurred in 155 (16·8%) women versus 185 (20·1%; relative risk 0·84, 95% CI 0·69-1·02, p=0·067). 27 adverse events were reported in the misoprostol group versus 25 in the Foley catheter group. None were directly related to the study procedure. INTERPRETATION: In women with an unfavourable cervix at term, induction of labour with oral misoprostol and Foley catheter has similar safety and effectiveness. FUNDING: FondsNutsOhra.

Internalization and thermal susceptibility of Shiga toxin-producing Escherichia coli (STEC) in marinated beef products.

This study evaluated the internalization and cooking susceptibility of seven individual Escherichia coli (STEC) serogroups in surface-inoculated (10(5)log CFU/cm(2)) and vacuum tumbled marinated (30 or 60 min) bottom sirloin steaks. After storage for 14 days (0 to 2°C), flaps were cooked to various endpoint temperatures (55, 60, 65, and 71°C) for evaluation of pathogen survival by direct plating or rapid PCR based detection (BAX®). Direct plating of cooked samples yielded no enumerable plates. The data indicate varied internalization, translocation, and heat susceptibility patterns among serogroups. Using the rapid PCR based detection method O26, O103, and O111 were detected in flaps after cooking to 55 and 60°C, while O157:H7 survived in flaps cooked to 60 and 65°C. However, STEC O145 was the only serogroup that survived in all cooking temperatures. Serogroup O121 was not detected by plating or PCR in any cooked products. Intriguingly, STEC serogroups can be internalized during marination and the internalized pathogens vary in thermal susceptibility.

HIV drug resistance testing by high-multiplex "wide" sequencing on the MiSeq instrument.

Limited access to HIV drug resistance testing in low- and middle-income countries impedes clinical decision-making at the individual patient level. An efficient protocol to address this issue must be established to minimize negative therapeutic outcomes for HIV-1-infected individuals in such settings. This is an observational study to ascertain the potential of newer genomic sequencing platforms, such as the Illumina MiSeq instrument, to provide accurate HIV drug resistance genotypes for hundreds of samples simultaneously. Plasma samples were collected from Canadian patients during routine drug resistance testing (n = 759) and from a Ugandan study cohort (n = 349). Amplicons spanning HIV reverse transcriptase codons 90 to 234 were sequenced with both MiSeq sequencing and conventional Sanger sequencing methods. Sequences were evaluated for nucleotide concordance between methods, using coverage and mixture parameters for quality control. Consensus sequences were also analyzed for disparities in the identification of drug resistance mutations. Sanger and MiSeq sequencing was successful for 881 samples (80%) and 892 samples (81%), respectively, with 832 samples having results from both methods. Most failures were for samples with viral loads of <3.0 log10 HIV RNA copies/ml. Overall, 99.3% nucleotide concordance between methods was observed. MiSeq sequencing achieved 97.4% sensitivity and 99.3% specificity in detecting resistance mutations identified by Sanger sequencing. Findings suggest that the Illumina MiSeq platform can yield high-quality data with a high-multiplex "wide" sequencing approach. This strategy can be used for multiple HIV subtypes, demonstrating the potential for widespread individual testing and annual population surveillance in resource-limited settings.

Nutrient database improvement project: Separable components and proximate composition of raw and cooked retail cuts from the beef loin and round.

Beef nutrition research has become increasingly important domestically and internationally for the beef industry and its consumers. The objective of this study was to analyze the nutrient composition of ten beef loin and round cuts to update the nutrient data in the USDA National Nutrient Database for Standard Reference. Seventy-two carcasses representing a national composite of Yield Grade, Quality Grade, sex classification, and genetic type were identified from six regions across the U.S. Beef short loins, strip loins, tenderloins, inside rounds, and eye of rounds (NAMP # 173, 175, 190A, 169A, and 171C) were collected from the selected carcasses and shipped to three university meat laboratories for storage, retail fabrication, and raw/cooked analysis of nutrients. Sample homogenates from each animal were analyzed for proximate composition. These data provide updated information regarding the nutrient status of beef, in addition, to determining the influence of Quality Grade, Yield Grade, and sex classification on nutrient composition.

The influence of beef quality characteristics on the internalization and thermal susceptibility of Shiga toxin-producing Escherichia coli (STEC) in blade-tenderized beef steaks.

The risk of Shiga toxin-producing Escherichia coli (STEC) survival in blade-tenderized beef is a concern for beef processors. This study evaluated the internalization and post-cooking survival of individual STEC serogroups (O157:H7, O26, O45, O103, O111, O121, and O145) in blade-tenderized beef steaks with different quality traits. Strip loins representing four combinations of USDA Quality Grade (Choice or Select) and pH category (High pH or Normal pH) were inoculated (10(6)logCFU/cm(2) attachment) with individual STEC serogroups before storage (14 days), blade tenderization, and cooking (50, 60, 71, or 85°C). Serogroup populations on raw steak surfaces and internal cores were determined. Rapid-based methods were used to detect the internal presence of STEC in cooked steaks. Internalization and post-cooking survival varied among STECs. All serogroups, except O45 and O121, were detected in the internal cores of steaks cooked to 50°C, while O103, O111, and O145 STEC were detected in steaks cooked to 50, 60, and 71°C.

Bacillary angiomatosis masquerading as Kaposi's sarcoma in East Africa.

BACKGROUND: Bacillary angiomatosis (BA) is a rare manifestation of infection caused by Bartonella species, which leads to vasoproliferative lesions of skin and other organs. Bacillary angiomatosis affects individuals with advanced HIV disease or other immunocompromised individuals. In sub-Saharan Africa, despite the high prevalence of HIV infection and documentation of the causative Bartonella species in humans, mammalian hosts, and arthropod vectors, BA has only rarely been described. METHODS: Three adult patients from Uganda and Kenya with deep purple dome-shaped papules or nodules of the skin underwent punch biopsies for histopathologic diagnosis. The biopsies of all 3 patients were sent to a local pathologist as well as to a dermatopathologist at the University of California, San Francisco. RESULTS: All 3 patients were clinically suspected to have Kaposi's sarcoma (KS), and local pathologists had interpreted the lesions as KS in 2 of the cases and nonspecific inflammation in the third. Histologic examination by dermatopathologists in the United States revealed nodular dermal proliferations of irregular capillaries lined by spindled to epithelioid endothelial cells. The surrounding stroma contained a mixed inflammatory infiltrate with lymphocytes, eosinophils, and neutrophils. Extracellular deposits of pale amphophilic granular material were noted in the surrounding stroma. A Warthin-Starry stain highlighted clumps of bacilli, confirming the diagnosis of BA. CONCLUSIONS: These 3 cases, to our knowledge, are the first reports of BA in East Africa in the biomedical literature. Each had been originally incorrectly diagnosed as KS. We speculate BA is underdiagnosed and underreported in resource-poor regions, such as sub-Saharan Africa, that have high endemic rates of HIV infection.

Comparative effects of beta-adrenergic agonist supplementation on the yield and quality attributes of selected subprimals from calf-fed Holstein steers.

Mechanical portioning tests were performed on beef rib, strip loin, tenderloin, and top sirloin subprimals obtained from calf-fed Holstein steers to characterize the influence of zilpaterol hydrochloride (ZH), ractopamine hydrochloride (RH), or no ß-adrenergic agonist (ßAA; CON) on subprimal and steak yield. In addition, ßAA effects on tenderness, composition, and raw and cooked color of steaks from the aforementioned strip loin subprimals were characterized. At 14 to 15 d (ribs, tenderloins, and top sirloin) or 16 d (strip loin) postmortem, subprimals were portioned into steaks using a mechanical portioning machine. The appropriate variables were measured before and after portioning to determine ßAA influence on trimmed and untrimmed subprimal weight, subprimal length (rib only), steak weight and yield, and steak thickness (rib only). Steaks obtained from the strip loin subprimals were subjected to analysis of raw instrument color (L*, a*, b*), proximate composition, and pH. In addition, strip steaks were aged (16 or 23 d) before analysis of cooked internal color, Warner-Bratzler shear force (WBSF), and slice shear force (SSF). Briefly, ZH supplementation increased (P < 0.01) the weight of all subprimals when compared to CON. Furthermore, subprimals from CON animals consistently had fewer and lighter steaks (P ≤ 0.04) than subprimals from ZH-fed steers. Additionally, raw steaks from ZH cattle were a less vivid red (lower a* and saturation index values; P < 0.01) when compared to CON and RH steaks, which did not differ (P > 0.05). There was no interaction between ßAA treatment and postmortem aging length for WBSF or SSF (P > 0.10). However, CON steaks (3.25 kg) had lower WBSF values (P < 0.05) than ZH or RH steaks (3.68 and 3.67 kg, respectively). Regardless, aging for 23 d vs. 16 d resulted in decreased WBSF and SSF (P < 0.01) for all ßAA treatments. Although differences were numerically small, evaluations indicated the internal cooked surfaces of ZH and RH steaks were less red (P < 0.05) than CON steaks. Overall, these data reemphasize increased subprimal weights due to ßAA supplementation, particularly ZH. However, the data are not indicative of increased steak yield due to ßAA supplementation. Furthermore, the data demonstrate ßAA supplementation increases the shear force of calf-fed Holstein strip steaks regardless of postmortem aging period. However, no differences in shear force between the ßAA treatments (ZH or RH) were noted.

Factors associated with pruritic papular eruption of human immunodeficiency virus infection in the antiretroviral therapy era.

BACKGROUND: Pruritic papular eruption (PPE) of HIV is common in HIV-infected populations living in the tropics. Its aetiology has been attributed to insect bite reactions and it is reported to improve with antiretroviral therapy (ART). Its presence after at least 6 months of ART has been proposed as one of several markers of treatment failure. OBJECTIVES: To determine factors associated with PPE in HIV-infected persons receiving ART. METHODS: A case-control study nested within a 500-person cohort from a teaching hospital in Mbarara, Uganda. Forty-five cases and 90 controls were enrolled. Cases had received ART for ≥ 15 months and had an itchy papular rash for at least 1 month with microscopic correlation by skin biopsy. Each case was individually matched with two controls for age, sex and ART duration. RESULTS: Twenty-five of 45 cases (56%) had microscopic findings consistent with PPE. At skin examination and biopsy (study enrolment), a similar proportion of PPE cases and matched controls had plasma HIV RNA < 400 copies mL(-1) (96% vs. 85%, P = 0·31). The odds of having PPE increased fourfold with every log increase in viral load at ART initiation (P = 0·02) but not at study enrolment. CD4 counts at ART initiation and study enrolment, and CD4 gains and CD8(+) T-cell activation measured 6 and 12 months after ART commencement were not associated with PPE. Study participants who reported daily insect bites had greater odds of being cases [odds ratio (OR) 8·3, P < 0·001] or PPE cases (OR 8·6, P = 0·01). CONCLUSIONS: Pruritic papular eruption in HIV-infected persons receiving ART for ≥ 15 months was associated with greater HIV viraemia at ART commencement, independent of CD4 count. Skin biopsies are important to distinguish between PPE and other itchy papular eruptions.

Economic analysis comparing induction of labor and expectant management in women with preterm prelabor rupture of membranes between 34 and 37 weeks (PPROMEXIL trial).

OBJECTIVE: To compare the costs of induction of labor and expectant management in women with preterm prelabor rupture of membranes (PPROM). DESIGN: Economic analysis based on a randomized clinical trial. SETTING: Obstetric departments of eight academic and 52 non-academic hospitals in the Netherlands. POPULATION: Women with PPROM near term who were not in labor 24 h after PPROM. METHODS: A cost-minimization analysis was done from a health care provider perspective, using a bottom-up approach to estimate resource utilization, valued with unit-costs reflecting actual costs. MAIN OUTCOME MEASURES: Primary health outcome was the incidence of neonatal sepsis. Direct medical costs were estimated from start of randomization to hospital discharge of mother and child. RESULTS: Induction of labor did not significantly reduce the probability of neonatal sepsis [2.6% vs. 4.1%, relative risk 0.64 (95% confidence interval 0.25-1.6)]. Mean costs per woman were €8094 for induction and €7340 for expectant management (difference €754; 95% confidence interval -335 to 1802). This difference predominantly originated in the postpartum period, where the mean costs were €5669 for induction vs. €4801 for expectant management. Delivery costs were higher in women allocated to induction than in women allocated to expectant management (€1777 vs. €1153 per woman). Antepartum costs in the expectant management group were higher because of longer antepartum maternal stays in hospital. CONCLUSIONS: In women with pregnancies complicated by PPROM near term, induction of labor does not reduce neonatal sepsis, whereas costs associated with this strategy are probably higher.

The impact of packaging system and temperature abuse on the shelf life characteristics of ground beef.

New ground beef packaging systems have warranted investigation of their spoilage and quality characteristics. Furthermore, analysis of ground beef spoilage in modified atmosphere packaging (MAP) and stored at abusive temperature is lacking. This research aimed to determine the effect of packaging systems and temperature abuse on the sensory and shelf-life characteristics of ground beef. Ground beef patties were packaged using polyvinyl chloride overwrap (OW), HI-OX MAP (80% O2, 20% CO2), LO-OX MAP (30% CO2, 70% N2), CO-MAP (0.4% CO, 30% CO2, 69.6% N2), or vacuum (VAC) prior to color, odor, biochemical, and microbial analyses over display. CO-MAP exhibited more desirable color and consumer acceptability throughout display. Lean discoloration and odor scores were lower for anaerobic packaging than aerobic packaging. Microbial results mirrored sensory preferences for anaerobic packaging. These results indicate anaerobic packaging extends shelf-life properties and desirable sensory attributes throughout display and temperature abuse.