Investigation of the suitability of 3 insect meals as protein sources for rainbow trout (Oncorhynchus mykiss).

An in vivo trial was conducted to determine the apparent digestibility coefficients (ADCs) of insect meals for rainbow trout, Oncorhynchus mykiss. Rainbow trout (approximately 370 g ±â€…23 g, mean ±â€…SD initial weight) were stocked 25 per tank into 400-liter tanks. Fish were fed a reference diet, or 1 of 5 test diets created by blending the reference diet in a 70:30 ratio (dry-weight basis) with menhaden fish meal (MFM), 2 house cricket (Acheta domesticus) meals (cricket A and cricket B), Galleria mellonella meal, and yellow mealworm (Tenebrio molitor) meal. Diets were assigned to 3 replicate tanks of fish and fed twice daily for 14 days prior to fecal collection. Ingredients, diets, and fecal matter were analyzed in duplicate for proximate, mineral, and amino acid composition. House cricket meals were 67.3% and 69.0% protein (CP) and 16.6% and 17.1% lipid (CL), for house cricket A and B, respectively. Yellow mealworm meal contained 56.5% CP and 27.7% CL, and G. mellonella larvae meal contained 32.5% CP and 54.2% CL. Protein ADCs were 78.9 for G. mellonella larvae meal, 78.0 for yellow mealworm meal, and 76.5 for house cricket A and not different from the MFM protein ADC of 76.6, while house cricket B protein ADC was 65.8 and was significantly lower than the MFM protein ADC (F = 7.39; df = 4,14; P = 0.0049). Together, these nutritional values suggest house crickets, and yellow mealworms show promise as alternative protein sources in salmonid feeds, with the potential of G. mellonella as an alternative lipid source.

Active optical table tilt stabilization.

We show that a simple modification to an optical table with pneumatic vibration isolation can be used to actively reduce the long term drift in the tilt of the table by nearly a factor of 1000. Without active stabilization, we measure a root-mean-square (rms) tilt variation of 270 µrad over three days. The active stabilization can be used to limit the tilt to 0.35 µrad rms over the same time period. This technique can be used to minimize drift in tilt-sensitive experiments.

Pathogen-specific leptospiral proteins in urine of patients with febrile illness aids in differential diagnosis of leptospirosis from dengue.

Leptospirosis and dengue are two commonly seen infectious diseases of the tropics. Differential diagnosis of leptospirosis from dengue fever is often difficult due to overlapping clinical symptoms and lack of economically viable and easy-to-perform laboratory tests. The gold standard for diagnosis is the microscopic agglutination test (MAT). In this study, the diagnostic potential of screening for pathogen-specific leptospiral antigens in urine samples is presented as a non-invasive method of disease diagnosis. In a study group of 40 patients, the serum was tested for anti-leptospiral antibodies by MAT and enzyme-linked immunosorbent assay (ELISA). Urine of these patients was screened for leptospiral antigens by ELISA using specific antibodies against LipL32, LipL41, Fla1, HbpA and sphingomyelinase. Group I patients (n = 23) were classified as leptospirosis-positive based on MAT and high titres of circulating IgM-specific anti-leptospiral antibodies. All of these patients excreted all five leptospiral antigens in the urine. The 17 MAT-negative cases included six patients with pyrexia of unknown origin (PUO; Group II) and 11 confirmed dengue patients (Group III). The latter tested negative for both serum anti-leptospiral antibodies and urinary leptospiral antigens. A salient outcome of this study was highlighting the usefulness of screening for urinary leptospiral antigens in disease diagnosis, as their presence confirmed leptospiral aetiology in two PUO patients. Immunoblots of urinary antigens identified well-defined bands corresponding to LipL32, HbpA and sphingomyelinase; the significance of the 42- and 58-kDa sphingomyelinase bands is discussed.

Prompt Electromagnetic Transients from Binary Black Hole Mergers.

Binary black hole (BBH) mergers provide a prime source for current and future interferometric GW observatories. Massive BBH mergers may often take place in plasma-rich environments, leading to the exciting possibility of a concurrent electromagnetic (EM) signal observable by traditional astronomical facilities. However, many critical questions about the generation of such counterparts remain unanswered. We explore mechanisms that may drive EM counterparts with magnetohydro-dynamic simulations treating a range of scenarios involving equal-mass black-hole binaries immersed in an initially homogeneous fluid with uniform, orbitally aligned magnetic fields. We find that the time development of Poynting luminosity, which may drive jet-like emissions, is relatively insensitive to aspects of the initial configuration. In particular, over a significant range of initial values, the central magnetic field strength is effectively regulated by the gas flow to yield a Poynting luminosity of 1045 - 1046 ρ -13 M 8 2 ergs-1, with BBH mass scaled to M 8 ≡ M/(108 M ⨀) and ambient density ρ -13 ≡ ρ/(10-13 g cm-3). We also calculate the direct plasma synchrotron emissions processed through geodesic ray-tracing. Despite lensing effects and dynamics, we find the observed synchrotron flux varies little leading up to merger.

Prebiotic Supplementation has Only Minimal Effects on Growth Efficiency, Intestinal Health and Disease Resistance of Westslope Cutthroat Trout Oncorhynchus clarkii lewisi Fed 30% Soybean Meal.

Prebiotics have successfully been used to prevent infectious diseases in aquaculture and there is an increasing amount of literature that suggests that these products can also improve alternative protein utilization and digestion. Therefore, the objective of this study was to examine whether prebiotic supplementation increased the growth efficiency, intestinal health, and disease resistance of cutthroat trout fed a high level of dietary soybean meal. To achieve this objective, juvenile Westslope cutthroat trout (Oncorhynchus clarkii lewisi) were fed a practical type formulation with 0 or 30% dietary soybean meal with or without the commercial prebiotic (Grobiotic-A) prior to experimental exposure to Flavobacterium psychrophilum. Juvenile Westslope cutthroat trout (initial weight 7.8 g/fish ±SD of 0.5 g) were stocked at 30 fish/tank in 75 L tanks with six replicate tanks per diet and fed their respective diets for 20 weeks. Final weights of Westslope cutthroat trout were affected by neither dietary soybean meal inclusion level (P = 0.9582) nor prebiotic inclusion (P = 0.9348) and no interaction was observed (P = 0.1242). Feed conversion ratios were similarly not affected by soybean meal level (P = 0.4895), prebiotic inclusion (P = 0.3258) or their interaction (P = 0.1478). Histological examination of the distal intestine of Westslope cutthroat trout demonstrated increases in inflammation due to both increased soybean meal inclusion level (P = 0.0038) and prebiotic inclusion (P = 0.0327) without significant interaction (P = 0.3370). Feeding dietary soybean meal level at 30% increased mortality of F. psychrophilum cohabitation challenged Westslope cutthroat trout (P = 0.0345) while prebiotic inclusion tended to decrease mortality (P = 0.0671). These results indicate that subclinical alterations in intestinal inflammation levels due to high dietary inclusion levels of soybean meal could predispose Westslope cutthroat trout to F. psychrophilum infection.

Carbonyl-twisted 6-acyl-2-dialkylaminonaphthalenes as solvent acidity sensors.

Derivatives of 2-propionyl-6-dimethylaminonaphthalene (PRODAN) with twisted carbonyl groups were investigated as highly responsive sensors of H-bond donating ability. The PRODAN derivative bearing a pivaloyl group (4) was prepared. The torsion angle between the carbonyl and naphthalene is 26° in the crystal. It shows solvatochromism that is similar to five other PRODAN derivatives (1-3, 5, 6). Twisted-carbonyl derivatives 3, 4, and 6 show strong fluorescence quenching in protic solvents. The order of magnitude of the quenching is linearly related to the H-bond donating ability of the solvent (SA) but not to other solvent properties. Binary mixtures of protic solvents show specific interaction effects with respect to quenching and solvatochromism. Aggregation in water is an issue with the pivaloyl derivatives.

Binary black-hole mergers in magnetized disks: simulations in full general relativity.

We present results from the first fully general relativistic, magnetohydrodynamic (MHD) simulations of an equal-mass black-hole binary (BHBH) in a magnetized, circumbinary accretion disk. We simulate both the pre- and postdecoupling phases of a BHBH-disk system and both "cooling" and "no-cooling" gas flows. Prior to decoupling, the competition between the binary tidal torques and the effective viscous torques due to MHD turbulence depletes the disk interior to the binary orbit. However, it also induces a two-stream accretion flow and mildly relativistic polar outflows from the BHs. Following decoupling, but before gas fills the low-density "hollow" surrounding the remnant, the accretion rate is reduced, while there is a prompt electromagnetic luminosity enhancement following merger due to shock heating and accretion onto the spinning BH remnant. This investigation, though preliminary, previews more detailed general relativistic, MHD simulations we plan to perform in anticipation of future, simultaneous detections of gravitational and electromagnetic radiation from a merging BHBH-disk system.

A clinical and laboratory profile of Cleistanthus collinus poisoning.

AIMS: 1. To study the clinical features in patients with Cleistanthus collinus poisoning, 2. To study in them the effect of Cleistanthus collinus poisoning on the various organ systems and metabolic parameters using standard laboratory investigations. METHODS: All patients admitted to the hospital between September 1998 and April 2000 were studied. Statistical analysis of the results was done using chi-square test, Fisher's exact test and Student's 't' test. RESULTS: Forty six cases were studied, 15 (32%) of whom died. Eighty percent of the patients were in the second to third decade. The female:male ratio was 3:2. Ingestion of the poison as a decoction prepared from the leaves and ingestion of a large number of leaves otherwise were associated with a poor outcome. While survivors remained relatively asymptomatic, fatally poisoned patients presented with significant clinical signs and symptoms, however, laboratory abnormalities such as hypokalaemia, hyponatremia, an elevated AST/LDH/CPK/CPK-MB, nonspecific ST-T changes and QTc prolongation on ECG, metabolic acidosis and hypoxia with widened alveolar-arterial oxygen difference (A-aDO2) were seen in both groups. CONCLUSION: It is a poisoning seen in the young with significant mortality. Cause of death appears to be mainly due to its cardiac and respiratory effects. Metabolic disturbances especially hypokalaemia was a prominent feature. Most deaths occurred on the 3rd day and all within a week. No specific antidote is available.

Effect of fractionated regional external beam radiotherapy on peripheral blood cell count.

PURPOSE: The purpose of this study was to assess the need for obtaining weekly complete blood count (CBC) values and to identify the pattern of changes in CBC during regional conventional fractionated radiotherapy. METHODS AND MATERIALS: A retrospective analysis of CBC data on 299 adult cancer patients who received definitive conventional radiotherapy to head and neck (n = 95), chest (n = 96), and pelvis (n = 108) was performed. Temporal patterns and magnitude of change in white blood cells, neutrophils, lymphocytes, and platelets during radiotherapy were examined. RESULTS: There were statistically significant declines in all counts, albeit not clinically significant. Notable differences between disease sites were found. The greatest weekly interval change in counts occurred during the first week of radiotherapy for all groups of patients. The mean WBC nadir values during treatment were 5.8 for head & neck, 6.8 for chest, and 5.4 for pelvis. The nadirs for all counts occurred toward the middle-to-end of radiotherapy. Lymphocytes were found to be more sensitive to radiotherapy than other leukocyte subcomponents. CONCLUSION: Our study suggests that weekly CBC monitoring is not necessary for all patients undergoing standard fractionated radiotherapy. Baseline blood counts may be used to determine an optimal schedule for monitoring CBCs in patients receiving conventional radiation alone. Reduced monitoring of CBC may result in significant financial savings.

Sensitivity of human glioma U-373MG cells to radiation and the protein kinase C inhibitor, calphostin C.

We assessed the radiosensitivity of the grade III human glioma cell line U-373MG by investigating the effects of radiation and the specific protein kinase C inhibitor, calphostin C on the cell cycle and cell proliferation. Irradiated glioma U-373MG cells progressed through G1-S and underwent an arrest in G2-M phase. The radiosensitivity of U-373MG cells to graded doses of either photons or electrons was determine by microculture tetrazolium assay. The data was fitted to the linear-quadratic model. The proliferation curves demonstrated that U-373MG cells appear to be highly radiation resistant since 8 Gy was required to achieve 50% cell mortality. Compared to radiation alone, exposure to calphostin C (250 nM) 1 h prior to radiation decreased the proliferation of U-373MG by 76% and calphostin C provoked a weakly synergistic effect in concert with radiation. Depending on the time of application following radiation, calphostin C produced an additive or less than additive effect on cell proliferation. We postulate that the enhanced radiosensitivity observed when cells are exposed to calphostin C prior to radiation may be due to direct or indirect inhibition of protein kinase C isozymes required for cell cycle progression.

Acute coronary syndrome: pharmacotherapy.

Acute coronary syndrome (ACS) refers to the spectrum of cardiac disease, from unstable angina to ST-segment-elevation myocardial infarction. In the emergency medical services (EMS) setting, ACS may be more broadly thought to include patients with chest pain or other symptoms believed to have a cardiac origin who have evidence of ischemia or acute myocardial infarction on a 12-lead electrocardiogram, or symptomatic patients with a previous cardiac event or known cardiac disease. Pharmacologic management of these patients is based on the use of three primary classes of drugs: those that affect clotting, those that establish and maintain hemodynamic control, and those that relieve pain. Many of these agents have been evaluated in large clinical trials for in-hospital use, and a number of ongoing studies are assessing their efficacy in the prehospital setting. The appropriateness of prehospital use of specific agents within each class depends on proper patient selection, the necessity of immediate intervention, ease of use in the field, expertise of EMS personnel, and cost-effectiveness of therapy. This consensus group reviewed agents from all three classes (including aspirin, GPIIb/IIIa inhibitors, unfractionated and low-molecular-weight heparins, fibrinolytics, beta-adrenergic blockers, calcium antagonists, nitrates, and morphine) for their overall indication, applicability to the prehospital setting, and current prehospital use.

Importance of the mini-mental status examination in the treatment of patients with brain metastases: a report from the Radiation Therapy Oncology Group protocol 91-04.

PURPOSE: Little information is available on the importance of pretreatment Mini-Mental Status Exam (MMSE) on long-term survival and neurologic function following treatment for unresectable brain metastases. This study examines the importance of the MMSE in predicting outcome in a group of patients treated with an accelerated fractionation regimen of 30 Gy in 10 daily fractions in 2 weeks. MATERIALS AND METHODS: The Radiation Therapy Oncology Group (RTOG) accrued 445 patients to a Phase III comparison of accelerated hyperfractionated (AH) radiotherapy (1.6 Gy b.i.d.) to a total dose of 54.4 Gy vs. an accelerated fractionation (AF) of 30 Gy in 10 daily fractions from 1991 through 1995. All patients had histologic proof of malignancy at the primary site. Brain metastases were measurable by CT or MRI scan and all patients had a Karnofsky performance score (KPS) of at least 70 and a neurologic function classification of 1 or 2. Two hundred twenty-four patients were entered on the accelerated fractionated arm, and 182 were eligible for analysis (7 patients were judged ineligible, no MMSE information in 29, no survival data in 1, no forms submitted in 1). RESULTS: Average age was 60 years; 58% were male and 25% had a single intracranial lesion on their pretherapy evaluation. KPS was 70 in 32%, 80 in 31%, 90 in 29%, and 100 in 14%. The average MMSE was 26.5, which is the lower quartile for normal in the U.S. population. The range of the MMSE scores was 11-30 with 30 being the maximum. A score of less than 23 indicates possible dementia, which occurred in 16% of the patients prior to treatment. The median time from diagnosis to treatment was 5 days (range, 0-158 days). The median survival was 4.2 months with a 95% confidence interval of 3.7-5.1 months. Thirty-seven percent of the patients were alive at 6 months, and 17% were alive at 1 year. The following variables were examined in a Cox proportional-hazards model to determine their prognostic value for overall survival: age, gender, KPS, baseline MMSE, time until MMSE below 23, time since diagnosis, number of brain metastases, and radiosurgery eligibility. In all Cox model analyses, age, KPS, baseline MMSE, time until MMSE below 23, and time since diagnosis were treated as continuous variables. Statistically significant factors for survival were pretreatment MMSE (p = 0.0002), and KPS (p = 0.02). Age was of borderline significance (p = 0.065) as well as gender (p = 0.074). A poorer outcome is associated with an increasing age, male gender, lower MMSE, and shorter time until MMSE below 23. Improvement in MMSE over time was assessed; 62 patients died prior to obtaining follow-up MMSE, and 30 patients had a baseline MMSE of 30 (the maximum), and, therefore, no improvement could be expected. Of the remaining 88, 48 (54.5%) demonstrated an improvement in their MMSE at any follow-up visit. Lack of decline of MMSE below 23 was seen in long-term survivors, with 81% at 6 months and 66% at 1 year of patients maintaining a MMSE above 23. Analysis of time until death from brain metastases demonstrated that decreasing baseline MMSE (p = 0.003) and primary site (breast vs. lung vs. other p = 0.032) were highly associated with a terminal event. CONCLUSION: While gender and perhaps age remain significant predictors for survival, MMSE is also an important way of assessing a patient's outcome. Accelerated fractionation used in the treatment of brain metastases (30 Gy in 10 fractions) appears to also be associated with an improvement in MMSE and a lack of decline of MMSE below 23 in long-term survivors.

Radiation therapy of the older patient.

Radiotherapy has a major role in the multidisciplinary approach to cancer therapy. It is widely used for curative and palliative treatment of cancer involving various sites. Radiotherapy is of particular benefit to older and frail cancer patients as an alternative to surgery and to systemic therapy. The available data on the sensitivity of normal tissues to radiotherapy in elderly patients strongly suggest that older patients with good functional status tolerate radiotherapy as well as younger patients and have comparable tumor response and survival rates. Aggressive radiotherapy should not be withheld from older patients because of chronological age alone.

Long-term ascorbic acid administration reverses endothelial vasomotor dysfunction in patients with coronary artery disease.

BACKGROUND: Loss of endothelium-derived nitric oxide (EDNO) contributes to the clinical expression of coronary artery disease (CAD). Increased oxidative stress has been linked to impaired endothelial vasomotor function in atherosclerosis, and recent studies demonstrated that short-term ascorbic acid treatment improves endothelial function. METHODS AND RESULTS: In a randomized, double-blind, placebo-controlled study, we examined the effects of single-dose (2 g PO) and long-term (500 mg/d) ascorbic acid treatment on EDNO-dependent flow-mediated dilation of the brachial artery in patients with angiographically established CAD. Flow-mediated dilation was examined by high-resolution vascular ultrasound at baseline, 2 hours after the single dose, and 30 days after long-term treatment in 46 patients with CAD. Flow-mediated dilation improved from 6.6+/-3.5% to 10.1+/-5.2% after single-dose treatment, and the effect was sustained after long-term treatment (9. 0+/-3.7%), whereas flow-mediated dilation was 8.6+/-4.7% at baseline and remained unchanged after single-dose (7.8+/-4.4%) and long-term (7.9+/-4.5%) treatment with placebo (P=0.005 by repeated-measures ANOVA). Plasma ascorbic acid concentrations increased from 41.4+/-12. 9 to 115.9+/-34.2 micromol/L after single-dose treatment and to 95. 0+/-36.1 micromol/L after long-term treatment (P<0.001). CONCLUSIONS: In patients with CAD, long-term ascorbic acid treatment has a sustained beneficial effect on EDNO action. Because endothelial dysfunction may contribute to the pathogenesis of cardiovascular events, this study indicates that ascorbic acid treatment may benefit patients with CAD.

EMS systems: foundations for the future.

Emergency medical services (EMS) occupy a unique position in the continuum of emergency health care delivery. The role of EMS personnel is expanding beyond their traditional identity as out-of-hospital care providers, to include participation and active leadership in EMS administration, education, and research. With these roles come new challenges, as well as new responsibilities. This paper was developed by the SAEM EMS Task Force and provides a discussion of these new concepts as well as recommendations for the specialty of emergency medicine to foster the continued development of all of the potentials of EMS.

EMS systems and managed care integration.

Emergency medical services systems and MCOs must cooperate and educate each other in order to effect delivery of reliable, high-quality emergency health care to the entire community. Shared goals are rapid access, medically appropriate care, and operational efficiency. An integrated approach is necessary in order to maintain the integrity of EMS systems. EMS systems serve as a safety net for patients with perceived emergencies. Changes in form and function should be guided by outcome studies that ensure the continued delivery of quality emergency health care services.

Ensuring the chain of recovery for stroke in your community. Chain of Recovery Writing Group.

Until recently, the prehospital and emergency department management of nonhemorrhagic stroke was largely supportive care. Studies now have demonstrated the potential of certain therapeutic interventions to reverse the debilitating consequences of such strokes. But despite the potential benefit, there exists a clear time dependency for such interventions, not only to ensure therapeutic efficacy, but also to diminish the likelihood of significant therapeutic complications. In turn, to optimize the chances of a better outcome for the patient with stroke, each community must establish and continue to refine a chain of recovery for stroke patients. The chain of recovery is a metaphor that describes a series of sequential actions that must take place in a timely fashion to optimize the chances of recovery from stroke. Each of these sequential actions forms an individual link in the chain, and each link must be intact. The links include: identification of the onset of stroke symptoms by the patient or bystanders; dispatch life support services, which preferably include enhanced 9-1-1 and medically supervised and trained dispatchers who can rapidly deploy the closest responders and transport units; emergency medical services (EMS) personnel who can rapidly assess and transport the stroke patient to the closest appropriate center capable of providing advanced stroke diagnostics and interventions; en route notification of the receiving facility so that appropriate personnel can be readied for rapid diagnosis and intervention; and receiving facilities capable of providing rapid diagnosis and advanced treatment of stroke, including the availability of specialists who can evaluate underlying etiologies as well as plan future therapies and rehabilitation. To ensure that the chain of recovery is in place, aggressive public education campaigns should be implemented to increase the probability that stroke symptoms and signs will be recognized as soon as possible by patients and bystanders. In addition, because most of the current training programs for EMS dispatchers and prehospital care personnel are lacking with regard to stroke, it is recommended that such personnel and their EMS system managers be updated on current management and treatment strategies for stroke.

Ensuring the chain of recovery for stroke in your community.

Until recently, the prehospital and ED management of nonhemorrhagic stroke was largely supportive care. Studies have now demonstrated the potential of certain therapeutic interventions to reverse the debilitating consequences of such strokes. The clinical benefit for such interventions and the risk of significant therapeutic complications are highly time-dependent. To optimize the chances of a better outcome for the patient with stroke, each community must establish and continue to refine a chain of recovery for stroke patients. The chain of recovery is a metaphor that describes a series of sequential actions that must take place in a timely fashion to optimize the chances of recovery from stroke. Each of these sequential actions forms an individual link in the chain, and each link must be intact. The links include: identification of the onset of stroke symptoms by the patient or bystanders; dispatch life support services, which preferably include enhanced 9-1-1 and medically supervised and trained dispatchers who can rapidly deploy the closest responders and transport units; emergency medical services (EMS) personnel who can rapidly assess and transport the stroke patient to the closest appropriate center capable of providing advanced stroke diagnostics and interventions; en route notification of the receiving facility so that appropriate personnel can be readied for rapid diagnosis and intervention; and receiving facilities capable of providing rapid diagnosis and advanced treatment of stroke, including the availability of specialists who can evaluate underlying etiologies as well as plan future therapies and rehabilitation. To ensure that the chain of recovery is in place, aggressive public education campaigns should be implemented to increase the probability that stroke symptoms and signs will be recognized as soon as possible by patients and bystanders. In addition, because most of the current training programs for EMS dispatchers and EMS personnel are lacking with regard to stroke, it is recommended that such personnel and their EMS system managers be updated on current management and treatment strategies for stroke.