Enhanced Bioaccessibility of Microencapsulated Puerarin Delivered by Pickering Emulsions Stabilized with OSA-Modified Hydrolyzed Pueraria montana Starch: In Vitro Release, Storage Stability, and Physicochemical Properties

Puerarin is a bioactive flavonoid isolated from Kudzu roots that possesses numerous health benefits. However, its poor bioavailability and existing complex delivery systems with safety issues are challenging tasks for its incorporation into functional foods. Preparing modified-starch-stabilized Pickering emulsions containing microencapsulated puerarin with improved bioaccessibility was the key objective of the present research work. Acid-hydrolyzed high-amylose Pueraria montana starch (PMS) was modified with octenyl succinic anhydride (OSA) and evaluated as an emulsifier to prepare emulsions. The FTIR, SEM, and XRD results showed that PMS was successfully modified. Furthermore, the emulsification index (EI), mean droplet size, and ζ-potential values showed that modified starch with a higher degree of substitution (DS) enhanced the storage stability of emulsions. Similarly, the retention degree and encapsulation efficiency results of puerarin proved the assumption after storage of 16 d. The Pickering emulsions also helped in the controlled release of microencapsulated puerarin in vitro. The study outcomes proved that Pickering emulsions stabilized with OSA-modified PMS have promising applicability in functional foods as efficient food-grade delivery systems, enhancing oral supplementation and accessibility of puerarin.

Impact of unemployment on cardiovascular mortality in united states: a nationwide county-level analysis 2010–2019

Background

Unemployment has been linked with a myriad of adverse health outcomes; however, its population-level impact on cardiovascular mortality (CVM), particularly amongst various demographic subgroups, remains understudied.

Purpose

To determine the impact of county unemployment levels on CVM rates, in overall and between different demographic subgroups.

Methods

We utilized the CDC WONDER database tool to retrieve county-level CVM rates for U.S. counties between 2010 and 2019. The County Health Rankings project was used to retrieve data on unemployment levels in each county as well as other characteristics used in an adjusted multivariate model. Generalized linear mixed models using Poisson regression were used to estimate the impact of unemployment on county-level CVM using relative (incidence rate ratios; IRR) and absolute (additional yearly deaths; AYD) measures.

Results

From 2010 to 2019, a total of 2904 U.S. counties (64.2% white; 50.81% female) with data available on CVM and unemployment levels were analyzed. In a multivariate model adjusted for demographic composition, CV risk, socioeconomic, environmental, and healthcare-access factors, unemployment was significantly associated with higher levels of CVM (IRR: 1.026; 95% CI: 1.018 to 1.033; 6.00 AYD). The relative impact of unemployment was strongest in elderly Blacks (IRR: 1.051; 95% CI: 1.029 to 1.074), middle-aged whites (IRR: 1.050; 95% CI: 1.032 to 1.067), and middle-aged females (IRR: 1.046; 95% CI: 1.018 to 1.075). The absolute impact of unemployment was highest in elderly Blacks (AYD: 94.70), elderly Whites (AYD: 35.30), and elderly females (AYD: 32.70). On a relative basis, the impact was more pronounced in the middle-aged (IRR: 1.030; 95% CI: 1.015 to 1.044) compared to the elderly (IRR: 1.022; 95% CI: 1.014 to 1.030), females (IRR: 1.026; 95% CI: 1.017 to 1.036) compared to males (IRR: 1.022; 95% CI: 1.014 to 1.031), and Blacks (IRR: 1.036; 95% CI: 1.016 to 1.057) compared to Whites (IRR: 1.030; 95% CI: 1.022 to 1.038).

Conclusion(s)

Unemployment is significantly associated with county-level CVM, and this impact is most pronounced in vulnerable demographic subgroups, namely females and Blacks. Efforts to reduce unemployment levels may significantly lower the burden of cardiovascular disease, particularly in groups most strongly affected by health disparities.

Funding Acknowledgement

Type of funding sources: None.

Impact of sexually transmitted infections on cardiovascular mortality in united states: a nationwide county-level analysis 2011–2019

Background

Sexually Transmitted Infections (STIs) are associated with a significantly increased risk of morbidity and mortality; however, its population-level effect on cardiovascular mortality (CVM), particularly amongst various demographic subgroups, remains unknown.

Purpose

To assess the impact of county STIs levels on CVM rates, in overall and between different patient groups stratified by age, sex and race.

Methods

The CDC WONDER database tool was utilized to retrieve age adjusted county-level CVM rates (ACVM) for U.S. counties between 2011 and 2019. Data on STIs were provided by the County Health Rankings project database. STIs is the number of newly diagnosed chlamydia (the most common STI in north America) cases per 100,000 population in a county. Rates measure the number of events in a given time period (generally one year) divided by the average number of people at risk during that period. The Behavioral risk Factors Surveillance System and County Health Rankings project were used to retrieve county data on demographics, CV risk, socioeconomic, environmental, and health care access factors. Generalized linear mixed models using Poisson regression were used to estimate the impact of unemployment on county-level CVM using relative (incidence rate ratios; IRR) and absolute (additional yearly deaths; AYD) measures.

Results

Of 3143 U.S. counties, a total of 2890 counties (62.09% white; 50.76% female; 14.12% aged ≥65) with data available on ACVM and STIs levels were analyzed. In a multivariate model adjusted for demographic composition, CV risk, socioeconomic, environmental, and healthcare-access factors, STIs were significantly associated with higher levels of ACVM (IRR: 1.015; 95% CI: 1.007 to 1.022; 3.40 AYD). Additionally, this association was relatively higher in the middle-aged [45–64] (IRR: 1.016; 95% CI: 1.002 to 1.030) compared to the elderly [≥65] (IRR: 1.010; 95% CI: 1.002 to 1.018), males (IRR: 1.013; 95% CI: 1.004 to 1.021) compared to females (IRR: 1.011; 95% CI: 1.002 to 1.020), and non-Hispanic Blacks (IRR: 1.026; 95% CI: 1.011 to 1.040) compared to non-Hispanic Whites (IRR: 1.010; 95% CI: 1.002 to 1.018). Notably, the relative impact of STIs was highest in middle-aged non-Hispanic Blacks (IRR: 1.038; 95% CI: 1.013 to 1.063; AYD: 10.50), and middle-aged males (IRR: 1.021; 95% CI: 1.006 to 1.037; AYD: 4.30), (Figure).

Conclusions

STIs is robustly associated with county-level ACVM, independent from several important confounders. This impact is most prominent in vulnerable demographic subgroups, namely middle-aged, males, and Blacks. Efforts to reduce STIs levels may significantly lower the burden of cardiovascular mortality attributable to STIs, particularly in groups most frequently affected by health disparities.

Funding Acknowledgement

Type of funding sources: None.

Prognosticating outcome using magnetic resonance imaging in patients with moderate to severe traumatic brain injury: a machine learning approach

INTRODUCTION

Over the last decade advancements in computer processing have enabled the application of machine learning (ML) to complex medical problems. Convolutional neural networks (CNN), a type of ML, have been used to interrogate medical images for variety of purposes. In this study, we aimed to investigate the potential application of CNN in prognosticating patients with traumatic brain injury (TBI).

METHODS

Patients with moderate to severe TBI and evidence of diffuse axonal injury (DAI) were selected retrospectively. A CNN model was developed using a training subgroup and a holdout subgroup was used as a testing dataset. We reported the model characteristics including area under the receiver operating characteristic curve (AUC).

RESULTS

We included a total of 38 patient, of which we generated 725 MRI sections. We developed a CNN model based on a modified AlexNet architecture that interpreted the brain stem injury to generate outcome predictions. The model was able to predict GOS outcomes with a specificity of 0.43 and a sensitivity of 0.997. It showed an AUC of 0.917.

CONCLUSION

The utilization of machine learning MRI analysis for prognosticating patients with TBI is a valued method that require further investigation. This will require multicentre collaboration to generate large datasets.

Isolation and characterization of bacteria residing in the oral, gut, and fecal samples of different pheasant species

There is a paucity of research conducted on microbial prevalence in pheasants. The microbiota of captive birds has zoonotic significance and must be characterize. Present study is therefore planned to assess the microbiota from oral, fecal and gut content of captive avian species. It will be helpful in characterization of harmful microbes. Different samples taken from oral, gut and feces of ring-necked pheasants (Phasianus colchicus), green pheasants (Phasianus versicolor), golden pheasant (Chrysolophus pictus) and silver pheasant (Lophura nycthemera). Samples were collected, diluted, and inoculated onto different agar plates (MacConkey, SS agar, MSA and nutrient agar) for cultivation of bacterial species. Colonies of E.coli, Staphylococcus spp. Brachyspira spp. and Campylobacter spp were observed based on colony morphology. Colony forming unit showed E. coli as frequently found bacteria in fecal, oral and gut contents of all the above pheasants. The overall significance difference was found among bacterial species of golden pheasants, green pheasant, ring-necked pheasant, and silver pheasants. It was concluded that E.coli is predominant isolated from heathy pheasants followed by Campylobacter, Staphylococcus and Brachyspira.

COVID-19 Pandemic and Food Safety Issues in Pakistan

The article's abstract is not available.  

Cross-genera amplification and identification of Colpodella sp. with Cryptosporidium primers in fecal samples of zoo felids from northeast China

The protozoans include many intracellular human pathogens. Accurate detection of these pathogens is necessary to treat the diseases. In clinical epidemiology, molecular identification of protozoan is considered a more reliable and rapid method for identification than microscopy. Among these protozoans, Cryptosporidium considered being one of the important water-borne zoonotic pathogens and a major cause of a diarrheal disease named cryptosporidiosis in humans, domestic animals, and wild animals. This study was aimed to identify Cryptosporidium in zoo felids (N= 56) belonging to different zoo of China, but accidentlly Colpodella was encountered in the zoo felids sample and phylogenetic data confirmed this unexpected amplification from fecal samples using two-step nested-PCR. Phylogenetic analysis revealed the fact about the specific primers used previously by many researchers and cross-genera amplification. We came to know that genetically sequenced amplicon gives more accurate identification of species. This study suggests more investigation on Colpodella which has been neglected previously but gains the attention of researchers after identified from humans and animals and has been known to correlate with neurological symptoms in patients.

468 IMPROVING ADVANCE CARE PLANNING SKILLS IN JUNIOR DOCTORS

Introduction

Junior doctors are increasingly encountering Advance Care Planning (ACP) when they look after frail, older or multi-morbid patients during their hospital rotations. However, there remains a lack of formal training and resources, particularly with DNACPR discussions and when engaging patients and their loved ones with Emergency Health Care Planning (EHCP). We aimed to assess the need for ACP, improve the infrastructure by which ACP is delivered, and better support junior doctors to have these difficult conversations.

Method

Discharges from the Geriatrics Department at Kettering General Hospital were reviewed initially in May 2019 and again in January 2020 following intervention. We introduced a focused communication skills training session delivered at departmental teaching, which included a combination of simulation training and lectures. We additionally designed and implemented an EHCP template to aid junior doctors’ discussions. This could also be copied to the discharge letter, to facilitate safe transfer of care to primary care.

Results

In May 2019 of 32 patients, 100% met at least one SPICTTM criterion, with median of 4 criteria, thus indicating a high need for ACP in this cohort. Despite this, only one discharge letter included an EHCP and two had a request for GP colleagues to complete one. Evaluation of discharges again in January of 2020 reconfirmed a similar need for ACP, but following our interventions, the number of EHCP’s performed had increased. Of 22 identified patients 4 had a completed EHCP and 3 were requested for completion by their GP. Qualitative questionnaires demonstrated an improvement in both knowledge and confidence amongst junior doctors following the training session.

Conclusion

We have shown that there is a necessity for ACP to be considered for Geriatrics inpatients, and that providing structure and training in this challenging area offers benefit to both patients and junior doctors.

Optimization of culture conditions for in vitro adventitious roots and selected flavonoids production in Boesenbergia rotunda liquid suspension culture

Boesenbergia rotunda (L.) Mansf. is one of the unique monocotyledonous perennial plant species belonging to the ginger (Zingiberaceae) family. Locally known as ‘Temu Kunci’ in Malaysia and Indonesia, this medicinal plant has been widely used in Asian dishes, particularly as a condiment or as traditional natural medicines. The important medicinal properties of B. rotunda majorly derived from flavonoids which are highly sought as pharmaceuticals. In this study, culture conditions for the growth of adventitious roots in liquid suspension cultures were optimized. The highest adventitious root production was achieved when cultured with initial inoculum density of 1.5 g and pH value at 5.8 after five weeks of culture. HPLC analysis discovered that production of valuable flavonoid compounds (pinostrobin, cardamonin and panduratin A) was significantly higher when the adventitious roots were cultured with initial inoculum density of 1.5 g whereas the initial pH medium did not significantly affect flavonoid production.

Augmenting yogurt quality attributes through hydrocolloidal gums

Objective

The present work was undertaken to determine the possibility of using xanthan and guar gums as stabilizers to enhance the yogurt quality.

Methods

Yogurt was manufactured from standardized milk (3.5% fat, 8.5% solid-not-fat contents) with the addition of 2% to 3% starter culture. Enzyme-hydrolyzed xanthan gum (0.1%, 0.5%, 1.0%) and guar gum (0.1%, 0.5%, 1.0%) were added to the yogurt as stabilizers. Prepared yogurt samples were kept at refrigeration temperature (4°C±2°C) for 21 days and various quality and sensory parameters were studied at regular intervals (7 days).

Results

Results showed that yogurt with 0.5% xanthan gum (T5) was best in terms of preventing syneresis and improving the viscosity, water holding capacity and texture of the product. Additionally, adding gums did not adversely affect the sensorial attributes of the product.

Conclusion

Modified gums were found useful in augmenting yogurt quality and therefore addition of gums is highly recommended for manufacturing yogurt.

Group B streptococcus infection in a sudden unexpected death of infancy - the importance of microbiological investigation at post-mortem

Group B streptococcus (GBS) is a common cause of infection in newborns and in early infants. However, GBS infection in an infant older than three months is infrequently reported in the literature. We reported a case of an apparently well six-month-old infant who died of sudden death due to GBS pneumonia, diagnosed at autopsy. The six-month-old, apparently well male infant was brought in dead to the Emergency Department. He underwent medicolegal autopsy four hours after death, as part of an overall sudden unexpected death in infancy investigation (SUDI). Apart from whitish froth oozing out of both nostrils, he appeared to be well-nourished infant without any deformity, syndromic features or obvious suspicious marks of injury externally. Internal examination showed generalized hyperinflated with patchy consolidation of upper and middle lobes of bilateral lung. Multiple matted mesenteric lymphadenopathy were also detected. Blood and lung tissue specimens collected under aseptic technique yielded growth of GBS. Post-mortem histology from consolidated lungs confirmed pneumonic features while mesenteric lymph nodes showed reactive changes inkeeping with underlying infective process. Death was attributed to GBS pneumonia. This case highlights the importance of a detailed autopsy in sudden unexpected death in infancy (SUDI) and the crucial role of post-mortem microbiological study in such cases. Relevant autopsy protocols that need to be employed during microbiological sampling are briefly discussed.

Hypothyroidism during second-line treatment of multidrug-resistant tuberculosis: a prospective study

SETTING

Hypothyroidism is an adverse effect of certain anti-tuberculosis drugs.

DESIGN

This is a prospective study of the frequency and possible pathomechanisms associated with hypothyroidism due to second-line treatment of multidrug-resistant tuberculosis. Fifty human immunodeficiency virus negative patients and 20 controls were included. All participants underwent ultrasonography of the thyroid and measurement of thyroid stimulating hormone (TSH). TSH levels were checked every 3 months. If hypothyroidism was present, T3, T4 and thyroid peroxidase autoantibodies were measured, and imaging extended to scintigraphy and repeated ultrasonography.

RESULTS

Before treatment, 7 patients (14%) and 1 control (5%) were hypothyreotic. During the first 6 months of treatment, TSH levels increased in 41 patients (82%), 39 (78%) had values above the normal range and 19 (38%) had overt hypothyroidism. As none of the patients had signs of autoimmune thyroiditis, interaction with anti-tuberculosis drugs was assumed to be the cause of hypothyroidism. Nine patients died during treatment, all of whom had developed hypothyroidism. In seven, the metabolic situation at their death was known, and they had become euthyreotic following levothyroxine substitution.

CONCLUSION

TSH levels should be checked before initiating anti-tuberculosis treatment and after 3 and 6 months to start timely replacement of levothyroxine. Further studies are needed to elucidate the exact pathomechanism involved in hypothyroidism and whether hypothyroidism can be used as predictor of treatment failure.

Preparation and quality characterization of soy milk based non-dairy ice cream

Soy milk made from soybean has prospective to be used as a substitute of milk due to its health benefits. It is a rich source of iso-flavones, omega-3-fatty acid, dietary fiber, vitamin C, carotenoids, protein and oligosaccharides. The current study was designed to examine the effects of galacto-manan on ice cream by using commercially available (<em>silk</em>) and locally prepared soy milk. Galacto-mannan (guar gum) was used in different concentration (0.3, 0.4, 0.5 and 0.6%) for the preparation of ice cream. Ice cream was analyzed for physico-chemical and sensory characteristics at 0, 30 and 60 days of storage interval. Overrun, meltdown, viscosity, total solids, pH and acidity were affected significantly by ice cream samples as well as storage. While non-significant effects of stabilizer and storage were found on fat, protein, and ash contents of ice cream. On organoleptic evaluation, the highest scores were awarded to the ice cream sample prepared with 0.5% of guar gum. Ice cream manufactured with locally prepared soy milk and guar gum revealed comparable quality with lower cost.

Assessing frailty in the acute medical admission of elderly patients

BACKGROUND

Managing acute admission of frail older patients is a challenge in hospitals. Length of inpatient stay, inpatient mortality and the 90-day readmission rate are significant in this group of patients. The Comprehensive Geriatric Assessment (CGA), a multidisciplinary diagnostic and treatment process, is the best approach for identifying medical conditions, mental health, functional capacity and social circumstances in acute geriatric care.

METHODS

A review of the records of older patients aged 75 and over, acutely admitted to a district general hospital in England from 15 March 2012 to 16 April 2012 was conducted. We developed a frailty assessment tool and applied it to these patients, in order to determine who would be classified as frail. We then established if the patients meeting this criteria were then correctly assessed using the CGA. All patient data were processed and analysed using a statistical package for data analysis.

RESULTS

A total of 232 patients with a mean age of 84.25 ± 5.8 years were included. Out of these, 129 patients (55.6%) fulfilled the frailty criteria as determined with our frailty-assessment tool; 80.6% presented with lack of mobility over 24 hours, 69.8% were admitted with falls, 47.3% had known dementia or delirium and 45% were admitted from care homes. Patients aged over 85 years were more likely to have frailty compared with patients aged 75-85 years old (odds ratio [OR]: 4.78, 95% confidence interval [CI]: 2.6-8.6, p value >0.001). Patients assessed by a front door geriatric team were more likely to be reviewed with the CGA than those not seen by this team (adjusted OR 2.8, 95% CI: 1-7.6, p value=0.04).

CONCLUSION

The prevalence of frailty is high in acute admissions of older patients and it is important that they are properly identified and assessed with a CGA in order to ensure effective multidisciplinary care.

Patterns of radiotherapy practice in the management of gastric cancer: Preliminary findings from the Quality Research in Radiation Oncology (QRRO) GI Committee process surveys

77

Background: The specific aim of the ACR QRRO survey was to determine the national patterns of radiotherapy (RT) practice in patients (pts) treated for stage IB–IV (non-metastatic) gastric cancer (GC).

Methods: A National Process Survey was conducted from randomly selected U.S. RT facilities to assess demographics, staging, geographic region, practice setting, and treatment through retrospective on-site record review of eligible GC cases treated from 2005-2007. Three clinical performance measures (CPMs): 1) use of CT-based treatment planning; 2) use of dose volume histograms (DVHs) to evaluate RT dose to the kidneys and liver; 3) completion of RT within the prescribed time frame were assessed. Three emerging quality indicators: 1) use of intensity modulated RT (IMRT); 2) use of image-guided tools (IGRT), other than CT, for RT target delineation; 3) use of preop RT were also assessed.

Results: CPMs were computed on data collected through Aug, 2010 for 250 eligible pts at 45 institutions. Median age was 62 years; 66% male; 60% Caucasian. 13% were AJCC 2002 stage I, 29% II, 32% IIIA, 10% IIIB and 12% IV. Most pts (43%) were treated at academic centers with 32% at large non-academic centers and 25% medium-small facilities. Almost all (99.5%) pts underwent CT-based planning and 75% had DVHs to evaluate normal tissue doses to the kidneys and liver. 70% completed RT within the prescribed time frame. IMRT and IGRT were used in 22% and 17% of pts, respectively. IGRT techniques included: PET (n = 20), MRI (n = 1), respiratory gating and/or 4D-CT (n = 22) and on-board imaging (n = 10). 19% of pts received preop RT.

Conclusions: Preliminary findings from QRRO's analysis of radiation practice patterns for non-metastatic gastric cancer indicate widespread adoption of CT-based planning with the use of DVHs to evaluate normal tissue doses. Moreover, most pts completed adjuvant RT in the prescribed time frame. Emerging RT techniques such as IMRT and IGRT were not routinely incorporated into clinical practice during the evaluated time period. These data will serve as a benchmark for future QRRO gastric cancer surveys.

No significant financial relationships to disclose.

Morphometric and molecular differentiation of Phlebotomus (Phlebotomus) sandflies

The closely related sandfly species of the subgenus Phlebotomus namely, Phlebotomus papatasi (Scopoli, 1786), Phlebotomus duboscqi Neveu-Lemair, 1906 and Phlebotomus bergeroti Parrot, 1934 (Diptera: Psychodidae), are major vectors of Leishmania major (Kinetoplastida: Trypanosomatidae), the causative agent of cutaneous leishmaniasis in the Old World. Although allopatric in most of their distribution, the three species exist sympatrically in many places in central and eastern Sudan. Males of the three species can be distinguished using morphological characters; however, females are much harder to identify, thus complicating epidemiological studies. We carried out a morphometric and a molecular study to determine reliable morphological features and develop a polymerase chain reaction (PCR) assay for distinguishing females of these species. Males and females from each species were collected from sites in Sudan, East Africa and from one site in Mali, West Africa. Males were analysed morphologically and 20 characters and 10 character ratios were used in a stepwise discriminant analysis. This led to the identification of four characters with high discriminant loading scores sufficient for accurate male species identification. Male DNA was then used for the development of a PCR-based species diagnostic based on the second internal transcribed spacer (ITS2) of the ribosomal DNA. A set of four primers was developed to generate fragment sizes that are specific to each species and can reliably identify females as well as hybrid DNA. Both the morphometric and the molecular findings of this study have important applications for studies of the epidemiology of cutaneous leishmaniasis.

Assessment of air quality of two metropolitan cities in Pakistan: Elemental analysis using INAA and AAS

For the assessment of air quality of two cities in Pakistan, Instrumental Neutron Activation Analysis (INAA) and Atomic Absorption Spectrometry (AAS) have been used. In all 26 elements were determined in suspended particulate matter (SPM) and soil samples. The SPM levels from different locations of Rawalpindi and Lahore indicate unhealthy to hazardous air quality much above the World Health Organization (WHO) guidelines. Metrological conditions and nature of soil that contains clay components mainly contribute to the inventory of the SPM elements of these cities. The calculated enrichment factors (EF) also indicate the dominance of the soil components. Contributions of inorganic elements due to heavy traffic with automotive exhaust and other commercial activities in this area have been identified. Areas of Qurtaba Chowk and Bank Square in Lahore in particular showed high EF for lead depicting burning of the automotive fuel and road dust. The accuracy and precision of the work has been maintained through the concurrent use of IAEA Reference Materials.

Modified Giemsa staining for rapid diagnosis of malaria infection

OBJECTIVES

To develop and evaluate a rapid method for the diagnosis of malaria infection by microscopy of stained blood films.

SUBJECTS AND METHODS

Blood specimens were collected from randomly selected confirmed malaria cases (n = 75) and suspected malaria cases (n = 175). The microscopy was done on each set of blood films stained by modified and the standard Giemsa staining methods.

RESULTS

All the 75 previously diagnosed malaria cases were confirmed by the microscopy of blood films stained by both methods. Forty-nine (28%) of the 175 cases suspected for malaria infection showed malarial parasites on microscopy of blood films stained by both methods. However, due to homogeneous staining and clearer background of the blood films it was possible to determine the parasite species in 65% of the cases on microscopy of the thick films stained with the modified method compared to only 20% with the standard method. Further, the turnaround time for reporting the microscopy test result was 15-20 and 45-50 min with modified and standard staining methods, respectively.

CONCLUSION

Our data showed that performance of the modified staining method in detecting malarial parasites was comparable to that of the standard staining method. Moreover, the modified staining method was rapid, easy to use, and reliable.

Potential of rice husks for antimony removal

The adsorption behavior of rice husks for antimony ions from aqueous solutions has been investigated as a function of appropriate electrolyte, equilibration time, hydrogen ions, amount of adsorbent, concentration of adsorbate, effect of diverse ions and temperature. The best conditions in which this material can be used as adsorbent have been explored. The radiotracer technique was employed to determine the distribution of antimony (122Sb) using a batch method. Maximum adsorption was observed at 0.01 mol L(-1) acid solutions (HNO3, HCl, H2SO4 and HClO4) using 1.0 g of adsorbent for 1.92 x 10(-5) mol L(-1) antimony concentration in 10 min equilibration time. Studies show that the adsorption decreases with the increase in the concentrations of all the acids. The adsorption data follow the Freundlich isotherm over the range of 1.92 x 10(-5) to 2.05 x 10(-4) mol L(-1) antimony concentration. The characteristic Freundlich constants i.e., 1/n = 0.82 +/- 0.05 and K = 4.61 +/- 0.07 m mol g(-1) have been computed for the sorption system. The uptake of antimony increases with the rise in temperature (299-323 K). Thermodynamic quantities i.e., deltaG0, deltaS0 and deltaH0 have also been calculated for the system. The sorption process was found to be endothermic.

Breast tumor characteristics as predictors of mammographic detection: comparison of interval- and screen-detected cancers

BACKGROUND

Although mammographic screening is useful for detecting early breast cancer, some tumors are detected in the interval between screening examinations. This study attempted to characterize fully the tumors detected in the two different manners.

METHODS

Our study utilized a case-control design and involved a cohort of women undergoing mammographic screening within the defined population of a health maintenance organization (the Group Health Cooperative of Puget Sound). Women were classified as having "interval" or "interval-detected" cancers (n = 150) if their diagnosis was made within 24 months after a negative-screening mammogram or one that indicated a benign condition. Cancers were classified as "screen detected" (n = 279) if the diagnosis occurred after a positive assessment by screening mammography. Tumors from women in each group were evaluated for clinical presentation, histology, proliferative characteristics, and expression of hormone receptors, p53 tumor suppressor protein, and c-erbB-2 protein.

RESULTS

Interval-detected cancers occurred more in younger women and were of larger tumor size than screen-detected cancers. In unconditional logistic regression models adjusted for age and tumor size, tumors with lobular (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 0.9-4.2) or mucinous (OR = 5.5; 95% CI = 1.5-19.4) histology, high proliferation (by either mitotic count [OR = 2.9; 95% CI = 1.5-5.7] or Ki-67 antigen expression [OR = 2.3; 95% CI = 1.3-4.1]), high histologic grade (OR = 2.1; 95% CI = 1.2-4.0), high nuclear grade (OR = 2.0; 95% CI = 1.0-3.7), or negative estrogen receptor status (OR = 1.8; 95% CI = 1.0-3.1) were more likely to surface in the interval between screening examinations. Tumors with tubular histology (OR = 0.2; 95% CI = 0.0-0.8) or with a high percentage of in situ components (50%) (OR = 0.5; 95% CI = 0.2-1.2) were associated with an increased likelihood of screen detection.

CONCLUSIONS

Our data from a large group of women in a defined population indicate that screening mammography may miss tumors of lobular or mucinous histology and some rapidly proliferating, high-grade tumors.

The relationship between Caesarean section and neonatal mortality in very-low-birthweight infants born in Washington State, USA

We examined the associations between Caesarean section and neonatal mortality in singleton liveborn very-low-birthweight (VLBW) infants (500-1499 g) born during 1984-95 in Washington State, USA, using data from the Washington State birth certificate files. The infants included in this study had no life-threatening congenital malformations and had not been delivered by a repeat Caesarean without a trial of labour (n = 5182). For infants weighing 500-749, 750-999, 1000-1249 and 1250-1499 g, the neonatal mortality rates were 57.8%, 18.6%, 9.7% and 4.7%, respectively, and the Caesarean section rates were 28.4%, 47.8%, 48.0% and 44.6%. The adjusted odds ratios (ORs) for neonatal death associated with Caesarean section were 0.55 [95% confidence interval 0.38, 0.78] for the 500-749 g infants (n = 1059), and 1.15 [0.91, 1.45] for the larger (750-1499 g) infants, after adjustment for birth year, type of hospital, birthweight, presence or absence of labour, breech/malpresentation, and other obstetric indications for Caesarean section (prolapsed cord, placenta praevia, eclampsia, pre-eclampsia and chronic hypertension). However, when the larger (750-1499 g) vertex-presenting (n = 3248) and breech/malpresenting (n = 809) infants were considered separately, the adjusted ORs were 1.42 [1.05, 1.91] and 0.37 [0.23, 0.58] respectively. In contrast, among infants weighing 500-749 g, the ORs were not modified by presentation. The results were similar when we restricted analyses to infants without the above obstetric indications for Caesarean section. Because such an observational study is liable to unmeasurable biases and incomplete reporting of obstetric complications, these OR estimates may be subject to residual confounding. In their present state, these recent population-based data support the view that Caesarean sections do not enhance the neonatal survival of larger (> 750 g) VLBW babies when obstetric complications are absent. The possibility of a protective effect of Caesarean section on the survival of breech/malpresenting infants and infants weighing 500-749 g deserves further studies.

Evolving self-image, pubertal manifestations, and pubertal hormones: preliminary findings in young adolescent girls

PURPOSE

Recent studies indicate that negative self-image increases in white females during early adolescence. This study was designed to examine the effects of physical and hormonal change during puberty on evolving self-image.

METHODS

The study sample consisted of 54 girls aged 10-14 yrs (mean 12.2 +/- 0.9). Evaluations at baseline and one-year follow-up included the Self-Image Questionnaire for Young Adolescents (SIQYA), physical examination, and assays of serum FSH, LH, estradiol, testosterone, and DHEAS. Tanner stage was assessed separately for breast and pubic hair, and the girls were classified as early-, mid-, or late-maturers for each.

RESULTS

Pearson correlations between baseline and follow-up scores on the nine SIQYA scales ranged from 0.28-0.72 (P < 0.05); three scales demonstrated declining function (P < 0.05). At baseline, 39 girls (72%) were pre-menarcheal compared to 27 (50%) at follow-up. Mean body mass index (BMI) increased from 18.62 +/- 2.38 to 19.01 +/- 1.84 (P < 0.001), Tanner stages each increased by one, and pubertal timing did not change. LH and testosterone increased (P < 0.05) over the year, DHEAS decreased (P < 0.01), and FSH and estradiol did not change. Stepwise linear regression revealed that change in breast stage was positively correlated with change in Body Image score and change in Adjustment score (beta weights 0.46 and 0.41, respectively). Change in testosterone was negatively correlated with change in Adjustment score (beta weight of -0.46). After controlling for baseline score, change in breast stage was positively correlated and FSH was negatively correlated with follow-up Body Image score (beta weights of 0.40 and -0.24, respectively).

CONCLUSION

We conclude that the rate of breast development and FSH level have independent, opposite effects on body image during early adolescence.