The impact of bias of underlying literature in guidelines on its recommendations: assessment of the German fluoride guideline

PURPOSE

The significance of the underlying literature in clinical guidelines can be weakened by the risk of bias, which could negatively affect the recommendations. Especially in controversial matters, such as fluoride use for caries prevention in children, biased results may be not reliable and lead to incorrect conclusions. This study was performed to detect bias in underlying literature of the German guideline for caries prevention using fluoride in children, where no consensus was reached between paediatricians and paediatric dentists.

METHODS

Three tools used for risk of bias assessments of different study designs were RoB 2 for RCTs, ROBINS-I for non-randomized studies, and ROBIS for systematic reviews. For each study cited in the guideline two independent risk of bias assessments were performed. Disagreements were resolved by consensus.

RESULTS

Out of 58 papers, 48.3% (n = 28) showed high risk of bias, with the majority in sections regarding fluoride tablets, fluoridated toothpaste, and paediatricians' recommendations. 9 out of 20 recommendations and statements were based on studies with high risk of bias, all of which were in these three controversial sections. 13 out of 29 RCTs showed high risk of bias (44.8%), as all 13 non-randomized trials did, while only 2 of 16 (12.5%) systematic reviews had high risk of bias.

CONCLUSION

Considering risk of bias of cited studies in clinical guidelines may result in substantial changes in its recommendations and aid in reaching consensus. Efforts should be made to assess risk of bias of underlying literature in future clinical guidelines.

Maternal self-reported polycystic ovary syndrome with offspring and maternal cardiometabolic outcomes

STUDY QUESTION

Do children born to mothers with polycystic ovary syndrome (PCOS) have an adverse cardiometabolic profile including arterial stiffness at 9 years of age compared to other children?

SUMMARY ANSWER

Children of mothers with PCOS did not have differing cardiometabolic outcomes than children without exposure.

WHAT IS KNOWN ALREADY

While women with PCOS themselves have higher risk of cardiometabolic conditions such as obesity and diabetes, the evidence on intergenerational impact is unclear. Given in utero sequalae of PCOS (e.g. hyperandrogenism, insulin resistance), the increased risk could be to both boys and girls.

STUDY DESIGN, SIZE, DURATION

The Upstate KIDS cohort is a population-based birth cohort established in 2008-2010 to prospectively study the impact of infertility treatment on children's health. After ∼10 years of follow-up, 446 mothers and their 556 children attended clinical visits to measure blood pressure (BP), heart rate, arterial stiffness by pulse wave velocity (PWV), mean arterial pressure, lipids, high-sensitivity C-reactive protein (hsCRP), hemoglobin A1c (HbA1c), and anthropometrics.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Women self-reported ever diagnoses of PCOS ∼4 months after delivery of their children in 2008-2010. Linear regression models applying generalized estimating equations to account for correlation within twins were used to examine associations with each childhood cardiometabolic outcome.

MAIN RESULTS AND THE ROLE OF CHANCE

In this cohort with women oversampled on infertility treatment, ∼14% of women reported a PCOS diagnosis (n = 61). We observed similarities in BP, heart rate, PWV, lipids, hsCRP, HbA1c, and anthropometry (P-values >0.05) among children born to mothers with and without PCOS. Associations did not differ by child sex.

LIMITATIONS, REASONS FOR CAUTION

The sample size of women with PCOS precluded further separation of subgroups (e.g. by hirsutism). The population-based approach relied on self-reported diagnosis of maternal PCOS even though self-report has been found to be valid. Participants were predominantly non-Hispanic White and a high proportion were using fertility treatment due to the original design. Differences in cardiometabolic health may be apparent later in age, such as after puberty.

WIDER IMPLICATIONS OF THE FINDINGS

Our results provide some reassurance that cardiometabolic factors do not differ in children of women with and without self-reported PCOS during pregnancy.

STUDY FUNDING/COMPETING INTEREST(S)

Supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, United States (contracts #HHSN275201200005C, #HHSN267200700019C, #HHSN275201400013C, #HHSN275201300026I/27500004, #HHSN275201300023I/27500017). The authors have no conflicts of interest.

REGISTRATION NUMBER

NCT03106493.

Vitamin D supplementation and adverse skeletal and non-skeletal outcomes in individuals at increased cardiovascular risk: Results from the International Polycap Study (TIPS)-3 randomized controlled trial

BACKGROUND AND AIMS

Vitamin D has mostly been tested in Western populations. We examined the effect of high dose vitamin D in a population drawn predominantly from outside of Western countries.

METHODS AND RESULTS

This randomized trial tested vitamin D 60,000 IU monthly in 5670 participants without vascular disease but at increased CV risk. The primary outcome was fracture. The secondary outcome was the composite of CV death, myocardial infarction stroke, cancer, fracture or fall. Death was a pre-specified outcome. Mean age was 63.9 years, and 3005 (53.0%) were female. 3034 (53.5%) participants resided in South Asia, 1904 (33.6%) in South East Asia, 480 (8.5%) in South America, and 252 (4.4%) in other regions. Mean follow-up was 4.6 years. A fracture occurred in 20 participants (0.2 per 100 person years) assigned to vitamin D, and 19 (0.1 per 100 person years) assigned to placebo (HR 1.06, 95% CI 0.57-1.99, p-value = 0.86). The secondary outcome occurred in 222 participants (1.8 per 100 person years) assigned to vitamin D, and 198 (1.6 per 100 person years) assigned to placebo (HR 1.13, 95% CI 0.93-1.37, p = 0.22). 172 (1.3 per 100 person years) participants assigned to vitamin D died, compared with 135 (1.0 per 100 person years) assigned to placebo (HR 1.29, 95% CI 1.03-1.61, p = 0.03).

CONCLUSION

In a population predominantly from South Asia, South East Asia and South America, high-dose vitamin D did not reduce adverse skeletal or non-skeletal outcomes. Higher mortality was observed in the vitamin D group.

REGISTRATION NUMBER

NCT01646437.

AMSA Meat Color Measurement Guidelines

Meat color is an important aspect of consumer’spurchase decisions regarding meat products. Perceived meat color results from the interaction of light, a detector(i.e. human eye), and numerous factors that are both intrinsic and extrinsic tothe muscle which influence the chemical state of myoglobin.  The complex nature of these interactions dictatesthat decisions regarding evaluations of meat color be made carefully, and thatinvestigators have a basic knowledge of the physical and chemical factorsaffecting their evaluations.  Theseguidelines were compiled to aid investigators in navigating the pitfalls ofmeat color evaluation and ensure the reporting of information needed forappropriate interpretation of the resulting data.  The guidelines provide an overview ofmyoglobin chemistry, the perception of meat color, in addition to details ofinstrumentation used in meat color evaluation. Moreover, these guidelines detail practical considerations for simulatedretail display studies and provide details of the most common laboratorytechniques used in meat color literature. Importantly, the guidelines indicate the information that should beincluded when reporting meat color research to aid in appropriateinterpretation.  Practical considerationsneeded for troubleshooting meat color problems in a commercial setting areincluded as well.  Investigators areencouraged to review the entire guidelines before designing and conducting meatcolor research.

Alternative Proteins: Market Research on Consumer Trends and Emerging Landscape

Meat and poultry consumption is set for global growth with increased demand. However, today’s market trends demonstrate that new consumers are interested in alternative proteins (i.e., non–animal-derived/plant proteins). In the past few years, this interest has been growing and has resulted in the revamp of “alternative protein” segments and new product launches that can compete with or complement traditional meat products. The market trends also strongly support a continued demand for meat and poultry consumption as the alternative protein segment possesses less than 4% of the total global protein share. At the same time, the accelerated growth (with Compound Annual Growth Rate 2–3 times greater than that for meat and poultry, globally) and market penetration of alternative proteins, coupled with consumer interests fueled by the “flexitarians,” present an opportunity to review the current situation, global trends, and consumer research and to evaluate the potential and gaps for the meat and poultry industry. Furthermore, the technological aspects of utilizing alternative proteins (non–animal-derived) also presents an opportunity to create new experiences for a customer familiar with meat/meat product consumption. The present International Congress of Meat Science and Technology proceedings paper, therefore, offers a short glance into the market landscape of alternative proteins, as we stride to a common goal of feeding 2 billion more people by 2050.

P1460Seismocardiographic measurement of systolic time intervals in left ventricular dysfunction: validation with transthoracic echo

Background

Systolic time intervals (STI) measured using Transthoracic Echo (TTE) have been shown to be sensitive indicators of contractile performance, but TTE is limited to a hospital setting. Recent advances in technology have enabled the simultaneous measurement of Electrocardiograms (ECG) and Seismocardiograms (SCG) using wearable devices. However, the use SCG to measure STIs has not been validated in a mobile setting, or on pathological subjects.

Purpose

To test the validity of an automated algorithm for measuring STIs using a wearable device recording ECG and SCG, in subjects with varying degrees of left ventricular dysfunction.

Methods

179 Patients with suspected left ventricular dysfunction were assessed using TTE performed by a Cardiologist. Patients were simultaneously fitted with a novel wearable device worn on a chest strap, recording SCG and single-lead ECG data, while the cardiologist measured the pre-ejection period (PEP) and left ventricular ejection time (LVET) with the patient in a supine position. Of these subjects 29 (16.2%) were diagnosed with Dilated cardiomyopathy (DCM), and 109 (60.8%) had Ischemic Heart disease.

The SCG and ECG data recorded on the wearable device was then analysed using a peak-detection algorithm, which detected the Q,R,S points on the ECG, and then determined the 4 most prominent peaks in the SCG signal corresponding to each R-peak. Heart rate, patient's age, gender and SCG time intervals were then used in a DecisionTree algorithm to determine the values of PEP and LVET, which were were then compared against those determined by the cardiologist using TTE.

Results

The correlation coefficient (r2) between PEP calculated using TTE, and the values obtained from the algorithm analyzing SCG data was 0.92 while the mean error was 7.47%. The r2 between the LVET calculated using the TTE and the algorithm was 0.75, while the mean error was 8.53% (p-value<0.001 for all cases).

Results All Subjects With IHD Without IHD With DCM Without DCM Number of Subjects 178 109 69 29 149 PEP (r2) 0.92 0.89 0.94 0.88 0.91 PEP (% age error) 7.47 7.50 7.42 6.99 7.56 LVET (r2) 0.75 0.81 0.66 0.55 0.83 LVET (% age error) 8.53 6.69 11.4 20.42 6.16 DCM, Dilate Cardiomyopathy; IHD, Ischemic Heart Disease.

ECG + SCG signals for a DCM patient

Conclusion

The algorithm-derived STIs measured by SCG correlate well with those measured by TTE across most patient groups, including those with Dilated Cardiomyopathy and Ischemic Heart Disease, opening prospects for continuous remote monitoring of STIs in a mobile setting.

Acknowledgement/Funding

Fourth Frontier Technologies

Transport of nano-objects in narrow channels: influence of Brownian diffusion, confinement and particle nature

This paper presents experimental results about transport of dilute suspensions of nano-objects in silicon-glass micrometric and sub-micrometric channels. Two kinds of objects are used: solid, rigid latex beads and spherical capsule-shaped, soft polymersomes. They are tracked using fluorescence microscopy. Three aspects are studied: confinement (ratio between particle diameter and channel depth), Brownian diffusion and particle nature. The aim of this work is to understand how these different aspects affect the transport of suspensions in narrow channels and to understand the different mechanisms at play. Concerning the solid beads we observe the appearance of two regimes, one where the experimental mean velocity is close to the expected one and another where this velocity is lower. This is directly related to a competition between confinement, Brownian diffusion and advection. These two regimes are shown to be linked to the inhomogeneity of particles distribution in the channel depth, which we experimentally deduce from velocity distributions. This inhomogeneity appears during the entrance process into the sub-micrometric channels, as for hydrodynamic separation or deterministic lateral displacement. Concerning the nature of the particles we observed a shift of transition towards the second regime likely due to the relationships between shear stress and polymersomes mechanical properties which could reduce the inhomogeneity imposed by the geometry of our device.

Slitted leading edge profiles for the reduction of turbulence-aerofoil interaction noise

Aerofoils operating in a turbulent flow are an efficient source of noise radiation by scattering vorticity into sound at the leading edge (LE). Much work has now been undertaken demonstrating the effectiveness of serrations, or undulations, introduced onto the LE can substantially reduce broadband LE interaction noise. However, all of this work is focused on sinusoidal LE serration profiles. In this paper, an alternative profile is proposed that is capable of providing significantly greater noise reductions than the maximum noise reductions that can be achieved by single-wavelength serrations of the same peak-to-root amplitude. In its most general realization, the LE serration profiles simply comprise of a sawtooth or single wavelength serration for which every root has a single narrow slit. This simple geometry, upon interaction with a turbulent flow, produces compact source regions at either end of the slit, which then destructively interfere, leading to considerably less efficient noise radiation than conventional single-wavelength geometries. The paper will demonstrate experimentally that even slits by themselves can provide greater levels of noise reduction than conventional profiles of the same peak-to-root amplitude.

Ion Transport and Precipitation Kinetics as Key Aspects of Stress Generation on Pore Walls Induced by Salt Crystallization

The stress generation on pore walls due to the growth of a sodium chloride crystal in a confined aqueous solution is studied from evaporation experiments in microfluidic channels in conjunction with numerical computations of crystal growth. The study indicates that the stress buildup on the pore walls is a highly transient process taking place over a very short period of time (in less than 1 s in our experiments). The analysis makes clear that what matters for the stress generation is not the maximum supersaturation at the onset of the crystal growth but the supersaturation at the interface between the solution and the crystal when the latter is about to be confined between the pore walls. The stress generation is summarized in a simple stress diagram involving the pore aspect ratio and the Damkhöler number characterizing the competition between the precipitation reaction kinetics and the ion transport towards the growing crystal. This opens up the route for a better understanding of the damage of porous materials induced by salt crystallization, an important issue in Earth sciences, reservoir engineering, and civil engineering.

Diagnostic yield of active case finding for tuberculosis and HIV at the household level in slums in Haiti

SETTING

Haiti has the highest burden of tuberculosis (TB) in the Americas, with an estimated prevalence of 254 per 100 000 population. The Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes, GHESKIO) conducted active case finding (ACF) for TB at the household level in nine slums in Port-au-Prince.

OBJECTIVE

We report on the prevalence of undiagnosed TB detected through GHESKIO's ACF campaign.

DESIGN

From 1 August 2014 to 31 July 2015, we conducted a retrospective cohort analysis using GHESKIO's ACF campaign data. All individuals who reported chronic cough (cough 2 weeks) were tested for TB at GHESKIO, and those aged 10 years were included in the analyses.

RESULTS

Of 104 097 individuals screened in the community, 5598 (5%) reported chronic cough and satisfied the study inclusion criteria. A total of 1110 (20%) were diagnosed with active TB disease (prevalence of 1066/100 000). Of the 5472 (98%) patients tested for human immunodeficiency virus (HIV), 528 (10%) were HIV-positive; 143 (3%) patients were diagnosed with both diseases.

CONCLUSION

Household-level screening for cough with TB and HIV testing for symptomatic patients was a high-yield strategy, leading to the detection of a prevalence of undiagnosed disease exceeding national estimates by more than four-fold for TB, and by five-fold for HIV.

Evaluation of New Antibacterial Drugs and their Combinations in a Murine Model to Identify Short Duration Alternative Chemotherapy for Leprosy

The objective of the research is to test the efficacy of new drugs and drug combinations in mice infected with Mycobacterium leprae (M. leprae) as alternative to current WHO MDT. Individual drugs tested were Rifampicin (RMP), Rifapentine (RPT) and Moxifloxacin (MOXI). Drug combinations were RMP, Clarithromycin (CLARI), Minocycline (MINO) and RMP, MINO and Ofloxacin (OFLO). RPT drug combinations were RPT, CLARI, MINO and RPT, OFLO, MINO. Both the drugs and drug combinations were used as daily regimen and intermittent regimen. WHO MB MDT served as a positive control. Mice pre-inoculated with M. leprae were allotted to daily and intermittent groups and administered selected drugs and drug combinations. At the end of 12 months post sub-inoculation, mice were sacrificed and the proportion % of viable bacilli were counted using Spearman and Karber method. It was noted that RMP, RPT and Moxifloxacin indicated a range of 89.99% to 99.99% bactericidal effect when used in daily or intermittent doses in both normal and TR mice. Drug combinations showed bactericidal effect comparable to that of WHO MDT. From the study it was concluded that if the present duration of MDT has to be shortened then daily dose regimen with RMP/MINO/OFLO or RPT/CLARI/MINO are recommended for a clinical trial.

Evaluation of anti-bacterial activity of Rifapentine, Clarithromycin, Minocycline, Moxifloxacin, Ofloxacin and their combinations in Murine Model of Rifampicin Resistant Leprosy

Leprosy, a debilitating disease of the skin and peripheral nerves is caused by Mycobacterium leprae (M. leprae) and is treated by multidrug therapy (MDT) comprising of Dapsone, Rifampicin and Clofazimine. Resistance to any of these drugs poses a threat to the current disease control strategies. With the emergence of Rifampicin resistance in leprosy, it is important that alternative drugs need to be tested to develop a treatment strategy to combat drug resistant leprosy. In the current study, we have investigated WHO MDT, Rifapentine, Clarithromycin, Minocycline, Moxifloxacin, Ofloxacin and their combinations in intermittent and daily dose regimens in rifampicin resistant strains of M. leprae through mouse foot pad experiments in order to determine the loss in viability of M. leprae in response to these drugs and their combinations. Our findings suggest that WHO MDT is still the best combination in Rifampicin resistance cases. Combination of Moxifloxacin with Minocycline and Clarithromycin may also be taken up for clinical trials in cases with Rifampicin resistant leprosy. Rifapentine and Moxifloxacin can be effective alternative drugs to replace Rifampicin where required either in daily dose shorter duration regimens or intermittent dose longer regimen to treat resistant strains.

Can Physician Incentives Improve Continuity of Care For Patients Receiving Depression Treatment in the Primary Care Setting?

Introduction

In 2008, the province of British Columbia, Canada introduced financial incentives to encourage general practitioners (GPs) to assume the role of major source of care for patients seeking mental health treatment in primary care. If successful, this intervention could strengthen GP–patient attachment and consequently improve continuity of care. The impact of this intervention, however, has never been investigated.

Aim

To estimate the population level impact of physician incentives on continuity of care (COC).

Method

This retrospective study examined linked health administrative data from physician claims, hospital separations, vital statistics, and insurance plan registries. Monthly cohorts of individuals with depression were identified and their GP visits tracked for 12 months, following receipt of initial diagnosis. COC indices were created, one for any visits (AV) and another for mental health visits (MHV) only. COC (range: 0–100) was calculated using published formula that accounts for the number of visits and number of GPs visited. Interrupted time series analysis was used to estimate the changes in COC before (01/2005–12/2007) and after (01/2008–12/2012) the introduction of physician incentives.

Results

The monthly number of people diagnosed with depression ranged from 7497 to 10,575; yearly rates remained stable throughout the study period. At the start of the study period, mean COC for AV and MHV were 75.6 and 82.2 respectively, with slopes of –0.11 and –0.06. Post-intervention, the downward trend was disrupted but did not reverse.

Conclusions

Physician incentives failed to enhance COC. However, results suggest that COC could have been worse without the incentives.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

More Women are Medicated While More Men are Talked Out: Persistent Gender Disparities in Mental Health Care

Introduction

Physician incentives have been shown in previous studies to help reduce socioeconomic disparities in health care. Its impact on gender disparities, however, has rarely been investigated.

Aim

The impact of physician incentives on gender disparities in mental health care was investigated in this retrospective study.

Method

De-identified health administrative data from physician claims, hospital separations, vital statistics, prescription database, and insurance plan registries were linked and examined. Monthly cohorts of individuals with depression who were residing in British Columbia, Canada were identified and their use of mental health services tracked for 12 months following receipt of initial diagnosis. indicators that assess receipt of the following services were created:

– counseling/psychotherapy (CP);

– minimally adequate counseling/psychotherapy (MACP);

– antidepressant therapy (AT);

– minimally adequate antidepressant therapy (MAAT).

interrupted time series analysis was used to estimate changes in these indicators before (01/2005–12/2007) and after (01/2008–12/2012) physician incentives were introduced.

Results

At the beginning of the study period, the percentage of individuals diagnosed with depression who received counseling/psychotherapy was higher, on average, among men (CP: 58.4%, MACP: 13.6%) than women (CP: 57.1%, MACP: 10.9%). in contrast, the percentage who received antidepressant therapy was higher among women (AT: 57.7%, MAAT: 47.4%) than men (AT: 53.6%, MAAT: 41.9%). Levels for these indicators have changed over time but the statistically significant differences between men and women were virtually the same before and after incentives were introduced.

Conclusions

Gender disparities in mental health care persist despite the introduction of physician incentives designed to enhance access to mental health services in primary care.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Filter-less submicron hydrodynamic size sorting

We propose a simple microfluidic device able to separate submicron particles (critical size ∼0.1 μm) from a complex sample with no filter (minimum channel dimension being 5 μm) by hydrodynamic filtration. A model taking into account the actual velocity profile and hydrodynamic resistances enables prediction of the chip sorting properties for any geometry. Two design families are studied to obtain (i) small sizes within minutes (low-aspect ratio, two-level chip) and (ii) micron-sized sorting with a μL flow rate (3D architecture based on lamination). We obtain quantitative agreement of sorting performances both with experiments and with numerical solving, and determine the limits of the approach. We therefore demonstrate a passive, filter-less sub-micron size sorting with a simple, robust, and easy to fabricate design.

Comparison of methods for the fabrication and the characterization of polymer self-assemblies: what are the important parameters?

The ability to self-assemble was evaluated for a large variety of amphiphilic block copolymers, including poly(ethyleneoxide-b-ε-caprolactone), poly(ethyleneoxide-b-d,l-lactide), poly(ethyleneoxide-b-styrene), poly(ethyleneoxide-b-butadiene) and poly(ethyleneoxide-b-methylmethacrylate). Different methods of formation are discussed, such as cosolvent addition, film hydration or electroformation. The influence of experimental parameters and macromolecular structures on the size and morphology of the final self-assembled structures is investigated and critically compared with the literature. The same process is carried out regarding the characterization of these structures. This analysis demonstrates the great care that should be taken when dealing with such polymeric assemblies. If the morphology of such assemblies can be predicted to some extent by macromolecular parameters like the hydrophilic/hydrophobic balance, those parameters cannot be considered as universal. In addition, external experimental parameters (methods of preparation, use of co-solvent, …) appeared as critical key parameters to obtain a good control over the final structure of such objects, which are very often not at thermodynamic equilibrium but kinetically frozen. A principal component analysis is also proposed, in order to examine the important parameters for forming the self-assemblies. Here again, the hydrophilic/hydrophobic fraction is identified as an important parameter.

Proteome basis for intramuscular variation in color stability of beef semimembranosus

The objective of the present study was to characterize the proteome basis for intramuscular color stability variations in beef semimembranosus. Semimembranosus muscles from eight carcasses (n=8) were fabricated into 2.54-cm thick color-labile inside (ISM) and color-stable outside (OSM) steaks. One steak for sarcoplasmic proteome analysis was immediately frozen, whereas other steaks were allotted to retail display under aerobic packaging. Color attributes were evaluated instrumentally and biochemically on 0, 2, and 4days. Sarcoplasmic proteome was analyzed using two-dimensional electrophoresis and tandem mass spectrometry. ISM steaks demonstrated greater (P<0.01) abundance of glycolytic enzymes (fructose-bisphosphate aldolase A, phosphoglycerate mutase 2, and beta-enolase) and phosphatidylethanolamine-binding protein 1 than their OSM counterparts. Possible rapid post-mortem glycolysis in ISM, insinuated by over-abundance of glycolytic enzymes, could lead to rapid pH decline during early post-mortem, which in turn could potentially compromise its color stability. These results indicated that differential abundance of sarcoplasmic proteome contributes to intramuscular variations in beef color stability.

Deinococcus as new chassis for industrial biotechnology: biology, physiology and tools

Deinococcus spp are among the most radiation-resistant micro-organisms that have been discovered. They show remarkable resistance to a range of damage caused by ionizing radiation, desiccation, UV radiation and oxidizing agents. Traditionally, Escherichia coli and Saccharomyces cerevisiae have been the two platforms of choice for engineering micro-organisms for biotechnological applications, because they are well understood and easy to work with. However, in recent years, researchers have begun using Deinococcus spp in biotechnologies and bioremediation due to their specific ability to grow and express novel engineered functions. More recently, the sequencing of several Deinococcus spp and comparative genomic analysis have provided new insight into the potential of this genus. Features such as the accumulation of genes encoding cell cleaning systems that eliminate organic and inorganic cell toxic components are widespread among Deinococcus spp. Other features such as the ability to degrade and metabolize sugars and polymeric sugars make Deinococcus spp. an attractive alternative for use in industrial biotechnology.

Single velocity-component modeling of leading edge turbulence interaction noise

A computational aeroacoustics approach is used to predict leading edge turbulence interaction noise for real airfoils. One-component (transverse), two-component (transverse and streamwise), and three-component (transverse, streamwise, and spanwise) synthesized turbulence disturbances are modeled instead of harmonic transverse gusts, to which previous computational studies of leading edge noise have often been confined. The effects of the inclusion of streamwise and spanwise disturbances on the noise are assessed. It is shown that accurate noise predictions can be made by modeling only transverse disturbances which reduces the computational expense of simulations. The accuracy of using only transverse disturbances is assessed for symmetric and cambered airfoils, and also for airfoils at non-zero angle of attack.

Sensory quality of broiler breast meat influenced by low atmospheric pressure stunning, deboning time and cooking methods

Stunning method (low atmospheric pressure stunning, LAPS and electrical stunning, ES), deboning time (0.75 h and 4 h), and cooking method (baking, frying, and sous vide) were evaluated for their impact on the descriptive sensory characteristics and consumer acceptability of breast meat (n=576, 144 birds per stunning × deboning time combination). Sensory evaluation was conducted by trained descriptive (n=8) and consumer (n=185) panels. On average, no differences (P>0.05) existed in the sensory acceptability of fried and sous vide cooked broiler breast treatment combinations. However, for oven-baking, the LAPS treatment that was deboned at 4 h was more acceptable (P<0.05) than other treatments and the ES and LAPS 4 h samples had greater (P<0.05) acceptability for texture than their ES and LAPS 0.75 h counterparts. Since consumers were highly variable in their liking of chicken breast treatments, consumers were grouped into clusters for each cooking method based on liking and preference. Cluster analysis data revealed that the largest groups of consumers liked (score≥6.0) all chicken breast treatments, but a larger proportion of consumers liked the 4 h LAPS and ES treatments when compared to the 0.75 h LAPS and ES treatments for all cooking methods. In addition, the consumers who indicated that baked chicken breast was highly acceptable preferred (P<0.05) 4 h LAPS over the 4 h ES samples. Based on sensory results, chicken breast meat from all stunning and deboning method combinations was highly acceptable to the majority of consumers, but the LAPS 4 h treatment had enhanced sensory characteristics when baked.

Osmotic flow through fully permeable nanochannels

Osmosis across membranes is intrinsically associated with the concept of semipermeability. Here, however, we demonstrate that osmotic flow can be generated by solute gradients across nonselective, fully permeable nanochannels. Using a fluorescence imaging technique, we are able to measure the water flow rate inside single nanochannels to an unprecedented sensitivity of femtoliters per minute flow rates. Our results indicate the onset of a convective liquid motion under salinity gradients, from the higher to lower electrolyte concentration, which is attributed to diffusio-osmotic transport. To our knowledge, this is the first experimental evidence and quantitative investigation of this subtle interfacially driven transport, which need to be accounted for in nanoscale dynamics. Finally, diffusio-osmotic transport under a neutral polymer gradient is also demonstrated. The experiments highlight the entropic depletion of polymers that occurs at the nanochannel surface, resulting in convective flow in the opposite direction to that seen for electrolytes.

Symmetric airfoil geometry effects on leading edge noise

Computational aeroacoustic methods are applied to the modeling of noise due to interactions between gusts and the leading edge of real symmetric airfoils. Single frequency harmonic gusts are interacted with various airfoil geometries at zero angle of attack. The effects of airfoil thickness and leading edge radius on noise are investigated systematically and independently for the first time, at higher frequencies than previously used in computational methods. Increases in both leading edge radius and thickness are found to reduce the predicted noise. This noise reduction effect becomes greater with increasing frequency and Mach number. The dominant noise reduction mechanism for airfoils with real geometry is found to be related to the leading edge stagnation region. It is shown that accurate leading edge noise predictions can be made when assuming an inviscid meanflow, but that it is not valid to assume a uniform meanflow. Analytic flat plate predictions are found to over-predict the noise due to a NACA 0002 airfoil by up to 3 dB at high frequencies. The accuracy of analytic flat plate solutions can be expected to decrease with increasing airfoil thickness, leading edge radius, gust frequency, and Mach number.

Management of colorectal cancer liver metastasis in a patient with immune thrombocytopaenia

Immune thrombocytopaenia (ITP) was referred to previously as idiopathic thrombocytopaenic purpura and is usually of autoimmune or viral aetiology. Colorectal cancer liver metastasis with concomitant ITP is rare and only three cases have been reported in the English literature. Adverse effects of adjuvant chemotherapy may aggravate ITP. The sequencing of chemotherapy, operation for the primary and liver metastasis, and a decision on splenectomy is important. We present our experience in the management of a 52-year-old man who, having undergone anterior resection one year earlier for carcinoma of the rectum, presented with liver metastasis and ITP. He underwent splenectomy with hepatectomy prior to chemotherapy.