Glennerlandsen5794

PURPOSE High-maternal caffeine intake during pregnancy may be harmful for perinatal outcomes and future child health, but the level of fetal cumulative exposure has been difficult to measure thus far. Here, we present maternal dietary caffeine intake during the last trimester and its correlation to caffeine content in newborn hair after birth. METHODS Maternal third trimester diets and dietary caffeine intake were prospectively collected in Kuopio Birth Cohort (KuBiCo) using a 160-item food frequency questionnaire (n = 2840). Newborn hair was collected within 48 h after birth and analyzed by high-resolution mass spectrometry (HRMS) for caffeine (n = 316). Correlation between dietary caffeine intake and neonatal hair caffeine content was evaluated from 203 mother-child pairs. RESULTS Mean dietary caffeine intake was 167 mg/days (95% CI 162-172  mg/days), of which coffee comprised 81%. Caffeine in the maternal diet and caffeine content in newborn hair correlated significantly (r = 0.50; p  less then  0.001). Older, multiparous, overweight women, and smokers had the highest caffeine levels in the maternal diet, as well as in their newborn babies' hair. CONCLUSION Caffeine exposure, estimated from newborn hair samples, reflects maternal third trimester dietary caffeine intake and introduces a new method to assess fetal cumulative caffeine exposure. Further studies to evaluate the effects of caffeine exposure on both perinatal and postnatal outcomes are warranted, since over 40% of pregnant women consume caffeine more than the current suggested recommendations (European Food Safety Association, EFSA recommendations).In temperate regions, some avian haemosporidian parasites have evolved seasonal transmission strategies, with chronic infections relapsing during spring and transmission peaking during the hosts' breeding season. Because lineages with seasonal transmission strategies are unlikely to produce gametocytes in winter, we predicted that (1) resident birds living within wintering areas of Neotropical migrants would unlikely be infected with North American parasite lineages; and (2) if infected, wintering migratory birds would be more likely to harbor Plasmodium spp. rather than Parahaemoproteus spp. JNJ-64619178 or Haemoproteus spp. parasites in their bloodstreams, as only Plasmodium produces life stages, other than gametocytes, that infect red blood cells. To test these predictions, we used molecular detection and microscopy to compare the diversity and prevalence of haemosporidian parasites among year-round residents and wintering migratory birds during February 2016, on three islands of The Bahamas archipelago, i.e., Andros, Grand Bahama, and Great Abaco. Infection prevalence was low and comparable between migratory (15/111) and resident (15/129) individuals, and it did not differ significantly among islands. Out of the 12 lineages detected infecting migratory birds, five were transmitted in North America; four lineages could have been transmitted during breeding, wintering, or migration; and three lineages were likely transmitted in The Bahamas. Resident birds mostly carried lineages endemic to the Caribbean region. All North American-transmitted parasite lineages detected among migratory birds were Plasmodium spp. Our findings suggest that haemosporidian parasites of migrants shift resource allocation seasonally, minimizing the production of gametocytes during winter, with low risk of infection spillover to resident birds.A few data are related to the anthropophily of Malagasy Phlebotomine sandflies. Prior studies focussed mainly to inventories and description of new species. Our goal was to emphasize the anthropophily of Malagasy Phlebotomine sandflies. We worked in the Makira region, using two simultaneous methods human landing catches (HLC) and CDC light traps. We collected sandflies in three rural communities adjacent to the Makira Natural Park. In each community, three different biotopes were sampled within community settlements; at the edge of forest, typically in agricultural land; and within the forest. We collected 61 sandflies belonging to two new species presently described Phlebotomus artemievi sp. nov. and Sergentomyia maroantsetraensis sp. nov. These sandflies were caught exclusively in the forest edge biotope. None were captured within communities or within forests. HLC provided 97% of the collected sandflies, corresponding to a human-biting rate of 15 females per human per night. CDC provided only two females. Ph. artemievi sp. nov. was predominantly captured by HLC and appears to be highly anthropophilic. Here, we update the behavioural ecology of sandflies and describe two new species. Further research is required to understand their vector competence and their ability to transmit arboviruses and other pathogens such as Leishmania.Microbial metabolism can shape cues important for animal attraction in service-resource mutualisms. Resources are frequently colonized by microbial communities, but experimental assessment of animal-microbial interactions often focus on microbial monocultures. Such an approach likely fails to predict effects of microbial assemblages, as microbe-microbe interactions may affect in a non-additive manner microbial metabolism and resulting chemosensory cues. Here, we compared effects of microbial mono- and cocultures on growth of constituent microbes, volatile metabolite production, sugar catabolism, and effects on pollinator foraging across two nectar environments that differed in sugar concentration. Growth in co-culture decreased the abundance of the yeast Metschnikowia reukaufii, but not the bacterium Asaia astilbes. Volatile emissions differed significantly between microbial treatments and with nectar concentration, while sugar concentration was relatively similar among mono- and cocultures. Coculture volatile emission closely resembled an additive combination of monoculture volatiles. Despite differences in microbial growth and chemosensory cues, honey bee feeding did not differ between microbial monocultures and assemblages. Taken together, our results suggest that in some cases, chemical and ecological effects of microbial assemblages are largely predictable from those of component species, but caution that more work is necessary to predict under what circumstances non-additive effects are important.The original version of this article unfortunately contained an error.PURPOSE Day-case thyroid surgery has been endorsed by the American Thyroid Association and the British Association of Day Surgery. Despite the many benefits of day surgery, day-case thyroid surgery is not widely practiced. We describe the use of sensitivity analysis modelling and cost analysis in determining and refining the patient cohort that safely meet the threshold for a new day-case thyroid lobectomy service at a tertiary referral head and neck centre. METHODS All cases of first-time thyroid lobectomy were identified between 2015 and Q2 2019. Patients suitable for day-case thyroid lobectomy were identified retrospectively, according to the following criteria Age  less then  65 years, ASA grade  less then  3, BMI  less then  30 kg/m2 and distance from tertiary unit  less then  / = 30 min. Sensitivity analysis was undertaken, manipulating each parameter in turn to assess the effect on eligibility and associated cost-savings. RESULTS 259 Thyroid lobectomy procedures were performed, 173 of these met inclusion criteria. Sensitivity analysis revealed that after increasing all day-case parameters by four increments, eligibility increased from 47 (27%) to 112 patients (64.7%), with only one outpatient to inpatient conversion. Multivariate logistical regression analysis found that age was the only variable to increase the risk of adverse outcomes (OR = 1.10, p  less then  0.05). Using data from the NHS reference costs, if 60% of all thyroid lobectomies nationally were undertaken as day-case, this would have amounted to savings of £26.3 m over five years. CONCLUSION Through sensitivity analysis, we determined that we could safely offer day-case thyroid lobectomy to 64.7% of our patient cohort.PURPOSE The optimal pain management concept in children after tonsil surgery is controversial. Ibuprofen on an "around-the-clock" basis has been suggested to control postoperative pain sufficiently. Therefore, we established a standard scheme with weight-adapted recommended maximum ibuprofen dose. A reliable assessment of pain intensity can be performed with the Children's and Infants' Postoperative Pain Scale (CHIPPS) in children  less then  5 years, or with the Faces Pain Scale-Revised (FPS-R) in children aged ≥ 5 years. The Parents' Postoperative Pain Measure (PPPM-D) may be a useful tool for both age groups. We hypothesized that not more than 30% of the children would need an opioid rescue medication during their in-hospital stay and analyzed the consistency of the PPPM-D with other pain scales. METHODS We included 158 in-patients aged 2-12 years. Ibuprofen was orally administered every 8 h. Three times daily, pain scores were assessed by CHIPPS or FPS-R, respectively. The PPPM-D was used in all children. Exceeding the cut-off value in one of the tools was regarded as relevant pain. RESULTS A rescue medication was needed in 82.1% of children after tonsillectomy and 51.3% of children after tonsillotomy (P  less then  0.001). The cut-off value for relevant pain was mostly exceeded in the PPPM-D, but its overall concordance to the reference scales was low. CONCLUSION High-dose ibuprofen "around-the-clock" is insufficient to control pain in children after tonsil surgery. Research is needed to find an optimal schema for management and assessment of postoperative pain.PURPOSE In an effort to make olfactory training (OT) simpler, we designed an 'olfactory training ball' (OTB)-a baseball-size ball with four odor-containing tubes to use in OT. The study aimed to investigate the effects of OT with the OTB in comparison to classical OT with special attention to the effects of adherence to OT on olfactory outcome measures. METHODS Sixty patients with olfactory dysfunction following infections of the upper respiratory tract received OT either with classical methods-sniffing odors from jars (COT)-or the OTB for 12 weeks. Patients exposed themselves to the odors for 5 min twice daily. Adherence was measured with a modified version of the Morisky scale. Before and after OT, all patients underwent extensive olfactory testing using the Sniffin' Sticks test. RESULTS At the end of the 12 weeks of OT, TDI composite score (22.1 ± 2.8 vs. 19.9 ± 4.7, P = 0.044) and odor discrimination subtest scores (9.1 ± 1.8 vs.7.6 ± 2.5, P = 0.013) of the OTB group were significantly higher than that of the COT group. Adequate adherence to OT was significantly higher in patients receiving OTB when compared to those receiving COT (63% vs. 30%, P = 0.019). CONCLUSION The present study shows that a novel OT device, the OTB, provides better adherence to the training process compared to COT. Moreover, findings of the current study show that better adherence to the OT process is associated with better olfactory outcomes.