Pollardmunck9939

PURPOSE To examine racial/ethnic differences in dietary intake of women in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Cross-sectional study. SETTING Data from the US National Health and Nutrition Examination Survey. PARTICIPANTS Women 19 to 50 years of age living in WIC-participating households. MEASURES Nutrient/food group intake from one 24-hour dietary recall. ANALYSIS Multivariable linear regression was used to evaluate the relationship between race/ethnicity and nutrient/food group intake. RESULTS Compared to non-Hispanic white women, Hispanic women had lower dietary energy density (1.7 ± 0.1 vs 2.2 ± 0.1 kcal/g, P less then .001), and better nutrient intake, including more folate (429 ± 20 vs 364 ± 29 µg, P = .024), fiber (20.1 ± 0.9 vs 13.6 ± 0.9 g, P ≤ .001), and potassium (2575 ± 78 vs 2251 ± 66 mg, P = .012). This may be related to greater consumption of total vegetables (1.67 ± 0.16 vs 1.17 ± 0.17 cup equivalents [c-eq], P = .029), including more red and orange vegetables (0.64 ± 0.11 vs 0.32 vs 0.09 c-eq, P = .013) and more legumes (0.17 ± 0.04 vs 0.07 ± 0.02 c-eq, P = .006). Both Hispanic and non-Hispanic black women consumed more sodium (Hispanic P = .015; non-Hispanic black P = .008), but less added sugars (Hispanic P ≤ .001; non-Hispanic black P = .015), than non-Hispanic white women. CONCLUSION These findings highlight differences in dietary intake by race/ethnicity and can inform nutrition messages of WIC nutrition educators and dietitians.BACKGROUND We aimed to externally validate an emergency department triage algorithm including five hierarchical clinical variables developed to identify chest pain patients at low risk of having an acute coronary syndrome justifying delayed rather than immediate evaluation. METHODS In a single-centre cohort enrolling 29,269 consecutive patients presenting with chest pain, the performance of the algorithm was compared against the emergency department discharge diagnosis. In an international multicentre study enrolling 4069 patients, central adjudication by two independent cardiologists using all data derived from cardiac work-up including follow-up served as the reference. Triage towards 'low-risk' required absence of all five clinical 'high-risk' variables history of coronary artery disease, diabetes, pressure-like chest pain, retrosternal chest pain and age above 40 years. Safety (sensitivity and negative predictive value (NPV)) and efficacy (percentage of patients classified as low risk) was tested in this initial proposal (Model A) and in two additional models omitting age criteria (Model B) and allowing up to one (any) of the five high-risk variables (Model C). RESULTS The prevalence of acute coronary syndrome was 9.4% in the single-centre and 28.4% in the multicentre study. The triage algorithm had very high sensitivity/NPV in both cohorts (99.4%/99.1% and 99.9%/99.1%, respectively), but very low efficacy (6.2% and 2.7%, respectively). Model B resulted in sensitivity/NPV of 97.5%/98.3% and 96.1%/89.4%, while efficacy increased to 14.2% and 10.4%, respectively. Model C resulted in sensitivity/NPV of 96.7%/98.6% and 95.2%/91.3%, with a further increase in efficacy to 23.1% and 15.5%, respectively. CONCLUSION A triage algorithm for the identification of low-risk chest pain patients exclusively based on simple clinical variables provided reasonable performance characteristics possibly justifying delayed rather than immediate evaluation in the emergency department.AIMS Removal of large calibre arterial sheaths, as employed in venoarterial extracorporeal membrane oxygenation, is still associated with a high risk for vascular access site complications. CDDP mouse In this study, we investigated the large bore Manta closure device as an option for venoarterial extracorporeal membrane oxygenation decannulation. METHODS AND RESULTS Sixteen patients weaned from venoarterial extracorporeal membrane oxygenation between January-June 2019 were prospectively included in a registry (eight during extracorporeal cardiopulmonary resuscitation, seven with severe cardiogenic shock and one patient with fulminant pulmonary embolism). All patients had an arterial sheath removed at bedside using the Manta device achieving rapid haemostasis without clinically relevant complications afterwards. A computed tomography angiography was available for 11 patients (68.8%) and reassessed with regards to relevant pathologies at the closure device. Average intraluminal area was 40.4 mm2 (12.2-76.3 mm2) at the closure site. All devices but one were correctly deployed. Three patients (27.3%) had a visible thrombus at the closure device resulting in a >60% stenosis, two of which had a puncture site distal of the femoral artery bifurcation. CONCLUSION Decannulation from venoarterial extracorporeal membrane oxygenation using the Manta closure device is a viable approach for rapid haemostasis, but is also associated with a significant risk of thrombotic vessel stenosis. These preliminary findings indicate that puncture in near proximity or distal to the femoral bifurcation might identify patients at risk and further studies are needed.Therapeutic options for coronavirus disease 2019 are desperately needed to respond to the ongoing severe acute respiratory syndrome coronavirus 2 pandemic. Both antiviral drugs and immunomodulators might have their place in the management of coronavirus disease 2019. Unfortunately, no drugs have been approved yet to treat infections with human coronaviruses. As it will take years to develop new therapies for severe acute respiratory syndrome coronavirus 2, the current focus is on the repurposing of drugs that have been approved or are in development for other conditions. Several clinical trials have already been conducted or are currently ongoing to evaluate the efficacy of such drugs. Here, we discuss the potential of these therapies for the treatment of coronavirus disease 2019.AIMS To improve attainment of LDL-cholesterol (LDL-c) targets, an expert group proposed an algorithm for lipid-lowering therapy during hospitalization for acute coronary syndrome and during follow-up. We aimed to assess adherence to this algorithm, and evaluate its impact on LDL-c levels and on attainment of therapeutic LDL-c targets in a population of post-acute coronary syndrome patients. METHODS AND RESULTS Prospective, observational study including patients admitted for acute coronary syndrome between February 2017 and September 2018. Patients admitted without statins or ezetimibe were considered 'naïve'. Baseline LDL-c was admission LDL-c in naïve patients, and for those taking lipid-lowering therapy at admission, baseline LDL-c was back-calculated. In line with the most recent guidelines, the target was a >50% reduction in naïve LDL-c and 50% reduction. Overall, 125/270 (46%) achieved the LDL-c goal. The reduction in LDL-c observed at two months persisted at five months. CONCLUSION Prescription of high-intensity statins, associated with ezetimibe where applicable, achieves LDL-c levels less then 55 mg/dL in 50% of patients at two months, and attains therapeutic goals defined by the European Society of Cardiology in 46% of cases.A regiodivergent organocatalytic enantioselective Michael addition/three-atom ring expansion sequence of electron-withdrawing group activated cyclobutanones with 2-nitrovinylindoles was developed. A series of azepino[1,2-a]indoles were obtained with exclusive regioselectivities and high diastereo- and enantioselectivities (up to >201 dr, 96% ee) with the application of the N1 nucleophilic site of the indole nucleus. Meanwhile, various cyclohepta[b]indoles could be accessed with high enantiopurity (up to 96% ee) through the Michael addition/boron-trifluoride-etherate-promoted indole C3-attack ring expansion process.Antitubercular agent levesquamide is a new polyketide-nonribosomal peptide (PK-NRP) hybrid marine natural product isolated from Streptomyces sp. RKND-216. The structure contains a rare isothiazolinone moiety which has only been reported in collismycin SN. Structure elucidation by NMR spectroscopy was a significant challenge due to a deficiency of protons in this aromatic moiety. Therefore, the genome of Streptomyces sp. link2 RKND-216 was sequenced to identify the levesquamide biosynthetic gene cluster (BGC). Analysis of the BGC provided structural insights and guided stable-isotope labeling experiments, which led to the assignment of the fused pyridine-isothiazolinone moiety. The BGC and the labeling experiments provide further insights into the biosynthetic origin of isothiazolinones. Levesquamide exhibited antimicrobial activity in the microplate alamarBlue assay (MABA) and low oxygen recovery assay (LORA) against Mycobacterium tuberculosis H37Rv with minimum inhibitory concentration (MIC) values of 9.65 and 22.28 μM, respectively. Similar activity was exhibited against rifampicin- and isoniazid-resistant M. tuberculosis strains with MIC values of 9.46 and 9.90 μM, respectively. This result suggests levesquamide has a different mode of action against M. tuberculosis compared to the two first-line antitubercular drugs rifampicin and isoniazid. Furthermore, levesquamide shows no cytotoxicity against the Vero cell line, suggesting it may have a useful therapeutic window.Lactococcus lactis subsp. lactis biovar diacetylactis is widely used in dairy fermentations as it can form the butter aroma compounds acetoin and diacetyl from citrate in milk. Here, we explore the possibility of producing acetoin from the more abundant lactose. Starting from a dairy isolate of L. lactis biovar diacetylactis, we obtained a series of mutants with low lactate dehydrogenase (ldh) activity. One isolate, RD1M5, only had a single insertion mutation in the ldh gene compared to its parental strain as revealed by whole genome resequencing. We tested the ability of RD1M5 to produce acetoin in milk. With aeration, all the lactose could be consumed, and the only product was acetoin. In a simulated cheese fermentation, a 50% increase in acetoin concentration could be achieved. RD1M5 turned out to be an excellent cell factory for acetoin and was able to convert lactose in dairy waste into acetoin with high titer (41 g/L) and high yield (above 90% of the theoretical yield). Summing up, RD1M5 was found to be highly robust and to grow excellently in milk or dairy waste. link3 Being natural in origin opens up for applications within dairies as well as for safe production of food-grade acetoin from low-cost substrates.The physicochemical properties of ionic liquids can be readily controlled. Currently, it is necessary to investigate the properties of different surfactants to elucidate the mixtures used in quaternary-ammonium-salt-type ionic liquids. Herein, the surface adsorption and bulk properties of homogeneous polyoxyethylene (EO)-type nonionic surfactant, quaternary-ammonium-salt-type cationic surfactant, and sulfobetaine-type zwitterionic surfactant are elucidated in quaternary-ammonium-salt-type amphiphilic monomeric ionic liquids and gemini ionic liquids with bis(fluorosulfonyl)imide or bis(trifluoromethanesulfonyl)imide as counterions. The monomeric amphiphilic ionic liquids that adsorbed at the interface were replaced with CxEOy (where x and y represent alkyl and EO chain lengths, respectively) as the concentration of CxEOy increased. On the other hand, in the gemini amphiphilic ionic liquids, the surface tensions of CxEOy were lower than those of the monomeric ionic liquids. Consequently, both gemini amphiphilic ionic liquids and CxEOy adsorbed efficiently at the interface and oriented themselves because of a synergistic effect.