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Studies on mind-body interactions have largely focused on how mental states modulate bodily physiological responses. Increasing evidence suggests that bodily states also modulate mental states. Here we investigated how both may be integrated in the brain at the resolution of a heartbeat, examining how phasic fluctuations of peripheral blood pressure and central attentional resources combine to influence cognition. We examined the effects of cardiac phase on the performance of two simultaneous tasks: a go/no-go letter detection task where targets were concurrently presented on background faces and a short-term memory face discrimination task. Short-term memory for the background face was better when the initial face was encoded during the systole rather than diastole phase and when it was paired with a target rather than a distractor. There was no significant interaction between cardiac phase and letter detection. These data suggest that peripheral blood pressure and central attention independently regulate cognitive performance., (Copyright © 2018. Published by Elsevier B.V.)

Background: Faecal calprotectin (FC) measurement distinguishes patients with inflammatory bowel disease (IBD) from those with irritable bowel syndrome but evidence of its performance in primary care is limited., Aims: To assess the yield of IBD from FC testing in primary care., Methods: Retrospective review of hospital records to assess the outcome following FC testing in primary care. Investigations for all patients undergoing FC testing in a single laboratory for 6 months from 1 October 2013 to 28 February 2014 were reviewed., Results: 410 patients (162 male; median age 42; range 16-91) were included. FC>50 µg/g was considered positive (FC+). 148/410 (36.1%; median age 44 (17-91)) were FC+ (median FC 116.5 µg/g (51-1770)). 122/148 FC-positive patients (82.4%) underwent further investigation. 97 (65.5%) underwent lower gastrointestinal endoscopy (LGIE), of which 7 (7.2%) had IBD. 49/262 (18.7%) FC-negative (FC-) patients (FC ≤50 µg/g) (median age 47 (19-76)) also underwent LGIE, of whom 3 (6.1%) had IBD.IBD was diagnosed in 11/410 (2.7%; 4 ulcerative colitis, 3 Crohn's disease, 4 microscopic colitis). 8/11 were FC+ (range 67-1170) and 3 FC-. At a 50 µg/g threshold, sensitivity for detecting IBD was 72.7%, specificity 64.9%, positive predictive value (PPV) 5.41% and negative predictive value 98.9%. Increasing the threshold to 100 µg/g reduced the sensitivity of the test for detecting IBD to 54.6%., Conclusions: FC testing in primary care has low sensitivity and specificity with poor PPV for diagnosing IBD. Its use needs to be directed to those with a higher pretest probability of disease. Local services and laboratories should advise general practitioners accordingly., Competing Interests: Competing interests: AJL has received fees for lectures or as a member of advisory boards for Vifor Pharma, Takeda UK, Abbvie, Shield Therapeutics, Janssen and Dr Falk. Other authors have no competing interest to declare., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

We describe an observational survey of diagnostic pathways in 104 patients attending four specialist allergy clinics in the United Kingdom following perioperative hypersensitivity reactions to chlorhexidine reactions. The majority were life-threatening. Men undergoing urological or cardiothoracic surgery predominated. Skin prick testing and specific immunoglobulin (sIg)E testing were the most common tests used for diagnosis. Fifty-three per cent of diagnoses were made on the basis of a single positive test. Where multiple tests were performed the sensitivity of intradermal, basophil activation and skin prick testing was 68% (50-86%), 50% (10-90%) and 35% (17-55%), respectively. Seven per cent were negative on screening tests initially, and 12 cases were only positive for a single test despite multiple testing. Intradermal tests appeared most sensitive in this context. Additional sensitization to other substances used perioperatively, particularly neuromuscular blocking agents (NMBA), was found in 28 patients, emphasizing the need to test for possible allergy to all drugs to which the patient was exposed even where chlorhexidine is positive., (© 2017 British Society for Immunology.)

Immunoglobulin (Ig)G4 disease can have apparently 'normal' levels of IgG4 due to antigen excess conditions. IgG4 measurement therefore appears falsely low. UK National External Quality Assurance Scheme (UK NEQAS) data and other reports have suggested that this problem occurred despite pre-existing antigen excess detection steps. To determine the clinical relevance of the problem, we examined the prevalence and characteristics of prozoning in our laboratory and patient cohorts. We establish that the prevalence of raised IgG4 in routine IgG4 analysis is low (< 1%) using one of the two routine methods in use in the United Kingdom. We show that subsequent assay modification appears to have reduced the likelihood of misleading readings. However, the original version of the assay prozoned to low levels (below 0·64 g/l) in 41% of high IgG4 samples in our patients. This may explain the previous reports of low sensitivity of raised IgG4 for IgG4RD, and predictive values should be re-evaluated in this disease using modified prozone-resistant protocols. All laboratories providing IgG4 measurements should verify that their assays are fit for the clinical quality requirement of detection raised IgG4 levels and must verify the upper limit of their reference ranges and freedom from prozoning., (© 2016 British Society for Immunology.)

Background: Salad dressings supplemented with pulse flours are novel products. A three-factor face-centered central composite design (CCD) was used to determine the effect of pulse flour concentration (3.5%, 7%, 10.5% w/w), egg yolk concentration (3%, 5%, 7% w/w) and oil concentration (20%, 35%, 50% w/w) on the rheological and color characteristics of salad dressings supplemented with pulse flours., Results: The consistency coefficient m, plateau modulus G(N)(0), recoverable strain Q(t) and color values were all affected by the concentrations of pulse flours used. Scanning electron microscopy showed that dressings with lower oil and egg yolk contents had a less densely packed network compared with dressings with higher oil and egg yolk contents. Sensory results were most promising for salad dressings supplemented with the whole green lentil, yellow pea with low flour content, and chickpea with high oil content., Conclusion: This study should be useful for designing novel types of salad dressings to meet market requirements as well as helping to increase pulse consumption., (© 2015 Society of Chemical Industry.)

Serum free light chain (sFLC) measurement has gained widespread acceptance and is incorporated into various diagnostic and response criteria. Non-linearity and antigen excess are the main causes of 'variability' in the measurement of sFLC using immunoassay, but the impact of these on measurement has been unclear. We performed a retrospective evaluation using a dilutional strategy to detect these phenomena. A total of 464 samples in 2009 and 373 samples in 2010 were analysed for sFLC. Non-linearity was detected in both high and apparently normal sFLC. Major non-linearity of more than twofold is common in high kappa (20·2%) and lambda (14·1%). It is less common in samples with apparently normal levels - kappa (6·4%) and lambda (9·5%). 9·4% of kappa and 15·5% of lambda showed antigen excess at screening dilutions. 34·4% of the samples had either non-linearity or antigen excess. We conclude that significant measurement variability is common in the measurement of sFLC. There is currently no reliable technique to detect non-linearity phenomena unless a serial dilution strategy is applied to every analysis. We recommend that laboratories routinely reporting sFLC results for clinical services need appropriate strategies for addressing these issues. Clinicians should be aware of these limitations in interpretation of sFLC assay for individual patients. Future guidelines should adopt action thresholds which are grounded firmly in test performance parameters., (© 2012 British Society for Immunology.)

National Institute of Clinical Excellence (NICE) and European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidance for the diagnosis of coeliac disease has been published. However, there is some controversy regarding the advice on the use of stratifying levels of immunoglobulin (IgA) tissue transglutaminase antibody (TG2) test positivity in the absence of test standardization and the vagueness of the indication to test equivocal samples. Using repeat service audit, we demonstrate that a combination of TG2 followed by IgA endomysial antibodies (EMA) is the best strategy for all degrees of mucosal abnormality using our test combination. Reliance upon immunoassay titre is not as effective, and cannot be applied consistently across populations in the absence of assay standardization. Guidelines advocating the use of tests should involve experts in laboratory diagnostics and external quality assurance to ensure that errors of generalization do not occur and that test performance is achievable in routine diagnostic use., (© 2012 British Society for Immunology.)

The updated ESPGHAN guidance on coeliac disease recommends the use of common multiples of the upper limit of normal (ULN) for IgA tissue transglutaminase antibodies (TG2) when deciding which diagnostic pathway to follow. The current lack of standardisation between assays makes it difficult to harmonise results between centres as different performance characteristics are observed with each assay. This variability is shown in data from external quality assessment distributions. As a result, the updated guidance is too generalised for use with all the commercial TG2 kits and is therefore not translatable for use in all centres.

Background: To increase pulse consumption, pita bread was fortified with pulse flours milled from green lentils, navy beans and pinto beans, which were ground to produce fine and coarse flours. Pita breads were prepared using composite flours containing pulse flours (25, 50, 75%) and wheat flour or 100% pulse flours and adjusting the amount of water required for mixing based on farinograph water absorption. Pita bread quality was evaluated according to diameter, pocket height, specific loaf volume, texture and crust colour., Results: Blends made from pulse flours with coarse particle size showed higher rates of water absorption. All composite flours and 100% pulse flours produced pitas with pockets, confirming their suitability for this product. Crust colour of pitas was affected less by navy bean flour than by lentil flour. Pita breads made with pinto bean flour were superior in texture. Overall, navy and pinto bean flours appeared more suitable for pita bread. Flours with coarse particle sizes produced pitas with better colour and texture. Sensory parameters of pitas containing 25% coarse pinto or navy bean flour were as good as or better than those from the wheat control., Conclusion: Acceptable pita breads can be made using pulse flours, although the substitution level is limited to 25%., (Copyright © 2012 Society of Chemical Industry.)

Volatiles of roasted chicken breast muscle and byproducts, such as backbones, breastbones, spent bones, and skin, were investigated. Total volatile concentrations ranged from 2030 ppb in the roasted backbones to 4049 ppb in the roasted skin. The major classes of volatile compounds detected in roasted samples were aldehydes (648-1532 ppb) and alcohols (336-1006 ppb). Nitrogen- and/or sulfur-containing compounds were also detected in appreciable quantities (161-706 ppb) in all samples. For all samples, hexanal and 2-methyl-2-buten-1-ol were dominant among the aldehydes and alcohols, respectively. Among the nitrogen- and sulfur-containing compounds, Maillard reaction products, such as tetrahydropyridazines, piperidines, and thiazoles, were the major contributors to the total volatile content in all samples. The composition of volatiles observed in roasted byproducts was markedly different from that of the roasted breast muscle. Therefore, the blending of the byproducts in appropriate proportions or blending of volatile flavor extracts from different byproducts may be necessary to obtain an aroma that mimics roasted chicken aroma.

Gastric emptying half-time and mouth to caecum transit time of a solid meal were measured in eight normal volunteers, once during a period of psychological stress and again during a period of relative calm. No consistent or significant effect on gastric emptying was observed, but mouth to caecum transit times were faster in all subjects and this difference was highly significant (p<0.01).