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Local wastewater treatment authorities levy surcharges from their non-residential customers that are based, in part, on the concentration of various pollutants in the customer’s wastewater. Blood has long been recognized as the most potent contributor to pollutant loads in chicken processing plant wastewater. Quantification of the impact of blood on wastewater characteristics and sewage surcharges is hindered by lack of information on specific characteristics of chicken blood, and by the highly variable methods used by local authorities for calculating surcharges. In this study, the most commonly used wastewater characteristics are determined for whole chicken blood as well as its individual components. The characteristics measured include biochemical oxygen demand, chemical oxygen demand, total suspended solids, fats oil and grease, total Kjeldahl nitrogen, ammonia, and total phosphorus. Sewage surcharge calculation methods were collected from 71 local wastewater authorities. The results show all components of the blood to be extremely highstrength pollutants. The impact of blood on sewage surcharges is shown to be highly variable depending on the rates applied by the local authority. [ABSTRACT FROM AUTHOR]

The throughput of automatic milking systems (AMS) is likely affected by differential traffic behavior and subsequent effects on the milking frequency and milk production of cows. This study investigated the effect of increasing stocking rate and partial mixed ration (PMR) on the milk production, dry matter intake (DMI), feed conversion efficiency (FCE) and use of AMS by two genotypes of Holstein-Friesian cows in mid-lactation. The study lasted 8 weeks and consisted in a factorial arrangement of two genotypes of dairy cattle, United States Holstein (USH) or New Zealand Friesian (NZF), and two pasture-based feeding treatments, a low stocking rate system (2 cows/ha) fed temperate pasture and concentrate, or a high stocking rate system (HSR; 3 cows/ha) fed same pasture and concentrate plus PMR. A total of 28 cows, 14 USH and 14 NZF, were used for comparisons, with 12 cows, six USH and six NZF, also used for tracking of animal movements. Data were analyzed by repeated measure mixed models for a completely randomized design. No differences (P >0.05) in pre- or post-grazing herbage mass, DMI and FCE were detected in response to increases in stocking rate and PMR feeding in HSR. However, there was a significant (P <0.05) grazing treatment x genotype x week interaction on milk production, explained by differential responses of genotypes to changes in herbage mass over time (P <0.001). A reduction (P <0.01) in hours spent on pasture was detected in response to PMR supplementation in HSR; this reduction was greater (P = 0.01) for USH than NZF cows (6v . 2 h, respectively). Regardless of the grazing treatment, USH cows had greater (P = 0.02) milking frequency (2.51v . 2.26 ± 0.08 milkings/day) and greater (P <0.01) milk yield (27.3v . 16.0 ± 1.2 kg/day), energy-corrected milk (24.8v . 16.5 ± 1.0 kg/day), DMI (22.1v . 16.6 ± 0.8 kg/day) and FCE (1.25v . 1.01 ± 0.06 kg/kg) than NZF cows. There was also a different distribution of milkings/h between genotypes (P <0.001), with patterns of milkings/h shifting (P <0.001) as a consequence of PMR feeding in HSR. Results confirmed the improved FCE of grazing dairy cows with greater milk production and suggested the potential use of PMR feeding as a tactical decision to managing HSR and milkings/day in AMS farms. [ABSTRACT FROM AUTHOR]

Background: Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment., Objective: To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system., Methods: 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects., Results: Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04-1.74; p  = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity., Conclusion: A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Fuentes-López, Galaz-Mella, Ayala, De la Fuente, Luna-Monsalve, Nieman and Marcotti.)

Background/Objectives: Low-uptake of hearing aids among older adults has long dogged the hearing care system in the U.S. and other countries. The introduction of over-the-counter hearing aids is set to disrupt the predominantly high-cost, specialty clinic-based delivery model of hearing care with the hope of increasing accessibility and affordability of hearing care. However, the current model of hearing care delivery may not be reaching everyone with hearing loss who have yet to use hearing aids. In this study, we examine the group of people who do not use hearing aids and describe their characteristics and health care utilization patterns. We also consider what other healthcare pathways may be utilized to increase access to hearing treatment. Design: Cross-sectional, the 2017 Medicare Current Beneficiary Survey. Setting: Non-institutionalized adults enrolled in Medicare, the U.S. public health insurance program for older adults (65 years and older) and those with qualifying medical conditions and disabilities. Participants: A nationally representative sample of 7,361 Medicare beneficiaries with self-reported trouble hearing and/or hearing aid use. Measurements: Survey-weighted proportions described the population characteristics and health care utilization of those with hearing loss by hearing aid use, and the characteristics of those with untreated hearing loss by health care service type utilized. Results: Women, racial/ethnic minorities, and low-income Medicare beneficiaries with self-reported hearing trouble were less likely to report using hearing aids than their peers. Among those who do not use hearing aids, the most commonly used health care services were obtaining prescription drugs (64%) and seeing a medical provider (50%). Only 20% did not access either service in the past year. These individuals were more likely to be young and to have higher educational attainment and income. Conclusion: Alternative models of care delivered through pharmacies and general medical practices may facilitate access to currently underserved populations as they are particularly high touch-points for Medicare beneficiaries with untreated hearing trouble. As care needs will vary across a spectrum of hearing loss, alternative models of hearing care should look to complement not substitute for existing access pathways to hearing care., Competing Interests: AW reports receiving a speaker honorarium from the American Speech-Language-Hearing Association and consulting honorarium from BioMedical Insights. CN serves on the non-profit board of directors for Access HEARS and the Hearing Loss Association of America. NR is a scientific advisory board member of Shoebox, Inc and Good Machine Studio but does not receive financial compensation. FL reports being a consultant to Frequency Therapeutics, receiving speaker honoraria from Caption Call, and being the director of a public health research center funded in part by a philanthropic gift from Cochlear Ltd to the Johns Hopkins Bloomberg School of Public Health. CM is on the scientific advisory board for Good Machine Inc but does not receive financial compensation. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Willink, Assi, Nieman, McMahon, Lin and Reed.)

Study Design: Mixed-methods with cross-sectional survey and interviews., Introduction: Hand therapy is a specialty area of practice for occupational (OT) and physical therapists (PT), requiring experience and certification beyond entry-level generalist education. Perspectives and inclusion of content related to hand therapy differs among entry-level OT programs and faculty., Purpose: Perception and inclusion of hand therapy content in OT programs was examined in this mixed-method study to better understand the trends in academia regarding integration of content related to hand therapy., Methods: A survey was developed, peer-reviewed, and emailed to all accredited entry-level masters and doctorate OT programs via Survey Monkey (SurveyMonkey, Inc., San Mateo, CA). Respondents were also given the opportunity to participate in an interview (n = 2; 5%)., Results: A total of 43 participants responded to the survey, representing a 23% response rate. Quantitative results revealed that 65% of OT programs report including 41+ hours of hand therapy content and 54% report integration of hand therapy content in 2-3 courses. Qualitative trends included the perception of hand content as necessary and beneficial to other areas of practice as well as the perspective that it is too specialized and advanced for generalist curriculum., Discussion: Educators have a largely positive opinion regarding inclusion and generalizability of hand therapy content within OT curricula with varied content inclusion. While hand therapy related content is valued, increased emphasis on occupation during didactic instruction is recommended for more holistic understanding and occupation-based practice., Conclusion: While trends of hand therapy content inclusion were revealed in the survey, perceptions of hand therapy within the broad spectrum of OT curricula were diverse, indicating a possible lack of unity within the profession regarding this specialty area of practice., (Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

The M and S forms of Anopheles gambiae have been the subject of intense study, but are morphologically indistinguishable and can only be identified using molecular techniques. PCR-based assays to distinguish the two forms have been designed and applied widely. However, the application of these assays towards identifying hybrids between the two forms, and backcrossed hybrids in particular, has been problematic as the currently available diagnostic assays are based on single locus and/or are located within a multicopy gene. Here, we present an alternative genotyping method for detecting hybridization and introgression between M and S molecular forms based on a multilocus panel of single-nucleotide polymorphisms (SNPs) fixed between the M and S forms. The panel of SNPs employed is located in so-called islands of divergence leading us to describe this method as the 'Divergence Island SNP' (DIS) assay. We show this multilocus SNP genotyping approach can robustly and accurately detect F1 hybrids as well as backcrossed individuals., (© 2013 John Wiley & Sons Ltd.)

Culex pipiens sensu lato populations represent significant nuisance pests and vectors of West Nile virus in California. Despite multiple years of investigation, identifying, controlling and understanding the behaviors and associated "biologies" of the complex members still remain a challenge. Population structure cluster analysis using microsatellite markers revealed extensive population structuring, particularly in the central parts of the State, over and above what can be explained by the presence of Cx. pipiens, Cx. quinquefasciatus and their hybrids. Ace 2 gene sequencing provided evidence for the presence of Cx. p. molestus in multiple locations both above and below ground in California. Lack of congruence of male genitalia morphology (dorsal and ventral arms/dorsal arm of phalosome) and polymerase chain reaction diagnostic assay identifications coupled with considerable heterozygosity of pyrethroid resistance in time and space all suggest complex population structuring not adequately explained using current concepts.

The purpose of this study was to test the hypothesis that with improved technology, the presence of abscess in a postoperative fluid collection may be prospectively made. This is an Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective review of computed tomography (CT)-guided intra-abdominal fluid collection drainages. The diagnostic CT scans of 95 consecutive patients performed on 16- and 64-multidetector CT (MDCT) were reviewed by four readers with varying abdominal imaging expertise. Readers were asked to determine fluid content, to document whether infection was present, and to rate reader confidence for infection. A fifth radiologist reviewed the collections for imaging characteristics. The gold standard for presence of infection was microbiological Gram stain and culture. The logistic regression model showed that both fluid collections containing gas or high attenuation fluid (average CT density 20 or greater Hounsfield units) are significant predictors of infection (P = 0.001). The average sensitivity over the four readers for determining presence of infection was 83.4 per cent and specificity was 39.3 per cent. Even in the era of MDCT, the ability to predict whether or not a fluid collection is infected or not, based on imaging findings alone, is limited. Presence of gas is a strong indicator of infection, but no imaging finding is characteristic of a sterile fluid collection.

The diaphragmatic hernia is a well recognized and common complication of both the penetrating and blunt thoracoabdominal trauma.The clinical presentation is eather in the acute phase, or later, when it features the symptoms of obstructive complications. The aim of the study is to report a case of delayed presentation of a blast wound with diaphragmatic hernia, complicated by herniation and perforation of the left colonic angle in the pleural cavity. The report highlights the multiple complications following the initial event and the staged management of the case.

Objective: The purpose of this study was to determine if the food exchange system allows subjects' nutrient intake to remain at recommended levels during a weight-loss program., Design: Subjects in an intervention were prescribed an energy-restriction diet and exercise program lasting 32 weeks, and nutrient intake was measured prestudy and after 12, 16, and 32 weeks., Subjects/setting: Healthy but overweight and obese premenopausal women (n = 219) were recruited at 6 university sites into community-based weight loss programs. One hundred fifteen women completed all aspects of the study., Intervention: Energy intake was set at 0.8 x resting metabolic rate (RMR) for weeks 1 through 12, 1.0 x RMR for weeks 13 through 20, and 1.2 x RMR for weeks 21 through 32. Energy intake was based on food exchange tables, with the number of food exchanges adjusted to encourage a distribution of 55% carbohydrate, 30% fat, and 15% protein. Subjects increased their daily walking distance to 3.2 km above prestudy levels., Main Outcome Measures: Nutrient intake was measured from four 3-day food records., Statistical Analyses Performed: Repeated measures analysis of variance, with specific time point changes assessed from paired t tests adjusted for multiple comparisons., Results: Body mass decreased by a mean +/- SD of 6.7 +/- 3.2 kg at week 12 and 7.8 +/- 6.2 kg by week 32. Walking distance increased by an average of 17.2 +/- 10.0 km/week during the first 12 weeks, and 12.4 +/- 12.4 km/week during the last 20 weeks. Despite a 23% to 36% reduction in energy intake during the study, intake of most nutrients was maintained. Intake of vitamin E, calcium, iron, and zinc decreased significantly from prestudy levels during the first 16 weeks of the intervention, but not at week 32., Applications/conclusions: Intake of most nutrients can remain at recommended levels when overweight and obese women follow the American Diabetes Association/American Dietetic Association food exchange system during a community-based weight-loss program.

Fungal homoserine dehydrogenase (HSD) is required for the biosynthesis of threonine, isoleucine and methionine from aspartic acid, and is a target for antifungal agents. HSD from the yeast Saccharomyces cerevisiae was overproduced in Escherichia coli and 25 mg of soluble dimeric enzyme was purified per liter of cell culture in two steps. HSD efficiently reduces aspartate semialdehyde to homoserine (Hse) using either NADH or NADPH with kcat/Km in the order of 10(6-7) M(-1) x s(-1) at pH 7.5. The rate constant of the reverse direction (Hse oxidation) was also significant at pH 9.0 (kcat/Km approximately 10(4-5) M(-1) x s(-1)) but was minimal at pH 7.5. Chemical modification of HSD with diethyl pyrocarbonate (DEPC) resulted in a loss of activity that could be obviated by the presence of substrates. UV difference spectra revealed an increase in absorbance at 240 nm for DEPC-modified HSD consistent with the modification of two histidines (His) per subunit. Amino acid sequence alignment of HSD illustrated the conservation of two His residues among HSDs. These residues, His79 and His309, were substituted to alanine (Ala) using site directed mutagenesis. HSD H79A had similar steady state kinetics to wild type, while kcat/Km for HSD H309A decreased by almost two orders of magnitude. The recent determination of the X-ray structure of HSD revealed that His309 is located at the dimer interface [B. DeLaBarre, P.R. Thompson, G.D. Wright, A.M. Berghuis, Nat. Struct. Biol. 7 (2000) 238-244]. The His309Ala mutant enzyme was found in very high molecular weight complexes rather than the expected dimer by analytical gel filtration chromatography analysis. Thus the invariant His309 plays a structural rather than catalytic role in these enzymes.

The purpose of this study was to measure the influence of diet, exercise, or both on body composition and cardiorespiratory fitness in obese women. Ninety-one obese subjects were randomized into one of four groups: diet (D) (4.19-5.44 MJ or 1,200-1,300 kcal/day), exercise (E) (five 45-min sessions at 78.5+/-0.5% maximum heart rate), exercise and diet (ED), and controls (C). Maximal aerobic power and body composition were measured in all subjects before and after a 12-week diet intervention period. Subjects in D and ED lost 7.8+/-0.7 and 8.1+/-0.6 kg body mass, with no significant change for E relative to C. Losses of percent body fat and fat mass were significantly greater in D and ED but not in E relative to C. The change in VO2max was greater in ED and E but not D when compared to C. Results indicate that moderate aerobic exercise training during a 12-week period has no discernible effects on body composition but does improve cardiorespiratory fitness in dieting obese women.

1. The effects of suramin, a trypanocidal drug which has been reported to be a P2-purinoceptor antagonist on smooth muscle, were investigated in human platelets, where adenosine 5'-diphosphate (ADP) induces aggregation by acting on a subtype of purinoceptors which has been called P2T. 2. Suramin (100 microM) had no inhibitory effect on ADP-induced platelet aggregation in plasma, even after 40 min incubation in the presence of bacitracin, a peptidase inhibitor, and did not affect the ability of adenosine 5'-triphosphate (ATP) (40 microM) to inhibit competitively ADP-induced aggregation. This lack of effect of suramin on platelets in plasma is probably due to its extensive binding to plasma proteins. 3. In washed platelets, suramin (50-400 microM) acted as an apparently competitive antagonist, causing parallel shifts to the right of the log concentration-response curve to ADP. No depression of the maximal response to ADP was observed at concentrations of suramin (50-150 microM) for which full log concentration-response curves to ADP could be obtained, but the slope of the Schild plot was around 2, indicating that this antagonism was not simply competitive. The apparent pA2 value for suramin, taken from this Schild plot, was 4.6. 4. Suramin (200-400 microM) also noncompetitively inhibited aggregation induced by U46619 (a thromboxane receptor agonist) or by 5-hydroxytryptamine in the presence of adrenaline (100 microM), and caused a depression of the maximal response to these agonists. This nonspecific effect of suramin may explain the high Schild plot slope obtained against ADP.5. These results provide evidence that the ADP receptor on human platelets is indeed similar to the P2-purinoceptors responding to adenine nucleotides on smooth muscle and other tissues, and show that suramin cannot distinguish between the proposed subtypes of the P2-purinoceptors.

We compared the general operating features and nutrient databases of six microcomputer dietary analysis systems. A 3-day food record with 73 food items was entered into each program; nutrient averages were compared with the US Department of Agriculture Nutrient Data Base for Standard Reference (USDA NDB), full version, release 9, for microcomputers. The six programs were found to vary widely in cost, number of foods and nutrients in the database, use of non-USDA data and imputation of data for missing values, number of print/export options, time to analyze the 3-day food record, and overall ease of use. Although all of the microcomputer dietary analysis systems were within 7% of the USDA NDB for energy, protein, total fat, and total carbohydrates, the proportion of other nutrients varying more than 15% from the USDA NDB varied considerably between programs. Variance among programs for 3-day food record nutrient values occurred because of differences in the number of food items included in the database (leading to varying degrees of substitution), the recency of the nutrient data (whether or not the most recent USDA releases had been incorporated), and the number of missing values (the degree to which non-USDA sources or estimated calculations were used to fill in the blanks from the USDA standard). Our results demonstrate that it is important for each dietitian to carefully choose a microcomputer dietary analysis system that is suitable to specific and predetermined needs.

A colourimetric enzyme-linked sandwich assay has been developed to investigate the binding of human platelets to fibrinogen. The presence of platelets bound to fibrinogen-coated plastic can easily be detected and quantitated. Platelets treated with chymotrypsin to expose the fibrinogen receptor, are fixed with paraformaldehyde, and stored frozen. The detection sandwich consists of a mouse monoclonal antibody directed against the human platelet CD9 antigen, and a rabbit anti-mouse immunoglobulin conjugated to the enzyme alkaline phosphatase. The cleavage of the phosphatase substrate p-nitrophenyl phosphate can be monitored colourimetrically. The data presented provide evidence that this method is capable of detecting platelet-fibrinogen binding in a physiologically relevant manner. The binding is inhibited by EDTA or excess fibrinogen. The fibrinogen alpha and gamma chain peptides, RGDS and LGGAKQAGDV, and the snake venom echistatin are also inhibitory with IC50 values of 135 microM, 1.8 mM and 100 nM respectively.

The results of this investigation show that when direct comparisons are made between the USDA NDB and microcomputer data bases (avoiding the confounding factors of coding judgment and the differences between older and newer USDA nutrient data), differences still can exist. N3 and FP chose to seek out alternate data when the USDA NDB provided no data for a certain nutrient. FP chose to use a large number of additional sources to supplement USDA Handbook No. 8. Although the USDA NDB was very complete for all nutrients listed except for vitamin E/total and copper, gaps are likely to continue to exist because the USDA NDB is and will be in continual revision as an increasing number of nutrients are reported for an ever-growing food supply. Therefore, in accordance with established local needs, the dietitian has the responsibility both for knowing the sources used in the microcomputer nutrient data base and for making sure that reported results are reasonable.