Long-term outcomes of patients receiving percutaneous endoscopic gastrostomy tubes

OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) tube placement is the preferred method for long-term enteral feeding of patients who are unable to take food by mouth. Despite the widespread acceptance of the procedure, no large-scale study of the long-term outcomes of patients receiving PEG tubes has been reported. The objective of this study was to determine the survival of patients in whom PEG tubes are placed. DESIGN: Retrospective cohort study using data obtained from two computerized databases. SETTING: Department of Veterans Affairs hospitals. PATIENTS: Seven thousand three hundred sixty-nine patients who received a PEG tube in fiscal years 1990 through 1992. RESULTS: For the 7,369 patients, the mean age was 68.1 years and 98.6% were men. PEG tubes were most commonly places in patients with cerebrovascular disease (18.9%), other organic neurologic disease (28.6%), or head and neck cancer (15.7%). Although the complication rate of the procedure itself was low (4%), because of the severity of their underlying disease, 1,732 patients (23.5%) died during the hospitalization in which the PEG tube was placed. The median survival of the full cohort was 7.5 months. CONCLUSIONS: This study documents the widespread placement of PEG tubes in severely ill patients, half of whom are in the terminal phase of their illness. Further study is needed to determine whether these patients benefit from PEG tube placement in terms of their quality of life and survival.     

Microwave‐Osmotic/Microwave‐Vacuum Drying of Whole Cranberries: Comparison with Other Methods

A novel drying method for frozen‐thawed whole cranberries was developed by combining microwave osmotic dehydration under continuous flow medium spray (MWODS) conditions with microwave vacuum finish‐drying. A central composite rotatable design was used to vary temperature (33 to 67 °C), osmotic solution concentration (33 to 67 °B), contact time (5 to 55 min), and flow rate (2.1 to 4.1 L/min) in order to the determine the effects of MWODS input parameters on quality of the dried berry. Quality indices monitored included colorimetric and textural data in addition to anthocyanin retention and cellular structure. Overall it was found that the MWODS‐MWV process was able to produce dried cranberries with quality comparable to freeze dried samples in much shorter time. Additionally, cranberries dried via the novel process exhibited much higher quality than those dried via either vacuum or convective air drying in terms of color, anthocyanin content, and cellular structure.     

A note on measuring normal science

Scientometrics - Petrovich provides an insightful study on analytic philosophy (AP) with the intention of determining whether this sub-field of philosophy has been operating within what Kuhn calls...     

Correction to: Citation concept analysis (CCA): a new form of citation analysis revealing the usefulness of concepts for other researchers illustrated by exemplary case studies including classic books by Thomas S. Kuhn and Karl R. Popper

Scientometrics - In Bornmann, Wray, and Haunschild (2020, p. 1059), the term “like” was inadvertently included in the list of uncertainty terms.     

Elemental content of commercial ‘ready to-feed’ poultry and fish based infant foods in the UK

The study reported herein was conducted in order to establish the concentration of 20 essential and non-essential elements in a representative range of commercial infant foods in the UK targeted for infants aged between 6–12 months. The primary objective of this study was to examine the nutritive values and safety of such complementary infant foods on the UK market in relation to dietary and safety guidelines. Quantitative analyses were conducted on eight different products representing four popular brands (poultry and fish based) of ready to-feed infant foods currently on sale in the UK. Six essential elements, namely: calcium, iron, magnesium, potassium, sodium and zinc were determined by ICP-OES. The concentrations of six essential trace elements (selenium, molybdenum, cobalt, copper, chromium, manganese) and eight non-essential, potentially toxic, elements (arsenic, barium, nickel, cadmium, antimony, lead, mercury, aluminium) were determined by ICP-MS due to the higher sensitivity required. The total daily intakes of essential and trace elements from the consumption of such products were then estimated, based on the results of this study, and were referenced to the Recommended Nutrient Intake (RNI) values and safety guidelines for 6–9 months old children. Based on these comparisons the concentration of essential, except for potassium, and trace elements were found to be inadequate in meeting the RNI. In terms of the risk of exposure to toxicity, the concentration of toxic elements in ready to feed products analysed in this study, were not considered to be of concern. These results suggest that commercial complementary infant foods on the UK market may not contain minimum levels of minerals required for labelling declaration of micronutrient content (Commission Directive 2006/125/EC). This provides opportunities and scope for product optimisation to improve their nutritive value.     

The effect of inhibition of myosin light chain kinase by Wortmannin on intracellular [Ca2+], electrical activity and force in phasic smooth muscle

To investigate the role of myosin light chain kinase (MLCK) in phasic contractions of intact smooth muscle, we have applied Wortmannin, an MLCK inhibitor, to strips of guinea-pig ureter. Simultaneous measurements of electrical activity, intracellular [Ca2+] ([Ca2+]i) and phasic force showed that Wortmannin (1-4 microM) abolishes force with little or no change in [Ca2+]i and electrical activity. High-K+-induced force production was also abolished by Wortmannin. The effects of Wortmannin were dose dependent - at lower concentrations (100 nM) Wortmannin reduced phasic contractility by 40-50%. It also significantly increased the delay between the Ca2+ peak and force production. These data show that, in phasic smooth muscle, inhibition of MLCK causes contraction to fail, despite normal electrical activity and Ca2+ transients. Our results also indicate that Wortmannin has no secondary effects and that other means of producing force, independent of myosin phosphorylation, are negligible in this tissue. The increased lag between the rise of Ca2+ and force production when MLCK is inhibited was surprising and suggests that post-phosphorylation steps may play a larger role in the delay than was previously considered.     

Mice as carriers of Salmonella enteritidis on persistently infected poultry units

Evidence of the possible role of wild mice in the epidemiology of Salmonella enteritidis infection on broiler breeder and layer breeder units was obtained by a bacteriological examination of local mice. Persistent S enteritidis infection in birds on these units had been a problem and a high proportion of the mice were found to carry salmonella. S enteritidis was isolated from the liver and the intestine of most of the mice, indicating a systemic infection. Three-week-old chicks were infected by contact with droppings from mice which had been infected experimentally with S enteritidis two and five months previously. Wild mice infected artificially or naturally excreted S enteritidis intermittently, with up to 10(4) organisms in some individual droppings. A naturally infected mouse which died after intermittently excreting small numbers of S enteritidis in its droppings for 19 weeks had 10(4) organisms/g of liver and 10(3)/g of macerated intestine and contents. S enteritidis was also found in fetal tissue in a naturally infected mouse suggesting the possibility that the organism might be transmitted vertically.