The importance of decolonizing International Human Rights Law: The prior consultation in Colombia case

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Jimena Sierra-Camargo

2017-08-01

Full Text Available Prior consultation has been recognized as one of the most emancipatory instruments within the framework of international human rights law, which currently allows indigenous peoples and ethnic communities defend their territories. Nevertheless, in some cases the prior consultation has had an ambivalent use by other agents who have used this instrument for different purposes than those stated in ILO Convention 169 and that have caused serious damages on these groups. In this sense, the main purpose of this article is to question the ambivalent use of prior consultation in Colombia from the perspective of ‘decolonial thinking’, and in particular, from the notion of ‘coloniality’. I argue that the problem of the restrictions and limitations of the prior consultation described in this article is due to the colonial bias of this instrument, which in turn is embedded in a liberal rationality.

International variations in primary care physician consultation time: a systematic review of 67 countries.

Science.gov (United States)

Irving, Greg; Neves, Ana Luisa; Dambha-Miller, Hajira; Oishi, Ai; Tagashira, Hiroko; Verho, Anistasiya; Holden, John

2017-11-08

To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes. One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction. There are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Quality Management in Project Management Consulting. A Case Study in an International Consulting Company

OpenAIRE

Ceptureanu, Eduard-Gabriel; Ceptureanu, Sebastian-Ion; Luchian, Cristian-Eugen; Luchian, Iuliana

2017-01-01

The present paper addresses quality management from the specific perspective of project management consulting service providers, in the framework of large infrastructure projects. Because of their supposed superiority in knowledge and experience, project management consultants have an ultimate responsibility for the proper implementing of the project. Therefore, quality management in consulting organizations should focus on critical success factors. As there is no consensus yet regarding the ...

Lactation support and breastfeeding duration in jaundiced infants: a randomized controlled trial.

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Catherine M Pound

Full Text Available Neonatal jaundice is the most common problem in full-term infants during the immediate post-natal period. We examined the effect of a lactation support intervention on breastfeeding duration in hospitalized jaundiced infants.We conducted a randomized controlled trial with a qualitative component involving mothers of hospitalized jaundiced breastfed infants <4 weeks of age. Mothers receiving the intervention met with an International Board-Certified Lactation Consultant in hospital and 1-3 times post discharge. Both groups received the standard care for jaundice. The primary outcome was exclusive breastfeeding at 3 months. To the exception of research assistants enrolling participants and completing qualitative interviews, all research staff, investigators and statisticians were blinded to group assignment. Qualitative interviews elicited feedback on breastfeeding experiences for both groups.99 participants were recruited, and 86 analyzed for primary outcome. There was no difference in exclusive breastfeeding at 3 months between groups (RR 0.84, 95% CI 0.56-1.24, p = 0.40 or in the secondary outcomes. 31 participants were included in the qualitative analysis. Participants in the intervention group described an increase in comfort and confidence levels with breastfeeding. Participants in the control group reported limited lactation support.Our hospital-based lactation support program did not result in a higher proportion of mothers exclusively breastfeeding at 3 months compared to current hospital standard care. Qualitative feedback from the intervention group suggests that mothers' confidence was increased, which is linked to breastfeeding duration. The decision to breastfeed is multifactorial and hospital-based lactation support may be only a small piece of the puzzle in hospitalized jaundiced infants. Further studies may be needed to fully elucidate the impact of an in-hospital lactation support program on successful breastfeeding for these

European Consulting Survey 2012 : The Future of European Management Consulting Firms' Business Models

OpenAIRE

Kreutzer, Markus; Menz, Markus

2012-01-01

This study report provides European management consulting firms' assessment of trends and currently prevailing business models in the industry. It depicts the different threats and opportunities that consulting firms with different business models, consulting foci, sizes, leverage ratios, international orientations, and geographical footprints face; it also reveals these firms' adaptation strategies. Based on an analysis of a survey of 311 consulting firms from 26 European countries, the repo...

Reliability of Lactation Assessment Tools Applied to Overweight and Obese Women.

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Chapman, Donna J; Doughty, Katherine; Mullin, Elizabeth M; Pérez-Escamilla, Rafael

2016-05-01

The interrater reliability of lactation assessment tools has not been evaluated in overweight/obese women. This study aimed to compare the interrater reliability of 4 lactation assessment tools in this population. A convenience sample of 45 women (body mass index > 27.0) was videotaped while breastfeeding (twice daily on days 2, 4, and 7 postpartum). Three International Board Certified Lactation Consultants independently rated each videotaped session using 4 tools (Infant Breastfeeding Assessment Tool [IBFAT], modified LATCH [mLATCH], modified Via Christi [mVC], and Riordan's Tool [RT]). For each day and tool, we evaluated interrater reliability with 1-way repeated-measures analyses of variance, intraclass correlation coefficients (ICCs), and percentage absolute agreement between raters. Analyses of variance showed significant differences between raters' scores on day 2 (all scales) and day 7 (RT). Intraclass correlation coefficient values reflected good (mLATCH) to excellent reliability (IBFAT, mVC, and RT) on days 2 and 7. All day 4 ICCs reflected good reliability. The ICC for mLATCH was significantly lower than all others on day 2 and was significantly lower than IBFAT (day 7). Percentage absolute interrater agreement for scale components ranged from 31% (day 2: observable swallowing, RT) to 92% (day 7: IBFAT, fixing; and mVC, latch time). Swallowing scores on all scales had the lowest levels of interrater agreement (31%-64%). We demonstrated differences in the interrater reliability of 4 lactation assessment tools when applied to overweight/obese women, with the lowest values observed on day 4. Swallowing assessment was particularly unreliable. Researchers and clinicians using these scales should be aware of the differences in their psychometric behavior. © The Author(s) 2015.

Report of the International Consultative Group on Nuclear Energy

International Nuclear Information System (INIS)

Anon.

1980-01-01

The International Consultative Groups on Nuclear Energy adopted as its working premise the proposition that nuclear power will play a significant part in meeting future energy needs in an increasing number of countries. The Group's concern has been to examine the international political and economic conditions under which civil nuclear activities may be conducted safely, rationally, and in a manner generally acceptable to the world community. The views are presented in sections entitled: Energy and Nuclear Power; Establishing Nuclear Options; Nuclear Safety and the Public Interest; Nuclear Trade and Nuclear Proliferation; Conditions for the Future in which five conditions are summarized. The Group believes that if nuclear power is to be available to meet an increasing fraction of the world's future energy needs, nuclear power must, despite the difficulty of the sort-term climate, be systematically developed, without interruption or undue delay; earn and retain public acceptance; present technologies for using uranium more efficiently and be developed and tested as soon as possible, with both the coming decades and the 21st century in mind; be less feared; and convince countries depending on nuclear technology, services, or materials of continued international access to them under safeguards, on acceptable terms

Global Consultation Processes: Lessons Learned from Refugee Teacher Consultation Research in Malaysia

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O'Neal, Colleen R.; Gosnell, Nicole M.; Ng, Wai Sheng; Clement, Jennifer; Ong, Edward

2018-01-01

The process of global consultation has received little attention despite its potential for promoting international mutual understanding with marginalized communities. This article details theory, entry, implementation, and evaluation processes for global consultation research, including lessons learned from our refugee teacher intervention. The…

Management Consultancy As Practice: A Study Of The Duality Of The Management Consultants' Role

OpenAIRE

Hartley, Jeanette

2017-01-01

The central question addressed in this research is: “How do practicing management consultants cope with the duality of their role?” Management consultants are often responsible for internal business leadership roles as well as developing business, people and knowledge alongside client delivery (Richter et al., 2008). The research sought to understand the nature of the potentially conflicting demands of their client-facing and consultancy-facing roles on management consultants, how conflicts a...

1H Magnetic resonance spectroscopy of the internal capsule in human brain: a feasibility study to detect lactate following contralateral motor activity

International Nuclear Information System (INIS)

Mostert, Jop P.; Keyser, Jacques De; Sijens, Paul E.; Oudkerk, Matthijs

2005-01-01

Animal experiments suggest that astrocytic glycogen may act as an energy source for axons especially during heightened activity. In this model astrocytic glycogen breaks down to lactate that is shuttled to axons where it is metabolized oxidatively to generate ATP. The aim of this study was to investigate whether 1 H-magnetic resonance spectroscopy could be used to detect a rise in lactate levels in human white matter during enhanced axonal activation. Six healthy volunteers (four women and two men; age range 21-38 years) participated in the study. We were unable to detect any significant MR spectral change, i.e. neither in the peak areas of inositol, choline, creatine, glutamate and N-acetylaspartate nor in the lactate level, in the contralateral posterior limb of the internal capsule during intense motor activation of the hand (four successive episodes of squeezing a soft ball for 7 min followed by 7 min rest). Possible explanations are that the technique is not sensitive enough to detect a small rise in lactate, or lactate turnover is too fast to be detected, or that another monocarboxylate different from lactate may be involved in axonal energy metabolism. (orig.)

International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China

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Chengquan Zhao

2015-01-01

Full Text Available Background: Telepathology is increasingly being employed to support diagnostic consultation services. Prior publications have addressed technology aspects for telepathology, whereas this paper will address the clinical telepathology experience of KingMed Diagnostics, the largest independent pathology medical laboratory in China. Beginning in 2012 the University of Pittsburgh Medical Center (UPMC and KingMed Diagnostics partnered to establish an international telepathology consultation service. Materials and Methods: This is a retrospective study that summarizes the telepathology experience and diagnostic consultation results between UPMC and KingMed over a period of 3 years from January 2012 to December 2014. Results: A total of 1561 cases were submitted for telepathology consultation including 144 cases in 2012, 614 cases in 2013, and 803 in 2014. Most of the cases (61.4% submitted were referred by pathologists, 36.9% by clinicians, and 1.7% by patients in China. Hematopathology received the most cases (23.7%, followed by bone/soft tissue (21.0% and gynecologic/breast (20.2% subspecialties. Average turnaround time (TAT per case was 5.4 days, which decreased from 6.8 days in 2012 to 5.0 days in 2014. Immunostains were required for most of the cases. For some difficult cases, more than one round of immunostains was needed, which extended the TAT. Among 855 cases (54.7% where a primary diagnosis or impression was provided by the referring local hospitals in China, the final diagnoses rendered by UPMC pathologists were identical in 25.6% of cases and significantly modified (treatment plan altered in 50.8% of cases. Conclusion: These results indicate that international telepathology consultation can significantly improve patient care by facilitating access to pathology expertise. The success of this international digital consultation service was dependent on strong commitment and support from leadership, information technology expertise, and

Implementing Experiential Action Learning in International Management Education: The Global Business Strategic (GLOBUSTRAT) Consulting Program

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Kamath, Shyam; Agrawal, Jagdish; Krickx, Guido

2008-01-01

This paper discusses the theoretical foundations and implementation challenges and outcomes of a unique "hands-on" global consulting program that is integrated into an international EMBA program for mid-career and senior American and European managers. It details the challenges for the integration of experiential action learning, double-loop…

Draft consultants' report. Consultants' meeting on requirements regarding the harmonization of laboratory quality assurance systems, 2-5 May 1995, Vienna, Austria

International Nuclear Information System (INIS)

2002-01-01

The consultants were requested to advise the Agency on the realization of a harmonized approach to internationally compatible quality assurance systems. The consultants presented their viewpoint and position papers in relation to initial questions posed, reflecting the international efforts and their own experiences in analytical quality assurance. The consultants made specific recommendations concerning various aspects of the Agency's Analytical Quality Assurance Services Programme

Doctor-patient communication: a comparison between telemedicine consultation and face-to-face consultation.

Science.gov (United States)

Liu, Xiao; Sawada, Yoshie; Takizawa, Takako; Sato, Hiroko; Sato, Mahito; Sakamoto, Hironosuke; Utsugi, Toshihiro; Sato, Kunio; Sumino, Hiroyuki; Okamura, Shinichi; Sakamaki, Tetsuo

2007-01-01

The objective of this study was to compare doctor-patient communications in clinical consultations via telemedicine technology to doctor-patient communications in face-to-face clinical consultations. Five doctors who had been practicing internal medicine for 8 to 18 years, and twenty patients were enrolled in this study; neither doctors nor patients had previous experience of telemedicine. The patients received both a telemedicine consultation and a face-to-face consultation. Three measures--video observation, medical record volume, and participants' satisfaction--were used for the assessment. It was found that the time spent on the telemedicine consultation was substantially longer than the time spent on the face-to-face consultation. No statistically significant differences were found in the number of either closed or open-ended questions asked by doctors between both types of consultation. Empathy-utterances, praise-utterances, and facilitation-utterances were, however, seen less in the telemedicine consultations than in the face-to-face consultations. The volume of the medical records was statistically smaller in the telemedicine consultations than in the face-to-face consultations. Patients were satisfied with the telemedicine consultation, but doctors were dissatisfied with it and felt hampered by the communication barriers. This study suggests that new training programs are needed for doctors to develop improved communication skills and the ability to express empathy in telemedicine consultations.

[The Teratology Information Service: medicines during pregnancy and lactation].

Science.gov (United States)

de Vries, Loes C; de Swart, Irene W; van Puijenbroek, Eugène P

2016-01-01

Many women use medication during pregnancy. Both the healthcare professional and the pregnant woman often have many questions about the possible adverse effects of the medication that are not always answered in the product information. The Teratology Information Service (TIS), a part of the Netherlands Pharmacovigilance Centre Lareb, is a centre of expertise in the field of the safety of medication use and other external influences during spermatogenesis, pregnancy and lactation. The TIS collects, interprets, and disseminates information that can contribute to patient care. Healthcare professionals can contact the TIS for information and individual risk assessments. In this article we discuss the background and positioning of the TIS, the characteristics of telephone consultations, the collection of data and the considerations that are important for the use of medication during pregnancy and lactation.

LACTATE PROFILE DURING GRECO-ROMAN WRESTLING MATCH

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Ognjen Uljevic

2009-11-01

Full Text Available The objective of this study was to determine and compare lactate profile of two groups of Greco-Roman wrestlers with different competences and training experience. Study was conducted on 10 wrestles that were members of Croatian national team and 10 wrestlers that were members of Wrestling club Split. Lactate samples were collected at four intervals during control fights that were held according to international wrestling rules of World wrestling federation FILA. Values of lactate increased as competition progressed, and they were highest at the end of the match for both groups of wrestlers. According to this study there were no significant differences in lactate between two groups at the end of the match, while significant differences were noted during the match. The information about lactate profile presented in this study can be used by coaches and wrestlers to develop condition programs

Analysis And Comments On The Consultative Document: International Framework For Liquidity Risk Measurement, Standards And Monitoring

OpenAIRE

Jacques Prefontaine; Jean Desrochers; Lise Godbout

2010-01-01

The market turmoil that began in mid-2007 re-emphasized the importance of liquidity to the functioning of financial markets and the banking sector. In December 2009, the Basel Committee on Banking Supervision (BCBS) of the Bank for International Settlements (BIS) released a consultative document entitled: “International Framework for Liquidity Risk Measurement, Standards and Monitoring”. Interested parties were invited to provide written comments by April 16th 2010. Given our interest in prom...

Education in sexual medicine: proceedings from the international consultation in sexual medicine, 2009.

Science.gov (United States)

Parish, Sharon J; Rubio-Aurioles, Eusebio

2010-10-01

Sexual problems in men and women are common; and physicians endorse many barriers to addressing these issues, including lack of knowledge about the diagnosis and management of sexual problems and inadequate training in sexual health communication and counseling. To update the recommendations published in 2004, from the International Consultation on Sexual Medicine (ICSM) relevant to the educational aspects of sexual health in undergraduate, graduate, and postgraducate medical education. A third international consultation in collaboration with the major sexual health organizations assembled over 186 multidisciplinary experts from 33 countries into 25 committees. Three experts from three countries contributed to this committee's review of Education in Sexual Medicine. Expert opinion was based on a comprehensive review of the medical literature, committee discussion, public presentation, and debate. A comprehensive review about the current state of undergraduate, graduate, and postgraduate sexual health education worldwide is provided. Recommendations about ideal sexual health curricula across training levels are provided. Best methods for achieving optimal training approaches to sexual health communication and interviewing, clinical skills and management, and counseling are described. Current sexual health education for undergraduate and practicing physicians is inadequate to meet the advancing science and technology and increasing patient demand for high-quality sexual health care. There is a need for enhanced training in medical institutions responsible for physician sexual health training worldwide. Future training programs at all levels of medical education should incorporate standardized measures of sexual health clinical skills acquisition and assessments of the impact on patient outcomes into the design of educational initiatives. © 2010 International Society for Sexual Medicine.

Dermatology consultations significantly contribute quality to care of hospitalized patients: a prospective study of dermatology inpatient consults at a tertiary care center.

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Galimberti, Fabrizio; Guren, Lauren; Fernandez, Anthony P; Sood, Apra

2016-10-01

Cutaneous abnormalities are common in hospitalized patients but are frequently missed or misdiagnosed by admitting teams. Inpatient dermatology consultations provide important information to help diagnose and manage these patients. However, few studies have analyzed dermatology inpatient consultations and their effect. We prospectively collected information for 691 consecutive dermatology consultations from November 2013 to November 2014. Patients ranged in age from newborns to 97 years old. The internal medicine service requested the most consultations (45%). Only 6.5% of consultations were requested within 24 hours of appearance of cutaneous findings. Before consultation, 70.3% of patients did not receive treatment for or based on their cutaneous findings. Dermatology consultation resulted in treatment change in 81.9% of patients. The most common diagnoses were drug rash and contact dermatitis. Biopsies confirmed 71.7% of the initial bedside diagnoses by the dermatology consultation team. Common skin diseases were responsible for the majority of dermatology consultations. Most patients were not treated for their cutaneous conditions before the dermatology consultation. Dermatology consultations resulted in treatment changes in the majority of cases. © 2016 The International Society of Dermatology.

Effect of components of a workplace lactation program on breastfeeding duration among employees of a public-sector employer.

Science.gov (United States)

Balkam, Jane A Johnston; Cadwell, Karin; Fein, Sara B

2011-07-01

The purpose of this study was to evaluate the impact of the individual services offered via a workplace lactation program of one large public-sector employer on the duration of any breastfeeding and exclusive breastfeeding. Exclusive breastfeeding was defined as exclusive feeding of human milk for the milk feeding. A cross-sectional mailed survey approach was used. The sample (n = 128) consisted of women who had used at least one component of the lactation program in the past 3 years and who were still employed at the same organization when data were collected. Descriptive statistics included frequency distributions and contingency table analysis. Chi-square analysis was used for comparison of groups, and both analysis of variance (ANOVA) and univariate analysis of variance from a general linear model were used for comparison of means. The survey respondents were primarily older, white, married, well-educated, high-income women. More of the women who received each lactation program service were exclusively breastfeeding at 6 months of infant age in all categories of services, with significant differences in the categories of telephone support and return to work consultation. After adjusting for race and work status, logistic regression analysis showed the number of services received was positively related to exclusive breastfeeding at 6 months and participation in a return to work consultation was positively related to any breastfeeding at 6 months. The study demonstrated that the workplace lactation program had a positive impact on duration of breastfeeding for the women who participated. Participation in the telephone support and return to work consultation services, and the total number of services used were related to longer duration of exclusive and/or any breastfeeding.

Implementing an International Consultation on Earth System Research Priorities Using Web 2.0 Tools

Science.gov (United States)

Goldfarb, L.; Yang, A.

2009-12-01

Leah Goldfarb, Paul Cutler, Andrew Yang*, Mustapha Mokrane, Jacinta Legg and Deliang Chen The scientific community has been engaged in developing an international strategy on Earth system research. The initial consultation in this “visioning” process focused on gathering suggestions for Earth system research priorities that are interdisciplinary and address the most pressing societal issues. It was implemented this through a website that utilized Web 2.0 capabilities. The website (http://www.icsu-visioning.org/) collected input from 15 July to 1 September 2009. This consultation was the first in which the international scientific community was asked to help shape the future of a research theme. The site attracted over 7000 visitors from 133 countries, more than 1000 of whom registered and took advantage of the site’s functionality to contribute research questions (~300 questions), comment on posts, and/or vote on questions. To facilitate analysis of results, the site captured a small set of voluntary information about each contributor and their contribution. A group of ~50 international experts were invited to analyze the inputs at a “Visioning Earth System Research” meeting held in September 2009. The outcome of this meeting—a prioritized list of research questions to be investigated over the next decade—was then posted on the visioning website for additional comment from the community through an online survey tool. In general, many lessons were learned in the development and implementation of this website, both in terms of the opportunities offered by Web 2.0 capabilities and the application of these capabilities. It is hoped that this process may serve as a model for other scientific communities. The International Council for Science (ICSU) in cooperation with the International Social Science Council (ISSC) is responsible for organizing this Earth system visioning process.

Experience of a year of adult hospital dermatology consultations.

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Storan, Eoin R; McEvoy, Marian T; Wetter, David A; El-Azhary, Rokea A; Camilleri, Michael J; Bridges, Alina G; Davis, Mark D P

2015-10-01

Dermatology consultations are frequently requested by inpatient hospital services. As inpatient dermatology services in the USA decline, dermatology hospital consultations are becoming increasingly important. We aim to describe the spectrum of skin diseases encountered and the health care subspecialties requesting dermatology hospital consultations. We performed a retrospective chart review of adult patient (age: ≥18 years) dermatology hospital consultations from January 1 to December 31, 2010. We examined patient demographic characteristics, consultation requesting services, and consultation diagnoses. Among dermatology services, 614 patients had 674 separate inpatient dermatology consultations during 2010. Of these patients, 55.9% were male (mean age: 59 years). In total, 205 consultations (30.4%) were requested by the internal medicine subspecialty, 137 (20.3%) by the hematology and oncology subspecialty, and 93 (13.8%) by the surgical subspecialty. The most common conditions seen by the hospital dermatology consulting service were skin infections (n = 125, 18.5%), dermatitis (n = 120, 17.8%), drug eruptions (n = 87, 12.9%), chronic wounds and ulcers (n = 55, 8.1%), cutaneous neoplasms (n = 39, 5.8%), graft-versus-host disease (n = 37, 5.5%), ecchymosis, purpura simplex or petechia (n = 26, 3.8%), intertrigo (n = 21, 3.1%), and urticaria (n = 20, 3.0%). The majority of consultations conducted by the dermatology hospital consulting service were for the management of common skin diseases, such as cutaneous infections, dermatitis, and drug eruptions. Most consultations were requested by the departments of internal medicine, hematology and oncology, and surgical services. © 2014 The International Society of Dermatology.

Inhibition of endogenous lactate turnover with lactate infusion in humans

International Nuclear Information System (INIS)

Searle, G.L.; Feingold, K.R.; Hsu, F.S.; Clark, O.H.; Gertz, E.W.; Stanley, W.C.

1989-01-01

The extent to which lactate infusion may inhibit endogenous lactate production, though previously considered, has never been critically assessed. To examine this proposition, single injection tracer methodology (U- 14 C Lactate) has been used for the estimation of lactate kinetics in 12 human subjects under basal conditions and with the infusion of sodium lactate. The basal rate of lactate turnover was measured on a day before the study with lactate infusion, and averaged 63.7 + 5.5 mg/kg/h. Six of these individuals received a stable lactate infusion at an approximate rate of 160 mg/kg/h, while the remaining six individuals were infused at the approximate rate of 100 mg/kg/h. It has been found that stable lactate infused at rates approximating 160 mg/kg/h consistently produced a complete inhibition of endogenous lactate production. Infusion of lactate at 100 mg/kg/h caused a lesser and more variable inhibition of endogenous lactate production (12% to 64%). In conclusion, lactate infusion significantly inhibits endogenous lactate production

Consulting-Research Froblems with German and American Multinational Firms.

Science.gov (United States)

Hildebrandt, Herbert W.

International researchers need to be aware of international problems and multinational managerial codes when they work with worldwide organizations. This paper develops the premise that consulting with German multinational companies is more complex than consulting with or researching for American firms. Discussion focuses on the following three…

Surveying Lactation Professionals Regarding Marijuana Use and Breastfeeding.

Science.gov (United States)

Bergeria, Cecilia L; Heil, Sarah H

2015-09-01

Breastfeeding is associated with substantial benefits for both the child and mother. Most guidelines state that women who use illicit drugs should not breastfeed. Although this recommendation has traditionally included marijuana, this drug's changing legal status and the limited scientific research regarding marijuana's effect on breastfeeding and the nursing child may lead to varying recommendations made by lactation professionals to clients who use marijuana. Additionally, to our knowledge, there are no data estimating the prevalence of marijuana use among breastfeeding women, making it unclear how common it is. This study assessed recommendations around breastfeeding and marijuana use and estimated the prevalence of marijuana use among breastfeeding women. A convenience sample of lactation professionals who practice throughout New England and were attending the 2014 Vermont Lactation Consultant Association conference was offered the opportunity to complete a five-item survey. Of 120 conference attendees, 74 completed the survey. Forty-four percent reported their recommendations around breastfeeding and marijuana use depended on factors like the severity of maternal use. Another 41% reported recommending continued breastfeeding because the benefits outweigh the harms. The remaining 15% reported recommending that a woman should stop breastfeeding if she cannot stop using marijuana. Survey completers estimated that 15% (1,203/7,843) of their breastfeeding clients in the past year used marijuana. Lactation professionals vary widely in their recommendations to breastfeeding clients who use marijuana. The estimate of prevalence also suggests this is a relatively common issue. More research is needed to assess the generalizability of these findings.

Amperometric biosensor for lactate analysis in wine and must during fermentation

OpenAIRE

Shkotova , L.V.; Goriushkina , T.B.; Tran-Minh , Canh; Chovelon , Jean-Marc; Soldatkin , A.P.; Dzyadevych , S.V.

2008-01-01

MADICA 2006 Conference, Fifth Maghreb-Europe Meeting on Materials and their Applicatons for Devices and Physical, Chemical and Biological Sensors, MADICA 2006 Conference, Fifth Maghreb-Europe Meeting on Materials and their Applicatons for Devices and Physical, Chemical and Biological Sensors; International audience; A lactate oxidase-based amperometric biosensor is designed for lactate determination. Two methods of lactate oxidase immobilization on the surface of commercial SensLab platinum p...

International Consultation and Training on Group Work in South Asia

Science.gov (United States)

Ibrahim, Farah A.

2015-01-01

This article presents a consultation and training for faculty and graduate students in South Asia under the auspices of the United Nations' Transfer of Knowledge Through Expatriate Nationals (TOKTEN) Program. It describes the development of a consultation relationship and training on group work. Needs assessments focusing on both cultural…

[Psychiatric consultations for nursing-home residents: aspects and course of such consultations].

Science.gov (United States)

Steenbeek, M; van Baarsen, C; Koekkoek, B

2012-01-01

Psychiatric symptoms occur frequently in nursing-home residents. The psychiatric expertise and support available to residents vary from one nursing home to another. International studies show that psychiatric consultations can be effective, but in the Netherlands very little research has been done on this topic. To list the types of psychiatric problems and symptoms for which consultations are requested and to determine whether a psychiatric consultation can have positive results for nursing-home residents and staff. The psychiatric consultations requested were tabulated and were analysed. Details of 71 psychiatric consultations were recorded. The percentage of women (average age 74 years) was slightly higher than the percentage of men. More than 75% of the patients suffered from agitation/aggression or irritability, 65% suffered from depression, 63% from anxiety and 56% from dysinhibition. A post-intervention assessment was performed in 54 patients (76%). In this group psychiatric symptoms were found to be greatly reduced, with regard to both frequency and severity. In addition, nursing staff seemed to suffer less of the stress and strain in their work. The patients for whom a consultation was requested seemed to suffer from serious psychiatric symptoms and were often aggressive. It was possible to achieve substantial progress as a result of a simple intervention. A possible explanation for this effect is probably the nature of the psychiatric consultation used; it was structured, multi-disciplinary and time-consuming. However, since no control group was involved, it is impossible to say with certainty that the reduction in symptoms can be attributed solely to the consultation.

Advanced training of tax consultants

Directory of Open Access Journals (Sweden)

Adigamova Farida F.

2016-01-01

Full Text Available The purpose of the research is to review and analyze the data on the necessity to provide an educational environment for training and advanced training of tax consultants in Russia. The article considers the types of tax consulting, the historical background of training financiers in Russia, as well as identifies conditions determining the significance of tax consulting. The research establishes the connection between the negative attitude to tax payment and tax evasion. The advanced training of tax consultants should be a continuous process as they need to take into account both external and internal taxpayers risks associated with the development of law and law-enforcement practice. Obviously, the training of tax consultants should take into account the experience of developed foreign countries, such as Germany, Austria, Czech Republic, Slovakia and other European countries as well. In Russia, it is necessary to open educational institutions, which will not only be involved in the certification of tax consultants, but also provide training courses. These courses should contribute to constant increase of tax consultants knowledge, consider the tax treatment of economic activities, as well changes in the legislation, economics, finance, accounting, manufacturing processes, which will improve the quality of services provided by tax consultants.

Exogenous lactate supply affects lactate kinetics of rainbow trout, not swimming performance

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Omlin, Teye; Langevin, Karolanne

2014-01-01

Intense swimming causes circulatory lactate accumulation in rainbow trout because lactate disposal (Rd) is not stimulated as strongly as lactate appearance (Ra). This mismatch suggests that maximal Rd is limited by tissue capacity to metabolize lactate. This study uses exogenous lactate to investigate what constrains maximal Rd and minimal Ra. Our goals were to determine how exogenous lactate affects: 1) Ra and Rd of lactate under baseline conditions or during graded swimming, and 2) exercise performance (critical swimming speed, Ucrit) and energetics (cost of transport, COT). Results show that exogenous lactate allows swimming trout to boost maximal Rd lactate by 40% and reach impressive rates of 56 μmol·kg−1·min−1. This shows that the metabolic capacity of tissues for lactate disposal is not responsible for setting the highest Rd normally observed after intense swimming. Baseline endogenous Ra (resting in normoxic water) is not significantly reduced by exogenous lactate supply. Therefore, trout have an obligatory need to produce lactate, either as a fuel for oxidative tissues and/or from organs relying on glycolysis. Exogenous lactate does not affect Ucrit or COT, probably because it acts as a substitute for glucose and lipids rather than extra fuel. We conclude that the observed 40% increase in Rd lactate is made possible by accelerating lactate entry into oxidative tissues via monocarboxylate transporters (MCTs). This observation together with the weak expression of MCTs and the phenomenon of white muscle lactate retention show that lactate metabolism of rainbow trout is significantly constrained by transmembrane transport. PMID:25121611

Lessons Learned from a Consultation Process Overseas

Science.gov (United States)

Merino-Soto, César

2014-01-01

In this commentary I discuss three international school consultation experiences, highlighting aspects that serve as lessons for professional development and the implementation of effective and helpful strategies that meet the needs of children and youth in school systems. Relationships developed and maintained between the consulting teams and the…

Business Communication Consulting and Research in Multinational Companies.

Science.gov (United States)

Hildebrandt, Herbert W.

1978-01-01

Describes three issues involved in communication research and consulting for multinational companies, particularly those in Germany: qualifications for doing international consulting and research, problems of American scholar-researchers in those firms, and suggestions for dealing with those issues. (JMF)

Lactate shuttles in nature.

Science.gov (United States)

Brooks, G A

2002-04-01

Once thought to be the consequence of oxygen lack in contracting skeletal muscle, the glycolytic product lactate is formed and utilized continuously under fully aerobic conditions. "Cell-cell" and "intracellular lactate shuttle" concepts describe the roles of lactate in the delivery of oxidative and gluconeogenic substrates, as well as in cell signalling. Examples of cell-cell shuttles include lactate exchanges between white-glycolytic and red-oxidative fibres within a working muscle bed, between working skeletal muscle and heart, and between tissues of net lactate release and gluconeogenesis. Lactate exchange between astrocytes and neurons that is linked to glutamatergic signalling in the brain is an example of a lactate shuttle supporting cell-cell signalling. Lactate uptake by mitochondria and pyruvate-lactate exchange in peroxisomes are examples of intracellular lactate shuttles. Lactate exchange between sites of production and removal is facilitated by monocarboxylate transport proteins, of which there are several isoforms, and, probably, also by scaffolding proteins. The mitochondrial lactate-pyruvate transporter appears to work in conjunction with mitochondrial lactate dehydrogenase, which permits lactate to be oxidized within actively respiring cells. Hence mitochondria function to establish the concentration and proton gradients necessary for cells with high mitochondrial densities (e.g. cardiocytes) to take up and oxidize lactate. Arteriovenous difference measurements on working cardiac and skeletal muscle beds as well as NMR spectral analyses of these tissues show that lactate is formed and oxidized within the cells of formation in vivo. Glycolysis and lactate oxidation within cells permits high flux rates and the maintenance of redox balance in the cytosol and mitochondria. Other examples of intracellular lactate shuttles include lactate uptake and oxidation in sperm mitochondria and the facilitation of beta-oxidation in peroxisomes by pyruvate-lactate

Lactate Biosensor Based on Cellulose Acetate Membrane Bound Lactate Oxidase

Directory of Open Access Journals (Sweden)

Suman

2007-05-01

Full Text Available Lactate biosensor was fabricated by immobilizing lactate oxidase in cellulose acetate membrane and by mounting over the sensing part of Pt electrode (working and connected to Ag/AgCl electrode (reference along with auxillary electrode through potentiostat. The enzyme electrode was anodically polarized at +400 mV to generate electrons from H2O2, which was formed from oxidation of serum lactate by immobilized lactate oxidase. The minimum detection limit of the electrode was 0.1mmoles/L and sensitivity of the sensor was 0.008 mA/mM/L lactate. Assay coefficients of variation were < 2% .A good correlation (r=0.99 was found between lactate values obtained by colorimetric method and lactate biosensor. The self-life of the biosensor was 18 days at 4ºC and enzyme electrode can be re-used 150 times without any significant loss in enzyme activity.

Inhibition of lactation.

Science.gov (United States)

Llewellyn-Jones, D

1975-01-01

The mechanism and hormonal regulation of lactation is explained and illustrated with a schematic representation. Circulating estrogen above a critical amount seems to be the inhibitory factor controlling lactation during pregnancy. Once delivery occurs, the level of estrogen falls, that of prolactin rises, and lactation begins. Nonsuckling can be used to inhibit lactation. Estrogens can also be used to inhibit lactation more quickly and with less pain. The reported association between estrogens and puerperal thromboembolism cannot be considered conclusive due to defects in the reporting studies. There is no reason not to use estrogens in lactation inhibition except for women over 35 who experienced a surgical delivery. Alternative therapy is available for these women. The recently-developed drug, brom-ergocryptine, may replace other methods of lactation inhibition.

External Reviews, Internal Influences: Consultations and the Undergraduate Neuroscience Curriculum

OpenAIRE

Wiertelak, Eric P.

2012-01-01

In 2007 FUN established the FUN Program and Department Consultations Service, or FUN-PDCS. Since that founding, the service has provided numerous consultation recommendations to undergraduate programs seeking assistance with external program reviews, designing and improving courses and many other programmatic needs. FUN-PDCS, like FUN, is primarily a grassroots organization and draws on the expertise of the FUN membership to aid programs in their more personalized pursuit of the FUN mission: ...

Engineering Consultancy: An Assessment of IT-enabled International Delivery of Services

DEFF Research Database (Denmark)

Baark, Erik

1999-01-01

The delivery of engineering consultancy services in global markets has been dominated by a small group of firms located in Europe and the US. Like many other service industries, engineering consultants have depended on the movement of highly qualified people and establishment of local affiliates...... services in arms-length transactions across national borders does not appear to have been significantly exploited. Nevertheless, IT-enabled delivery of engineering consultancy services opens up possibilities for business process reengineering that may provide some firms new competitive advantages in global...... markets and lead to further integration of design and construction in partnerships or project consortia, or in the strengthening of design-build approaches in project execution....

Chronic oral lactate supplementation does not affect lactate disappearance from blood after exercise

DEFF Research Database (Denmark)

Brouns, F; Fogelholm, M; Van Hall, Gerrit

1995-01-01

This study tested the hypothesis that a 3-week oral lactate supplementation affects postexercise blood lactate disappearance in untrained male subjects. Fifteen men were randomly assigned to either a lactate supplementation (n = 8) or a placebo (n = 7) treatment. During the treatment period...... they drank an oral lactate or a maltodextrin (placebo) supplement twice a day. The lactate drink contained 10 g of lactate as calcium, sodium, and potassium salts. Blood lactate concentrations were studied before, during, and immediately after three exercise tests, both pre- and posttreatment. Peak lactate...... values for placebo (PL) or lactate (L) treatment groups during different tests were as follows: Test 1 PL, 13.49 +/- 3.71; L, 13.70 +/- 1.90; Test 2 PL, 12.64 +/- 2.32; L, 12.00 +/- 2.23; Test 3 PL, 12.29 +/- 2.92; L, 11.35 +/- 1.38 and were reached 3 min postexercise. The decrease in blood lactate...

Summary report of consultants' meeting on IAEA international database on irradiated nuclear graphite properties

International Nuclear Information System (INIS)

Humbert, D.; Wickham, A.J.

2007-06-01

The '9th Meeting of the Technical Steering Committee for the International Database on Irradiated Nuclear Graphite Properties' was held on 26-27 March 2007 at the IAEA Headquarters, Vienna, Austria. All discussions, recommendations and actions of this Consultants' Meeting are recorded in this report. The purposes of the meeting were to review the matters and actions identified in the previous meeting, undertake a review of the current status of the database and make recommendations for actions for the next year. This report contains the current status of the identified actions as well as a summary of the recommendations on enhancements to the database. (author)

Managing outpatient consultations: from referral to discharge.

Science.gov (United States)

Mitchell, Rachael; Jacob, Hannah; Morrissey, Benita; Macaulay, Chloe; Gomez, Kumudini; Fertleman, Caroline

2017-08-01

Although a great deal of paediatric consultations are not urgent, doctors in training spend so much time providing service for acute conditions that they spend little time focusing on outpatient work before they become a consultant. Engaging clinicians in the managerial aspects of providing clinical care is a key to improving outcomes, and this article addresses these aspects of the outpatient consultation from referral to discharge. We aim to provide doctors in training with a tool to use during their training and their first few years as a consultant, to think about how outpatient work is organised and how it can be improved to maximise patient experience. The non-urgent consultation varies across the world; this article is aimed to be relevant to an international audience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Point-of-care lactate and creatinine analysis for sick obstetric patients at Queen Elizabeth Central Hospital in Blantyre, Malawi: A feasibility study.

Science.gov (United States)

Glasmacher, S A; Bonongwe, P; Stones, W

2016-03-01

To achieve good outcomes in critically ill obstetric patients, it is necessary to identify organ dysfunction rapidly so that life-saving interventions can be appropriately commenced. However, timely access to clinical chemistry results is problematic, even in referral institutions, in the sub-Saharan African region. Reliable point-of-care tests licensed for clinical use are now available for lactate and creatinine. We aimed to assess whether implementation of point-of-care testing for lactate and creatinine is feasible in the obstetric unit at the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, by obtaining the opinions of clinical staff on the use of these tests in practice. During a two-month evaluation period nurse-midwives, medical interns, clinical officers, registrars, and consultants were given the opportunity to use StatStrip® and StatSensor® (Nova Biomedical, Waltham, USA) devices, for lactate and creatinine estimation, as part of their routine clinical practice in the obstetric unit. They were subsequently asked to complete a short questionnaire. Thirty-seven questionnaires were returned by participants: 22 from nurse-midwives and the remainder from clinicians. The mean satisfaction score for the devices was 7.6/10 amongst clinicians and 8.0/10 amongst nurse-midwives. The majority of participants stated that the obstetric high dependency unit (HDU) was the most suitable location for the devices. For lactate, 31 participants strongly agreed that testing should be continued and 24 strongly agreed that it would influence patient management. For creatinine, 29 strongly agreed that testing should be continued and 28 strongly agreed that it would influence their patient management. Twenty participants strongly agreed that they trust point-of-care devices. Point-of-care clinical chemistry testing was feasible, practical, and well received by staff, and was considered to have a useful role to play in the clinical care of sick obstetric patients at

High-pressure phase behavior of propyl lactate and butyl lactate in supercritical carbon dioxide

International Nuclear Information System (INIS)

Cho, Dong Woo; Shin, Jungin; Shin, Moon Sam; Bae, Won; Kim, Hwayong

2012-01-01

Highlights: ► The phase behavior of propyl lactate and butyl lactate in scCO 2 was measured. ► Experimental data were correlated by the PR-EOS. ► The critical constants were estimated by the three group contribution methods. ► Acentric factor was estimated by the Lee–Kesler method. ► The Nannoolal–Rarey and Lee–Kesler method shows the best correlation results. - Abstract: Lactate esters synthesized with lactic acid and ester are used as solvents and reactants in various industries, including agricultural chemistry, pharmaceuticals, electronics, and fine chemicals. Among lactate esters, high purity propyl lactate and butyl lactate are used to produce fine chemicals and in the synthesis of chiral intermediates for use in pesticides and drugs. However, distillation for the removal of propyl lactate and butyl lactate alters or degenerates products due the high boiling points of these two lactate esters. This problem can be solved by supercritical fluid extraction (SCFE) at lower temperatures. SCFE process requires high-pressure phase behavior data on CO 2 and lactates for its design and operation. In this study, high-pressure phase behavior of propyl lactate and butyl lactate in CO 2 was measured from (323.2 to 363.2) K using a variable-volume view cell apparatus. Experimental data were well correlated by the Peng–Robinson equation of state using the van der Waals one-fluid mixing rules. The critical constants were estimated by the Joback method, the Constantinou–Gani method, and the Nannoolal–Rarey method. Acentric factor was estimated by the Lee–Kesler method.

Digital audio recordings improve the outcomes of patient consultations

DEFF Research Database (Denmark)

Wolderslund, Maiken; Kofoed, Poul-Erik; Holst, René

2017-01-01

OBJECTIVES: To investigate the effects on patients' outcome of the consultations when provided with: a Digital Audio Recording (DAR) of the consultation and a Question Prompt List (QPL). METHODS: This is a three-armed randomised controlled cluster trial. One group of patients received standard care......, while the other two groups received either the QPL in combination with a recording of their consultation or only the recording. Patients from four outpatient clinics participated: Paediatric, Orthopaedic, Internal Medicine, and Urology. The effects were evaluated by patient-administered questionnaires...

Can audio recording of outpatient consultations improve patient outcome?

DEFF Research Database (Denmark)

Wolderslund, Maiken; Kofoed, Poul-Erik; Axboe, Mette

different departments: Orthopedics, Urology, Internal Medicine and Pediatrics. A total of 5,460 patients will be included from the outpatient clinics. All patients randomized to an intervention group are offered audio recording of their consultation. An Interactive Voice Response platform enables an audio....... The intervention will be evaluated using a questionnaire measuring different aspect of patients recall and understanding of the information given, patients need for additional information subsequent to the consultation and their overall satisfaction with the consultation. Results The study will be conducted from...

Consulting Basics for the Teacher-Turned-Technology Consultant.

Science.gov (United States)

Stager, Sue; Green, Kathy

1988-01-01

Discusses the role of educational technology consultants who may be classroom teachers with no formal training in consulting. Consulting models are described, including content-oriented and process-oriented approaches; Schein's process facilitator model is examined; and Kurpius' consulting model is explained and expanded. (LRW)

Dinosaur lactation?

Science.gov (United States)

Else, Paul L

2013-02-01

Lactation is a process associated with mammals, yet a number of birds feed their newly hatched young on secretions analogous to the milk of mammals. These secretions are produced from various sections (crop organ, oesophageal lining and proventriculus) of the upper digestive tract and possess similar levels of fat and protein, as well as added carotenoids, antibodies and, in the case of pigeons and doves, epidermal growth factor. Parental care in avian species has been proposed to originate from dinosaurs. This study examines the possibility that some dinosaurs used secretory feeding to increase the rate of growth of their young, estimated to be similar to that of present day birds and mammals. Dinosaur 'lactation' could also have facilitated immune responses as well as extending parental protection as a result of feeding newly hatched young in nest environments. While the arguments for dinosaur lactation are somewhat generic, a case study for lactation in herbivorous site-nesting dinosaurs is presented. It is proposes that secretory feeding could have been used to bridge the gap between hatching and establishment of the normal diet in some dinosaurs.

Interprofessional communication with hospitalist and consultant physicians in general internal medicine: a qualitative study

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Gotlib Conn Lesley

2012-11-01

Full Text Available Abstract Background Studies in General Internal Medicine [GIM] settings have shown that optimizing interprofessional communication is important, yet complex and challenging. While the physician is integral to interprofessional work in GIM there are often communication barriers in place that impact perceptions and experiences with the quality and quantity of their communication with other team members. This study aims to understand how team members’ perceptions and experiences with the communication styles and strategies of either hospitalist or consultant physicians in their units influence the quality and effectiveness of interprofessional relations and work. Methods A multiple case study methodology was used. Thirty-one semi-structured interviews were conducted with physicians, nurses and other health care providers [e.g. physiotherapist, social worker, etc.] working across 5 interprofessional GIM programs. Questions explored participants’ experiences with communication with all other health care providers in their units, probing for barriers and enablers to effective interprofessional work, as well as the use of communication tools or strategies. Observations in GIM wards were also conducted. Results Three main themes emerged from the data: [1] availability for interprofessional communication, [2] relationship-building for effective communication, and [3] physician vs. team-based approaches. Findings suggest a significant contrast in participants’ experiences with the quantity and quality of interprofessional relationships and work when comparing the communication styles and strategies of hospitalist and consultant physicians. Hospitalist staffed GIM units were believed to have more frequent and higher caliber interprofessional communication and collaboration, resulting in more positive experiences among all health care providers in a given unit. Conclusions This study helps to improve our understanding of the collaborative environment

Exploring how IBCLCs manage ethical dilemmas: a qualitative study

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Noel-Weiss Joy

2012-07-01

Full Text Available Abstract Background Professional health care practice should be based on ethical decisions and actions. When there are competing ethical standards or principles, one must choose between two or more competing options. This study explores ethical dilemmas experienced by International Board Certified Lactation Consultants. Methods The investigator interviewed seven International Board Certified Lactation Consultants and analyzed the interviews using qualitative research methods. Results "Staying Mother-Centred" emerged as the overall theme. It encompassed six categories that emerged as steps in managing ethical dilemmas: 1 recognizing the dilemma; 2 identifying context; 3 determining choices; 4 strategies used; 5 results and choices the mother made; and 6 follow-up. The category, "Strategies used", was further analyzed and six sub-themes emerged: building trust; diffusing situations; empowering mothers; finding balance; providing information; and setting priorities. Conclusions This study provides a framework for understanding how International Board Certified Lactation Consultants manage ethical dilemmas. Although the details of their stories changed, the essence of the experience remained quite constant with the participants making choices and acting to support the mothers. The framework could be the used for further research or to develop tools to support IBCLCs as they manage ethical dilemmas and to strengthen the profession with a firm ethics foundation.

Exploring how IBCLCs manage ethical dilemmas: a qualitative study

Science.gov (United States)

2012-01-01

Background Professional health care practice should be based on ethical decisions and actions. When there are competing ethical standards or principles, one must choose between two or more competing options. This study explores ethical dilemmas experienced by International Board Certified Lactation Consultants. Methods The investigator interviewed seven International Board Certified Lactation Consultants and analyzed the interviews using qualitative research methods. Results "Staying Mother-Centred" emerged as the overall theme. It encompassed six categories that emerged as steps in managing ethical dilemmas: 1) recognizing the dilemma; 2) identifying context; 3) determining choices; 4) strategies used; 5) results and choices the mother made; and 6) follow-up. The category, "Strategies used", was further analyzed and six sub-themes emerged: building trust; diffusing situations; empowering mothers; finding balance; providing information; and setting priorities. Conclusions This study provides a framework for understanding how International Board Certified Lactation Consultants manage ethical dilemmas. Although the details of their stories changed, the essence of the experience remained quite constant with the participants making choices and acting to support the mothers. The framework could be the used for further research or to develop tools to support IBCLCs as they manage ethical dilemmas and to strengthen the profession with a firm ethics foundation. PMID:22824376

Early lactation production, health, and welfare characteristics of cows selected for extended lactation.

Science.gov (United States)

Lehmann, J O; Mogensen, L; Kristensen, T

2017-02-01

Some cows are able to achieve relatively high milk yields during extended lactations beyond 305 d in milk, and farmers may be able to use this potential by selecting the most suitable cows for an extended lactation. However, the decision to postpone insemination has to rely on information available in early lactation. The main objectives of this study were, therefore, to assess the association between the information available in early lactation and the relative milk production of cows on extended lactation, and to investigate if this information can be used to differentiate time of first insemination between cows. Data came from 4 Danish private herds practicing extended lactation in which some cows are selected to have a delayed time of planned first insemination. Average herd size varied from 93 to 157 cows, and milk yield varied from 7,842 to 12,315 kg of energy-corrected milk (ECM) per cow per year across herds. The analysis was based on 422 completed extended lactations (427 ± 87 d), and each lactation was assigned to 1 of 3 (low, medium, and high) milk performance groups (MPG) within parity group within herd based on a standardized lactation yield. For cows in the high MPG, peak ECM yield, and ECM yield at dry off were significantly greater, the relative reduction in milk yield between 60 and 305 d in milk was significantly smaller, and a smaller proportion had a body condition score (scale: 1-5) at dry off of 3.5 or greater compared with cows in low MPG. Previous lactation days in milk at peak ECM yield and ECM yield at dry off were higher, the relative reduction in milk yield between 60 and 305 d in milk was smaller, and the number of inseminations per conception was higher for multiparous cows in high MPG compared with low. Current lactation ECM yield at second and third milk recording were greater for cows in high MPG compared with low. A principal component analysis indicated that variables related to fertility, diseases, and milk yield explained most

Mapping quantitative trait loci (QTL in sheep. IV. Analysis of lactation persistency and extended lactation traits in sheep

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Lam Mary K

2011-06-01

Full Text Available Abstract Background In sheep dairy production, total lactation performance, and length of lactation of lactation are of economic significance. A more persistent lactation has been associated with improved udder health. An extended lactation is defined by a longer period of milkability. This study is the first investigation to examine the presence of quantitative trait loci (QTL for extended lactation and lactation persistency in sheep. Methods An (Awassi × Merino × Merino single-sire backcross family with 172 ewes was used to map QTL for lactation persistency and extended lactation traits on a framework map of 189 loci across all autosomes. The Wood model was fitted to data from multiple lactations to estimate parameters of ovine lactation curves, and these estimates were used to derive measures of lactation persistency and extended lactation traits of milk, protein, fat, lactose, useful yield, and somatic cell score. These derived traits were subjected to QTL analyses using maximum likelihood estimation and regression analysis. Results Overall, one highly significant (LOD > 3.0, four significant (2.0 Conclusion This study identified ten novel QTL for lactation persistency and extended lactation in sheep, but results suggest that lactation persistency and extended lactation do not have a major gene in common. These results provide a basis for further validation in extended families and other breeds as well as targeting regions for genome-wide association mapping using high-density SNP arrays.

Oxytocin and prolactin suppress cortisol responses to acute stress in both lactating and non-lactating sheep.

Science.gov (United States)

Cook, C J

1997-08-01

Cortisol response to stress appears to differ between lactating and non-lactating animals. Lactating (14 d post partum) and non-lactating sheep were fitted with probes so that drugs and hormones could be infused directly into the posterior pituitary and paraventricular nucleus of the hypothalamus. The animals were also fitted with instruments to allow monitoring of heart rate, body temperature and blood cortisol levels. Their reactions to a source of acute stress (a barking dog) were then followed, with or without drug and hormone manipulation. Results in both lactating and non-lactating animals indicated shortcomings in the use of cortisol as a stress indicator. Infusing prolactin and oxytocin into either the posterior pituitary or the paraventricular nucleus of the hypothalamus suppressed cortisol responsiveness to stress in both lactating and non-lactating animals (the latter to a greater extent). In the absence of drugs, lactating animals had a slightly higher basal level of cortisol and a lower cortisol response to stress than their non-lactating counterparts. Despite suppression of cortisol responses, with or without drugs, other indicators of stress still changed with the presence of a barking dog, suggesting the complexity of control involved in stress responses.

COMMUNICATION TOPICS AND STRATEGIES IN E-MAIL CONSULTATION: COMPARISON BETWEEN AMERICAN AND INTERNATIONAL UNIVERSITY STUDENTS

Directory of Open Access Journals (Sweden)

Sigrun Biesenbach-Lucas

2005-05-01

Full Text Available On today's "wired" college campuses, students avail themselves in increasing numbers of electronic channels, most notably e-mail, as a means to consult with their professors. While some research has investigated the purposes for which university students communicate with their instructors via e-mail, little research has examined differences in e-mail use between American and international students. In the present study, e-mail messages sent by American and international students enrolled in a teacher-preparation program to their professor were collected over the course of one semester. The messages were examined for three major communication topics (facilitative, substantive, relational and communication strategies (requesting, negotiating, reporting. Results indicate quantitative and qualitative differences in American and international students' e-mail topics and strategies, suggesting, similar to findings for face-to-face academic advising sessions, that American students demonstrate greater initiative and ability to adapt to the spatial and temporal remoteness between interlocutors in e-mail interaction, especially when using e-mail to solicit face-to-face appointments and input on projects. Findings also show that messages from both groups of students contained substantial relational communication, perhaps in an attempt to compensate for the lack of visual and paralinguistic clues in the e-mail medium.

Quantitative studies of skeletal muscle lactate metabolism

International Nuclear Information System (INIS)

Pagliassotti, M.J.

1988-01-01

In Situ, single-pass perfusions were employed on three isolated rabbit skeletal muscle preparations of differing fiber type and oxidative capacity to investigate the influence of fiber type and oxidative capacity per se on net carbon, 14 C-lactate, and 3 H-glucose fluxes. Preparations were exposed to six lactate concentrations ranging from 1-11mM. At basal lactate concentrations all preparations displayed net lactate release, 14 C-lactate removal and 14 CO 2 release, all were linearly correlated with lactate concentration. By 4mM all preparations switched to net lactate uptake and 14 C-lactate removal always exceeded net lactate uptake. To quantify the fate of net carbon, 14 C-lactate, and 3 H-glucose removal preparations were perfused at either basal or elevated lactate. Under basal conditions net carbon influx from glucose and glycogen was removed primarily via net lactate release in the glycolytic and mixed preparations and oxidation and net lactate release in the oxidative preparation. At elevated lactate, net carbon influx from lactate, pyruvate and glucose was removed primarily by net glycogen synthesis in the glycolytic preparation and both alanine release and oxidation in the mixed and oxidative preparations

Lactate in bitches with pyometra.

Science.gov (United States)

Volpato, R; Rodello, L; Abibe, R B; Lopes, M D

2012-12-01

Lactate is a compound produced by the anaerobic metabolism of glucose, and hyperlactataemia occurs when the rate of production of lactate exceeds the rate of elimination. This occurs in situations of hypoxia and tissue hypoperfusion. Lactate has been considered a useful prognostic indicator in critically ill patients. Pyometra is a disease of adult female dogs characterized by inflammation of the uterus with an accumulation of exudate, which occurs during the luteal phase. It is one of the most common diseases that occur in the genital tract of female dogs. A total of 31 dogs were diagnosed with pyometra. The diagnosis was confirmed at ultrasonography. Of the 31 dogs, 25 females had open cervix pyometra and six had closed cervix pyometra. Plasma lactate concentrations were determined by an enzymatic colorimetric method. The average concentration (±SD) of plasma lactate in all 31 bitches with pyometra was 3.55 ± 0.46 mm. Healthy dogs had plasma lactate concentrations between 0.3 and 2.5 mm (mean ± SD). Concentrations ranged from 0.8 to 2.9 mm when plasma lactate was measured with a portable device and 0.4-2.6 mm with the blood gas analyser. Even though plasma lactate values vary between several studies and equipment used to measure concentrations, our results for dogs with pyometra are higher indicating hyperlactataemia (Thorneloe et al. , Can Vet J 48, 283-288). Plasma lactate in dogs with closed cervix pyometra was mean ± SD and in dogs with open cervix pyometra, it was mean ± SD. The plasma lactate concentration in dogs with pyometra was higher than in healthy bitches, and there was no influence of patency of the cervix on the concentration of plasma lactate concentrations. Plasma lactate concentrations were similar for animals with open and closed pyometra (3.54 ± 0.52 to 3.64 ± 1.03 mm). © 2012 Blackwell Verlag GmbH.

Lactate versus pH levels in fetal scalp blood during labor--using the Lactate Scout System

DEFF Research Database (Denmark)

Lundin, Ingeborg Christina Rørbye; Perslev, Anette; Nickelsen, Carsten Nahne Amtoft

2016-01-01

OBJECTIVE: To assess if lactate measured with the Scout Lactate System is a reliable alternative to pH in intrapartum monitoring of the fetus. METHODS: A prospective study analyzing (1) the correlation between scalp lactate measured by the Scout Lactate System and the Automatic Blood Laboratory (...

What are fair study benefits in international health research? Consulting community members in Kenya.

Directory of Open Access Journals (Sweden)

Maureen Njue

Full Text Available Planning study benefits and payments for participants in international health research in low- income settings can be a difficult and controversial process, with particular challenges in balancing risks of undue inducement and exploitation and understanding how researchers should take account of background inequities. At an international health research programme in Kenya, this study aimed to map local residents' informed and reasoned views on the effects of different levels of study benefits and payments to inform local policy and wider debates in international research.Using a relatively novel two-stage process community consultation approach, five participatory workshops involving 90 local residents from diverse constituencies were followed by 15 small group discussions, with components of information-sharing, deliberation and reflection to situate normative reasoning within debates. Framework Analysis drew inductively and deductively on voice-recorded discussions and field notes supported by Nvivo 10 software, and the international research ethics literature. Community members' views on study benefits and payments were diverse, with complex contextual influences and interplay between risks of giving 'too many' and 'too few' benefits, including the role of cash. While recognising important risks for free choice, research relationships and community values in giving 'too many', the greatest concerns were risks of unfairness in giving 'too few' benefits, given difficulties in assessing indirect costs of participation and the serious consequences for families of underestimation, related to perceptions of researchers' responsibilities.Providing benefits and payments to participants in international research in low-income settings is an essential means by which researchers meet individual-level and structural forms of ethical responsibilities, but understanding how this can be achieved requires a careful account of social realities and local

Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

Science.gov (United States)

Qiblawi, Sara; Ghanayem, Haifa

2018-01-01

Background Breastfeeding women with hypogalactia are commonly recommended to use fenugreek as a galactogogue. This study aimed to achieve formal consensus among breastfeeding women and healthcare providers on which potential harms and benefits of using fenugreek need to be communicated and discussed during clinical consultations. Methods A two-iterative round Delphi technique was used in two separate panels of breastfeeding women (n = 65) and healthcare providers (n = 56) to achieve formal consensus on a list of 24 and 16 items related to potential harms and benefits of fenugreek. Results About 70% of the healthcare providers recommended quite often herbal remedies for breastfeeding women and about 68% of the women had been recommended to use herbal remedies many times by their healthcare providers. Consensus was achieved on 21 potential harms and 14 potential benefits of using fenugreek to enhance human milk supply that need to be discussed with breastfeeding women during consultations. Conclusion Probably, potential harms and benefits of recommending fenugreek as herbal galactogogue for breastfeeding women seeking recommendations to increase their human milk supply need to be discussed during clinical consultations. Further observational studies are needed to assess what is being discussed in daily consultations when herbal remedies are recommended. PMID:29849697

Performing Drug Safety Research During Pregnancy and Lactation: Biomedical HIV Prevention Research as a Template.

Science.gov (United States)

Beigi, Richard H; Noguchi, Lisa; Brown, Gina; Piper, Jeanna; Watts, D Heather

2016-07-01

Evidence-based guidance regarding use of nearly all pharmaceuticals by pregnant and lactating women is limited. Models for performing research may assist in filling these knowledge gaps. Internationally, reproductive age women are at high risk of human immunodeficiency virus (HIV) acquisition. Susceptibility to HIV infection may be increased during pregnancy, and risk of maternal-child transmission is increased with incident HIV infection during pregnancy and lactation. A multidisciplinary meeting of experts was convened at the United States National Institutes of Health to consider paradigms for drug research in pregnancy and lactation applicable to HIV prevention. This report summarizes the meeting proceedings and describes a framework for research on candidate HIV prevention agent use during pregnancy and lactation that may also have broader applications to other pharmaceutical products.

The Contemporary Consultant

DEFF Research Database (Denmark)

Olson, Thomas; Poulfelt, Flemming; Greiner, Larry

This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent to cur...... current management issues facing consulting firms. These cases, together with the handbook, will prepare consultants and other business managers for a successful future in a highly competitive consulting environment.......This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent...... to current management consulting. Each of the four parts of the text presents a cogent introduction by the editors, delineating topics that are critical for today's consultants to understand. The cases represent major practice areas of consulting and afford new insights into change processes and other...

Consultancy services and the urban hierarchy in Western Europe

OpenAIRE

P W Daniels; J H J Van Dinteren; M C Monnayer

1992-01-01

A cross-national survey of the relationship between the evolving organisation and structure of consultancy service enterprises and the urban hierarchy in Europe has been undertaken. Primate cities in Europe are still the preeminent foci for business services performing strong national and international control. The relationship between markets for consultancy services and the urban hierarchy is complex, but it is possible to suggest a typology of firms on the basis of client characteristics a...

CSF LACTATE IN MENINGITIS

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Anjampakuthikal Aboobekar Haris

2017-05-01

Full Text Available BACKGROUND Meningitis is an infection within the subarachnoid space characterised by a CNS inflammatory reaction. It is a serious condition requiring immediate diagnosis and appropriate treatment to be started at the earliest to prevent mortality as well as irreversible neurological deficits. CSF lactate has been found useful in differentiating bacterial meningitis from viral meningitis in many studies in the western population, but studies in Indian population are limited. The aim of the study is to study whether CSF lactate can be used to distinguish bacterial from viral meningitis and to study the levels of CSF lactate in tuberculosis meningitis. MATERIALS AND METHODS This was a descriptive study conducted in a tertiary care hospital. In this study, 78 cases of meningitis were selected. Cases are patients with bacterial, viral or tuberculosis meningitis admitted to the hospital under the Department of Medicine and Neurology. Cases are grouped into bacterial, viral and tuberculosis meningitis based on clinical picture, CSF analysis and imaging characteristics. CSF lactate estimation was done by dry chemistry method. Using appropriate statistical methods and SPSS software, CSF lactate levels were compared among these groups and analysed for any association with the final outcome. RESULTS The levels of CSF lactate in bacterial meningitis were higher than viral meningitis with a statistical significance of p 35 mg/dL for bacterial meningitis in this study was 95% and 100% respectively and the positive predictive value was 100% and the negative predictive value was 96%. The mean CSF lactate values in bacterial, viral and tuberculosis meningitis were 124.40 ± 35.85 mg/dL, 24.34 ± 6.05 mg/dL and 50.13 ± 9.89 mg/dL, respectively. CONCLUSION CSF lactate level was significantly elevated in bacterial meningitis than tuberculosis or viral meningitis and can be used as a marker for differentiating bacterial from viral meningitis.

Lactate: link between glycolytic and oxidative metabolism.

Science.gov (United States)

Brooks, George A

2007-01-01

Once thought to be the consequence of oxygen lack in contracting skeletal muscle, the glycolytic product lactate is formed and utilised continuously under fully aerobic conditions. 'Cell-cell' and 'intracellular lactate shuttle' concepts describe the roles of lactate in delivery of oxidative and gluconeogenic substrates as well as in cell signalling. Examples of cell-cell shuttles include lactate exchanges (i) between white-glycolytic and red-oxidative fibres within a working muscle bed; (ii) between working skeletal muscle and heart; and (iii) between tissues of net lactate release and gluconeogenesis. Lactate shuttles exist in diverse tissues including in the brain, where a shuttle between astrocytes and neurons is linked to glutamatergic signalling. Because lactate, the product of glycogenolysis and glycolysis, is disposed of by oxidative metabolism, lactate shuttling unites the two major processes of cellular energy transduction. Lactate disposal is mainly through oxidation, especially during exercise when oxidation accounts for 70-75% of removal and gluconeogenesis the remainder. Lactate flux occurs down proton and concentration gradients that are established by the mitochondrial lactate oxidation complex. Marathon running is a power activity requiring high glycolytic and oxidative fluxes; such activities require lactate shuttling. Knowledge of the lactate shuttle is yet to be imparted to the sport.

A retrospective analysis of medical record use in e-consultations.

Science.gov (United States)

Pecina, Jennifer L; North, Frederick

2017-06-01

Introduction Under certain circumstances, e-consultations can substitute for a face-to-face consultation. A basic requirement for a successful e-consultation is that the e-consultant has access to important medical history and exam findings along with laboratory and imaging results. Knowing just what information the specialist needs to complete an e-consultation is a major challenge. This paper examines differences between specialties in their need for past information from laboratory, imaging and clinical notes. Methods This is a retrospective study of patients who had an internal e-consultation performed at an academic medical centre. We reviewed a random sample of e-consultations that occurred in the first half of 2013 for the indication for the e-consultation and whether the e-consultant reviewed data in the medical record that was older than one year to perform the e-consultation. Results Out of 3008 total e-consultations we reviewed 360 (12%) randomly selected e-consultations from 12 specialties. Questions on management (35.8%), image results (27.2%) and laboratory results (25%) were the three most common indications for e-consultation. E-consultants reviewed medical records in existence more than one year prior to the e-consultation 146 (40.6%) of the time with e-consultants in the specialties of endocrinology, haematology and rheumatology, reviewing records older than one year more than half the time. Labs (20.3%), office notes (20%) and imaging (17.8%) were the types of medical data older than one year that were reviewed the most frequently overall. Discussion Management questions appear to be the most common reason for e-consultation. E-consultants frequently reviewed historical medical data that is older than one year at the time of the e-consultation, especially in endocrinology, haematology and rheumatology specialties. Practices engaging in e-consultations that require transfer of data may want to include longer time frames of historical information

Duration of breast milk expression among working mothers enrolled in an employer-sponsored lactation program.

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Ortiz, Joan; McGilligan, Kathryn; Kelly, Patricia

2004-01-01

Maternal employment has been one of the greatest barriers to breastfeeding. Women are increasingly solving this problem by expressing milk at work and taking it home to their infants. The objective was to determine duration of breast milk expression among working mothers enrolled in an employer-sponsored lactation program. Retrospective reviews were conducted on the lactation records of 462 women employed by 5 corporations in order to describe and characterize their experiences. The lactation program included the employees' choice of (a) a class on the benefits of breastfeeding; (b) services of a certified lactation consultant (CLC); and (c) private room in the workplace with equipment for pumping. Breastfeeding was initiated by 97.5% of the participants, with 57.8% continuing for at least 6 months. Of the 435 (94.2%) who returned to work after giving birth, 343 (78.9%) attempted pumping milk at work, and 336 (98%) were successful. They expressed milk in the workplace for a mean of 6.3 months (SD = 3.9, range 2 weeks to 21 months). The mean age of infants when the mothers stopped pumping at work was 9.1 months (SD = 4.1, range 1.9 to 25 months). Most of the women who pumped their milk at work were working full time (84.2%). The mean postnatal maternity leave was 2.8 months. The proportion of women who chose to pump at work was higher among women who were salaried than among those who were paid hourly wages (p < 0.01). Company-sponsored lactation programs can enable employed mothers to provide breast milk for their infants as long as they wish, thus helping the nation attain the Healthy People 2010 goals of 50% of mothers breastfeeding until their infants are 6-months-old.

22 CFR 181.4 - Consultations with the Secretary of State.

Science.gov (United States)

2010-04-01

... international agreements of the United States are fully consistent with United States foreign policy objectives... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Consultations with the Secretary of State. 181.4 Section 181.4 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL AGREEMENTS COORDINATION...

Urinary incontinence in frail elderly persons: Report from the 5th International Consultation on Incontinence.

Science.gov (United States)

Wagg, Adrian; Gibson, William; Ostaszkiewicz, Joan; Johnson, Theodore; Markland, Alayne; Palmer, Mary H; Kuchel, George; Szonyi, George; Kirschner-Hermanns, Ruth

2015-06-01

Evidence based guidelines for the management of frail older persons with urinary incontinence are rare. Those produced by the International Consultation on Incontinence represent an authoritative set of recommendations spanning all aspects of management. To update the recommendations of the 4th ICI. A series of systematic reviews and evidence updates were performed by members of the working group in order to update the 2009 recommendations. The resulting guidelines were presented at the 2012 meeting of the European Associatioon of Urology. Along with the revision of the treatment algorithm and accompanying text. There have been significant advances in several areas including pharmacological treatment of overactive bladder. The committee continue to notes the relative paucity of data concerning frail older persons and draw attention to knowledge gaps in this area. © 2014 Wiley Periodicals, Inc.

Lactational Infertility- A Review

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Ramachandran Prema

1987-01-01

Full Text Available Studies undertaken by the National Institute of Nutrition during the last 10 years indicate that prolonged breast-feeding is still the rule among rural and urban low income group population in Hyderabad. Lactation induced hyperprolactinaemia prolongs postpartum amenorrhea and inter pregnancy interval by about 6 months. Duration of lactational amenorrhea infants results in a fall of plasma prolactin levels and rapid return of menstruation and fertility. Lactational amenorrhea lasts longer in undernourished women with low body weight and low fat fold rural women, duration of lactational amenorrhea is longer as compared to urban women. This might be partly attributable to the delay in introduction of supplements to the rural infants and partly to the lower body weight and fat fold thickness of rural women.

Creating a Business Plan for a Start-up Business Consultancy in Namibia

OpenAIRE

von Wietersheim, Julia

2011-01-01

The objective of this Thesis is to investigate the process of creating an extensive Business Plan and thereby to practically apply the theory studied during the Degree Programme of International Business. To achieve this objective, a practical business plan for a start-up Business Consultancy in Namibia (called VW-Business Consulting) is created, which at the same time provides a deeper understanding of the current demand for, and awareness of, business consulting companies in Namibia. An...

Effect of bicarbonate and lactate buffer on glucose and lactate metabolism during hemodiafiltration in patients with multiple organ failure.

Science.gov (United States)

Bollmann, Marc-Daniel; Revelly, Jean-Pierre; Tappy, Luc; Berger, Mette M; Schaller, Marie-Denise; Cayeux, Marie-Christine; Martinez, Alexandre; Chioléro, René-Louis

2004-06-01

To compare the effects of sodium bicarbonate and lactate for continuous veno-venous hemodiafiltration (CVVHDF) in critically ill patients. Prospective crossed-over controlled trial in the surgical and medical ICUs of a university hospital. Eight patients with multiple organ dysfunction syndrome (MODS) requiring CVVHDF. Each patient received the two buffers in a randomized sequence over two consecutive days. The following variables were determined: acid-base parameters, lactate production and utilization ((13)C lactate infusion), glucose turnover (6,6(2)H(2)-glucose), gas exchange (indirect calorimetry). No side effect was observed during lactate administration. Baseline arterial acid-base variables were equal with the two buffers. Arterial lactate (2.9 versus 1.5 mmol/l), glycemia (+18%) and glucose turnover (+23%) were higher in the lactate period. Bicarbonate and glucose losses in CVVHDF were substantial, but not lactate elimination. Infusing (13)C lactate increased plasma lactate levels equally with the two buffers. Lactate clearance (7.8+/-0.8 vs 7.5+/-0.8 ml/kg per min in the bicarbonate and lactate periods) and endogenous production rates (14.0+/-2.6 vs 13.6+/-2.6 mmol/kg per min) were similar. (13)C lactate was used as a metabolic substrate, as shown by (13)CO(2) excretion. Glycemia and metabolic rate increased significantly and similarly during the two periods during lactate infusion. Lactate was rapidly cleared from the blood of critically ill patients without acute liver failure requiring CVVHDF, being transformed into glucose or oxidized. Lactate did not exert undesirable effects, except moderate hyperglycemia, and achieved comparable effects on acid-base balance to bicarbonate.

[Motivations for a consultation before adoption: A multicenter study].

Science.gov (United States)

Thieblemont, M; Francois, P; Poirier, V; Bosdure, E; Munck, M-R; Borsa-Dorion, A; Hazart, I; Moukagni-Pelzer, M; Brunel, D; Peyron, F; de Monleon, J-V

2016-01-01

While the number of international adoptions in France is decreasing, adopted children are older and in poorer health than they used to be. This phenomenon has resulted in an increase in the demand for preadoption consultations over the past several years. This study analyses the reasons for these consultations. Prospective multicenter study conducted from 1 January to 31 December 2013. Ten centers contributed to the study, i.e., 196 preadoption consultations. Seeking medical advice was the reason for 88% of the consultations, whether the advice was based on the study of an identified child's medical file (32%) or a country's healthcare characteristics, whether the country was identified (34%) or not (23%). In 6% of cases, the motive for preadoption consultations was social and familial, and in the last 5% it was to obtain general information about adoption and its procedures. In more than 40% of the cases, whether the child or the country identified, Russia is the subject of the consultation because of the complexity of the files and because of the dreaded but rarely mentioned fetal alcohol syndrome. The deterioration of adopted children's health is an additional worry for future adoption applicants. To provide them with the best information possible without making choices for them, specialists should have substantial experience in adoption before going into these preadoption consultations. Copyright © 2015. Published by Elsevier SAS.

Metabolic kinetics and absorbed doses of 137Cs in lactating rats and progeny during suckling

International Nuclear Information System (INIS)

Lyaginskaya, A.M.; Osipov, V.A.; Dement'ev, S.I.; Ermalitskij, A.P.

2000-01-01

The transfer of 137 Cs with maternal milk to progeny was studied in rats The rats were administered with 25 kBq/g of 137 Cs nitrate (pH = 6) in a single oral dose immediately after delivery. Nonpregnant females served as control. Absorbed doses per activity unit to lactating rats were 23 % lover than to nonlactating ones. Over the suckling period absorbed doses to young rats amounted to about 35 % of the absorbed dose to the nursing female. For nonlactating females the internal dose approximately equalled the sum of doses to the nursing female and young rats. Lactating is the effective way for removal of 1 '3 7 Cs from organism of the rats. Content of 1 '3 7 Cs in lactating rat becomes on 42.9 % lower than in organism of nonlactating rat during period of lactating (near 20 days) [ru

Characterization of Lactate Sensors Based on Lactate Oxidase and Palladium Benzoporphyrin Immobilized in Hydrogels

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Liam P. Andrus

2015-07-01

Full Text Available An optical biosensor for lactate detection is described. By encapsulating enzyme-phosphor sensing molecules within permeable hydrogel materials, lactate-sensitive emission lifetimes were achieved. The relative amount of monomer was varied to compare three homo- and co-polymer materials: poly(2-hydroxyethyl methacrylate (pHEMA and two copolymers of pHEMA and poly(acrylamide (pAam. Diffusion analysis demonstrated the ability to control lactate transport by varying the hydrogel composition, while having a minimal effect on oxygen diffusion. Sensors displayed the desired dose-variable response to lactate challenges, highlighting the tunable, diffusion-controlled nature of the sensing platform. Short-term repeated exposure tests revealed enhanced stability for sensors comprising hydrogels with acrylamide additives; after an initial “break-in” period, signal retention was 100% for 15 repeated cycles. Finally, because this study describes the modification of a previously developed glucose sensor for lactate analysis, it demonstrates the potential for mix-and-match enzyme-phosphor-hydrogel sensing for use in future multi-analyte sensors.

Lactate up-regulates the expression of lactate oxidation complex-related genes in left ventricular cardiac tissue of rats.

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Daniele Gabriel-Costa

Full Text Available Besides its role as a fuel source in intermediary metabolism, lactate has been considered a signaling molecule modulating lactate-sensitive genes involved in the regulation of skeletal muscle metabolism. Even though the flux of lactate is significantly high in the heart, its role on regulation of cardiac genes regulating lactate oxidation has not been clarified yet. We tested the hypothesis that lactate would increase cardiac levels of reactive oxygen species and up-regulate the expression of genes related to lactate oxidation complex.Isolated hearts from male adult Wistar rats were perfused with control, lactate or acetate (20mM added Krebs-Henseleit solution during 120 min in modified Langendorff apparatus. Reactive oxygen species (O2●-/H2O2 levels, and NADH and NADPH oxidase activities (in enriched microsomal or plasmatic membranes, respectively were evaluated by fluorimetry while SOD and catalase activities were evaluated by spectrophotometry. mRNA levels of lactate oxidation complex and energetic enzymes MCT1, MCT4, HK, LDH, PDH, CS, PGC1α and COXIV were quantified by real time RT-PCR. Mitochondrial DNA levels were also evaluated. Hemodynamic parameters were acquired during the experiment. The key findings of this work were that lactate elevated cardiac NADH oxidase activity but not NADPH activity. This response was associated with increased cardiac O2●-/H2O2 levels and up-regulation of MCT1, MCT4, LDH and PGC1α with no changes in HK, PDH, CS, COXIV mRNA levels and mitochondrial DNA levels. Lactate increased NRF-2 nuclear expression and SOD activity probably as counter-regulatory responses to increased O2●-/H2O2.Our results provide evidence for lactate-induced up-regulation of lactate oxidation complex associated with increased NADH oxidase activity and cardiac O2●-/H2O2 driving to an anti-oxidant response. These results unveil lactate as an important signaling molecule regulating components of the lactate oxidation complex in

Cerebral Lactate Concentration in Neonatal Hypoxic-Ischemic Encephalopathy: In Relation to Time, Characteristic of Injury, and Serum Lactate Concentration

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Tai-Wei Wu

2018-05-01

Full Text Available BackgroundCerebral lactate concentration can remain detectable in neonatal hypoxic-ischemic encephalopathy (HIE after hemodynamic stability. The temporal resolution of regional cerebral lactate concentration in relation to the severity or area of injury is unclear. Furthermore, the interplay between serum and cerebral lactate in neonatal HIE has not been well defined. The study aims to describe cerebral lactate concentration in neonatal HIE in relation to time, injury, and serum lactate.Design/methodsFifty-two newborns with HIE undergoing therapeutic hypothermia (TH were enrolled. Magnetic resonance imaging and spectroscopy (MRI + MR spectroscopy were performed during and after TH at 54.6 ± 15.0 and 156 ± 57.6 h of life, respectively. Severity and predominant pattern of injury was scored radiographically. Single-voxel 1H MR spectra were acquired using short-echo (35 ms PRESS sequence localized to the basal ganglia (BG, thalamus (Thal, gray matter (GM, and white matter. Cerebral lactate concentration was quantified by LCModel software. Serum and cerebral lactate concentrations were plotted based on age at time of measurement. Multiple comparisons of regional cerebral lactate concentration based on severity and predominant pattern of injury were performed. Spearman’s Rho was computed to determine correlation between serum lactate and cerebral lactate concentration at the respective regions of interest.ResultsOverall, serum lactate concentration decreased over time. Cerebral lactate concentration remained low for less severe injury and decreased over time for more severe injury. Cerebral lactate remained detectable even after TH. During TH, there was a significant higher concentration of cerebral lactate at the areas of injury and also when injury was more severe. However, these differences were no longer observed after TH. There was a weak correlation between serum lactate and cerebral lactate concentration at the BG (rs�

Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study

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Bazzano AN

2017-02-01

Full Text Available Alessandra N Bazzano,1 Lauren Cenac,1 Amelia J Brandt,1 Josephine Barnett,2 Shelley Thibeau,3 Katherine P Theall1 1Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, 2City University of New York, CUNY Graduate Center, New York, NY, 3Ochsner Clinic Foundation, New Orleans, LA, USA Abstract: An increase in the marketing and use of herbal galactagogues among breastfeeding mothers in the US has raised the issue of how best to provide support and information on the use of these products, particularly in light of limited availability of certified lactation counselors and continued suboptimal rates of breastfeeding globally. Currently, no cross-sectional data are available on the experiences and attitudes of mothers regarding the use of herbal and pharmaceutical galactagogues for lactation in the US. The findings of an online survey of 188 breastfeeding mothers on experiences with and sources of information on galactagogues are presented. Most mothers (76% reported that while breastfeeding, they felt as though they were not making enough milk to meet the needs of their child, and yet 54% also indicated that they had not supplemented with formula. A large proportion of respondents reported utilizing galactagogues to increase lactation and finding them useful. The results indicated that most women learned about galactagogues from the Internet or by word of mouth through friends. Lactation consultants were the third-most reported sources of information on these products. While many respondents reported perceiving galactagogues as innocuous, more evidence on safety and efficacy is needed to support women properly who seek out and use them. Large-scale studies of the prevalence of galactagogue use in the US and rigorous evaluation of use globally are needed to ensure that mothers who choose to breastfeed may safely avail themselves of all options when counseling

A Successful Induction of Lactation in Surrogate Pregnancy with Metoclopramide and Review of Lactation Induction

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Elahe Mirzaaga

2010-01-01

Full Text Available In surrogate pregnancies genetic parents have little opportunity for early bonding with their infants,either prenatally (in utero or during the immediate postnatal period. Procedures commonlyused to induce lactation include both pharmacologic and nonpharmacologic methods, often incombination. Studies reporting induced lactation are sparse, due to the rarity of augmentedlactation. Here we report a case of lactation induction following a surrogate pregnancy. Othermethods that can be used to augment lactation are described below. We used metoclopramide inthis case due to the success rates reported in previous studies and case reports. Additionally, itis a well tolerated and safe agent.

Invited review: Carryover effects of early lactation feeding on total lactation performance in dairy cows

DEFF Research Database (Denmark)

Jørgensen, Carina; Spörndly, R; Bertilsson, J

2016-01-01

In comparison with the intensive research on the direct effects of energy supply on dairy cow lactation performance, little attention has been paid to the effect of early lactation feeding on subsequent production. The present paper reviews 9 studies carried out with the aim of quantifying...... the immediate and subsequent responses in milk production and body weight to early lactation feeding. Most results showed that a more generous feeding in early lactation caused a positive carryover effect on subsequent production, whereas an inadequate level of feed in early lactation has been shown to reduce...... to be determined by several factors including duration of the treatment and post-treatment feeding level. The most important factor though appears to be the magnitude of over- or underfeeding (i.e., a strong relationship between the treatment period feeding level and the subsequent response in production)....

Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study.

Science.gov (United States)

Bazzano, Alessandra N; Cenac, Lauren; Brandt, Amelia J; Barnett, Josephine; Thibeau, Shelley; Theall, Katherine P

2017-01-01

An increase in the marketing and use of herbal galactagogues among breastfeeding mothers in the US has raised the issue of how best to provide support and information on the use of these products, particularly in light of limited availability of certified lactation counselors and continued suboptimal rates of breastfeeding globally. Currently, no cross-sectional data are available on the experiences and attitudes of mothers regarding the use of herbal and pharmaceutical galactagogues for lactation in the US. The findings of an online survey of 188 breastfeeding mothers on experiences with and sources of information on galactagogues are presented. Most mothers (76%) reported that while breastfeeding, they felt as though they were not making enough milk to meet the needs of their child, and yet 54% also indicated that they had not supplemented with formula. A large proportion of respondents reported utilizing galactagogues to increase lactation and finding them useful. The results indicated that most women learned about galactagogues from the Internet or by word of mouth through friends. Lactation consultants were the third-most reported sources of information on these products. While many respondents reported perceiving galactagogues as innocuous, more evidence on safety and efficacy is needed to support women properly who seek out and use them. Large-scale studies of the prevalence of galactagogue use in the US and rigorous evaluation of use globally are needed to ensure that mothers who choose to breastfeed may safely avail themselves of all options when counseling support is insufficient.

Lactate promotes specific differentiation in bovine granulosa cells depending on lactate uptake thus mimicking an early post-LH stage

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Anja Baufeld

2018-02-01

Full Text Available Abstract Background The LH-induced folliculo-luteal transformation is connected with alterations of the gene expression profile in cells of the granulosa layer. It has been described that hypoxic conditions occur during luteinization, thus favoring the formation of L-lactate within the follicle. Despite being a product of anaerobic respiration, L-lactate has been shown to act as a signaling molecule affecting gene expression in neuronal cells. During the present study, we tested the hypothesis that L-lactate may influence differentiation of follicular granulosa cells (GC. Methods In a bovine granulosa cell culture model effects of L- and D-lactate, of increased glucose concentrations and of the lactate transport inhibitor UK5099 were analyzed. Steroid hormone production was analyzed by RIA and the abundance of key transcripts was determined by quantitative real-time RT-PCR. Results L-lactate decreased the production of estradiol and significantly affected selected genes of the folliculo-luteal transition as well as genes of the lactate metabolism. CYP19A1, FSHR, LHCGR were down-regulated, whereas RGS2, VNN2, PTX3, LDHA and lactate transporters were up-regulated. These effects could be partly or completely reversed by pre-treatment of the cells with UK5099. The non-metabolized enantiomer D-lactate had even more pronounced effects on gene expression, whereas increased glucose concentrations did not affect transcript abundance. Conclusions In summary, our data suggest that L-lactate specifically alters physiological and molecular characteristics of GC. These effects critically depend on L-lactate uptake, but are not triggered by increased energy supply. Further, we could show that L-lactate has a positive feedback on the lactate metabolism. Therefore, we hypothesize that L-lactate acts as a signaling molecule in bovine and possibly other monovular species supporting differentiation during the folliculo-luteal transformation.

Lactate transport and signaling in the brain

DEFF Research Database (Denmark)

Bergersen, Linda Hildegard

2015-01-01

AMP. The localization and function of HCAR1 and the three MCTs (MCT1, MCT2, and MCT4) expressed in brain constitute the focus of this review. They are possible targets for new therapeutic drugs and interventions. The author proposes that lactate actions in the brain through MCTs and the lactate receptor underlie part......Lactate acts as a ‘buffer’ between glycolysis and oxidative metabolism. In addition to being exchanged as a fuel by the monocarboxylate transporters (MCTs) between cells and tissues with different glycolytic and oxidative rates, lactate may be a ‘volume transmitter’ of brain signals. According...... to some, lactate is a preferred fuel for brain metabolism. Immediately after brain activation, the rate of glycolysis exceeds oxidation, leading to net production of lactate. At physical rest, there is a net efflux of lactate from the brain into the blood stream. But when blood lactate levels rise...

Small Business & Consultancy: Exploration of an Experiment with Student Consultants

NARCIS (Netherlands)

I. Hollaender

2007-01-01

In this paper I’ll discuss the first outcomes of an explorative research concerning the consultancy projects of a consultancy-based learning programme (Minor Consultancy 2006 - 2007, half-year bachelor programme University of Applied Sciences, Hogeschool Utrecht, The Netherlands). In order to

Lactate quantification by proton magnetic resonance spectroscopy using a clinical MRI machine: a basic study

International Nuclear Information System (INIS)

Isobe, T.; Muraishi, H.; Matsumura, A.; Kawamura, H.; Shibata, Y.; Anno, I.; Minami, M.

2007-01-01

The purpose of this study was to establish quantification method of lactate concentration by proton magnetic resonance spectroscopy (MRS) carried out using a conventional 1.5-T MRI machine. We used a lactate phantom with known concentrations (1, 1.5, 3, 6, 12 and 14 mmol/L). As a clinical example, a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) was evaluated. Proton MRS was carried out using a clinical 1.5-T super-conducting magnetic resonance whole-body system. Data were acquired by point resolved spectroscopy. A coupling constant of J = 7.35 Hz (2/7 = 272 ms) and two long in-phase echo time of 272 ms and 544 ms were used to calculate the T2 relaxation time. The tissue water signal was used as an internal standard to quantify lactate. The correlation coefficient R between the calculated lactate concentrations and the known concentration of lactate was 0.99 with a constant factor of 0.32 (1/3.14). In patients with MELAS, the lactate concentration measured by MRS was 6.2 mmol/kg wet weight, which is similar to the value obtained in previous studies. In the present study, we have established a reliable method for lactate quantification in a phantom study and have shown a sample of clinical case of MELAS

Exploring accountability of clinical ethics consultants: practice and training implications.

Science.gov (United States)

Weise, Kathryn L; Daly, Barbara J

2014-01-01

Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.

75 FR 54064 - Consultation Agreements: Proposed Changes to Consultation Procedures

Science.gov (United States)

2010-09-03

... State consultants performing worksite visits. Following the successful completion of an on-site... all types of complaints in a similar fashion. As a result, OSHA does not need to distinguish between...) * * * (2) The Consultant shall terminate an onsite consultative visit already in progress where one of the...

Lactic acid and lactates

NARCIS (Netherlands)

Schreurs, V.V.A.M.

2010-01-01

This review aims to integrate the present state of knowledge on lactate metabolism in human and mammalian physiology as far as it could be subject to nutritional interventions. An integrated view on the nutritional, metabolic and physiological aspects of lactic acid and lactates might open a

Maintained exercise-enhanced brain executive function related to cerebral lactate metabolism in men

DEFF Research Database (Denmark)

Hashimoto, Takeshi; Tsukamoto, Hayato; Takenaka, Saki

2018-01-01

. Fourteen healthy, male subjects performed 2 HIIE protocols separated by 60 min of rest. Blood samples were obtained from the right internal jugular venous bulb and from the brachial artery to determine differences across the brain for lactate (a-v difflactate), glucose (diffglucose), oxygen (diffoxygen......High-intensity interval exercise (HIIE) improves cerebral executive function (EF), but the improvement in EF is attenuated after repeated HIIE, perhaps because of lower lactate availability for the brain. This investigation examined whether improved EF after exercise relates to brain lactate uptake......), and brain-derived neurotrophic factor (BDNF; diffBDNF). EF was evaluated by the color-word Stroop task. The first HIIE improved EF for 40 min, whereas the second HIIE improved EF only immediately after exercise. The a-v diffglucose was unchanged, whereas the a-v diffBDNF increased similarly after both HIIEs...

A Successful Induction of Lactation in Surrogate Pregnancy with Metoclopramide and Review of Lactation Induction

OpenAIRE

Elahe Mirzaaga; Arezoo Arabipoor; Mitra Frotan; Marzieh Shiva

2010-01-01

In surrogate pregnancies genetic parents have little opportunity for early bonding with their infants,either prenatally (in utero) or during the immediate postnatal period. Procedures commonlyused to induce lactation include both pharmacologic and nonpharmacologic methods, often incombination. Studies reporting induced lactation are sparse, due to the rarity of augmentedlactation. Here we report a case of lactation induction following a surrogate pregnancy. Othermethods that can be used to au...

Glucose metabolism in lactating reindeer

Energy Technology Data Exchange (ETDEWEB)

White, R G; Luick, J R

1976-01-01

Changes in glucose synthesis during the lactation cycle were estimated in pen-fed and grazing reindeer. The pool size, space, transfer rate, and irreversible loss of glucose were determined using simultaneous injections of (2-/sup 3/H)glucose and primed infusions of (U-/sup 14/C)glucose in reindeer lactating for 1-2, 4-5, 8-9, and 12-16 weeks. Glucose transfer rate and irreversible loss were higher during early to midlactation than at other times of the year; maximum estimates were at 8-9 week postpartum (July), and a decline was noted at 12-16 weeks (August). During the first 1-2 weeks in pen-fed and 4-5 weeks in grazing reindeer, glucose transfer rate and irreversible loss were almost twice the values reported for reindeer at maintenance. No difference in the irreversible loss of glucose was noted between lactating and non-lactating reindeer at 18-20 weeks postpartum (September), and there is evidence that this may occur as early as 12-16 weeks postpartum. No significant trend was noted in the glucose space throughout lactation; however, a significant increase in plasma glucose concentration and pool size was noted when glucose synthesis was highest (8-9 weeks postpartum). Glucose turnover time was consistently faster (78-88 min) in lactating than in non-lactating reindeer (107-140 min). Reindeer used a smaller proportion of plasma glucose-C for lactose synthesis than did other domestic species. This probably results from the low lactose content of reindeer milk and the relatively low rate of milk secretion. (auth)

Five-year follow-up of a woman with pregnancy and lactation-associated osteoporosis and vertebral fractures

Directory of Open Access Journals (Sweden)

Sato Y

2012-04-01

Full Text Available Jun Iwamoto1, Yoshihiro Sato2, Mitsuyoshi Uzawa3, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, 2Department of Neurology, Mitate Hospital, Fukuoka, 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanAbstract: We report the 5-year follow-up of a young woman who developed vertebral fractures after pregnancy and lactation and was treated with active vitamin D hormone. A 32-year-old Japanese woman consulted us because of acute lower back pain caused by L2 and L5 vertebral fractures after pregnancy and lactation. Following cessation of breast-feeding, analgesia, bed rest, and wearing of a hard brace, her lower back pain disappeared within 2 months. After 5 years of treatment with alfacalcidol 1 µg daily, the lumbar spine (L1, L3, L4 bone mineral density increased by 21.4% following vigorous reductions in bone turnover markers. No osteoporotic fractures occurred, and the vertebral fractures healed. The patient experienced no side effects, including hypercalcemia. Thus, the present case report shows long-term changes in bone turnover markers and lumbar spine bone mineral density, as well as long-term safety of alfacalcidol treatment in a young woman with pregnancy and lactation-associated osteoporosis and vertebral fractures.Keywords: young woman, pregnancy, alfacalcidol, bone mineral density, osteoporosis, vertebral fracture

Lactate oxidation in human skeletal muscle mitochondria

DEFF Research Database (Denmark)

Jacobs, Robert A; Meinild, Anne-Kristine; Nordsborg, Nikolai B

2013-01-01

of four separate and specific substrate titration protocols, the respirometric analysis revealed that mitochondria were capable of oxidizing lactate in the absence of exogenous LDH. The titration of lactate and NAD(+) into the respiration medium stimulated respiration (P = 0.003). The addition...... of exogenous LDH failed to increase lactate-stimulated respiration (P = 1.0). The results further demonstrate that human skeletal muscle mitochondria cannot directly oxidize lactate within the mitochondrial matrix. Alternately, these data support previous claims that lactate is converted to pyruvate within...

Institutional policy learning and public consultation: the Canadian xenotransplantation experience.

Science.gov (United States)

Jones, Mavis; Einsiedel, Edna

2011-09-01

Attempts to evaluate public consultations, participatory technology assessment, and deliberative democracy have typically considered impacts on either policy or participants. The determination of impacts on policy institutions has been limited due to the challenges of tracing effects through the policy process, or penetrating bureaucratic walls. This paper presents findings from a retrospective study exploring the institutional lessons learned from a 2001 Canadian national public consultation on xenotransplantation. The consultation was conducted through an arm's-length process and involved the use of citizen juries in six regional sites. We conducted in-depth interviews of regulatory and policy actors who were engaged in early policy discussions and the consultation process. We reviewed evaluations of this process, both internal and external, which gave us richer insights into what institutional actors saw as the impacts of this consultative experience on their policy environment. Participants in our research identified a broader shift toward openness in policy culture which they linked specifically to the innovative consultation process employed for xenotransplantation. We argue that beyond input into policy decisions, a consultation may have an impact in terms of its contribution to overall shifts in institutional culture (related to institutional learning), such as an "opening" of technological decision processes to a broader range of actors, knowledge, and values. Copyright © 2011 Elsevier Ltd. All rights reserved.

21 CFR 582.1207 - Calcium lactate.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Calcium lactate. 582.1207 Section 582.1207 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Additives § 582.1207 Calcium lactate. (a) Product. Calcium lactate. (b) Conditions of use. This substance is...

Lactate in Bitches with Pyometra

OpenAIRE

Volpato, R. [UNESP; Rodello, L. [UNESP; Abibe, R. B. [UNESP; Lopes, Maria Denise [UNESP

2012-01-01

Lactate is a compound produced by the anaerobic metabolism of glucose, and hyperlactataemia occurs when the rate of production of lactate exceeds the rate of elimination. This occurs in situations of hypoxia and tissue hypoperfusion. Lactate has been considered a useful prognostic indicator in critically ill patients. Pyometra is a disease of adult female dogs characterized by inflammation of the uterus with an accumulation of exudate, which occurs during the luteal phase. It is one of the mo...

Bisphenol S Alters the Lactating Mammary Gland and Nursing Behaviors in Mice Exposed During Pregnancy and Lactation.

Science.gov (United States)

LaPlante, Charlotte D; Catanese, Mary C; Bansal, Ruby; Vandenberg, Laura N

2017-10-01

High doses of estrogenic pharmaceuticals were once prescribed to women to halt lactation. Yet, the effects of low-level xenoestrogens on lactation remain poorly studied. We investigated the effects of bisphenol S (BPS), an estrogen receptor (ER) agonist, on the lactating mammary gland; the arcuate nucleus, a region of the hypothalamus important for neuroendocrine control of lactational behaviors; and nursing behavior in CD-1 mice. Female mice were exposed to vehicle, 2 or 200 µg BPS/kg/d from pregnancy day 9 until lactational day (LD) 20, and tissues were collected on LD21. Tissues were also collected from a second group at LD2. BPS exposure significantly reduced the fraction of the mammary gland comprised of lobules, the milk-producing units, on LD21, but not LD2. BPS also altered expression of Esr1 and ERα in the mammary gland at LD21, consistent with early involution. In the arcuate nucleus, no changes were observed in expression of signal transducer and activator of transcription 5, a marker of prolactin signaling, or ERα, suggesting that BPS may act directly on the mammary gland. However, observations of nursing behavior collected during the lactational period revealed stage-specific effects on both pup and maternal nursing behaviors; BPS-treated dams spent significantly more time nursing later in the lactational period, and BPS-treated pups were less likely to initiate nursing. Pup growth and development were also stunted. These data indicate that low doses of BPS can alter lactational behaviors and the maternal mammary gland. Together, they support the hypothesis that pregnancy and lactation are sensitive to low-dose xenoestrogen exposures. Copyright © 2017 Endocrine Society.

Relationship between season, lactation number and incidence of clinical mastitis in different stages of lactation in a Holstein dairy farm

Directory of Open Access Journals (Sweden)

Maede Moosavi

2013-12-01

Full Text Available The aim of the present study was to compare the occurrence and duration of clinical mastitis in different seasons, stages of lactation period and parities in a Holstein dairy farm in Iran. A retrospective epidemiological survey from April 2005 to March 2008 was conducted on 884 clinical mastitis cases of 7437 lactations. Data of each case including calendar-date of mastitis onset, days in milk (DIM of mastitis onset (early: 0-74 DIM; middle: 75-150 DIM, and late ≥ 150 DIM, duration of mastitis, and parity (1, 2, and ≥ 3 were recorded. Based on date of mastitis onset, cases were classified into stages of lactation. Moreover, beginning of mastitis was seasonally categorized. Duration of clinical mastitis after treatment in early lactation was less than late lactation in the first-parity cows (p = 0.005. In early lactation period, the first-parity cows suffered clinical mastitis in days earlier than two other parity groups (p < 0.001. Moreover, in late lactation period, the first-parity cows had clinical mastitis in days later than cows in the third and more parities (p = 0.002. Occurrence of clinical mastitis in summer increased in late lactation period but in winter increased in early lactation period (p = 0.001. In addition, occurrence time of clinical mastitis in summer were in days later than in spring (p = 0.02 and winter (p = 0.03 in early lactation period. In conclusion, occurrence of mastitis in winter and spring during early lactation and in summer during late lactation period were more prevalent especially in lower parities.

Computed exercise plasma lactate concentrations: A conversion formula

Directory of Open Access Journals (Sweden)

Lia Bally

2016-04-01

Full Text Available Objectives: Blood lactate measurements are common as a marker of skeletal muscle metabolism in sport medicine. Due to the close equilibrium between the extracellular and intramyocellular space, plasma lactate is a more accurate estimate of muscle lactate. However, whole blood-based lactate measurements are more convenient in field use. The purpose of this investigation was therefore (1 to establish a plasma-converting lactate formula for field use, and (2 to validate the computed plasma lactate levels by comparison to a laboratory standard method. Design and methods: A total of 91 venous samples were taken from 6 individuals with type 1 diabetes during resting and exercise conditions and assessed for whole blood and plasma lactate using the YSI 2300 analyzer. A linear model was applied to establish a formula for converting whole blood lactate to plasma lactate. The validity of computed plasma lactate values was assessed by comparison to a laboratory standard method. Results: Whole blood YSI lactate could be converted to plasma YSI values (slope 1.66, intercept 0.12 for samples with normal hematocrit. Computed plasma levels compared to values determined by the laboratory standard method using Passing-Bablok regression yielded a slope of 1.03 (95%CI:0.99:1.08 with an intercept of -0.11 (95%CI:-0.18:-0.06. Conclusions: Whole blood YSI lactate values can be reliably converted into plasma values which are in line with laboratory determined plasma measurements. Keywords: Lactate, Plasma vs whole-blood, Hematocrit, Enzyme electrodes, Sample treatment

Colonic lactate metabolism and D-lactic acidosis

DEFF Research Database (Denmark)

Hove, H; Mortensen, P B

1995-01-01

D-Lactic acidosis is seen in patients with intestinal bypass or short bowels in whom colonic produced D-lactate accumulates. An intestinal bypassed patient with D-lactic acidosis had higher fecal D-lactate (122.4 mmol/liter) and L-lactate (90.1 mmol/liter) than described before in humans. D......-Lactate fluctuated between 0.5 and 3.1 mmol/liter in plasma (normal liter) and between 1.1 and 52.8 mmol/liter in urine (normal liter) within a few hours, indicating that the human organism do metabolize and excrete D-lactate. The patient with D-lactic acidosis had a 10-fold increased DL......-lactate in feces (84.0 mmol/liter) and plasma (2.3 mmol/liter) considerably in the patient with D-lactic acidosis. Intestinal prolongation (22 cm ileum) had a temporary effect on fecal and plasma D-lactate, but intestinal continuity was reestablished 26 months later because D-lactic acidosis recurred (plasma 8...

Lactate in cystic fibrosis sputum

DEFF Research Database (Denmark)

Bensel, Tobias; Stotz, Martin; Borneff-Lipp, Marianne

2011-01-01

Antibiotic therapy is thought to improve lung function in patients with cystic fibrosis (CF) by decreasing neutrophil-derived inflammation. We investigated the origin and clinical significance of lactate in the chronically inflamed CF lung. Methods Lactate was measured in sputa of 18 exacerbated...... and 25 stable CF patients via spectrophotometry and gaschromatography. Lung function was assessed via spirometry. Seven patients with chronic obstructive pulmonary disease (COPD) and three patients with acute lung inflammation served as control groups. Neutrophil and bacterial lactate production...

Consultation Models Revisited

International Nuclear Information System (INIS)

Fawaz, S.; Khan, Zulfiquar A.; Mossa, Samir Y.

2006-01-01

A new definition is proposed for analyzing the consultation in the primary health care, integrating other models of consultation and provides a framework by which general practitioners can apply the principles of consultation using communication skills to reconcile the respective agenda and autonomy of both doctor and patient into a negotiated agreed plan, which includes both management of health problems and health promotion. Achieving success of consultations depends on time and mutual cooperation between patient and doctor showed by doctor-patient relationship. (author)

Treatment of mastitis during lactation.

Science.gov (United States)

Pyörälä, S

2009-04-01

Treatment of mastitis should be based on bacteriological diagnosis and take national and international guidelines on prudent use of antimicrobials into account. In acute mastitis, where bacteriological diagnosis is not available, treatment should be initiated based on herd data and personal experience. Rapid bacteriological diagnosis would facilitate the proper selection of the antimicrobial. Treating subclinical mastitis with antimicrobials during lactation is seldom economical, because of high treatment costs and generally poor efficacy. All mastitis treatment should be evidence-based, i.e., the efficacy of each product and treatment length should be demonstrated by scientific studies. Use of on-farm written protocols for mastitis treatment promotes a judicious use of antimicrobials and reduces the use of antimicrobials.

On becoming a consultant: A study exploring the journey to consultant practice

International Nuclear Information System (INIS)

Henwood, S.; Booth, L.

2016-01-01

Background: This paper reports a qualitative study exploring the establishment of non-medical consultant roles in Radiography. Given the difficulties reported in recruiting and retaining staff in these posts, we hope this paper offers a historical documentation of those consultants who were some of the first in post, sharing their stories of how they obtained and transitioned into their roles. Methods: This paper is part of a two year case study exploring the leadership domain of consultant practice. The focus of this paper is a reflection, by the consultants, of their journey to becoming a consultant; a documentation of some of the practical issues in establishing the roles; and the transition to higher levels of practice. Eight consultant radiographers participated in the initial interviews (two consultants withdrew from the study subsequent to this). In-depth iterative interviewing was used to explore and record individual stories and experiences. Findings: The consultants shared their perceptions of being in post, including their own motivation to progress to a new role, how prepared they felt initially, the lack of role models, the lack of clarity surrounding the role and a perception of ‘being on display’. Conclusions: The paper offers insight into the journey of these consultants and some of the common characteristics they share. These characteristics give some indication of what motivated them to step into higher level roles, in particular the need to drive change and improvement. The paper also offers suggestions for how the transition into the role could be more effectively supported. - Highlights: • Identifies characteristics thought to contribute to effective consultant practice. • A desire to change practice is a major motivator in applying for a consultant post. • The consultant role was a natural evolution for some, not a desired career pathway. • There is recognition that the initial consultants were pioneers for the profession. �

Operational research in practice: Consultancy in industry revisited

NARCIS (Netherlands)

Fortuin, L.; Zijlstra, M.

2000-01-01

Experiences of an OR group in a large industrial organisation, from 1981 to the middle of 1988, were described in a paper published in 1989. Much has changed since then: (1) having started as an internal staff department, the group has become an independent consultancy bureau, owing to the fact that

Quinone-dependent D-lactate dehydrogenase Dld (Cg1027 is essential for growth of Corynebacterium glutamicum on D-lactate

Directory of Open Access Journals (Sweden)

Oikawa Tadao

2010-12-01

Full Text Available Abstract Background Corynebacterium glutamicum is able to grow with lactate as sole or combined carbon and energy source. Quinone-dependent L-lactate dehydrogenase LldD is known to be essential for utilization of L-lactate by C. glutamicum. D-lactate also serves as sole carbon source for C. glutamicum ATCC 13032. Results Here, the gene cg1027 was shown to encode the quinone-dependent D-lactate dehydrogenase (Dld by enzymatic analysis of the protein purified from recombinant E. coli. The absorption spectrum of purified Dld indicated the presence of FAD as bound cofactor. Inactivation of dld resulted in the loss of the ability to grow with D-lactate, which could be restored by plasmid-borne expression of dld. Heterologous expression of dld from C. glutamicum ATCC 13032 in C. efficiens enabled this species to grow with D-lactate as sole carbon source. Homologs of dld of C. glutamicum ATCC 13032 are not encoded in the sequenced genomes of other corynebacteria and mycobacteria. However, the dld locus of C. glutamicum ATCC 13032 shares 2367 bp of 2372 bp identical nucleotides with the dld locus of Propionibacterium freudenreichii subsp. shermanii, a bacterium used in Swiss-type cheese making. Both loci are flanked by insertion sequences of the same family suggesting a possible event of horizontal gene transfer. Conclusions Cg1067 encodes quinone-dependent D-lactate dehydrogenase Dld of Corynebacterium glutamicum. Dld is essential for growth with D-lactate as sole carbon source. The genomic region of dld likely has been acquired by horizontal gene transfer.

The impact of dermatology consultation on diagnostic accuracy and antibiotic use among patients with suspected cellulitis seen at outpatient internal medicine offices: a randomized clinical trial.

Science.gov (United States)

Arakaki, Ryan Y; Strazzula, Lauren; Woo, Elaine; Kroshinsky, Daniela

2014-10-01

Cellulitis is a common and costly problem, often diagnosed in the outpatient setting. Many cutaneous conditions may clinically mimic cellulitis, but little research has been done to assess the magnitude of the problem. To determine if obtaining dermatology consultations in the outpatient primary care setting could assist in the diagnosis of pseudocellulitic conditions and reduce the rate of unnecessary antibiotic use. Nonblinded randomized clinical trial of competent adults who were diagnosed as having cellulitis by their primary care physicians (PCPs), conducted at outpatient internal medical primary care offices affiliated with a large academic medical center. Outpatient dermatology consultation. Primary outcomes were final diagnosis, antibiotic use, and need for hospitalization. A total of 29 patients (12 male and 17 female) were enrolled for participation in this trial. Nine patients were randomized to continue with PCP management (control group), and 20 patients were randomized to receive a dermatology consultation (treatment group). Of the 20 patients in the dermatology consultation group, 2 (10%) were diagnosed as having cellulitis. In the control group, all 9 patients were diagnosed as having cellulitis by PCPs, but dermatologist evaluation determined that 6 (67%) of these patients had a psuedocellulitis rather than true infection. All 9 patients (100%) in the control group were treated for cellulitis with antibiotics vs 2 patients (10%) in the treatment group (P Dermatology consultation in the primary care setting improves the diagnostic accuracy of suspected cellulitis and decreases unnecessary antibiotic use in patients with pseudocellulitic conditions. Obtaining an outpatient dermatology consultation may be a cost-effective strategy that improves quality of care. clinicaltrials.gov Identifier:NCT01795092.

Channel-Mediated Lactate Release by K+-Stimulated Astrocytes

KAUST Repository

Sotelo-Hitschfeld, T.

2015-03-11

Excitatory synaptic transmission is accompanied by a local surge in interstitial lactate that occurs despite adequate oxygen availability, a puzzling phenomenon termed aerobic glycolysis. In addition to its role as an energy substrate, recent studies have shown that lactate modulates neuronal excitability acting through various targets, including NMDA receptors and G-protein-coupled receptors specific for lactate, but little is known about the cellular and molecular mechanisms responsible for the increase in interstitial lactate. Using a panel of genetically encoded fluorescence nanosensors for energy metabolites, we show here that mouse astrocytes in culture, in cortical slices, and in vivo maintain a steady-state reservoir of lactate. The reservoir was released to the extracellular space immediately after exposure of astrocytes to a physiological rise in extracellular K+ or cell depolarization. Cell-attached patch-clamp analysis of cultured astrocytes revealed a 37 pS lactate-permeable ion channel activated by cell depolarization. The channel was modulated by lactate itself, resulting in a positive feedback loop for lactate release. A rapid fall in intracellular lactate levels was also observed in cortical astrocytes of anesthetized mice in response to local field stimulation. The existence of an astrocytic lactate reservoir and its quick mobilization via an ion channel in response to a neuronal cue provides fresh support to lactate roles in neuronal fueling and in gliotransmission.

Comparison and evaluation of mathematical lactation curve ...

African Journals Online (AJOL)

p2492989

A mathematical model of the lactation curve provides summary information about culling and milking strategies ..... Table 2 Statistics of the edited data for first lactation Holstein cows ..... Application of different models to the lactation curves of.

The Effect of the Strictness of Consultation Requirements on Fraud Consultation

NARCIS (Netherlands)

Gold, A.H.; Knechel, W.R.; Wallage, P.

2012-01-01

We investigate how the strictness of a requirement to consult on potential client fraud affects auditors' propensity to consult with firm experts. We consider two specific forms of guidance about fraud consultations: (1) strict, i.e., mandatory and binding; and (2) lenient, i.e., advisory and

Comparative transcriptome analysis reveals different molecular mechanisms of Bacillus coagulans 2-6 response to sodium lactate and calcium lactate during lactic acid production.

Directory of Open Access Journals (Sweden)

Jiayang Qin

Full Text Available Lactate production is enhanced by adding calcium carbonate or sodium hydroxide during fermentation. However, Bacillus coagulans 2-6 can produce more than 180 g/L L-lactic acid when calcium lactate is accumulated, but less than 120 g/L L-lactic acid when sodium lactate is formed. The molecular mechanisms by which B. coagulans responds to calcium lactate and sodium lactate remain unclear. In this study, comparative transcriptomic methods based on high-throughput RNA sequencing were applied to study gene expression changes in B. coagulans 2-6 cultured in non-stress, sodium lactate stress and calcium lactate stress conditions. Gene expression profiling identified 712 and 1213 significantly regulated genes in response to calcium lactate stress and sodium lactate stress, respectively. Gene ontology assignments of the differentially expressed genes were performed. KEGG pathway enrichment analysis revealed that 'ATP-binding cassette transporters' were significantly affected by calcium lactate stress, and 'amino sugar and nucleotide sugar metabolism' was significantly affected by sodium lactate stress. It was also found that lactate fermentation was less affected by calcium lactate stress than by sodium lactate stress. Sodium lactate stress had negative effect on the expression of 'glycolysis/gluconeogenesis' genes but positive effect on the expression of 'citrate cycle (TCA cycle' genes. However, calcium lactate stress had positive influence on the expression of 'glycolysis/gluconeogenesis' genes and had minor influence on 'citrate cycle (TCA cycle' genes. Thus, our findings offer new insights into the responses of B. coagulans to different lactate stresses. Notably, our RNA-seq dataset constitute a robust database for investigating the functions of genes induced by lactate stress in the future and identify potential targets for genetic engineering to further improve L-lactic acid production by B. coagulans.

Comparative transcriptome analysis reveals different molecular mechanisms of Bacillus coagulans 2-6 response to sodium lactate and calcium lactate during lactic acid production.

Science.gov (United States)

Qin, Jiayang; Wang, Xiuwen; Wang, Landong; Zhu, Beibei; Zhang, Xiaohua; Yao, Qingshou; Xu, Ping

2015-01-01

Lactate production is enhanced by adding calcium carbonate or sodium hydroxide during fermentation. However, Bacillus coagulans 2-6 can produce more than 180 g/L L-lactic acid when calcium lactate is accumulated, but less than 120 g/L L-lactic acid when sodium lactate is formed. The molecular mechanisms by which B. coagulans responds to calcium lactate and sodium lactate remain unclear. In this study, comparative transcriptomic methods based on high-throughput RNA sequencing were applied to study gene expression changes in B. coagulans 2-6 cultured in non-stress, sodium lactate stress and calcium lactate stress conditions. Gene expression profiling identified 712 and 1213 significantly regulated genes in response to calcium lactate stress and sodium lactate stress, respectively. Gene ontology assignments of the differentially expressed genes were performed. KEGG pathway enrichment analysis revealed that 'ATP-binding cassette transporters' were significantly affected by calcium lactate stress, and 'amino sugar and nucleotide sugar metabolism' was significantly affected by sodium lactate stress. It was also found that lactate fermentation was less affected by calcium lactate stress than by sodium lactate stress. Sodium lactate stress had negative effect on the expression of 'glycolysis/gluconeogenesis' genes but positive effect on the expression of 'citrate cycle (TCA cycle)' genes. However, calcium lactate stress had positive influence on the expression of 'glycolysis/gluconeogenesis' genes and had minor influence on 'citrate cycle (TCA cycle)' genes. Thus, our findings offer new insights into the responses of B. coagulans to different lactate stresses. Notably, our RNA-seq dataset constitute a robust database for investigating the functions of genes induced by lactate stress in the future and identify potential targets for genetic engineering to further improve L-lactic acid production by B. coagulans.

Inpatient Consultative Dermatology.

Science.gov (United States)

Biesbroeck, Lauren K; Shinohara, Michi M

2015-11-01

Dermatology consultation can improve diagnostic accuracy in the hospitalized patient with cutaneous disease. Dermatology consultation can streamline and improve treatment plans, and potentially lead to cost savings. Dermatology consultants can be a valuable resource for education for trainees, patients, and families. Inpatient consultative dermatology spans a breadth of conditions, including inflammatory dermatoses,infectious processes, adverse medication reactions, and neoplastic disorders, many of which can be diagnosed based on dermatologic examination alone, but when necessary, bedside skin biopsies can contribute important diagnostic information. Copyright © 2015 Elsevier Inc. All rights reserved.

21 CFR 184.1207 - Calcium lactate.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Calcium lactate. 184.1207 Section 184.1207 Food and... Substances Affirmed as GRAS § 184.1207 Calcium lactate. (a) Calcium lactate (C6H10CaO6.xH2O, where x is any... calcium carbonate or calcium hydroxide. (b) The ingredient meets the specifications of the Food Chemicals...

Lactation and changes in maternal metabolic risk factors.

Science.gov (United States)

Gunderson, Erica P; Lewis, Cora E; Wei, Gina S; Whitmer, Rachel A; Quesenberry, Charles P; Sidney, Steve

2007-03-01

To examine the relationship between duration of lactation and changes in maternal metabolic risk factors. This 3-year prospective study examined changes in metabolic risk factors among lactating women from preconception to postweaning and among nonlactating women from preconception to postdelivery, in comparison with nongravid women. Of 1,051 (490 black, 561 white) women who attended two consecutive study visits in years 7 (1992-1993) and 10 (1995-1996), 942 were nongravid and 109 had one interim birth. Of parous women, 48 (45%) did not lactate, and 61 (55%) lactated and weaned before year 10. The lactated and weaned women were subdivided by duration of lactation into less than 3 months and 3 months or more. Multiple linear regression models estimated mean 3-year changes in metabolic risk factors adjusted for age, race, parity, education, and behavioral covariates. Both parous women who did not lactate and parous women who lactated and weaned gained more weight (+5.6, +4.4 kg) and waist girth (+5.3, +4.9 cm) than nongravid women over the 3-year interval; Pdecrements for both parous women who did not lactate and parous women who lactated and weaned were 4.0 mg/dL greater than for nongravid women (Pdecrement in high-density lipoprotein cholesterol (-1.3 mg/dL versus -7.3 mg/dL for less than 3 months; P<.01). Lactation may attenuate unfavorable metabolic risk factor changes that occur with pregnancy, with effects apparent after weaning. As a modifiable behavior, lactation may affect women's future risk of cardiovascular and metabolic diseases. II.

Continuous lactation in dairy cows

DEFF Research Database (Denmark)

Madsen, Torben Gosvig; Nielsen, Mette Benedicte Olaf; Andersen, Jens Bech

2008-01-01

Reports over the past decade have indicated that normal lactational performance can be achieved in genetically superior and high-producing dairy cows, even when the dry period between 2 lactations is omitted. The hypothesis tested in this experiment was that normal lactogenesis I and metabolic...... function may be achievable in continuously milked high-yielding dairy cows as a result of the genetic selection for lactation performance and hence longevity of mammary epithelial cells. The milk production and mammary nutrient uptake in response to omission of the dry period for cows with an expected peak...... milk yield higher than 45 kg/d were studied in 28 Holstein dairy cows managed without bovine somatotropin. Performance and metabolic parameters were followed in late gestation and in the following early lactation. Fourteen cows were milked continuously throughout late gestation, and another 14 dairy...

Consequences of supplying methyl donors during pregnancy on the methylome of the offspring from lactating and non-lactating dairy cattle.

Directory of Open Access Journals (Sweden)

Alex Bach

Full Text Available The aim of this study was to evaluate the potential effects of methyl donor supplementation of pregnant animals in the presence or absence of a concomitant lactation on the methylome of the offspring. Twenty Holstein cows, 10 nulliparous (non-lactating while pregnant and 10 multiparous (lactating while pregnant were blocked by parity and randomly assigned to an i.m. weekly injections of a placebo (CTRL or a solution containing methyl donors (MET. After calving, 5 calves randomly selected from each treatment (two born to non-lactating and three to lactating dams were blood-sampled to determine their full methylome. There were more than 2,000 CpG differentially methylated between calves born to CTRL and those born to MET, and also between calves born to lactating and non-lactating dams. Most of the differences affected genes involved in immune function, cell growth regulation and differentiation, kinase activity, and ion channeling. We conclude that the coexistence of pregnancy and lactation affects the methylome of the offspring, and that supplementation of methyl donors early in gestation has also consequences on the methylome.

THE CONSUMPTION OF RED PUPUNHA (BACTRIS GASIPAES KUNTH) INCREASES HDL CHOLESTEROL AND REDUCES WEIGHT GAIN OF LACTATING AND POST-LACTATING WISTAR RATS.

Science.gov (United States)

Carvalho, R Piccolotto; Lemos, J R Gonzaga; de Aquino Sales, R Souza; Martins, M Gassen; Nascimento, C H; Bayona, M; Marcon, J L; Monteiro, J Barros

2013-09-01

The lactating and post-lactating periods are marked by large metabolic change. Production of milk is 60% lipid dependent. We reported in a recent scientific meeting that Red pupunha palm tree fruit increases HDL cholesterol in lactating rats. This study evaluated if consumption of Red Pupunha by adult female rats has a beneficial impact on the lipid metabolism of lacting and post-lacting adult rats. Evaluate if consumption of red pupunha has a beneficial effect in the lipid metabolism of lacting and post-lacting adult Wistar rats. Four groups including two for control; (1) control adult lactating rats, (2) control adults post-lactating rats; and two experimental groups; (3) pupunha adults lactating rats and (4) pupunha adult post-lactating rats were evaluated and compared regarding: weight gain, food consumption, plasma total protein, glucose, total lipid, triglycerides, total cholesterol and HDL-cholesterol levels. The mean difference and its 95% confidence intervals were used for group comparisons. Group comparisons were evaluated by using analysis of variance (one-way ANOVA). The statistical significance of the pairwise differences among groups was assessed by using the two-sided Tukey test. There were no important differences in food consumption, plasma glucose, total lipids and triglycerides among groups. The red pupunha lactating group gain less weight showing lower body mass index (BMI) than controls (p < 0.05). Total cholesterol was lower in red pupunha lactating than in controls but not in the red pupunha post-lactating group as compared to controls. Triglycerides were lower in the post-lactating red pupunha group as compared to the control group (p = 0.039) but not for the lactating groups. Red pupunha lactating and post-lactating groups had higher HDL-cholesterol than their corresponding control groups (p ≤ 0.01). Original findings include the beneficial effect of red pupunha in post-lactating rats increasing the HDL-cholesterol and lowering the BMI

Manipulation of reproductive performance of lactating buffaloes using melatonin and controlled internal drug release device treatment during out-of-breeding season under tropical conditions.

Science.gov (United States)

Ramadan, T A; Sharma, R K; Phulia, S K; Balhara, A K; Ghuman, S S; Singh, I

2016-09-01

Twelve lactating Murrah buffalo, divided into control and treatment group of six animals each, were used to study the effect of melatonin and controlled internal drug release (CIDR) device treatment on the resumption of ovarian activity during out-of-breeding season (summer solstice). Treated group implanted with melatonin (18-mg melatonin/50-kg body weight) for 45 days and then animals of both groups received CIDR for 9 days. All animals received intramuscular 500 IU eCG, at day before CIDR removal, and 10-μg GnRH at day after CIDR withdrawal. All animals were subjected to estrus detection daily. Blood samples in conjunction with transrectal ultrasonography were performed once a week to determine serum concentrations of melatonin, progesterone, and antioxidant enzyme activities, as well as to monitor the ovarian activity. Melatonin treatment resulted in an increase (P Day 21 and Day 30 after artificial insemination and achieved higher percentage of conception rate than control. In conclusion, the CIDR treatment preceded by melatonin improved the reproductive performance in lactating buffaloes during out-of-breeding season under tropical conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

[Teenagers' drawings in transcultural consultations].

Science.gov (United States)

Simon, Amalini; Titia Rizzi, Alice

The place of teenagers' drawings has been studied as part of a transcultural consultation, based on the creativity of the children of migrants. When speaking is difficult, drawings enable teenagers to show another dimension of their internal world. Aravin, a young Tamil boy, who lacked the necessary words, was able to express all the complexity of his thoughts through his drawings, finally being able to formulate in the group the difficult situations which he was drawing. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Brain lactate metabolism in humans with subarachnoid hemorrhage.

Science.gov (United States)

Oddo, Mauro; Levine, Joshua M; Frangos, Suzanne; Maloney-Wilensky, Eileen; Carrera, Emmanuel; Daniel, Roy T; Levivier, Marc; Magistretti, Pierre J; LeRoux, Peter D

2012-05-01

Lactate is central for the regulation of brain metabolism and is an alternative substrate to glucose after injury. Brain lactate metabolism in patients with subarachnoid hemorrhage has not been fully elucidated. Thirty-one subarachnoid hemorrhage patients monitored with cerebral microdialysis (CMD) and brain oxygen (PbtO(2)) were studied. Samples with elevated CMD lactate (>4 mmol/L) were matched to PbtO(2) and CMD pyruvate and categorized as hypoxic (PbtO(2) 119 μmol/L) versus nonhyperglycolytic. Median per patient samples with elevated CMD lactate was 54% (interquartile range, 11%-80%). Lactate elevations were more often attributable to cerebral hyperglycolysis (78%; interquartile range, 5%-98%) than brain hypoxia (11%; interquartile range, 4%-75%). Mortality was associated with increased percentage of samples with elevated lactate and brain hypoxia (28% [interquartile range 9%-95%] in nonsurvivors versus 9% [interquartile range 3%-17%] in survivors; P=0.02) and lower percentage of elevated lactate and cerebral hyperglycolysis (13% [interquartile range, 1%-87%] versus 88% [interquartile range, 27%-99%]; P=0.07). Cerebral hyperglycolytic lactate production predicted good 6-month outcome (odds ratio for modified Rankin Scale score, 0-3 1.49; CI, 1.08-2.05; P=0.016), whereas increased lactate with brain hypoxia was associated with a reduced likelihood of good outcome (OR, 0.78; CI, 0.59-1.03; P=0.08). Brain lactate is frequently elevated in subarachnoid hemorrhage patients, predominantly because of hyperglycolysis rather than hypoxia. A pattern of increased cerebral hyperglycolytic lactate was associated with good long-term recovery. Our data suggest that lactate may be used as an aerobic substrate by the injured human brain.

Elevated lactate during psychogenic hyperventilation

NARCIS (Netherlands)

ter Avest, E.; Patist, F. M.; ter Maaten, J. C.; Nijsten, M. W. N.

Study objective Elevated arterial lactate levels are closely related to morbidity and mortality in various patient categories. In the present retrospective study, the relation between arterial lactate, partial pressure of carbon dioxide (Pco(2)) and pH was systematically investigated in patients who

Population Consultation: A Powerful Means to Ensure that Health Strategies are Oriented Towards Universal Health Coverage.

Science.gov (United States)

Rohrer, Katja; Rajan, Dheepa; Schmets, Gerard

2017-01-01

We seek to highlight why population consultations need to be promoted more strongly as a powerful means to move health reforms towards Universal Health Coverage (UHC). However, despite this increasing recognition that the "population" is the key factor of successful health planning and high-quality service delivery, there has been very little systematic reflection and only limited (international) attention brought to the idea of specifically consulting the population to improve the quality and soundness of health policies and strategies and to strengthen the national health planning process and implementation. So far, research has done little to assess the significance of population consultations for the health sector and its importance for strategic planning and implementation processes; in addition, there has been insufficient evaluation of population consultations in the health sector or health-related areas. We drew on ongoing programmatic work of World Health Organization (WHO) offices worldwide, as most population consultations are not well-documented. In addition, we analyzed any existing documentation available on population consultations in health. We then elaborate on the potential benefits of bringing the population's voice into national health planning. We briefly mention the key methods used for population consultations, and we put forward recent country examples showing that population consultation is an effective way of assessing the population's needs and expectations, and should be more widely used in strategizing health. Giving the voice to the population is a means to strengthen accountability, to reinforce the commitment of policy makers, decision-makers and influencers (media, political parties, academics, etc.) to the health policy objectives of UHC, and, in the specific case of donor-dependent countries, to sensitize donors' engagement and alignment with national health strategies. The consequence of the current low international interest for

International practices in the provision of teratology information: a survey of international teratogen information programmes and comparisons with the North American model.

Science.gov (United States)

Hancock, Rebecca L; Ungar, Wendy J; Einarson, Adrienne; Koren, Gideon

2010-10-01

Teratology Information Services (TIS) provide health care professionals and the public with information regarding the safety and/or risk of exposures during pregnancy and lactation, mainly via telephone consultations. An international comparison of clinical practices at TIS has never been conducted. The survey objective was to compare international TIS to North American TIS, with an aim to identify strengths and challenges that can lead to service improvement. Twenty-two international TIS were approached for participation during an international conference. TIS were surveyed on information in six categories: services, staffing, operations, data collection, knowledge transfer activities and additional information. Data were summarized using descriptive statistics. Statistical tests were conducted using SPSS®. Sixteen TIS from 12 countries participated. Survey results were compared with previously reported results from a similar survey of North American TIS (16 US, two Canadian). TIS exist in a variety of departments and settings, but most commonly are in university hospitals. Pregnant women were the most commonly counselled group worldwide. International TIS spent significantly more time fielding inquiries regarding medications, while North American TIS had a wider variety of inquiry categories. All TIS could improve budget tracking. Overall, service practices and goals were similar, although international TIS conducted more follow-up with service users than North American TIS. This report offers TIS the first ever opportunity to compare practices. Increased dialogue between TIS encourages sharing of best practices and improves the ability of these important public health programmes to support women and health care providers. © 2010 Blackwell Publishing Ltd.

Exploring the research domain of consultant practice: Experiences of consultant radiographers

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim of the overall study was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This second part of the study involved telephone interviews with twenty five consultant radiographers. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers. The principal barriers revealed were: lack of time; excessive clinical workload; lack of skills and confidence to undertake research; poor research culture; and lack of support. The main facilitators noted were: dedicated time, research training and up-skilling; mutually beneficial collaborations; managerial understanding of the research domain of the role; and research focussed on clinical demand. Conclusion: Fulfilling the clinical role is imperative and integral to the profession at consultant level; however, if it is undertaken to the detriment of the other domains then these practitioners may not be operating at ‘consultant’ level. Overall improvements must be made to ensure that the consultant radiographer role is delivering on current expectations and is safeguarded for the future of the next generation of radiographers. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work regularly. • Consultant radiographers allocate little protected time for research due to clinical demands.

Lactate fuels the human brain during exercise

DEFF Research Database (Denmark)

Quistorff, Bjørn; Secher, Niels H; Van Lieshout, Johannes J

2008-01-01

The human brain releases a small amount of lactate at rest, and even an increase in arterial blood lactate during anesthesia does not provoke a net cerebral lactate uptake. However, during cerebral activation associated with exercise involving a marked increase in plasma lactate, the brain takes up......)] from a resting value of 6 to exercise, cerebral activation associated with mental activity, or exposure to a stressful situation. The CMR decrease is prevented with combined beta(1)- and beta(2)-adrenergic receptor...

Exploring the research domain of consultant practice: Perceptions and opinions of consultant radiographers

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This first part of the study involved electronic questionnaires being sent to all those known in consultant radiographer posts in the United Kingdom. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers, and not all agreed that research should be a core domain of consultant practice. Main facilitators to research were noted as: time; skills and knowledge of the researcher; a well defined research question. Main barriers to research were noted as: lack of allocated time; lack of skills/experience; clinical workload. Conclusion: Research is one of the four core domains of consultant allied health professional and nursing roles but, as yet, it is not fully embedded into those of all consultant radiographers. Many consultant radiographers appear to spend more of their time on the ‘clinical expert’ element of their role at the expense of the research domain. This study concludes that there is an urgent need for consultant radiographers to understand that research is one of the four core domains and to recognise the need to embed research into their clinical practice. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work routinely. • Consultant radiographers allocate little protected time for research due to clinical demands. • Almost half of the consultant radiographers feel research should not be a core part of their roles.

Accompanied consultations in occupational health.

Science.gov (United States)

Hobson, J; Hobson, H; Sharp, R

2016-04-01

Accompanied consultations are often reported as difficult by occupational physicians but have not been studied in the occupational health setting. To collect information about accompanied consultations and the impact of the companion on the consultation. We collected data on all accompanied consultations by two occupational physicians working in a private sector occupational health service over the course of 16 months. Accompanied consultations were matched to non-accompanied consultations for comparison. We collected data on 108 accompanied consultations. Accompanied consultations were more likely to be connected with ill health retirement (P Occupational health practitioners may benefit from better understanding of accompanied consultations and guidance on their management. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Insights from an international stakeholder consultation to identify informational needs related to seafood safety

Energy Technology Data Exchange (ETDEWEB)

Tediosi, Alice, E-mail: alice.tediosi@aeiforia.eu [Aeiforia Srl, 29027 Gariga di Podenzano (PC) (Italy); Fait, Gabriella [Aeiforia Srl, 29027 Gariga di Podenzano (PC) (Italy); Jacobs, Silke [Department of Public Health, Ghent University, 9000 Ghent (Belgium); Department of Agricultural Economics, Ghent University, 9000 Ghent (Belgium); Verbeke, Wim [Department of Agricultural Economics, Ghent University, 9000 Ghent (Belgium); Álvarez-Muñoz, Diana [Catalan Institute for Water Research (ICRA), Parc Científic i Tecnològic de la Universitat de Girona, 17003 Girona (Spain); Diogene, Jorge [IRTA, 43540 Sant Carles de la Ràpita (Spain); Reuver, Marieke [AquaTT, Dublin 2 (Ireland); Marques, António [Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA), 1449-006 Lisbon (Portugal); Capri, Ettore [Università Cattolica del Sacro Cuore, 29122 Piacenza (Italy)

2015-11-15

Food safety assessment and communication have a strong importance in reducing human health risks related to food consumption. The research carried out within the ECsafeSEAFOOD project aims to assess seafood safety issues, mainly related to non-regulated priority environmental contaminants, and to evaluate their impact on public health. In order to make the research results accessible and exploitable, and to respond to actual stakeholders' demands, a consultation with international stakeholders was performed by means of a survey. The focus was on policy and decision makers, food producers and processors, and agencies (i.e. EU and National or Regional agencies related to Food Safety or Public Health) and consumer organisations. The survey considered questions related to: seafood safety assessment and mitigation strategies, availability of data, such as the level of information on different contaminants, and communication among different stakeholder groups. Furthermore, stakeholders were asked to give their opinion on how they believe consumers perceive risks associated with environmental contaminants. The survey was distributed to 531 key stakeholders and 91 responses were received from stakeholders from 30 EU and non-EU countries. The main results show that communication between different groups of stakeholders needs to be improved and that there is a deficit of information and data in the field of seafood safety. This pertains mainly to the transfer of contaminants between the environment and seafood, and to the diversity of environmental contaminants such as plastic additives, algal toxins and hormones. On-line tools were perceived to be the most useful communication channel. - Highlights: • We consulted stakeholders to identify their needs about seafood safety. • An on-line survey was prepared and sent to gather stakeholders' opinions. • Communication among stakeholders needs to be improved. • There is a deficit of information and data in the

Insights from an international stakeholder consultation to identify informational needs related to seafood safety

International Nuclear Information System (INIS)

Tediosi, Alice; Fait, Gabriella; Jacobs, Silke; Verbeke, Wim; Álvarez-Muñoz, Diana; Diogene, Jorge; Reuver, Marieke; Marques, António; Capri, Ettore

2015-01-01

Food safety assessment and communication have a strong importance in reducing human health risks related to food consumption. The research carried out within the ECsafeSEAFOOD project aims to assess seafood safety issues, mainly related to non-regulated priority environmental contaminants, and to evaluate their impact on public health. In order to make the research results accessible and exploitable, and to respond to actual stakeholders' demands, a consultation with international stakeholders was performed by means of a survey. The focus was on policy and decision makers, food producers and processors, and agencies (i.e. EU and National or Regional agencies related to Food Safety or Public Health) and consumer organisations. The survey considered questions related to: seafood safety assessment and mitigation strategies, availability of data, such as the level of information on different contaminants, and communication among different stakeholder groups. Furthermore, stakeholders were asked to give their opinion on how they believe consumers perceive risks associated with environmental contaminants. The survey was distributed to 531 key stakeholders and 91 responses were received from stakeholders from 30 EU and non-EU countries. The main results show that communication between different groups of stakeholders needs to be improved and that there is a deficit of information and data in the field of seafood safety. This pertains mainly to the transfer of contaminants between the environment and seafood, and to the diversity of environmental contaminants such as plastic additives, algal toxins and hormones. On-line tools were perceived to be the most useful communication channel. - Highlights: • We consulted stakeholders to identify their needs about seafood safety. • An on-line survey was prepared and sent to gather stakeholders' opinions. • Communication among stakeholders needs to be improved. • There is a deficit of information and data in the field of

Treatment of mastitis during lactation

Directory of Open Access Journals (Sweden)

Pyörälä S

2009-04-01

Full Text Available Abstract Treatment of mastitis should be based on bacteriological diagnosis and take national and international guidelines on prudent use of antimicrobials into account. In acute mastitis, where bacteriological diagnosis is not available, treatment should be initiated based on herd data and personal experience. Rapid bacteriological diagnosis would facilitate the proper selection of the antimicrobial. Treating subclinical mastitis with antimicrobials during lactation is seldom economical, because of high treatment costs and generally poor efficacy. All mastitis treatment should be evidence-based, i.e., the efficacy of each product and treatment length should be demonstrated by scientific studies. Use of on-farm written protocols for mastitis treatment promotes a judicious use of antimicrobials and reduces the use of antimicrobials.

Application of isotopes to the study of lactate metabolism

International Nuclear Information System (INIS)

Katz, J.

1986-01-01

The use of 14 C as tracer to measure lactate turnover and oxidation and its role in gluconeogenesis are discussed. Lactate is formed as well as utilized in many cells, and most of it in the body is present within cells so that interpretation of 14 C data from labelled lactate is more complex and more difficult than that of compounds present largely extracellularly, such as glucose. Apparent uptake of [ 14 C]lactate may occur in the absence of net lactate utilization, and 14 CO 2 production does not provide a measure of true lactate oxidation. In vivo sites of tracer administration and sampling of blood are of critical significance for evaluation of lactate turnover, lactate space, its incorporation into glucose, and oxidation

Consultant management estimating tool.

Science.gov (United States)

2012-04-01

The New York State Department of Transportation (NYSDOT) Consultant Management Bureaus primary responsibilities are to negotiate staffing hours/resources with : engineering design consultants, and to monitor the consultant's costs. Currently the C...

Choline and Choline Metabolite Patterns and Associations in Blood and Milk during Lactation in Dairy Cows

Science.gov (United States)

Artegoitia, Virginia M.; Middleton, Jesse L.; Harte, Federico M.; Campagna, Shawn R.; de Veth, Michael J.

2014-01-01

Milk and dairy products are an important source of choline, a nutrient essential for human health. Infant formula derived from bovine milk contains a number of metabolic forms of choline, all contribute to the growth and development of the newborn. At present, little is known about the factors that influence the concentrations of choline metabolites in milk. The objectives of this study were to characterize and then evaluate associations for choline and its metabolites in blood and milk through the first 37 weeks of lactation in the dairy cow. Milk and blood samples from twelve Holstein cows were collected in early, mid and late lactation and analyzed for acetylcholine, free choline, betaine, glycerophosphocholine, lysophosphatidylcholine, phosphatidylcholine, phosphocholine and sphingomyelin using hydrophilic interaction liquid chromatography-tandem mass spectrometry, and quantified using stable isotope-labeled internal standards. Total choline concentration in plasma, which was almost entirely phosphatidylcholine, increased 10-times from early to late lactation (1305 to 13,535 µmol/L). In milk, phosphocholine was the main metabolite in early lactation (492 µmol/L), which is a similar concentration to that found in human milk, however, phosphocholine concentration decreased exponentially through lactation to 43 µmol/L in late lactation. In contrast, phosphatidylcholine was the main metabolite in mid and late lactation (188 µmol/L and 659 µmol/L, respectively), with the increase through lactation positively correlated with phosphatidylcholine in plasma (R 2 = 0.78). Unlike previously reported with human milk we found no correlation between plasma free choline concentration and milk choline metabolites. The changes in pattern of phosphocholine and phosphatidylcholine in milk through lactation observed in the bovine suggests that it is possible to manufacture infant formula that more closely matches these metabolites profile in human milk. PMID:25157578

Choline and choline metabolite patterns and associations in blood and milk during lactation in dairy cows.

Directory of Open Access Journals (Sweden)

Virginia M Artegoitia

Full Text Available Milk and dairy products are an important source of choline, a nutrient essential for human health. Infant formula derived from bovine milk contains a number of metabolic forms of choline, all contribute to the growth and development of the newborn. At present, little is known about the factors that influence the concentrations of choline metabolites in milk. The objectives of this study were to characterize and then evaluate associations for choline and its metabolites in blood and milk through the first 37 weeks of lactation in the dairy cow. Milk and blood samples from twelve Holstein cows were collected in early, mid and late lactation and analyzed for acetylcholine, free choline, betaine, glycerophosphocholine, lysophosphatidylcholine, phosphatidylcholine, phosphocholine and sphingomyelin using hydrophilic interaction liquid chromatography-tandem mass spectrometry, and quantified using stable isotope-labeled internal standards. Total choline concentration in plasma, which was almost entirely phosphatidylcholine, increased 10-times from early to late lactation (1305 to 13,535 µmol/L. In milk, phosphocholine was the main metabolite in early lactation (492 µmol/L, which is a similar concentration to that found in human milk, however, phosphocholine concentration decreased exponentially through lactation to 43 µmol/L in late lactation. In contrast, phosphatidylcholine was the main metabolite in mid and late lactation (188 µmol/L and 659 µmol/L, respectively, with the increase through lactation positively correlated with phosphatidylcholine in plasma (R2 = 0.78. Unlike previously reported with human milk we found no correlation between plasma free choline concentration and milk choline metabolites. The changes in pattern of phosphocholine and phosphatidylcholine in milk through lactation observed in the bovine suggests that it is possible to manufacture infant formula that more closely matches these metabolites profile in human milk.

Characterization of the L-lactate dehydrogenase from Aggregatibacter actinomycetemcomitans.

Directory of Open Access Journals (Sweden)

Stacie A Brown

Full Text Available Aggregatibacter actinomycetemcomitans is a Gram-negative opportunistic pathogen and the proposed causative agent of localized aggressive periodontitis. A. actinomycetemcomitans is found exclusively in the mammalian oral cavity in the space between the gums and the teeth known as the gingival crevice. Many bacterial species reside in this environment where competition for carbon is high. A. actinomycetemcomitans utilizes a unique carbon resource partitioning system whereby the presence of L-lactate inhibits uptake of glucose, thus allowing preferential catabolism of L-lactate. Although the mechanism for this process is not fully elucidated, we previously demonstrated that high levels of intracellular pyruvate are critical for L-lactate preference. As the first step in L-lactate catabolism is conversion of L-lactate to pyruvate by lactate dehydrogenase, we proposed a model in which the A. actinomycetemcomitans L-lactate dehydrogenase, unlike homologous enzymes, is not feedback inhibited by pyruvate. This lack of feedback inhibition allows intracellular pyruvate to rise to levels sufficient to inhibit glucose uptake in other bacteria. In the present study, the A. actinomycetemcomitans L-lactate dehydrogenase was purified and shown to convert L-lactate, but not D-lactate, to pyruvate with a K(m of approximately 150 microM. Inhibition studies reveal that pyruvate is a poor inhibitor of L-lactate dehydrogenase activity, providing mechanistic insight into L-lactate preference in A. actinomycetemcomitans.

Client/consultant model services agreement

CERN Document Server

International Federation of Consulting Engineers

2006-01-01

The terms of the Client Consultant Model Services agreement (The White Book) have been prepared by the Fédération Internationale des Ingénieurs-Conseils (FIDIC) and are recommended for general use for the purposes of pre-investment and feasibility studies, designs and administration of construction and project management, where proposals for such services are invited on an international basis. They are equally adaptable for domestic agreements. - See more at: http://fidic.org/books/clientconsultant-model-services-agreement-4th-ed-2006-white-book#sthash.3Uxy5qT3.dpuf

From Solution Shop to Boutique Consulting? Capturing Recent Developments on the German Consulting Marke

Directory of Open Access Journals (Sweden)

Jörg Jasper DÖTSCH

2016-12-01

Full Text Available Digitalization, globalization, new technologies and shorter product life cycles are only a few keywords underlining the fact that companies are under increasing pressure for faster adaptation, innovation and hence applying a higher knowledge intensity. We assume that these conditions require an increasingly important role of consulting companies, because they seem to be the intermediaries needed to bridge the faster growing gaps between existing business models, organizational structures and accelerating market change. Market pressure is growing on the market for consultant companies as well. New technologies and digitalization should influence both the structure of the consultancy market and the business models of consultancies. Christensen suggested a trend from Dzsolution shop” to Dzboutique consulting.” To track current developments, we concentrate on the German consulting market as one of the most important consultant markets worldwide and explore changes of the last two years based on various studies. Processes of change seem to be both substantially driven by digitalization and to reflect change on the non-consultancy markets. A high willingness to switch among providers documents a high pressure on performance. The impact of digitalisation seem• to be observable in structural and qualitative change. With regard to the German consulting market and the latest available data we cannot validate a tendency from a dominance of “solution shop” consultancies to “boutique” consultancy services.

The 'hidden work' of a hospital neurologist: 1000 consults later.

LENUS (Irish Health Repository)

Ali, E

2012-02-01

BACKGROUND: A new Web-based, internal neurology referral service was introduced in our department to expedite inpatient review for other departments and to allow assessment of the impact of neurology consults on patient care throughout the hospital, especially in the emergency department (ED). The results of the analysis of the first 1000 referrals using the new system are presented. Methods: An intranet referral system was designed by the consultant neurologists. The previous method of referral was by handwritten letter. The electronic template included \\'drop-down\\' menus and mandatory fields to help guide referring teams. An outcome section is completed by the neurology team. Results: An average of 17 referrals was seen weekly. Seventy-seven per cent were seen within 24 h of referral. A consultant neurologist saw 87% of the referrals directly; 13% were first seen by a registrar and later discussed with a consultant. Forty per cent were seen in the ED of which a one-third of the patients were discharged following assessment. The most common reason for referral was seizure(s) or an episode of collapse (28%). Patients presenting with stroke\\/transient ischaemic attack represented 13.5%, and 12.5% presented with headaches. The management of 79% of referred cases was deemed to have been significantly changed after neurology review. Discussion: The introduction of a neurology consultant-designed and consultant-led intranet referral service has greatly enhanced the delivery of the consult service to patients in our hospital. This referral system contributes significantly to hospital efficiency and to access for patients to specialist assessment.

Telemedicine and international disaster response. Medical consultation to Armenia and Russia via a Telemedicine Spacebridge.

Science.gov (United States)

Houtchens, B A; Clemmer, T P; Holloway, H C; Kiselev, A A; Logan, J S; Merrell, R C; Nicogossian, A E; Nikogossian, H A; Rayman, R B; Sarkisian, A E

1993-01-01

The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.

Telemedicine and international disaster response: medical consultation to Armenia and Russia via a Telemedicine Spacebridge.

Science.gov (United States)

Houtchens, B A; Clemmer, T P; Holloway, H C; Kiselev, A A; Logan, J S; Merrell, R C; Nicogossian, A E; Nikogossian, H A; Rayman, R B; Sarkisian, A E; Siegel, J H

1993-01-01

The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.

Short- and long-term effects of high milking frequency during the first 21 days of lactation on production and reproductive performance in high-lactating cows.

Science.gov (United States)

Shoshani, E; Cohen, M; Doekes, J J

2017-01-01

We examined short- and long-term effects of high milking frequency (HMF) for the first 21 days of lactation. The study included 122 Israeli Holstein cows - 32 pregnant heifers, 40 cows in second lactation and 50 cows in >second lactation. Heifers were paired according to predicted transmitting ability and cows according to energy-corrected milk (ECM) production, age, days in milk and expected calving date. Thin cows (body condition score second lactation cows relative to their control counterparts (-0.37%); ECM production was also higher in 6× milking first and second lactation (7.6% and 5%, respectively) but not for >second lactation cows. Furthermore, HMF had long-lasting effects, expressed as significantly higher milk production through the succeeding lactation in the previous first lactation cows (10%); a tendency toward significance in the second lactation cows relative to the controls (4.7%), but a deleterious effect on the >second lactation cows, reflected by lower milk production (-5.25%) than in controls; similar patterns were found for the ECM. For the entire 305 days of lactation, fat and protein yields were higher for first and second lactation cows, whereas protein yield for >second lactation cows was lower in the 6× milking v. Given that HMF during the first 21 days of first or second lactation increases milk and ECM yields throughout the concurrent and successive lactation with no adverse effect on energy balance, mastitis, metabolic diseases or reproduction, it seems to be economically beneficial. However, caution should be paid for >second lactation cows due to absence of significant effect in the entire of the first HMF applied lactation and the deleterious effect in the succeeding lactation.

Lactate Test

Science.gov (United States)

... Plasma Free Metanephrines Platelet Count Platelet Function Tests Pleural Fluid Analysis PML-RARA Porphyrin Tests Potassium Prealbumin ... ency/article/000391.htm . (2002 January, Updated). Lactate (Liquid) Reagent Set. Pointe Scientific, Inc. [On-line Reagent ...

Child consultation patterns in general practice comparing "high" and "low" consulting families.

OpenAIRE

Campion, P D; Gabriel, J

1984-01-01

All children's consultations with their general practitioner over a 12 month period in a small urban practice were analysed. Overall consultation rates ranged from 2.2 per child a year for 8 to 11 year olds, to 6.8 for those under 2. Families were grouped according to their average rate of new consultation for children, standardised for age. Families with higher consulting rates scored higher on an index of economic disadvantage, with mothers who scored higher on a test of "tendency to consul...

Glycolysis and the significance of lactate in traumatic brain injury

Directory of Open Access Journals (Sweden)

Keri Linda Carpenter

2015-04-01

Full Text Available In traumatic brain injury (TBI patients, elevation of the brain extracellular lactate concentration and the lactate/pyruvate ratio are well recognised, and are associated statistically with unfavourable clinical outcome. Brain extracellular lactate was conventionally regarded as a waste product of glucose, when glucose is metabolised via glycolysis (Embden-Meyerhof-Parnas pathway to pyruvate, followed by conversion to lactate by the action of lactate dehydrogenase, and export of lactate into the extracellular fluid. In TBI, glycolytic lactate is ascribed to hypoxia or mitochondrial dysfunction, although the precise nature of the latter is incompletely understood. Seemingly in contrast to lactate’s association with unfavourable outcome is a growing body of evidence that lactate can be beneficial. The idea that the brain can utilise lactate by feeding into the tricarboxylic acid (TCA cycle of neurons, first published two decades ago, has become known as the astrocyte-neuron lactate shuttle hypothesis. Direct evidence of brain utilisation of lactate was first obtained 5 years ago in a cerebral microdialysis study in TBI patients, where administration of 13C-labelled lactate via the microdialysis catheter and simultaneous collection of the emerging microdialysates, with 13C NMR analysis, revealed 13C labelling in glutamine consistent with lactate utilisation via the TCA cycle. This suggests that where neurons are too damaged to utilise the lactate produced from glucose by astrocytes, i.e. uncoupling of neuronal and glial metabolism, high extracellular levels of lactate would accumulate, explaining association between high lactate and poor outcome. An intravenous exogenous lactate supplementation study in TBI patients showed evidence for a beneficial effect judged by surrogate endpoints. Here we review current knowledge about glycolysis and lactate in TBI, how it can be measured in patients, and whether it can be modulated to achieve better

HEMATOLOGICAL PARAMETERS IN THE ALPINE GOATS DURING LACTATION

Directory of Open Access Journals (Sweden)

Zvonko Antunović

2013-06-01

Full Text Available The aim of this paper is to present haematological parameters in the Alpine goats during lactation. The study included 15 goats average age of 5 years in the 4th lactation. The blood sampling of goats was conducted on the 30th, 60th, 90th and 120th days of lactation. In the blood of goats, significant decrease in the number of red blood cells was determined, as lactation progressed, and their growth in the latter measure, but with no significant difference. Also, a significant decrease was found in the number of leukocytes as lactation progressed, whereas the 120th day of lactation showed their increase compared to the 90th day. A similar trend was found out for the content of hemoglobin and hematocrit. The mean volume of red blood cells and a significant proportion of monocytes were declining as lactation advance, while the mean concentration of hemoglobin significantly increased, and in the end of the study significantly decreased, compared to the measurement of 90th day. The above mentioned changes in hematological parameters indicate the quality of recovery and adjustment of goats in lactation.

Pregnancy rate evaluation in lactating and non-lactating Nelore cows subjected to fixed-time artificial insemination using injectable progesterone

Directory of Open Access Journals (Sweden)

Jefferson Tadeu Campos

2016-08-01

Full Text Available Most fixed-time artificial insemination (FTAI protocols utilize progesterone (P4 as a hormonal source to achieve synchronization of estrus in cattle. The use of an injectable P4 source to control estrus would be an interesting pharmacological strategy owing to the practicality of parenteral application. However, the effects of injectable P4 on estrus cycle control in cattle remain poorly studied. In particular, no existing studies have investigated the effect of injectable P4 on the fertility of cows subjected to FTAI. The aim of this study was to evaluate the pregnancy rate of lactating and non-lactating Nelore cows subjected to FTAI with injectable P4. Of the 422 non-lactating cows in this study, 162 (38.3% became pregnant by 60 days post-FTAI. In the lactating group (n = 516, 166 (32.1% were pregnant by 60 days after treatment with injectable P4. The proportions of lactating and non-lactating cows becoming pregnant were compared using the chi-square test, adopting a significance level of P < 0.05. It was found that the pregnancy rate of the cows subjected to FTAI with injectable P4 was influenced by lactation status. Lactating cows had lower reproductive performance, possibly because of their higher nutritional requirements. However, the use of injectable P4 shows promising results and may prove to be a useful strategy in large-scale livestock production.

Lactate produced by glycogenolysis in astrocytes regulates memory processing.

Science.gov (United States)

Newman, Lori A; Korol, Donna L; Gold, Paul E

2011-01-01

When administered either systemically or centrally, glucose is a potent enhancer of memory processes. Measures of glucose levels in extracellular fluid in the rat hippocampus during memory tests reveal that these levels are dynamic, decreasing in response to memory tasks and loads; exogenous glucose blocks these decreases and enhances memory. The present experiments test the hypothesis that glucose enhancement of memory is mediated by glycogen storage and then metabolism to lactate in astrocytes, which provide lactate to neurons as an energy substrate. Sensitive bioprobes were used to measure brain glucose and lactate levels in 1-sec samples. Extracellular glucose decreased and lactate increased while rats performed a spatial working memory task. Intrahippocampal infusions of lactate enhanced memory in this task. In addition, pharmacological inhibition of astrocytic glycogenolysis impaired memory and this impairment was reversed by administration of lactate or glucose, both of which can provide lactate to neurons in the absence of glycogenolysis. Pharmacological block of the monocarboxylate transporter responsible for lactate uptake into neurons also impaired memory and this impairment was not reversed by either glucose or lactate. These findings support the view that astrocytes regulate memory formation by controlling the provision of lactate to support neuronal functions.

Nurse consultants 10 years on: an insight to the role for nurse managers.

Science.gov (United States)

Mullen, Chris; Gavin-Daley, Ann; Kilgannon, Helen; Swift, Juliette

2011-09-01

To evaluate the Non-Medical Consultant role in the North West of England. The objective was to identify the current number of Non-Medical Consultants, what they do and the impact of the role in practice. The Non-Medical Consultant role for nursing and midwifery was introduced in the UK in 2000 to provide better outcomes for patients by improving service and quality; strengthening clinical leadership; and providing a new career opportunity to help retain experienced and expert professionals in practice. A combined qualitative and quantitative design was adopted. This included desktop review of previous studies, a survey questionnaire to current consultants, focus group meetings with Non-Medical Consultants, sponsors and champions. The role is effective, flexible, responsive and outward facing both internal to the organization and externally on a local, regional and national basis. A key challenge for the Non-Medical Consultants was organizational understanding of the role. The small size of the Non-Medical Consultant workforce can limit individual organizations experience of establishing and supporting the role. Effective Non-Medical Consultants lead, drive and support quality improvement, increased productivity and service effectiveness. Other impacts include sharing and promoting best practice with colleagues, income generation and financial savings through service redesign and/or staff skill mix changes. Managerial issues identified may assist Nurse Managers seeking to introduce new consultant roles and/or support, and retain existing consultants to reach their full potential. 2011 Blackwell Publishing Ltd.

IAEA International Database on Irradiated Nuclear Graphite Properties. Summary report of consultants' meeting. 12. meeting of the Technical Steering Committee

International Nuclear Information System (INIS)

Chung, H.K.; Wickham, A.J.

2010-02-01

The 12th Meeting of the Technical Steering Committee for the International Database on Irradiated Nuclear Graphite Properties was held on 12-13 November 2009 at the IAEA Headquarters, Vienna, Austria. All discussions, recommendations and actions of this Consultants' Meeting are recorded in this report. The purposes of the meeting were to review the matters and actions identified in the previous meeting, undertake a review of the current status of the database, and make recommendations for action over the next year. This report contains the status of the identified actions as well as a summary of the recommendations on enhancements to the database. (author)

Effectiveness of controlled internal drug release device treatment to alleviate reproductive seasonality in anestrus lactating or dry Barki and Rahmani ewes during non-breeding season.

Science.gov (United States)

El-Mokadem, M Y; Nour El-Din, Anm; Ramadan, T A; Rashad, A M; Taha, T A; Samak, M A; Salem, M H

2018-04-01

This study aimed to evaluate the effectiveness of hormonal treatments on ovarian activity and reproductive performance in Barki and Rahmani ewes during non-breeding season. Forty-eight multiparous ewes, 24 Barki and 24 Rahmani ewes were divided into two groups, 12 lactating and 12 dry ewes for each breed. Controlled internal drug release (CIDR) device was inserted in all ewes for 14 days in conjunction with intramuscular 500 IU equine chronic gonadotrophin (eCG) at day of CIDR removal. Data were analysed using PROC MIXED of SAS for repeated measures. Breed, physiological status and days were used as fixed effects and individual ewes as random effects. Barki ewes recorded higher (p ewes. Lactating ewes recorded higher (p ewes. Number and diameter of large follicles recorded the highest (p ewes recorded longer (p ewes. In conclusion, CIDR-eCG protocol was more potent in improving ovarian activity in Barki compared to Rahmani ewes, but this protocol seems to induce hormonal imbalance in Barki ewes that resulted in increasing conception failure compared to Rahmani ewes. © 2017 Blackwell Verlag GmbH.

Glucose feeds the TCA cycle via circulating lactate.

Science.gov (United States)

Hui, Sheng; Ghergurovich, Jonathan M; Morscher, Raphael J; Jang, Cholsoon; Teng, Xin; Lu, Wenyun; Esparza, Lourdes A; Reya, Tannishtha; Le Zhan; Yanxiang Guo, Jessie; White, Eileen; Rabinowitz, Joshua D

2017-11-02

Mammalian tissues are fuelled by circulating nutrients, including glucose, amino acids, and various intermediary metabolites. Under aerobic conditions, glucose is generally assumed to be burned fully by tissues via the tricarboxylic acid cycle (TCA cycle) to carbon dioxide. Alternatively, glucose can be catabolized anaerobically via glycolysis to lactate, which is itself also a potential nutrient for tissues and tumours. The quantitative relevance of circulating lactate or other metabolic intermediates as fuels remains unclear. Here we systematically examine the fluxes of circulating metabolites in mice, and find that lactate can be a primary source of carbon for the TCA cycle and thus of energy. Intravenous infusions of 13 C-labelled nutrients reveal that, on a molar basis, the circulatory turnover flux of lactate is the highest of all metabolites and exceeds that of glucose by 1.1-fold in fed mice and 2.5-fold in fasting mice; lactate is made primarily from glucose but also from other sources. In both fed and fasted mice, 13 C-lactate extensively labels TCA cycle intermediates in all tissues. Quantitative analysis reveals that during the fasted state, the contribution of glucose to tissue TCA metabolism is primarily indirect (via circulating lactate) in all tissues except the brain. In genetically engineered lung and pancreatic cancer tumours in fasted mice, the contribution of circulating lactate to TCA cycle intermediates exceeds that of glucose, with glutamine making a larger contribution than lactate in pancreatic cancer. Thus, glycolysis and the TCA cycle are uncoupled at the level of lactate, which is a primary circulating TCA substrate in most tissues and tumours.

Skills for Effective Consultation.

Science.gov (United States)

Dustin, Dick; Ehly, Stewart

1984-01-01

Discusses counselor skills that promote effective consultation. Reviews research on effective school consultation and presents a five-stage model which involves phasing in, problem identification, implementation, evaluation, and termination. Provides recommendations for the process and products of consultation. (JAC)

International collaboration to enhance the fight against HIV/AIDS: Report of a consultative meeting between the University of Buea in Cameroon and the Goldfarb School of Nursing in the USA

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Dickson S. Nsagha

2011-09-01

Full Text Available HIV/AIDS is a major public health pandemic affecting the development, survival and life of young people both in Cameroon and the USA. Youths are more adaptive to change and less hindered by prejudice than adults. Student-to-student peer mentoring is a non-formal way for students to learn new life skills and different cross-cultural values. We report on a two-day consultative meeting on developing international collaboration for the fight against HIV/AIDS between Cameroonian and USA nursing students. We used adult learning approaches consisting of presentations, discussions, questions and answer sessions, role plays and demonstrations. Deliberations and resolutions from the consultative meeting enabled the Vice-Chancellor of the University of Buea to sign a memorandum of understanding with the Goldfarb School of Nursing in the USA on HIV/AIDS international collaboration paving the way forward for more developmental health projects in this domain.

International collaboration to enhance the fight against HIV/AIDS: report of a consultative meeting between the University of Buea in Cameroon and the Goldfarb School of Nursing in the USA.

Science.gov (United States)

Nsagha, Dickson S; Rosenburg, Neal; Diesel, Holly; Sab, Clement M; Taliaferro, Donna

2011-09-05

HIV/AIDS is a major public health pandemic affecting the development, survival and life of young people both in Cameroon and the USA. Youths are more adaptive to change and less hindered by prejudice than adults. Student-to-student peer mentoring is a non-formal way for students to learn new life skills and different cross-cultural values. We report on a two-day consultative meeting in 2010 on developing international collaboration for the fight against HIV/AIDS between Cameroonian and USA nursing students. We used adult learning approaches consisting of presentations, discussions, questions and answer sessions, role plays and demonstrations. Deliberations and resolutions from the consultative meeting enabled the Vice-Chancellor of the University of Buea to sign a memorandum of understanding with the Goldfarb School of Nursing in the USA on HIV/AIDS international collaboration paving the way forward for more developmental health projects in this domain.

Wipro Consulting Services: Building an Effective Global Configuration in Business and IT Consulting Industry

OpenAIRE

Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu

2010-01-01

The Wipro Consulting Services (WCS) case charts the evolution of the consulting initiative within Wipro Technologies; the strategic choices the management made during this evolution and the challenges facing the firm once it consolidated the various consulting initiatives to set up Wipro Consulting Services in 2008. The case deals with several questions facing the leadership team, such as the competencies to develop to move up the value chain in delivering consulting services and the extent t...

Dietary intake of Croatian lactating women

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Greta Krešić

2012-01-01

Full Text Available Nutritional inadequacies during lactation may affect the well-being of both the mother and the infant. For this reason, breast-feeding women usually pay attention to their dietary practice during the breast-feeding period. The aim of this study was to examine changes in dietary intake of Croatian lactating women during six months postpartum. The study sample consisted of 83 lactating women whose diet records were collected at three measurements rounds: at 1 ± 0.25, 3 ± 0.25 and 6 ± 0.25 months postpartum. The mothers´ diets were investigated using two consecutive 24-hour dietary recalls. Energy and nutrient intakes were estimated using a nutritional database. The obtained results have shown that the diet of Croatian lactating women is hypocaloric (65.73 – 79.52 % DRI, p < 0.001 and deficient in magnesium, zinc, vitamins A, B1, B6, D and folate. Also evident was a moderate imbalance in the distribution of energy percentages from macronutrients. During six months postpartum, lactating women continuously decreased food intake resulting in a gradual decrease in energy intake (p < 0.001 and in the intake of all micronutrients. However, during six months postpartum, lactating women increased the share of total fat in energy intake (p = 0.006 and the share of saturated fatty acids (p = 0.048, while the share of monounsaturated fatty acids in total energy intake decreased (p = 0.004. It could be concluded that it is worthwhile to further study the nutritional status of Croatian lactating women during this vulnerable period especially regarding their micronutrients intake in order to achieve the recommended dietary requirements.

Validity of the international consultation on incontinence questionnaire-pediatric lower urinary tract symptoms: a screening questionnaire for children.

Science.gov (United States)

De Gennaro, Mario; Niero, Mauro; Capitanucci, Maria Luisa; von Gontard, Alexander; Woodward, Mark; Tubaro, Andrea; Abrams, Paul

2010-10-01

Lower urinary tract symptoms are common in pediatric patients. To our knowledge no validated instruments properly designed to screen lower urinary tract symptoms in the pediatric population have been published to date. In the International Consultation on Incontinence Questionnaire Committee the psychometric properties of a screening questionnaire for pediatric lower urinary tract symptoms were assessed. The 12-item International Consultation on Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms was developed in child and parent self-administered versions, and produced in English, Italian and German using a standard cross-cultural adaptation process. The questionnaire was self-administered to children 5 to 18 years old and their parents presenting for lower urinary tract symptoms (cases) or to pediatric/urological clinics for other reasons (controls). A case report form included history, urinalysis, bladder diary, flowmetry/post-void residual urine volume and clinician judgment on whether each child did or did not have lower urinary tract symptoms. Questionnaire psychometric properties were evaluated and data were stratified into 3 age groups, including 5 to 9, 10 to 13 and 14 to 18 years. A total of 345 questionnaires were completed, of which 147 were negative and 198 were positive for lower urinary tract symptoms. A mean of 1.67% and 2.10% of items were missing in the child and parent versions, respectively. Reliability (Cronbach's α) was unacceptable in only the 5 to 9-year-old group. The high ICC of 0.847 suggested fair child/parent equivalence. Sensitivity and specificity were 89% and 76% in the child version, and 91% and 73.5% in the parent version, respectively. The questionnaire is an acceptable, reliable tool with high sensitivity and specificity to screen for lower urinary tract symptoms in pediatric practice. Problems related to literacy suggest use of the child versions for patients older than 9 years. In research this questionnaire

Inducing Lactation: Breastfeeding for Adoptive Moms

Science.gov (United States)

... Dynamics > Adoption & Foster Care > Inducing Lactation: Breastfeeding for Adoptive Moms Family Life Listen Español Text Size Email Print Share Inducing Lactation: Breastfeeding for Adoptive Moms Page Content Article Body A growing number ...

Bioethics Consultations and Resources

OpenAIRE

Thomas, Jennie

2011-01-01

Making difficult healthcare decisions is often helped by consultation with a bioethics committee. This article reviews the main bioethics principles, when it is appropriate and how to call a bioethics consult, ethical concerns, and members of the consult team. Bioethics resources are included.

Safety assessment of lactate esters

NARCIS (Netherlands)

Clary, J.J.; Feron, V.J.; Velthuijsen, J.A. van

1998-01-01

Lactate eaters have an oral LD50 greater than 2000 mg/kg and the inhalation LC50 is generally above 5000 mg/m3 and they may be potential eye and skin irritants, but not skin sensitizers. No evidence of teratogenicity or maternal toxicity was observed in an inhalation (2-ethylhexyl-L-lactate) or

Western Political Consulting Techniques and Post-Soviet Political Technology in Political Campaigns in Latvia

OpenAIRE

Bērziņa, Ieva

2012-01-01

Western Political Consulting Techniques and Post-Soviet Political Technology in Political Campaigns in Latvia Ieva Dmitričenko Keywords: political campaignsm political consulting, political technology, parties, marketing, media Political campaigning is an international phenomenon, because there is a free flow of information, knowledge and human resource among practitioners of political campaigning in various countries. As a result political campaigning techniques that have proven to ...

Lactate storm marks cerebral metabolism following brain trauma.

Science.gov (United States)

Lama, Sanju; Auer, Roland N; Tyson, Randy; Gallagher, Clare N; Tomanek, Boguslaw; Sutherland, Garnette R

2014-07-18

Brain metabolism is thought to be maintained by neuronal-glial metabolic coupling. Glia take up glutamate from the synaptic cleft for conversion into glutamine, triggering glial glycolysis and lactate production. This lactate is shuttled into neurons and further metabolized. The origin and role of lactate in severe traumatic brain injury (TBI) remains controversial. Using a modified weight drop model of severe TBI and magnetic resonance (MR) spectroscopy with infusion of (13)C-labeled glucose, lactate, and acetate, the present study investigated the possibility that neuronal-glial metabolism is uncoupled following severe TBI. Histopathology of the model showed severe brain injury with subarachnoid and hemorrhage together with glial cell activation and positive staining for Tau at 90 min post-trauma. High resolution MR spectroscopy of brain metabolites revealed significant labeling of lactate at C-3 and C-2 irrespective of the infused substrates. Increased (13)C-labeled lactate in all study groups in the absence of ischemia implied activated astrocytic glycolysis and production of lactate with failure of neuronal uptake (i.e. a loss of glial sensing for glutamate). The early increase in extracellular lactate in severe TBI with the injured neurons rendered unable to pick it up probably contributes to a rapid progression toward irreversible injury and pan-necrosis. Hence, a method to detect and scavenge the excess extracellular lactate on site or early following severe TBI may be a potential primary therapeutic measure. © 2014 by The American Society for Biochemistry and Molecular Biology, Inc.

The association between question type and the outcomes of a Dermatology eConsult service.

Science.gov (United States)

O'Toole, Ashley; Joo, Jiyeh; DesGroseilliers, Jean-Pierre; Liddy, Clare; Glassman, Steven; Afkham, Amir; Keely, Erin

2017-08-01

eConsult is a web based service that facilitates communication between primary care providers (PCPs) and specialists, which can reduce the need for face-to-face consultations with specialists. One example is the Champlain BASE (Building Access to Specialist through eConsultation) service with dermatology being the largest specialty consulted. Dermatology eConsults submitted from July 2011 to January 2015 were reviewed. Post eConsult surveys for PCPs were analyzed to determine the number of traditional consults avoided and perceived value of eConsults. The time it took the PCP to receive a reply and the amount of time reported by the specialist to answer eConsult were proactively recorded and analyzed. A subset of 154 most recent eConsults was categorized for dermatology content and question type (e.g. diagnosis or management) using a validated taxonomy. A total of 965 eConsults were directed to dermatology from 217 unique PCPs. The majority of eConsults (64%) took the specialist between 10 and 15 minutes to answer. The overall value of this service to the provider was rated as very good or excellent in 95% of cases. In 49%, traditional in-person assessments were avoided. In the subset of the most recent cases, diagnosis was the most common question type asked (65.2%) followed by management (29%) and drug treatment (10.6%). The top five subject areas (40%) were: Dermatitis, Infections, Neoplasm, Nevi, and Pruritus. eConsults was feasible and well received by PCPs, which improves access to dermatology care with a potential to reduce wait times for traditional consultation. © 2017 The International Society of Dermatology.

78 FR 48342 - Consultation Agreements: Proposed Changes to Consultation Procedures

Science.gov (United States)

2013-08-08

... clarify the high priority enforcement cases when OSHA may initiate a non-programmed inspection at those.... OSHA-2010-0010] RIN 1218-AC32 Consultation Agreements: Proposed Changes to Consultation Procedures AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Withdrawal of proposed rule...

3 CFR - Tribal Consultation

Science.gov (United States)

2010-01-01

.... Recommendations for improving the plans and making the tribal consultation process more effective, if any, should... 3 The President 1 2010-01-01 2010-01-01 false Tribal Consultation Presidential Documents Other Presidential Documents Memorandum of November 5, 2009 Tribal Consultation Memorandum for the Heads of Executive...

Analysis of (In Effectiveness of the Right to Prior Consultation to Indigenous Peoples in Brazil

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Lucas Rodrigues Vieira

2017-02-01

Full Text Available This paper aims to analyze how the right to prior, free and informed consultation has been effected to indigenous peoples in Brazil. First, the protection will be discussed at the international level such rights to indigenous communities. Will study the ILO Convention 169 and the UN Declaration on the Rights of Indigenous Peoples, as well as the importance of International Mechanisms of Human Rights. After that, focus will be given to the inter-American human rights system. Finally, it will be held discussion on the realization of the right to consultation of indigenous peoples in Brazil.

Electrochemical lactate biosensor based upon chitosan/carbon nanotubes modified screen-printed graphite electrodes for the determination of lactate in embryonic cell cultures.

Science.gov (United States)

Hernández-Ibáñez, Naiara; García-Cruz, Leticia; Montiel, Vicente; Foster, Christopher W; Banks, Craig E; Iniesta, Jesús

2016-03-15

l-lactate is an essential metabolite present in embryonic cell culture. Changes of this important metabolite during the growth of human embryo reflect the quality and viability of the embryo. In this study, we report a sensitive, stable, and easily manufactured electrochemical biosensor for the detection of lactate within embryonic cell cultures media. Screen-printed disposable electrodes are used as electrochemical sensing platforms for the miniaturization of the lactate biosensor. Chitosan/multi walled carbon nanotubes composite have been employed for the enzymatic immobilization of the lactate oxidase enzyme. This novel electrochemical lactate biosensor analytical efficacy is explored towards the sensing of lactate in model (buffer) solutions and is found to exhibit a linear response towards lactate over the concentration range of 30.4 and 243.9 µM in phosphate buffer solution, with a corresponding limit of detection (based on 3-sigma) of 22.6 µM and exhibits a sensitivity of 3417 ± 131 µAM(-1) according to the reproducibility study. These novel electrochemical lactate biosensors exhibit a high reproducibility, with a relative standard deviation of less than 3.8% and an enzymatic response over 82% after 5 months stored at 4 °C. Furthermore, high performance liquid chromatography technique has been utilized to independently validate the electrochemical lactate biosensor for the determination of lactate in a commercial embryonic cell culture medium providing excellent agreement between the two analytical protocols. Copyright © 2015 Elsevier B.V. All rights reserved.

Lactate metabolism in chronic liver disease

DEFF Research Database (Denmark)

Jeppesen, Johanne B; Mortensen, Christian; Bendtsen, Flemming

2013-01-01

Background. In the healthy liver there is a splanchnic net-uptake of lactate caused by gluconeogenesis. It has previously been shown that patients with acute liver failure in contrast have a splanchnic release of lactate caused by a combination of accelerated glycolysis in the splanchnic region...... and a reduction in hepatic gluconeogenesis. Aims. The aims of the present study were to investigate lactate metabolism and kinetics in patients with chronic liver disease compared with a control group with normal liver function. Methods. A total of 142 patients with chronic liver disease and 14 healthy controls...... underwent a liver vein catheterization. Blood samples from the femoral artery and the hepatic and renal veins were simultaneously collected before and after stimulation with galactose. Results. The fasting lactate levels, both in the hepatic vein and in the femoral artery, were higher in the patients than...

CD147 required for corneal endothelial lactate transport.

Science.gov (United States)

Li, Shimin; Nguyen, Tracy T; Bonanno, Joseph A

2014-06-26

CD147/basigin is a chaperone for lactate:H(+) cotransporters (monocarboxylate transporters) MCT1 and MCT4. We tested the hypothesis that MCT1 and -4 in corneal endothelium contribute to lactate efflux from stroma to anterior chamber and that silencing CD147 expression would cause corneal edema. CD147 was silenced via small interfering ribonucleic acid (siRNA) transfection of rabbit corneas ex vivo and anterior chamber lenti-small hairpin RNA (shRNA) pseudovirus in vivo. CD147 and MCT expression was examined by Western blot, RT-PCR, and immunofluorescence. Functional effects were examined by measuring lactate-induced cell acidification, corneal lactate efflux, [lactate], central cornea thickness (CCT), and Azopt (a carbonic anhydrase inhibitor) sensitivity. In ex vivo corneas, 100 nM CD147 siRNA reduced CD147, MCT1, and MCT4 expression by 85%, 79%, and 73%, respectively, while MCT2 expression was unaffected. CD147 siRNA decreased lactate efflux from 3.9 ± 0.81 to 1.5 ± 0.37 nmol/min, increased corneal [lactate] from 19.28 ± 7.15 to 56.73 ± 8.97 nmol/mg, acidified endothelial cells (pHi = 6.83 ± 0.07 vs. 7.19 ± 0.09 in control), and slowed basolateral lactate-induced acidification from 0.0034 ± 0.0005 to 0.0012 ± 0.0005 pH/s, whereas apical acidification was unchanged. In vivo, CD147 shRNA increased CCT by 28.1 ± 0.9 μm at 28 days; Azopt increased CCT to 24.4 ± 3.12 vs. 12.0 ± 0.48 μm in control, and corneal [lactate] was 47.63 ± 6.29 nmol/mg in shCD147 corneas and 17.82 ± 4.93 nmol/mg in paired controls. CD147 is required for the expression of MCT1 and MCT4 in the corneal endothelium. Silencing CD147 slows lactate efflux, resulting in stromal lactate accumulation and corneal edema, consistent with lactate efflux as a significant component of the corneal endothelial pump. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Consultant tells how to reduce nuclear risk

International Nuclear Information System (INIS)

Smock, R.

1983-01-01

John Garrick of Pickard, Lowe, and Garrick, an Irvine, CA, consulting firm, thinks nuclear plant risks can be measured and managed through creative use of probabilistic risk assessments (PRA). PRAs can be used to quantify the likelihood of an accident from all causes except sabotage or war, says Garrick. Although that use has been criticized, the Nuclear Regulatory Commission is moving toward formal use of PRAs in its internal analyses. 7 figures, 1 table

Lactate uptake against a concentration gradient

DEFF Research Database (Denmark)

Nordström, Carl-Henrik; Nielsen, Troels Halfeld; Nielsen, Hans Boye

2014-01-01

The recently published article by Jalloh et al (Jalloh I, Helmy A, Shannon RJ, Gallagher CN, Menon D, Carpenter K, Hutchinson P. Lactate uptake by the injured human brain - evidence from an arterio-venous gradient and cerebral microdialysis study. J Neurotrauma. 2013 Aug 22. [Epub ahead of print......]) concludes that lactate may be transported across the blood brain barrier into the brain against a concentration gradient. Unfortunately the authors have misinterpreted the concept of analytical imprecision and their conclusion is based on analytical artifact. As the topic of lactate transport into the brain...

Importance of measuring lactate levels in children with sepsis.

Science.gov (United States)

Anil, Nisha

2017-10-10

Sepsis is a major public health problem as well as one of the leading causes of preventable death in children because of failure to recognise the early signs and symptoms and to resuscitate rapidly. Blood lactate levels are used to assess the severity of sepsis and the effectiveness of resuscitation. Lactate levels are easily obtainable and should be checked in all patients admitted with suspected sepsis within six hours of presentation. The test should be repeated four and eight-hours post-diagnosis of sepsis. For the diagnosis of sepsis, patients' clinical symptoms, along with the combined analysis of partial pressure of oxygen, carbon dioxide and lactate levels, should be used. A multitude of factors can cause elevated lactate levels and so clinicians should use elevated levels cautiously by considering all other aetiologies. This article, which focuses on practice in Australia but makes reference to the UK, discusses the importance of measuring lactate levels in sepsis, the pathophysiology of lactate production, causes of elevated lactate levels, lactate measurement, nursing management of patients with elevated lactate levels, limitations of using lactate as a biomarker for diagnosing sepsis and implications for practice. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

L-lactate transport in Ehrlich ascites-tumour cells.

Science.gov (United States)

Spencer, T L; Lehninger, A L

1976-01-01

Ehrlich ascites-tumour cells were investigated with regard to their stability to transport L-lactate by measuring either the distribution of [14C]lactate or concomitant H+ ion movements. The movement of lactate was dependent on the pH difference across the cell membrane and was electroneutral, as evidenced by an observed 1:1 antiport for OH- ions or 1:1 symport with H+ ions. 2. Kinetic experiments showed that lactate transport was saturable, with an apparent Km of approx. 4.68 mM and a Vmax. as high as 680 nmol/min per mg of protein at pH 6.2 and 37 degrees C. 3. Lactate transport exhibited a high temperature dependence (activation energy = 139 kJ/mol). 4. Lactate transport was inhibited competitively by (a) a variety of other substituted monocarboxylic acids (e.g. pyruvate, Ki = 6.3 mM), which were themselves transported, (b) the non-transportable analogues alpha-cyano-4-hydroxycinnamate (Ki = 0.5 mM), alpha-cyano-3-hydroxycinnamate (Ki = 2mM) and DL-p-hydroxyphenyl-lactate (Ki = 3.6 mM) and (c) the thiol-group reagent mersalyl (Ki = 125 muM). 5. Transport of simple monocarboxylic acids, including acetate and propionate, was insensitive to these inhibitors; they presumably cross the membrane by means of a different mechanism. 6. Experiments using saturating amounts of mersalyl as an "inhibitor stop" allowed measurements of the initial rates of net influx and of net efflux of [14C]lactate. Influx and efflux of lactate were judged to be symmetrical reactions in that they exhibited similar concentration dependence. 7. It is concluded that lactate transport in Ehrlich ascites-tumour cells is mediated by a carrier capable of transporting a number of other substituted monocarboxylic acids, but not unsubstituted short-chain aliphatic acids. PMID:7237

Application of L-lactate-cytochrome c-oxidoreductase for development of amperometric biosensor for L-lactate determination

Directory of Open Access Journals (Sweden)

Dzyadevych S. V.

2009-06-01

Full Text Available Aim. Development of amperometric biosensor based on L-lactate-cytochrome c-oxidoreductase (flavocytochrome b2, FC b2 for lactate determination. Methods. All experiments were performed using the amperometric method of detection. The methods of electrochemical polymerization and immobilization in glutaraldehyde vapors were used for FC b2 immobilization on the surface of electrodes. Results. The FC b2 preparation, which demonstrated the best operational characteristics after immobilization in poly (3,4-ethylen dioxythiophene, was selected. The selectivity, operational and storage stability, and pH-optimum for operation of the created biosensor were determined. The analysis of L-lactate in the model solutions and wine samples was carried outusing the developed biosensor. Conclusion. The FC b2-based biosensor due to its high stability can be effectively used for lactate determination in blood and other liquids containing no ethanol. After the selectivity optimization, the devise can be also applied for wine analysis.

Leg and arm lactate and substrate kinetics during exercise

DEFF Research Database (Denmark)

Van Hall, Gerrit; Jensen-Urstad, M; Rosdahl, H

2003-01-01

To study the role of muscle mass and muscle activity on lactate and energy kinetics during exercise, whole body and limb lactate, glucose, and fatty acid fluxes were determined in six elite cross-country skiers during roller-skiing for 40 min with the diagonal stride (Continuous Arm + Leg) followed...... kinetics changed multiple times when exercise mode was changed. Whole body glucose and glycerol turnover was unchanged during the different skiing modes; however, limb net glucose uptake changed severalfold. In conclusion, the arterial lactate concentration can be maintained at a relatively low level...... despite high lactate R(a) during exercise with a large muscle mass because of the large capacity of active skeletal muscle to take up lactate, which is tightly correlated with lactate delivery. The limb lactate uptake during exercise is oxidized at rates far above resting oxygen consumption, implying...

Lactate metabolism during exercise in patients with mitochondrial myopathy

DEFF Research Database (Denmark)

Jeppesen, Tina Dysgaard; Ørngreen, Mette Cathrine; van Hall, Gerrit

2013-01-01

Patients with mitochondrial DNA mutations often have elevated plasma lactate at rest and during exercise, but it is unknown whether the high lactate levels are caused by a high production, an impaired oxidation or a combination. We studied lactate kinetics in 10 patients with mtDNA mutations and 10...... matched healthy control subjects at rest and during cycle exercise with a combination of femoral arterio-venous differences of lactate, and lactate tracer dilution methodology. During exercise, lactate concentration and production rates were several-fold higher in patients, but despite mitochondrial...... is not solely an indicator of impaired oxidative capacity, but an important fuel for oxidative metabolism, even in muscle with severely impaired mitochondrial function....

The Role of Ethics Committees and Ethics Consultation in Allocation Decisions

Science.gov (United States)

Strech, Daniel; Hurst, Samia; Danis, Marion

2013-01-01

Background Decisions about the allocation and rationing of medical interventions likely occur in all health care systems worldwide. So far very little attention has been given to the question of what role ethics consultation and ethics committees could or should play in questions of allocation at the hospital level. Objectives and Methods This article argues for the need for ethics consultation in rationing decisions using empirical data about the status quo and the inherent nature of bedside rationing. Subsequently, it introduces a 4-stage process for establishing and conducting ethics consultation in rationing questions with systematic reference to core elements of procedural justice. Results Qualitative and quantitative findings show a significant demand for ethics consultation expressed directly by doctors, as well as additional indirect evidence of such a need as indicated by ethically challenging circumstances of inconsistent and structurally disadvantaging rationing decisions. To address this need, we suggest 4 stages for establishing and conducting ethics consultation in rationing questions we recommend: (1) training, (2) identifying actual scarcity-related problems at clinics, (3) supporting decision-making, and (4) evaluation. Conclusion This process of ethics consultation regarding rationing decisions would facilitate the achievement of several practical goals: (i) encouragement of an awareness and understanding of ethical problems in bedside rationing, (ii) encouragement of achieving efficiency along with rationing, (iii) reinforcement of consistency in inter- and intraindvidual decision-making, (iv) encouragement of explicit reflection and justification of the prioritization criteria taken into consideration, (v) improvement in internal (in-house) and external transparency, and (vi) prevention of the misuse of the corresponding consulting structures. PMID:20706163

Lactate dehydrogenase has no control on lactate production but has a strong negative control on formate production in Lactococcus lactis

DEFF Research Database (Denmark)

Andersen, H.W.; Pedersen, M.B.; Hammer, Karin

2001-01-01

enhanced in the strain deleted for lactate dehydrogenase. What is more surprising is that the enzyme had a strong negative control (C- LDH(F1)J=-1.3) on the flux to formate at the wild-type level of lactate dehydrogenase. Furthermore, we showed that L. lactis has limited excess of capacity of lactate...

Peripheral administration of lactate produces antidepressant-like effects

KAUST Repository

Carrard, A; Elsayed, M; Margineanu, Michael B.; Boury-Jamot, B; Fragniè re, L; Meylan, E M; Petit, J-M; Fiumelli, Hubert; Magistretti, Pierre J.; Martin, J-L

2016-01-01

In addition to its role as metabolic substrate that can sustain neuronal function and viability, emerging evidence supports a role for l-lactate as an intercellular signaling molecule involved in synaptic plasticity. Clinical and basic research studies have shown that major depression and chronic stress are associated with alterations in structural and functional plasticity. These findings led us to investigate the role of l-lactate as a potential novel antidepressant. Here we show that peripheral administration of l-lactate produces antidepressant-like effects in different animal models of depression that respond to acute and chronic antidepressant treatment. The antidepressant-like effects of l-lactate are associated with increases in hippocampal lactate levels and with changes in the expression of target genes involved in serotonin receptor trafficking, astrocyte functions, neurogenesis, nitric oxide synthesis and cAMP signaling. Further elucidation of the mechanisms underlying the antidepressant effects of l-lactate may help to identify novel therapeutic targets for the treatment of depression.

Peripheral administration of lactate produces antidepressant-like effects

KAUST Repository

Carrard, A

2016-10-18

In addition to its role as metabolic substrate that can sustain neuronal function and viability, emerging evidence supports a role for l-lactate as an intercellular signaling molecule involved in synaptic plasticity. Clinical and basic research studies have shown that major depression and chronic stress are associated with alterations in structural and functional plasticity. These findings led us to investigate the role of l-lactate as a potential novel antidepressant. Here we show that peripheral administration of l-lactate produces antidepressant-like effects in different animal models of depression that respond to acute and chronic antidepressant treatment. The antidepressant-like effects of l-lactate are associated with increases in hippocampal lactate levels and with changes in the expression of target genes involved in serotonin receptor trafficking, astrocyte functions, neurogenesis, nitric oxide synthesis and cAMP signaling. Further elucidation of the mechanisms underlying the antidepressant effects of l-lactate may help to identify novel therapeutic targets for the treatment of depression.

Development of methodology for evaluation of 99mTc and 131I incorporated activities during lactation

International Nuclear Information System (INIS)

Santos, L.; Dantas, A.L.A.; Mesquita, S.A.; Oliveira, S.M.V.; Instituto de Radioprotecao e Dosimetria

2012-01-01

Internal contamination of babies may occur for milk ingestion or inhalation of mothers occupationally exposed to ionizing radiation with possible incorporation or mothers submitted to medical exposures during lactation. Radionuclide concentrations in the mother's milk may cause organ absorbed doses in the babies proportionally to the breast volumes. Milk analysis allow to determine activities ingested by the babies by determining the peak of mother's milk considering the decrease of the activity rate and the milk activities drunk at different time intervals. The work had the aim to develop simulators and methodology to evaluate 99m Tc and 131 I in lactation, in the following steps: to prepare standard solution of contaminated milk separately with 99m Tc and 131 I; to build four breast simulators (600 g and 800 g) and respective calibration for two geometries (breast and whole-body) in the Whole-Body Counter Unit in Instituto de Radioprotecao e Dosimetria. The results demonstrated the system efficiency to determine 99m Tc and 131 I activities in breasts during the lactation period. The methodology for positioning in the 'breast geometry' seemed to be more efficient than the 'whole-body geometry' for different breast volumes. The experiment allows achieving better evaluation of internal dosimetry of mothers and their young children. (author)

Renal lactate elimination is maintained during moderate exercise in humans

DEFF Research Database (Denmark)

Volianitis, Stefanos; Dawson, Ellen A; Dalsgaard, Mads

2012-01-01

(2) (CaO(2)-CvO(2)) and lactate concentration differences were 0.8 ± 0.2 and 0.02 ± 0.02 mmol x L(-1), respectively. During exercise, arterial lactate and CaO(2)-CvO(2) increased to 7.1 ± 1.1 and 2.6 ± 0.8 mmol x L(-1), respectively (P renal blood flow...... with no significant change in the renal venous erythropoietin concentration (0.8 ± 1.4 U x L(-1)). The a-v lactate concentration difference increased to 0.5 ± 0.8 mmol x L(-1), indicating similar lactate elimination as at rest. In conclusion, a -70% reduction in renal blood flow does not provoke critical renal......Reduced hepatic lactate elimination initiates blood lactate accumulation during incremental exercise. In this study, we wished to determine whether renal lactate elimination contributes to the initiation of blood lactate accumulation. The renal arterial-to-venous (a-v) lactate difference...

Glymphatic clearance controls state-dependent changes in brain lactate concentration

DEFF Research Database (Denmark)

Lundgaard, Iben; Lu, Minh Lon; Yang, Ezra

2017-01-01

Brain lactate concentration is higher during wakefulness than in sleep. However, it is unknown why arousal is linked to an increase in brain lactate and why lactate declines within minutes of sleep. Here, we show that the glymphatic system is responsible for state-dependent changes in brain lacta......-lymphatic clearance. This analysis provides fundamental new insight into brain energy metabolism by demonstrating that glucose that is not fully oxidized can be exported as lactate via glymphatic-lymphatic fluid transport.......Brain lactate concentration is higher during wakefulness than in sleep. However, it is unknown why arousal is linked to an increase in brain lactate and why lactate declines within minutes of sleep. Here, we show that the glymphatic system is responsible for state-dependent changes in brain lactate...... concentration. Suppression of glymphatic function via acetazolamide treatment, cisterna magna puncture, aquaporin 4 deletion, or changes in body position reduced the decline in brain lactate normally observed when awake mice transition into sleep or anesthesia. Concurrently, the same manipulations diminished...

Glymphatic clearance controls state-dependent changes in brain lactate concentration.

Science.gov (United States)

Lundgaard, Iben; Lu, Minh Lon; Yang, Ezra; Peng, Weiguo; Mestre, Humberto; Hitomi, Emi; Deane, Rashid; Nedergaard, Maiken

2017-06-01

Brain lactate concentration is higher during wakefulness than in sleep. However, it is unknown why arousal is linked to an increase in brain lactate and why lactate declines within minutes of sleep. Here, we show that the glymphatic system is responsible for state-dependent changes in brain lactate concentration. Suppression of glymphatic function via acetazolamide treatment, cisterna magna puncture, aquaporin 4 deletion, or changes in body position reduced the decline in brain lactate normally observed when awake mice transition into sleep or anesthesia. Concurrently, the same manipulations diminished accumulation of lactate in cervical, but not in inguinal lymph nodes when mice were anesthetized. Thus, our study suggests that brain lactate is an excellent biomarker of the sleep-wake cycle and increases further during sleep deprivation, because brain lactate is inversely correlated with glymphatic-lymphatic clearance. This analysis provides fundamental new insight into brain energy metabolism by demonstrating that glucose that is not fully oxidized can be exported as lactate via glymphatic-lymphatic fluid transport.

Lactate and lactate dehydrogenase in predicting the severity of transient tachypnea of the newborn.

Science.gov (United States)

Ozkiraz, Servet; Gokmen, Zeynel; Boke, Saltuk Bugra; Kilicdag, Hasan; Ozel, Deniz; Sert, Ahmet

2013-08-01

Low Apgar score is strongly associated with the incidence of transient tachypnea of the newborn (TTN) and other respiratory diseases of the newborn. We aimed to investigate the relationship between hypoxia determinants and the prolonged oxygen and respiratory support requirement even if the Apgar scores were normal. Retrospective case-controlled study. Infants born after 35 weeks of gestational age with clinical signs, chest X-ray findings and clinical course consistent with TTN were included. Receiver operating characteristic curves were used to assess the predictive values of determinants in predicting the risk for prolonged oxygen requirement and mechanical ventilatory support. We showed a positive correlation between the duration of oxygen with lactate and lactate dehydrogenase (LDH) levels. LDH offered the best predictive value for prolonged oxygen requirement with a positive predictive value (PPV) of 88.9%. The predictive value of lactate exceeds the predictive value of LDH, aspartate aminotransferase, and percentage of normoblasts to predict the requirement of respiratory support with a PPV of 88.5%. Lactate and LDH might be useful for clinicians at first level hospitals for decision making to refer the TTN patient to the secondary or tertiary level neonatal intensive care unit before the clinical situation is worsened.

Longer-term impact of cardiology e-consults.

Science.gov (United States)

Wasfy, Jason H; Rao, Sandhya K; Kalwani, Neil; Chittle, Melissa D; Richardson, Calvin A; Gallen, Kathleen M; Isselbacher, Eric M; Kimball, Alexandra B; Ferris, Timothy G

2016-03-01

Cardiac e-consults may be an effective way to deliver value-oriented outpatient cardiology care in an accountable care organization. Initial results of cardiac e-consults have demonstrated high satisfaction among both patients and referring providers, no known adverse events, and low rates of diagnostic testing. Nevertheless, differences between e-consults and traditional consults, effects of e-consults on traditional consult volume, and whether patients seek traditional consults after e-consults are unknown. We established a cardiac e-consult program on January 13, 2014. We then conducted detailed medical record reviews of all patients with e-consults to detect any adverse clinical events and detect subsequent traditional visits to cardiologists. We also performed 2 comparisons. First, we compared age, gender, and referral reason for e-consults vs traditional consults. Second, we compared changes in volume of referrals to cardiology vs other medical specialties that did not have e-consults. From January 13 to December 31, 2014, 1,642 traditional referrals and 165 e-consults were requested. The proportion of e-consults of all evaluations requested over that period was 9.1%. Gender balance was similar among traditional consults and e-consults (44.8% male for e-consults vs 45.0% for traditional consults, P = .981). E-consult patients were younger than traditional consult patients (55.3 vs 60.4 years, P cardiology visit during the follow-up period. E-consults are an effective and safe mechanism to enhance value in outpatient cardiology care, with low rates of bounceback to traditional consults. E-consults can account for nearly one-tenth of total outpatient consultation volume at 1 year within an accountable care organization and are associated with a reduction in traditional referrals to cardiologists. Copyright © 2015 Elsevier Inc. All rights reserved.

Summary report of consultants meeting on IAEA International Database on Irradiated Nuclear Graphite Properties. 11. meeting of the Technical Steering Committee

International Nuclear Information System (INIS)

Humbert, D.; Wickham, A.J.

2009-05-01

The 11th Meeting of the Technical Steering Committee for the International Database on Irradiated Nuclear Graphite Properties was held on 25-26 March 2009 at the IAEA Headquarters, Vienna, Austria. All discussions, recommendations and actions of this Consultants' Meeting are recorded in this report. The purposes of the meeting were to review the matters and actions identified in the previous meeting, undertake a review of the current status of the database, and make recommendations for action over the next year. This report contains the status of the identified actions as well as a summary of the recommendations on enhancements to the database. (author)

Summary report of consultants' meeting - IAEA International Database on Irradiated Nuclear Graphite Properties. 8th meeting of the Technical Steering Committee

International Nuclear Information System (INIS)

Humbert, D.; Wickham, A.J.

2006-05-01

The '8th Meeting of the Technical Steering Committee for the International Database on Irradiated Nuclear Graphite Properties' was held on 15-16 March 2006 at the IAEA Headquarters, Vienna, Austria. All discussions, recommendations and actions of this Consultants' Meeting are recorded in this report. The purposes of the meeting were to review the matters and actions identified in the previous meeting, undertake a review of the current status of the database and make recommendations for actions for the next year. This report contains the current status of the identified actions as well as a summary of the recommendations on enhancements to the database. (author)

Normal lactate concentration range in the neonatal brain.

Science.gov (United States)

Tomiyasu, Moyoko; Aida, Noriko; Shibasaki, Jun; Tachibana, Yasuhiko; Endo, Mamiko; Nozawa, Kumiko; Shimizu, Eiji; Tsuji, Hiroshi; Obata, Takayuki

2016-11-01

Lactate peaks are occasionally observed during in vivo magnetic resonance spectroscopy (MRS) scans of the neonatal brain, even in healthy patients. The purpose of this study was to investigate the normal range of neonatal brain lactate concentration, as a definitive normal range would be clinically valuable. Using a clinical 3T scanner (echo/repetition times, 30/5000ms), single-voxel MRS data were obtained from the basal ganglia (BG) and centrum semiovale (CS) in 48 healthy neonates (postconceptional age (PCA), 30-43weeks), nine infants (age, 1-12months old), and 20 children (age, 4-15years). Lactate concentrations were calculated using an MRS signal quantification program, LCModel. Correlations between regional lactate concentration and PCA (neonates), or age (all subjects) were investigated. Absolute lactate concentrations of the BG and CS were as follows: neonates, 0.77mM (0-2.02) [median (range)] and 0.77 (0-1.42), respectively; infants, 0.38 (0-0.79) and 0.49 (0.17-1.17); and children, 0.17 (0-0.76) and 0.22 (0-0.80). Overall, subjects' lactate concentrations decreased significantly with age (Spearman: BG, n=61, ρ=-0.38, p=0.003; CS, n=68, ρ=-0.57, p<0.001). However, during the neonatal period no correlations were detected between lactate concentration in either region and PCA. We determined normal ranges of neonatal lactate concentration, which may prove useful for diagnostic purposes. Further studies regarding changes in brain lactate concentration during development would help clarify the reasons for higher concentrations observed during the neonatal period, and contribute to improvements in diagnoses. Copyright © 2016 Elsevier Inc. All rights reserved.

Nutrition during lactation

National Research Council Canada - National Science Library

Committee on Nutritional Status During Pregnancy and Lactation, Institute of Medicine

On the basis of a comprehensive literature review and analysis, Nutrition During Lactation points out specific directions for needed research in understanding the relationship between the nutrition...

Lactate biosensors: current status and outlook.

Science.gov (United States)

Rassaei, Liza; Olthuis, Wouter; Tsujimura, Seiya; Sudhölter, Ernst J R; van den Berg, Albert

2014-01-01

Many research efforts over the last few decades have been devoted to sensing lactate as an important analytical target in clinical care, sport medicine, and food processing. Therefore, research in designing lactate sensors is no longer in its infancy and now is more directed toward viable sensors for direct applications. In this review, we provide an overview of the most immediate and relevant developments toward this end, and we discuss and assess common transduction approaches. Further, we critically describe the pros and cons of current commercial lactate sensors and envision how future sensing design may benefit from emerging new technologies.

Cerebral lactate production and blood flow in acute stroke

DEFF Research Database (Denmark)

Henriksen, O; Gideon, P; Sperling, B

1992-01-01

that follows reperfusion. The amount of lactate present in the acute phase reflects the severity of ischemia in the affected region. The lactate level was still above normal in the subacute phase with hyperemia, suggesting lactate production through aerobic glycolysis. Thus, the lactate level in the subacute...... phase probably does not reflect the degree of anaerobic glycolysis in hypoxic neuronal tissue....

Reflections on the role of consultant radiographers in the UK: What is a consultant radiographer?

International Nuclear Information System (INIS)

Booth, L.; Henwood, S.; Miller, P.

2016-01-01

Context: This paper is the second paper from a two year in depth case study, exploring the role of consultant radiographers in the UK. Methods: A longitudinal case study approach was used to determine the role of consultant radiographers. Interviews were used to explore experiences of being a consultant, which were analysed using thematic analysis. Eight consultant radiographers participated (Note, two of the consultants withdrew after the first interview due to workload). Therefore two consultants were interviewed only once. The remaining six consultants were interviewed twice over a 12 month period. Findings: The data presented in this paper explores the nature of the role, differences between roles, the four domains of practice, and how the role fits into local organisational structures. The study shows wide variation in the types of roles undertaken, reflecting that the creation of these roles were in response to local clinical need and often related to an individual practitioner's skills. The broad scope of the role was shown across all the consultants, with evidence of roles developing into new areas of service delivery. Conclusions: The paper offers insight into the role(s) of consultant radiographers in the UK. The range and scope of their practice is extensive, with much variation. It is evident that the clinical aspect of the role dominates, with research being the least supported domain of practice. There remains a lack of clarity around the role, with concerns about remuneration and other limitations that may restrict the role developing further. - Highlights: • This paper shows the variation in roles between consultant radiographers. • The commonality with medical roles is highlighted. • Problem solving is identified as a core skill in consultant radiography. • Consultants offered evidence of the roles developing service provision. • While all four domains of practice are covered, research is the least well supported.

Regional differences in adipocyte lactate production from glucose

International Nuclear Information System (INIS)

Newby, F.D.; Sykes, M.N.; DiGirolamo, M.

1988-01-01

Having shown that lactate is an important product of glucose metabolism by rat epididymal adipocytes, the authors investigated possible regional differences in adipocyte lactate production and the role of the animals' nutritional state and stage of development. [U- 14 C]glucose metabolism, lactate production, and response to insulin were measured in fat cells isolated from four adipose regions from young lean and older fatter rats, killed either in the fed state or after fasting for 48 h. In the absence of insulin, mesenteric fat cells from either age group metabolized significantly more glucose per cell and converted more glucose to lactate than cells from other depots, regardless of nutritional state. Adipocytes from fasted lean rats showed a significant increase in the relative glucose conversion to lactate in all depots when compared with cells from fed lean rats. Fasting of older fatter rats, however, had limited effects on the relative adipocyte glucose conversion to lactate since lactate production was already high. Mesenteric fat cells had the lowest relative response to insulin, possibly due to the high basal rate of glucose metabolism. These findings indicate that differences exist among adipose regions in the rates of glucose metabolism, lactate production and response to insulin. The anatomical location of the mesenteric adipose depot, coupled with a high metabolic rate and blood perfusion, suggests that mesenteric adipocytes may provide a unique and more direct contribution of metabolic substrates for hepatic metabolism than adipocytes from other depots

Users enlist consultants to calculate costs, savings

Energy Technology Data Exchange (ETDEWEB)

1982-05-24

Consultants who calculate payback provide expertise and a second opinion to back up energy managers' proposals. They can lower the costs of an energy-management investment by making complex comparisons of systems and recommending the best system for a specific application. Examples of payback calculations include simple payback for a school system, a university, and a Disneyland hotel, as well as internal rate of return for a corporate office building and a chain of clothing stores. (DCK)

Blood lactate kinetics in normal and stress-susceptible pigs

International Nuclear Information System (INIS)

Darrah, P.S.; Beitz, D.C.; Topel, D.G.; Christian, L.L.

1981-01-01

In vitro rates of lactate metabolism were determined in stress-susceptible (SS) and stress-resistant (SR) pigs. Three SR and three SS pigs were given 20 muCi of [U-/sup 14/C] L-lactate by a single injection method and resting blood lactate kinetics were measured. Seventeen blood samples were taken during the 60 min after injection. Lactate was separated from the deproteinized plasma by silicic acid column chromatography, and specific radioactivity was determined. Kinetic characteristics were calculated from plots of specific activity versus time. Pigs met steady-state requirements during the sampling period. There were no differences in kinetic characteristics of resting SS and SR pigs. Later, a second isotope injection was given after 5 min of electrical stress. Lactate pool sizes increased similarly in both types of pigs after stress; however, SS pigs had greater plasma lactate concentrations after stress. It is concluded that SS and SR pigs respond differently to stress but have similar capacities to metabolize lactate while resting

Lactate rescues neuronal sodium homeostasis during impaired energy metabolism.

Science.gov (United States)

Karus, Claudia; Ziemens, Daniel; Rose, Christine R

2015-01-01

Recently, we established that recurrent activity evokes network sodium oscillations in neurons and astrocytes in hippocampal tissue slices. Interestingly, metabolic integrity of astrocytes was essential for the neurons' capacity to maintain low sodium and to recover from sodium loads, indicating an intimate metabolic coupling between the 2 cell types. Here, we studied if lactate can support neuronal sodium homeostasis during impaired energy metabolism by analyzing whether glucose removal, pharmacological inhibition of glycolysis and/or addition of lactate affect cellular sodium regulation. Furthermore, we studied the effect of lactate on sodium regulation during recurrent network activity and upon inhibition of the glial Krebs cycle by sodium-fluoroacetate. Our results indicate that lactate is preferentially used by neurons. They demonstrate that lactate supports neuronal sodium homeostasis and rescues the effects of glial poisoning by sodium-fluoroacetate. Altogether, they are in line with the proposed transfer of lactate from astrocytes to neurons, the so-called astrocyte-neuron-lactate shuttle.

Lactate rescues neuronal sodium homeostasis during impaired energy metabolism

Science.gov (United States)

Karus, Claudia; Ziemens, Daniel; Rose, Christine R

2015-01-01

Recently, we established that recurrent activity evokes network sodium oscillations in neurons and astrocytes in hippocampal tissue slices. Interestingly, metabolic integrity of astrocytes was essential for the neurons' capacity to maintain low sodium and to recover from sodium loads, indicating an intimate metabolic coupling between the 2 cell types. Here, we studied if lactate can support neuronal sodium homeostasis during impaired energy metabolism by analyzing whether glucose removal, pharmacological inhibition of glycolysis and/or addition of lactate affect cellular sodium regulation. Furthermore, we studied the effect of lactate on sodium regulation during recurrent network activity and upon inhibition of the glial Krebs cycle by sodium-fluoroacetate. Our results indicate that lactate is preferentially used by neurons. They demonstrate that lactate supports neuronal sodium homeostasis and rescues the effects of glial poisoning by sodium-fluoroacetate. Altogether, they are in line with the proposed transfer of lactate from astrocytes to neurons, the so-called astrocyte-neuron-lactate shuttle. PMID:26039160

Lactate biosensors: current status and outlook

NARCIS (Netherlands)

Rassaei, Liza; Olthuis, Wouter; Tsujimura, Seiya; Sudhölter, Ernst J.R.; Sudholter, Ernst; van den Berg, Albert

2013-01-01

Many research efforts over the last few decades have been devoted to sensing lactate as an important analytical target in clinical care, sport medicine, and food processing. Therefore, research in designing lactate sensors is no longer in its infancy and now is more directed toward viable sensors

Non-linear modelling to describe lactation curve in Gir crossbred cows

Directory of Open Access Journals (Sweden)

Yogesh C. Bangar

2017-02-01

Full Text Available Abstract Background The modelling of lactation curve provides guidelines in formulating farm managerial practices in dairy cows. The aim of the present study was to determine the suitable non-linear model which most accurately fitted to lactation curves of five lactations in 134 Gir crossbred cows reared in Research-Cum-Development Project (RCDP on Cattle farm, MPKV (Maharashtra. Four models viz. gamma-type function, quadratic model, mixed log function and Wilmink model were fitted to each lactation separately and then compared on the basis of goodness of fit measures viz. adjusted R2, root mean square error (RMSE, Akaike’s Informaion Criteria (AIC and Bayesian Information Criteria (BIC. Results In general, highest milk yield was observed in fourth lactation whereas it was lowest in first lactation. Among the models investigated, mixed log function and gamma-type function provided best fit of the lactation curve of first and remaining lactations, respectively. Quadratic model gave least fit to lactation curve in almost all lactations. Peak yield was observed as highest and lowest in fourth and first lactation, respectively. Further, first lactation showed highest persistency but relatively higher time to achieve peak yield than other lactations. Conclusion Lactation curve modelling using gamma-type function may be helpful to setting the management strategies at farm level, however, modelling must be optimized regularly before implementing them to enhance productivity in Gir crossbred cows.

Development and Evaluation of a Novel Survey Tool Assessing Inpatient Consult Service Performance.

Science.gov (United States)

Miloslavsky, Eli M; Chang, Yuchiao

2017-12-01

Subspecialty consultation in inpatient medicine is increasing, and enhancing performance of consultation services may have a broad-reaching impact. Multisource feedback is an important tool in assessing competence and improving performance. A mechanism for primary team resident feedback on performance of consult services has not been described. We developed and evaluated an instrument designed to assess internal medicine (IM) subspecialty inpatient consult service performance. We hypothesized that the instrument would be feasible to administer and provide important information to fellowship directors. The instrument was administered in 2015 and 2016 at a single academic center. All IM residents were invited to evaluate 10 IM subspecialty consult services on 4 items and an overall satisfaction rating. The instrument allowed for free-text feedback to fellows. Program directors completed another survey assessing the impact of the consult service evaluation. A total of 113 residents responded (47 in 2015 and 66 in 2016, for a combined response rate of 35%). Each of the 4 items measured (communication, professionalism, teaching, and pushback) correlated significantly with the overall satisfaction rating in univariate and multivariate analyses. There were no differences in ratings across postgraduate year or year of administration. There was considerable variation in ratings among the services evaluated. The 7 program directors who provided feedback found the survey useful and made programmatic changes following evaluation implementation. A primary team resident evaluation of inpatient medicine subspecialty consult services is feasible, provides valuable information, and is associated with changes in consult service structure and curricula.

The Dream Consultant

DEFF Research Database (Denmark)

Muhr, Sara Louise; Kirkegaard, Line

2013-01-01

Consultants are known to work extreme hours. We show empirically how consultants fantasize about off-work activities, which are impossible to realize with their work schedule. These fantasies are, however, not obstructing their work, but important to justify the extreme hours and sustain desire f...

Lactate kinetics in human tissues at rest and during exercise

DEFF Research Database (Denmark)

van Hall, Gerrit

2010-01-01

lactate metabolism at rest and during exercise and suggestions are put forward to explain the simultaneous lactate uptake and release; and (2) lactate metabolism in the heart, liver, kidneys, brain, adipose tissue and lungs will be discussed and its potential importance in these tissues.......Lactate production in skeletal muscle has now been studied for nearly two centuries and still its production and functional role at rest and during exercise is much debated. In the early days skeletal muscle was mainly seen as the site of lactate production during contraction and lactate production...... associated with a lack of muscle oxygenation and fatigue. Later it was recognized that skeletal muscle not only played an important role in lactate production but also in lactate clearance and this led to a renewed interest, not the least from the Copenhagen School in the 1930s, in the metabolic role...

Non-nutritional factors affecting lactation persistency in dairy ewes: a review

Directory of Open Access Journals (Sweden)

Antonello Cannas

2010-01-01

Full Text Available Milk production is largely related to the shape of the lactation curve. Key elements of the lactation pattern are peak yield, which is the maximum daily yield reached during lactation, and lactation persistency, which is the medium rate of milk yield decrease after the lactation peak. The ideal lactation curve should have a reasonably high peak and a flat trend afterwards. A more persistent lactation is desirable because it is related to better animal health and reduction of feeding costs. Effective strategies to improve lactation persistency require a deep understanding of the main factors that affect this trait, including genetics, hormonal status and administration, udder morphology, seasonal changes, management, animal health (e.g. mastitis, stress and nutrition. This review covers the effects of non-nutritional factors on lactation persistency in dairy sheep.

Changes in myocardial lactate, pyruvate and lactate-pyruvate ratio during cardiopulmonary bypass for elective adult cardiac surgery: Early indicator of morbidity

Directory of Open Access Journals (Sweden)

P M Kapoor

2011-01-01

Full Text Available Background: Myocardial lactate assays have been established as a standard method to compare various myocardial protection strategies. This study was designed to test whether coronary sinus (CS lactates, pyruvate and lactate-pyruvate (LP ratio correlates with myocardial dysfunction and predict postoperative outcomes. Materials and Methods: This prospective observational study was conducted on 40 adult patients undergoing elective cardiac surgery with the aid of cardiopulmonary bypass (CPB. CS blood sampling was done for estimation of myocardial lactate (ML, pyruvate (MP and lactate-pyruvate ratio (MLPR namely: pre-CPB (T 1 , after removal of aortic cross clamp (T 2 and 30 minutes post-CPB (T 3 . Results: Baseline myocardial LPR strongly correlated with Troponin-I at T1 (s: 0.6. Patients were sub grouped according to the median value of myocardial lactate (2.9 at baseline T1 into low myocardial lactate (LML group, mean (2.39±0.4 mmol/l, n=19 and a high myocardial lactate (HML group, mean (3.65±0.9 mmol/l, n=21. A significant increase in PL, ML, MLPR and TropI occurred in both groups as compared to baseline. Patients in HML group had significant longer period of ICU stay. Patients with higher inotrope score had significantly higher ML (T2, T3. ML with a baseline value of 2.9 mmol/l had 70.83% sensitivity and 62.5% specificity (ROC area: 0.7109 Std error: 0.09 while myocardial pyruvate with a baseline value of 0.07 mmol/l has 79.17% sensitivity and 68.75% specificity (ROC area: 0.7852, Std error: 0.0765 for predicting inotrope requirement after CPB. Conclusion: CS lactate, pyruvate and LP ratio correlate with myocardial function and can predict postoperative outcome.

Self-Powered Electrochemical Lactate Biosensing

Directory of Open Access Journals (Sweden)

Ankit Baingane

2017-10-01

Full Text Available This work presents the development and characterization of a self-powered electrochemical lactate biosensor for real-time monitoring of lactic acid. The bioanode and biocathode were modified with D-lactate dehydrogenase (D-LDH and bilirubin oxidase (BOD, respectively, to facilitate the oxidation and reduction of lactic acid and molecular oxygen. The bioelectrodes were arranged in a parallel configuration to construct the biofuel cell. This biofuel cell’s current–voltage characteristic was analyzed in the presence of various lactic acid concentrations over a range of 1–25 mM. An open circuit voltage of 395.3 mV and a short circuit current density of 418.8 µA/cm² were obtained when operating in 25 mM lactic acid. Additionally, a 10 pF capacitor was integrated via a charge pump circuit to the biofuel cell to realize the self-powered lactate biosensor with a footprint of 1.4 cm × 2 cm. The charge pump enabled the boosting of the biofuel cell voltage in bursts of 1.2–1.8 V via the capacitor. By observing the burst frequency of a 10 pF capacitor, the exact concentration of lactic acid was deduced. As a self-powered lactate sensor, a linear dynamic range of 1–100 mM lactic acid was observed under physiologic conditions (37 °C, pH 7.4 and the sensor exhibited an excellent sensitivity of 125.88 Hz/mM-cm2. This electrochemical lactate biosensor has the potential to be used for the real-time monitoring of lactic acid level in biological fluids.

Blood lactate clearance after maximal exercise depends on active recovery intensity.

Science.gov (United States)

Devlin, J; Paton, B; Poole, L; Sun, W; Ferguson, C; Wilson, J; Kemi, O J

2014-06-01

High-intensity exercise is time-limited by onset of fatigue, marked by accumulation of blood lactate. This is accentuated at maximal, all-out exercise that rapidly accumulates high blood lactate. The optimal active recovery intensity for clearing lactate after such maximal, all-out exercise remains unknown. Thus, we studied the intensity-dependence of lactate clearance during active recovery after maximal exercise. We constructed a standardized maximal, all-out treadmill exercise protocol that predictably lead to voluntary exhaustion and blood lactate concentration>10 mM. Next, subjects ran series of all-out bouts that increased blood lactate concentration to 11.5±0.2 mM, followed by recovery exercises ranging 0% (passive)-100% of the lactate threshold. Repeated measurements showed faster lactate clearance during active versus passive recovery (P40%>passive recovery, Pexercise clears accumulated blood lactate faster than passive recovery in an intensity-dependent manner, with maximum clearance occurring at active recovery of 80% of lactate threshold.

Flexible graphene bio-nanosensor for lactate.

Science.gov (United States)

Labroo, Pratima; Cui, Yue

2013-03-15

The development of a flexible nanosensor for detecting lactate could expand opportunities for using graphene, both in fundamental studies for a variety of device platforms and in practical applications. Graphene is a delicate single-layer, two-dimensional network of carbon atoms with ultrasensitive sensing capabilities. Lactic acid is important for clinical analysis, sports medicine, and the food industry. Recently, wearable and flexible bioelectronics on plastics have attracted great interest for healthcare, sports and defense applications due to their advantages of being light-weight, bendable, or stretchable. Here, we demonstrate for the first time the development of a flexible graphene-based bio-nanosensor to detect lactate. Our results show that flexible lactate biosensors can be fabricated on a variety of plastic substrates. The sensor can detect lactate sensitively from 0.08 μM to 20 μM with a fast steady-state measuring time of 2s. The sensor can also detect lactate under different mechanical bending conditions, the sensor response decreased as the bending angle and number of bending repetitions increased. We anticipate that these results could open exciting opportunities for fundamental studies of flexible graphene bioelectronics by using other bioreceptors, as well as a variety of wearable, implantable, real-time, or on-site applications in fields ranging from clinical analysis to defense. Copyright © 2012 Elsevier B.V. All rights reserved.

Shared consultant physician posts.

LENUS (Irish Health Repository)

Cooke, J

2012-01-31

Our aim was to assess the acceptability and cost-efficiency of shared consultancy posts. Two consultant physicians worked alternate fortnights for a period of twelve months. Questionnaires were distributed to general practitioners, nurses, consultants and junior doctors affected by the arrangement. Patients or their next of kin were contacted by telephone. 1\\/17 of consultants described the experience as negative. 14\\/19 junior doctors reported a positive experience. 11 felt that training had been improved while 2 felt that it had been adversely affected. 17\\/17 GPs were satisfied with the arrangement. 1\\/86 nurses surveyed reported a negative experience. 1\\/48 patients were unhappy with the arrangement. An extra 2.2 (p<0.001) patients were seen per clinic. Length of stay was shortened by 2.49 days (p<0.001). A saving of 69,212 was made due to decreased locum requirements. We present data suggesting structured shared consultancy posts can be broadly acceptable and cost efficient in Ireland.

Can Knowledge Management Become Global? - Consulting Engineering Companies in the Knowledge Economy

DEFF Research Database (Denmark)

Koch, Christian

2004-01-01

The paper presents different strategies for consulting engineering companies in the emergent global economy. It is a common assumption that players can obtain market gain through cross border mergers, acquisitions, or strategic alliances in synchronisation with internal organisation. Many big...

Starting a nursing consultation practice.

Science.gov (United States)

Schulmeister, L

1999-03-01

Because the clinical nurse specialist (CNS) role has been changed or eliminated in many hospital organizations, many CNSs in career transition are considering establishing collaborative or independent nursing consultation practices. Opportunities for consultants exist in diverse practice settings and specialties. Before starting a consultation practice, the CNS should carefully examine goals, identify resources, and begin contacting potential referral sources. He or she must also decide what form of business organization to establish and write a business plan to solidify ideas and prepare for the unexpected. Most CNS consultants rely on personal savings to cover initial business and personal expenses, and many continue working as a CNS until the consultation practice is established. Fees can be set based on community standards, what the market will bear, desired projected income, or a third-party payor's fee schedule. The consultation practice can be marketed by word of mouth, inexpensive advertising techniques such as distributing flyers and business cards, direct mall, and media advertising. In today's healthcare marketplace, opportunities abound for the CNS risk-taker interested in starting a nursing consultation practice.

Conducting Participatory Culture-Specific Consultation: A Global Perspective on Multicultural Consultation.

Science.gov (United States)

Nastasi, Bonnie K.; Varjas, Kristen; Bernstein, Rachel; Iavasena, Asoka

2000-01-01

Describes a participatory approach to consultation that builds upon contemporary models of research and practice and is designed to address the culture-specific needs of individuals and systems. The Participatory Culture-Specific Consultation (PCSC) model embodies a participatory interpersonal process and relies on ethnographic and action research…

In a free healthcare system, why do men not consult for lower urinary tract symptoms (LUTS?

Directory of Open Access Journals (Sweden)

lai U Chong

2011-06-01

Full Text Available Abstract Background The prevalence of lower urinary tract symptoms (LUTS varies among different populations but the rate of seeking medical advice is consistently low. Little is known about the reasons for this low rate. In the city of Macau, China, primary healthcare is free and easily accessible to all citizens. We aim to study the patients' rate of consulting for LUTS and their reasons for not consulting under a free healthcare system. Method A convenience sample of 549 male patients aged 40-85 years in a government health centre filled in the International Prostate Symptoms Scale (IPSS questionnaire. They were also asked if they had consulted doctors for LUTS, and if not, why not. Result Of the whole sample, 64 men (11.7% had ever consulted doctors for LUTS. Of 145 with moderate to severe LUTS, 35 (24.1% consulted. Of 73 who were dissatisfied with their quality of life, 22 (30.1% consulted. Regarding the symptoms as normal or not problematic was the main reason for not consulting. Advancing age and duration of symptoms were the significant factors for consulting. Conclusion Primary care doctors could help many of LUTS patients by sensitively initiating the discussion when these patients consult for other problems.

Support to the Consultative Group on International Agricultural ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le CRDI lance un nouveau projet dans la région de l'ANASE. L'honorable Chrystia Freeland, ministre du Commerce international, a annoncé le lancement d'un nouveau projet financé par le Centre de recherches pour le développement international (CRDI). Voir davantageLe CRDI lance un nouveau projet dans la région ...

Efficiency principles of consulting entrepreneurship

OpenAIRE

Moroz Yustina S.; Drozdov Igor N.

2015-01-01

The article reviews the primary goals and problems of consulting entrepreneurship. The principles defining efficiency of entrepreneurship in the field of consulting are generalized. The special attention is given to the importance of ethical principles of conducting consulting entrepreneurship activity.

Lactate is oxidized outside of the mitochondrial matrix in rodent brain.

Science.gov (United States)

Herbst, Eric A F; George, Mitchell A J; Brebner, Karen; Holloway, Graham P; Kane, Daniel A

2018-05-01

The nature and existence of mitochondrial lactate oxidation is debated in the literature. Obscuring the issue are disparate findings in isolated mitochondria, as well as relatively low rates of lactate oxidation observed in permeabilized muscle fibres. However, respiration with lactate has yet to be directly assessed in brain tissue with the mitochondrial reticulum intact. To determine if lactate is oxidized in the matrix of brain mitochondria, oxygen consumption was measured in saponin-permeabilized mouse brain cortex samples, and rat prefrontal cortex and hippocampus (dorsal) subregions. While respiration in the presence of ADP and malate increased with the addition of lactate, respiration was maximized following the addition of exogenous NAD + , suggesting maximal lactate metabolism involves extra-matrix lactate dehydrogenase. This was further supported when NAD + -dependent lactate oxidation was significantly decreased with the addition of either low-concentration α-cyano-4-hydroxycinnamate or UK-5099, inhibitors of mitochondrial pyruvate transport. Mitochondrial respiration was comparable between glutamate, pyruvate, and NAD + -dependent lactate oxidation. Results from the current study demonstrate that permeabilized brain is a feasible model for assessing lactate oxidation, and support the interpretation that lactate oxidation occurs outside the mitochondrial matrix in rodent brain.

The Occurrence of Propyl Lactate in Chinese Baijius (Chinese Liquors Detected by Direct Injection Coupled with Gas Chromatography-Mass Spectrometry

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Jihong Wu

2015-10-01

Full Text Available As one of the oldest distillates in the world, flavor compounds of Chinese Baijiu (Chinese liquor were extremely complex. Propyl lactate was firstly detected by direct injection and gas chromatography-mass spectrometry (GC-MS in 72 Chinese Baijius. The objectives were to detect the contents of propyl lactate and evaluate its contribution to the aroma of Chinese Baijiu based on odor activity values (OAVs. The levels of propyl lactate in these distillates were determined by internal standard method and selective ion monitoring (SIM, which ranged from 0.050 to 1.900 mg∙L−1 under investigation. Its detection threshold was determined by Three-Alternative Forced-Choice (3-AFC and curve fitting (CF, which was 0.740 mg∙L−1 in 38% ethanol solution. The contribution of propyl lactate on the aroma of these distillate drinks was evaluated by their odor activity values (OAVs, which varied from 0.066 to 4.440. The OAVs of propyl lactate were found to exceed 1 in 13 Chinese Baijius, including 50° Jingzhi Guniang 5 years (4.440, 52° Jingzhi Guniang 10 years (3.024, Jingyanggang (2.568, Xianghe Ronghe Shaofang (2.313, and 1956 Laolang (1.431, which indicated that propyl lactate was one of odor-active components in these Chinese Baijius.

The art of consultation.

Science.gov (United States)

Bhangoo, Kulwant S

2014-05-01

Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon's practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years.

Cross-cultural adaptation of the international consultation incontinence questionnaire male lower urinary tract symptoms-long form (ICIQ-MLUTS-LF) in Persian.

Science.gov (United States)

Pourmomeny, Abbas Ali; Mazdak, Hamid

2017-06-01

The purpose of this study was to translate male lower urinary tract symptoms long form (MLUTS-LF) questionnaire and determine its psychometric properties in Persian speaking subjects. Assessment instrument is essential for research, making diagnosis, and for evaluating the treatment outcomes in subjects with lower urinary tract disorders of either gender. Long form of MLUTS questionnaire is a robust self-report questionnaire that investigates the major aspects of lower urinary tract symptoms and their impact on quality of life. After getting permission from the International Consultation International Questionnaire website, the forward and backward translation MLUTS carried out by researcher team and assess content/face/construct validity, reliability in sample of MLUTS Iranian patients and, quality rating and pilot testing. The irritating and obstructing lower urinary disorders were categorized as mild, moderate, and severe in the study sample. Twenty two subjects were suffering from urinary incontinence and most of the participants had benign prostate hyperplasia (BPH). Cronbach's alpha coefficient was 0.819. Correlations between the MLUTS and International prostate symptom score (IPSS) was 0.753. The MLUTS Questionnaire showed good internal consistency, content validity, and construct validity, as measured by correlation with scores on the IPSS. The Iranian version of the MLUTS questionnaire is a valid and robust instrument that can be used in clinical settings and in research. © 2016 Wiley Periodicals, Inc.

[Bone loss in lactating women and post-pregnancy osteoporosis].

Science.gov (United States)

Hirata, Go; Chaki, Osamu

2011-09-01

Measurement of the bone mineral density have shown that lactating women had 1 to 3% decrease in bone mineral density. Post pregnancy osteoporosis is rare condition that causes fragile fracture mostly in vertebrae. The bone loss in lactating women is caused by calcium loss, decrease in estrogen level, and increase in PTHrP (parathyroid hormone related protein) level. Some data have shown that extended lactation and amenorrhea had an association with the degree of bone loss. Mostly, the bone loss of the lactating women recovers to the baseline level, soon after the weaning, and there is no long term effect. Post pregnancy osteoporosis should be concerned, when we see a lactating woman with fragile fracture of the vertebrae.

Glycogen synthesis from lactate in a chronically active muscle

International Nuclear Information System (INIS)

Talmadge, R.J.; Scheide, J.I.; Silverman, H.

1989-01-01

In response to neural overactivity (pseudomyotonia), gastrocnemius muscle fibers from C57Bl/6Jdy2J/dy2J mice have different metabolic profiles compared with normal mice. A population of fibers in the fast-twitch superficial region of the dy2J gastrocnemius stores unusually high amounts of glycogen, leading to an increased glycogen storage in the whole muscle. The dy2J muscle also contains twice as much lactate as normal muscle. A [ 14 C]lactate intraperitoneal injection leads to preferential 14 C incorporation into glycogen in the dy2J muscle compared with normal muscle. To determine whether skeletal muscles were incorporating lactate into glycogen without body organ (liver, kidney) input, gastrocnemius muscles were bathed in 10 mM [ 14 C]lactate with intact neural and arterial supply but with impeded venous return. The contralateral gastrocnemius serves as a control for body organ input. By using this in situ procedure, we demonstrate that under conditions of high lactate both normal and dy2J muscle can directly synthesize glycogen from lactate. In this case, normal whole muscle incorporates [14C] lactate into glycogen at a higher rate than dy2J whole muscle. Autoradiography, however, suggests that the high-glycogen-containing muscle fibers in the dy2J muscle incorporate lactate into glycogen at nearly four times the rate of normal or surrounding muscle fibers

Tribal Consultation Tracking System

Data.gov (United States)

U.S. Environmental Protection Agency — The consultation-related information the AIEO Consultation Team working with our Tribal Portal contractors has developed a Lotus Notes Database that is capable of...

Addressing Palliative Sedation during Expert Consultation: A Descriptive Analysis of the Practice of Dutch Palliative Care Consultation Teams.

Science.gov (United States)

Hoek, Patrick; Grandjean, Ilse; Verhagen, Constans A H H V M; Jansen-Landheer, Marlies L E A; Schers, Henk J; Galesloot, Cilia; Vissers, Kris C P; Engels, Yvonne; Hasselaar, Jeroen G J

2015-01-01

Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation. We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations). We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations. Of the 44,443 initial consultations, most were requested by general practitioners (73%) and most concerned patients with cancer (86%). Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12) or COPD (OR 1.39; 95% CI: 1.15-1.69) than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40), agitation/delirium (OR 1.57; 95% CI: 1.47-1.68), exhaustion (OR 2.89; 95% CI: 2.61-3.20), euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96) or existential issues (OR 1.55; 95% CI: 1.31-1.83). In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.

Addressing Palliative Sedation during Expert Consultation: A Descriptive Analysis of the Practice of Dutch Palliative Care Consultation Teams.

Directory of Open Access Journals (Sweden)

Patrick Hoek

Full Text Available Since palliative sedation is considered a complex intervention, consultation teams are increasingly established to support general practice. This study aims to offer insight into the frequency and characteristics of expert consultations regarding palliative sedation.We performed a retrospective analysis of a longitudinal database. This database contained all patient-related consultations by Dutch Palliative Care Consultation teams, that were requested between 2004 and 2011. We described the frequency and characteristics of these consultations, in particular of the subgroup of consultations in which palliative sedation was addressed (i.e. PSa consultations. We used multivariate regression analysis to explore consultation characteristics associated with a higher likelihood of PSa consultations.Of the 44,443 initial consultations, most were requested by general practitioners (73% and most concerned patients with cancer (86%. Palliative sedation was addressed in 18.1% of all consultations. Palliative sedation was relatively more often discussed during consultations for patients with a neurologic disease (OR 1.79; 95% CI: 1.51-2.12 or COPD (OR 1.39; 95% CI: 1.15-1.69 than for patients with cancer. We observed a higher likelihood of PSa consultations if the following topics were also addressed during consultation: dyspnoea (OR 1.30; 95% CI: 1.22-1.40, agitation/delirium (OR 1.57; 95% CI: 1.47-1.68, exhaustion (OR 2.89; 95% CI: 2.61-3.20, euthanasia-related questions (OR 2.65; 95% CI: 2.37-2.96 or existential issues (OR 1.55; 95% CI: 1.31-1.83.In conclusion, PSa consultations accounted for almost one-fifth of all expert consultations and were associated with several case-related characteristics. These characteristics may help clinicians in identifying patients at risk for a more complex disease trajectory at the end of life.

The art of consultation

Directory of Open Access Journals (Sweden)

Kulwant S Bhangoo

2014-01-01

Full Text Available Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon′s practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years.

Ethics in Management Consulting

OpenAIRE

Carlo Vallini

2007-01-01

Ethics is a relevant value in business and management consulting. The presence of recognized ethics tends to reduce the need for informative or legal-contractual precautions in the formalization of relationships, for both of the parts involved in a negotiation. Management Consulting on ethics will develop more and more. Law will consider more and more ethics in business and management consulting. The ethics of corporations influences their workers and behaviour with the customers. It is an e...

Kinetics of lactate turnover and oxidation in man

International Nuclear Information System (INIS)

Searle, G.L.; Shames, D.; Cavalieri, R.R.; DeGrazia, J.; Zarcone, V.; Porte, D. Jr.; Bagdade, J.D.

1975-01-01

The turnover and oxidation of lactic acid have been studied in man by means of 14 C-lactic acid, 14 C-glucose, and 14 C-alanine. The use of these labels in separate studies has enabled us to describe a complete scheme for the kinetics of lactic acid in man. We have determined that lactate arises from a minimum of two sources in overnight fasted man. 66% of lactate at this time arises from the metabolism of glucose while approximately 15% is derived from alanine. These sources and others unidentified supply lactate to the body pool at a rate of approximately 95 mg per kg per h. The disposal of this quantity of lactate is achieved through a minimum of three routes. Approximately 57% of the lactate turnover is oxidized to carbon dioxide, 15% is reduced to glucose, and approximately 25% is converted to alanine. The quantitative changes in the kinetics of this system that are brought on by fasting add an interesting dimension to the system. In agreement with the concepts of fuel economy in fasting the contribution of glucose carbon to lactic acid falls and, in turn, the contribution of lactate carbon to body glucose rises. The study of additional permutations of this system suggest that lactate, with pyruvate, is in the main stream of the intermediary metabolism of the body. The authors suggest that the study of this system offers promise of a fuller understanding of the derangements of metabolic disease. (author)

Why do people consult the doctor?

Science.gov (United States)

Campbell, S M; Roland, M O

1996-02-01

Symptoms are an everyday part of most peoples' lives and many people with illness do not consult their doctor. The decision to consult is not based simply on the presence or absence of medical problems. Rather it is based on a complex mix of social and psychological factors. This literature review seeks to explore some of the pathways to care and those factors associated with low and high rates of consultation. The paper examines the impact of socioeconomic and demographic factors on consultation rates and, using a revised version of the Health Belief Model, it highlights the psychological factors which influence decisions to seek medical care. Barriers which can inhibit consultation are discussed, as the decision to seek care will only result in a consultation if there is adequate access to care. Whilst poor health status and social disadvantage increase both "objective" medical need and in turn, consultation rates, a range of other social and psychological factors have been shown to influence consulting behaviour.

Stakeholder consultations on community-based rehabilitation guidelines in Ghana and Uganda

Directory of Open Access Journals (Sweden)

Mary Wickenden

2012-10-01

Objectives: To consult with key stakeholders in the disability arena in Uganda and Ghana, in order to gain their opinions and suggestions for improvements to the then draft CBR guidelines, as part of a wider global participatory process of consultation on the document. Methods: The INGO Sightsavers gathered qualitative data through focus group discussions and questionnaires in both countries. Results: The participants’ critiques of the draft guidelines carried out in multiagency participatory processes were analysed thematically and fed back to the CBR guidelines editorial team. Conclusion: The paper concludes that stakeholders in diverse communities can actively contribute to shaping policy and practice through participatory consultations. Local and national government and non-government organisations and other key informants can inform the development of national and international guidelines and policies. This participatory approach can be successfully facilitated by INGOs. In turn, these processes have prompted organisations to adapt their own policies and programmes in order to be more responsive to the local needs and concerns of PWDs.

Consultation and cooperation in NATO: nuclear planning, 1975-1987

Energy Technology Data Exchange (ETDEWEB)

Chernoff, F.B.

1987-01-01

This study looks at three types of explanation of international cooperation, which deal in different ways with communication and consultation. Themost-general theoretical explanation contrasts recent realist theories, like those of Waltz and Gilpin, with Keohane's functional theory of regimes. Secondly, the study looks at theories of information flow and processing (an element of consultation) within the alliance, like those of Deutsch and Steinbruner. Such theories explain governmental behavior using concepts like equilibrium of systems and feedback loop. Third, the study considers hypotheses that deal specifically with NATO and military alliances. The hypotheses relate alliance consultation processes to the cooperativeness of the cases' outcomes. Evidence is drawn from case studies of NATO decision-making. The cases include politically sensitive deployment issues, like the enhanced radiation warhead controversy in 1977-78 and the intermediate-range nuclear force deployment decision in 1979, and important, but less politically volatile arms-control decisions, including the 1975 option three proposal, the French plan for a conference on disarmament in Europe, approved in 1980, and the 1987 American zero-zero proposal on short- and intermediate-range nuclear forces in Europe.

Blood lactate is an important energy source for the human brain

DEFF Research Database (Denmark)

G., van Hall; Stromstad, M.; Rasmussen, P.

2009-01-01

Lactate is a potential energy source for the brain. The aim of this study was to establish whether systemic lactate is a brain energy source. We measured in vivo cerebral lactate kinetics and oxidation rates in 6 healthy individuals at rest with and without 90 mins of intravenous lactate infusion...... is taken up and oxidized by the human brain and is an important substrate for the brain both under basal and hyperlactatemic conditions.Journal of Cerebral Blood Flow & Metabolism advance online publication, 1 April 2009; doi:10.1038/jcbfm.2009.35.......Lactate is a potential energy source for the brain. The aim of this study was to establish whether systemic lactate is a brain energy source. We measured in vivo cerebral lactate kinetics and oxidation rates in 6 healthy individuals at rest with and without 90 mins of intravenous lactate infusion...

Consultant's Playbook: A Survey of Pharmacy Consultant Experiences Among Hospitals In the University HealthSystem Consortium.

Science.gov (United States)

Hicks, Dave; McCarthy, Bryan; Fanikos, John; Emamifar, Amir; Nedved, Andrea; Thompson, Bruce; Bender, Fred; McMahon, Patrick

2013-10-01

Our team surveyed a group of pharmacy directors to learn about their experiences with pharmacy consultants so that the directors might be able to use their consulting resources in a more effective manner. In May 2012, the University HealthSystem Consortium (UHC) Pharmacy Council Financial Performance Committee developed an electronic survey that collectively measured the characteristics, goals, and methodology of historical pharmacy consultant engagements and level of satisfaction. After e-mailing the initial electronic survey, we conducted follow-up telephone interviews with respondents from July through November 2012. These interviews were designed to include questions about expected outcomes, recommendations for evaluation processes, timelines for implementing the recommendations, consultants' expenses, and insights gained. A total of 23 pharmacy directors responded to the initial electronic survey; their organizations had engaged at least one consultant within the previous 5 years. Data were collected for 28 consultant engagements. Subsequent telephone interviews were conducted with 20 of the 23 pharmacy directors (87%) who completed the initial electronic survey, accounting for 25 of the 28 consultant engagements (89%). Cost reduction along with revenue enhancement was most often the focus of these engagements. These engagements were also mainly within the scope of an organization-wide effort initiated by the executive board or executive team. Consultant experiences varied greatly in terms of (1) the degree to which assistance was provided to the organization, (2) benchmarking methodologies and resources, and (3) timelines for implementing the consultants' recommendations. In general, most respondents rated their consultant experience as positive and were able to provide "pearls of wisdom" or lessons learned.

MICROBIOLOGY AND SENSITIVITY PATTERN OF LACTATIONAL AND NON-LACTATIONAL BREAST ABSCESS IN SOUTHERN ODISHA

Directory of Open Access Journals (Sweden)

Niranjan Sahoo

2017-10-01

Full Text Available BACKGROUND Breast abscess is one of the most frequently encountered cases in the General Surgery OPD among females. This fact can be supported by the fact that 4.6% and 11% of the women in developed and developing countries are affected by breast abscess. Breast abscesses are generally categorised as one of two types: Lactational abscesses and non-lactational abscesses. MATERIALS AND METHODS The present study was conducted from December 2015 to January 2017 on female patients visiting the General Surgery OPD of MKCG Medical College and Hospital with presumptive diagnosis of breast abscess. Both lactational and non-lactational females were included in the study. A total of 53 subjects with breast abscess were included in the study. The diagnosis of breast abscess was made from the clinical signs and symptoms of infection. Patients having any benign or malignant disease of breast were excluded from the study. RESULTS Of the 53 specimens found positive for bacterial yield, 43 were monomicrobial and only 10 were polymicrobial. Out of the 53 samples collected, only 6 showed anaerobic growth. Most common aerobic Gram positive isolate found in the sample was Staphylococcus aureus followed by Staphylococcus epidermidis. Most common aerobic Gram negative organism isolated was Pseudomonas aeruginosa found in 14 cases followed by Escherichia coli in 10 cases. Anaerobic bacteria were found only in nonlactational breast abscess. Of the anaerobic isolates, 5 are monomicrobial and 1 was polymicrobial. Aerobic Gram positive isolates showed sensitivity to most of the commonly used antibiotics. All the 4 gram negative isolates were found to be 100% sensitive to Piperacillin Tazobactam combination and Imipenem/Cilastatin combination. Pseudomonas was found to be somewhat resistant to Amikacin, Levofloxacin and Cephalosporins. Anaerobes were found to be fully sensitive to Metronidazole, Clindamycin and Piperacillin-Tazobactam combination. CONCLUSION Hence, this

Blood flow changes in Alzheimer's disease induced by lactate

International Nuclear Information System (INIS)

Pavics, L.; Sera, T.; Kalman, J.; Janka, Z.; Csernay, L.

2002-01-01

Full text: Lactate, as metabolite of the glycolysis is a source of energy of the nerves. In vitro and in vivo experiments showed the neuroprotective effect of lactate and improvement of brain function after ischaemic injury. Intravenous infusion of lactate increases the global cerebral blood flow (CBF). In Alzheimer disease (AD) characteristic regional blood flow abnormalities and in the cerebrospinal fluid abnormal lactate levels were detected. Since disturbed CBF and vasoregulation was found in AD the effect of intravenous Na-lactate on CBF and related metabolic parameters was examined in order to assess the CBF response in the AD brain. In twenty (14 woman, 6 man, age ± SD.: 74 ± 7 years) patients with Alzheimer's disease (DSM IV, MMT.:13 ± 6) self-control study was performed. rCBF SPECT (99mTc-HMPAO) investigations were fulfilled during 5 mg/kg body weight 0.5 M Na-lactate infusion and in control state (0.9 % saline infusion) one week apart. The rCBF changes visually and by statistical parametric mapping were analyzed. ECG, blood pressure, heart rate, venous blood pH, pCO 2 , bicarbonate, serum lactate and cortisol level were measured before and after the SPECT investigation. Acute panic inventory and anxiety rating scales were used to access the psychiatric effect of lactate. The serum lactate levels increased in average from 0.8 mmol/L to 4.6 mmol/L, and 6.1 mmol/L 10 and 20 minutes after lactate infusion respectively. Compensatory changes were found in the venous blood pH, pCO 2 and bicarbonate levels. Significant psychiatric symptoms and blood pressure and heart rate increase were not observed. The serum cortisol level remained unchanged. At the baseline investigation all of the patients have bilateral temporal or parietal hypoperfused areas in 8 patients with other additional localization of abnormalities. In 12 patients the global cerebral blood flow increased, in 8 decreased rCBF was detected by visual evaluation. According to the SPM analysis the

Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology

Science.gov (United States)

American Psychologist, 2007

2007-01-01

The purpose of these "Guidelines for Education and Training at the Doctoral and Postdoctoral Levels in Consulting Psychology/Organizational Consulting Psychology" is to provide a common framework for use in the development, evaluation, and review of education and training in consulting psychology/organizational consulting psychology (CP/OCP). The…

Minimizing the effects of oxygen interference on l-lactate sensors by a single amino acid mutation in Aerococcus viridansl-lactate oxidase.

Science.gov (United States)

Hiraka, Kentaro; Kojima, Katsuhiro; Lin, Chi-En; Tsugawa, Wakako; Asano, Ryutaro; La Belle, Jeffrey T; Sode, Koji

2018-04-30

l-lactate biosensors employing l-lactate oxidase (LOx) have been developed mainly to measure l-lactate concentration for clinical diagnostics, sports medicine, and the food industry. Some l-lactate biosensors employ artificial electron mediators, but these can negatively impact the detection of l-lactate by competing with the primary electron acceptor: molecular oxygen. In this paper, a strategic approach to engineering an AvLOx that minimizes the effects of oxygen interference on sensor strips was reported. First, we predicted an oxygen access pathway in Aerococcus viridans LOx (AvLOx) based on its crystal structure. This was subsequently blocked by a bulky amino acid substitution. The resulting Ala96Leu mutant showed a drastic reduction in oxidase activity using molecular oxygen as the electron acceptor and a small increase in dehydrogenase activity employing an artificial electron acceptor. Secondly, the Ala96Leu mutant was immobilized on a screen-printed carbon electrode using glutaraldehyde cross-linking method. Amperometric analysis was performed with potassium ferricyanide as an electron mediator under argon or atmospheric conditions. Under argon condition, the response current increased linearly from 0.05 to 0.5mM l-lactate for both wild-type and Ala96Leu. However, under atmospheric conditions, the response of wild-type AvLOx electrode was suppressed by 9-12% due to oxygen interference. The Ala96Leu mutant maintained 56-69% of the response current at the same l-lactate level and minimized the relative bias error to -19% from -49% of wild-type. This study provided significant insight into the enzymatic reaction mechanism of AvLOx and presented a novel approach to minimize oxygen interference in sensor applications, which will enable accurate detection of l-lactate concentrations. Copyright © 2017 Elsevier B.V. All rights reserved.

ANALYSIS OF THE RELATIONSHIP BETWEEN FIRST THREE LACTATIONS OF HOLSTEIN COWS

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Vesna Gantner

2005-12-01

Full Text Available The objective of this study was to evaluate relationship between milk yield in the first three lactations regarding levels of milk yield in the first lactation and levels of age at the first calving. Prediction of milk yield in later lactation based on milk yield in the earlier one was also carried out. The data used in this study were 5743 lactation yields collected from 1995 to 2003. All cows finished the first three lactations. Mean value of milk yield in the first lactation was 5283.5 kg, 6033.5 kg in the second and 6338.4 kg the third one. The milk yield estimation coefficients between the first and second lactation was 1.164, between the first and third was 1.231, and 1.079 between the second and third. The levels of milk yield in the first lactation highly significant influenced the value of estimation coefficient between first three lactations, while the age at first calving influenced less significantly. Determination coefficient (R2 values for models used in prediction ranged from 0.348 to 0.396.

Brain Lactate Metabolism in Humans With Subarachnoid Hemorrhage

OpenAIRE

Oddo M; Levine JM; Frangos S; Maloney-Wilensky E; Carrera E; Daniel RT; Levivier M; Magistretti PJ; LeRoux PD

2012-01-01

Abstract BACKGROUND AND PURPOSE: Lactate is central for the regulation of brain metabolism and is an alternative substrate to glucose after injury. Brain lactate metabolism in patients with subarachnoid hemorrhage has not been fully elucidated. METHODS: Thirty one subarachnoid hemorrhage patients monitored with cerebral microdialysis (CMD) and brain oxygen (PbtO(2)) were studied. Samples with elevated CMD lactate (>4 mmol/L) were matched to PbtO(2) and CMD pyruvate and categorized as hypoxi...

Lactate as a fuel for mitochondrial respiration

DEFF Research Database (Denmark)

Van Hall, Gerrit

2000-01-01

Lactate production in skeletal muscle has now been studied for nearly two centuries and still its production and functional role at rest and during muscle contraction is a subject of debate. Historically, skeletal muscle was seen mainly as the site of lactate production during contraction...

Lactate Transport and Receptor Actions in Retina

DEFF Research Database (Denmark)

Kolko, Miriam; Vosborg, Fia; Henriksen, Jens Ulrik Lütken

2016-01-01

known as HCAR1, may contribute importantly to the control of retinal cell functions in health and disease. GPR81, a G-protein coupled receptor, is known to downregulate cAMP both in adipose and nervous tissue. The receptor also acts through other down-stream mechanisms to control functions......In retina, like in brain, lactate equilibrates across cell membranes via monocarboxylate transporters and in the extracellular space by diffusion, forming a basis for the action of lactate as a transmitter of metabolic signals. In the present paper, we argue that the lactate receptor GPR81, also...

Monocarboxylate Transporters and Lactate Metabolism in Equine Athletes: A Review

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Pösö AR

2002-06-01

Full Text Available Lactate is known as the end product of anaerobic glycolysis, a pathway that is of key importance during high intensity exercise. Instead of being a waste product lactate is now regarded as a valuable substrate that significantly contributes to the energy production of heart, noncontracting muscles and even brain. The recent cloning of monocarboxylate transporters, a conserved protein family that transports lactate through biological membranes, has given a new insight into the role of lactate in whole body metabolism. This paper reviews current literature on lactate and monocarboxylate transporters with special reference to horses.

Management of hyperthyroidism during pregnancy and lactation.

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Azizi, Fereidoun; Amouzegar, Atieh

2011-06-01

Poorly treated or untreated maternal overt hyperthyroidism may affect pregnancy outcome. Fetal and neonatal hypo- or hyper-thyroidism and neonatal central hypothyroidism may complicate health issues during intrauterine and neonatal periods. To review articles related to appropriate management of hyperthyroidism during pregnancy and lactation. A literature review was performed using MEDLINE with the terms 'hyperthyroidism and pregnancy', 'antithyroid drugs and pregnancy', 'radioiodine and pregnancy', 'hyperthyroidism and lactation', and 'antithyroid drugs and lactation', both separately and in conjunction with the terms 'fetus' and 'maternal.' Antithyroid drugs are the main therapy for maternal hyperthyroidism. Both methimazole (MMI) and propylthiouracil (PTU) may be used during pregnancy; however, PTU is preferred in the first trimester and should be replaced by MMI after this trimester. Choanal and esophageal atresia of fetus in MMI-treated and maternal hepatotoxicity in PTU-treated pregnancies are of utmost concern. Maintaining free thyroxine concentration in the upper one-third of each trimester-specific reference interval denotes success of therapy. MMI is the mainstay of the treatment of post partum hyperthyroidism, in particular during lactation. Management of hyperthyroidism during pregnancy and lactation requires special considerations and should be carefully implemented to avoid any adverse effects on the mother, fetus, and neonate.

Diammonium phosphate stimulates transcription of L-lactate dehydrogenase leading to increased L-lactate production in the thermotolerant Bacillus coagulans strain.

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Sun, Lifan; Li, Yanfeng; Wang, Limin; Wang, Yanping; Yu, Bo

2016-08-01

Exploration of cost-effective fermentation substrates for efficient lactate production is an important economic objective. Although some organic nitrogen sources are also cheaper, inorganic nitrogen salts for lactate fermentation have additional advantages in facilitating downstream procedures and significantly improving the commercial competitiveness of lactate production. In this study, we first established an application of diammonium phosphate to replace yeast extract with a reduced 90 % nitrogen cost for a thermotolerant Bacillus coagulans strain. In vivo enzymatic and transcriptional analyses demonstrated that diammonium phosphate stimulates the gene expression of L-lactate dehydrogenase, thus providing higher specific enzyme activity in vivo and increasing L-lactic acid production. This new information provides a foundation for establishing a cost-effective process for polymer-grade L-lactic acid production in an industrial setting.

Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.

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Drake, Marcus John; Apostolidis, Apostolos; Cocci, Andrea; Emmanuel, Anton; Gajewski, Jerzy B; Harrison, Simon C W; Heesakkers, John P F A; Lemack, Gary E; Madersbacher, Helmut; Panicker, Jalesh N; Radziszewski, Piotr; Sakakibara, Ryuji; Wyndaele, Jean Jacques

2016-08-01

Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential. The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. 35:657-665, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

In Vivo Evidence for a Lactate Gradient from Astrocytes to Neurons

KAUST Repository

Mä chler, Philipp; Wyss, Matthias  T.; Elsayed, Maha; Stobart, Jillian; Gutierrez, Robin; von  Faber-Castell, Alexandra; Kaelin, Vincens; Zuend, Marc; San  Martí n, Alejandro; Romero-Gó mez, Ignacio; Baeza-Lehnert, Felipe; Lengacher, Sylvain; Schneider, Bernard  L.; Aebischer, Patrick; Magistretti, Pierre J.; Barros, L.  Felipe; Weber, Bruno

2015-01-01

Investigating lactate dynamics in brain tissue is challenging, partly because in vivo data at cellular resolution are not available. We monitored lactate in cortical astrocytes and neurons of mice using the genetically encoded FRET sensor Laconic in combination with two-photon microscopy. An intravenous lactate injection rapidly increased the Laconic signal in both astrocytes and neurons, demonstrating high lactate permeability across tissue. The signal increase was significantly smaller in astrocytes, pointing to higher basal lactate levels in these cells, confirmed by a one-point calibration protocol. Trans-acceleration of the monocarboxylate transporter with pyruvate was able to reduce intracellular lactate in astrocytes but not in neurons. Collectively, these data provide in vivo evidence for a lactate gradient from astrocytes to neurons. This gradient is a prerequisite for a carrier-mediated lactate flux from astrocytes to neurons and thus supports the astrocyte-neuron lactate shuttle model, in which astrocyte-derived lactate acts as an energy substrate for neurons. © 2016 Elsevier Inc.

In Vivo Evidence for a Lactate Gradient from Astrocytes to Neurons

KAUST Repository

Mächler, Philipp

2015-11-19

Investigating lactate dynamics in brain tissue is challenging, partly because in vivo data at cellular resolution are not available. We monitored lactate in cortical astrocytes and neurons of mice using the genetically encoded FRET sensor Laconic in combination with two-photon microscopy. An intravenous lactate injection rapidly increased the Laconic signal in both astrocytes and neurons, demonstrating high lactate permeability across tissue. The signal increase was significantly smaller in astrocytes, pointing to higher basal lactate levels in these cells, confirmed by a one-point calibration protocol. Trans-acceleration of the monocarboxylate transporter with pyruvate was able to reduce intracellular lactate in astrocytes but not in neurons. Collectively, these data provide in vivo evidence for a lactate gradient from astrocytes to neurons. This gradient is a prerequisite for a carrier-mediated lactate flux from astrocytes to neurons and thus supports the astrocyte-neuron lactate shuttle model, in which astrocyte-derived lactate acts as an energy substrate for neurons. © 2016 Elsevier Inc.

CRE answer to the European Commission public consultation on the new electricity market design

International Nuclear Information System (INIS)

Ladoucette, Philippe de

2015-01-01

On July 15, 2015, the European Commission launched a public consultation on the new Electricity Market Design. All National Regulatory Authorities (NRAs), and CRE in particular, contributed to the joint ACER-CEER response to the consultation. CRE supports this joint response, and further develops some topics in this document, building on its particular experience in the implementation of the internal energy market: implementation of the network codes, in particular those regarding the markets, development of demand-side flexibility, development of interconnections, and alignment of fragmented balancing markets

Portable lactate analyzer for measuring lactate in cerebrospinal fluid (CSF and plasma ? method-comparison evaluations

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Sérgio Monteiro de Almeida

2014-07-01

Full Text Available Increased plasma lactate levels can indicate the presence of metabolic disorders in HIV infected individuals. Objective: To determine whether a portable analyzer is valid for measuring cerebrospinal fluid (CSF and plasma lactate levels in HIV infected individuals. Method: CSF and plasma were collected from 178 subjects. Samples tested by the Accutrend® portable analyzer were compared to those tested by a reference device (SYNCHRON LX® 20. Results: The portable analyzer had in plasma sensitivity of 0.95 and specificity 0.87. For CSF the specificity was 0.95; the sensitivity 0.33; the negative predictive value was 95% and the positive predictive value 33%. Conclusions: These findings support the validity of the portable analyzer in measuring lactate concentrations in CSF that fall within the normal range. The relatively poor positive predictive value indicates that a result above the reference range may represent a “false positive test”, and should be confirmed by the reference device before concluding abnormality.

Cerebrospinal fluid lactate and pyruvate concentrations and their ratio.

Science.gov (United States)

Zhang, Wan-Ming; Natowicz, Marvin R

2013-05-01

Determinations of cerebrospinal fluid (CSF) lactate and pyruvate concentrations and CSF lactate:pyruvate (L/P) ratios are important in several clinical settings, yet published normative data have significant limitations. We sought to determine a large dataset of stringently-defined normative data for CSF lactate and pyruvate concentrations and CSF L/P ratios. We evaluated data from 627 patients who had determinations of CSF lactate and/or CSF pyruvate from 2001 to 2011 at the Cleveland Clinic. Inclusion in the normal reference population required normal CSF cell counts, glucose and protein and routine serum chemistries and absence of progressive brain disorder, epilepsy, or seizure within 24h. Brain MRI, if done, showed no evidence of tumor, acute changes or basal ganglia abnormality. CSF cytology, CSF alanine and immunoglobulin levels, and oligoclonal band analysis were required to be normal, if done. Various inclusion/exclusion criteria were compared. 92 patients fulfilled inclusion/exclusion criteria for a reference population. The 95% central intervals (2.5%-97.5%) for CSF lactate and pyruvate levels were 1.01-2.09mM and 0.03-0.15mM, respectively, and 9.05-26.37 for CSF L/P. There were no significant gender-related differences of CSF lactate or pyruvate concentrations or of CSF L/P. Weak positive correlations between the concentration of CSF lactate or pyruvate and age were noted. Using stringent inclusion/exclusion criteria, we determined normative data for CSF lactate and pyruvate concentrations and CSF L/P ratios in a large, well-characterized reference population. Normalcy of routine CSF and blood analytes are the most important parameters in determining reference intervals for CSF lactate and pyruvate. Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Psychiatric Consultation at Your Fingertips: Descriptive Analysis of Electronic Consultation From Primary Care to Psychiatry.

Science.gov (United States)

Lowenstein, Margaret; Bamgbose, Olusinmi; Gleason, Nathaniel; Feldman, Mitchell D

2017-08-04

Mental health problems are commonly encountered in primary care, with primary care providers (PCPs) experiencing challenges referring patients to specialty mental health care. Electronic consultation (eConsult) is one model that has been shown to improve timely access to subspecialty care in a number of medical subspecialties. eConsults generally involve a PCP-initiated referral for specialty consultation for a clinical question that is outside their expertise but may not require an in-person evaluation. Our aim was to describe the implementation of eConsults for psychiatry in a large academic health system. We performed a content analysis of the first 50 eConsults to psychiatry after program implementation. For each question and response, we coded consults as pertaining to diagnosis and/or management as well as categories of medication choice, drug side effects or interactions, and queries about referrals and navigating the health care system. We also performed a chart review to evaluate the timeliness of psychiatrist responses and PCP implementation of recommendations. Depression was the most common consult template selected by PCPs (20/50, 40%), followed by the generic template (12/50, 24%) and anxiety (8/50, 16%). Most questions (49/50, 98%) pertained primarily to management, particularly for medications. Psychiatrists commented on both diagnosis (28/50, 56%) and management (50/50, 100%), responded in an average of 1.4 days, and recommended in-person consultation for 26% (13/50) of patients. PCPs implemented psychiatrist recommendations 76% (38/50) of the time. For the majority of patients, psychiatrists provided strategies for ongoing management in primary care without an in-person evaluation, and PCPs implemented most psychiatrist recommendations. eConsults show promise as one means of supporting PCPs to deliver mental health care to patients with common psychiatric disorders. ©Margaret Lowenstein, Olusinmi Bamgbose, Nathaniel Gleason, Mitchell D Feldman

Antioxidant treatment attenuates lactate production in diabetic nephropathy

DEFF Research Database (Denmark)

Laustsen, Christoffer; Nielsen, Per Mose; Stokholm Nørlinger, Thomas

2017-01-01

-IDEAL spiral sequence. Untreated diabetic rats showed increased renal lactate production compared with that shown by the controls. However, chronic TEMPOL treatment significantly attenuated diabetes-induced lactate production. No significant effects of diabetes or TEMPOL were observed on [13C]alanine levels......, indicating an intact glucose-alanine cycle, or [13C]bicarbonate, indicating normal flux through the Krebs cycle. In conclusion, this study demonstrates that diabetes-induced pseudohypoxia, as indicated by an increased lactate-to-pyruvate ratio, is significantly attenuated by antioxidant treatment......The early progression of diabetic nephropathy is notoriously difficult to detect and quantify before the occurrence of substantial histological damage. Recently, hyperpolarized [1-13C]pyruvate has demonstrated increased lactate production in the kidney early after the onset of diabetes, implying...

Ischemic Heart Disease and Work Disability in Patients Treated at the Internal Medicine Consultation and Assessed by the Expert Medical Labor Commission

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Belkis Vicente Sánchez

2016-02-01

Full Text Available Background: ischemic heart disease represents a major challenge given the large number of people affected by this condition, its increasing contribution to overall mortality, the frequent disability resulting from it, and the complexity and high cost of its treatment. Objective: to describe the work disability caused by ischemic heart disease in patients treated at the internal medicine consultation and assessed by the Expert Medical Labor Commission of Cienfuegos municipality. Methods: a cross-sectional study was conducted including all patients with ischemic heart disease treated at the internal medicine consultation and assessed by the Expert Medical Labor Commission of Cienfuegos municipality from October 2012 to July 2013. The variables analyzed were: age, sex, occupation, years of work and accrued salary, clinical diagnosis, length of time the condition had been present and associated chronic diseases; existence of prior assessment by an Expert Medical Labor Commission and decision reached, previous days of sick leave and current decision of the commission. The data were analyzed using SPSS (version 18.0 and the results are shown in tables and graphs as numbers and percentages. Results: a predominance of men was observed. Forty two point nine percent were service workers and the average number of years of work was 24.60. Forty two point nine percent were previously assessed by the commission. Two hundred one point thirteen days of sick leave were granted and social security expenditure in a month was high. Diabetes mellitus was the most common chronic disease followed by hypertension, obesity and dyslipidemia. Of the workers previously assessed, half received permanent and temporary disability benefits. Conclusions: ischemic heart disease causes different degrees of disability. Its costs in terms of social security are increasing.

Lactate biosensor based on a bionanocomposite composed of titanium oxide nanoparticles, photocatalytically reduced graphene, and lactate oxidase

International Nuclear Information System (INIS)

Casero, Elena; Petit- Domínguez, María Dolores; Parra-Alfambra, Ana María; Suárez, Edna; Pariente, Félix; Lorenzo, Encarnación; Alonso, Concepción; Vázquez, Luis; Álvarez-García, Susana; Andrés, Alicia de; Merino, Pablo

2014-01-01

We have developed a lactate biosensor based on a bionanocomposite (BNC) composed of titanium dioxide nanoparticles (TiO 2 -NPs), photo catalytically reduced graphene, and lactate oxidase. Graphene oxide was photochemically reduced (without using any chemical reagents) in the presence of TiO 2 -NPs to give graphene nano sheets that were characterized by atomic force microscopy, Raman and X-ray photoelectron spectroscopy. The results show the nano sheets to possess few oxygen functionalities only and to be decorated with TiO 2 -NPs. These nano sheets typically are at least 1 μm long and have a thickness of 4.2 nm. A BNC was obtained by mixing lactate oxidase with the nano sheets and immobilized on the surface of a glassy carbon electrode. The resulting biosensor was applied to the determination of lactate. Compared to a sensor without TiO 2 -NPs, the sensor exhibits higher sensitivity (6.0 μA mM −1 ), a better detection limit (0.6 μM), a wider linear response (2.0 μM to 0.40 mM), and better reproducibility (3.2 %). (author)

Lactate dehydrogenase activity is inhibited by methylmalonate in vitro.

Science.gov (United States)

Saad, Laura O; Mirandola, Sandra R; Maciel, Evelise N; Castilho, Roger F

2006-04-01

Methylmalonic acidemia (MMAemia) is an inherited metabolic disorder of branched amino acid and odd-chain fatty acid metabolism, involving a defect in the conversion of methylmalonyl-coenzyme A to succinyl-coenzyme A. Systemic and neurological manifestations in this disease are thought to be associated with the accumulation of methylmalonate (MMA) in tissues and biological fluids with consequent impairment of energy metabolism and oxidative stress. In the present work we studied the effect of MMA and two other inhibitors of mitochondrial respiratory chain complex II (malonate and 3-nitropropionate) on the activity of lactate dehydrogenase (LDH) in tissue homogenates from adult rats. MMA potently inhibited LDH-catalyzed conversion of lactate to pyruvate in liver and brain homogenates as well as in a purified bovine heart LDH preparation. LDH was about one order of magnitude less sensitive to inhibition by MMA when catalyzing the conversion of pyruvate to lactate. Kinetic studies on the inhibition of brain LDH indicated that MMA inhibits this enzyme competitively with lactate as a substrate (K (i)=3.02+/-0.59 mM). Malonate and 3-nitropropionate also strongly inhibited LDH-catalyzed conversion of lactate to pyruvate in brain homogenates, while no inhibition was observed by succinate or propionate, when present in concentrations of up to 25 mM. We propose that inhibition of the lactate/pyruvate conversion by MMA contributes to lactate accumulation in blood, metabolic acidemia and inhibition of gluconeogenesis observed in patients with MMAemia. Moreover, the inhibition of LDH in the central nervous system may also impair the lactate shuttle between astrocytes and neurons, compromising neuronal energy metabolism.

Evolution of D-lactate dehydrogenase activity from glycerol dehydrogenase and its utility for D-lactate production from lignocellulose

Science.gov (United States)

Wang, Qingzhao; Ingram, Lonnie O.; Shanmugam, K. T.

2011-01-01

Lactic acid, an attractive, renewable chemical for production of biobased plastics (polylactic acid, PLA), is currently commercially produced from food-based sources of sugar. Pure optical isomers of lactate needed for PLA are typically produced by microbial fermentation of sugars at temperatures below 40 °C. Bacillus coagulans produces L(+)-lactate as a primary fermentation product and grows optimally at 50 °C and pH 5, conditions that are optimal for activity of commercial fungal cellulases. This strain was engineered to produce D(−)-lactate by deleting the native ldh (L-lactate dehydrogenase) and alsS (acetolactate synthase) genes to impede anaerobic growth, followed by growth-based selection to isolate suppressor mutants that restored growth. One of these, strain QZ19, produced about 90 g L-1 of optically pure D(−)-lactic acid from glucose in coagulans and the QZ19 derivative can be used to produce either L(+) or D(−) optical isomers of lactic acid (respectively) at high titers and yields from nonfood carbohydrates. PMID:22065761

Blood lactate levels in 31 female dogs with pyometra

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Karlstam Erika

2009-01-01

Full Text Available Abstract Background Canine pyometra is a life-threatening disease common in countries where spaying of dogs is not routinely performed. The disease is associated with endotoxemia, sepsis, systemic inflammatory response syndrome (SIRS and a 3–4% mortality rate. Blood lactate analysis is clinically valuable in predicting prognosis and survival, evaluating tissue perfusion and treatment response in human and veterinary critical care settings. The aims of the present study were to investigate 1 the blood lactate levels of female dogs with pyometra by a hand-held analyser and 2 if these levels are related with the clinical status or other biochemical or hematological disorders. Methods In total 31 female dogs with pyometra admitted for surgical ovariohysterectomy and 16 healthy female control dogs were included in the present study. A complete physical examination including SIRS-status determination was performed. Blood samples for lactate concentrations, hematological and biochemical parameters, acid-base and blood gas analysis and other laboratory parameters were collected and subsequently analysed. The diagnosis pyometra was verified with histopathological examination of the uterus and ovaries. Increased hospitalisation length and presence of SIRS were used as indicators of outcome. Results In the pyometra group the median blood lactate level was 1,6 mmol l-1 (range -1. In the control group the median lactate level was 1,2 mmol l-1 (range -1. Of the 31 bitches 19 (61% fulfilled 2 or more criteria for SIRS at inclusion, 10 bitches (32% fulfilled 3 of the SIRS criteria whereas none accomplished more than 3 criteria. Lactate levels did not differ significantly between the pyometra and control group, or between the SIRS positive and SIRS negative dogs with pyometra. Increased lactate concentration (>2.5 mmol l-1 was demonstrated in one female dog with pyometra (3%, and was not associated with longer hospitalisation or presence of SIRS. Lactate

Vitamin D Levels Among Pregnant and Lactating Women

International Nuclear Information System (INIS)

Sharif, S.; Farasat, T.; Fazal, S.

2013-01-01

Objective: To assess the serum level of vitamin D in pregnant and lactating women. Study Design: Case-control study. Place and Duration of Study: Gynaecological Unit 1 of Jinnah Hospital, Lahore, from December 2010 to May 2011. Methodology: A total of 100 women comprised of three groups: pregnant (n = 40), lactating (n = 40) and control (n = 20) groups. The information regarding age, educational level, socioeconomic status, exposure to sunlight and dietary vitamin D intake were collected through self-structured questionnaire. Serum concentration of vitamin D was measured by ELISA and serum calcium and phosphate levels were measured by chemistry analyzer. Statistical analysis was done using SPSS (version 13). The values were considered significant at 0.05 level of significance. Results: The mean serum vitamin D level in the pregnant and lactating mothers was 26.5 +- 17.1 nmol/L and 21.4 +- 16.3 nmol/L respectively and in control group was 33.8 +- 21.1 nmol/L. The mean calcium level in the pregnant, lactating and control group was 10.3 +- 1.2 mg/dL, 9.7 +- 1.3 mg/dL and 9.7 +- 1.3 mg/dL respectively. The mean phosphate in pregnant was 3.2 +- 0.76 mg/dl, in lactating was 3.3 +- 0.76 mg/dl and in control was 3.5 +- 0.92 mg/dl. Significant difference (p = 0.041 and p = 0.037 respectively) in the serum levels of vitamin D and calcium was observed among the pregnant and lactating women as compared to control group. Conclusion: Low serum vitamin D concentration was observed in lactating women and pregnant women as compared to control group. (author)

Vitamin D levels among pregnant and lactating women.

Science.gov (United States)

Sharif, Saima; Farasat, Tasnim; Shoaib, Hamna; Saqib, Muhammad; Fazal, Sabiha

2013-12-01

To assess the serum level of vitamin D in pregnant and lactating women. Case-control study. Gynaecological Unit 1 of Jinnah Hospital, Lahore, from December 2010 to May 2011. A total of 100 women comprised of three groups: pregnant (n = 40), lactating (n = 40) and control (n = 20) groups. The information regarding age, educational level, socioeconomic status, exposure to sunlight and dietary vitamin D intake were collected through self-structured questionnaire. Serum concentration of vitamin D was measured by ELISA and serum calcium and phosphate levels were measured by chemistry analyzer. Statistical analysis was done using SPSS (version 13). The values were considered significant at 0.05 level of significance. The mean serum vitamin D level in the pregnant and lactating mothers was 26.5 ± 17.1 nmol/L and 21.4 ± 16.3 nmol/L respectively and in control group was 33.8 ± 21.1 nmol/L. The mean calcium level in the pregnant, lactating and control group was 10.3 ± 1.2 mg/dL, 9.7 ± 1.3 mg/dL and 9.7 ± 1.3 mg/dL respectively. The mean phosphate in pregnant was 3.2 ± 0.76 mg/dl, in lactating was 3.3 ± 0.76 mg/dl and in control was 3.5 ± 0.92 mg/dl. Significant difference (p = 0.041 and p = 0.037 respectively) in the serum levels of vitamin D and calcium was observed among the pregnant and lactating women as compared to control group. Low serum vitamin D concentration was observed in lactating women and pregnant women as compared to control group.

Metabolism of D-lactate and structurally related organic acids in Chlamydomonas reinhardtii

International Nuclear Information System (INIS)

Husic, D.W.

1986-01-01

During the initial minutes of anaerobiosis, 14 C-labeled D-lactate, derived from the photosynthetic sugar phosphate pool, accumulated in the unicellular green alga, Chlamydomonas reinhardtii. The production of the D-isomer of lactate by algae is in contrast to plant and mammalian cells in which L-lactate is formed. After initial lactate formation, Chlamydomonas exhibits a mixed-acid type fermentation, thereby avoiding lactate accumulation and enabling the cells to tolerate extended periods of anaerobiosis. A pyruvate reductase which catalyzes the formation of D-lactate in Chlamydomonas was partially purified and characterized. Lactate produced anaerobically was metabolized only when Chlamydomonas cells were returned to aerobic conditions, and reoxidation of the D-lactate was apparently catalyzed by a mitochondrial membrane-bound dehydrogenase, rather than by the soluble pyruvate reductase. Mutants of Chlamydomonas, deficient in mitochondrial respiration, were used to demonstrate that lactate metabolism was linked to the mitochondrial electron transport chain. In addition, the oxidation of glycolate, a structural analog of lactate, was also linked to mitochondrial electron transport in vivo

Managing antiepileptic drugs during pregnancy and lactation

DEFF Research Database (Denmark)

Sabers, Anne; Tomson, Torbjörn

2009-01-01

PURPOSE OF REVIEW: This review discusses data on the pharmacokinetics of antiepileptic drugs (AEDs) in pregnancy and lactation, and the clinical consequences thereof, thus providing a basis for a rational management of AEDs during pregnancy and lactation. RECENT FINDINGS: Studies have confirmed...... of AEDs in pregnancy and during lactation is important to enable optimal treatment. Gestation induced alterations in pharmacokinetics vary with the AED but also between patients and are difficult to predict. Therapeutic drug monitoring is, therefore, advisable during pregnancy and the use...... of the individual patient's optimal prepregnancy drug level is recommended as reference. Breastfeeding is in general safe but needs appropriate observation of the nursing infant....

Nutrition in pregnancy and lactation: how a healthy infant is born

Directory of Open Access Journals (Sweden)

Federico Mecacci

2015-10-01

Full Text Available Maternal nutrition during pregnancy and lactation influences the growth and potential development of the fetus and contributes to the maturity of a healthy baby.The lack of sufficient calories, of macro- and micronutrients, can lead to deficiencies in building materials for the development and growth of the fetus: moreover there is growing evidence that the maternal nutritional status can alter the epigenetic state of the fetal genome, therefore alterations in nutrition during crucial periods of fetal development may result in developmental adaptations that permanently change the physiology, the metabolism of the offspring, and, as a consequence, predispose these individuals to diseases as adults.In this review we collected indications for the recommended intake of calories and nutrients for a healthy diet during pregnancy and lactation, also analyzing some nutritional choices that may increase the risk of nutritional deficiencies and the way to prevent them.Pregnancy-related dietary changes should begin prior to conception, with appropriate modifications throughout pregnancy and lactation, and appropriate supplementation of vitamins and minerals. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

Gene regulatory networks in lactation: identification of global principles using bioinformatics

Directory of Open Access Journals (Sweden)

Pollard Katherine S

2007-11-01

Full Text Available Abstract Background The molecular events underlying mammary development during pregnancy, lactation, and involution are incompletely understood. Results Mammary gland microarray data, cellular localization data, protein-protein interactions, and literature-mined genes were integrated and analyzed using statistics, principal component analysis, gene ontology analysis, pathway analysis, and network analysis to identify global biological principles that govern molecular events during pregnancy, lactation, and involution. Conclusion Several key principles were derived: (1 nearly a third of the transcriptome fluctuates to build, run, and disassemble the lactation apparatus; (2 genes encoding the secretory machinery are transcribed prior to lactation; (3 the diversity of the endogenous portion of the milk proteome is derived from fewer than 100 transcripts; (4 while some genes are differentially transcribed near the onset of lactation, the lactation switch is primarily post-transcriptionally mediated; (5 the secretion of materials during lactation occurs not by up-regulation of novel genomic functions, but by widespread transcriptional suppression of functions such as protein degradation and cell-environment communication; (6 the involution switch is primarily transcriptionally mediated; and (7 during early involution, the transcriptional state is partially reverted to the pre-lactation state. A new hypothesis for secretory diminution is suggested – milk production gradually declines because the secretory machinery is not transcriptionally replenished. A comprehensive network of protein interactions during lactation is assembled and new regulatory gene targets are identified. Less than one fifth of the transcriptionally regulated nodes in this lactation network have been previously explored in the context of lactation. Implications for future research in mammary and cancer biology are discussed.

Consultant breast radiographers: Where are we now?

International Nuclear Information System (INIS)

Rees, Zebby

2014-01-01

Introduction: The aim of this study is to: • Evaluate the current role of the consultant breast radiographer. • Compare current practice with the four key components for consultant practice. • Gauge the support of radiologist colleagues. • Determine the other professional commitments involved with the role. This study could be the precursor for a macro study of all consultant radiographer practice in other specialities. Methodology: Methodology used was a comparative ethnographic study. Questionnaires to the 24 consultant breast radiographers currently in post, and consultant breast radiologists, who work with them, were conducted. Data collection was a qualitative thematic approach. Conclusion: Consultant breast radiographers provide high quality care to patients through excellent clinical practice, leadership and good communication. However, this study shows hospital Trusts emphasis for non medical consultants is for clinical practice first. Some radiologists are still a barrier to progression for consultant breast radiographers, and radiologists have a big influence in recruitment decisions. Consultant breast radiographer posts are well established, their numbers are increasing through recognition of the role and of their abilities and performance. Consultant breast radiographers state that becoming a consultant is the major achievement of their career, proving the Society of Radiographers' vision of the four-tier career structure has been well received by the radiography profession

No change in energy efficiency in lactation: Insights from a longitudinal study.

Science.gov (United States)

Bender, Richard L; Williams, Heather S; Dufour, Darna L

2017-11-01

Lactation is the most energy-demanding phase of reproduction for human females, but it is still unclear how women in different environments are able to meet this additional energy demand. Previous studies have investigated whether changes in metabolism could have an energy-sparing effect in lactation, with conflicting results. Here, we asked whether increased energy efficiency in physical activity serves as an energy-sparing mechanism in lactation. We used a longitudinal design with a control group. Participants were 33 well-nourished, exclusively breastfeeding women and 29 non-pregnant, non-lactating (NPNL) controls aged 32 ± 4 years. Lactating women were measured at peak- and post-lactation. NPNL controls completed a baseline measurement and a follow-up visit. Energy efficiency in physical activity was assessed using a graded submaximal exercise test and calculated as delta efficiency (change in work accomplished over change in energy expended) and gross efficiency (work accomplished over energy expended). There was no significant change in either delta efficiency or gross efficiency from peak to post lactation in lactating women, and no significant difference in delta efficiency between lactating women and NPNL controls at any time period. However, lactating women showed greater between-visit variation in delta efficiency than the NPNL controls. Additionally, 79% of lactating participants lost weight between visits (mean weight loss -3.6 ± 2.3kg), consistent with a mobilization of body tissues to support lactation. We found no support for the idea that lactating women undergo an increase in energy efficiency to support the energy costs of lactation. © 2017 Wiley Periodicals, Inc.

Music Education for the Improvement of Coexistence in and beyond the Classroom: A Study Based on the Consultation of Experts

Science.gov (United States)

Cabedo-Mas, Alberto; Díaz-Gómez, Maravillas

2016-01-01

This study examines theoretical principles and models of music education to promote interpersonal and social relations. It focuses on the primary and secondary stages of education in Spain. To this end, relevant national and international figures in education, music or critical thinking were consulted. Their responses to the consultation were…

Calcium and bone metabolism disorders during pregnancy and lactation.

Science.gov (United States)

Kovacs, Christopher S

2011-12-01

Pregnancy and lactation cause a substantial increase in demand for calcium that is met by different maternal adaptations within each period. Intestinal calcium absorption more than doubles during pregnancy, whereas the maternal skeleton resorbs to provide most of the calcium content of breast milk during lactation. These maternal adaptations also affect the presentation, diagnosis, and management of disorders of calcium and bone metabolism. Although some women may experience fragility fractures as a consequence of pregnancy or lactation, for most women, parity and lactation do not affect the long-term risks of low bone density, osteoporosis, or fracture. Copyright © 2011 Elsevier Inc. All rights reserved.

Lactate Parameters Predict Clinical Outcomes in Patients with Nonvariceal Upper Gastrointestinal Bleeding.

Science.gov (United States)

Lee, Seung Hoon; Min, Yang Won; Bae, Joohwan; Lee, Hyuk; Min, Byung Hoon; Lee, Jun Haeng; Rhee, Poong Lyul; Kim, Jae J

2017-11-01

The predictive role of lactate in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) has been suggested. This study evaluated several lactate parameters in terms of predicting outcomes of bleeding patients and sought to establish a new scoring model by combining lactate parameters and the AIMS65 score. A total of 114 patients with NVUGIB who underwent serum lactate level testing at least twice and endoscopic hemostasis within 24 hours after admission were retrospectively analyzed. The associations between five lactate parameters and clinical outcomes were evaluated and the predictive power of lactate parameter combined AIMS65s (L-AIMS65s) and AIMS56 scoring was compared. The most common cause of bleeding was gastric ulcer (48.2%). Lactate clearance rate (LCR) was associated with 30-day rebleeding (odds ratio [OR], 0.931; 95% confidence interval [CI], 0.872-0.994; P = 0.033). Initial lactate (OR, 1.313; 95% CI, 1.050-1.643; P = 0.017), maximal lactate (OR, 1.277; 95% CI, 1.037-1.573; P = 0.021), and average lactate (OR, 1.535; 95% CI, 1.137-2.072; P = 0.005) levels were associated with 30-day mortality. Initial lactate (OR, 1.213; 95% CI, 1.027-1.432; P = 0.023), maximal lactate (OR, 1.271; 95% CI, 1.074-1.504; P = 0.005), and average lactate (OR, 1.501; 95% CI, 1.150-1.959; P = 0.003) levels were associated with admission over 7 days. Although L-AIMS65s showed the highest area under the curve for prediction of each outcome, differences between L-AIMS65s and AIMS65 did not reach statistical significance. In conclusion, lactate parameters have a prognostic role in patients with NVUGIB. However, they do not increase the predictive power of AIMS65 when combined. © 2017 The Korean Academy of Medical Sciences.

A guide to defining the competence required of a consultant in clinical chemistry and laboratory medicine.

Science.gov (United States)

Beastall, Graham; Kenny, Desmond; Laitinen, Paivi; ten Kate, Joop

2005-01-01

A definition has been agreed for the most senior professional (consultant) in clinical chemistry and laboratory medicine. A model job description for a consultant has been determined, which is intended to act as a toolkit to assist employing authorities and professional bodies to define the role of individual consultant posts. A total of 86 competences for a consultant have been designated and expressed in the form of simple generic proficiency standards. These competences have been allocated to six broad areas: clinical [13]; scientific [15]; technical [12]; communication [12]; management and leadership [20]; professional autonomy and accountability [14]. The competences are intended to be illustrative rather than definitive and to enable the duties of any consultant post to be defined. Assessment of competence is likely to entail consideration of qualifications, registration status, continuing professional development and performance review. The project is intended as a guide to European societies of clinical chemistry and laboratory medicine. The guide should be capable of local interpretation to encourage a greater degree of commonality in the role of the consultant whilst protecting national identity. The guide should stimulate international understanding and collaboration and contribute to an overall improvement in the quality of practice.

Extent and types of management consulting services to SMEs in Vojvodina

Directory of Open Access Journals (Sweden)

Dragan Dukić

2013-11-01

Full Text Available Growth and development of small and medium enterprises depends on many external and internal factors, as well as the volume, type and quality of support available to them. This paper highlights the importance of management knowledge and skills in small business, and the importance of management consulting in their acquisition and development. We have researched and analyzed the extent to management consulting (MC services, separately in the micro, small and medium enterprises. In addition, we learn which types of MC services are most commonly used by companies of different sizes. In that way, we provided qualitative and quantitative data for each group of enterprises, both in the type and volume of services used. It is observed that micro-enterprises use a small amount  MC services, and those of more general type. With the growth of the enterprises, comes an increase in scope, and sophistication of services used. The results may be useful both for small and medium enterprises, as well as for institutional and private providers of management consulting services.

Cumulative lactate and hospital mortality in ICU patients

NARCIS (Netherlands)

van Beest, Paul A.; Brander, Lukas; Jansen, Sebastiaan P. A.; Rommes, Johannes H.; Kuiper, Michael A.; Spronk, Peter E.

2013-01-01

Background: Both hyperlactatemia and persistence of hyperlactatemia have been associated with bad outcome. We compared lactate and lactate-derived variables in outcome prediction. Methods: Retrospective observational study. Case records from 2,251 consecutive intensive care unit (ICU) patients

Lactate induces osteoblast differentiation by stabilization of HIF1α.

Science.gov (United States)

Wu, Yu; Wang, Miaomiao; Feng, Haihua; Peng, Ying; Sun, Jieyun; Qu, Xiuxia; Li, Chunping

2017-09-05

Aerobic glycolysis is involved in osteoblast differentiation induced by Wnt signaling or PTH treatment. However, it is still unclear whether lactate, the end product of aerobic glycolysis, plays any role in osteoblast differentiation. Herein we report that in cultures of osteoblast-lineage cells, lactate promoted alkaline phosphatase-positive cell formation, increased the activity of alkaline phosphatase, and induced the expression of osteocalcin. This osteoblast differentiation-inducing effect of lactate can be inhibited by blocking its entry into cells with MCT1 siRNA or inhibitors, and by interfering with its metabolism by using specific siRNAs for LDHB and PDH. Moreover, lactate stabilized HIF1α expression and inhibited HIF1α activity, with BAY87-2243 lowering the osteoblast differentiation-inducing effect of lactate. Thus, these findings reveal an unrecognized role for aerobic glycolysis in osteoblast differentiation via its end product, lactate. Copyright © 2017 Elsevier B.V. All rights reserved.

The Application of Standards and Recommendations to Clinical Ethics Consultation in Practice: An Evaluation at German Hospitals.

Science.gov (United States)

Schochow, Maximilian; Rubeis, Giovanni; Steger, Florian

2017-06-01

The executive board of the Academy for Ethics in Medicine (AEM) and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study. We contacted 1.858 German hospitals between September 2013 and January 2014. A follow-up survey was conducted between October 2014 and January 2015. The data of the initial survey and the follow-up survey were merged and evaluated. The statements of the participants were compared with the standards and recommendations. The standards of the AEM concerning the tasks of clinical ethics consultation (including ethics consultation, ethics training and the establishment of policy guidelines) are employed by a majority of participants of the study. Almost all of these participants document their consultation activities by means of protocols or entries in the patient file. There are deviations from the recommendations of the AEM working groups regarding the drafting of statutes, activity reports, and financial support. The activities of clinical ethics consultation predominantly comply with the standards of the AEM and recommendations for the documentation. The recommendations for evaluation should be improved in practice. This applies particularly for activity reports in order to evaluate the activities. Internal evaluation could take place accordingly.

Effects of antibiotic dry-cow therapy and internal teat sealant on milk somatic cell counts and clinical and subclinical mastitis in early lactation.

Science.gov (United States)

Golder, H M; Hodge, A; Lean, I J

2016-09-01

The objective of this study was to determine the efficacy of an internal teat sealant (TS; Teatseal; Zoetis Australia, Silverwater, NSW, Australia), when used in combination with antibiotic dry-cow therapy (ADCT) administered at dry-off, on milk individual somatic cell count (ISCC), milk production and components, and the incidence of clinical and subclinical mastitis in dairy cows up to 60 d after calving, when compared with ADCT only. Multiparous Holstein, Jersey, or Holstein cross cows (n=2,200) from 8 farms in southern and eastern Australia were randomly assigned to treatment of all 4 quarters with ADCT alone or with ADCT plus TS (ADCT + TS) at dry-off in this randomized, multisite clinical trial. Individual milk yield, fat and protein percentages, and ISCC were measured at intervals of 14±3 d after calving for the first 60 d of lactation. The first measurement occurred between 10 and 24 d after calving. Clinical mastitis and health events were recorded from dry-off to 60 d of lactation. Milk samples were collected from first cases of clinical mastitis and subjected to bacteriology. Treatment and the interaction of treatment by time did not affect milk yield, ISCC weighted by milk yield, or fat and protein percentages. Treatment with ADCT + TS decreased geometric mean ISCC compared with treatment with ADCT alone over the first 60 d of lactation. Geometric mean ISCC (×10(3) cells/mL) was 32.0 [95% confidence interval (CI): 26.8 to 38.3] and 43.5 (95% CI: 36.2 to 52.1) for ADCT + TS and ADCT alone, respectively. The odds of at least 1 case of subclinical mastitis (ISCC ≥250,000 cells/mL) were 1.9 times higher (95% CI: 1.4 to 2.6) with ADCT alone in the first 60 d of lactation compared with ADCT + TS. Use of ADCT + TS reduced the estimated incidence of at least 1 case of subclinical mastitis on all 8 farms, compared with use of ADCT alone. Only 4 cows that calved 40 to 100 d after dry-off had a first case of clinical mastitis in the dry period. Five percent of

Lay Consultations in Heart Failure Symptom Evaluation.

Science.gov (United States)

Reeder, Katherine M; Sims, Jessica L; Ercole, Patrick M; Shetty, Shivan S; Wallendorf, Michael

2017-01-01

Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher's exact tests, along with logistic regression were used to characterize lay consultations in this sample. A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions.

Channel-Mediated Lactate Release by K+-Stimulated Astrocytes

KAUST Repository

Sotelo-Hitschfeld, T.; Niemeyer, M. I.; Machler, P.; Ruminot, I.; Lerchundi, R.; Wyss, M. T.; Stobart, J.; Fernandez-Moncada, I.; Valdebenito, R.; Garrido-Gerter, P.; Contreras-Baeza, Y.; Schneider, B. L.; Aebischer, P.; Lengacher, S.; San Martin, A.; Le Douce, J.; Bonvento, G.; Magistretti, Pierre J.; Sepulveda, F. V.; Weber, B.; Barros, L. F.

2015-01-01

in response to local field stimulation. The existence of an astrocytic lactate reservoir and its quick mobilization via an ion channel in response to a neuronal cue provides fresh support to lactate roles in neuronal fueling and in gliotransmission.

Arterial versus venous lactate: a measure of sepsis in children.

Science.gov (United States)

Samaraweera, Sahan Asela; Gibbons, Berwyck; Gour, Anami; Sedgwick, Philip

2017-08-01

This study assessed the agreement between arterial and venous blood lactate and pH levels in children with sepsis. This retrospective, three-year study involved 60 PICU patients, with data collected from electronic or paper patient records. The inclusion criteria comprised of children (≤17 years old) with sepsis and those who had a venous blood gas taken first with an arterial blood gas taken after within one hour. The lactate and pH values measured through each method were analysed. There is close agreement between venous and arterial lactate up to 2 mmol/L. As this value increases, this agreement becomes poor. The limits of agreement (LOA) are too large (±1.90 mmol/L) to allow venous and arterial lactate to be used interchangeably. The mean difference and LOA between both methods would be much smaller if derived using lactate values under 2.0 mmol/L. There is close agreement between arterial and venous pH (MD = -0.056, LOA ± 0.121). However, due to extreme variations in pH readings during sepsis, pH alone is an inadequate marker. A venous lactate ≤2 mmol/L can be used as a surrogate for arterial lactate during early management of sepsis in children. However, if the value exceeds 2 mmol/L, an arterial sample must confirm the venous result. What is known: • In children with septic shock, a blood gas is an important test to show the presence of acidosis and high lactic acid. Hyperlactataemia on admission is an early predictor of outcome and is associated with a greater mortality risk. • An arterial sample is the standard for lactate measurement, however getting a sample may be challenging in the emergency department or a general paediatric ward. Venous samples are quicker and easier to obtain. Adult studies generally advise caution in replacing venous lactate values for the arterial standard, whilst paediatric studies are limited in this area. What is new: • This is the first study assessing the agreement between arterial and peripheral venous

Victims' barriers to discussing domestic violence in clinical consultations: a qualitative enquiry.

Science.gov (United States)

Othman, Sajaratulnisah; Goddard, Chris; Piterman, Leon

2014-05-01

Victims of domestic violence frequently attend health care facilities. In many cases, their abusive experience is neither disclosed nor discussed during clinical consultations. This study examined the barriers faced by women when discussing abuse with health care providers, specifically in cases involving Malaysian women with a history of domestic violence. A qualitative study using in-depth interviews was conducted with 10 women with a history of domestic violence residing at a shelter. Purposive sampling was conducted until data saturation. Using the grounded theory approach of analysis, themes that emerged from these interviews were then further analyzed to examine the barriers faced by these women. Women who experienced domestic violence faced multiple barriers while discussing their accounts of abuse with others. Values placed on the privacy of domestic violence; upholding the traditional gender roles; preserving the family unity; minimizing the abuse, the feeling of shame, self-blame; and fearing their abuser generally create internal barriers when discussing their encounters of abuse with health care providers. The perceived unknown role of health care professionals when dealing with patients experiencing domestic violence as well as the previous negative experiences in clinical consultations acted as external barriers for discussing abuse with health care providers. Women with domestic violence experiences faced internal and external barriers to discussing their abuse during clinical consultations. Physicians and health care providers must consider domestic violence in consultations with female patients. A good doctor-patient relationship that encompasses empathy, confidence, trust, support, assurance, confidentiality, and guidance can help patients with abusive backgrounds overcome these barriers, leading to the disclosure and discussion of their abusive encounters. Proper education, guidelines, and support for health care providers are required to help

Consultancy driven Business Process Re-engineering in Denmark and its impact on Organizations and Working Environment

DEFF Research Database (Denmark)

Manske, Fred; Koch, Christian; Vogelius, Peter

1998-01-01

The articel present some interim results from a Danish research project on social constitution of BPR in Denmark and the consequences for working environment. The consultants play a key role in developing and promoting management concepts internationally. Also in the development and diffusion...... of BPR in Denmark consultants are central but they are in interaction with enterprises, professional associations, publishers, the press, a/o. Whether this interaction leads to a special national (e.g. Danish) variant of BPR. is an central question in the discussion, On the basis of it interviews...... with consultants it concluded that we can't identify any special Danish version of BPR informed by a sort of "Scandinavian tradition"....

Lactate promotes plasticity gene expression by potentiating NMDA signaling in neurons

KAUST Repository

Yang, Jiangyan; Ruchti, Evelyne; Petit, Jean Marie; Jourdain, Pascal; Grenningloh, Gabriele; Allaman, Igor; Magistretti, Pierre J.

2014-01-01

L-lactate is a product of aerobic glycolysis that can be used by neurons as an energy substrate. Here we report that in neurons L-lactate stimulates the expression of synaptic plasticity-related genes such as Arc, c-Fos, and Zif268 through a mechanism involving NMDA receptor activity and its downstream signaling cascade Erk1/2. L-lactate potentiates NMDA receptor-mediated currents and the ensuing increase in intracellular calcium. In parallel to this, L-lactate increases intracellular levels of NADH, thereby modulating the redox state of neurons. NADH mimics all of the effects of L-lactate on NMDA signaling, pointing to NADH increase as a primary mediator of L-lactate effects. The induction of plasticity genes is observed both in mouse primary neurons in culture and in vivo in the mouse sensory-motor cortex. These results provide insights for the understanding of the molecular mechanisms underlying the critical role of astrocyte-derived L-lactate in long-term memory and long-term potentiation in vivo. This set of data reveals a previously unidentified action of L-lactate as a signaling molecule for neuronal plasticity.

Lactate promotes plasticity gene expression by potentiating NMDA signaling in neurons

KAUST Repository

Yang, Jiangyan

2014-07-28

L-lactate is a product of aerobic glycolysis that can be used by neurons as an energy substrate. Here we report that in neurons L-lactate stimulates the expression of synaptic plasticity-related genes such as Arc, c-Fos, and Zif268 through a mechanism involving NMDA receptor activity and its downstream signaling cascade Erk1/2. L-lactate potentiates NMDA receptor-mediated currents and the ensuing increase in intracellular calcium. In parallel to this, L-lactate increases intracellular levels of NADH, thereby modulating the redox state of neurons. NADH mimics all of the effects of L-lactate on NMDA signaling, pointing to NADH increase as a primary mediator of L-lactate effects. The induction of plasticity genes is observed both in mouse primary neurons in culture and in vivo in the mouse sensory-motor cortex. These results provide insights for the understanding of the molecular mechanisms underlying the critical role of astrocyte-derived L-lactate in long-term memory and long-term potentiation in vivo. This set of data reveals a previously unidentified action of L-lactate as a signaling molecule for neuronal plasticity.

Dietary Iodine Sufficiency and Moderate Insufficiency in the Lactating Mother and Nursing Infant: A Computational Perspective.

Science.gov (United States)

Fisher, W; Wang, Jian; George, Nysia I; Gearhart, Jeffery M; McLanahan, Eva D

2016-01-01

The Institute of Medicine recommends that lactating women ingest 290 μg iodide/d and a nursing infant, less than two years of age, 110 μg/d. The World Health Organization, United Nations Children's Fund, and International Council for the Control of Iodine Deficiency Disorders recommend population maternal and infant urinary iodide concentrations ≥ 100 μg/L to ensure iodide sufficiency. For breast milk, researchers have proposed an iodide concentration range of 150-180 μg/L indicates iodide sufficiency for the mother and infant, however no national or international guidelines exist for breast milk iodine concentration. For the first time, a lactating woman and nursing infant biologically based model, from delivery to 90 days postpartum, was constructed to predict maternal and infant urinary iodide concentration, breast milk iodide concentration, the amount of iodide transferred in breast milk to the nursing infant each day and maternal and infant serum thyroid hormone kinetics. The maternal and infant models each consisted of three sub-models, iodide, thyroxine (T4), and triiodothyronine (T3). Using our model to simulate a maternal intake of 290 μg iodide/d, the average daily amount of iodide ingested by the nursing infant, after 4 days of life, gradually increased from 50 to 101 μg/day over 90 days postpartum. The predicted average lactating mother and infant urinary iodide concentrations were both in excess of 100 μg/L and the predicted average breast milk iodide concentration, 157 μg/L. The predicted serum thyroid hormones (T4, free T4 (fT4), and T3) in both the nursing infant and lactating mother were indicative of euthyroidism. The model was calibrated using serum thyroid hormone concentrations for lactating women from the United States and was successful in predicting serum T4 and fT4 levels (within a factor of two) for lactating women in other countries. T3 levels were adequately predicted. Infant serum thyroid hormone levels were adequately

ARALAR/AGC1 deficiency, a neurodevelopmental disorder with severe impairment of neuronal mitochondrial respiration, does not produce a primary increase in brain lactate.

Science.gov (United States)

Juaristi, Inés; García-Martín, María L; Rodrigues, Tiago B; Satrústegui, Jorgina; Llorente-Folch, Irene; Pardo, Beatriz

2017-07-01

ARALAR/AGC1 (aspartate-glutamate mitochondrial carrier 1) is an important component of the NADH malate-aspartate shuttle (MAS). AGC1-deficiency is a rare disease causing global cerebral hypomyelination, developmental arrest, hypotonia, and epilepsy (OMIM ID #612949); the aralar-KO mouse recapitulates the major findings in humans. This study was aimed at understanding the impact of ARALAR-deficiency in brain lactate levels as a biomarker. We report that lactate was equally abundant in wild-type and aralar-KO mouse brain in vivo at postnatal day 17. We find that lactate production upon mitochondrial blockade depends on up-regulation of lactate formation in astrocytes rather than in neurons. However, ARALAR-deficiency decreased cell respiration in neurons, not astrocytes, which maintained unchanged respiration and lactate production. As the primary site of ARALAR-deficiency is neuronal, this explains the lack of accumulation of brain lactate in ARALAR-deficiency in humans and mice. On the other hand, we find that the cytosolic and mitochondrial components of the glycerol phosphate shuttle are present in astrocytes with similar activities. This suggests that glycerol phosphate shuttle is the main NADH shuttle in astrocytes and explains the absence of effects of ARALAR-deficiency in these cells. © 2017 International Society for Neurochemistry.

International Consultation on Peace Education and Research in Higher Education.

Science.gov (United States)

Higher Education in Europe, 1986

1986-01-01

A January 1986 UNESCO international conference on the role of higher education in promoting international understanding, cooperation, peace, and respect for human rights focused on the nuclear threat and conventional warfare, the role of international governmental and nongovernmental organizations, research and education for peace, and…

34 CFR 75.191 - Consultation costs.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Consultation costs. 75.191 Section 75.191 Education... Development of Curricula Or Instructional Materials § 75.191 Consultation costs. An applicant may budget reasonable consultation fees or planning costs in connection with the development of curricula or...

Cow's milk quality and energy value during different lactation stages.

Science.gov (United States)

Salamończyk, Ewa

2013-01-01

The quality of dairy products, raw milk in particular, depends on many factors. Low bacterial and somatic cell counts are basic determinants of the appropriate raw milk quality. The objective of the work was to assess the effect of selected factors, that is, the age of cows and their daily milk performance, on cytological quality (somatic cell count) and energy value of milk produced at individual stages of lactation. Somatic cell count and energy value of cow's milk were assessed. A total of 229 792 milk samples were examined. Data for analysis were taken from milk records of 350 dairy herds. It was demonstrated that, of all the lactations studied, the fi rst lactation (from calving to the 100th day of lactation) was characterised by the highest daily milk performance (25.1 kg) and the lowest somatic cell count (356 thous./1 ml), fat, protein and dry matter contents (4.06, 2.96 and 12.41%, respectively) and milk calorific value (732 kcal/kg). The highest energy value was recorded in cow's milk produced towards the end of lactation, that is from day 300 till the end of lactation (842 kcal/kg). High milk calorific value in late lactation and high fat and protein contents were accompanied by low raw milk quality.

Program Performance Assessment System (PPAS). External reviewers' report of the consultants' meeting on analytical quality control services

International Nuclear Information System (INIS)

2001-01-01

In reviewing the recommendations of previous Consultants' Meetings concerning the AQCS program, it is apparent that there has been a clear and consistent agreement on what the objectives of the AQCS activities should be. The mission statement as given in the Agency's 'Blue Book 1997-1998' states 'To assist analytical laboratories in Member States in maintaining/improving the quality of their analytical measurements, to achieve internationally acceptable levels of quality assurance and to develop and supply appropriate reference standards to achieve these objectives'. In concert with this mission statement, the consultants have endorsed an elaboration of these objectives for both the Agency' s laboratories and Member State laboratories as outlined in the 1994 Consultants' Report (KONA, HI, USA) which includes: the improvement of the reliability of results for the intended purposes; the enhancement of the comparability of results from one measurement laboratory to another; the attainment of compatibility of results in physical and chemical sciences with specific coverage of international standards for food and agriculture, human health, environment, industry, earth sciences, radiation safety, and safeguards activities; the demonstration of quality measurement systems sufficient for laboratory/analyst accreditation or acceptance, and; the establishment of traceability of radioactivity measurements and chemical analyses to the international SI system of measurements

Academic Development for Careers in Management Consulting

Science.gov (United States)

Adams, Susan M.; Zanzi, Alberto

2004-01-01

Explores the extent to which academic offerings are serving the consulting industry and identifies ways that academia can help. The numbers of management consulting courses, field experiences in consulting and consulting concentrations by graduate business schools were tracked over a three-year period to assess the current state of offerings. A…

Summary report of consultants' meeting to review the requirements to improve and extend the IRDF library (International Reactor Dosimetry File (IRDF-2002))

International Nuclear Information System (INIS)

Greenwood, L.R.; Nichols, A.L.

2007-01-01

Presentations, recommendations and conclusions of a Consultants' Meeting to 'Review the Requirements to Improve and Extend the IRDF library (International Reactor Dosimetry File (IRDF-2002))' are summarized is this report. The main aims of this meeting were to discuss scientific and technical matters related to reactor dosimetry and to consider the needs for improvements to the existing data in IRDF-2002 and possible extensions to other higher neutron energy applications. Specific tasks were assigned and deadlines agreed. The requirements for fusion studies are particularly challenging (up to 60 MeV) and should include adequate covariance data - the provision of these neutron cross sections will require additional effort and assessment prior to initiating any work programme, and specific participants agreed to undertake preliminary exercises. (author)

Consultations

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC CRDI

Qu'arrive-t-il si j'engage des dépenses avant d'avoir signé mon contrat? Combien de ... Facture-type de consultant. Cette fiche ... Le représentant du CRDI dont le nom figure dans votre contrat est votre source d'information la plus fiable.

Reliability and Validity of the Persian Language Version of the International Consultation on Incontinence Questionnaire - Male Lower Urinary Tract Symptoms (ICIQ-MLUTS).

Science.gov (United States)

Pourmomeny, Abbas Ali; Ghanei, Behnaz; Alizadeh, Farshid

2018-05-01

Assessment instruments are essential for research, allowing diagnosis and evaluating treatment outcomes in subjects with lower urinary tract disorders of both genders. The purpose of this study was to translate the Male Lower Urinary Tract Symptoms (MLUTS) Questionnaire and determine its psychometric properties in Persian subjects. After getting permission from the International Consultation on Incontinence Modular Questionnaire (ICIQ) web site, the forward and backward translation of the MLUTS questionnaire were carried out by researcher team. The content/face validity, construct validity and reliability were assessed in a sample of MLUTS Iranian patients by measuring with the Cronbach's alpha test. In total, 121 male patients were included in the study. The mean age of the patients was 60.5 years. Cronbach alpha value was 0.757, consecrated the internal consistency of the form (r > 0.7). The internal consistency of each question was examined separately and found to be over 0.7. For the evaluation of reliability test-retest was done, the test was administered to 20% of the patients for a second time with an interval of 1-2 weeks. The intraclass correlation coefficient (ICC) score was 0.901. The Correlation coefficient between the MLUTS and International Prostate Symptoms Score (IPSS) was 0.879. ICIQ-MLUTS is a robust instrument, which can be used for evaluating male LUTS in Persian patients. We believe that the Persian version of the MLUTS is an important tool for research and clinical setting. © 2017 John Wiley & Sons Australia, Ltd.

Comparison of lactate and bicarbonate buffered haemofiltration fluids: use in critically ill patients.

Science.gov (United States)

Thomas, A N; Guy, J M; Kishen, R; Geraghty, I F; Bowles, B J; Vadgama, P

1997-06-01

To compare acid-base balance, lactate concentration, and haemodynamic and O2 transport variables during haemofiltration with replacement fluid containing 44.5 mmol/l Na+ lactate or 40 mmol/l Na+ HCO3- and 3 mmol/l lactic acid. A prospective, randomized trial. A multidisciplinary, adult intensive care unit in a university hospital. Forty acidotic patients who required haemofiltration, were dependent on mechanical ventilation, and had PA catheters in situ. During haemofiltration patients received lactate or bicarbonate replacement fluid at a mean rate of 1.7 l/h (SD 0.3). Arterial blood gases, plasma lactate, and haemodynamic and O2 transport variables were measured before and after 12 and 24 h haemofiltration. Ultrafiltrate was collected for lactate estimation. As means (SD). The net gain of lactate was 63 mmol/h (12 mmol) with Na+ lactate and 0 mmol/h (0.3 mmol) with Na+ HCO3-. There was a significant increase in pH and [lactate] in both groups, but [lactate] was higher in patients receiving lactate. Twenty-one patients survived to ICU discharge, these patients were significantly less acidotic after filtration (lactate group: 0 h: pH 7.23 (0.09), [lactate] 2.4 mmol/l (1.7); 12 h: pH 7.34 (0.09), [lactate] 4.7 mmol/l (2.4); 24 h: pH 7.36 (0.07), [lactate] 4.7 mmol (2.7). HCO3 group: 0 h: pH 7.23 (0.09), [lactate] 2.3 (1.3); 12 h: pH 7.32 (0.06), [lactate] 2.9 mmol/l (1.8); 24 h: pH 7.35 (0.08), [lactate] 2.8 mmol/l (2.0). Base deficit: survivors: 0 h: 9 mmol/l (4); 12 h: 2 mmol/l (3). Non-survivors: 0 h: 10 mmol/l (3); 12 h: 6 mmol/l (3)). Haemodynamic and O2 transport variables were not significantly affected by treatment group or outcome. The degree of correction of acidosis during the first 24 h of haemofiltration was determined by patients outcome but was not affected by the substitution of bicarbonate- for lactate-containing replacement fluids.

Central thermoregulatory effects of lactate in the toad Bufo paracnemis.

Science.gov (United States)

Branco, L G; Steiner, A A

1999-04-01

Hypoxia induces a regulated decrease in body temperature (Tb; anapyrexia) in organisms ranging from protozoans to mammals, but very little is known about the mechanisms involved. Several candidates have been suggested to mediate hypoxia-induced anapyrexia, among them lactate, which is a classical compansion of hypoxic stress in vertebrates. The present study was designed to assess the central thermoregulatory effects of lactate in Bujo paracnemis. Toads equipped with a temperature probe were tested over a thermal gradient (10-40 degrees C). Lactate injected systemically (4.0 mmol kg-1) caused a significant reduction of Tb from 24.6 +/- 2.1 to 17.4 +/- 3.9 degrees C. To assess the role of central thermoregulatory mechanisms, a lower dose (0.4 mmol kg-1) of lactate was injected into the fourth cerebral ventricle or systemically. Intracerebroventricular injection of lactate caused a similar decrease in Tb, whereas systemic injection caused no change. The data indicate that lactate may play a role in hypoxia-induced anapyrexia in central rather than peripheral sites.

15 CFR 923.57 - Continuing consultation.

Science.gov (United States)

2010-01-01

... § 923.57 Continuing consultation. (a) As required by subsection 306(d)(3)(B) of the Act, a State must establish an effective mechanism for continuing consultation and coordination between the management agency... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Continuing consultation. 923.57...

Learning to consult with computers.

Science.gov (United States)

Liaw, S T; Marty, J J

2001-07-01

To develop and evaluate a strategy to teach skills and issues associated with computers in the consultation. An overview lecture plus a workshop before and a workshop after practice placements, during the 10-week general practice (GP) term in the 5th year of the University of Melbourne medical course. Pre- and post-intervention study using a mix of qualitative and quantitative methods within a strategic evaluation framework. Self-reported attitudes and skills with clinical applications before, during and after the intervention. Most students had significant general computer experience but little in the medical area. They found the workshops relevant, interesting and easy to follow. The role-play approach facilitated students' learning of relevant communication and consulting skills and an appreciation of issues associated with using the information technology tools in simulated clinical situations to augment and complement their consulting skills. The workshops and exposure to GP systems were associated with an increase in the use of clinical software, more realistic expectations of existing clinical and medical record software and an understanding of the barriers to the use of computers in the consultation. The educational intervention assisted students to develop and express an understanding of the importance of consulting and communication skills in teaching and learning about medical informatics tools, hardware and software design, workplace issues and the impact of clinical computer systems on the consultation and patient care.

Lactate in the brain: from metabolic end-product to signalling molecule

KAUST Repository

Magistretti, Pierre J.

2018-03-08

Lactate in the brain has long been associated with ischaemia; however, more recent evidence shows that it can be found there under physiological conditions. In the brain, lactate is formed predominantly in astrocytes from glucose or glycogen in response to neuronal activity signals. Thus, neurons and astrocytes show tight metabolic coupling. Lactate is transferred from astrocytes to neurons to match the neuronal energetic needs, and to provide signals that modulate neuronal functions, including excitability, plasticity and memory consolidation. In addition, lactate affects several homeostatic functions. Overall, lactate ensures adequate energy supply, modulates neuronal excitability levels and regulates adaptive functions in order to set the \\'homeostatic tone\\' of the nervous system.

Lactation transcriptomics in the Australian marsupial, Macropus eugenii: transcript sequencing and quantification

Directory of Open Access Journals (Sweden)

Whitley Jane C

2007-11-01

Full Text Available Abstract Background Lactation is an important aspect of mammalian biology and, amongst mammals, marsupials show one of the most complex lactation cycles. Marsupials, such as the tammar wallaby (Macropus eugenii give birth to a relatively immature newborn and progressive changes in milk composition and milk production regulate early stage development of the young. Results In order to investigate gene expression in the marsupial mammary gland during lactation, a comprehensive set of cDNA libraries was derived from lactating tissues throughout the lactation cycle of the tammar wallaby. A total of 14,837 express sequence tags were produced by cDNA sequencing. Sequence analysis and sequence assembly were used to construct a comprehensive catalogue of mammary transcripts. Sequence data from pregnant and early or late lactating specific cDNA libraries and, data from early or late lactation massively parallel sequencing strategies were combined to analyse the variation of milk protein gene expression during the lactation cycle. Conclusion Results show a steady increase in expression of genes coding for secreted protein during the lactation cycle that is associated with high proportion of transcripts coding for milk proteins. In addition, genes involved in immune function, translation and energy or anabolic metabolism are expressed across the lactation cycle. A number of potential new milk proteins or mammary gland remodelling markers, including noncoding RNAs have been identified.

Making consultations run smoothly

DEFF Research Database (Denmark)

Jespersen, Astrid Pernille; Elgaard Jensen, Torben

2012-01-01

This article investigates the skilful use of time in general practice consultations. It argues that consultation work involves social and material interactions, which are only partially conceptualized in existing medical practice literatures. As an alternative, this article employs ideas from the......-inspired analysis opens up a wider discussion of time as a complex resource and problem in general practice....

Dermatological treatment during pregnancy and lactation

Directory of Open Access Journals (Sweden)

Lilianna Kulczycka

2010-02-01

Full Text Available Since wellbeing and health have become fashionable and widespread polypragmasia is popular, adverse drug reactions are a particularly important medical problem. Pregnant women as well as breast-feeding mothers need very particular care from the physician. Treatment during pregnancy or lactation is a more complicated issue not only because it concerns at least two persons, but also because of the many anatomical and functional differences between the adult and fetus or newborn organism. The safety aspects of dermatological treatment during pregnancy and lactation are presented. Both topical and systemic treatment, mainly for bacterial, viral, fungal, and parasitic dermatoses and acne, alopecia, psoriasis, and autoimmunological processes, are discussed. Moreover, the most recent methods of dermatological treatment are mentioned taking into consideration their safety during pregnancy and lactation. Furthermore, the traditional drug classification made by the United States Food and Drug Administration as well as the most modern division, which is under construction, are presented.

Patient assessment: effective consultation and history taking.

Science.gov (United States)

Kaufman, Gerri

This article explores patient consultation with specific reference to the Calgary-Cambridge consultation guide. It provides an overview of history taking and explores the patient's perspective during the consultation. The article also discusses the skills required to provide information effectively. In addition, the article addresses 'safety netting' and emphasises the interdependence of communication and consultation skills.

Osteoporosis presenting in pregnancy, puerperium, and lactation.

Science.gov (United States)

Kovacs, Christopher S

2014-12-01

To describe our current state of knowledge about the pathophysiology, incidence, and treatment of osteoporosis that presents during pregnancy, puerperium, and lactation. When vertebral fractures occur in pregnant or lactating women, it is usually unknown whether the skeleton was normal before pregnancy. Maternal adaptations increase bone resorption modestly during pregnancy but markedly during lactation. The net bone loss may occasionally precipitate fractures, especially in women who have underlying low bone mass or skeletal fragility prior to pregnancy. Bone mass and strength are normally restored postweaning. Transient osteoporosis of the hip is a sporadic disorder localized to one or both femoral heads; it is not due to generalized skeletal resorption. Anecdotal reports have used bisphosphonates, strontium ranelate, teriparatide, or vertebroplasty/kyphoplasty to treat postpartum vertebral fractures, but it is unclear whether these therapies had any added benefit over the spontaneous skeletal recovery that normally occurs after weaning. These relatively rare fragility fractures result from multifactorial causes, including skeletal disorders that precede pregnancy, and structural and metabolic stresses that can compromise skeletal strength during pregnancy and lactation. Further study is needed to determine when pharmacological or surgical therapy is warranted instead of conservative or expectant management.

Radiology consultation in the era of precision oncology: A review of consultation models and services in the tertiary setting

Energy Technology Data Exchange (ETDEWEB)

DiPiro, Pamela J.; Krajewski, Katherine M.; Giardino, Angela A.; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H. [Dept. of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States)

2017-01-15

The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting.

Science.gov (United States)

DiPiro, Pamela J; Krajewski, Katherine M; Giardino, Angela A; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H

2017-01-01

The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

Vulvar lactating adenoma associated to a fibroadenoma: common ...

African Journals Online (AJOL)

Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating ...

Induction of lactational estrus in organic piglet production

DEFF Research Database (Denmark)

Kongsted, Anne Grete; Hermansen, John Erik

2009-01-01

, if lactational estrus is to be beneficial under practical husbandry conditions, it is crucial that the majority of sows are successfully mated within a few days to make batch farrowing procedures possible. The objective of this study was to investigate the occurrence and timing of lactational estrus...

Lactic acid and Lactates in Health and wellness

NARCIS (Netherlands)

Gertjan Schaafsma; Victor Schreurs

2010-01-01

This review aims to integrate the present state of knowledge on lactate metabolism in human and mammalian physiology as far as it could be subject to nutritional interventions. An integrated view on the nutritional, metabolic and physiological aspects of lactic acid and lactates might open a

Associations between the time of conception and the shape of the lactation curve in early lactation in Norwegian dairy cattle

DEFF Research Database (Denmark)

Andersen, Fredrik; Østerås, Olav; Reksen, Olav

2011-01-01

This study was carried out to determine if an association exists between the shape of the lactation curve before it is influenced by the event of conception and the time from calving to conception in Norwegian dairy cattle. Lactation curves of Norwegian Red cows during 5 to 42 days in milk (DIM) ...

Understanding communication between emergency and consulting physicians: a qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner.

Science.gov (United States)

Chan, Teresa; Orlich, Donika; Kulasegaram, Kulamakan; Sherbino, Jonathan

2013-01-01

To define the important elements of an emergency department (ED) consultation request and to develop a simple model of the process. From March to September 2010, 61 physicians (21 emergency medicine [EM], 20 general surgery [GS], 20 internal medicine [IM]; 31 residents, 30 attending staff) were questioned about how junior learners should be taught about ED consultation. Two investigators independently reviewed focus group and interview transcripts using grounded theory to generate an index of themes until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. All transcripts were coded using this index of themes; 30% of transcripts were coded in duplicate to determine the agreement. A total of 245 themes and subthemes were identified. The agreement between reviewers was 77%. Important themes in the process were as follows: initial preparation and review of investigations by EM physician (overall endorsement 87% [range 70-100% in different groups]); identification of involved parties (patient and involved physicians) (100%); hypothesis of patient's diagnosis (75% [range 62-83%]) or question for the consulting physician (70% [range 55-95%]); urgency (100%) and stability (74% [range 62-80%]); questions from the consultant (100%); discussion/communication (98% [range 95-100%]); and feedback (98% [range 95-100%]). These components were reorganized into a simple framework (PIQUED). Each clinical specialty significantly contributed to the model (χ2  =  7.9; p value  =  0.019). Each group contributed uniquely to the final list of important elements (percent contributions: EM, 57%; GS, 41%; IM, 64%). We define important elements of an ED consultation with input from emergency and consulting physicians. We propose a model that organizes these elements into a simple framework (PIQUED) that may be valuable for junior learners.

Consultation document Energy Market Concentrations

International Nuclear Information System (INIS)

De Maa, J.; Van Gemert, M.; Karel, A.; La Bastide, G.; Giesbertz, P.; Buijs, F.; Vermeulen, M.; Beusmans, P.

2006-06-01

This the second consultation document of the Netherlands Competition Authority (NMa) on the title subject (the first was in 2002). The purpose of the consultation is to involve all the relevant and interested parties in the development of the energy market in the Netherlands and to consult those parties on studies that have been carried out by the NMa so far: (1) defining (possible) relevant markets in the electricity sector, and (2) the vision and opinion of the NMa with respect to mergers and take-overs. Also, the consultation document is a contribution to the response of the letter from the Dutch Minister of Economic Affairs of May 2005 in which the NMa was requested to give an overview of the preconditions with regard to competition and it's legal aspects [nl

Estimating the Lactation Curve on a.m./p.m. Milkings in Dairy Cows

Directory of Open Access Journals (Sweden)

Ludovic Toma Cziszter

2013-10-01

Full Text Available A pilot study was conducted in order to assess the effect of a.m./p.m. milkings on the shape of the lactation curve during a normal lactation. Data from a.m. and p.m. milkings from 86 Romanian Spotted cows were used. Cows calved during January, February and March 2011 and concluded their lactations by the end of February 2012. Results showed that there was a difference between morning and evening milkings regarding the shape of the lactation curve. The shape of the lactation curve for morning milking was more resembling to the shape of the lactation curve for total daily milk. Modelling the lactation curve with gamma incomplete function led to a milk production estimate very close to the real production, although the model overestimated the yield in early lactation and underestimated it in middle lactation. If alternative milkings are going to use for milk yield estimation it is preferable to measure the evening milking at the beginning.

Postpartum consultation: Occurrence, requirements and expectations

Directory of Open Access Journals (Sweden)

Carlgren Ingrid

2008-07-01

Full Text Available Abstract Background As a matter of routine, midwives in Sweden have spoken with women about their experiences of labour in a so-called 'postpartum consultation'. However, the possibility of offering women this kind of consultation today is reduced due to shortage of both time and resources. The aim of this study was to explore the occurrence, women's requirements of, and experiences of a postpartum consultation, and to identify expectations from women who wanted but did not have a consultation with the midwife assisting during labour. Methods All Swedish speaking women who gave birth to a live born child at a University Hospital in western Sweden were consecutively included for a phone interview over a three-week period. An additional phone interview was conducted with the women who did not have a postpartum consultation, but who wanted to talk with the midwife assisting during labour. Data from the interviews were analysed using qualitative content analysis. Results Of the 150 interviewed women, 56% (n = 84 had a postpartum consultation of which 61.9% (n = 52 had this with the midwife assisting during labour. Twenty of the 28 women who did not have a consultation with anyone still desired to talk with the midwife assisting during labour. Of these, 19 were interviewed. The content the women wanted to talk about was summarized in four categories: to understand the course of events during labour; to put into words, feelings about undignified management; to describe own behaviour and feelings, and to describe own fear. Conclusion The survey shows that the frequency of postpartum consultation is decreasing, that the majority of women who give birth today still require it, but only about half of them receive it. It is crucial to develop a plan for these consultations that meets both the women's needs and the organization within current maternity care.

Biochemical and Haematological Blood Parameters at Different Stages of Lactation in Cows

Directory of Open Access Journals (Sweden)

Cristian Ovidiu COROIAN

2017-05-01

Full Text Available The health status of cows is evaluated and depending on haematological and biochemical profile of blood. Nutrition is the main technological factor that can produce profound changes in the metabolic profile in animals (Dhiman et al., 1991; Khaled et al., 1999; Ingvartsen, 2006. Blood parameters analyze can lead to identify if there are errors in nutrition of lactating cows (Payne et al., 1970. The aim of this study was the evaluation of metabolic and biochemical changes that occur during colostrum period and in terms of number of lactations in cows. The biological material was represented by a total of 60 heads of dairy cows from a family farm from Sălaj County, Romania. The cows are all from Holstein breed and presented no clinical signs of any specific pathology. Blood samples were collected from the jugular vein of each cow and analyzed. 10 individuals from each of the six lactations have been randomly selected. Haematological and biochemical parameters showed variations depending on factors analyzed here. In lactation 1 Hb was 7.55±3.05 (g/dl, while in lactation 6 the value was 12.5±2.10 (g/dl. RBC ranged as follows: in lactation 1 - 28.50±2.05 and in lactation 6 - 30.02±2.05. Lymphocytes varied within very wide limits under the influence of lactation: in lactation 1 - 2.8±1.56 and in lactation 6 - 7.55±1.80. The number of lactations and lactation rank have influenced blood biochemical and hematological parameters in dairy cows. Biochemical parameters are influenced by post-partum day, showing the lowest values in the early days of colostral period and the highest in the last few days of the same period.

Knowledge Sharing in IT Consultant and SME Interactions

Directory of Open Access Journals (Sweden)

Adrian Bradshaw

2015-10-01

Full Text Available Many small and medium enterprises (SMEs depend on consultants to overcome knowledge barriers, especially for IT projects. This paper aims to determine how IT consultants affect the IT knowledge of SMEs when IT consultants and SMEs interact. Data were collected using face-to-face interviews with both IT consultants and SME managers. The study is the first to identify what and how SMEs learn from consultants during an IT implementation project. Consultants help SMEs gain different types of knowledge, employing a broad range of knowledge sharing mechanisms. As consultants are an important part of the knowledge creation processes of SMEs, SMEs should strive to form long-term relationships with consultants and use these interactions to develop IT knowledge within the SME.

Expression of Lactate Dehydrogenase in Aspergillus niger for L-Lactic Acid Production

Science.gov (United States)

Dave, Khyati K.; Punekar, Narayan S.

2015-01-01

Different engineered organisms have been used to produce L-lactate. Poor yields of lactate at low pH and expensive downstream processing remain as bottlenecks. Aspergillus niger is a prolific citrate producer and a remarkably acid tolerant fungus. Neither a functional lactate dehydrogenase (LDH) from nor lactate production by A. niger is reported. Its genome was also investigated for the presence of a functional ldh. The endogenous A. niger citrate synthase promoter relevant to A. niger acidogenic metabolism was employed to drive constitutive expression of mouse lactate dehydrogenase (mldhA). An appraisal of different branches of the A. niger pyruvate node guided the choice of mldhA for heterologous expression. A high copy number transformant C12 strain, displaying highest LDH specific activity, was analyzed under different growth conditions. The C12 strain produced 7.7 g/l of extracellular L-lactate from 60 g/l of glucose, in non-neutralizing minimal media. Significantly, lactate and citrate accumulated under two different growth conditions. Already an established acidogenic platform, A. niger now promises to be a valuable host for lactate production. PMID:26683313

Political consultation and large-scale research

International Nuclear Information System (INIS)

Bechmann, G.; Folkers, H.

1977-01-01

Large-scale research and policy consulting have an intermediary position between sociological sub-systems. While large-scale research coordinates science, policy, and production, policy consulting coordinates science, policy and political spheres. In this very position, large-scale research and policy consulting lack of institutional guarantees and rational back-ground guarantee which are characteristic for their sociological environment. This large-scale research can neither deal with the production of innovative goods under consideration of rentability, nor can it hope for full recognition by the basis-oriented scientific community. Policy consulting knows neither the competence assignment of the political system to make decisions nor can it judge succesfully by the critical standards of the established social science, at least as far as the present situation is concerned. This intermediary position of large-scale research and policy consulting has, in three points, a consequence supporting the thesis which states that this is a new form of institutionalization of science: These are: 1) external control, 2) the organization form, 3) the theoretical conception of large-scale research and policy consulting. (orig.) [de

Validity of Lactate Thresholds in Inline Speed Skating.

Science.gov (United States)

Hecksteden, Anne; Heinze, Tobias; Faude, Oliver; Kindermann, Wilfried; Meyer, Tim

2015-09-01

Lactate thresholds are commonly used as estimates of the highest workload where lactate production and elimination are in equilibrium (maximum lactate steady state [MLSS]). However, because of the high static load on propulsive muscles, lactate kinetics in inline speed skating may differ significantly from other endurance exercise modes. Therefore, the discipline-specific validity of lactate thresholds has to be verified. Sixteen competitive inline-speed skaters (age: 30 ± 10 years; training per week: 10 ± 4 hours) completed an exhaustive stepwise incremental exercise test (start 24 km·h, step duration 3 minutes, increment 2 km·h) to determine individual anaerobic threshold (IAT) and the workload corresponding to a blood lactate concentration of 4 mmol·L (LT4) and 2-5 continuous load tests of (up to) 30 minutes to determine MLSS. The IAT and LT4 correlated significantly with MLSS, and the mean differences were almost negligible (MLSS 29.5 ± 2.5 km·h; IAT 29.2 ± 2.0 km·h; LT4 29.6 ± 2.3 km·h; p > 0.1 for all differences). However, the variability of differences was considerable resulting in 95% limits of agreement in the upper range of values known from other endurance disciplines (2.6 km·h [8.8%] for IAT and 3.1 km·h [10.3%] for LT4). Consequently, IAT and LT4 may be considered as valid estimates of the MLSS in inline speed skating, but verification by means of a constant load test should be considered in cases of doubt or when optimal accuracy is needed (e.g., in elite athletes or scientific studies).

Licensing Process for International Projects

International Nuclear Information System (INIS)

Raetzke, Christan

2014-01-01

Christan Raetzke, lawyer, then outlined why nuclear constructions were always international projects and in which cases it would make sense to also make the licensing process be international. His law consulting firm CONLAR focuses specifically on design review so he could adequately present why an international process would make a lot of sense without being a loss of sovereignty

Understanding the consultation processes

International Nuclear Information System (INIS)

Laing, A.C.

1998-01-01

This presentation focuses on the consultation processes between industry, government and First Nations communities regarding resource development. The expectations of the Crown are to facilitate capacity building within First Nations, to promote traditional use studies and to participate with industry proponents on certain consultation issues. The role of industry is to encourage partnerships between established contractors and First Nations contracting firms to allow First Nations firms to grow and experience success under the guidance of a mentor company. It is important to realize that solid First Nations relations are the key to shorter time lines and lower costs in developing projects. However, consultation and involvement must be 'real' with benefits and participation that fall within the First Nations Communities' definition of success

Associations of insulin resistance later in lactation on fertility of dairy cows.

Science.gov (United States)

Baruselli, P S; Vieira, L M; Sá Filho, M F; Mingoti, R D; Ferreira, R M; Chiaratti, M R; Oliveira, L H; Sales, J N; Sartori, R

2016-07-01

The challenge of getting dairy cows pregnant during early lactation is a well-described, worldwide problem. However, specifically in farms with poor reproductive, nutritional, and environmental conditions/management, a low pregnancy rate during early lactation is followed inevitably by an increased number of nonpregnant cows after 150 days in milk, with even more difficulties to achieve pregnancy. Therefore, several studies were designed to understand and develop strategies to mitigate reduced fertility of cows during late lactation. Experiments were performed under tropical regions to determine metabolic status during lactation and association of stage of lactation on oocyte quality and fertility. Lactating cows with extended days not pregnant (e.g.,>150 days in milk) often had systemic metabolic alterations, including development of peripheral insulin resistance and various oocyte alterations, including reduced expression of genes encoding glucose transport proteins, reduced amounts of mtDNA, increased expression of mitochondria-related genes, and increased expression of apoptosis-related genes. Additionally, in vitro embryo production and pregnancy per AI were lower in late- versus early-lactation cows in some but not all studies. Notwithstanding, when a normal embryo was transferred to a cow in late lactation, the pregnancy per transfer was reasonable, reinforcing the assertion that fertility problems in late-lactation cows may be associated with oocyte quality, fertilization, and/or failure of early embryo development. In conclusion, insulin resistance may reduce oocyte competence and consequently fertility in late-lactation dairy cows. Copyright © 2016 Elsevier Inc. All rights reserved.

The pρT behaviour of the lactate family

International Nuclear Information System (INIS)

Lomba, Laura; Pino, M. Rosa; Lafuente, Carlos; Lopez, M. Carmen; Giner, Beatriz

2013-01-01

Highlights: ► PrhoT behaviour of three lactates are reported. ► The experimental results have been compared with the available literature data. ► TRIDENT model has been used to correlate experimental data of the compounds. ► Derived properties have been calculated from densities using Tait equation. -- Abstract: The densities of methyl lactate, ethyl lactate and butyl lactate have been measured using a high-pressure, high-temperature vibrating tube densimeter system over a temperature range from T = (283.15 to 338.15) K and a pressure range from p = (0.1 to 60.0) MPa. The experimental densities have been satisfactorily correlated with temperature and pressure using the TRIDEN equation. Finally, from the experimental densities, properties such as isobaric expansibility and isothermal compressibility have been calculated

Nutritional strategies to cope with reduced litter weight gain and total tract digestibility in lactating sows.

Science.gov (United States)

Álvarez-Rodríguez, J; Mir, L; Seradj, A R; Morazán, H; Balcells, J; Babot, D

2017-10-01

Twelve lactating sows were used to evaluate the effects of reducing dietary crude protein (CP) (14% vs. 12%) and increasing neutral detergent fibre (NDF) levels (18% vs. 22%) on litter performance, total tract apparent digestibility and manure composition in a 4 × 4 latin square arrangement during a 36-day lactation period. Diets were isoenergetic (2.9 Mcal ME/kg) and had similar total lysine content (0.9%). In addition, a second aim was to compare a reference external marker method (Cr 2 O 3 ) with an internal feed marker [acid-insoluble ash (AIA)] for the calculation of apparent total tract digestibility of nutrients in lactating sows. The reduction of dietary CP level in lactating sows had no effect on either live-weight or backfat thickness or apparent total tract digestibility of nutrients. However, the piglets' average daily gain (ADG) was reduced in low dietary CP diets, which suggests that sows reduced milk production due to an underestimation of certain essential amino acid requirements (e.g. valine). The increase of dietary NDF level did not affect sow and litter performance. Nevertheless, the total tract apparent digestibility of organic matter, CP and carbohydrates was reduced, and ether extract digestion was increased in high NDF compared to normal NDF diets equally balanced for ME and lysine content. The coefficients of total tract apparent digestibility of nutrients in lactating sows were greater when using AIA compared to Cr 2 O 3 marker, regardless of dietary CP or NDF level, but their coefficients of variation were lower in the former than in the latter. In lactating sows, a trade-off between litter performance and nutrient digestion is established when reducing dietary CP or increasing NDF levels while maintaining similar lysine content through synthetic amino acids and balancing metabolizable energy through dietary fat sources. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

Elevated blood lactate is associated with increased motor cortex excitability.

Science.gov (United States)

Coco, Marinella; Alagona, Giovanna; Rapisarda, Giuseppe; Costanzo, Erminio; Calogero, Roberto Antonio; Perciavalle, Valentina; Perciavalle, Vincenzo

2010-01-01

No information has yet been provided about the influence of blood lactate levels on the excitability of the cerebral cortex, in particular, of the motor cortex. The aim of the present study was to examine the effects of high blood lactate levels, induced with a maximal cycling or with an intravenous infusion, on motor cortex excitability. The study was carried out on 17 male athletes; all the subjects performed a maximal cycling test on a mechanically braked cycloergometer, whereas 6 of them were submitted to the intravenous infusion of a lactate solution (3 mg/kg in 1 min). Before the exercise or the injection, at the end, as well as 5 and 10 min after the conclusion, venous blood lactate was measured and excitability of the motor cortex was evaluated by using the transcranial magnetic stimulation. In both of these experimental conditions, it was observed that an increase of blood lactate is associated with a decrease of motor threshold, that is, an enhancement of motor cortex excitability. We conclude by hypothesizing that in the motor cortex the lactate could have a protective role against fatigue.

Fluorometric determination of d-lactate in biological fluids

DEFF Research Database (Denmark)

Larsen, Torben

2017-01-01

in the body may lead to D-lactate acidosis and neurotoxicity; consequently, the possibility of diagnosis of this condition is important. Several analytical procedures for D-lactate have been introduced, but it is absolutely mandatory to distinguish this metabolite from the much more abundant and naturally......-up in the laboratory....

New enzymatic assay, parasite lactate dehydrogenase in diagnosis ...

African Journals Online (AJOL)

Background: The unique ability of plasmodial lactate dehydrogenase p(LDH) to utilise 3-acetyl pyridine dinucleotide (APAD) in lieu of NAD as a coenzyme in the conversion of pyruvate to lactate, led to the development of a biochemical assay for the detection of plasmodial parasitaemia. Researchers have reported that ...

Peer assessment of outpatient consultation letters – feasibility and satisfaction

Directory of Open Access Journals (Sweden)

Dojeiji Suzan

2007-05-01

Full Text Available Abstract Background Written correspondence is one of the most important forms of communication between health care providers, yet there is little feedback provided to specialists. The objective of this study was to determine the feasibility and satisfaction of a peer assessment program on consultation letters and to determine inter-rater reliability between family physicians and specialists. Methods A rating scale of nine 5-point Likert scale items including specific content, style items, education value of the letter and an overall rating was developed from a previous validated tool. Nine Internal Medicine specialists/subspecialists from two tertiary care centres submitted 10 letters with patient and physician identifiers removed. Two Internal Medicine specialists, and 2 family physicians from the other centre rated each letter (to protect writer anonymity. A satisfaction survey was sent to each writer and rater after collation of the results. A follow-up survey was sent 6–8 months later. Results There was a high degree of satisfaction with the process and feedback. The rating scale information was felt to be useful and appropriate for evaluating the quality of consultation letters by 6/7 writers. 5/7 seven writers felt that the feedback they received resulted in immediate changes to their letters. Six months later, 6/9 writers indicated they had maintained changes in their letters. Raters rank ordered letters similarly (Cronbach's alpha 0.57–0.84 but mean scores were highly variant. At site 1 there were significant differences in scoring brevity (p Conclusion Most participants found peer assessment of letters feasible and beneficial and longstanding changes occurred in some individuals. Family physicians and specialists appear to have different expectations on some items. Further studies on reliability and validity, with a larger sample, are required before high stakes professional assessments include consultation letters.

Nuclear consultant - a new profession

International Nuclear Information System (INIS)

Hardung von Hardung, H.

1976-01-01

The nuclear field is an area fraugh with particular difficulties for industries, banks, public authorities etc. in acquiring the precise knowledge needed for decision making. This gap can be filled by the activities of nuclear consultants; in view of the size of the market which, in Europe, probably involves a capital investment by far exceeding DM 100 billion, chances are promising. These consultant activities include technological problems as well as economics, organization, strategy, and training in nuclear technology. Of course, the consultant staff must have broad and specialized knowledge. (orig.) [de

Nuclear consultant: a new profession

Energy Technology Data Exchange (ETDEWEB)

Hardung von Hardung, H

1976-02-01

The nuclear field is an area fraught with particular difficulties for industries, banks, and public authorities etc. in acquiring the precise knowledge needed for decision making. This gap can be filled by the activities of nuclear consultants; in view of the size of the market which, in Europe, probably involves a capital investment by far exceeding DM 100 billion, chances are promising. These consultant activities include technological problems as well as economics, organization, strategy, and training in nuclear technology. Of course, the consultant staff must have broad and specialized knowledge.

Evidence of In Vivo Absorption of Lactate and Modulation of Short Chain Fatty Acid Absorption from the Reticulorumen of Non-Lactating Cattle Fed High Concentrate Diets.

Directory of Open Access Journals (Sweden)

Muhammad Qumar

Full Text Available Short-chain fatty acids (SCFAs and lactate are endproducts of rumen fermentation and important energy sources for the host ruminant. Because their rapid accumulation results in ruminal acidosis, enhancement of the absorption of SCFA and lactate across reticuloruminal wall is instrumental in increasing energy supply and preventing ruminal acidosis in cattle. This study investigated whether the reticuloruminal absorption of SCFAs and lactate was altered by different strategies of high concentrate feeding. Eight rumen-cannulated, non-lactating Holstein cows were fed a forage-only diet (baseline and then gradually adapted over 6 d to a 60% concentrate level. Thereafter, this concentrate-rich diet was fed for 4 wk either continuously (Con; n = 8 or interruptedly (Int; n = 8. Absorption of SCFAs and lactate was determined in vivo from the experimental buffer introduced into the washed reticulorumen. The buffer contained acetate, propionate, butyrate and lactate at a concentration of 60, 30, 10 and 5 mmol/L, respectively and Cr-EDTA as a marker for correcting ruminal water fluxes. The reticuloruminal absorption after 35 and 65 min of buffer incubation was measured at the baseline, after 1 wk of 60% concentrate feeding in the interrupted model (Int-1 and after 4 wk of concentrate feeding in both feeding models (Int-4 and Con-4. Data showed that the absorption rates of individual and total SCFAs during the first 35 min of incubation of Con-4 were highest (~1.7 times compared to baseline, while Int-1 and Int-4 were similar to respective baseline. Lactate was not absorbed during forage-only baseline and 1-wk concentrate feeding, but after 4-wk feeding of concentrates in both models. In conclusion, SCFAs absorption across the reticulorumen of non-lactating cattle was enhanced by the 4-wk continuous concentrate feeding, which seems to be more advantageous in terms of rumen acidosis prevention compared to the interrupted feeding model. The study provides

Conflict prevention, conflict mitigation, and manifestations of conflict during emergency department consultations.

Science.gov (United States)

Chan, Teresa; Bakewell, Francis; Orlich, Donika; Sherbino, Jonathan

2014-03-01

The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations. From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature. All participants recalled some manifestation of conflict. There were 12 negative conflict-producing themes and 10 protective conflict-mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model. Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations. © 2014 by the Society for Academic Emergency Medicine.

[Amperometric biosensor for lactate analysis in wines and grape must during fermentation].

Science.gov (United States)

Shkotova, L V; Horiushkina, T B; Slast'ia, E A; Soldatkin, O P; Tranh-Minh, S; Chovelon, J M; Dziadevych, S V

2005-01-01

The amperometric biosensor based on lactate oxidase for determination of lactate has been developed, and two methods of immobilization of lactate oxidase on the surface of industrial screen-printed platinum electrodes SensLab were compared. A sensor with immobilized in the Resydrol polymer lactate oxidase by the method of physical adsorption is characterized of narrow dynamic range and greater response value in comparison with a biosensor based on immobilised in poly(3,4-ethylenedioxythiophene) lactate oxidase by the method of electrochemical polymerization. Operational stability of the biosensor developed was studied and it was shown, that the immobilization method does not influence their stability. The analysis of the lactate in wine and during wine fermentation has been conducted. High correlation of the data obtained by means of amperometric lactate biosensor and a standard method of an ionic chromatography has been shown. The developed biosensor could be applied in the food industry for the control and optimization of the wine fermentation process, and quality control of wine.

Navigating Return to Work and Breastfeeding in a Hospital with a Comprehensive Employee Lactation Program.

Science.gov (United States)

Froh, Elizabeth B; Spatz, Diane L

2016-11-01

The Surgeon General's Call to Action to Support Breastfeeding details the need for comprehensive employer lactation support programs. Our institution has an extensive employee lactation program, and our breastfeeding initiation and continuation rates are statistically significantly higher than state and national data, with more than 20% of our employees breastfeeding for more than 1 year. The objective of this research was complete secondary data analysis of qualitative data collected as part of a larger study on breastfeeding outcomes. In the larger study, 545 women who returned to work full or part time completed an online survey with the ability to provide free text qualitative data and feedback regarding their experiences with breastfeeding after return to work. Qualitative data were pulled from the online survey platform. The responses to these questions were analyzed using conventional content analysis by the research team (2 PhD-prepared nurse researchers trained and experienced in qualitative methodologies and 1 research assistant) in order to complete a thematic analysis of the survey data. Analysis of the data yielded 5 major themes: (1) positive reflections, (2) nonsupportive environment/work culture, (3) supportive environment/work culture, (4) accessibility of resources, and (5) internal barriers. The themes that emerged from this research clearly indicate that even in a hospital with an extensive employee lactation program, women have varied experiences-some more positive than others. Returning to work while breastfeeding requires time and commitment of the mother, and a supportive employee lactation program may ease that transition of return to work.

Clinical use of lactate monitoring in critically ill patients

NARCIS (Netherlands)

J. Bakker (Jan); M.W.N. Nijsten (Maarten); T.C. Jansen (Tim)

2013-01-01

textabstractIncreased blood lactate levels (hyperlactataemia) are common in critically ill patients. Although frequently used to diagnose inadequate tissue oxygenation, other processes not related to tissue oxygenation may increase lactate levels. Especially in critically ill patients, increased

A two-diet feeding regime for lactating sows reduced nutrient deficiency in early lactation and improved milk yield

DEFF Research Database (Denmark)

Pedersen, Trine Friis; Sønderby Bruun, Thomas; Feyera, Takele

2016-01-01

was recorded weekly. In addition, weekly milk samples and blood samples on d 3 and 17 were collected. Furthermore, sows were enriched with D2O (deuterated water) on d 2 and 28 after parturition to calculate body pools of fat and protein. Sows’ feed intake and weight loss interacted with diet regime across wk......The objective of the present study was to evaluate whether a new feeding concept composed of two dietary components fed daily throughout lactation could minimize sow weight loss and increase milk yield (MY) and piglet weight gain. In total, 14 sows were included in the experiment from parturition...... until weaning 28 d later. The sows were fed one of two dietary feeding regimes from lactation d 2 and throughout lactation. The 1-diet feeding regime represented the Danish feeding standards and recommendations. The new 2-diet regime supplied sows feed and nutrients (ME and AA) according...

Search Results | Page 958 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 9571 - 9580 of 9580 ... Shainoor is Managing Director of Better Business Enterprise Ltd, a consulting firm operating internationally, working with multiple stakeholders ... Jessica Perkins is the Director, Risk Management and Internal Audit.

Search Results | Page 849 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 8481 - 8489 of 8489 ... Shainoor is Managing Director of Better Business Enterprise Ltd, a consulting firm operating internationally, working with multiple stakeholders ... Jessica Perkins is the Director, Risk Management and Internal Audit.

Arterial cord blood lactate at birth correlates with duration of pushing efforts.

Science.gov (United States)

Dessolle, Lionel; Lebrec, Jeremie; Daraï, Emile

2010-01-01

To evaluate the impact of the duration of pushing efforts on arterial cord blood lactate values. This was a prospective observational study of 124 consecutive normal vaginal deliveries in a tertiary teaching hospital. Arterial cord blood lactate was determined immediately at birth with a test strip method. Univariate and multivariate analyses were performed to check for clinical determinants of lactate levels. The main measure was lactate according to the duration of pushing efforts. Arterial cord lactates increased significantly and were strongly correlated with the duration of pushing efforts, independent of gestational age and birthweight. Women pushing for more than 20 min had higher arterial cord blood lactates (4.9 +/- 1.4 vs. 3.3 +/- 1.16 mM, respectively) and a higher rate of lactates >6 mM (18 vs. 3%) than those pushing for less than 20 min. At normal delivery, arterial cord blood lactates increase significantly with the duration of pushing efforts. Pushing for more than 20 min is associated with an increased risk of metabolic acidosis in the neonate. Further studies are required to evaluate the clinical significance of these observations. 2009 S. Karger AG, Basel.

Workplace Lactation Support in Milwaukee County 5 Years After the Affordable Care Act.

Science.gov (United States)

Lennon, Tyler; Willis, Earnestine

2017-02-01

Workplace lactation support has become increasingly important because returning to work is associated with discontinuing breastfeeding and women in the workforce are increasing. Research aim: This study examined workplace lactation support among Milwaukee County businesses 5 years after implementation of the Affordable Care Act's Break Time for Nursing Mothers provision. A cross-sectional survey of Milwaukee County businesses was conducted in the summer of 2015 that inquired about workplace policies, lactation spaces, and other lactation resources offered. Business supports were stratified based on employer sizes: large (> 500 employees), medium (50-499 employees), and small (20-49 employees). A lactation amenity score was calculated for each business based on lactation resources available. Three hundred surveys were distributed and 71 businesses voluntarily completed the survey. Small employers were excluded from statistical analysis due to fewer responses ( n = 8). Overall, 87.3% ( n = 55) of respondents reported providing access to a multiuser space for lactation and 65.1% ( n = 41) reported providing a designated lactation space. Large employers ( n = 30) were more likely than medium employers ( n = 33) to provide a designated lactation space for breastfeeding or expressing (86.7% vs. 45.5%, p increase additional lactation support for women in the workplace.

Placental and lactating transfer of 147Pm in mice

International Nuclear Information System (INIS)

Tao Feng; Zhu Shoupeng

1990-08-01

The placental and lactating transfer of 147 Pm in late pregnant mice and lactating mice as well as the distribution of 147 Pm in some organs of mother mice were studied and compared. The pregnant mice and lactating mice had intravenous injection with 147 Pm nitrate at the 17th day of gestation and the next day of parturition respectively. The two groups were sacrified at the 1st, 4th, 9th, 14th and 21st day after the injection. The retentions of 147 Pm in the liver, right femur, uterus, spleen, placenta, fetal membrane and litter were determined by the method of liquid scintillation. The results showed that the amount of 147 Pm in litters of both groups was increasing with the days after injection. In the 1st and 4th day of injection the amount of 147 Pm in litters of lactating mice was 20 times higher than those in litters of pregnant mice. The amount of 147 Pm in livers and skeletons and the half-retention time of prenant and lactating dams were much greater than those of control group

SOME INDICATORS OF CONSULTATIVE SERVICES DEVELOPMENT IN SERBIA

Directory of Open Access Journals (Sweden)

Vesna PARAUSIC

2012-01-01

Full Text Available Transition process and Serbia's entering into the European Union is possible to hasten by adequate and timely consultative services, before all during the programs and methodologies creation for conducting the enterprises' restructuring processes. In such conditions, the consultative organizations help the enterprises in accomplishing their goals, solving problems in business and management, identifying and using new possibilities, increasing their knowledge and applying suggested changes in the practice. Consulting is a result of manager need for integrated and complex business information. To obtain the transfer of consultant knowledge and manager skills development, a certain conditions must be fulfilled. First of all, business integrity and consultant competence are the most important. Business integrity, i.e. consultant ethics contributes image and reputation and is important competitiveness factor on consultant services market. Regarding actual consulting trends in countries within our region, as well as developmental level of consulting in EU countries, the market of consultative services in Serbia has not significantly changed in previous period (as we saw, the acknowledgement of it was got also by empirical research. The owners and managers of enterprises still do not feel a need for external services, in order to solve business problems. Having in mind a level and quality of demand, neither a supply of consultative services had not reached satisfactory level.

Accuracy of Handheld Point-of-Care Fingertip Lactate Measurement in the Emergency Department

Directory of Open Access Journals (Sweden)

Gaieski, David G

2013-02-01

Full Text Available Introduction: Early recognition of elevated lactate levels in sepsis may hasten the detection of those patients eligible for aggressive resuscitation. Point-of-care (POC testing is now increasingly available for use in the emergency department (ED. We examined the accuracy and time-saving effect of a handheld POC device for the measurement of fingertip and whole blood lactate as compared with reference laboratory testing in critically ill ED patients.Methods: A convenience sample of adult ED patients receiving serum lactate testing was prospectively enrolled at an urban, tertiary care US hospital. Consenting patients underwent fingertip POC lactate measurement with a portable device and simultaneous whole blood sampling for analysis by both the POC device and standard laboratory analyzer (‘‘reference method’’. Lactate measurements were compared by intraclass correlation (ICC and Bland and Altman plots. Differences in time to test result were compared by paired t test.Results: Twenty-four patients, 19 (79% with sepsis and 21 (88% with lactate levels below 4 mmol/L, were included from April 2005 to May 2005. Fingertip POC and whole blood POC lactate measurements each correlated tightly with the reference method (ICC ¼ 0.90 and ICC ¼ 0.92, respectively. Mean time between obtaining fingertip lactate samples and whole blood reference lactate samples was 8 6 13 minutes. Mean time between obtaining POC and reference laboratory lactate results was 65 minutes (95% confidence interval, 30–103.Conclusion: Fingertip POC lactate measurement is an accurate method to determine lactate levels in infected ED patients with normal or modestly elevated lactate values and significantly decreases time to test results. These findings should be verified in a larger, more critically ill, ED population. [West J Emerg Med. 2013;14(1:58-62.

Efficacy of an internal teat seal associated with a dry cow intramammary antibiotic for prevention of intramammary infections in dairy cows during the dry and early lactation periods

Directory of Open Access Journals (Sweden)

Lívio R. Molina

Full Text Available ABSTRACT: The present study aimed to evaluate the use of an internal dry period teat seal containing bismuth subnitrate (Teatseal®, Zoetis®, Florham Park, Nova Jersey, USA associated with a long-acting cloxacilin preparation (Orbenin® Extra dry cow, Zoetis®, Florham Park, Nova Jersey, USA, in preventing new infections during the dry-off and early postpartum period. A total of 150 Holstein cows (average production of 9,000 kg of milk per lactation, with four functional udder quarters without clinical mastitis was included in the study. All animals were dried-off 60 days before the expected calving date. Two teats positioned diagonal-contralaterally received only dry cow antibiotic, control group C (n=300 and the other two teats, treatment group T (n=300 received dry cow antibiotic and infusion with an internal teat seal. Data from SCC variable were transformed by log base-10 transformation. Duncan’s test was used accepting 5% as the level of statistical significance. The occurrence of intramammary infection (IMI and chronicity rate, and frequency of microorganisms isolated at drying and immediately postpartum in teats of group C and group T were evaluated using a non-parametric Chi-square Test, accepting 10% as the statistical significance level. There was a decrease in the occurrence of new infections in the early postpartum in cows which the sealant was used (C=19.6%, T=11.4%. In the postpartum period, Gram-negative bacteria were isolated from 16 teats in C and seven in T. The greatest reduction was observed for Escherichia coli (8 vs 1 in group T. There was no effect using the internal sealant on the frequency of isolation of environmental Streptococus. The use of sealant reduced the prevalence of subclinical mastitis cows between drying-off and the early postpartum period (C=51% versus T=42% and resulted in a lower somatic cell count (SCC in the treatment group when compared with the control group (T=1,073x103, C=1,793x103. The use of

Strangers at the Benchside: Research Ethics Consultation

Science.gov (United States)

Cho, Mildred K.; Tobin, Sara L.; Greely, Henry T.; McCormick, Jennifer; Boyce, Angie; Magnus, David

2008-01-01

Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should be mitigated. We make preliminary recommendations for the structure and process of research ethics consultation, based on our initial experiences in a pilot program. PMID:18570086

Methods for early prediction of lactation flow in Holstein heifers

Directory of Open Access Journals (Sweden)

Vesna Gantner

2010-12-01

Full Text Available The aim of this research was to define methods for early prediction (based on I. milk control record of lactation flow in Holstein heifers as well as to choose optimal one in terms of prediction fit and application simplicity. Total of 304,569 daily yield records automatically recorded on a 1,136 first lactation Holstein cows, from March 2003 till August 2008., were included in analysis. According to the test date, calving date, the age at first calving, lactation stage when I. milk control occurred and to the average milk yield in first 25th, T1 (and 25th-45th, T2 lactation days, measuring monthcalving month-age-production-time-period subgroups were formed. The parameters of analysed nonlinear and linear methods were estimated for each defined subgroup. As models evaluation measures,adjusted coefficient of determination, and average and standard deviation of error were used. Considering obtained results, in terms of total variance explanation (R2 adj, the nonlinear Wood’s method showed superiority above the linear ones (Wilmink’s, Ali-Schaeffer’s and Guo-Swalve’s method in both time-period subgroups (T1 - 97.5 % of explained variability; T2 - 98.1 % of explained variability. Regarding the evaluation measures based on prediction error amount (eavg±eSD, the lowest average error of daily milk yield prediction (less than 0.005 kg/day, as well as of lactation milk yield prediction (less than 50 kg/lactation (T1 time-period subgroup and less than 30 kg/lactation (T2 time-period subgroup; were determined when Wood’s nonlinear prediction method were applied. Obtained results indicate that estimated Wood’s regression parameters could be used in routine work for early prediction of Holstein heifer’s lactation flow.

American Internal Medicine in the 21st Century

Science.gov (United States)

Huddle, Thomas S; Centor, Robert; Heudebert, Gustavo R

2003-01-01

American internal medicine suffers a confusion of identity as we enter the 21st century. The subspecialties prosper, although unevenly, and retain varying degrees of connection to their internal medicine roots. General internal medicine, identified with primary care since the 1970s, retains an affinity for its traditional consultant-generalist ideal even as primary care further displaces that ideal. We discuss the origins and importance of the consultant-generalist ideal of internal medicine as exemplified by Osler, and its continued appeal in spite of the predominant role played by clinical science and accompanying subspecialism in determining the academic leadership of American internal medicine since the 1920s. Organizing departmental clinical work along subspecialty lines diminished the importance of the consultant-generalist ideal in academic departments of medicine after 1950. General internists, when they joined the divisions of general internal medicine that appeared in departments of medicine in the 1970s, could sometimes emulate Osler in practicing a general medicine of complexity, but often found themselves in a more limited role doing primary care. As we enter the 21st century, managed care threatens what remains of the Oslerian ideal, both in departments of medicine and in clinical practice. Twenty-first century American internists will have to adjust their conditions of work should they continue to aspire to practice Oslerian internal medicine. PMID:12950486

Tin-containing silicates: Alkali salts improve methyl lactate yield from sugars

DEFF Research Database (Denmark)

Tolborg, Søren; Sádaba, Irantzu; Osmundsen, Christian Mårup

2015-01-01

This study focuses on increasing the selectivity to methyl lactate from sugars using stannosilicates as heterogeneous catalyst. All group I ions are found to have a promoting effect on the resulting methyl lactate yield. Besides, the alkali ions can be added both during the preparation of the cat......This study focuses on increasing the selectivity to methyl lactate from sugars using stannosilicates as heterogeneous catalyst. All group I ions are found to have a promoting effect on the resulting methyl lactate yield. Besides, the alkali ions can be added both during the preparation...

Is lactate a volume transmitter of metabolic states of the brain?

DEFF Research Database (Denmark)

Bergersen, Linda H; Gjedde, Albert

2012-01-01

We present the perspective that lactate is a volume transmitter of cellular signals in brain that acutely and chronically regulate the energy metabolism of large neuronal ensembles. From this perspective, we interpret recent evidence to mean that lactate transmission serves the maintenance...... of network metabolism by two different mechanisms, one by regulating the formation of cAMP via the lactate receptor GPR81, the other by adjusting the NADH/NAD(+) redox ratios, both linked to the maintenance of brain energy turnover and possibly cerebral blood flow. The role of lactate as mediator...

Prevention of acute/severe hypoglycemia-induced neuron death by lactate administration.

Science.gov (United States)

Won, Seok Joon; Jang, Bong Geom; Yoo, Byung Hoon; Sohn, Min; Lee, Min Woo; Choi, Bo Young; Kim, Jin Hee; Song, Hong Ki; Suh, Sang Won

2012-06-01

Hypoglycemia-induced cerebral neuropathy can occur in patients with diabetes who attempt tight control of blood glucose and may lead to cognitive dysfunction. Accumulating evidence from animal models suggests that hypoglycemia-induced neuronal death is not a simple result of glucose deprivation, but is instead the end result of a multifactorial process. In particular, the excessive activation of poly (ADP-ribose) polymerase-1 (PARP-1) consumes cytosolic nicotinamide adenine dinucleotide (NAD(+)), resulting in energy failure. In this study, we investigate whether lactate administration in the absence of cytosolic NAD(+) affords neuroprotection against hypoglycemia-induced neuronal death. Intraperitoneal injection of sodium L-lactate corrected arterial blood pH and blood lactate concentration after hypoglycemia. Lactate administered without glucose was not sufficient to promote electroencephalogram recovery from an isoelectric state during hypoglycemia. However, supplementation of glucose with lactate reduced neuronal death by ∼80% in the hippocampus. Hypoglycemia-induced superoxide production and microglia activation was also substantially reduced by administration of lactate. Taken together, these results suggest an intriguing possibility: that increasing brain lactate following hypoglycemia offsets the decrease in NAD(+) due to overactivation of PARP-1 by acting as an alternative energy substrate that can effectively bypass glycolysis and be fed directly to the citric acid cycle to maintain cellular ATP levels.

Should consultation recording use be a practice standard? A systematic review of the effectiveness and implementation of consultation recordings.

Science.gov (United States)

Rieger, Kendra L; Hack, Thomas F; Beaver, Kinta; Schofield, Penelope

2018-04-01

To conduct a systematic review of the effectiveness of consultation recordings and identify factors contributing to their successful implementation in health-care settings. A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in health care. Two independent reviewers assessed the relevance and quality of retrieved quantitative studies by using standardized criteria. Study findings were examined to determine consultation recording effectiveness and to identify barriers and facilitators to implementation. A supplementary review of qualitative evidence was performed to further explicate implementation factors. Of the 3373 articles retrieved in the quantitative search, 26 satisfied the standardized inclusion criteria (12 randomized controlled trials, 1 quasi-experiment, and 13 cross-sectional studies). Most patients found consultation recordings beneficial. Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes: knowledge, perception of being informed, information recall, decision-making factors, anxiety, and depression. Implementation barriers included strength of evidence concerns, patient distress, impact of the recording on consultation quality, clinic procedures, medico-legal issues, and resource costs. Facilitators included comfort with being recorded, clinical champions, legal strategies, efficient recording procedures, and a positive consultation recording experience. Consultation recordings are valuable to patients and positively associated with patient-reported outcomes. Successful integration of consultation recording use into clinical practice requires an administratively supported, systematic approach to addressing implementation factors. Copyright © 2017 John Wiley & Sons, Ltd.

The guideline "consultation psychiatry" of the Netherlands Psychiatric Association.

Science.gov (United States)

Leentjens, Albert F G; Boenink, Annette D; Sno, Herman N; Strack van Schijndel, Rob J M; van Croonenborg, Joyce J; van Everdingen, Jannes J E; van der Feltz-Cornelis, Christina M; van der Laan, Niels C; van Marwijk, Harm; van Os, Titus W D P

2009-06-01

In 2008, the Netherlands Psychiatric Association authorized a guideline "consultation psychiatry." To set a standard for psychiatric consultations in nonpsychiatric settings. The main objective of the guideline is to answer three questions: Is psychiatric consultation effective and, if so, which forms are most effective? How should a psychiatric consultations be performed? What increases adherence to recommendations given by the consulting psychiatrist? Systematic literature review. Both in general practice and in hospital settings psychiatric consultation is effective. In primary care, the effectiveness of psychiatric consultation is almost exclusively studied in the setting of "collaborative care." Procedural guidance is given on how to perform a psychiatric consultation. In this guidance, psychiatric consultation is explicitly looked upon as a complex activity that requires a broad frame of reference and adequate medical and pharmacological expertise and experience and one that should be performed by doctors. Investing in a good relation with the general practitioner, and the use of a "consultation letter" increased efficacy in general practice. In the hospital setting, investing in liaison activities and an active psychiatric follow-up of consultations increased adherence to advice. Psychiatric consultations are effective and constitute a useful contribution to the patients' treatment. With setting a standard consultations will become more transparent and checkable. It is hoped that this will increase the quality of consultation psychiatry.

Services of strategic consulting: special features and types

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Klenin Oleh Volodymyrovych

2016-09-01

Full Text Available In the article essence of terms “consulting” and “strategic consulting” was studied. It was proved that strategic consulting must be analyzed as professional activity in the system of enterprise strategic management. Specific features of consultative services and its composition was added from the point of view of strategic management and innovative development were studied. In the process of providing consulting services it was suggested to take into account the strategic orientation of human capital of consulting company that was accepted to determine as professional actions of consultants. It was found out main problems that could prevent stable activity of industrial enterprises. It was proved necessity of researches concerning authentication factors of industrial enterprises innovative development and the role of consulting company in its decision making. It was made review of the most widespread classifications of consulting services. Was shown author`s view concerning forming more demanded services of strategic consulting by subject basis.

Functional interaction between bicarbonate transporters and carbonic anhydrase modulates lactate uptake into mouse cardiomyocytes.

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Peetz, Jan; Barros, L Felipe; San Martín, Alejandro; Becker, Holger M

2015-07-01

Blood-derived lactate is a precious energy substrate for the heart muscle. Lactate is transported into cardiomyocytes via monocarboxylate transporters (MCTs) together with H(+), which couples lactate uptake to cellular pH regulation. In this study, we have investigated how the interplay between different acid/base transporters and carbonic anhydrases (CA), which catalyze the reversible hydration of CO2, modulates the uptake of lactate into isolated mouse cardiomyocytes. Lactate transport was estimated both as lactate-induced acidification and as changes in intracellular lactate levels measured with a newly developed Förster resonance energy transfer (FRET) nanosensor. Recordings of intracellular pH showed an increase in the rate of lactate-induced acidification when CA was inhibited by 6-ethoxy-2-benzothiazolesulfonamide (EZA), while direct measurements of lactate flux demonstrated a decrease in MCT transport activity, when CA was inhibited. The data indicate that catalytic activity of extracellular CA increases lactate uptake and counteracts intracellular lactate-induced acidification. We propose a hypothetical model, in which HCO3 (-), formed from cell-derived CO2 at the outer surface of the cardiomyocyte plasma membrane by membrane-anchored, extracellular CA, is transported into the cell via Na(+)/HCO3 (-) cotransport to counteract intracellular acidification, while the remaining H(+) stabilizes extracellular pH at the surface of the plasma membrane during MCT activity to enhance lactate influx into cardiomyocytes.

ARL/OMS Consultant Training Program.

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Euster, Joanne R.

1982-01-01

Describes Academic Library Consultant Training Program begun in 1979, sponsored by Office of Management Studies (OMS) and designed to provide 80 consultants to aid academic libraries in improving performance. Viewpoints are included from OMS Director and participants concerning program objectives, trainee selection, workshops, internships, and the…

Exploring gender differences in the working lives of UK hospital consultants.

Science.gov (United States)

Jefferson, Laura; Bloor, Karen; Spilsbury, Karen

2015-05-01

Internationally, increasing numbers of women are practising medicine. Gender differences in doctors' working hours, specialty choices and communication styles are well documented, but studies often neglect contextual factors such as the role of socialised gender expectations on behaviours in the workplace and the medical profession. These may be important as recent studies have reported gender differences in doctors' activity rates that cannot be explained by specialty or contracted hours, suggesting other sources of variation. This study sought to explore the working lives of hospital doctors and how their work is negotiated according to gender and context. Gender differences in the day-to-day work of hospital specialists (consultants) in the NHS were investigated using a qualitative approach, including observation and interview methods. Data were analysed inductively using qualitative observation and interview methods. Two NHS hospital trusts in England. Data were collected from 13 participants working in a variety of specialties and in a range of clinical and non-clinical settings. Various behaviours, attitudes and experiences were explored, such as doctor-patient communication, interactions with colleagues and workload. Influences at both individual and situational levels, appear to affect differentially the work of male and female doctors. Female consultants described awareness of the impact of behaviours on relationships with colleagues, and their interactions appeared to be more carefully performed. Nurses and other colleagues tend to demonstrate less cooperation with female consultants. Gender differences also exist in patient communication, feelings of work-family conflict and barriers to career progression. These variations in hospital consultants' work may have implications for both the quantity and quality of care provided by male and female consultants. This is timely and of importance to the medical workforce as the gender composition approaches

Improving Indonesian Construction Consulting Services

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Rizal Z. Tamin

2015-05-01

Full Text Available Indonesian construction consulting services are facing a complex problem in fulfilling the nation’s expectations regarding high quality infrastructure development and the construction industry’s competitiveness. A study of this problem and a formulation of solutions to improve the situation are presented in this paper. A survey was carried out in Jakarta, West Java, East Java, and North Sumatra provinces to collect data related to this problem. A focus group discussion and a workshop with all stakeholders were conducted to formulate improvement actions that need to be taken. It was revealed that the problems faced include, among others, the limited number of professional engineers compared to the number of national consultancy companies, the uneven distribution of engineers in Indonesian regions, an imperfect procurement system, and low-quality work output in general. Recommended actions include improvement of the government’s role in consulting services nurturing and facilitation, development of partnerships, and amelioration of the professional engineer and consultant certification system.

Events occurring during the previous lactation, the dry period, and peripartum as risk factors for early lactation mastitis in cows receiving 2 different intramammary dry cow therapies.

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Pinedo, P J; Fleming, C; Risco, C A

2012-12-01

The objective of this study was to investigate the association between mastitis events occurring during the previous lactation, the dry period, and the peripartum period on the incidence of early lactation mastitis in cows receiving ceftiofur hydrochloride or penicillin dihydrostreptomycin as intramammary dry cow antibiotic therapy. Cows (n=402) from 2 large dairy farms in Central Florida were enrolled in the study at the time of dry-off processing and were randomly assigned to 1 of 2 dry cow therapies: ceftiofur hydrochloride or penicillin dihydrostreptomycin. Composite milk samples were collected at dry-off and after calving for bacteriological examination and somatic cell count. Peripartal health disorders were monitored during the first 30 d of lactation and included calving difficulty, metritis, ketosis, and left displaced abomasum. Milk production and individual somatic cell scores (SCS) were recorded monthly by the Dairy Herd Improvement Association. The main outcome variables were the risk of clinical mastitis during the first 30 and 60 d of lactation, and the risk of subclinical mastitis at the first 2 monthly Dairy Herd Improvement Association tests after calving (up to 70 d in milk). Additionally, the SCS and the presence of mastitis pathogens in milk at dry-off and at calving were analyzed. Explanatory variables consisted of events occurring during the previous lactation, at dry-off and during the dry period, at calving, and within the first 30 d after calving. Multiple events occurring during the previous lactation had a significant effect on the incidence of mastitis in the subsequent lactation. These events included low milk yield, intermediate lactation length, clinical mastitis, and lactation SCS average. Similarly, intramammary infections with environmental bacteria at dry-off increased the chances of clinical mastitis the first month after calving. Dry-off therapy had a significant effect on mastitis incidence; cows treated with ceftiofur

Improving 1H MRSI measurement of cerebral lactate for clinical applications.

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Corrigan, Neva M; Richards, Todd L; Friedman, Seth D; Petropoulos, Helen; Dager, Stephen R

2010-04-30

Accurate measurement of cerebral lactate is critical to the understanding of brain function for psychiatric disorders such as panic disorder and bipolar disorder as well as mitochondrial dysfunction. Proton magnetic spectroscopic imaging (MRSI) techniques can be used to study lactate in vivo; however, accurate measurement of cerebral lactate, which is normally at low basal abundance, can be challenging. In this study, regional lactate measurements obtained with two different MRSI analytic approaches were evaluated using proton echo-planar spectroscopic imaging (PEPSI) data from 18 healthy adults participating in an in vivo sodium lactate infusion study. The results demonstrate that averaging data within a region of interest (ROI) before spectral fitting with LCModel results in significantly improved lactate measurement as compared to averaging chemical concentrations derived from the fitting of individual voxels in the ROI. Simulation results that confirm this finding are also presented. This study additionally outlines an atlas-based approach for the systematic computation of regional distributions of chemical concentrations in large MRSI data sets. Copyright @ 2009 Elsevier Ireland Ltd. All rights reserved.

Cord lactate, pH, and blood gases from healthy neonates.

Science.gov (United States)

Shirey, T; St Pierre, J; Winkelman, J

1996-01-01

Lactate, pH, pO2, and pCO2 were determined in arterial, venous, and free-flowing mixed umbilical cord blood obtained from deliveries of apparently healthy neonates. The goals of this study were to establish reference ranges for lactate and pH against which results in cases of high-risk labor and delivery could be compared, to see how the gases correlated with these values, and to determine whether easily accessible mixed umbilical cord blood can serve as the sample in lieu of cord arterial or cord venous blood. Arterial and venous cord lactates were 2.98 mmol/l (+/- 1.40) and 2.80 mmol/l (+/- 1.35), respectively, from 85 cords obtained from vaginal and cesarean deliveries. Mixed cord blood lactate, obtained on 48 cords, was 2.72 mmol/l (+/- 1.28) versus 3.14 and 2.97 mmol/l for the arterial and venous samples from those cords, respectively, and correlated quite well with lactate from the venous specimens (r = 0.97). Differences of > 0.5 mmol/l occurred between mixed and arterial cord bloods in 21 patients, and between mixed and venous cord bloods in 6 of the 48 patients, respectively. We conclude that (1) less than 2.5% of deliveries of apparently healthy neonates have arterial, venous, or mixed cord lactates > or = 7.0 mmol/l and pH pO2 nor pCO2 correlate well with cord venous lactate, and (3) readily available mixed cord blood is a satisfactory specimen for the measurement of venous cord latate.

The rose of Sharon: what is the ideal timing for palliative care consultation versus ethics consultation?

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La Via, Jennifer; Schiedermayer, David

2012-01-01

Ethics committees and palliative care consultants can function in a complementary fashion, seamlessly and effectively. Ethics committees can "air" and help resolves issues, and palliative care consultants can use a low-key, longitudinal approach.

Stereotactic Radiotherapy of Primary Lung Cancer and Other Targets: Results of Consultant Meeting of the International Atomic Energy Agency

International Nuclear Information System (INIS)

Nagata, Yasushi; Wulf, Joern; Lax, Ingmar; Timmerman, Robert; Zimmermann, Frank; Stojkovski, Igor; Jeremic, Branislav

2011-01-01

To evaluate the current status of stereotactic body radiotherapy (SBRT) and identify both advantages and disadvantages of its use in developing countries, a meeting composed of consultants of the International Atomic Energy Agency was held in Vienna in November 2006. Owing to continuous developments in the field, the meeting was extended by subsequent discussions and correspondence (2007-2010), which led to the summary presented here. The advantages and disadvantages of SBRT expected to be encountered in developing countries were identified. The definitions, typical treatment courses, and clinical results were presented. Thereafter, minimal methodology/technology requirements for SBRT were evaluated. Finally, characteristics of SBRT for developing countries were recommended. Patients for SBRT should be carefully selected, because single high-dose radiotherapy may cause serious complications in some serial organs at risk. Clinical experiences have been reported in some populations of lung cancer, lung oligometastases, liver cancer, pancreas cancer, and kidney cancer. Despite the disadvantages expected to be experienced in developing countries, SBRT using fewer fractions may be useful in selected patients with various extracranial cancers with favorable outcome and low toxicity.

Lactational Lead Exposure Perturbates Androgenesis in Juvenile and Pubertal Wistar Rats

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Odukoya SOA

2017-10-01

Full Text Available Background: High to low lead (Pb concentrations in breast milk has been found to perturb some biological events in the postnatal life. While postnatal Pb exposure has been reported to impair some andrological parameters in mammals, the age-dependent andrological signature of lactational Pb poisoning is not clear. Aims and Objectives: This study investigated the effects of Pb exposure during lactational period on the testicular andrological profiles of rats at certain postlactational ages using varying doses of Pb. Material and Methods: Lactating mothers and their pups were randomly divided into 4 groups comprising 24 pups each. The treatment groups received 10mg/dL, 30mg/dL, and 70mg/dLof lead acetate in their drinking water from postnatal day one (P1 to P21 of the lactational period. The control rats received distilled water. At P22, P60, P90 and P120, the pups from each group were euthanized, testes were collected, homogenized and the supernatant was used to assay for testosterone and oestrogen using standard methods. Results: Lactational lead poisoning was associated with depressed testicular testosterone productions (P<0.05 compared with controls and abnormally high levels of testicular oestrogen. These statistically significant differences (P<0.05 in androgens levels were corrected to near normal with increasing postnatal ages at low doses. Conclusion: These results show that lactational Pb intoxication causes reversible androgenic perturbations at low doses but irreversible damage at high doses during postnatal life. Conclusively, high lactational Pb is associated with post-lactational irreversible impairment of androgenic profiles.

Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services.

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Adams, Traci N; Bonsall, Joanna; Hunt, Daniel; Puig, Alberto; Richards, Jeremy B; Yu, Liyang; McSparron, Jakob I; Shah, Nainesh; Weissler, Jonathan; Miloslavsky, Eli M

2018-05-01

Medicine subspecialty consultation is becoming increasingly important in inpatient medicine. We conducted a survey study in which we examined hospitalist practices and attitudes regarding medicine subspecialty consultation. The survey instrument was developed by the authors based on prior literature and administered online anonymously to hospitalists at 4 academic medical centers in the United States. The survey evaluated 4 domains: (1) current consultation practices, (2) preferences regarding consultation, (3) barriers to and facilitating factors of effective consultation, and (4) a comparison between hospitalist-fellow and hospitalist-subspecialty attending interactions. One hundred twenty-two of 261 hospitalists (46.7%) responded. The majority of hospitalists interacted with fellows during consultation. Of those, 90.9% reported that in-person communication occurred during less than half of consultations, and 64.4% perceived pushback at least "sometimes " in their consult interactions. Participants viewed consultation as an important learning experience, preferred direct communication with the consulting service, and were interested in more teaching during consultation. The survey identified a number of barriers to and facilitating factors of an effective hospitalist-consultant interaction, which impacted both hospitalist learning and patient care. Hospitalists reported more positive experiences when interacting with subspecialty attendings compared to fellows with regard to multiple aspects of the consultation. The hospitalist-consultant interaction is viewed as important for both hospitalist learning and patient care. Multiple barriers and facilitating factors impact the interaction, many of which are amenable to intervention.

Compensation Consultants and CEO Pay

NARCIS (Netherlands)

Kabir, Mohammed Rezaul; Minhat, Marizah

2014-01-01

The study examines the practice of employing multiple compensation consultants. Examining data of a sample of UK companies over the period 2003–2006 we find that CEOs receive higher equity-based pay when firms employ more than one compensation consultant. An increase in the number of compensation

The Lawyer-Therapist Consultation Team.

Science.gov (United States)

Korelitz, Ann; Schulder, Diane

1982-01-01

Discusses a pilot study in which joint consultations with a family therapist and a matrimonial attorney were offered to 10 couples and one woman contemplating divorce. Videotaped sessions. Suggests joint consultations can be useful in helping couples understand the psychological and legal implications of conflicts expressed during separation.…

Discussing patient's lifestyle choices in the consulting room: analysis of GP-patient consultations between 1975 and 2008

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van Dulmen Sandra

2010-11-01

Full Text Available Abstract Background The increasing prevalence of chronic diseases and the growing understanding that lifestyle behaviour plays an essential role in improving overall health suggest a need for increased attention to lifestyle choices in the consulting room. This study aims to examine whether or not healthy and unhealthy lifestyle choices of patients are currently being discussed more often in primary care consultations than in former decades. Furthermore, we are interested in GPs' approach to lifestyle behaviour during consultations. Lastly, we examine whether lifestyle behaviour is discussed more with certain patients during consultations, depending on gender, age and educational background. Method We analysed video-recordings of medical consultations, collected between 1975 and 2008 in Dutch GP practices. Data were analysed using logistic regression. Results This study shows that discussion of smoking behaviour and physical activity has increased somewhat over time. A change in discussion of nutrition and alcohol is, however, less clear. Overall, alcohol use is the least discussed and physical activity the most discussed during consultations. GPs mainly refer to lifestyle when it is relevant to the patient's complaints (symptom approach. GPs' approach to lifestyle behaviour did not change over time. In general, lifestyle behaviour is discussed more with older, male patients (except for nutrition. GPs talk about lifestyle behaviour with patients from different educational backgrounds equally (except for physical activity. Conclusion In recent years there is greater awareness of a healthy lifestyle, which is reflected to a limited extent in this study. Still, lifestyle behaviour is discussed in only a minority of consultations. GPs do not refer to lifestyle behaviour as a routine procedure, i.e. do not include it in primary prevention. This highlights the importance of the introduction of prevention consultations, where GPs can discuss lifestyle

Adverse event reporting and developments in radiation biology after normal tissue injury: International Atomic Energy Agency consultation

International Nuclear Information System (INIS)

Chen Yuhchyau; Trotti, Andy; Coleman, C. Norman; Machtay, Mitchell; Mirimanoff, Rene O.; Hay, John; O'Brien, Peter C.; El-Gueddari, Brahim; Salvajoli, Joao V.; Jeremic, Branislav

2006-01-01

Purpose: Recent research has enhanced our understanding of radiation injury at the molecular-cellular and tissue levels; significant strides have occurred in standardization of adverse event reporting in clinical trials. In response, the International Atomic Energy Agency, through its Division of Human Health and its section for Applied Radiation Biology and Radiotherapy, organized a consultation meeting in Atlanta (October 2, 2004) to discuss developments in radiobiology, normal tissue reactions, and adverse event reporting. Methods and Materials: Representatives from cooperative groups of African Radiation Oncology Group, Curriculo Radioterapeutica Ibero Latino Americana, European Organization for Research and Treatment of Cancer, National Cancer Institute of Canada Clinical Trials Group, Radiation Therapy Oncology Group, and Trans-Tasman Radiation Oncology Group held the meeting discussion. Results: Representatives of major radiotherapy groups/organizations and prominent leaders in radiotherapy discussed current understanding of normal tissue radiobiologic effects, the design and implementation of future clinical and translational projects for normal tissue injury, and the standardization of adverse-event reporting worldwide. Conclusions: The consensus was to adopt NCI comprehensive adverse event reporting terminology and grading system (CTCAE v3.0) as the new standard for all cooperative group trials. Future plans included the implementation of coordinated research projects focusing on normal tissue biomarkers and data collection methods

Malnutrition and iron deficiency anaemia in lactating women in ...

African Journals Online (AJOL)

Objective: To determine the status of iron deficiency anaemia (IDA) and malnutrition in lactating women. Design: A cross-sectional study. Setting: Six urban slum communities in Teklehaimanot district, Addis Ababa. Subjects: One thousand and seventeen lactating women were enrolled and assessed for their haemoglobin ...

Ultrasonographic findings of breast diseases during pregnancy and lactating period

Energy Technology Data Exchange (ETDEWEB)

Lee, Yeon Hee [Dnakook University College of Medicine, Cheonan (Korea, Republic of); Park, Yong Hyun; Kwon, Tae Hee [Cha Women' s Hospital of Seoul, Seoul (Korea, Republic of)

1995-09-15

To evaluate ultrasonographic findings and usefulness in the diagnosis of breast diseases during pregnancy and lactating period. The authors evaluated the ultrasonographic findings of 18 breast diseases during pregnancy and lactation retrospectively. The ultrasonographic examinations were performed with linear-array 5 MHz transducer (ATL). Final diagnoses were obtained by the excisional biopsy, fine needle aspiration and clinical follow-up. Total 18 cases of breast diseases were consisted of 8 cases of galactocele, 4 cases of fibroadenoma, 3 cases of axillary accessory breast, 2 cases of lactating adenoma, and 1 case of phylloides tumor. The ultrasonographic findings of the above breast diseases were valuable in the diagnosis and therapeutic planning. Ultrasonography is the initial and useful method of diagnosing breast diseases during pregnancy and lactating period.

Ultrasonographic findings of breast diseases during pregnancy and lactating period

International Nuclear Information System (INIS)

Lee, Yeon Hee; Park, Yong Hyun; Kwon, Tae Hee

1995-01-01

To evaluate ultrasonographic findings and usefulness in the diagnosis of breast diseases during pregnancy and lactating period. The authors evaluated the ultrasonographic findings of 18 breast diseases during pregnancy and lactation retrospectively. The ultrasonographic examinations were performed with linear-array 5 MHz transducer (ATL). Final diagnoses were obtained by the excisional biopsy, fine needle aspiration and clinical follow-up. Total 18 cases of breast diseases were consisted of 8 cases of galactocele, 4 cases of fibroadenoma, 3 cases of axillary accessory breast, 2 cases of lactating adenoma, and 1 case of phylloides tumor. The ultrasonographic findings of the above breast diseases were valuable in the diagnosis and therapeutic planning. Ultrasonography is the initial and useful method of diagnosing breast diseases during pregnancy and lactating period

Energy Consumption of Lactating Mothers: Current Situation and Problems

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Sandra Fikawati

2014-08-01

Full Text Available Recommendations on the adequacy of nutrient intake indicate that lactating mothers have higher nutritional needs than do pregnant mothers. High nutrient intake is necessary to help mothers recover after childbirth, produce milk, and maintain the quantity and quality of breast milk. It also prevents maternal malnutrition. Research has shown, however, that the dietary energy consumption of mothers during lactation was significantly lower than that during pregnancy. The current study explored the factors associated with decreased nutritional intake during maternal lactation. The study was conducted in March–April 2013, and the subjects were mothers with infants aged >6 months. Results revealed that the factors causing low dietary energy consumption among breastfeeding mothers were poor nutritional knowledge and attitude toward high energy intake requirements during lactation, lack of time to cook and eat because of infant care, reduced consumption of milk and supplements, dietary restrictions and prohibitions, and suboptimal advice from midwives/health personnel. Beginning from the antenatal care visit, health personnel should conduct effective counseling on the importance of nutrient intake during lactation. Advice should be provided not only to mothers, but also to their families to enable them to thoroughly support the mothers as they breastfeed their infants.

(13)C MR spectroscopy study of lactate as substrate for rat brain.

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Qu, H; Håberg, A; Haraldseth, O; Unsgård, G; Sonnewald, U

2000-01-01

In order to address the question whether lactate in blood can serve as a precursor for cerebral metabolites, fully awake rats were injected intravenously with [U-(13)C]lactate or [U-(13)C]glucose followed 15 min later by decapitation. Incorporation of label from [U-(13)C]glucose was seen mainly in glutamate, GABA, glutamine, aspartate, alanine and lactate. More label was found in glutamate than glutamine, underscoring the predominantly neuronal metabolism of pyruvate from [U-(13)C]glucose. It was estimated that the neuronal metabolism of acetyl CoA from glucose accounts for at least 66% and the glial for no more than 34% of the total glucose consumption. When [U-(13)C]lactate was the precursor, label incorporation was similar to that observed from [U-(13)C]glucose, but much reduced. Plasma analysis revealed the presence of approximately equal amounts of [1,2,3-(13)C]- and [1,2-(13)C]glucose, showing gluconeogenesis from [U-(13)C]lactate. It was thus possible that the labeling seen in the cerebral amino acids originated from labeled glucose, not [U-(13)C]lactate. However, the presence of significantly more label in [U-(13)C]- than in [2,3-(13)C]alanine demonstrated that [U-(13)C]lactate did indeed cross the blood-brain barrier, and was metabolized further in the brain. Furthermore, contributions from pyruvate carboxylase (glial enzyme) were detectable in glutamine, glutamate and GABA, and were comparatively more pronounced in the glucose group. This indicated that relatively more pyruvate from lactate than glucose was metabolized in neurons. Surprisingly, the same amount of lactate was synthesized via the tricarboxylic acid cycle in both groups, indicating transfer of neurotransmitters from the neuronal to the astrocytic compartment, as previous studies have shown that this lactate is synthesized primarily in astrocytes. Taking into consideration that astrocytes take up glutamate more avidly than GABA, it is conceivable that neuronal lactate metabolism was more

Core Competencies for Training Effective School Consultants

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Burkhouse, Katie Lynn Sutton

2012-01-01

The purpose of this research was to develop and validate a set of core competencies of effective school-based consultants for preservice school psychology consultation training. With recent changes in service delivery models, psychologists are challenged to engage in more indirect, preventative practices (Reschly, 2008). Consultation emerges as…

Edgar Schein's Process versus Content Consultation Models.

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Rockwood, Gary F.

1993-01-01

Describes Schein's three models of consultation based on assumptions inherent in different helping styles: purchase of expertise and doctor-patient models, which focus on content of organization problems; and process consultation model, which focuses on how organizational problems are solved. Notes that Schein has suggested that consultants begin…

Prognosis of cerebral ischemia, significance of CSF-lactate-level and computerized tomography

International Nuclear Information System (INIS)

Busse, O.

1982-01-01

In patients (n = 120) with supratentorial ischemic cerebral infarction CSF lactate was determined and a CT was carried out on the 1st, 3rd and 7th day after the stroke. On the 3rd and 7th day the comparative investigation revealed a close correlation between the measure of the ischemic edema and the level of CSF-lactate. Thus the lactate-concentration can be regarded as a measure for the spread of the edema after cerebral infarction. Already on the 3rd day CT- and CSF-lactate results allow a relatively reliable prediction for the course of the stroke. An edema grade III in CT and a CSF-lactate concentration more than 4 mmol/l were prognostically critical. On the other hand good chances of survival were indicated by a CSF lactate level under 2.5 mmol/l and an edema grade I. (orig.) [de

[Why women consult sexologists: an approach for practicing physicians].

Science.gov (United States)

Buffat, Juliette

2005-03-16

Female sexual dysfunctions are less known than male ones because women are more discrete and introverted. Female genitals are mostly internal and women live sex more cerebrally and sentimentally than men. Still half the patients my current sexological consultation are women. They seek help due for lack of desire, frigidity, coital or clitoridal anorgasmy, dyspareuny, vaginism and problems related to pregnancy or the post-partum period. This article describes how to construct a precise clinical etiology following a "5 circles" scheme, which will help to determine the most adequate therapeutic approach.

Increased Blood Lactate Level Deteriorates Running Economy in World Class Endurance Athletes.

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Hoff, Jan; Støren, Øyvind; Finstad, Arnstein; Wang, Eivind; Helgerud, Jan

2016-05-01

Blood lactate accumulation is associated with development of muscle fatigue and negatively correlated to endurance performance. No research has quantified the effects of lactate presence at moderate levels of lactate accumulation. The purpose of this study was to test whether 2 moderate blood lactate concentration levels affect running economy (RE) when running at the individual lactate threshold (LT). Seven male world class endurance athletes with an average V[Combining Dot Above]O2max of 80.7 ± 2.7 ml·kg·min or 5.8 ± 0.5 L·min participated in this study. After the V[Combining Dot Above]O2max test, the subjects were resting or walking and in a random order tested for RE at their LT velocity when the blood lactate level reached either 3 mmol·L or 5 mmol·L. After a new 5-minute exercising period at maximal aerobic velocity, the crossover lactate value RE testing was performed. Running economy was significantly (p ≤ 0.05) deteriorated from 0.668 ± 0.044 to 0.705 ± 0.056 ml·kg·m or 5.5% (p ≤ 0.05) for blood lactate level of 3 mmol·L compared with 5 mmol·L, respectively. Increased lactate level from 3 to 5 mmol·L is thus accompanied by deteriorated RE at LT running velocity. The deteriorated RE at moderate levels of lactate concentration emphasizes the importance of avoiding intensities above LT in the early parts of a dominantly aerobic endurance competition. It also emphasizes the importance of a high V[Combining Dot Above]O2max for aerobic endurance athletes and may partly explain the V[Combining Dot Above]O2 slow component as impaired RE.

Community Resources for International Trade Education.

Science.gov (United States)

Blanco, Virgil H.; Channing, Rose M.

1985-01-01

Describes Middlesex Community College's involvement in education and training programs aimed at encouraging local business involvement in international trade and the activities of its National Resource for International Trade Education (e.g., information dissemination; consulting services; seminars and workshops; a speakers bank; research; staff…

Lactate overrides central nervous but not beta-cell glucose sensing in humans.

Science.gov (United States)

Schmid, Sebastian M; Jauch-Chara, Kamila; Hallschmid, Manfred; Oltmanns, Kerstin M; Peters, Achim; Born, Jan; Schultes, Bernd

2008-12-01

Lactate has been shown to serve as an alternative energy substrate in the central nervous system and to interact with hypothalamic glucose sensors. On the background of marked similarities between central nervous and beta-cell glucose sensing, we examined whether lactate also interacts with pancreatic glucose-sensing mechanisms in vivo. The effects of intravenously infused lactate vs placebo (saline) on central nervous and pancreatic glucose sensing were assessed during euglycemic and hypoglycemic clamp experiments in 10 healthy men. The release of neuroendocrine counterregulatory hormones during hypoglycemia was considered to reflect central nervous glucose sensing, whereas endogenous insulin secretion as assessed by serum C-peptide levels served as an indicator of pancreatic beta-cell glucose sensing. Lactate infusion blunted the counterregulatory hormonal responses to hypoglycemia, in particular, the release of epinephrine (P = .007) and growth hormone (P = .004), so that higher glucose infusion rates (P = .012) were required to maintain the target blood glucose levels. In contrast, the decrease in C-peptide concentrations during the hypoglycemic clamp remained completely unaffected by lactate (P = .60). During euglycemic clamp conditions, lactate infusion did not affect the concentrations of C-peptide and of counterregulatory hormones, with the exception of norepinephrine levels that were lower during lactate than saline infusion (P = .049) independently of the glycemic condition. Data indicate that glucose sensing of beta-cells is specific to glucose, whereas glucose sensing at the central nervous level can be overridden by lactate, reflecting the brain's ability to rely on lactate as an alternative major energy source.

Reliability and Validation of the International Consultation on Incontinence Questionnaire in Over Active Bladder to Persian Language.

Science.gov (United States)

Sari Motlagh, Reza; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun; Joodi Tutunsaz, Javad

2015-05-01

Overactive bladder syndrome is a common syndrome in the world in both men and women. Correct diagnosis and accurate measurement of symptoms severity and also quality of life of patients is necessary to ensure proper treatment and to facilitate sound relationships among patients, researchers and doctors. The International Consultation on Incontinence Questionnaire in Over Active Bladder (ICIQ-OAB) questionnaire is a concise and strong tool to evaluate the symptoms of OAB and their effects on patients' quality of life and treatment results. The objective of this study was to translate and validate a simple and strong tool that could be used in clinics and research. First, the original British English questionnaire was translated into Persian by two bilingual and originally Persian-speaking translators. Then the Persian version was back translated to English and a native English speaker studied and compared the questionnaire with the original version. At the end, the translated and corrected Persian version was finalized by a research team. Content validity of the items and ensuring that the questions could convey the main concept to readers was assessed through Modified Content Validity Index (MCVI). Reliability was calculated by Cronbach's α coefficient. Internal Consistency of the questionnaire with the calculation of Kendall correlation coefficient were evaluated by performing test-retest in 50 participants. The modified content validity index was > 0.78 for all of the questions. Cronbach's α coefficient was calculated 0.76 for all of the participants. Kendall correlation coefficient was calculated for test-re-test assessment 0.66. Both of which indicates the reliability of this questionnaire. Persian version of ICIQ-OAB questionnaire is a simple and strong tool for research, treatment and screening purposes. © 2014 Wiley Publishing Asia Pty Ltd.

Effects of feeding brown midrib corn silage with a high dietary concentration of alfalfa hay on lactational performance of Holstein dairy cows for the first 180 days of lactation.

Science.gov (United States)

Holt, M S; Eun, J-S; Thacker, C R; Young, A J; Dai, X; Nestor, K E

2013-01-01

This experiment was conducted to test a hypothesis that lactating dairy cows fed 35% brown midrib (BMR) corn silage and 25% alfalfa hay (dry matter (DM) basis) would consume more DM around peak lactation compared with those fed conventional corn silage (CS), resulting in longer peak milk production. Twenty-eight multiparous Holstein cows were used starting at the onset of lactation through 180 d in milk (DIM). Treatments were formulated to maintain a forage-to-concentrate ratio of 60:40, differing only in the CS hybrids used. Two dietary treatments were assessed in a completely randomized design: total mixed ration based on conventional CS (CCS) and total mixed ration based on BMR silage. Through peak lactation (1-60 DIM), DM intake was not different between dietary treatments, whereas DM intake post-peak lactation (61-180 DIM) tended to increase by feeding the BMR diet compared with the CCS diet (25.8 vs. 24.7 kg/d). Cows fed the BMR diet tended to lose less body weight through peak lactation compared with those fed the CCS diet (-0.22 vs. -0.52 kg/d). Although milk yield was not different between dietary treatments through peak lactation, milk yield post-peak lactation increased by feeding the BMR diet compared with the CCS diet (41.0 vs. 38.8 kg/d). Yield of 3.5% fat-corrected milk was similar between dietary treatments throughout the experiment (41.4 kg/d, on average), but milk fat concentration decreased by feeding the BMR diet compared with the CCS diet post-peak lactation (3.47 vs. 3.80%). Overall milk protein concentration was similar between dietary treatments throughout the experiment (2.96%, on average), whereas milk protein yield tended to be higher for the BMR diet post-peak lactation compared with the CCS diet (1.19 vs.1.13 kg/d). Feeding BMR silage with a high dietary concentration of alfalfa hay maintained more body weight, but did not affect milk production through peak lactation; however, cows fed the BMR diet post-peak lactation consumed more

Muscle glycogen depletion and lactate concentration during downhill skiing.

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Tesch, P; Larsson, L; Eriksson, A; Karlsson, J

1978-01-01

Skilled and unskilled skiers were studied during downhill skiing. Muscle glycogen and muscle lactate concentrations in the vastus lateralis muscle were determined following different skiing conditions. Heavy glycogen utilization was found in the groups studied during a day of skiing. The skilled and unskilled skiers differed with respect to selective glycogen depletion pattern and the skilled subjects demonstrated greater depletion of slow twitch fibers than the unskilled subjects. Lactate concentrations ranged from approximately 5-26 mmoles x kg-1 wet muscle after approximately one minute of maximal skiing. This wide range was not found to be related to the level of skiing proficiency. However, skiing with varyingly angled boots, resulting in different knee angles, did affect lactate concentration. Lactate concentration was positively correlated to individual muscle fiber composition expressed as a percent of fast twitch fibers. The results suggest more pronounced involvement of aerobic energy metabolism in skilled skiers than in unskilled skiers.

Inconsistency of residents' communication performance in challenging consultations.

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Wouda, Jan C; van de Wiel, Harry B M

2013-12-01

Communication performance inconsistency between consultations is usually regarded as a measurement error that jeopardizes the reliability of assessments. However, inconsistency is an important phenomenon, since it indicates that physicians' communication may be below standard in some consultations. Fifty residents performed two challenging consultations. Residents' communication competency was assessed with the CELI instrument. Residents' background in communication skills training (CST) was also established. We used multilevel analysis to explore communication performance inconsistency between the two consultations. We also established the relationships between inconsistency and average performance quality, the type of consultation, and CST background. Inconsistency accounted for 45.5% of variance in residents' communication performance. Inconsistency was dependent on the type of consultation. The effect of CST background training on performance quality was case specific. Inconsistency and average performance quality were related for those consultation combinations dissimilar in goals, structure, and required skills. CST background had no effect on inconsistency. Physician communication performance should be of high quality, but also consistent regardless of the type and complexity of the consultation. In order to improve performance quality and reduce performance inconsistency, communication education should offer ample opportunities to practice a wide variety of challenging consultations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Attentive processes, blood lactate and CrossFit®.

Science.gov (United States)

Perciavalle, Valentina; Marchetta, Nunzio Salvatore; Giustiniani, Salvatore; Borbone, Carlo; Perciavalle, Vincenzo; Petralia, Maria Cristina; Buscemi, Andrea; Coco, Marinella

2016-11-01

To analyze the influences of blood lactate produced during a specific session of CrossFit® on intensity and selectivity of attention. The first was evaluated by measuring the reaction time and the second by analyzing divided attention with a dual task. Fifteen male professionals of CrossFit® volunteered in the study. The training session was the Workout Of the Day (WOD) called 15.5, marked as: 27-21-15-9 repetitions (without recovery) in term of calories measured by using a rowing ergometer (e.g. 27 rowed calories) and in term of barbell full squats (raising a weight of 43 kg for men and of 29.5 kg for women). Blood lactate, blood glucose, reaction time, execution time of a dual task, number of errors and number of omissions were measured at rest, at the conclusion of the session and 15 minutes after its end. The levels of the blood lactate before the start of the session were considerably higher than those which normally occur at rest (CrossFit®, with high levels of blood lactate even at rest, should consequently have attentional performances somewhat limited.

Validation of the Sinhala translation of the International Consultation on Incontinence Modular Questionnaire for female lower urinary tract symptoms among women in Sri Lanka.

Science.gov (United States)

de Silva, Gayan; Furukan, Rameez; Goonewardene, Malik

2017-12-01

The objective of this study was to translate the International Consultation on Incontinence Modular Questionnaire for female lower urinary tract symptoms (ICIQ-FLUTS) into Sinhala and validate the Sinhala translation for use in clinical practice. The ICIQ-FLUTS was translated into Sinhala in accordance with the ICIQ validation protocol. The Sinhala translation was validated by administering it to 133 women with FLUTS, mainly urinary incontinence and or urgency, and to 118 women with symptoms other than FLUTS during the period 25 October 2013 to 23 December 2016, in the Academic Obstetrics and Gynaecology Unit, Teaching Hospital Mahamodara, Galle, Sri Lanka. The Sinhala translation had good content validity (assessed by a panel of clinicians including a content specialist, and a group of women with and without FLUTS), good internal consistency (Cronbach's alpha coefficient in the range 0.69-0.75) was stable (no significant differences between median test-retest scores in a subgroup of 24 women with FLUTS), had good construct validity (marked difference between median scores in women presenting with and without FLUTS, p urinary incontinence and/or urgency.

Exercise timing and blood lactate concentrations in individuals with type 2 diabetes.

Science.gov (United States)

Heden, Timothy D; Liu, Ying; Kanaley, Jill A

2017-07-01

The purpose of this study was to characterize how resistance exercise prior to or after a meal alters fasting and postprandial blood lactate concentrations in individuals with type 2 diabetes. Obese individuals with type 2 diabetes (N = 12) completed three 2-day trials, including (i) no exercise (NoEx), (ii) resistance exercise prior to dinner (Ex-M), and (iii) resistance exercise beginning at 45 min postdinner (M-Ex). During day 1 of each trial, fasting and postprandial blood lactate concentrations, perceived exertion, and substrate oxidation were measured, and subsequently on day 2 the following morning fasting blood lactate was measured. The premeal lactate incremental area under the curve (iAUC) during Ex-M (109 ± 66 mmol·L -1 ·1.6 h -1 ) was over 100-fold greater (P 0.05). Perceived exertion, substrate oxidation, or fasting blood lactate concentrations the day after testing were not different between trials. Blood lactate concentrations during acute resistance exercise are greater when exercise is performed in the postprandial period. Acute resistance exercise performed the night prior does not alter fasting blood lactate concentrations the following morning.

Lactate minimum in a ramp protocol and its validity to estimate the maximal lactate steady state

Directory of Open Access Journals (Sweden)

Emerson Pardono

2009-01-01

Full Text Available http://dx.doi.org/10.5007/1980-0037.2009v11n2p174   The objectives of this study were to evaluate the validity of the lactate minimum (LM using a ramp protocol for the determination of LM intensity (LMI, and to estimate the exercise intensity corresponding to maximal blood lactate steady state (MLSS. In addition, the possibility of determining aerobic and anaerobic fitness was investigated. Fourteen male cyclists of regional level performed one LM protocol on a cycle ergometer (Excalibur–Lode consisting of an incremental test at an initial workload of 75 Watts, with increments of 1 Watt every 6 seconds. Hyperlactatemia was induced by a 30-second Wingate anaerobic test (WAT (Monark–834E at a workload corresponding to 8.57% of the volunteer’s body weight. Peak power (11.5±2 Watts/kg, mean power output (9.8±1.7 Watts/kg, fatigue index (33.7±2.3% and lactate 7 min after WAT (10.5±2.3 mmol/L were determined. The incremental test identified LMI (207.8±17.7 Watts and its respective blood lactate concentration (2.9±0.7 mmol/L, heart rate (153.6±10.6 bpm, and also maximal aerobic power (305.2±31.0 Watts. MLSS intensity was identified by 2 to 4 constant exercise tests (207.8±17.7 Watts, with no difference compared to LMI and good agreement between the two parameters. The LM test using a ramp protocol seems to be a valid method for the identification of LMI and estimation of MLSS intensity in regional cyclists. In addition, both anaerobic and aerobic fitness parameters were identified during a single session.

The work patterns of lactating women in Madura.

Science.gov (United States)

Launer, L J

1993-08-01

Little is known about the work patterns of mildly malnourished lactating women: are they modified to accommodate the demands of lactation? What factors influence their pattern of work during this period of nutritional stress? These questions were addressed using quantitative and qualitative data collected from 36 randomly selected women living in a poor community in Madura, Indonesia. Work patterns of the lactating women and their family members were documented for the first 12 months post-partum. Changes in work activity were analysed within four time periods corresponding to Madurese views on development during infancy: the vulnerable neonatal (birth-40 days), early (6-12 wk) and mid (13-31 wk) stages and the independent late (32-54 wk) stage. Quantitative data suggest that women did adjust work patterns to accommodate the demands of lactation and that these adjustments went beyond the neonatal stage. Mothers curtailed their participation in high- and low-energy income-generating activities, modified their conditions of work to promote maternal-infant proximity and conserved energy while performing specific activities. These patterns were most common through the mid infancy stage. Data are presented that describe how cultural values supporting maternal-infant proximity, intra- and inter-familial work exchanges, season and resources played a role in the type of accommodations mothers were able to make to breast-feed. These data suggest that even in relatively poor environments alterations in work patterns that may be favourable to lactation are possible, particularly when cultural concepts of infancy support such a trade-off.

The establishment of research ethics consultation services (RECS): an emerging research resource.

Science.gov (United States)

McCormick, Jennifer B; Sharp, Richard R; Ottenberg, Abigale L; Reider, Carson R; Taylor, Holly A; Wilfond, Benjamin S

2013-02-01

Emphasis on translational research to facilitate progression from the laboratory into the community also creates a dynamic in which ethics and social policy questions and solutions are ever pressing. In response, academic institutions are creating Research Ethics Consultation Services (RECS). All Clinical Translational Science Award institutions were surveyed in early 2010 to determine which institutions have a RECS in operation and what is their composition and function. Of the 46 institutions surveyed, 33 (70%) have a RECS. Only 15 RECS have received any consult requests in the last year. Issues that are common among these relatively nascent services include relationships with institutional oversight committees, balancing requestor concerns about confidentiality with research integrity and human subjects protection priorities, tracking consult data and outcomes, and developing systems for internal evaluation. There is variability in how these issues are approached. It will be important to be attentive to the institutional context to develop an appropriate approach. Further data about the issues raised by requestors and the recommendations provided are necessary to build a community of scholars who can navigate and resolve ethical issues encountered along the translational research pathway. © 2012 Wiley Periodicals, Inc.

Does professional-centred training improve consultation outcomes?

DEFF Research Database (Denmark)

Parkin, Tracey; Barnard, K.; Cradock, S.

2006-01-01

discussed and decisions made. Patients also completed the Health Care Climate Questionnaire (HCCQ). Pre-training results were fed back to the professionals to provide an objective measure of current practice. Training day one comprised 10 minutes' observation of videoed consultations of each professional......This study aimed to examine whether professional-centred training improves consultation outcomes. Using a pre- and post-data collection design. Immediately after consultations, professionals and patients completed a consultation review sheet which was coded for the level of agreement on issues...... in order to identify strengths and training needs. Each professional identified key areas of their consultation that they felt needed further development. Training day two centred on goal setting and negotiating agendas as these were identified as priority areas requiring more skills. Data from 110...

Comparative 2D-DIGE proteomic analysis of bovine mammary epithelial cells during lactation reveals protein signatures for lactation persistency and milk yield.

Directory of Open Access Journals (Sweden)

Jagadeesh Janjanam

Full Text Available Mammary gland is made up of a branching network of ducts that end with alveoli which surrounds the lumen. These alveolar mammary epithelial cells (MEC reflect the milk producing ability of farm animals. In this study, we have used 2D-DIGE and mass spectrometry to identify the protein changes in MEC during immediate early, peak and late stages of lactation and also compared differentially expressed proteins in MEC isolated from milk of high and low milk producing cows. We have identified 41 differentially expressed proteins during lactation stages and 22 proteins in high and low milk yielding cows. Bioinformatics analysis showed that a majority of the differentially expressed proteins are associated in metabolic process, catalytic and binding activity. The differentially expressed proteins were mapped to the available biological pathways and networks involved in lactation. The proteins up-regulated during late stage of lactation are associated with NF-κB stress induced signaling pathways and whereas Akt, PI3K and p38/MAPK signaling pathways are associated with high milk production mediated through insulin hormone signaling.

Blood and Milk Contents of Triiodothyronine (T3) and Cortisol in Lactating Buffaloes and Changes in Milk Yield and Composition as a Function of Lactation Number and Ambient Temperature

International Nuclear Information System (INIS)

Habeeb, A.M. Al-Saied.; Ibrahim, M.Kh.

2000-01-01

The effect of lactation number and ambient temperature on T 3 and cortisol levels in milk and blood and milk composition of lactating Water buffaloes was the objective of this study. Two experiment were carried out on 72 animals in two periods through 1994. The first one was carried out on 36 animals during February, where the average of ambient temperature was 17.5 degree while the second was conducted on another 36 animals during July where the average of ambient temperature was 37.1 degree. In both two periods, the animals were classified according to lactation number into 6 equal groups from the 1 st to the 6 Th lactation number. The data showed that milk yield and T-3 either in milk or in blood besides milk fat, protein and lactose were significantly lower in july than in february. Whereas the opposite trend was noted for cortisol levels either in milk or in blood. Concerning the effect of lactation lactation number, it was observed that milk and blood T 3 , mil and blood cortisol, milk fat, protein and lactose were affected significantly by lactation number

Practical Liability Issues of Information Technology Education: Internship and Consulting Engagements

Directory of Open Access Journals (Sweden)

Daniel A. Peak

1998-01-01

Full Text Available This article examines university liability created by internship and consulting relationships. Business clients participating in outreach relationships formulate performance expectations based on perceptions of experience and / or qualifications. Clients assign tasks accordingly, and the university incurs liability that is conditioned by business clients’ expectations. Substantial liability is related to unusually large and rare unfavorable outcomes in the outreach engagement, known as tail events. Tail events can significantly and negatively impact the client. Both the liability for and the probability of tail events increase as universities continue to expand business outreach activities. As internship and consulting engagements increase, the probability of a tail event also increases. The responsibilities of IT intern engagements and potential liability of the sponsoring university are analyzed. The university is the primary insurer for the client and indemnifies its representatives. All internship engagements should be formalized by written contract. An example contract is attached.

Telephone Consultation as a Substitute for Routine Out-patient Face-to-face Consultation for Children With Inflammatory Bowel Disease: Randomised Controlled Trial and Economic Evaluation.

Science.gov (United States)

Akobeng, Anthony K; O'Leary, Neil; Vail, Andy; Brown, Nailah; Widiatmoko, Dono; Fagbemi, Andrew; Thomas, Adrian G

2015-09-01

Evidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD. We conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8-16 years) with IBD were randomized to receive telephone consultation or face-to-face consultation for 24 months. The primary outcome measure was the paediatric IBD-specific IMPACT quality of life (QOL) score at 12 months. Secondary outcome measures included patient satisfaction with consultations, disease course, anthropometric measures, proportion of consultations attended, duration of consultations, and costs to the UK National Health Service (NHS). Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02319798. Eighty six patients were randomised to receive either telephone consultation (n = 44) or face-to-face consultation (n = 42). Baseline characteristics of the two groups were well balanced. At 12 months, there was no evidence of difference in QOL scores (estimated treatment effect in favour of the telephone consultation group was 5.7 points, 95% CI - 2.9 to 14.3; p = 0.19). Mean consultation times were 9.8 min (IQR 8 to 12.3) for telephone consultation, and 14.3 min (11.6 to 17.0) for face-to-face consultation with an estimated reduction (95% CI) of 4.3 (2.8 to 5.7) min in consultation times (p consultation had a mean cost of UK£35.41 per patient consultation compared with £51.12 for face-face consultation, difference £15.71 (95% CI 11.8-19.6; P consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs. Telephone consultation is a cost-effective alternative to face-to-face consultation for the

IT Consultants in Acquisition IT Integration

DEFF Research Database (Denmark)

Henningsson, Stefan; Øhrgaard, Christian

2016-01-01

strategic IT initiatives and how companies can draw effectively on their services. The paper investigates the use of consultants in relation to one type of major strategic IT initiative: acquisition IT integration. Acquisition IT integration, which is the integration of the acquirer’s and target......’s IT following a corporate acquisition, presents a difficult but crucial IT challenge for the many acquiring organizations. Through a comparative case study of four acquirers, theoretically grounded in the resource-based view of the firm, it is analyzed how acquirers draw on external consultants to realize...... acquisition IT integration. Two complementary and two supplementary roles consultants assume in these projects are identified. Additionally, three characteristics of the acquisition IT integration strategy are identified that influence how the acquirers assign different roles to IT consultants. The resulting...

Induction of lactation in the intended mother of a surrogate pregnancy: case report.

Science.gov (United States)

Biervliet, F P; Maguiness, S D; Hay, D M; Killick, S R; Atkin, S L

2001-03-01

A case of a successful induction of lactation in a commissioning mother of a surrogate pregnancy is reported. Induction of lactation was achieved with oral metoclopramide which was well tolerated. Alternative methods to induce lactation are reviewed. The advantages of breast-feeding and the relative ease with which lactation can be induced after a surrogate pregnancy would suggest that this could be offered to all commissioning mothers.

Diurnal rhythms in gonadotropins and progesterone in lactating and photoperiod induced acyclic hamsters

International Nuclear Information System (INIS)

Bridges, R.S.; Goldman, B.D.

1975-01-01

Levels of LH, FSH, and progesterone in serum were measured in lactating hamsters and in hamsters in which acyclicity was induced with altered photoperiod. Lactating hamsters were found to have low titers of LH, FSH, and progesterone in serum at 0900 (lights on 0500--1900) on Days 4, 9, 14, and 19 of lactation and increased levels of these hormones at 1600. Levels of LH and FSH in serum at both 0900 and 1600 remained relatively constant throughout lactation. In contrast, levels of progesterone in serum obtained at both 0900 and 1600 sampling times increased as lactation progressed. Ovariectomy on Day 9 of lactation reduced serum levels of progesterone at both 0900 and 1600 and eliminated the afternoon surge in progesterone in animals bled 5 days after surgery. The levels and pattern of LH in serum remained unchanged after ovariectomy in lactating hamsters. However, serum FSH levels in the ovariectomized, lactating animals were elevated at both 0900 and 1600 when compared to levels present in intact, lactating hamsters bled at the same times. Females which were acyclic due to altered photoperiod displayed similar patterns of LH, FSH, and progesterone in serum. Levels of LH, FSH, and progesterone in serum were low at 1000 (lights on 0500--1500) and were increased 2 to 10 fold at 1500. Ovariectomy was followed by lower progesterone levels in serum at 1000 and 1500 and eliminated the afternoon rise of this hormone. Serum levels of LH were unaffected by ovariectomy. As in lactating hamsters, levels of FSH in serum were elevated 3--4 days following ovariectomy at both bleeding times, but the levels were higher at 1500. These results indicate that acyclicity induced by lactation or exposure to a short photoperiod is characterized by similar diurnal patterns of circulating hormones in the hamster

On-farm evaluation of the effect of metabolic diseases on the shape of the lactation curve in dairy cows through the MilkBot lactation model.

Science.gov (United States)

Hostens, M; Ehrlich, J; Van Ranst, B; Opsomer, G

2012-06-01

The effects of metabolic diseases (MD) occurring during the transition period on milk production of dairy cows have been evaluated in many different ways, often with conflicting conclusions. The present study used a fitted lactation model to analyze specific aspects of lactation curve shape and magnitude in cows that avoided culling or death in the first 120 d in milk (DIM). Production and health records of 1,946 lactations in a 1-yr follow-up study design were collected from a transition management facility in Germany to evaluate both short- and long-term effects of MD on milk production. Milk production data were fitted with the nonlinear MilkBot lactation model, and health records were used to classify cows as healthy (H), affected by one MD (MD), or by multiple MD (MD+). The final data set contained 1,071 H, 348 MD, and 136 MD+ cows, with distinct incidences of 3.7% twinning, 4.8% milk fever, 3.6% retained placenta, 15.4% metritis, 8.3% ketosis, 2.0% displaced abomasum, and 3.7% mastitis in the first 30 DIM. The model containing all healthy and diseased cows showed that lactations classified as H had milk production that increased faster (lower ramp) and also declined faster (lower persistence) compared with cows that encountered one or more metabolic problems. The level of production (scale) was only lowered in MD+ cows compared with H and MD cows. Although the shape of the lactation curve changed when cows encounter uncomplicated (single) MD or complicated MD (more than one MD), the slower increase to a lower peak seemed to be compensated for by greater persistency, resulting in the overall 305-d milk production only being lowered in MD+ cows. In the individual disease models, specific changes in the shape of the lactation curve were found for all MD except twinning. Milk fever, retained placenta, ketosis, and mastitis mainly affected the lactation curve when accompanied by another MD, whereas metritis and displaced abomasum affected the lactation curve

Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site.

Science.gov (United States)

Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

2012-01-01

Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma.

Histological features in the mammary glands of female dogs throughout lactation.

Science.gov (United States)

Orfanou, D C; Pourlis, A; Ververidis, H N; Mavrogianni, V S; Taitzoglou, I A; Boscos, C M; Fthenakis, G C

2010-10-01

The objective of this study was to describe the histology of the mammary glands of female dogs throughout lactation. Twelve lactating female dogs were operated 4, 7, 10, 14, 21, 28, 35, 42, 56, 70 and 84 days post-partum; four mammary glands of each animal were excised for histological, ultrastructural and morphometric examination. During early lactation and mid-lactation, all lobes and lobules within the same gland had similar features; alveoli were well developed and distended and had a spherical to slightly ovoid structure, with muscular fibres grasping them around; inflammatory cells were seen in the inter- and intra-alveolar space; mammary lobules were separated with a scant amount of connective tissue. In late lactation, connective tissue was abundant and dense, with large numbers of inflammatory cells; alveoli appeared to be irregularly shaped and collapsing, shrunken or fully collapsed. Number of alveoli per lobule and number of epithelial cells per alveolus, as well as diameter of alveoli and height of epithelial cells decreased as lactation progressed. The third mammary glands (from caudal to cranial) had a significantly smaller number of alveoli, but not of epithelial cells per alveolus, than each of the two mammary glands caudally to that. The results suggest that progressive involution of the normal mammary gland starts around the end of the 2nd month of lactation and continues until the end of the 3rd month. © 2010 Blackwell Verlag GmbH.

Milk losses associated with somatic cell counts by parity and stage of lactation.

Science.gov (United States)

Gonçalves, Juliano L; Cue, Roger I; Botaro, Bruno G; Horst, José A; Valloto, Altair A; Santos, Marcos V

2018-05-01

The reduction of milk production caused by subclinical mastitis in dairy cows was evaluated through the regression of test-day milk yield on log-transformed somatic cell counts (LnSCC). Official test-day records (n = 1,688,054) of Holstein cows (n = 87,695) were obtained from 719 herds from January 2010 to December 2015. Editing was performed to ensure both reliability and consistency for the statistical analysis, and the final data set comprised 232,937 test-day records from 31,692 Holstein cows in 243 herds. A segmented regression was fitted to estimate the cutoff point in the LnSCC scale where milk yield started to be affected by mastitis. The statistical model used to explain daily milk yield included the effect of herd as a random effect and days in milk and LnSCC as fixed effects regressions, and analyses were performed by parity and stage of lactation. The cutoff point where milk yield starts to be affected by changes in LnSCC was estimated to be around 2.52 (the average of all estimates of approximately 12,400 cells/mL) for Holsteins cows from Brazilian herds. For first-lactation cows, milk losses per unit increase of LnSCC had estimates around 0.68 kg/d in the beginning of the lactation [5 to 19 d in milk (DIM)], 0.55 kg/d in mid-lactation (110 to 124 DIM), and 0.97 kg/d at the end of the lactation (289 to 304 DIM). For second-lactation cows, milk losses per unit increase of LnSCC had estimates around 1.47 kg/d in the beginning of the lactation (5 to 19 DIM), 1.09 kg/d in mid-lactation (110 to 124 DIM), and 2.45 kg/d at the end of the lactation (289 to 304 DIM). For third-lactation cows, milk losses per unit increase of LnSCC had estimates around 2.22 kg/d in the beginning of the lactation (5 to 19 DIM), 1.13 kg/d in mid-lactation (140 to 154 DIM), and 2.65 kg/d at the end of the lactation (289 to 304 DIM). Daily milk losses caused by increased LnSCC were dependent on parity and stage of lactation, and these factors should be considered when estimating

A prospective, randomized, controlled study demonstrating a novel, effective model of transfer of care between physicians: the 5 Cs of consultation.

Science.gov (United States)

Kessler, Chad S; Afshar, Yalda; Sardar, Gurkiran; Yudkowsky, Rachel; Ankel, Felix; Schwartz, Alan

2012-08-01

The objective was to evaluate whether a standardized consultation model in the emergency department (ED), the 5 Cs of Consultation (Contact, Communicate, Core Question, Collaboration, and Closing the Loop), would improve physicians' ability to relay appropriate information and communicate successfully during a consultation. This was a prospective, randomized study at a large, academic, urban, tertiary care medical center in Chicago. Forty-three emergency medicine (EM) and EM/internal medicine (EM/IM) residents were randomized into two groups, an intervention group and an unstructured group, stratified by postgraduate year (PGY). Intervention group participants received an interactive educational session on the 5 Cs of Consultation, a standardized consultation model. Intervention and unstructured groups placed two simulated consultation phone calls, based on pretested simulated patient cases, to a standardized consultant. Three raters, naive to the consultation model and blinded to group assignments, individually assessed recordings of each call using a seven-item, five-point global rating scale (GRS). Finally, an attending surgeon and an attending psychiatrist each rated respective cases using a single global rating to provide validity evidence for the scale. Residents trained with the 5 Cs model communicated significantly better, regardless of PGY and clinical case. The intervention group had significantly higher mean GRS scores than the unstructured group (4.1 vs. 3.5, F(1,39) = 33.5, p effectiveness of consultation communication from the ED. Residents trained with the 5 Cs of Consultation scored better on consultation assessments compared with untrained residents. Training programs should consider adopting standardized consultation models. © 2012 by the Society for Academic Emergency Medicine.

The Availability of Information on Induced Lactation in Malaysia.

Science.gov (United States)

Rahim, Norsyamlina Che Abdul; Sulaiman, Zaharah; Ismail, Tengku Alina Tengku

2017-08-01

Induced lactation is a method of stimulating the production of breast milk in women who have not gone through the process of pregnancy. Recent advances in technology have given such women the opportunity to breastfeed adopted children. Previous studies conducted in Western countries have explored the breastfeeding of adopted children, as well as the experiences, successes and challenges of this process. However, research on procedures for breastfeeding adopted children is lacking in Malaysia. The authors have therefore reviewed literature related to induced lactation in Malaysia to fill this gap. Of the 30 related articles identified, 19 described the breastfeeding practices and experiences of adoptive mothers in Malaysia. Out of 19 articles, there were four journal articles, five circulars and regulations, two books, two post-graduate theses, four blogs posts and forum discussions, and two online newspaper articles. Medical information relating to induced lactation procedures was also reviewed, showing that there was a lack of scientific studies focusing on induced lactation practices among adoptive mothers. Information on religious, specifically Islamic, perspectives on breastfeeding and child adoption laws was gathered from websites, social networks, blogs, magazines and online news sources. In consideration of recent advancements in medical technology and the dire need among Malaysians, it is crucial that evidence-based, accurate and reliable information on induced lactation is made available to professionals and other individuals in this country.

"Systematizing" ethics consultation services.

Science.gov (United States)

Bruce, Courtenay R; Eves, Margot M; Allen, Nathan G; Smith, Martin L; Peña, Adam M; Cheney, John R; Majumder, Mary A

2015-03-01

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: (1) train-the-trainer, (2) local capacity-building, (3) circuit-riding, and (4) consolidated accountability. We note each model's benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations.

Consultant radiographers: Profile of the first generation

International Nuclear Information System (INIS)

Forsyth, Lesley J.; Maehle, Valerie

2010-01-01

Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

Consultant radiographers: Profile of the first generation

Energy Technology Data Exchange (ETDEWEB)

Forsyth, Lesley J., E-mail: l.forsyth@rgu.ac.u [School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom); Maehle, Valerie [Faculty of Health and Social Care, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom)

2010-11-15

Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

[Length of lactational amenorrhea in an urban population of Temuco, Chile].

Science.gov (United States)

Valdés, Patricio; Sierralta, Pablo; Ossa, Ximena; Barría, Angélica

2002-01-01

Studies done in Santiago, Chile show that menses return before the sixth month of puerperium in 50% of lactating women, even in those that continue with exclusive breast feeding. To study the length of lactational amenorrhea in a group of women living in Southern Chile. One hundred fourteen women giving exclusive breast feeding, were followed from the third postpartum month, to determine the length of lactational amenorrhea. Its relationship with general characteristics of the mothers and children and breast feeding pattern was also studied. Sixty six women (58%) recovered their menses before the 6th postpartum month and their length of lactational amenorrhea was 101 +/- 5 days. In the rest of the sample, the length was 277 +/- 10 days. No differences in characteristics of the mothers and children or breast feeding pattern, were observed between these two groups. A short lactational amenorrhea is common in the Chilean population. Clinical characteristics or pattern of breast feeding do not explain the length of LA in this population.

Excretion of Calcium, Phosphorus, Magnesium and Sodium in Lactating Sows

Directory of Open Access Journals (Sweden)

Novotný J.

2016-06-01

Full Text Available The aim of this study was to evaluate the excretion of calcium (Ca, phosphorus (P, magnesium (Mg and sodium (Na via milk, urine and faeces during the lactation period of sows. Six clinically healthy lactating sows (crossbreed Large White × Landrace were selected for these experiments and were housed in standard conditions and fed with commercially prepared dry mixture for this category of sows. The blood serum, milk, urine and faecal samples were collected on the 7th, 14th, 21st, and 28th day of lactation. During four weeks of lactation, we recorded the relatively stable and physiological concentrations of Ca, P, Mg and Na in blood serum. The analysis of the sow’s milk showed the highest concentration of Ca and P at the end of lactation, while the highest concentration of Mg and Na was observed on the 7th lactation day. The following macro-mineral excretion was recorded in urine: 98.83-194.00 mg.l-1 for Ca; 11.88- 53.09 mg.l-1 for P; 171.67-344.05 mg.l-1 for Mg; and 56.50-74.83 mg.l-1 for Na; and in the faeces, 1824.5- 3045.5 mg.kg-1 for Ca; 1566.93-2483.2 mg.kg-1 for P; 1916.2-2505.2 mg.kg-1 for Mg; and 516.8-748.2 mg. kg-1 for Na.

Theoretical predictions of lactate and hydrogen ion distributions in tumours.

Directory of Open Access Journals (Sweden)

Maymona Al-Husari

Full Text Available High levels of lactate and H(+-ions play an important role in the invasive and metastatic cascade of some tumours. We develop a mathematical model of cellular pH regulation focusing on the activity of the Na(+/H(+ exchanger (NHE and the lactate/H(+ symporter (MCT to investigate the spatial correlations of extracellular lactate and H(+-ions. We highlight a crucial role for blood vessel perfusion rates in determining the spatial correlation between these two cations. We also predict critical roles for blood lactate, the activity of the MCTs and NHEs on the direction of the cellular pH gradient in the tumour. We also incorporate experimentally determined heterogeneous distributions of the NHE and MCT transporters. We show that this can give rise to a higher intracellular pH and a lower intracellular lactate but does not affect the direction of the reversed cellular pH gradient or redistribution of protons away from the glycolytic source. On the other hand, including intercellular gap junction communication in our model can give rise to a reversed cellular pH gradient and can influence the levels of pH.

Continuous lactation effects on mammary remodeling during late gestation and lactation in dairy goats

DEFF Research Database (Denmark)

Safayi, Sina; Theil, Peter Kappel; Hou, Lei

2010-01-01

The present study aimed to 1) elucidate whether continuous milking during late gestation in dairy goats negatively affects mammary remodeling and hence milk production in the subsequent lactation, and 2) identify the regulatory factors responsible for changes in cell turnover and angiogenesis in ...

The economic benefit of treating subclinical Streptococcus agalactiae mastitis in lactating cows.

Science.gov (United States)

Yamagata, M; Goodger, W J; Weaver, L; Franti, C

1987-12-15

The economic benefits of treating lactating cows for Streptococcus agalactiae mastitis were studied at a large (689 milking cows) central California dairy. Postcure milk production of case cows (infected, treated, and cured) was compared with production of paired control cows (uninfected) and was matched for yield, days in milk, days in gestation, and parity. A simulation was used to plot expected lactation curves for mastitic cows (infected, not treated) with characteristics similar to those of each control cow, and these curves were compared with actual case-cow lactation curves. The difference in actual and expected production was used to calculate net economic benefits of treatment. Comparison of expected with actual production indicated a net benefit from treatment of $396/cow for cows treated in early lactation and $237 for cows treated in midlactation, but a net loss of $55 for cows treated in late lactation. Lactation number did not have a significant impact on economic benefits of treatment. In contrast to other studies indicating no economic benefit from treating mastitis during lactation, this study's positive results may have been attributable to the high cure rate (98%) and the subclinical form of mastitis being treated. Streptococcus agalactiae mastitis treatment during early and midlactation would appear to be an economically justifiable option for dairy managers.