Establishing an SEIR-based framework for local modelling of COVID-19 infections, hospitalisations and deaths.

Without timely assessments of the number of COVID-19 cases requiring hospitalisation, healthcare providers will struggle to ensure an appropriate number of beds are made available. Too few could cause excess deaths while too many could result in additional waits for elective treatment. As well as supporting capacity considerations, reliably projecting future "waves" is important to inform the nature, timing and magnitude of any localised restrictions to reduce transmission. In making the case for locally owned and locally configurable models, this paper details the approach taken by one major healthcare system in founding a multi-disciplinary "Scenario Review Working Group", comprising commissioners, public health officials and academic epidemiologists. The role of this group, which met weekly during the pandemic, was to define and maintain an evolving library of plausible scenarios to underpin projections obtained through an SEIR-based compartmental model. Outputs have informed decision-making at the system's major incident Bronze, Silver and Gold Commands. This paper presents illustrated examples of use and offers practical considerations for other healthcare systems that may benefit from such a framework.

Viral metagenomics reveals the presence of novel Zika virus variants in Aedes mosquitoes from Barbados.

BACKGROUND: The Zika virus (ZIKV) epidemic of 2015/2016 spread throughout numerous countries. It emerged in mainland Latin America and spread to neighboring islands, including the Caribbean island of Barbados. Recent studies have indicated that the virus must have already been circulating in local mosquito populations in Brazil for almost 2 years before it was identified by the World Health Organization in 2015. Metagenomic detection assays have the potential to detect emerging pathogens without prior knowledge of their genomic nucleic acid sequence. Yet their applicability as vector surveillance tools has been widely limited by the complexity of DNA populations from field-collected mosquito preparations. The aim of this study was to investigate local vector biology and characterize metagenomic arbovirus diversity in Aedes mosquitoes during the ongoing 2015/2016 ZIKV epidemic. METHODS: We performed a short-term vector screening study on the island of Barbados during the ongoing 2015/2016 ZIKV epidemic, where we sampled local Aedes mosquitoes. We reanalyzed mosquito viral microbiome data derived from standard Illumina MiSeq sequencing to detect arbovirus sequences. Additionally, we employed deep sequencing techniques (Illumina HiSeq) and designed a novel bait capture enrichment assay to increase sequencing efficiency for arbovirus sequences from complex DNA samples. RESULTS: We found that Aedes aegypti seemed to be the most likely vector of ZIKV, although it prevailed at a low density during the observed time period. The number of detected viruses increased with sequencing depth. Arbovirus sequence enrichment of metagenomic DNA preparations allowed the detection of arbovirus sequences of two different ZIKV genotypes, including a novel one. To our knowledge, this is the first report of the S3116W mutation in the NS5 gene region of ZIKV polyprotein. CONCLUSIONS: The metagenomic arbovirus detection approach presented here may serve as a useful tool for the identification of epidemic-causing arboviruses with the additional benefit of enabling the collection of phylogenetic information on the source. Apart from detecting more than 88 viruses using this approach, we also found evidence of novel ZIKV variants circulating in the local mosquito population during the observed time period.

Taxonomic annotation of 16S rRNA sequences of pig intestinal samples using MG-RAST and QIIME2 generated different microbiota compositions.

Environmental microbiome studies rely on fast and accurate bioinformatics tools to characterize the taxonomic composition of samples based on the 16S rRNA gene. MetaGenome Rapid Annotation using Subsystem Technology (MG-RAST) and Quantitative Insights Into Microbial Ecology 2 (QIIME2) are two of the most popular tools available to perform this task. Their underlying algorithms differ in many aspects, and therefore the comparison of the pipelines provides insights into their best use and interpretation of the outcomes. Both of these bioinformatics tools are based on several specialized algorithms pipelined together, but whereas MG-RAST is a user-friendly webserver that clusters rRNA sequences based on their similarity to create Operational Taxonomic Units (OTU), QIIME2 employs DADA2 in the construction of Amplicon Sequence Variants (ASV) by applying an error model that considers the abundance of each sequence and its similarity to other sequences. Taxonomic compositions obtained from the analyses of amplicon sequences of DNA from swine intestinal gut and faecal microbiota samples using MG-RAST and QIIME2 were compared at domain-, phylum-, family- and genus-levels in terms of richness, relative abundance and diversity. We found significant differences between the microbiota profiles obtained from each pipeline. At domain level, bacteria were relatively more abundant using QIIME2 than MG-RAST; at phylum level, seven taxa were identified exclusively by QIIME2; at family level, samples processed in QIIME2 showed higher evenness and richness (assessed by Shannon and Simpson indices). The genus-level compositions obtained from each pipeline were used in partial least squares-discriminant analyses (PLS-DA) to discriminate between sample collection sites (caecum, colon and faeces). The results showed that different genera were found to be significant for the models, based on the Variable Importance in Projection, e.g. when using sequencing data processed by MG-RAST, the three most important genera were Acetitomaculum, Ruminococcus and Methanosphaera, whereas when data was processed using QIIME2, these were Candidatus Methanomethylophilus, Sphaerochaeta and Anaerorhabdus. Furthermore, the application of differential filtering procedures before the PLS-DA revealed higher accuracy when using non-restricted datasets obtained from MG-RAST, whereas datasets obtained from QIIME2 resulted in more accurate discrimination of sample collection sites after removing genera with low relative abundances (<1%) from the datasets. Our results highlight the differences in taxonomic compositions of samples obtained from the two separate pipelines, while underlining the impact on downstream analyses, such as biomarkers identification.

Complete Genome Sequences of Nine Mycobacteriophages from New Zealand, Beatrix, Carthage, Daegal, Dulcie, Fancypants, Fenn, Inca, Naira, and Robyn.

Beatrix, Carthage, Daegal, Dulcie, Fancypants, Fenn, Inca, Naira, and Robyn are newly isolated bacteriophages capable of infecting Mycolicibacterium smegmatis mc2 155. We discovered, sequenced, and annotated these New Zealand bacteriophages. These phages illustrate that New Zealand harbors a selection of the highly diverse and distributed mycobacteriophage clusters found globally.

A multi-centre cohort study evaluating the role of inflammatory markers in patient's presenting with acute ureteric colic (MIMIC).

BACKGROUND: Spontaneous Stone Passage (SSP) rates in acute ureteric colic range from 47 to 75%. There is conflicting evidence on the role of raised inflammatory markers in acute ureteric colic. The use of an easily applicable biomarker that could predict SSP or need for intervention would improve the management of obstructing ureteric stones. Thus, there is a need to determine in an appropriately powered study, in patients who are initially managed conservatively, which factors at the time of acute admission can predict subsequent patient outcome such as SSP and the need for intervention. Particularly, establishing whether levels of white cell count (WBC) at presentation are associated with likelihood of SSP or intervention may guide clinicians on the management of these patients' stones. DESIGN: Multi-center cohort study disseminated via the UK British Urology Researchers in Surgical Training (BURST) and Australian Young Urology Researchers Organisation (YURO). PRIMARY RESEARCH QUESTION: What is the association between WBC and SSP in patients discharged from emergency department after initial conservative management? PATIENT POPULATION: Patients who have presented with acute renal colic with CT KUB evidence of a solitary ureteric stone. A minimum sample size of 720 patients across 15 centres will be needed. HYPOTHESIS: A raised WBC is associated with decreased odds of spontaneous stone passage. PRIMARY OUTCOME: The occurrence of SSP within six months of presentation with acute ureteric colic (YES/NO). SSP was defined as absence of need for intervention to assist stone passage. STATISTICAL ANALYSIS PLAN: A multivariable logistic regression model will be constructed, where the outcome of interest is SSP using data from patients who do not undergo intervention at presentation. A random effect will be used to account for clustering of patients within hospitals/institutions. The model will include adjustments for gender, age as control variables.

Draft Genome Sequences of Six Different Staphylococcus epidermidis Clones, Isolated Individually from Preterm Neonates Presenting with Sepsis at Edinburgh's Royal Infirmary.

Herein, we report the draft genome sequences of six individual Staphylococcus epidermidis clones, cultivated from blood taken from different preterm neonatal sepsis patients at the Royal Infirmary, Edinburgh, Scotland, United Kingdom.

Dietary potassium intake and renal handling, and their impact on the cardiovascular health of normotensive afro-caribbeans.

OBJECTIVE: Recent nutritional profiles of dietary intake have indicated a shift from the ancient diet to the Western diet. The ancient diet provided a high potassium and low sodium intake, which in turn leads to sodium conservation and potassium excretion. This change in the dietary intake is expected to affect potassium and sodium handling in the kidneys. Numerous studies have been done to emphasize the importance of sodium handling by the kidneys and its impact on cardiovascular health. This study will investigate potassium intake and handling, and its impact on the cardiovascular health of a sample of normotensive Afro-Caribbeans by the possible modulation of the renin angiotensin aldosterone system (RAAS). METHODS: A sample of 51 normotensive Afro-Caribbean participants was recruited for the study. Participants were observed over a two-day period in which they were given a 24-hour ambulatory blood pressure monitor and a container to collect blood pressure data and a 24-hour urine sample. Anthropometric measurements were noted. Urinary electrolytes and supine plasma renin activity (PRA) were determined from the 24-hour urine collection and a blood sample. Dietary potassium intake was estimated based on dietary intake observations and calculated based on the urinary potassium excretion. SPSS version 19 was used to analyse the data to make inferences. RESULTS: The daily potassium intake was observed to be 2.95 g/day and measured intake from the urinary potassium was between 4.95 and 7.32 g/day. Urinary potassium excretion was 3.66 (± 1.40) g/day. The urinary potassium excretion in the Afro-Caribbean sample in Barbados was higher than the other population samples. The averaged PRA of the participants (supine) was 0.778 (± 1.072) ng/mL/hour. The averaged nocturnal systolic blood pressure dip of the participants was 5.97 (± 4.324) %. There was no significant correlation between urinary potassium excretion, blood pressure, nocturnal systolic blood pressure dip and PRA. CONCLUSIONS: The Afro-Caribbean sample has an inadequate daily potassium intake based on the observed intake and recommended values, with a high urinary excretion of the electrolyte compared to other values in the literature. This high potassium excretion could have been partly due to low plasma renin activity levels in the study participants. As a possible consequence, an increase in the nocturnal peripheral resistance is a likely cause for the diminished systolic dip. The lack of correlations between dietary potassium excretion and the blood pressure parameters does not allow any firm inference of the electrolyte's handling and its impact on cardiovascular health in the normotensive Afro-Caribbean participants. However, further research is needed to get a more accurate daily potassium intake value, and a more statistically robust sample to assess whether potassium handling and blood pressure would be affected by a change in potassium intake.

Optimal quantum control of multimode couplings between trapped ion qubits for scalable entanglement.

We demonstrate entangling quantum gates within a chain of five trapped ion qubits by optimally shaping optical fields that couple to multiple collective modes of motion. We individually address qubits with segmented optical pulses to construct multipartite entangled states in a programmable way. This approach enables high-fidelity gates that can be scaled to larger qubit registers for quantum computation and simulation.

Beat note stabilization of mode-locked lasers for quantum information processing.

We stabilize a chosen radio frequency beat note between two optical fields derived from the same mode-locked laser pulse train in order to coherently manipulate quantum information. This scheme does not require access or active stabilization of the laser repetition rate. We implement and characterize this external lock, in the context of two-photon stimulated Raman transitions between the hyperfine ground states of trapped 171Yb(+) quantum bits.

Shape selectivity by guest-driven restructuring of a porous material.

A flexible metal-organic framework selectively sorbs para- (pX) over meta-xylene (mX) by synergic restructuring around pX coupled with generation of unused void space upon mX loading. The nature of the structural change suggests more generally that flexible structures which are initially mismatched in terms of fit and capacity to the preferred guest are strong candidates for effective molecular separations.

Dietary potassium intake and renal handling, and their impact on the cardiovascular health of normotensive Afro-Caribbeans / Ingesta dietética de potasio y manejo renal, y su impacto en la salud cardiovascular de los normotensos Afrocaribeños

OBJECTIVE: Recent nutritional profiles of dietary intake have indicated a shift from the ancient diet to the Western diet. The ancient diet provided high potassium and low sodium intake, which in turn led to sodium conservation and potassium excretion. This change in the dietary intake is expected to affect potassium and sodium handling in the kidneys. Numerous studies have been done to emphasize the importance of sodium handling by the kidneys and its impact on cardiovascular health . This study will investigate potassium intake and handling, and its impact on the cardiovascular health of a sample of normotensive Afro-Caribbeans by the possible modulation of the renin angiotensin aldosterone system (RAAS). METHODS: A sample of 51 normotensive Afro-Caribbean participants was recruited for the study. Participants were observed over a two-day period in which they were given a 24-hour ambulatory blood pressure monitor and a container to collect blood pressure data and a 24-hour urine sample. Anthropometric measurements were noted. Urinary electrolytes and supine plasma renin activity (PRA) were determined from the 24-hour urine collection and a blood sample. Dietary potassium intake was estimated based on dietary intake observations, and calculated based on the urinary potassium excretion. SPSS version 19 was used to analyse the data to make inferences. RESULTS: The daily potassium intake was observed to be 2.95 g/day and measured intake from the urinary potassium was between 4.95 and 7.32 g/day. Urinary potassium excretion was 3.66 (± 1.40) g/day. The urinary potassium excretion in the Afro-Caribbean sample in Barbados was higher than the other population samples. The averaged PRA of the participants (supine) was 0.778 (± 1.072) ng/mL/hour. The averaged nocturnal systolic blood pressure dip of the participants was 5.97 (± 4.324) %. There was no significant correlation between urinary potassium excretion, blood pressure, nocturnal systolic blood pressure dip and PRA. CONCLUSIONS: The Afro-Caribbean sample has an inadequate daily potassium intake based on the observed intake and recommended values, with a high urinary excretion of the electrolyte compared to other values in the literature. This high potassium excretion could have been partly due to low plasma renin activity levels in the study participants. As a possible consequence, an increase in the nocturnal peripheral resistance is a likely cause for the diminished systolic dip. The lack of correlations between dietary potassium excretion and the blood pressure parameters does not allow any firm inference of the electrolyte's handling and its impact on cardiovascular health in the normotensive Afro-Caribbean participants. However, further research is needed to get a more accurate daily potassium intake value, and a more statistically robust sample to assess whether potassium handling and blood pressure would be affected by a change in potassium intake.

OBJETIVO: Los perfiles nutricionales recientes de ingesta dietética han indicado un cambio de la dieta antigua a la dieta occidental. La dieta antigua ofrecía un consumo alto de potasio frente a un consumo bajo de sodio, lo que a su vez llevaba a la conservación del sodio y a la excreción del potasio. Se espera que este cambio en la ingesta dietética afecte el manejo del potasio y el sodio en los riñones. Se han realizado numerosos estudios con el fin de enfatizar la importancia del manejo del sodio por los riñones y su impacto en la salud cardiovascular. Este estudio investigará la ingesta y manejo del potasio, y su impacto en la salud cardiovascular de una muestra de normotensos afrocaribeños mediante la posible modulación del sistema renina-angiotensina-aldosterona (SRAA). MÉTODOS: Una muestra de 51 participantes normotensos afrocaribeños fue reclutada para el estudio. Los participantes fueron puestos bajo observación por un período de dos días, en los que recibieron un monitor ambulatorio para registrar la presión arterial por 24 horas, y un recipiente para recoger los datos de la presión arterial, y una muestra de orina de 24 horas. Se observaron las mediciones antropométricas. Los electrolitos urinarios y la actividad de renina plasmática (ARP) en posición supina, se determinaron a partir de la orina de 24 horas y una muestra de sangre. La ingesta dietética de potasio fue estimada en base a las observaciones hechas de la ingesta dietética, y se calculó a partir de la excreción del potasio urinario. La versión 19 del SPSS fue utilizada para analizar los datos y hacer inferencias. RESULTADOS: Se observó una ingestión diaria de potasio de 2.95 g/día, y la ingestión medida a partir del potasio urinario estuvo entre 4.95 y 7,32 g/día. La excreción del potasio urinario fue 3.66 (± 1.40) g/día. La excreción del potasio urinario en la muestra afrocaribeña en Barbados fue mayor que en las otras poblaciones. La actividad ARP promedio (supina) de los participantes fue 0.778 (± 1.072) ng/mL/hora. La caída nocturna promedio de la presión arterial sistólica de los participantes fue (± 4.324) 5.97%. No hubo ninguna correlación significativa entre la excreción del potasio urinario, la presión arterial, la caída nocturna de la presión arterial sistólica, y la actividad ARP. CONCLUSIONES: Partiendo de la base del consumo observado y los valores recomendados, la muestra afrocaribeña presenta una ingesta diaria inadecuada de potasio, con una alta excreción urinaria de electrólito, en comparación con otros valores en la literatura. Esta elevada excreción de potasio podría haberse debido en parte a niveles bajos de actividad de renina plasmática en los participantes del estudio. Una posible consecuencia es el aumento de la resistencia periférica nocturna como causa probable del descenso sistólico. La falta de correlación entre los parámetros de la presión arterial y la excreción de potasio dietético no permite ninguna inferencia sólida del manejo del electrólito y su impacto sobre la salud cardiovascular en los normotensos afrocaribeños participantes. Sin embargo, es necesario investigar más a fin de obtener un valor más exacto de la ingesta diaria de potasio y una muestra estadísticamente más sólida para evaluar si el manejo del potasio y la presión arterial podrían ser afectados por un cambio en la ingesta de potasio.

Predicting 24-hour urinary protein excretion in Afro-Caribbean Barbadians by comparing urine protein excretion over different durations versus spot collection / Predicción de la excreción de proteína en orina de 24 horas en Barbadenses Afrocaribeños mediante la comparación de la excreción de proteínas en la orina en diferentes períodos de tiempo frente a la recogida al azar

AIM: The gold standard for the determination of proteinuria, an independent risk factor for cardiovascular and renal disease, is the measurement of protein in a 24-hour urine collection. However, this method has been shown to be unreliable mainly due to poor compliance of sampling by patients. This study investigates other appropriate means of predicting 24-hour urinary protein excretion in a sample of Afro-Caribbeans in Barbados by assessing the correlation of actual and estimated urinary protein excretion between a 24-hour urine collection sample, 12hour (AM and PM) and spot (AM and PM) urine collections. SUBJECTS AND METHOD: A convenient sample of 30 healthy participants of Afro-Caribbean origin between the ages of 21 and 55 years was recruited for the study. The 24-hour urine samples and anthropometric data were collected as documented in the study's standard clinical procedure. A 24-hour urine sample was collected as two separate 12hour AM and PM samples. In addition, two spot samples (AM and PM) were taken during each 12hour sample collection period. Analysis of the urinary protein and creatinine was done with a Roche/Hitachi Modular System (Roche Diagnostics, IN, USA). SPSS version 19 was used to analyse the data to make inferences. RESULTS: Thirty Afro-Caribbean persons participated in the study: 16 females and 14 males. The average age and body mass index (BMI) were 38 ± 17 years and 25.32 ± 5.98 kg/m², respectively. The Spearman Rho's correlation was used to interpret associations of the urinary parameters in 24-hour collected sample and the other samples. The strongest correlation of the protein:creatinine ratio in the 24-hour collected sample to the other samples was observed with the 12hour AM sample (r = + 0.743, p < 0.01) followed by the 12hour PM sample (r = +0.672, p < 0.01). On analysing gender, the more significant correlations found were among the males for the 12hour timed samples with r = +0.945, p < 0.01 and r = +0.736, p < 0.01 for the AM and PM samples, respectively. There were very strong correlations between the 24-hour urinary protein excretion and the estimated 24-hour protein excretion from the 12hour AM and PM samples (r = +0.846, p < 0.01 and r = +0.637, p < 0.01, respectively). Both males and females had the strongest correlation for the estimation of 24-hour protein excretion in the 12hour AM sample (r = +0.795, p < 0.01 and r = +0.965, p < 0.01, respectively). CONCLUSION: The use of a 12hour timed sample, specifically the morning sample, may be a more convenient way to assess proteinuria in the Afro-Caribbean population. This method allows for a quicker assessment of proteinuria which not only allows earlier diagnosis of renal disease but may also reduce the clinical cost of the disease's management.

OBJETIVO: La regla de oro para la determinación de la proteinuria - un factor de riesgo independiente para las enfermedades cardiovasculares y renales - es la medición de la proteína en una recogida de la orina de 24 horas. Ha quedado demostrado que este método es poco confiable debido principalmente al pobre cumplimiento del muestreo por parte de los pacientes. Este estudio investiga otros medios adecuados para predecir la excreción urinaria de 24 horas de proteínas en los afrocaribeños de Barbados, evaluando la correlación real y estimada de la excreción urinaria de proteínas entre una muestra de recogida de orina de 24 horas, 12 horas (AM y PM) y las recogidas de orina al azar (AM y PM). SUJETOS Y MÉTODOS: Una muestra conveniente de 30 participantes sanos de origen afrocaribeño de edades entre 21 y 55 años fue reclutada para el estudio. Se obtuvieron muestras de orina de 24 horas y datos antropométricos como se indica en el procedimiento clínico estándar del estudio. Se recogió una muestra de orina de 24 horas, separadas en dos muestras de 12 horas AM y 12 horas PM. Además, se tomaron dos muestras al azar (AM y PM) durante cada periodo de recogida de muestras de 12 horas. El análisis del proteína urinaria y la creatinina urinaria se realizó con un sistema analítico modular Roche/Hitachi. La versión 19 de SPSS se utilizó para analizar los datos con el fin de hacer inferencias RESULTADOS: Treinta personas afrocaribeñas participaron en el estudio: 16 mujeres y 14 hombres. La edad promedio y el índice de masa corporal (IMC) fueron 38 ± 17 años y 25.32 ± 5.98 kg/m², respectivamente. La correlación Spearman Rho fue utilizada para interpretar las asociaciones de los parámetros urinarios en la muestra recogida de 24 horas y las otras muestras. La correlación más fuerte de la relación proteína: creatinina en la muestra recogida de 24 horas con respecto a las otras muestras, se observó en la muestra de 12 horas AM (r = +0.743, p < 0.01), seguida por la muestra de la 12 horas PM (r = +0.672, p < 0.01). En el análisis de género, las correlaciones más significativas fueron aquellas encontradas entre los varones para las muestras cronometradas de 12 horas con r = +0.945, p < 0.01 y r = +0.736, p < 0.01 para las muestras de AM y PM, respectivamente. Hubo correlaciones muy fuertes entre la excreción de proteína urinaria de 24 horas y la excreción de proteína de 24 horas estimada de las muestras de 12 horas AM y PM (r = +0.846, p < 0.01 y r = +0.637, p < 0.01, respectivamente). Tanto los varones como las hembras mostraron una fuerte correlación con respecto al estimado de la excreción proteica de 24 horas en la muestra de 12 horas (r = +0.795, p < 0.01 and r = +0.965, p < 0.01, respectivamente). CONCLUSIÓN: El uso de muestras cronometradas de 12 horas - específicamente la muestra de la mañana - puede ser una manera más conveniente de evaluar la proteinuria en la población afrocaribeña. Este método permite una evaluación más rápida de la proteinuria, la cual no solamente permite un diagnóstico más temprano de la enfermedad renal, sino que también hace posible reducir el costo clínico del tratamiento de la enfermedad.

Predicting 24-hour urinary sodium excretion in Afro-Caribbean Barbadians by comparing urine sodium excretion over different durations versus spot collection / Predicción de la excreción del sodio urinario de 24 horas en Barbadenses Afrocaribeños mediante la comparación de la excreción del sodio en la orina en diferentes periodos de tiempo en contraste con la eecogida al azar

AIM: Urinary sodium excretion is used as an assessment tool for salt intake and salt handling. Even though cumbersome, the most reliable and readily used method in clinical and epidemiological studies is the 24-hour urine collection. This study investigates other appropriate means of predicting 24-hour urinary sodium excretion in a sample of Afro-Caribbeans in Barbados by assessing the correlation of actual and estimated urinary sodium excretion between a 24-hour urine collection sample, 12-hour (AM and PM), and spot (AM and PM) urine collections. METHOD: A convenient sample of 30 healthy participants of Afro-Caribbean origin between the ages of 21 and 55 years was recruited for the study. The 24-hour urine samples and anthropometric data were collected as documented in the study's standard clinical procedure. A 24-hour urine sample was collected as two separate 12-hour AM and PM samples. In addition, two spot samples (AM and PM) were taken during each 12-hour sample collection period. Analysis of the urinary sodium and creatinine was done with a Roche/Hitachi Modular System (Roche Diagnostics, IN, USA). SPSS version 19 was used to analyse the data to make inferences. RESULTS: Thirty Afro-Caribbean subjects participated in this study: 16 females and 14 males. The average age and body mass index (BMI) were 38 ± 17 years and 25.32 ± 5.98 kg/m2, respectively. The greatest correlation of the estimated 24-hour sodium excretion to the measured 24-hour sodium excretion was observed in the 12-hour PM sample (Pearson's correlation, r = 0.786, p < 0.001) followed by the 12-hour AM sample (Pearson's correlation, r = 0.774, p < 0.001). The PM spot sample showed a weaker, but still statistically significant correlation to the 24-hour timed sample (Pearson's correlation, r = 0.404, p < 0.045). The AM spot sample showed a very weak and insignificant correlation (Pearson's correlation, r = 0.05, p = 0.807) to the 24-hour timed sample. Similarly to the whole sample, the gender analysis demonstrated that estimated 24-hour sodium excretion in the female's 12-hour PM sample had the greatest correlation (r = 0.819, p < 0.001) to the measured 24- hour sodium excretion, followed by the 12-hour AM (r = 0.793, p = 0.001) and the PM spot samples (r = 0.741, p = 0.02). The correlation between variables is weaker in males compared to the females. CONCLUSION: Overall, this study shows a clear correlation between the estimated 24-hour sodium excretion from the 12-hour timed PM sample and the measured 24-hour sodium excretion. Such findings support the thought of using other alternatives to determine sodium excretion, in view of replacing the cumbersome 24-hour urinary collection with a smaller timed sample. Nonetheless, a more robust and randomized population sample as well as a method to correct for high creatinine variability is required to further enhance the significance of the obtained results.

OBJETIVO: La excreción del sodio en orina se utiliza como una herramienta de evaluación para la ingesta y manejo de la sal. Si bien resulta engorroso, el método más fiable y fácilmente utilizado en los estudios clínicos y epidemiológicos es la recolección de orina de 24 horas. Este estudio investiga otros medios apropiados de predicción de la excreción del sodio urinario de 24 horas en los afrocaribeños en Barbados, evaluando la correlación real y estimada de la excreción del sodio en orina entre una muestra de orina de 24 horas, 12 horas (AM y PM), y recogidas aleatorias (AM y PM). MÉTODO: Una muestra conveniente de 30 participantes sanos de origen afrocaribeño entre las edades de 21 y 55 años, fue reclutada para el estudio. Las muestras de orina de 24 horas y los datos antropométricos, fueron recogidos tal como se documenta en el procedimiento clínico estándar del estudio. Una muestra de orina de 24 horas fue recogida en forma de muestras de 12 horas AM y PM por separado. Además, se tomaron dos muestras (AM y PM) al azar durante cada periodo de recolección de muestras de 12 horas. El análisis del sodio y la creatinina urinarios fue hecho con un Sistema Modular Roche/Hitachi (Roche Diagnostic, IN, USA). La versión 19 de SPSS fue utilizada para analizar los datos para hacer las inferencias. RESULTADOS: Treinta sujetos afrocaribeños participaron en este estudio: 16 mujeres y 14 hombres. La edad media y el índice de masa corporal (IMC) promedio fueron 38 ± 17 años y 25.32 ± 5.98 kg/m², respectivamente. La mayor correlación de la excreción estimada de sodio de 24 horas con la excreción medida de sodio 24 horas, se observó en la muestra de 12 horas PM (correlación de Pearson, r = 0.786, p < 0.001), seguida por la muestra de 12 horas AM (correlación de Pearson, r = 0.774, p < 0.001). La muestra aleatoria PM mostró una correlación más débil, pero de todos modos estadísticamente significativa con respecto a la muestra cronometrada de 24 horas (correlación de Pearson, r = 0.404, p < 0.045). La muestra aleatoria AM mostró una correlación muy débil y estadísticamente no significativa (correlación de Pearson, r = 0. 05, p = 0.807) con respecto a la muestra cronometrada de 24 horas. De modo similar a la muestra en su totalidad, el análisis de género demostró que la excreción de sodio estimada de 24 horas en la muestra PM de 12 horas de las mujeres, tenía la mayor correlación (r = 0819, p < 0.001) con respecto a la excreción de sodio medida de 24 horas, seguida por las muestras de 12 horas AM (r = 0.793, p = 0.001) y las muestras PM al azar (r = 0.741, p = 0.02). La correlación entre las variables es más débil en los varones en comparación con las hembras. CONCLUSIÓN: En general, este estudio muestra una clara correlación entre la excreción de sodio estimada de 24 horas a partir de la muestra PM cronometrada de 12 horas, y la excreción de sodio medida de 24 horas. Estos hallazgos respaldan la idea de utilizar otras alternativas para determinar la excreción de sodio, teniendo en la mira el reemplazar la engorrosa recogida de orina de 24 horas por una muestra recogida en un tiempo menor. No obstante, una muestra de población más sólida y aleatoria, así como un método para corregir la variabilidad de la creatinina alta, son necesarios para mejorar aún más la importancia de los resultados obtenidos.

Predicting 24-hour urinary sodium excretion in Afro-Caribbean Barbadians by comparing urine sodium excretion over different durations versus spot collection.

AIM: Urinary sodium excretion is used as an assessment tool for salt intake and salt handling. Even though cumbersome, the most reliable and readily used method in clinical and epidemiological studies is the 24-hour urine collection. This study investigates other appropriate means ofpredicting 24-hour urinary sodium excretion in a sample of Afro-Caribbeans in Barbados by assessing the correlation of actual and estimated urinary sodium excretion between a 24-hour urine collection sample, 12-hour (AM and PM), and spot (AM and PM) urine collections. METHOD: A convenient sample of 30 healthy participants of Afro-Caribbean origin between the ages of 21 and 55 years was recruited for the study. The 24-hour urine samples and anthropometric data were collected as documented in the study's standard clinical procedure. A 24-hour urine sample was collected as two separate 12-hour AM and PM samples. In addition, two spot samples (AM and PM) were taken during each 12-hour sample collection period. Analysis of the urinary sodium and creatinine was done with a Roche/Hitachi Modular System (Roche Diagnostics, IN, USA). SPSS version 19 was used to analyse the data to make inferences. RESULTS: Thirty Afro-Caribbean subjects participated in this study: 16 females and 14 males. The average age and body mass index (BMI) were 38 +/- 17 years and 25.32 +/- 5.98 kg/m2, respectively. The greatest correlation of the estimated 24-hour sodium excretion to the measured 24-hour sodium excretion was observed in the 12-hour PM sample (Pearson's correlation, r = 0.786, p < 0.001) followed by the 12-hour AM sample (Pearson's correlation, r = 0.774, p < 0.001). The PM spot sample showed a weaker, but still statistically significant correlation to the 24-hour timed sample (Pearson 's correlation, r = 0.404, p < 0.045). The AM spot sample showed a very weak and insignificant correlation (Pearson 's correlation, r = 0.05, p = 0.807) to the 24-hour timed sample. Similarly to the whole sample, the gender analysis demonstrated that estimated 24-hour sodium excretion in the female's 12-hour PM sample had the greatest correlation (r = 0.819, p < 0.001) to the measured 24-hour sodium excretion, followed by the 12-hour AM (r = 0.793, p = 0.001) and the PM spot samples (r = 0.741, p = 0.02). The correlation between variables is weaker in males compared to the females. CONCLUSION: Overall, this study shows a clear correlation between the estimated 24-hour sodium excretion from the 12-hour timed PM sample and the measured 24-hour sodium excretion. Such findings support the thought of using other alternatives to determine sodium excretion, in view of replacing the cumbersome 24-hour urinary collection with a smaller timed sample. Nonetheless, a more robust and randomized population sample as well as a method to correct for high creatinine variability is required to further enhance the significance of the obtained results.

Predicting 24-hour urinary protein excretion in Afro-Caribbean Barbadians by comparing urine protein excretion over different durations versus spot collection.

AIM: The gold standard for the determination of proteinuria, an independent risk factor for cardiovascular and renal disease, is the measurement of protein in a 24-hour urine collection. However this method has been shown to be unreliable mainly due to poor compliance of sampling by patients. This study investigates other appropriate means of predicting 24-hour urinary protein excretion in a sample of Afro-Caribbeans in Barbados by assessing the correlation of actual and estimated urinary protein excretion between a 24-hour urine collection sample, 12-hour (AM and PM) and spot (AM and PM) urine collections. SUBJECTS AND METHOD: A convenient sample of 30 healthy participants of Afro-Caribbean origin between the ages of21 and 55 years was recruited for the study The 24-hour urine samples and anthropometric data were collected as documented in the study s standard clinical procedure. A 24-hour urine sample was collected as two separate 12-hour AM and PM samples. In addition, two spot samples (AM and PM) were taken during each 12-hour sample collection period. Analysis of the urinary protein and creatinine was done with a Roche/Hitachi Modular System (Roche Diagnostics, IN, USA). SPSS version 19 was used to analyse the data to make inferences. RESULTS: Thirty Afro-Caribbean persons participated in the study: 16 females and 14 males. The average age and body mass index (BMI) were 38 +/- 17 years and 25.32+/- 5.98 kg/m2, respectively. The Spearman Rho 's correlation was used to interpret associations of the urinary parameters in 24-hour collected sample and the other samples. The strongest correlation of the protein:creatinine ratio in the 24-hour collected sample to the other samples was observed with the 12-hour AM sample (r = + 0.743, p < O.01)followed by the 12-hour PM sample (r = +0.672, p < 0.01). On analysing gender, the more significant correlations found were among the males for the 12-hour timed samples with r = +0.945, p < 0.01 and r = +0.736, p < 0.01 for the AM and PM samples, respectively. There were very strong correlations between the 24-hour urinary protein excretion and the estimated 24-hour protein excretion from the 12-hour AM and PM samples (r = +0.846, p < 0.01 and r = +0.637, p < 0.01, respectively). Both males and females had the strongest correlation for the estimation of 24-hour protein excretion in the 12-hour AM sample (r = +0.795, p < 0.01 and r = +0.965, p < 0.01, respectively). CONCLUSION: The use ofa 12-hour timed sample, specifically the morning sample, may be a more convenient way to assess proteinuria in the Afro-Caribbean population. This method allows for a quicker assessment of proteinuria which not only allows earlier diagnosis of renal disease but may also reduce the clinical cost of the disease s management.

The impact of the healthcare system in Barbados (provision of health insurance and the benefit service scheme) on the use of herbal remedies by Christian churchgoers.

AIM: To determine the impact of health insurance and the government's Benefit Service Scheme, a system that provides free drugs to treat mostly chronic illnesses to persons aged 16 to 65 years, on the use of herbal remedies by Christian churchgoers in Barbados. METHODS: The eleven parishes of Barbados were sampled over a six-week period using a survey instrument developed and tested over a four-week period prior to administration. Persons were asked to participate and after written informed consent, they were interviewed by the research team. The data were analysed by the use of IBM SPSS version 19. The data were all nominal, so descriptive statistics including counts, the frequencies, odds ratios and percentages were calculated. RESULTS: More than half of the participants (59.2%) were female, a little less than a third (29.9%) were male, and one tenth of the participants (10.9%) did not indicate their gender The majority of the participants were between the ages of 41 and 70 years, with the age range of 51-60 years comprising 26.1% of the sample interviewed. Almost all of the participants were born in Barbados (92.5%). Approximately 33% of the respondents indicated that they used herbal remedies to treat various ailments including chronic conditions. The odds ratio of persons using herbal remedies and having health insurance to persons not using herbal remedies and having health insurance is 1.01 (95% CI 0.621, 1.632). There was an increase in the numbers of respondents using herbal remedies as age increased. This trend continued until the age group 71-80 years which showed a reduction in the use of herbal remedies, 32.6% of respondents compared with 38.3% of respondents in the 61-70-year category. CONCLUSIONS: The data demonstrated that only a third of the study population is using herbal remedies for ailments. Health insurance was not an indicator neither did it influence the use of herbal remedies by respondents. The use of herbal remedies may not be associated with affluence. The reduction in the use of herbal remedies in the age group 71-80 years could be due to primarily a lower response rate from this age group, and secondarily due to the Benefit Service Scheme offering free medication to persons who have passed the age of 65 years.

Parvalbumin in fish skin-derived gelatin: is there a risk for fish allergic consumers?

The major allergen parvalbumin was purified from cod muscle tissues, and polyclonal antibodies were raised towards it. The antibodies were tested for specificity and an enzyme-linked immunosorbent assay (ELISA) was developed using these antibodies. The ELISA was applied to measure parvalbumin in cod skin, the starting material for fish gelatin made from deep sea, wild fish. The ELISA was sufficiently sensitive (LLOQ = 0.8 ng ml(-1) in extracts, corresponding to 0.02 µg of parvalbumin per g of tissue), and did not cross-react with common food constituents. Fish gelatin, wine and beer, matrices for the potential use of this ELISA, did not cause disturbance of the assay performance. The data show that the parvalbumin content in cod muscle tissue is 6.25 mg g(-1), while the skins contained considerably less, 0.4 mg g(-1). Washing of the skins, a common industrial procedure during the manufacturing of fish gelatin, reduced the level of parvalbumin about 1000-fold to 0.5 µg g(-1), or 0.5 ppm. From 95 commercial lots of fish gelatin it is shown that 73 are below 0.02 µg g(-1) parvalbumin. From the other 22 lots, the one with the highest concentration contained 0.15 µg g(-1) of parvalbumin. These levels are generally assumed to be safe for fish-allergic individuals.

The impact of the healthcare system in Barbados (Provision of health insurance and the Benefit Service Scheme) on the use of herbal remedies by Christian churchgoers / El Impacto del sistema de salud en Barbados (Provisión de seguro de salud y Plan de Servicios y Beneficios) sobre el uso de remedios herbarios por parte de los feligreses Cristianos

AIM: To determine the impact of health insurance and the government's Benefit Service Scheme, a system that provides free drugs to treat mostly chronic illnesses to persons aged 16 to 65 years, on the use of herbal remedies by Christian churchgoers in Barbados. METHODS: The eleven parishes of Barbados were sampled over a six-week period using a survey instrument developed and tested over a four-week period prior to administration. Persons were asked to participate and after written informed consent, they were interviewed by the research team. The data were analysed by the use of IBM SPSS version 19. The data were all nominal, so descriptive statistics including counts, the frequencies, odds ratios and percentages were calculated. RESULTS: More than half of the participants (59.2%) were female, a little less than a third (29.9%) were male, and one tenth of the participants (10.9%) did not indicate their gender. The majority of the participants were between the ages of 41 and 70 years, with the age range of 51-60 years comprising 26.1% of the sample interviewed. Almost all of the participants were born in Barbados (92.5%). Approximately 33% of the respondents indicated that they used herbal remedies to treat various ailments including chronic conditions. The odds ratio of persons using herbal remedies and having health insurance to persons not using herbal remedies and having health insurance is 1.01 (95% CI 0.621, 1.632). There was an increase in the numbers of respondents using herbal remedies as age increased. This trend continued until the age group 71-80 years which showed a reduction in the use of herbal remedies, 32.6% of respondents compared with 38.3% of respondents in the 61-70-year category. CONCLUSIONS: The data demonstrated that only a third of the study population is using herbal remedies for ailments. Health insurance was not an indicator neither did it influence the use of herbal remedies by respondents. The use of herbal remedies may not be associated with affluence. The reduction in the use of herbal remedies in the age group 71-80 years could be due to primarily a lower response rate from this age group, and secondarily due to the Benefit Service Scheme offering free medication to persons who have passed the age of 65 years.

OBJETIVO: Investigar si el Seguro de Saludy el Plan de Servicios y Beneficios del Gobierno - un sistema que proporciona medicina libremente para tratar principalmente enfermedades crónicas en personas de 16 a 65 anos de edad - influyen en el uso de remedios herbarios por los feligreses cristianos en Barbados. MÉTODOS: Se realizó un muestreo en once provincias de Barbados por un período de seis semanas, usando como instrumento una encuesta desarrollada y probada durante un período de cuatro semanas antes de ser aplicada. Se le pidió participación a distintas personas y luego de obtener el consen-timiento informado por escrito, las mismas fueron entrevistadas por el equipo de investigación. Los datos fueron analizados mediante la versión 19 de IBM SPSS. Todos los datos eran nominales, de modo que se calcularon las estadísticas descriptivas, incluyendo conteos, frecuencia, cociente de probabilidades (odds ratio), y porcentajes. RESULTADOS: Más de la mitad de los participantes (59.2%) eran mujeres; poco menos de un tercio (29.9%) eran hombres; y una décima parte de los participantes (10.9%) no indicó su sexo. La mayoría de los participantes se encontraban entre las edades de 41 y 70 anos, para un rango de edad de 51-60 anos que comprendía el 26.1% de la muestra entrevistada. Casi todos los participantes nacieron en Barbados (92.5%). Aproximadamente 33% de los entrevistados indicaron que usaban remedios herbarios para tratar varias dolencias, incluyendo condiciones crónicas. El odds ratio de las personas que usan remedios herbarios y poseen seguro de salud es 1.01 (95% CI 0.621, 1.632). Seprodujo un aumento en el número de entrevistados que usaban remedios herbarios, según aumentaba su edad. Esta tendencia continuó hasta el grupo etario de 71-80 anos, el cual mostró una reducción en el uso de remedios herbarios, 32.6% de los entrevistados en comparación con el 38.3% de los entrevistados en la categoría de los 61-70 anos. CONCLUSIONS: Los datos mostraron que sólo una tercera parte de la población está usando remedios herbarios para sus dolencias. El seguro de salud no fue un indicador ni influyó sobre el uso de remedios herbarios por los entrevistados. El uso de remedios herbarios no puede asociarse con la afluencia. La reducción en el uso de remedios herbarios en el grupo etario 71-80 anos podrían deberse principalmente a una tasa de respuesta más baja de este grupo etario, y secundariamente al Plan de Servicios y Beneficios que ofrece medicamentos gratuitamente a personas que han pasado la edad de 65 anos.

Healthcare costs of methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa infections in veterans: role of vitamin D deficiency.

Methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (P. aeruginosa) infections are frequently associated with hospitalization and increased healthcare costs. Vitamin D deficiency may contribute to increased costs for patients with these infections and there is evidence that vitamin D may have an antimicrobial role. To evaluate the role of vitamin D deficiency in the costs incurred with these infections, we studied the relationship of serum 25(OH)D levels to healthcare costs in veterans in the southeastern United States. Patients with both infections were vitamin D deficient to a similar extent and so were combined for further analysis. Vitamin D deficient patients had higher costs and service utilization than those who were not vitamin D deficient. Those with vitamin D deficiency had higher inpatient costs compared to the non-deficient group, and this difference was across most categories except for the number of inpatient hospitalizations or total number of days as an inpatient. Vitamin D deficiency was not significantly related to outpatient cost or service utilization parameters. We conclude that vitamin D deficiency is intimately linked to adverse healthcare costs in veterans with MRSA and P. aeruginosa infections. Vitamin D status should be assayed in patients with these infections.

Drug-herb interaction: database of medicinal plants of the caribbean, their indications, toxicities and possible interactions with conventional medication / La Interacción entre medicamentos y hierbas: base de datos de las plantas medicinales en el caribe, sus indicaciones, toxicidades y posibles interacciones con la medicina convencional

OBJECTIVE: Healthcare professionals in the Caribbean today know very little about these drug-herb interactions of the popular West Indian medicinal herb practices linked to the immigrants from West Africa and India, and to the indigenous Amerindians. It is the intent of this project to produce a database which comprehensively summarizes indications and possible drug-herb interactions of these plants. METHOD: Using the database programme Epi Info 3.5.1, one hundred and eighty-three herbs used in the Caribbean as medicine by locals have been entered into the West Indian Drug Herb Interaction Database version 0.06 (WIDHID 0.06). RESULTS: A range of one to three common names have been entered with the family and scientific name of each herb, in addition to a range of one to six conditions/illnesses for which a particular plant was to be used as a medicinal herb. One to four bioactive compounds have been made to correlate with the typical herbal preparation methods and toxicity. Thirty of the most common and popular herbs have been researched for their drug herb interactions. CONCLUSION: West Indian Drug Herb Interaction Database version 0.06 for the first time allows easy access to Caribbean ethno-medicinal plant cures with their possible drug-herb interactions reference sources, a feature often absent although so important. In addition, WIDHID 0.06 will support pharmaco-epidemiological studies in the field. It will also ensure future public access to ethnomedicinal information through developed web pages or programmes.

OBJETIVO: Los profesionales de la atención a la salud en el Caribe saben hoy muy poco sobre las interacciones entre medicamentos y las hierbas de las prácticas herbarias populares de las Indias Occidentales, relacionadas con los inmigrantes de África Occidental y a los aborígenes amerindios. El propósito de este proyecto es crear una base de datos que resuma de manera integral las indicaciones así como las posibles interacciones medicamento-hierba presentes en estas plantas. MÉTODO: Usando el programa del base de datos Epi Info 3.5.1, ciento ochenta y tres hierbas usadas como medicina en el Caribe, fueron entradas en la Base de Datos Interacción Medicamento-Hierba de West Indies, versión 0.06 (WIDHID 0.06). RESULTADOS: Un rango de uno a tres nombres comunes se ha entrado con la familia y el nombre científico de cada hierba, además de un rango de una a seis condiciones/enfermedades para las cuales una planta en particular puede usarse como hierba medicinal. Los compuestos bioactivos entre los rangos de uno a cuatro han sido entrados junto con su clase química respectiva. Las tres partes más comúnmente usadas de las plantas han sido puestas en correlación con los métodos de preparación herbarios típicos y la toxicidad. Se han investigado treinta de las hierbas más comunes y populares en cuanto a sus interacciones medicamento-hierba. CONCLUSIÓN: La Base de Datos Interacción Medicamento-Hierba de West Indies versión 0.06 permite por primera vez fácil acceso fácil a la rica base de curaciones mediante plantas etno-medicinales caribeñas con sus fuentes de referencias a sus posibles interacciones medicamento-hierba, un aspecto a menudo omitido a pesar de su importancia. Además, WIDHID 0.06 permite que se emprendan estudios epidemiológicos. También asegurará el acceso público futuro a la información etno-medicinal a través del desarrollo de programas y páginas web.