Hearing loss and employment: a systematic review of the association between hearing loss and employment among adults.

BACKGROUND: Hearing loss affects over 1.3 billion individuals worldwide, with the greatest burden among adults. Little is known regarding the association between adult-onset hearing loss and employment. METHODS: Seven databases (PubMed, Embase, Cochrane Library, ABI/Inform Collection, Business Source Ultimate, Web of Science and Scopus) were searched through to October 2018. The key word terms used related to hearing loss and employment, excluding paediatric or congenital hearing loss and deaf or culturally deaf populations. RESULTS: The initial search resulted in 13 144 articles. A total of 7494 articles underwent title and abstract screening, and 243 underwent full-text review. Twenty-five articles met the inclusion criteria. Studies were set in 10 predominantly high-income countries. Seven of the 25 studies analysed regionally or nationally representative datasets and controlled for key variables. Six of these seven studies reported associations between hearing loss and employment. CONCLUSION: The highest quality studies currently available indicate that adult-onset hearing loss is associated with unemployment. However, considerable heterogeneity exists, and more rigorous studies that include low- and middle-income countries are needed.

The effect of chicken blood and its components on wastewater characteristics and sewage surcharges.

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

Differential response to stocking rates and feeding by two genotypes of Holstein-Friesian cows in a pasture-based automatic milking system.

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

Late presentation of a shrapnel wound-induced traumatic intra-thoracic abdominal evisceration, as colon perforation with left faecopneumothorax.

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

Characterization of yeast homoserine dehydrogenase, an antifungal target: the invariant histidine 309 is important for enzyme integrity.

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

Intakes of most nutrients remain at acceptable levels during a weight management program using the food exchange system.

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

Influence of diet and/or exercise on body composition and cardiorespiratory fitness in obese women.

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

Effects of the P2-purinoceptor antagonist, suramin, on human platelet aggregation induced by adenosine 5'-diphosphate.

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

Comparison of six microcomputer dietary analysis systems with the USDA Nutrient Data Base for Standard Reference.

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

A colourimetric enzyme-linked sandwich assay for the detection of human platelets bound to a fibrinogen-coated surface.

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

A comparative study of two microcomputer nutrient data bases with the USDA Nutrient Data Base for Standard Reference.

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

Effects of caffeine, tetracaine, and ryanodine on calcium-dependent oscillations in sheep cardiac Purkinje fibers.

Membrane current and tension were measured in voltage-clamped sheep cardiac Purkinje fibers. Elevating the intracellular calcium concentration ([Ca2+]i) results in oscillations of membrane current and tension both at rest and during stimulation. During stimulation, an oscillatory transient inward current and an after contraction follow repolarization. We have examined the effects on the oscillations of changing the extracellular calcium concentration ([Ca2+]o) and of adding various drugs. In agreement with previous work, high concentrations of drugs that affect the sarcoplasmic reticulum, namely caffeine (10-20 mM), tetracaine (1 mM), and ryanodine (10 microM), abolish the oscillations. However, at lower concentrations, these three drugs have different effects on the oscillations. Caffeine (1-2 mM) decreases the oscillation amplitude but increases the frequency. Tetracaine (100-500 microM) has little effect on the magnitude of the oscillations but decreases their frequency. Ryanodine, at all concentrations used (0.1-10 microM), eventually abolishes the oscillations but, in doing so, decreases the magnitude, leaving the frequency unaffected. When [Ca2+]o was changed in order to vary [Ca2+]i, both the frequency and the magnitude of the oscillations always changed in the same direction. This suggests that these three drugs have effects in addition to just changing [Ca2+]i.