Energy-dense, low-volume paediatric oral nutritional supplements improve total nutrient intake and increase growth in paediatric patients requiring nutritional support: results of a randomised controlled pilot trial.

Children with or at risk of faltering growth require nutritional support and are often prescribed oral nutritional supplements (ONS). This randomised controlled trial investigated the effects of energy-dense paediatric ONS (2.4 kcal/ml, 125 ml: cONS) versus 1.5 kcal/ml, 200 ml ONS (sONS) in community-based paediatric patients requiring oral nutritional support. Fifty-one patients (mean age 5.8 years (SD 3)) with faltering growth and/or requiring ONS to meet their nutritional requirements were randomised to cONS (n = 27) or sONS (n = 24) for 28 days. Nutrient intake, growth, ONS compliance and acceptability, appetite and gastro-intestinal tolerance were assessed. Use of the cONS resulted in significantly greater mean total daily energy (+ 531 kcal/day), protein (+ 10.1 g/day) and key micronutrient intakes compared with the sONS group at day 28 and over time, due to high ONS compliance (81% of patients ≥ 75%), maintained intake from diet alone and improved appetite in the cONS group, compared with the sONS group. Although growth increased in both intervention groups, results were significant in the cONS group (weight (p = 0.007), height (p < 0.001) and height z-score (p = 0.006)).Conclusions: This study shows that use of energy-dense (2.4 kcal/ml) low-volume paediatric-specific ONS leads to improved nutrient intakes, growth and appetite in paediatric patients requiring oral nutrition support compared with standard energy density ONS.Trial registration: The trial is registered at clinicaltrials.gov , identification number NCT02419599. What is Known: • Faltering growth is the failure of children to achieve adequate growth at a normal rate for their age and requires nutritional support, including the use of oral nutritional supplements (ONS). • Energy-dense, low-volume ONS have benefits over standard ONS in adults. What is New: • This is the first RCT to investigate the effects of energy-dense, low-volume ONS (2.4 kcal/ml, 125 ml) in children with faltering growth, showing significant improvements in total nutrient intake and increased growth. • Energy-dense, low-volume ONS can play a key role in the management of faltering growth.

Using a Student-Generated Mock Magazine Issue To Improve Students' Awareness of Diverse Scientists.

This study explores whether integrating multicultural content within a genetics laboratory course affected students' awareness of diversity and their perceptions of scientists' identities. Genetics laboratory curricula typically focus on content and experimental procedures, with cursory references to the scientists who made these discoveries. The resulting poor racial and gender representation in the curricula propagate biases about the abilities and contributions of scientists from underrepresented groups, which may adversely affect the retention and success of students in these groups. Initially, students completed a pre-test in which they were asked to recall the names of geneticists and their scientific contributions. Later students created a mock magazine issue featuring a diverse set of experts in genetics, specifically members of traditionally underrepresented gender/sexuality and/or racial/ethnic groups. To facilitate this assignment, students were randomly assigned a geneticist from a pool of active research scientists, spanning a wide range of scientific and cultural backgrounds and identities. Each student wrote a 500-word biography of their assigned geneticist and read biographies composed by peers. Then, in groups, the students categorized biographies based on student-selected unifying themes into a table of contents. On the final exam, the pre-test was repeated as a post-test. In the pre-test, scientists listed by students were 94% male and 6% female, with no members of other underrepresented groups included. In the post-test, scientists listed by students shifted to 84% male and 16% female with 18% from underrepresented groups. These data suggest that this intervention increases awareness of the multicultural nature of scientists.

The Ethylene Signaling Pathway Negatively Impacts CBF/DREB-Regulated Cold Response in Soybean (Glycine max).

During cold stress, soybean CBF/DREB1 transcript levels increase rapidly; however, expected downstream targets appear unresponsive. Here, we asked whether the ethylene signaling pathway, which is enhanced in the cold can negatively regulate the soybean CBF/DREB1 cold responsive pathway; thus contributing to the relatively poor cold tolerance of soybean. Inhibition of the ethylene signaling pathway resulted in a significant increase in GmDREB1A;1 and GmDREB1A;2 transcripts, while stimulation led to decreased GmDREB1A;1 and GmDREB1B;1 transcripts. A cold responsive reporter construct (AtRD29Aprom::GFP/GUS), as well as predicted downstream targets of soybean CBF/DREB1 [Glyma.12g015100 (ADH), Glyma.14g212200 (ubiquitin ligase), Glyma.05g186700 (AP2), and Glyma.19g014600 (CYP)] were impacted by the modulation of the ethylene signaling pathway. Photosynthetic parameters were affected by ethylene pathway stimulation, but only at control temperatures. Freezing tolerance (as measured by electrolyte leakage), free proline, and MDA; in both acclimated and non-acclimated plants were increased by silver nitrate but not by other ethylene pathway inhibitors. This work provides evidence that the ethylene signaling pathway, possibly through the action of EIN3, transcriptionally inhibits the CBF/DREB1 pathway in soybean.

Exploring deployment experiences of Army medical department personnel.

The purpose of this study was to describe Operation Iraqi/Enduring Freedom and Operation Desert Storm/Shield deployment experiences from the perspectives of 39 Army Medical Department personnel using a qualitative method in 2004. Thematic content analysis revealed themes from data collected during twelve focus groups. The themes with the most discussion that transcended across wars, branches, echelons of care, and grade were leadership and readiness concerns, followed closely by safety issues. The majority of discussion was about deficiency needs during deployment and the data suggests that problems experienced during deployment are timeless and are not unit-specific; issues were strikingly similar across the two wars, as well as across the varying AMEDD roles and types of medical units. Therefore, the findings of this study may be generically applicable to deployed AMEDD personnel with the potential to alter current policy regarding leadership, readiness, and safety for future AMEDD deployments.

Army nurses' knowledge base for determining triage categories in a mass casualty.

The timing, location, and participants in a mass casualty scenario cannot be predicted. Nurses may be involved in performing triage, yet there is no published documentation of military nurses' ability to triage. A prospective design was used to describe 82 Army nurses' knowledge base related to designating triage categories for patients during a mass causality, examining the relationships among their education and experience as evaluated by The Darnall Mass Casualty Triage Test and Demographic Data Form. The most significant areas associated with higher scores on the Triage Test were: completion of Advanced Cardiac Life Support, advanced certification as a Certified Registered Nurse Anesthetists, Certified Emergency Nurse, or Critical Care Registered Nurse, and attendance to the Medical Management of Nuclear Weapons Course. An improved average score for nurses overall was also noted when compared with previous work with the Darnall MASCAL Triage Test.