Spatial patterns of prostate-specific antigen testing in asymptomatic men across Australia: a population-based cohort study, 2017-2018.

OBJECTIVES: In Australia, while prostate-specific antigen (PSA) testing rates vary by broad area-based categories of remoteness and socio-economic status, little is known about the extent of variation within them. This study aims to describe the small-area variation in PSA testing across Australia. STUDY DESIGN: This was a retrospective population-based cohort study. METHODS: We received data for PSA testing from the Australian Medicare Benefits Schedule. The cohort included men (n = 925,079) aged 50-79 years who had at least one PSA test during 2017-2018. A probability-based concordance was applied across multiple iterations (n = 50) to map each postcode to small areas (Statistical Areas 2; n = 2,129). For each iteration, a Bayesian spatial Leroux model was used to generate smoothed indirectly standardized incidence ratios across each small area, with estimates combined using model averaging. RESULTS: About a quarter (26%) of the male population aged 50-79 years had a PSA test during 2017-2018. Testing rates among small areas varied 20-fold. Rates were higher (exceedance probability>0.8) compared with the Australian average in the majority of small areas in southern Victoria and South Australia, south-west Queensland, and some coastal regions of Western Australia but lower (exceedance probability<0.2) in Tasmania and Northern Territory. CONCLUSIONS: The substantial geographical variation in PSA testing rates across small areas of Australia may be influenced by differences in access to and guidance provided by clinicians and attitudes and preferences of men. Greater understanding of PSA testing patterns by subregions and how these patterns relate to health outcomes could inform evidence-based approaches to identifying and managing prostate cancer risk.

Effect of Feeding a Postbiotic Derived from Saccharomyces cerevisiae Fermentation as a Preharvest Food Safety Hurdle for Reducing Salmonella Enteritidis in the Ceca of Layer Pullets.

ABSTRACT: Salmonella Enteritidis is responsible for a significant proportion of foodborne salmonellosis in the United States and continues to be attributable to table eggs despite increased federal oversight. Technologies, including feed additives, continue to be evaluated for preharvest application and their potential food safety benefits. Diamond V Original XPC, a Saccharomyces cerevisiae fermentation-based postbiotic (SCFP), was evaluated for its effectiveness in reducing Salmonella Enteritidis (SE) colonization in young layer pullets. A total of 40 day-old Hy-Line W-36 layer pullets were equally divided and randomly assigned to one of two dietary treatments, with SCFP or without SCFP (PCON), and orally gavaged on day 28 with SE at 106 CFU/mL. Another 20 day-old pullets were fed the same control feed without SCFP and blank inoculated on day 28 with 1 mL of sterile phosphate-buffered saline to serve as a negative control. Qualitative and quantitative analyses of cecal contents for Salmonella were performed for all birds on day 32. The prevalence of SE in the ceca of all directly challenged birds was 100%; however, the SE concentration in birds fed SCFP diet (3.35 log CFU/g) was significantly lower (P < 0.0001) than that of the PCON birds not fed SCFP (4.49 log CFU/g). The proportion of birds with enumerable SE concentrations was lower in SCFP-fed pullets (57.9%) than in the PCON pullets (95.0%). These data suggest that inclusion of SCFP in the diet may aid in the reduction of SE within the ceca of commercial laying hens and could serve as an additional preharvest food safety hurdle.

Long-term unmet supportive care needs of prostate cancer survivors: 15-year follow-up from the NSW Prostate Cancer Care and Outcomes Study.

PURPOSE: To determine the prevalence, severity, and baseline associations of self-reported long-term unmet supportive care needs in a population-wide cohort of men with prostate cancer (PC), 15 years post-diagnosis. METHODS: Participants were drawn from the New South Wales (NSW) Prostate Cancer Care and Outcomes Study. Eligible men were diagnosed with PC between 2000 and 2002, aged less than 70 years at diagnosis, and completed a 15-year follow-up survey. Demographic and clinical data were collected at baseline. The validated Cancer Survivors' Unmet Needs (CaSUN) Survey was administered to assess unmet needs. RESULTS: Of 578 eligible men, 351 completed CaSUN. Mean age was 75.8 (range 59-84) with a mean follow-up time of 15.2 years post-diagnosis. Over a third of men (37.4%) reported at least one unmet need at 15 years. Most frequently reported unmet needs pertained to the comprehensive cancer care (34.1%) domain. 87.2% of participants who reported problems with sexual function reported this need as moderate/severe. Higher diagnostic prostate-specific antigen (PSA) levels (20+ ng/mL) at diagnosis were associated with future unmet needs (PSA 20+: OR = 4.80, 95% CI [1.33-17.35]). CONCLUSION: Many PC survivors continue to report unmet needs 15 years post-diagnosis. There is a pressing need for clinicians to work together to coordinate PC care, and to proactively, regularly, and openly enquire about men's sexual adjustment to PC. The needs of PC survivors could better be met with more coordinated approaches to multidisciplinary care and timely interventions and support for chronic sexual dysfunction.

Effect of elevated dietary inorganic zinc on live performance, carcass yield, and quality of male and female broilers.

This study evaluated the effects of elevated dietary inorganic zinc (Zn) on live performance, carcass and parts yield, and carcass and meat quality of broilers. A total of 288 d-old Ross 344 × 708 broilers were distributed among 3 dietary treatments with 12 replicate cages per treatment and raised sex-separate with 8 birds per cage. Birds were fed practical diets supplemented with either 0, 120, or 240 mg Zn/kg diet. Feed intake and body weight (BW) were measured and feed conversion ratio (FCR) was calculated. At 42 d, 3 birds per cage were processed to assess carcass and meat quality. Male BW at 42 d was increased (P ≤ 0.05) by 120 mg Zn/kg. The FCR to 42 d was also improved (P ≤ 0.05) for males supplemented with 120 mg Zn/kg as compared to 240 mg Zn/kg with the 0 mg Zn/kg diet intermediate. Dietary Zn had no effect on BW or FCR of females. Dietary Zn had no effect on carcass weight and parts yield but absolute weights of male, but not female, total breast and tenders were increased by 240 mg Zn/kg relative to 0 mg Zn/kg with 120 mg Zn/kg intermediate. Breast fillets cook yield and tenderness as well as color were not influenced by Zn in either sex. Supplementing 120 mg Zn/kg resulted in increased Zn in male breast muscle (P ≤ 0.01) whereas 240 mg Zn/kg reduced Zn in breast muscle of females. The 240 mg Zn/kg diet increased Zn in femurs (P ≤ 0.05) of males relative to the other diets. For females, Zn concentration in femurs was increased (P ≤ 0.05) by 240 mg Zn/kg relative to 120 mg Zn/kg with the non-supplemented birds intermediate.

An initial melanoma diagnosis may increase the subsequent risk of prostate cancer: Results from the New South Wales Cancer Registry.

Emerging evidence suggests that a diagnosis of cutaneous melanoma (CM) may be associated with prostate cancer (PC) incidence. We examined if the incidence of CM was associated with an increased subsequent risk of PC. We used data from the New South Wales Cancer Registry for all CM and PC cases diagnosed between January 1972 and December 2008. We calculated the age standardized incidence ratio (SIR) and 95% confidence intervals (95% CI) for PC incidence following a CM diagnosis, applying age- and calendar- specific rates to the appropriate person years at risk. We determined rate ratio (RR) and 95% CI of PC incidence according to specified socio-demographic categories and disease related characteristics, using a negative binomial model. There were 143,594 men diagnosed with PC or CM in the study period and of these 101,198 and 42,396 were diagnosed with PC and CM, respectively, as first primary cancers. Risk of PC incidence increased following CM diagnosis (n = 2,114; SIR = 1.25; 95% CI:1.20.8-1.31: p < 0.0001), with the increased risk apparent in men diagnosed with localised CM (n = 1,862;SIR = 1.26; 95% CI:1.20-1.32). CM diagnosis increased the subsequent risk of PC incidence. This raises the potential for future PC risk to be discussed with newly diagnosed males with CM.

"Prostate cancer is far more hidden ": Perceptions of stigma, social isolation and help-seeking among men with prostate cancer.

The purpose of this study was to provide in-depth insight into men's experiences of prostate cancer, specifically: perceived stigma and self-blame, social isolation, unmet need and help-seeking. A qualitative descriptive approach was used. Semi-structured interviews were undertaken with 20 men diagnosed with prostate cancer, and thematic analysis was undertaken. Some participants perceived a stigma associated with prostate cancer and cancer in general, which sometimes acted as a barrier to disclosure. Self-blame and internalisation of cause was not a prominent issue. Participants' descriptions of emotional distress, social isolation and anxiety demonstrated the impact of prostate cancer. Social isolation was most commonly reported as a physical consequence of treatment and/or side effects. Participants felt both support and ongoing care were limited at post-treatment. Most did not seek or receive help for emotional or psychosocial problems from a formal source due to anticipated awkwardness, autonomous coping, not burdening others, unwanted sympathy and retaining privacy. Prostate cancer can cause considerable emotional and social burden for some men, and many are unlikely to seek or receive help. Men, and their support networks, require active encouragement throughout diagnosis, treatment and follow-up to overcome barriers and access additional support, particularly for sexual, emotional and psychosocial issues.

Financial toxicity: a potential side effect of prostate cancer treatment among Australian men.

The purpose of this study was to understand the extent, nature and variability of the current economic burden of prostate cancer among Australian men. An online cross-sectional survey was developed that combined pre-existing economic measures and new questions. With few exceptions, the online survey was viable and acceptable to participants. The main outcomes were self-reported out-of-pocket costs of prostate cancer diagnosis and treatment, changes in employment status and household finances. Men were recruited from prostate cancer support groups throughout Australia. Descriptive statistical analyses were undertaken. A total of 289 men responded to the survey during April and June 2013. Our study found that men recently diagnosed (within 16 months of the survey) (n = 65) reported spending a median AU$8000 (interquartile range AU$14 000) for their cancer treatment while 75% of men spent up to AU$17 000 (2012). Twenty per cent of all men found the cost of treating their prostate cancer caused them 'a great deal' of distress. The findings suggest a large variability in medical costs for prostate cancer treatment with 5% of men spending $250 or less in out-of-pocket expenses and some men facing very high costs. On average, respondents in paid employment at diagnosis stated that they had retired 4-5 years earlier than planned.

Noninvasive inhaled nitric oxide for persistent pulmonary hypertension of the newborn: A single center experience.

INTRODUCTION: Nitric oxide is a potent, selective pulmonary vasodilator that has been proven to decrease pulmonary vascular resistance and has been part of the treatment arsenal for persistent pulmonary hypertension of the newborn (PPHN). In 2009, the approach to the administration of inhaled nitric oxide (iNO) at Winnie Palmer Hospital for Women and Babies (WPH) changed to emphasize avoiding invasive ventilation while maintaining optimal ventilation to perfusion ratio, avoiding hyperventilation and alkalosis agents, and avoiding hyperoxemia and hyperoxia exposure. Our aim is to describe the outcomes of babies whose primary treatment for PPHN was noninvasive (NIV) iNO. METHODS: A retrospective chart review of neonates born at WPH from October 1, 2009 through October 1, 2014. INCLUSION CRITERIA: >34 weeks' gestation, echocardiographic evidence of PPHN within the first week of life, and NIV iNO as the primary treatment. RESULTS: Twenty-four babies met criteria: 21 solely treated noninvasively, 3 required invasive support. Supplemental oxygen need was ≥50% for 21 babies pre-iNO treatment and dropped to <30% for all babies post-iNO. Average exposure to supplemental oxygen was 6.3 days. Mean duration of iNO administration was 2.5 days. Average length of stay was 14 days. All babies survived. CONCLUSION: Our review revealed a low incidence of escalation to invasive ventilation. Non-invasive iNO was found to be an effective and well-tolerated frontline approach for treating PPHN in near-term and term infants with an intact respiratory drive. Further studies could provide the necessary evidence on clinical outcomes as well as cost effectiveness to guide best practice.

An examination of prostate cancer trends in Australia, England, Canada and USA: Is the Australian death rate too high?

PURPOSE: To compare prostate cancer incidence and mortality rates in Australia, USA, Canada and England and quantify the gap between observed prostate cancer deaths in Australia and expected deaths, using US mortality rates. METHODS: Analysis of age-standardised prostate cancer incidence and mortality rates, using routinely available data, in four similarly developed countries and joinpoint regression to quantify the changing rates (annual percentage change: APC) and test statistical significance. Expected prostate cancer deaths, using US mortality rates, were calculated and compared with observed deaths in Australia (1994-2010). RESULTS: In all four countries, incidence rates initially peaked between 1992 and 1994, but a second, higher peak occurred in Australia in 2009 (188.9/100,000), rising at a rate of 5.8 % (1998-2008). Mortality rates in the USA (APC: -2.9 %; 2004-2010), Canada (APC: -2.9 %; 2006-2011) and England (APC: -2.6 %; 2003-2008) decreased at a faster rate compared with Australia (APC: -1.7 %; 1997-2011). In 2010, mortality rates were highest in England and Australia (23.8/100,000 in both countries). The mortality gap between Australia and USA grew from 1994 to 2010, with a total of 10,895 excess prostate cancer deaths in Australia compared with US rates over 17 preceding years. CONCLUSIONS: Prostate cancer incidence rates are likely heavily influenced by prostate-specific antigen testing, but the fall in mortality occurred too soon to be solely a result of testing. Greater emphasis should be placed on addressing system-wide differences in the management of prostate cancer to reduce the number of men dying from this disease.

Marinade with thyme and orange oils reduces Salmonella Enteritidis and Campylobacter coli on inoculated broiler breast fillets and whole wings.

Essential oils have been reported to possess antimicrobial properties and therefore have potential usage as natural antimicrobials in food. In a previous study, thyme orange essential oil combination (TOC) used at the 0.5% level as a dip application on chicken cut-up parts had a significant antibacterial effect against Salmonella and Campylobacter. A study was designed to evaluate the effect of salt-phosphate marinade solution containing 0.5% TOC to 1) reduce Salmonella Enteritidis and Campylobacter coli numbers on broiler breast fillets and whole wings marinated by vacuum tumbling, and 2) reduce cross-contamination of both pathogens between inoculated and uninoculated parts during marination. A total of 52 skinless breast fillets and 52 whole wings were used for the 2 replications. For each replication, each cut-up part was randomly assigned to 1 of 5 groups: treatment 1: uninoculated parts marinated without TOC; treatment 2: inoculated parts marinated without TOC; treatment 3: uninoculated parts marinated with TOC; treatment 4: inoculated parts marinated with TOC; and control: nonmarinated inoculated parts. Samples were dipped in an inoculum containing a mixture of Salmonella Enteritidis and C. coli. The treatment samples were marinated by vacuum tumbling. All samples were immediately evaluated to determine Salmonella Enteritidis and C. coli numbers. Results indicated that TOC at the 0.5% level in the marinade solution applied by vacuum tumbling significantly reduced (P < 0.05) numbers of viable Salmonella Enteritidis by 2.6 and 2.3 log cfu/mL on broiler breast fillets and C. coli by 3.6 and 3.1 log cfu/mL on whole wings. Cross-contamination was observed as the uninoculated chicken parts marinated with inoculated parts were positive. However, the number of bacterial cells recovered from the TOC treated samples were significantly lower (P < 0.05) than the numbers recovered from the untreated samples. Marination with a salt phosphate formulation containing 0.5% TOC successfully reduced Salmonella and Campylobacter numbers on poultry products.

Sampling naturally contaminated broiler carcasses for Salmonella by three different methods.

Postchill neck skin maceration (NSM) and whole-carcass rinsing (WCR) are frequently used methods to detect salmonellae from processed broilers. These are practical, nondestructive methods, but they are insensitive and may result in false negatives (20 to 40%). Neck skin samples comprise only 4% of the skin from the broiler carcass by weight, while WCR will not detect firmly attached Salmonella organisms and only 7.5% of the rinsate is utilized. Whole-carcass enrichment (WCE) involves incubation of the whole carcass overnight in a preenrichment broth and can recover as few as 8 inoculated Salmonella cells per carcass. The objective of this study was to use NSM, WCR, and WCE sampling to detect naturally occurring Salmonella from the same commercially processed broiler either prechill or postchill. Ten carcasses were obtained prechill and another 10 postchill on each of two replicate days from each of two commercial processing plants. From each carcass, 8.3 g of neck skin was sampled, and then the carcass was rinsed with 400 ml of 1% buffered peptone water. Thirty milliliters was removed and incubated (WCR), and the remaining 370 ml of broth and the carcass were incubated at 37°C for 24 h (WCE). Overall, Salmonella organisms were detected on 21, 24, and 32 of 40 prechill carcasses by NSM, WCR, and WCE, respectively, while 2, 2, and 19 of 40 postchill carcasses were positive by the respective methods. Prechill carcasses were 64% (77 of 120) positive for Salmonella, while postchill carcasses were 19% (23 of 120) positive. Commercial processing reduced the positive-sample prevalence by 45%. Salmonella organisms were detected on 20% (24 of 120) of the samples from plant 1 and 63% (76 of 120) of the carcasses from plant 2. This study demonstrates significant differences in the results for Salmonella prevalence among sampling methods both before and after immersion chilling, as well as between processing plants on days that samples were taken.

Numbers of Salmonella recovered by sponge or low volume whole carcass rinse sampling of inoculated commercial turkey carcasses.

Processed turkey carcasses are sampled for Salmonella via sponge sampling, whereas broilers are sampled via whole carcass rinses. Because different sampling methods have been reported to produce different results, sponge sampling and whole carcass rinsing (WCR) were performed on turkey hen carcasses inoculated with a known amount of nalidixic acid-resistant Salmonella enterica serovar Enteritidis. Five turkey hen carcasses were collected from the shackle line in a commercial processing plant in each of 4 replicate trials. Carcasses were placed in a cooler with a small amount of ice and transported to the laboratory for approximately 1.5 h. Salmonella inoculum was applied by spreading 0.5 mL on the back and 0.5 mL on the thigh. After 10 min, the carcasses were sampled via a premoistened 4×8-cm sponge, swiping 10 times vertically and 10 horizontally on the back, and then repeating the same sequence on the thigh using a 10×5-cm template. After sponge sampling carcasses were placed in a clean plastic bag, 200 mL of buffered peptone was added, and bags were manually shaken for 60 s for a low volume whole carcass rinse (WCR). Liquid from stomached sponges and from WCR rinsate was serially diluted in 0.85% saline and plated onto Brilliant Green agar with sulfapyridine containing 200 ppm of nalidixic acid. Plates were incubated at 37°C for 24 h and colonies indicative of Salmonella were counted and transformed from cfu/mL to log cfu/cm2. The low volume WCR recovered significantly more Salmonella than sponge sampling in trial 3 (log 3.1 vs. 2.3, respectively) and trial 4 (log 3.1 vs. 2.2, respectively). No differences were observed in trials 1 and 2 due to sample method. Low volume WCR is equal to or more effective than sponge sampling for recovering inoculated Salmonella from turkey carcasses.

Meat quality and sensory attributes of a conventional and a Label Rouge-type broiler strain obtained at retail.

Some consumers have reported preferences for meat from alternative broiler strains as compared with meat from conventional broiler strains relative to taste and texture, but relatively few objective measurements have been conducted on these particular strains. To directly compare meat quality from a Label Rouge-type alternative and a conventional broiler strain available at retail, 4 ready-to-cook conventional and 6 alternative strain carcasses were obtained from retail or a processing plant on each of 6 d. Boneless skinless breast fillets and boneless thighs were taken from each carcass and weighed. Raw meat was then assigned to different testing lots for cooking to evaluate yield, objective texture, meat color, sensory profile, and proximate composition (percentage protein, moisture, fat, and ash). Analyses of data revealed no significant difference (P < 0.05) due to broiler strain for percentage protein, moisture, fat, and ash, for either breast or thigh meat. Conventional breast (raw and cooked) weights were significantly higher than the alternative strain, but there was no difference in cooked yield. There were no differences between strain for thigh weights or yield. Both thigh and breast meat from the conventional broilers was more tender than meat from alternative broilers. Cooked conventional breast meat was darker and yellower, whereas cooked thigh was lighter, less red, and more yellow than alternative meat. Sensory analysis found no difference between strains for breast meat attributes. Conventional thigh meat scored higher than alternative for appearance, tenderness, juiciness, and how well the panelist liked the appearance, but there was no difference in aftertaste or overall liking. Although minimal differences were observed for cooked breast meat due to strain, conventional cooked thigh meat scored higher than the thigh meat from the Label Rouge-type alternative for most of the sensory attributes.

Onsite wastewater nitrogen reduction with expanded media and elemental sulfur biofiltration.

A passive biofiltration process has been developed to enhance nitrogen removal from onsite sanitation water. The system employs an initial unsaturated vertical flow biofilter with expanded clay media (nitrification), followed in series by a horizontal saturated biofilter for denitrification containing elemental sulfur media as electron donor. A small-scale prototype was operated continuously over eight months on primary wastewater effluent with total nitrogen (TN) of 72.2 mg/L. The average hydraulic loading to the unsaturated biofilter surface was 11.9 cm/day, applied at a 30 min dosing cycle. Average effluent TN was 2.6 mg/L and average TN reduction efficiency was 96.2%. Effluent nitrogen was 1.7 mg/L as organic N, 0.93 mg/L as ammonium (NH(4)-N), and 0.03 as oxidized (NO(3) + NO(2)) N. There was no surface clogging of unsaturated media, nitrate breakthrough, or replenishment of sulfur media over eight months. Visual and microscopic examinations revealed substantially open pores with limited material accumulation on the upper surface of the unsaturated media. Material accumulation was observed at the inlet zone of the denitrification biofilter, and sulfur media exhibited surface cavities consistent with oxidative dissolution. Two-stage biofiltration is a simple and resilient system for achieving high nitrogen reductions in onsite wastewater.

Survival gains needed to offset persistent adverse treatment effects in localised prostate cancer.

BACKGROUND: Men diagnosed with localised prostate cancer (LPC) face difficult choices between treatment options that can cause persistent problems with sexual, urinary and bowel function. Controlled trial evidence about the survival benefits of the full range of treatment alternatives is limited, and patients' views on the survival gains that might justify these problems have not been quantified. METHODS: A discrete choice experiment (DCE) was administered in a random subsample (n=357, stratified by treatment) of a population-based sample (n=1381) of men, recurrence-free 3 years after diagnosis of LPC, and 65 age-matched controls (without prostate cancer). Survival gains needed to justify persistent problems were estimated by substituting side effect and survival parameters from the DCE into an equation for compensating variation (adapted from welfare economics). RESULTS: Median (2.5, 97.5 centiles) survival benefits needed to justify severe erectile dysfunction and severe loss of libido were 4.0 (3.4, 4.6) and 5.0 (4.9, 5.2) months. These problems were common, particularly after androgen deprivation therapy (ADT): 40 and 41% overall (n=1381) and 88 and 78% in the ADT group (n=33). Urinary leakage (most prevalent after radical prostatectomy (n=839, mild 41%, severe 18%)) needed 4.2 (4.1, 4.3) and 27.7 (26.9, 28.5) months survival benefit, respectively. Mild bowel problems (most prevalent (30%) after external beam radiotherapy (n=106)) needed 6.2 (6.1, 6.4) months survival benefit. CONCLUSION: Emerging evidence about survival benefits can be assessed against these patient-based benchmarks. Considerable variation in trade-offs among individuals underlines the need to inform patients of long-term consequences and incorporate patient preferences into treatment decisions.

Effect of stomaching on numbers of bacteria recovered from chicken skin.

Stomaching of skin samples releases only slightly more bacteria than a single rinse. Successive rinses, however, continue to remove almost as many bacteria as the first rinse. One hypothesis to explain this observation is that relatively violent treatment of skin generates smaller pieces of skin, thus increasing the net surface area and effectively sequestering bacteria in a water film on the skin pieces so that numbers of bacteria suspended in the rinsate do not increase. An experiment was conducted to determine whether inoculated marker bacteria are removed from the rinse liquid as skin pieces are stomached and naturally occurring bacteria are released. In each of 4 replications, 5 prechill broiler carcasses were collected from a commercial processing plant. Two 5-g pieces (n = 40) of breast skin were removed from each carcass and placed in a stomacher bag. An inoculum of 30 mL of 0.85% saline solution containing approximately 10(4) of nalidixic acid-resistant Salmonella enterica serovar Typhimurium per milliliter was added to each sample. Skin samples were hand-massaged for 30 s to mix the inoculum, after which a 1-mL aliquot was removed for enumeration of bacteria. A similar sample was taken after 4 min of vigorous stomaching of the skin sample. Bacterial counts recovered from the 30-s hand-massage were 4.3, 2.7, 2.6, and 3.7 log(10) cfu/mL of rinsate for aerobic bacteria, coliforms, Escherichia coli, and Salmonella, respectively. After stomaching, counts were 4.3, 2.9, 2.8, and 3.8, respectively. There was no difference in aerobic plate counts, but mean coliform and E. coli counts were significantly higher (P < 0.05) after stomaching. Numbers of inoculated Salmonella did not decrease. Breaking up the skin into smaller pieces by stomaching did not reduce the number of inoculated bacteria suspended in the rinsate.

The investigation of infants with RhD-negative mothers: can we safely omit the umbilical cord blood direct antiglobulin test?

Historically, the investigation of a neonate at risk of Rhesus D antigen (RhD)-associated haemolytic disease has included a direct antiglobulin test on umbilical cord blood. However, the introduction of routine antenatal anti-RhD prophylaxis has led to a significant number of false positive results and recent studies suggest that a positive cord blood direct antiglobulin test is poorly predictive of subsequent hyperbilirubinaemia. The British Committee for Standards in Haematology guidelines now recommend that a direct antiglobulin test should no longer be performed routinely on umbilical cord blood in infants born to RhD-negative mothers. We review the recent changes in antenatal management of RhD-negative mothers and their impact on the neonatal presentation of RhD-associated haemolytic disease of the newborn that underpin this recommendation. We conclude that there is convincing evidence to support the guidelines. Finally, we consider how babies born to RhD-negative mothers should be investigated and consider alternative strategies to detect neonatal hyperbilirubinaemia.

Comparison of neck skin excision and whole carcass rinse sampling methods for microbiological evaluation of broiler carcasses before and after immersion chilling.

Sampling protocols for detecting Salmonella on poultry differ among various countries. In the United States, the U.S. Department of Agriculture Food Safety and Inspection Service dictates that whole broiler carcasses should be rinsed with 400 ml of 1% buffered peptone water, whereas in the European Union 25-g samples composed of neck skin from three carcasses are evaluated. The purpose of this study was to evaluate a whole carcass rinse (WCR) and a neck skin excision (NS) procedure for Salmonella and Escherichia coli isolation from the same broiler carcass. Carcasses were obtained from three broiler processing plants. The skin around the neck area was aseptically removed and bagged separately from the carcass, and microbiological analysis was performed. The corresponding carcass was bagged and a WCR sample was evaluated. No significant difference (alpha

Apoptosis and non-inflammatory phagocytosis can be induced by mitochondrial damage without caspases.

A central issue regarding vertebrate apoptosis is whether caspase activity is essential, particularly for its crucial biological outcome: non-inflammatory clearance of the dying cell. Caspase-9 is required for the proteolytic cascade unleashed by the mitochondrial outer membrane permeabilization (MOMP) regulated by the Bcl-2 protein family. However, despite the severely blunted apoptosis in cells from Casp9(-/-) mice, some organs with copious apoptosis, such as the thymus, appear unaffected. To address this paradox, we investigated how caspase-9 loss affects apoptosis and clearance of mouse fibroblasts and thymocytes. Although Casp9(-/-) cells were initially refractory to apoptotic insults, they eventually succumbed to slower caspase-independent cell death. Furthermore, in gamma-irradiated mice, the dying Casp9(-/-) thymocytes were efficiently cleared, without apparent inflammation. Notably, MOMP proceeded normally, and the impaired mitochondrial function, revealed by diminished mitochondrial membrane potential (DeltaPsi(m)), committed cells to die, as judged by loss of clonogenicity. Upon the eventual full collapse of DeltaPsi(m), presumably reflecting failure of respiration, intact dying Casp9(-/-) cells unexpectedly exposed the prototypic 'eat-me' signal phosphatidylserine, which allowed their recognition and engulfment by phagocytes without overt inflammation. Hence, caspase-9-induced proteolysis accelerates apoptosis, but impaired mitochondrial integrity apparently triggers a default caspase-independent program of cell death and non-inflammatory clearance. Thus, caspases appear dispensable for some essential biological functions of apoptosis.

The presence of the glycolysis operon in SAR11 genomes is positively correlated with ocean productivity.

Bacteria in the SAR11 clade are highly abundant in marine surface waters, but currently little is known about the carbon compounds that support these large heterotrophic populations. To better understand the carbon requirements of these organisms, we conducted a multiphasic exploration of carbohydrate utilization among SAR11 isolates from the Northeast Pacific Ocean and the Sargasso Sea. A comparison of three SAR11 genomes showed they all lacked a recognizable PTS system, the oxidative portion of the pentose phosphate shunt (zwf-, pgl-), genes for the Embden-Meyerhoff-Parnas (pfk-, pyk-) and Entner-Doudoroff (eda-) pathways of glycolysis. Strain HTCC7211, isolated from an ocean gyre, was missing other glycolysis genes as well. Growth assays, radioisotopes, metagenomics and microarrays were used to test the hypothesis that these isolates might be limited in their abilities to transport and oxidize exogenous carbohydrates. Galactose, fucose, rhamnose, arabinose, ribose and mannose could not serve as carbon sources for the isolates tested. However, differences in glucose utilization were detected between coastal and ocean gyre isolates, with the coastal isolates capable of transporting, incorporating and oxidizing glucose while the open ocean isolate could not. Subsequent microarray analysis of a coastal isolate suggested that an operon encoding a variant of the Entner-Doudoroff pathway is likely responsible for the observed differences in glucose utilization. Metagenomic analysis indicated this operon is more commonly found in coastal environments and is positively correlated with chlorophyll a concentrations. Our results indicated that glycolysis is a variable metabolic property of SAR11 metabolism and suggest that glycolytic SAR11 are more common in productive marine environments.