Short-term and long-term exposure to combined elevated temperature and CO2 leads to differential growth, toxicity, and fatty acid profiles in the harmful dinoflagellate Karlodinium veneficum

Frontiers in Marine Science · 2024-04-09 · 2 citations

Ocean warming and acidification may significantly alter the distribution and intensity of harmful algal blooms as well as their effects on marine food webs. Estimating such effects rely, in part, on understanding the physiological response of individual algal species to controlled laboratory simulations of climate change conditions. Here we report the physiological response of the harmful dinoflagellate Karlodinium veneficum to the combined effects of elevated temperature and CO 2 (29°C/1000 ppm CO 2 ). We first examined these effects by comparing ambient control (25°C/441 ppm CO 2 ) and elevated conditions under short-term (~20 generations) growth. Next, we compared the short-term elevated condition to a longer-term (~200 generations) growth scenario under the same elevated temperature and CO 2 . Under the short-term elevated conditions, K. veneficum growth declined, cell toxicity increased, and saturated and mono-unsaturated fatty acid (FA) composition varied significantly from ambient conditions. Meanwhile, after ~ 200 generations of growth under elevated temperature and CO 2 , K. veneficum carbon assimilation, growth, and cell toxicity were significantly higher than the short-term elevated treatment. Further, while total saturated FA declined, essential fatty acids increased and likely represented an adaptive temporal response to long-term exposure to high temperature and CO 2 . Such shifts in FA profiles and cell toxicity may possibly alter K. veneficum nutritional quality as prey and its mixotrophic behavior, thereby affecting the energy and mass transfer through the marine food webs as well as bloom dynamics.

85. Dose-response effects of diets partially replaced by food processing industrial by-products on in vitro ruminal fermentation and methane production

Animal - science proceedings · 2024-03-01

Integrating Formative Research and Human-Centered Design to Design Strategies to Achieve High Adherence to Prenatal Supplementation in Burkina Faso, Pakistan, and Zimbabwe

Current Developments in Nutrition · 2024-06-29

P01-40 Contemporary in vitro toxicology assessment of a novel Herbal Heated Product (HHP) compared to cigarette smoke

Toxicology Letters · 2024-09-01

The effect of an intervention to reduce aflatoxin consumption from 6 to 18 mo of age on length-for-age z-scores in rural Tanzania: a cluster-randomized trial

American Journal of Clinical Nutrition · 2024-11-26 · 6 citations

BACKGROUND: Linear growth faltering continues to negatively affect children in low- and middle-income countries and is associated with poor cognitive, developmental, and educational outcomes. Laboratory and observational data suggest that aflatoxin (AF) is a contributor to stunting. OBJECTIVE: The Mycotoxin Mitigation Trial was a cluster-randomized, community-based 2-group trial conducted in Kongwa District, Tanzania, between 2018 and 2020. The trial assessed whether a 12-mo intervention to reduce AF consumption increased length-for-age z-scores (LAZ) at 18 mo. METHODS: Low-AF maize and groundnut flours were provided to the intervention group each month; skin lotion was distributed to the control group monthly. Infant and young child feeding education was delivered equally in 52 health facilities (clusters). Anthropometry and the AF blood biomarker serum AF-albumin (AF-alb) were assessed at 6, 12, and 18 mo of age. Outcomes were analyzed as intention-to-treat and per-protocol using linear mixed-effects models. RESULTS: Two thousand eight hundred forty-two maternal-infant dyads were recruited into the study. The intervention did not create a contrast in AF-alb. At 18 mo, 36% (n = 186/520) of infants had detectable levels of AF-alb compared with 54% (n = 195/364) at baseline, with no difference between groups. Mean LAZ in the intervention group at 18 mo was -1.83 (n = 1231, 95% CI: -1.93, -1.73) compared to -1.90 (n = 1287, 95% CI: -1.99, -1.82) in the control group (P = 0.28). CONCLUSIONS: An intervention to reduce AF exposure did not alter AF-alb nor anthropometric measures between treatment groups. Drought and agricultural data indicated less favorable conditions for toxin production, resulting in low levels of exposure in both trial arms. Annual, seasonal, and geographic heterogeneity of AF contamination make it difficult to study in an ethically designed trial. Our formative research and early trial data indicate that stunting and intermittent AF exposure continue to be a problem in this region. However, the low-AF exposure levels during the trial led to inconclusive results. TRIAL REGISTRATION NUMBER: NCT03940547 (ClinicalTrials.org).

Optimization of Patient Progression in a New Era

Professional Case Management · 2024-02-29 · 1 citations

PURPOSE/OBJECTIVES: The onset of the coronavirus disease 2019 pandemic increased the demand for inpatient services and led to widespread staffing shortages in the acute and post-acute setting, contributing to delayed inpatient throughput and leading to capacity crises. Novel strategies are needed to facilitate the efficient progression of hospitalized patients when medically ready for lower levels of care. The authors have developed a foundational strategic framework for patient progression to ensure capture of patient progression data, enhance efficiency, and optimal utilization of post-acute resources in increasingly complex and resource-constrained acute and post-acute environments. PRIMARY PRACTICE SETTINGS: Interventions were implemented, and metrics of success tracked as part of an overarching framework to test new models of care or optimize existing assets related to barriers to patient progression. Brigham and Women's Hospital (BWH) and Brigham and Women's Faulkner Hospital (BWFH) comprise an academic medical center and a community hospital, respectively, that are affiliated with Massachusetts General Brigham (MGB), a nonprofit health care system in Massachusetts. Key interventions include (1) screening to prioritize patients needing case management services through a modified early screening for discharge planning tool and process; (2) communicating, documenting, identifying patient progression status, barriers to discharge and post-acute needs through interdisciplinary care optimization rounds, a novel tool in the electronic health record, and an associated dashboard; (3) managing active high-risk patients through a novel complex care team and post-acute strategy development; (4) developing novel transportation and hospice pathways; and (5) establishing community hospital repatriation and a physical therapy "Why Not Home" campaign. FINDINGS: Key metrics of success were (1) modified discharge planning tool resulting in screening out low-risk patients (53%) and impacting length of stay (0.55-day reduction, p = .083) during a 3-month intervention versus control study; (2) documentation adherence in more than 98% of patients 10 months postimplementation; (3) complex care team achieving a 2.5% reduction in Case Mix Index-adjusted length of stay 6 months postimplementation; (4) use of care van offsetting ambulance/chair car in 10% of cases, and earlier discharge time/length of stay in 21% of cases 3 months postimplementation; and (5) implementation of community repatriation impacting delay days to discharge (10-month pilot, 40 patients accounting for 1,000 delay days). CONCLUSIONS: Implementation of a novel comprehensive framework focusing on optimizing patient progression resulted in increased operational efficiency and positively impacted length of stay at our academic and community hospitals. Additional study is actively ongoing to understand long-term benefit of the innovations that the authors have developed. Further interventions are needed to wholly mitigate evolving capacity challenges in the acute and post-acute settings. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: The authors' implementation of the Brigham framework for progression demonstrates that innovative approaches to case management can help address the evolving challenges in care transitions planning. Notable opportunities include approaches that empower case managers as multidisciplinary team leaders, improve workflow, utilize patient progression data, prioritize patients with complex care needs support key patient populations, and promote post-acute collaboration.

Comparison of mineral profiles between cows’ milk and plant-based beverages in the UK

Proceedings of The Nutrition Society · 2024-11-01

Cows’ milk (CM) and plant-based beverages (PBB), used as milk alternatives, are not nutritionally equivalent (1) and PBB composition is highly varied (2) . However, assessing the potential nutritional risk for UK populations after dietary replacement of milk with PBB is challenging, because analytical determination of PBBs’ nutrient profiles is lacking (3) . This study determined and compared the mineral concentrations of milk and PBB in the UK market. Ultra-heat treated and pasteurised samples (n = 178), including 20 brands of semi-skimmed milks and 69 brands of fortified PBBs (based on almond (17; ALMO), coconut (14; COCO), oat (19; OAT) and soya (20; SOYA)) were collected in summer 2023 and winter 2024. All PBB samples had added Ca and Na, but only 62 were fortified with I. Minerals concentration was determined using microwave assisted digestion, inductively coupled plasma-optical emission spectrometry (for microminerals) and inductively coupled plasma and mass spectrometry (for trace elements and heavy metals). Data were analysed using Minitab®22.1, with linear mixed effects models using ingredient, thermal treatment and season, and their interactions, as fixed factors, and brand ID as a random factor. The main ingredient affected all mineral concentrations (p<0.001), except Ca and Co. SOYA had more Mg than milk (+27.5mg/kg), and milk had more Mg than ALMO, COCO, and OAT (+41.783.3mg/kg). Milk and SOYA had more P and K than other PBB (P, +411 mg/kg and +381mg/kg; K, +920 mg/kg, and +631 mg/kg, respectively). Milk had less Na than PBB (-126-64 mg/kg) with the exception of COCO. Milk contained more I (+157-200.4 µg/kg) and Zn (+1.41-3.71 mg/kg) than PBB. SOYA contained more Cu, Mg, and Mo than other PBB (for Cu 65-70 mg/kg; for Mn +1.00-1.06 mg/kg; for Mo +46-93.5 µg/kg, respectively) and milk (Cu +0.77 mg/kg; Mn +1.44 mg/kg; Mo +84.1 µg/kg). Overall, SOYA contained the most Cd, Cr, and Ni (although difference to OAT was not significant for Cr and Ni), while milk had the lowest concentration of Cd. Concentrations of Mg, P, Cu, I, Mn, Mo, and Co varied according to season (P<0.05). When compared with summer, winter PBB and milk had more Mg (+4.4 mg/kg), Cu (+0.04 mg/kg), I (+41 µg/kg), and Mo (+9.8 µg/kg), but less P (-76 mg/kg), Mn (−0.08 mg/kg), Zn (−0.21 mg/kg), and Co (-5.21 μg/kg). There were no differences in mineral concentrations due to thermal processing (UHT, pasteurisation; P>0.05). The minerals composition of fortified PBB varied between main ingredient, and compared to milk, and seasonal variation was high. To prevent micronutrient inadequacies from the substitution of milk for PBB (in particular for I and Zn), consumers should be aware of differences in the intrinsic nutrient composition between PBB derived from different ingredients and milk, as this study showed and adopt suitable dietary and supplementation adjustments.

Provision of low‐aflatoxin local complementary porridge flour reduced urinary aflatoxin biomarker in children aged 6–18 months in rural Tanzania

Maternal and Child Nutrition · 2023-03-09 · 7 citations

Aflatoxins are toxic secondary metabolites of fungi that colonize staple food crops, such as maize and groundnut, frequently used in complementary feeding. In preparation for a large trial, this pilot study examined if provision of a low-aflatoxin infant porridge flour made from local maize and groundnuts reduced the prevalence of a urinary aflatoxin biomarker in infants. Thirty-six infants aged 6-18 months were included from four villages in Kongwa District, Tanzania. The study was conducted over 12 days with a three-day baseline period and a 10 days where low-AF porridge flour was provided. Porridge intake of infants was assessed using quantitative 24-h recalls by mothers. Household food ingredients used in infant porridge preparation and urine samples were collected on Days 1-3 (baseline) and 10-12 (follow-up). Aflatoxins were measured in household foods, and AFM1 was measured in urine. At baseline and follow-up, 78% and 97%, respectively, of the infants consumed porridge in the previous 24 h, with a median volume of 220 mL (interquartile range [IQR]: 201, 318) and 460 mL (IQR: 430, 563), respectively (p < 0.001). All 47 samples of homemade flour/ingredients were contaminated with AFs (0.3-723 ng/g). The overall prevalence of individuals with detectable urinary AFM1 was reduced by 81%, from 15/36 (42%) at baseline to 3/36 (8%) at follow-up (p = 0.003). Provision of low-aflatoxin porridge flour was acceptable to caregivers and their infants and successfully reduced the prevalence of detectable urinary AFM1 in infants, thus, confirming its potential to be tested in future large-scale health outcomes trial.

Formulation and acceptability of local nutrient‐dense foods for young children: A formative study for the Child Health, Agriculture and Integrated Nutrition (CHAIN) Trial in rural Zimbabwe

Maternal and Child Nutrition · 2023-12-13 · 4 citations

Stunting affects almost one-quarter of children globally, leading to reduced human capacity and increased long-term risk of chronic disease. Despite intensive infant and young child feeding (IYCF) interventions, many children do not meet their requirements for essential nutrients. This study aimed to assess the feasibility of implementing an IYCF intervention utilizing nutrient-dense powders from egg, biofortified sugar beans and Moringa oleifera leaf in rural Zimbabwe. A mixed-methods formative study was conducted comprising the following: (i) a recipe formulation trial, (ii) trials of improved practices to assess acceptability of the intervention, and (iii) a participatory message formulation process to develop counselling modules for the IYCF-plus intervention. Twenty-seven mother-baby pairs were recruited between November 2019 and April 2020. Key domains affecting IYCF practices that emerged were time, emotional and physical space, cultural and religious beliefs, indigenous knowledge systems and gender dynamics. Household observations and sensory evaluation indicated high acceptability of the new ingredients. Recipe formulation and participatory message formulation by participants instilled community ownership and served to demystify existing misconceptions about the new food products. Families noted the potential for intervention sustainability because the foods could be grown locally. Supplementing complementary foods with nutrient-dense local food ingredients as powders has the potential to sustainably address nutrient-gaps in the diets of young children living in rural lower- and middle-income countries. Comprehensive IYCF counselling utilizing a gender-lens approach, family support and indigenous knowledge systems or resources are key elements to support positive behaviour change in complementary feeding interventions.

Correction: Implementation of Psychosocial Screening into Diabetes Clinics: Experience from the Type 1 Diabetes Exchange Quality Improvement Network

Current Diabetes Reports · 2023-01-28 · 3 citations