Essential surgery: the way forward.

INTRODUCTION: Very little surgical care is performed in low- and middle-income countries (LMICs). An estimated two billion people in the world have no access to essential surgical care, and non-surgeons perform much of the surgery in remote and rural areas. Surgical care is as yet not recognized as an integral aspect of primary health care despite its self-demonstrated cost-effectiveness. We aimed to define the parameters of a public health approach to provide surgical care to areas in most need. METHODS: Consensus meetings were held, field experience was collected via targeted interviews, and a literature review on the current state of essential surgical care provision in Sub-Saharan Africa (SSA) was conducted. Comparisons were made across international recommendations for essential surgical interventions and a consensus-driven list was drawn up according to their relative simplicity, resource requirement, and capacity to provide the highest impact in terms of averted mortality or disability. RESULTS: Essential Surgery consists of basic, low-cost surgical interventions, which save lives and prevent life-long disability or life-threatening complications and may be offered in any district hospital. Fifteen essential surgical interventions were deduced from various recommendations from international surgical bodies. Training in the realm of Essential Surgery is narrow and strict enough to be possible for non-physician clinicians (NPCs). This cadre is already active in many SSA countries in providing the bulk of surgical care. CONCLUSION: A basic package of essential surgical care interventions is imperative to provide structure for scaling up training and building essential health services in remote and rural areas of LMICs. NPCs, a health cadre predominant in SSA, require training, mentoring, and monitoring. The cost of such training is vastly more efficient than the expensive training of a few polyvalent or specialist surgeons, who will not be sufficient in numbers within the next few generations. Moreover, these practitioners are used to working in the districts and are much less prone to gravitate elsewhere. The use of these NPCs performing "Essential Surgery" is a feasible route to deal with the almost total lack of primary surgical care in LMICs.

Impact dehulling oat grain to improve quality of on-farm produced feed 2

Selostus: Kauran kuorinnan aiheuttama jyvien rikkoutuminen ei heikennä säilyvyyttä

Impact dehulling oat grain to improve quality of on-farm produced feed 1

Selostus: Kotoisen kauran ravitsemuksellista arvoa ja energiapitoisuutta voidaan parantaa kuorinnalla

Effect of feed fat by-products with trans fatty acids and heated oil on cholesterol and oxycholesterols in chicken

Chicken is the most widely consumed meat all over the world due to chickens being easy to rear, their fast growth rate and the meat having good nutritional characteristics. The main objective of this paper was to study the effects of dietary fatty by-products in low, medium and high levels of oxidized lipids and trans fatty acids (TFAs) on the contents of cholesterol and oxycholesterols in meat, liver, and plasma of chickens. A palm fatty acid distillate, before and after hydrogenation, and a sunflower-olive oil blend (70/30, v/v) before and after use in a commercial frying process were used in feeding trials after adding 6% of the fats to the feeds. Highly oxidized lipid and TFA feeds significantly increased the contents of cholesterol and oxycholesterols in all tissues of chicken (0.01 < p <= 0.05). The contents of oxycholesterols in chicken meat, liver and plasma obtained from TFA feeding trials varied between 17 and 48 μg/100 g in meat, 19-42 μg/100 g in liver and 105-126 μg/dL in plasma. In contrast, in the oxidized lipid feeding trials, oxycholesterols varied between 13 and 75 μg/100 g in meat, 30-58 μg/100 g in liver and 66-209 μg/dL in plasma. Meat from chickens fed with feeds containing high levels of TFAs or oxidized lipids may contribute to higher ingestion of cholesterol and oxycholesterols by humans.

Kalvoerotusprosessin esikäsittely

Työn tavoitteena oli tutkia kiertoveden puhdistamiseen käytetyn kalvosuodatuksen esikäsittelymenetelmien vaikutusta ultrasuodatukseen. Suodatettava vesi oli kierrätyskuitua käyttävän paperikoneen kiekkosuotimen kirkassuodosta. Koeajon loppuosassa käytettiin biokirkassuodosta. Paperitehtaassa oli suljettu vesikierto. Pilot-laitteistona käytettiin Metso PaperChemin OptiFilter CR550/40 ultrasuodatusyksikköä. Testatut kalvot olivat C30 kalvoja. Suodatuksissa seurattiin esikäsittelymenetelmien vaikutusta permeaatin määrään ja laatuun. Ultrasuodatus tehtiin sekä ilman esikäsittelyä että lamelliselkeytin esikäsittelynä. Esikäsittelykemikaalina käytettiin talkkia. Ultrasuodatuksissa havaittiin, että suodatuslämpötilalla oli suora vaikutus kapasiteettiin. Lämpötila vaikutti lineaarisesti kirkassuodoksen ja biokirkassuodoksen permeaattivuohon. Lämpötila nostettiin 55oC:een suodatuslämpötilasta 35 – 40oC. Korkeassa lämpötilassa kirkassuodos oli kapasiteetiltaan suurempi kuin biokirkassuodos. Konsentrointiajoista nähtiin, että ultrasuodatuksen syötön konsentraatioaste vaikutti kirkassuodoksen permeaattivuohon. Syötön konsentraatioastetta lisättäessä kapasiteetti laski. Konsentrointiajoja vertailtaessa havaitaan, että ilman esikäsittelyä vuo laski konsentroitaessa nopeammin kuin suodatuksissa, joissa käytettiin esikäsittelyä. Lamelliselkeyttimellä ja talkilla esikäsitelty suodatus laski kapasiteettia vähiten. Konsentraatioasteen nostaminen lisäsi konsentraatin kemiallista hapenkulutusta. Konsentraatin viskositeetti nousi konsentraatioastetta lisättäessä. Analyysitulosten perusteella saadaan ultrasuodatuskalvoille tyypilliset reduktiot. COD-reduktio oli 10 – 30 %, anionisuuden 40 – 70 % ja värin 80 – 90 %. Vuon kanssa korreloivat pH, uuteaine, ligniini, viskositeetti ja hemiselluloosat.

Benthos of Spanish lakes and reservoirs

A summary of the results from the study of benthos of lakes and reservoirs in Spain is provided, with a list of the species found to date. Spanish natural lakes are smaller than European lakes; the largest is Lake Sanabria, of glacial origin, which is 3 Km long and half a kilorneter wide. Many are very small and situated in the mountains; more than 200 hundred have been recorded in Spain, but only in Lake Sanabria and Lake Banyoles have the benthos been studied. Lake Sanabria is a cold oligotrophic, monomictic lake with oxygen always present in the deepest zones. Its fauna is similar to that of other central European lakes, with Mici.opsectra c.orztractu (a chironomid) as the dominan1 species. Lake Banyoles is a karstic, monomictic and multibasin lake; despite the low primary productivity, due to the abundante of sulphate in the water, the allochthonous inflow of organic matter and the inflow of water from bottom springs, the profunda1 environinent is very stressing for benthic fauna. Very low oxygen concentrations and high sulphide content in the water and sediments dueto meromixis mean that only the larva of the dipteran Chaohoi.lcs flai7icans was present in one of the 5 basins of the lake. In other basins, when oxygen is available (no meromixis), the fauna is similar to that of tlie inineralized lakes of the Aegean region and some lakes in central Italia. On the other hand, preliminary data from the Pyrenean lakes and from Sierra Nevada ponds reveal no differences with northern cold lakes. Tlie largest lakes in Spain are the reservoirs. There are nearly 1000 and data are available on 100 of them, including the kargest. In addition to oxygen and sulphide content in the bottom waters, water level fluctuation and high sedimentation rates are disturbance factors that prevented the organization of the community. Allochthonous inputs of organic matter are also an important factor both in the reservoirs and also in the small, oligotrophic lakes like Banyoles and Sanabria. As a result the meiofaunal loop is very important in many of the Spanish water bodies . For this reason the natural lakes and reservoirs of Spain are dominated by Oligochaeta, small crustaceans and the microcarnivore chironomids (such as Procladi~ls, Cladopelma and Mi(,rnc.hil-onnmus) that feed on these meoifaunal elements. The phytophagous chironomids, like Chironomus, are only abundan1 in the shallow areas of mesotrophic and eutrophic reservoirs. This situation makes it difficult to apply the typological system of SAETHER which predicts with some confidence only the benthic communities of Spanish natural lakes above 1500 m in the Pyrenees or the ponds above 2000 m in Sierra Nevada mountains. Higher temperatures (which originate a longer stratification period), the presence of sulphate in the waters of the eastern part of Spain and high inputs of sediments and allochthonous organic matter seem to be the factors that originated the differences between the benthic profunda1 faunas of Spanish lakes and reservoirs and those of the temperate lakes of north and central Europe.

Protein loop compaction and the origin of the effect of arginine and glutamic acid mixtures on solubility, stability and transient oligomerization of proteins

Addition of a 50 mM mixture of l-arginine and l-glutamic acid (RE) is extensively used to improve protein solubility and stability, although the origin of the effect is not well understood. We present Small Angle X-ray Scattering (SAXS) and Nuclear Magnetic Resonance (NMR) results showing that RE induces protein compaction by collapsing flexible loops on the protein core. This is suggested to be a general mechanism preventing aggregation and improving resistance to proteases and to originate from the polyelectrolyte nature of RE. Molecular polyelectrolyte mixtures are expected to display long range correlation effects according to dressed interaction site theory. We hypothesize that perturbation of the RE solution by dissolved proteins is proportional to the volume occupied by the protein. As a consequence, loop collapse, minimizing the effective protein volume, is favored in the presence of RE.

Complete genome sequence of the type strain of Bacillus toyonensis BCT-7112T, the active ingredient of the feed additive preparation Toyocerin

Strain BCT-7112, previously identified as Bacillus cereus var. toyoi, is the type strain of the species Bacillus toyonensis, a novel species of the B. cereus group. The complete genome of this strain, which is the active ingredient of the feed additive preparation Toyocerin, has been sequenced and annotated to reveal the genetic properties of this probiotic organism with a long history of safe use in animal nutrition.

Effect of compressibility in bubble formation in closed systems

We analyze the stability of small bubbles in a closed system with fixed volume, temperature, and number of molecules. We show that there exists a minimum stable size of a bubble. Thus there exists a range of densities where no stable bubbles are allowed and the system has a homogeneous density which is lower than the coexistence density of the liquid. This becomes possible due to the finite liquid compressibility. Capillary analysis within the developed"modified bubble" model illustrates that the existence of the minimum bubble size is associated to the compressibility and it is not possible when the liquid is strictly incompressible. This finding is expected to have very important implications in cavitation and boiling.

A thematic analysis of delusion with religious content in schizophrenia: open, closed, and mixed dynamics

The aim of the present study was to elicit how patients with delusions with religious contents conceptualized or experienced their spirituality and religiousness. Sixty-two patients with present or past religious delusions went through semistructured interviews, which were analyzed using the three coding steps described in the grounded theory. Three major themes were found in religious delusions: ''spiritual identity,'' ''meaning of illness,'' and ''spiritual figures.'' One higher-order concept was found: ''structure of beliefs.'' We identified dynamics that put these personal beliefs into a constant reconstruction through interaction with the world and others (i.e., open dynamics) and conversely structural dynamics that created a complete rupture with the surrounding world and others (i.e., closed structural dynamics); those dynamics may coexist. These analyses may help to identify psychological functions of delusions with religious content and, therefore, to better conceptualize interventions when dealing with it in psychotherapy.

Socially anxious and confident men interact with a forward virtual woman: an experiment study

Male volunteers entered an immersive virtual reality that depicted a party, where they were approached by a lone virtual woman who initiated a conversation. The goal was to study how socially anxious and socially confident men would react to this event. Interest focused on whether the socially anxious participants would exhibit sustained anxiety during the conversation or whether this would diminish over time, and differ from the responses of the more socially confident men.

“Of Spitzenkandidaten and European Leaders”: Is the new 2014 "politicized” Presidency of the Commission going to be a real step forward in the EU legitimization process?

Thanks to ART.17.7 of the Lisbon Treaty, the European Council now has to “take into account” the results of EP Elections when selecting a candidate for the role of Commission President. The European Parliament has grabbed the opportunity to launch the first electoral race for spitzenkandidaten to the Presidency. Is this the start of a new democratizing (and thus, politicizing) process for the European Union? This dissertation will try to give a possible answer to the dilemma by constructing a comprehensive framework around EP Elections 2014 that will involve both the Commission and the Parliament and an analysis of the debate beyond legal provisions and the possibility of a politicized presidency of the Commission.