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PubMed2006

Non-lactic acid, contaminating microbial flora in ready-to-eat foods: a potential food-quality index.

The bacteriological profile of 87 samples of commercially available ready-to-eat (RTE) dairy and meat-products, packaged sandwiches and salads was obtained by testing for aerobic colony count, for lactic acid bacterial (LAB) count, for the presence and the extent of non-LAB microflora (contaminating microflora), and by testing for certain food-borne pathogens. The pathogens Listeria monocytogenes, Salmonella spp. and sulfite-reducing clostridia were not detected in any of the analysed samples. Whereas only three samples (3.4%) were deemed unacceptable for consumption for exceeding the established pathogen tolerance levels (for Staphylococcus aureus and Escherichia coli), several samples were found to contain non-lactic acid contaminating microflora of considerable magnitude. The log10 cfu g(-1) counts for contaminating microflora in the food categories examined were as follows: hard cheeses 4.85 (SD 1.17); semi-hard cheeses 5.39 (SD 1.37); soft cheeses 5.13 (SD 1.03); whey cheeses 6.55 (1.24); fermented meat-products 4.18 (SD 1.48); heat-treated meat-products 3.47 (SD 1.99); salads 3.37 (SD 1.56) and sandwiches 5.04 (SD 0.96). Approximately 1 in every 30 to 80 bacterial cells found on different types of cheeses and salads was a non-LAB microorganism; the respective ratios for fermented meat-products, heat-treated meat-products and sandwiches were 1 in 6, 2.5 and 15. The assessment of the contaminating microflora magnitude at various steps during the manufacture and distribution of RTE foods can serve as an index for monitoring the microbiological quality of the starting materials, the sanitation efficacy during processing and possible temperature abuse during processing, transportation or storage.

Colony Count, Microbial↗
PubMedDate not supplied

Determination of volatile chemicals released from microwave-heat-susceptor food packaging.

Microwave heat susceptors that convert electromagnetic energy to heat attain high temperatures that make it possible to cook some foods to golden crispness in a microwave oven. Susceptors are typically packaged with foods intended for microwave use, e.g., waffles, pizzas, and french fries. The high temperatures > 302 degrees F used to cook some foods release trace levels of volatile chemicals from metalized polyester film, adhesive, and paper packaging materials; these volatile chemicals may be absorbed by the food. We simulated microwave susceptor cooking conditions and developed protocols by using headspace concentration capillary gas chromatography and mass spectrometry to identify volatile chemicals released from heated susceptors. We purchased a limited, cross-sectional sample of local retail microwave food products packaged with susceptors and used our protocol to analyze 10 different susceptor products. Although more than 140 unique chromatographic peaks were tabulated, only 44 volatile chemicals were identified, including 1,1,1-trichloroethane, benzene, and 2-(2-butoxyethoxy)ethanol, which were derived primarily from the paper and adhesive susceptor components. No one susceptor contained all the identified substances. The standard additions technique was the preferred method for quantitation. Trichloroethane and 2-(2-butoxyethoxy)ethanol were present in several products at 75-122 micrograms/in.2 of susceptor surface area. Benzene was found in 3 susceptors at < or = 0.22 microgram/in.2 levels. Examination indicates that adhesives used in more recent susceptor products were reformulated to remove even this trace level of benzene.

Benzene↗
PubMed2004

Shelf life and safety concerns of bakery products--a review.

Bakery products are an important part of a balanced diet and, today, a wide variety of such products can be found on supermarket shelves. This includes unsweetened goods (bread, rolls, buns, crumpets, muffins and bagels), sweet goods (pancakes, doughnuts, waffles and cookies) and filled goods (fruit and meat pies, sausage rolls, pastries, sandwiches, cream cakes, pizza and quiche). However, bakery products, like many processed foods, are subject to physical, chemical and microbiological spoilage. While physical and chemical spoilage limits the shelf life of low and intermediate moisture bakery products, microbiological spoilage by bacteria, yeast and molds is the concern in high moisture products i.e., products with a water activity (a(w)) > 0.85. Furthermore, several bakery products also have been implicated infoodborne illnesses involving Salmonella spp., Listeria monoctyogenes and Bacillus cereus, while Clostridium botulinum is a concern in high moisture bakery products packaged under modified atmospheres. This extensive review is divided into two parts. Part I focuses on the spoilage concerns of low, intermediate and high moisture bakery products while Part II focuses on the safety concerns of high moisture bakery products only. In both parts, traditional and novel methods of food preservation that can be used by the bakery industry to extend the shelf life and enhance the safety of products are discussed in detail.

Animals↗
PubMed2005

Analysis of carbon monoxide in commercially treated tuna (Thunnus spp.) and mahi-mahi (Coryphaena hippurus) by gas chromatography/mass spectrometry.

A simple and confirmative method for quantitative determination of carbon monoxide in tuna and mahi-mahi tissues using GC/MS, following chemical liberation of CO into headspace, is described. Carbon monoxide in recent years has been employed by the fishery industry to preserve fresh appearance in selected species of finfish during frozen storage, particularly in vacuum-packaged products. Indigenous CO contents of fresh Ahi tuna and mahi-mahi were examined using the method described in this study and found to be close to or less than 150 and 100 ng/g, respectively. Commercially CO-treated, vacuum-packaged tuna from multiple sources consistently showed CO level near or greater than 1 mug/g, while CO level in the only CO-treated frozen mahi-mahi sample was in the 500 ng/g range. The difference between untreated and treated specimens was in the range of 1 order of magnitude and thus suggested an easy quantitative and confirmative method of CO using widely available instrumentation that may be potentially useful for regulatory purpose in determining whether a commercially available product has been exposed to CO even if not labeled as such.

Animals↗
PubMed2006

Influence of different histories of the inoculum on lag phase and growth of Listeria monocytogenes in meat models.

The aim of this study was to determine the effect of history of inoculum and preservatives on the lag phase and growth rate of Listeria monocytogenes strains in meat products packaged under modified atmosphere conditions. Inocula with different histories were added to meat models, and growth rate and lag phase of two strains of L. monocytogenes were measured at 5 and 10 degrees C. The meat model stored at 10 degrees C contained sodium lactate, but the model stored at 5 degrees C did not. The five different histories of the inocula included cold propagation, biofilm formation, and starvation. The lag phase ranged from 1 to 10 days and was affected by the history of the inoculum, whereas the growth rate was constant except for one combination of history of inoculum and strain, where growth did not start during the incubation period. In a second series of experiments, the growth rate and lag phase of the two Listeria strains and the effects of two different histories of inoculum were tested in meat models with pH 5.7 or 6.5 and increasing amounts of NaCl. The growth rate depended on salt concentration, bacterial strain, and pH, whereas lag phase duration depended on history of inoculum, salt concentration, and pH. The lag phase duration was highly dependent on the history of the inoculum, and higher amounts of preservative (NaCl) made these effects even more noticeable. The results of this study underline the importance of the effects of the history of the inoculum on lag phase duration and could be used to predict lag phase in industrial meat products.

Animals↗
PubMed1995

Perspectives on soy protein as a nonpharmacological approach for lowering cholesterol.

Dietary therapy is the first step in the treatment of hyperlipidemia. However, some patients are unable to lower their cholesterol concentrations to a desirable range with diet alone. For primary prevention of coronary artery disease, physicians and patients often wish to avoid pharmacologic therapy of elevated cholesterol concentrations. The use of adjuncts to diet such as soluble fibers, garlic and soy protein may allow target lipid concentrations to be reached without the use of drugs. Soy protein incorporated into a low-fat diet can reduce cholesterol and LDL-cholesterol concentrations. The main obstacles to greater use of soy protein in the therapy of hyperlipidemia include lack of knowledge by physicians and patients of its effects and lack of availability of easily used products. Although soy products such as tofu and soymilk are available in many stores, consumers may be unaware of their presence and uses. Without the publication of articles in mainstream medical journals on the cholesterol-lowering effects of soy protein, few physicians are likely to know of possible uses. Readily available packaged products, recipes and cookbooks also will be necessary to make incorporation of soy protein into the American diet a reality.

Anticholesteremic Agents↗
PubMed1991

An introduction to product line management.

Management by product line has been used successfully in the manufacturing industry for decades. As the healthcare industry evolves, implementation of Product Line Management is emerging as one strategy to increase efficiency, effectiveness, and profitability. Product Line Management is an organizational scheme and alternative management system for focusing on the programmatic scope of operations in order to achieve particular objectives. Product Line Management in a hospital setting requires deviation from linear functional management paradigms to a reorganization in thinking that focuses on end-result objectives. This management structure recognizes the need to integrate operational and clinical management in response to market-driven forces from both the standpoint of packaging products for the marketplace and appropriate management of those products to improve organizational effectiveness and profitability. However, a "test of time" is necessary to evaluate whether Product Line Management has a positive impact on clinical intervention and outcome. Although Product Line Management seems to be a method to increase profitability, its effect on the quality of client care remains unclear. Speech-language pathologists and audiologists need to be well informed about Product Line Management in the healthcare industry, and should prepare for the possibility of participating within such a framework. Finally, speech-language pathologists and audiologists need to examine and consider their particular qualifications for assuming leadership within such a structure.

American Speech-Language-Hearing Association↗
PubMed1994

Use of rice-based oral rehydration solution in a large diarrhoea treatment centre in Bangladesh: in-house production, use and relative cost.

Glucose-based oral rehydration salt (ORS) is an appropriate and cost-effective tool to treat diarrhoeal dehydration. In patients with a high purging rate, particularly due to cholera, rice-based ORS has been shown to substantially reduce stool output compared to glucose ORS. However, it is not used in the hospitals or diarrhoea treatment centres largely because of the non-availability of a ready-to-use inexpensive packaged product and because of the problem of cooking. In a large diarrhoea treatment centre in Bangladesh (with an annual ORS consumption of approximately 140,000 litres), we have maintained in-house production of rice ORS and used it routinely for more than 600,000 patients over the last nine years. Semi-literate health workers cook rice ORS and supervise mothers in its use. Rice ORS is less costly (US $0.15 per patient treated compared with US $0.37 for glucose ORS) and is well accepted. It is an attractive alternative to glucose ORS in many fixed facility treatment centres in countries where rice is a staple and cholera is endemic. The process of its in-house preparation and use is described in this report which may assist hospitals wishing to use rice ORS in treating diarrhoea patients. Availability of a low cost ready-to-use rice ORS packet (which needs no cooking) with adequate shelf-life will increase its use at fixed facilities.

Bangladesh↗
PubMed1996

Chromium, copper, iron, manganese, selenium and zinc levels in dairy products: in vitro study of absorbable fractions.

Because milk and dairy products are some of the most widespread foods in the human diet, they contribute a large fraction of mineral intake. We determined levels of chromium, copper, iron, manganese, selenium and zinc in 60 samples of 10 widely consumed dairy products. Graphite furnace atomic absorption spectrometry was used to analyze samples processed with a slurry procedure to minimize sample pretreatment. The accuracy and precision of our method were verified. In analyzed samples, mean values ranged from not detectable to 0.950 microgram/g for Cr, from 0.020 to 2.800 micrograms/g for Cu, from 0.750 to 20.0 micrograms/g for Fe, from 0.010 to 0.900 microgram/g for Mn, from not detectable to 0.140 microgram/g for Se, and from 0.250 to 4.500 micrograms/g for Zn. The highest levels of Cr, Cu, Fe, Mn and Zn were detected in children's milk. Increased concentrations of Cr, Cu, Fe and Mn were detected in products packaged in glazed ceramic containers. We also studied the absorbable fractions of these elements using in vitro techniques which simulate human gastric and intestinal digestion.

Absorption↗
PubMed2004

The Global TB Drug Facility: innovative global procurement.

The Global TB Drug Facility (GDF) is a new initiative to increase access to high quality tuberculosis drugs. The GDF, a project of the Global Partnership to Stop TB, is managed by its secretariat, in the World Health Organization (WHO), Geneva. It aims to provide tuberculosis drugs to treat up to 11.6 million patients over the next 5 years and to assist countries to reach the WHO global TB control targets by 2005. The GDF was launched on 24 March 2001. Six rounds of applications have been completed, with 46 countries and non-governmental organisations (NGOs) approved for support. The GDF is not a traditional procurement mechanism. It has adopted an innovative approach to the supply of drugs, by linking demand for drugs to supply and monitoring, using partners to provide services, using product packaging to simplify drug management and linking grants to TB programme performance. This paper describes the GDF operational procedures and experience gained so far. Key achievements to date are also outlined, including the creation of a flexible supply system to meet differing programme needs, rapid establishment of procedures, reduction in TB drug prices--a catalyst for DOTS expansion in countries, standardisation of products, and collaboration with partners. The GDF is flexible enough to meet the needs of countries with a TB burden. The GDF experience could be used as an example for global procurement of drugs and commodities for other diseases, such as HIV/AIDS and malaria. In the future it is likely that the GDF will expand to include second-line drugs and diagnostic materials for TB and could assist other partnerships to develop similar mechanisms and facilities to meet country needs.

Antitubercular Agents↗
PubMed2003

Benzophenone in cartonboard packaging materials and the factors that influence its migration into food.

Benzophenone may be present in cartonboard food-packaging materials as a residue from UV-cured inks and lacquers used to print on the packaging. It may also be present if the cartonboard is made from recycled fibres recovered from printed materials. A method has been devised to test for benzophenone in cartonboard packaging materials and to test for migration levels in foodstuffs. Packaging is extracted with solvent containing d10-benzophenone as the internal standard. Foods are extracted with solvent containing d10-benzophenone and the extract defatted using hexane. The extracts are analysed by GC-MS. For analysis of food, the limit of detection was 0.01 mg x kg(-1) and the limit of quantification was 0.05 mg x kg(-1). The calibration was linear from 0.05 to 20 mg x kg(-1). The method for food analysis was validated in-house and it also returned satisfactory results in a blind check-sample exercise organized by an independent laboratory. The methods were applied to the analysis of 350 retail samples that used printed cartonboard packaging. A total of 207 (59%) packaging samples had no significant benzophenone (<0.05 mg x dm(-2)). Seven (2%) were in the range 0.05- 0.2 mg x dm(-2), 60 (17%) were from 0.2 to 0.8 mg x dm(-2) and 76 (22%) were from 0.8 to 3.3 mg x dm(-2). A total of 71 samples were then selected at random from the 143 packaging samples that contained benzophenone, and the food itself was analysed. Benzophenone was detected in 51 (72%) of the foods. Two food samples (3%) were in the range 0.01-0.05 mg kg(-1). A total of 29 (41%) were from 0.05 to 0.5 mg kg(-1), 17 (24%) were from 0.5 to 5 mg x kg(-1) and three (4%) food samples exceeded 5 mg x kg(-1). The highest level of benzophenone in food was 7.3 mg x kg(-1) for a high-fat chocolate confectionery product packaged in direct contact with cartonboard, with room temperature storage conditions and with a high contact area:food mass ratio. When the mass fraction of benzophenone migration was calculated for the different contact and storage regimes involved, the attenuation effects of indirect contact and of low temperature storage were cumulative. Thus, there was a sixfold reduction in migration for indirect contact compared with direct contact, a sixfold reduction for chilled/frozen storage compared with ambient storage, and 40-fold reduction for the two contact conditions combined.

Benzophenones↗
PubMedDate not supplied

Nonprescription H2-receptor antagonists.

OBJECTIVE: This article reviews the use of nonprescription histamine2-receptor antagonists (H2RAs) in the management of secretory disorders of the upper gastrointestinal tract. DATA SOURCES: The scientific and consumer literature pertaining to the over-the-counter availability and therapeutic uses of H2RAs was reviewed. STUDY SELECTION: References related to safety, efficacy, comparative efficacy with antacids, and economic impact of H2RA therapy were emphasized. Additional importance was placed on information describing the pharmacist's role in nonprescription H2RA therapy. DATA EXTRACTION: Data from product package inserts as well as the scientific literature were extrapolated to provide information on indications, dosage and administration, adverse effects, drug interactions, and patient information. DATA SYNTHESIS: The literature review focused on the relative role of these agents as an alternative to traditional nonprescription treatment of self-limiting gastrointestinal conditions as well as the advice and instructions that the patient should receive. CONCLUSION: H2RAs represent a nonprescription option for the prevention and treatment of heartburn, acid indigestion, and sour stomach. They are effective and safe, but take longer to work and are more expensive than antacids. The availability of H2RAs without a prescription may reduce overall health care costs by decreasing the need for physician office visits. However, the pharmacist should counsel patients on the proper use of these products. In their role as primary care providers, pharmacists must evaluate whether the products will relieve a given patient's symptoms or whether the patient requires referral to another clinician (e.g., physician) for a more thorough examination and treatment.

Drug Interactions↗
PubMed2001

Female condom reuse in Lusaka, Zambia: evidence from 12 cases.

Female condom reuse could address one of the principal barriers to use, namely, cost; however, the safety of reuse has not been established. Recent reports have provided information related to reuse safety under carefully specified research study conditions. Still, little is known about reuse outside a research study context, and there are outstanding questions related to feasibility of reuse among general populations. This study reports on naturally occurring reuse from a small, purposive sample of self-identified women who, prior to the study, had reused the female condom of their own volition without reuse instruction. Three types of reuse were identified. Most women attempted to clean devices between removal and reinsertion. A number of agents, including water (only), bath soap, laundry detergent, Dettol, and beer were used for cleaning. A number of agents were used for relubrication, including Reality((R)) lubricant, various kinds of cooking oil, and Vaseline((TM)). Perception of the strength and integrity of female condoms making them suitable for reuse were influenced by both provider advice and product packaging. Most participants reported no problems with reuse. Some women, faced with barriers to single use of a female condom or use of an acceptable alternative, will resort to reuse and rely on their own "common sense" notions to implement reuse. Providers and purveyors have opportunities to shape responses to reuse for the better, and the research community is obligated to provide a solid scientific base regarding reuse safety.

Adult↗
PubMed1996

Post-transcriptional transactivation of human retroviral envelope glycoprotein expression by herpes simplex virus Us11 protein.

Herpes simplex virus type 1 (HSV-1) Us11 protein, a true late gene product packaged within the virion, is delivered into cells after infection, exhibits a nucleocytoplasmic localization at early times, and later accumulates in the nucleoli. This RNA-binding basic phosphoprotein, capable of oligomerization, is supposed to be involved in post-transcriptional regulation of gene expression after HSV-1 infection. Expression of human T-cell leukaemia/lymphoma virus type-I (HTLV-I) and of human immunodeficiency virus type 1 (HIV-1) is post-transcriptionally regulated by Rex and Rev, respectively. These proteins are required for the cytoplasmic expression of unspliced gag-pol and singly spliced env transcripts. Here we show that HSV-1 Us11 protein is able to bind Rex- and Rev-responsive elements and to transactivate envelope retroviral glycoprotein expression.

Cytoplasm↗
PubMed1999

Forecasting patient outcomes in the management of hyperlipidemia.

BACKGROUND: To forecast adult patient outcomes in the management of hyperlipidemia using adult National Health and Examination Survey III (NHANES III) population statistics and National Cholesterol Education Program (NCEP) guidelines for goals of therapy. METHODS: Review of the hyperlipidemia drug therapy English-language medical literature with emphasis on randomized controlled trials of more than 6 weeks' duration published in the last 7 years, product package inserts, US Food and Drug Administration submission information, and NHANES III population statistics. Data were extracted from studies of lipid-lowering therapy to modify low-density lipoprotein (LDL) levels for primary and secondary prevention of coronary heart disease. The data that were evaluated included sample size, study design, therapeutic intervention, length of study, percentage change in LDL levels, and patient demographics. RESULTS: Cumulative frequency curves of the LDL distribution among the US adult population were constructed. The mean efficacy of drug therapy from qualified studies was used to extrapolate the percentage of the population expected to respond to the intervention and to forecast the patient outcome. CONCLUSIONS: A useful tool for clinicians was constructed to approximate the percentage of patients, based on risk stratification, who would reach NCEP target goal after a given pharmacotherapeutic intervention to decrease LDL levels.

Adult↗
PubMed1999

Insertional mutagenesis of AAV2 capsid and the production of recombinant virus.

The structural genes of adeno-associated virus serotype 2 (AAV2) have been altered by linker insertional mutagenesis in order to define critical components of virion assembly and infectivity. An in-frame restriction site linker was inserted across the capsid coding domain of a recombinant plasmid. After complementation in vivo, recombinant AAV2 viruses were generated and assayed for capsid production, packaging, transduction, heparin agarose binding, and morphology. Three classes of capsid mutants where identified. Class I mutants expressed structural proteins but were defective in virion assembly. Class II mutants generated intact virions that protected the viral genome from DNase, but failed to infect target cells. The majority of these mutants bound the heparin affinity matrix, suggesting that attachment to the AAV primary receptor was not rate limiting. One class II mutant, H2634, assembled virions and bound heparin using only Vp3, indicating that this subunit is responsible for mediating AAV receptor attachment. Finally, class III mutants assembled virions, encapsidated DNA, and infected target cells. Infectivity of these mutants ranged from 5 to 100% of that of the wild-type, demonstrating for the first time the ability to alter capsid proteins without interfering with infectivity. These AAV virions with altered capsid subunits will provide critical templates for manipulating AAV vectors for cell-specific gene delivery in vivo. In summary, the AAV capsid variants described here will facilitate further study of virus assembly, entry, and infection, as well as advance the development of this versatile vector system.

Capsid↗
PubMed2006

Porosome: the fusion pore revealed by multiple imaging modalities.

Secretion occurs in all cells of multicellular organisms and involves the delivery of secretory products packaged in membrane-bound vesicles to the cell exterior. Specialized cells for neurotransmission, enzyme secretion, or hormone release utilize a highly regulated secretory process. Secretory vesicles are transported to specific sites at the plasma membrane, where they dock and fuse to release their contents. Similar to other cellular processes, cell secretion is found to be highly regulated and a precisely orchestrated event. It has been demonstrated that membrane-bound secretory vesicles dock and fuse at porosomes, which are specialized supramolecular structures at the cell plasma membrane. Swelling of secretory vesicles results in a buildup of pressure, allowing expulsion of intravesicular contents. The extent of secretory vesicle swelling dictates the amount of intravesicular contents expelled during secretion. The discovery of the porosome, its isolation, its structure and dynamics at nanometer resolution and in real time, and its biochemical composition and functional reconstitution into artificial lipid membrane have been determined. The molecular mechanism of secretory vesicle fusion at the base of porosomes and vesicle swelling have also been resolved. These findings reveal the molecular machinery and mechanism of cell secretion. In this chapter, the discovery of the porosome, its isolation, its structure and dynamics at nanometer resolution and in real time, and its biochemical composition and functional reconstitution into artificial lipid membrane are discussed.

Animals↗
PubMed1997

Biological monitoring of workers exposed to low levels of 2-butoxyethanol.

OBJECTIVES: (1) To assess the value of urinary butoxyacetic acid (BAA) measurement for the monitoring of workers exposed to low concentration of 2-butoxyethanol (BE); (2) to evaluate the in vivo effect of low occupational BE exposure on the erythrocyte lineage; and (3) to test the possible influence of genetic polymorphism for cytochrome P450 2E1 (CYP 2E1) on urinary BAA excretion rate. METHODS: Thirty-one male workers exposed to BE in a beverage package production plant were examined according to their external (BE) and internal (BAA) solvent exposure. The effect of this exposure on erythrocyte lineage [red blood cell numeration (RBC), hemoglobin (Hb), hematocrit (Htc), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), haptoglobin (Hp), reticulocyte numeration (Ret) and osmotic resistance (OR)], hepatic [aspartate aminotransferase (GOT), alanine aminotransferase (GPT)] and renal [plasmatic creatinine, urinary retinol binding protein (RBP)] parameters was also investigated. DNA purified from whole blood was used for CYP 2E1 genotyping. RESULTS: Average airborne concentration of BE was 2.91 mg/m3 (0.59 ppm) with a standard deviation of 1.30 mg/m3 (0.27 ppm). There was a relatively good correlation between external and internal exposure estimated by measuring BAA in post-shift urine samples (average 10.4 mg/g creatinine; r = 0.55; P = 0.0012). Compared with a matched control group (n = 21) exposed workers had a statistically significant decrease (3.3%; P = 0.03) in Hct while MCHC was increased (2.1%; P = 0.02). No significant difference was observed either in other erythroid parameters or in hepatic and renal biomarkers. One exposed individual exhibited a mutant allele with increased cytochrome P450 oxidative activity which coincided with a very low urinary BAA excretion. CONCLUSIONS: Single determination of BAA in post-shift urine samples can be used to assess exposure to low levels of BE. A slight but significant effect on erythroid parameters suggesting membrane damage was observed in exposed workers. The influence of the genetic polymorphism for CYP 2E1 deserves further investigation for the interpretation of urinary BAA measurements.

Adult↗