An infаnt hаs substаntial small-bоwel lоss after surgery fоr NEC. Small human-milk feeds are tolerated, the abdomen is soft, and ostomy output is stable, but parenteral nutrition is still needed to meet nutrient requirements. Which feeding strategy best supports intestinal adaptation and growth?
DIRECTIONS: Chооse the best аnswer fоr eаch question. How Sаfe Is Our Food? [A] The everyday activity of eating involves more risk than you might think. It is estimated that each year in the United States, 48 million people suffer from foodborne diseases; 128,000 of them are hospitalized, and 3,000 die. In the developing world, contaminated food and water kill over half a million children a year. In most cases, virulent 1 types of bacteria are to blame. [B] Bacteria are an integral part of a healthy life. There are 200 times as many bacteria in the intestines 2 of a single human as there are human beings who have ever lived. Most of these bacteria help with digestion, making vitamins, shaping the immune system, and keeping us healthy. Nearly all raw food has bacteria in it as well. But the bacteria that produce foodborne illnesses are of a different, more dangerous kind. Bad Bacteria[C] Many of the bacteria that produce foodborne illnesses are present in the intestines of the animals we raise for food. When a food animal containing dangerous bacteria is cut open during processing, bacteria inside can contaminate the meat. Fruits and vegetables can pick up dangerous bacteria if washed or watered with contaminated water. A single bacterium, given the right conditions, divides rapidly enough to produce billions over the course of a day. This means that even only lightly contaminated food can be dangerous. Bacteria can also hide and multiply on dishtowels, cutting boards, sinks, knives, and kitchen counters, where they're easily transferred to food or hands. [D] Changes in the way in which farm animals are raised also affect the rate at which dangerous bacteria can spread. In the name of efficiency and economy, fish, cattle, and chickens are raised in giant "factory" farms, which confine large numbers of animals in tight spaces. Cattle, for example, are crowded together under such conditions that if only one animal is contaminated with the virulent bacteria E. coli O157:H7, it will likely spread to others. Tracking the Source[E] Disease investigators, like Patricia Griffin, are working to find the sources of these outbreaks 3 and prevent them in the future. Griffin, of the Centers for Disease Control and Prevention (CDC) in the United States, has worked in the foodborne-disease business for 15 years. Periodic E. coli outbreaks turned her attention to the public food safety threat that exists in restaurants and in the food production system. Food safety is no longer just a question of handling food properly in the domestic kitchen. "Now," Griffin says, "we are more aware that the responsibility does not rest solely with the cook. We know that contamination often occurs early in the production process - at steps on the way from farm or field or fishing ground to market." [F] Griffin's job is to look for trends in food-related illness through the analysis of outbreaks. Her team tries to identify both the food source of an outbreak and the contaminating bacteria. To link cases together, the scientists use a powerful tool called PulseNet, a national computer network of health laboratories that matches types of bacteria using DNA 4 analysis. PulseNet allows scientists to associate an illness in California, say, with one in Texas, tying together what might otherwise appear as unrelated cases. Then it's the job of the investigators to determine what went wrong in the food's journey to the table. This helps them decide whether to recall 5 a particular food or to change the process by which it's produced. [G] In January 2000, public health officials in the state of Virginia noted an unusual group of patients sick with food poisoning from salmonella. 6 Using PulseNet, the CDC identified 79 patients in 13 states who were infected with the same type of salmonella bacteria. Fifteen had been hospitalized; two had died. What was the common factor? All had eaten mangoes during the previous November and December. The investigation led to a single large mango farm in Brazil, where it was discovered that mangoes were being washed in contaminated water containing a type of salmonella bacteria. Salmonella contamination is a widespread problem; salmonella cases involving contaminated chicken, melons, coconut, and cereals were reported in 2018. [H] The mango outbreak had a larger lesson: We no longer eat only food that is in season or that is grown locally. Instead, we demand our strawberries, peaches, mangoes, and lettuce year-round. As a result, we are depending more and more on imports. Eating food grown elsewhere in the world means depending on the soil, water, and sanitary conditions in those places, and on the way in which their workers farm, harvest, process, and transport the food. Reducing the Risk[I] There are a number of success stories that provide hope and show us how international food production need not mean increased risk of contamination. Costa Rica has made sanitary production of fruits and vegetables a nationwide priority. Fresh fruits and vegetables are packed carefully in sanitary conditions; frequent hand washing is compulsory; and proper toilets are provided for workers in the fields. Such changes have made Carmela Velazquez, a food scientist from the University of Costa Rica, optimistic about the future. "The farmers we've trained," she says, "will become models for all our growers." [J] In Sweden, too, progress has been made in reducing the number of foodborne disease at an early stage. Swedish chicken farmers have eliminated salmonella from their farms by thoroughly cleaning the area where their chickens are kept, and by using chicken feed that has been heated to rid it of dangerous bacteria. Consequently, the chickens that Swedes buy are now salmonella-free. These successes suggest that it is indeed feasible for companies and farms to produce safe and sanitary food, while still making a profit. 1 Something that is virulent is dangerous or poisonous. 2 Your intestines are the tubes in your body through which food passes when it has left your stomach. 3 If there is an outbreak of something unpleasant, such as violence or a disease, it happens suddenly. 4 DNA is a material in living things that contains the code for their structure and many of their functions. 5 When sellers recall a product, they ask customers to return it to them. 6 Salmonella is a group of bacteria that cause food poisoning. Around how many children in the developing world die each year from contaminated food and water?
DIRECTIONS: Chооse the best аnswer fоr eаch question. Feаthers of Love [A] Covered in soft, black feathers, the noble performer bows deeply to his audience. From the top of his head grow several long feathers that tap the ground as he begins his dance. This dancing bird is Carola's parotia, just one of the many birds of paradise that live on the island of New Guinea. This male bird is attempting to impress a row of females that are watching him from a branch above. [B] Keeping the females' attention isn't easy. He pauses for dramatic effect, then commences his dance again. His neck sinks and his head goes up and down, head feathers bouncing. He jumps and shakes his feathers until his performance finally attracts the attention of one of the females. An Amazing Performance [C] In the dense jungle of New Guinea is nature's most absurd theater, the special mating game of the birds of paradise. To attract females, males' feathers resemble costumes worthy of the stage. The bright reds, yellows, and blues stand out sharply against the green of the forest. It seems that the more extreme the male's costume and colors, the better his chance of attracting a mate. [D] In addition to having extremely beautiful feathers, each species has its own type of display behavior. Some dance on the ground, in areas that they have cleared and prepared like their own version of a dance floor. Others perform high in the trees. [E] The male red bird of paradise shows off his red and yellow feathers in a display called a "butterfly dance." He spreads and moves his wings intensely, like a giant butterfly. The male Carola's parotia, however, is the dance king of the birds of paradise; he has serious dance moves! These include one in which he spreads out his feathers like a dress, in a move called the "ballerina 1 dance." While some birds of paradise perform alone, others perform in groups, creating an eye-catching performance that female birds find impossible to resist. Hanging from nearby branches, male Goldie's birds prominently display the soft red feathers that rise from their backs as they flap 2 their wings. Excited females soon choose the one that pleased them the most. The Evolution of Color[F] These brilliantly colored birds of paradise have developed over millions of years from ancient birds whose feathers were dark and boring in comparison. Of today's 45 brightly colored birds of paradise species, most live only on New Guinea. These birds of paradise invite us to solve a mystery of nature. It seems to be a contradiction 3 that such extreme feathers and colors could have been favored by the process of evolution. After all, these same brightly colored feathers that attract mates also make the birds much more noticeable to predators. The answer lies in the safe environment in which the birds live, and a process of evolution known as sexual selection. [G] "Life here is pretty comfortable for birds of paradise. The island's unique environment has allowed them to go to extremes unheard of elsewhere," says biologist Ed Scholes. Under harsher conditions, he says, "evolution simply wouldn't have come up with these birds." Fruit and insects are abundant all year round, and predators are few. The result is a perfect environment for birds. [H] Sexual selection has thus been the driving force in the evolution of birds of paradise. Freed of other pressures, birds of paradise began to specialize in attracting mates. Over millions of years, they have slowly undergone changes in their colors, feathers, and other talents. Characteristics that made one bird more attractive than another were passed on and enhanced over time. "The usual rules of survival aren't as important here as the rules of successful mating," Scholes adds. [I] The diversity of New Guinea's birds also springs from its varied environments: from coastal plains to cloud forests, from swamps 4 to mountains rising as high as 5,000 meters. The landscape has many physical barriers that isolate animal populations, allowing them to develop into distinct species. Trouble in Paradise[J] The people of New Guinea have been watching the displays of the birds of paradise for centuries. "Locals will tell you they went into the forest and copied their rituals from the birds," says anthropologist Gillian Gillison. At local dance performances, the painted dancers still evoke the birds with their movements and beautiful costumes. "By wearing the feathers," Gillison says, "... you capture the animal's life force." [K] In the past, demand for the birds' feathers resulted in a huge amount of hunting. At the peak of the trade in the early 1900s, 80,000 skins a year were exported from New Guinea for European ladies' hats. Nowadays, few birds die for fashion or for traditional costumes: Ceremonial feathers are passed down from generation to generation. Although local people are still permitted to hunt the birds for traditional uses, they usually target older male birds, leaving younger males to continue breeding. [L] There are more serious threats to the birds, however. An illegal market in feathers still exists. Large farms use up thousands of hectares of forest where birds of paradise once lived. Logging, 5 oil prospecting, and mining also present dangers to New Guinea's forests. Meanwhile, human populations continue to grow. [M] David Mitchell, a conservationist, is relying on the help of local villagers to record where the birds display and what they eat. He hopes to not only gather data, but also encourage protection of the birds' habitat. The strategy seems to be working. "I had come to cut down some trees and plant yam 6 vines," says Ambrose Joseph, one of Mitchell's farmers. "Then I saw the birds land there, so I left the trees alone." For millions of years, these impressive birds have danced to find their mates. They'll keep dancing for as long as the forest offers them a stage. 1 A ballerina is a female ballet dancer. 2 If a bird or an insect flaps its wings, the wings move quickly up and down. 3 If an aspect of a situation is a contradiction, it is completely different from other aspects and makes the situation confusing. 4 A swamp is an area of very wet land with wild plants growing in it. 5 Logging is the business of cutting down trees for use as wood. 6 A yam is a root vegetable, like a potato, that grows in tropical areas. What is the purpose of this passage?