Randomised positive control trial of NSAID and antimicrobial treatment for calf fever caused by pneumonia

One hundred and fifty-four preweaning calves were followed between May and October 2015. Calves were fitted with continuous monitoring temperature probes (TempVerified FeverTag), programmed so a flashing light emitting diode (LED) light was triggered following six hours of a sustained ear canal temperature of ≥39.7°C. A total of 83 calves (61.9 per cent) developed undifferentiated fever, with a presumptive diagnosis of pneumonia through exclusion of other calf diseases. Once fever was detected, calves were randomly allocated to treatment groups. Calves in group 1 (NSAID) received 2 mg/kg flunixin meglumine (Allevinix, Merial) for three consecutive days and group 2 (antimicrobial) received 6 mg/kg gamithromycin (Zactran, Merial). If fever persisted for 72 hours after the initial treatment, calves were given further treatment (group 1 received antimicrobial and group 2 received NSAID). Calves in group 1 (NSAID) were five times more likely (P=0.002) to require a second treatment (the antimicrobial) after 72 hours to resolve the fever compared with the need to give group 2 (antimicrobial) calves a second treatment (NSAID). This demonstrates the importance of ongoing monitoring and follow-up of calves with respiratory disease. However, of calves with fever in group 1 (NSAID), 25.7 per cent showed resolution following NSAID-only treatment with no detrimental effect on the development of repeated fever or daily live weight gain. This suggests that NSAID alone may be a useful first-line treatment, provided adequate attention is given to ongoing monitoring to identify those cases that require additional antimicrobial treatment

Clinical investigation of an outbreak of alveolitis and asthma in a car engine manufacturing plant

Background Exposure to metal working fluid (MWF) has been associated with outbreaks of EAA in the US, with bacterial contamination of MWF being a possible cause, but was uncommon in the UK. Twelve workers developed extrinsic allergic alveolitis (EAA) in a car engine manufacturing plant in the UK, presenting clinically between December 2003 and May 2004. This paper reports the subsequent epidemiological investigation of the whole workforce. This had three aims:- • To measure the extent of the outbreak by identifying other workers who may have developed EAA or other work-related respiratory diseases. • To provide case-detection so that those affected can be treated. • To provide epidemiological data to identify the cause of the outbreak. Methods The outbreak was investigated in a three-phase cross-sectional survey of the workforce. Phase I A respiratory screening questionnaire was completed by 808/836 workers (96.7%) in May 2004. Phase II 481 employees with at least one respiratory symptom on screening and 50 asymptomatic controls were invited for investigation at the factory in June 2004. This included a questionnaire, spirometry and clinical opinion. 454/481(94.4%) responded along with 48/50(96%) controls. Workers were identified who needed further investigation and serial measurements of peak expiratory flow (PEF). Phase III 162 employees were seen at the Birmingham Occupational Lung Disease clinic. 198 employees returned PEF records, including 141 of the 162 who attended for clinical investigation. Case definitions for diagnoses were agreed. Results 87 workers (10.4% of workforce) met case definitions for occupational lung disease, comprising EAA(19), occupational asthma(74) and humidifier fever(7). 12 workers had more than one diagnosis. The peak onset of work-related breathlessness was Spring 2003. The proportion of workers affected was higher for those using metal working fluid (MWF) from a large sump(27.3%) compared with working all over the manufacturing area (7.9%) (OR=4.39,p<0.001). Two workers had positive specific provocation tests to the used but not the unused MWF solution. Conclusions Extensive investigation of the outbreak of EAA detected a large number of affected workers, not only with EAA but also occupational asthma. This is the largest reported outbreak in Europe. Mist from used MWF is the likely cause. In workplaces using MWF, there is a need to carry out risk assessments, to monitor and maintain fluid quality, to control mist and to carry out respiratory health surveillance

Relevance of pseudospin symmetry in proton-nucleus scattering

The manifestation of pseudospin-symmetry in proton-nucleus scattering is discussed. Constraints on the pseudospin-symmetry violating scattering amplitude are given which require as input cross section and polarization data, but no measurements of the spin rotation function. Application of these constraints to p-58Ni and p-208Pb scattering data in the laboratory energy range of 200 MeV to 800 MeV, reveals a significant violation of the symmetry at lower energies and a weak one at higher energies. Using a schematic model within the Dirac phenomenology, the role of the Coulomb potential in proton-nucleus scattering with regard to pseudospin symmetry is studied. Our results indicate that the existence of pseudospin-symmetry in proton-nucleus scattering is questionable in the whole energy region considered and that the violation of this symmetry stems from the long range nature of the Coulomb interaction.Comment: 22 pages including 9 figures, correction of 1 reference, revision of abstract and major modification of chapter 4, Fig. 6, and Fig. 7; addition of Fig. 8 and Fig.

Wittgensteinian content‐externalism

Content-externalism is the view that a subject’s relations to a context can play a role in individuating the content of her mental states. According to social content-externalists, relations to a socio-linguistic context can play a fundamental individuating role. Åsa Wikforss has suggested that ‘social externalism depends on the assumption that individuals have an incomplete grasp of their own concepts’ (Wikforss 2004, p. 287). In this paper, I show that this isn’t so. I develop and defend an argument for social content-externalism which does not depend on this assumption. The argument is animated by strands of thought in the later work of Wittgenstein. In addition to demonstrating that social externalists are not necessarily committed to thinking that a subject can have thoughts involving concepts which she incompletely understands, this argument is important insofar as it: (1) supports a form of content-externalism with extended scope; (2) avoids the controversy surrounding the claim that subjects can think with concepts which they incompletely understand; and (3) situates Wittgenstein’s later work with respect to contemporary debates about content-externalism

Single shot measurement of a silicon single electron transistor

We have fabricated a custom cryogenic Complementary Metal-Oxide-Semiconductor (CMOS) integrated circuit that has a higher measurement bandwidth compared with conventional room temperature electronics. This allowed implementing single shot operations and observe the real-time evolution of the current of a phosphorous-doped silicon single electron transistor that was irradiated with a microwave pulse. Relaxation times up to 90 us are observed, suggesting the presence of well isolated electron excitations within the device. It is expected that these are associated with long decoherence time and the device may be suitable for quantum information processing

Regional variation in primary care improvement strategies and policy: case studies that consider qualitative contextual data for performance measurement in three Canadian provinces

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordOBJECTIVE: To explore regional primary care improvement strategies that are potentially determinants of primary care performance. DESIGN: Multiple comparative embedded case study. SETTING: Three regions in Canada: Fraser East, British Columbia; Eastern Ontario Health Unit, Ontario; Central Zone, Nova Scotia. DATA SOURCES: (1) In-depth interviews with purposively selected key informants (eg, primary care decision-makers, physician leads, regulatory agencies) and focus groups with patients and clinicians (n=68 participants) and (2) published and grey literature (n=205 documents). OUTCOME MEASURES: Variations in spread and uptake of primary care improvement strategies across the three study regions. NVivo (V.11) was used to manage data and perform content analysis to identify categories within and across cases. The coding structure was developed by researchers through iterative collaboration, using inductive and deductive processes. RESULTS: Six overarching primary care improvement strategies, differing in focus and spread, were implemented across the three study regions: interprofessional team-based approaches, provider skill mix expansion, physician groups and networks, information systems, remuneration and performance measurement and reporting infrastructure. CONCLUSION: The addition of information on regional improvement strategies to primary care performance reports could add important contextual insights into primary care performance results. This could help identify possible drivers of reported performance outcomes and levers for change in practice, regional and system-level settings.Canadian Institutes of Health ResearchMichael Smith Foundation for Health Researc

FORCE2: A state-of-the-art two-phase code for hydrodynamic calculations

A three-dimensional computer code for two-phase flow named FORCE2 has been developed by Babcock and Wilcox (B W) in close collaboration with Argonne National Laboratory (ANL). FORCE2 is capable of both transient as well as steady-state simulations. This Cartesian coordinates computer program is a finite control volume, industrial grade and quality embodiment of the pilot-scale FLUFIX/MOD2 code and contains features such as three-dimensional blockages, volume and surface porosities to account for various obstructions in the flow field, and distributed resistance modeling to account for pressure drops caused by baffles, distributor plates and large tube banks. Recently computed results demonstrated the significance of and necessity for three-dimensional models of hydrodynamics and erosion. This paper describes the process whereby ANL's pilot-scale FLUFIX/MOD2 models and numerics were implemented into FORCE2. A description of the quality control to assess the accuracy of the new code and the validation using some of the measured data from Illinois Institute of Technology (UT) and the University of Illinois at Urbana-Champaign (UIUC) are given. It is envisioned that one day, FORCE2 with additional modules such as radiation heat transfer, combustion kinetics and multi-solids together with user-friendly pre- and post-processor software and tailored for massively parallel multiprocessor shared memory computational platforms will be used by industry and researchers to assist in reducing and/or eliminating the environmental and economic barriers which limit full consideration of coal, shale and biomass as energy sources, to retain energy security, and to remediate waste and ecological problems