Microbiological swabs have no role in the management of acute pilonidal abscesses

Aims: Microbiological swabs are often taken at the time of surgery for the treatment of acute pilonidal abscesses. This audit assessed whether swabs play a role in the management of these patients. Methods: A retrospective audit of electronic records was undertaken over a 2-year period between 1st January 2012 and December 31st 2013. Variables measured included patient sex, episode index, swab results, antibiotic use and recurrences. Results: Over the 2-year period there were 182 operations for acute pilonidal abscesses. Microbiological swabs were taken in 151 cases (83%). The most common culture was anaerobe (36%) followed by no growth (19%) and skin flora (8%). In total, 114 reports (94%) were issued after the patient had been discharged. Post-operative antibiotics were prescribed in 15 cases (8%) and within this group 9 patients (60%) had no growth on swab results. There were 11 recurrences (6%) with no correlation between the initial swab results and recurrent swab results being observed. Conclusions: In this audit, swab results did not alter any patient's treatment and nearly all reports were issued after the patient had been discharged. Recurrent abscesses do not appear to be linked to initial swab results

Optimal management of malignant left-sided large bowel obstruction: do international guidelines agree?

Background Approximately 20% of patients diagnosed with colorectal cancer will present with left-sided large bowel obstruction. The optimal management of this cohort of patients remains unclear. We aimed to review international guidelines to see if there was a consensus on the treatment of this surgical emergency. Methods The PubMed and Medline databases were searched for guidelines on the management of left-sided, malignant large bowel obstruction (MBO) between 2010 and 2018. Results Nineteen guidelines were identified spanning a range of continents. There was no clear consensus on the management of potentially resectable disease. Eight guidelines (42%) suggested primary surgery, two guidelines (11%) suggested stenting as a bridge to surgery and nine guidelines (47%) suggested surgery or stenting could be performed. Primary resection with or without anastomosis was the most frequently recommended procedure (n = 6 35%), but over a third of guidelines gave no operative recommendations. There was very limited detail on the stenting procedure and how long elective surgery should be deferred. In the palliative situation, there was general agreement that stents should be offered in preference to surgery. Conclusion International guidelines offer limited and contrasting recommendations on the management of left-sided MBO. There is a lack of high-quality evidence to support whether emergency surgery or stenting as a bridge to surgery is the optimal procedure in terms of morbidity, mortality and long-term oncological outcome

How do early career teachers value different types of support? A scale-adjusted latent class choice model

© 2015 Elsevier Ltd. Using a discrete choice experimental approach and associated Scale-Adjusted Latent Class Model (SALCM), we quantify the relative value early career teachers (ECTs) place on various types of support in the form of affirmation, resources, collegial opportunities, mentoring, and professional development. ECTs with intentions to depart the profession, place greater relative value on the sharing of resources, cooperative teaching and planning, offsite discussions about classroom management and programming with mentors, and having a greater professional voice. In contrast, those with intentions to remain, place greater value on observation from and conversations about teaching with more experienced teachers at their school

AZD1775 Induces Toxicity Through Double-Stranded DNA Breaks Independently of Chemotherapeutic Agents in p53-Mutated Colorectal Cancer Cells

AZD1775 is a small molecule WEE1 inhibitor used in combination with DNA-damaging agents to cause premature mitosis and cell death in p53-mutated cancer cells. Here we sought to determine the mechanism of action of AZD1775 in combination with chemotherapeutic agents in light of recent findings that AZD1775 can cause double-stranded DNA (DS-DNA) breaks. AZD1775 significantly improved the cytotoxicity of 5-FU in a p53-mutated colorectal cancer cell line (HT29 cells), decreasing the IC50 from 9.3 μM to 3.5 μM. Flow cytometry showed a significant increase in the mitotic marker pHH3 (3.4% vs. 56.2%) and DS-DNA break marker γH2AX (5.1% vs. 50.7%) for combination therapy compared to 5-FU alone. Combination therapy also increased the amount of caspase-3 dependent apoptosis compared to 5-FU alone (4% vs. 13%). The addition of exogenous nucleosides to combination therapy significantly rescued the increased DS-DNA breaks and caspase-3 dependent apoptosis almost to the levels of 5-FU monotherapy. In conclusion, AZD1775 enhances 5-FU cytotoxicity through increased DS-DNA breaks, not premature mitosis, in p53-mutated colorectal cancer cells. This finding is important for designers of future clinical trials when considering the optimal timing and duration of AZD1775 treatment

Short term fat feeding rapidly increases plasma insulin but does not result in dyslipidaemia

Although the association between obesity and hypertension is well known, the underlying mechanism remains elusive. Previously, we have shown that 3 week fat feeding in rabbits produces greater visceral adiposity, hypertension, tachycardia and elevated renal sympathetic nerve activity compared to rabbits on a normal diet. Because hyperinsulinaemia, hyperleptinemia and dyslipidaemia are independent cardiovascular risk factors associated with hypertension we compared plasma insulin, leptin and lipid profiles in male New Zealand White rabbits fed a normal fat diet (NFD 4.3% fat, n = 11) or high fat diet (HFD 13.4% fat, n = 13) at days 1, 2, 3 and weeks 1, 2, 3 of the diet. Plasma concentrations of diacylglyceride (DG), triacylglyceride (TG), ceramide and cholesteryl esters (CE) were obtained after analysis by liquid chromatography mass spectrometry. Plasma insulin and glucose increased within the first 3 days of the diet in HFD rabbits (P <0.05) and remained elevated at week 1 (P <0.05). Blood pressure and heart rate followed a similar pattern. By contrast, in both groups, plasma leptin levels remained unchanged during the first few days (P >0.05), increasing by week 3 in fat fed animals alone (P <0.05). Concentrations of total DG, TG, CE and Ceramide at week 3 did not differ between groups (P >0.05). Our data show plasma insulin increases rapidly following consumption of a HFD and suggests that it may play a role in the rapid rise of blood pressure. Dyslipidaemia does not appear to contribute to the hypertension in this animal model

Towards Many-objective Optimisation with Hyper-heuristics: Identifying Good Heuristics with Indicators

PPSN 2016: 14th International Conference on Parallel Problem Solving from Nature, 17-21 September 2016, Edinburgh, ScotlandThis is the author accepted manuscript. The final version is available from Springer Verlag via the DOI in this record.The use of hyper-heuristics is increasing in the multi-objective optimisation domain, and the next logical advance in such methods is to use them in the solution of many-objective problems. Such problems comprise four or more objectives and are known to present a significant challenge to standard dominance-based evolutionary algorithms. We in- corporate three comparison operators as alternatives to dominance and investigate their potential to optimise many-objective problems with a hyper-heuristic from the literature. We discover that the best results are obtained using either the favour relation or hypervolume, but conclude that changing the comparison operator alone will not allow for the generation of estimated Pareto fronts that are both close to and fully cover the true Pareto front.This work was funded under EPSRC grant EP/K000519/1

CASTNet: Community-Attentive Spatio-Temporal Networks for Opioid Overdose Forecasting

Opioid overdose is a growing public health crisis in the United States. This crisis, recognized as "opioid epidemic," has widespread societal consequences including the degradation of health, and the increase in crime rates and family problems. To improve the overdose surveillance and to identify the areas in need of prevention effort, in this work, we focus on forecasting opioid overdose using real-time crime dynamics. Previous work identified various types of links between opioid use and criminal activities, such as financial motives and common causes. Motivated by these observations, we propose a novel spatio-temporal predictive model for opioid overdose forecasting by leveraging the spatio-temporal patterns of crime incidents. Our proposed model incorporates multi-head attentional networks to learn different representation subspaces of features. Such deep learning architecture, called "community-attentive" networks, allows the prediction of a given location to be optimized by a mixture of groups (i.e., communities) of regions. In addition, our proposed model allows for interpreting what features, from what communities, have more contributions to predicting local incidents as well as how these communities are captured through forecasting. Our results on two real-world overdose datasets indicate that our model achieves superior forecasting performance and provides meaningful interpretations in terms of spatio-temporal relationships between the dynamics of crime and that of opioid overdose.Comment: Accepted as conference paper at ECML-PKDD 201

The SALFORD low-energy house : Learning from our past

The SALFORD low-energy house was designed in the late 1970s for Salford City Council in a joint project with the University. A semi-detached experimental pair and a prototype terrace of six mixed dwellings were built and extensively monitored. The results showed substantial energy savings and occupant satisfaction. To mark the University’s focus upon the cross-cutting themes of Energy and Social Justice a new study was launched in 2010 to explore the long-term performance of the SALFORD dwellings

Activation of Ventral Tegmental Area 5-HT2C Receptors Reduces Incentive Motivation

FUNDING AND DISCLOSURE The research was funded by Wellcome Trust (WT098012) to LKH; and National Institute of Health (DK056731) and the Marilyn H. Vincent Foundation to MGM. The University of Michigan Transgenic Core facility is partially supported by the NIH-funded University of Michigan Center for Gastrointestinal Research (DK034933). The remaining authors declare no conflict of interest. ACKNOWLEDGMENTS We thank Dr Celine Cansell, Ms Raffaella Chianese and the staff of the Medical Research Facility for technical assistance. We thank Dr Vladimir Orduña for the scientific advice and technical assistance.Peer reviewedPublisher PD

The LSST DESC data challenge 1: Generation and analysis of synthetic images for next-generation surveys

Data Challenge 1 (DC1) is the first synthetic data set produced by the Rubin Observatory Legacy Survey of Space and Time (LSST) Dark Energy Science Collaboration (DESC). DC1 is designed to develop and validate data reduction and analysis and to study the impact of systematic effects that will affect the LSST data set. DC1 is comprised of r-band observations of 40 deg2 to 10 yr LSST depth. We present each stage of the simulation and analysis process: (a) generation, by synthesizing sources from cosmological N-body simulations in individual sensor-visit images with different observing conditions; (b) reduction using a development version of the LSST Science Pipelines; and (c) matching to the input cosmological catalogue for validation and testing. We verify that testable LSST requirements pass within the fidelity of DC1. We establish a selection procedure that produces a sufficiently clean extragalactic sample for clustering analyses and we discuss residual sample contamination, including contributions from inefficiency in star-galaxy separation and imperfect deblending. We compute the galaxy power spectrum on the simulated field and conclude that: (i) survey properties have an impact of 50 per cent of the statistical uncertainty for the scales and models used in DC1; (ii) a selection to eliminate artefacts in the catalogues is necessary to avoid biases in the measured clustering; and (iii) the presence of bright objects has a significant impact (2-6) in the estimated power spectra at small scales (> 1200), highlighting the impact of blending in studies at small angular scales in LSST