Murray Valley encephalitis: a review of clinical features, diagnosis and treatment

Murray Valley encephalitis virus (MVEV) is a mosquito-borne virus that is found across Australia, Papua New Guinea and Irian Jaya. MVEV is endemic to northern Australia and causes occasional outbreaks across south-eastern Australia. 2011 saw a dramatic increase in MVEV activity in endemic regions and the re-emergence of MVEV in south-eastern Australia. This followed significant regional flooding and increased numbers of the main mosquito vector, Culex annulirostris, and was evident from the widespread seroconversion of sentinel chickens, fatalities among horses and several cases in humans, resulting in least three deaths. The last major outbreak in Australia was in 1974, during which 58 cases were identified and the mortality rate was about 20%. With the potential for a further outbreak of MVEV in the 2011–2012 summer and following autumn, we highlight the importance of this disease, its clinical characteristics and radiological and laboratory features. We present a suspected but unproven case of MVEV infection to illustrate some of the challenges in clinical management. It remains difficult to establish an early diagnosis of MVEV infection, and there is a lack of proven therapeutic options

SARS–associated Coronavirus Replication in Cell Lines

Virus can replicate in several common cell lines, sometimes without cytopathic effect

Salvage radiotherapy after radical prostatectomy: analysis of toxicity by dose-fractionation in the RADICALS-RT trial

ABSTRACT: Emerging data indicate comparable disease control and toxicity of postoperative normo-fractionation and moderate hypofractionation radiotherapy (RT) in prostate cancer. In RADICALS-RT, patients were planned for treatment with either 66Gy in 33 fractions over 6.5 weeks or 52.5Gy in 20 fractions over 4 weeks. In this non-randomized, exploratory analysis, we explore the toxicity of these two schedules in patients who had adjuvant RT. METHODS: Information on RT dose was collected in all patients. Radiation Therapy Oncology Group toxicity score was recorded every 4 months for 2 years, 6-monthly until 5 years, then annually until 15 years. Patient-reported data were collected at baseline, 1, 5, and 10 years with use of standard questionnaires including Vaizey (bowel) and International Continence Society Male Short-Form (urinary incontinence). The highest grade of event was recorded within the first 2 years, and beyond 2 years, and compared between treatment groups using the χ² test. RESULTS: 217/634 (34%) patients were planned for 52.5Gy/20f and 417/634 (66%) for 66Gy/33f. In the first two years, grade 1 - 2 cystitis was reported more frequently among the 66Gy/33f group (52.5Gy/20f: 20% vs 66Gy/33f: 30%, p=0.04). After two years, grade 1-2 cystitis was reported in 16% in the 66Gy group, and 9% in the 52.5Gy group (p=0.08). Other toxicities were similar in the two groups and very few patients had any grade 3 - 4 toxicity. Patients reported slightly higher urinary and faecal incontinence scores at one year than at baseline, but no clinically meaningful differences were reported between 52.5Gy/20f and 66Gy/33f groups. Patient reported health was similar at baseline and at one year, and similar between 52.5Gy/20f and 66Gy/33f groups. CONCLUSION: Severe toxicity is rare after prostate bed radiotherapy with either 52.5Gy/20f or 66Gy/33f. Only modest differences were recorded in toxicity or in patient reported outcomes between these two schedules

Mapping and monitoring tick (Acari, Ixodida) distribution, seasonality, and host associations in the United Kingdom between 2017 and 2020

Tick-borne disease risk is intrinsically linked to the distribution of tick vector species. To assess risk and anticipate disease emergence, an understanding of tick distribution, host associations, and seasonality is needed. This can be achieved, to some extent, using passive surveillance supported by engagement with the public, animal health, and public health experts. The Tick Surveillance Scheme (TSS) collects data and maps tick distribution across the United Kingdom (UK). Between 2017 and 2020, 3720 tick records were received and 39 tick species were detected. Most records were acquired in the UK, with a subset associated with recent overseas travel. The dominant UK acquired species was Ixodes ricinus (Ixodida: Ixodidae, Linnaeus), the main vector of Lyme borreliosis. Records peaked during May and June, highlighting a key risk period for tick bites. Other key UK species were detected, including Dermacentor reticulatus (Ixodida: Ixodidae, Fabricius) and Haemaphysalis punctata (Ixodida: Ixodidae, Canestrini & Fanzago) as well as several rarer species that may present novel tick-borne disease risk to humans and other animals. Updated tick distribution maps highlight areas in the UK where tick exposure has occurred. There is evidence of increasing human tick exposure over time, including during the COVID-19 pandemic, but seasonal patterns remain unchanged

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Steward of Headwaters: U.S. Army Corps of Engineers, St. Paul District 1975-2000

The U.S. Army Corps of Engineers, St. Paul District, is one of fortyone districts in the Corps’ organization. As the northernmost district in the Mississippi Valley Division, it centers on the headwaters of the Mississippi River and the uppermost section of the river’s nine-foot navigation channel. The St. Paul District oversees civil works projects and conducts disaster relief within the geographic boundaries of the district, implements the Corps’ regulatory program in the states of Minnesota and Wisconsin and assists with other Corps’ missions wherever needed. The following history updates the book Creativity, Conflict & Controversy: A History of the St. Paul District, U.S. Army Corps of Engineers, published in 1979. This book describes how the St. Paul District responded to enormous changes in the Corps’ missions and organization in the last quarter of the twentieth century

“An Investigation into Accessibility Issues on Campus and the Proposed Solutions”

The purpose of this research was to aid Access and Diversity in making a Campus Accessibility Map which would aid students and faculty that live with or without a disability in traversing the campus. People with different disabilities encounter different struggles in their everyday lives, and even without a disability, navigating such a large and diverse campus can be overwhelming with the constant change in infrastructure and layout that UBC experiences constantly. Therefore, data was collected through the use of a survey distributed to students at UBC, as well as through secondary sources such as articles and textbooks that discuss the difficulties those living with a disability face in terms of navigating through areas of inaccessibility. The two main disabilities that were tackled were visual and mobility impairments, simply because these disabilities had the most amount of research readily available, and because brainstorming led to the most interesting solutions when focusing on these disabilities. The main difficulties visually impaired people have is having a hard time navigating new territory they haven’t experienced yet, as well as not being able to see obstacles in front of them as easily as someone with vision can. With UBC’s constant construction and changing of routes one can and cannot take, the visually impaired must constantly learn new pathways and deal with uneven terrain when traversing the campus. Those with mobility impairments will often struggle with long distances, or in the case of a wheelchair user, have a hard time with inclines and slopes. Once again, uneven and gravel terrain due to construction and an ever-changing landscape also poses a challenge to the mobility impaired. The solutions proposed are two phone applications which provide real time data on construction and elevation changes to aid those with mobility impairments, and a method of creating braille maps for the visually impaired to use. The phone applications use data collected from Google Maps and UBC’s Campus + Planning website to map out the alternative routes created to bypass construction, and to find the routes that allow for the least amount of distance and elevation gain to minimize the difficulty of traveling long, difficult distances for the mobility impaired. The braille map is a method of using 3D printing or raised braille paper to produce physical copies of maps that can be mounted in specific locations on campus or printed for visual impaired individuals to carry with them. It should also be noted that during the research into finding solutions to the accessibility issues on campus, a handful of easy fixes that can be done cheaply and quickly to greatly improve cracks and tripping hazards from uneven ground were also found, and so have been included in this report as an alternate means of increasing accessibility to students, even though the solution is not in the form of a map. By the end of this report, the conclusion that a mobile application that can be updated instantly and maintained at a very low cost was decided to be the best way to implement the accessibility map, due to the fact that most users are students who use these smartphones and so the largest amount of people can be benefitted through this method. Disclaimer: “UBC SEEDS provides students with the opportunity to share the findings of their studies, as well as their opinions, conclusions and recommendations with the UBC community. The reader should bear in mind that this is a student project/report and is not an official document of UBC. Furthermore readers should bear in mind that these reports may not reflect the current status of activities at UBC. We urge you to contact the research persons mentioned in a report or the SEEDS Coordinator about the current status of the subject matter of a project/report.”Applied Science, Faculty ofUnreviewedUndergraduat