Drugs, dogs, and driving: the potential for year-round thermal stress in UK vehicles

Background: Dogs are regularly transported or housed in vehicles, with guidelines for housing dogs suggesting that the ambient temperature should be maintained between 15°C and 24°C. Veterinary drugs are routinely stored and carried in vehicles providing ambulatory veterinary care. Non-refrigerated medications typically require storage between 8°C and 25°C. Aim: This study aims to investigate the potential for thermal stress associated with vehicular storage and transportation of drugs and dogs in a temperate climate, such as the United Kingdom. Methods: The study used data loggers to continuously record internal temperatures of four vehicles at 15-minute intervals over a two-year period, to investigate the effect of seasonality and time of day on the internal car temperature. Results: The internal car temperature ranged from −7.4°C to 54.5°C during the study period. Temperatures fell below 8°C every month, except June and July. The internal car temperature exceeded typical drug storage recommendations (>25°C) during every month, and exceeded the canine thermoneutral zone (>35°C) from April to September. Peak temperatures occurred between 14:00 and 17:00 hours. Conclusion: The results demonstrate the year-round potential for thermal stress of both dogs and drugs left in cars. Public awareness campaigns highlighting the risks of leaving dogs in hot cars are typically launched in late spring, but should consider launching earlier in light of these findings. Veterinary surgeons transporting drugs should take measures to ensure that drugs are stored within the manufacturer’s temperature range year-round. This will limit the potential for drug degradation and decreased efficacy

Label-free profiling of white adipose tissue of rats exhibiting high or low levels of intrinsic exercise capacity

Divergent selection has created rat phenotypes of high- and low-capacity runners (HCR and LCR, respectively) that have differences in aerobic capacity and correlated traits such as adiposity. We analyzed visceral adipose tissue of HCR and LCR using label-free high-definition MS (elevated energy) profiling. The running capacity of HCR was ninefold greater than LCR. Proteome profiling encompassed 448 proteins and detected 30 significant (p <0.05; false discovery rate <10%, calculated using q-values) differences. Approximately half of the proteins analyzed were of mitochondrial origin, but there were no significant differences in the abundance of proteins involved in aerobic metabolism. Instead, adipose tissue of LCR rats exhibited greater abundances of proteins associated with adipogenesis (e.g. cathepsin D), ER stress (e.g. 78 kDa glucose response protein), and inflammation (e.g. Ig gamma-2B chain C region). Whereas the abundance antioxidant enzymes such as superoxide dismutase [Cu-Zn] was greater in HCR tissue. Putative adipokines were also detected, in particular protein S100-B, was 431% more abundant in LCR adipose tissue. These findings reveal low running capacity is associated with a pathological profile in visceral adipose tissue proteome despite no detectable differences in mitochondrial protein abundance

The discovery of a five-image lensed quasar at z = 3.34 using PanSTARRS1 and Gaia

We report the discovery, spectroscopic confirmation, and mass modelling of the gravitationally lensed quasar system PS J0630-1201. The lens was discovered by matching a photometric quasar catalogue compiled from Pan-STARRS and WISE photometry to the Gaia DR1 catalogue, exploiting the high spatial resolution of the latter (FWHM $\sim$0.1") to identify the three brightest components of the lens. Follow-up spectroscopic observations with the WHT confirm the multiple objects are quasars at redshift $z_{q}=3.34$. Further follow-up with Keck AO high-resolution imaging reveals that the system is composed of two lensing galaxies and the quasar is lensed into a $\sim$2.8" separation four-image cusp configuration with a fifth image clearly visible, and a 1.0" arc due to the lensed quasar host galaxy. The system is well-modelled with two singular isothermal ellipsoids, reproducing the position of the fifth image. We discuss future prospects for measuring time delays between the images and constraining any offset between mass and light using the faintly detected Einstein arcs associated with the quasar host galaxy

Modelling ground vibrations induced by harmonic loads

A finite-element model combining the frequency domain thin-layer method with paraxial boundary conditions to simulate the semi-infinite extent of a soil medium is presented in this paper. The combined numerical model is used to deal with harmonic vibrations of surface rigid foundations on non-horizontal soil profiles. The model can deal with soil media over rigid bedrock or significant depths of half-space. Structured finite elements are used to mesh simple geometry soil domains, whereas unstructured triangular mesh grids are employed to deal with complex geometry problems. Dynamic responses of homogeneous as well as layered soil profiles are simulated and validated against analytical and approximate solutions. Finally, the model is used to deal with surface ground vibration reduction, in which it is first validated against published results and then followed by an example involving a bridge

Designing nutrition-based interventional trials for the future: addressing the known knowns

Abstract The consistent decline in critical illness mortality has a significant effect on trial design, whereby either an improbable effect sizes or large number of patients are required. The signal-to-noise ratio is of particular interest for the critically ill. When considering the potential signal, interventions need to match outcomes in regard to biological plausibility. Provision of nutrition is a complex decision with many underappreciated aspects of noise. However, a fundamental interaction is often not accounted for time. Working as a community to evolve trial design will be our challenge for nutrition interventions in the critically ill for the future

Primary care management for optimized antithrombotic treatment [PICANT]: study protocol for a cluster-randomized controlled trial

Background: Antithrombotic treatment is a continuous therapy that is often performed in general practice and requires careful safety management. The aim of this study is to investigate whether a best practice model that applies major elements of case management, including patient education, can improve antithrombotic management in primary health care in terms of reducing major thromboembolic and bleeding events. Methods: This 24-month cluster-randomized trial will be performed in 690 adult patients from 46 practices. The trial intervention will be a complex intervention involving general practitioners, health care assistants and patients with an indication for oral anticoagulation. To assess adherence to medication and symptoms in patients, as well as to detect complications early, health care assistants will be trained in case management and will use the Coagulation-Monitoring-List (Co-MoL) to regularly monitor patients. Patients will receive information (leaflets and a video), treatment monitoring via the Co-MoL and be motivated to perform self-management. Patients in the control group will continue to receive treatment-as-usual from their general practitioners. The primary endpoint is the combined endpoint of all thromboembolic events requiring hospitalization, and all major bleeding complications. Secondary endpoints are mortality, hospitalization, strokes, major bleeding and thromboembolic complications, severe treatment interactions, the number of adverse events, quality of anticoagulation, health-related quality of life and costs. Further secondary objectives will be investigated to explain the mechanism by which the intervention is effective: patients' assessment of chronic illness care, self-reported adherence to medication, general practitioners' and health care assistants' knowledge, patients' knowledge and satisfaction with shared decision making. Practice recruitment is expected to take place between July and December 2012. Recruitment of eligible patients will start in July 2012. Assessment will occur at three time points: baseline (T0), follow-up after 12 (T1) and after 24 months (T2). Discussion: The efficacy and effectiveness of individual elements of the intervention, such as antithrombotic interventions, self-management concepts in orally anticoagulated patients and the methodological tool, case-management, have already been extensively demonstrated. This project foresees the combination of several proven instruments, as a result of which we expect to profit from a reduction in the major complications associated with antithrombotic treatment

Etiology of Severe Non-malaria Febrile Illness in Northern Tanzania: A Prospective Cohort Study.

The syndrome of fever is a commonly presenting complaint among persons seeking healthcare in low-resource areas, yet the public health community has not approached fever in a comprehensive manner. In many areas, malaria is over-diagnosed, and patients without malaria have poor outcomes. We prospectively studied a cohort of 870 pediatric and adult febrile admissions to two hospitals in northern Tanzania over the period of one year using conventional standard diagnostic tests to establish fever etiology. Malaria was the clinical diagnosis for 528 (60.7%), but was the actual cause of fever in only 14 (1.6%). By contrast, bacterial, mycobacterial, and fungal bloodstream infections accounted for 85 (9.8%), 14 (1.6%), and 25 (2.9%) febrile admissions, respectively. Acute bacterial zoonoses were identified among 118 (26.2%) of febrile admissions; 16 (13.6%) had brucellosis, 40 (33.9%) leptospirosis, 24 (20.3%) had Q fever, 36 (30.5%) had spotted fever group rickettsioses, and 2 (1.8%) had typhus group rickettsioses. In addition, 55 (7.9%) participants had a confirmed acute arbovirus infection, all due to chikungunya. No patient had a bacterial zoonosis or an arbovirus infection included in the admission differential diagnosis. Malaria was uncommon and over-diagnosed, whereas invasive infections were underappreciated. Bacterial zoonoses and arbovirus infections were highly prevalent yet overlooked. An integrated approach to the syndrome of fever in resource-limited areas is needed to improve patient outcomes and to rationally target disease control efforts

Anthropometric factors and breast cancer risk among urban and rural women in South India: a multicentric case–control study

Breast cancer (BC) incidence in India is approximately twice as high in urban women than in rural women, among whom we investigated the role of anthropometric factors and body size. The study was conducted at the Regional Cancer Centre, Trivandrum, and in three cancer hospitals in Chennai during 2002–2005. Histologically confirmed cases (n=1866) and age-matched controls (n=1873) were selected. Anthropometric factors were measured in standard ways. Information on body size at different periods of life was obtained using pictograms. Odds ratios (OR) of BC were estimated through logistic regression modelling. Proportion of women with body mass index (BMI)>25.0 kg/m2, waist size >85 cm and hip size >100 cm was significantly higher among urban than rural women. Risk was increased for waist size >85 cm (pre-menopausal: OR=1.24, 95% CI: 0.96–1.62; post-menopausal: 1.61, 95% CI: 1.22–2.12) and hip size >100 cm (pre-menopausal: OR=1.47, 95% CI: 1.05–2.06; post-menopausal 2.42, 95% CI: 1.72–3.41). Large body size at age 10 (OR=1.75, 95% CI: 1.01–3.03) and increased BMI (OR=1.33, 95% CI: 1.05–1.69 for 25.0–29.9 kg/m2 and OR=1.56, 95% CI: 1.03–2.35 for 30+ kg/m2) were associated with pre-menopausal BC risk. Our data support the hypotheses that increased anthropometric factors are risk factors of BC in India