Case study: Tuberculination, serology and bacteriology of sows at a farrowing unit suspected of an infection with Mycobacterium avium

Mycobacterium avium (MA) is considered a zoonotic hazard in pork. Herds delivered at slaughter showing gross lesions indicative of a mycobacterial infection, eg. specific abcesses in lymphoreticular tissue, were bacteriologically positive for MA. A risk factor analysis revealing different possible sources of primary infection was carried out at farms supplying these pigs. Also the common farrowing farm supplying the piglets to these farms was taken into account as a possible source of infection. Intradermal tuberculin testing, serology and tissue sampling was carried out on the sows and finishing pigs

The rationale of opportunistic bilateral salpingectomies (OBS) during benign gynaecological and obstetric surgery : a consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG)

Ovarian cancer (OC), is a disease difficult to diagnose in an early stage implicating a poor prognosis. The 5-year overall survival in Belgium has not changed in the last 18 years and remains 44 %. There is no effective screening method (secondary prevention) to detect ovarian cancer at an early stage. Primary prevention of ovarian cancer came in the picture through the paradigm shift that the fallopian tube is often the origin of ovarian cancer and not the ovary itself. Opportunistic bilateral salpingectomy (OBS) during benign gynaecological and obstetric surgery might have the potential to reduce the risk of ovarian cancer by as much as 65 %. Bilateral risk-reducing salpingectomy during a benign procedure is feasible, safe, appears to have no impact on the ovarian function and seems to be cost effective. The key question is whether we should wait for a RCT or implement OBS directly in our daily practice. Guidelines regarding OBS within our societies are therefore urgently needed. Our recommendation is to inform all women without a child wish, undergoing a benign gynaecological or obstetrical surgical procedure about the pro’s and the con’s of OBS and advise a bilateral salpingectomy. Furthermore, there is an urgent need for a prospective registry of OBS. The present article is the consensus text of the Flemish Society of Obstetrics and Gynaecology (VVOG) regarding OBS

Beyond feedback: introducing the 'engagement gap' in organizational energy management

This paper discusses socio-technical relationships between people, organizations and energy in workplaces. Inspired by Sherry Arnstein’s ladder of citizen participation, it explores widening energy management beyond energy managers to other employees, introducing the idea of an ‘engagement gap’ to support a move beyond unidirectional forms of engagement (e.g. feedback and nudging) to more socially interactive processes. Results are drawn from two projects researching energy practices in public authorities and retail organizations. The first project, ‘GoodDeeds’, collaboratively created an information and communication technology tool and explored participatory processes within a municipality. The second project, Working with Infrastructure, Creation of Knowledge, and Energy strategy Development (WICKED), explored energy management in retail companies. The paper uses a ‘4Cs’ framework to articulate the influences of concerns, capacities and technical conditions within organizational communities. The results concur with previous research that energy management sits against a backdrop of competing organizational, institutional and political concerns. New data reveal discrepancies across organizations with regard to energy management capacities and technical metering conditions. The authors suggest employee engagement can be broadened by treating energy as a communal subject for discussion, negotiation and partnership. This objective moves beyond the ‘information-deficit’ approach intrinsic in the existing focus on analytics, dashboards and feedback

First finds of Prunus domestica L. in Italy from the Phoenician and Punic periods (6th-2nd centuries BC)

Abstract During the archaeological excavations in the Phoenician and Punic settlement of Santa Giusta (Oristano, Sardinia, Italy), dating back to the 6th–2nd centuries bc, several Prunus fruitstones (endocarps) inside amphorae were recovered. The exceptional state of preservation of the waterlogged remains allowed morphometric measurements to be done by image analysis and statistical comparisons made with modern cultivated and wild Prunus samples collected in Sardinia. Digital images of modern and archaeological Prunus fruitstones were acquired with a flatbed scanner and analysed by applying image analysis techniques to measure 26 morphometric features. By applying stepwise linear discriminant analysis, a morphometric comparison was made between the archaeological fruitstones of Prunus and the modern ones collected in Sardinia. These analyses allowed identification of 53 archaeological fruitstones as P. spinosa and 11 as P. domestica. Moreover, the archaeological samples of P. spinosa showed morphometric similarities in 92.5% of the cases with the modern P. spinosa samples currently growing near the Phoenician and Punic site. Likewise, the archaeological fruitstones identified as P. domestica showed similarities with the modern variety of P. domestica called Sanguigna di Bosa which is currently cultivated near the village of Bosa. Currently, these findings represent the first evidence of P. domestica in Italy during the Phoenician and Punic periods. Keywords Archaeobotany · Image analysis · Morphometric features · Prunus · Sardini

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Case study: Tuberculination, serology and bacteriology of sows at a farrowing unit suspected of an infection with Mycobacterium avium

Mycobacterium avium (MA) is considered a zoonotic hazard in pork. Herds delivered at slaughter showing gross lesions indicative of a mycobacterial infection, eg. specific abcesses in lymphoreticular tissue, were bacteriologically positive for MA. A risk factor analysis revealing different possible sources of primary infection was carried out at farms supplying these pigs. Also the common farrowing farm supplying the piglets to these farms was taken into account as a possible source of infection. Intradermal tuberculin testing, serology and tissue sampling was carried out on the sows and finishing pigs.</p

A new lease of life? Investigating UK property investor attitudes to low carbon investment decisions in commercial buildings

This paper reviews the barriers and drivers influencing energy efficiency investment decisions in the non-residential property sector and examines the effectiveness of recent UK government policy looking for signs of a new lease of life within the sector. A review of both the academic and ‘grey’ literature shows that the primary barrier is the lack of a compelling business case, as buildings with improved energy efficiency do not command premium rents or capital values. The UK Government has introduced policy drivers aimed at influencing change, by requiring the mandatory improvement of poor energy performing buildings and tougher building regulations on new property. To explore the effectiveness of these polices, senior UK based investment decision makers are interviewed, to understand ‘real-life perspectives on how energy efficiency drivers affect the market and their decisions. The interviews reveal that where the business case justifies, investors will take a beyond compliance approach but otherwise there is little appetite for such initiatives. The market is coping with the government’s mandatory approach because the cost of compliance is manageable. However, the relatively low cost of energy within total business costs, means that interest by landlords and tenants in reducing energy continues to be weak and this will present difficulties if policies are extended to capture more properties. Further research is recommended to see whether these conclusions are representative of the wider market