Contributions to variability of clinical measures for use as indicators of udder health status in a clinical protocol

A cross-sectional observational study with repeated observations was conducted on 16 Danish dairy farms to quantify the influence of observer, parity, time (stage in lactation) and farm on variables routinely selected for inclusion in clinical protocols, thereby to enable a more valid comparison of udder health between different herds. During 12 months, participating herds were visited 5 times by project technicians, who examined 20 cows and scored the selected clinical variables. The estimates of effect on variables were derived from a random regression model procedure. Statistical analyses revealed that, although estimates for occurrence of several the variables, e.g. degree of oedema, varied significantly between observers, the effects on many of these estimates were similar in size. Almost all estimates for occurrences of variables were significantly affected either parity and lactation stage, or by both e.g. udder tissue consistency. Some variables, e.g. mange, had high estimates for the farm component, and others e.g. teat skin quality had a high individual component. Several of the variables, e.g. wounds on warts, had a high residual component indicating that a there still was a major part of the variation in data, which was unexplained. It was concluded that most of the variables were relevant for implementation in herd health management, but that adjustments need to be made to improve reliability

Cancer patients’ experiences of error and consequences during diagnosis and treatment

The study objective was to investigate patient experienced error during diagnosis and treatment of cancer. The design included a nationwide patient survey on quality and safety in Danish cancer care. Responses regarding patient experienced error were separately analyzed, quantitative responses using descriptive statistics and qualitative responses using systematic text analysis. Study participants included 6,720 adult patients with a first time diagnosis of cancer registered between May 1st and August 31st 2010. The patients received a questionnaire concerning their experiences of care received by general practitioners, specialist practitioners and at the hospital. A response rate of 65% was achieved. 10 – 25% of patients experienced error during diagnosis or treatment. 61% reported that hospital errors had consequences. Unexpected surgical errors/complications (27%), delay due to doctors’ assessment errors (24%) and unavailable test results (21%) were the most frequent types of errors identified using closed questions. 819 qualitative responses supplemented this information and revealed errors related to cancer detection, planning & coordination, patient-provider communication, administrative processes and treatment & medication. Physical, psychological, social as well as organizational consequences of the errors were uncovered. Patient experiences of errors suggest that practices related to informed consent, diagnostic reasoning as well as handling of test results, referrals and the medical chart should be further improved. In addition, safety aspects of the patient-provider communication and involvement of patients as an extra safety barrier merit further study

Assessment of muscle function using hybrid PET/MRI:comparison of ¹⁸F-FDG PET and T2-weighted MRI for quantifying muscle activation in human subjects

PURPOSE: The aim of this study was to determine the relationship between relative glucose uptake and MRI T (2) changes in skeletal muscles following resistance exercise using simultaneous PET/MRI scans. METHODS: Ten young healthy recreationally active men (age 21 – 28 years) were injected with (18)F-FDG while activating the quadriceps of one leg with repeated knee extension exercises followed by hand-grip exercises for one arm. Immediately following the exercises, the subjects were scanned simultaneously with (18)F-FDG PET/MRI and muscle groups were evaluated for increases in (18)F-FDG uptake and MRI T (2) values. RESULTS: A significant linear correlation between (18)F-FDG uptake and changes in muscle T (2) (R (2) = 0.71) was found. for both small and large muscles and in voxel to voxel comparisons. Despite large intersubject differences in muscle recruitment, the linear correlation between (18)F-FDG uptake and changes in muscle T (2) did not vary among subjects. CONCLUSION: This is the first assessment of skeletal muscle activation using hybrid PET/MRI and the first study to demonstrate a high correlation between (18)F-FDG uptake and changes in muscle T (2) with physical exercise. Accordingly, it seems that changes in muscle T (2) may be used as a surrogate marker for glucose uptake and lead to an improved insight into the metabolic changes that occur with muscle activation. Such knowledge may lead to improved treatment strategies in patients with neuromuscular pathologies such as stroke, spinal cord injuries and muscular dystrophies

A mixed methods inquiry into the validity of data

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Methods for the Study of Marine Biodiversity

Recognition of the threats to biodiversity and its importance to society has led to calls for globally coordinated sampling of trends in marine ecosystems. As a step to defining such efforts, we review current methods of collecting and managing marine biodiversity data. A fundamental component of marine biodiversity is knowing what, where, and when species are present. However, monitoring methods are invariably biased in what taxa, ecological guilds, and body sizes they collect. In addition, the data need to be placed, and/or mapped, into an environmental context. Thus a suite of methods will be needed to encompass representative components of biodiversity in an ecosystem. Some sampling methods can damage habitat and kill species, including unnecessary bycatch. Less destructive alternatives are preferable, especially in conservation areas, such as photography, hydrophones, tagging, acoustics, artificial substrata, light-traps, hook and line, and live-traps. Here we highlight examples of operational international sampling programmes and data management infrastructures, notably the Continuous Plankton Recorder, Reef Life Survey, and detection of Harmful Algal Blooms and MarineGEO. Data management infrastructures include the World Register of Marine Species for species nomenclature and attributes, the Ocean Biogeographic Information System for distribution data, Marine Regions for maps, and Global Marine Environmental Datasets for global environmental data. Existing national sampling programmes, such as fishery trawl surveys and intertidal surveys, may provide a global perspective if their data can be integrated to provide useful information. Less utilised and emerging sampling methods, such as artificial substrata, light-traps, microfossils and eDNA also hold promise for sampling the less studied components of biodiversity. All of these initiatives need to develop international standards and protocols, and long-term plans for their governance and support.published_or_final_versio

Goal-directed haemodynamic therapy during general anaesthesia for noncardiac surgery:a systematic review and meta-analysis

BACKGROUND: During general anaesthesia for noncardiac surgery, there remain knowledge gaps regarding the effect of goal-directed haemodynamic therapy on patient-centred outcomes. METHODS: Included clinical trials investigated goal-directed haemodynamic therapy during general anaesthesia in adults undergoing noncardiac surgery and reported at least one patient-centred postoperative outcome. PubMed and Embase were searched for relevant articles on March 8, 2021. Two investigators performed abstract screening, full-text review, data extraction, and bias assessment. The primary outcomes were mortality and hospital length of stay, whereas 15 postoperative complications were included based on availability. From a main pool of comparable trials, meta-analyses were performed on trials with homogenous outcome definitions. Certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). RESULTS: The main pool consisted of 76 trials with intermediate risk of bias for most outcomes. Overall, goal-directed haemodynamic therapy might reduce mortality (odds ratio=0.84; 95% confidence interval [CI], 0.64 to 1.09) and shorten length of stay (mean difference=–0.72 days; 95% CI, –1.10 to –0.35) but with low certainty in the evidence. For both outcomes, larger effects favouring goal-directed haemodynamic therapy were seen in abdominal surgery, very high-risk surgery, and using targets based on preload variation by the respiratory cycle. However, formal tests for subgroup differences were not statistically significant. Goal-directed haemodynamic therapy decreased risk of several postoperative outcomes, but only infectious outcomes and anastomotic leakage reached moderate certainty of evidence. CONCLUSIONS: Goal-directed haemodynamic therapy during general anaesthesia might decrease mortality, hospital length of stay, and several postoperative complications. Only infectious postoperative complications and anastomotic leakage reached moderate certainty in the evidence

Fraction of Inspired Oxygen During General Anesthesia for Non-Cardiac Surgery:Systematic Review and Meta-Analysis

BACKGROUND: Controversy exists regarding the effects of a high versus a low intraoperative fraction of inspired oxygen (FiO(2)) in adults undergoing general anesthesia. This systematic review and meta‐analysis investigated the effect of a high versus a low FiO(2) on postoperative outcomes. METHODS: PubMed and Embase were searched on March 22, 2022 for randomized clinical trials investigating the effect of different FiO(2) levels in adults undergoing general anesthesia for non‐cardiac surgery. Two investigators independently reviewed studies for relevance, extracted data, and assessed risk of bias. Meta‐analyses were performed for relevant outcomes, and potential effect measure modification was assessed in subgroup analyses and meta‐regression. The evidence certainty was evaluated using GRADE. RESULTS: This review included 25 original trials investigating the effect of a high (mostly 80%) versus a low (mostly 30%) FiO(2). Risk of bias was intermediate for all trials. A high FiO(2) did not result in a significant reduction in surgical site infections (OR: 0.91, 95% CI 0.81–1.02 [p = .10]). No effect was found for all other included outcomes, including mortality (OR = 1.27, 95% CI: 0.90–1.79 [p = .18]) and hospital length of stay (mean difference = 0.03 days, 95% CI −0.25 to 0.30 [p = .84). Results from subgroup analyses and meta‐regression did not identify any clear effect modifiers across outcomes. The certainty of evidence (GRADE) was rated as low for most outcomes. CONCLUSIONS: In adults undergoing general anesthesia for non‐cardiac surgery, a high FiO(2) did not improve outcomes including surgical site infections, length of stay, or mortality. However, the certainty of the evidence was assessed as low

Resistance to penicillin of Staphylococcus aureus isolates from cows with high somatic cell counts in organic and conventional dairy herds in Denmark

BACKGROUND: Quarter milk samples from cows with high risk of intramammary infection were examined to determine the prevalence of Staphylococcus aureus (SA) and penicillin resistant SA (SAr) in conventional and organic dairy herds and herds converting to organic farming in a combined longitudinal and cross-sectional study. METHODS: 20 conventional herds, 18 organic herds that converted before 1995, and 19 herds converting to organic farming in 1999 or 2000 were included in the study. Herds converting to organic farming were sampled three times one year apart; the other herds were sampled once. Risk of infection was estimated based on somatic cell count, milk production, breed, age and lactation stage. RESULTS: The high-risk cows represented about 49 % of the cows in the herds. The overall prevalence of SA and SAr among these cows was 29% (95% confidence interval: 24%–34%) and 4% (95% confidence interval: 2%–5%) respectively. The prevalence of penicillin resistance among SA infected cows was 12% (95% confidence interval: 6%–19%) when calculated from the first herd visits. No statistically significant differences were observed in the prevalence of SAr or the proportion of isolates resistant to penicillin between herd groups. CONCLUSION: The proportion of isolates resistant to penicillin was low compared to studies in other countries except Norway and Sweden. Based on the low prevalence of penicillin resistance of SA, penicillin should still be the first choice of antimicrobial agent for treatment of bovine intramammary infection in Denmark

On Imprimitive Representations of Finite Reductive Groups in Non-defining Characteristic

In this paper, we begin with the classification of Harish-Chandra imprimitive representations in non-defining characteristic. We recall the connection of this problem to certain generalizations of Iwahori-Hecke algebras and show that Harish-Chandra induction is compatible with the Morita equivalence by Bonnaf\'{e} and Rouquier, thus reducing the classification problem to quasi-isolated blocks. Afterwards, we consider imprimitivity of unipotent representations of certain classical groups. In the case of general linear and unitary groups, our reduction methods then lead to results for arbitrary Lusztig series