Epidemiological analysis of spatially misaligned data: a case of highly pathogenic avian influenza virus outbreak in Nigeria

This research is focused on the epidemiological analysis of the transmission of the highly pathogenic avian influenza (HPAI) H5N1 virus outbreak in Nigeria. The data included 145 outbreaks together with the locations of the infected farms and the date of confirmation of infection. In order to investigate the environmental conditions that favoured the transmission and spread of the virus, weather stations were realigned with the locations of the infected farms. The spatial Kolmogorov–Smirnov test for complete spatial randomness rejects the null hypothesis of constant intensity (P < 0·0001). Preliminary exploratory analysis showed an increase in the incidence of H5N1 virus at farms located at high altitude. Results from the Poisson log-linear conditional intensity function identified temperature (−0·9601) and wind speed (0·6239) as the ecological factors that influence the intensity of transmission of the H5N1 virus. The model also includes distance from the first outbreak (−0·9175) with an Akaike’s Information Criterion of −103·87. Our analysis using a point process model showed that geographical heterogeneity, seasonal effects, temperature, wind as well as proximity to the first outbreak are very important components of spread and transmission of HPAI H5N1.Web of Scienc

Has the character of gastric cancer changed? A descriptive study of a IO-year period

Over the 10-year period January 1976 - December 1985, 446 patients with histologically verified adenocarcinoma of the stomach were treated at Tygerberg Hospital. Coloured patients made up 63,4% of the study population and a significant increase in the annual proportion of this group was observed. Coloured men comprised 47,6% of the total group. The mean age of white and coloured patients differed significantly (68,9 v. 56,5; P &lt; 0,001). The symptom complex was essentially similar in the two racial groups and in general the character of the symptoms had no bearing on the prevalence of resection. Although antral tumours were most common in whites and in coloureds, there was a significant increase in tumours located in the fundus in whites. The resection rate remained unchanged over the 10-year period. Only 4 cases of early gastric cancer were detected during this period without any signs of an increased yield of early lesions over time. This audit revealed no beneficial changes over time, which is in stark contrast with reports from Japan regarding the proportion of curable lesions

Exploring the anthelmintic properties of Australian native shrubs with respect to their potential role in livestock grazing systems

We measured in vitro anthelmintic activity in extracts from 85 species of Australian native shrub, with a view to identifying species able to provide a degree of worm control in grazing systems. Approximately 40% of the species showed significant activity in inhibiting development of Haemonchus contortus larvae. The most active extracts showed IC50 values of 60–300 mg/ml. Pre-incubation with polyvinylpolypyrrolidine removed the activity from some extracts, implicating tannins as the bioactive agent, while in other cases the pre-incubation had no effect, indicating the presence of other anthelmintic compounds. Plant reproductive maturity (onset of flowering or fruiting) was associated with increasing anthelmintic activity in some species. Variability was observed between plants of the same species growing in different environments, while variation between individual plants of the same species within a single field suggests the existence of distinct chemotypes. Significant activity against adult H. contortus worms in vitro was also demonstrated in a limited number of extracts tested against this life stage. Our study indicates that there is potential for Australian native shrubs to play an anthelmintic role in grazing systems, and highlights some plant biology factors which will need to be considered in order to maximize any anthelmintic effects.A. C. Kotze, J. O’Grady, J. Emms, A. F. Toovey, S. Hughes, P. Jessop, M. Bennell P. E. Vercoe and D. K. Revel

Factors supporting and constraining the implementation of robot-assisted surgery: a realist interview study

YesTo capture stakeholders’ theories concerning how and in what contexts robot-assisted surgery becomes integrated into routine practice. A literature review provided tentative theories that were revised through a realist interview study. Literature-based theories were presented to the interviewees, who were asked to describe to what extent and in what ways those theories reflected their experience. Analysis focused on identifying mechanisms through which robot-assisted surgery becomes integrated into practice and contexts in which those mechanisms are triggered. Nine hospitals in England where robot-assisted surgery is used for colorectal operations. Forty-four theatre staff with experience of robot-assisted colorectal surgery, including surgeons, surgical trainees, theatre nurses, operating department practitioners and anaesthetists. Interviewees emphasised the importance of support from hospital management, team leaders and surgical colleagues. Training together as a team was seen as beneficial, increasing trust in each other’s knowledge and supporting team bonding, in turn leading to improved teamwork. When first introducing robot-assisted surgery, it is beneficial to have a handpicked dedicated robotic team who are able to quickly gain experience and confidence. A suitably sized operating theatre can reduce operation duration and the risk of de-sterilisation. Motivation among team members to persist with robot-assisted surgery can be achieved without involvement in the initial decision to purchase a robot, but training that enables team members to feel confident as they take on the new tasks is essential. We captured accounts of how robot-assisted surgery has been introduced into a range of hospitals. Using a realist approach, we were also able to capture perceptions of the factors that support and constrain the integration of robot-assisted surgery into routine practice. We have translated these into recommendations that can inform future implementations of robot-assisted surgery

IGR J19552+0044: A new asynchronous short period polar: "Filling the gap between intermediate and ordinary polars"

Based on XMM--Newton X-ray observations IGR J19552+0044 appears to be either a pre-polar or an asynchronous polar. We conducted follow-up optical observations to identify the sources and periods of variability precisely and to classify this X-ray source correctly. Extensive multicolor photometric and medium- to high-resolution spectroscopy observations were performed and period search codes were applied to sort out the complex variability of the object. We found firm evidence of discording spectroscopic (81.29+/-0.01m) and photometric (83.599+/-0.002m) periods that we ascribe to the white dwarf (WD)\ spin period and binary orbital period, respectively. This confirms that IGR J19552+0044 is an asynchronous polar. Wavelength-dependent variability and its continuously changing shape point at a cyclotron emission from a magnetic WD with a relatively low magnetic field below 20 MG. The difference between the WD spin period and the binary orbital period proves that IGR J19552+0044 is a polar with the largest known degree of asynchronism (0.97 or 3%).Comment: 9 pages, 10 figures, A&A accepte

SALT spectroscopy of the accreting millisecond pulsar binary SAX J1808-3658 during its recent increased activity

Following the announcement of increased optical activity of the accreting millisecond pulsar binary (AMXP) SAX J1808-3658 on July 30 (ATel# 12964) and of an abrupt brightening beginning August 5 (ATel #12993) and August 6 (ATel #13000), we carried out long-slit optical spectroscopy on August 2, 3 and 6 with the Southern African Large Telescope (SALT)

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

YesBackground: The implementation of robot-assisted surgery (RAS) can be challenging, with reports of surgical robots being underused. This raises questions about differences compared with open and laparoscopic surgery and how best to integrate RAS into practice. Objectives: To (1) contribute to reporting of the ROLARR (RObotic versus LAparoscopic Resection for Rectal cancer) trial, by investigating how variations in the implementation of RAS and the context impact outcomes; (2) produce guidance on factors likely to facilitate successful implementation; (3) produce guidance on how to ensure effective teamwork; and (4) provide data to inform the development of tools for RAS. Design: Realist process evaluation alongside ROLARR. Phase 1 – a literature review identified theories concerning how RAS becomes embedded into practice and impacts on teamwork and decision-making. These were refined through interviews across nine NHS trusts with theatre teams. Phase 2 – a multisite case study was conducted across four trusts to test the theories. Data were collected using observation, video recording, interviews and questionnaires. Phase 3 – interviews were conducted in other surgical disciplines to assess the generalisability of the findings. Findings: The introduction of RAS is surgeon led but dependent on support at multiple levels. There is significant variation in the training provided to theatre teams. Contextual factors supporting the integration of RAS include the provision of whole-team training, the presence of handpicked dedicated teams and the availability of suitably sized operating theatres. RAS introduces challenges for teamwork that can impact operation duration, but, over time, teams develop strategies to overcome these challenges. Working with an experienced assistant supports teamwork, but experience of the procedure is insufficient for competence in RAS and experienced scrub practitioners are important in supporting inexperienced assistants. RAS can result in reduced distraction and increased concentration for the surgeon when he or she is supported by an experienced assistant or scrub practitioner. Conclusions: Our research suggests a need to pay greater attention to the training and skill mix of the team. To support effective teamwork, our research suggests that it is beneficial for surgeons to (1) encourage the team to communicate actions and concerns; (2) alert the attention of the assistant before issuing a request; and (3) acknowledge the scrub practitioner’s role in supporting inexperienced assistants. It is beneficial for the team to provide oral responses to the surgeon’s requests. Limitations: This study started after the trial, limiting impact on analysis of the trial. The small number of operations observed may mean that less frequent impacts of RAS were missed. Future work: Future research should include (1) exploring the transferability of guidance for effective teamwork to other surgical domains in which technology leads to the physical or perceptual separation of surgeon and team; (2) exploring the benefits and challenges of including realist methods in feasibility and pilot studies; (3) assessing the feasibility of using routine data to understand the impact of RAS on rare end points associated with patient safety; (4) developing and evaluating methods for whole-team training; and (5) evaluating the impact of different physical configurations of the robotic console and team members on teamwork.National Inst for Health Research (NIHR

Volatiles associated with different flower stages and leaves of Acacia cyclops and their potential role as host attractants for Dasineura dielsi (Diptera: Cecidomyiidae)

Acacia cyclops (Fabaceae) is an Australian species which was introduced into South Africa in the nineteenth century. Because of its invasive status in South Africa, a gall midge, Dasineura dielsi (Diptera: Cecidomyiidae), was released in 2001 in order to impact its reproduction by inducing galls on the flowers and thereby preventing seed set. Nothing is known about the cues used by D. dielsi for locating its host flowers. As part of an initial investigation into whether or not chemical cues might play a role in host finding, we analysed headspace samples of Acacia cyclops volatiles from leaves and reproductive parts at different stages (early bud, late bud, early flowering, and senescing flowering stages) using gas chromatography–mass spectrometry (GC–MS). In total, 72 different compounds were detected of which 62 were identified. The analyses showed that open flowers, the stage used by D. dielsi for oviposition, and yellow buds had similar odour compositions with (Z)-3-hexen-1-ol acetate, 4-oxoisophorone, (Z)-β-ocimene, an unknown aliphatic compound, heptadecane, and nonadecane dominating in open flowers. Leaf volatiles were distinct from those in the reproductive plant parts by their high relative amount of (Z)-β-ocimene. (Z)-3-Hexen-1-ol acetate had its maximum relative amount in the green bud samples and was much lower in the later floral stages. In contrast, 4-oxoisophorone peaked in yellow buds and open flowers with little or none of it found in younger or older stages. The volatile compounds of the different flower stages and leaves are discussed in relation to their potential role as attractants used by the biocontrol agent D. dielsi to locate its host plant

Volatiles associated with different flower stages and leaves of Acacia cyclops and their potential role as host attractants for Dasineura dielsi (Diptera: Cecidomyiidae)

Acacia cyclops (Fabaceae) is an Australian species which was introduced into South Africa in the nineteenth century. Because of its invasive status in South Africa, a gall midge, Dasineura dielsi (Diptera: Cecidomyiidae), was released in 2001 in order to impact its reproduction by inducing galls on the flowers and thereby preventing seed set. Nothing is known about the cues used by D. dielsi for locating its host flowers. As part of an initial investigation into whether or not chemical cues might play a role in host finding, we analysed headspace samples of Acacia cyclops volatiles from leaves and reproductive parts at different stages (early bud, late bud, early flowering, and senescing flowering stages) using gas chromatography–mass spectrometry (GC–MS). In total, 72 different compounds were detected of which 62 were identified. The analyses showed that open flowers, the stage used by D. dielsi for oviposition, and yellow buds had similar odour compositions with (Z)-3-hexen-1-ol acetate, 4-oxoisophorone, (Z)-β-ocimene, an unknown aliphatic compound, heptadecane, and nonadecane dominating in open flowers. Leaf volatiles were distinct from those in the reproductive plant parts by their high relative amount of (Z)-β-ocimene. (Z)-3-Hexen-1-ol acetate had its maximum relative amount in the green bud samples and was much lower in the later floral stages. In contrast, 4-oxoisophorone peaked in yellow buds and open flowers with little or none of it found in younger or older stages. The volatile compounds of the different flower stages and leaves are discussed in relation to their potential role as attractants used by the biocontrol agent D. dielsi to locate its host plant