To What Extent Did Blood Transfusion Systems and Technologies Modernize During World War II?

This investigation will explore changes in blood transfusion during World War II (1939-1945). Medical technology and collection systems for whole blood and blood plasma in particular will be examined. The focus of this investigation will be the United States, but Great Britain will also be mentioned due to its close blood transfusion-related interactions with the United States during this period. Additionally, blood transfusion prior to World War II and in modern times will also be considered in this investigation to provide context and to allow assessment of modernization during the war. However, artificial blood substitutes will not be considered, nor any other areas of medicine such as surgery or antibiotics

Case 5 : Vaccination Under the Midnight Sun: Validation of an Immunization Registry in the Northwest Territories

With the implementation of mandatory reporting of all immunizations in the Northwest Territories (NWT) in 2012, the Department of Health and Social Services’ (DHSS) Disease Registry Unit was working toward the implementation of a new immunization registry similar to those implemented across the country. However, the current immunization registry was in the format of an Excel workbook. The DHSS noticed several issues with the quality of the data maintained in the spreadsheets. As part of Janet’s practicum, she conducted an audit of the immunizations for the cohort of children born between 2012 and 2014, inclusive, within the registry. Community health centres are required to submit immunizations they have administered via a monthly spreadsheet. The Disease Registry team then validates and cleans the information submitted and consolidates all the data into the immunization registry on one master Excel workbook. It is important to note that the original data submitted to the DHSS from the health centres is only added to the immunization registry after the Disease Registries Officer has confirmed that the data are clean. To assess the validity and reliability of the data, the community health centres were contacted and asked to submit all paper immunization records for children in this cohort, which were then entered into another spreadsheet. The cohort spreadsheet and the immunization registry were compared to determine the number of errors across various variables. To summarize, the audit was a comparison of the original community spreadsheet submitted to the DHSS with the paper immunization cards, which Janet entered into a separate spreadsheet to easily compare the two datasets

The efficacy of teat sealants in dairy cows at dry-off to prevent new intra-mammary infections during the dry-period or clinical mastitis during early lactation: A protocol for a systematic review

Rationale: The majority of antibiotic use in the dairy industry is for intramammary infections (IMI), with a large portion of this aimed at treating and preventing IMI during the dry period (Lam et al., 2102). During dry off, formation of the teat-canal keratin plug plays an important role in susceptibility to IMI (Huxley et al., 2002), but there is wide variation between cows on time to complete closure of the teat-canal, or indeed if closure occurs at all (Dingwell et al., 2003). In heifers, pre-partum IMI is an important risk factor for the development of clinical mastitis in early lactation, and the impact of this disease on future udder health and productivity is far greater than in multiparous animals (Piepers et al., 2009). Moreover, the incidence of clinical mastitis at freshening in heifers is roughly double that of multiparous cows (Ali Naqvi et al., 2018). Teat sealants provide a non-antibiotic strategy to prevent IMI in the pre-calving period, which is of increasing importance due to concern for antimicrobial use and its relationship with the development of antimicrobial resistance (WHO, 2015). Understanding the efficacy of these products is essential to optimizing their use in order to decrease reliance on antibiotics for both treatment and prevention. Systematic reviews of randomized controlled trials in these areas will yield the highest level of evidence for efficacy of treatment under field conditions (Sargeant and O’Connor, 2014). Establishing the efficacy of teat sealants at dry-off, and pre-partum in heifers, to reduce the incidence of both clinical mastitis and/or IMI, will serve to improve decision makers’ ability to engage in effective stewardship of antibiotics thorough the strategic use of non-antibiotic alternatives

The efficacy of antibiotic treatments in dairy cows at dry-off to prevent new intramammary infections during the dry-period or clinical mastitis during early lactation: A protocol for a systematic review

Rationale: The majority of antibiotic use in the dairy industry is for the treatment and prevention of intramammary infections (IMI); in the Netherlands, approximately 60 % of all antimicrobial use in dairy is for this purpose, with two-thirds being dry cow therapy (Lam et al., 2012). In the United States, over 90 % of dairy cows receive dry cow therapy after every lactation (USDA-APHIS, 2016), with the goal of treating or preventing IMI during the dry period. These infections are strongly associated with risk of development of clinical mastitis in the first two weeks post-calving, which represents the highest risk period for this disease (Green et al., 2002). To combat this, blanket dry cow therapy (intramammary antimicrobial treatment of all quarters of all cows after the last milking of the lactation) was recommended for decades as part of a comprehensive strategy to reduce IMI in the dry period (Neave et al., 1969), and has been widely adopted in North America and the United Kingdom (Ruegg, 2017). Although cow2 level selective dry cow therapy has been in use in some regions for several decades (Schultze, 1983), interest has more recently increased worldwide, in part driven by concern for antimicrobial use and its relationship with the development of antimicrobial resistance between species (WHO, 2015), including nation-specific regulations (Santman-Berends et al., 2016). Selective dry cow therapy has been employed because it is a means to rapidly reduce the amount of antimicrobials used in dairy cattle (Vanhoudt et al., 2018), rather than because it is known to contribute importantly to antimicrobial resistance (Oliver et al., 2011). With a greater concern for prudent antibiotic use in the dairy industry, it is important that decision making with regards to dry cow therapy at both the cow and herd levels be evidencebased. Choosing ineffective antibiotics, or using antibiotic when not warranted, unnecessarily contributes to use while having little impact on controlling disease, which has substantial bearing to both profitability and animal welfare (Leslie & Petersson-Wolfe, 2012). Systematic reviews of randomized controlled trials yield the highest level of evidence for efficacy of treatment under field conditions (Sargeant and O’Connor, 2014), and comparative efficacy can be examined using network meta-analysis for multiple comparisons. Establishing the efficacy of both cow-level antibiotic therapy and herd-level dry cow antibiotic protocols for the prevention of IMI will serve to improve decision makers’ ability to engage in effective stewardship of antibiotics

Automated pastures and the digital divide: how agricultural technologies are shaping labour and rural communities

A “digital revolution” in agriculture is underway. Advanced technologies like sensors, artificial intelligence, and robotics are increasingly being promoted as a means to increase food production efficiency while minimizing resource use. In the process, agricultural digitalization raises critical social questions about the implications for diverse agricultural labourers and rural spaces as digitalization evolves. In this paper, we use literature and field data to outline some key trends being observed at the nexus of agricultural production, technology, and labour in North America, with a particular focus on the Canadian context. Using the data, we highlight three key tensions observed: rising land costs and automation; the development of a high-skill/low-skilled bifurcated labour market; and issues around the control of digital data. With these tensions in mind, we use a social justice lens to consider the potential implications of digital agricultural technologies for farm labour and rural communities, which directs our attention to racial exploitation in agricultural labour specifically. In exploring these tensions, we argue that policy and research must further examine how to shift the trajectory of digitalization in ways that support food production as well as marginalized agricultural labourers, while pointing to key areas for future research—which is lacking to date. We emphasize that the current enthusiasm for digital agriculture should not blind us to the specific ways that new technologies intensify exploitation and deepen both labour and spatial marginalization

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Anthropometric measures and serum estrogen metabolism in postmenopausal women: the Women’s Health Initiative Observational Study

Background: Several anthropometric measures have been associated with hormone-related cancers. However, it is unknown whether estrogen metabolism plays an important role in these relationships. We examined whether measured current body mass index (BMI), waist-to-hip ratio (WHR), height, and self-reported BMI at age 18 years were associated with serum estrogens/estrogen metabolites using baseline, cross-sectional data from 1835 postmenopausal women enrolled in the Women’s Health Initiative Observational Study. Methods: Fifteen estrogens/estrogen metabolites were quantified using liquid chromatography-tandem mass spectrometry. Geometric means (GMs) of estrogens/estrogen metabolites (in picomoles per liter) were estimated using inverse probability weighted linear regression, adjusting for potential confounders and stratified on menopausal hormone therapy (MHT) use. Results: Among never or former MHT users, current BMI (≥30 vs. <25 kg/m2) was positively associated with parent estrogens (multivariable adjusted GM 432 vs. 239 pmol/L for estrone, 74 vs. 46 pmol/L for estradiol; p-trend < 0.001 for both) and all of the 2-, 4-, and 16-pathway estrogen metabolites evaluated (all p-trend ≤ 0.02). After additional adjustment for estradiol, unconjugated methylated 2-catechols were inversely associated (e.g., 2-methoxyestrone multivariable GM 9.3 vs. 12.0 pmol/L; p-trend < 0.001). Among current MHT users, current BMI was not associated with parent estrogens but was inversely associated with methylated catechols (e.g., 2-methoxyestrone multivariable GM 216 vs. 280 pmol/L; p-trend = 0.008). Similar patterns of association were found with WHR; however, the associations were not independent of BMI. Height and BMI at age 18 years were not associated with postmenopausal estrogens/estrogen metabolite levels. Conclusions: Our data suggest that postmenopausal BMI is associated with increased circulating levels of parent estrogens and reduced methylation of catechol estrogen metabolites, the estrogen metabolism patterns that have previously been associated with higher breast cancer risk. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0810-0) contains supplementary material, which is available to authorized users

The Canadian Chronic Disease Surveillance System: A model for collaborative surveillance

Chronic diseases have a major impact on populations and healthcare systems worldwide. Administrative health data are an ideal resource for chronic disease surveillance because they are population-based and routinely collected. For multi-jurisdictional surveillance, a distributed model is advantageous because it does not require individual-level data to be shared across jurisdictional boundaries. Our objective is to describe the process, structure, benefits, and challenges of a distributed model for chronic disease surveillance across all Canadian provinces and territories (P/Ts) using linked administrative data. The Public Health Agency of Canada (PHAC) established the Canadian Chronic Disease Surveillance System (CCDSS) in 2009 to facilitate standardized, national estimates of chronic disease prevalence, incidence, and outcomes. The CCDSS primarily relies on linked health insurance registration files, physician billing claims, and hospital discharge abstracts. Standardized case definitions and common analytic protocols are applied to the data for each P/T; aggregate data are shared with PHAC and summarized for reports and open access data initiatives. Advantages of this distributed model include: it uses the rich data resources available in all P/Ts; it supports chronic disease surveillance capacity building in all P/Ts; and changes in surveillance methodology can be easily developed by PHAC and implemented by the P/Ts. However, there are challenges: heterogeneity in administrative databases across jurisdictions and changes in data quality over time threaten the production of standardized disease estimates; a limited set of databases are common to all P/Ts, which hinders potential CCDSS expansion; and there is a need to balance comprehensive reporting with P/T disclosure requirements to protect privacy. The CCDSS distributed model for chronic disease surveillance has been successfully implemented and sustained by PHAC and its P/T partners. Many lessons have been learned about national surveillance involving jurisdictions that are heterogeneous with respect to healthcare databases, expertise and analytical capacity, population characteristics, and priorities

Cholesterol and Lipoprotein Dynamics in a Hibernating Mammal

Hibernating mammals cease feeding during the winter and rely primarily on stored lipids to fuel alternating periods of torpor and arousal. How hibernators manage large fluxes of lipids and sterols over the annual hibernation cycle is poorly understood. The aim of this study was to investigate lipid and cholesterol transport and storage in ground squirrels studied in spring, summer, and several hibernation states. Cholesterol levels in total plasma, HDL and LDL particles were elevated in hibernators compared with spring or summer squirrels. Hibernation increased plasma apolipoprotein A-I expression and HDL particle size. Expression of cholesterol 7 alpha-hydroxylase was 13-fold lower in hibernators than in active season squirrels. Plasma triglycerides were reduced by fasting in spring but not summer squirrels. In hibernators plasma β-hydroxybutyrate was elevated during torpor whereas triglycerides were low relative to normothermic states. We conclude that the switch to a lipid-based metabolism during winter, coupled with reduced capacity to excrete cholesterol creates a closed system in which efficient use of lipoproteins is essential for survival