Opportunities for system level improvement in antibiotic use across the surgical pathway

Optimizing antibiotic prescribing across the surgical pathway (before, during, and after surgery) is a key aspect of tackling important drivers of antimicrobial resistance and simultaneously decreasing the burden of infection at the global level. In the UK alone, 10 million patients undergo surgery every year, which is equivalent to 60% of the annual hospital admissions having a surgical intervention. The overwhelming majority of surgical procedures require effectively limited delivery of antibiotic prophylaxis to prevent infections. Evidence from around the world indicates that antibiotics for surgical prophylaxis are administered ineffectively, or are extended for an inappropriate duration of time postoperatively. Ineffective antibiotic prophylaxis can contribute to the development of surgical site infections (SSIs), which represent a significant global burden of disease. The World Health Organization estimates SSI rates of up to 50% in postoperative surgical patients (depending on the type of surgery), with a particular problem in low- and middle-income countries, where SSIs are the most frequently reported healthcare-associated infections. Across European hospitals, SSIs alone comprise 19.6% of all healthcare-acquired infections. Much of the scientific research in infection management in surgery is related to infection prevention and control in the operating room, surgical prophylaxis, and the management of SSIs, with many studies focusing on infection within the 30-day postoperative period. However it is important to note that SSIs represent only one of the many types of infection that can occur postoperatively. This article provides an overview of the surgical pathway and considers infection management and antibiotic prescribing at each step of the pathway. The aim was to identify the implications for research and opportunities for system improvement

Host Selection of the giant willow aphid (Tuberolachnus salignus)

The giant willow aphid [Tuberolachnus salignus (Gmelin)] has recently become noteworthy as a potential pest species due to the increased uptake of willow, its host-plant, for use in growing biomass for energy production. In this paper we describe host selection studies of T. salignus on short rotation coppice (SRC) willow varieties in laboratory bioassays and field experiments. In laboratory olfactometry tests, T. salignus was significantly attracted to certain SRC willow varieties, but not to others. Field trials during 2007 and 2008 showed that T. salignus infestation levels varied significantly on different SRC willow varieties and that levels are highest on the varieties to which they are most strongly attracted in the laboratory bioassays

On-the-fly memory compression for multibody algorithms.

Memory and bandwidth demands challenge developers of particle-based codes that have to scale on new architectures, as the growth of concurrency outperforms improvements in memory access facilities, as the memory per core tends to stagnate, and as communication networks cannot increase bandwidth arbitrary. We propose to analyse each particle of such a code to find out whether a hierarchical data representation storing data with reduced precision caps the memory demands without exceeding given error bounds. For admissible candidates, we perform this compression and thus reduce the pressure on the memory subsystem, lower the total memory footprint and reduce the data to be exchanged via MPI. Notably, our analysis and transformation changes the data compression dynamically, i.e. the choice of data format follows the solution characteristics, and it does not require us to alter the core simulation code

Outdoor learning spaces: the case of forest school

© 2017 The Author. Area published by John Wiley & Sons Ltd on behalf of Royal Geographical Society (with the Institute of British Geographers). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.This paper contributes to the growing body of research concerning use of outdoor spaces by educators, and the increased use of informal and outdoor learning spaces when teaching primary school children. The research takes the example of forest school, a form of regular and repeated outdoor learning increasingly common in primary schools. This research focuses on how the learning space at forest school shapes the experience of children and forest school leaders as they engage in learning outside the classroom. The learning space is considered as a physical space, and also in a more metaphorical way as a space where different behaviours are permitted, and a space set apart from the national curriculum. Through semi-structured interviews with members of the community of practice of forest school leaders, the paper seeks to determine the significance of being outdoors on the forest school experience. How does this learning space differ from the classroom environment? What aspects of the forest school learning space support pupils’ experiences? How does the outdoor learning space affect teaching, and the dynamics of learning while at forest school? The research shows that the outdoor space provides new opportunities for children and teachers to interact and learn, and revealed how forest school leaders and children co-create a learning environment in which the boundaries between classroom and outdoor learning, teacher and pupil, are renegotiated to stimulate teaching and learning. Forest school practitioners see forest school as a separate learning space that is removed from the physical constraints of the classroom and pedagogical constraints of the national curriculum to provide a more flexible and responsive learning environment.Peer reviewe

Spatio-temporal factors influencing the occurrence of Syngamus trachea within release pens in the South West of England

a b s t r a c t Syngamus trachea is a pathogenic tracheal nematode that causes syngamiasis in wild and game birds, especially when birds are managed at high densities. Despite its pathogenic nature, very little is known about its epidemiology and relationship with ambient temperature and humidity. The spatial and temporal modelling of disease was undertaken on two pheasant estates within the South West of England from April 2014 to August 2014. Significant differences between the mean numbers of eggs per gram of soil were identified between pens at both site 1 and site 2 but did not differ significantly between sites. Egg abundance was significantly associated with soil moisture content, with greater egg survival between years in pens with higher average volumetric soil moisture content. Previous years stocking density and pen age were also associated with greater egg survival between years with more eggs being recovered in pens with greater stocking densities, and pens that had been sited longer. The greatest model to explain the variation in the numbers of eggs per gram of soil per pen was a combination of soil moisture content, stocking density and pen age. Larval recovery differed significantly between sites. Larval abundance was significantly and positively associated with temperature and relative humidity at site 1. Similarly, temperature and humidity were also positively and significantly associated with larval abundance at site 2. Rainfall did not influence larval recovery at either site 1 or site 2. The model with the greatest ability to explain larval abundance at both sites, was a combination of temperature, humidity and rainfall. Infection status (positive faecal egg counts) was significantly and positively associated with larval abundance at both sites, but rainfall was only positively associated at site 1. Temperature and humidity were positively associated with infection status at site 2, but not at site 1. The present study highlights the influence of climatic variables on both egg survival and larval abundance, and could therefore be used to develop more targeted treatment strategies around periods of higher disease risk. The frequent use of release pens is a clear factor in the epidemiology of syngamiasis, and it is recommended that pens be rested and/or rotated in order to reduce infection pressure in subsequent flocks

Is the Insect Apocalypse upon us? How to Find Out

In recent decades, entomologists have documented alarming declines in occurrence, taxonomic richness, and geographic range of insects around the world. Additionally, some recent studies have reported that insect abundance and biomass, often of common species, are rapidly declining, which has led some to dub the phenomenon an “Insect Apocalypse”. Recent reports are sufficiently robust to justify immediate actions to protect insect biodiversity worldwide. We caution, however, that we do not yet have the data to assess large-scale spatial patterns in the severity of insect trends. Most documented collapses are from geographically restricted studies and, alone, do not allow us to draw conclusions about insect declines on continental or global scales, especially with regards to future projections of total insect biomass, abundance, and extinction. There are many challenges to understanding insect declines: only a small fraction of insect species have had any substantial population monitoring, millions of species remain unstudied, and most of the long-term population data for insects come from human-dominated landscapes in western and northern Europe. But there are still concrete steps we can take to improve our understanding of potential declines. Here, we review the challenges scientists face in documenting insect population and diversity trends, including communicating their findings, and recommend research approaches needed to address these challenges

Project MOSI: rationale and pilot-study results of an initiative to help protect zoo animals from mosquito-transmitted pathogens and contribute data on mosquito spatio–temporal distribution change

Mosquito-borne pathogens pose major threats to both wildlife and human health and, largely as a result of unintentional human-aided dispersal of their vector species, their cumulative threat is on the rise. Anthropogenic climate change is expected to be an increasingly significant driver of mosquito dispersal and associated disease spread. The potential health implications of changes in the spatio-temporal distribution of mosquitoes highlight the importance of ongoing surveillance and, where necessary, vector control and other health-management measures. The World Association of Zoos and Aquariums initiative, Project MOSI, was established to help protect vulnerable wildlife species in zoological facilities from mosquito-transmitted pathogens by establishing a zoo-based network of fixed mosquito monitoring sites to assist wildlife health management and contribute data on mosquito spatio-temporal distribution changes. A pilot study for Project MOSI is described here, including project rationale and results that confirm the feasibility of conducting basic standardized year-round mosquito trapping and monitoring in a zoo environment

On-the-fly memory compression for multibody algorithms

Memory and bandwidth demands challenge developers of particle-based codes that have to scale on new architectures, as the growth of concurrency outperforms improvements in memory access facilities, as the memory per core tends to stagnate, and as communication networks cannot increase bandwidth arbitrary. We propose to analyse each particle of such a code to find out whether a hierarchical data representation storing data with reduced precision caps the memory demands without exceeding given error bounds. For admissible candidates, we perform this compression and thus reduce the pressure on the memory subsystem, lower the total memory footprint and reduce the data to be exchanged via MPI. Notably, our analysis and transformation changes the data compression dynamically, i.e. the choice of data format follows the solution characteristics, and it does not require us to alter the core simulation code

Acid-yield measurements of the gas-phase ozonolysis of ethene as a function of humidity using Chemical Ionisation Mass Spectrometry (CIMS)

Gas-phase ethene ozonolysis experiments were conducted at room temperature to determine formic acid yields as a function of relative humidity (RH) using the integrated EXTreme RAnge chamber-Chemical Ionisation Mass Spectrometry technique, employing a CH<sub>3</sub>I ionisation scheme. RHs studied were <1, 11, 21, 27, 30 % and formic acid yields of (0.07±0.01) and (0.41±0.07) were determined at <1 % RH and 30 % RH respectively, showing a strong water dependence. It has been possible to estimate the ratio of the rate coefficient for the reaction of the Criegee biradical, CH<sub>2</sub>OO with water compared with decomposition. This analysis suggests that the rate of reaction with water ranges between 1×10<sup>−12</sup>–1×10<sup>−15</sup> cm<sup>3</sup> molecule<sup>−1</sup> s<sup>−1</sup> and will therefore dominate its loss with respect to bimolecular processes in the atmosphere. Global model integrations suggest that this reaction between CH<sub>2</sub>OO and water may dominate the production of HC(O)OH in the atmosphere