Are Child's Class C Patients With Acute Variceal Bleeding Worth Treating?

In the ten year period January 1980 to December 1989, 102 patients with Child’s Class C liver disease (Pugh's Modification) were admitted with acute variceal bleeding to one surgical unit with a policy of early sclerotherapy. There were 56 males and 46 females; the average age was 55 years (range 28–77). Fifty-three suffered from alcoholic cirrhosis. Four died before definitive treatment could be carried out, three from liver failure and one from uncontrolled bleeding. Of the remaining 98 patients, eight had urgent oesophageal transection with three deaths from hepatorenal failure; 90 had sclerotherapy with 19 hospital deaths, nine from recurrent bleeding, eight from liver failure often coupled with renal failure and two from respiratory complications. Of the 76 who survived to leave hospital, 52 received chronic injection sclerotherapy, 10 had elective oesophageal transection and 14 did not have further elective intervention for various reasons. Surviving patients have been followed up at a special Liver Clinic with minimum follow up of one year. Although no patient has yet survived ten years, the one, five and eight year survivals of 50%, 21% and 13% suggest that salvage of thdse patients is worthwhile

Taking down ‘the Ivory Tower’: leveraging academia for better health outcomes in Uganda

http://deepblue.lib.umich.edu/bitstream/2027.42/112732/1/12914_2011_Article_147.pd

The US Distribution of Physicians from Lower Income Countries

Introduction: Since the 1960 s, the number of international medical graduates (IMGs) in the United States has increased significantly. Given concerns regarding the effects of this loss to their countries of origin, the authors undertook a study of IMGs from lower income countries currently practicing in the United States. Methods: The AMA Physician Masterfile was accessed to identify all 265,851 IMGs in active practice in the United States. These were divided by state of practice and country of origin. World Bank income classification was used to identify lowe

Welfare Challenges of Dairy Cows in India Identified Through On-Farm Observations

India has the largest population of dairy cattle in the world at over 48 million animals, yet there has been little formal assessment of their welfare reported. Through observations of dairy cows on 38 farms in Kerala, India, we aimed to investigate the welfare of these animals and the practicality of animal-based assessments within common farming systems. Substantial welfare challenges were identified. All cows were close-tied (less than 1 m length) via a halter that pierced the nasal septum when housed, which was for the entire day (50% of farms) or part thereof. When outside access was available, it was also usually restricted by close-tying, longline tether, or hobbling. Ad libitum water was only available on 22% of farms and food access was also restricted (mean of 4.3 hrs/day). Future work should focus on encouraging dairy farmers in India to improve the welfare of their dairy cattle by ceasing to tie and tether cattle or at least providing tied and tethered cattle with exercise opportunities, unlimited access to drinking water and a readier supply of food (especially quality green forage/fodder); clean housing more frequently; provide strategies to prevent heat stress; breed cattle suited to environmental conditions and with increased resistance to heat stress; carry out welfare assessments more regularly using a validated protocol; rectify the causes of poor welfare. Such changes could substantially improve the welfare of tens of millions of cattle

GWIPS-viz: 2018 update

The GWIPS-viz browser (http://gwips.ucc.ie/) is an on-line genome browser which is tailored for exploring ribosome profiling (Ribo-seq) data. Since its publication in 2014, GWIPS-viz provides Ribo-seq data for an additional 14 genomes bringing the current total to 23. The integration of new Ribo-seq data has been automated thereby increasing the number of available tracks to 1792, a 10-fold increase in the last three years. The increase is particularly substantial for data derived from human sources. Following user requests, we added the functionality to download these tracks in bigWig format. We also incorporated new types of data (e.g. TCP-seq) as well as auxiliary tracks from other sources that help with the interpretation of Ribo-seq data. Improvements in the visualization of the data have been carried out particularly for bacterial genomes where the Ribo-seq data are now shown in a strand specific manner. For higher eukaryotic datasets, we provide characteristics of individual datasets using the RUST program which includes the triplet periodicity, sequencing biases and relative inferred A-site dwell times. This information can be used for assessing the quality of Ribo-seq datasets. To improve the power of the signal, we aggregate Ribo-seq data from several studies into Global aggregate tracks for each genome

Factors affecting site use preference of grazing cattle studied from 2000 to 2020 through GPS tracking - A review

Understanding the behaviour of grazing animals at pasture is crucial in order to develop management strategies that will increase the potential productivity of grazing systems and simultaneously decrease the negative impact on the environment. The objective of this review is to summarize and analyse the scientific literature that has addressed the site use preference of grazing cattle using global positioning systems (GPS) collars in the past 21 years (2000-2020) to aid the development of more sustainable grazing livestock systems. The 84 studies identified were undertaken in several regions of the world, in diverse production systems, under different climate conditions and with varied methodologies and animal types. This work presents the information in categories according to the main findings reviewed, covering management, external and animal factors driving animal movement patterns. The results show that some variables such as stocking rate, water and shade location, weather conditions and pasture (terrain and vegetation) characteristics have a significant impact on the behaviour of grazing cattle. Other types of bio-loggers can be deployed in grazing ruminants to gain insights into their metabolism and its relationship with the landscape they utilise. Changing management practices based on these findings could improve the use of grasslands towards more sustainable and productive livestock systems

Repetitive mild traumatic brain injury causes optic nerve and retinal damage in a mouse model

There is increasing evidence that long-lasting morphologic and functional consequences can be present in the human visual system after repetitive mild traumatic brain injury (r-mTBI). The exact lo- cation and extent of the damage in this condition are not well un- derstood. Using a recently developed mouse model of r-mTBI, we assessed the effects on the retina and optic nerve using histology and immunohistochemistry, electroretinography (ERG), and spectral- domain optical coherence tomography (SD-OCT) at 10 and 13 weeks after injury. Control mice received repetitive anesthesia alone (r-sham). We observed decreased optic nerve diameters and increased cellularity and areas of demyelination in optic nerves in r-mTBI versus r-sham mice. There were concomitant areas of decreased cellularity in the retinal ganglion cell layer and approximately 67% decrease in brain- specific homeobox/POU domain protein 3AYpositive retinal ganglion cells in retinal flat mounts. Furthermore, SD-OCT demonstrated a de- tectable thinning of the inner retina; ERG demonstrated a decrease in the amplitude of the photopic negative response without any change in a- or b-wave amplitude or timing. Thus, the ERG and SD-OCT data correlated well with changes detected by morphometric, histologic, and immunohistochemical methods, thereby supporting the use of these noninvasive methods in the assessment of visual function and morphology in clinical cases of mTBI