Standardised proformas improve patient handover: Audit of trauma handover practice

<p>Abstract</p> <p>Background</p> <p>The implementation of the European Working Time Directive has meant the introduction of shift patterns of working for junior doctors. Patient handover between shifts has become a necessary part of practice in order to reduce the risk of medical errors. Data handed over between shifts are used to prioritise clinical jobs outstanding, and to create theatre lists. We present a closed-loop audit of handover practice to assess whether standardised proformas improve clinical data transfer between shifts during handover in our Orthopaedic Unit.</p> <p>Methods</p> <p>We collected data handed over between shifts for a period of one week at our department. The data were in the form of hand written data on plain paper used to assist verbal handover. Data were analysed and a standardised handover sheet was trialled. After feedback from juniors the sheet was revised and implemented. A re-audit, of handover data, was then undertaken using the revised standardised proforma during a period of 1 week.</p> <p>Results</p> <p>Forty-eight patients were handed over in week 1 while 55 patients were handed over during re-audit. The standardised proformas encouraged use of pre-printed patient labels which contained legible patient identifiers, use of labels increased from 72.9% to 93.4%. Handover of outstanding jobs increased from 31.25% to 100%. Overall data handed over increased from 72.6% to 93.2%. Handover of relevant blood results showed little improvement from 18.8% to 20.7%</p> <p>Conclusion</p> <p>This audit highlights the issue of data transfer between shifts. Standardised proformas encourage filling of relevant fields and increases the data transferred between shifts thereby reducing the potential for clinical error cause by shift patterns.</p

Androgen action on renal calcium and phosphate handling: Effects of bisphosphonate treatment and low calcium diet

Renal calcium and phosphate handling is an important contributor to mineral homeostasis and bone health and the androgen receptor (AR) is highly expressed in the kidney. We investigated the short term effects of androgen deprivation on renal calcium and phosphate reabsorption, independent of their effects on bone. Two weeks following orchidectomy (ORX) of adult mice, bone loss occurred along with hypercalciuria, which was similarly prevented by testosterone and dihydrotestosterone supplementation. Treatment with bisphosphonates prior to ORX also inhibited hypercalciuria, indicating that the calcium flux originated from the bone. Renal calcium and phosphate transporter expression was increased post-ORX, independent of bisphosphonates. Furthermore, androgen deprivation appeared to stimulate local synthesis of 1,25(OH)2D3. When bisphosphonate-treated mice were fed a low calcium diet, bone resorption was no longer blocked and secondary hyperparathyroidism developed, which was more pronounced in ORX mice than sham-operated mice. In conclusion, this study shows that androgen deprivation increased renal calcium and phosphate transporter expression, independent of bone, and underlines the importance of adequate intestinal calcium supply in circumstances of androgen deprivation and bisphosphonate treatment.status: publishe

Nanoinformatics: developing new computing applications for nanomedicine

Nanoinformatics has recently emerged to address the need of computing applications at the nano level. In this regard, the authors have participated in various initiatives to identify its concepts, foundations and challenges. While nanomaterials open up the possibility for developing new devices in many industrial and scientific areas, they also offer breakthrough perspectives for the prevention, diagnosis and treatment of diseases. In this paper, we analyze the different aspects of nanoinformatics and suggest five research topics to help catalyze new research and development in the area, particularly focused on nanomedicine. We also encompass the use of informatics to further the biological and clinical applications of basic research in nanoscience and nanotechnology, and the related concept of an extended ?nanotype? to coalesce information related to nanoparticles. We suggest how nanoinformatics could accelerate developments in nanomedicine, similarly to what happened with the Human Genome and other -omics projects, on issues like exchanging modeling and simulation methods and tools, linking toxicity information to clinical and personal databases or developing new approaches for scientific ontologies, among many others

Solisluumurtumien konservatiivinen ja operatiivinen hoito : Systemaattinen kirjallisuuskatsaus 1190 potilaasta

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Factors influencing citrus fruit scarring caused by Pezothrips kellyanus

[EN] Kelly s citrus thrips (KCT) Pezothrips kellyanus (Bagnall) (Thysanoptera: Thripidae) is a recently recorded cosmopolitan citrus pest, causing fruit scarring that results in downgrading of fruit. Due to the detrimental effects caused on fruits by KCT, we wanted to study some of the factors influencing fruit scarring. Specifically, the objectives were: (1) to determine the fruit development stage when citrus fruits are damaged by KCT and the population structure of KCT during this period, (2) to study the influence of temperature on intensity of damage, and finally, (3) to identify alternative host plants. KCT populations on flowers and fruitlets and alternate plant hosts were sampled in four citrus orchards from 2008 to 2010. The percentage of damaged fruits was also recorded. The exotic vine Araujia sericifera (Apocynaceae) was recorded as a new host for KCT. Thrips scarring started to increase at 350 650 degree-days (DD) above 10.2 C, coinciding with a peak abundance of the second instar larval stages over all 3 years of the study. The maximum percentage of larval stages of KCT was observed in the 3 years at about 500 DD, a period which corresponds to the end of May or early June. Variation in the severity of fruit scarring appeared to be related to air temperature. Temperature likely affects the synchronisation between the peak in abundance of KCT larvae, and the period when fruitlets are susceptible to thrips damage. Temperature can also influence the survival and development of KCT populations in citrus and other host plants in the citrus agro-ecosystem.The authors thank Alejandro Tena for his valuable suggestions and two anonymous referees for their careful review and helpful comments. We also extend our thanks to the owners of the commercial orchards for giving us permission to use their citrus orchards. The first author was awarded an FPI fellowship from the Polytechnic University of Valencia to obtain her PhD degree.Navarro Campos, C.; Pekas, A.; Aguilar Martí, MA.; Garcia Marí, F. (2013). Factors influencing citrus fruit scarring caused by Pezothrips kellyanus. Journal of Pest Science. (86):459-467. doi:10.1007/s10340-013-0489-7S45946786Baker GJ (2006) Kelly citrus thrips management. Fact sheet. Government of South Australia, primary industries and resources SA. http://www.sardi.sa.gov.au/__data/assets/pdf_file/0010/44875/kctfact_sheet.pdf . Accessed 16 July 2012Baker GJ, Jackman DJ, Keller M, MacGregor A, Purvis S (2002) Development of an integrated pest management system for thrips in Citrus. HAL Final Report CT97007. http://www.sardi.sa.gov.au/pestsdiseases/horticulture/horticultural_pests/kelly_citrus_thrips/research_report_1997-2000 . Accessed 16 July 2012Bedford ECG (1998) Thrips, wind and other blemishes. Citrus pests in the Republic of South Africa. In: Bedford ECG, van den Berg MA, de Villiers EA (eds) ARC-Institute for tropical and subtropical crops, Nelspruit, South Africa, pp 170–183Blank RH, Gill GSC (1997) Thrips (Thysanoptera: Terebrantia) on flowers and fruit of citrus in New Zealand. N Z J Crop Hortic Sci 25:319–332Chellemi D, Funderburk F, Hall D (1994) Seasonal abundance of flower-inhabiting Frankliniella species (Thysanoptera: Thripidae) on wild plant species. Environ Entomol 23:337–342Conti F, Tuminelli R, Amico C, Fisicaro R, Frittitta C, Perrotta G, Marullo R (2001) Monitoring Pezothrips kellyanus on citrus in eastern Sicily, Thrips and tospoviruses. In: Proceedings of the 7th international symposium on Thysanoptera, Reggio Calabria, 1–8 July 2001, Italy, pp 207–210Costa L, Mateus C, zurStrassen R, Franco JC (2006) Thrips (Thysanoptera) associated to lemon orchards in the Oeste region of Portugal. IOBC/WPRS Bull 29:285–291European Plant Protection Organisation Reporting Service [EPPO] (2006) Pezothrips kellyanus. http://www.eppo.org/QUARANTINE/Pest_Risk_Analysis/PRAdocs_insects/06-12760%20DS%20PEZTKE.doc. Accessed 18 June 2012European Plant ProtectionOrganisation Reporting Service [EPPO] (2005) Scirtothrips aurantii, Scirtothrips citri, Scirtothrips dorsalis. EPPO Bull 35:353–356Franco JC, Garcia-Marí F, Ramos AP, Besri M (2006) Survey on the situation of citrus pest management in Mediterranean countries. IOBC/WPRS Bull 29:335–346Froud KJ, Stevens PS, Steven D (2001) Survey of alternative host plants for Kelly’s citrus thrips (Pezothrips kellyanus) in citrus growing regions. N Z Plant Prot 54:15–20Gomez-Clemente F (1952) Un tisanóptero causante de daños en las naranjas de algunas zonas de Levante. Boletín de Patología Vegetal y Entomología Agrícola 19:135–146Grout TG, Morse JG, O’Connell NV, Flaherty DL, Goodell PB, Freeman MW, Coviello RL (1986) Citrus thrips (Thysanoptera: Thripidae) phenology and sampling in the San Joaquin Valley. J Econ Entomol 79:1516–1523Horton J (1918) The citrus thrips. US Dep Agric Bull 616:1–42Kirk WDJ (1987) A key to the larvae of some common Australian flower thrips (Insecta: Thysanoptera), with a host-plant survey. Aust J Zool 35:173–185Lacasa A, Llorens JM, Sánchez JA (1996) Un Scirtothrips (Thysanoptera: Thripidae) causa daños en los cítricos en España. Bol San Veg Plagas 22:79–95Lewis HC (1935) Factors influencing citrus thrips damage. J Econ Entomol 28:1011–1015Lewis T (1997) Distribution, abundance and population dynamics. In: Lewis T (ed) Thrips as crop pests. CAB International, Wallingford, pp 217–258Lovatt C, Streeter S, Minter T, O’connell N, Flaherty D, Freeman M, Goodell P (1984) Phenology of flowering in Citrus sinensis (L.) Osbeck, cv. Washington navel orange. Proc Int Soc Citric 1:186–190Marullo R (1998) Pezothrips kellyanus, un nuovo tripide parassita delle colture meridionali. Informatore Fitopatologico 48:72–75Milne JR, Milne M, Walter GH (1997) A key to larval thrips (Thysanoptera) from Granite Belt stonefruit trees and a first description of Pseudanaphothrips achaetus (Bagnall) larvae. Aust J Entomol 36:319–326Mound LA, Jackman DJ (1998) Thrips in the economy and ecology of Australia, In: Zalucki MP, RAI Drew RAI, White GG (eds) Pest Management: future challenges, Proceedings of the sixth Australian applied entomological research conference, University of Queensland, St. Lucia, pp 472–478Mound LA, Marullo R (1996) The thrips of Central and South America (Insecta: Thysanoptera): an introduction. Mem Entomol Int 6:1–487Mound LA, Walker AK (1982) Terebrantia (Insecta: Thysanoptera). Fauna N Z 1:1–113Navarro-Campos C, Marzal C, Aguilar A, GarciaMarí F (2010) Presencia del microlepidóptero Anatrachyntisbadia en cítricos: descripción, comportamiento y daños al fruto. Levante Agrícola 402:270–276Navarro-Campos C, Aguilar A, Garcia-Marí F (2011) Population trend and fruit damage of Pezothrips kellyanus in citrus orchards in Valencia (Spain). IOBC/WPRS Bull 62: 285–292Navarro-Campos C, Aguilar A, Garcia-Marí F (2012) Aggregation pattern, sampling plan and intervention threshold for Pezothrips kellyanus in citrus groves. Entomol Exp Appl 142:130–139Northfield TD, Paini DR, Funderburk JE, Reitz SR (2008) Annual cycles of Frankliniella spp. (Thysanoptera: Thripidae) thrips abundance on North Florida uncultivated reproductive hosts: predicting possible sources of pest outbreaks. Ann Entomol Soc Am 101:769–778Orphanides G (1997) Thrips on citrus. Annual Review for 1997. Agricultural Research Institute, Nicosia, CyprusPerrotta G, Conti F (2008) A threshold hypothesis for an integrated control of thrips infestation on citrus in South-Eastern Sicily. IOBC/WPRS Bull 38:204–209Reitz S, Yu-lin G, Zhong-ren L (2011) Thrips: pests of concern to China and the United States. Agric Sci China 10:867–892Rhodes AA, Morse JG (1989) Scirtothrips citri sampling and damage prediction on California navel oranges. Agric Ecosyst Environ 26:117–129Schellhorn NA, Glatz RV, Wood GM (2010) The risk of exotic and native plants as hosts for four pest thrips (Thysanoptera: Thripinae). Bull Entomol Res 100:501–510Schweizer H, Morse JG (1997) Estimating the level of fruit scarring by citrus thrips from temperature conditions prior to the end of bloom. Crop Prot 16:743–752Smith D, Beattie GAC, Broadley R (eds) (1997) Citrus pests and their natural enemies: integrated pest management in Australia. Information series Q197030. Queensland Department of Primary Industries, BrisbaneStatgraphics (1994) Version 5.1 Plus. Statistical Graphics System by Statistical Graphics Corporation. Manugistics, RockvilleTanigoshi LK, Nishio JY, Moreno DS, Fargerlund J (1980) Effect of temperature on development and survival of Scirtothrips citri on citrus foliage. Ann Entomol Soc Am 73: 378–338Teksam I, Tunç I (2009) An analysis of Thysanoptera associated with citrus flowers in Antalya, Turkey: composition, distribution, abundance and pest status of species. Appl Entomol Zool 44:455–464Varikou K, Tsitsipis JA, Alexandrakis V, Mound LA (2002) Pezothrips kellyanus (Bagnall) (Thysanoptera: Thripidae), a new pest of citrus trees in Crete, In: Proceedings of the VII European congress of entomology, Thessaloniki, Greece, 7–13 Oct 2002, p 33Varikou K, Tsitsipis I, Alexandrakis V, Hoddle M (2009) Effect of temperature on the development and longevity of Pezothrips kellyanus (Thysanoptera: Thripidae). Ann Entomol Soc Am 102:835–841Varikou K, Birouraki A, Tsitsipis I, Sergentani CHR (2012) Effect of temperature on the fecundity of Pezothrips kellyanus (Thysanoptera: Thripidae). Ann Entomol Soc Am 105:60–65Vassiliou VA (2007) Chemical control of Pezothrips kellyanus (Thysanoptera: Thripidae) in citrus plantations in Cyprus. Crop Prot 26:1579–1584Vassiliou VA (2010) Ecology and behavior of Pezothrips kellyanus (Thysanoptera: Thripidae) on Citrus. J Econ Entomol 103:47–53Vierbergen G, Kucharczyk H, Kirk WDJ (2010) A key to the second instar larvae of the Thripidae of the Western Palearctic region. Tijdschr Entomol 153:99–160Webster KW, Cooper P, Mound LA (2006) Studies on Kelly’s citrus thrips, Pezothrips kellyanus (Bagnall) (Thysanoptera: Thripidae): sex attractants, host associations and country of origin. Aust J Entomol 45:67–74Wiesenborn W, Morse JG (1986) Feeding rate of Scirtothripscitri (Moulton) (Thysanoptera: Thripidae) as influenced by life stage and temperature. Environ Entomol 15:763–76

Similarity in Recombination Rate Estimates Highly Correlates with Genetic Differentiation in Humans

Recombination varies greatly among species, as illustrated by the poor conservation of the recombination landscape between humans and chimpanzees. Thus, shorter evolutionary time frames are needed to understand the evolution of recombination. Here, we analyze its recent evolution in humans. We calculated the recombination rates between adjacent pairs of 636,933 common single-nucleotide polymorphism loci in 28 worldwide human populations and analyzed them in relation to genetic distances between populations. We found a strong and highly significant correlation between similarity in the recombination rates corrected for effective population size and genetic differentiation between populations. This correlation is observed at the genome-wide level, but also for each chromosome and when genetic distances and recombination similarities are calculated independently from different parts of the genome. Moreover, and more relevant, this relationship is robustly maintained when considering presence/absence of recombination hotspots. Simulations show that this correlation cannot be explained by biases in the inference of recombination rates caused by haplotype sharing among similar populations. This result indicates a rapid pace of evolution of recombination, within the time span of differentiation of modern humans

Air pollution and mortality in the Canary Islands: a time-series analysis

<p>Abstract</p> <p>Background</p> <p>The island factor of the cities of Las Palmas de Gran Canaria and Santa Cruz de Tenerife, along with their proximity to Africa and their meteorology, create a particular setting that influences the air quality of these cities and provides researchers an opportunity to analyze the acute effects of air-pollutants on daily mortality.</p> <p>Methods</p> <p>From 2000 to 2004, the relationship between daily changes in PM₁₀, PM_2.5, SO₂, NO₂, CO, and ozone levels and daily total mortality and mortality due to respiratory and heart diseases were assessed using Generalized Additive Poisson models controlled for potential confounders. The lag effect (up to five days) as well as the concurrent and previous day averages and distributed lag models were all estimated. Single and two pollutant models were also constructed.</p> <p>Results</p> <p>Daily levels of PM₁₀, PM_2.5, NO₂, and SO₂were found to be associated with an increase in respiratory mortality in Santa Cruz de Tenerife and with increased heart disease mortality in Las Palmas de Gran Canaria, thus indicating an association between daily ozone levels and mortality from heart diseases. The effects spread over five successive days. SO₂was the only air pollutant significantly related with total mortality (lag 0).</p> <p>Conclusions</p> <p>There is a short-term association between current exposure levels to air pollution and mortality (total as well as that due specifically to heart and respiratory diseases) in both cities. Risk coefficients were higher for respiratory and cardiovascular mortality, showing a delayed effect over several days.</p