N-(2-Methoxy­ethyl)phthalimide

The title mol­ecule, C11H11NO3, lies on a crystallographic mirror plane which bis­ects the plane of the phthalimide unit and contains the C and O atoms of the 2-methoxy­ethyl group

The impact of admission diagnosis on gastric emptying in critically ill patients

Introduction Disturbed gastric emptying (GE) occurs commonly in critically ill patients. Admission diagnoses are believed to influence the incidence of delayed GE and subsequent feed intolerance. Although patients with burns and head injury are considered to be at greater risk, the true incidence has not been determined by examination of patient groups of sufficient number. This study aimed to evaluate the impact of admission diagnosis on GE in critically ill patients. Methods A retrospective review of patient demographics, diagnosis, intensive care unit (ICU) admission details, GE, and enteral feeding was performed on an unselected cohort of 132 mechanically ventilated patients (94 males, 38 females; age 54 ± 1.2 years; admission Acute Physiology and Chronic Health Evaluation II [APACHE II] score of 22 ± 1) who had undergone GE assessment by 13C-octanoic acid breath test. Delayed GE was defined as GE coefficient (GEC) of less than 3.20 and/or gastric half-emptying time (t50) of more than 140 minutes. Results Overall, 60% of the patients had delayed GE and a mean GEC of 2.9 ± 0.1 and t50 of 163 ± 7 minutes. On univariate analysis, GE correlated significantly with older age, higher admission APACHE II scores, longer length of stay in ICU prior to GE measurement, higher respiratory rate, higher FiO2 (fraction of inspired oxygen), and higher serum creatinine. After these factors were controlled for, there was a modest relationship between admission diagnosis and GE (r = 0.48; P = 0.02). The highest occurrence of delayed GE was observed in patients with head injuries, burns, multi-system trauma, and sepsis. Delayed GE was least common in patients with myocardial injury and non-gastrointestinal post-operative respiratory failure. Patients with delayed GE received fewer feeds and stayed longer in ICU and hospital compared to those with normal GE. Conclusion Admission diagnosis has a modest impact on GE in critically ill patients, even after controlling for factors such as age, illness severity, and medication, which are known to influence this function.Nam Q Nguyen, Mei P Ng, Marianne Chapman, Robert J Fraser and Richard H Hollowa

Use of farm buildings by wild badgers: implications for the transmission of bovine tuberculosis

Diseases transmitted from wildlife to livestock or people may be managed more effectively if it is known where transmission occurs. In Britain, farm buildings have been proposed as important sites of Mycobacterium bovis transmission between wild badgers (Meles meles) and cattle, contributing to the maintenance of bovine tuberculosis (TB). Farmers are therefore advised to exclude badgers from buildings. We used GPS-collars and remote cameras to characterise badgers’ use of farm buildings at four TB-affected sites in southwestern Britain. Across 54 GPS-collared badgers, 99.8% of locations fell ≥3m from farm buildings. Remote cameras deployed in feed stores recorded just 12 nights with badger visits among 3,134 store-nights of monitoring. GPS-collared badgers used space near farm buildings less than expected based on availability, significantly preferring land ≥100m from buildings. There was no positive association between badgers’ use of farm buildings and the infection status of either badgers or cattle. Six GPS-collared badgers which regularly visited farm buildings all tested negative for M. bovis. Overall, test-positive badgers spent less time close to farm buildings than did test-negative animals. Badger visits to farm buildings were more frequent where badger population densities were high. Our findings suggest that, while buildings may offer important opportunities for M. bovis transmission between badgers and cattle, building use by badgers is not a prerequisite for such transmission. Identifying ways to minimise infectious contact between badgers and cattle away from buildings is therefore a management priority

A service evaluation of FIT and anaemia for risk stratification in the two week wait pathway for colorectal cancer

Introduction: New national guidance on urgent referral for investigation for Colorectal Cancer (CRC) included faecal occult blood testing in 2015. We evaluated faecal immunochemical testing (FIT) and anaemia as risk stratification tools in symptomatic patients suspected of having CRC.Methods: Postal FIT was incorporated into the CRC two week wait (2WW) pathway for all patients without rectal bleeding in 2016. Patients were investigated in the 2WW pathway as normal and outcomes of investigations were prospectively recorded. Anaemia was defined as haemoglobin less than 120g/L in women and less than 130g/L in men.Results: FIT kits were sent to 1106 patients with an 80.9% return rate; 810 patients completed investigation with 40 CRCs diagnosed (4.9%). Median FIT results were significantly higher in patients who were anaemic (median 4.8 iqr 0.8-34.1 versus 1.2 iqr 0-6.4, Mann-Whitney p less than 0.001).Some 538 (60.4%) had a result of less than 4 µgHb/gFaeces (limit of detectability) and 621 (69.7%) a result less than 10 µgHb/gFaeces. Sixty per cent of CRCs had a FIT reading of >150 µgHb/gFaeces. Five CRCs diagnosed in patients with a FIT4 µgHb/gFaeces had 97.5% sensitivity and 64.5% specificity for CRC diagnosis. A FIT result of >4 µgHb/gFaeces and/or anaemia had a 100% sensitivity and 45.3% specificity for CRC diagnosis.Conclusion: FIT is most useful at the extremes of detectability; strongly positive readings predict high rates of CRC and other significant pathology, whilst very low readings in the absence of anaemia or palpable rectal mass identify a group with very low risk. High return rates for FIT within this 2WW pathway indicate its acceptability

Lifting the Dusty Veil With Near- and Mid-Infrared Photometry: I. Description and Applications of the Rayleigh-Jeans Color Excess Method

The Milky Way (MW) remains a primary laboratory for understanding the structure and evolution of spiral galaxies, but typically we are denied clear views of MW stellar populations at low Galactic latitudes because of extinction by interstellar dust. However, the combination of 2MASS near-infrared (NIR) and Spitzer-IRAC mid-infrared (MIR) photometry enables a powerful method for determining the line of sight reddening to any star: the sampled wavelengths lie in the Rayleigh-Jeans part of the spectral energy distribution of most stars, where, to first order, all stars have essentially the same intrinsic color. Thus, changes in stellar NIR-MIR colors due to interstellar reddening are readily apparent, and (under an assumed extinction law) the observed colors and magnitudes of stars can be easily and accurately restored to their intrinsic values, greatly increasing their usefulness for Galactic structure studies. In this paper we explore this "Rayleigh-Jeans Color Excess" (RJCE) method and demonstrate that use of even a simple variant of the RJCE method based on a single reference color, (H-[4.5um]), can rather accurately remove dust effects from previously uninterpretable 2MASS color-magnitude diagrams of stars in fields along the heavily reddened Galactic mid-plane, with results far superior to those derived from application of other dereddening methods. We also show that "total" Galactic midplane extinction looks rather different from that predicted using 100um emission maps from the IRAS/ISSA and COBE/DIRBE instruments as presented by Schlegel et al. Instead, the Galactic mid-plane extinction strongly resembles the distribution of 13-CO (J=1->0) emission. Future papers will focus on refining the RJCE method and applying the technique to understand better not only dust and its distribution, but the distribution of stars intermixed with the dust in the low-latitude Galaxy.Comment: Accepted to ApJ; 21 pages, 17 figure

Detection of rare variant effects in association studies: extreme values, iterative regression, and a hybrid approach

We develop statistical methods for detecting rare variants that are associated with quantitative traits. We propose two strategies and their combination for this purpose: the iterative regression strategy and the extreme values strategy. In the iterative regression strategy, we use iterative regression on residuals and a multimarker association test to identify a group of significant variants. In the extreme values strategy, we use individuals with extreme trait values to select candidate genes and then test only these candidate genes. These two strategies are integrated into a hybrid approach through a weighting technology. We apply the proposed methods to analyze the Genetic Analysis Workshop 17 data set. The results show that the hybrid approach is the most powerful approach. Using the hybrid approach, the average power to detect causal genes for Q1 is about 40% and the powers to detect FLT1 and KDR are 100% and 68% for Q1, respectively. The powers to detect VNN3 and BCHE are 34% and 30% for Q2, respectively

Association between hourly wages and dietary intake after the first phase of implementation of the Minneapolis minimum wage ordinance

Objective: In 2018, Minneapolis began phased implementation of an ordinance to increase the local minimum wage to 15/h. We sought to determine whether the first phase of implementation was associated with changes in frequency of consumption of fruits and vegetables (F&V), whole-grain-rich foods, and foods high in added sugars among low-wage workers. Design: Natural experiment. Setting: The Wages Study is a prospective cohort study of 974 low-wage workers followed throughout the phased implementation of the ordinance (2018-2022). We used difference-in-difference analysis to compare outcomes among workers in Minneapolis, Minnesota, to those in a comparison city (Raleigh, North Carolina). We assessed wages using participants' pay stubs and dietary intake using the National Cancer Institute Dietary Screener Questionnaire. Participants: Analyses use the first two waves of Wages data (2018 (baseline), 2019) and includes 267 and 336 low-wage workers in Minneapolis and Raleigh, respectively. Results: After the first phase of implementation, wages increased in both cities, but the increase was 0·84 greater in Minneapolis (P = 0·02). However, the first phase of the policy's implementation was not associated with changes in daily frequency of consumption of F&V (IRR = 1·03, 95 % CI: 0·86, 1·24, P = 0·73), whole-grain-rich foods (IRR = 1·23, 95 % CI: 0·89, 1·70, P = 0·20), or foods high in added sugars (IRR = 1·13, 95 % CI: 0·86, 1·47, P = 0·38) among workers in Minneapolis compared to Raleigh. Conclusions: The first phase of implementation of the Minneapolis minimum wage policy was associated with increased wages, but not with changes in dietary intake. Future research should examine whether full implementation is associated dietary changes

Permeating the social justice ideals of equality and equity within the context of Early Years: challenges for leadership in multi-cultural and mono-cultural primary schools

The ideology and commitment of social justice principles is central to Early Years practice, however, the term social justice in education is complex and remains contested. This paper explores the ideology of social justice through links between equality and equity and how it is embedded within Early Years, and what remain the potential challenges for leadership. Interviews in English multi-cultural and mono-cultural primary schools were conducted. Findings showed that the ideology of social justice, equality and equity was interpreted differently. Multi-cultural schools appear to use a greater variety of activities to embed social justice principles that involved their diverse communities more to enrich the curriculum. In mono-cultural schools leadership had to be more creative in promoting equality and equity given the smaller proportion of their diverse pupil and staff population. Tentative conclusions suggest that the vision for permeating equality and equity in Early Years, at best, is at early stages