Comparative Study on Efficacy of CowManager Technology

A comparative study of the CowManager tag versus visual observations was conducted to measure the efficacy of cow behavior measuring technologies. The study used 30 Angus cross beef steers grouped into pens of 6. The steers were monitored once a week every other week for a total of 6 days. Each observation period was within 4 hours from the hours of 7am to 11am using the scanning method at an interval of 5 minutes. The behaviors that were monitored by the observer and CowManager technology included time spent ruminating, eating, and being active. Each behavior time was put on an hour time scale and compared. After SAS analysis there was no statistical difference in the time spent ruminating when using observational methods versus those that the CowManager reported. However, there was a statistical difference in time spent eating when comparing observational and CowManager data. The CowManager data appeared to under report the amount of time spent eating. These results indicate that CowManager tags can accurately measure rumination time but are unable to accurately measure feeding time when used in beef cattle production systems. This is significant for beef cattle research and industries looking to use this technology

Prognostic factors for musculoskeletal sickness absence and return to work among welders and metal workers

OBJECTIVES: To analyse factors that determine the occurrence of sickness absence due to musculoskeletal problems and the time it takes to return to work. METHODS: A longitudinal study with two year follow up was conducted among 283 male welders and metal workers. The survey started with a standardised interview on the occurrence of musculoskeletal complaints. 61 (22%) workers were lost to follow up. Data on sickness absence among 222 workers during the follow up were collected from absence records and self reports. Regression analysis based on proportional hazards models was applied to identify risk factors for the occurrence and duration of sickness absence due to various musculoskeletal complaints. RESULTS: During the follow up 51% of the workers attributed at least one period of sickness absence to musculoskeletal complaints which accounted for 44% of all work days lost. A history of back pain was not associated with sickness absence for back pain, partly because subjects with back pain were more likely to be lost to follow up. Neck or shoulder pain and pain of the upper extremities contributed significantly to neck or shoulder absence (relative risk (RR) 3.35; 95% confidence interval (95% CI) 1.73 to 6.47) and to upper extremities absence (RR 2.29; 95% CI 1.17 to 4.46), respectively. Company and job title were also significant predictors for sickness absence due to these musculoskeletal complaints. Absence with musculoskeletal complaints was not associated with age, height, body mass index, smoking, and duration of employment. Return to work after neck or shoulder absence was worse among metal workers than welders (RR 2.12; 95% CI 1.08 to 4.17). Return to work after lower extremities absence was strongly influenced by visiting a physician (RR 11.31; 95% CI 2.94 to 43.46) and by musculoskeletal comorbidity (RR 2.81; 95% CI 1.18 to 6.73). CONCLUSIONS: Complaints of the neck or shoulder and upper extremities in the 12 months before the study were associated with sickness absence for these complaints during the follow up. Workers with absence due to pain from back, neck or shoulder, upper extremities, or lower extremities were at higher risk of subsequent sickness absence in the next year

Optimising cardiovascular care of patients with multiple myeloma

Multiple myeloma (MM) is the third most common haematological malignancy, with increasing prevalence over recent years. Advances in therapy have improved survival, changing the clinical course of MM into a chronic condition and meaning that management of comorbidities is fundamental to improve clinical outcomes. Cardiovascular (CV) events affect up to 7.5% of individuals with MM, due to a combination of patient, disease and treatment-related factors and adversely impact survival. MM typically affects older people, many with pre-existing CV risk factors or established CV disease, and the disease itself can cause renal impairment, anaemia and hyperviscosity, which exacerabate these further. Up to 15% of patients with MM develop systemic amyloidosis, with prognosis determined by the extent of cardiac involvement. Management of MM generally involves administration of multiple treatment lines over several years as disease progresses, with many drug classes associated with adverse CV effects including high rates of venous and arterial thrombosis alongside heart failure. Recommendations for holistic management of patients with MM now include routine baseline risk stratification including ECG and echocardiography and administration of thromboprophylaxis drugs for patients treated with immunomodulatory drugs. Close surveillance of high-risk patients with collaboration between haematology and cardiology is required, with prompt investigation in the event of CV symptoms, in order to identify and treat complications early. Decisions regarding discontinuation of cardiotoxic therapies should be made in a multidisciplinary setting, taking into account the severity of the complication, prognosis, expected benefits and the availability of effective alternatives

Prognostic models versus single risk factor approach in first-trimester selective screening for gestational diabetes mellitus: a prospective population-based multicentre cohort study

Objectives: To evaluate whether (1) first-trimester prognostic models for gestational diabetes mellitus (GDM) outperform the currently used single risk factor approach, and (2) a first-trimester random venous glucose measurement improves model performance. Design: Prospective population-based multicentre cohort. Setting: Thirty-one independent midwifery practices and six hospitals in the Netherlands. Population: Women recruited before 14 weeks of gestation without pre-existing diabetes. Methods: The single risk factor approach (presence of at least one risk factor: BMI ≥30 kg/m2, previous macrosomia, history of GDM, positive first-degree family history of diabetes, non-western ethnicity) was compared with the four best performing models in our previously published external validation study (Gabbay-Benziv 2014, Nanda 2011, Teede 2011, van Leeuwen 2010) with and without the addition of glucose. Main outcome measures: Discrimination was assessed by c-statistics, calibration by calibration plots, added value of glucose by the likelihood ratio chi-square test, net benefit by decision curve analysis and reclassification by reclassification plots. Results: Of the 3723 women included, a total of 181 (4.9%) developed GDM. The c-statistics of the prognostic models were higher, ranging from 0.74 to 0.78 without glucose and from 0.78 to 0.80 with glucose, compared with

What are Effective Strategies to Reduce Low-Value Care? An Analysis of 121 Randomized Deimplementation Studies

Background: Low-value care is healthcare leading to no or little clinical benefit for the patient. The best (combinations of) interventions to reduce low-value care are unclear. Purpose: To provide an overview of randomized controlled trials (RCTs) evaluating deimplementation strategies, to quantify the effectiveness and describe different combinations of strategies. Methods: Analysis of 121 RCTs (1990-2019) evaluating a strategy to reduce low-value care, identified by a systematic review. Deimplementation strategies were described and associations between strategy characteristics and effectiveness explored. Results: Of 109 trials comparing deimplementation to usual care, 75 (69%) reported a significant reduction of low-value healthcare practices. Seventy-three trials included in a quantitative analysis showed a median relative reduction of 17% (IQR 7%-42%). The effectiveness of deimplementation strategies was not associated with the number and types of interventions applied. Conclusions and Implications: Most deimplementation strategies achieved a considerable reduction of low-value care. We found no signs that a particular type or number of interventions works best for deimplementation. Future deimplementation studies should map relevant contextual factors, such as the workplace culture or economic factors. Interventions should be tailored to these factors and provide details regarding sustainability of the effect.</p

Самоподобие массивов сетевых публикаций по компьютерной вирусологии

Описан подход к организации анализа потока тематических публикаций по компьютерной вирусологии, представленных в web-пространстве. Обоснована фрактальная природа информационных потоков, описаны основные алгоритмы, применяемые в процессе исследований, а также приведены прогнозные выводы на основе свойств персистентности временных рядов.Описано підхід до організації аналізу потоку тематичних публікацій з комп’ютерної вірусології, які наведені у web-просторі. Обґрунтовано фрактальну природу інформаційних потоків, описано основні алгоритми, що застосовуються в процесі досліджень, а також наведено прогнозні висновки на базі властивостей персистентності часових рядів.An approach to the organization of the analysis of a thematic publications stream on computer virology, submitted in web-space, is described. The fractal nature of information streams is proved, the basic algorithms used during researches are described and forecasts conclusions on the basis of persistent properties of time series are given

Study protocol for a randomised trial for atosiban versus placebo in threatened preterm birth : The APOSTEL 8 study

Peer reviewedPublisher PD