Experimental infectious pancreatic necrosis infections: propagative or point-source epidemic?

AbstractExperimentally initiated epidemics of infectious pancreatic necrosis in rainbow-trout fry were analyzed using a modification of the standard mathematical model for a simple propagative epidemic. Contrary to expectations, the value of the transmission parameter (β) was inversely related to initial density of susceptible hosts. This anomaly can be explained if we assume that the experimental epidemics were point-source rather than propagative epidemics. The implications of this conclusion for modeling experimental and natural epidemics are discussed

Studies of oxidative stress in cellular systems The interaction of monocytes and erythrocytes

Abstract1H spin echo NMR spectroscopy is used to follow the interaction of intact and viable erythrocytes and monocytes obtained from different sources in mixed cultures. After a lag time (270 min) erythrocyte glutathione is observed to become more oxidised. This result is believed to occur as a consequence of monocyte activation generating hydrogen peroxide or hypochlorous acid, which is targeted at the erythrocyte. The red cell in turn employs its sulphydryl system as an anti-oxidant defence

The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death

INTRODUCTION: Early warning scores (EWS) are recommended as part of the early recognition and response to patient deterioration. The Royal College of Physicians recommends the use of a National Early Warning Score (NEWS) for the routine clinical assessment of all adult patients. METHODS: We tested the ability of NEWS to discriminate patients at risk of cardiac arrest, unanticipated intensive care unit (ICU) admission or death within 24h of a NEWS value and compared its performance to that of 33 other EWSs currently in use, using the area under the receiver-operating characteristic (AUROC) curve and a large vital signs database (n=198,755 observation sets) collected from 35,585 consecutive, completed acute medical admissions. RESULTS: The AUROCs (95% CI) for NEWS for cardiac arrest, unanticipated ICU admission, death, and any of the outcomes, all within 24h, were 0.722 (0.685-0.759), 0.857 (0.847-0.868), 0.894 (0.887-0.902), and 0.873 (0.866-0.879), respectively. Similarly, the ranges of AUROCs (95% CI) for the other 33 EWSs were 0.611 (0.568-0.654) to 0.710 (0.675-0.745) (cardiac arrest); 0.570 (0.553-0.568) to 0.827 (0.814-0.840) (unanticipated ICU admission); 0.813 (0.802-0.824) to 0.858 (0.849-0.867) (death); and 0.736 (0.727-0.745) to 0.834 (0.826-0.842) (any outcome). CONCLUSIONS: NEWS has a greater ability to discriminate patients at risk of the combined outcome of cardiac arrest, unanticipated ICU admission or death within 24h of a NEWS value than 33 other EWSs

Relationships between production and product traits in subpopulations of Bonsmara and Nguni cattle

Ninety bull calves of five Bonsmara strains, viz. Edelheer (E), T-49 (T), Wesselsvlei (W), Roodebos (R) and Belmont Red (BR), and two Nguni sub-populations, viz. Bartlow (B) and non-Bartlow (NB), were fattened under intensive feeding conditions and serially slaughtered at four different slaughter weights. Phylogenetic relationships between the five Bonsmara strains and between the two Nguni subpopulations were determined by means of blood typing. Growth performance, carcass characteristics and meat quality characteristics were compared between the sub-populations of each breed. Genetic distances between the Bonsmara animals confirmed the existence of five genetic subpopulations with variation in genetic distances between them. The genetic distance between the two Nguni subpopulations was very small, indicating genetic similarity. Means for production and product characteristics were adjusted for mean subcutaneous fat percentage by means of analysis of covariance. T gained weight faster and more efficiently on a live and carcass weight basis than the other Bonsmara groups, while B gained carcass and muscle weight more efficiently than NB. T had proportionally more meat in the high-priced cuts of the carcass than W. Muscle of the W line had a higher ageing potential (measured as myofibrillar fragmentation; MFI) than T, resulting in higher tenderness scores for W. Similarly, B had higher MFI for muscle aged for one or seven days, coupled with more tender meat than NB. Pairwise correlations between growth and muscle characteristics indicated that fast growing animals tend to produce less tender meat. South African Journal of Animal Science, Vol 31, Issue 3, Oct – Dec (2001): pp.181-19

A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection.

OBJECTIVES: The Sepsis-3 task force recommended the quick Sequential (Sepsis-Related) Organ Failure Assessment score for identifying patients with suspected infection who are at greater risk of poor outcomes, but many hospitals already use the National Early Warning Score to identify high-risk patients, irrespective of diagnosis. We sought to compare the performance of quick Sequential (Sepsis-Related) Organ Failure Assessment and National Early Warning Score in hospitalized, non-ICU patients with and without an infection. DESIGN: Retrospective cohort study. SETTING: Large U.K. General Hospital. PATIENTS: Adults hospitalized between January 1, 2010, and February 1, 2016. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We applied the quick Sequential (Sepsis-Related) Organ Failure Assessment score and National Early Warning Score to 5,435,344 vital signs sets (241,996 hospital admissions). Patients were categorized as having no infection, primary infection, or secondary infection using International Classification of Diseases, 10th Edition codes. National Early Warning Score was significantly better at discriminating in-hospital mortality, irrespective of infection status (no infection, National Early Warning Score 0.831 [0.825-0.838] vs quick Sequential [Sepsis-Related] Organ Failure Assessment 0.688 [0.680-0.695]; primary infection, National Early Warning Score 0.805 [0.799-0.812] vs quick Sequential [Sepsis-Related] Organ Failure Assessment 0.677 [0.670-0.685]). Similarly, National Early Warning Score performed significantly better in all patient groups (all admissions, emergency medicine admissions, and emergency surgery admissions) for all outcomes studied. Overall, quick Sequential (Sepsis-Related) Organ Failure Assessment performed no better, and often worse, in admissions with infection than without. CONCLUSIONS: The National Early Warning Score outperforms the quick Sequential (Sepsis-Related) Organ Failure Assessment score, irrespective of infection status. These findings suggest that quick Sequential (Sepsis-Related) Organ Failure Assessment should be reevaluated as the system of choice for identifying non-ICU patients with suspected infection who are at greater risk of poor outcome

A fundamental conflict of care: nurses' accounts of balancing sleep with taking vital signs observations at night.

AIMS AND OBJECTIVES: To explore why adherence to vital signs observations scheduled by an Early Warning Score protocol reduces at night. BACKGROUND: Regular vital signs observations can reduce avoidable deterioration in hospital. Early Warning Score protocols set the frequency of these observations by the severity of a patient's condition. Vital signs observations are taken less frequently at night, even with an Early Warning Score in place, but no literature has explored why. DESIGN: A qualitative interpretative design informed this study. METHODS: Seventeen semi-structured interviews with nursing staff working on wards with varying levels of adherence to scheduled vital signs observations. A thematic analysis approach was used. RESULTS: At night, nursing teams found it difficult to balance the competing care goals of supporting sleep with taking vital signs observations. The night-time frequency of these observations was determined by clinical judgement, ward-level expectations of observation timing and the risk of disturbing other patients. Patients with COPD or dementia could be under-monitored while patients nearing the end of life could be over-monitored. CONCLUSION: In this study we found an Early Warning Score algorithm focused on deterioration prevention did not account for long-term management or palliative care trajectories. Nurses were therefore less inclined to wake such patients to take vital signs observations at night. However the perception of widespread exceptions and lack of evidence regarding optimum frequency risks delegitimising the Early Warning Score approach. This may pose a risk to patient safety, particularly patients with dementia or chronic conditions. RELEVANCE TO CLINICAL PRACTICE: Nurses should document exceptions and discuss these with the wider team. Hospitals should monitor why vital signs observations are missed at night, identify which groups are under-monitored and provide guidance on prioritising competing expectations. Early Warning Score protocols should take account of different care trajectories. This article is protected by copyright. All rights reserved

Erbium fibre laser pumped nanosecond optical parametric oscillator

We report a periodically-poled lithium niobate optical parametric oscillator pumped by a frequency doubled Q-switched erbium-fibre laser. Pump tuning of the OPO signal with thresholds below 10µJ was demonstrated. Signal tuning range was 0.99-1.45µm

A comparison of the ability of the National Early Warning Score and the National Early Warning Score 2 to identify patients at risk of in-hospital mortality: A multi-centre database study.

AIMS: To compare the ability of the National Early Warning Score (NEWS) and the National Early Warning Score 2 (NEWS2) to identify patients at risk of in-hospital mortality and other adverse outcomes. METHODS: We undertook a multi-centre retrospective observational study at five acute hospitals from two UK NHS Trusts. Data were obtained from completed adult admissions who were not fit enough to be discharged alive on the day of admission. Diagnostic coding and oxygen prescriptions were used to identify patients with type II respiratory failure (T2RF). The primary outcome was in-hospital mortality within 24 h of a vital signs observation. Secondary outcomes included unanticipated intensive care unit admission or cardiac arrest within 24 h of a vital signs observation. Discrimination was assessed using the c-statistic. RESULTS: Among 251,266 adult admissions, 48,898 were identified to be at risk of T2RF by diagnostic coding. In this group, NEWS2 showed statistically significant lower discrimination (c-statistic, 95% CI) for identifying in-hospital mortality within 24 h (0.860, 0.857-0.864) than NEWS (0.881, 0.878-0.884). For 1394 admissions with documented T2RF, discrimination was similar for both systems: NEWS2 (0.841, 0.827-0.855), NEWS (0.862, 0.848-0.875). For all secondary endpoints, NEWS2 showed no improvements in discrimination. CONCLUSIONS: NEWS2 modifications to NEWS do not improve discrimination of adverse outcomes in patients with documented T2RF and decrease discrimination in patients at risk of T2RF. Further evaluation of the relationship between SpO2 values, oxygen therapy and risk should be investigated further before wide-scale adoption of NEWS2

Statistical properties of thermodynamically predicted RNA secondary structures in viral genomes

By performing a comprehensive study on 1832 segments of 1212 complete genomes of viruses, we show that in viral genomes the hairpin structures of thermodynamically predicted RNA secondary structures are more abundant than expected under a simple random null hypothesis. The detected hairpin structures of RNA secondary structures are present both in coding and in noncoding regions for the four groups of viruses categorized as dsDNA, dsRNA, ssDNA and ssRNA. For all groups hairpin structures of RNA secondary structures are detected more frequently than expected for a random null hypothesis in noncoding rather than in coding regions. However, potential RNA secondary structures are also present in coding regions of dsDNA group. In fact we detect evolutionary conserved RNA secondary structures in conserved coding and noncoding regions of a large set of complete genomes of dsDNA herpesviruses.Comment: 9 pages, 2 figure