Contemporary management of drug-packers

Experience with management of drug-packers (mules) is variable among different centres. However, despite a recorded increase in drug trafficking in general, as yet, no unified, clear guidelines exist to guide the medical management of those who only occasionally encounter these individuals. We describe our recent experience with this growing problem and discuss the most salient points concerning the contemporary management of body packers. Our recent experience demonstrates that type IV packages may now be managed conservatively for the most part

Northern Bobwhite Response to Control of Red Imported Fire Ants in the Gulf Coast Prairie of Texas

The population decline of northern bobwhite (Colinus virginianus; hereafter, bobwhite) on the Texas Gulf Coast Prairie, USA is largely attributed to habitat loss. However, red imported fire ants (Solenopsis invicta) occur throughout the region and are considered a possible contributing factor to the bobwhite decline. The objectives of our study were to determine the influence of red imported fire ants on bobwhites by comparing bobwhite nest success, survival, and density between sites treated with fire ant bait (treatment) and reference (control) sites. Our study was conducted on 3 private ranches in Goliad and Refugio counties, Texas. Each ranch contained 2 paired experimental units that consisted of a treatment and control site (500 ha each). The treatment sites received an aerial application of fire ant bait (Extinguish® Plus) during April 2018, whereas the control sites were not treated. We estimated mound density by counting fire ant mounds using distance sampling. We used radio-telemetry to monitor bobwhite nest success and survival, and we estimated bobwhite densities using distance sampling via helicopter surveys. Fire ant mound density decreased through time on both treatment and control sites. However, fire ant mound density was lower on treatment sites than control sites, indicating the insecticide was effective at decreasing fire ant mound density. Bobwhite survival, nest success, and density did not statistically differ between control and treated sites either pre-treatment (2017) or post-treatment (2018), but survival and nest success metrics were numerically higher in treated units. Bobwhite survival remained relatively stable in the treatment units 4 weeks after application but decreased in the control units. Following treatment, apparent nest success in the treated units increased by 37.4% while nest success in the control units decreased by 35.2%. Bobwhite populations were low in this ecoregion, which influenced our ability to trap and monitor many bobwhites or monitor many nests. In addition, it may be possible that repeated, annual treatments for fire ants are necessary for a benefit to accrue and be observed in bobwhites. Our results indicate that there may be potential benefits to bobwhites from fire ant reduction that deserve further research attention

Uncovering the Neural Signature of Lapsing Attention: Electrophysiological Signals Predict Errors up to 20 s before They Occur

The extent to which changes in brain activity can foreshadow human error is uncertain yet has important theoretical and practical implications. The present study examined the temporal dynamics of electrocortical signals preceding a lapse of sustained attention. Twenty-one participants performed a continuous temporal expectancy task, which involved continuously monitoring a stream of regularly alternating patterned stimuli to detect a rarely occurring target stimulus whose duration was 40% longer. The stimulus stream flickered at a rate of 25 Hz to elicit a steady-state visual-evoked potential (SSVEP), which served as a continuous measure of basic visual processing. Increasing activity in the band (8 –14 Hz) was found beginning20 s before a missed target. This was followed by decreases in the amplitude of two event-related components over a short pretarget time frame: the frontal P3 (3– 4 s) and contingent-negative variation (during the target interval). In contrast, SSVEP amplitude before hits and misses was closely matched, suggesting that the efficacy of ongoing basic visual processing was unaffected. Our results show that the specific neural signatures of attentional lapses are registered in the EEG up to 20 s before an error

A cancer-associated, genome protective programme engaging PKCε.

Associated with their roles as targets for tumour promoters, there has been a long-standing interest in how members of the protein kinase C (PKC) family act to modulate cell growth and division. This has generated a great deal of observational data, but has for the most part not afforded clear mechanistic insights into the control mechanisms at play. Here, we review the roles of PKCε in protecting transformed cells from non-disjunction. In this particular cell cycle context, there is a growing understanding of the pathways involved, affording biomarker and interventional insights and opportunities

The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial.

Background: Thyroid drains following thyroid surgery are routinely used despite minimal supportive evidence. Our aim in this study is to determine the impact of routine open drainage of the thyroid bed postoperatively on ultrasound-determined fluid accumulation at 24 hours. Methods: We conducted a prospective randomised clinical trial on patients undergoing thyroid surgery. Patients were randomly assigned to a drain group (n = 49) or a no-drain group (n = 44) immediately prior to wound closure. Patients underwent a neck ultrasound on day 1 and day 2 postoperatively. After surgery, we evaluated visual analogue scale pain scores, postoperative analgesic requirements, self-reported scar satisfaction at 6 weeks and complications. Results: There was significantly less mean fluid accumulated in the drain group on both day 1, 16.4 versus 25.1 ml (P-value = 0.005), and day 2, 18.4 versus 25.7 ml (P-value = 0.026), following surgery. We found no significant differences between the groups with regard to length of stay, scar satisfaction, visual analogue scale pain score and analgesic requirements. There were four versus one wound infections in the drain versus no-drain groups. This finding was not statistically significant (P = 0.154). No life-threatening bleeds occurred in either group. Conclusions: Fluid accumulation after thyroid surgery was significantly lessened by drainage. However, this study did not show any clinical benefit associated with this finding in the non-emergent setting. Drains themselves showed a trend indicating that they may augment infection rates. The results of this study suggest that the frequency of acute life-threatening bleeds remains extremely low following abandoning drains. We advocate abandoning routine use of thyroid drains. Trial registration: ISRCTN94715414

A cancer-associated, genome protective programme engaging PKCε

Associated with their roles as targets for tumour promoters, there has been a long-standing interest in how members of the protein kinase C (PKC) family act to modulate cell growth and division. This has generated a great deal of observational data, but has for the most part not afforded clear mechanistic insights into the control mechanisms at play. Here, we review the roles of PKCε in protecting transformed cells from non-disjunction. In this particular cell cycle context, there is a growing understanding of the pathways involved, affording biomarker and interventional insights and opportunities

CDC Botswana : sharing another partnership success

CDC Botswana, in partnership with the Ministry of Health since 1995--for a safer, healthier Botswana.Publication date from document properties.CDCBotswanaSharesSuccess_19_07_12.pd

Training in the use of intrapartum electronic fetal monitoring with cardiotocography: systematic review and meta‐analysis

Background: Sub‐optimal classification, interpretation and response to intrapartum electronic fetal monitoring using cardiotocography are known problems. Training is often recommended as a solution, but there is lack of clarity about the effects of training and which type of training works best. Objectives: Systematic review of the effects of training healthcare professionals in intrapartum cardiotocography (PROSPERO protocol: CRD42017064525). Search strategy: CENTRAL, Cochrane Library, MEDLINE, EMBASE, PsycINFO, British Nursing Database, CINAHL, ERIC, Scopus, Web of Science, ProQuest, grey literature and ongoing clinical trials were searched. Selection criteria: Primary studies that reported impact of training healthcare professionals in intrapartum cardiotocography. Title/abstract, full‐text screening and quality assessment were conducted in duplicate. Data collection and analysis: Data were synthesised both narratively and using meta‐analysis. Risk of bias and overall quality were assessed with the Mixed Methods Appraisal Tool and GRADE. Main results: Sixty‐four studies were included. Overall, training and reporting were heterogeneous, the outcomes evaluated varied widely and study quality was low. Five randomised controlled trials reported that training improved knowledge of maternity professionals compared with no training, but evidence was of low quality. Evidence for the impact of cardiotocography training on neonatal and maternal outcomes was limited, showed inconsistent effects, and was of low overall quality. Evidence for the optimal content and method of delivery of training was very limited. Conclusions: Given the scale of harm and litigation claims associated with electronic fetal monitoring, the evidence‐base for training requires improvement. It should address intervention design, evaluation of clinical outcomes and system‐wide contexts of sub‐optimal practice. Tweetable abstract: Training in fetal monitoring: systematic review finds little evidence of impact on neonatal outcomes