End-user experiences with two incident and injury reporting systems designed for led outdoor activities - challenges for implementation of future data systems

Background: Injury and incident (near miss) prevention is heavily dependent upon robust and high-quality data systems. Evaluations of surveillance systems designed to report factors associated with incidents and injuries are essential to understand their value, as well as to improve their performance and efficiency. Despite, this there have been few such evaluations published in the peer-review literature. Methods: The attitudes and experiences of industry representatives who used one of two variants of an incident and injury surveillance system to collect injury and incident data for the led outdoor activity setting were obtained through an online self-report survey following a 12-month trial. Survey respondents were 18 representatives of 33 organisations who were users of a comprehensive incident reporting and surveillance system - the Understanding and Preventing Led Outdoor Accidents Data System Software Tool (UPLOADS-ST) - and six out of 11 users of a modified system (UPLOADS-Lite). The survey collected information on user experiences in relation to system training, accessibility, ease of use, security, feedback and perceived value to the sector of collating and reporting data across organisations. Findings: Only four UPLOADS-ST responding users found the system easy to use and just three considered entering incident reports to be easy. However, many considered the training on reporting incidents to be sufficient and that the incident reports contained relevant details. Fewer than half of respondents (seven for UPLOADS-ST, three for UPLOADS-Lite) believed entering data was a good use of staff time and resources. Nonetheless, a majority of respondents (seven for UPLOADS-ST, five for UPLOADS-Lite) found the reporting format easy to read and felt the information provided was useful for their organisation. Conclusions: Usability barriers to incident reporting were identified, particularly for UPLOADS-ST, including time constraints and user friendliness. The majority of users believed aggregating and reporting incident and injury data across organisations would be of value in making the led outdoor activity sector safer. Improving the utility of the surveillance systems will assist in ensuring their sustainability in the led outdoor activity sector

Heat and sun related medical concerns in Australian led outdoor activities: a three-year prospective study

Active participation in the outdoors is beneficial for health and wellbeing. However, the impact of extreme weather, particularly heat, on safe participation is causing concern for organisations who lead these activities. Local mitigation strategies and acute management of heat- and sun-related illness (HSRI) are generally well understood by researchers and medical practitioners, however, cases continue to occur so further understanding of why this happens is required. This study aimed to identify the number, nature and contributory factors of HSRI in Australian led outdoor activities in order to seek opportunities for their prevention. This study presents a descriptive analysis of contributory factors to HSRI occurring during led outdoor activities. Cases were prospectively collected across 3 years (2014-2017) from a national Australian incident reporting system. Cases were included by identification of keywords linked with sun or heat exposure. From 2,015 incident cases, 48 cases were included: 25 termed heat stroke and 23 as “other adverse outcomes related to sun or heat.” One in three (35%) cases occurred during outdoor walking or running, and one in four occurred while camping. A total 146 contributory factors were identified. These factors were attributed to the activity participant (e.g. competence, decision making); equipment and resources (e.g. food/drink, dehydration); and environment (e.g. hot weather.). Mild to moderate HSRI was identifiable by signs/symptoms. Contributory factors were linked to the individual participant. Potentially, these factors could be mitigated through system focused approaches. Awareness of wider responsibility for preventing HSRI should be promoted across led outdoor activities

Distinct Types of Fibrocyte Can Differentiate from Mononuclear Cells in the Presence and Absence of Serum

Background: Ageing, immunity and stresstolerance are inherent characteristics of all organisms. In animals, these traits are regulated, at least in part, by forkhead transcription factors in response to upstream signals from the Insulin/Insulin–like growth factor signalling (IIS) pathway. In the nematode Caenorhabditis elegans, these phenotypes are molecularly linked such that activation of the forkhead transcription factor DAF-16 both extends lifespan and simultaneously increases immunity and stress resistance. It is known that lifespan varies significantly among the Caenorhabditis species but, although DAF-16 signalling is highly conserved, it is unclear whether this phenotypic linkage occurs in other species. Here we investigate this phenotypic covariance by comparing longevity, stress resistance and immunity in four Caenorhabditis species. Methodology/Principal Findings: We show using phenotypic analysis of DAF-16 influenced phenotypes that among four closely related Caenorhabditis nematodes, the gonochoristic species (Caenorhabditis remanei and Caenorhabditis brenneri) have diverged significantly with a longer lifespan, improved stress resistance and higher immunity than the hermaphroditic species (C. elegans and Caenorhabditis briggsae). Interestingly, we also observe significant differences in expression levels between the daf-16 homologues in these species using Real-Time PCR, which positively correlate with the observed phenotypes. Finally, we provide additional evidence in support of a role for DAF-16 in regulating phenotypic coupling by using a combination of wildtype isolates, constitutively active daf-16 mutants and bioinformatic analysis. Conclusions: The gonochoristic species display a significantly longer lifespan (p<0.0001) and more robust immune and stress response (p<0.0001, thermal stress; p<0.01, heavy metal stress; p<0.0001, pathogenic stress) than the hermaphroditic species. Our data suggests that divergence in DAF-16 mediated phenotypes may underlie many of the differences observed between these four species of Caenorhabditis nematodes. These findings are further supported by the correlative higher daf-16 expression levels among the gonochoristic species and significantly higher lifespan, immunity and stress tolerance in the constitutively active daf-16 hermaphroditic mutants

Chemokine receptors in the rheumatoid synovium: upregulation of CXCR5

In patients with rheumatoid arthritis (RA), chemokine and chemokine receptor interactions play a central role in the recruitment of leukocytes into inflamed joints. This study was undertaken to characterize the expression of chemokine receptors in the synovial tissue of RA and non-RA patients. RA synovia (n = 8) were obtained from knee joint replacement operations and control non-RA synovia (n = 9) were obtained from arthroscopic knee biopsies sampled from patients with recent meniscal or articular cartilage damage or degeneration. The mRNA expression of chemokine receptors and their ligands was determined using gene microarrays and PCR. The protein expression of these genes was demonstrated by single-label and double-label immunohistochemistry. Microarray analysis showed the mRNA for CXCR5 to be more abundant in RA than non-RA synovial tissue, and of the chemokine receptors studied CXCR5 showed the greatest upregulation. PCR experiments confirmed the differential expression of CXCR5. By immunohistochemistry we were able to detect CXCR5 in all RA and non-RA samples. In the RA samples the presence of CXCR5 was observed on B cells and T cells in the infiltrates but also on macrophages and endothelial cells. In the non-RA samples the presence of CXCR5 was limited to macrophages and endothelial cells. CXCR5 expression in synovial fluid macrophages and peripheral blood monocytes from RA patients was confirmed by PCR. The present study shows that CXCR5 is upregulated in RA synovial tissue and is expressed in a variety of cell types. This receptor may be involved in the recruitment and positioning of B cells, T cells and monocytes/macrophages in the RA synovium. More importantly, the increased level of CXCR5, a homeostatic chemokine receptor, in the RA synovium suggests that non-inflammatory receptor–ligand pairs might play an important role in the pathogenesis of RA

Stapes Surgery for Patients with Preoperative Small Air Bone Gap

peer reviewedPurpose of Review: This review summarized the existing literature on the stapes surgery for patients with a preoperative air bone gap (ABG) under 30 dB. Recent Findings: Early surgery for otosclerosis appears to give good results without increasing the risks of complications, but the topic is still controverted. Summary: Stapes surgeries for patients with a preoperative ABG lower than the classical 30 dB are more common today and some studies support this change in paradigm. The risk/benefit balance needs to be discussed with the patients

ZFOURGE: Using Composite Spectral Energy Distributions to Characterize Galaxy Populations at 1<z<4

We investigate the properties of galaxies as they shut off star formation over the 4 billion years surrounding peak cosmic star formation. To do this we categorize $\sim7000$ galaxies from $1<z<4$ into $90$ groups based on the shape of their spectral energy distributions (SEDs) and build composite SEDs with $R\sim 50$ resolution. These composite SEDs show a variety of spectral shapes and also show trends in parameters such as color, mass, star formation rate, and emission line equivalent width. Using emission line equivalent widths and strength of the 4000\AA\ break, $D(4000)$, we categorize the composite SEDs into five classes: extreme emission line, star-forming, transitioning, post-starburst, and quiescent galaxies. The transitioning population of galaxies show modest H$\alpha$ emission ($EW_{\rm REST}\sim40$\AA) compared to more typical star-forming composite SEDs at $\log_{10}(M/M_\odot)\sim10.5$ ($EW_{\rm REST}\sim80$\AA). Together with their smaller sizes (3 kpc vs. 4 kpc) and higher S\'ersic indices (2.7 vs. 1.5), this indicates that morphological changes initiate before the cessation of star formation. The transitional group shows a strong increase of over one dex in number density from $z\sim3$ to $z\sim1$, similar to the growth in the quiescent population, while post-starburst galaxies become rarer at $z\lesssim1.5$. We calculate average quenching timescales of 1.6 Gyr at $z\sim1.5$ and 0.9 Gyr at $z\sim2.5$ and conclude that a fast quenching mechanism producing post-starbursts dominated the quenching of galaxies at early times, while a slower process has become more common since $z\sim2$.Comment: Accepted for publication in The Astrophysical Journa

Injury causation in the great outdoors: A systems analysis of led outdoor activity injury incidents

Despite calls for a systems approach to assessing and preventing injurious incidents within the led outdoor activity domain, applications of systems analysis frameworks to the analysis of incident data have been sparse. This article presents an analysis of 1014 led outdoor activity injury and near miss incidents whereby a systems-based risk management framework was used to classify the contributing factors involved across six levels of the led outdoor activity 'system'. The analysis identified causal factors across all levels of the led outdoor activity system, demonstrating the framework's utility for accident analysis efforts in the led outdoor activity injury domain. In addition, issues associated with the current data collection framework that potentially limited the identification of contributing factors outside of the individuals, equipment, and environment involved were identified. In closing, the requirement for new and improved data systems to be underpinned by the systems philosophy and new models of led outdoor activity accident causation is discussed.© 2013 Elsevier Ltd. All rights reserved.C

Lost in translation: the validity of a systemic accident analysis method embedded in an incident reporting software tool

ABSTRACT Despite the proposed advantages of systems accident analysis (SAA) methods for understanding incident causation, they have not been widely adopted by practitioners. The aim of this study was to evaluate the criterion-referenced validity of an SAA method embedded within an incident reporting software tool. Thirteen practitioners used the tool to collect and analyse incident data within their organisation. The incident data were then analysed by researchers experienced in using the SAA method. Overall, there were low levels of agreement between participants and researchers regarding the identification and classification of factors and relationships. The findings indicate the systems thinking principles underpinning the SAA method may have been ‘lost in translation’, in that participants often identified only one or two factors and showed a poor understanding of how to identify relationships between factors. The methodological developments required to ensure that practitioners can validly apply the SAA method are discussed

Monocytes/macrophages express chemokine receptor CCR9 in rheumatoid arthritis and CCL25 stimulates their differentiation

Available Gold OAAbstract Introduction Monocytes/macrophages accumulate in the rheumatoid (RA) synovium where they play a central role in inflammation and joint destruction. Identification of molecules involved in their accumulation and differentiation is important to inform therapeutic strategies. This study investigated the expression and function of chemokine receptor CCR9 in the peripheral blood (PB) and synovium of RA, non-RA patients and healthy volunteers. Methods CCR9 expression on PB monocytes/macrophages was analysed by flow cytometry and in synovium by immunofluorescence. Chemokine receptor CCR9 mRNA expression was examined in RA and non-RA synovium, monocytes/macrophages from PB and synovial fluid (SF) of RA patients and PB of healthy donors using the reverse transcription polymerase chain reaction (RT-PCR). Monocyte differentiation and chemotaxis to chemokine ligand 25 (CCL25)/TECK were used to study CCR9 function. Results CCR9 was expressed by PB monocytes/macrophages in RA and healthy donors, and increased in RA. In RA and non-RA synovia, CCR9 co-localised with cluster of differentiation 14+ (CD14+) and cluster of differentiation 68+ (CD68+) macrophages, and was more abundant in RA synovium. CCR9 mRNA was detected in the synovia of all RA patients and in some non-RA controls, and monocytes/macrophages from PB and SF of RA and healthy controls. CCL25 was detected in RA and non-RA synovia where it co-localised with CD14+ and CD68+ cells. Tumour necrosis factor alpha (TNFα) increased CCR9 expression on human acute monocytic leukemia cell line THP-1 monocytic cells. CCL25 induced a stronger monocyte differentiation in RA compared to healthy donors. CCL25 induced significant chemotaxis of PB monocytes but not consistently among individuals. Conclusions CCR9 expression by monocytes is increased in RA. CCL25 may be involved in the differentiation of monocytes to macrophages particularly in RA.Peer Reviewe