Evaluating the effect of care around labor and delivery practices on early neonatal mortality in the global network\u27s maternal and newborn health registry

Background: Neonatal deaths in first 28-days of life represent 47% of all deaths under the age of five years globally and are a focus of the United Nation\u27s (UN\u27s) Sustainable Development Goals. Pregnant women are delivering in facilities but that does not indicate quality of care during delivery and the postpartum period. The World Health Organization\u27s Essential Newborn Care (ENC) package reduces neonatal mortality, but lacks a simple and valid composite index that measures its effectiveness.Methods: Data on 5 intra-partum and 3 post-partum practices (indicators) recommended as part of ENC, routinely collected in NICHD\u27s Global Network\u27s (GN) Maternal Newborn Health Registry (MNHR) between 2010 and 2013, were included. We evaluated if all 8 practices (Care around Delivery - CAD), combined as an index was associated with reduced early neonatal mortality rates (days 0-6 of life).Results: A total of 150,848 live births were included in the analysis. The individual indicators varied across sites. All components were present in 19.9% births (range 0.4 to 31% across sites). Present indicators (8 components) were associated with reduced early neonatal mortality [adjusted RR (95% CI):0.81 (0.77, 0.85); p \u3c 0.0001]. Despite an overall association between CAD and early neonatal mortality (RR \u3c 1.0 for all early mortality): delivery by skilled birth attendant; presence of fetal heart and delayed bathing were associated with increased early neonatal mortality.Conclusions: Present indicators (8 practices) of CAD were associated with a 19% reduction in the risk of neonatal death in the diverse health facilities where delivery occurred within the GN MNHR. These indicators could be monitored to identify facilities that need to improve compliance with ENC practices to reduce preventable neonatal deaths. Three of the 8 indicators were associated with increased neonatal mortality, due to baby being sick at birth. Although promising, this composite index needs refinement before use to monitor facility-based quality of care in association with early neonatal mortality. Trial registration The identifier of the Maternal Newborn Health Registry at ClinicalTrials.gov is NCT01073475

Animal welfare impacts of badger culling operations

We are writing to express our extreme concern following recent media coverage1, 2 relating to the methodology being used by contractors to kill badgers under licence, as part of the government’s policy to control bovine TB in cattle. The coverage relates to the shooting of badgers that have been captured in live traps. Covert video footage (https://bit.ly/2Eud1iR ) from Cumbria shows a trapped badger being shot with a firearm at close range, following which it appears to take close to a minute to stop moving. The contractor clearly observes the animal during this time but makes no attempt to expedite the death of the badger and prevent further suffering, as required by the current Natural England best practice guide which states: ‘Immediately after shooting, the animal should be checked to ensure it is dead, and if there is any doubt, a second shot must be taken as soon as possible.’3 The conversation between the contractor and his companion also suggests they were considering moving the badger to another site before finally bagging the carcase, again breaching the best practice guide. While the footage only relates to the experience of a single badger, and while the degree to which the badger was conscious in the period immediately following the shot is unclear, we can by no means be certain that the badger did not suffer. It also raises serious questions about the training, competence and behaviour of contractors, in relation to both badger welfare, and biosecurity. This adds to existing concerns relating to the humaneness of ‘controlled shooting’ (targeting free-roaming badgers with rifles), which continues to be a permitted method under culling licences, in spite of the reservations expressed by both the government-commissioned Independent Expert Panel in its 2014 report,4 and the BVA, which concluded in 2015 that it ‘can no longer support the continued use of controlled shooting as part of the badger control policy’.5 (However, it has since continued to support the issuing of licences which permit the method). The BVA has consistently indicated its support for what it calls the ‘tried and tested’ method of trapping and shooting, but has thus far failed to provide comprehensive and robust evidence for the humaneness of this method. Figure1 Download figure Open in new tab Download powerpoint Natural England reported that its monitors observed 74 (just over 0.6 per cent) of controlled shooting events for accuracy and humaneness During 2017, almost 20,000 badgers were killed under licence across 19 cull zones, around 60 per cent of which were killed by controlled shooting, the remainder being trapped and shot.6 Natural England reported that its monitors observed 74 (just over 0.6 per cent) of controlled shooting events for accuracy and humaneness. No information has been provided on the extent to which trapping and shooting activities were monitored. This raises serious concerns about the extent of suffering that might be experienced by very large numbers of animals, for which contractors are not being held to account. If contractors reach their maximum culling targets set by Natural England for 2018, as many as 41,000 additional badgers could be killed.7 The extent to which these animals will suffer is once again being left in the hands of contractors, with woefully inadequate oversight, and in the face of anecdotal evidence of breaches of best practice guidance. This situation is clearly unacceptable from an animal welfare perspective and it is our view that by endorsing the policy, the BVA is contradicting the principles contained within its own animal welfare strategy.8 We therefore urge the BVA to withdraw its support for any further licensed badger culling, and the RCVS to make it clear that any veterinarian who provides support for culling activities that result in unnecessary and avoidable animal suffering could face disciplinary proceedings. The veterinary profession has no business supporting this licensed mass killing with all its inherent negative welfare and biosecurity implications, and for which the disease control benefits are, at best, extremely uncertain. We believe the continued support for the culls by veterinary bodies in the face of poor evidence for its efficacy damages the credibility of the profession, and that same support in the face of potential animal suffering on a large scale undermines its reputation. We stand ready to discuss these issues in more detail

Comparative antibacterial potential of selected aldehyde-based biocides and surfactants against planktonic Pseudomonas fluorescens

The antimicrobial efficacy of two aldehydebased biocides (glutaraldehyde, GTA, and orthophthalaldehyde, OPA) and two surfactants (cetyltrimethyl ammonium bromide, CTAB, and sodium dodecyl sulphate, SDS) was tested against planktonic Pseudomonas fluorescens. The antimicrobial effects were evaluated by respiratory activity as a measure of the oxygen uptake rate, adenosine triphosphate (ATP) release, outer membrane proteins (OMP) expression and cellular colour changes. The results were compared with the bacterial characteristics without chemical treatment. Tests in the presence of bovine serum albumin (BSA), in order to mimic a disinfection process in the real situation under dirty conditions, were performed according to the European Standard EN-1276. P. fluorescens was completely inactivated with OPA (minimum bactericidal concentration, MBC = 0.5 mM) and CTAB (MBC = 5 mM) and was resistant to GTA and SDS. Only CTAB promoted cellular disruption and consequent ATP release. The antimicrobial action of the chemicals tested was significantly reduced when BSA was introduced into the bacterial cultures, increasing markedly the MBC values. Additionally, the presence of BSA acted as a disruption protective agent when CTAB was applied and stimulated the bacterial respiratory activity when lower concentrations of SDS were tested. The OMP of the bacterial cells was affected by the application of both surfactants. OMP expression remained unaltered after biocide treatment. Bacterial colour change was noticed after treatment with biocides and surfactants. In summary, P. fluorescens was extremely resistant to GTA and SDS, with antimicrobial action being quenched markedly by the reaction with BSA.Instituto de Biotecnologia e Química Fina (IBQF).Fundação para a Ciência e a Tecnologia (FCT) - (Project CHEMBIO - POCI/BIO/61872/2004

Event Texture Search for Phase Transitions in Pb+Pb Collisions

NA44 uses a 512 channel Si pad array covering $1.5 <\eta < 3.3$ to study charged hadron production in 158 A GeV Pb+Pb collisions at the CERN SPS. We apply a multiresolution analysis, based on a Discrete Wavelet Transformation, to probe the texture of particle distributions event-by-event, allowing simultaneous localization of features in space and scale. Scanning a broad range of multiplicities, we search for signals of clustering and of critical behavior in the power spectra of local density fluctuations. The data are compared with detailed simulations of detector response, using heavy ion event generators, and with a reference sample created via event mixing. An upper limit is set on the probability and magnitude of dynamical fluctuations

Ecological approaches in veterinary epidemiology: mapping the risk of bat-borne rabies using vegetation indices and night-time light satellite imagery

Rabies remains a disease of significant public health concern. In the Americas, bats are an important source of rabies for pets, livestock, and humans. For effective rabies control and prevention, identifying potential areas for disease occurrence is critical to guide future research, inform public health policies, and design interventions. To anticipate zoonotic infectious diseases distribution at coarse scale, veterinary epidemiology needs to advance via exploring current geographic ecology tools and data using a biological approach. We analyzed bat-borne rabies reports in Chile from 2002 to 2012 to establish associations between rabies occurrence and environmental factors to generate an ecological niche model (ENM). The main rabies reservoir in Chile is the bat species Tadarida brasiliensis; we mapped 726 occurrences of rabies virus variant AgV4 in this bat species and integrated them with contemporary Normalized Difference Vegetation Index (NDVI) data from the Moderate Resolution Imaging Spectroradiometer (MODIS). The correct prediction of areas with rabies in bats and the reliable anticipation of human rabies in our study illustrate the usefulness of ENM for mapping rabies and other zoonotic pathogens. Additionally, we highlight critical issues with selection of environmental variables, methods for model validation, and consideration of sampling bias. Indeed, models with weak or incorrect validation approaches should be interpreted with caution. In conclusion, ecological niche modeling applications for mapping disease risk at coarse geographic scales have a promising future, especially with refinement and enrichment of models with additional information, such as night-time light data, which increased substantially the model’s ability to anticipate human rabies

North Atlantic Paleoceanography: The Last Five Million Years

In the North Atlantic, cold, relatively salty water sinks in the icy Labrador and Greenland seas, forming North Atlantic Deep Water (NADW). This circulates through the global ocean, driving ocean overturning and global heat transport and, thus, impacting global climate. As one of the most climatically sensitive regions on Earth, the North Atlantic has experienced abrupt changes to its ocean-atmosphere-cryosphere system, triggered by fluctuations in meltwater delivery to source areas of NADW formation. For about the past 100 thousand years, these abrupt jumps in climate state have manifested as ‘Dansgaard/Oeschger’ (D/O) oscillations (millennial-scale warm-cold oscillations) and ‘Heinrich’ events in ice and marine sediment cores, respectively [e.g., Dansgaard et al.,1993; Bond and Lotti, 1995]. These Heinrich events are characterized as huge input of ice-rafted debris (IRD) and meltwater pulses, documenting episodes of sudden instability and collapse of the current Greenland ice sheets and the Laurentide ice sheet, the latter of which covered northern North America several times during the Pleistocene Epoch