National survey of variations in practice in the prevention of surgical site infections in adult cardiac surgery, United Kingdom and Republic of Ireland

Background: Currently no national standards exist for the prevention of surgical site infection (SSI) in cardiac surgery. SSI rates range from 1% to 8% between centres. Aim: The aim of this study was to explore and characterize variation in approaches to SSI prevention in the UK and the Republic of Ireland (ROI). Methods: Cardiac surgery centres were surveyed using electronic web-based questionnaires to identify variation in SSI prevention at the level of both institution and consultant teams. Surveys were developed and undertaken through collaboration between the Cardiothoracic Interdisciplinary Research Network (CIRN), Public Health England (PHE) and the National Cardiac Benchmarking Collaborative (NCBC) to encompass routine pre-, intra- and postoperative practice. Findings: Nineteen of 38 centres who were approached provided data and included responses from 139 consultant teams. There was no missing data from those centres that responded. The results demonstrated substantial variation in over 40 aspects of SSI prevention. These included variation in SSI surveillance, reporting of SSI infection rates to external bodies, utilization of SSI risk prediction tools, and the use of interventions such as sternal support devices and gentamicin impregnated sponges. Conclusion: Measured variation in SSI prevention in cardiac centres across the UK and ROI is evidence of clinical uncertainty as to best practice, and has identified areas for quality improvement as well as knowledge gaps to be addressed by future research

On the modeling and analysis of a vibration absorber for overhead powerlines with multiple resonant frequencies

Stockbridge dampers are primarily used to suppress or reduce Aeolian vibrations of transmission lines. The number of resonant frequencies characterizes the effectiveness of the Stockbridge damper. Aeolian vibrations refers to the vibration of conductor cables in the range of 3–150 Hz. Unlike the primitive Stockbridge damper which has only two resonant frequencies, the asymmetric Stockbridge damper exhibits up to four resonant frequencies. The numerical simulations and parametric studies conducted previously showed a correlation between the increase of natural frequencies and the change in the geometry of the counterweight. This paper presents an analytical model of a novel Aeolian vibration damper with an increased number of resonant frequencies. The analytical model is used to deduce the resonant frequencies of the damper. A 3D finite element model is developed to validate the analytical model. The natural frequencies and the subsequent mode shapes of both analytical and finite element models are presented. Experiment is conducted to validate the proposed models

Effect of Different Rates and Times of Nitrogen Application on Growth, Yield Attributes and Yield of Sweet Corn (Zea mays L. saccharata) Under South Gujarat Condition

A field experiment was conducted during the rabi season in 2017-18 to study the effect of different rates and times of nitrogen application on growth, yield attributes and yield of sweet corn (Zea mays L. saccharata) under south Gujarat conditions. The experiment was laid out in a Factorial randomized block design (FRBD) with three replications. The factors consisted of four nitrogen levels i.e., 90 kg ha-1 (N1), 120 kg ha-1 (N2), 150 kg ha-1 (N3) and 180 kg ha-1 (N4) and four treatments of split application i.e., ½ basal + ½ at knee height (T1), ½ basal + ¼ knee height + ¼ tasseling (T2), 1 /3 basal + 1 /3 knee height + 1 /3tasseling (T3), ¼ basal + ½ at knee height + ¼ tasseling (T4). The results revealed that increasing the nitrogen level from 90 (N1) to 180 (N4) kg   ha-1 significantly increased the growth attributes viz, plant height, stem diameter, number of leaves, yield attributes viz, number of grains per cob, weight of grains per cob, weight of cob per plant, green cob and fodder yield. Significantly higher green cob (132.94 q ha-1) and fodder yield (307.29 q ha-1) with net return (Rs.258239 ha-1) and benefit: cost ratio of 4.74 was obtained with 180 kg ha-1 nitrogen application. Application of nitrogen in three splits i.e., at ¼ basal + ½ at knee height + ¼ tasseling (T4) recorded significantly higher growth characters viz, plant height, stem diameter, number of leaves, yield attributes viz, number of grains per cob, weight of grains per cob, weight of cob per plant, green cob (126.99 q ha-1) and fodder yield (293.14 q ha-1) with net return (Rs.242739 ha-1) and benefit: cost ratio of 4.47

Size at birth, adult intestinal calcium absorption and 1,25(OH)(2) vitamin D

Background: Adult bone mineral status is modified by early environmental influences, but the mechanism of this phenomenon is unknown. Intestinal calcium absorption and vitamin D metabolism are integrally involved in bone metabolism and may be programmed during early life.Aim: To examine the early-life influences on calcium absorption and its control in 322 post-menopausal female twins.Methods: Intestinal calcium absorption was assessed by the stable strontium (Sr) method. Serum PTH, 25(OH) and 1,25(OH)2 vitamin D were measured and recalled birth weight recorded.Results: Fractional intestinal Sr absorption (alphaSr) was correlated with serum 1,25(OH)2 vitamin D (p<0.001), but not with 25(OH) vitamin D. Birth weight was inversely associated with serum 1,25(OH)2 vitamin D (p=0.04), the association being independent of serum calcium, phosphate, creatinine and PTH. Birth weight was inversely correlated with alphaSr (p=0.03), this association being independent of age, season, customary calcium intake and serum 25(OH) vitamin D; however, when serum 1,25(OH)2 vitamin D was added into the model, the association became non-significant, suggesting that the association was partially mediated via serum 1,25(OH)2 vitamin D.Discussion: We found a significant inverse association between birth weight and intestinal calcium absorption that is partially explained by an association between serum 1,25(OH)2 vitamin D and birth weight. This suggests a mechanism whereby the intra-uterine environment might affect adult skeletal status

Early outcomes and complications following cardiac surgery in patients testing positive for coronavirus disease 2019: An international cohort study

The outbreak of severe acute respiratory syndromecoronavirus-2, the cause of coronavirus disease 2019 (COVID-19) in December 2019 represented a global emergency accounting for more than 2.5 million deaths worldwide.1 It has had an unprecedented influence on cardiac surgery internationally, resulting in cautious delivery of surgery and restructuring of services.2 Understanding the influence of COVID-19 on patients after cardiac surgery is based on assumptions from other surgical specialties and single-center studies.The Cardiothoracic Interdisciplinary Research Network and the COVIDSurg Collaborative, Royal Adelaide Hospital, H.M Kroon ... N.N. Dudi-Venkata ... T Sammour, ... et al