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

Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: current status in 37 ESC countries

Aims Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy in ST-elevation myocardial infarction (STEMI). We conducted this study to evaluate the contemporary status on the use and type of reperfusion therapy in patients admitted with STEMI in the European Society of Cardiology (ESC) member countries. Methods and results A cross-sectional descriptive study based on aggregated country-level data on the use of reperfusion therapy in patients admitted with STEMI during 2010 or 2011. Thirty-seven ESC countries were able to provide data from existing national or regional registries. In countries where no such registries exist, data were based on best expert estimates. Data were collected on the use of STEMI reperfusion treatment and mortality, the numbers of cardiologists, and the availability of PPCI facilities in each country. Our survey provides a brief data summary of the degree of variation in reperfusion therapy across Europe. The number of PPCI procedures varied between countries, ranging from 23 to 884 per million inhabitants. Primary percutaneous coronary intervention and thrombolysis were the dominant reperfusion strategy in 33 and 4 countries, respectively. The mean population served by a single PPCI centre with a 24-h service 7 days a week ranged from 31 300 inhabitants per centre to 6 533 000 inhabitants per centre. Twenty-seven of the total 37 countries participated in a former survey from 2007, and major increases in PPCI utilization were observed in 13 of these countries. Conclusion Large variations in reperfusion treatment are still present across Europe. Countries in Eastern and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encourage

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

From impression to addiction: The pathways of adolescent tobacco use

Aim: To understand the psychodynamics of tobacco use among 11- to 14-year-olds in Ahmedabad, India. Materials and Methods: A self-administered questionnaire was used to gather information on tobacco use from 5,266 students, aged 11 to 14, enrolled in government-aided English medium schools in Ahmedabad. IBM® SPSS® 26.0 software along with Chi-square tests were used to analyze the data. Results: A total of 7.2% (376) had ever used tobacco. Of the users, 96.6% (363) knew it was harmful, 76.3% (287) were boys, and 85.2% (320) were initiated by family and friends. Conclusion: Despite being aware of the dangers of tobacco and being unable to purchase from vendors, children continued to obtain tobacco products, being influenced by their close social networks. An effective cessation measure should be directed toward this psychodynamic etiology

Comparative analysis of machine learning models for predicting dielectric properties in MoS2 nanofiller-reinforced epoxy composites

This research investigates the dielectric properties of nano epoxy composites by incorporating various concentrations of MoS2 into epoxy resin. The study explores the impact of synthesized nanoparticles on undoped epoxy composites, specifically focusing on their potential applications in dielectric materials. The experimental synthesis and characterization of nanoepoxy composites typically involve time-consuming and expensive methods. This study compares five machine learning (ML) models—random forests, decision trees, extra trees, XGBoost, and gradient boosting—in order to predict the frequency-dependent dielectric constants in these composites under different nanofiller variations in order to address this challenge. To ensure robust model performance, training is carried out on different subsets of the dataset, ranging from 60% to 30%, while the remaining portions are reserved for testing purposes (40% to 70%). The main objective of the study is to assess the performance of each regressor technique using metrics such as adjusted R2 score, MSE, RMSE, and MAE, in which the ET regressor excels. The ET method demonstrates exceptional performance, achieving an adjusted R2 value of 0.9977 and 0.9912 for target variables ε′ and ε′′, respectively when tested with a size of 0.4. The findings underscore the potential of ML models for precise and efficient prediction of frequency-dependent dielectric constants of nanoepoxy composites with various concentrations of nanofillers, offering an alternative to time-consuming and expensive laboratory work