Requirements for a Dashboard to Support Quality Improvement Teams in Pain Management

Pain management is often considered lower priority than many other aspects of health management in hospitals. However, there is potential for Quality Improvement (QI) teams to improve pain management by visualising and exploring pain data sets. Although dashboards are already used by QI teams in hospitals, there is limited evidence of teams accessing visualisations to support their decision making. This study aims to identify the needs of the QI team in a UK Critical Care Unit (CCU) and develop dashboards that visualise longitudinal data on the efficacy of patient pain management to assist the team in making informed decisions to improve pain management within the CCU. This research is based on an analysis of transcripts of interviews with healthcare professionals with a variety of roles in the CCU and their evaluation of probes. We identified two key uses of pain data: direct patient care (focusing on individual patient data) and QI (aggregating data across the CCU and over time); in this paper, we focus on the QI role. We have identified how CCU staff currently interpret information and determine what supplementary information can better inform their decision making and support sensemaking. From these, a set of data visualisations has been proposed, for integration with the hospital electronic health record. These visualisations are being iteratively refined in collaboration with CCU staff and technical staff responsible for maintaining the electronic health record. The paper presents user requirements for QI in pain management and a set of visualisations, including the design rationale behind the various methods proposed for visualising and exploring pain data using dashboards

Effects of canopy architecture and microclimate on grapevine health in two training systems

Semi minimal pruned hedge (SMPH) is a time and cost saving grapevine training system, which is becoming more and more popular in German viticulture. In this study we compared the canopy architecture and its effect on the microclimate of SMPH trained grapevines with those of plants trained in vertical shoot positioning (VSP). We detected a 3 % points higher humidity and a 0.9 °C lower mean temperature within the complex canopy architecture of SMPH trained vines compared to VSP. Moreover, we investigated the influence of the differing microclimate, canopy and bunch architecture, as well as berry skin characteristics of the two training systems on the incidence of the major fungal grapevine diseases Downy Mildew, Powdery Mildew and Botrytis Bunch Rot, as well as on the occurrence and damage of the invasive insect pest Drosophila suzukii. We demonstrate that SMPH trained vines can be more susceptible to Downy Mildew and Powdery Mildew than VSP trained vines. The incidence of Botrytis Bunch Rot can be higher in the latter system, even if berry skin characteristics are the same in both training systems. We trapped a higher number of D. suzukii in SMPH canopies, however no increased berry damage was observed. Based on our results we recommend a more adapted plant protection regime for SMPH trained vines due to their higher susceptibility to the major fungal diseases. Furthermore, we propose a combination of SMPH and fungal resistant grapevine cultivars, e.g. 'Reberger', to achieve a more competitive, environmentally friendly and high quality grapevine production

Effect of Feeding Field Peas on Fresh Beef Quality

Th is study was conducted over two years to evaluate the use of field peas during two phases of production (grazing and finishing) on overall fresh beef quality. The backgrounding treatments included: no supplement, field peas, or dry- rolled corn and finishing treatments included the presence or absence of field peas. Loin samples (n = 232) were aged for 14 d and placed under retail display conditions for 7 d. Dietary treatments had no effect on tenderness (WBSF or SSF) or visual discoloration and minimal effects on objective color, lipid oxidation and fatty acid composition. These data indicate field peas may be used as an alternative feed for growing and finishing cattle with minimal to no negative impact on fresh meat quality

Effect of Feeding Field Peas on Fresh Beef Quality

Th is study was conducted over two years to evaluate the use of field peas during two phases of production (grazing and finishing) on overall fresh beef quality. The backgrounding treatments included: no supplement, field peas, or dry- rolled corn and finishing treatments included the presence or absence of field peas. Loin samples (n = 232) were aged for 14 d and placed under retail display conditions for 7 d. Dietary treatments had no effect on tenderness (WBSF or SSF) or visual discoloration and minimal effects on objective color, lipid oxidation and fatty acid composition. These data indicate field peas may be used as an alternative feed for growing and finishing cattle with minimal to no negative impact on fresh meat quality

Impact of Dietary Fat Source on Beef Display Life

This study was conducted to evaluate the effects of dietary fat source with modified distillers grains plus solubles (MDGS) on beef display life. Steers were fed either a corn control, full-fat MDGS, de-oiled MDGS, or de-oiled MDGS plus corn oil diet. Strip loins were aged for 2, 9, 16 and 23 days and placed under retail conditions for 7 days. Results suggest that feeding MDGS to cattle increases polyunsaturated fatty acid content of beef and has the potential to reduce beef color and lipid stability in comparison to corn diets. These data indicate that feeding MDGS to cattle may decrease beef display life. Addition of corn oil to de-oiled MDGS decreased redness and increased discoloration and lipid oxidation in comparison to corn control diets

Genetic diversity of Colletotrichum lupini and its virulence on white and Andean lupin

Lupin cultivation worldwide is threatened by anthracnose, a destructive disease caused by the seed- and air-borne fungal pathogen Colletotrichum lupini. In this study we explored the intraspecific diversity of 39 C. lupini isolates collected from different lupin cultivating regions around the world, and representative isolates were screened for their pathogenicity and virulence on white and Andean lupin. Multi-locus phylogeny and morphological characterizations showed intraspecific diversity to be greater than previously shown, distinguishing a total of six genetic groups and ten distinct morphotypes. Highest diversity was found across South America, indicating it as the center of origin of C. lupini. The isolates that correspond to the current pandemic belong to a genetic and morphological uniform group, were globally widespread, and showed high virulence on tested white and Andean lupin accessions. Isolates belonging to the other five genetic groups were mostly found locally and showed distinct virulence patterns. Two highly virulent strains were shown to overcome resistance of advanced white lupin breeding material. This stresses the need to be careful with international seed transports in order to prevent spread of currently confined but potentially highly virulent strains. This study improves our understanding of the diversity, phylogeography and pathogenicity of a member of one of the world’s top 10 plant pathogen genera, providing valuable information for breeding programs and future disease management

A surrogate method for comparison analysis of salivary concentrations of Xylitol-containing products

Background: Xylitol chewing gum has been shown to reduce Streptococcus mutans levels and decay. Two studies examined the presence and time course of salivary xylitol concentrations delivered via xylitol-containing pellet gum and compared them to other xylitol-containing products. Methods: A within-subjects design was used for both studies. Study 1, adults (N = 15) received three xylitol-containing products (pellet gum (2.6 g), gummy bears (2.6 g), and commercially available stick gum (Koolerz, 3.0 g)); Study 2, a second group of adults (N = 15) received three xylitol-containing products (pellet gum, gummy bears, and a 33% xylitol syrup (2.67 g). For both studies subjects consumed one xylitol product per visit with a 7-day washout between each product. A standardized protocol was followed for each product visit. Product order was randomly determined at the initial visit. Saliva samples (0.5 mL to 1.0 mL) were collected at baseline and up to 10 time points (~16 min in length) after product consumption initiated. Concentration of xylitol in saliva samples was analyzed using high-performance liquid chromatography. Area under the curve (AUC) for determining the average xylitol concentration in saliva over the total sampling period was calculated for each product. Results: In both studies all three xylitol products (Study 1: pellet gum, gummy bears, and stick gum; Study 2: pellet gum, gummy bears, and syrup) had similar time curves with two xylitol concentration peaks during the sampling period. Study 1 had its highest mean peaks at the 4 min sampling point while Study 2 had its highest mean peaks between 13 to 16 minutes. Salivary xylitol levels returned to baseline at about 18 minutes for all forms tested. Additionally, for both studies the total AUC for the xylitol products were similar compared to the pellet gum (Study 1: pellet gum - 51.3 [micro]g.min/mL, gummy bears - 59.6 [micro]g.min/mL, and stick gum - 46.4 [micro]g.min/mL; Study 2: pellet gum - 63.0 [micro]g.min/mL, gummy bears - 55.9 [micro]g.min/mL, and syrup - 59.0 [micro]g.min/mL). Conclusion: The comparison method demonstrated high reliability and validity. In both studies other xylitol-containing products had time curves and mean xylitol concentration peaks similar to xylitol pellet gum suggesting this test may be a surrogate for longer studies comparing various products.NIDCR-NIH U54 DE14254; Head Start, HRSA 90YD0188/03; and MCHB, HRSA R40MC03622-03

Genome‑wide association study reveals white lupin candidate gene involved in anthracnose resistance

White lupin (Lupinus albus L.) is a re-emerging protein crop and promising alternative to soybean. Its cultivation, however, is severely threatened by anthracnose disease caused by the fungal pathogen Colletotrichum lupini. To dissect the genetic architecture for anthracnose resistance, genotyping-by-sequencing (GBS) was performed on white lupin accessions collected from the center of domestication and traditional cultivation regions. GBS resulted in 4,611 high-quality single-nucleotide polymorphisms (SNPs) for 181 accessions, which were combined with resistance data observed under controlled conditions to perform a genome-wide association study (GWAS). Obtained disease phenotypes were shown to highly correlate to overall three-year disease assessments under Swiss field conditions (r > 0.8). GWAS results identified two significant SNPs associated with anthracnose resistance on gene Lalb_Chr05_g0216161 encoding a RING zinc-finger E3 ubiquitin ligase which is potentially involved in plant immunity. Population analysis showed a remarkably fast linkage disequilibrium (LD) decay, weak population structure and grouping of commercial varieties with landraces, corresponding to the slow domestication history and scarcity of modern breeding efforts in white lupin. Together with 15 highly resistant accessions identified in the resistance assay, our findings show promise for further crop improvement. This study provides the basis for marker-assisted selection, genomic prediction and studies aimed at understanding anthracnose resistance mechanisms in white lupin and contributes to improving breeding programs worldwide