10,515 research outputs found

    Modelling the healthcare costs of an opportunistic chlamydia screening programme.

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    OBJECTIVES: To estimate the average cost per screening offer, cost per testing episode and cost per chlamydia positive episode for an opportunistic chlamydia screening programme (including partner management), and to explore the uncertainty of parameter assumptions, based on the costs to the healthcare system. METHODS: A decision tree was constructed and parameterised using empirical data from a chlamydia screening pilot study and other sources. The model was run using baseline data from the pilot, and univariate and multivariate sensitivity analyses were conducted. RESULTS: The total estimated cost for offering screening over 12 months to 33,215 females aged 16-24 was 493,412 pounds . The average cost (with partner management) was 14.88 pounds per screening offer (90% credibility interval (CI) 10.34 to 18.56), 21.83 pounds per testing episode (90% CI 18.16 to 24.20), and 38.36 pounds per positive episode (90% CI 33.97 to 42.25). The proportion of individuals accepting screening, the clinician (general practitioner/nurse) time and their relative involvement in discussing screening, the test cost, the time to notify patients of their results, and the receptionist time recruiting patients had the greatest impact on the outcomes in both the univariate and multivariate sensitivity analyses. CONCLUSIONS: Results from this costing study may be used to inform resource allocation for current and future chlamydia screening programme implementation

    The effect of diabetes mellitus on portal blood hepatotrophic factors in dogs

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    Ten nondiabetic dogs were submitted to a procedure called splanchnic division which directed the nutrient rich venous return from the intestines into the left lobes of the liver and the hormone rich pancreatico gastroduodeno splenic venous return into the right lobes. Two mth later, the right lobes had undergone the expected gross and microscopic hypertrophy. Compared with the abnormal shrunken and glycogen depleted hepatocytes of the left lobes, the large and otherwise normal hepatocytes of the right lobes had a higher rate of cell division as judged by microscopic examination, measurements of deoxyribonucleic acid synthesis and the results of autoradiography. Both sides had greater cell replication than in the livers of normal unaltered dogs. The dominance of the right lobes following splanchnic division was almost completely eliminated by the prior creation of alloxan induced diabetes in 4 dogs and by the performance of total pancreatectomy at the same time as splanchnic division in 6 dogs. In these 10 diabetic dogs, which were treated with Sc administered insulin for the 2 mth period of the postoperative study, hepatic lobar and cell size were nearly equal on both sides. By light and electron microscopy, the hepatocytes on both sides had abnormalities, somewhat less pronounced on the right. However, the most active cell division was now transferred to the left lobes. The results with alloxan induced diabetes were similar to those after total pancreatectomy, except that lipid deposits were less on both liver sides in the alloxan experiments, and the glycogen was selectively reduced in the right lobes. The latter finding presumably was due to the continued action of glucagon in dogs made diabetic with alloxan. 12 nondiabetic dogs had a procedure called partial portacaval transposition which directed systemic venous blood from the hindquarters, kidneys and adrenal glands into the left lobes of the liver and the total splanchnic venous return into the right lobes. Two mth later, the degree of relative hypertrophy and hyperplasia of the glycogen rich right lobes was even greater than after splanchnic division, as was the morphologic damage to the left lobar hepatocytes. The degree of right lobar hypertrophy following partial portacaval transposition was reduced but not eliminated by pre existing alloxan induced diabetes in 4 dogs and by concomitant total pancreatectomy in 6 more dogs. The dogs were Sc treated with insulin. Structurally, the hepatocytes on the right side after 2 mth were in better condition than were those on the left, although both were abnormal. The dominance of cell division on the right side was reduced, as judged by standard microscopy and by autoradiography, but there was not a shifting of sides. The biochemical analyses reflected the presence or absence of glucagon. These findings are consistent with the earlier multifactorial hypothesis which holds that portal hepatotrophic factors are mainly interreacting hormones generated by splanchnic organs and delivered straight to the liver and that the hormone interrelationships might have augmented significance because of the high concentration of nutritional substrate in the same venous blood. The observations also substantiate by direct testing the suggestion that insulin is the most important hepatotrophic factor and that it profoundly affects many aspects of liver cell structure, division and function

    An experimental study of tomographic imaging in layered media

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    Ultrasonic tomography has found its applications in material evaluation since the later 70’s. However, the techniques in this field are far less developed compared to their x-ray counterparts, which have been widely used in the medical community. One of the practical problems in acoustic tomography is that acoustic waves will not necessarily propagate along straight paths in a nonhomogeneous medium. The situation will be more complicated when material inhomogeneities are coupled with anisotropy as the approach is applied to composite media. In order to resolve the situation, one has either to tolerate the consequence of using straight line ray paths or to seek a way to correct the errors due to ray bending. Indeed, most of the previous work in this area has been based on the straight path assumption. As pointed out by Dines and Lytle[1], if the material inhomogeneity is not serious, the errors caused by straight path assumption can be safely neglected. However, in practice, situations may arise where serious inhomogeneities exist. Even with small inhomogeneities correction is highly desirable when accuracy is of particular concern

    The effect of thermal variance on the phenotype of marine turtle offspring.

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    PublishedJournal ArticleTemperature can have a profound effect on the phenotype of reptilian offspring, yet the bulk of current research considers the effects of constant incubation temperatures on offspring morphology, with few studies examining the natural thermal variance that occurs in the wild. Over two consecutive nesting seasons, we placed temperature data loggers in 57 naturally incubating clutches of loggerhead sea turtles Caretta caretta and found that greater diel thermal variance during incubation significantly reduced offspring mass, potentially reducing survival of hatchlings during their journey from the nest to offshore waters and beyond. With predicted scenarios of climate change, behavioral plasticity in nest site selection may be key for the survival of ectothermic species, particularly those with temperature-dependent sex determination.We thank all the volunteers of the Marine Turtle Conservation Project (northern Cyprus) who aided in data collection during the 2011/2012 nesting seasons. This work would not have been possible without the Society for the Protection of Turtles (SPOT) and the Department for Environmental Protection. For their continued support we thank the British Chelonia Group, the British High Commission, the British Resident’s Society, Ektam Kıbrıs, Erwin Warth Foundation, Friends of SPOT, Gemini Dataloggers (UK), and Kuzey Kıbrıs Turkcell

    Detecting green shoots of recovery: The importance of long-term individual-based monitoring of marine turtles

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    This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordPopulation monitoring is an essential part of evaluating the effectiveness of management interventions for conservation. Coastal breeding aggregations of marine vertebrate species that come ashore to pup or nest provide an opportunistic window of observation into otherwise widely dispersed populations. Green turtle (Chelonia mydas) nesting on the north and west coasts of northern Cyprus has been monitored consistently and exhaustively since 1993, with an intensive saturation tagging programme running at one key site for the same duration. This historically depleted nesting population is showing signs of recovery, possibly in response to nest protection approaching two decades, with increasing nest numbers and rising levels of recruitment. Strong correlation between year-to-year magnitude of nesting and the proportion of new breeders in the nesting cohort implies that recruitment of new individuals to the breeding population is an important driver of this recovery trend. Recent changes in fishing activities may be impacting the local juvenile neritic stage, however, which may hinder this potential recovery. Individuals returning to breed after two years laid fewer clutches than those returning after three or four years, demonstrating a trade-off between remigration interval and breeding output. Average clutch frequencies have remained stable around a median of three clutches a year per female despite the demographic shift towards new nesters, which typically lay fewer clutches in their first season. We show that where local fecundity has been adequately assessed, the use of average clutch frequencies can be a reliable method for deriving nester abundance from nest counts. Index sites where individual-based monitoring is possible will be important in monitoring long-term climate driven changes in reproductive rates.European Social Fun

    Development and evaluation of a diagnostic cytokine-release assay for Mycobacterium suricattae infection in meerkats (Suricata suricatta)

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    CITATION: Clarke, C., et al. 2017. Development and evaluation of a diagnostic cytokine-release assay for mycobacterium suricattae infection in meerkats (Suricata suricatta). BMC Veterinary Research, 13:2, doi:10.1186/s12917-016-0927-x.The original publication is available at http://bmcvetres.biomedcentral.comBackground: Sensitive diagnostic tools are necessary for the detection of Mycobacterium suricattae infection in meerkats (Suricata suricatta) in order to more clearly understand the epidemiology of tuberculosis and the ecological consequences of the disease in this species. We therefore aimed to develop a cytokine release assay to measure antigen-specific cell-mediated immune responses of meerkats. Results: Enzyme-linked immunosorbent assays (ELISAs) were evaluated for the detection of interferon-gamma (IFN-γ) and IFN-γ inducible protein 10 (IP-10) in meerkat plasma. An IP-10 ELISA was selected to measure the release of this cytokine in whole blood in response to Bovigam® PC-HP Stimulating Antigen, a commercial peptide pool of M. bovis antigens. Using this protocol, captive meerkats with no known M. suricattae exposure (n = 10) were tested and results were used to define a diagnostic cut off value (mean plus 2 standard deviations). This IP-10 release assay (IPRA) was then evaluated in free-living meerkats with known M. suricattae exposure, categorized as having either a low, moderate or high risk of infection with this pathogen. In each category, respectively, 24.7%, 27.3% and 82.4% of animals tested IPRA-positive. The odds of an animal testing positive was 14.0 times greater for animals with a high risk of M. suricattae infection compared to animals with a low risk. Conclusion: These results support the use of this assay as a measure of M. suricattae exposure in meerkat populations. Ongoing longitudinal studies aim to evaluate the value of the IPRA as a diagnostic test of M. suricattae infection in individual animals.http://bmcvetres.biomedcentral.com/articles/10.1186/s12917-016-0927-xPublisher's versio

    Can sacrificial feeding areas protect aquatic plants from herbivore grazing? Using behavioural ecology to inform wildlife management

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    Effective wildlife management is needed for conservation, economic and human well-being objectives. However, traditional population control methods are frequently ineffective, unpopular with stakeholders, may affect non-target species, and can be both expensive and impractical to implement. New methods which address these issues and offer effective wildlife management are required. We used an individual-based model to predict the efficacy of a sacrificial feeding area in preventing grazing damage by mute swans (Cygnus olor) to adjacent river vegetation of high conservation and economic value. The accuracy of model predictions was assessed by a comparison with observed field data, whilst prediction robustness was evaluated using a sensitivity analysis. We used repeated simulations to evaluate how the efficacy of the sacrificial feeding area was regulated by (i) food quantity, (ii) food quality, and (iii) the functional response of the forager. Our model gave accurate predictions of aquatic plant biomass, carrying capacity, swan mortality, swan foraging effort, and river use. Our model predicted that increased sacrificial feeding area food quantity and quality would prevent the depletion of aquatic plant biomass by swans. When the functional response for vegetation in the sacrificial feeding area was increased, the food quantity and quality in the sacrificial feeding area required to protect adjacent aquatic plants were reduced. Our study demonstrates how the insights of behavioural ecology can be used to inform wildlife management. The principles that underpin our model predictions are likely to be valid across a range of different resource-consumer interactions, emphasising the generality of our approach to the evaluation of strategies for resolving wildlife management problems

    High-Temperature Transport Properties of Yb4−xSmxSb3

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    Polycrystalline L4Sb3 (L = La, Ce, Sm, and Yb) and Yb4−x Sm x Sb3, which crystallizes in the anti-Th3P4 structure type (I-43d no. 220), were synthesized via high-temperature reaction. Structural and chemical characterization were performed by x-ray diffraction and electronic microscopy with energy-dispersive x-ray analysis. Pucks were densified by spark plasma sintering. Transport property measurements showed that these compounds are n-type with low Seebeck coefficients, except for Yb4Sb3, which shows semimetallic behavior with hole conduction above 523 K. By partially substituting Yb by a trivalent rare earth we successfully improved the thermoelectric figure of merit of Yb4Sb3 up to 0.7 at 1273 K
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