Carrion Beetles (Coleoptera: Silphidae) of Wisconsin

The first comprehensive faunal survey of the carrion beetles (Coleoptera: Silphidae) of Wisconsin is presented. Six genera and 14 species are recorded from the state, including a new state record, Heterosilpha ramosa (Say). Nicrophorus americanus Olivier was not recovered during this study. An annotated checklist includes species-specific geographical and temporal distributions, remarks on foods and habitat, and counties of specimen collections for each species

Implementing IPE in an Academic Health Science Center: changing Attitudes, Beliefs, & Knowledge

Completion of 3-year pilot Interprofessional Education Program involving graduate students in an Academic Health Science Center yielded pre- and post-program evaluations of attitudes, beliefs, and knowledge of students and faculty. This session offers a description of a program without curricular level changes, presentation of research outcomes, and resulting planned modifications

Cleft Lip and/or Palate in Infants Prenatally Exposed to Opioids

Objective: To determine the prevalence and odds ratios for cleft lip and/or palate (CL/P) among infants prenatally exposed to opioids with or without neonatal opioid withdrawal syndrome (NOWS). Design: This study represents an exploratory, retrospective cohort study design of newborn medical health records from 2011 to 2016. Setting: Records were drawn from a regional health system located in South Central Appalachia. Population and study sample: The original population yielded 3 cohorts of infants: (1) infants with opioid exposure (OE) but not requiring pharmacological intervention (OE; N = 168); (2) infants with NOWS requiring pharmacological intervention (N = 294); and (3) infants with no opioid exposure (NOE; N = 16 090), the primary comparison group. Main outcome: Infants in the NOWS and OE groups showed significantly increased prevalence and odds ratios for CL/P when compared to those in the NOE group. Results: Prevalence rates per 1000 live births for infants with OE (35.71) and infants with NOWS (6.80) were significantly higher than those for infants with NOE (1.37). Comparison of infants with OE to the NOE group revealed significantly increased odds for CL/P, isolated cleft palate (CP), cleft lip (CL), and cleft lip and palate (CLP) (27.05, 41.81, 19.26, 19.37, respectively; all Ps \u3c .008). The odds ratios for infants with NOWS compared to the NOE group were significantly higher for CL/P and CP (5.00 and 10.98, respectively; Ps \u3c .03) but not for CL and CLP. Conclusion: The results provide additional evidence that prenatal OE should be considered among the critical environmental risk factors that can contribute to CL/P

Designing whole-systems commissioning: lessons from the English experience

The paucity of formal evidence, allied to the requirement for strategies that are sensitive to local history and context, means that a ‘blueprint’ for successful strategic commissioning is not currently available for adoption. We are therefore confined to proposing ‘design principles’ for those seeking to embark upon a transition towards a whole systems approach to strategic commissioning. People and relationships are of critical importance all the way through the chain from strategic commissioning to micro-commissioning. Most crucially, experience suggests that structural solutions alone cannot deliver effective relationships and will not be effective when relationships are neglected. The need to ensure staff, partner and political buy-in suggests that relationship management and consensus-building are an integral component of the leadership role in moving toward strategic commissioning. As with any major re-organisation, the move to strategic commissioning is essentially a change management initiative and therefore will stand or fall according to whether it adheres to good practice in the change management process. Central to this, and to achieving commissioning outcomes, is the requirement for meaningful service user and public engagement. Effective commissioning emphasizes individual capabilities as well as needs, and community assets as well as deficits and problems. Adoption of strategic commissioning approaches is still at the developmental and learning stage and arguably all structural arrangements should be regarded as transitional

Targeting colorectal cancer with anti-epidermal growth factor receptor antibodies: focus on panitumumab

The tumor biology targeted therapies have improved outcomes in colorectal cancer (CRC). The epidermal growth factor receptor (EGFR) inhibitors represent one of these successful strategies. EGFR is frequently overexpressed in CRCs and associated with a malignant phenotype. Two EGFR inhibitors have shown efficacy in metastatic CRC, cetuximab and panitumumab. Cetuximab is a human–mouse chimeric monoclonal antibody that binds to the extracellular domain of the EGF-receptor. Similarly, panitumumab is a fully humanized monoclonal IgG2 antibody, directed against EGFR. Being fully humanized, panitumumab does not contain mouse protein reducing the risk of hypersensitivity. In a pivotal clinical trial, panitumumab was well tolerated and effective, demonstrating an objective response rate of 10% vs best supportive care (ORR = 0%; P < 0.0001). Panitumumab was approved for the treatment of mCRC by the FDA in 2006. Studies combining panitumumab with cytotoxic chemotherapy and other targeted therapies have been completed while others are ongoing to further evaluate the clinical utility of this agent. Recently it has been demonstrated that mutations in KRAS predict the efficacy of panitumumab and cetuximab, limiting their use to CRC patients with wild-type KRAS, and moving the clinical field towards personalized cancer care

Health Disparities in Low Income Areas

The goal of our presentation is to discuss the healthcare disadvantages within lower income areas within the Unites States. It has been found that dependent upon the area in which an individual lives, their access to various forms of healthcare can be scarce and practically non-beneficial to them. Throughout our presentation, we hope to not only bring awareness to this unfortunate issue but also focus and incorporate ways in which healthcare professionals, such as nurses, can take initiative and help to give the community the healthcare needed to survive and maintain

Analysis of the 2007/8 Defra Farm Business Survey Energy Module

Key points This study has delivered an invaluable baseline estimate of energy use and greenhouse gas (GHG) emissions on commercial farms in England. Energy use and GHG emissions associated with particular commodities were quantified and results broadly agreed with those derived by Life Cycle Assessment, but with much scatter in the environmental performance of farms.Direct energy use on farms was generally less that indirect (embedded) energy use, except for horticulture, which is dominated by heating fuel use. In contrast, most GHG emissions are incurred on farms, rather than as embedded emissions.Scatter in both environmental and economic performance underlies the somewhat disappointing finding of no clear positive link between farm financial performance and energy use or GHG emissions. However, the mere existence of these ranges shows that there is scope for improvement in both financial and environmental performance and that there is no apparent barrier for both to be achievable in harmony. The recording of such farm-level energy data is essential for the future, as it should enable improvements to be made in efficiency of energy use. The improved UK agricultural GHG inventory will depend on high quality energy data on agricultural activities. This study will be invaluable in identifying the level of detail needed. Future data requirements include: contractor work rates and fuel use per unit area and per unit time, fertiliser and pesticide use by brand name, enhanced output data, especially animal live weights, and horticultural produce recorded by weight rather than by value

Does a 4–6 Week Shoeing Interval Promote Optimal Foot Balance in the Working Equine?

Variation in equine hoof conformation between farriery interventions lacks research, despite associations with distal limb injuries. This study aimed to determine linear and angular hoof variations pre- and post-farriery within a four to six week shoeing/trimming interval. Seventeen hoof and distal limb measurements were drawn from lateral and anterior digital photographs from 26 horses pre- and post-farriery. Most lateral view variables changed significantly. Reductions of the dorsal wall, and weight bearing and coronary band lengths resulted in an increased vertical orientation of the hoof. The increased dorsal hoof wall angle, heel angle, and heel height illustrated this further, improving dorsopalmar alignment. Mediolateral measurements of coronary band and weight bearing lengths reduced, whilst medial and lateral wall lengths from the 2D images increased, indicating an increased vertical hoof alignment. Additionally, dorsopalmar balance improved. However, the results demonstrated that a four to six week interval is sufficient for a palmer shift in the centre of pressure, increasing the loading on acutely inclined heels, altering DIP angulation, and increasing the load on susceptible structures (e.g., DDFT). Mediolateral variable asymmetries suit the lateral hoof landing and unrollment pattern of the foot during landing. The results support regular (four to six week) farriery intervals for the optimal prevention of excess loading of palmar limb structures, reducing long-term injury risks through cumulative, excessive loading