Evidence of a high incidence of subclinically affected calves in a herd of cattle with fatal cases of Bovine Neonatal Pancytopenia (BNP).

BACKGROUND: Bovine Neonatal Pancytopenia (BNP) is a disease of calves characterised by bone marrow trilineage hypoplasia, mediated by ingestion of alloantibodies in colostrum. Suspected subclinical forms of BNP have been reported, suggesting that observed clinical cases may not represent the full extent of the disease. However to date there are no objective data available on the incidence of subclinical disease or its temporal distribution. This study aimed to 1) ascertain whether subclinical BNP occurs and, if so, to determine the incidence on an affected farm and 2) determine whether there is evidence of temporal clustering of BNP cases on this farm. To achieve these aims, haematological screening of calves born on the farm during one calving season was carried out, utilising blood samples collected at defined ages. These data were then analysed in comparison to data from both known BNP-free control animals and histopathologically confirmed BNP cases. An ordinal logistic regression model was used to create a composite haematology score to predict the probabilities of calves being normal, based on their haematology measurements at 10–14 days old. RESULTS: This study revealed that 15% (21 of 139) of the clinically normal calves on this farm had profoundly abnormal haematology (<5% chance of being normal) and could be defined as affected by subclinical BNP. Together with clinical BNP cases, this gave the study farm a BNP incidence of 18%. Calves with BNP were found to be distributed throughout the calving period, with no clustering, and no significant differences in the date of birth of cases or subclinical cases were found compared to the rest of the calves. This study did not find any evidence of increased mortality or increased time from birth to sale in subclinical BNP calves but, as the study only involved a single farm and adverse effects may be determined by other inter-current diseases it remains possible that subclinical BNP has a detrimental impact on the health and productivity of calves under certain circumstances. CONCLUSIONS: Subclinical BNP was found to occur at a high incidence in a herd of cattle with fatal cases of BNP

Temporal patterns in habitat use by small cetaceans at an oceanographically dynamic marine renewable energy test site in the Celtic Sea

Shelf-seas are highly dynamic and oceanographically complex environments, which likely influences the spatio-temporal distributions of marine megafauna such as marine mammals. As such, understanding natural patterns in habitat use by these animals is essential when attempting to ascertain and assess the impacts of anthropogenically induced disturbances, such as those associated with marine renewable energy installations (MREIs). This study uses a five year (2009–2013) passive acoustics (C-POD) dataset to examine the use of an oceanographically dynamic marine renewable energy test site by small cetaceans, dolphins (unspecified delphinids) and harbour porpoises Phocoena phocoena, in the southern Celtic Sea. To examine how temporal patterns in habitat use across the site related to oceanographic changes occurring over broad seasonal scales as well as those driven by fine scale (bi-weekly) localised processes (that may be masked by seasonal trends), separate analyses were conducted using (1) all daily animal detection rates spanning the entire five year dataset and (2) daily animal detection rates taken only during the summer months (defined as mid-June to mid-October) of 2010 (when continuous monitoring was carried out at multiple discrete locations across the site). In both instances, generalised additive mixed effects models (GAMMs) were used to link detection rates to a suite of environmental variables representative of the oceanography of the region. We show that increased harbour porpoise detection rates in the late winter/early spring (January–March) are associated with low sea surface temperatures (SST), whilst peaks in dolphin detection rates in the summer (July–September) coincide with increased SSTs and the presence of a tidal-mixing front. Moreover, across the summer months of 2010, dolphin detection rates were found to respond to small scale changes in SST and position in the spring-neap cycle, possibly reflective of a preference for the stratified waters immediately offshore of the front. Together, these findings suggest that habitat use by small cetaceans within shelf-seas is temporally variable, species specific and likely driven by complex bottom-up processes. As such, the effective conservation management of shelf-seas requires that we understand the dynamic complexities of these systems and the species that inhabit them. In particular, we emphasise the need for a good understanding of the natural drivers of habitat use by marine megafauna before the potential impacts of anthropogenically induced disturbances, such as those associated with the construction, maintenance and operation of MREIs, can be assessed

Continuously Tuneable Critical Current in Superconductor-Ferromagnet Multilayers

We demonstrate that the critical current of superconducting Nb/Ni multilayers can be continuously tuned by up to a factor of three during magnetization reversal of the Ni films under an applied in-plane magnetic field. Our observations are in reasonably good agreement with a model of vortex pinning by Bloch domain walls that proliferate in the samples during magnetization reversal, whereby each vortex interacts with at most one wall in any of the Ni layers. Our model suggests ways in which the controllable pinning effect could be significantly enhanced, with important potential applications in tuneable superconducting devices

What do we know about emotional labour in nursing? A narrative review

Nurses have to manage their emotions and the expression of emotion to perform best care, and their behaviours pass through emotional labour (EL). However, EL seems to be an under-appreciated aspect of caring work and there is no synthetic portrait of literature about EL in the nursing profession. This review was conducted to synthesise and to critically analyse the literature in the nursing field related to EL. Twenty-seven papers were included and analysed with a narrative approach, where two main themes were found: EL strategies and EL antecedents and consequences. Hence, EL is a multidimensional, complex concept and it represents a nursing competence to provide the best care. Moreover, nurses have a high awareness of EL as a professional competence, which is a fundamental element to balance engagement with an appropriate degree of detachment to accomplish tasks for best practice, and to provide high-quality patient care

Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Childhood asthma is common in Cape Town, a province of South Africa, but is underdiagnosed by general practitioners. Medications are often prescribed inappropriately, and care is episodic. The objective of this study is to assess the impact of educational outreach to general practitioners on asthma symptoms of children in their practice.</p> <p>Methods</p> <p>This is a cluster randomised trial with general practices as the unit of intervention, randomisation, and analysis. The setting is Mitchells Plain (population 300,000), a dormitory town near Cape Town. Solo general practitioners, without nurse support, operate from storefront practices. Caregiver-reported symptom data were collected for 318 eligible children (2 to 17 years) with moderate to severe asthma, who were attending general practitioners in Mitchells Plain. One year post-intervention follow-up data were collected for 271 (85%) of these children in all 43 practices.</p> <p>Practices randomised to intervention (21) received two 30-minute educational outreach visits by a trained pharmacist who left materials describing key interventions to improve asthma care. Intervention and control practices received the national childhood asthma guideline. Asthma severity was measured in a parent-completed survey administered through schools using a symptom frequency and severity scale. We compared intervention and control group children on the change in score from pre-to one-year post-intervention.</p> <p>Results</p> <p>Symptom scores declined an additional 0.84 points in the intervention vs. control group (on a nine-point scale. p = 0.03). For every 12 children with asthma exposed to a doctor allocated to the intervention, one extra child will have substantially reduced symptoms.</p> <p>Conclusion</p> <p>Educational outreach was accepted by general practitioners and was effective. It could be applied to other health care quality problems in this setting.</p

Bioclimatic rehabilitation of an open market place by a computational fluid dynamics simulation assessment

These days urban design of open spaces is strongly related to bioclimatic techniques and practices. It is here presented the procedure of a bioclimatic study by the use of simulation tools. The area of an open market place is characterized of decreased human thermal comfort conditions during summer time. The employment of computational fluid dynamics has contributed in the understanding of what interventions should be made at the open space in order to succeed the defined thermal related targets. Table of the proposed rehabilitation explains what the interventions would contribute in the improvement of the local environment.The authors greatly acknowledge the support of the Mayor of Eordaia Mrs Paraskevi Vrizidou during all simulation stages. ANSYS-CFD simulations were carried out in the framework of student instruction and demonstration of the Department of Environmental Engineering, Democritus University of Thrace in Greece

Mechanism of PP2A-mediated IKKβ dephosphorylation: a systems biological approach

BACKGROUND: Biological effects of nuclear factor-kappaB (NF kappaB) can differ tremendously depending on the cellular context. For example, NF kappaB induced by interleukin-1 (IL-1) is converted from an inhibitor of death receptor induced apoptosis into a promoter of ultraviolet-B radiation (UVB)-induced apoptosis. This conversion requires prolonged NF kappaB activation and is facilitated by IL-1 + UVB-induced abrogation of the negative feedback loop for NF kappaB, involving a lack of inhibitor of kappaB (I kappaB alpha) protein reappearance. Permanent activation of the upstream kinase IKK beta results from UVB-induced inhibition of the catalytic subunit of Ser-Thr phosphatase PP2A (PP2Ac), leading to immediate phosphorylation and degradation of newly synthesized I kappaB alpha. RESULTS: To investigate the mechanism underlying the general PP2A-mediated tuning of IKK beta phosphorylation upon IL-1 stimulation, we have developed a strictly reduced mathematical model based on ordinary differential equations which includes the essential processes concerning the IL-1 receptor, IKK beta and PP2A. Combining experimental and modelling approaches we demonstrate that constitutively active, but not post-stimulation activated PP2A, tunes out IKK beta phosphorylation thus allowing for I kappaB alpha resynthesis in response to IL-1. Identifiability analysis and determination of confidence intervals reveal that the model allows reliable predictions regarding the dynamics of PP2A deactivation and IKK beta phosphorylation. Additionally, scenario analysis is used to scrutinize several hypotheses regarding the mode of UVB-induced PP2Ac inhibition. The model suggests that down regulation of PP2Ac activity, which results in prevention of I kappaB alpha reappearance, is not a direct UVB action but requires instrumentality. CONCLUSION: The model developed here can be used as a reliable building block of larger NF kappa B models and offers comprehensive simplification potential for future modeling of NF kappa B signaling. It gives more insight into the newly discovered mechanisms for IKK deactivation and allows for substantiated predictions and investigation of different hypotheses. The evidence of constitutive activity of PP2Ac at the IKK complex provides new insights into the feedback regulation of NF kappa B, which is crucial for the development of new anti-cancer strategies

Acupuncture for the Treatment of Dry Eye: A Multicenter Randomised Controlled Trial with Active Comparison Intervention (Artificial Teardrops)

To evaluate the effects of acupuncture compared to a control group using artificial tears.multicenter randomised controlled trial (three local research hospitals of South Korea).150 patients with moderate to severe dry eye.Participants were randomly allocated into four weeks of acupuncture treatment (bilateral BL2, GB14, TE 23, Ex1, ST1, GB20, LI4, LI11 and single GV23) or to the artificial tears group (sodium carboxymethylcellulose).The ocular surface disease index (OSDI), tear film break-up time (TFBUT), Schirmer Ι test, visual analogue scale (VAS) for self-assessment of ocular discomfort, general assessment (by both acupuncture practitioners and participants) and quality of life (QOL) through the Measure Yourself Medical Outcome Profile-2 (MYMOP-2).There was no statistically significant difference between two groups for the improvement of dry eye symptoms as measured by OSDI (MD -16.11, 95% CI [-20.91, -11.32] with acupuncture and -15.37, 95% CI [-19.57, -11.16] with artificial tears; P = 0.419), VAS (acupuncture: -23.84 [-29.59, -18.09]; artificial tears: -22.2 [-27.24, -17.16], P = 0.530) or quality of life (acupuncture: -1.32 [-1.65, -0.99]; artificial tears: -0.96 [-1.32, -0.6], P = 0.42) immediately after treatment. However, compared with artificial tears group, the OSDI (acupuncture: -16.15 [-21.38, -10.92]; artificial tears: -10.76 [-15.25, -6.27], P = 0.030) and VAS (acupuncture: -23.88 [-30.9, -16.86]; artificial tears: -14.71 [-20.86, -8.55], P = 0.018) were significantly improved in the acupuncture group at 8 weeks after the end of acupuncture treatment. TFBUT measurements increased significantly in the acupuncture group after treatment.Acupuncture may have benefits on the mid-term outcomes related to dry eye syndrome compared with artificial tears.ClinicalTrials.gov NCT01105221

Multi-class glioma segmentation on real-world data with missing MRI sequences: comparison of three deep learning algorithms

This study tests the generalisability of three Brain Tumor Segmentation (BraTS) challenge models using a multi-center dataset of varying image quality and incomplete MRI datasets. In this retrospective study, DeepMedic, no-new-Unet (nn-Unet), and NVIDIA-net (nv-Net) were trained and tested using manual segmentations from preoperative MRI of glioblastoma (GBM) and low-grade gliomas (LGG) from the BraTS 2021 dataset (1251 in total), in addition to 275 GBM and 205 LGG acquired clinically across 12 hospitals worldwide. Data was split into 80% training, 5% validation, and 15% internal test data. An additional external test-set of 158 GBM and 69 LGG was used to assess generalisability to other hospitals’ data. All models’ median Dice similarity coefficient (DSC) for both test sets were within, or higher than, previously reported human inter-rater agreement (range of 0.74–0.85). For both test sets, nn-Unet achieved the highest DSC (internal = 0.86, external = 0.93) and the lowest Hausdorff distances (10.07, 13.87 mm, respectively) for all tumor classes (p < 0.001). By applying Sparsified training, missing MRI sequences did not statistically affect the performance. nn-Unet achieves accurate segmentations in clinical settings even in the presence of incomplete MRI datasets. This facilitates future clinical adoption of automated glioma segmentation, which could help inform treatment planning and glioma monitoring

Effects of baricitinib on radiographic progression of structural joint damage at 1 year in patients with rheumatoid arthritis and an inadequate response to conventional synthetic disease-modifying antirheumatic drugs

Background: Baricitinib was efficacious in a 24-week phase III study in patients with rheumatoid arthritis (RA) and an inadequate response to conventional synthetic disease-modifying anti rheumatic drugs (DMARDs) (csDMARDs) (RA-BUILD). Objectives: To evaluate radiographic progression of structural joint damage in RA-BUILD patients over 48 weeks of baricitinib treatment in the long-term extension study, RA-BEYOND. Methods: In RA-BUILD, patients were randomised to placebo, baricitinib 2 mg or 4 mg once daily, with rescue possible from week 16. Patients completing RA-BUILD and entering RA-BEYOND continued to receive the baricitinib dose received at the end of RA-BUILD. Patients receiving placebo were switched to baricitinib 4 mg in RA-BEYOND. Joint damage was measured using the van der Heijde modified total Sharp score. To account for missing scores and scores obtained after rescue, switch or discontinuation of study drug, data were analysed using (1) linear extrapolation (LE) and (2) observed/last observation carried forward (LOCF). The observed/LOCF method used all available observed data, including after rescue or switch, with patients analysed according to original treatment assignment. Results: Using LE, radiographic progression at 24 and 48 weeks was statistically significantly lower for both baricitinib 2 or 4 mg compared with placebo. Only baricitinib 4 mg demonstrated statistically significant inhibition of progressive radiographic joint damage compared with patients initially randomised to placebo using observed/LOCF at week 48. Conclusions: Once daily oral baricitinib inhibited radiographic progression of structural joint damage in patients with an inadequate response or intolerance to csDMARDs over 48 weeks. The most robust benefit was seen for the 4 mg dose