Cross infection control measures and the treatment of patients at risk of Creutzfeldt Jakob disease in UK general dental practice

AIMS: To determine the suitability of key infection control measures currently employed in UK dental practice for delivery of dental care to patients at risk of prion diseases. MATERIALS AND METHODS: Subjects: Five hundred dental surgeons currently registered with the General Dental Council of the UK. Data collection: Structured postal questionnaire. Analysis: Frequencies, cross-tabulations and chi-squared analysis. RESULTS: The valid response rate to the questionnaire was 69%. 33% of practices had no policy on general disinfection and sterilisation procedures. Only 10 of the 327 responding practices (3%) possessed a vacuum autoclave. 49% of dentists reported using the BDA medical history form but less than 25% asked the specific questions recommended by the BDA to identify patients at risk of iatrogenic or familial CJD. However, 63% of practitioners would refer such patients, if identified, to a secondary care facility. Of the 107 practitioners who were prepared to provide dental treatment, 75 (70%) would do so using routine infection control procedures. CONCLUSIONS: Most of the dental practices surveyed were not actively seeking to identify patients at risk of prion diseases. In many cases, recommended procedures for providing safe dental care for such patients were not in place

Oocyte donor age has a significant impact on oocyte recipients' cumulative live-birth rate: a population-based cohort study

© 2019 Objective: To study the impact of the donor's and recipient's age on the cumulative live-birth rate (CLBR) in oocyte donation cycles. Design: A population-based retrospective cohort study. Setting: Not applicable. Patient(s): All women using donated oocytes (n = 1,490) in Victoria, Australia, between 2009 and 2015. Intervention(s): None. Main Outcome Measure(s): The association between the donor's and recipient's age and CLBR modeled by multivariate Cox proportional hazard regression with the covariates of male partner's age, recipient parity, and cause of infertility adjusted for, and donor age grouped as <30, 30–34, 35–37, 38–40, and ≥41 years, and recipient age as <35, 35–37, 38–40, 41–42, 43–44, and ≥45 years. Result(s): The mean age of the oocyte donors was 33.7 years (range: 21 to 45 years) with 49% aged 35 years and over. The mean age of the oocyte recipients was 41.4 years (range: 19 to 53 years) with 25.4% aged ≥45 years. There was a statistically significant relationship between the donor's age and the CLBR. The CLBR for recipients with donors aged <30 years and 30–34 years was 44.7% and 43.3%, respectively. This decreased to 33.6% in donors aged 35–37 years, 22.6% in donors aged 38–40 years, and 5.1% in donors aged ≥41 years. Compared with recipients with donors aged <30 years, the recipients with donors aged 38–40 years had 40% less chance of achieving a live birth (adjusted hazard ratio 0.60; 95% CI, 0.43–0.86) and recipients with donors aged ≥41 years had 86% less chance of achieving a live birth (adjusted hazard ratio 0.14; 95% CI, 0.04–0.44). The multivariate analysis showed no statistically significant effect of the recipient's age on CLBR. Conclusion(s): We have demonstrated that the age of the oocyte donor is critical to the CLBR and is independent of the recipient woman's age. Recipients using oocytes from donors aged ≥35 years had a statistically significantly lower CLBR when compared with recipients using oocytes from donors aged <35 years

A SIMPLE-MODEL OF ROSSBY-WAVE HYDRAULIC BEHAVIOR

This paper considers hydraulic control and upstream influence in systems where the only wave propagation mechanism arises from the variation of vorticity or potential vorticity. These systems include two-dimensional shear flows as well as many simple paradigms for large-scale geophysical flows. The simplest is a flow in which the vorticity or potential vorticity is piecewise constant. We consider such a flow confined to a rotating channel and disturbed by a topographic perturbation. We analyse the behaviour of the system using steady nonlinear long-wave theory and demonstrate that it exhibits behaviour analogous to open-channel hydraulics, with the possibility of different upstream and downstream states. The manner by which the system achieves such states is examined using time-dependent long-wave theory via integration along characteristics and using full numerical solution via the contour-dynamics technique.The full integrations agree well with the hydraulic interpretation of the steady-state theory. One aspect of the behaviour of the system that is not seen in open-channel hydraulics is that for strong subcritical flows there is a critical topographic amplitude beyond which information from the control cannot propagate far upstream. Instead flow upstream of the topographic perturbation adjusts until the long-wave speed is zero, the control moves to the leading edge of the obstacle and flow downstream of the control is supercritical, with a transition from one supercritical branch to another on the downstream slope of the obstacle

Staff unavailability and safe staffing: Are headroom allowances 'realistic'?

Background “Hours per patient day” (HPPD) is an internationally recognised resourcing metric used to measure direct nursing care hours. However, hospitals often under-estimate indirect time (unavailability) and specify unrealistic targets for planned unavailability (“headroom”). Aims To investigate the disparities between planned unavailability (“headroom”) and actual staff unavailability. Methods Data were collected from the e-rostering systems of 87 NHS Trusts. This was compared with published data from 35 roster policies. Results Many hospitals use headroom as a Key Performance Indicator (KPI) and set targets for its components in their roster policies. This research highlights large variations in unavailability (15.8% to 33.6%) and lower variations in headroom (16-26%). Conclusions Hospitals operationalise headroom around an idealised ‘target’ value. This may be detrimental. Compelling a unit with unavailability between 28-30%, to adopt an institution-wide headroom of, say, 22% may, at best, increase spending on bank/agency staff, or, at worse, jeopardise patient safety

Self-repair ability of evolved self-assembling systems in cellular automata

Self-repairing systems are those that are able to reconfigure themselves following disruptions to bring them back into a defined normal state. In this paper we explore the self-repair ability of some cellular automata-like systems, which differ from classical cellular automata by the introduction of a local diffusion process inspired by chemical signalling processes in biological development. The update rules in these systems are evolved using genetic programming to self-assemble towards a target pattern. In particular, we demonstrate that once the update rules have been evolved for self-assembly, many of those update rules also provide a self-repair ability without any additional evolutionary process aimed specifically at self-repair

Perceptual Compressive Sensing

Compressive sensing (CS) works to acquire measurements at sub-Nyquist rate and recover the scene images. Existing CS methods always recover the scene images in pixel level. This causes the smoothness of recovered images and lack of structure information, especially at a low measurement rate. To overcome this drawback, in this paper, we propose perceptual CS to obtain high-level structured recovery. Our task no longer focuses on pixel level. Instead, we work to make a better visual effect. In detail, we employ perceptual loss, defined on feature level, to enhance the structure information of the recovered images. Experiments show that our method achieves better visual results with stronger structure information than existing CS methods at the same measurement rate.Comment: Accepted by The First Chinese Conference on Pattern Recognition and Computer Vision (PRCV 2018). This is a pre-print version (not final version

Visual art inspired by the collective feeding behavior of sand-bubbler crabs

Sand--bubblers are crabs of the genera Dotilla and Scopimera which are known to produce remarkable patterns and structures at tropical beaches. From these pattern-making abilities, we may draw inspiration for digital visual art. A simple mathematical model is proposed and an algorithm is designed that may create such sand-bubbler patterns artificially. In addition, design parameters to modify the patterns are identified and analyzed by computational aesthetic measures. Finally, an extension of the algorithm is discussed that may enable controlling and guiding generative evolution of the art-making process

Reproducibility of cutaneous vascular conductance responses to slow local heating assessed using 7-laser array probes.

OBJECTIVE: Gradual local heating of the skin induces a largely nitric oxide(NO)-mediated vasodilatation. However, use of this assessment of microvascular health is limited because little is known about its reproducibility. METHODS: Healthy volunteers (n=9) reported twice to the laboratory. Cutaneous vascular conductance (CVC), derived from laser Doppler flux and mean arterial pressure, was examined in response to a standardised local heating protocol (0.5°C per 150s from 33-42°C, followed by 20-minutes at 44°C). Skin responses were examined at two locations on the forearm (between-site). Heating was repeated after a break of 24-72 hours (between-day). Reproducibility of skin-responses at 33-42°C is presented for absolute CVC and relative CVC-responses corrected for maximal CVC at 44°C (%CVCmax ). RESULTS: Between-day reproducibility of baseline CVC and %CVCmax for both sites was relatively poor (22-30%). At 42°C, CVC and %CVCmax responses showed less variation (9-19%), whilst absolute CVC-responses at 44°C were 14-17%. Between-day variation for %CVCmax increased when using data from site 1 on day 1, but site 2 on the subsequent day (25%). CONCLUSION: Day-to-day reproducibility of baseline laser Doppler-derived skin perfusion responses is poor, but acceptable when absolute and relative skin perfusion to a local gradual heating protocol is utilised and site-to-site variation is minimised. This article is protected by copyright. All rights reserved

Directional emission of light from a nano-optical Yagi-Uda antenna

The plasmon resonance of metal nanoparticles can enhance and direct light from optical emitters in much the same way that radio frequency (RF) antennas enhance and direct the emission from electrical circuits. In the RF regime, a typical antenna design for high directivity is the Yagi-Uda antenna, which basically consists of a one-dimensional array of antenna elements driven by a single feed element. Here, we present the experimental demonstration of directional light emission from a nano-optical Yagi-Uda antenna composed of an array of appropriately tuned gold nanorods. Our results indicate that nano-optical antenna arrays are a simple but efficient tool for the spatial control of light emission.Comment: 4 pages, including 4 figure