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Early in a foodborne disease outbreak investigation, illness incubation periods can help focus case interviews, case definitions, clinical and environmental evaluations and predict an aetiology. Data describing incubation periods are limited. We examined foodborne disease outbreaks from laboratory-confirmed, single aetiology, enteric bacterial and viral pathogens reported to United States foodborne disease outbreak surveillance from 1998–2013. We grouped pathogens by clinical presentation and analysed the reported median incubation period among all illnesses from the implicated pathogen for each outbreak as the outbreak incubation period. Outbreaks from preformed bacterial toxins (Staphylococcus aureus, Bacillus cereus and Clostridium perfringens) had the shortest outbreak incubation periods (4–10 h medians), distinct from that of Vibrio parahaemolyticus (17 h median). Norovirus, salmonella and shigella had longer but similar outbreak incubation periods (32–45 h medians); campylobacter and Shiga toxin-producing Escherichia coli had the longest among bacteria (62–87 h medians); hepatitis A had the longest overall (672 h median). Our results can help guide diagnostic and investigative strategies early in an outbreak investigation to suggest or rule out specific etiologies or, when the pathogen is known, the likely timeframe for exposure. They also point to possible differences in pathogenesis among pathogens causing broadly similar syndromes.
Feed represents a substantial proportion of production costs in the dairy industry and is a useful target for improving overall system efficiency and sustainability. The objective of this study was to develop methodology to estimate the economic value for a feed efficiency trait and the associated methane production relevant to Canada. The approach quantifies the level of economic savings achieved by selecting animals that convert consumed feed into product while minimizing the feed energy used for inefficient metabolism, maintenance and digestion. We define a selection criterion trait called Feed Performance (FP) as a 1 kg increase in more efficiently used feed in a first parity lactating cow. The impact of a change in this trait on the total lifetime value of more efficiently used feed via correlated selection responses in other life stages is then quantified. The resulting improved conversion of feed was also applied to determine the resulting reduction in output of emissions (and their relative value based on a national emissions value) under an assumption of constant methane yield, where methane yield is defined as kg methane/kg dry matter intake (DMI). Overall, increasing the FP estimated breeding value by one unit (i.e. 1 kg of more efficiently converted DMI during the cow’s first lactation) translates to a total lifetime saving of 3.23 kg in DMI and 0.055 kg in methane with the economic values of CAD $0.82 and CAD $0.07, respectively. Therefore, the estimated total economic value for FP is CAD $0.89/unit. The proposed model is robust and could also be applied to determine the economic value for feed efficiency traits within a selection index in other production systems and countries.
We evaluated the impact of an electronic health record based 72-hour antimicrobial time-out (ATO) on antimicrobial utilization. We observed that 6 hours after the ATO, 21% of empiric antimicrobials were discontinued or de-escalated. There was a significant reduction in the duration of antimicrobial therapy but no impact on overall antimicrobial usage metrics.
Introduction: Although use of point of care ultrasound (PoCUS) protocols for patients with undifferentiated hypotension in the Emergency Department (ED) is widespread, our previously reported SHoC-ED study showed no clear survival or length of stay benefit for patients assessed with PoCUS. In this analysis, we examine if the use of PoCUS changed fluid administration and rates of other emergency interventions between patients with different shock types. The primary comparison was between cardiogenic and non-cardiogenic shock types. Methods: A post-hoc analysis was completed on the database from an RCT of 273 patients who presented to the ED with undifferentiated hypotension (SBP <100 or shock index > 1) and who had been randomized to receive standard care with or without PoCUS in 6 centres in Canada and South Africa. PoCUS-trained physicians performed scans after initial assessment. Shock categories and diagnoses recorded at 60 minutes after ED presentation, were used to allocate patients into subcategories of shock for analysis of treatment. We analyzed actual care delivered including initial IV fluid bolus volumes (mL), rates of inotrope use and major procedures. Standard statistical tests were employed. Sample size was powered at 0.80 (α:0.05) for a moderate difference. Results: Although there were expected differences in the mean fluid bolus volume between patients with non-cardiogenic and cardiogenic shock, there was no difference in fluid bolus volume between the control and PoCUS groups (non-cardiogenic control 1878 mL (95% CI 1550 – 2206 mL) vs. non-cardiogenic PoCUS 1687 mL (1458 – 1916 mL); and cardiogenic control 768 mL (194 – 1341 mL) vs. cardiogenic PoCUS 981 mL (341 – 1620 mL). Likewise there were no differences in rates of inotrope administration, or major procedures for any of the subcategories of shock between the control group and PoCUS group patients. The most common subcategory of shock was distributive. Conclusion: Despite differences in care delivered by subcategory of shock, we did not find any significant difference in actual care delivered between patients who were examined using PoCUS and those who were not. This may help to explain the previously reported lack of outcome difference between groups.
Introduction: Point of care ultrasound has been reported to improve diagnosis in non-traumatic hypotensive ED patients. We compared diagnostic performance of physicians with and without PoCUS in undifferentiated hypotensive patients as part of an international prospective randomized controlled study. The primary outcome was diagnostic performance of PoCUS for cardiogenic vs. non-cardiogenic shock. Methods: SHoC-ED recruited hypotensive patients (SBP < 100 mmHg or shock index > 1) in 6 centres in Canada and South Africa. We describe previously unreported secondary outcomes relating to diagnostic accuracy. Patients were randomized to standard clinical assessment (No PoCUS) or PoCUS groups. PoCUS-trained physicians performed scans after initial assessment. Demographics, clinical details and findings were collected prospectively. Initial and secondary diagnoses including shock category were recorded at 0 and 60 minutes. Final diagnosis was determined by independent blinded chart review. Standard statistical tests were employed. Sample size was powered at 0.80 (α:0.05) for a moderate difference. Results: 273 patients were enrolled with follow-up for primary outcome completed for 270. Baseline demographics and perceived category of shock were similar between groups. 11% of patients were determined to have cardiogenic shock. PoCUS had a sensitivity of 80.0% (95% CI 54.8 to 93.0%), specificity 95.5% (90.0 to 98.1%), LR+ve 17.9 (7.34 to 43.8), LR-ve 0.21 (0.08 to 0.58), Diagnostic OR 85.6 (18.2 to 403.6) and accuracy 93.7% (88.0 to 97.2%) for cardiogenic shock. Standard assessment without PoCUS had a sensitivity of 91.7% (64.6 to 98.5%), specificity 93.8% (87.8 to 97.0%), LR+ve 14.8 (7.1 to 30.9), LR- of 0.09 (0.01 to 0.58), Diagnostic OR 166.6 (18.7 to 1481) and accuracy of 93.6% (87.8 to 97.2%). There was no significant difference in sensitivity (-11.7% (-37.8 to 18.3%)) or specificity (1.73% (-4.67 to 8.29%)). Diagnostic performance was also similar between other shock subcategories. Conclusion: As reported in other studies, PoCUS based assessment performed well diagnostically in undifferentiated hypotensive patients, especially as a rule-in test. However performance was similar to standard (non-PoCUS) assessment, which was excellent in this study.
We have been using the technique of pulsed neutron powder diffraction to study several problems in the physics and chemistry of the actinide elements. In these elements one often encounters very complex structures resulting from polymorphic transformations presumably induced by the presence of 5f-electrons. For exampie, at least five distinct structures of plutonium metal are found between room temperature and its melting point of 640°C, and two of the structures are monoclinic! Single crystals are usually not available, and the high resolution which is intrinsic to the time-of-flight powder technique is a powerful tool in the solution of complex structural problems. The relatively low absorption coefficients for neutrons for at least some actinide isotopes is an advantage when surface oxidation is a problem (as in high-temperature experiments) and provides good particle statistics so that high-quality data are available for Rietveld refinement. The low absorption of neutrons by other materials such as vanadium and fused silica enables the use of these materials for the containment of samples in high- and low-temperature environments, and the fixed geometry of the time-of-flight technique simplifies the design of furnaces and cryostats.
Pulsed neutron powder diffraction studies at IPNS have expanded our understanding of the phases present in Integral Fast Reactor (IFR) metal fuel alloys at temperatures in the range of reactor operating conditions. We report results from the binary alloy (U-10wt.%Zr) and ternary alloys (U-8%Pu-10%Zr) and (U-19%Pu-10%Zr). Determining the role and the location of Zr and Pu in these alloys is considered of fundamental importance for maximizing engineering efficiency.
Rietveld profile analysis was utilized to study the phase diagrams. Data were collected at temperatures ranging from 25-650°C. Although the expected U/Pu/Zr phases (α-U, β-U, γ-U, δ-U/Zr/Pu, ζ-U/Pu) were observed in appropriate temperature ranges, there were some unexpected results. Relative amounts of all phases at each temperature were calculated from Rietveld scale factors and inferences were made as to the location of zirconium and plutonium, i.e. amounts in each phase, from site occupancies and absorption characteristics of the phases present. Finally, we were able to identify ZrO and ZrO1-x inclusion phases in the U-Zr alloy present in very small (0.5-1.0%) amounts.
We have determined the strain and particle size for several samples of palladium powder by time-of-flight nrutron powder diffraction on two different diffractometers and by x-ray powder diffraction. The results are compared and found to be in fair agreement. The time-of-flight method gives good enough precision to reveal deficiencies in the simple models used for strain and particle size line broadening.
Background: EMBRACE (NCT02462759) Part 1 is a randomized, double-blind, sham-procedure controlled study assessing safety/tolerability of intrathecal nusinersen (12-mg equivalent dose) in symptomatic infants/children with SMA who were not eligible to participate in ENDEAR or CHERISH. Methods: Eligible participants had onset of SMA symptoms at ≤6 months with 3 SMN2 copies; onset at ≤6 months, age >7 months and 2 copies; or onset at >6 months, age ≤18 months, and 2/3 copies. Safety/tolerability was the primary endpoint. Exploratory endpoints included Hammersmith Infant Neurological Examination Section 2 (HINE-2) motor milestone attainment, change in ventilator use, and growth. Results: EMBRACE Part 1 was terminated early based on positive results from ENDEAR. Safety/tolerability was similar to previous trials. More nusinersen-treated (11/14;79%) vs. sham–treated individuals (2/7;29%) were HINE-2 motor milestone responders. Between Day 183 and 302, mean (SD) hours of ventilator use changed by +1.236 (3.712) hours in nusinersen-treated (n=12) and +2.123 (3.023) hours in sham–treated individuals (n=7). Similar increases in weight and body length were observed in nusinersen-treated and sham–treated individuals by Day 183. Conclusions: In EMBRACE Part 1, nusinersen demonstrated a favorable benefit-risk profile. These results add to the aggregated efficacy, safety/tolerability data of nusinersen in SMA.
Whilst many of the on-farm factors identified as enhancing pigmeat meat eating quality are already standard commercial practice, variability in quality is still a problem whose reasons are poorly understood. Particular uncertainty exists about the effect on eating quality of increasing slaughter weight, a current development which facilitates reduced cost of production by spreading carcass overhead costs between more kg of saleable meat. However, this strategy means that pigs will be older at slaughter, which carries uncertainties about the risk of increased toughness and boar taint. In targeting a market for branded pigmeat of high eating quality, there may also be beneficial strategies for adoption in carcass selection and post-slaughter management. These questions were addressed as part of a research project on the improvement of meat eating quality in the Scottish red meat sector.
Previous studies have demonstrated that including fish oil (FO) in the diet of beef cattle resulted in increased long chain C20n -3 PUFA (20:5n -3 and 22:6n -3) in muscle resulting in a lower n -6:n -3 ratio (Scollan et al., 2001). However, it may result in negative effects on colour shelf life and organoleptic properties (Vatansever et al., 2000). Fish oil is also a good inhibitor of biohydrogenation in the rumen, resulting in increased production of 18:1trans (TVA), the precursor for conjugated linoleic acid (CLA cis -9, trans -11) in muscle. This study investigated the effects of incremental levels of fish oil in the diet on the fatty acid composition of the m. longissimus dorsi and meat quality.
Sensory characteristics of tenderness, juiciness and flavour of beef are important criteria that affect consumer’s evaluation of beef quality. Near infrared reflectance spectroscopy (NIR) may be an effective tool to predict sensory characteristics of beef meat. This method is non-destructive, fast and potentially suitable for on-line measurements. The association between NIR measurements and sensory characteristics is expected to be based on chemical (e.g. water, lipid and protein content) and physical or structural (e.g. muscle fibre characteristics) properties of the meat. Objective measurements of physical or structural characteristics can be obtained using Volodkevitch shear force or slice shear force techniques (Shackelford et al., 1999). The objective of this study was to investigate the associations between eating quality traits of beef and NIR measurements.
We have previously demonstrated that feeding red clover relative to grass silage results in meat characterised by higher levels of polyunsaturated fatty acids (PUFA) but reduced shelf life which was associated with lower levels of vitamin E in the muscle (Scollan et al., 2006). Colour shelf life could be ameliorated by feeding additional vitamin E (Scollan et al., 2006). Feeding red clover silage followed by finishing off pasture may help alleviate the problem of colour shelf life while maintaining the benefit of the legume in delivering higher PUFA into meat. Hence this study examined feeding red clover compared with grass silage during the winter, following by a summer finishing period at grass, on fatty acid composition, vitamin E content of meat, colour shelf life and sensory attributes of beef.
There are many studies that show that breed, gender, age and feeding regime influence animal growth rate, meat yield and composition. These factors, together with slaughter and post-slaughter conditions, are thought to influence tenderness and flavour attributes of meat (Thompson, 2002)). Low variability is highly desirable and processes such as ‘A blueprint for improved consistent quality lamb’ (MLC, 1999) in the UK have attempted to improve the level and consistency of lamb eating quality. The purpose of this trial was to test whether the adoption of several key enhanced on–farm and in-abattoir practices led to improved eating quality throughout the lamb production season, especially for heavier, lean carcasses.
X-ray computed tomography (CT) measurements of live sheep have been used to predict carcass composition very accurately (Macfarlane et al., 2006). The utilisation of spiral CT scans (SCTS) for quantifying muscle volumes and weights, using automatic image analysis procedures has also been shown to be very accurate in sheep (Navajas et al., 2006). Although the limiting size of the CT gantry prevents CT scanning of live beef cattle, beef primal joints are small enough to be scanned. Hence, SCTS could be used to quantify beef carcass composition, and provide valuable information for breeding programmes including composition faster than by anatomical dissection. The objective of this study was to develop a CT image analysis procedure to assess fat, muscle and bone weights of beef carcasses and to evaluate its accuracy.
There are many studies that show that breed, gender, age and feeding regime influence animal growth rate, meat yield and composition. These factors, together with slaughter and post-slaughter conditions, are thought to influence tenderness and flavour attributes of meat (Thompson, 2002)). Low variability is highly desirable and processes such as ‘A blueprint for improved consistent quality beef’ (MLC, 1999) in the UK has attempted to improve the level and consistency of beef eating quality. This project was designed to test a package of best-practice techniques, both on-farm and in-abattoir, on the eating quality of Scottish beef as assessed by a trained sensory panel and a recruited take-home panel.
Breed and diet are important production factors in pigs, affecting growth rate and fat deposition. Subcutaneous fat and intramuscular (marbling) fat are important for carcass and meat quality and this study has investigated how these two fat depots are affected by breed and diet.
Feeding lambs diets formulated to be synchronous in terms of hourly energy and protein supply to the rumen has been reported to improve the efficiency of energy utilisation (Richardson et al. 1999). In a previous study Sinclair et al. (1995) reported that the efficiency of microbial protein production was improved when animals were fed a synchronous diet. The objectives of the present study were to investigate whether the changes in metabolism reported by Richardson et al. (1999) may be related to rumen microbial protein production and diet digestibility.