The aim of this study was to review microbiology results from testing >2500 raw drinking milk and dairy products made with unpasteurised milk examined in England between 2013 and 2019. Samples were collected as part of incidents of contamination, investigation of infections or as part of routine monitoring and were tested using standard methods for a range of both pathogens and hygiene indicators. Results from testing samples of raw cow's milk or cheese made from unpasteurised milk for routine monitoring purposes were overall of better microbiological quality than those collected during incident or investigations of infections. Results from routine monitoring were satisfactory for 62% of milks, 82% of cream, 100% of ice-cream, 51% of butter, 63% of kefir and 79% of cheeses, with 5% of all samples being considered potentially hazardous. Analysis of data from cheese demonstrated a significant association between increasing levels of indicator Escherichia coli with elevated levels of coagulase positive staphylococci and decreased probability of isolation of Shiga toxin-producing E. coli. These data highlight the public health risk associated with these products and provide further justification for controls applied to raw drinking milk and dairy products made with unpasteurised milk.

Background: Diffusion-tensor imaging (DTI) tractography is commonly used in neurosurgical practice, but is largely limited to the preoperative setting. This is due primarily to image degradation caused by susceptibility artifact when conventional single-shot (SS) echo-planar imaging DTI is acquired for open cranial, surgical position intraoperative DTI (iDTI). A novel, artifact-resistant, readout-segmented (RS) DTI has not yet been evaluated in the intraoperative MRI (iMRI) environment. Our objective was to evaluate the performance of RS-DTI versus SS-DTI for intraoperative white matter imaging. Methods: Pre- and intraoperative 3T, T1-weighted and DTI (RS-iDTI and SS-iDTI) in 22 adults undergoing intraaxial iMRI resections (low-grade glioma: 14, 64%; high-grade glioma: 7, 32%; cortical dysplasia: 1). Regional susceptibility artifact, anatomical deviation relative to T1WI, and tractographic output were compared between iDTI sequences. Results: RS-iDTI resulted in less regional susceptibility artifact and mean anatomic deviation (RS-iDTI: 2.7±0.2 mm versus SS-iDTI 7.5±0.4 mm; p<0.0001). Tractographic failure occurred in 8/22 (36%) patients for SS-iDTI whereas RS-iDTI permitted successful reconstruction in 4 of these 8. Maximal tractographic differences between DTI sequences were substantial (mean 9.7±5.7 mm). Conclusions: Readout-segmented EPI enables higher quality and more accurate DTI for surgically relevant tractography of major white matter tracts in intraoperative, open cranium, neurosurgical applications at 3T.

Background: External ventricular drain (EVD) insertion is a common neurosurgical procedure performed in patients with life-threatening conditions, but can be associated with complications. The objectives of this study are to evaluate data on national practice patterns and complications rates in order to optimize clinical care Methods: The Canadian Neurosurgery Research Collaborative conducted a prospective multi-centre registry of patients undergoing EVD insertions at Canadian residency programs Results: In this interim analysis, 4 sites had recruited 46 patients (mean age: 53.9 years, male:female 2:1). Most EVD insertions occurred outside of the operating theatre, using free-hand technique, and performed by junior neurosurgery residents (R1-R3). The catheter tip was in the ipsilateral frontal horn or body of the lateral ventricle in 76% of cases. Suboptimally placed catheters did not have higher rates of short-term occlusion. EVD-related hemorrhage occurred in 6.5% (3/45) with only 1 symptomatic patient. EVD-related infection occurred in 13% (6/46) at a mean of 6 days and was associated with longer duration of CSF drainage (P=0.039; OR: 1.13) Conclusions: Interim results indicate rates of EVD-related complications may be higher than previously thought. This study will continue to recruit patients to confirm these findings and determine specific risk factors associated with them

Background: Surgical treatment of trigeminal neuralgia (TN) can be highly effective, but durability of pain relief varies and factors influencing surgical failure are poorly understood. We hypothesized that structural brain differences—assessed using magnetic resonance imaging (MRI)—might distinguish surgical responders from early non-responders. Methods: We retrospectively identified 35 TN patients treated surgically from 2005-2017 with high-resolution, -pre-operative MRI scans adequate for quantitative structural analysis. Patients were classified as non-responders if, within 12-months after surgery, they: 1) underwent or were offered another surgical procedure; or 2) reported persistent, inadequately-controlled pain. Volumes of pain-relevant subcortical structures (amygdala, thalamus, and hippocampus) were measured on T1-weighted MRI scans using an automated approach (FSL-FIRST). Results: Surgical responders had significantly larger hippocampi bilaterally compared to early non-responders. Thalamus and amygdala volumes did not differ between groups. Conclusions: Pre-operative differences in brain structure, notably in the hippocampus, may predict durability of response to surgery in patients with TN.

The Arizona Department of Health Services identified unusually high levels of influenza activity and severe complications during the 2015–2016 influenza season leading to concerns about potential increased disease severity compared with prior seasons. We estimated state-level burden and severity to compare across three seasons using multiple data sources for community-level illness, hospitalisation and death. Severity ratios were calculated as the number of hospitalisations or deaths per community case. Community influenza-like illness rates, hospitalisation rates and mortality rates in 2015–2016 were higher than the previous two seasons. However, ratios of severe disease to community illness were similar. Arizona experienced overall increased disease burden in 2015–2016, but not increased severity compared with prior seasons. Timely estimates of state-specific burden and severity are potentially feasible and may provide important information during seemingly unusual influenza seasons or pandemic situations.

Latest Pleistocene-Holocene basaltic lava fields of the Snake River Plain, Idaho, have been dated by the radiocarbon method. Backhoe excavations beneath lava flows typically yielded carbon-bearing, charred eolian sediment. This material provided most of the samples for this study; the sediment typically contains less than 0.2% carbon. Charcoal fragments were obtained from tree molds but only from a few backhoe excavations. Contamination of the charred sediments and charcoal by younger carbon components is extensive; the effects of contamination were mitigated but appropriate pretreatment of samples using acid and alkali leaches. Twenty of the more than 60 lava flows of the Craters of the Moon lava field have been dated; their ages range from about 15,000 to about 2000 yr B.P. The ages permit assignment of the flows to eight distinct eruptive periods with an average recurrence interval of about 2000 yr. The seven other latest Pleistocene-Holocene lava fields were all emplaced in short eruptive bursts. Their 14C ages (yr B.P.) are: Kings Bowl (2222± 100), Wapi (2270 ± 50), Hells Half Acre (5200 ± 150), Shoshone (10,130 ± 350), North Robbers and South Robbers (11.980 ± 300), and Cerro Grande (13,380 ± 350).

Rangea is the type genus of the Rangeomorpha, an extinct clade near the base of the evolutionary tree of large, complex organisms which prospered during the late Neoproterozoic. It represents an iconic Ediacaran taxon, but the relatively few specimens previously known significantly hindered an accurate reconstruction. Discovery of more than 100 specimens of Rangea in two gutter casts recovered from Farm Aar in southern Namibia significantly expands this data set, and the well preserved internal and external features on these specimens permit new interpretations of Rangea morphology and lifestyle. Internal structures of Rangea consist of a hexaradial axial bulb that passes into an axial stalk extending the length of the fossil. The axial bulb is typically filled with sediment, which becomes increasingly loosely packed and porous distally, with the end of the stalk typically preserved as an empty, cylindrical cone. This length of the axial structure forms the structural foundation for six vanes arranged radially around the axis, with each vane consisting of a bilaminar sheet composed of a repetitive pattern of elements exhibiting at least three orders of self-similar branching. Rangea was probably an epibenthic frond that rested upright on the sea bottom, and all known fossil specimens were transported prior to their final burial in storm deposits.

A brief infestation of near outbreak proportions by larvae of Hylemya extremitata Malloch occurred on bromegrass, Bromus inermis Leyss and B. pumpellianus Scribn., at Beaverlodge, Alta., in 1971–72. Larvae feeding primarily on meristematic tissue caused injury to as many as 20% of the grass tillers examined. Mature larvae overwintered within the tillers. Adults emerged in mid-June. Descriptions are given of the three larval stages of this species and of mature larvae of the first two of the following four species of Chloropidae, which were also found living within the bromegrass: Olcella provocans (Becker), Oscinella coxendix (Fitch), Oscinella incerta Becker, and Conioscinella melancholica Becker.

IN 1999 AND EARLY 2000, THE ASSOCIATION FOR European Paediatric Cardiology published the European Paediatric Cardiac Code as independent but linked Short and Long Lists, containing 650 and 3876 primary terms respectively. The historical background and rationale for development of this coding system has been previously detailed, but essentially it followed a series of meeting of the coding committee of the Association between 1997–1999, during which a pre-existing Long List was adopted and then used to create the condensed Short List. The system was published as the recommended standard coding system for use across Europe, covering the diagnosis and therapy of children with congenital and acquired cardiac disease. The scope of the lists was to encompass the needs of all those involved with such patients, from the fetal cardiologist through to the specialist in adult congenital heart disease; and from the general paediatric cardiologist and cardiac surgeon, to those specialising in transcatheter interventions, paediatric electrophysiology, and paediatric echocardiographers. In addition, the code was crossmapped to the 9th and 10th revisions of the International Classification of Diseases (“ICD-9” and “ICD-10”) provided by the World Health Organisation in order to facilitate returns to central government, a requirement in most countries. In so doing, it was hoped to address the concerns of many centres that such information submitted by professional coding staff was often inaccurate due to the complex nature of congenital cardiac disease, together with the limited scope and vague terminology of the International listings.