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The Louvre Museum recently placed online Mariette’s notebooks from the mid 19thcentury which include information on the find-spots of stelae from the Lesser Vaults of the Memphis Serapeum, the underground tomb complex of the Apis bulls at Saqqara. Some of these stelae name the reigning pharaoh and/or give dates for the bulls. The tombs had been ransacked but it seems that enough stelae remained close to their original positions to help determine the approximate location of each bull burial, a subject which has long been debated. Analysis of Mariette’s documents suggests a greater overlap between Dynasties 22 and 25 than is generally accepted.

Indigenous persons shared their stories about being part of a research team. Their stories highlighted the importance and potential of doing research in partnership with Indigenous community members. These stories and experiences could inspire others in the field.

The first British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS)-endorsed faecal microbiota transplant (FMT) guidelines were published in 2018. Over the past 5 years, there has been considerable growth in the evidence base (including publication of outcomes from large national FMT registries), necessitating an updated critical review of the literature and a second edition of the BSG/HIS FMT guidelines. These have been produced in accordance with National Institute for Health and Care Excellence-accredited methodology, thus have particular relevance for UK-based clinicians, but are intended to be of pertinence internationally. This second edition of the guidelines have been divided into recommendations, good practice points and recommendations against certain practices. With respect to FMT for Clostridioides difficileinfection (CDI), key focus areas centred around timing of administration, increasing clinical experience of encapsulated FMT preparations and optimising donor screening. The latter topic is of particular relevance given the COVID-19 pandemic, and cases of patient morbidity and mortality resulting from FMT-related pathogen transmission. The guidelines also considered emergent literature on the use of FMT in non-CDI settings (including both gastrointestinal and non-gastrointestinal indications), reviewing relevant randomised controlled trials. Recommendations are provided regarding special areas (including compassionate FMT use), and considerations regarding the evolving landscape of FMT and microbiome therapeutics.

Rising compounding prevalence of inflammatory bowel disease (IBD) (Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2021;18:56–66.) and pandemic-exacerbated health system resource limitations have resulted in significant variability in access to high-quality, evidence-based, person-centered specialty care for Canadians living with IBD. Individuals with IBD have identified long wait times, gaps in biopsychosocial care, treatment and travel expenses, and geographic and provider variation in IBD specialty care and knowledge as some of the key barriers to access. Care delivered within integrated models of care (IMC) has shown promise related to impact on disease-related outcomes and quality of life. However, access to these models is limited within the Canadian healthcare systems and much remains to be learned about the most appropriate IMC team composition and roles. Although eHealth technologies have been leveraged to overcome some access challenges since COVID-19, more research is needed to understand how best to integrate eHealth modalities (i.e., video or telephone visits) into routine IBD care. Many individuals with IBD are satisfied with these eHealth modalities. However, not all disease assessment and monitoring can be achieved through virtual modalities. The need for access to person-centered, objective disease monitoring strategies, inclusive of point of care intestinal ultrasound, is more pressing than ever given pandemic-exacerbated restrictions in access to endoscopy and cross-sectional imaging. Supporting learning healthcare systems for IBD and research relating to the strategic use of innovative and integrative implementation strategies for evidence-based IBD care interventions are greatly needed. Data derived from this research will be essential to appropriately allocating scarce resources aimed at improving person-centred access to cost-effective IBD care.This article reviews studies on access to and models of care for people with inflammatory bowel disease (IBD). IBD is a disease that causes the intestines to become inflamed. People with IBD report problems with access to care. These include access to virtual, specialist and diverse care. Diverse care is provided by a team with multiple specialists. Some specialists may include IBD physicians, dietitians, mental health care providers and others. Access to virtual care is very important to people living in rural and Northern areas. It is also important to those without local specialist care. Part of diverse care is access to new tools like intestinal ultrasound. Ultrasound is often preferred by people with IBD to other tests of disease activity. Ultrasound requires less prep and less time. People with IBD should have a say in how they receive care. Having access to virtual and diverse care can have a large impact. This impact helps people with IBD, IBD care providers and health care systems. People with IBD may see better health outcomes. IBD care providers can offer better treatment options. Health care systems may see cost savings as a result.

360° virtual reality (VR) video has emerged as an innovative technology with exciting potential for facilitating immersive learning experiences in health sciences training areas such as resuscitation. 360° VR using virtual reality headsets offers a portable and standardized way to provide 3-dimensional (3D) videos in a convenient and flexible way to healthcare providers across many different geographic locales. The purpose of this study was to explore the use of VR headsets and 360° video for pediatric and neonatal resuscitation training. A phenomenological approach was adopted to explore healthcare providers’ experiences of VR headsets and 360° video. Thirty-six (N = 36) healthcare providers (physicians, registered nurses and respiratory therapists) and learners trained in the Neonatal Resuscitation Program (NRP) and/or the Pediatric Advanced Life Support (PALS) program viewed 360° video(s) relevant to their training using Oculus Go Goggles and provided feedback via focus groups or interviews. Participant experiences were analyzed using a thematic analysis technique based on descriptive phenomenology. The key reported benefits of 360° video included enhanced experience of immersion in resuscitation scenarios, a strong sense of presence, and a greater level of interest. The main educational value reported included use for self-learning and supplementing traditional teaching methods and resources. Suggestions for enhancements and future use included improving visual and audio quality, interactivity, and realistic features. A high level of acceptance of VR headsets and 360° video was reported by healthcare providers with key suggestions for enhancing use of this simulation technology in the future.

Transcriptional enhancers enable exquisite spatiotemporal control of gene expression in metazoans. Enrichment of monomethylation of histone H3 lysine 4 (H3K4me1) is a major chromatin signature of transcriptional enhancers. Lysine (K)-specific demethylase 1A (KDM1A, also known as LSD1), an H3K4me2/me1 demethylase, inactivates stem-cell enhancers during the differentiation of mouse embryonic stem cells (mESCs). However, its role in undifferentiated mESCs remains obscure. Here, we show that KDM1A actively maintains the optimal enhancer status in both undifferentiated and lineage-committed cells. KDM1A occupies a majority of enhancers in undifferentiated mESCs. KDM1A levels at enhancers exhibit clear positive correlations with its substrate H3K4me2, H3K27ac, and transcription at enhancers. In Kdm1a-deficient mESCs, a large fraction of these enhancers gains additional H3K4 methylation, which is accompanied by increases in H3K27 acetylation and increased expression of both enhancer RNAs (eRNAs) and target genes. In postmitotic neurons, loss of KDM1A leads to premature activation of neuronal activity-dependent enhancers and genes. Taken together, these results suggest that KDM1A is a versatile regulator of enhancers and acts as a rheostat to maintain optimal enhancer activity by counterbalancing H3K4 methylation at enhancers.

The emergence of uncommon Salmonellaserotypes with the potential to cause foodborne outbreaks linked to turkeys demands sustainable broad-spectrum preharvest safety approaches. We investigated the effects of three preharvest interventions [turkey-origin probiotic, Lactobacillus salivariusUMNPBX2 (LS), dairy-origin probiotic, Propionibacterium freudenreichii subsp. freudenreichii(PF), and a live, attenuated S. Typhimurium vaccine (VC)] against a cluster of three emerging commercial turkey-sourced Salmonellaserotypes (S. Reading, S. Saintpaul, and S. Agona) in 6-week-old growing turkeys. Two experiments were conducted. In each experiment, 42, one-day-old turkey poults were randomly distributed into two control groups [Negative control (NC) and Positive control (PC) groups], LS group, PF group, VC group, and two combinations (LSVC = LS+VC and PFVC = PF+VC) groups with ad libitumaccess to feed and water. Poults in the probiotic-supplemented groups (LS, PF, LSVC, PFVC) received 105CFU/ml through drinking water until six weeks of age. Poults in the vaccination groups (VC, LSVC, PFVC) received the Salmonellavaccine on day one and two boosters. At week 5, all birds except the NC group were inoculated with 6 log10CFU/bird Salmonella(three-serotype mixture) by crop gavage. Salmonellawas recovered from the cecum, liver, spleen, and crop seven days after inoculation. Statistical analysis was performed using ANOVA, and a significant difference was determined at P< 0.05. All treatments significantly reduced Salmonellacolonization in the cecum of growing turkeys by 1.4 – 2 log10CFU/g compared to PC (P< 0.05). Treatments also effectively reduced Salmonelladissemination to the liver and spleen and crop recolonization. No pathological differences between the treatment groups were apparent in histopathology and immunohistochemistry analyses of liver samples. This study indicates the potential of novel preharvest approaches against multiple serotypes of Salmonellacolonizing in tandem in commercial growing turkeys.

In 2013, the TRAPPED-1 survey reported inconsistent availability of pain and distress management strategies across all 15 Canadian paediatric emergency department (PEDs). The objective of the TRAPPED-2 study was to utilize a procedural pain quality improvement collaborative (QIC) and evaluate the number of newly introduced pain and distress-reducing strategies in Canadian PEDs over a 2-year period.

Staphylococcus aureusbacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureuskilling, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection.

The incursion of highly pathogenic avian influenza (HPAI) into the United States during 2014 resulted in an unprecedented foreign animal disease (FAD) event; 232 outbreaks were reported from 21 states. The disease affected 49.6 million birds and resulted in economic losses of $950 million. Minnesota is the largest turkey-producing state, accounting for 18% of U.S. turkey production. Areas with concentrated numbers of turkeys in Minnesota were the epicenter of the outbreak. The first case was presumptively diagnosed in the last week of February 2015 at the Minnesota Veterinary Diagnostic Laboratory (MVDL) and confirmed as HPAI H5N2 at the National Veterinary Services Laboratories on March 4, 2015. A total of 110 farms were affected in Minnesota, and the MVDL tested >17,000 samples from March to July 2015. Normal service was maintained to other clients of the laboratory during this major FAD event, but challenges were encountered with communications, staff burnout and fatigue, training requirements of volunteer technical staff, test kit validation, and management of specific pathogen–free egg requirements.

We review the issues involved in designing a mechanism for allocating resource rights. We focus on the case of exploration and development rights for oil and gas leases in US federal lands to highlight the trade-offs at play. The main issues concern the design of the lease contract, the design of the auction, and the supply of leases. A distinguishing feature of oil and gas leases is that the mechanism must solve not only the adverse selection problem of selecting the bidder with the highest valuation but also the moral hazard problem of ensuring that right holders make efficient investment decisions.

The purpose of this study was to describe the use of analgesic interventions in children with acute supracondylar fractures presenting to a pediatric emergency department (ED) and to explore the relationship between timely interventions and severity of injury.

The performances of three attitude determination algorithms are compared in this paper. The three methods are the Complementary Filter, a Quaternion-based Kalman Filter and a Quaternion-based Gradient Descent Algorithm. An analysis of their performance based on an experimental investigation was undertaken. This paper shows that the Complementary Filter requires the least computational power; Quaternion-based Kalman Filter has the best noise filtering ability; and the Quaternion-based Gradient Descent Algorithm produced estimates with the highest accuracy. As many attitude determination methodologies make use of the quaternion rotation representation, the attitude quaternion to Euler angle singularity property has been investigated. Experiments conducted show that when Y-rotation approach the singularity position (±90°), the X-rotation drifts away from the reference input. This paper proposes the use of an imaginary set of sensor measurements to replace the original sensor measurements as the Y-rotation approaches the singularity. The proposed methodology for overcoming the conversion singularity has been experimentally verified.

Given the public health importance of suicide-related behaviors and the corresponding gap in the performance measurement literature, we sought to identify key candidate process indicators (quality of care measures) and structural measures (organizational resources and attributes) important for emergency department (ED) management of pediatric suicide-related behaviors.

We present the first assay combining a dual aptamer sandwich format with detection by anodic stripping voltammetry with ionic silver amplification. This assay format lends itself to rapid point-of-care tests, where the use of aptamers could improve the overall stability of the assay. We have used human alpha-thrombin as a model system, and demonstrate a detection limit of 6.09 μg L−1. We present the optimization of the aptamer-silver colloid attachment chemistry and the final assay format to achieve sensitive analyte detection. The use of a sandwich assay coupled with magnetic separation and ionic silver amplification, generates an assay with similar sensitivity than those reported in the literature in a format that can be used in rapid, portable testing regimes.

The laboratory measurement of cardiac troponin (cTn) concentration is a critical tool in the diagnosis of acute myocardial infarction (MI). Current cTnI assays produce different absolute troponin numbers and use different clinical cut-off values; hence cTnI values cannot be interchanged, with consequent confusion for clinicians. A recent Australian study compared patient results for seven cTnI assays and showed that between-method variation was approximately 2- to 5-fold.

This work demonstrates the use of silver nanoparticles as a simple electrochemical biolabel to induce 106signal enhancement. We propose a mechanism of measuring the silver nanoparticles on a specific screen‐printed planar carbon electrode, without the requirement for the harsh oxidant or toxic reagents described in prior‐art for gold sol methods. The possible measurement process was validated with orthogonal techniques such as UV/Vis spectroscopy, dynamic light scattering and by anodic stripping voltammetry (ASV). The findings were utilized to develop a novel electrochemical sandwich immunoassay where the analyte concentration is directly proportional to ASV oxidation peak of silver. This technique in the future is envisaged to form the foundation of a generic Point of Care platform. The assay was applied to cardiac marker: myoglobin with detection limit of 3 ng/mL.

Brain tissue from 12 aborted bovine fetuses submitted to the Wisconsin Veterinary Diagnostic Laboratory revealed histologic lesions that consisted of glial nodules and variable degrees of mononuclear inflammation, microhemorrhage, neuronal necrosis, and cerebral cortical cavitation. A diagnosis of Bovine herpesvirus 1(BHV-1) abortion had been made in all of these cases through multiple testing modalities. Brain tissue from 8 of the 12 fetuses was immunohistochemically stained with a monoclonal antibody specific to BHV-1, and, in 5 fetuses, there was positive intralesional staining of neurons, glial cells, and endothelial cells. This preliminary data suggested that herpesviral infection of brain tissue led to the described neurologic lesions. BHV-1 was then amplified from brain tissue in all 12 of the fetuses and was confirmed by partial sequencing of the thymidine kinase and glycoprotein C genes. To the authors' knowledge, neurologic lesions have not previously been described in BHV-1–infected fetuses, nor has BHV-1 previously been identified in bovine fetal brain tissue. The neurologic histopathology attributed to BHV-1 infection in these cases overlaps with the neurologic lesions produced by Neospora caninum, a common etiologic agent of bovine abortion. Therefore, when bovine fetal neurologic lesions are found, both etiologies should be considered and then distinguished by using additional diagnostic tools.

Abstract. Objective:To predict severe hyperkalemia from single electrocardiogram (ECG) tracings. Methods:Ten conditioned dogs each underwent this protocol three times: Under isoflurane anesthesia, 2 mEq/kg/hr of potassium chloride was given intravenously until P‐waves were absent from the ECG and ventricular rates decreased ≥20% in ≤5 minutes. Serum potassium levels (K+) were measured at regular intervals with concurrent digital storage of lead II of the surface ECG. A three‐layer artificial neural network with four hidden nodes was trained to predict K+from 15 separate elements of corresponding ECG data. Data were divided into a training set and a test set. Sensitivity, specificity, and diagnostic accuracy for recognizing hyperkalemia were calculated for the test set based on a prospectively defined K+= 7.5. Results:The model produced data for 189 events; 139 were placed in the training set and 50 in the test set. The test set had 37 potassium levels at or above 7.5 mmol/L. The neural network had a sensitivity of 89% (95% CI = 75% to 97%) and a specificity of 77% (95% CI = 46% to 95%) in recognizing these. The positive likelihood ratio was 3.87. Overall accuracy of this model was 86% (95% CI = 73% to 94%). Mean (±SD) difference between predicted and actual K+values was 0.4 ± 2.0 (95% CI = ‐0.2 to 1.0). Conclusions:An artificial neural network can accurately diagnose experimental hyperkalemia using ECG parameters. Further work could potentially demonstrate its usefulness in bedside diagnosis of human subjects.

To determine the frequency of alcohol ingestion in adolescent victims of major trauma and determine whether alcohol ingestion is associated with increased injury severity or death.

Objectives:To compare outcomes one year after hospital admission for patients initially discharged with a diagnosis of acute myocardial infarction (AMI), other ischaemic heart disease (other IHD), congestive heart failure (CHF) or stroke. Design:Cohort study. Setting:Hunter Area Heart and Stroke Register, which registers all patients admitted with heart disease or stroke to any of the 22 hospitals in the Hunter Area Health Service in New South Wales. Patients:4981 patients with AMI, other IHD, CHF or stroke admitted to hospital as an emergency between 1 July 1995 and 30 June 1997 and followed for at least one year. Main outcome measures:Death from any cause or emergency hospital readmission for cardiovascular disease. Results: ln‐hospital mortality varied from 1% of those with other IHD to 22% of those with stroke. Almost a third of all patients discharged alive (and 38% of those aged 70 or more) had died or been readmitted within one year. This varied from 22% of those with stroke to 49% of those with CHF. The causes of death and readmission were from a spectrum of cardiovascular disease, regardless of the cause of the original hospital admission. Conclusions:Data from this population register show the poor outcome, especially with increasing age, among patients admitted to hospital with cardiovascular disease. This should alert us to determine whether optimal secondary prevention strategies are being adopted among such patients.

Antibodies raised against the conducting polymer, carbazole as a hapten, react to modulate the polymer's electrochemistry. Using cyclic voltammetry the reaction of the antiserum was discovered to influence the polymer matrix's electrochemistry by an amperometric response. It is suggested that these observation form the basis of a direct sensor for immunoassay.

Alcohol effect expectancies and situational self-efficacy are important factors in addiction relapse. The extent to which these cognitive factors change during alcohol treatment and the relations between change in these two domains may facilitate our understanding of the transition out of addictive lifestyles. To evaluate such change, 101 male and female participants in an abstinence focused inpatient alcohol and drug treatment program completed measures of alcohol effect expectancies (AEQ) and self-efficacy (SCQ) during the first and fourth (final) week of inpatient treatment. Analyses confirmed our predictions that alcohol effect expectancies and self-efficacy were inversely correlated at the beginning of treatment, and that both alcohol expectancies and self-efficacy changed significantly during the four-week treatment program. Larger decreases in alcohol effect expectancies were evident for individuals who entered treatment with less confidence in their ability to resist drinking compared to those with more confidence in potential drinking situations. Results suggest that both expectancies and self-efficacy are useful factors to target in alcohol treatment.