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The voluntary digestible organic matter intake (DOMI) of mature barley crops (Hordeum spp.) for sheep depends largely on straw quality. Direct measurement of DOMI is laborious; consequently, the research reported here evaluated indicator traits for improving barley straw DOMI by crop breeding. It hypothesized that some indicator traits for straw quality are heritable, facilitate genetic gain in DOMI, and reveal straw properties that constrain genetic gain. In 4 years, 32 genotypes of barley were grown at ICARDA, northern Syria, with no fertilizer in one year and supplementary irrigation in another. Indicator traits for predicting DOMI included in situ straw dry matter losses (DML) at nine incubation times (0–120 h), four parameters of the DML curve, seven laboratory tests, grain yield and straw yield. Heritability (h2) was highest for traits associated with indigestible cell wall constituents, including potential DML (h2 = 0.61), DML at 48–120 h of incubation (h2 = 0.48–0.58), and acid detergent fibre (ADF) (h2 = 0.41). Heritability was lower for DOMI itself (h2 = 0.24), neutral detergent fibre (NDF) (h2 = 0.20), and total Kjeldahl nitrogen (h2 = 0.17), and was lowest for DML at 6–18 h (h2 = 0.08–0.09) and the in situ parameters Lag and relative loss rate of slowly degradable DM (h2 ≤ 0.03). Correlations between indicator traits and DOMI tended to increase with heritability. Grain and straw yields were not correlated with DOMI; of these, only grain yield was heritable. In conclusion, genetic gain in barley straw nutritive value can be achieved by crop breeding under diverse growing conditions, using indicator traits associated with indigestible cell wall constituents.

Background Weight loss in the older adult is often multifactorial and can be associated with increased morbidity and mortality. Our quality improvement project focused on nutritional care of patients 75 years or older. This hospital has a standardised Nutrition and Hydration Policy based on NICE guidelines to prevent malnutrition in hospital inpatients including weighing patients every 72 hours, daily screening and food/hydration charts. Our project aimed to increase adherence, with a focus on increasing the percentage of patients being regularly weighed over a 6-month period to 90%. Methods Our stakeholder analysis highlighted the multidisciplinary nature of our project, particularly involving the healthcare assistants. The percentage of patients weighed within 72 hours was recorded weekly. The first PDSA cycle introduced the project and gained buy-in from the MDT, highlighting required weights in MDT meetings/board rounds. The second cycle included an education session for doctors. The third cycle involved a poster in each bay aiming to act as a prompt and promote patient and family involvement. Results Our run chart shows that following our first two PDSA cycles eight consecutive results were higher than the baseline (40% of patients weighed). Results ranged from 70-90%. Following the third intervention compliance returned to baseline but coincided with significant disruption to the ward structure and team. Our successful intervention of nutritional teaching was then repeated as a fourth PDSA cycle and the mean returned to 80%. Conclusions Nutritional care requires multidisciplinary involvement. The educational session had the most impact and in future could be delivered to additional MDT members. Disappointingly the poster did not stimulate patient or family participation. We would like to create an ethos on elderly wards where nutrition routinely features in ward-based comprehensive geriatric assessments. Future plans hope to further engage patients and families as visiting restrictions eased.

RESUMEN El rayador (Rynchops niger) visita las costas de Chile durante los veranos australes, observándose en bandadas de distinto tamaño principalmente en humedales costeros. Por medio del uso de una base de datos de observaciones de ciencia ciudadana junto a nuestros monitoreos de largo plazo, estimamos que el tamaño poblacional promedio para la especie en Chile alcanzó los 10.227 individuos entre 2014 y 2018. Tres sitios (estuarios de los ríos Mataquito, Itata, y Tubul) congregaron a más del 50% de la población. El análisis de la abundancia relativa a través del año para cuatro macrozonas geográficas reflejaría el movimiento de la especie en las costas de Chile. La zona Norte muestra un peak de abundancia en noviembre con la llegada de individuos, no siendo tan clara su estrategia de retorno. Las zonas Centro-Norte y Centro del país muestran dos peaks en la llegada y partida de individuos, sugiriendo un uso más bien de tránsito. La existencia de un solo peak en el mes de febrero, además de las mayores concentraciones de individuos, indicarían que las zonas Centro-Sur y Sur del país serían potencialmente el destino para gran parte de la población de rayadores. El seguimiento de individuos por medio de radiotelemetría permitió detectar movimiento de individuos entre una red de humedales costeros. Estos desplazamientos ocurrirían frecuentemente a lo largo de toda la temporada y tanto en dirección norte como hacia el sur. Este trabajo presenta información relevante para la evaluación del estado de la especie en Chile, país que potencialmente alberga un porcentaje significativo de la población de la subespecie cinerascens durante el período no reproductivo.

Background: For health care services to address the health care needs of populations and respond to changes in needs over time, workforces must be planned. This requires quantitative models to estimate future workforce requirements that take account of population size, oral health needs, evidence-based approaches to addressing needs, and methods of service provision that maximize productivity. The aim of this scoping review was to assess whether and how these 4 elements contribute to existing models of oral health workforce planning. Methods: A scoping review was conducted. MEDLINE, Embase, HMIC, and EconLit were searched, all via OVID. Additionally, gray literature databases were searched and key bodies and policy makers contacted. Workforce planning models were included if they projected workforce numbers and were specific to oral health. No limits were placed on country. A single reviewer completed initial screening of abstracts; 2 independent reviewers completed secondary screening and data extraction. A narrative synthesis was conducted. Results: A total of 4,009 records were screened, resulting in 42 included articles detailing 47 models. The workforce planning models varied significantly in their use of data on oral health needs, evidence-based services, and provider productivity, with most models relying on observed levels of service utilization and demand. Conclusions: This review has identified quantitative workforce planning models that aim to estimate future workforce requirements. Approaches to planning the oral health workforce are not always based on deriving workforce requirements from population oral health needs. In many cases, requirements are not linked to population needs, while in models where needs are included, they are constrained by the existence and availability of the required data. It is critical that information systems be developed to effectively capture data necessary to plan future oral health care workforces in ways that relate directly to the needs of the populations being served. Knowledge Transfer Statement: Policy makers can use the results of this study when making decisions about the planning of oral health care workforces and about the data to routinely collect within health services. Collection of suitable data will allow for the continual improvement of workforce planning, leading to a responsive health service and likely future cost savings.

Topic Hospital admissions for older people are increasing with subsequent pressure on out-patient (OP) clinics. By early 2018, 350 patients were waiting up to 6 months for follow-up, with limited capacity in existing clinics. There were concerns regarding potential harm to patients from delayed review of significant results. Intervention A working group considered options for managing the OP waiting list. We decided to pilot a fortnightly virtual clinic (VC) where cases were reviewed without the patient present. All patients awaiting results were listed for the VC rather than routine OP. Each VC had 50 patients listed. Patient’s GP received a clear action plan. Clinic rules were modified as issues were identified. Links with other specialities evolved reducing the number of missing results. Data was analysed for 50% of consultations between January 2018 and March 2019. Improvement 311 VC appointments were reviewed: 207 in 2018 and 104 up to March 2019. Maximum 25 cases could be completed per clinic, additional sessions cleared initial backlog within 3 months. Completion time/case ranged from 2-15 minutes depending on complexity. Main reason for VC was test results: 82% in 2018, increasing to 93% in 2019. 61% in 2018, 80% in 2019 were discharged directly from VC. 20% required a 2nd VC for outstanding results. OP review post-VC fell from 16% in 2018 to just 2% in 2019. General OP requirements fell from 24hrs to 10 hours/ week as a result of VCs, releasing consultants for other clinical areas. Discussion VCs are an effective means of reviewing outstanding results from recent admissions and OP consultations. Routine listing of patients with outstanding investigations provides a safety net. Most results are normal and do not require follow-up. Repeat CXRs at 6 weeks continue to be requested for severely frail people who are unlikely to benefit.

ObjectivesTo determine recommendations for the use of personal protective equipment (PPE) based on transmission risk for paediatric procedures in the Emergency Department during the COVID-19 pandemic. MethodsTwo survey rounds were conducted in April-May 2020. The survey presented a number of emergency medicine procedures relevant to the care of children, and asked respondents to provide PPE recommendations according to levels of community transmission, and whether or not the child had symptoms of acute respiratory illness. ResultsParticipants were recruited by approaching relevant professional groups, with 15 from the PREDICT network and 12 from the Australasian Society of Infectious Diseases (ASID) Paediatric Infectious Diseases (ANZPID) Group. Airborne PPE is recommended for resuscitative procedures and various respiratory procedures in most situations There were differences in opinion between emergency and paediatric infectious disease specialists with regards to most appropriate PPE for children without symptoms of COVID-19 in a setting of low community transmission, and for procedures involving the head, neck or airway. In general, emergency physicians were more likely to favour airborne PPE than infectious disease specialists. In the setting of high community transmission, there was a stronger tendency to recommend at least droplet precautions for most procedures – regardless of whether or not the child had symptoms. ConclusionsDifferences in PPE recommendations for various paediatric procedures between infectious disease specialists and emergency physicians were identified. Further research is urgently needed to clarify and quantify risks for many common interventions and determine strategies for multidisciplinary consensus regarding future recommendations.

The present study evaluated the in vitro potency of ceftazidime and cefepime among carbapenem-resistant Pseudomonas aeruginosa isolates collected as part of a global surveillance program and assessed the pharmacodynamic implications using previously published population pharmacokinetics. When susceptible, MICs resulted at the high end of distribution for both ceftazidime and cefepime, thus 6 g/day was required to achieve optimal pharmacodynamic profiles. These findings should be considered in the clinic and for the application of CLSI susceptibility breakpoints. © 2021 American Society for Microbiology.

IntroductionPembrolizumab is an established first-line option for patients with advanced non-small-cell lung cancer (NSCLC) expressing programmed death-ligand 1 ≥50%. Durable responses are seen in a subset of patients; however, many derive little clinical benefit. Biomarkers of the systemic inflammatory response predict survival in NSCLC. We evaluated their prognostic significance in patients receiving first-line pembrolizumab for advanced NSCLC.MethodsPatients treated with first-line pembrolizumab for advanced NSCLC with programmed death-ligand 1 expression ≥50% at two regional Scottish cancer centres were identified. Pretreatment inflammatory biomarkers (white cell count, neutrophil count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, albumin, prognostic nutritional index) were recorded. The relationship between these and progression-free survival (PFS) and overall survival (OS) were examined.ResultsData were available for 219 patients. On multivariate analysis, albumin and neutrophil count were independently associated with PFS (P < 0.001, P = 0.002, respectively) and OS (both P < 0.001). A simple score combining these biomarkers was explored. The Scottish Inflammatory Prognostic Score (SIPS) assigned 1 point each for albumin 7.5 × 109/l to give a three-tier categorical score. SIPS predicted PFS [hazard ratio 2.06, 95% confidence interval (CI) 1.68-2.52 (P < 0.001)] and OS [hazard ratio 2.33, 95% CI 1.86-2.92 (P < 0.001)]. It stratified PFS from 2.5 (SIPS2), to 8.7 (SIPS1) to 17.9 months (SIPS0) (P < 0.001) and OS from 5.1 (SIPS2), to 12.4 (SIPS1) to 28.7 months (SIPS0) (P < 0.001). The relative risk of death before 6 months was 2.96 (95% CI 1.98-4.42) in patients with SIPS2 compared with those with SIPS0-1 (P < 0.001).ConclusionsSIPS, a simple score combining albumin and neutrophil count, predicts survival in patients with NSCLC receiving first-line pembrolizumab. Unlike many proposed prognostic scores, SIPS uses only routinely collected pretreatment test results and provides a categorical score. It stratifies survival across clinically meaningful time periods that may assist clinicians and patients with treatment decisions. We advocate validation of the prognostic utility of SIPS in this and other immune checkpoint inhibitor treatment settings.

Between January-August 2017, the movements of 18 individual Yellow-billed Pintail (Anas georgica) were studied after capture at the Carampangue wetland in Central Chile and equipped with GPS transmitters. The goal was to describe the movements of the species in terms of the distance travelled at different times of the day. Approximately 80% of all movements detected within 6-h time intervals were shorter than 1 km (median = 0.35 km). A total of 36 (0.3%) flights of more than 50 km (max dispersal = 317 km) were recorded, performed by 10 of the individuals. The distribution of flights of different distances varied significantly during the day, with short movements (0-1 km) occurring more frequently than expected during daylight, flights 1-50 km of distance being significantly more frequent during twilight, and long distance (> 50 km) flights concentrated during the night. There was no evidence of birds preferentially selecting clear-sky nights for long-distance flights.

Supplemental material, sj-pdf-1-jct-10.1177_2380084420979585 for Workforce Planning Models for Oral Health Care: A Scoping Review by L. O’Malley, R. Macey, T. Allen, P. Brocklehurst, F. Thomson, J. Rigby, R. Lalloo, G. Tomblin Murphy, S. Birch and M. Tickle in JDR Clinical & Translational Research

Introduction The National Institute for Health and Care Excellence guidance Improving Supportive and Palliative Care for Adults with Cancer (2004) and the Cancer Reform Strategy (2007) support the premise that assessment and discussion of patients’ needs for physical, social, psychological, and spiritual wellbeing should be undertaken during oncology follow-up. We report the use of the Patient Concerns Inventory in a routine head and neck cancer clinic setting over a seven-year period, summarising the number of available clinics, the number of patients completing the inventory within a clinic, the range of clinical characteristics and the concerns they wanted to discuss. Methods The data were analysed from oncology follow-up clinics between 1 August 2007 and 10 December 2014. Audit approval was given by the Clinical Audit Department, University Hospital Aintree. Results There were 386 patients with 1198 inventories completed at 220 clinics, median 6 (range 4–7) per clinic. The most common concerns raised by patients across all the clinic consultations were dry mouth (34%), fear of recurrence (33%), sore mouth (26%), dental health (25%), chewing (22%) and fatigue/tiredness (21%). Conclusions The incorporation of the Patient Concerns Inventory as part of routine oncology clinics allows for a more patient initiated and focused consultation available to the majority of patients throughout their follow-up. The inventory allows for greater opportunity to provide holistic targeted multiprofessional intervention and support.

This work describes the development and verification of a cascade feedback regulation system to reduce temporal field fluctuations to allow nuclear magnetic resonance (NMR) spectroscopy experiments in powered magnets. Powered magnets provide higher magnetic fields than persistent mode superconducting magnets, but require an external power source to achieve high fields. High magnetic field strengths provide improved sensitivity and spectral resolution for NMR spectroscopy. Unfortunately, powered magnets suffer from temporal magnetic field fluctuations due to the power supply ripple and variations in cooling water temperature and flow rate. Powered magnets also suffer from spatial inhomogeneity. The combination of field fluctuations and spatial inhomogeneity make powered magnets infeasible for NMR spectroscopy. In particular, two-dimensional NMR spectroscopy experiments which resolve off-diagonal cross peaks requires the spatial homogeneity and time-invariant field strength afforded by persistent mode magnets. Previous work has shown that feedback regulation using an inductive sensor can dramatically reduce the effect of temporal fluctuations on the magnetic field, and a combination of ferroshims and sample spinning can be used to improve spatial homogeneity. This work presents a cascade feedback regulation system that utilizes both inductive and NMR measurements. To verify the field regulation algorithm, we demonstrate a well-known two-dimensional NMR spectroscopy experiment in which cross peaks are resolved in a 16.3 MW powered magnet that provides a 25 T field. To our knowledge, this is the first 2D NMR spectroscopy results reported for a powered magnet where cross peaks are resolved.

The underwater environment - Preparations before travel - Diving medicine - Effects of high-pressure gases - Decompression sickness - Barotrauma - Other problems

Palladium-catalyzed cross-coupling reactions of 2-bromobenzaldehyde and 6-bromo-2,3-dimethoxybenzaldehyde with 4-methyl-1-naphthaleneboronic acid and acenaphthene-5-boronic acid gave corresponding o-naphthyl benzaldehydes. Corey-Fuchs olefination followed by reaction with n-BuLi led to various 1-(2-ethynylphenyl)naphthalenes. Cycloisomerization of individual 1-(2-ethynylphenyl)naphthalenes to various benzo[c]phenanthrene (BcPh) analogues was accomplished smoothly with catalytic PtCl2 in PhMe. In the case of 4,5-dihydrobenzo[l]acephenanthrylene, oxidation with DDQ gave benzo[l]acephenanthrylene. The dimethoxy-substituted benzo[c]phenanthrenes were demethylated with BBr3 and oxidized to the o-quinones with PDC. Reduction of these quinones with NaBH4 in THF/EtOH in an oxygen atmosphere gave the respective dihydrodiols. Exposure of the dihydrodiols to N-bromoacetamide in THF-H2O led to bromohydrins that were cyclized with Amberlite IRA 400 HO(-) to yield the series 1 diol epoxides. Epoxidation of the dihydrodiols with mCPBA gave the isomeric series 2 diol epoxides. All of the hydrocarbons as well as the methoxy-substituted ones were crystallized and analyzed by X-ray crystallography, and these data are compared to other previously studied BcPh derivatives. The methodology described is highly modular and can be utilized for the synthesis of a wide variety of angularly fused polycyclic aromatic hydrocarbons and their putative metabolites and/or other derivatives.

The α-helix is a prevalent secondary structure in proteins and is critical in mediating protein-protein interactions (PPIs). Peptide mimetics that adopt stable helices have become powerful tools for the modulation of PPIs in vitro and in vivo. Hydrogen-bond surrogate (HBS) α-helices utilize a covalent bond in place of an N-terminal i to i+4 hydrogen bond and have been used to target and disrupt PPIs that become dysregulated in disease states. These compounds have improved conformational stability and cellular uptake as compared to their linear peptide counterparts. The protocol presented here describes current methodology for the synthesis of HBS α-helical mimetics. The solid-phase synthesis of HBS helices involves solid-phase peptide synthesis with three key steps involving incorporation of N-allyl functionality within the backbone of the peptide, coupling of a secondary amine, and a ring-closing metathesis step. Curr. Protoc. Chem. Biol. 6:101-116 © 2014 by John Wiley & Sons, Inc. Keywords: α-helix mimetics; hydrogen-bond surrogate; protein-protein interactions

Root rot of parsnip (Pastinaca sativa) and parsley (Petroselinum crispum) crops in south-eastern Australia is a disease complex, causing up to 80 % and 100 % yield losses, respectively. It is attributed to a range of fungi and oomycetes. We report on isolation and identification of eleven Pythium spp. from naturally infected roots of parsnip and parsley collected during systematic monthly surveys of commercial, winter-grown crops with prevailing root rots at Devon Meadows and Clyde, Victoria, Australia in 2009 to 2011. Pythium intermedium, P. ultimum var. ultimum, P. rostratifingens and species from the P. dissotocum complex were common to both hosts. Pythium irregulare, P. sylvaticum, P. camurandrum, P. vanterpoolii and P. tracheiphilum were isolated only from parsnip; and P. mastophorum and P. sulcatum only from parsley. This is the first report of P. camurandrum and P. rostratifingens in Australia and the first report of P. tracheiphilum and P. vanterpoolii from parsnip in Australia. Selected Pythium spp. tested for their pathogenicity in glasshouse conditions were pathogenic to both hosts. Pythium sulcatum, P. mastophorum and P. tracheiphilum caused severe root in 35 %, 53 % and 25 % of parsley seedlings, respectively. Pythium sulcatum and P. intermedium caused severe root in 50 % and 15 % of parsnip seedlings, respectively. In growth chamber studies, P. sulcatum was pathogenic to parsley seedlings at 10 °C, 18 °C and 24 °C.

Options for the integrated management of white blister (caused by Albugo candida) of Brassica crops include the use of well timed overhead irrigation, resistant cultivars, programs of weekly fungicide sprays or strategic fungicide applications based on the disease risk prediction model, Brassicaspot™. Initial systematic surveys of radish producers near Melbourne, Victoria, indicated that crops irrigated overhead in the morning (0800–1200 h) had a lower incidence of white blister than those irrigated overhead in the evening (2000–2400 h). A field trial was conducted from July to November 2008 on a broccoli crop located west of Melbourne to determine the efficacy and economics of different practices used for white blister control, modifying irrigation timing, growing a resistant cultivar and timing spray applications based on Brassicaspot™. Growing the resistant cultivar, ‘Tyson’, instead of the susceptible cultivar, ‘Ironman’, reduced disease incidence on broccoli heads by 99 %. Overhead irrigation at 0400 h instead of 2000 h reduced disease incidence by 58 %. A weekly spray program or a spray regime based on either of two versions of the Brassicaspot™ model provided similar disease control and reduced disease incidence by 72 to 83 %. However, use of the Brassicaspot™ models greatly reduced the number of sprays required for control from 14 to one or two. An economic analysis showed that growing the more resistant cultivar increased farm profit per ha by 12 %, choosing morning irrigation by 3 % and using the disease risk predictive models compared with weekly sprays by 15 %. The disease risk predictive models were 4 % more profitable than the unsprayed control.

In addition to regular review work, the Pharmacology and Toxicology Statistics Team in CDER/FDA is actively engaged in a number of research projects. In this chapter we summarize some of our recent investigations and findings.

Los rellenos sanitarios constituyen un foco de atracción para la avifauna, aunque las implicancias de esta relación no han sido exploradas en el país. Nosotros monitoreamos la actividad de aves en un relleno sanitario ubicado en las proximidades de la ciudad de Santiago, capital administrativa de Chile. Las principales aves en el área fueron la gaviota dominicana (Larus dominicanus Lichtenstein), el tiuque (Milvago chimango Vieillot), la garza boyera {Buculbus ibis Linnaeus) y el águila (Geranoaetus melanoleucus Swann). La gaviota dominicana alcanzó los valores de abundancia más altos (entre 358 y 1950 individuos por día) y destacó por su comportamiento bimodal, directamente relacionado con los niveles de operación en el relleno sanitario. En el caso del águila se registró una conducta carroñera cleptoparásita sobre los tiuques, estos últimos seleccionan desechos orgánicos (pescados, tripas, carne), que les son usurpados por ellas. Finalmente señalamos medidas simples de manejo que deberían disminuir los números de aves en este tipo de actividad industrial.Landfills are considered an attractive habitat for several bird species; however, implications of this condition have not yet been explored in the country. We monitored birds' activity patterns that use a landfill located in the vicinity of Santiago, Chile's capital. Main birds recorded in the area were, Kelp gull (Larus dominicanus Lichtenstein), Chimango caracara (Milvago chimango Vieillot), Cattle egret (Buculbus ibis Linnaeus) and Black Chested Eagle (Geranoaetus melanoleucus Swann). Kelp Gull was the most abundant species, (with values between 358 to 1950 individuals per day) and that also displayed a bimodal behavior linked directly to the landfill operation levels. In the case of Black Chested Eagle, we observed a kleptoparasitic behavior over Chimango Caracara which selected organic offal (fishes, innards, meat) for its feeding and that are stolen by the eagle. Finally we highlight simple management activities that should decrease the number of birds in these kinds of facilities.