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The proliferation in mesoherbivore numbers and their associated impact on the detrital ground cover were deemed responsible for the decline in fossorial herpetofaunal densities in Ndumo Game Reserve during the early 2000s. Subsequent increased poaching pressure and wildlife declines allowed the reassessment of the sand forest fossorial herpetofaunal community to test this assumption. We found no significant increase in the two most abundant soil‐living reptiles despite significant mesoherbivore declines. This may indicate that either fossorial herpetofaunal numbers increase very slowly, or that the initial two survey methodologies were incomparable. Alternatively, some unknown environmental factor may be suppressing populations or the survey results are not representative of the fossorial herpetofaunal community. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasound is the standard imaging technique for diagnosing lower limb deep venous thrombosis (DVT). The National Institute for Health and Care Excellence (NICE) guidance 158 recommendation 1.1.3 states that all patients with sufficient pretest probability for DVT should be offered a proximal leg vein ultrasound within four hours. However, due to high patient volumes, formal radiology department ultrasound wait times often exceed one week. Point-of-care ultrasound (POCUS) is used to bridge diagnostic delay in our emergency department (ED). This study aimed to quantify numbers offered POCUS for suspected proximal lower DVT in our ED and accuracy of such studies. Method: A retrospective review of electronic records was conducted for patients who underwent formal lower-limb ultrasound for suspected DVT at our hospital over a three-month period (August 1, 2022-October 12, 2022). Patient charts for all ED presentations were assessed to determine whether POCUS was offered and whether DVT was diagnosed. Statistical analysis was conducted using PRISM v9. Results: 80 formal ultrasound scans were performed at our hospital for lower limb DVT. 58 were requested for patients presenting to ED, of which 42 had complete records available meeting selection criteria. POCUS was offered to 24 patients in ED (57.1%). Sensitivity was 66% (95% CI 12%- 98%), and specificity was 94.1% (95% CI 75%-99%). Overall accuracy was 90%, with only one false negative study identified at formal follow-up ultrasound. Conclusion: Although sample size was small, our results suggest that POCUS is an accurate but underused tool to diagnose lower limb DVT. Developing a standardized protocol for performing and reporting POCUS DVT scans in ED should allow for earlier diagnosis and initiation of appropriate treatment where necessary. [ABSTRACT FROM AUTHOR]

Introduction: Molecular assay for diagnosing and detecting SARS-COV-2 is an essential tool in pandemic management, allowing for early informed decision-making. Worldwide, the gold standard for testing SARS-COV-2 includes real-time reverse transcription-polymerase chain reaction assay (RT-PCR). The Cepheid Xpert-Xpress was authorized for emergency diagnosis of SARS-COV-2. This platform demonstrated various advantages, including faster results, due to a decreased turnaround time, and decreased contamination risk. However, inconclusive results often leave clinicians uncertain regarding individual patient management decisions. Often leading to more confusion than answers. The aim of this literature review includes the following: identify the frequency and clinical implications of inconclusive results for SARS-COV-2 diagnosis utilizing GeneXpert assay whether inconclusive results should be interpreted as negative assessing the reliability of the GeneXpert platform to diagnose SARS-COV-2 Method: A narrative literature review was conducted with eight critically appraised articles which met the inclusion criteria. After the initial data collection, the SANRA Framework was implemented to aid in the sorting and filtering of data. The analysis of data was conducted with a critical appraisal tool. Results: The GeneXpert SARS-COV-2 assay demonstrated high sensitivity and specificity. Studies indicated that inconclusive results associated with a high cycle-threshold value (CT-value) of more than thirty-five on the Cepheid Xpert Xpress were associated with a decreased viral load and, thus, decreased infectivity. However, numerous factors influence the CT-value, such as specimen integrity. Thus, results must not be interpreted in isolation. Conclusion: This narrative literature review demonstrated the need for institutions to assist clinicians with decision-making regarding inconclusive results. A flow diagram grading a patient's risk of having SARS-COV-2 with an inconclusive result could be of immense value. The flow diagram should incorporate the current epidemiology in the area, patient symptomology and risk and duration of exposure. [ABSTRACT FROM AUTHOR]

Introduction: The consequences of missed lower-limb deep vein thromboses (DVT) can be life-threatening. Similarly, inappropriate treatment with anticoagulation in low-risk patients carries a significant risk of harm. Early diagnosis and appropriate treatment with anticoagulation rely on timely ultrasound access. The National Institute for Health and Care Excellence (NICE) recommends timeframes for ultrasound acquisition based on Well's score and D-dimer value. If rapid ultrasound (Point of care Ultrasound POCUS in our context) demonstrates no features of DVT, it is safe to arrange follow-up scan within eight days without empiric anticoagulation. If, however, no bedside ultrasound is performed, anticoagulation is commenced until a formal scan excludes DVT. NG158 recommends this scan be performed within 24 hours. This audit investigated our compliance with NG158 time standards at Wexford General Hospital (WGH) emergency department (ED). Method: Electronic records for patients undergoing formal ultrasound for suspected DVT between 08/01/2022-10/13/2022 were reviewed using the hospital's databases. Charts were reviewed to determine if POCUS was performed. In total, 42 records met selection criteria. Audit Committee governance review was obtained. Fisher's exact test was used to compare compliance rates between those that underwent bedside ultrasound and those that did not. Results: Overall compliance with NG158 was 40.5%. Compliance rates for those offered bedside ultrasound were significantly higher than those that weren't (58.3% vs. 16.7% p<0.0106). The mean waiting time for a radiology department ultrasound is six days, 12 hours, and 16 minutes. Conclusion: Overall compliance is low, and delays to obtaining formal ultrasound are long. We observed that compliance rates for those who underwent bedside ultrasound were significantly higher than for those who did not. This suggests that bedside ultrasound is under-utilized in our ED. Training more staff to perform bedside scans would alleviate current delays to ultrasound diagnosis and reduce risks associated with empiric anticoagulation. [ABSTRACT FROM AUTHOR]

Ecological data on soil living amphibians and reptiles are largely lacking. Specialised methods relying on substrate excavation are required to adequately quantify fossorial herpetofaunal densities as surveying techniques which rely on surface movement (e.g. pitfall or funnel trap surveys) are biased against soil-living species which infrequently move over the soil surface. As part of a larger study, we quantified baseline densities for fossorial herpetofauna in grassland at Sileza Nature Reserve and in savanna at Tembe Elephant Park. All sites were underlain by aeolian sand. Grassland surveys were conducted at two adjoining sites, one during summer, and one in winter while both savanna sites were only surveyed during winter. Quadrats of 4 m2 (2 m x 2 m) were excavated to a mean depth of 0.25 m (volume of 1 m3) as most species of fossorial herpetofauna are considered to live at shallow soil depths. The excavated substrate was momentarily stored in 20 litre buckets before being sifted through a 2 mm x 2 mm (4 mm2) metal mesh, exposing soil living reptiles and amphibians. Grassland fossorial herpetofaunal densities were marginally lower during winter (0.56 individuals.m-2) compared to the summer (0.67 individuals.m-2) survey. Grassland species richness consisted of a single amphibian, Breviceps mossambicus, as well as five reptile species. Although amphibian species richness was considerably lower in grassland compared to reptiles, densities were higher especially during summer. Inter-seasonal demographic variability was observed in the grassland amphibian population with higher numbers of juveniles present during the summer. Herpetofaunal fossorial densities at savanna sites were on average more than four times lower (0.11 and 0.14 individuals.m-2 respectively) compared to grassland. Once again, the only amphibian present was B. mossambicus, but in much lower densities (0.01 and 0.02 individuals.m-2). It is hoped that the outcomes of this study will contribute to a better ecological understanding of soil megafauna in grassland and savanna ecosystems. [ABSTRACT FROM AUTHOR]

The Karoo boasts a wide variety of unique flora and fauna yet the region is still currently poorly surveyed for biodiversity. This lack of knowledge is true for all taxonomic groups, but none more so than reptiles. For example, only 3.5% of South Africa's reptile records have been obtained from the Karoo despite the region making up more than 30% of the country's total land mass and offering exceptional habitat for many of our reptile species. The Karoo has also been identified as an important development area for South Africa. Large scale international development projects such as shale gas drilling, uranium mining and the Square Kilometre Array, in conjunction with renewable energy infrastructure and continued farming will require responsible and informed planning. Here we present a detailed account of the herpetological surveys conducted by SANBI as part of the Karoo Biogaps Project made possible by a grant from the Foundational Biodiversity Information Programme (FBIP), and offer preliminary investigations into the herpetological diversity of this unique region. [ABSTRACT FROM AUTHOR]

Over 50% of South African reptile species are endemic, with at least 35% of these species found in the semi-arid Karoo region. The research attraction of the Karoo however, has been eclipsed by megadiverse areas within South Arica, resulting in a lack of baseline biodiversity data for the region. Shale gas development (fracking) in the Karoo has been proposed as a benefit for South Africa in terms of economy, job creation and the current energy crisis. However, the potential impacts on biodiversity could be substantial. Without sufficient biodiversity data, decisions relating to infrastructure development will be poorly informed, and monitoring future impacts on species diversity and ecosystem function will not be possible. Here we discuss the outcomes of the Karoo BioGaps Project, with particular interest in the contributions to reptiles in the region. From 2016-2018, 36 sites were surveyed in the Karoo, where over 2,000 new records were collected for 84 reptile species. Our surveys have doubled the number of individual records from the region. At some survey sites, we validated the presence of a large percentage of expected species, but we also found a number of unexpected species at several sites. DNA barcoding was an integral part of the project, and results suggests that some taxa are in need of revision. These findings demonstrate that biodiversity patterns can shift and change given improved survey data. Poor data therefore, can result in poor land use management decisions and emphasis should be placed on improving data in data deficient areas. [ABSTRACT FROM AUTHOR]