Report on the Alternative Platform Observer Program in North Carolina: March 2006 to March 2007

In February 2006, an Alternative Platform Observer Program (APP) was implemented in North Carolina (NC) to observe commercial gillnet trips by small vessels [<24 ft (7.2 m)] in nearshore waters out to three nm (5.6 km). Efforts began with outreach to the fishing industry while simultaneously gathering information to be incorporated in a Database of Fishermen. From 30 March 2006 through 31 March 2007, 36 trips were observed. Observed trips of the NC nearshore gillnet fishery targeted seven species: kingfish (Menticirrhus spp.), Spanish mackerel (Scomberomorus maculatus), spiny dogfish (Squalus acanthias), spot (Leiostomus xanthurus), spotted seatrout (Cynoscion nebulosus), striped bass (Morone saxatilis), and weakfish (Cynoscion regalis). Of the 36 trips, 20 (55.6%) were with vessels that were new to the Northeast Fisheries Observer Program (NEFOP), having never carried an observer. Based on the landings data for small vessels from North Carolina Division of Marine Fisheries (NCDMF), the APP has achieved 10.1% coverage by number of trips and 4.0% by pounds landed. No incidental takes of bottlenose dolphins were observed by the APP, although bottlenose dolphins were sighted during 19 (52.8%) observed trips. The APP has drastically increased the number of observed trips of small vessels in the nearshore waters of NC. When combined with trips observed by NEFOP (n=205), the APP resulted in a 15.6% increase in the number of observed gillnet trips. (PDF contains 34 pages

Influenza control can be achieved in a custodial setting: pandemic (H1N1) 2009 and 2011 in an Australian prison

OBJECTIVES: Information on the effectiveness of interventions regarding control in closed institutional settings, including prisons, is limited. This study gathered evidence relating to influenza control in an Australian prison. STUDY DESIGN: This study built on a 2009 H1N1 outbreak investigation at the Alexander Maconochie Centre (AMC) in the Australian Capital Territory (ACT). METHODS: Influenza surveillance data, ACT 2010 Inmate Health Survey data, New South Wales 2001 and 2009 Inmate Health Survey data, ACT Department of Corrective Services administrative data, and ACT Health clinical data were analysed. RESULTS: In 2011, the AMC was exposed to influenza virus, resulting in a single case. Public health activities included exclusion of symptomatic cases from the health facility, isolation of cases, and quarantine of contacts. Contact between prisoners and the ACT community was maintained; the AMC detainee visitor rate was one visitor per prisoner every 10 days. CONCLUSIONS: The rehabilitative benefits of human contact for AMC detainees were not compromised during the surveillance period, despite the potential that a higher visitor rate may suggest. This highlights some features of the AMC which make its operational context different from many other correctional settings, but gives some indication of how good public health practice supports human rights.NHMRC (National Health and Medical Research Council of Australia

Identifying which septic patients have increased mortality risk using severity scores:a cohort study

Background: Early aggressive therapy can reduce the mortality associated with severe sepsis but this relies on prompt recognition, which is hindered by variation among published severity criteria. Our aim was to test the performance of different severity scores in predicting mortality among a cohort of hospital inpatients with sepsis. Methods: We anonymously linked routine outcome data to a cohort of prospectively identified adult hospital inpatients with sepsis, and used logistic regression to identify associations between mortality and demographic variables, clinical factors including blood culture results, and six sets of severity criteria. We calculated performance characteristics, including area under receiver operating characteristic curves (AUROC), of each set of severity criteria in predicting mortality. Results: Overall mortality was 19.4% (124/640) at 30 days after sepsis onset. In adjusted analysis, older age (odds ratio 5.79 (95% CI 2.87-11.70) for &ge;80y versus &lt;60y), having been admitted as an emergency (OR 3.91 (1.31-11.70) versus electively), and longer inpatient stay prior to sepsis onset (OR 2.90 (1.41-5.94) for &gt;21d versus &lt;4d), were associated with increased 30 day mortality. Being in a surgical or orthopaedic, versus medical, ward was associated with lower mortality (OR 0.47 (0.27-0.81) and 0.26 (0.11-0.63), respectively). Blood culture results (positive vs. negative) were not significantly association with mortality. All severity scores predicted mortality but performance varied. The CURB65 community-acquired pneumonia severity score had the best performance characteristics (sensitivity 81%, specificity 52%, positive predictive value 29%, negative predictive value 92%, for 30 day mortality), including having the largest AUROC curve (0.72, 95% CI 0.67-0.77). Conclusions: The CURB65 pneumonia severity score outperformed five other severity scores in predicting risk of death among a cohort of hospital inpatients with sepsis. The utility of the CURB65 score for risk-stratifying patients with sepsis in clinical practice will depend on replicating these findings in a validation cohort including patients with sepsis on admission to hospital

Urine Specimens from Pregnant and Nonpregnant Women Inhibitory to Amplification of \u3cem\u3eChlamydia trachomatis\u3c/em\u3e Nucleic Acid by PCR, Ligase Chain Reaction, and Transcription-Mediated Amplification: Identification of Urinary Substances Associated with Inhibition and Removal of Inhibitory Activity

The presence of endogenous amplification inhibitors in urine may produce false-negative results for the detection of Chlamydia trachomatis nucleic acids by tests such as PCR, ligase chain reaction (LCR), and transcription-mediated amplification (TMA). Consecutive urine specimens from 101 pregnant women and 287 nonpregnant women submitted for urinalysis were processed for C. trachomatis detection. Aliquots were spiked with the equivalent of one C. trachomatis elementary body and were tested by three commercial assays: AMPLICOR CT/NG, Chlamydia LCX, and Chlamydia TMA. The prevalence of inhibitors resulting in complete inhibition of amplification was 4.9% for PCR, 2.6% for LCR, and 7.5% for TMA. In addition, all three assays were partially inhibited by additional urine specimens. Only PCR was more often inhibited by urine from pregnant women than by urine from nonpregnant women (9.9 versus 3.1%; P = 0.011). A complete urinalysis including dipstick and a microscopic examination was performed. Logistic regression analysis revealed that the following substances were associated with amplification inhibition: beta-human chorionic gonadotropin (odd ratio [OR], 3.3) and crystals (OR, 3.3) for PCR, nitrites for LCR (OR, 14.4), and hemoglobin (OR, 3.3), nitrites (OR, 3.3), and crystals (OR, 3.3) for TMA. Aliquots of each inhibitory urine specimen were stored at 4 and -70°C and a dilution of 1:10 (84% for PCR, 100% for LCR, and 92% for TMA). Five urine specimens (three for PCR and two for TMA) required phenol-chloroform extraction to remove inhibitors. The results indicate that the prevalence of nucleic acid amplification inhibitors in female urine is different for each technology, that this prevalence may be predicted by the presence of urinary factors, and that storage and dilution remove most of the inhibitors

Modelling the atomic structure of very high-density amorphous ice

The structure of very high-density amorphous (VHDA) ice has been modelled by positionally disordering three crystalline phases, namely ice IV, VI and XII. These phases were chosen because only they are stable or metastable in the region of the ice phase diagram where VHDA ice is formed, and their densities are comparable to that of VHDA ice. An excellent fit to the medium range of the experimentally observed pair-correlation function g(r) of VHDA ice was obtained by introducing disorder into the positions of the H2O molecules, as well as small amounts of molecular rotational disorder, disorder in the O--H bond lengths and disorder in the H--O--H bond angles. The low-k behaviour of the experimental structure factor, S(k), is also very well reproduced by this disordered-crystal model. The fraction of each phase present in the best-fit disordered model is very close to that observed in the probable crystallization products of VHDA ice. In particular, only negligible amounts of ice IV are predicted, in accordance with experimental observation.Comment: 4 pages, 3 figures, 1 table, v2: changes made in response to referees' comments, the justification for using certain ice phases is improved, and ice IV is now disordered as wel

Do managed clinical networks improve quality of diabetes care? : Evidence from a retrospective mixed methods evaluation

Peer reviewedPostprin

Heterotopic Ossification following Suprapatellar Intramedullary Nailing.

Introduction: Tibial shaft fractures are common fractures seen in trauma and orthopedic practice today. The majority of these fractures are treated with intramedullary nailing (IMN) which is rapidly becoming a gold standard. The procedure itself is performed by either a suprapatellar approach or infrapatellar approach. Suprapatellar approach is gaining popularity due to relative ease of insertion, decreased associated risk of anterior knee pain, and more accurate reduction. We report a case of heterotopic ossification noted in the knee following IMN of tibia performed using a suprapatellar approach. Case Report: A 27-year-old male, having sustained a left, Gustilo IIIB tibial shaft fracture following a motor vehicle accident, underwent a reamed intramedullary nail fixation performed through a suprapatellar approach. Two months later, he presented with intra-articular heterotopic ossification which was limiting his knee movement. He then underwent arthroscopic removal of the bony fragments which resolved his symptoms. Conclusion: An extensive search of literature did not yield any reported incidence of heterotopic ossification associated with IMN performed through a suprapatellar approach. We present this case report to raise awareness that although IMN through a suprapatellar approach is a safe approach, it does have associated risk of heterotopic ossification which needs to be included in the consent process

Colored Apparel - Relevance to Attraction in Humans

There are numerous different dyes available, many varied fashion trends, and various different ways to change/enhance physical aesthetics. Predicting color preferences and how colors and color combinations, in a shape context, stimulate certain emotions, represents a challenging prospect. Color is a critical cue for sexual signaling, but what the preferred colors actually are in humans, is difficult to predict. Understanding color preferences and perception of color within a context such as attraction, is essential for improving color forecasting and gaining a deeper understanding of color perception. The appearance of color can change based on lighting, shape, texture, and the surrounding environment and associated colors. While these provide physical color characteristics, human vision and perception contributes to how a color appears to the individual. Perception is unique to each individual and is constantly changing due to the influence of a range of variables. This can cause someone to appear visually attractive or visually unattractive. By taking into account all the variables that contribute to human studies in color perception, tailored research can continue to be undertaken to further develop a deeper understanding of color perception and human attraction regarding visual stimulation