The factors contributing to better workplaces for farmers on pasture-based dairy farms.

Herd size expansion, combined with the reduced availability of people to work on farms, has led to an increased focus on techniques that can improve dairy farm social sustainability. Effective work organization is one such entity, which could influence farm social sustainability; focusing on having a productive, flexible and standardized farm workload. The objective of this study was to examine the factors that contribute to better workplaces for the farmer using a survey of representative pasture-based dairy farms in Ireland. Potential contributing factors to better workplaces for farmers were identified, namely; farm and farmer characteristics, working day structure, farmer attitudes, farm facilities, labor efficient practices and human resource management practices. A survey was completed by 313 Irish dairy farmers between 20 November and 3 January 2019 to capture relevant information. One proxy indicator was selected to represent each of productivity, flexibility and standardization within the workplace, and each of the 313 farms were categorized into quartiles based on their ranking for these 3 indicators (1 = most effective quartile to 4 = least effective quartile). The average farmer that completed the survey was 51 years old, milked 125 cows, reported to work 69.6 h/ week, take 10.3 d of holidays/ year and had a finish time of 19:52 in spring. The quartile of farms with the most effective farmer workplace reported reduced hours worked per week (58.6 v 82.6 h per week), more holiday days (16.6 v 5.1 d) and weekends off (8.3 v 2.4) per year, and earlier finish times (18:41 v 21:14 in spring) compared with the least effective quartile. Similarly, the most effective farms reported better facilities, and greater implementation of labor efficient and human resource management practices compared with the least effective farms. The most effective quartile for farmer workplace effectiveness were more positive about the industry's potential to offer an effective work-life balance, would be more likely to encourage young people to pursue careers in dairy, and had more positive attitudes toward attracting and retaining workers compared with the least effective quartile. The study highlighted the range of factors contributing to more effective workplaces for farmers, indicating scope for improvement on many farms, and challenges across all farms when compared with other industries in the case of some indicators (e.g., time-off). The results can support the continued extension of concepts regarding work organization to assist farms in alleviating social sustainability challenges; highlighting the differentiating factors between the most and least effective farmer workplaces.

An examination of labor time-use on spring-calving dairy farms in Ireland.

The seasonal workload associated with pasture-based dairy farms, combined with increasing herd sizes, has led to a renewed focus on labor time-use and efficiency on dairy farms. The objective of this study was to examine labor time-use on pasture-based dairy farms in the spring and summer seasons. A total of 82 spring-calving Irish dairy farms completed the study from February 1 to June 30, 2019 (150 d). Each farmer recorded their labor input on one alternating day each week using a smartphone app. Any labor input by farm workers not using the app was recorded through a weekly online survey. Farms with data for each month (n = 76) were classified into 1 of 4 herd size categories (HSC) for analysis: farms with 50 to 90 cows (HSC 1); 91 to 139 cows (HSC 2); 140 to 239 cows (HSC 3); and ≥240 cows (HSC 4). Total hours of labor input was similar on HSC 1 (1,821 h) and HSC 2 (2,042 h) farms, but predictably as HSC increased further, total hours of labor input increased (HSC 3: 2,462 h, HSC 4: 3,040 h). On a monthly basis, labor input peaked in February (15.4 h/d) and March (15.7 h/d). The farmer worked on average 60.0 h/wk over the duration of the study period. Hired labor and contractors completed a greater amount of work as HSC increased. Labor efficiency, as measured by hours/cow, improved as HSC increased (HSC 1: 26.3 h/cow, HSC 2: 17.7 h/cow, HSC 3: 14.3 h/cow, HSC 4: 10.9 h/cow), though there were large variations in labor efficiency within HSC. Milking was the most time-consuming task, representing 31% of farm labor input making it an important focus for potential improvements in efficiency. The next 5 most time-consuming tasks were calf care (14%), grassland management (13%), cow care (10%), repairs and maintenance (10%), and administration/business (8%). This study contributes to the understanding of labor use during the busiest (most labor demanding) time of the year on pasture-based dairy farms and points to areas where labor efficiency improvements can be made on farms. The considerable variation in farm labor efficiency observed within HSCs emphasizes the necessity for a greater focus on knowledge transfer of methods to achieve improved labor efficiency and a better work-life balance on many dairy farms. As the 2 busiest months on most dairy farms, February and March require the most focus for identification of potential labor savings.

Estimating the effect of different work practices and technologies on labor efficiency within pasture-based dairy systems.

Herd size expansion combined with the seasonal workload on pasture-based dairy farms has led to an increased focus on techniques that can improve farm labor efficiency such as work practices and technologies. The objective of this study was to identify the work practices and technologies associated with labor efficiency of particular tasks, and estimate the time savings that could be made through their implementation during the period of peak labor input on spring-calving dairy farms. Data from an existing labor time-use study, completed from February 1 to June 30, 2019 (150 d), on 76 Irish dairy farms was used in conjunction with a survey on work practice and technology implementation. One hundred ten work practices and technologies were included in the initial survey, and of these, 59 were found to have an association with labor efficiency for their respective tasks. Best practice, regarding labor efficiency, was identified for the 59 work practices and technologies. An accumulation score was compiled for work practice and technology implementation; each farm received one point for each work practice or technology implemented. On average, farms implemented 31 labor-efficient work practices and technologies (ranging from 10-45). The most labor-efficient 25% of farms implemented a greater number of work practices and technologies (n = 37) than the least labor-efficient 25% of farms (n = 25). Multiple regression models estimated that each additional work practice or technology implemented would improve farm labor efficiency by 0.6 h/cow. Additionally, backward-regression models were used to predict the labor-savings associated with the most important work practices and technologies. Labor-savings were estimated for 12 significant individual work practices and technologies, of which 5 were related to milking, 4 to calf care, 2 to cow care, and one to grassland management. The work practices and technologies that offered the largest labor-savings included having one person in the milking pit during the mid-lactation period (-3.04 h/cow), having automatic cluster removers present (-2.55 h/cow) and contracting slurry spreading (-1.78 h/cow). This study focused on the variety of labor-efficient work practices and technologies available and highlighted those that farmers should focus on to improve labor efficiency. The results indicated that there is scope for improvement in the adoption of labor-saving work practices and technologies on many farms. The positive effect of implementing the identified labor-saving techniques on labor efficiency could be used to support future adoption.

Controlling the Local Electronic Properties of Si(553)-Au through Hydrogen Doping.

We propose a quantitative and reversible method for tuning the charge localization of Au-stabilized stepped Si surfaces by site-specific hydrogenation. This is demonstrated for Si(553)-Au as a model system by combining density functional theory simulations and reflectance anisotropy spectroscopy experiments. We find that controlled H passivation is a two-step process: step-edge adsorption drives excess charge into the conducting metal chain "reservoir" and renders it insulating, while surplus H recovers metallic behavior. Our approach illustrates a route towards microscopic manipulation of the local surface charge distribution and establishes a reversible switch of site-specific chemical reactivity and magnetic properties on vicinal surfaces.

Evidence of ß-antimonene at the Sb/Bi2Se3 interface.

We report a study of the interface between antimony and the prototypical topological insulator Bi2Se3. Scanning tunnelling microscopy measurements show the presence of ordered domains displaying a perfect lattice match with bismuth selenide. Density functional theory calculations of the most stable atomic configurations demonstrate that the ordered domains can be attributed to stacks of ß-antimonene.

Appropriate clinical use of human leukocyte antigen typing for coeliac disease: an Australasian perspective.

The past decade has seen human leukocyte antigen (HLA) typing emerge as a remarkably popular test for the diagnostic work-up of coeliac disease with high patient acceptance. Although limited in its positive predictive value for coeliac disease, the strong disease association with specific HLA genes imparts exceptional negative predictive value to HLA typing, enabling a negative result to exclude coeliac disease confidently. In response to mounting evidence that the clinical use and interpretation of HLA typing often deviates from best practice, this article outlines an evidence-based approach to guide clinically appropriate use of HLA typing, and establishes a reporting template for pathology providers to improve communication of results.

ABO incompatible renal transplantation without antibody removal using conventional immunosuppression alone.

ABO incompatible living donor renal transplantation (ABOi) can achieve outcomes comparable to ABO compatible transplantation (ABOc). However, with the exception of blood group A2 kidneys transplanted into recipients with low titer anti-A antibody, regimens generally include antibody removal, intensified immunosuppression and splenectomy or rituximab. We now report a series of 20 successful renal transplants across a range of blood group incompatibilities using conventional immunosuppression alone in recipients with low baseline anti-blood group antibody (ABGAb) titers. Incompatibilities were A1 to O (3), A1 to B (2), A2 to O (2), AB to A (2), AB to B (1), B to A1 (9), B to O (1); titers 1:1 to 1:16 by Ortho. At 36 months, patient and graft survival are 100%. Antibody-mediated rejection (AbMR) occurred in one patient with thrombophilia and low level donor-specific anti-HLA antibody. Four patients experienced cellular rejection (two subclinical), which responded to oral prednisolone. This series demonstrates that selected patients with low titer ABGAb can undergo ABOi with standard immunosuppression alone, suggesting baseline titer as a reliable predictor of AbMR. This reduces morbidity and cost of ABOi for patients with low titer ABGAb and increases the possibility of ABOi from deceased donors.

Casting light on the darkening of colors in historical paintings.

The degradation of colors in historical paintings affects our cultural heritage in both museums and archeological sites. Despite intensive experimental studies, the origin of darkening of one of the most ancient pigments known to humankind, vermilion (α-HgS), remains unexplained. Here, by combining many-body theoretical spectroscopy and high-resolution microscopic x-ray diffraction, we clarify the composition of the damaged paint work and demonstrate possible physicochemical processes, induced by illumination and exposure to humidity and air, that cause photoactivation of the original pigment and the degradation of the secondary minerals. The results suggest a new path for the darkening process which was never considered by previous studies and prompt a critical examination of their findings.

Potassium titanyl phosphate laser surface tympanoplasty as a novel treatment for chronic granular myringitis in a series of 14 patients.

OBJECTIVE: Granular myringitis is a chronic and difficult-to-treat condition of the tympanic membrane. This paper presents a minimally invasive treatment technique using the potassium titanyl phosphate laser. DESIGN: A retrospective case review of patients who underwent potassium titanyl phosphate laser treatment between 2015 and 2020 was performed. All patients underwent final telephone follow up in 2020 to ascertain whether they had any ongoing myringitis symptoms, and all were offered further face-to-face follow up. RESULTS: Fourteen patients with myringitis were identified, with one patient having both ears affected. Of the 15 affected ears, 2 required a second treatment, resulting in a total of 17 laser treatment cases. At the first post-operative review, the appearance of the drum had improved in 10 out of 17 treatments (59 per cent). CONCLUSION: Potassium titanyl phosphate laser surface tympanoplasty may provide safe, quick and effective resolution of myringitis.

Successful ABO-incompatible kidney transplantation with antibody removal and standard immunosuppression.

ABO-incompatible (ABOi) kidney transplantation is an established therapy, though its implementation to date has been in part limited by the requirement for additional immunosuppression. Here, we describe the outcomes of 37 patients undergoing ABOi kidney transplantation utilizing perioperative antibody depletion and receiving an identical tacrolimus-based immunosuppressive regimen to contemporaneous ABO-compatible (ABOc) recipients, with the exception that mycophenolate was commenced earlier (7-14 days pretransplant). Antibody depletion was scheduled according to baseline anti-ABO antibody titer (tube IAT method: median 1:128, range 1:8 to 1:4096). Patient and graft survival for the 37 ABOi recipients was 100% after a median 26 months (interquartile range [IQR] 18-32). Eight rejection episodes (two antibody-mediated and six cellular) in ABOi recipients were successfully treated with biopsy-proven resolution. Latest median eGFR is 50 mL/min × 1.73 m² (IQR 40-64) for ABOi patients and 54 mL/min × 1.73 m² (IQR 44-66) in the ABOc patients (p = 0.25). We conclude that ABOi transplantation can be performed successfully with perioperative antibody removal and conventional immunosuppression. This suggests that access to ABOi transplantation can include a broader range of end-stage kidney disease patients.

Care Team Perspectives About an Inpatient Portal: Benefits and Challenges of Patients' Portal Use During Hospitalization.

While current research about inpatient portals has focused largely on the patient perspective, it is also critical to consider the care team point of view, as support from these individuals is essential to successful portal implementation and use. We held brief in-person interviews with 433 care team members across a six-hospital health system to explore opinions about patients' use of an inpatient portal as perceived by care team members. Using the Inpatient Portal Evaluation Framework, we characterized benefits and challenges of portal use that care team members reported affected patients, themselves, and the collaborative work of these care teams with their patients. Interviewees noted inpatient portals can improve patient care and experience and also indicated room for improvement in portal use for hospitalized patients. Further understanding of the care team perspective is critical to inform approaches to inpatient portal implementation that best benefit both patients and providers.

Topologization of ß-antimonene on Bi2Se3 via proximity effects.

Topological surface states usually emerge at the boundary between a topological and a conventional insulator. Their precise physical character and spatial localization depend on the complex interplay between the chemical, structural and electronic properties of the two insulators in contact. Using a lattice-matched heterointerface of single and double bilayers of ß-antimonene and bismuth selenide, we perform a comprehensive experimental and theoretical study of the chiral surface states by means of microscopy and spectroscopic measurements complemented by first-principles calculations. We demonstrate that, although ß-antimonene is a trivial insulator in its free-standing form, it inherits the unique symmetry-protected spin texture from the substrate via a proximity effect that induces outward migration of the topological state. This "topologization" of ß-antimonene is found to be driven by the hybridization of the bands from either side of the interface.

Management of osteoporosis in primary care in Australia.

UNLABELLED: This study reviewed factors influencing osteoporosis management in primary care settings in Australia and examined risk profiles of patients (n = 37,957) for osteoporosis. Only 29.7% of patients with a prior fracture were currently on specific medication for osteoporosis. The results highlight the need for further exploration of barriers to osteoporosis management. INTRODUCTION: Osteoporosis management in primary care is suboptimal even for high-risk people with a history of prior fracture. METHODS: This study reviewed factors influencing the management of individuals at risk for osteoporosis in primary care settings in Australia and examined risk profiles of patients for osteoporosis. Patients (n = 37,957, mean age 71) were recruited over a 12-month period (February 2006-Jan 2007) and interviewed. RESULTS: With regard to risk factors for osteoporosis, 12.6% of patients reported a history of prior minimal trauma fracture, 7.5% reported a family history of osteoporosis, 7.4% reported they were current smokers, 11.4% reported low dietary calcium intake, 31.8% reported no regular weekly physical exercise and 10.3% reported current use of glucocorticoids. Of those with a prior fracture, only 29.7% were currently on specific medication for osteoporosis. Radiography (n = 17,754) demonstrated a prior vertebral fracture in 30.1%, but only 3.8% of the 17,754 patients reported current use of specific osteoporosis medication. CONCLUSIONS: This study has confirmed low rates of treatment in primary care even in individuals who have already suffered a prior fracture or have other risk factors. This study highlights the need for further exploration of barriers to osteoporosis management in the primary care setting.

Physiological evidence for involvement of a kinesin-related protein during anaphase spindle elongation in diatom central spindles.

We have developed a new model system for studying spindle elongation in vitro using the pennate, marine diatom Cylindrotheca fusiformis. C. fusiformis can be grown in bulk to high densities while in log phase growth and synchronized by a simple light/dark regime. Isolated spindles can be attained in quantities sufficient for biochemical analysis and spindle tubulin is approximately 5% of the total protein present. The spindle isolation procedure results in a 10-fold enrichment of diatom tubulin and a calculated 40-fold increase in spindle protein. Isolated spindles or spindles in permeabilized cells can elongate in vitro by the same mechanism and with the same pharmacological sensitivities as described for other anaphase B models (Cande and McDonald, 1986; Masuda et al., 1990). Using this model, in vitro spindle elongation rate profiles were developed for a battery of nucleotide triphosphates and ATP analogs. The relative rates of spindle elongation produced by various nucleotide triphosphates parallel relative rates seen for kinesin-based motility in microtubule gliding assays. Likewise ATP analogs that allow discrimination between myosin-, dynein-, and kinesin-mediated motility produce relative spindle elongation rates characteristic of kinesin motility. Also, isolated spindle fractions are enriched for a kinesin related protein as identified by a peptide antibody against a conserved region of the kinesin superfamily. These data suggest that kinesin-like motility contributes to spindle elongation during anaphase B of mitosis.

Secretion of nerve growth factor by central nervous system glioma cells in culture.

Bacteriophage immunoassays, radioimmunoassays, and biological assays have been used to measure levels of NGF in media conditioned by rat C-6 glioma cells in culture. By all three criteria, these cells secrete a macromolecule which is indistinguishable from mouse submandibular gland NGF.

Thrombotic thrombocytopenic purpura is associated with a high relapse rate after plasma exchange: a single-centre experience.

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a rare condition characterized by microangiopathic haemolytic anaemia, thrombocytopenia, renal and/or neurological dysfunction secondary to microvascular or macrovascular thrombosis. Despite advances in treatment, TTP remains a serious condition with significant morbidity and mortality. METHODS: We undertook an audit of patients with TTP over 14 years to assess remission, relapse, survival and factors predictive of outcome using current therapy based on plasma exchange with fresh-frozen plasma. RESULTS: Forty patients were identified between January 1992 and December 2005. Thirty-one (82%) achieved complete response (CR) to therapy using plasma exchange with fresh-frozen plasma (median 11 exchanges) and steroids. Twelve (37%) relapsed a median of 14 days following cessation of therapy, with multiple relapses occurring in two patients. TTP-related death occurred in four patients during their initial presentation and in two during subsequent relapse. Four patients were only partially responsive to first-line therapy. The absence of neurological features at presentation was the only factor predicting a sustained CR to first-line therapy (P = 0.027, log-rank analysis). The mean duration of inpatient treatment was 18 days (range 4-38 days) with 30% of patients requiring intensive care admission. Thirty-four per cent of patients acquired central venous line infection, with a median of two episodes of line sepsis per patient. CONCLUSION: Our results indicate the need for better treatments to reduce the high early relapse rate and significant mortality associated with current therapy.

Rapid antimicrobial susceptibility testing by VITEK®2 directly from blood cultures in patients with Gram-negative rod bacteremia.

OBJECTIVE: Optimizing therapy for bacteremia is currently limited by the 1-2-day turnaround time required for antimicrobial susceptibility testing (AST). Here, we assess a rapid AST method with VITEK®2 (bioMérieux, France) directly from positive blood cultures. METHODS: Patient-derived positive blood cultures with Gram-negative rods identified as Enterobacteriaceae and Pseudomonas aeruginosa were prospectively tested, and other blood culture bottles were spiked with carbapenem-resistant Enterobacteriaceae (CRE). Positive cultures were subjected to red blood cell lysis and centrifugation, and setup on VITEK®2. RESULTS: A total of 109 patient blood cultures and 52 spiked blood cultures were tested. Overall, essential agreement was 97.7% [95% confidence interval (CI) 96.4-99.0], and categorical agreement was 96.8% (95% CI 95.0-98.6). Mean turnaround time from setup to susceptibility results for Enterobacteriaceae in the clinical cultures was 9.0 (±1.3) h. CONCLUSIONS: Direct susceptibility testing of blood cultures by VITEK®2 for Enterobacteriaceae is an accurate, practical, and inexpensive diagnostic strategy for rapid automated AST.

Many-body perturbation theory calculations using the yambo code.

yambo is an open source project aimed at studying excited state properties of condensed matter systems from first principles using many-body methods. As input, yambo requires ground state electronic structure data as computed by density functional theory codes such as Quantum ESPRESSO and Abinit. yambo's capabilities include the calculation of linear response quantities (both independent-particle and including electron-hole interactions), quasi-particle corrections based on the GW formalism, optical absorption, and other spectroscopic quantities. Here we describe recent developments ranging from the inclusion of important but oft-neglected physical effects such as electron-phonon interactions to the implementation of a real-time propagation scheme for simulating linear and non-linear optical properties. Improvements to numerical algorithms and the user interface are outlined. Particular emphasis is given to the new and efficient parallel structure that makes it possible to exploit modern high performance computing architectures. Finally, we demonstrate the possibility to automate workflows by interfacing with the yambopy and AiiDA software tools.

Electronic structure of the Ge/Si(1 0 5) hetero-interface: an ARPES and DFT study.

We present a joint experimental and theoretical study of the electronic properties of the rebonded-step reconstructed Ge/Si(1 0 5) surface which is the main strained face found on Ge/Si(0 0 1) quantum dots and is considered a prototypical model system for surface strain relaxation in heteroepitaxial growth. Using a vicinal surface as a model system for obtaining a stable single-domain film structure with large terraces and rebonded-step surface termination, we realized an extended and ordered Ge/Si planar hetero-junction suitable for direct study with angle-resolved photoemission spectroscopy. At the coverage of four Ge monolayers photoemission spectroscopy reveals the presence of 2D surface and film bands displaying energy-momentum dispersion compatible with the 5 × 4 periodicity of the system. The good agreement between experiment and first-principles electronic structure calculations confirms the validity of the rebonded-step structural model. The direct observation of surface features within 1 eV below the valence band maximum corroborates previously reported analysis of the electronic and optical behavior of the Ge/Si hetero-interface.