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.

Airborne protection for staff is associated with reduced hospital-acquired COVID-19 in English NHS trusts.

INTRODUCTION: The rate of hospital-acquired coronavirus disease 2019 has reduced from 14.3% to 4.2% over the last year, but substantial differences still exist between English National Health Service (NHS) hospital trusts. METHODS: This study assessed rates of hospital-acquired infection (HAI), comparing NHS hospital trusts using airborne respiratory protection (e.g. FFP3 masks) for all staff, as a marker of measures to reduce airborne spread, with NHS hospital trusts using mainly droplet precautions (e.g. surgical masks). RESULTS/DISCUSSION: The use of respiratory protective equipment was associated with a 33% reduction in the odds of HAI in the Delta wave, and a 21% reduction in the odds of HAI in the Alpha wave (P<0.00001). It is recommended that all hospitals should prioritize airborne mitigation.

Perioperative metabolic acidosis: The Bradford Anaesthetic Department Acidosis Study.

Metabolic acidosis is considered deleterious but is common in post-surgical patients admitted to intensive care unit. We evaluated the prevalence and time course of metabolic acidosis in elective major surgery, and generated hypotheses about causes, by hourly arterial blood sampling in 92 patients. Metabolic acidosis began before incision and most had occurred by the next hour. Seventy-eight per cent of patients had a significant metabolic acidosis post-operatively. Two overlapping phases were observed. The early phase started before incision, characterised by a rising chloride and falling anion gap, unrelated to saline use. The late phase was partly associated with lactate, related to surgery type, and early fluids appeared protective. There was a trend towards longer intensive care unit (+1.3 days) and hospital (+3.2 days) stay with metabolic acidosis. This is the first large study of the evolution of this common finding, demonstrating a pre-incision component. The early phase appears unavoidable or unpredictable, but the late phase might be modified by early fluid administration. It remains unclear whether acidosis of this type should be avoided.

Chiral nanoscale pores created during the surface explosion of tartaric acid on Cu(111).

The autocatalytic decomposition of tartaric acid on Cu(111) exhibits unique kinetics, which are linked to a hexagonal surface structure adopted at high coverage. The chirality imposed on the surface by tartaric acid throughout the explosion process is presented, and the hexagonal structure shows promise as a chiral template for enantiospecific surface chemistry.

Influence of step faceting on the enantiospecific decomposition of aspartic acid on chiral Cu surfaces vicinal to Cu{111}.

On surfaces vicinal to Cu{111}, l-aspartic acid (l-Asp) adsorption causes steps to facet enantiospecifically into {310}R and {320}S steps. l-Asp has its highest heat of adsortion on surfaces that naturally expose the {310}R or {320}S steps but decomposes preferentially on the {310}R steps.

Nitrosopumilus maritimus genome reveals unique mechanisms for nitrification and autotrophy in globally distributed marine crenarchaea.

Ammonia-oxidizing archaea are ubiquitous in marine and terrestrial environments and now thought to be significant contributors to carbon and nitrogen cycling. The isolation of Candidatus "Nitrosopumilus maritimus" strain SCM1 provided the opportunity for linking its chemolithotrophic physiology with a genomic inventory of the globally distributed archaea. Here we report the 1,645,259-bp closed genome of strain SCM1, revealing highly copper-dependent systems for ammonia oxidation and electron transport that are distinctly different from known ammonia-oxidizing bacteria. Consistent with in situ isotopic studies of marine archaea, the genome sequence indicates N. maritimus grows autotrophically using a variant of the 3-hydroxypropionate/4-hydroxybutryrate pathway for carbon assimilation, while maintaining limited capacity for assimilation of organic carbon. This unique instance of archaeal biosynthesis of the osmoprotectant ectoine and an unprecedented enrichment of multicopper oxidases, thioredoxin-like proteins, and transcriptional regulators points to an organism responsive to environmental cues and adapted to handling reactive copper and nitrogen species that likely derive from its distinctive biochemistry. The conservation of N. maritimus gene content and organization within marine metagenomes indicates that the unique physiology of these specialized oligophiles may play a significant role in the biogeochemical cycles of carbon and nitrogen.

Differential patterns of allelic loss in estrogen receptor-positive infiltrating lobular and ductal breast cancer.

The two main histological types of infiltrating breast cancer, lobular (ILC) and the more common ductal (IDC) carcinoma are morphologically and clinically distinct. To assess the molecular alterations associated with these breast cancer subtypes, we conducted a whole-genome study of 166 archival estrogen receptor (ER)-positive tumors (89 IDC and 77 ILC) using the Affymetrix GeneChip(R) Mapping 10K Array to identify sites of loss of heterozygosity (LOH) that either distinguished, or were shared by, the two phenotypes. We found single nucleotide polymorphisms (SNPs) of high-frequency LOH (>50%) common to both ILC and IDC tumors predominately in 11q, 16q, and 17p. Overall, IDC had a slightly higher frequency of LOH events across the genome than ILC (fractional allelic loss = 0.186 and 0.156). By comparing the average frequency of LOH by chromosomal arm, we found IDC tumors with significantly (P < 0.05) higher frequency of LOH on 3p, 5q, 8p, 9p, 20p, and 20q than ILC tumors. We identified additional chromosomal arms differentiating the subtypes when tumors were stratified by tumor size, mitotic rate, or DNA content. Of 5,754 informative SNPs (>25% informativity), we identified 78 and 466 individual SNPs with a higher frequency of LOH (P < 0.05) in ILC and IDC tumors, respectively. Hierarchical clustering of these 544 SNPs grouped tumors into four major groups based on their patterns of LOH and retention of heterozygosity. LOH in chromosomal arms 8p and 5q was common in higher grade IDC tumors, whereas ILC and low-grade IDC grouped together by virtue of LOH in 16q.

Introduction to the DAPPLE Air Pollution Project.

The Dispersion of Air Pollution and its Penetration into the Local Environment (DAPPLE) project brings together a multidisciplinary research group that is undertaking field measurements, wind tunnel modelling and computer simulations in order to provide better understanding of the physical processes affecting street and neighbourhood-scale flow of air, traffic and people, and their corresponding interactions with the dispersion of pollutants at street canyon intersections. The street canyon intersection is of interest as it provides the basic case study to demonstrate most of the factors that will apply in a wide range of urban situations. The aims of this paper are to introduce the background of the DAPPLE project, the study design and methodology for data collection, some preliminary results from the first field campaign in central London (28 April-24 May 2003) and the future for this work. Updated information and contact details are available on the web site at http://www.dapple.org.uk.

The effect of continuous repetition training and intra-set rest training on bench press strength and power.

AIM: The purpose of this research was to compare the effects of continuous repetition and intra-set rest training on maximal strength and power output of the upper body. METHODS: The 6 repetition maximum (6RM) and bench press throw power output against masses of 20, 30 and 40 kg of 26 elite junior male basketball and soccer players were tested on 2 separate occasions for reliability purposes. Subjects were then randomly assigned to either a continuous repetition (CR - 4 sets x 6 repetitions) or intra-set rest (ISR - 8 sets x 3 repetitions) training regime over 6-weeks. Volume (sets x repetitions x %6RM) between groups was equated and both groups completed all sets in the same time period (13 minutes and 20 seconds). The total concentric work time was determined to identify differences in training regimes. Independent sample t-tests on preintervention and postintervention percentage change scores were analysed for significant differences (p<0.05). RESULTS: The observed coefficients of variation (1.7% to 4.8%) and intraclass correlation coefficients (r=0.87 to 0.98) indicated stability of these measures across testing occasions. The CR group significantly increased 6RM strength (9.7%) compared with the ISR group (4.9%). The total concentric work time was significantly longer in CR training than ISR (36.03+/- 4.03 s and 31.74+/-4.71 s; p=0.13). Power output increases across the 20, 30 and 40 kg loads ranged from 5.8% to 10.9% for both training groups but the between-group percentage change scores were not significantly different. CONCLUSIONS: Bench press training involving 4 sets of 6 continuous repetitions elicited a greater improvement in bench press strength than 8 sets of 3 repetitions at the same percentage load of their 6RM. Both ISR and CR training were equally effective in increasing power output.

STR primer concordance study.

Over 1500 population database samples comprising African Americans, Caucasians, Hispanics, Native Americans, Chamorros and Filipinos were typed using the PowerPlex 16 and the Profiler Plus/COfiler kits. Except for the D8S1179 locus in Chamorros and Filipinos from Guam, there were eight examples in which a typing difference due to allele dropout was observed. At the D8S1179 locus in the population samples from Guam, there were 13 examples of allele dropout observed when using the Profiler Plus kit. The data support that the primers used in the PowerPlex 16, Profiler Plus, and COfiler kits are reliable for typing reference samples that are for use in CODIS. In addition, allele frequency databases have been established for the STR loci Penta D and Penta E. Both loci are highly polymorphic.

Cyclosporin A-induced fibroadenomas of the breast: report of five cases.

Five female patients undergoing cyclosporin A therapy had newly developed breast masses. Masses were bilateral in three of the five patients and palpable in four patients. The imaging findings were suggestive of fibroadenomas, and biopsy results were used to confirm the diagnosis. With the development of new breast lesions in patients after transplantation surgery, the diagnosis of cyclosporin A-induced fibroadenomas should be considered.

Axillary web syndrome after axillary dissection.

BACKGROUND: Some patients undergoing axillary lymph node dissection (ALND) experience postoperative pain and limited range of motion associated with a palpable web of tissue extending from the axilla into the ipsilateral arm. The purpose of this study is to characterize the previously undescribed axillary web syndrome (AWS). METHODS: To identify patients with AWS, a retrospective review was performed of all invasive breast cancer patients treated by a single surgeon (REM) between 1980 and 1996. Records were also reviewed of 4 more recent patients who developed AWS after undergoing sentinel node lymph node dissection (SLND) without ALND. RESULTS: Among 750 sequentially treated patients, 44 (6%) developed AWS between 1 and 8 weeks after their axillary procedure. The palpable subcutaneous cords extended from the axillary crease down the ipsilateral arm, across the antecubital space, and in severe cases down to the base of the thumb. The web was associated with pain and limited shoulder abduction (< or = 90 degrees in 74% of patients). AWS resolved in all cases within 2 to 3 months. AWS also occurred after SLND. Tissue sampling of webs in 4 patients showed occlusion in lymphatic and venous channels. CONCLUSIONS: AWS is a self-limiting cause of morbidity in the early postoperative period. More limited axillary surgery, with less lymphovenous disruption, might reduce the severity and incidence of this syndrome, although SLND does not eliminate its occurrence.

Diabetic mastopathy in men: imaging findings in two patients.

The classic imaging findings of diabetic mastopathy, an uncommon entity manifesting in patients with a history of long-standing insulin-dependent diabetes mellitus, have been reported in the literature in women but not, to the authors' knowledge, in men. Two men with diabetic mastopathy presented with palpable breast masses. The clinical histories of the men in whom this condition was diagnosed were similar to those reported for women with the condition. The mammographic findings in both men, at presentation, were suggestive of gynecomastia.

The impact of a multidisciplinary breast cancer center on recommendations for patient management: the University of Pennsylvania experience.

BACKGROUND: Advances in the diagnosis and treatment of breast carcinoma have led to a multidisciplinary approach to management for patients with breast carcinoma. To assess the effect of this approach, the authors performed an evaluation for a cohort of patients examined in a multidisciplinary breast cancer center. METHODS: An analysis was performed for the records of 75 consecutive women with 77 breast lesions examined in consultation in a multidisciplinary breast cancer center between January and June 1998. Each patient's case was evaluated by a panel consisting of a medical oncologist, surgical oncologist, radiation oncologist, pathologist, diagnostic radiologist, and, when indicated, plastic surgeon. A comprehensive history and physical examination was performed, and the relevant mammograms, pathology slides, and medical records were reviewed. Treatment recommendations made before this evaluation were compared with the consensus recommendations made by the panel. RESULTS: For the 75 patients, the multidisciplinary panel disagreed with the treatment recommendations from the outside physicians in 32 cases (43%), and agreed in 41 cases (55%). Two patients (3%) had no treatment recommendation before consultation. For the 32 patients with a disagreement, the treatment recommendations were breast-conservation treatment instead of mastectomy (n = 13; 41%) or reexcision (n = 2; 6%); further workup instead of immediate definitive treatment (n = 10; 31%); treatment based on major change in diagnosis on pathology review (n = 3; 9%); addition of postmastectomy radiation treatment (n = 3; 9%); or addition of hormonal therapy (n = 1; 3%). CONCLUSIONS: The multidisciplinary breast cancer evaluation program provided an integrated program in which individual patients were evaluated by a team of physicians and led to a change in treatment recommendation for 43% (32 of 75) of the patients examined. This multidisciplinary program provided important second opinions for many patients with breast carcinoma.

Calcifications of lobular carcinoma in situ of the breast: radiologic-pathologic correlation.

OBJECTIVE: Because lobular carcinoma in situ is thought to be an incidental finding at breast pathology, the finding of lobular carcinoma in situ at core biopsy poses a diagnostic dilemma of radiologic-pathologic concordance. The purpose of this article is to describe the radiologic-pathologic correlation of calcifications associated with lobular carcinoma in situ of the breast. MATERIALS AND METHODS: Between July 1999 and July 2000, seven excisional biopsies resulted in findings of lobular carcinoma in situ of mammographic calcifications. The radiographic features of the calcifications were characterized by the Breast Imaging Reporting and Data System lexicon, and pathologic features were reviewed. RESULTS: Two forms of lobular carcinoma in situ were associated with calcifications: the classic form with small, uniform cells, and the pleomorphic form with larger cells frequently associated with central necrosis. On mammography, all calcifications were clustered, punctate, high density, and smaller than or equal to 0.5 mm, although mammographically visible calcifications found in the pleomorphic type tended to be larger and more dense. Additionally, infiltrating lobular carcinoma was found after surgical excision in two (40%) of five patients with pleomorphic lobular carcinoma in situ. CONCLUSION: Calcifications can be associated with lobular carcinoma in situ and therefore concordant at stereotactic core biopsy. The classic form may be incidental and clinically innocuous. The pleomorphic form is morphologically similar to ductal carcinoma in situ and may have a greater tendency for invasion.

Differential expression of E-cadherin in lobular and ductal neoplasms of the breast and its biologic and diagnostic implications.

We studied the pattern of E-cadherin expression in 183 invasive carcinomas (100 ductal, 42 lobular, 41 with mixed ductal and lobular features) and 198 in situ carcinomas (131 ductal, 53 lobular, 14 in situ with ductal and lobular features) by immunohistochemistry. We found a highly significant correlation of E-cadherin membrane expression with the histologic phenotype of the tumors. While moderate to strong membrane expression of E-cadherin was seen in all invasive and in situ ductal carcinomas, 41 of 42 invasive and 50 of 53 in situ lobular carcinomas showed complete loss of expression. All in situ carcinomas diagnosed histologically as showing mixed ductal and lobular features demonstrated complete loss of staining. Invasive carcinomas with ductal and lobular features showed 3 staining patterns: (1) complete or almost complete lack of membrane staining similar to that seen in lobular carcinomas, (2) uniform membrane expression throughout the tumor similar to ductal carcinomas, and (3) focal loss of E-cadherin staining, which correlated well with the histologic impression of focal lobular features. In tumors with histologically equivocal features, immunohistochemical detection of E-cadherin expression can be a useful diagnostic tool for the differentiation of ductal and lobular carcinomas of the breast.

Contrast-enhanced 3D MRA using SENSE.

Sensitivity encoding (SENSE) was used to improve the performance of three-dimensional contrast-enhanced magnetic resonance angiography (3D CE-MRA). Utilizing an array of receiver coils for sensitivity encoding, the encoding efficiency of gradient-echo imaging was increased by factors of up to three. The feasibility of the approach was demonstrated for imaging of the abdominal vasculature. On the one hand, using a SENSE reduction factor of two, the spatial resolution of a breath-hold scan of 17 seconds was improved to 1.0 x 2.0 x 2.0 mm(3). On the other hand, using threefold reduction, time-resolved 3D CE-MRA was performed with a true temporal resolution of 4 seconds, at a spatial resolution of 1.6 x 2.1 x 4.0 mm(3). CE-MRA with SENSE was performed in healthy volunteers and patients and compared with a standard protocol. Throughout, diagnostic quality images were obtained, showing the ability of sensitivity encoding to enhance spatial and/or temporal resolution considerably in clinical angiographic examinations.

Intercellular adhesion molecule expression in ductal carcinoma of the breast: correlation of immunohistochemical staining with cytologic smear pattern.

Recent studies suggest that altered expression of intercellular adhesion molecules (ICAM) in ductal carcinoma of the breast is associated with a higher incidence of metastases and decreased patient survival. In addition, the presence of significant cellular dyscohesion in cytologic smear preparations has been found to correlate with the presence of regional and distant metastases in a subset of patients. In this study, we correlate the smear pattern in preparations taken directly from surgically excised breast tumors with their immunohistochemical staining pattern, using antibodies directed against a panel of ICAM. We found excellent correlation, as all three tumors with an extremely high degree of tumor cell cohesion showed strong staining with all ICAM antibodies in the vast majority (>/=90%) of tumor cells in corresponding tissue sections. In contrast, five tumors displaying a largely dyscohesive smear pattern demonstrated decreased staining (