Strategies to Generate Nitrogen-centered Radicals That May Rely on Photoredox Catalysis: Development in Reaction Methodology and Applications in Organic Synthesis.

For more than 70 years, nitrogen-centered radicals have been recognized as potent synthetic intermediates. This review is a survey designed for use by chemists engaged in target-oriented synthesis. This review summarizes the recent paradigm shift in access to and application of N-centered radicals enabled by visible-light photocatalysis. This shift broadens and streamlines approaches to many small molecules because visible-light photocatalysis conditions are mild. Explicit attention is paid to innovative advances in N-X bonds as radical precursors, where X = Cl, N, S, O, and H. For clarity, key mechanistic data is noted, where available. Synthetic applications and limitations are summarized to illuminate the tremendous utility of photocatalytically generated nitrogen-centered radicals.

Directed Photochemically Mediated Nickel-Catalyzed (Hetero)arylation of Aliphatic C-H Bonds.

Site-selective functionalization of unactivated C(sp3)-H centers is challenging because of the ubiquity and strength of alkyl C-H bonds. Herein, we disclose a position-selective C(sp3)-C(sp2) cross-coupling reaction. This process engages C(sp3)-H bonds and aryl bromides, utilizing catalytic quantities of a photoredox-capable molecule and a nickel precatalyst. Using this technology, selective C-H functionalization arises owing to a 1,6-hydrogen atom transfer (HAT) process that is guided by a pendant alcohol-anchored sulfamate ester. These transformations proceed directly from N-H bonds, in contrast to previous directed, radical-mediated, C-H arylation processes, which have relied on prior oxidation of the reactive nitrogen center in reactions with nucleophilic arenes. Moreover, these conditions promote arylation at secondary centers in good yields with excellent selectivity.

Racial/Ethnic Discrimination and Food Consumption: Examination in Diverse Samples.

BACKGROUND: Racial/ethnic discrimination has been linked to poor health outcomes. Effects of discrimination on health behaviors, including patterns of food consumption, may contribute to health outcomes. PURPOSE: We examined relations of discrimination to consumption of healthy and unhealthy foods in two diverse samples. Structural equation modeling was used to examine variations in associations of discrimination to consumption by the timing and type of discrimination, for healthy vs. unhealthy food, and by sample. METHODS: Study 1 included a racially and ethnically diverse sample of adults from New York City (NYC: N = 157); Study 2 included a sample of American Indian and Alaska Native (AI/AN) adults from the Denver metro area (N = 303), many of whom also identified with other racial/ethnic groups. Participants completed self-report measures of racial/ethnic discrimination, food consumption, life stressors, and sociodemographic variables. RESULTS: Structural equation models indicated discrimination was associated with food consumption. Tests of model invariance indicated that the model of discrimination to food consumption can be applied to both samples. Discrimination within the past-week was associated with more frequent consumption of both unhealthy and healthy foods, whereas lifetime discrimination was associated with more frequent consumption only of unhealthy foods. CONCLUSIONS: The data were limited to self-report measures and only the frequency of consumption was assessed. The findings suggest discrimination may contribute to health disparities through effects on food consumption. Differential effects for past-week and lifetime discrimination suggest that multiple mechanisms may be involved.

Experiencing racial discrimination may undermine health through effects on health behavior, including patterns of food consumption. In two studies, we tested whether racial discrimination was linked with food consumption, specifically the frequency with which people ate healthy and unhealthy foods. We investigated both lifetime exposure to discrimination as well as more recent (past-week) exposure as predictors of food consumption. Study 1 focused on racially and ethnically diverse adults from New York City (NYC); Study 2 focused on American Indian and Alaska Native (AI/AN) adults from the Denver metro area. Overall, we found that higher levels of discrimination were associated with more frequent consumption of both unhealthy and healthy food. The timing of discrimination mattered. Higher levels of discrimination within the past-week were associated with more frequent consumption of healthy and unhealthy foods. In contrast, higher levels of lifetime discrimination were associated only with more frequent consumption of unhealthy food. The links between discrimination and food consumption remained significant controlling for socioeconomic status. The relations of discrimination to food consumption were similar across the diverse sample from NYC and the AI/AN sample from Denver. These findings may help researchers understand how discrimination may contribute to health disparities.

Challenges involved in the collection of appropriate data for the completion of disease outbreak risk assessments.

Risk assessment is an essential tool used in the control of disease outbreaks. Without it, key risk pathways might not be identified, resulting in potential spread of disease. The devastating effects of disease spread can ripple through society, affecting the economy and trade and having considerable impact on animal health and potentially human health. The World Organisation for Animal Health (WOAH, founded as OIE) has highlighted that risk analysis, which includes risk assessment, is not consistently used across all Members, with some low-income countries making policy decisions without prior risk assessment. The failure of some Members to rely on risk assessment could be caused by a lack of staff and risk assessment-related training, poor funding in the animal health sector, and lack of understanding regarding the use and application of risk analysis. However, to complete effective risk assessment, high-quality data must be collected, and other factors such as geographical conditions, use (or not) of technology, and varying production systems all influence the ability to collect these data. Demographic and population-level data can be collected during peacetime in the form of surveillance schemes and national reports. Having these data before an outbreak occurs better equips a country for controlling or preventing disease outbreaks. In order for all WOAH Members to meet risk analysis requirements, an international effort must be made for cross-working and the development of collaborative schemes. Technology can play an important role in the development of risk analysis, and low-income countries must not be left behind in the efforts to protect animal and human populations from disease.

L'évaluation du risque est un outil essentiel pour le contrôle des foyers épidémiques. Sans cet outil, certaines voies d'introduction à haut risque pourraient ne pas être identifiées, donnant lieu à une possible propagation des maladies. Une telle propagation a des effets dévastateurs qui peuvent gagner toute la société et affecter l'économie et le commerce, en plus d'avoir un impact considérable sur la santé des animaux, voire des personnes. L'Organisation mondiale de la santé animale (OMSA, fondée en tant qu'OIE) a souligné l'absence d'homogénéité parmi ses Membres dans l'utilisation de l'analyse du risque (dont l'évaluation du risque est l'une des composantes), certains pays à faibles revenus prenant des décisions sur les politiques à mener sans recourir à une évaluation du risque préalable. L'incapacité de certains Membres à s'appuyer sur l'évaluation du risque est probablement due au manque de personnel, à l'inexistence de formations dans le domaine de l'évaluation du risque, au financement médiocre du secteur de la santé animale et au fait que les principes de l'utilisation et de l'application de l'analyse du risque sont mal compris. Pour être efficace, l'évaluation du risque doit reposer sur des données de grande qualité ; or, l'aptitude à collecter de telles données est tributaire de facteurs comme la situation géographique, le recours (ou non) aux technologies, et la diversité des systèmes de production concernés. Les données démographiques ainsi que celles à l'échelle d'une population peuvent être recueillies en temps de paix dans le cadre de programmes de surveillance et sous forme de rapports nationaux. Un pays qui dispose de ces données avant la survenue d'un foyer épidémique est mieux équipé pour lutter contre les foyers ou pour les prévenir. Pour que tous les Membres de l'OMSA soient en mesure de satisfaire aux exigences de la conduite de l'analyse du risque, des initiatives devront être déployées à l'échelle internationale afin de mettre en place une coopération transversale et des programmes collaboratifs. La technologie peut jouer un rôle important dans le développement de l'analyse du risque et il convient de ne pas laisser les pays à faibles revenus en marge des efforts visant à protéger la santé des populations animales et humaines.

La determinación del riesgo es una herramienta esencial para el control de brotes infecciosos. Sin ella, podría ocurrir que se obviasen muy importantes vías de riesgo, lo que a su vez podría causar la diseminación de enfermedades. Los devastadores efectos de la propagación de una enfermedad pueden transmitirse en cadena al conjunto de la sociedad, afectando a la economía y el comercio y repercutiendo sensiblemente en la sanidad animal y quizá también en la salud humana. La Organización Mundial de Sanidad Animal (OMSA, fundada como OIE) ha insistido en que no todos los Miembros utilizan de forma sistemática el análisis del riesgo, proceso que engloba el de determinación del riesgo, y que algunos países de bajo nivel de renta adoptan decisiones sobre las medidas que se han de tomar sin pasar por un proceso previo de determinación del riesgo. Este déficit podría explicarse por factores como la falta de personal y de formaciones en determinación del riesgo, una insuficiente financiación del sector de la sanidad animal o el desconocimiento de los usos y aplicaciones del análisis del riesgo. Aun así, para realizar una eficaz determinación del riesgo es preciso reunir datos de gran calidad y, en este sentido, hay otros factores, como las condiciones geográficas, la utilización (o no) de tecnología o la heterogeneidad de los sistemas productivos, que siempre influyen en la capacidad para obtener tales datos. Es posible reunir datos demográficos y poblacionales "en tiempos de paz" por medio de sistemas de vigilancia y de informes nacionales. Si dispone de antemano de tales datos, un país estará mejor preparado para combatir o prevenir brotes infecciosos en el momento en que estos se produzcan. Para que todos los Miembros de la OMSA puedan efectuar los requeridos análisis del riesgo, se precisa un esfuerzo a escala internacional que se plasme en una labor de intercambio y en la creación de mecanismos de colaboración. La tecnología puede cumplir una importante función en el desarrollo del análisis del riesgo y, en el camino para proteger de la enfermedad a las poblaciones animales y humanas, de ningún modo cabe dejar atrás a los países de renta baja.

Photochemically Mediated Nickel-Catalyzed Synthesis of N-(Hetero)aryl Sulfamides.

A general method for the N-arylation of sulfamides with aryl bromides is described. The protocol leverages a dual-catalytic system, with [Ir(ppy)2(dtbbpy)]PF6 as a photosensitizer, NiBr2·glyme as a precatalyst, and 1,8-diazabicyclo(5.4.0)undec-7-ene (DBU) as a base, and proceeds at room temperature under visible light irradiation. Using these tactics, aryl boronic esters and aryl chlorides can be carried through the reaction untouched. The developed reactions efficiently engage simple bromoarenes and primary sulfamides in between 66% and quantitative yields. For more challenging substrates, such as secondary sulfamides, the reaction efficiency is documented. Thereby, these methods complement the known Buchwald-Hartwig coupling methods for N-arylation of sulfamides.

Cost-effectiveness of immediate versus delayed sequential bilateral cataract surgery in the Netherlands (the BICAT-NL study): study design of a prospective multicenter randomised controlled trial.

BACKGROUND: Cataract surgery is one of the most frequently performed types of surgery. Most patients suffer from bilateral cataract and while cataract surgery of only one eye is effective in restoring functional vision, second-eye surgery leads to further improvements in health-related quality of life, and is cost-effective. At present, most patients undergo cataract surgery in both eyes on separate days as recommended in national guidelines, referred to as delayed sequential bilateral cataract surgery (DSBCS). An alternative procedure involves operating both eyes on the same day, but as separate procedures, known as immediately sequential bilateral cataract surgery (ISBCS). The aim of this study is to evaluate the effectiveness and costs of ISBCS compared to DSBCS, in order to test the hypothesis that ISBCS is non-inferior to DSBCS in terms of effectiveness and superior to ISBCS in terms of cost-effectiveness. METHODS/DESIGN: Multicenter non-inferiority randomised controlled clinical trial. Patients (18 years or older) with bilateral cataract and an indication for bilateral cataract surgery with an expected uncomplicated intraoperative and postoperative course are included in the study. Patients are randomly assigned to either ISBCS or DSBCS. The primary endpoint is the proportion of patients with a refractive outcome in the second eye within 1.0 dioptre from the target refraction, at 4 weeks after surgery. Secondary outcomes include corrected and uncorrected distance visual acuity, complications, patient reported outcomes (PROMs), cost-effectiveness, and budget impact. Follow-up visits are planned at 1 week after first-eye surgery and 4 weeks after second-eye surgery. At 3 months after first-eye surgery, the occurrence of complications is checked and patients fill in a final questionnaire. DISCUSSION: This study protocol describes the design of a multicenter non-inferiority randomised controlled trial. Current studies on ISBCS often lack information on safety regarding refractive outcomes. In addition, there is a lack of well-designed cost-effectiveness studies using established methods. The BICAT-NL study will provide more insight in refractive and cost-effectiveness outcomes for ISBCS compared to DSBCS. TRIAL REGISTRATION: This study was prospectively registered at Clinicaltrials.gov on January 17th 2018. (Identifier: NCT03400124 .

Correlation of MRI with the Neuropathologic Changes in Two Cats with Bromethalin Intoxication.

Two cats were presented with multifocal neurological signs. One cat's signs progressed over 2 wk; the other cat progressed over 5 days. Examinations were consistent with a process involving the prosencephalon, vestibular system, and general proprioceptive/upper motor neuron systems. MRI of the brain and cervical spinal cord reveal widespread T2 hyperintensity of the white matter. Affected areas included the cerebrum, cerebral peduncles, corticospinal tracts of the pons and medulla, and the cerebellum. T2 hyperintensity was present in all funiculi of the spinal cord. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps were consistent with cytotoxic or intramyelinic edema. Differential diagnosis included toxic or metabolic/degenerative leukoencephalopathies. Necropsies revealed widespread spongy degeneration of the central nervous system white matter. Toxicologic assays of liver specimens revealed desmethylbromethalin, a metabolite of bromethalin. Bromethalin is a rodenticide that causes uncoupling of oxidative phosphorylation. Antemortem diagnosis is challenging. DWI and ADC maps were instrumental in narrowing the differential diagnosis and raised the index of suspicion for bromethalin. Bromethalin intoxication should be considered in all animals with a progressive course of multifocal neurologic deficits. MRI, specifically, DWI and ADC maps, may serve as a biomarker of cytotoxic or intramyelinic edema associated with spongiform leukoencephalomyelopathy.

Longitudinal study on the occurrence in pigs of colistin-resistant Escherichia coli carrying mcr-1 following the cessation of use of colistin.

AIMS: In 2015, colistin-resistant Escherichia coli and Salmonella with the mcr-1 gene were isolated from a pig farm in Great Britain. Pigs were subsequently monitored over a ~20-month period for the occurrence of mcr-1-mediated colistin resistance and the risk of mcr-1 E. coli entering the food chain was assessed. METHODS AND RESULTS: Pig faeces and slurry were cultured for colistin-resistant E. coli and Salmonella, tested for the mcr-1 gene by PCR and selected isolates were further analysed. Seventy-eight per cent of faecal samples (n = 275) from pigs yielded mcr-1 E. coli after selective culture, but in positive samples only 0·2-1·3% of the total E. coli carried mcr-1. Twenty months after the initial sampling, faecal samples (n = 59) were negative for E. coli carrying mcr-1. CONCLUSIONS: The risk to public health from porcine E. coli carrying mcr-1 was assessed as very low. Twenty months after cessation of colistin use, E. coli carrying mcr-1 was not detected in pig faeces on a farm where it was previously present. SIGNIFICANCE AND IMPACT OF THE STUDY: The results suggest that cessation of colistin use may help over time to reduce or possibly eliminate mcr-1 E. coli on pig farms where it occurs.

Is there a decline in bovine spongiform encephalopathy cases born after reinforced feed bans? A modelling study in EU member states.

Occasional cases of classical bovine spongiform encephalopathy (BSE) still continue to occur within the European Union (EU) for animals born after reinforced feed bans (BARBs), which should in theory have eliminated all risk of infection. The study aimed to determine (i) whether a common rate of decline of BSE infection was evident across EU member states, i.e. to determine whether control measures have been equally effective in all member states, (ii) whether there was any evidence of spontaneous occurrence of BSE in the data and (iii) the expected date for the last BSE case in UK. It was found that there was no significant difference in the rate of decline of BSE prevalence between member states, with a common rate of decline of 33·9% per annum (95% CI 30·9-37%) in successive annual birth cohorts. Trend analysis indicated an ultimate decline to 0 prevalence, suggesting that spontaneous occurrence does not explain the majority of cases. Projecting forward the trends from the back-calculation model indicated that there was approximately a 50% probability of further cases in the UK, and should the current rate of decline continue, there remains the possibility of further occasional cases up until 2026.

The challenge of using experimental infectivity data in risk assessment for Ebola virus: why ecology may be important.

Analysis of published data shows that experimental passaging of Zaire ebolavirus (EBOV) in guinea pigs changes the risk of infection per plaque-forming unit (PFU), increasing infectivity to some species while decreasing infectivity to others. Thus, a PFU of monkey-adapted EBOV is 10(7) -fold more lethal to mice than a PFU adapted to guinea pigs. The first conclusion is that the infectivity of EBOV to humans may depend on the identity of the donor species itself and, on the basis of limited epidemiological data, the question is raised as to whether bat-adapted EBOV is less infectious to humans than nonhuman primate (NHP)-adapted EBOV. Wildlife species such as bats, duikers and NHPs are naturally infected by EBOV through different species giving rise to EBOV with different wildlife species-passage histories (heritages). Based on the ecology of these wildlife species, three broad 'types' of EBOV-infected bushmeat are postulated reflecting differences in the number of passages within a given species, and hence the degree of adaptation of the EBOV present. The second conclusion is that the prior species-transmission chain may affect the infectivity to humans per PFU for EBOV from individuals of the same species. This is supported by the finding that the related Marburg marburgvirus requires ten passages in mice to fully adapt. It is even possible that the evolutionary trajectory of EBOV could vary in individuals of the same species giving rise to variants which are more or less virulent to humans and that the probability of a given trajectory is related to the heritage. Overall the ecology of the donor species (e.g. dog or bushmeat species) at the level of the individual animal itself may determine the risk of infection per PFU to humans reflecting the heritage of the virus and may contribute to the sporadic nature of EBOV outbreaks.

Modeling of Salmonella Contamination in the Pig Slaughterhouse.

In this article we present a model for Salmonella contamination of pig carcasses in the slaughterhouse. This model forms part of a larger QMRA (quantitative microbial risk assessment) on Salmonella in slaughter and breeder pigs, which uses a generic model framework that can be parameterized for European member states, to describe the entire chain from farm-to-consumption and the resultant human illness. We focus on model construction, giving mathematical formulae to describe Salmonella concentrations on individual pigs and slaughter equipment at different stages of the slaughter process. Variability among individual pigs and over slaughterhouses is incorporated using statistical distributions, and simulated by Monte Carlo iteration. We present the results over the various slaughter stages and show that such a framework is especially suitable to investigate the effect of various interventions. In this article we present the results of the slaughterhouse module for two case study member states. The model outcome represents an increase in average prevalence of Salmonella contamination and Salmonella numbers at dehairing and a decrease of Salmonella numbers at scalding. These results show good agreement when compared to several other QMRAs and microbiological studies.

A Transport and Lairage Model for Salmonella Transmission Between Pigs Applicable to EU Member States.

A model for the transmission of Salmonella between finisher pigs during transport to the abattoir and subsequent lairage has been developed, including novel factors such as environmental contamination and the effect of stress, and is designed to be adaptable for any EU Member State (MS). The model forms part of a generic farm-to-consumption model for Salmonella in pigs, designed to model potentially important risk factors and assess the effectiveness of interventions. In this article, we discuss the parameterization of the model for two case study MSs. For both MSs, the model predicted an increase in the average MS-level prevalence of Salmonella-positive pigs during both transport and lairage, accounting for a large amount of the variation between reported on-farm prevalence and reported lymph-node prevalence at the slaughterhouse. Sensitivity analysis suggested that stress is the most important factor during transport, while a number of factors, including environmental contamination and the dose-response parameters, are important during lairage. There was wide variation in the model-predicted change in prevalence in individual batches; while the majority of batches (80-90%) had no increase, in some batches the increase in prevalence was over 70% and in some cases infection was introduced into previously uninfected batches of pigs. Thus, the model suggests that while the transport and lairage stages of the farm-to-consumption exposure pathway are unlikely to be responsible for a large increase in average prevalence at the MS level, they can have a large effect on prevalence at an individual-batch level.

Impact of dose-finding studies on administration of oxytocin during caesarean section in the UK.

Debate continues over the dose and methods of administration of oxytocin for the prevention of haemorrhage during caesarean section. We surveyed 206 lead obstetric anaesthetists in the UK to determine standard practice in their unit as well as any differences in practice for high-risk cases. There were 150 responses (72.9% response rate). A total of 149 units use oxytocin. The majority use an initial 5-IU dose, whilst a small proportion (8; 5.3%) administer a dose < 5 IU for elective caesarean section. The administration of a 10-IU dose has ceased altogether. There is a broad range of administration methods, particularly with infusions. Forty (26.8%) respondents give a different oxytocin regimen following caesarean section in patients with severe pre-eclampsia, 72 (48.3%) in those with cardiac disease of New York Heart Association class 1-2, and 100 (66.7%) with class 3-4. In conclusion, there is a trend towards the use of lower doses of oxytocin in caesarean section, but there are still wide variations in detail. We suggest that there is a need for a national protocol to standardise oxytocin administration.

An Intensive Longitudinal Assessment Approach to Surveilling Trajectories of Burnout over the First Year of the COVID Pandemic.

Frontline clinicians responding to the COVID-19 pandemic are at increased risk of burnout, but less is known about the trajectory of clinician burnout as caseloads increase and decrease. Personal and professional resources, including self-efficacy and hospital support, can attenuate the risk of burnout. Yet, empirical data documenting how burnout and resources changed as the pandemic waxed and waned are limited. This intensive longitudinal prospective study employed ecological momentary assessment methods to examine trajectories of burnout and resources over the pandemic's first year in a New York City hospital. A 10-item survey was emailed every 5 days to frontline clinicians (physicians, nurses, and physician assistants). The primary outcome was a single-item validated measure of burnout; predictors included daily hospital COVID-19-related caseloads and personal and professional resources. Clinicians (n = 398) completed the initial survey and an average of 12 surveys over the year. Initially, 45.3% of staff reported burnout; over the year, 58.7% reported burnout. Following the initial COVID peak, caseloads declined, and burnout levels declined. During the second wave of COVID, as caseloads increased and remained elevated and personal and professional resource levels decreased, burnout increased. This novel application of intensive longitudinal assessment enabled ongoing surveillance of burnout and permitted us to evaluate how fluctuations in caseload intensity and personal and professional resources related to burnout over time. The surveillance data support the need for intensified resource allocation during prolonged pandemics.

A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS).

The 2003-2005 Confidential Enquiry into Maternal and Child Health report recommended the introduction of the modified early obstetric warning system (MEOWS) in all obstetric inpatients to track maternal physiological parameters, and to aid early recognition and treatment of the acutely unwell parturient. We prospectively reviewed 676 consecutive obstetric admissions, looking at their completed MEOWS charts for triggers and their notes for evidence of morbidity. Two hundred patients (30%) triggered and 86 patients (13%) had morbidity according to our criteria, including haemorrhage (43%), hypertensive disease of pregnancy (31%) and suspected infection (20%). The MEOWS was 89% sensitive (95% CI 81-95%), 79% specific (95% CI 76-82%), with a positive predictive value 39% (95% CI 32-46%) and a negative predictive value of 98% (95% CI 96-99%). There were no admissions to the intensive care unit, cardio respiratory arrests or deaths during the study period. This study suggests that MEOWS is a useful bedside tool for predicting morbidity. Adjustment of the trigger parameters may improve positive predictive value.

Detecting new and emerging diseases on livestock farms using an early detection system.

The monitoring and surveillance of animal diseases is becoming increasingly important to policy-makers in Great Britain particularly given recent incursions of avian influenza and the emergence of bovine spongiform encephalopathy. To meet this surveillance objective, data from British livestock is collected and analysed retrospectively on an ongoing basis. However, these data can also be analysed prospectively within an early detection system which raises alerts to significant increases in disease reporting soon after they occur in the field. The feasibility of such an approach has been examined previously for Salmonella. This paper applied the approach to a further subset of surveillance data to alert those monitoring disease to increases in potentially new and emerging diseases. Thus far, the analysis, conducted on a quarterly basis, has proved a useful additional tool in enhanced surveillance by raising alerts to significant increases in several syndromes in both sheep and cattle.

Salmonella Typhimurium and Salmonella Enteritidis in England: costs to patients, their families, and primary and community health services of the NHS.

This is the first study comparing societal costs of acute illness with Salmonella Typhimurium (ST) and Salmonella Enteritidis (SE) in the UK. It included the cost and severity of the illness and explored the impact of each Salmonella serovar on the patients, their families, the NHS, and the wider economy. The study ascertained confirmed cases of ST and SE between July and November 2008. The mean costs per case were £1282 (ST) and £993 (SE). The indirect costs associated with the work-time lost by the case, parents, or carers were £409 (ST) and £228 (SE); this difference was statistically significant. The aggregate cost of ST and SE identified using laboratory test results for the UK as a whole was estimated as £6.5 million. Work-time lost and caring activities are cost categories that are not frequently investigated within the infectious intestinal disease literature, although they represent an important societal cost.

Determining pig holding type from British movement data using analytical and machine learning approaches.

Determining the size, location and structure of a livestock population is an essential aspect of surveillance and research as it provides understanding of the representativeness and coverage of any project or scheme. It is an important input for a variety of epidemiological analyses, for example, allowing generation of more accurate sample size calculations for estimating prevalence or freedom from disease, cost-benefit analyses for control measures to reduce or eradicate livestock disease, or development of between-herd network models to estimate the impact of movement of animals between farms on the spread of livestock diseases. The work described here provides information on how British pig movement data was compared against other datasets related to the British pig population to define its appropriateness for defining pig holding demographics. The data were then used to identify the location of pig holdings and the estimated herd size (split into five categories). Two methods are described that were used to classify the holding type of the identified pig holdings. The first method was an epidemiological method that used expert opinion to determine a set of rules based on movement characteristics to classify each holding. The second method was a machine learning approach that used k means cluster analysis to automatically estimate the holding type based on a set of proxy indicators. Each method had a good accuracy rate, when compared to matched holdings present in data provided by the Annual June Agricultural Survey, but all misclassified some holdings. While both of the methods on their own provided a reasonable estimate, it was concluded that a consensus model, considering the results of both models and the Survey, provided the most accurate result. However, the machine learning approach was beneficial, as although some technical expertise was needed to set up the model, it was considerably faster to implement than the other method, as well as being quicker and easier to adapt and re-run with updated information.

Diagnostic value of abdominal follow-up sonography in polytrauma patients: A retrospective study.

In many German trauma centres, it is routine to perform abdominal follow-up sonography (AFS) 6 h after admission for patients with multiple trauma, even if the clinical course is uneventful and multi-slice computed tomography (MSCT) reveals no abdominal pathology. However, this approach is not recommended in the German Guidelines for trauma, and recent studies have questioned the value of AFS to these patients. The present study aimed to evaluate the revised German Guidelines for trauma with respect to the omission of AFS.We included patients with multiple injuries with no clinical signs of abdominal trauma and with normal abdominal MSCT. We collected clinical data of 370 consecutive patients who underwent AFS (Group A) and another 370 consecutive patients who did not undergo AFS (Group B).No abdominal injury was missed by the omission of AFS, and thus, no patient suffered from its omission or benefitted from the use of AFS. In our study population, the negative predictive value of normal MSCT results combined with no clinical signs of abdominal trauma was 100% (95% confidence interval: 99.5%-100.0%).This single-centre study conducted in a large German trauma centre demonstrates AFS to have no utility in the diagnosis of abdominal injury. Moreover, omission of AFS for conscious patients without clinical signs of abdominal trauma and with negative abdominal MSCT does not appear to have negative consequences in terms of missed abdominal injury.Therefore, AFS can be safely omitted in the majority of cases of polytrauma, which simplifies the imaging workup tremendously.

Livestock Health and Food Chain Risk Assessment.

The EUFORA fellowship programme 'Livestock Health and Food Chain Risk Assessment' was proposed by the Animal and Plant Health Agency (APHA), a British governmental institution responsible for safeguarding animal and plant health in the UK. The working programme, which was organised into four different modules, covered a wide range of aspects related to risk assessment including identification of emerging risks, risk prioritisation methods, scanning surveillance, food production exposure assessment and import risk assessment of animal and human infectious diseases. Over the course of the year, the Fellow had the opportunity to work for international projects with experts in these disciplines. This allowed for significant opportunities to 'learn-by-doing' the methods and the techniques that are employed to assess animal health and food safety risks. Moreover, he consolidated his knowledge by attending several training courses and academic lessons, submitting scientific papers to peer-reviewed journals and conferences, giving presentations and using modelling software.