Post-acute COVID-19 complications in UK doctors: results of a cross-sectional survey.

BACKGROUND: As a consequence of their occupation, doctors and other healthcare workers were at higher risk of contracting coronavirus disease 2019 (COVID-19), and more likely to experience severe disease compared to the general population. However, systematic information on post-acute COVID complications in doctors is very limited. AIMS: This study aimed to determine the symptoms, perceived determinants, health and occupational impact, and consequent needs relating to post-acute COVID complications in UK doctors. METHODS: An online cross-sectional survey was distributed to UK doctors self-identifying as having Long COVID or other post-acute COVID complications. RESULTS: Of 795 responses, 603 fulfilled the inclusion criteria of being a UK-based medical doctor experiencing one or more post-acute COVID complications. Twenty-eight per cent reported a lack of adequate Respiratory Protective Equipment at the time of contracting COVID-19. Eighteen per cent of eligible respondents reported that they had been unable to return to work since acquiring COVID. CONCLUSIONS: Post-acute COVID (Long COVID) in UK doctors is a substantial burden for respondents to our questionnaire. The results indicated that insufficient respiratory protection could have contributed to occupational disease, with COVID-19 being contracted in the workplace, and resultant post-COVID complications. Although it may be too late to address the perceived determinants of inadequate protection for those already suffering with Long COVID, more investment is needed in rehabilitation and support of those afflicted.

Beta-blockers and mechanical dyssynchrony in heart failure assessed by radionuclide ventriculography.

BACKGROUND: Radionuclide ventriculography (RNVG) can be used to quantify mechanical dyssynchrony and may be a valuable adjunct in the assessment of heart failure with reduced ejection fraction (HFrEF). The study aims to investigate the effect of beta-blockers on mechanical dyssynchrony using novel RNVG phase parameters. METHODS: A retrospective study was carried out in a group of 98 patients with HFrEF. LVEF and dyssynchrony were assessed pre and post beta-blockade. Dyssynchrony was assessed using synchrony, entropy, phase standard deviation, approximate entropy, and sample entropy from planar RNVG phase images. Subgroups split by ischemic etiology were also investigated. RESULTS: An improvement in dyssynchrony and LVEF was measured six months post beta-blockade for both ischemic and non-ischemic groups. CONCLUSIONS: A significant improvement in dyssynchrony and LVEF was measured post beta-blockade using novel measures of dyssynchrony.

Annual prevalence estimation of lymphatic malformation with a cutaneous component: observational study of a national representative sample of physicians.

BACKGROUND: Lymphatic malformations (LMs) represent a potentially life-threatening, rare disease of the lymphatic system characterized by development of abnormal vessels, outpouchings, or cysts filled with lymphatic fluid. There are three morphologic types of LMs based on the size of the individual cysts: macrocystic (typically > 2 cm), microcystic (generally < 2 cm), and mixed (includes aspects of both). Macrocystic LMs typically exist beneath the skin and often can involve vascular components and/or organs. Microcystic LMs often have a cutaneous component and clinically present with lymphorrhea, bleeding, pain, itching, malodor, and functional deficits. There are no treatments approved by the US Food and Drug Administration (FDA) for either macrocystic or microcystic lymphatic malformations. The totality of the epidemiologic literature for LM is limited to the incidence of the disease among various birth cohorts. This is the first nationally representative study to estimate the national managed prevalence for patients with microcystic LM or combined LM with a cutaneous component annually across physician specialties likely to manage this condition. We conducted a retrospective observational survey of a nationally representative sample of patient-care physicians in the United States most likely to manage lymphatic malformations with a cutaneous component (LMC). Once recruited, target physicians participated via an electronic questionnaire. We weighted study physician self-estimates of the number of LMC patients treated in the past 12 months to reflect the specialists' corresponding proportion in the national universe. All patient information was anonymous; no personally identifiable information was collected. RESULTS: Of the 420 physicians who visited the study website, 316 agreed to be screened and to participate (75.2% participation rate). Our survey results indicated the estimated number of unique annually managed LMC patients by target specialists is 79,920 (CI 66,600-93,250). This number corresponds to managed prevalence of 24.1 LMC patients per 100,000 population (CI 19.6/100,000-28.4/100,000). CONCLUSIONS: The study indicates that while rare, LMC affects a substantial number of people in the US (79,920) who are being managed by one or more specialists. By better understanding the prevalence of people living with LMC who require treatment, efforts to both increase disease awareness and to identify underserved populations in need of potential new treatments can be better focused.

Radionuclide ventriculography phase analysis for risk stratification of patients undergoing cardiotoxic cancer therapy.

BACKGROUND: Accurate diagnostic tools to identify patients at risk of cancer therapy-related cardiac dysfunction (CTRCD) are critical. For patients undergoing cardiotoxic cancer therapy, ejection fraction assessment using radionuclide ventriculography (RNVG) is commonly used for serial assessment of left ventricular (LV) function. METHODS: In this retrospective study, approximate entropy (ApEn), synchrony, entropy, and standard deviation from the phase histogram (phase SD) were investigated as potential early markers of LV dysfunction to predict CTRCD. These phase parameters were calculated from the baseline RNVG phase image for 177 breast cancer patients before commencing cardiotoxic therapy. RESULTS: Of the 177 patients, 11 had a decline in left ventricular ejection fraction (LVEF) of over 10% to an LVEF below 50% after treatment had commenced. This patient group had a significantly higher ApEn at baseline to those who maintained a normal LVEF throughout treatment. Of the parameters investigated, ApEn was superior for predicting the risk of CTRCD. Combining ApEn with the baseline LVEF further improved the discrimination between the groups. CONCLUSIONS: The results suggest that RNVG phase analysis using approximate entropy may aid in the detection of sub-clinical LV contraction abnormalities, not detectable by baseline LVEF measurement, predicting a subsequent decline in LVEF.

Marking to weaning production aspects of lambs provided with NSAID analgesia compared with lambs receiving no analgesia at the time of elastrator ring marking.

The provision of analgesia at the time of marking has been adopted by the Australian sheep industry, but data on production benefits are lacking. In the current study, alternate lambs were provided with either meloxicam (non-steroidal anti-inflammatory drug [NSAID], n = 781) or no analgesia (NONE, n = 822) at the time of ring castration and tail docking. Six distinct management groups of lambs were studied. Lambs were weighed immediately before marking and then again at weaning. There was no significant effect of treatment on average daily gain between marking and weaning in cross-bred lambs. In Merino lambs, average daily gain was 5 g/day lower (P < 0.005) in lambs receiving NSAID, but this may not be biologically significant. Lamb losses were significantly (P < 0.05) lower in the NSAID group (1.1%) than in the NONE group (2.7%). This observation is worth validating in larger studies, particularly considering that lamb mortality is a significant cost to production and welfare concern.

Efficacy of meloxicam in a pain model in sheep.

OBJECTIVE: To evaluate the efficacy of the non-steroidal anti-inflammatory drug, meloxicam, in alleviating pain and inflammation and on production-related variables in a model of sterile acute inflammation in sheep. METHODS: Groups of 12 mature Merino ewes received 0, 0.5, 1.0 or 1.5 mg/kg meloxicam subcutaneously 90 min before injection of 0.1 mL turpentine subcutaneously on the anterior aspect of the proximal phalanx of a forelimb. Pain- and inflammation-related variables were assessed at -18, 3, 6, 9, 12, 24, 48 and 72 h relative to meloxicam administration. Daily feed intake and body weight change 7 days later were also assessed. Pain-related variables measured were weight borne on each forelimb, lameness score, time each forelimb was raised in a 20-s interval and tolerance to a noxious mechanical stimulus. Inflammation-related variables measured were skin temperature, limb circumference, body temperature, plasma haptoglobin concentration and peripheral blood leucocyte parameters. RESULTS: Meloxicam was effective in improving all pain-related variables. A dose-dependent response was seen between 0 and 1.0 mg/kg, with no additional benefit provided by 1.5 mg/kg. At a dose rate of 1.0 mg/kg, meloxicam improved weight borne on the turpentine-treated limb by 14%, reduced the time the treated limb was held in a non-weight-bearing posture by 46%, reduced the lameness score by 58% and improved tolerance to pressure by 52%. No significant effects of meloxicam on inflammatory variables or appetite were observed. CONCLUSIONS: Using a validated pain model, the data suggested that 1.0 mg/kg meloxicam provided significant analgesic benefits to sheep.

Development of a microwave stunning system for cattle 2: Preliminary observations on behavioural responses and EEG.

DTS: Diathermic Syncope® (DTS) is a novel system for rendering animals insensible prior to slaughter, utilizing microwave energy to induce a rise in temperature in the brain to a point at which the animal is expected to lose consciousness. During development and optimisation of the system, two trials were carried out utilizing non-anaesthetized adult cattle, to gather data on behavioural outcomes and EEG changes following energy application. In trial1, ten cattle received DTS treatments (high energy >290 kJ, n = 3; low energy <200 kJ, n = 4; and intermediate 200 < 290 kJ, n = 3), and seven received captive bolt stunning, prior to exsanguination. In trial 2, following improvements to the efficiency of energy delivery, 20 cattle received DTS (200-360 kJ). Post treatment EEG was characterized by seizure-like activity and reductions in 95% spectral edge and median frequencies; with EEG suppression persisting for at least 80 s up to over 4 min post treatment application. Animals showed: Loss of posture, Loss of corneal responses; Loss of withdrawal response (pinprick); Eye staring, not following movement. The animals remained unresponsive to stimuli for up to 4 min post DTS, and behavioural expression of distress was not observed. Seventeen of the 30 animals showed indications of returning reflex responses after 100 s post treatment, suggesting that animals receiving lower energy applications may recover from the stun.

Marine plastics threaten giant Atlantic Marine Protected Areas.

There has been a recent shift in global perception of plastics in the environment, resulting in a call for greater action. Science and the popular media have highlighted plastic as an increasing stressor [1,2]. Efforts have been made to confer protected status to some remote locations, forming some of the world's largest Marine Protected Areas, including several UK overseas territories. We assessed plastic at these remote Atlantic Marine Protected Areas, surveying the shore, sea surface, water column and seabed, and found drastic changes from 2013-2018. Working from the RRS James Clark Ross at Ascension, St. Helena, Tristan da Cunha, Gough and the Falkland Islands (Figure 1A), we showed that marine debris on beaches has increased more than 10 fold in the past decade. Sea surface plastics have also increased, with in-water plastics occurring at densities of 0.1 items m-3; plastics on seabeds were observed at ≤ 0.01 items m-2. For the first time, beach densities of plastics at remote South Atlantic sites approached those at industrialised North Atlantic sites. This increase even occurs hundreds of meters down on seamounts. We also investigated plastic incidence in 2,243 animals (comprising 26 species) across remote South Atlantic oceanic food webs, ranging from plankton to seabirds. We found that plastics had been ingested by primary consumers (zooplankton) to top predators (seabirds) at high rates. These findings suggest that MPA status will not mitigate the threat of plastic proliferation to this rich, unique and threatened biodiversity.

Equine gestational length and location: is there more that the research could be telling us?

Clear definitions of 'normal' equine gestation length (GL) are elusive, with GL being subject to a considerable number of internal and external variables that have confounded interpretation and estimation of GL for over 50 years. Consequently, the mean GL of 340 days first established by Rossdale in 1967 for Thoroughbred horses in northern Europe continues to be the benchmark value referenced by veterinarians, breeders and researchers worldwide. Application of a 95% confidence limit to reported GL range values indicates a possible connection between geographic location and GL. Improved knowledge of this variable may help in assessing the degree of the neonate's prematurity and dysmaturity at or soon after birth, and identification of conditions such as incomplete ossification of the carpal and tarsal bones. Associated pathologies such as bone malformation and fracture, angular limb deformity and degenerative joint disease can cause chronic unsoundness, rendering horses unsuitable for athletic purpose and shortening ridden careers. This review will examine both the factors contributing to GL variation and the published data to determine whether there is potential to refine our understanding of GL by establishing a more accurate and regionally relevant GL range based on a 95% confidence limit. This may benefit both equine industry economics and equine welfare by improving early identification of skeletally immature neonates, so that appropriate intervention may be considered.

Infrared thermal imaging as a method to evaluate heat loss in newborn lambs.

Thermal imaging technology has been identified as a potential method for non-invasive study of thermogenesis in the neonatal lamb. In comparison to measurement of the core body temperature, infrared thermography may observe thermal loss and thermogenesis linked to subcutaneous brown fat depots. This study aimed to identify a suitable method to measure heat loss in the neonatal lamb under a cold challenge. During late pregnancy (day 125), ewes were subjected to either shearing (n=15) or mock handling (sham-shorn for 2min mimicking the shearing movements) (n=15). Previous studies have shown an increase in brown adipose tissue deposition in lambs born to ewes shorn during pregnancy and we hypothesized that the shearing treatment would impact thermoregulatory capacities in newborn lambs. Lambs born to control ewes (n=14; CONTROL) and shorn ewes (n=13; SHORN) were subjected to a cold challenge of 1h duration at 4h after birth. During the cold challenge, thermography images were taken every 10min, from above, at a fixed distance from the dorsal midline. On each image, four fixed-size areas were identified (shoulder, mid loin, hips and rump) and the average and maximum temperatures of each recorded. In all lambs, body surface temperature decreased over time. Overall the SHORN lambs appeared to maintain body surface temperature better than CONTROL lambs, while CONTROL lambs appeared to have higher core temperature. At 30min post cold challenge SHORN lambs tended to have higher body surface temperatures than lambs (P=0.0474). Both average and maximum temperatures were highest at the hips. Average temperature was lowest at the shoulder (P<0.05), while maximum temperatures were lowest at both shoulder and rump (P<0.005). These results indicate that lambs born to shorn ewes maintained their radiated body surface temperature better than CONTROL lambs. In conjunction with core temperature changes under cold challenge, this insight will allow us to understand whether increased body surface temperature contributes to increased overall heat loss or whether increased body surface temperature is indeed a mechanism contributing to maintenance of core body temperature under cold challenge conditions. This study has confirmed the utility of infrared thermography images to capture and identify different levels of thermoregulatory capacity in newborn lambs.

Development of a microwave energy delivery system for reversible stunning of cattle.

Stunning prior to slaughter is commonly used to render the animal insensible to pain. However, for certain markets, stunning is disallowed, unless the animal can fully recover if not slaughtered. There are very few available methods of inducing a fully recoverable stun. This paper describes the development of a microwave energy application system for stunning cattle. Cadaver heads were used to demonstrate that brain temperature could be raised to a point at which insensibility would be expected to occur (44°C), and to calculate the power and time combinations required to achieve this in a range of cattle weights. Surface heating was identified as a cause for potential concern, which was mitigated by the development of another type of microwave applicator. Although the applicator and process variables require validation in animal studies, this technology shows promise as a method of inducing a recoverable stun.

Effect of local infusion of NSAID analgesics administered alone or in combination on the pain associated with band castration in calves.

OBJECTIVE: To evaluate the analgesic efficacy of flunixin alone or in combination with diclofenac administered locally to the scrotum at the time of band castration of calves. METHODS: Angus bull calves (n = 40; ≈7-9 weeks old) were allocated to four treatment groups (n = 10 per group) to examine the effects of two non-steroidal anti-inflammatory analgesics (NSAIDs) administered locally at the time of band castration: sham control; castration + flunixin; castration + flunixin + diclofenac; castration + saline. The NSAIDs and saline were administered subcutaneously into the scrotum under the band. Blood was sampled at -0.5, 0.5, 1.5, 3, 12, 24, 48 and 72 h relative to castration. Haematology parameters and plasma cortisol levels were determined in samples at all time points and plasma haptoglobin levels determined in samples collected at -0.5, 24, 48 and 72 h. Pain avoidance and postural behaviours were measured for 2 and 12 h, respectively, after castration. RESULTS: Band-castrated calves exhibited significantly higher peak cortisol and higher integrated cortisol responses during the first 6 h post-castration relative to sham controls. Individual active pain avoidance behaviours observed for 1 h post-castration were not significantly different between treatment groups; however; the sum of the total behaviours was significantly increased by castration (P = 0.023). Postural changes included increased abnormal ventral lying for all castrated groups and decreased normal standing and increased combined abnormal postures for the flunixin- and saline-treated groups. Growth rates of calves were not affected by treatments during weeks 1 and 2 post-castration; however, growth rates of castrated calves were significantly lower than those of sham-treated calves in week 3 post-castration (1.41 vs 0.84, 0.75 and 0.56±0.19 kg/day for sham, flunixin-, flunixin + diclofenac- and saline-treated groups, respectively). CONCLUSIONS: The administration of flunixin or flunixin + diclofenac intrascrotally at several sites at the time of banding did not improve the welfare of young Angus bull calves undergoing this method of castration when assessed by both physiological and behavioural parameters. In this study, band castration at 7-9 weeks of age had less effect compared with results for older calves reported previously. Further research is required to develop effective analgesic treatments that can be administered at the time of castration to large numbers of animals.

Trial of human laser epilation technology for permanent wool removal in Merino sheep.

OBJECTIVE: To assess whether human laser epilation technology can permanently prevent wool growth in sheep. DESIGN: An observational study. METHODS: Two commercial human epilation lasers (Sharplan alexandrite 755 nm laser, and Lumenis LightSheer 800 nm diode laser) were tested at energies between 10 and 100 J/cm2 and pulse widths from 2 to 400 ms. Wool was clipped from flank, breech, pizzle and around the eyes of superfine Merino sheep with Oster clippers. After initial laser removal of residual wool to reveal bare skin, individual skin sites were treated with up to 15 cycles of laser irradiation. Behavioural responses during treatment, skin temperature immediately after treatment and skin and wool responses for 3 months after treatment were monitored. RESULTS: A clear transudate was evident on the skin surface within minutes. A dry superficial scab developed by 24 h and remained adherent for at least 6 weeks. When scabs were shed, there was evidence of scarring at sites receiving multiple treatment cycles and normal wool growth in unscarred skin. There was no evidence of laser energy level or pulse width affecting the response of skin and wool to treatment and no evidence of permanent inhibition of wool growth by laser treatment. Laser treatment was well tolerated by the sheep. CONCLUSIONS: Treatment of woolled skin with laser parameters that induce epilation by selective photothermolysis in humans failed to induce permanent inhibition of wool growth in sheep. Absence of melanin in wool may have contributed to the result.

Efficacy of a buccal meloxicam formulation for pain relief in Merino lambs undergoing knife castration and tail docking in a randomised field trial.

OBJECTIVE: To assess the efficacy of oral transmucosal meloxicam for pain relief in lambs at marking. DESIGN: A blinded, placebo-controlled, randomised, block design field study of 60 Merino lambs aged 7-10 weeks allocated to placebo and meloxicam treatments and studied in two cohorts of 30. Placebo-treated lambs received 1 mL/10 kg of drug vehicle and meloxicam-treated lambs received 1 mg/kg meloxicam at 10 mg/mL. Treatments were administered into the buccal cavity immediately before knife castration and hot-iron tail docking. Lambs were then released into a grassed paddock (0.34 ha). Time to mother-up was recorded and behaviours were observed every 15 min for 8 h and again for 45 min at 24 h. The sequence in which lambs exited the paddock with their mothers was then recorded. Weight change and wound scores were recorded 4 and 7 days after marking. RESULTS: Meloxicam did not affect mothering-up. In the 8 h following marking, meloxicam led to a 7-fold reduction (P < 0.001) in combined abnormal behaviours (hunched standing, standing with a stretched posture, walking stiffly). The meloxicam group spent significantly less time in standing postures and tended to spend more time grazing, suckling and in normal lying postures. At 24 h, the meloxicam group spent more time lying and less time standing. There was no effect of treatments on the sequence in which lambs moved into a fresh paddock or on weight change. CONCLUSIONS: The buccal meloxicam formulation provided substantial analgesia to lambs on the day of marking. Slight benefits were evident the following morning.

Predictors of contact tracing completion and outcomes in tuberculosis: a 21-year retrospective cohort study.

SETTING: Birmingham, UK, 1990-2010. OBJECTIVE: To identify predictors in contacts for completion of screening and of a positive screening outcome, i.e., a diagnosis of latent tuberculous infection (LTBI) or active tuberculosis (TB). DESIGN: A retrospective cohort study of TB notifications for a European city. RESULTS: A total of 46,158 contacts were identified from 7365 index cases. Over the study period 17,471 (40.9%) failed to complete screening. Active TB or LTBI was diagnosed in 2220 (7.0%) contacts of cases of pulmonary TB (PTB) and in 222 (2.7%) contacts of cases of extra-pulmonary TB (EPTB). The proportion of contacts offered LTBI treatment increased (P < 0.001) over the study period. Age, ethnicity, sex and use of interferon-gamma release assays (IGRA) were the most important predictors of screening completion, with working age adult males who were Black or from the Indian subcontinent least likely to complete. Age, smear positivity status of the index case and IGRA usage were the most important predictors of a positive screening outcome (active TB or LTBI diagnosed). CONCLUSION: Contact tracing of both PTB and EPTB index cases is useful for active case finding. The findings of this study can be used to target screening and improve the effectiveness and efficiency of local contact tracing programmes.

Nitrogen losses in anoxic marine sediments driven by Thioploca-anammox bacterial consortia.

Ninety per cent of marine organic matter burial occurs in continental margin sediments, where a substantial fraction of organic carbon escapes oxidation and enters long-term geologic storage within sedimentary rocks. In such environments, microbial metabolism is limited by the diffusive supply of electron acceptors. One strategy to optimize energy yields in a resource-limited habitat is symbiotic metabolite exchange among microbial associations. Thermodynamic and geochemical considerations indicate that microbial co-metabolisms are likely to play a critical part in sedimentary organic carbon cycling. Yet only one association, between methanotrophic archaea and sulphate-reducing bacteria, has been demonstrated in marine sediments in situ, and little is known of the role of microbial symbiotic interactions in other sedimentary biogeochemical cycles. Here we report in situ molecular and incubation-based evidence for a novel symbiotic consortium between two chemolithotrophic bacteria--anaerobic ammonium-oxidizing (anammox) bacteria and the nitrate-sequestering sulphur-oxidizing Thioploca species--in anoxic sediments of the Soledad basin at the Mexican Pacific margin. A mass balance of benthic solute fluxes and the corresponding nitrogen isotope composition of nitrate and ammonium fluxes indicate that anammox bacteria rely on Thioploca species for the supply of metabolic substrates and account for about 57 ± 21 per cent of the total benthic N2 production. We show that Thioploca-anammox symbiosis intensifies benthic fixed nitrogen losses in anoxic sediments, bypassing diffusion-imposed limitations by efficiently coupling the carbon, nitrogen and sulphur cycles.

A novel oral tracer procedure for measurement of habitual myofibrillar protein synthesis.

RATIONALE: Conventionally, myofibrillar protein synthesis is measured over time periods of hours. In clinical studies, interventions occur over weeks. Functional measures over such periods may be more representative. We aimed to develop a novel method to determine myofibrillar protein fractional synthetic rate (FSR) to estimate habitual rates, while avoiding intravenous tracer infusions. METHODS: Four healthy males were given 100 g water enriched to 70 Atom % with (2)H2O as a single oral bolus. Vastus-lateralis needle biopsies were performed and plasma samples collected, 3-13 days post-dose. (2)H enrichment in body water was measured in plasma using continuous flow isotope ratio mass spectrometry (IRMS). Myofibrillar protein was isolated from muscle biopsies and acid hydrolysed. (2)H enrichment of protein-bound and plasma-free alanine was measured by gas chromatography (GC)/pyrolysis/IRMS. Myofibrillar protein FSR was calculated (% day(-1)). RESULTS: The tracer bolus raised the initial enrichment of body water to 1514 ppm (2)H excess. Water elimination followed a simple exponential. The average elimination half-time was 8.3 days. Plasma alanine, labelled during de novo synthesis, followed the same elimination kinetics as water. The weighted average myofibrillar protein FSR from the four subjects was 1.38 % day(-1) (range, 1.0-1.9 % day(-1) ). CONCLUSIONS: Myofibrillar protein FSR was measured in free-living healthy individuals over 3-13 days. Using a single oral (2)H2O bolus, endogenous labelling of alanine occurred in a predictable manner giving estimates of synthesis comparable with published values. Furthermore, the protocol does not compromise the ability to measure other important metabolic processes such as total energy expenditure.

Quality Assessment of Longissimus and Semitendinosus Muscles from Beef Cattle Subjected to Non-penetrative and Penetrative Percussive Stunning Methods.

This study provides a comparative analysis of the effects of pre-slaughter penetrative and non-penetrative stunning and post-slaughter stunning on meat quality attributes in longissimus lumborum (LL) and semitendinosus (ST) muscles in heifers. Ten animals were assigned to each of four treatment groups: i) animals were subjected to conventional Halal slaughter (a clean incision through the structures at the front of the upper neck - the trachea, oesophagus, carotid arteries and jugular veins) and post-cut penetrating mechanical stun within 10 to 20 s of the neck cut (Unstunned; US); ii) high power non-penetrating mechanical stunning followed by the neck cut (HPNP); iii) low power non-penetrating mechanical stunning followed by the neck cut (LPNP); and iv) penetrative stunning using a captive bolt pistol followed by the neck cut (P). For each carcass, muscle samples were removed within 45 min of slaughter, portioned and analysed for pH, cooking loss, water holding capacity (WHC), tenderness (WBS), lipid oxidation (TBARS) and color, over a two week storage period. Stunning did not affect pH and cooking loss. Significant differences in water holding capacity, tenderness, lipid oxidation and color were present at different storage time points. HPNP stunning resulted in lower WHC and color values, particularly lightness (L*), higher TBARS values and peak force values compared with those stunned using LPNP, P and US. These adverse effects on quality were mostly encountered in the ST muscle. In conclusion, the meat quality achieved using P, LPNP and US treatments was comparable, and no treatment stood out as considerably better than another.

Takotsubo cardiomyopathy: an Australian single centre experience with medium term follow up.

BACKGROUND: Takotsubo cardiomyopathy (TC) is increasingly recognised in patients presenting with features of acute coronary syndrome. We present a single centre experience of TC with medium term follow up. METHODS: Fifty-two consecutive patients presenting with a diagnosis of TC were included. The clinical presentation, complications, baseline and follow-up echocardiograms and cardiac magnetic resonance imaging were analysed. RESULTS: Fifty-one patients were female. A stressful event preceded presentation in 37 (71%) patients. Chest pain was the most common symptom (83%). Two patients presented with an out-of-hospital cardiac arrest. ST segment elevation (40%) and global T wave inversion (44%) were the most frequent electrocardiogram changes. Left ventricular assessment demonstrated typical apical ballooning in 41 patients and 11 patients demonstrated the mid-wall variant. In-hospital complications occurred in 11 patients (21%) and included acute pulmonary oedema (n = 2), cardiogenic shock (n = 5); two of whom had a significant left ventricular outflow gradient, atrial fibrillation (n = 1), left ventricular thrombus (n = 2) and a cerebrovascular event (n = 2). Left ventricular function at presentation and follow up was compared in 40 patients. The mean ejection fraction in this group at presentation was 47% (20-70%) compared with that at follow up of 63% (44-76%). There were no significant complications or recurrences at follow up. CONCLUSIONS: While TC is a reversible condition with low rates of complications and recurrence at follow up it is, as demonstrated in our cohort, associated with significant in-hospital morbidity in a proportion of patients.

Concentration and prevalence of Escherichia coli O157 and Salmonella serotypes in sheep during slaughter at two Australian abattoirs.

OBJECTIVE: This study aimed to determine the presence and concentration of Escherichia coli O157 and Salmonella spp. on fleece, faeces and carcases of sheep during slaughter. PROCEDURE: Faeces, fleece and pre-chill carcase samples were collected from 164 sheep slaughtered at two Australian abattoirs. The presence of E. coli O157 and Salmonella spp. were determined by use of automated immunomagnetic separation (AIMS) with enumeration by use of the 'most probable number' (MPN) method. RESULTS: Escherichia coli O157 was isolated from 5% of faeces, 3% of fleeces and 0.6% of pre-chill carcases. The mean log(10) count of E. coli O157 positive faecal samples was 2.32 MPN/g, but counts on fleeces and carcases were below the countable limit (-1 log(10) MPN/cm(2) ). Salmonella spp. were isolated from 20% of faeces, 13% of fleeces and 1.3% of pre-chill carcases. The mean log(10) count of Salmonella spp. in faeces was 1.43 MPN/g and on fleece was -0.24 MPN/cm(2) , but counts on carcases were below the countable limit (-1 log(10) MPN/cm(2) ). CONCLUSION: The prevalence and concentration of pathogens were low in the sheep tested in this study, indicating a low risk of human infection from products derived from these animals.