Measurement of the

^{140}Ce(n,γ) is a key reaction for slow neutron-capture (s-process) nucleosynthesis due to being a bottleneck in the reaction flow. For this reason, it was measured with high accuracy (uncertainty ≈5%) at the n_TOF facility, with an unprecedented combination of a high purity sample and low neutron-sensitivity detectors. The measured Maxwellian averaged cross section is up to 40% higher than previously accepted values. Stellar model calculations indicate a reduction around 20% of the s-process contribution to the Galactic cerium abundance and smaller sizeable differences for most of the heavier elements. No variations are found in the nucleosynthesis from massive stars.

Is prone positioning a valid intervention for ARDS in the deployed intensive care unit?

Prone positioning is an intervention used for patients with acute respiratory distress syndrome (ARDS) whose hypoxia is worsening despite conventional treatment. Previously used infrequently, it became an important treatment escalation strategy for hypoxia during the COVID-19 pandemic. Current evidence for prone positioning suggests increased survivability in intubated patients with moderate to severe ARDS who are prone for >12 hours a day. As a relatively low-cost, low-tech intervention with a growing evidence base, the viability of prone positioning in the deployed land environment is considered in this article. The practical technique of prone positioning is easy to teach to healthcare staff experienced in manual handling. However, it requires significant resources, in particular staff numbers, and time to execute and maintain, and necessitates a pressure-minimising mattress. Additionally, staff are placed at increased risk of musculoskeletal injuries and potential exposure to aerosolised microbes if there is a disconnection of the breathing system. We conclude that in the deployed 2/1/2/12 facility (or larger), with access to higher staff numbers and high-specification mattresses, prone positioning is a valid escalation technique for intubated hypoxic patients with ARDS. However, in smaller facilities where resources are constrained, its implementation is unlikely to be achievable.

Inter-laboratory ring trial to compare four quantitative polymerase chain reaction assays employed for detection of Mycobacterium avium subspecies paratuberculosis.

Johne's disease is an infectious enteric disease caused by Mycobacterium avium subspecies paratuberculosis (MAP) affecting ruminant species worldwide. In Project 1, an independent performance comparison ring trail was conducted between three different commercial MAP quantitative polymerase chain reaction (qPCR) assay services (B, C, and D) currently marketed in Great Britain by three separate laboratories against each other and against a fourth assay (A) not available commercially in Great Britain. A total of 205 individual ovine and bovine samples from five farms were analyzed to give 41 sets of pooled results (pool size five) from each laboratory according to their specific protocols. The numbers of positive pools for assays A-D were 18, 12, 11, and 1 (43.9%, 29.2%, 26.8%, and 2.4%), respectively. Assessment of interrater reliability produced a Fleiss' kappa coefficient of 0.15, indicating very poor overall agreement between the four laboratories. Laboratories A-D diagnosed 4, 3, 2, and 1 flocks at the farm level, respectively, as MAP positive. In Project 2, 38 pooled ovine samples from 10 flocks were analyzed to compare the performance of laboratories A and B. The numbers of positive results for laboratories A and B were 24 (63.1%) and 17 (44.7%), respectively (Cohen's kappa 0.54), indicating that laboratory A was more sensitive than B in line with results from Project 1. Variation between laboratories offering MAP qPCR assays is a significant concern, and further work is warranted to validate and standardize the performance of assays between laboratories for both ovine and bovine samples.IMPORTANCEOur study reports the findings of an inter-laboratory ring trial comparing the performance of four different quantitative polymerase chain reaction (qPCR) assay services for detecting Mycobacterium avium subspecies paratuberculosis (MAP) infection in cattle and sheep. MAP is the causative agent of Johne's disease (also known as paratuberculosis), a significant production-limiting disease in livestock populations with a worldwide distribution. The content of this paper is significant and novel as it is the first to highlight the marked variation between the diagnostic sensitivity and reproducibility of the three principal commercial laboratories offering MAP qPCR diagnostic and screening services in Great Britain. The low sensitivity and high variability between the laboratories are of great concern and relevance to veterinary practitioners and livestock producers.

The World Rugby and International Rugby Players Contact Load Guidelines: From conception to implementation and the future.

Managing training load in rugby union is crucial for optimising performance and injury prevention. Contact training warrants attention because of higher overall injury and head impact risk, yet players must develop physical, technical, and mental skills to withstand the demands of the game. To help coaches manage contact loads in professional rugby, World Rugby and International Rugby Players convened an expert working group. They conducted a global survey with players to develop contact load guidelines. This commentary aims to describe the contact load guidelines and their implementation, and identify areas where future work is needed to support their evolution.

Chlamydia pneumoniae infection and ethnic origin

OBJECTIVES: To test the association of Chlamydia pneumoniae infection with ethnic origin. DESIGN: A prospective study by micro-immunofluorescence of antibodies to C. pnuemoniae in patients admitted to one hospital with a variety of non-pulmonary, non-cardiovascular disorders. SETTING: A large district general hospital serving a multi-ethnic inner-city population in Birmingham, UK. SUBJECTS: There were 1518 patients, 1061 of whom were Caucasian, 290 Asian and 167 Afro-Caribbean. Each of 169 Asian and 141 Afro-Caribbeans was matched with two Caucasians for age, sex, smoking habit, steriod medication and date of admission, and logistic regression methods were used to compared the effects on C. pneumoniae antibody levels of ethnic origin, these confounding variables, diabetes mellitus and social deprivation. OUTCOME MEASURES: Serological evidence of acute C. pnuemoniae infection or reinfection (defined by titres of IgM > or = 8, a four-fold rise in IgG or IgG > or = 512) and previous infection (IgG 64-256 or IgA > or = 8). RESULTS: Results showed 4.8 percent of Caucasians, 6.6 percent of Asians and 10.2 percent of Afro-Caribbeans had antibody titres suggesting acute (re) infection; and 11.2 percent of Caucasians, 13.4 percent Asians and 21.0 percent of Afro-Caribbeans had titres suggesting previous infection. On chi 2 analysis, the distributions of the three possible serological outcomes (acute, previous and no infection) differed significantly (p < 0.05) between the Afro-Caribbean and Caucasian groups, but not between Asians and Caucasians or between Afro-Caribbeans and Asians. After adjusting for possible confounding variables, odds ratios for Afro-Caribbean versus Caucasian origin were 5.5 (95 percent confidence intervals 2.0-15.0) for acute (re) infection and 1.9 (1.0-3.7) for previous infection. CONCLUSION: Our results suggest that C. pneumoniae infection may be more prevalent among Afro-Caribbean than among Caucasian people, and that Asians may lie somewhere them in this respect. The behaviour of this pathogen in different ethnic groups deserve further investigation. Future studies of this organism should give due attention to the ethnic origins of patients.(AU)