bluuebunny/crossref_metadata_2025 huggingface dataset:
Institutional and legislative regulation of the food market
Authors: Tumalanov N V , Urusova I N , Morozova N V , Sokolova G N , Ivanitskaya I P , Berezina N V , Taranova O L
Published: February 2020

The relevance of the research topic is due to the problem of deterioration in the food quality market and the lack of high-quality products. The aim of the study was to deepen knowledge of food market and explore the reasons for deterioration of product quality; justification of institutional restrictions ensuring market growth is also considered. It was established that adverse changes in the external and internal competitive environment led to a sharp increase in prices of suppliers of manufactured goods without increasing purchase prices by retail chains. It was established that external changes led to an increase in prices of suppliers together with low purchase prices. This prompted to make a profit through worsening product quality. It is substantiated that there exist opportunities for the production of high-quality food. To limit the decommodification of food and create a market for high-quality products it is proposed to adopt a basic law on the food market. Legal acts are aimed at improving regulation of production, market circulation, environmental purity and genetic integrity. The novelty of the work relates to the fact that in the country with rich resources a new growth axis will be formed. This axis seems to be attractive for investment.
Justification of non-power rotational working body for “STRIP-TILL”
Authors: Smirnov P A , Smirnov M P , Alekseev E P , Prokopieva E V
Published: February 2020

In the last decade, the idea of narrow-band tillage for row crops has gained not only material realization, but also a real estimated framework in terms of energy and resource saving. The article presents a variant of the working body for strip tillage, as the simplest and most reliable in construction, at the same time the most effective in terms of achieving the agrotechnical quality of the treated soil. The design of the non-power rotary working body is as follows. At the maximum approaching of two symmetric afrontal and needle disks inclined from the vertical to the crossing of their rolling planes, a zone of soil destruction due to a fixed shift is formed. In this zone, the needles of the first disk make a working stroke approximately perpendicular to the direction of movement, and the needles of the second disk make a similar movement in the opposite direction in the intervals of the needles of the first disk. The soil in this area is first pinched between the needles, then destroyed, including large lumps. To exclude wear on the tips of the needles and the unstable progress of the entire non-driven rotary working body, the manufacture of needles in the self-sharpening mode is proposed, the recommended operating modes are given. An optimal variant of using a non-driven rotary working body as part of the transformer “narrow-band tillage adapter - seeder” is also proposed, on which the adapter can be aggregated with any seeder for row crops.
Optimization of plant nutrition using non-traditional organic fertilizers and zeolite-containing tripoli
Authors: Eliseev I P , Shashkarov L G , Vasiliev O A , Eliseeva L V , Mitrofanov E L
Published: February 2020

The problem of conservation and reproduction of soil fertility by using unconventional organic fertilizers, particularly the replacement of the mineral nitrogen fertilizer to its organic form is discussed. The growth of the livestock industry lays the groundwork for the recovery of meat processing industry waste of horned ungulate crumbs (HAC) as fertilizer for inter-tilled crops. HAC contains about 14% nitrogen. Experiments on the application of HAC as a nitrogen fertilizer and sorption-type ameliorant – zeolite-containing tripoli were organized in 2012-2016 in the crop rotation link on the light gray forest soil of the experimental field of the FSBEI HE Chuvash State Agricultural Academy, Chuvash Republic. In this paper, the effect of the HAC-form on the optimization of nitrogen nutrition of the studied crops both separately and for tripoli having phosphorus-potassium mineral fertilizers is studied. The positive effect of HAC and tripoli on the growth and development of potato and fodder beet plants, soil biological activity, leaf surface area, yield and quality indicators of potato tubers and fodder beet root crops both in the first year when fertilizers are applied and in their aftereffect in the second year for barley yield was revealed. The study materials contribute to the practical solution of the problem of the recovery of meat processing industry waste and rational use of resources in the fertilizer system, being a guide to energy and resource conservation in agriculture.
The impact of the digital divide on the development of socio-economic systems
Authors: Popova A L , Nuttunen P A , Kanavtsev M V , Serditov V A
Published: February 2020

The article presents studies of the impact of digital inequality on the development of rural areas as socio-economic systems. The difference in the levels of socio-economic development of rural areas and cities in the transition to the information society is not smoothed, but rather increases, which threatens to turn most of the territory of the Russian Federation into one huge depressed region. Among the key factors determining the negative impact of digital transformations, the study highlights the rapid deterioration of the quality of human resources, which is a consequence and cause of digital inequality. The process of concentration of innovative potential in large cities and individual industries, which leads to the depletion of rural areas, and unpredictable transformations in agriculture, where the lack of mass application of high technologies leads to a sharp decrease in efficiency and General degradation of a number of resources, is critically comprehended. To solve this problem, the authors propose the concept of information model of digital transformation of management processes of socio-economic systems, taking into account the influence of territorial and sectoral factors of formation of resource potential of rural areas in the information society.
Prevention of transport stress in imported heifers improves their health status and their productive parameters
Authors: Semenov V , Mudarisov P , Larionov G , Tsarevsky I , Nikitin D , Simurzina E , Ivanova T
Published: February 2020

The dynamics of bioamines in platelets, neutrophils, lymphocytes and blood plasma of imported heifers indicated that experimental group of animals experience stress, which is accompanied by an adequate release of bioamines from the deposit sites: catecholamines - by 9.2-17.1%, histamine - by 2.2-6.1% and serotonin by 1.0-3.9% (P <0.05-0.001). Intramuscular injection of PS-7 and Prevention-N-C preparations to transported animals had a supportive effect on the formation of body biochemical adaptation mechanisms to the conditions of long-term transportation. After application of biopreparations the improvement of the reproductive traits of heifers of the 1st and 2nd experimental group was indicated the age of successful insemination was shortened by 1.35 and 1.53 months, the first calving age - by 1.0 and 1.2 months, the insemination index - by 1.42 and 1.93 times, the service period - by 8.8 and 12.2 days and increased fertilization after the first insemination by 1.7 and 2.0 times (P <0.05-0.01), rather than in the control. Heifers of the 1st and 2nd experimental group surpassed their peers of the control group in milk yield for 305 days of lactation by 109 and 125 kg (P <0.05), fat content by 0.16 and 0.27% and protein content by 0.04 and 0.07%.
Green economy: preconditions and directions of development in the agricultural sector
Authors: Abrosimova M , Makushev A , Litvinova O , Nesterova N , Gordeeva L , Semenova A , Tolstova M
Published: February 2020

The most intense trend in the modern economy is the introduction of a green economy as one of the main conditions for maintaining a balanced state of the environment for future generations. The strategy of “green” development is becoming increasingly used in different countries. Green growth is a strategy for transforming an economic system in which investments in environmental resources and services become the driving force of economic development. The success of the strategy depends not only on political will but also to a greater extent on centralized funding and planning for green programs. The need to implement the concept of a “green” economy is particularly acute in agricultural production.
Efficiency of poultry house heating and ventilation upgrading
Authors: Saleeva I , Sklyar A , Marinchenko T , Postnova M , Ivanov A
Published: February 2020

The genetic potential of bird productivity can be fully revealed only in conditions of an optimal microclimate to be ensured by sufficiently energy-intensive ventilation and heating (cooling) air systems. In this regard, energy conservation is an urgent task for poultry farms given the significant share of the energy component in the cost of poultry products (9-14 %) and rising energy prices. In poultry houses, the greatest heat losses are in exhaust ventilation (up to 29, 000 gigacalories in poultry farms for the heating season), where heat recovery units are needed, which are designed to perform high-quality sanitation in heat-exchange channels; for the economical heating of poultry and premises, the use of local gas heating systems able to work with positive pressure and depression in the poultry house and disinfect the air is required. The experiments on the use of gas air heaters for growing meat chickens showed that in an autonomous heating system with heat recovery units, air heaters become the main heat generators and heat source that heats up the air supply, which allows the system to be used in “hybrid” modes, i.e. at high pressure during the first period of broiler operation and with depressurizing during the second period of broiler operation. At the same time, there was no negative effect of burning oxygen and combustion products on livestock productivity; a high level of veterinary and sanitary protection of the livestock due to air disinfection by gas burners is provided as well.
The scientific and practical rationale for the inclusion of enzyme preparations in the feed of young pigs
Authors: Danilova N V , Yu Lavrent’ev A , Yu Nemtseva E , Sherne V S , Evdokimov N V , Petrov N S
Published: February 2020

Studies on growing young pigs for rearing and fattening using a mixture of enzyme preparations were carried out on animals aged 2 to 7 months in the dynamics of their growth and development. The animals receiving compound feed used in the economy served as control. The compound feed of the first experimental group was enriched with a mixture of additional enzyme preparations amylosubtilin G3x and cellolux-F, and the second experimental group – a mixture of amylosubtilin G3x and protosubtilin G3x. The use of a mixture of amylosubtilin G3x and cellolux-F increases the average daily growth by 13.6 %, reduces feed costs by 11.8 % compared to the control group’s pigs, a mixture of amylosubtilin G3x and protosubtilin G3x - an average daily increase of 8.7 %, a decrease in feed costs by 7.9 % compared to the control group’s pigs. The highest content of muscle tissue in the half-carcasses was observed in animals in the first experimental group (58.5 %) and in the second experimental group (58.17 %), which is higher in the control group by 0.93 and 0.6, respectively. The results of research in the technology of pork production reveal new possibilities of using a mixture of enzyme preparations.
A new approach to obtaining prolonged nitrogen fertilizers and appraisal of their agrochemical efficiency
Authors: Khuziakhmetov R , Sabirov A , Mukhametshina A , Nizamov A
Published: February 2020

A new approach to obtain prolonged nitrogen fertilizers, based on the “gauging” of industrial instant nitrogen fertilizers (ammonium nitrate and urea) by Sorel cement, is proposed. The resulting alkaline complex N(Mg)-fertilizers help neutralize soil acidity (“Sorel cement” - nMg(OH)2 • Mg(SO4, NO3) • mH2O also contain plant nutrients). The main quality criteria for prolonged N(Mg)-fertilizers have been developed. The results of evaluating the agrochemical effectiveness of prolonged N(Mg)-fertilizers (as well as urea-formaldehyde fertilizers - UFF) are presented. In the growing experiments the application of these fertilizers contributed to increase in the yield of wheat and green mass of Sudan grass by 20-30%. In the weather and climatic conditions of Tatarstan, prolonged UFF make it possible to obtain a full second mowing of Sudan grass in the autumn period and N(Mg)-fertilizers contributed to an increase in wheat yield by 15%.
Effect of transgenic overexpression of BMP antagonist noggin on chemically-induced skin carcinogenesis
Authors: Mardaryev A N , Mardaryeva N V , Larionov G A , Gordova V S , Terentyeva M G
Published: February 2020

To study the role of BMP signaling pathway in the development of skin tumors, we employed two-stage chemical carcinogenesis protocol on K14-Noggin mice expressing BMP antagonist noggin in the epidermis. A comparative analysis showed an earlier appearance and a significant increase in the number of skin papillomas in K14-Noggin mice compared to the wild-type control (FVB). In contrast to control mice, the transgenic K14-Noggin mice also developed squamous cell carcinoma with local metastasis of malignant cells into the dermis of the skin. The results of this work indicate the tumor suppressive role of BMP signaling pathway in the skin epithelium.
The effectiveness of the use of alternative fertilizers in the conditions of the Chuvash Republic
Authors: Vasilyev O A , Ilyin A N , Nursov I N , Zaitseva N N , Vasilyev A O , Fadeeva N A , Lozhkin A G
Published: February 2020

The article presents for the first time the results of using organic substances belonging to the category of industrial waste as fertilizers for agricultural crops. The dairy industry has waste (hereinafter referred to as cake) generated during the cleaning of milk pipes and requiring additional costs for their disposal. Biogas plant products (hereinafter referred to as biofertilizer) obtained from fresh chicken manure by fermentation in an anaerobic environment are also promising as fertilizer for agricultural crops. Biofertilizer and cake were applied superficially at different plots at doses of 3 kg/m2 (30 t/ha), 6 kg/m2 (60 t/ha) and 9 kg/m2 (90 t/ha). The potato tubers of the ‘Gala’ variety of German selection were planted. It was found that the higher the dose of the used substances, the greater the yield of potatoes. The yield increase in the variant of 30 t/ha of cake was 5.9 t/ha of potato tubers, 60 t/ha of cake - 11.3 t/ha, and in the variant of 90 t/ha of cake - 15.5 t/ha. The use of biofertilizers also caused an increase in yield. The use of waste as fertilizers enhances the biological activity of soils, increases the content of mobile nutrients of plants of light gray forest soil.
The effect of greenhouse irradiators on the load factor of step-down transformers
Authors: Kondrateva N , Terentyev P , Filatov D , Maksimov I , Kirillov N , Ovchukova S , Rybakov L
Published: February 2020

The aim of the work is to determine the permissible load factors of step-down transformers when powering various types of greenhouse irradiators. All examined irradiators have nonlinear volt-ampere characteristic and generate upper current harmonics. The object of research are greenhouse illuminators with high pressure sodium lamps, induction and light-emitting diodes greenhouse illuminators (LED) with active and passive power factor. The permissible load factors of transformers are calculated using obtained data: for high-pressure sodium lamp light is 0.95 max; for LED lamps with active power factor corrector – 0.76 max; for LED lamps with passive power factor correction – 0.59 max; for electrodeless lamp light – 0.98 max. To reduce current harmonics in systems with LED lamps and to increase the load factor of transformers, it is necessary to apply special devices – active or passive harmonic filters. For greenhouse irradiators with sodium lamps and induction irradiators, the use of harmonic filters is not required.
Spark plasma sintering plus heat-treatment of Ta-doped Li7La3Zr2O12 solid electrolyte and its ionic conductivity
Authors: Xue Jiali , Zhang Kuibao , Chen Daimeng , Zeng Jianjun , Luo Baozhu
Published: February 2020

Ta-doped Li7La3Zr2O12 (Ta-LLZO) solid electrolyte ceramics were synthesized by solid-state sintering, spark plasma sintering (SPS) and SPS plus heat-treatment (two-step method) using LiOH·H2O, La2O3, ZrO2 and Ta2O5 as the raw materials. The Ta-LLZO samples prepared from these three routes are all in cubic phase structure. However, the solid-state method results in Ta-LLZO samples with different particle sizes and porous morphology, while the samples prepared by SPS route contain fewer internal voids and smaller particle size. The two-step method not only retains the high compactness of SPS samples, but also the increment of grain size. The SEM results demonstrate that Ta-LLZO sintered by the two-step method shows optimal electrical properties. And the total ionic conductivity is 4.6 × 10−3 S cm−1 at 150 °C and the activation energy is calculated to be 0.38 eV.
Investigation of self-consistent site-dependent DFT + U effect on electronic band structure and optical properties of SiFe2O4 spinel
Authors: Idris M C , Shaari A , Razali R , Lawal Abdullahi , Ahams S T
Published: February 2020

The first-principle investigation of SiFe2O4 (SFO) spinel was performed with the help of a plane-wave pseudopotential technique within the generalized gradient approximation (GGA) and local density approximation (LDA) as implemented in Quantum Espresso Simulation package. The Electronic band structure and optical properties of SFO spinel-type material have been investigated and discussed in this paper. The calculated band structure reveals that SFO spinel-type material is a direct bandgap semiconductor. Using GGA + U and LDA + U the band gap value so obtained is 3.52 eV and 2.96 eV respectively. The contribution to valence and conduction bands due to different bands was analyzed on the basis of the total and partial density of state. The Optical properties of SFO spinel-type material have been calculated and discussed in detail. The real,

ε

1

ω

and the imaginary,

ε

2

ω

part of the complex dielectric constants is found to be 6.52 and 5.42 at energies of 3.44 eV and 6.21 eV respectively. The refractive index

n

0

and the reflectivity index

(
R

ω

)
,

at zero energy value were found to be 1.88 and 10% respectively. We found that SFO spinel-type material has good properties for optical devices.
Exploring dynamics of resonance energy transfer in hybrid Quantum Dot Sensitized Solar Cells (QDSSC)
Authors: Ramanarayanan Rajita , Ummer Fadeela Chundekat , Swaminathan Sindhu
Published: February 2020

Graphene based nanomaterials are known to provide new avenues to improve semiconductor based light harvesting devices. This work makes use of graphene quantum dots (GQD) to improve the efficiency of a CdSe Quantum Dot Sensitized Solar Cell (QDSSC) by Förster Resonance Energy Transfer (FRET) mechanism. FRET describes non-radiative energy transfer between two adjacent molecules typically in range from 1 to 10 nm with one molecule as donor and other molecule as acceptor. If the acceptor is in close proximity of the excited donor, then their dipoles align resulting in transfer of excitation energy from donor to acceptor. Here graphene quantum dot acts as the energy donor to enhance light harvesting of CdSe quantum dot which acts as an acceptor in the hybrid solar cell. The introduction of GQD increases the efficiency of CdSe sensitized QDSSC from 0.18 to 0.28% showing an efficiency enhancement of 55%. The improved efficiency is mainly attributed to the 46% increase in current density of the GQD-CdSe solar cell compared to the CdSe QDSSC. The increased performance of the QDSSC owes to the existence of non-radiative energy transfer (FRET) between GQD and CdSe evident from photoluminescence (PL) quenching and lifetime measurements. This FRET system of GQD (donor)-CdSe (acceptor) shows an energy transfer of 48.7% providing new insights for selective light harvesting of the solar spectrum which can be utilised for various potential applications in future.
What is important to people with dementia living at home? A set of core outcome items for use in the evaluation of non-pharmacological community-based health and social care interventions
Authors: Reilly Siobhan T , Harding Andrew J E , Morbey Hazel , Ahmed Faraz , Williamson Paula R , Swarbrick Caroline , Leroi Iracema , Davies Linda , Reeves David , Holland Fiona , Hann Mark , Keady John
Published: February 2020

Objectives

inconsistency in outcome measurement in dementia care trials impedes the comparisons of effectiveness between trials. The key aim of this study is to establish an agreed standardised core outcome set (COS) for use when evaluating non-pharmacological health and social care interventions for people with dementia living at home.

Method

we used a mixed-methods research design, including substantive qualitative research with five key stakeholders groups. We consulted with people living with dementia for many aspects of this research. We applied a modified two-round 54 item Delphi approach to attain consensus on core outcomes. The COS was finalised in a face-to-face consensus meeting in 2018.

Results

of the 288 who completed round 1 (21 people living with dementia, 58 care partners, 137 relevant health and social care professionals, 60 researchers, 12 policy makers), 246 completed round 2 (85% response rate). Twenty participants attended the consensus meeting. We reached consensus for the inclusion of 13 outcome items.

Conclusion

we identified 13 outcome items which are considered core; many relate to social health. Providing there are adequate measures, measuring these core outcome items will enhance comparisons for effectiveness making trial evidence more useful. The items will provide commissioners and service planners with information on what types of interventions are most likely to be valued highly by people living with dementia.

Trial registration

The study is registered on the COMET initiative database.
6 Perioperative Urinary Catheterisation in Hip Fracture Patients
Authors: Bell R , Michael A
Published: February 2020

Introduction

There are currently no national guidelines, in the UK, advising when to catheterize hip fracture patients and when to trial without a catheter (TWOC). We audited the practice in a UK teaching hospital where there is a consultants’ consensus that all patients should be catheterized on the day of admission (or day of surgery; which is usually within 36 hours of admission) and TWOC as soon as possible within 72 hours postoperatively. We also correlated delays in TWOC with urinary tract infection (UTI) rates.

Methods

Audit of consecutive hip fracture patients who had undergone surgery. Patients who had long term indwelling urinary catheter were excluded. Data collected include: demographics and date and time of admission, catheterisation, operation and TWOC, also duration of catheter post operatively, reason if TWOC delayed and whether the patient had a UTI.

Results

43 patients were included; 30 males and 13 females with a mean age of 82.9 and 83.9 years respectively. Urinary catheters were inserted in 100% of patients preoperatively. Overall 23% of patients had a UTI. There were more UTIs with prolonged catheterization. The results are summarised in the table. The reason for delaying a TWOC was not documented in any of patients’ notes.

Discussion

The low rate of TWOC within 72 hours can be attributed to:Lack of clear guidelinesReluctance to have a TWOC for older patients with poor postoperative mobility with concerns regarding inability to reach the toilet timely.Reluctance to have a TWOC for those who did not open their bowels postoperatively.Time and resources pressure.

Conclusion and recommendations

National guidelines for urinary catheterisation in hip fracture patients are needed meanwhile Orthopaedic Department guidelines will improve the care in these patients. Patients should have a urinary catheter “passport” documenting the date of insertion, expected date of TWOC and the reasons for delaying TWOC. It is important to educate the team about the importance of TWOC as early as possible and improve communication.
24 Improving the Investigation and Treatment of Anaemia in Older Adults Admitted Through the Acute Medical Unit
Authors: Kaza N , Nassour V , Ehsanullah J , Gravell R , Yeoman A , Chia G , Todorov G , Wright P
Published: February 2020

Background

This project was based within acute medical unit within a tertiary hospital in London and was conducted by junior doctors working both in geriatrics and in acute medicine. The patient group this project was aimed at was adults aged 65 and over who were admitted under acute medicine.

Introduction

Anaemia is common in older adults and associated with poor outcomes. This project aimed to explore attitudes and improve recognition, investigation and management of anaemic older adults in acute medicine through a multi-pronged approach.

Methods

Serial PDSA cycles were conducted over 3 months. Retrospective audit was performed, reviewing electronic records to compare a 2-week period before and after the interventions, identifying which patients admitted under acute medicine and aged over 65 years were anaemic, underwent haematinics and treatment.

Interventions

Firstly, a survey explored doctors’ attitudes and knowledge of anaemia in older adults as well as identifiable barriers to investigating anaemia when working in acute medicine. The data from this was used to design interventions to address the gaps which emerged. Interventions included an algorithm regarding haematinic interpretation disseminated amongst junior doctors, multiple teaching sessions conducted and posters distributed which highlighted the importance of investigating and treating anaemia.

Results

The initial audit included 144 patients, of which 50 were anaemic, and the re-audit included 148 patients of which 56 were anaemic. Following the interventions, more patients had haematinics requested, from 60% to 70%, and more were treated, from 30 to 55% (p<0.05). Doctors were surveyed before and after the intervention. The repeat survey demonstrated that more doctors felt addressing anaemia was important, 83% from 55% (p<0.05). More doctors were also confident in the interpretation of haematinics, 61% from 28% (p<0.05) and in prescribing iron, 66% from 27% (p<0.05).

Conclusions

Anaemia amongst elderly patients in the acute setting is under-estimated, investigated and treated. Targeted educational interventions can improve doctors’ attitudes and knowledge, helping to facilitate the investigation of older adults and enable treatment.
30 The Role of A Virtual Clinic in Reducing Waiting Times for Out-Patient Follow-Up
Authors: Thomson F , Richards K
Published: February 2020

Topic

Hospital admissions for older people are increasing with subsequent pressure on out-patient (OP) clinics. By early 2018, 350 patients were waiting up to 6 months for follow-up, with limited capacity in existing clinics. There were concerns regarding potential harm to patients from delayed review of significant results.

Intervention

A working group considered options for managing the OP waiting list. We decided to pilot a fortnightly virtual clinic (VC) where cases were reviewed without the patient present. All patients awaiting results were listed for the VC rather than routine OP. Each VC had 50 patients listed. Patient’s GP received a clear action plan. Clinic rules were modified as issues were identified. Links with other specialities evolved reducing the number of missing results. Data was analysed for 50% of consultations between January 2018 and March 2019.

Improvement

311 VC appointments were reviewed: 207 in 2018 and 104 up to March 2019. Maximum 25 cases could be completed per clinic, additional sessions cleared initial backlog within 3 months. Completion time/case ranged from 2-15 minutes depending on complexity. Main reason for VC was test results: 82% in 2018, increasing to 93% in 2019. 61% in 2018, 80% in 2019 were discharged directly from VC. 20% required a 2nd VC for outstanding results. OP review post-VC fell from 16% in 2018 to just 2% in 2019. General OP requirements fell from 24hrs to 10 hours/ week as a result of VCs, releasing consultants for other clinical areas.

Discussion

VCs are an effective means of reviewing outstanding results from recent admissions and OP consultations. Routine listing of patients with outstanding investigations provides a safety net. Most results are normal and do not require follow-up. Repeat CXRs at 6 weeks continue to be requested for severely frail people who are unlikely to benefit.
58 Can Volunteers Improve the Well-Being, Participation and Activity of Patients on An Acute Older-Persons’ Unit in Hospital?
Authors: Jacob C , Roff K , Fleet J , Jones J , Wood C A , Jensen H , Allen S , Bryan A , Romero D , Ray L , Meldrum T , Owen B
Published: February 2020

Background

A multi-disciplinary led, charity-funded initiative was implemented to deliver an Activity Promotion Project (APP) on the older adult wards of a large teaching hospital, providing acute medical management for adults over 65 with complex needs.

Introduction

Previous local studies show that our patients are inactive, lonely and their activity is inhibited by ward culture. Cognitively impaired patients experiencing long delays for placement are often agitated and restless. Staff feel disheartened by their inability to spare time for non-medical needs. To respond to the Social Prescribing directive the APP aims to create a sustainable volunteer team to provide patients with company, stimulation and opportunities to be active.

Methods

A Volunteer and Activity Coordinator (VAC) was appointed to recruit, train and coordinate applicants for the volunteer role on the unit which is advertised on the trust website. Analysis of volunteer team impact has been through patient, carer and staff surveys. Observational studies recorded patients’ physical position, activity and company as well as use of the dayrooms before and during the project.

Interventions

Patients of all functional abilities can be referred by any staff member. Individual and group activities include conversation, games, reminiscence quizzes, lunch and tea parties, musical bingo, walking tours, trips to hospital facilities and gardens and visits from therapy dogs and musicians. Before discharge participating patients are given information about local social and exercise opportunities.

Results

All staff surveyed would recommend the project to colleagues, 97% thought it improved patient mood. One noted: ‘volunteers have created a new energy on the ward, the patients appear to be much more engaged and occupied, and the dayroom is being used as it is intended to be’. Observational data showed a change in the percentage of patients resting in bed from 59% before the intervention to 49% during and a decrease in patients who were alone from 83% to 60%.

Conclusions

The volunteer team has had a positive effect on ward culture and patient well-being and could be replicated in other ward settings. The programme’s impact is contingent on the consistency and reliability of volunteers, which makes the role of the VAC essential for careful management and communication of clear expectations. The VAC role will be proposed in business planning for next financial year.
67 Reducing Delays to Operative Management of Anti-Coagulated Patients With Hip Fractures
Authors: Ensanullah J , Shah B , Fertleman M
Published: February 2020

Introduction

In the UK, the gold-standard treatment of a hip fracture is surgical fixation within 36 hours. Reduced delay to surgery has been shown to minimise the risk of complications. Locally, frequent delays to surgery were observed in patients taking long-term anticoagulation. There are no national guidelines regarding anticoagulation reversal and surgery timing in patients with hip fractures, and doctors are often unfamiliar with increasingly prevalent Direct Oral Anti-coagulants (DOACs). This quality improvement project aimed to reduce delays to surgery in anti-coagulated patients with hip fractures.

Methods

A guideline was formulated following literature review and consultation with a Consultant Ortho-geriatrician, Orthopaedic Surgeon and Haematologist. Retrospective casenote audit was conducted including 3-month period before and after implementation. The new guideline was disseminated in poster form. Due to the observation that delays in receiving INR results resulted in reversal delay, patient’s on warfarin were recommended to receive 5 mg IV Vitamin K prior to receiving INR results. The INR was rechecked after 6 hours, and if less than 1.6, surgery could proceed. Those on DOACs could undergo surgery 24 hours after the last dose providing eGFR >30, and after 48 hours if eGFR <30. Exclusions were those anti-coagulated for metallic heart valves or recent venous thromboembolism.

Results

In the 3 months prior to guideline implementation, 71 patients had a hip fracture; 15 were anti-coagulated. Of these, 8 patients were delayed due to their anticoagulation. Repeat audit after implementation, included 46 patients with a hip fracture over the 3-month period; 7 were anti-coagulated. None were delayed due to anticoagulation (p < 0.05).

Conclusions

This improvement project describes formulation of a simple protocol with evidence from the literature and local expert opinion in order to reduce unnecessary delays in anti-coagulated patients with hip fractures.
Contrasting multilevel relationships between behavior and body mass in blue tit nestlings
Authors: Class Barbara , Brommer Jon
Published: February 2020

Repeatable behaviors (i.e., animal personality) are pervasive in the animal kingdom and various mechanisms have been proposed to explain their existence. Genetic and nongenetic mechanisms, which can be equally important, predict correlations between behavior and body mass on different levels (e.g., genetic and environmental) of variation. We investigated multilevel relationships between body mass measured on weeks 1, 2, and 3 and three behavioral responses to handling, measured on week 3, which form a behavioral syndrome in wild blue tit nestlings. Using 7 years of data and quantitative genetic models, we find that all behaviors and body mass on week 3 are heritable (h2 = 0.18–0.23) and genetically correlated, whereas earlier body masses are not heritable. We also find evidence for environmental correlations between body masses and behaviors. Interestingly, these environmental correlations have different signs for early and late body masses. Altogether, these findings indicate genetic integration between body mass and behavior and illustrate the impacts of early environmental factors and environmentally mediated growth trajectory on behaviors expressed later in life. This study, therefore, suggests that the relationship between personality and body mass in developing individuals is due to various underlying mechanisms, which can have opposing effects. Future research on the link between behavior and body mass would benefit from considering these multiple mechanisms simultaneously.
Application of CRISPR/Cas9 technology in sepsis research
Authors: Wu Miao , Hu Niandan , Du Xianjin , Wei Jie
Published: February 2020

CRISPR/Cas9, as a new genome-editing tool, offers new approaches to understand and treat diseases, which is being rapidly applied in various areas of biomedical research including sepsis field. The type II prokaryotic CRISPR/Cas system uses a single-guide RNA (sgRNA) to target the Cas9 nuclease to a specific genomic sequence, which is introduced into disease models for functional characterization and for testing of therapeutic strategies. This incredibly precise technology can be used for therapeutic research of gene-related diseases and to program any sequence in a target cell. Most importantly, the multifunctional capacity of this technology allows simultaneous editing of several genes. In this review, we focus on the basic principles, advantages and limitations of CRISPR/Cas9 and the use of the CRISPR/Cas9 system as a powerful tool in sepsis research and as a new strategy for the treatment of sepsis.
Sowing Uncertainty: What We Do and Don’t Know about the Planting of Pesticide-Treated Seed
Authors: Hitaj Claudia , Smith David J , Code Aimee , Wechsler Seth , Esker Paul D , Douglas Margaret R
Published: February 2020

Farmers, regulators, and researchers rely on pesticide use data to assess the effects of pesticides on crop yield, farm economics, off-target organisms, and human health. The publicly available pesticide use data in the United States do not currently account for pesticides applied as seed treatments. We find that seed treatment use has increased in major field crops over the last several decades but that there is a high degree of uncertainty about the extent of acreage planted with treated seeds, the amount of regional variability, and the use of certain active ingredients. One reason for this uncertainty is that farmers are less likely to know what pesticides are on their seed than they are about what pesticides are applied conventionally to their crops. This lack of information affects the quality and availability of seed treatment data and also farmers’ ability to tailor pesticide use to production and environmental goals.
Polygenic Architecture of Human Neuroanatomical Diversity
Authors: Biton Anne , Traut Nicolas , Poline Jean-Baptiste , Aribisala Benjamin S , Bastin Mark E , Bülow Robin , Cox Simon R , Deary Ian J , Fukunaga Masaki , Grabe Hans J , Hagenaars Saskia , Hashimoto Ryota , Kikuchi Masataka , Muñoz Maniega Susana , Nauck Matthias , Royle Natalie A , Teumer Alexander , Valdés Hernández Maria , Völker Uwe , Wardlaw Joanna M , Wittfeld Katharina , Yamamori Hidenaga ,   Alzheimer’s Disease Neuroimaging Initiative, Bourgeron Thomas , Toro Roberto
Published: February 2020

We analyzed the genomic architecture of neuroanatomical diversity using magnetic resonance imaging and single nucleotide polymorphism (SNP) data from >26 000 individuals from the UK Biobank project and 5 other projects that had previously participated in the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) consortium. Our results confirm the polygenic architecture of neuroanatomical diversity, with SNPs capturing from 40% to 54% of regional brain volume variance. Chromosomal length correlated with the amount of phenotypic variance captured, r ~ 0.64 on average, suggesting that at a global scale causal variants are homogeneously distributed across the genome. At a local scale, SNPs within genes (~51%) captured ~1.5 times more genetic variance than the rest, and SNPs with low minor allele frequency (MAF) captured less variance than the rest: the 40% of SNPs with MAF <5% captured <one fourth of the genetic variance. We also observed extensive pleiotropy across regions, with an average genetic correlation of rG ~ 0.45. Genetic correlations were similar to phenotypic and environmental correlations; however, genetic correlations were often larger than phenotypic correlations for the left/right volumes of the same region. The heritability of differences in left/right volumes was generally not statistically significant, suggesting an important influence of environmental causes in the variability of brain asymmetry. Our code is available athttps://github.com/neuroanatomy/genomic-architecture.
Continued Evidence of the Impact of Rotavirus Vaccine in Children Less Than 3 Years of Age From the United States New Vaccine Surveillance Network: A Multisite Active Surveillance Program, 2006–2016
Authors: Staat Mary Allen , Payne Daniel C , Halasa Natasha , Weinberg Geoffrey A , Donauer Stephanie , Wikswo Mary , McNeal Monica , Edwards Kathryn M , Szilagyi Peter G , Bernstein David I , Curns Aaron T , Sulemana Iddrisu , Esona Mathew D , Bowen Michael D , Parashar Umesh D ,   New Vaccine Surveillance Network (NVSN)
Published: February 2020

Background

Since 2006, the New Vaccine Surveillance Network has conducted active, population-based surveillance for acute gastroenteritis (AGE) hospitalizations and emergency department (ED) visits in 3 United States counties. Trends in the epidemiology and disease burden of rotavirus hospitalizations and ED visits were examined from 2006 to 2016.

Methods

Children < 3 years of age hospitalized or visiting the ED with AGE were enrolled from January 2006 through June 2016. Bulk stool specimens were collected and tested for rotavirus. Rotavirus-associated hospitalization and ED visit rates were calculated annually with 2006–2007 defined as the prevaccine period and 2008–2016 as the postvaccine period. Rotavirus genotype trends were compared over time.

Results

Over 11 seasons, 6954 children with AGE were enrolled and submitted a stool specimen (2187 hospitalized and 4767 in the ED). Comparing pre- and postvaccine periods, the proportion of children with rotavirus dramatically declined for hospitalization (49% vs 10%) and ED visits (49% vs 8%). In the postvaccine era, a biennial pattern of rotavirus rates was observed, with a trend toward an older median age. G1P[8] (63%) was the predominant genotype in the prevaccine period with a significantly lower proportion (7%) in the postvaccine period (P < .001). G2P[4] remained stable (8% to 14%) in both periods, whereas G3P[8] and G12P[8] increased in proportion from pre- to postvaccine periods (1% to 25% and 17% to 40%), respectively.

Conclusions

The epidemiology and disease burden of rotavirus has been altered by rotavirus vaccination with a biennial disease pattern, sustained low rates of rotavirus in children < 3 years of age, and a shift in the residual genotypes from G1P[8] to other genotypes.
Multistate, Population-Based Distributions of Candidate Vaccine Targets, Clonal Complexes, and Resistance Features of Invasive Group B Streptococci Within the United States, 2015–2017
Authors: McGee Lesley , Chochua Sopio , Li Zhongya , Mathis Saundra , Rivers Joy , Metcalf Benjamin , Ryan Alison , Alden Nisha , Farley Monica M , Harrison Lee H , Snippes Vagnone Paula , Lynfield Ruth , Smelser Chad , Muse Alison , Thomas Ann R , Schrag Stephanie , Beall Bernard W
Published: February 2020

Background

Group B Streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis and an important cause of invasive infections in pregnant and nonpregnant adults. Vaccines targeting capsule polysaccharides and common proteins are under development.

Methods

Using whole genome sequencing, a validated bioinformatics pipeline, and targeted antimicrobial susceptibility testing, we characterized 6340 invasive GBS isolates recovered during 2015–2017 through population-based Active Bacterial Core surveillance (ABCs) in 8 states.

Results

Six serotypes accounted for 98.4% of isolates (21.8% Ia, 17.6% V, 17.1% II, 15.6% III, 14.5% Ib, 11.8% IV). Most (94.2%) isolates were in 11 clonal complexes (CCs) comprised of multilocus sequence types identical or closely related to sequence types 1, 8, 12, 17, 19, 22, 23, 28, 88, 452, and 459. Fifty-four isolates (0.87%) had point mutations within pbp2x associated with nonsusceptibility to 1 or more β-lactam antibiotics. Genes conferring resistance to macrolides and/or lincosamides were found in 56% of isolates; 85.2% of isolates had tetracycline resistance genes. Two isolates carrying vanG were vancomycin nonsusceptible (minimum inhibitory concentration = 2 µg/mL). Nearly all isolates possessed capsule genes, 1–2 of the 3 main pilus gene clusters, and 1 of 4 homologous alpha/Rib family determinants. Presence of the hvgA virulence gene was primarily restricted to serotype III/CC17 isolates (465 isolates), but 8 exceptions (7 IV/CC452 and 1 IV/CC17) were observed.

Conclusions

This first comprehensive, population-based quantitation of strain features in the United States suggests that current vaccine candidates should have good coverage. The β-lactams remain appropriate for first-line treatment and prophylaxis, but emergence of nonsusceptibility warrants ongoing monitoring.
The Impact of Clinical Decision Support Alerts onClostridioides difficileTesting: A Systematic Review
Authors: Dunn Aaron N , Radakovich Nathan , Ancker Jessica S , Donskey Curtis J , Deshpande Abhishek
Published: February 2020

Background

Several studies have investigated the utility of electronic decision support alerts in diagnostic stewardship for Clostridioides difficile infection (CDI). However, it is unclear if alerts are effective in reducing inappropriate CDI testing and/or CDI rates. The aim of this systematic review was to determine if alerts related to CDI diagnostic stewardship are effective at reducing inappropriate CDI testing volume and CDI rates among hospitalized adult patients.

Methods

We searched Ovid Medline and 5 other databases for original studies evaluating the association between alerts for CDI diagnosis and CDI testing volume and/or CDI rate. Two investigators independently extracted data on study characteristics, study design, alert triggers, cointerventions, and study outcomes.

Results

Eleven studies met criteria for inclusion. Studies varied significantly in alert triggers and in study outcomes. Six of 11 studies demonstrated a statistically significant decrease in CDI testing volume, 6 of 6 studies evaluating appropriateness of CDI testing found a significant reduction in the proportion of inappropriate testing, and 4 of 7 studies measuring CDI rate demonstrated a significant decrease in the CDI rate in the postintervention vs preintervention period. The magnitude of the increase in appropriate CDI testing varied, with some studies reporting an increase with minimal clinical significance.

Conclusions

The use of electronic alerts for diagnostic stewardship for C. difficile was associated with reductions in CDI testing, the proportion of inappropriate CDI testing, and rates of CDI in most studies. However, broader concerns related to alerts remain understudied, including unintended adverse consequences and alert fatigue.