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Computed tomography in cystic fibrosis lung disease: a focus on radiation exposure
No full textThoracic computed tomography (CT) is the imaging reference method in the diagnosis, assessment and management of lung disease. In the setting of cystic fibrosis (CF), CT demonstrates increased sensitivity compared with pulmonary function tests and chest radiography, and findings correlate with clinical outcomes. Better understanding of the aetiology of CF lung disease indicates that even asymptomatic infants with CF can have irreversible pulmonary pathology. Surveillance and early diagnosis of lung disease in CF are important to preserve lung parenchyma and to optimise long-term outcomes. CF is associated with increased cumulative radiation exposure due to the requirement for repeated imaging from a young age. Radiation dose optimisation, important for the safe use of CT in children with CF, is best achieved in a team environment where paediatric radiologists work closely with paediatric respiratory physicians, physicists and radiography technicians to achieve the best patient outcomes. Despite the radiation doses incurred, CT remains a vital imaging tool in children with CF. Radiologists with special interests in CT dose optimisation and respiratory disease are key to the appropriate use of CT in paediatric imaging. Paediatric radiologists strive to minimise radiation dose to children whilst providing the best possible assessment of lung disease
Novel strategy for the calorimetry-based control of fed-batch cultivations of saccharomyces cerevisiae
No full textTypical controllers for fed-batch cultivations are based on the estimation and control of the specific growth rate in real time. Biocalorimetry allows one to measure a heat signal proportional to the substrate consumed by cells. The derivative of this heat signal is usually used to evaluate the specific growth rate, introducing noise to the resulting estimate. To avoid this, this study investigated a novel controller based directly on the heat signal. Time trajectories of the heat signal setpoint were modelled for different specific growth rates, and the controller was set to follow this dynamic setpoint. The developed controller successfully followed the setpoint during aerobic cultivations of Saccharomyces cerevisiae, preventing the Crabtree effect by maintaining low glucose concentrations. With this new method, fed-batch cultivations of S. cerevisiae could be reliably controlled at specific growth rates between 0.075 h−1 and 0.20 h−1, with average root mean square errors of 15 ± 3%
White Paper by the European Society for Swallowing Disorders: Screening and Non Instrumental Assessment for Dysphagia in Adults
No full textThis White Paper by the European Society for Swallowing Disorders (ESSD) reports on the current state of screening and non-instrumental assessment for dysphagia in adults. An overview is provided on the measures that are available, and how to select screening tools and assessments. Emphasis is placed on different types of screening, patient-reported measures, assessment of anatomy and physiology of the swallowing act, and clinical swallowing evaluation. Many screening and non-instrumental assessments are available for evaluating dysphagia in adults; however, their use may not be warranted due to poor diagnostic performance or lacking robust psychometric properties. This white paper provides recommendations on how to select best evidence-based screening tools and non-instrumental assessments for use in clinical practice targeting different constructs, target populations and respondents, based on criteria for diagnostic performance, psychometric properties (reliability, validity, and responsiveness), and feasibility. In addition, gaps in research that need to be addressed in future studies are discussed. The following recommendations are made: (1) discontinue the use of non-validated dysphagia screening tools and assessments; (2) implement screening using tools that have optimal diagnostic performance in selected populations that are at risk of dysphagia, such as stroke patients, frail older persons, patients with progressive neurological diseases, persons with cerebral palsy, and patients with head and neck cancer; (3) implement measures that demonstrate robust psychometric properties; and (4) provide quality training in dysphagia screening and assessment to all clinicians involved in the care and management of persons with dysphagia
Herd-level factors associated with detection of calves persistently infected with bovine viral diarrhoea virus (BVDV) in Irish cattle herds with negative herd status (NHS) during 2017
No full textA compulsory national BVD eradication programme commenced in Ireland in 2013. Since then considerable progress has been made, with the animal-level prevalence of calves born persistently infected (PI) falling from 0.67 % in 2013 to 0.06 % in 2018. The herd-level prevalence fell from 11.3 % in 2013 to 1.1 % in 2018. In the Irish programme, herds in which all animals have a known negative status and which have not contained any PI animals for 12 months or more are assigned a negative herd status (NHS). While considerable progress towards eradication has been made, PI calves have been identified in a small proportion of herds that had previously been assigned NHS. Given this context, a case-control study was conducted to investigate potential risk factors associated with loss of NHS in 2017. 546 herds which had NHS on 1 January 2017 and lost that status during 2017 (case herds) were matched with 2191 herds (control herds) that retained their NHS status throughout 2017. Previous history of BVD infection, herd size, herd expansion, the purchase of cattle including potential Trojan cattle and the density of BVD infection within 10 km of the herd emerged as significant factors in a multivariable logistic regression model. This work adds to the evidence base in support of the BVD eradication programme, particularly establishing why BVD re-emerged in herds which had been free of BVD for at least the previous 12 months prior to the identification of a BVD positive calf. This information will be especially important in the context of identifying herds which may be more likely to contain BVD positive animals once the programme moves to herd-based serology status for trading purposes in the post-eradication phase.Department of Agriculture, Food and the Marin
Factoring Ethics in Technology, Policy Making and Regulation
No full textWorldwide, there are a multiplicity of parallel activities being undertaken in developing international standards, regulations and individual organisational policies related to AI and its trustworthiness characteristics. The current lack of mappings between these activities presents the danger of a highly fragmented global landscape emerging in AI trustworthiness. This could present society, government and industry with competing standards, regulations and organisational practices that will then serve to undermine rather than build trust in AI. This chapter presents a simple ontology that can be used for checking the consistency and overlap of concepts from different standards, regulations and policies. The concepts in this ontology are grounded in an overview of AI standardisation currently being undertaken in ISO/IEC JTC 1/SC 42 and identifies its project to define an AI management system standard (AIMS or ISO/IEC WD 42001) as the starting point for establishing conceptual mapping between different initiatives. We propose a minimal, high level ontology for the support of conceptual mapping between different documents and show in the first instance how this can help map out the overlaps and gaps between and among SC 42 standards currently under developmen
“… as the young girl told them so”: Women and Old Calendarism in Interwar Romania
No full textThis article explores the role of women and young girls in Old Calendarist communities in Romania and presents new sources relating to neglected history of the practice of incarceration in Orthodox monasteries in the region. The community developed into a spiritual mass movement that soon became the target of the secret police. Women played an important role within these communities in terms of membership but also in relation to the preservation of Old Calendarist ideas. Explored through the prism of the former secret police archival documents, these women were deemed dangerous and were accused of luring people into the Old Calendarist groups. In contrast to the extremely negative representation of these women that we find in contemporary Orthodox Church publications, police reports and popular press articles, the letters and postcards that they wrote from detention offer us an insight into the private life, personality and motivation of these women
Severity and Mortality of SARS-COV-2 infection and 25-hydroxyvitamin D concentration: a metanalysis
No full textIntroduction: There is increasing scientific interest in the possible association between hypovitaminosis D and the risk of SARS-CoV-2 infection severity and/or mortality.
Objective: To conduct a metanalysis of the association between 25-hydroxyvitamin D (25(OH)D) concentration and SARS-CoV-2 infection severity or mortality.
Material and methods: We searched PubMed, EMBASE, Google scholar and the Cochrane Database of Systematic Reviews for studies published between December 2019 and December 2020. Effect statistics were pooled using random effects models. The quality of included studies was assessed with the Newcastle–Ottawa Scale (NOS). Targeted outcomes: mortality and severity proportions in COVID-19 patients with 25(OH)D deficiency, defined as serum 25(OH)D < 50 nmol/L.
Results: In the 23 studies included (n = 2692), the mean age was 60.8 (SD ± 15.9) years and 53.8% were men. Results suggested that vitamin 25(OH)D deficiency was associated with increased risk of severe SARS-CoV-2 disease (RR 2.00; 95% CI 1.47–2.71, 17 studies) and mortality (RR 2.45; 95% CI 1.24–4.84, 13 studies). Only 7/23 studies reported C-reactive protein values, all of which were > 10 mg/L.
Conclusions: 25(OH)D deficiency seems associated with increased SARS-CoV-2 infection severity and mortality. However, findings do not imply causality, and randomized controlled trials are required, and new studies should be designed to determine if decreased 25(OH)D is an epiphenomenon or consequence of the inflammatory process associated with severe forms of SARS-CoV-2. Meanwhile, the concentration of 25(OH)D could be considered as a negative acute phase reactant and a poor prognosis in COVID-19 infection
Pharmaceutical design of a delivery system for the bacteriocin lacticin 3147
No full textLacticin 3147 is a dual-acting two-peptide bacteriocin which is generally active against Gram-positive bacteria, including Listeria monocytogenes and antimicrobial-resistant bacteria such as Closteroides diffcile in the colon. L. monocytogenes infections can cause life-long effects in the elderly and vulnerable and can cause severe complications in pregnant women. C. diffcile causes one of the most common healthcare-associated infections and can be fatal in vulnerable groups such as the elderly. Although lacticin 3147 is degraded by intestinal proteases and has poor aqueous solubility, encapsulation of the bacteriocin could enable its use as an antimicrobial for treating these bacterial infections locally in the gastrointestinal tract. Lacticin 3147 displayed activity in aqueous solutions at a range of pH values and in gastric and intestinal fluids. Exposure to trypsin and α-chymotrypsin resulted in complete inactivation, implying that lacticin 3147 should be protected from these enzymes to achieve successful local delivery to the gastrointestinal tract. The amount of lacticin 3147 dissolved, i.e. its solution concentration, in water or buffered solutions at pH 1.6 and 7.4 was low and varied with time but increased and
was stabilized in gastrointestinal fluids by the phospholipid and bile salt components present. Thus, the feasibility of a solid lipid nanoparticle (SLN) delivery system for local administration of lacticin 3147 was investigated. Bacteriocin activity was observed after encapsulation and release from a lipid matrix. Moreover, activity was seen after exposure to degrading enzymes. Further optimization of SLN delivery systems could enable the successful pharmaceutical development of active lacticin 3147 as an alternative to traditional antibiotics
Private groundwater supply management as a response to flooding events: Perceptions of Irish well owners
No full textOver 720,000 people in the Republic of Ireland rely on private groundwater resources (i.e. private wells) for daily consumption, and as these extractions are unregulated, users are solely responsible for managing/mitigating contamination risks to their supplies. However, low levels of exposure to appropriate guidance on well water protection and ongoing maintenance are not uncommon, particularly regarding responses to sporadic environmental threats, such as significant flooding. Despite this, very little is known regarding the factors leading to (or inhibiting) preparedness among groundwater-reliant individuals in the context of health threats triggered by flooding events. Accordingly, the purpose of this study is to bridge this knowledge gap and explore current behaviours, knowledge, risk perception, and experience relating to this issue in the Irish context. This was attempted via a combination of quantitative and qualitative methodologies, including a nation-wide online survey with 405 Irish well owners and six localized focus group meetings. Results show the need to go beyond knowledge-based interventions, and use socio-hydrogeological and/or socio-epidemiological approaches to target risk perception and potential structural constraints as a mean to turn protective intentions into protective actions when dealing with adverse effects of sporadic natural events, particularly in a changing climate
A study of Tusla - Child and Family Agency’s actions and decision-making process following An Garda Síochána’s application of Section 12 of the Child Care Act 1991: Executive Summary
No full textIn 2017, the Minister for Children and Youth Affairs requested Tusla Child and Family Agency, to commission new research into the number of children who have been subject to a Section 12 and reflect the demographic profile by age and location.
The main objectives of the research were:
To identify the pathways for children who have been subject to Section 12 of the Child Care Act 1991 between 1 July 2016 and 30 June 2017
To explore the rationale and decision-making process of social workers in the aftermath of Section 12
To describe the characteristics of communications between Tusla and An Garda Síochána in relation to Section 12 notifications and follow-ups from the perspective of Tusla social work and Tusla management
To ascertain the role of the Out-of-Hours Service in Tusla s response to Section 12
To examine and determine the circumstances relating to children being removed more than once