A taxonomy of occupational and organisational stressors and protectors of mental health reported by veterinary professionals in Australasia.

AIM: To develop a taxonomy of positive and negative occupational and organisational factors reported that impact the mental health of veterinary professionals. METHODS: Veterinary professionals working in Australasia were surveyed between February and June of 2021. The survey comprised two questions related to participants' perceptions of the positive and negative aspects of their job role that impact their mental health and wellbeing. Reflexive thematic analysis was employed to analyse the responses and generate two taxonomies of occupational and organisation stressors and protectors reported by participants. RESULTS: Fifty-three responses from veterinary professionals were analysed. The final stressor taxonomy generated contained 9 overarching themes and 36 subthemes. The most common of these were negative work conditions, challenging relationships with clients, and adverse events and patient outcomes. The taxonomy of protectors contained 11 overarching themes and 32 subthemes, with the most common including fulfillment and satisfaction, positive work conditions, and relationships with colleagues. CONCLUSION: This study is the first to examine both positive and negative factors in the veterinary industry reported by veterinary professionals in Australasia. The results highlighted stressors that can be addressed on both an individual and organisational level to promote the mental and health well-being of professionals working in the animal care industry.

Late subannular aortic root rupture following transcatheter aortic valve implantation presenting as ST elevation myocardial infarction.

Transcatheter aortic valve implantation (TAVI) has transformed the treatment of severe aortic stenosis. Here, we present a case of late aortic root rupture presenting as ST-elevation myocardial infarction five weeks following successful TAVI. Aortic root rupture is a rare complication of TAVI, which occurs in ∼1% of procedures and usually arises during or soon after the procedure and is associated with high mortality (∼50%). Early recognition of late-presenting complications related to TAVI, including aortic root rupture, is essential for specialists and nonspecialists. © 2016 Wiley Periodicals, Inc.

A novel method of measuring the melting point of animal fats.

The melting point (TM) of fat is relevant to health, but available methods of determining TM are cumbersome. One of the standard methods of measuring TM for animal and vegetable fats is the slip point, also known as the open capillary method. This method is imprecise and not amenable to automation or mass testing. We have developed a technique for measuring TM of animal fat using the Rotor-Gene Q (Qiagen, Hilden, Germany). The assay has an intra-assay SD of 0.08°C. A single operator can extract and assay up to 250 samples of animal fat in 24 h, including the time to extract the fat from the adipose tissue. This technique will improve the quality of research into genetic and environmental contributions to fat composition of meat.

Observation of the Kibble-Zurek scaling law for defect formation in ion crystals.

Traversal of a symmetry-breaking phase transition at finite rates can lead to causally separated regions with incompatible symmetries and the formation of defects at their boundaries, which has a crucial role in quantum and statistical mechanics, cosmology and condensed matter physics. This mechanism is conjectured to follow universal scaling laws prescribed by the Kibble-Zurek mechanism. Here we determine the scaling law for defect formation in a crystal of 16 laser-cooled trapped ions, which are conducive to the precise control of structural phases and the detection of defects. The experiment reveals an exponential scaling of defect formation γ(ß), where γ is the rate of traversal of the critical point and ß=2.68±0.06. This supports the prediction of ß=8/3≈2.67 for finite inhomogeneous systems. Our result demonstrates that the scaling laws also apply in the mesoscopic regime and emphasizes the potential for further tests of non-equilibrium thermodynamics with ion crystals.

Controlling fast transport of cold trapped ions.

We realize fast transport of ions in a segmented microstructured Paul trap. The ion is shuttled over a distance of more than 10(4) times its ground state wave function size during only five motional cycles of the trap (280 µm in 3.6 µs). Starting from a ground-state-cooled ion, we find an optimized transport such that the energy increase is as low as 0.10±0.01 motional quanta. In addition, we demonstrate that quantum information stored in a spin-motion entangled state is preserved throughout the transport. Shuttling operations are concatenated, as a proof-of-principle for the shuttling-based architecture to scalable ion trap quantum computing.

Dispersive optical interface based on nanofiber-trapped atoms.

We dispersively interface an ensemble of 1000 atoms trapped in the evanescent field surrounding a tapered optical nanofiber. This method relies on the azimuthally asymmetric coupling of the ensemble with the evanescent field of an off-resonant probe beam, transmitted through the nanofiber. The resulting birefringence and dispersion are significant; we observe a phase shift per atom of ∼1 mrad at a detuning of 6 times the natural linewidth, corresponding to an effective resonant optical density per atom of 0.027. Moreover, we utilize this strong dispersion to nondestructively determine the number of atoms.

Optical interface created by laser-cooled atoms trapped in the evanescent field surrounding an optical nanofiber.

Trapping and optically interfacing laser-cooled neutral atoms are essential requirements for their use in advanced quantum technologies. Here we simultaneously realize both of these tasks with cesium atoms interacting with a multicolor evanescent field surrounding an optical nanofiber. The atoms are localized in a one-dimensional optical lattice about 200 nm above the nanofiber surface and can be efficiently interrogated with a resonant light field sent through the nanofiber. Our technique opens the route towards the direct integration of laser-cooled atomic ensembles within fiber networks, an important prerequisite for large scale quantum communication schemes. Moreover, it is ideally suited to the realization of hybrid quantum systems that combine atoms with, e.g., solid state quantum devices.

Doppler-free spectroscopy of the 1S0-3P0 optical clock transition in laser-cooled fermionic isotopes of neutral mercury.

We report direct laser spectroscopy of the 1S0-3P0 transition at 265.6 nm in fermionic isotopes of neutral mercury in a magneto-optical trap. Measurements of the frequency against the LNE-SYRTE primary reference using an optical frequency comb yield 1 128 575 290 808.4+/-5.6 kHz in 199Hg and 1 128 569 561 139.6+/-5.3 kHz in 201Hg. The uncertainty, allowed by the observation of the Doppler-free recoil doublet, is 4 orders of magnitude lower than previous indirect determinations. Mercury is a promising candidate for future optical lattice clocks due to its low sensitivity to blackbody radiation.

A prospective infant manikin-based observational study of telephone-cardiopulmonary resuscitation.

INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) has been shown to significantly improve outcome in sudden cardiac arrest in children. In view of this, most emergency medicine services deliver telephone instructions for carrying out CPR to laypeople who call the emergency services. Little is known as to whether laypeople carrying out these instructions deliver effective CPR. METHODS: Adult volunteers who had no previous experience of CPR were recruited. They were presented with a scenario and asked to perform CPR for 3 min on a training manikin according to the instructions they were given by telephone. Tidal volume, compression rate and depth, time to the beginning of CPR and hand positioning were recorded. RESULTS: Fifty-five volunteers were recruited; three were excluded (two had previous CPR training and one refused to perform CPR). None of the subjects identified correctly that the manikin was not breathing and achieved a level of CPR performance that was consistent with all of the current guidelines. Median tidal volume of rescue breaths was 38 mL. Only 23% of subjects delivered rescue breaths of optimal volume (40-50 mL) and 23% delivered no effective breaths at all. Chest compressions were performed at a median rate of 95 min(-1) with 37% delivering compressions at the optimum rate of 90-110 min(-1). CONCLUSION: None of our volunteers performed telephone-CPR at a level consistent with current guidelines. Further investigation is necessary to determine whether the instructions can be improved to optimise CPR performance.

Optical frequency synthesis from a cryogenic microwave sapphire oscillator.

We demonstrate an optical frequency comb with fractional frequency instability of

Improving the positive predictive value of exercise testing in women.

OBJECTIVE: To identify exercise test variables that can improve the positive predictive value of exercise testing in women. DESIGN: Cohort study. SETTING: Regional cardiothoracic centre. SUBJECTS: 1286 women and 1801 men referred by primary care physicians to a rapid access chest pain clinic, of whom 160 women and 406 men had ST depression of at least 1 mm during exercise testing. The results for 136 women and 124 men with positive exercise tests were analysed. MAIN OUTCOME MEASURES: The proportion of women with a positive exercise test who could be identified as being at low risk for prognostic coronary heart disease and the resulting improvement in the positive predictive value. RESULTS: Independently of age, an exercise time of more than six minutes, a maximum heart rate of more than 150 beats/min, and an ST recovery time of less than one minute were the variables that best identified women at low risk. One to three of these variables identified between 11.8% and 41.2% of women as being at low risk, with a risk for prognostic disease of between 0-11.5%. The positive predictive value for the remaining women was improved from 47.8% up to 61.5%, and the number of normal angiograms was potentially reducible by between 21.1-54.9%. By the same criteria, men had higher risks for prognostic disease. CONCLUSIONS: A strategy of discriminating true from false positive exercise tests is worthwhile in women but less successful in men.

Autotransfusion decreases blood usage following cardiac surgery -- a prospective randomized trial.

INTRODUCTION: 10% of blood issued by the National Blood Service (220,000) is utilised in cardiac procedures. Transfusion reactions, infection risk and cost should stimulate us to decrease this transfusion rate. We tested the efficacy of autotransfusion of washed postoperative mediastinal fluid in a prospective randomized trial. PATIENTS AND METHODS: 166 patients undergoing coronary artery bypass grafting (CABG), valve or CABG + valve procedures were randomized into three groups. The indication for transfusion was a postoperative haemoglobin (Hb) < 10 g/l or a packed cell volume (PCV) < 30. When applicable, group A patients received washed post-operative drainage fluid. Group B all received blood processed from the cardiopulmonary bypass (CPB) circuit following separation from CPB and if appropriate washed post-operative drainage fluid. Group C were controls. Groups were compared using analysis of variance. RESULTS: There was no significant difference in age, sex, type of operation, CPB time and preoperative Hb and PCV between the groups. Blood requirements were as shown. [table - see text] Twelve patients in group A and 10 in group B did not require a homologous transfusion following processing of the mediastinal drainage fluid. CONCLUSION: Autotransfusion of washed postoperative mediastinal fluid can decrease the amount of homologous blood transfused following cardiac surgery. There was no demonstrable benefit in processing blood from the CPB circuit as well as mediastinal drainage fluid.

Sex differences in investigation results and treatment in subjects referred for investigation of chest pain.

OBJECTIVE: To evaluate differences in investigation results and treatment between men and women referred for diagnostic treadmill exercise testing and coronary arteriography. DESIGN: Cohort study. SETTING: Tertiary cardiology centre. SUBJECTS: 1522 subjects referred by primary care physicians to an open access chest pain clinic for initial investigation of chest pain, of whom 485 were subsequently referred for coronary arteriography; and a similar cohort of 107 subjects referred directly by secondary care physicians for diagnostic coronary arteriography. MAIN OUTCOME MEASURES: Rates of positive exercise tests and rates for referral for arteriography and revascularisation according to sex. RESULTS: Overall, women were less likely to be referred for arteriography and revascularisation than men. However, men were more likely to have positive exercise tests, and for various exercise test diagnostic end points men were also more likely to have significant coronary artery disease. After taking this into account, there was no sex difference in referral rates for arteriography or revascularisation. CONCLUSIONS: There was no evidence of a sex bias resulting in inappropriate underinvestigation or undertreatment of women. However, the positive predictive value of treadmill exercise testing is low for women and further research is needed into how best to investigate women with chest pain.

Mid-term results with 1,503 CarboMedics mechanical valve implants.

BACKGROUND AND AIM OF THE STUDY: The CarboMedics bileaflet prosthetic heart valve was introduced in 1986, and first implanted by the authors in March 1991. The aim of this study was to analyze the authors' clinical experience with this valve. METHODS: Between March 1991 and October 1998, 1,503 valves were implanted in 1,350 patients (758 males, 592 female; mean age 62 +/- 13 years). Follow up was 99% complete and totaled 4,342 patient-years (pt-yr). RESULTS: The hospital mortality rate was 4.3% (59/1,350). Preoperative NYHA class (p = 0.012), emergency surgery (p = 0.03) and cardiopulmonary bypass time (p = 0.01) were significantly associated with increased risk of operative death (multiple logistic regression). Mean (+/- SEM) survival rates at one and five years were 92.0 +/- 0.7% (n = 1,109) and 80.0 +/- 1.3% (n = 335). Freedom from valve-related complications (linearized rate 5.6%/pt-yr) at one and five years was 89.5 +/- 0.8% (n = 1,031) and 76.3 +/- 1.4% (n = 284). Linearized rates for bleeding events were 2.19%/pt-yr, thromboembolic events 2%/pt-yr, operated valvular endocarditis 0.18%/pt-yr, valve thrombosis 0.14%/pt-yr and non-structural dysfunction 1.22%/pt-yr. Freedom from reoperation at one and five years was 98.5 +/- 0.3% (n = 1,107) and 97.3 +/- 0.5% (n = 334). CONCLUSION: Mid-term results demonstrate that the CarboMedics prosthetic heart valve exhibits a low incidence of valve-related complications.

A single-center experience with 1,378 CarboMedics mechanical valve implants.

BACKGROUND: The CarboMedics bileaflet prosthetic heart valve was introduced in 1986. We first implanted it in March 1991. The purpose of this study was to analyze our clinical experience with this valve. METHODS: Between March 1991 and December 1997, 1,378 valves were implanted in 1,247 patients, 705 men (56.5%) and 542 (43.5%) women with a mean age of 62 +/- 11.9 years (+/- the standard deviation). Follow-up is 99% complete and totals 3,978 patient-years. RESULTS: The early mortality rate was 4.4% (55/1,247). The survival rates at 1 year and 5 years were 91.8% +/- 0.8% (+/- the standard error of mean) (n = 1,062) and 79.2% +/- 1.4% (n = 281), respectively. Freedom from valve-related complications (linearized rate, 4.9% per patient-year) at 1 year and 5 years was 90.6% +/- 0.8% (+/- the standard error of the mean) (n = 996) and 80.6% +/- 1.4% (n = 243), respectively. Linearized rates for various complications were as follows: bleeding events, 1.73% per patient-year; embolic events, 1.76% per patient-year; operated valvular endocarditis, 0.18% per patient-year; valve thrombosis, 0.10% per patient year; and nonstructural dysfunction, 1.21% per patient-year. Freedom from reoperation at 1 year and 5 years was 98.6% +/- 0.3% (+/- the standard error of the mean) (n = 1,070) and 97.7% +/- 0.5% (n = 285), respectively. CONCLUSIONS: Midterm results demonstrate that the CarboMedics prosthetic heart valve exhibits a low incidence of valve-related complications.

Pulmonary alveolar proteinosis: a possible sequel of NO2 exposure.

Pulmonary alveolar proteinosis was diagnosed via bronchoscopy in a patient. There was no previous history of inhalation dust exposure. NO2 has been implicated in pulmonary alveolar proteinosis development in animal models. In this case, the diffusion capacity was a sensitive indicator of the disease process.

Comparison of sigma- and kappa-opiate receptor ligands as excitatory amino acid antagonists.

Using the technique of microelectrophoresis in pentobarbitone-anaesthetized cats and rats, the effects of benzomorphans, with known actions at sigma- and kappa- opioid receptors, were tested on responses of spinal neurones to amino acids and acetylcholine. The racemic mixture and both enantiomers of the sigma opiate receptor agonist, N-allylnormetazocine (SKF 10, 047), and the dissociative anaesthetic, ketamine, reduced or abolished excitation evoked by N-methyl-aspartate (NMA) with only small and variable effects on responses to quisqualate or kainate. (+)-SKF 10, 047 was 1.2 +/- 0.7 times more potent than the (-)-enantiomer in antagonizing NMA. On Renshaw cells, (+)-SKF 10, 047 enhanced responses to acetylcholine whereas the (-) enantiomer produced only a small reduction. The kappa- opiate receptor agonist, ethylketocyclazocine, had no selective effects on responses to amino acids or to acetylcholine. We conclude that actions at sigma- but not kappa-, opiate receptors are responsible for the NMA antagonism observed with benzomorphans.

Drug effects on clinical laboratory tests.

Drugs and xenobiotics can affect clinical laboratory test results either by interfering with the analytical systems themselves, or by influencing endogenous constituents. National and international bodies have brought widespread recognition to this problem and have proposed protocols for its thorough scientific study. In this survey the authors discuss studies in their laboratories concerning the effects of drugs on thousands of patients undergoing a routine clinical screen. A database is described for storing both patient information and a detailed analysis of the published literature on drug effects. Analytical interferences in clinical tests must be examined in validating the procedure. However, highly specific analytical techniques are increasingly helping to reduce such interferences. Biological effects can be classified as physiological, pharmacological or toxicological. In some cases, biological effects can be used to advantage in monitoring treatment by potentially hazardous drugs, such as the cardiac glycosides. The requirement for a well-defined reference population for each drug and for access to all clinical and medical data for each patient is discussed. The need for greater awareness of the influence of drugs on clinical laboratory results is considered, together with the suggestion that the health professions should try to exploit such effects in monitoring possible toxicity problems, in defining genetic constitution and in designing medication programmes.

Variability of serum ferritin concentration in normal subjects.

Serum ferritin concentrations were measured in normal subjects over periods of 1 day, 1 week and 7 weeks. The variation of the results was compared with variation of control of control sera. In most of the subjects the variation in the results could be attributed to the variation in the method of measurement. No diurnal variation in serum ferritin concentration was observed.