Sexual assault of the older person: Attendances to the Republic of Ireland's sexual assault treatment unit network

BACKGROUND

Sexual assault (SA) poses a threat to all areas of contemporary society. Although older individuals represent a vulnerable demographic, a considerable gap exists in the literature regarding the context in which older individuals experience SA. This study aims to provide a comprehensive description of older individuals' attendances at the Sexual Assault Treatment Unit (SATU) network in the Republic of Ireland.

METHODS

A 7-year national cross-sectional study was performed to analyse the attendances of older people (≥65 years old) to the SATU network, and to compare them with younger attendances (<65 years old), with a more in-depth subset analysis of Dublin SATU attendances.

RESULTS

During the study period, there were 6478 attendances to the SATU network, of which 0.93 % (n = 60) were older people. These included 59 females and 1 male, with the average age of 76.05 years ± 8.16. Forensic examinations were performed in 81.7 %, with the majority seeking assistance within 7 days (80 %). Comparison of older (≥65 years) and younger (<65 years) attendees revealed older individuals were more uncertain whether a sexual assault had occurred (35.5 % vs. 14.4 %, p < 0.001) but more likely to report the incident to the police (78.3 % vs. 64.3 %, p = 0.02). Assault by a person in authority was significantly more common in older age groups (11.7 % vs. 1.8 %, p < 0.001). Older individuals were significantly more likely to be assaulted in their own home (33.3 % vs. 21.5 p < 0.03) or in 'other-indoors' settings (e.g. nursing home/hospital) (43.3 % vs. 23.4 % p < 0.001). They were less likely to be assaulted in the assailant's home (5.0 % vs. 22.9 %, p < 0.001) or outdoors (5.0 % vs. 19.7 %, p = 0.004). In our subset analysis of 19 cases, 73.7 % occurred in healthcare facilities, 63.2 % had dementia, and 42.1 % were care dependent. Genital injuries were present in 44.4 % of patients and extra-genital injuries in 22.2 %.

CONCLUSION

Unique patterns are evident in sexual assault experienced by older people, underscoring the necessity for tailored interventions and effective support systems for reporting and addressing this vulnerable demographic. This is especially crucial in healthcare environments, where a notable proportion of cases occur, frequently involving individuals with dementia and requiring care assistance.

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.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Seasonal evaluation of downscaled land surface temperature: A case study in a humid tropical city

The present study evaluates the seasonal variation of estimated error in downscaled land surface temperatures (LST) over a heterogeneous urban land. Thermal sharpening (TsHARP) downscaling algorithm has been used with a separate combination of four selected remote sensing indices. This study assesses the capability of TsHARP technique over mixed land use/land covers (LULC) by analyzing the correlation between LST and remote sensing indices, namely, normalized difference built-up index (NDBI), normalized difference vegetation index (NDVI), normalized difference water index (NDWI), and normalized multi-band drought index (NMDI) and by determining the root mean square error (RMSE) and mean error (ME) produced by downscaled LST. Landsat 8 OLI (Operational Land Imager) and TIRS (Thermal Infrared Sensor) images have been used for pre-monsoon, monsoon, post-monsoon, and winter seasons in 2014 covering the whole Raipur City, India. The RMSE of the downscaled LST decreases from 120 to 480 m spatial resolution in all the four seasons. It is concluded that NDBI is the most effective LULC index having the least error produced in TsHARP downscaling technique, irrespective of any season. Post-monsoon season reflects the most successful result followed by monsoon season. Even in the monsoon season of high vegetation coverage, NDBI presents a lower range of downscaled error compared to NDVI. This indicates better performance of NDBI in detecting the spatial and temporal distribution of mixed urban land.

Systematic analysis of early phase clinical studies for patients with breast cancer: Inclusion of patients with brain metastasis

PURPOSE

This systematic review aims to better define the limitations and patterns with which patients with MBC and CNS metastasis are enrolled into early phase developmental therapeutics trials.

METHODS

In June 2016, PubMed search was conducted using the following keywords: "Breast cancer". Drug-development phase 1, phase 2 or phase 1/2 trials for patients with MBC were included. Multiple-histology trials and trials without an efficacy endpoint were excluded.

RESULTS

In total, 1474 studies were included; Inclusion criteria for 423 (29%) allowed for CNS metastasis, 770 (52%) either excluded or did not document eligibility of patients with CNS disease. Trials accruing patients with HER2-positive MBC and including targeted therapies had higher odds of allowing for patients with CNS disease (adjusted OR 1.56, 95% CI 1.08-2.2.6; p=0.019 and 1.49, 95% 1.08-2.06; p=0.014, respectively). There were also higher odds of accrual of patients with CNS involvement into clinical trials over time (odds ratio=1.10, 95% CI 1.07-1.12; p<0.0001).

CONCLUSION

Most published early phase clinical trials either did not clearly document or did not allow for accrual of patients with CNS disease. Early phase trials with targeted agents or enrolling HER2+ MBC had higher odds of permitting CNS metastases.

Evaluating the success of a marine protected area: A systematic review approach

Marine Protected Areas (MPAs), marine areas in which human activities are restricted, are implemented worldwide to protect the marine environment. However, with a large proportion of these MPAs being no more than paper parks, it is important to be able to evaluate MPA success, determined by improvements to biophysical, socio-economic and governance conditions. In this study a systematic literature review was conducted to determine the most frequently used indicators of MPA success. These were then applied to a case study to demonstrate how success can be evaluated. The fifteen most frequently used indicators included species abundance, level of stakeholder participation and the existence of a decision-making and management body. Using the indicator framework with a traffic light system, we demonstrate how an MPA can be evaluated in terms of how well it performs against the indicators using secondary data from the literature. The framework can be used flexibly. For example, where no MPA data currently exist, the framework can be populated by qualitative data provided by local stakeholder knowledge. This system provides a cost-effective and straightforward method for managers and decision-makers to determine the level of success of any MPA and identify areas of weakness. However, given the variety of motivations for MPA establishment, this success needs to be determined in the context of the original management objectives of the MPA with greater weighting being placed on those objectives where appropriate.

Impact-induced muscle damage and urinary pterins in professional rugby: 7,8-dihydroneopterin oxidation by myoglobin

Muscle damage caused through impacts in rugby union is known to increase oxidative stress and inflammation. Pterins have been used clinically as markers of oxidative stress, inflammation, and neurotransmitter synthesis. This study investigates the release of myoglobin from muscle tissue due to force-related impacts and how it is related to the subsequent oxidation of 7,8-dihydroneopterin to specific pterins. Effects of iron and myoglobin on 7,8-dihydroneopterin oxidation were examined in vitro via strong cation-exchange high-performance liquid chromatography (SCX-HPLC) analysis of neopterin, xanthopterin, and 7,8-dihydroxanthopterin. Urine samples were collected from 25 professional rugby players pre and post four games and analyzed for myoglobin by enzyme-linked immunosorbent assay, and 7,8-dihydroneopterin oxidation products by HPLC. Iron and myoglobin oxidized 7,8-dihydroneopterin to neopterin, xanthopterin, and 7,8-dihydroxanthopterin at concentrations at or above 10 μM and 50 μg/mL, respectively. All four games showed significant increases in myoglobin, neopterin, total neopterin, biopterin, and total biopterin, which correlated between each variable (P < 0.05). Myoglobin and iron facilitate 7,8-dihydroneopterin oxidation to neopterin and xanthopterin. In vivo delocalization of myoglobin due to muscle damage may contribute to oxidative stress and inflammation after rugby. Increased concentrations of biopterin and total biopterin may indicate production of nitric oxide and monoamine neurotransmitters in response to the physical stress.

Labor and neonatal outcomes after term induction of labor in gestational diabetes

OBJECTIVE

To identify the optimal gestational age (GA) for induction of labor (IOL) at term among patients with gestational diabetes (GDMA) according to perinatal outcomes.

STUDY DESIGN

The US Natality Database from 2007 to 2010 was reviewed. Inclusion criteria were singleton delivery, IOL at 37 to 42 weeks and GDMA. Exclusion criteria included congenital anomalies, pre-gestational diabetes, hypertensive disorders, previous cesarean, breech presentation and rupture of membranes. Controls were non-GDMA cases delivered in geographic and temporal proximity. Delivery mode, macrosomia and perinatal complications were analyzed. Logistic regression adjusted for confounders was used to calculate odds ratios by GA using 39 weeks non-GDMA as reference.

RESULTS

In all, 96,964 cases and 176,079 controls were included. Increased risk for all adverse outcomes among GDMA cases was found. The nadir for intrapartum and neonatal complications was 38 and 40 weeks, respectively, whereas for cesarean and macrosomia was 39 weeks.

CONCLUSION

The optimal timing for IOL at term in GDMA appears to be 39 to 40 weeks.

Assessing the Effectiveness of Selected Biomarkers in the Acute and Cumulative Physiological Stress Response in Professional Rugby Union through Non-invasive Assessment

Rugby union is a sport involving high force and frequency impacts making the likelihood of injury a significant risk. The aim of this study was to measure and report the individual and group acute and cumulative physiological stress response during 3 professional rugby games through non-invasive sampling. 24 professional rugby players volunteered for the study. Urine and saliva samples were collected pre and post 3 matches. Myoglobin, salivary immunoglobulin A, cortisol, neopterin and total neopterin (neopterin+7,8-dihydroneopterin) were analysed by high performance liquid chromatography or enzyme linked immunosorbent assay. Significant increases in cortisol, myoglobin, neopterin and total neopterin when urine volume was corrected with specific gravity were observed (p<0.05). Significant decreases in salivary immunoglobulin A concentration were observed for games 1 and 2 while secretion rate decreased after games 2 and 3. Significant decreases were seen with the percent of 7,8-dihydroneopterin being converted to neopterin following games 2 and 3. The intensity of 3 professional rugby games was sufficient to elicit significant changes in the physiological markers selected for our study. Furthermore, results suggest the selected markers not only provide a means for analysing the stress encountered during a single game of rugby but also highlight the unique pattern of response for each individual player.

Laminar flow reduces cases of surgical site infections in vascular patients

Introduction

Numerous strategies are employed routinely in an effort to lower rates of surgical site infections (SSIs). A laminar flow theatre environment is generally used during orthopaedic surgery to reduce rates of SSIs. Its role in vascular surgery, especially when arterial bypass grafts are used, is unknown.

Methods

A retrospective review of a prospectively maintained database was undertaken for all vascular procedures performed by a single consultant over a one-year period. Cases were performed, via random allocation, in either a laminar or non-laminar flow theatre environment. Demographic data, operative data and evidence of postoperative SSIs were noted. A separate subgroup analysis was undertaken for patients requiring an arterial bypass graft. Univariate and multivariate logistical regression was undertaken to identify significant factors associated with SSIs.

Results

Overall, 170 procedures were analysed. Presence of a groin incision, insertion of an arterial graft and a non-laminar flow theatre were shown to be predictive of SSIs in this cohort. In the subgroup receiving arterial grafts, only a non-laminar flow theatre environment was shown to be predictive of an SSI.

Conclusions

This study suggests that laminar flow may reduce incidences of SSI, especially in the subgroup of patients receiving arterial grafts.

Ongoing outbreak of Shigella flexneri serotype 3a in men who have sex with men in England and Wales, data from 2009–2011

Diagnoses of Shigella flexneri in the United Kingdom (UK) are usually travel-related. However, since 2009, there has been an overall increase in UK-acquired cases. The Health Protection Agency has been investigating a national outbreak of S. flexneri detected in 2011 and which is still ongoing. Cases occurred mostly in men who have sex with men and were of serotype 3a. The investigation aimed at obtaining epidemiological data to inform targeted outbreak management and control.

Ongoing outbreak of Shigella flexneri serotype 3a in men who have sex with men in England and Wales, data from 2009-2011

Diagnoses of Shigella flexneri in the United Kingdom (UK) are usually travel-related. However, since 2009, there has been an overall increase in UK-acquired cases. The Health Protection Agency has been investigating a national outbreak of S. flexneri detected in 2011 and which is still ongoing. Cases occurred mostly in men who have sex with men and were of serotype 3a. The investigation aimed at obtaining epidemiological data to inform targeted outbreak management and control.

Warm-up affects diurnal variation in power output

The purpose of this study was to examine whether time of day variations in power output can be accounted for by the diurnal fluctuations existent in body temperature. 8 recreationally trained males (29.8±5.2 yrs; 178.3±5.2 cm; 80.3±6.5 kg) were assessed on 4 occasions following a: (a) control warm-up at 8.00 am; (b) control warm-up at 4.00 pm; (c) extended warm-up at 8.00 am; and, (d) extended warm-up at 4.00 pm. The control warm-up consisted of dynamic exercises and practice jumps. The extended warm-up incorporated a 20 min general warm-up on a stationary bike prior to completion of the control warm-up, resulting in a whole body temperature increase of 0.3±0.2°C. Kinetic and kinematic variables were measured using a linear optical encoder attached to a barbell during 6 loaded counter-movement jumps. Results were 2-6% higher in the afternoon control condition than morning control condition. No substantial performance differences were observed between the extended morning condition and afternoon control condition where body temperatures were similar. Results indicate that diurnal variation in whole body temperature may explain diurnal performance differences in explosive power output and associated variables. It is suggested that warm-up protocols designed to increase body temperature are beneficial in reducing diurnal differences in jump performance.

Increased detection of the HIV-1 reverse transcriptase M184V mutation using mutation-specific minority assays in a UK surveillance study suggests evidence of unrecognized transmitted drug resistance

OBJECTIVES

The aim of the study was to estimate the levels of transmitted drug resistance (TDR) in HIV-1 using very sensitive assays to detect minority drug-resistant populations.

METHODS

We tested unlinked anonymous serum specimens from sexual health clinic attendees, who had not received an HIV diagnosis at the time of sampling, by both standard genotyping and using minority detection assays.

RESULTS

By standard genotyping, 21 of 165 specimens (12.7%) showed evidence of drug resistance, while, using a combination of standard genotyping and minority mutation assays targeting three commonly observed drug resistance mutations which cause high-level resistance to commonly prescribed first-line antiretroviral therapy (ART), this rose to 32 of 165 (19.4%). This increase of 45% in drug resistance levels [95% confidence interval (CI) 15.2-83.7%; P=0.002] was statistically significant. Almost all of this increase was accounted for by additional detections of the M184V mutation.

CONCLUSIONS

Future surveillance studies of TDR in the United Kingdom should consider combining standard genotyping and minority-specific assays to provide more accurate estimates, particularly when using specimens collected from chronic HIV infections in which TDR variants may have declined to low levels.

The Test of Everyday Attention for Children (TEA-Ch): Patterns of Performance in Children With ADHD and Clinical Controls

The present study explores the utility of the Test of Everyday Attention for Children (TEA-Ch) as a measure of the attentional impairments displayed by children with Attention Deficit Hyperactivity Disorder (ADHD). Sixty-three children with ADHD and 23 non-ADHD Clinical Control children were compared on subtests of the TEA-Ch reflecting three attentional domains: sustained, selective, and attentional control. Results show that children with ADHD performed significantly worse than clinical controls on subtests of sustained attention and attentional control. The groups did not differ, however, on subtests of selective attention. These findings suggest that the TEA-Ch is sensitive to attentional deficits unique to ADHD and holds promise as a useful tool in the assessment of ADHD. Performance patterns and future directions are discussed.

Gonococcal NAATs: what is the current state of play in England and Wales?

The aim of this study was to determine how widespread the use is of dual nucleic acid amplification tests (NAATs) for the diagnosis of both Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in England and Wales. A structured telephone questionnaire was used to collect information on the method of dual testing used by laboratories, the patient groups tested, the types of specimens obtained and the use of GC culture. Of the 108 laboratories participating, 29% performed dual CT and GC NAAT assays. The platforms used included: (i) BD Probetec (19/31), (ii) Aptima Combo 2 (9/31) and (iii) COBAS AMPLICOR (2/31). GC-positive specimens were either repeated using the same test (21) or an alternative target (9). Most laboratories confirmed positive GC NAATs by performing culture (26/31). Laboratories performed dual NAAT testing on specimens sourced from both community and genitourinary medicine clinic settings, and on a wide variety of different specimen types. This survey highlights a lack of consistency in the current use of dual NAAT platforms in the UK and the need for national guidelines.

Effect of cold water immersion on repeated cycling performance and limb blood flow

The purpose of the present study was to compare the effects of cold water immersion (CWI) and active recovery (ACT) on resting limb blood flow, rectal temperature and repeated cycling performance in the heat. Ten subjects completed two testing sessions separated by 1 week; each trial consisted of an initial all-out 35-min exercise bout, one of two 15-min recovery interventions (randomised: CWI or ACT), followed by a 40-min passive recovery period before repeating the 35-min exercise bout. Performance was measured as the change in total work completed during the exercise bouts. Resting limb blood flow, heart rate, rectal temperature and blood lactate were recorded throughout the testing sessions. There was a significant decline in performance after ACT (mean (SD) -1.81% (1.05%)) compared with CWI where performance remained unchanged (0.10% (0.71%)). Rectal temperature was reduced after CWI (36.8°C (1.0°C)) compared with ACT (38.3°C (0.4°C)), as was blood flow to the arms (CWI 3.64 (1.47) ml/100 ml/min; ACT 16.85 (3.57) ml/100 ml/min) and legs (CW 4.83 (2.49) ml/100 ml/min; ACT 4.83 (2.49) ml/100 ml/min). Leg blood flow at the end of the second exercise bout was not different between the active (15.25 (4.33) ml/100 ml/min) and cold trials (14.99 (4.96) ml/100 ml/min), whereas rectal temperature (CWI 38.1°C (0.3°C); ACT 38.8°C (0.2°C)) and arm blood flow (CWI 20.55 (3.78) ml/100 ml/min; ACT 23.83 (5.32) ml/100 ml/min) remained depressed until the end of the cold trial. These findings indicate that CWI is an effective intervention for maintaining repeat cycling performance in the heat and this performance benefit is associated with alterations in core temperature and limb blood flow.

Situation of HIV infections and STIs in the United Kingdom in 2007

In the United Kingdom (UK) in 2007, an estimated 77,400 persons were living with human immunodeficiency virus (HIV) of whom 28% are unaware of their infection. A total of 7,734 persons were newly diagnosed with HIV infection in 2007, of which 31% were diagnosed late. This highlights the need for wider HIV testing, especially in those areas with a high diagnosed prevalence, as recommended in recent national guidelines. Among newly diagnosed cases of HIV in 2007, 41% acquired their infection through sex between men (four in five of whom acquired their infection in the UK) and 55% through heterosexual contact (four in five of whom acquired their infection abroad, mainly in sub-Saharan Africa). Young persons aged 16 to 24 years are disproportionally affected by sexually transmitted diseases (STIs) accounting for 65% of genital chlamydia infections, 50% of cases of genital warts and 50% of cases of gonorrhoea that were diagnosed in 2007.

Situation of HIV infections and STIs in the United Kingdom in 2007

In the United Kingdom (UK) in 2007, an estimated 77,400 persons were living with human immunodeficiency virus (HIV) of whom 28% are unaware of their infection. A total of 7,734 persons were newly diagnosed with HIV infection in 2007, of which 31% were diagnosed late. This highlights the need for wider HIV testing, especially in those areas with a high diagnosed prevalence, as recommended in recent national guidelines. Among newly diagnosed cases of HIV in 2007, 41% acquired their infection through sex between men (four in five of whom acquired their infection in the UK) and 55% through heterosexual contact (four in five of whom acquired their infection abroad, mainly in sub-Saharan Africa). Young persons aged 16 to 24 years are disproportionally affected by sexually transmitted diseases (STIs) accounting for 65% of genital chlamydia infections, 50% of cases of genital warts and 50% of cases of gonorrhoea that were diagnosed in 2007.

Continuing high levels of HIV diagnoses in men who have sex with men in the United Kingdom

The latest HIV data for 2007 has recently been published for the United Kingdom (UK). During the year, an estimated 6,840 (95% confidence intervals 6,600-7,050) persons (adjusted for reporting delays) were newly diagnosed with HIV in the UK. This represents a 12% decline from a peak of new HIV diagnoses reported in 2005 (7,800). Almost all this decline in new HIV diagnoses was in HIV-infected heterosexuals from sub-Saharan Africa who were probably infected in their country of origin.

Effect of hydrotherapy on recovery from fatigue

The present study investigated the effects of three hydrotherapy interventions on next day performance recovery following strenuous training. Twelve cyclists completed four experimental trials differing only in 14-min recovery intervention: cold water immersion (CWI), hot water immersion (HWI), contrast water therapy (CWT), or passive recovery (PAS). Each trial comprised five consecutive exercise days of 105-min duration, including 66 maximal effort sprints. Additionally, subjects performed a total of 9-min sustained effort (time trial - TT). After completing each exercise session, athletes performed one of four recovery interventions (randomly assigned to each trial). Performance (average power), core temperature, heart rate (HR), and rating of perceived exertion (RPE) were recorded throughout each session. Sprint (0.1 - 2.2 %) and TT (0.0 - 1.7 %) performance were enhanced across the five-day trial following CWI and CWT, when compared to HWI and PAS. Additionally, differences in rectal temperature were observed between interventions immediately and 15-min post-recovery; however, no significant differences were observed in HR or RPE regardless of day of trial/intervention. Overall, CWI and CWT appear to improve recovery from high-intensity cycling when compared to HWI and PAS, with athletes better able to maintain performance across a five-day period.

Relationship of pulsed-field profiles with key phage types of Salmonella enterica serotype Enteritidis in Europe: results of an international multi-centre study

Salmonella is one of the most common causes of foodborne infection in Europe with Salmonella enterica serovar Enteritidis (S. Enteritidis) being the most commonly identified serovar. The predominant phage type for S. Enteritidis is phage type (PT) 4, although PT 8 has increased in incidence. Within these phage types, pulsed-field gel electrophoresis (PFGE) provides a method of further subdivision. The international project, Salm-gene, was established in 2001 to develop a database of PFGE profiles within nine European countries and to establish criteria for real-time pattern recognition. It uses DNA fingerprints of salmonellas to investigate outbreaks and to evaluate trends and emerging issues of foodborne infection within Europe. The Salm-gene database contains details of about 11 700 S. Enteritidis isolates, demonstrating more than 65 unique PFGE profiles. The clonal nature of S. Enteritidis is evidenced by the high similarity and distribution of PFGE profiles. Over 56% (6603/11 716) of the submitted isolates of several different phage types were profile SENTXB.0001, although this profile is most closely associated with PT 4. The next most common profiles, SENTXB.0002 and SENTXB.0005, were closely associated with PT 8 and PT 21 respectively. Studies to investigate the relationship of profile types with outbreaks and possible vehicles of infection suggest that the incidence of PFGE profile SENTXB.0002, and thus PT 8, in some countries may be due to importation of foods or food production animals from Eastern Europe, where PT 8 is amongst the most frequently identified phage types. Collation of subtyping data, especially in the commonly recognized phage types, is necessary in order to evaluate trends and emerging issues in salmonella infection.

Eurosurveillance comes of age and moves to ECDC

Eurosurveillance was created in 1995 to support exchange and dissemination of authoritative scientific information within the part of public health community involved in the field of infectious disease surveillance and control, at a time when European surveillance networks were at an early stage of growth. Now part of a large network, the publication is entering a new stage: the editorial function will now be hosted at the European Centre for Disease Prevention and Control (ECDC) in Stockholm. This will strengthen the platform for the next stage in Eurosurveillance’s development as the major home of peer-reviewed European information on infectious disease surveillance and control.

Effect of recovery modality on 4-hour repeated treadmill running performance and changes in physiological variables

The purpose of this study was to compare the effectiveness of three different recovery modalities--active (ACT), passive (PAS) and contrast temperature water immersion (CTW)--on the performance of repeated treadmill running, lactate concentration and pH. Fourteen males performed two pairs of treadmill runs to exhaustion at 120% and 90% of peak running speed (PRS) over a 4-hour period. ACT, PAS or CTW was performed for 15-min after the first pair of treadmill runs. ACT consisted of running at 40% PRS, PAS consisted of standing stationary and CTW consisted of alternating between 60-s cold (10 degrees C) and 120-s hot (42 degrees C) water immersion. Run times were converted to time to cover set distance using critical power. Type of recovery modality did not have a significant effect on change in time to cover 400 m (Mean +/- SD; ACT 2.7 +/- 3.6 s, PAS 2.9 +/- 4.2 s, CTW 4.2 +/- 6.9 s), 1000 m (ACT 2.2 +/- 4.0 s, PAS 4.8 +/- 8.6 s, CTW 2.1 +/- 7.2 s) or 5000 m (ACT 1.4 +/- 29.0 s, PAS 16.7 +/- 58.5 s, CTW 11.7 +/- 33.0 s). Post exercise blood lactate concentration was lower in ACT and CTW compared with PAS. Participants reported an increased perception of recovery in the CTW compared with ACT and PAS. Blood pH was not significantly influenced by recovery modality. Data suggest both ACT and CTW reduce lactate accumulation after high intensity running, but high intensity treadmill running performance is returned to baseline 4-hours after the initial exercise bout regardless of the recovery strategy employed.

Reduction in heat-induced gastrointestinal hyperpermeability in rats by bovine colostrum and goat milk powders

Male Sprague-Dawley rats were assigned to one of three dietary groups [standard diet (Cont; n = 8), standard diet plus bovine colostrum powder (BColost 1.7 g/kg; n = 8), or goat milk powder (GMilk 1.7 g/kg; n = 8)] to determine the ability of these supplements to reduce gastrointestinal hyperpermeability induced by heat. Raising core body temperature of rats to 41.5 degrees C increased transfer of (51)Cr-EDTA from gut into blood 34-fold relative to the ambient temperature value (P < 0.05) in the Cont group of rats, indicative of increased gastrointestinal permeability. Significantly less (P < 0.01) (51)Cr-EDTA was transferred into the blood of rats in either the BColost (27% of Cont) or GMilk group (10% of Cont) after heating, showing that prior supplementation with either bovine colostrum or goat milk powder significantly reduced the impact of heat stress on gastrointestinal permeability. The changes in the BColost group were not significantly different than those of the GMilk group. The potential mechanism of the protective effect of bovine colostrum and goat milk powders may involve modulation of tight junction permeability, because both powders were able to maintain transepithelial resistance in Madin Darby canine kidney cells challenged with EGTA compared with cells maintained in media only. The results show that bovine colostrum powder can partially alleviate the effects of hyperthermia on gastrointestinal permeability in the intact animal. Moreover, goat milk powder was equally as effective as bovine colostrum powder, and both may be of benefit in other situations where gastrointestinal barrier function is compromised.

The Salm-gene project - a European collaboration for DNA fingerprinting for food-related salmonellosis

An external quality assessment of PFGE method to discriminate between salmonella serotypes and lysotypes was carried out by the Salm-Gene project in Europe. A set of 16 strains of S. Enteritidis was sent to 9 national salmonella reference laboratories. By using a harmonised protocol, the PFGE profiles produced were comparable between each centre. In most cases, there was at least 90% similarity between isolates tested in the different European laboratories and there was usually >95% similarity. This suggests that PFGE analyses are reproducible and therefore can be used as a valuable investigation tool combined with epidemiological data.