Background: Neutropenic sepsis is a potentially fatal complication of cytotoxic chemotherapy requiring rapid, specialist input. The NICE Clinical Guideline 1511 advises door to needle antibiotic time of less than one hour in patients with suspected neutropenic sepsis. This is a clear quality standard for oncology services2.It is well established that dedicated clinical pathways/care bundles improve patient safety and clinical performance.Aim: Develop a clinical pathway based on 'Sepsis Six Care Bundle'3 to treat patients with suspected neutropenic sepsis and reduce time to antibiotics.Standard: 100% of patients presenting to an oncology helpline, who have received chemotherapy within six weeks, and have infective symptoms or pyrexia of 38°C, have antibiotics within one hour of arrival.Target: 100%Methodology: Baseline Retrospective Audit.Clinical notes review of patients attending oncology helpline with suspected neutropenic sepsis over two-week period.Results: 31% of patients received antibiotics in less than an hour.Action Plan:1)Multidisciplinary Neutropenic Clinical Pathway created with principles of the Sepsis Six Care Bundle. Antibiotics given before knowledge of neutrophil count in eligible patients.2)Patient Group Direction (PGD) for nurse led prescribing/delivery of first dose of antibiotics.3)Multidisciplinary Team Education programme developed for all staff.4)Prospective re-audit.Results of Re-audit:Demographics – mean age 62.5 yrs, Palliative versus Adjuvant chemotherapy, 65% versus 35% respectively.97% patients received antibiotics in less than one hour with 0% mortality/referral to critical care department. There was no increase in time to antibiotics out of hours.Two further audits have demonstrated sustained clinical performance.This audit cycle, with development of a dedicated clinical pathway/care bundle involving nurse-led prescribing/delivery of treatment, has significantly improved door to needle time for antibiotics in patients with suspected neutropenic sepsis.It has led to improved patient experience/safety with implementation of NICE Guidance.Key references[1] National Institute for Health and Care Excellence (NICE) CG151 http://www.nice.org.uk/nicemedia/live/13905/60866/60866.pdf[2] NHS England Standard Contract for Cancer: Chemotherapy (Adult). Section B Part 1 – Service Specifications, http://www.england.nhs.uk/wp-content/uploads/2013/06/b15-cancr-chemoth.pdf.[3] Sepsis six care bundle http://www.survivingsepsis.org. Background: Neutropenic sepsis is a potentially fatal complication of cytotoxic chemotherapy requiring rapid, specialist input. The NICE Clinical Guideline 1511 advises door to needle antibiotic time of less than one hour in patients with suspected neutropenic sepsis. This is a clear quality standard for oncology services2. It is well established that dedicated clinical pathways/care bundles improve patient safety and clinical performance. Aim: Develop a clinical pathway based on 'Sepsis Six Care Bundle'3 to treat patients with suspected neutropenic sepsis and reduce time to antibiotics. Standard: 100% of patients presenting to an oncology helpline, who have received chemotherapy within six weeks, and have infective symptoms or pyrexia of 38°C, have antibiotics within one hour of arrival. Target: 100% Methodology: Baseline Retrospective Audit. Clinical notes review of patients attending oncology helpline with suspected neutropenic sepsis over two-week period. Results: 31% of patients received antibiotics in less than an hour. Action Plan:1)Multidisciplinary Neutropenic Clinical Pathway created with principles of the Sepsis Six Care Bundle. Antibiotics given before knowledge of neutrophil count in eligible patients.2)Patient Group Direction (PGD) for nurse led prescribing/delivery of first dose of antibiotics.3)Multidisciplinary Team Education programme developed for all staff.4)Prospective re-audit. Results of Re-audit: Demographics – mean age 62.5 yrs, Palliative versus Adjuvant chemotherapy, 65% versus 35% respectively. 97% patients received antibiotics in less than one hour with 0% mortality/referral to critical care department. There was no increase in time to antibiotics out of hours. Two further audits have demonstrated sustained clinical performance. This audit cycle, with development of a dedicated clinical pathway/care bundle involving nurse-led prescribing/delivery of treatment, has significantly improved door to needle time for antibiotics in patients with suspected neutropenic sepsis. It has led to improved patient experience/safety with implementation of NICE Guidance. Key references [1] National Institute for Health and Care Excellence (NICE) CG151 http://www.nice.org.uk/nicemedia/live/13905/60866/60866.pdf [2] NHS England Standard Contract for Cancer: Chemotherapy (Adult). Section B Part 1 – Service Specifications, http://www.england.nhs.uk/wp-content/uploads/2013/06/b15-cancr-chemoth.pdf. [3] Sepsis six care bundle http://www.survivingsepsis.org.

The animal food chain contributes significantly to emission of greenhouse gases (GHGs). We explored studies that addressed options to mitigate GHG emissions in the animal production chain and concluded that most studies focused on production systems in developed countries and on a single GHG. They did not account for the complex interrelated effects on other GHGs or their relation with other aspects of sustainability, such as eutrophication, animal welfare, land use or food security. Current decisions on GHG mitigation in animal production, therefore, are hindered by the complexity and uncertainty of the combined effect of GHG mitigation options on climate change and their relation with other aspects of sustainability. There is an urgent need to integrate simulation models at animal, crop and farm level with a consequential life cycle sustainability assessment to gain insight into the multidimensional and sometimes conflicting consequences of GHG mitigation options.

The potential for physical removal of Mycobacterium avium ssp. paratuberculosis (M. paratuberculosis) from milk by centrifugation and microfiltration was investigated by simulating commercial processing conditions in the laboratory by means of a microcentrifuge and syringe filters, respectively. Results indicated that both centrifugation of preheated milk (60°C) at 7000 × g for 10 s, and microfiltration through a filter of pore size 1.2 µm, were capable of removing up to 95–99.9% of M. paratuberculosis cells from spiked whole milk and Middlebrook 7H9 broth suspensions, respectively. Centrifugation and microfiltration may therefore have potential application within the dairy industry as pretreatments to reduce M. paratuberculosis contamination of raw milk.

ABSTRACTThe effect of various pasteurization time-temperature conditions with and without homogenization on the viability ofMycobacterium aviumsubsp.paratuberculosiswas investigated using a pilot-scale commercial high-temperature, short-time (HTST) pasteurizer and raw milk spiked with 101to 105M. aviumsubsp.paratuberculosiscells/ml. ViableM. aviumsubsp.paratuberculosiswas cultured from 27 (3.3%) of 816 pasteurized milk samples overall, 5 on Herrold's egg yolk medium and 22 by BACTEC culture. Therefore, in 96.7% of samples,M. aviumsubsp.paratuberculosishad been completely inactivated by HTST pasteurization, alone or in combination with homogenization. Heat treatments incorporating homogenization at 2,500 lb/in2, applied upstream (as a separate process) or in hold (at the start of a holding section), resulted in significantly fewer culture-positive samples than pasteurization treatments without homogenization (P< 0.001 for those in hold andP< 0.05 for those upstream). Where colony counts were obtained, the number of survivingM. aviumsubsp.paratuberculosiscells was estimated to be 10 to 20 CFU/150 ml, and the reduction in numbers achieved by HTST pasteurization with or without homogenization was estimated to be 4.0 to 5.2 log10. The impact of homogenization on clump size distribution inM. aviumsubsp.paratuberculosisbroth suspensions was subsequently assessed using a Mastersizer X spectrometer. These experiments demonstrated that large clumps ofM. aviumsubsp.paratuberculosiscells were reduced to single-cell or “miniclump” status by homogenization at 2,500 lb/in2. Consequently, when HTST pasteurization was being applied to homogenized milk, theM. aviumsubsp.paratuberculosiscells would have been present as predominantly declumped cells, which may possibly explain the greater inactivation achieved by the combination of pasteurization and homogenization.

Trichosphaerium sieboldi is a marine amoeba with a cosmopolitan distribution. The ability of three strains, from different geographical regions, to digest a range of macroalgae was investigated. Prior to these experiments, methods were developed for the axenic cultivation of T. sieboldi. Algae included Fucus vesiculosus, F. spiralis, Laminaria digitata, L. saccharina, Mastocarpus stellatus, Palmaria palmata, Porhyra sp., and Ulva sp. All were degraded with equivalent ease; typically 50% of the tissue biomass was removed within seven days. The wall of this amoeba was studied to obtain clues on how a protist could be digesting macroalgal tissue. The fibrous nature of the outer cell wall presumably allows the wall to part and remesh during consumption of large particles. It is suggested that during digestion of macroalgae, the wall is parted to enable digestive enzymes to be localized along the surface of the seaweed wall, effectively forming an ‘enzyme pocket’. Trichosphaerium has both polysaccharidases and glycosidases, notably glucosidase, cellobiosidase, mannosidase and fucosidase. These enzymes work in concert to facilitate the breakdown of the complex polysaccharides found across the range of seaweeds used. These studies suggest that T. sieboldi could be a primary invader of seaweeds in the field. They also suggest that some protistan groups may be important in the degradation and recycling of algal material in coastal waters.

Selective deposition of tungsten on metals and silicon in the presence of insulators is important in several very large scale integrated circuit applications. The results of experiments investigating this selectivity are reported. The influence of the total area and composition of the selective growth surface on the nucleation of tungsten on adjacent insulators are illustrated. Specifically, nucleation is shown to occur preferentially in close proximity to the area of tungsten growth. The extent of nucleation on silicon dioxide compared to silicon nitride or phosphorus-doped glass is dependent on the composition of the surface on which the initial selective tungsten growth occurs. The qualitative observations presented here form the basis for further quantitative investigations.

EcologyVolume 67, Issue 6 p. 1619-1627 Article Premature Leaf Abscission: An Induced Plant Defense Against Gall Aphids Alan G. Williams, Alan G. WilliamsSearch for more papers by this authorThomas G. Whitham, Thomas G. WhithamSearch for more papers by this author Alan G. Williams, Alan G. WilliamsSearch for more papers by this authorThomas G. Whitham, Thomas G. WhithamSearch for more papers by this author First published: 01 December 1986 https://doi.org/10.2307/1939093Citations: 97AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract We hypothesized that premature leaf abscission represents an adaptive plant response to herbivore attack. To the extent that this host response reduces the pest population and is cost effective, it should be considered an induced plant defense. To test this hypothesis we examined the patterns of abscission by two species of cottonwoods (Populus), quantified the impacts of abscission on the survival of two Pemphigus gall aphid species, and examined aphid behavioral and life history countermeasures to this host response. These studies revealed that premature leaf abscission is induced by gall aphid attack. This host response reduced the aphid population by 25% on narrowleaf cottonwood and by 53% on Fremont cottonwood. Galled leaves rapidly declined in quality; only 1 wk after colonization ungalled leaves contained 10.9% more chlorophyll than galled leaves, and differences continued to increase with time. This induce host response is selective and dosage dependent; leaves with 3 or more galls were four times as likely to be dropped as leaves with 1 gall, and 20 times as likely to be dropped as ungalled leaves. Selective abscission is effective even at low aphid densities. At least 98% of the aphids in the galls of abscised leaves died, 90% within 48 h of abscission. Mature aphids on senescing leaves had lower body masses than those on green leaves, demonstrating that the process of leaf abscission is detrimental to aphids before leaves actually fall. A few aphids (≤1%) escaped leaf drop by migrating from deteriorating galls to nearby galls in less danger of imminent abscission. Since the effect of premature leaf fall force gall aphids to emigrate, shifting to new hosts may have evolved as a counteradaptation to escape this induced plant defense. Sessile plant pests should be particularly susceptible to induced leaf abscission, and this may explain why galling aphid species are 3.5 times as likely to host—shift as nongalling aphids. Citing Literature Volume67, Issue6December 1986Pages 1619-1627 RelatedInformation