An evaluation of the effectiveness of an algorithm intervention in reducing inappropriate faecal samples sent for Clostridium difficile testing.

Background: Clostridium difficile (C. difficile) is a leading cause of infectious diarrhoea in hospitals. Sending faecal samples for testing expedites diagnosis and appropriate treatment. Clinical suspicion of C. difficile based on patient history, signs and symptoms is the basis for sampling. Sending faecal samples from patients with diarrhoea ‘just in case’ the patient has C. difficile may be an indication of poor clinical management.

Aim: To evaluate the effectiveness of an intervention by an Infection Prevention and Control Team (IPCT) in reducing inappropriate faecal samples sent for C. difficile testing.

Method: An audit of numbers of faecal samples sent before and after a decision-making algorithm was introduced. The number of samples received in the laboratory was retrospectively counted for 12-week periods before and after an algorithm was introduced.
Findings: There was a statistically significant reduction in the mean number of faecal samples sent post the algorithm. Results were compared to a similar intervention carried out in 2009 in which the same message was delivered by a memorandum. In 2009 the memorandum had no effect on the overall number of weekly samples being sent.

Conclusion: An algorithm intervention had an effect on the number of faecal samples being sent for C. difficile testing and thus contributed to the effective use of the laboratory service.

Estimation of Mycobacterium avium subsp. paratuberculosis load in raw bulk tank milk in Emilia-Romagna Region (Italy) by qPCR

Consumption of milk and dairy products is considered one of the main routes of human exposure to Mycobacterium avium subsp. paratuberculosis (MAP). Quantitative data on MAP load in raw cows’ milk are essential starting point for exposure assessment. Our study provides this information on a regional scale, estimating the load of MAP in bulk tank milk (BTM) produced in Emilia-Romagna region (Italy). The survey was carried out on 2934 BTM samples (88.6% of the farms herein present) using two different target sequences for qPCR (f57 and IS900). Data about the performances of both qPCRs are also reported, highlighting the superior sensitivity of IS900-qPCR. Seven hundred and eighty-nine samples tested MAP-positive (apparent prevalence 26.9%) by IS900 qPCR. However, only 90 of these samples were quantifiable by qPCR. The quantifiable samples contained a median load of 32.4 MAP cells mL−1 (and maximum load of 1424 MAP cells mL−1). This study has shown that a small proportion (3.1%) of BTM samples from Emilia-Romagna region contained MAP in excess of the limit of detection (1.5 × 101 MAP cells mL−1), indicating low potential exposure for consumers if the milk subsequently undergoes pasteurization or if it is destined to typical hard cheese production.

Integration of design of experiment, surface response methodology and multi-layer validation to predict the effect of blanching on colour of tomato juice

Response surface methodology was used to develop models to predict the effect of tomato cultivar, juice pH, blanching temperature and time on colour change of tomato juice after blanching. The juice from three tomato cultivars with adjusted pH levels ranging from 3.9 to 4.6 were blanched at temperatures from 60-100 °C for 1-5 min using the central composite design (CCD). The colour change was assessed by calculating the redness (a/b) and total colour change (∆E) after measuring the Hunter L, a and b values. Developed models for both redness and ∆E were significant (p<0.0001) with satisfactory coefficient of determination (R2 = 0.99 and 0.97) and low coefficient of variation (CV% = 1.89 and 7.23), respectively. Multilevel validation that was implemented revealed that the variation between the predicted and experimental values obtained for redness and ∆E were within the acceptable error range of 7.3 and 22.4%, respectively

Validation of a high-throughput immunobead array technique for multiplex detection of three foodborne pathogens in chicken products

This study rigorously evaluated a previously developed immunobead array method to simultaneously detect three important foodborne pathogens, Campylobacter jejuni, Listeria monocytogenes, and Salmonella spp., for its actual application in routine food testing. Due to the limitation of the detection limit of the developed method, an enrichment step was included in this study by using Campylobacter Enrichment Broth for C. jejuni and Universal Pre-enrichment Broth for L. monocytogenes and Salmonella spp.. The findings show that the immunobead array method was capable of detecting as low as 1 CFU of the pathogens spiked in the culture media after being cultured for 24 hours for all three pathogens. The immunobead array method was further evaluated for its pathogen detection capabilities in ready-to-eat (RTE) and ready-to-cook (RTC) chicken samples and proven to be able to detect as low as 1 CFU of the pathogens spiked in the food samples after being cultured for 24 hours in the case of Salmonella spp., and L. monocytogenes and 48 hours in the case of C. jejuni. The method was subsequently validated with three types of chicken products (RTE, n=30; RTC, n=20; raw chicken, n=20) and was found to give the same results as the conventional plating method. Our findings demonstrated that the previously developed immunobead array method could be used for actual food testing with minimal enrichment period of only 52 hours, whereas the conventional ISO protocols for the same pathogens take 90-144 hours. The immunobead array was therefore an inexpensive, rapid and simple method for the food testing.

Automated retinal image quality assessment on the UK Biobank dataset for epidemiological studies

Morphological changes in the retinal vascular network are associated with future risk of many systemic and vascular diseases. However, uncertainty over the presence and nature of some of these associations exists. Analysis of data from large population based studies will help to resolve these uncertainties. The QUARTZ (QUantitative Analysis of Retinal vessel Topology and siZe) retinal image analysis system allows automated processing of large numbers of retinal images. However, an image quality assessment module is needed to achieve full automation. In this paper, we propose such an algorithm, which uses the segmented vessel map to determine the suitability of retinal images for use in the creation of vessel morphometric data suitable for epidemiological studies. This includes an effective 3-dimensional feature set and support vector machine classification. A random subset of 800 retinal images from UK Biobank (a large prospective study of 500,000 middle aged adults; where 68,151 underwent retinal imaging) was used to examine the performance of the image quality algorithm. The algorithm achieved a sensitivity of 95.33% and a specificity of 91.13% for the detection of inadequate images. The strong performance of this image quality algorithm will make rapid automated analysis of vascular morphometry feasible on the entire UK Biobank dataset (and other large retinal datasets), with minimal operator involvement, and at low cost.

Proyecto de Factibilidad para la creación de una empresa dedicada a la elaboración de papel a base del pinzote de banano, ubicado en el sector Rumicucho, parroquia San Antonio de Pichincha, Canctón Quito. Provincia de Pichincha.

El presente trabajo investigativo contiene cinco capítulos los cuales están ordenados en una forma secuencial y lógica para el entendimiento de los lectores. El Capítulo I, es el Estudio de Mercado, en el cual como método de investigación se utilizo la encuesta, para conocer la cantidad de personas que requieren adquirí el producto, sus necesidades, además de indagar en las ofertas existentes, las tendencias que tienen estos, para de esta manera saber en qué mercado queremos incursionar y cuál sería la oferta que podemos presentar. El Capítulo II, es el Estudio de Tamaño y Localización, se analizo factores de producción, maquinaria los que permiten conocer cuál es el tamaño óptimo de la planta, el tamaño de la maquinaria para de esta manera analizar la distribución espacial de la planta. La localización a pesar de conocerla, se analizó para saber las características con las que cuenta este lugar tanto como las falencias del mismo. El Capítulo III, es el Estudio de Ingeniería del Proyecto, este nos permitió conocer los recursos humanos, de infraestructura, materia prima, de equipos y maquinaria, que se necesitarán para la implementación de la planta, el costo que estos implican, para considerar la selección adecuada de los mismos. El Capítulo VI, Estudio Financiero, es el que permite establecer la factibilidad del proyecto de manera cuantitativa a través de la inversión que se realizará, los, costos, los ingresos, que permiten conocer la utilidad que genera el proyecto, además de analizar con métodos financieros la viabilidad de la empresa a base de sus resultados. El Capítulo V, Análisis Legal y Organizacional, establece las bases jurídicas tanto internas y externas que debe cumplir la empresa, desde su constitución y durante todo el horizonte del proyecto. En lo referente a la organización se estable la misión, visión, organigramas y la importancia del personal en la empresa.

Año por año: Las fiestas de San Pedro en Ayora-Cayambe

La variedad lingüística, cultural y social del Ecuador se manifiesta también en en existencia de una, increíble diversidad de fiestas y rituales que constituyen un rasgo omnipresente en el espacio rural e indígena de los Andes. Estas fiestas y rituales, por lo general, han sido muy superficialmente considerados: algunas veces corno simples manifestaciones de un supuesto "folklore nacional"; otras, como costumbres pintorescas que vale Ia pena tener en cuenta junto a la belleza del paisaje. Tampoco estuvo ausente la idea de que constituyen tradiciones que han logrado pervivir desactualizada y anocrónicamente ante los cambios sociales, culturales y económicos que homogeneizan cada vez más la población del Ecuador.

Mundo Shuar 11: La cocina

La doctora Irene Paredes de Martínez, profesora en la Universidad Central de Quito y especialista en folklore de la alimentación, me hacía notar un día que el "hambre" nos la quitamos de cualquier manera y con cualquier material apenas comestible, pero cuando se trata del apetito entran en juego reglas culturales a veces muy sofisticadas.