Active travel (cycling, walking) is beneficial for the health due to increased physical activity (PA). However, active travel may increase the intake of air pollution, leading to negative health consequences. We examined the riskbenefit balance between active travel related PA and exposure to air pollution across a range of air pollution and PA scenarios. The health effects of active travel and air pollution were estimated through changes in all-cause mortality for different levels of active travel and air pollution. Air pollution exposure was estimated through changes in background concentrations of fine particulate matter (PM 2.5 ), ranging from 5 to 200 μg/m3. For active travel exposure, we estimated cycling and walking from 0 up to 16 h per day, respectively. These refer to long-term average levels of active travel and PM 2.5 exposure. For the global average urban background PM 2.5 concentration (22 μg/m3) benefits of PA by far outweigh risks from air pollution even under the most extreme levels of active travel. In areas with PM 2.5 concentrations of 100 μg/m3, harms would exceed benefits after 1 h 30 min of cycling per day or more than 10 h of walking per day. If the counterfactual was driving, rather than staying at home, the benefits of PA would exceed harms from air pollution up to 3 h 30 min of cycling per day. The results were sensitive to dose-response function (DRF) assumptions for PM 2.5 and PA. PA benefits of active travel outweighed the harm caused by air pollution in all but the most extreme air pollution concentrations.

The quality of videos on YouTube regarding male UC is widely variable. Preselected videos are deemed useful by junior doctors regarding male UC and can be used as an educational adjunct before performing hands-on tasks.

Dynamic overground endoscopic examination could be considered a suitable means of assessing URT function in TB yearlings and may provide additional pertinent information to that obtained during standard resting examination.

Bacterial environmental and surgical site infection (SSI) surveillance was implemented from 2011–2016 in a UK Equine Referral Veterinary Hospital and identified 81 methicillin-resistant Staphylococcus aureus (MRSA) isolates. A cluster of MRSA SSIs occurred in early 2016 with the isolates confirmed as ST398 by multilocus sequence typing (MLST), which prompted retrospective analysis of all MRSA isolates obtained from the environment (n = 62), SSIs (n = 13) and hand plates (n = 6) in the past five years. Sixty five of these isolates were typed to CC398 and a selection of these (n = 38) were further characterised for resistance and virulence genes, SCCmec and spa typing. Overall, MRSA was identified in 62/540 (11.5%) of environmental samples, 6/81 of the hand-plates (7.4%) and 13/208 of the SSIs (6.3%). spa t011 was the most frequent (24/38) and Based Upon Repeat Pattern (BURP) analysis identified spa t011 as one of the two group founders of the main spa CC identified across the five years (spa CC011/3423). However, 3 singletons (t073, t786, t064) were also identified suggesting separate introductions into the hospital environment. This long-term MRSA surveillance study revealed multiple introductions of MRSA CC398 in a UK Equine Hospital, identifying an emerging zoonotic pathogen so far only sporadically recorded in the UK.

The Ramirez ylide undergoes electrophilic substitution with acetylenedicarboxylates to form Z and E adducts. The latter can react by cycloaddition with another equivalent of the alkyne to provide a new route to novel tetra-substituted azulenes, which show interesting bond localisation and crystal packing effects.

Objective To evaluate two different barbed sutures for closure of pelvic flexure enterotomies and compare results achieved with two previously described closure techniques. Study design Ex vivo. Sample population Twenty‐four fresh cadaver adult equine large colons. Methods Cadavers were randomly assigned to four closure groups (n = 6 each group): single‐layer absorbable suture, double‐layer absorbable suture, single‐layer unidirectional barbed suture, or single‐layer bidirectional barbed suture. Construction time, luminal reduction (percentage), bursting pressure, and method of failure were measured. Cost, leakage, exposed suture, and general appearance were recorded. Comparisons were performed with one‐way analysis of variance and post hoc Bonferroni test (P < .05). Results Double‐layer absorbable closure had the highest bursting pressure (mean = 178.5 mm Hg, SD = 9.79, P < .001) but took more time (P = .001) compared with all other groups. The construction time of both barbed suture closures did not differ from the single‐layer closure (P > .06). Bursting strengths of both unidirectional (mean = 91.6 mm Hg, SD = 5.57) and bidirectional (mean = 87.5 mm Hg, SD = 8.69) barbed sutures were lower (P > .006 for both) than those of both single‐ (mean = 117.6 mm Hg, SD = 11.69) and double‐layer (mean = 178.5 mm Hg, SD = 9.79) closures. Unidirectional barbed suture closure had a reduction in lumen diameter (P = .004) compared with bidirectional and single‐layer closures. Conclusion Enterotomy closures with the two different barbed suture patterns were comparable in bursting strength and construction time. However, the barbed suture patterns had lower bursting strength compared with traditional single‐ and double‐layer closures. Unidirectional barbed suture closure also reduced lumen diameter. Clinical significance Closure of a large colon enterotomy with barbed suture patterns may be less secure than single‐ and double‐layer suture closure.

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Universities are coming under increasing pressure to re-invent the way that engineering is taught in order to produce graduates that are capable of meeting the skills needs of the country’s industries. This paper described an active project where Design Thinking (DT) methodology is being applied in a novel way to Engineering Curriculum Development. Enterprise partners from a range of different manufacturing sectors participated in a series of Curriculum Development workshops and the results were cross referenced with subjects taught on existing engineering programmes internationally. This process highlighted the need for increased training in Lean, 6-Sigma, transversal and soft skills competencies, and the need to review how and when content is delivered. A survey was developed from the results of the workshops and sent out to a larger cohort of industry contacts for feedback on the proposed Engineering curriculum. Design Thinking methodology has helped ensure our customers’ needs are met by building the curriculum framework around competencies identified by both industry and academia while ensuring the students engage in a significant learning experience through experiential and applied learning using the latest immersive technologies.