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Primary leiomyosarcoma (LMS) is a rare type of malignant spindle cell tumor which arises from smooth muscle fibers. It is very uncommon in the oral cavity and only accounts for 4% of all soft tissue sarcomas in head and neck area, with intraosseous presentation even more rare. In this report, we present a new case of primary intraosseous LMS of the mandible and review the literature for previously reported cases. A 19-year-old female presented with an asymptomatic well defined radiolucent lesion of the right body of the mandible.
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Πέμπτη, 17 Αυγούστου 2017
Primary leiomyosarcoma (LMS) is a rare type of malignant spindle cell tumor which arises from smooth muscle fibers. It is very uncommon in the oral cavity and only accounts for 4% of all soft tissue sarcomas in head and neck area, with intraosseous presentation even more rare. In this report, we present a new case of primary intraosseous LMS of the mandible and review the literature for previously reported cases. A 19-year-old female presented with an asymptomatic well defined radiolucent lesion of the right body of the mandible.
We present a case series of oral hairy leukoplakia (OHL), an oral mucosal lesion caused by Epstein-Barr virus (EBV) that is classically seen on the lateral tongue in patients with HIV/AIDS. We report on the features of OHL seen in the University of Pittsburgh Oral Pathology Biopsy Service and Medical Center.
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Odontoameloblastoma (OA) is a rare mixed odontogenic tumor with both ameloblastic (epithelial) and odontoma-like (ectomesenchymal) features. It presents as a unilocular or multilocular radiolucent to mixed lesion with root resorption, boney expansion, and/or jaw pain. Microscopically, the epithelial component often resembles a follicular or plexiform variant of a conventional ameloblastoma. In contrast to an ameloblastoma, however, the surrounding mesenchyme consists of dental hard tissue in the form of a compound or complex odontoma.
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Increased Expiratory Computed Tomography Density Reveals Possible Abnormalities in Radiologically Preserved Lung Parenchyma in Idiopathic Pulmonary Fibrosis.
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Increased Expiratory Computed Tomography Density Reveals Possible Abnormalities in Radiologically Preserved Lung Parenchyma in Idiopathic Pulmonary Fibrosis.
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MR Imaging Biomarkers in Amyotrophic Lateral Sclerosis
Publication date: Available online 16 August 2017
Source:Academic Radiology
Author(s): Elias R. Melhem
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Differences in Texture Analysis Parameters Between Active Alveolitis and Lung Fibrosis in Chest CT of Patients with Systemic Sclerosis
Publication date: Available online 12 August 2017
Source:Academic Radiology
Author(s): Christopher Kloth, Anya C. Blum, Wolfgang M. Thaiss, Heike Preibsch, Hendrik Ditt, Rainer Grimmer, Jan Fritz, Konstantin Nikolaou, Hans Bösmüller, Marius Horger
Rationale and ObjectivesThis study aimed to determine the diagnostic aid of computed tomography (CT) features for the differentiation of active alveolitis and fibrosis using a CT texture analysis (CTTA) prototype and CT densitometry in patients with systemic sclerosis (SSc) using ancillary high-resolution computed tomography (HRCT) features and their longitudinal course as standard of reference.Materials and MethodsWe retrospectively analyzed thin-slice noncontrast chest CT image data of 43 patients with SSc (18 men, mean age 51.55 ± 15.52 years; range 23–71 years). All of them had repeated noncontrast enhanced HRCT of the lung. Classification into active alveolitis or fibrosis was done on HRCT based on classical HRCT findings (active alveolitis [19; 44.2%] and fibrosis [24; 55.8%]) and their course at midterm. Results were compared to pulmonary functional tests and were followed up by CT. Ground glass opacity was considered suggestive of alveolitis, whereas coarse reticulation with parenchymal distortion, traction bronchiectasis, and honeycombing were assigned to fibrosis.ResultsStatistically significant differences in CTTA were found for first-order textural features (mean intensity, average, deviation, skewness) and second-order statistics (entropy of co-occurrence matrix, mean number of nonuniformity (NGLDM), entropy of NGLDM, entropy of heterogeneity, intensity, and average). Cut-off value for the prediction of fibrosis at baseline was significant for entropy of intensity (P value < .001) and for mean deviation (P value < .001), and for prediction of alveolitis was significant for uniformity of intensity (P value < .001) and for NGLDM (P value < .001).At pulmonary functional tests, forced expiratory volume in 1 second and single-breath diffusion capacity for carbon monoxide were significantly lower in fibrosis than in alveolitis 2.03 ± 0.78 vs. 2.61 ± 0.83, P < .016 and 4.51 ± 1.61 vs. 6.04 ± 1.75, P < .009, respectively. Differences in CT densitometry between alveolitis and fibrosis were not significant.ConclusionsCTTA parameters are significantly different in active alveolitis vs. fibrosis in patients with SSc and may be helpful for differentiation of these two entities.
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Introduction of a synthetic Thermococcus-derived α-amlyase gene into barley genome for increased enzyme thermostability in grains
Publication date: Available online 15 August 2017
Source:Electronic Journal of Biotechnology
Author(s): Daniel Mihálik, Marcela Gubišová, Ján Kraic, Martina Hudcovicová, Michaela Havrlentová, Jana Moravčíková, Miroslav Glasa, Ildikó Matušíková
BackgroundThe enzymes utilized in the process of beer production are generally sensitive to higher temperatures. About 60% of them are deactivated in drying the malt that limits the utilization of starting material in the fermentation process. Gene transfer from thermophilic bacteria is a promising tool for producing barley grains harboring thermotolerant enzymes.ResultsGene for α-amylase from hydrothermal Thermococcus, optimally active at 75–85°C and pH between 5.0 and 5.5, was adapted in silico to barley codon usage. The corresponding sequence was put under control of the endosperm-specific promoter 1Dx5 and after synthesis and cloning transferred into barley by biolistics. In addition to model cultivar Golden Promise we transformed three Slovak barley cultivars Pribina, Levan and Nitran, and transgenic plants were obtained. Expression of the ~50kDa active recombinant enzyme in grains of cvs. Pribina and Nitran resulted in retaining up to 9.39% of enzyme activity upon heating to 75°C, which is more than 4 times higher compared to non-transgenic controls. In the model cv. Golden Promise the grain α-amylase activity upon heating was above 9% either, however, the effects of the introduced enzyme were less pronounced (only 1.22 fold difference compared with non-transgenic barley).ConclusionsExpression of the synthetic gene in barley enhanced the residual α-amylase activity in grains at high temperatures.
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Fast three-dimensional whole-body post-mortem magnetic resonance angiography
Publication date: Available online 15 August 2017
Source:Journal of Forensic Radiology and Imaging
Author(s): Patrick J Laberke, Garyfalia Ampanozi, Thomas D Ruder, Dominic Gascho, Michael J Thali, Juergen Fornaro
PurposeThe goal of this study was to perform whole-body post-mortem magnetic resonance (PMMR) angiography with imaging quality comparable to that of post-mortem computed tomography (PMCT) angiography.MethodsAfter contrast medium injection into the arterial and venous vascular system of seven human corpses PMMR was performed using a fast three-dimensional T1 weighted spoiled gradient-echo sequence, followed by PMCT imaging. The contrast medium volumes inside the descending aorta and inside the inferior vena cava were measured both on PMMR and on PMCT images by means of image segmentation. Visualization quality of arterial and venous vessels as a function of contrast filling was scored according to a four-point scale and compared using the paired Wilcoxon signed rank test.ResultsThe contrast medium volume in the descending aorta decreased 12% on average from PMMR to PMCT angiography, while the contrast medium volume in the inferior vena cava increased by 11% on average. A total of 410 vessels were analyzed. Scores for all vessels were statistically significantly smaller for the PMMR angiography when compared to PMCT angiography (p=0.01). No statistically significant differences were found for the subgroups of large vessels (p=0.21), for the head and neck (p=0.16) or the abdomen (p=0.83) as well as for the thorax when the coronary arteries were left out (p=0.23).ConclusionsThis study demonstrates that immediate image acquisition after contrast injection and rapid 3D whole-body image acquisition offers good image quality in PMMR angiography with a vascular contrast comparable to PMCT angiography.
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Maternal hypothyroidism: An overview of current experimental models.
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Maternal hypothyroidism: An overview of current experimental models.
Life Sci. 2017 Aug 11;:
Authors: Ghanbari M, Ghasemi A
Maternal hypothyroidism (MH) is the most common cause of transient congenital hypothyroidism. Different animal models are used for assessing developmental effects of MH in offspring. The severity and status of hypothyroidism in animal models must be a reflection of the actual conditions in humans. To obtain comparable results with different clinical conditions, which lead to MH in humans, several factors have been suggested for researchers to consider before designing the experimental models. Regarding development of fetal body systems during pregnancy, interference at different times provides different results and the appropriate time for induction of hypothyroidism should be selected based on accurate time of development of the system under assessment. Other factors that should be taken into consideration include, physiological and biochemical differences between humans and other species, thyroid hormone-independent effects of anti-thyroid drugs, circadian rhythms in TSH secretion, sex differences, physical and psychological stress. This review addresses essential guidelines for selecting and managing the optimal animal model for MH as well as discussing the pros and cons of currently used models.
PMID: 28807719 [PubMed - as supplied by publisher]
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Encapsulated follicular variant of papillary thyroid cancer: are these tumors really benign?
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Encapsulated follicular variant of papillary thyroid cancer: are these tumors really benign?
J Surg Res. 2017 Aug;216:138-142
Authors: Aburjania Z, Jang S, Montemayor-Garcia C, Lloyd RV, Schneider DF, Sippel RS, Chen H, Elfenbein DM
BACKGROUND: Recent studies suggest that the encapsulated form of follicular variant of papillary thyroid cancer (eFVPTC) behaves more similarly to benign lesions and can be treated with thyroid lobectomy alone instead of total thyroidectomy. To distinguish aggressive cancers from more benign lesions more clearly, the objective of this study was to determine if the eFVPTC behaves less aggressively than the nonencapsulated variant (neFVPTC).
METHODS: A prospectively collected endocrine surgery database in our institution was reviewed for all patients with FVPTC on surgical pathology from 1999 to 2012. Samples were rereviewed to determine if the tumor was eFVPTC or neFVPTC, which were correlated with patient outcomes.
RESULTS: Of the 68 patients, 59 (87%) had eFVPTC and 9 (13%) had neFVPTC. The mean age was 48 y and 63% were female. Fifty-four of 64 patients (84%) who had a total thyroidectomy received radioactive iodine. The eFVPTC group had lower rates of cervical LN involvement (5% versus 22%, P = 0.2504). The median follow-up time was 3 y (0-13 y) and only two patients had recurrence, one with eFVPTC and one with neFVPTC. None of the patients had distant metastasis or died of their disease.
CONCLUSIONS: eFVPTCs appear to have a lower rate of cervical lymph node metastases compared with neFVPTCs, but recurrent disease may be seen in both subtypes. These findings suggest eFVPTC can be managed more conservatively.
PMID: 28807198 [PubMed - in process]
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Long-term outcomes of lateral neck dissection in patients with recurrent or persistent well-differentiated thyroid cancer.
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Long-term outcomes of lateral neck dissection in patients with recurrent or persistent well-differentiated thyroid cancer.
Thyroid. 2017 Aug 15;:
Authors: Chinn SB, Zafereo M, Waguespack SG, Edeiken BS, Roberts DB, Clayman G
BACKGROUND: Well-differentiated thyroid carcinoma (WDTC) has a high predilection for regional metastatic spread; rates for WDTC lateral neck recurrence are reported to be as high as 24% in patients after initial thyroidectomy, lateral neck surgery and adjuvant radioactive iodine treatment (RAI). The objective of the study was to evaluate the efficacy, safety, and long-term outcome of comprehensive lateral neck dissection (LND) of levels II-V for recurrent or persistent WDTC in a tertiary referral center.
METHODS: We retrospectively analyzed our standardized approach of LND for recurrent WDTC in the lateral neck compartment. Survival was analyzed by Cox-regression analysis.
RESULTS: Three-hundred and seven patients underwent 429 LND for cytopathology confirmed lateral neck recurrent WDTC at the University of Texas MD Anderson Cancer Center between 1994 and 2012. The vast majority (90%) of patients were treated originally elsewhere. Multi-level lateral neck dissection had been originally performed in 80% of patients, with 17% having undergone at least 2 previous operations. Two-hundred sixty-seven patients (87%) had previous RAI. The most common levels of recurrence were levels III and IV (33% and 33%, respectively). Post-operative complications were seen in 7% of patients. Median follow-up was 7.2 years. In-field lateral neck control was 96% at 10 years. Overall lateral neck regional control, overall survival (OS) and disease-specific survival (DSS) at 10 years was 88%, 78% and 91% respectively. When stratifying by age (<24 years, 24-50 years and >50 years), OS and DSS was significantly better in patients <50 years (OS: p<0.001 and DSS: p<0.001), however there was worse overall lateral neck control in the younger group (<24 years) (p=0.04). Regional recurrence after salvage LND occurred within a median time interval of 20.0 months (2.9-121.3 months), of which 2% (8/429) developed in-field lateral neck recurrences. Of those with any lateral neck recurrence after salvage LND, 24 out of 30 patients (80%) successfully underwent another LND, resulting in an ultimate 98% lateral neck regional control rate.
CONCLUSIONS: Expert comprehensive LND of levels II-V is associated with few perioperative complications and results in very high in-field regional control rate and ultimate lateral neck control in recurrent/persistent WDTC.
PMID: 28806882 [PubMed - as supplied by publisher]
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Antitumor activity of the dual PI3K/MTOR inhibitor, PF-04691502, in combination with radiation in head and neck cancer
Publication date: Available online 16 August 2017
Source:Radiotherapy and Oncology
Author(s): Nathan Tonlaar, Sandra Galoforo, Bryan J. Thibodeau, Samreen Ahmed, Thomas G. Wilson, Paola Yumpo Cardenas, Brian Marples, George D. Wilson
Background and purposeHead and neck squamous cell carcinoma (HNSCC) remains a clinical challenge where new treatments are required to supplement the current-standard-of care of concurrent chemoradiation. The PI3K/AKT/MTOR pathway has been identified from several next generation DNA sequencing studies to be commonly altered and activated in HNSCC.Material and methodsIn this study we investigated the activity of PF-04691502, an orally active ATP-competitive, dual inhibitor of PI3K and mTOR, in combination with a clinically relevant fractionated radiation treatment in two contrasting, well characterized, low passage HNSCC models.ResultsWe found that PF-04691502 combined synergistically with radiation in the UT-SCC-14 model derived from a primary cancer but was ineffective in the UT-SCC-15 model which was derived from a nodal recurrence. Further examination of the status of key signaling pathways combined with next generation DNA sequencing of a panel of 160 cancer-associated genes revealed crucial differences between the two models that could account for the differential effect. The UT-SCC-15 cell line was characterized by a higher mutational burden, an excess of variants in the PI3K/AKT/MTOR pathway, increased constitutive activity of PI3K, AKT1 and 2 and MTOR and an inability to inhibit key phosphorylation events in response to the treatments.ConclusionThis study clearly highlights the promise of agents such as PF-04691502 in selected HNSCCs but also emphasizes the need for molecular characterization and alternative treatment strategies in non-responsive HNSCCs.
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Development of a virtual spacer to support the decision for the placement of an implantable rectum spacer for prostate cancer radiotherapy: Comparison of dose, toxicity and cost-effectiveness
Publication date: Available online 16 August 2017
Source:Radiotherapy and Oncology
Author(s): Yvonka van Wijk, Ben G.L. Vanneste, Sean Walsh, Skadi van der Meer, Bram Ramaekers, Wouter van Elmpt, Michael Pinkawa, Philippe Lambin
IntroductionPrevious studies have shown that the implantable rectum spacer (IRS) is not beneficial for all patients. A virtual IRS (V-IRS) was constructed to help identify the patients for whom it is cost-effective to implant an IRS, and its viability as a tool to tailor the decision of an IRS implantation to be beneficial for the specified patient was assessed. Please watch animation:(https://www.youtube.com/watch?v=tDlagSXMKqw)Materials and methodsThe V-IRS was tested on 16 patients: 8 with a rectal balloon implant (RBI) and 8 with a hydrogel spacer. A V-IRS was developed using 7 computed tomography (CT) scans of patients with a RBI. To examine the V-IRS, CT scans before and after the implantation of an IRS were used. IMRT plans were made based on CT scans before the IRS, after IRS and with the V-IRS, prescribing 70 Gray (Gy) to the planning target volume. Toxicity was accessed using externally validated normal tissue complication probability (NTCP) models, and the Cost-effectiveness was analyzed using a published Markov model.ResultsThe rectum volume receiving 75Gy (V75) were improved by both the IRS and the V-IRS with on average 4.2% and 4.3% respectively. The largest NTCP reduction resulting from the IRS and the V-IRS was 4.0% and 3.9% respectively. The RBI was cost-effective for 1 out of 8 patients, and the hydrogel was effective for 2 out of 8 patients, and close to effective for a third patient. The classification accuracy of the model, regarding cost-effectiveness, was 100%.ConclusionThe V-IRS approach in combination with a toxicity prediction model and a cost-effectiveness analyses is a promising basis for a decision support tool for the implantation of either a hydrogel spacer or a rectum balloon implant.
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Sparing all salivary glands with IMRT for head and neck cancer: Longitudinal study of patient-reported xerostomia and head-and-neck quality of life
Publication date: Available online 16 August 2017
Source:Radiotherapy and Oncology
Author(s): Peter G. Hawkins, Jae Y. Lee, Yanping Mao, Pin Li, Michael Green, Francis P. Worden, Paul L. Swiecicki, Michelle L. Mierzwa, Matthew E. Spector, Matthew J. Schipper, Avraham Eisbruch
Background and purposeWhile parotid-sparing intensity modulated radiotherapy (IMRT) has demonstrated superiority to conventional RT in terms of observer-rated xerostomia, patient-reported outcome measures (PROMs) have only marginally improved. We investigated how sparing all salivary glands affects PROMs.Materials and methodsPatients treated to the bilateral neck with all-gland-sparing IMRT answered xerostomia (XQ) and head-and-neck quality of life (HNQOL) questionnaires. Longitudinal regression was used to assess the relationship between questionnaire scores and mean bilateral parotid gland (bPG), contralateral submandibular gland (cSMG), and oral cavity (OC) doses. Marginal R2 and Akaike information criterion (AIC) were used for model evaluation.Results252 patients completed approximately 600 questionnaires. On univariate analysis, bPG, cSMG, and OC doses significantly correlated with XQ-summary, XQ-eating, and HNQOL-eating scores. On multivariate analysis, bPG and OC doses significantly correlated with XQ-summary, XQ-eating, and HNQOL-eating scores; and cSMG dose with HNQOL-summary. Combining doses to all three structures yielded the highest R2 for XQ-summary, XQ-rest, XQ-eating, and HNQOL-eating. In the 147 patients who received a mean cSMG dose ≤39Gy, there were no failures in contralateral level IB.ConclusionsReducing doses to all salivary glands maximizes PROMs. A cSMG dose constraint of ≤39Gy does not increase failure risk.
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Treatment of the ventral intermediate nucleus for medically refractory tremor: A cost-analysis of stereotactic radiosurgery versus deep brain stimulation
Publication date: Available online 14 August 2017
Source:Radiotherapy and Oncology
Author(s): Shearwood McClelland, Jerry J. Jaboin
IntroductionMedically refractory tremor treatment has evolved over the past half-century from intraoperative thalamotomy to deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM). Within the past 15years, unilateral radiosurgical VIM thalamotomy has emerged as a comparably efficacious treatment modality.MethodsAn extensive literature search of VIM DBS series was performed; the total cost of VIM DBS was calculated from hospitals geographically representative of the entire United States using current procedural terminology and work relative value unit (RVU) codes. The 2016 Medicare Ambulatory Payment Classification for stereotactic radiosurgery (SRS) was added to the work RVU to determine the total cost of VIM SRS for both Gamma Knife and linear accelerator SRS. Cost estimates assumed that VIM DBS was performed without intraoperative microelectrode recording.ResultThe mean unilateral VIM DBS cost was $17,932.41 per patient. For SRS VIM, the total costs for Gamma Knife ($10,811.77) and linear accelerator ($10,726.40) were 40% less expensive than for unilateral VIM DBS.ConclusionRadiosurgery of the VIM is 40% less expensive than unilateral VIM DBS in treatment of medically refractory tremor, regardless of radiosurgical modality. This finding argues for increased radiation oncology involvement in the management of medically refractory tremor patients.
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Patient safety is improved with an incident learning system—Clinical evidence in brachytherapy
Publication date: Available online 17 August 2017
Source:Radiotherapy and Oncology
Author(s): Christopher L. Deufel, Luke B. McLemore, Luis E. Fong de los Santos, Kelly L. Classic, Sean S. Park, Keith M. Furutani
Background and purposeHealth leaders have advocated for incident learning systems (ILSs) to prevent errors, but there is limited evidence demonstrating that ILSs improve cancer patient safety. Herein, we report a long-term retrospective review of ILS reports for the brachytherapy practice at a large academic institution.Material and methodsOver a nine-year period, the brachytherapy practice was encouraged to report all standard operating procedure deviations, including low risk deviations. A multidisciplinary committee assigned root causes and risk scores to all incidents. Evidence based practice changes were made using ILS data, and relevant incidents were communicated to all staff in order to reduce recurrence rates.Results5258 brachytherapy procedures were performed and 2238 incidents were reported from 2007 to 2015. A ramp-up period was observed in ILS participation between 2007 (0.12 submissions/procedures) and 2011 (1.55 submissions/procedures). Participation remained stable between 2011 and 2015, and we achieved a 60% (p<0.001) decrease in the risk of dose error or violation of radiation safety policy and a 70% (p<0.001) decrease in frequency of high composite-risk scores. Significant decreases were also observed in incidents with root causes of poor communication (60% decrease, p<0.001) and poor quality of written procedures (59% decrease, p<0.001).ConclusionsImplementation of an ILS in brachytherapy significantly reduced risk during cancer patient care. Safety improvements have been sustained over several years.
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Radioecological assessment and radiometric dating of sediment cores from dynamic sedimentary systems of Pra and Volta estuaries (Ghana) along the Equatorial Atlantic
Publication date: November 2017
Source:Journal of Environmental Radioactivity, Volumes 178–179
Author(s): E. Klubi, J.M. Abril, E. Nyarko, A. Laissaoui, M. Benmansour
The Volta and Pra estuaries (Ghana, West Africa) are dynamical sedimentary systems whose natural equilibrium is being affected by anthropogenic activities. This paper reports depth-distributions of 210Pb, 226Ra, 234Th, 40K, 228Ra and 137Cs for two sediment cores from these estuaries. Bulk densities were not steady-state and well correlated with 40K (p < 0.00005). Unsupported 210Pb profiles were incomplete, non-monotonic and showed large fluctuations. The assumptions involved in the common 210Pb-based dating models were not meet in these dynamical scenarios, and the use of 137Cs as a time-marker is difficult in Equatorial and South-Hemisphere countries due to its low fallout rates. Chronologies have been solved with the new 210Pb-based TERESA model, which operates with varying but statistically correlated fluxes and sediment accumulation rates (SAR). The core from the Volta reflects the conditions prevailing after the construction of the Akosombo Dam, with a mean SAR of 1.05 ± 0.03 g cm−2·y−1, while a higher value of 2.73 ± 0.06 g cm−2·y−1 was found in the Pra, affected by intense gold mining activities along its course. Radiological and radioecological assessments have been conducted by applying the UNSCEAR protocols and the ERICA model, respectively. The measured radionuclide concentrations do not pose any significant risk for the environment and human health.
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Improved performance comparisons of radioxenon systems for low level releases in nuclear explosion monitoring
Publication date: November 2017
Source:Journal of Environmental Radioactivity, Volumes 178–179
Author(s): Derek A. Haas, Paul W. Eslinger, Theodore W. Bowyer, Ian M. Cameron, James C. Hayes, Justin D. Lowrey, Harry S. Miley
The Comprehensive Nuclear-Test-Ban Treaty bans all nuclear tests and mandates development of verification measures to detect treaty violations. One verification measure is detection of radioactive xenon isotopes produced in the fission of actinides. The International Monitoring System (IMS) currently deploys automated radioxenon systems that can detect four radioxenon isotopes. Radioxenon systems with lower detection limits are currently in development. Historically, the sensitivity of radioxenon systems was measured by the minimum detectable concentration for each isotope. In this paper we analyze the response of radioxenon systems using rigorous metrics in conjunction with hypothetical representative releases indicative of an underground nuclear explosion instead of using only minimum detectable concentrations. Our analyses incorporate the impact of potential spectral interferences on detection limits and the importance of measuring isotopic ratios of the relevant radioxenon isotopes in order to improve discrimination from background sources particularly for low-level releases. To provide a sufficient data set for analysis, hypothetical representative releases are simulated every day from the same location for an entire year. The performance of three types of samplers are evaluated assuming they are located at 15 IMS radionuclide stations in the region of the release point. The performance of two IMS-deployed samplers and a next-generation system is compared with proposed metrics for detection and discrimination using representative releases from the nuclear test site used by the Democratic People's Republic of Korea.
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Applications of radon and radium isotopes to determine submarine groundwater discharge and flushing times in Todos os Santos Bay, Brazil
Publication date: November 2017
Source:Journal of Environmental Radioactivity, Volumes 178–179
Author(s): Vanessa Hatje, Karina Kammer Attisano, Marcelo Friederichs Landim de Souza, Barbara Mazzilli, Joselene de Oliveira, Tamires de Araújo Mora, William C. Burnett
Todos os Santos Bay (BTS) is the 2nd largest bay in Brazil and an important resource for the people of the State of Bahia. We made measurements of radon and radium in selected areas of the bay to evaluate if these tracers could provide estimates of submarine groundwater discharge (SGD) and flushing times of the Paraguaçu Estuary and BTS. We found that there were a few areas along the eastern and northeastern shorelines that displayed relatively high radon and low salinities, indicating possible sites of enhanced SGD. A time-series mooring over a tidal cycle at Marina do Bonfim showed a systematic enrichment of the short-lived radium isotopes 223Ra and 224Ra during the falling tide. Assuming that the elevated radium isotopes were related to SGD and using measured radium activities from a shallow well at the site, we estimated groundwater seepage at about 70 m3/day per unit width of shoreline. Extrapolating to an estimated total shoreline length provided a first approximation of total (fresh + saline) SGD into BTS of 300 m3/s, about 3 times the average river discharge into the bay. Just applying the shoreline lengths from areas identified with high radon and reduced salinity results in a lower SGD estimate of 20 m3/s. Flushing times of the Paraguaçu Estuary were estimated at about 3–4 days based on changing radium isotope ratios from low to high salinities. The flushing time for the entire BTS was also attempted using the same approach and resulted in a surprisingly low value of only 6–8 days. Although physical oceanographic models have proposed flushing times on the order of months, a simple tidal prism calculation provided results in the range of 4–7 days, consistent with the radium approach. Based on these initial results, we recommend a strategy for refining both SGD and flushing time estimates.
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Temporary Hearing Threshold Shift in Healthy Volunteers with Hearing Protection Caused by Acoustic Noise Exposure during 3-T Multisequence MR Neuroimaging.
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Temporary Hearing Threshold Shift in Healthy Volunteers with Hearing Protection Caused by Acoustic Noise Exposure during 3-T Multisequence MR Neuroimaging.
Radiology. 2017 Aug 16;:161622
Authors: Jin C, Li H, Li X, Wang M, Liu C, Guo J, Yang J
Purpose To determine whether a single 51-minute exposure to acoustic noise during 3-T multisequence magnetic resonance (MR) neuroimaging could affect the hearing threshold of healthy adults with earplugs and sponge mats as hearing protection. Materials and Methods With earplugs and motion-refraining sponge mats as hearing protection, 26 healthy young adults underwent 3-T MR neuroimaging imaging that included T1-weighted three-dimensional gradient-echo sequence, T2-weighted fast spin-echo sequence, diffusion-tensor imaging, diffusion-kurtosis imaging, T2*-weighted three-dimensional multiecho gradient-echo sequence, and blood oxygen level-dependent imaging. Automated auditory brainstem response (ABR) was used to measure the hearing thresholds within 24 hours before, within 20 minutes after, and 25 days after the MR examination. One-way repeated-measure analysis of variance with Bonferroni adjustment was used to compare automated ABR results among the three tests and partial η(2) (ηp(2)) was reported as a measure of effect size. Results Automated ABR results showed significantly increased mean threshold shift of 5.0 dB ± 8.1 (standard deviation) (left ear: 4.8 dB ± 9.2 [95% confidence interval: 1.09, 8.53], ηp(2) = 0.221, P = .013; right ear: 5.2 dB ± 6.9 [95% confidence interval: 2.36, 8.02], ηp(2) = 0.364, P = .001) immediately after the MR examination compared with the baseline study. This shift is below the temporary threshold shift of 40-50 dB that is associated with cochlea nerve changes. Automated ABR obtained at day 25 after MR imaging showed no significant differences from baseline (left ear: -2.3 dB ± 8.6 [95% confidence interval: -5.79, 1.78], ηp(2) = 0.069, P = .185; right ear: 0.4 dB ± 7.3 [95% confidence interval: -3.35, 2.58], ηp(2) = 0.003, P = .791). Conclusion A 3-T MR neuroimaging examination with the acoustic noise at equivalent sound pressure level of 103.5-111.3 dBA lasting 51 minutes can cause temporary hearing threshold shift in healthy volunteers with hearing protection. (©) RSNA, 2017.
PMID: 28813235 [PubMed - as supplied by publisher]
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Cardiac MR Strain: A Noninvasive Biomarker of Fibrofatty Remodeling of the Left Atrial Myocardium.
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Cardiac MR Strain: A Noninvasive Biomarker of Fibrofatty Remodeling of the Left Atrial Myocardium.
Radiology. 2017 Aug 16;:162787
Authors: Huber AT, Lamy J, Rahhal A, Evin M, Atassi F, Defrance C, Lebreton G, Clément K, Berthet M, Isnard R, Leprince P, Cluzel P, Hatem SN, Kachenoura N, Redheuil A
Purpose To determine whether left atrial (LA) strain quantification with cardiac magnetic resonance (MR) imaging feature tracking is associated with the severity of LA fibrofatty myocardial remodeling at histologic analysis. Materials and Methods This prospective case-control study was approved by the institutional review board. LA strain was evaluated with cardiac MR feature tracking between January 2014 and March 2015 in 13 consecutive patients (mean age, 61 years ± 19; nine male) with mitral regurgitation in the 24 hours before mitral valve surgery and 13 age- and sex-matched healthy control subjects. LA strain parameters were compared first between control subjects and patients and then according to atrial fibrillation and mitral regurgitation status. Associations between LA strain and histology of preoperative biopsies were reported by using receiver operating characteristic curve analysis and Spearman correlation. Results Peak longitudinal atrial strain (PLAS) was significantly lower in patients with mitral regurgitation than in healthy control subjects (P < .001). Increased LA remodeling was significantly related to altered LA strain, and the strongest association was found between PLAS and the degree of fibrofatty myocardial replacement at histologic analysis (r = -0.75, P = .017). LA end-diastolic volume was increased in patients with mitral regurgitation when compared with that in healthy volunteers (P < .001) because of volume overload; however, volume did not correlate with the histologic degree of LA fibrofatty replacement (r = -0.35, P = .330). Conclusion LA strain, especially PLAS, correlates strongly with the degree of fibrofatty replacement at histologic analysis. Such functional imaging biomarker in combination with LA volumetry could help to guide clinical decisions, since myocardial structural remodeling is a known morphologic substrate of LA dysfunction leading to atrial fibrillation with adverse outcome. (©) RSNA, 2017 Online supplemental material is available for this article.
PMID: 28813234 [PubMed - as supplied by publisher]
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Risk of Meningioma after CT of the Head.
|Related Articles
Risk of Meningioma after CT of the Head.
Radiology. 2017 Aug 14;:161433
Authors: Nordenskjöld AC, Bujila R, Aspelin P, Flodmark O, Kaijser M
Purpose To investigate the association between exposure to head computed tomography (CT) and subsequent risk of meningioma. Materials and Methods The study was approved by the local ethics committee. A cohort of 26 370 subjects was retrospectively collected from a radiology archive of CT examinations of the head performed from 1973 through 1992. For comparison, an age- and sex-matched cohort of 96 940 subjects who were not exposed to CT (unexposed cohort) was gathered. The risk of meningioma was assessed by using data from the Swedish Cancer Registry; however, one-third of patients with meningioma had to be excluded because they either had a prevalent meningioma or other brain tumor at the first CT examination or had undergone radiation treatment to the head. Hazard ratios (HRs) were calculated from time of exposure to the occurrence of meningioma or death or until December 31, 2010, with logistic regression. Results Comparison of exposed and unexposed cohorts showed that there was no statistically significant increase in the risk of meningioma after exposure to CT of the head (HR: 1.49; 95% confidence interval: 0.97, 2.30; P = .07). If incident cases at the time of the first CT examination were not excluded, the risk of meningioma would have been falsely increased (HR: 2.28; 95% confidence interval: 1.56, 3.33; P = .0001). Conclusion When prevalent cases of meningioma at first exposure to CT of the head are excluded, no statistically significant increase in risk of meningioma was found among exposed subjects compared with unexposed control subjects. (©) RSNA, 2017.
PMID: 28809584 [PubMed - as supplied by publisher]
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Iodixanol versus Iopromide at Coronary CT Angiography: Lumen Opacification and Effect on Heart Rhythm-the Randomized IsoCOR Trial.
|Related Articles
Iodixanol versus Iopromide at Coronary CT Angiography: Lumen Opacification and Effect on Heart Rhythm-the Randomized IsoCOR Trial.
Radiology. 2017 Aug 15;:162779
Authors: Lubbers MM, Kock M, Niezen A, Galema T, Kofflard M, Bruning T, Kooij HS, van Valen H, Dijkshoorn M, Booij R, Padmos A, Vogels A, Budde RPJ, Nieman K
Purpose To show that equal coronary lumen opacification can be achieved with iso- and low-osmolar contrast media when it is injected at the same iodine delivery rate with contemporary cardiac computed tomographic (CT) protocols and to investigate the cardiovascular effect of iso-osmolar contrast media and the image quality achieved. Materials and Methods Institutional review board approval and written informed consent were obtained for the Effect of Iso-osmolar Contrast Medium on Coronary Opacification and Heart Rhythm in Coronary CT Angiography, or IsoCOR, trial. Between November 2015 and August 2016, 306 patients (167 [55%] women) at least 18 years old (weight range, 50-125 kg), were prospectively randomized to receive iso-osmolar iodixanol 270 or low-osmolar iopromide 300 contrast media. All coronary segments were assessed for intraluminal opacification and image quality and were compared by using the Student t test. Heart rate, arrhythmia, patient discomfort, and adverse events also were monitored. Results Mean measured coronary attenuation values ± standard deviation were comparable between the iodixanol 270 and iopromide 300 contrast media groups (469 HU ± 167 vs 447 HU ± 166, respectively [P = .241]; 95% confidence interval: -15.1, 60.0), including those from subanalyses. Adjusted for the lower iodine concentration, the mean iodixanol 270 bolus was larger compared with that of iopromide 300 (76.8 mL ± 11.6 vs 69.7 mL ± 10.8, respectively; P < .001). The higher injection rate was associated with higher pressure (777 kPa ± 308 vs 630 kPa ± 252, respectively; P < .001). Although in the iodixanol 270 group patients experienced less heat discomfort (72% vs 86%, respectively; P < .001), no differences in heart rate or rhythm were observed. Conclusion If injected at comparable iodine delivery rates, the iso-osmolar contrast medium iodixanol 270 is not inferior to low-osmolar contrast medium iopromide 300 for assessment of coronary opacification. Iodixanol 270 was associated with less heat discomfort, but did not affect heart rate differently compared with iopromide 300. (©) RSNA, 2017 Online supplemental material is available for this article.
PMID: 28809582 [PubMed - as supplied by publisher]
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Quantitative approach to the posterior cranial fossa and craniocervical junction in asymptomatic children with achondroplasia
We propose an magnetic resonance imaging (MRI)-based quantitative morphovolumetric approach to the posterior cranial fossa (PCF) and craniocervical junction (CCJ) changes in achondroplastic patients investigating possible associations with ventriculomegaly and medullary compression.
We analyzed MRI of 13 achondroplastic children not treated by surgery. 3D FSPGR T1-weighted images were used to analyze (1) PCF synchondroses; (2) PCF volume (PCFV), PCF brain volume (PCFBV), PCFV/PCFBV ratio, cerebellar volume, cerebrospinal fluid (CSF) spaces volume, and IV ventricle volume; (3) PCF (clivus, supraocciput, exocciput lengths, tentorial angle) and CCJ (AP and LL diameters of foramen magnum (FM)) morphometry; (4) measurements of FM and jugular foramina (JF) areas; and (5) supratentorial ventricular volume.
All patients showed synostosis of spheno-occipital synchondroses, eight showed synostosis of intra-occipital synchondroses, nine showed CCJ impingement on the cervical cord but only three had cervical myelopathy. Compared to controls, clivus and exocciput lengths, LL and AP diameters of FM, FM area and JF area were significantly reduced, supraocciput length, tentorial angle, PCFV, PCFBV, cerebellar volume, supratentorial ventricular system volume were significantly increased. A correlation was found between clivus length and supratentorial ventricular volume, premature closure of intra-occipital synchondroses and FM area while a trend was found between FM area and supraocciput length.
Our analysis demonstrates a relationship between the shortening of the clivus and the ventriculomegaly. On the other hand the premature closure of PCF synchondroses, the shape, and the growth direction of supraocciput bone contribute to reduce the FM area, causing in some patients medullary compression.
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Bildgebende Verfahren der modernen Schockraumdiagnostik
Das moderne Schockraummanagement setzt die interdisziplinäre Zusammenarbeit sowie die horizontale Kommunikation eines Kernteams aus Anästhesisten, Chirurgen und Radiologen voraus. Da die Verweildauer im Schockraum die Behandlungsergebnisse und die Morbidität/Letalität eines Schwerverletzten beeinflusst, stellt die Zeitoptimierung eines der Hauptziele dar. Mithilfe der direkten Einbindung moderner bildgebender Verfahren sollen die Traumaschäden binnen kürzester Zeit erkannt werden, um ein prioritätenorientiertes Vorgehen bezüglich der Therapie zu ermöglichen. Die Radiologie nimmt Einfluss auf die Struktur- und Prozessqualität, das Management und die Weiterentwicklung der Schockraumalgorithmen im Hinblick auf den Einsatz bildgebender Verfahren. Im Einzelfall wird dies durch interventionelle Therapieverfahren ergänzt. Basierend auf der gegenwärtigen Datenlage und den Frankfurter Erfahrungen werden die aktuellen diagnostischen Konzepte in der Schockraumdiagnostik vorgestellt.
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Quantitative approach to the posterior cranial fossa and craniocervical junction in asymptomatic children with achondroplasia
We propose an magnetic resonance imaging (MRI)-based quantitative morphovolumetric approach to the posterior cranial fossa (PCF) and craniocervical junction (CCJ) changes in achondroplastic patients investigating possible associations with ventriculomegaly and medullary compression.
We analyzed MRI of 13 achondroplastic children not treated by surgery. 3D FSPGR T1-weighted images were used to analyze (1) PCF synchondroses; (2) PCF volume (PCFV), PCF brain volume (PCFBV), PCFV/PCFBV ratio, cerebellar volume, cerebrospinal fluid (CSF) spaces volume, and IV ventricle volume; (3) PCF (clivus, supraocciput, exocciput lengths, tentorial angle) and CCJ (AP and LL diameters of foramen magnum (FM)) morphometry; (4) measurements of FM and jugular foramina (JF) areas; and (5) supratentorial ventricular volume.
All patients showed synostosis of spheno-occipital synchondroses, eight showed synostosis of intra-occipital synchondroses, nine showed CCJ impingement on the cervical cord but only three had cervical myelopathy. Compared to controls, clivus and exocciput lengths, LL and AP diameters of FM, FM area and JF area were significantly reduced, supraocciput length, tentorial angle, PCFV, PCFBV, cerebellar volume, supratentorial ventricular system volume were significantly increased. A correlation was found between clivus length and supratentorial ventricular volume, premature closure of intra-occipital synchondroses and FM area while a trend was found between FM area and supraocciput length.
Our analysis demonstrates a relationship between the shortening of the clivus and the ventriculomegaly. On the other hand the premature closure of PCF synchondroses, the shape, and the growth direction of supraocciput bone contribute to reduce the FM area, causing in some patients medullary compression.
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New techniques in interventional neuroradiology: Should we really randomize the first patient?
Publication date: Available online 12 August 2017
Source:Journal of Neuroradiology
Author(s): L. Pierot, L. Kanagaratnam, M. Gawlitza, S. Soize, M. Dramé
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Aviation safety investigations & reports
Total power loss involving a Mooney M20J, VH-NFP, at Canberra Airport, ACT, 2 June 2013
On 2 June 2013, the pilot of a Mooney M20J aircraft, registered VH‑NFP (NFP), conducted his pre-flight checks at Canberra Airport, Australian Capital Territory for a private flight to Albury, New South Wales under visual flight rules.
As it had rained at Canberra Airport earlier in the morning, the pilot paid particular attention to conducting pre-flight fuel drains and checking for water, with none found.
During the take-off run, at about 1038 Eastern Standard Time, the pilot reported that all cockpit indications were normal, the aircraft obtained full power and achieved the expected rotate speed followed by a positive rate of climb.
The pilot retracted the landing gear at about 100 ft above ground level. Within seconds of retracting the gear, the engine stopped. The aircraft descended and landed on the runway heavily on the left wing and landing gear, with the propeller striking the ground. The aircraft was substantially damaged and the pilot suffered minor injuries.
An inspection of the engine after the accident revealed water in the left tank, fuel system and fuel injector lines. The pilot reported that he contacted the Mooney Service Centre and was advised that incorrect re-sealing of the M20 series aircraft fuel tanks could allow 1 to 2 litres of water to be retained in the wing, which could not be drained.
This accident highlights the importance of currency in emergency procedures training. A pre-take-off safety briefing can remind the pilot of the procedure in event of an engine failure at low altitude. Controlling the aircraft at low altitude and maintaining airspeed can reduce the severity of these incidents.
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General details
|02 June 2013
|Investigation status:
|Investigation level:
|Short - click for an explanation of investigation levels
|Location (show map):
|Canberra Airport
|Australian Capital Territory
|Occurrence type:
|Engine failure or malfunction
|Release date:
|17 September 2013
|Occurrence category:
|Report status:
|Highest injury level:
Aircraft details
|Aircraft manufacturer
|Mooney Aircraft Corp
|Aircraft model
|Aircraft registration
|Serial number
|Type of operation
|Damage to aircraft
|Departure point
|Canberra, ACT
|Albury, NSW

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Dating Beautiful Women Is Not As Difficult As You Think Posted by Learn to Approach | Filed under Dating
Most guys believe that when it comes to beautiful women they stand no chance or are not up to the task. Though most people may not know this, most women have an inner sense that helps them notice the lack of confidence in a guy.
This negative attitude not only puts off the woman you want to pick up, it may also make her walk away leaving in you in an embarrassing situation. Therefore, the most important thing here is to have a lot of confidence but you should not be too over-confident. To a woman, having confidence may actually make a guy look better than just having good looks with zero confidence. The next tip concerns being comfortable. Even though you are around a beautiful woman, it does not mean that you have to resort to some stupid actions just to please that woman. In actual fact these actions may end up having the opposite effect and you lose your chance. Most guys are unable to be comfortable in the presence of such women and thud result in weak attempts that may ultimately flop in their faces.
Thirdly, remember to always keep your cool especially when you are around a beautiful girl. Though it is well known that a woman's beauty often causes a guy to do some bone headed stuff, being calm and patient will actually attract the woman to you than some of the other rash actions. At first this may seem like an uphill task, but over time and with a little effort you may just see the fruits of remaining calm.
All in all, dating a beautiful woman is not at all hard. Sure you may have some impulses to do some stupid things and at times you may feel a drop in confidence, however, remember to believe in yourself and in who you are. Women are not all about money and looks. This is a just a common misconception. A woman needs you to have all of the above qualities to fall into your arms. Just get out there and start approaching women and you will be amazed at how well things work out.


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Foodborne diseases are defined as diseases associated with the ingestion of contaminated food.(1) Each year, foodborne illnesses cause 1 in 6 Americans (or 48 million Americans) to get sick, 128,000 to be hospitalized, and 3,000 to die.(2) The World Health Organization (WHO) estimates that each year 60 million people, almost 1 in 10 people in the world, become ill after eating contaminated food and 420,000 die. Children under 5 years of age carry the highest burden of foodborne disease acccouting for 125,000 deaths each year.(3) The World Health Organization (WHO) lists the major concerns for food safety:
The WHO reports that diarrheal diseases are the most common illnesses resulting from the consumption of contaminated food, and are estimated to cause 550 million people to fall ill and 230,000 deaths every year.(4)
There are 31 foodborne pathogens known today. The majority (80%) of foodborne illnesses are due to unspecified agents. The leading causes (among known pathogens) of foodborne illness include:
Although norovirus usually only causes mild illness, it is the leading cause of foodborne illness because it affects so many people. Norovirus is highly contagious and can infect anyone. An individual can become infected with norovirus multiple times. This virus is the most common cause of gastroenteritis in the United States.(6)
Table of Common Foodborne Pathogens(7)
Associated Foods
Symptoms and Potential Impact
Campylobacter jejuni
Contaminated water, raw or unpasteurized milk, and raw or undercooked meat, poultry, or shellfish.
Diarrhea (sometimes bloody), cramping, abdominal pain, and fever that appear 2 to 5 days after eating; may last 7 days. May spread to bloodstream and cause a life- threatening infection.
Cook meat and poultry to a safe minimum internal temperature; do not drink or consume unpasteurized milk or milk products; wash your hands after coming in contact with feces.
Clostridium botulinum
Improperly canned foods, garlic in oil, vacuum-packed and tightly wrapped food.
Bacteria produce a nerve toxin that causes illness, affecting the nervous system. Toxin affects the nervous system. Symptoms usually appear 18 to 36 hours, but can sometimes appear as few as 6 hours or as many as 10 days after eating; double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. If untreated, these symptoms may progress causing muscle paralysis and even death.
Do not use damaged canned foods or canned foods showing signs of swelling, leakage, punctures, holes, fractures, extensive deep rusting, or crushing/denting severe enough to prevent normal stacking.
Clostridium perfringens
Meats, meat products and gravy Called "the cafeteria germ" because many outbreaks result from food left for long periods in steam tables or at room temperature.
Intense abdominal cramps nausea, and diarrhea may appear 6 to 24 hours after eating; usually last about 1 day, but for immune comprised individuals, symptoms may last 1 to 2 weeks. Complications and/or death can occur only very rarely.
Keep hot foods hot and cold foods cold! Once food is cooked, it should be held hot, at an internal temperature of 140 °F or above. Use a food thermometer to make sure. Discard all perishable foods left at room temperature longer than 2 hours; 1 hour in temperatures above 90 °F.
Soil, food, water, contaminated surfaces. Swallowing contaminated water, including that from recreational sources, (e.g., a swimming pool or lake); eating uncooked or contaminated food; placing a contaminated object in the mouth.
Dehydration, weight loss, stomach cramps or pain, fever, nausea, and vomiting; respiratory symptoms may also be present. Symptoms begin 2 to 10 days after becoming infected, and may last 1 to 2 weeks. Immune-comprised individuals may experience a more serious illness.
Wash your hands before and after handling raw meat products, and after changing diapers, going to the bathroom, or touching animals. Avoid water that might be contaminated. (Do not drink untreated water from shallow wells, lakes, rivers, springs, ponds, and streams.)
Escherichia coli
Uncooked beef (especially ground beef), unpasteurized milk and juices (e.g., "fresh" apple cider); contaminated raw fruits and vegetables, or water. Person to person contamination can also occur.
Severe diarrhea (often bloody diarrhea), abdominal cramps, and vomiting. Usually little or no fever. Can begin 2 to 8 days, but usually 3-4 days after consumption of contaminated food or water and last about 5 to 7 days depending on severity. Children under 5 are at greater risk of developing hemolytic uremic syndrome (HUS), which causes acute kidney failure.
Cook hamburgers and ground beef to a safe minimum internal temperature of 160°F. Drink only pasteurized milk, juice, or cider. Rinse fruits and vegetables under running tap water, especially those that will not be cooked. Wash your hands with warm water and soap after changing diapers, using the bathroom, handling pets or having any contact with feces.
Listeria monocytogenes
Ready-to-eat foods such as hot dogs, luncheon meats, cold cuts, fermented or dry sausage, and other deli-style meat and poultry. Also, soft cheeses made with unpasteurized milk. Smoked seafood and salads made in the store such as ham salad, chicken salad, or seafood salad.
Fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea or diarrhea. If infection spreads to the nervous system, symptoms such as headache, stiff neck, confusion, loss of balance, or convulsions can occur. Those at risk (including pregnant women and newborns, older adults, and people with weakened immune systems) may later develop more serious illness; death can result from Listeria. Can cause severe problems with pregnancy, including miscarriage or death in newborns.
Cook raw meat, poultry and seafood to a safe minimum internal temperature; prevent cross contamination, separating ready to eat foods from raw eggs, and raw meat, poultry, seafood, and their juices; wash your hands before and after handling raw meat ,poultry, seafood and egg products. Those with a weakened immune system should avoid eating hot dogs, and deli meats, unless they are reheated to 165 ºF or steaming hot. Do not drink raw (unpasteurized) milk or foods that have unpasteurized milk in them, (e.g. soft cheeses). Do not eat deli salads made in store, such as ham, egg, tuna or seafood salad.
Salmonella(over 2300 types)
Raw or undercooked eggs, poultry, and meat; unpasteurized milk and juice; cheese and seafood; and contaminated fresh fruits and vegetables.
Diarrhea, fever, and abdominal cramps usually appear 12 to 72 hours after eating; may last 4 to 7 days. In people with weakened immune system, the infection may be more severe and lead to serious complications, including death.
Cook raw meat, poultry, and egg products to a safe temperature. Do not eat raw or undercooked eggs. Avoid consuming raw or unpasteurized milk or other dairy products. Produce should be thoroughly washed before consuming.
Shigella (over 30 types)
Person-to-person by fecal-oral route; fecal contamination of food and water. Most outbreaks result from food, especially salads, prepared and handled by workers using poor personal hygiene.
Disease referred to as "shigellosis" or bacillary dysentery. Diarrhea (watery or bloody) , fever, abdominal cramps; 1 to 2 days from ingestion of bacteria and usually resolves in 5 to 7 days
Hand washing is a very important step to prevent shigellosis. Always wash your hands with warm water and soap before handling food and after using the bathroom, changing diapers or having contact with an infected person.
Staphylococcus aureus
Commonly found on the skin and in the noses of up to 25% of healthy people and animals. Person-to-person through food from improper food handling. Multiply rapidly at room temperature to produce a toxin that causes illness. Contaminated milk and cheeses.
Severe nausea, abdominal cramps, vomiting, and diarrhea occur 30 minutes to 6 hours after eating; recovery from 1 to 3 days — longer if severe dehydration occurs.
Because the toxins produced by this bacterium are resistant to heat and cannot be destroyed by cooking, preventing the contamination of food before the toxin can be produced is important. Keep hot foods hot (over 140°F) and cold foods cold (40°F or under); wash your hands with warm water and soap and wash kitchen counters with hot water and soap before and after preparing food.
Vibrio vulnificus
Uncooked or raw seafood (fish or shellfish); oysters
In healthy persons symptom include diarrhea, stomach pain, and vomiting May result in a blood infection and death for those with a weakened immune systems particularly with underlying liver disease.
Do not eat raw oysters or other raw shellfish; cook shellfish (oysters, clams, mussels) thoroughly. Prevent cross-contamination by separating cooked seafood and other foods from raw seafood and its juices. Refrigerate cooked shellfish within two hours after cooking.
Estimated annual number of domestically acquired foodborne illnesses, hospitalizations, and deaths due to 31 pathogens and unspecified agents transmitted through food in the United States(8)
Foodborne Agents
Estimated annual number of illnesses
Estimated annual number of hospitalizations
Estimated annual number of deaths
31 known pathogens
9.4 million
Unspecified agents
38.4 million
47.8 million
Top five pathogens contributing to domestically acquired foodborne illnesses(9)
Estimated number of illnesses
90% Credible Interval
Salmonella, nontyphoidal
Incidence of foodborne illnesses has increased in recent years, likely due to a variety of factors. First, changes in farm practices and a higher demand for meat and poultry increase the risk of foodborne illness. Additionally, extensive and interconnected food distribution systems facilitate the contamination of feed products. Furthermore, intensive animal husbandry techniques currently employed have triggered the emergence of new zoonotic diseases.
Chemical toxins can be found in foods that contain natural toxicants, including mycotoxins (produced by microfungi). Mycoses are diseases caused by the growth of fungi on animal hosts, while mycotoxicoses are those caused by dietary, respiratory, or dermal exposure to toxic fungal metabolies. Mycoses range from the relatively mild athlete's foot to the lethal aspergillosis, and can be acquired via inhalation of spores or from a growth on the skin or gastrointestinal tract. Most mycotoxicoses, on the other hand, result from eating contaminated food.(10)
Furthermore, environmental toxins, such as mercury and lead, can have dangerous health consequences when ingested. Today, mercury poisoning is generally caused by the consumption of fish. Mercury poisoning can lead to many neural diseases, including acrodynia (pink disease), Hunter-Russell syndrome, and Minamata disease. Lead, another heavy metal, can also interfere with the nervous system, as well as with the heart, bones, intestines, kidneys, and reproductive system.(11) Lead can enter the body through multiple routes, including inhaling lead dust in the air, ingesting lead paint, and drinking contaminated water. No amount of lead in the body is safe.
The FDA also regulates the following chemical toxins:
Genetically modified organisms (GMOs) are organisms whose DNA has been altered through genetic engineering. Genetically modified organisms and foods were originally developed to improve crop resistance to plant diseases.(17) For example, plants that have the gene for toxin production by the bacterium Bacillus thuringiensis (BT) require lower quantities of insecticide spray. This BT toxin is safe for human consumption. Today, organisms are modified for more traits, including pest resistance, herbicide tolerance (so that weeds die but GMO crops do not), disease resistance, cold tolerance, drought tolerance, and higher nutrient levels. Rice illustrates one attempt to use genetic engineering to increase nutritional benefit. A staple food for many nations, rice does not contain many nutrients. Researchers have created a "golden" strain of rice that contains a high amount of beta-carotene (vitamin A).(18) Therefore, proponents of GMOs argue that GM foods may be the key to alleviating malnutrition and increasing food security.
GM foods traded internationally have passed risk assessments, and are thus generally safe to consume. GM foods must pass Codex Alimentarius standards (or the Codex system), which are food standards set by a joint FAO/WHO body. The Codex system was implemented in 1963, and deals with all government-regulated characteristics of certain commodities. Furthermore, the Cartagena Protocol on Biosafety (CPB) is an environmental treaty that regulates transboundary movements of living GMOs.
Debates on the health effects of GM foods are primarily concerned with allergenicity. Many children have allergies to multiple foods, and experts worry that introducing a gene into a plant or animal may introduce a new allergen or cause allergic reactions. To avoid allergic outbreaks, extensive testing is required before selling GM foods on the market. While there are other worries about more possible health detriments of GM foods, current evidence does not suggest any other health concerns.(19)
(1) WHO Department of Food Safety, Zoonoses and Foodborne Diseases Sustainable Development and Healthy Environments. WHO Consultation to Develop a Strategy to Estimate the Global Burden of Foodborne Diseases. France: WHO, 2006. Print.
(2) CDC. "Burden of Foodborne Illness in the United States." (July 15, 2016) https://www.cdc.gov/foodborneburden/burden/index.html. Accessed on 14 September 2018.
(3) WHO. "Food Safety." (October 31, 2017) http://www.who.int/news-room/fact-sheets/detail/food-safety. Accessed on 14 September 2018.
(4) Ibid.
(5) CDC. "Burden of Foodborne Illness in the United States." (July 15, 2016) https://www.cdc.gov/foodborneburden/burden/index.html. Accessed on 14 September 2018.
(6) CDC. "Norovirus." https://www.cdc.gov/norovirus/ (July 16, 2018) Accessed on 14 September 2018.
(7) USDA Food Safety and Inspection Service. "Common Foodborne Pathogens." https://bit.ly/2p8UUok. Accessed on 14 September 2018.
(8) CDC. "Burden of Foodborne Illness in the United States." (July 15, 2016) https://www.cdc.gov/foodborneburden/burden/index.html. Accessed on 14 September 2018.
(9) Ibid.
(10) Bennett JW, & Klich M. "Mycotoxins." Clinical Microbiology Review. 2003;16:497–516.
(11) Mayo Clinic Staff. "Lead Poisoning." (December 6, 2016) https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717. Mayo Foundation for Medical Education and Research. Accessed on 14 September 2018.
(12) Robin, L. Acrylamide, Furan, and the FDA. Rep. Ed. Sebastian Cianci. Target Group, 2007. Print.
(13) FDA. "Dioxin Analysis Results/Exposure Estimates." (November 2007) https://www.fda.gov/food/foodborneillnesscontaminants/chemicalcontaminants/ucm077444.htm. Accessed on 14 September 2018.
(14) FDA. "Ethyl Carbamate Preventative Action Manual." (December 12, 2017) https://www.fda.gov/food/foodborneillnesscontaminants/chemicalcontaminants/ucm078546.htm. Accessed on 14 September 2018.
(15) Robin, L. Acrylamide, Furan, and the FDA. Rep. Ed. Sebastian Cianci. Target Group, 2007. Print.
(16) Food and Agriculture Organization of the United Nations. "Melamine." (2018) http://www.fao.org/food/food-safety-quality/a-z-index/melamine/en/. Accessed on 14 September 2018.
(17) WHO. "20 Questions on Genetically Modified Foods." (May 2014) http://www.who.int/foodsafety/areas_work/food-technology/faq-genetically-modified-food/en/. Accessed on 14 September 2018.
(18) Whitman, D. "Genetically Modified Foods: Harmful or Helpful?" (2000) CSA Discovery Guides. 1-13.
(19) Ibid.


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Event details
£12 per person | 10.30am
Discover tales from 'below stairs' - from historic political graffiti on floorboards to names scratched on window panes, find out about her favourite things often unseen by visitors.
This talk includes:
- 10.30am - Refreshments in the Cavendish restaurant
- 11am - Talk in the Hartington room
Looking for somewhere to stay?
We have a collection of hotels, inns, cottages and restaurants on and around the Chatsworth Estate that will make your visit that little bit more comfortable and special. Visit our chatsworthstays.co.uk website to find out more and to book online.


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Understanding the concept of shares in a limited company can be difficult for those who are thinking about company formation for the first time. We explain share capital, the different types of shares, voting rights and how to issue new ones after incorporation.
In order to register a private limited company, you must issue at least one share. It is essentially a 'piece' of the company, or a percentage of the business. Think of it like a cake cut into slices, or a pie chart. If a company issues only one, it is worth 100% of the company. If one person owns that one unit, one person owns the whole company.
If two or more shares are issued to more than one person, each person owns a piece of the company. Each unit normally represents one vote in a company; therefore, owning more provides a greater degree of voting power and control over the affairs of the company, and a bigger chunk of the business profits.
What is share capital?
This is the total capital of a limited company divided into shares (which have a nominal value). The minimum capital is one share and there is no maximum statutory share capital. Examples:
- A company issues 1 share at £1 (the nominal value of the share) – the total capital is £1.
- A company issues 10 shares at £1 each – the total capital is £10.
- A company issues 20 shares at £10 each – the total capital is £200.
Share capital sets the limited liability as well as the profit entitlement and decision-making powers of each owner.
What is authorised share capital?
Authorised capital is the maximum number of shares a company is authorised to issue. This restriction no longer applies to companies incorporated after 1st October 2009 (when the Companies Act 2006 came into force), unless they add the provision to their articles of association.
What is issued share capital?
This is the total nominal value of all shares issued by a company. The actual value (market value) may be different, depending on how much the business is worth at the time of selling the share. The nominal value is normally £1 per share, but can be otherwise.
The total nominal value of each member's unpaid shares represents their total financial liability. They are legally required to contribute the nominal value of their unpaid shares if the business is unable to pay its bills or is wound up, or if the directors otherwise demand such payment be made (the shares are called upon).
For example:
- If a limited company issues one share, it represents 100% of the business. If only one is issued, the company can only have one shareholder. He or she will be the sole owner of that business. This is commonplace when setting up a company on your own as the sole shareholder and director.
- If two shares are issued, each worth 50% of the business, the company can have one or two owners. One person can purchase both of them and own 100% of the company. Or two people can each purchase one, thus each owning 50% of the business.
- If 100 shares are issued, each one is worth 1% of the business. The company can have between one and 100 shareholders. One person could buy all of them and own all of the business with a view to selling some at a later date. Alternatively, multiple people could buy one or more, thus each owning a portion of the company.
Different types of limited company shares
A share 'class' is a type of share. Each class has its own rights and conditions attached to it. These are outlined in the Articles of Association. There are many different classes, but most limited companies issue 'Ordinary' shares. As the name suggests, this is a standard class that usually offers equal voting rights, equal profit entitlement, and equal capital rights to all members.
Ordinary shares keep things simple, but this class may not be suitable or desirable for all companies; therefore, additional classes can be created during and after company formation to provide different rights and powers. The four most common classes other than ordinary are: preference, non-voting, and redeemable.
This class usually offers a preferential right above other classes to receive dividend payments from company profits. The dividend amount is usually a percentage of each share's nominal value. Preference shares are typically non-voting and, in the event of a company winding up, they usually offer no right to surplus capital above and beyond the dividend amount.
These shares, which might enjoy rights to dividend payments, but have no say in how the company is run, are often issued to company employees as a tax-efficient strategy for paying part of their salaries as dividends. They are also created for family members of the main members of a company.
These are issued with an agreement that they will be bought back by the company after a fixed period of time, or at the instigation of the shareholder or company (dependent on the articles of association). Redeemable shares are often issued to employees with the proviso that they will be taken back at their nominal value if the employee leaves the company. In many cases, preference shares will be redeemable.
Other share classes
- Management: Carry multiple votes per share, or they have a smaller nominal value than other classes. They are usually issued to subscribers (the first owners of the company) to allow them to retain more control of the business than new members.
- Deferred Ordinary: Offer dividend payments after all other classes have been paid.
- Alphabet: These are usually ordinary shares divided into different classes, such as 'A' ordinary, 'B' ordinary, and 'C' ordinary. The purpose of this class is to alter the percentage of each right carried by an ordinary share. For example: A company has two members – one may have 50% voting rights, 50% dividend rights and 80% capital rights; the other will have 50% voting rights, 50% dividend rights and 20% capital rights.
The creation of new share classes usually requires the approval of the members, who also need to authorise the allotment of such shares.
Which class of shares is best when setting up a company?
As previously mentioned, most private limited companies in the UK are registered with Ordinary shares. However, it is entirely possible to issue more than one class of share during and after company formation. It really depends on the needs of your firm, but most small businesses only need to issue ordinary shares. This is certainly the case if they are set up with just one or two shareholders (members) and directors.
Ordinary shares are commonly used because they provide equal voting rights, dividend rights and capital rights. Increasingly, however, some companies will issue additional classes or convert existing shares to vary the rights of the owners. This may be desirable or necessary if members want to vary their voting rights to reflect different levels of superiority, or modify dividend and capital rights to reflect varying degrees of investment.
PLEASE NOTE: If you are considering issuing various classes, please speak to an accountant for professional advice.
Can I issue shares without voting rights?
Yes, a limited company can issue any class of share it wishes, including shares that carry no voting rights (although a company needs shares in issue that can indeed vote at all times). There are two common share classes that do not provide voting rights to the shareholder:
- Non-voting ordinary shares
- Preference shares
Typically, these classes are issued to people who have invested less capital and have therefore taken a smaller financial risk in the business. Their right to vote on certain affairs is either proportionally reduced or removed entirely.
Non-voting ordinary shares
Non-voting ordinary shares are often given to family members of existing shareholders, or to staff members through an employee share scheme. This allows the existing shareholders to distribute shares to other people whilst maintaining control of the company.
Issuing shares to employees can encourage new people to join a company, and it can help to retain and motivate existing staff. Share schemes are often an effective way to align employees' interests with those of the company's voting shareholders. The harder the employees work for the company, the bigger the potential reward because of their vested interest in the success of the business.
Companies can also use non-voting ordinary shares as a tax-efficient way to pay part of an employee's salary. By paying some of an employee's remuneration as a dividend, a company will have no tax liability on this money, other than the Corporation Tax it has already paid on profits (dividends are not an allowable deduction against company profits). Likewise, the employee will have no personal tax liabilities on any dividend payments received (up to the 40% income tax threshold).
Preference shares
Preference shares provide a shareholder with a preferential right to receive a fixed percentage of company profits through dividend payments before the shareholders of all other share classes. This type of share may also provide preferential rights over other shareholders to receive a portion of any remaining capital if the company is wound up.
Can I issue more shares after company formation?
The vast majority of private companies can issue more shares after company formation, provided the articles do not stipulate an authorised share capital. This is a now optional clause that restricts the total value of shares a company can issue.
If no restrictions are in place, and the directors are duly authorised, a company can issue as many shares as it wishes during or after formation. However, it is important to realise that when a company issues more shares, each one becomes diluted because they represent smaller portions of the company.
PLEASE NOTE: Guidance on issuing more shares after incorporation can be found at the end of this article.
How many issued shares should a company have?
There is no right or wrong number. It depends on the needs and preferences of the owners. If you are setting up a company as the sole owner and director, you can issue just one. But if you plan to grow your business and want the option of selling parts of the company in exchange for capital or to bring in a business partner, you should consider issuing more than one at the start. There is always the option of creating more after incorporation, but generally, it is easier to transfer ones that have already been issued.
The most popular quantities to issue are whole numbers like 10, 100, or 1000. This is because it's far easier to apportion a percentage of ownership to these figures, rather than an odd number like 23. Issuing a higher quantity will allow you to sell small portions of the business to lots of different people.
However, the value of issued capital represents the financial liability of the owners. Therefore, if your business runs up any debts that it can't afford to pay, the shareholders are legally required to contribute the nominal value of their shares toward these debts.
The nominal value is usually set at £1.00. If you issue one share at this value, your financial liability will only be £1.00. If you issue 100, the total liability of the owners will be £100. This is worth remembering if you are thinking about issuing thousands of shares and owning all of them yourself!
What are the Prescribed Particulars?
The prescribed particulars are the rights that are attached to each class of share in a company limited by shares. They can be found in the company formation documents, and are required as part of the Statement of Capital.
Standard particulars
There is a standard set of prescribed particulars available for ordinary shares, but these are only available for companies that use the model articles of association provided in the Companies (Model Articles) Regulations 2008. The standard prescribed particulars are as follows:
- particulars of any voting rights attached to the shares, including rights that arise only in certain circumstances;
- particulars of any rights attached to the shares, as respects dividends, to participate in a distribution;
- particulars of any rights attached to the shares, as respects capital, to participate in a distribution (including on winding up);
- whether the shares are to be redeemed or are liable to be redeemed at the option of the company or the shareholder.
Bespoke particulars
Companies not using the model articles of association will be able to draft their own prescribed particulars for each class of share, and in most cases, the rights attached to these shares will be determined by an agreement between the company and its shareholders.
When do I need to pay for my shares?
Shareholders are normally required to pay for their shares immediately upon taking them. This may be during or after company formation. In smaller companies, however, the first members who take their shares during the company registration process often leave them unpaid until the company requests payment (through a call up) or it is wound up. It depends on the provisions stated in the articles of association.
In larger corporations, payments are usually requested immediately. Some companies will allow members to make part payments with the proviso that the remaining balance is paid upon request.
How much do shares cost?
The cost of limited company shares can vary immensely, but most companies set a nominal value of £1.00 each.
The nominal value is the base amount (i.e. 'face value' or 'par value') that the company chooses. This is the absolute minimum value that can be accepted. It will remain unchanged for the life of the issued shares (unless changed with the approval of the Members, such as through a subdivision or consolidation of shares).
Companies are not legally permitted to sell them for less than their nominal value, but they can sell them for more.
Most members buy shares at their nominal value but the actual market value can increase as a company becomes more successful and profitable. In such instances, a premium will be added to the nominal value of any shares issued to new members. They will therefore have to pay the market value, not the nominal value.
How do I pay for my shares?
They are usually paid for in cash, but other considerations may be given at the company's discretion. Other forms of payment include:
- Services
- Labour
- Knowledge and expertise
- Goods or equipment
- Land or property
- Shares in other companies
- In exchange for debt repayment
- Goodwill
Members may be able to pay wholly in cash or wholly in non-cash, partly in cash and partly in non-cash, or wholly in non-cash. Any cash payments must be paid into the company's business bank account and recorded in its accounting records.
The director is responsible for updating the statement of capital on the next confirmation statement (formerly known as the 'annual return') to state which shares have been paid for and which remain unpaid. Companies House will disclose this information on public record.
Do I have to pay tax on shares?
Members do not pay tax if they are given shares for nothing, e.g. as a gift or as part of an employee scheme. Stamp Duty of 0.5% is payable if shares are bought through a stock transfer form for more than £1,000, but no tax is payable if the transaction is less than this amount. This tax must be rounded up to the nearest £5 and paid to HMRC.
Total sale value is £1550; 0.5% of this value is £7.75. This will be rounded up to £10.
If they are bought electronically through the CREST system (a computerised register of shares and shareholders) or outside of CREST ('off-market' payments), Stamp Duty Reserve Tax (SDRT) of 0.5% of the transaction is payable. SDRT is not payable if a recipient is given shares for nothing. If a recipient pays for them by some form of non-cash consideration, SDRT is still charged on the value of the non-cash consideration.
SDRT is deducted automatically through the CREST system and paid to HMRC. If they are purchased electronically outside of CREST, the purchaser is responsible for sending HMRC a written notice of the transaction.
What is share capital used for?
The money a company receives for its issued shares is typically used to expand or improve the business or pay debts. If a company allows its members to leave them unpaid, the nominal value will probably be requested only if the company requires capital to pay its debts or the company is being wound up.
Are members liable for more than the value of their shares?
The financial liability of company owners is limited to the nominal value of their shares, not the actual market value. If a company is unable to pay its debts or is wound up, members are not legally required to contribute more than the nominal value of their unpaid shares. If they have already been paid for, the members have no further financial obligation to the company.
How to issue more shares after company formation
If you have issued more shares after incorporation, you'll need to let Companies House know with the Form SH01 'Return of Allotment'. The following information will be required:
- Company name.
- Registration number (CRN).
- Date of allotment(s).
- Details of new allotments – number, class, currency, nominal value, amount paid or unpaid in each.
- Details of non-cash payments, if applicable.
- Statement of capital – details of all issued shares in the company after the allotment of new ones.
- Prescribed particulars – the voting rights, dividend rights, capital rights and redeemable rights attached to each share.
- Authorising signature of the director.
Before issuing more shares, you must check the articles of association for any restrictions such as authorised capital, pre-emption rights, and the directors' power to allot.
Upon issuing more, the director must deliver Form SH01 within one month of the allotment date. Details of new members do not have to be provided at this time because you will include this information on the next annual confirmation statement (previously called the 'annual return'). It is considered good practice to send file a confirmation statement as soon as you can following the allotment.
The director must issue certificates for every allotment and update the statutory register of members, which is kept at the registered office address or SAIL address. A copy of each certificate should also be kept by the company. The PSC register may also have to be updated if any of the shareholders becomes eligible for entry onto it.


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Lori Alexander of The Transformed Wife is back beating the bones of one of her favorite dead hobby horses – leggings are immodest. That's even as she's admitted in her private chatroom that she does sometimes wear leggings at home. But that's not even the worst thing she's come out with yesterday. Lori Alexander says that immodest women do not deserve respect. Plus her definition of respect is a skewed one.
Here's her public post on modesty and leggings. She is complaining that the world does not like it when you tell young girls not to dress immodestly. Like she's the world's foremost expert on the subject instead of just another jealous woman angry as her husband looks at thonged rear ends on the beach.
I missed this 'feminist flash mob'. Where were they, and what did they do? The article Lori citing as evidence of a 'flash mob' looks more like Lori-stan propaganda with a group of concerned mothers showing up to protest an unfair school policy in yoga pants. The same yoga pants that Lori herself admits wearing at home.
Good for the mamas for not allowing their girls to be publicly shamed for having feminine bodies. Yes, modesty culture has always been rape culture as it puts women in charge of men's sexuality, which is not their job. It absolves men of any responsiblity for their own actions, making them little better than beasts. Only men should be in charge of their own sexuality, just like only women should be over their own.
Reducing men, wonderful men, kind men, saintly men into the same animalistic grouping with rapists and other evil sexual abusers. That's exactly what purity culture does that makes it rape culture.
But that's not the awful part of Lori's words. It's this. a screen cap of her words from her own private chat room about respect and women. One of my loyal readers sent this to me last night and I could hardly believe she would admit in writing that she does not think all women deserve respect.
Calling women nasty names? Check. Claiming that others do not deserve respect? Check. Looks like just another day in the gulag that is the mind of Lori Alexander. This is disgraceful and disgusting.
See what Lori did here? She pulled the first of the definitions that popped up on Google. The first general one. This is literally the first one of many and is not from an organization like the Merriam Websters Dictionary, which defines more accurately respect this way.
Also, Lori usually straight up orders everyone to not have emotions or feelings, yet her definition of respect involves… wait for it…. feelings. She claims feelings and emotions are selfish.That's the noun, so let's look at the verb usage.
Not much deep admiration going on there. It's like this, you can respect the office of the president and still dislike the actual person of the president. Prisoners respect the ability of the iron bars to keep them in their cells. I respect the authority of the local policia enough to not speed even if I may or may not like them. Respect and admiration don't always go hand in hand.
One thing I do know. It's never right, or Christian, or loving to call women you do not know names like 'harlots' and say they are not worthy of respect. Everyone is worthy of respect by the sheer dint of being human.
I leave you with the immortal Aretha Franklin and her song on the subject from the movie 'The Blues Brothers 2000'
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Exploring what makes a good delivery...
We need it. We choose it. We buy it. And then we… wait for it to be delivered.
It's no wonder customer expectations are increasing to rise for the delivery experience; everything else happens so quickly – why can't our purchases be here now? With Amazon Prime offering unlimited free delivery on same-day/next-day deliveries, customers expect purchases to arrive faster and faster.
In this series of blog posts, we explore customer reviews to understand how the top delivery companies such as DPD, Hermes, DHL and Yodel are meeting these challenging customer expectations.
Using state-of-the-art Natural Language Processing (NLP) techniques, Senti (our AI-analyst) has read over 300,000 customer reviews; understanding the topics that are important to us, and how we feel about them. From these insights, we can explore the delivery topics we care about the most, what irritates us, and what actions make us loyal to a company.
As we saw in our last blog post, drivers are an integral part of the customer experience before the actual delivery even takes place. In this second blog post of the series, we will understand the impact of drivers and their role in ensuring the best customer outcome when leaving parcels with customers.
Factors impacting delivery satisfaction
The last mile, where the delivery driver drops off our parcel, is unsurprisingly the most talked about by customers and contributes, on average, 42% to the overall customer satisfaction score of a delivery company.
The following themes come up as important for customers at this stage: 1. driver attitude, 2. delivery punctuality, 3. calling card not left, 4. delivered to safe place and 5. delivered to neighbour.
Is my delivery on time?
By the time customers place an order, there is usually an estimate for how long our delivery will take. As long as delivery companies stick to this estimated time slot, customers are happy with a service they can rely on:
However, Hermes customer satisfaction is damaged when customers pay for next day or nominated day delivery and their parcel arrives late:
The face of the company
DPD performs well when customers mention their drivers; describing them as kind, helpful and punctual.
Drivers are an important topic for a customer's experience. Delivery providers must focus on problems caused by drivers to achieve long-lasting positive change in customer satisfaction. For example, many comment on drivers not attempting to drop off parcels from scheduled deliveries:
Sorry we missed you
One of the main grievances customers have across all delivery companies is when drivers say they have left a calling card as evidence that they attempted delivery but no card can be found.
At Yodel, this is a popular problem for customers. Tracking messages state a card was left, however customers often never find the calling card:
Safe places and neighbours
Deliveries often happen when customers are out of the house and can't receive the parcel personally. When this happens, customers expect drivers to deliver packages in a safe manner; away from view or delivered to a neighbour, with a calling card describing where to find their parcel.
In practice, when faced with busy schedules, drivers may not pay as much attention to the care of the package as they should:
When delivering to neighbours, customer opinion is mixed. For some, leaving parcels with neighbours is appreciated. However, for others, delivering parcels to neighbours is unwanted:
Due to these differing customer needs, deliveries can often go wrong in the eyes of the customer. When companies make it easy to leave specific instructions for drivers, and drivers adhere to these instructions, deliveries are likely to become more positive experiences.
Drivers are the centre of the delivery experience
When drivers miss deliveries and leave parcels in plain sight, the delivery experience has been damaged for a customer. Delivery providers now have an opportunity to work more with drivers and driver instructions to achieve the best possible delivery outcome for each order.
In our next blog, we'll be looking into how the different delivery companies respond to customers when something goes wrong. Are delivery providers and their customer service staff well-equipped to deal with missing parcels and late deliveries?


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Tongyu become approved Telstra antenna supplier from 2016
Thu, 04/07/2016 - 10:48
After successful testing and Validation Tongyu was selected and approved as Base Station Antenna Supplier to Telstra.
Director Lee Gill spoke about this Great Milestone- " We worked hard and believed Tongyu had some great innovative Design & Core Antenna Technology.?
In the end this led to our success and we look forward to having a great future with such a well regarded and respected Industry leader".?