Multilevel competing risk models to evaluate the risk of nosocomial infection

Introduction Risk factor analyses for nosocomial infections (NIs) are complex. First, due to competing events for NI, the association between risk factors of NI as measured using hazard rates may not coincide with the association using cumulative probability (risk). Second, patients from the same intensive care unit (ICU) who share the same environmental exposure are likely to be more similar with regard to risk factors predisposing to a NI than patients from different ICUs. We aimed to develop an analytical approach to account for both features and to use it to evaluate associations between patient- and ICU-level characteristics with both rates of NI and competing risks and with the cumulative probability of infection. Methods We considered a multicenter database of 159 intensive care units containing 109,216 admissions (813,739 admission-days) from the Spanish HELICS-ENVIN ICU network. We analyzed the data using two models: an etiologic model (rate based) and a predictive model (risk based). In both models, random effects (shared frailties) were introduced to assess heterogeneity. Death and discharge without NI are treated as competing events for NI. Results There was a large heterogeneity across ICUs in NI hazard rates, which remained after accounting for multilevel risk factors, meaning that there are remaining unobserved ICU-specific factors that influence NI occurrence. Heterogeneity across ICUs in terms of cumulative probability of NI was even more pronounced. Several risk factors had markedly different associations in the rate-based and risk-based models. For some, the associations differed in magnitude. For example, high Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were associated with modest increases in the rate of nosocomial bacteremia, but large increases in the risk. Others differed in sign, for example respiratory vs cardiovascular diagnostic categories were associated with a reduced rate of nosocomial bacteremia, but an increased risk. Conclusions A combination of competing risks and multilevel models is required to understand direct and indirect risk factors for NI and distinguish patient-level from ICU-level factors.

Virtual 3D models of insects for accelerated quarantine control

We learn from the past that invasive species have caused tremendous damage to native species and serious disruption to agricultural industries. It is crucial for us to prevent this in the future. The first step of this process is to identify correctly an invasive species from native ones. Current identification methods, relying on mainly 2D images, can result in low accuracy and be time consuming. Such methods provide little help to a quarantine officer who has time constraints to response when on duty. To deal with this problem, we propose new solutions using 3D virtual models of insects. We explain how working with insects in the 3D domain can be much better than the 2D domain. We also describe how to create true-color 3D models of insects using an image-based 3D reconstruction method. This method is ideal for quarantine control and inspection tasks that involve the verification of a physical specimen against known invasive species. Finally we show that these insect models provide valuable material for other applications such as research, education, arts and entertainment. © 2013 IEEE.

Capturing natural-colour 3D models of insects for species discovery and diagnostics

Collections of biological specimens are fundamental to scientific understanding and characterization of natural diversity - past, present and future. This paper presents a system for liberating useful information from physical collections by bringing specimens into the digital domain so they can be more readily shared, analyzed, annotated and compared. It focuses on insects and is strongly motivated by the desire to accelerate and augment current practices in insect taxonomy which predominantly use text, 2D diagrams and images to describe and characterize species. While these traditional kinds of descriptions are informative and useful, they cannot cover insect specimens "from all angles" and precious specimens are still exchanged between researchers and collections for this reason. Furthermore, insects can be complex in structure and pose many challenges to computer vision systems. We present a new prototype for a practical, cost-effective system of off-the-shelf components to acquire natural-colour 3D models of insects from around 3 mm to 30 mm in length. ("Natural-colour" is used to contrast with "false-colour", i.e., colour generated from, or applied to, gray-scale data post-acquisition.) Colour images are captured from different angles and focal depths using a digital single lens reflex (DSLR) camera rig and two-axis turntable. These 2D images are processed into 3D reconstructions using software based on a visual hull algorithm. The resulting models are compact (around 10 megabytes), afford excellent optical resolution, and can be readily embedded into documents and web pages, as well as viewed on mobile devices. The system is portable, safe, relatively affordable, and complements the sort of volumetric data that can be acquired by computed tomography. This system provides a new way to augment the description and documentation of insect species holotypes, reducing the need to handle or ship specimens. It opens up new opportunities to collect data for research, education, art, entertainment, biodiversity assessment and biosecurity control. © 2014 Nguyen et al.

Comparison of eight published lumbar spine finite element models

Due to its ability to represent intricate systems with material nonlinearities as well as irregular loading, boundary, geometrical and material domains, the finite element (FE) method has been recognized as an important computational tool in spinal biomechanics. Current FE models generally account for a single distinct spinal geometry with one set of material properties despite inherently large inter-subject variability. The uncertainty and high variability in tissue material properties, geometry, loading and boundary conditions has cast doubt on the reliability of their predictions and comparability with reported in vitro and in vivo values. A multicenter study was undertaken to compare the results of eight well-established models of the lumbar spine that have been developed, validated and applied for many years. Models were subjected to pure and combined loading modes and their predictions were compared to in vitro and in vivo measurements for intervertebral rotations, disc pressures and facet joint forces. Under pure moment loading, the predicted L1-5 rotations of almost all models fell within the reported in vitro ranges; their median values differed on average by only 2° for flexion-extension, 1° for lateral bending and 5° for axial rotation. Predicted median facet joint forces and disc pressures were also in good agreement with previously published median in vitro values. However, the ranges of predictions were larger and exceeded the in vitro ranges, especially for facet joint forces. For all combined loading modes, except for flexion, predicted median segmental intervertebral rotations and disc pressures were in good agreement with in vivo values. The simulations yielded median facet joint forces of 0 N in flexion, 38 N in extension, 14 N in lateral bending and 60 N in axial rotation that could not be validated due to the paucity of in vivo facet joint forces. In light of high inter-subject variability, one must be cautious when generalizing predictions obtained from one deterministic model. This study demonstrates however that the predictive power increases when FE models are combined together. The median of individual numerical results can hence be used as an improved tool in order to estimate the response of the lumbar spine.

Hydrochemical evolution and groundwater flow processes in the Galilee and Eromanga basins, Great Artesian Basin, Australia: A multivariate statistical approach

The Galilee and Eromanga basins are sub-basins of the Great Artesian Basin (GAB). In this study, a multivariate statistical approach (hierarchical cluster analysis, principal component analysis and factor analysis) is carried out to identify hydrochemical patterns and assess the processes that control hydrochemical evolution within key aquifers of the GAB in these basins. The results of the hydrochemical assessment are integrated into a 3D geological model (previously developed) to support the analysis of spatial patterns of hydrochemistry, and to identify the hydrochemical and hydrological processes that control hydrochemical variability. In this area of the GAB, the hydrochemical evolution of groundwater is dominated by evapotranspiration near the recharge area resulting in a dominance of the Na–Cl water types. This is shown conceptually using two selected cross-sections which represent discrete groundwater flow paths from the recharge areas to the deeper parts of the basins. With increasing distance from the recharge area, a shift towards a dominance of carbonate (e.g. Na–HCO3 water type) has been observed. The assessment of hydrochemical changes along groundwater flow paths highlights how aquifers are separated in some areas, and how mixing between groundwater from different aquifers occurs elsewhere controlled by geological structures, including between GAB aquifers and coal bearing strata of the Galilee Basin. The results of this study suggest that distinct hydrochemical differences can be observed within the previously defined Early Cretaceous–Jurassic aquifer sequence of the GAB. A revision of the two previously recognised hydrochemical sequences is being proposed, resulting in three hydrochemical sequences based on systematic differences in hydrochemistry, salinity and dominant hydrochemical processes. The integrated approach presented in this study which combines different complementary multivariate statistical techniques with a detailed assessment of the geological framework of these sedimentary basins, can be adopted in other complex multi-aquifer systems to assess hydrochemical evolution and its geological controls.

Mentor feedback : models, viewpoints and strategies

A mentor’s feedback can present professional insights to allow a mentee to reflect and develop practice. This paper positions two models for feedback that have emanated from empirical studies. It also demonstrates the diverse viewpoints of mentors and suggests strategies for providing quality feedback. In one qualitative study, 24 mentors observed a final-year preservice teacher through a professionally video-recorded lesson and wrote their observations towards giving feedback to the potential mentee. Tables illustrated in the paper, show that mentors’ positive feedback and constructive criticisms vary considerably on the same observed events. Data from this study were synthesised to posit a theoretical model for analysing mentor feedback in an interconnected, three-way Venn diagram, namely: visual, auditory and conceptual frames. Another study (n=28), which is a collection of mentor teachers’ work samples during the Mentoring for Effective Teaching (MET) program, provides strategies within six feedback practices, that is: (1) negotiated mentor-mentee expectations for providing feedback on practices, (2) reviewing teaching plans, (3) arranging for observations of practices, (4) providing oral feedback, (5) providing written feedback, and; (6) presenting opportunities for the mentee to evaluate teaching practices with consideration of the mentor’s feedback. For example, on the last mentioned practice (6) there were strategies such as “Plan a time for evaluation of practices (guided reflection)”, “Read the mentee’s reflection on practice and discuss how it aligns with your observations of their practices”, and “Highlight verbally and/or in writing where the mentee is perceptive about the reflection and how the reflection could be enhanced for future evaluations”. Developing a range of strategies that may assist the mentee in professional growth, include enlisting a community of mentors, ensuring mentors have a repertoire of strategies for articulating feedback, and using mentor feedback tools and models. This study has implications for the development of feedback models and strategies.

“Back to the future” – a retrospective analysis of university business models

Using established strategic management and business model frameworks we map the evolution of universities in the context of their value proposition to students as consumers of their products. We argue that in the main universities over time have transitioned from a value-based business model through to an efficiency-based business model that for numerous reasons, is becoming rapidly unsustainable. We further argue that the future university business models would benefit with a reconfiguration towards a network value based model. This approach requires a revised set of perceived benefits, better aligned to the current and future expectations and an alternate approach to the delivery of those benefits to learner / consumers.

Models of protein linear molecular motors for dynamic nanodevices

Protein molecular motors are natural nano-machines that convert the chemical energy from the hydrolysis of adenosine triphosphate into mechanical work. These efficient machines are central to many biological processes, including cellular motion, muscle contraction and cell division. The remarkable energetic efficiency of the protein molecular motors coupled with their nano-scale has prompted an increasing number of studies focusing on their integration in hybrid micro- and nanodevices, in particular using linear molecular motors. The translation of these tentative devices into technologically and economically feasible ones requires an engineering, design-orientated approach based on a structured formalism, preferably mathematical. This contribution reviews the present state of the art in the modelling of protein linear molecular motors, as relevant to the future design-orientated development of hybrid dynamic nanodevices. © 2009 The Royal Society of Chemistry.

Using Bayesian Mixture Models That Combine Expert Knowledge and GIS Data to Define Ecoregions

Conservation planning and management programs typically assume relatively homogeneous ecological landscapes. Such “ecoregions” serve multiple purposes: they support assessments of competing environmental values, reveal priorities for allocating scarce resources, and guide effective on-ground actions such as the acquisition of a protected area and habitat restoration. Ecoregions have evolved from a history of organism–environment interactions, and are delineated at the scale or level of detail required to support planning. Depending on the delineation method, scale, or purpose, they have been described as provinces, zones, systems, land units, classes, facets, domains, subregions, and ecological, biological, biogeographical, or environmental regions. In each case, they are essential to the development of conservation strategies and are embedded in government policies at multiple scales.