Eradication and phenotypic tolerance of Burkholderia cenocepacia biofilms exposed to atmospheric pressure non-thermal plasma.

Chronic lung infection with bacteria from the Burkholderia cepacia complex (BCC), and in particular B. cenocepacia, is associated with significant morbidity and mortality in patients with cystic fibrosis (CF). B. cenocepacia can spread from person to person and exhibits intrinsic broad-spectrum antibiotic resistance. Recently, atmospheric pressure non-thermal plasmas (APNTPs) have gained increasing attention as a novel approach to the prevention and treatment of a variety of hospital-acquired infections. In this study, we evaluated an in-house-designed kHz-driven plasma source for the treatment of biofilms of a number of clinical CF B. cenocepacia isolates. The results demonstrated that APNTP is an effective and efficient tool for the eradication of B. cenocepacia biofilms but that efficacy is highly variable across different isolates. Determination of phenotypic differences between isolates in an attempt to understand variability in plasma tolerance revealed that isolates which are highly tolerant to APNTP typically produce biofilms of greater biomass than their more sensitive counterparts. This indicates a potential role for biofilm matrix components in biofilm tolerance to APNTP exposure. Furthermore, significant isolate-dependent differences in catalase activity in planktonic bacteria positively correlated with phenotypic resistance to APNTP by isolates grown in biofilms.

Bimodal biometric verification based on face and lips

In this paper, we present a novel approach to person verification by fusing face and lip features. Specifically, the face is modeled by the discriminative common vector and the discrete wavelet transform. Our lip features are simple geometric features based on a lip contour, which can be interpreted as multiple spatial widths and heights from a center of mass. In order to combine these features, we consider two simple fusion strategies: data fusion before training and score fusion after training, working with two different face databases. Fusing them together boosts the performance to achieve an equal error rate as low as 0.4% and 0.28%, respectively, confirming that our approach of fusing lips and face is effective and promising.

Viability of Pseudomonas aeruginosa in cough aerosols generated by persons with cystic fibrosis

Background Person-to-person transmission of respiratory pathogens, including Pseudomonas aeruginosa, is a challenge facing many cystic fibrosis (CF) centres. Viable P aeruginosa are contained in aerosols produced during coughing, raising the possibility of airborne transmission.

Methods Using purpose-built equipment, we measured viable P aeruginosa in cough aerosols at 1, 2 and 4 m from the subject (distance) and after allowing aerosols to age for 5, 15 and 45 min in a slowly rotating drum to minimise gravitational settling and inertial impaction (duration). Aerosol particles were captured and sized employing an Anderson Impactor and cultured using conventional microbiology. Sputum was also cultured and lung function and respiratory muscle strength measured.

Results Nineteen patients with CF, mean age 25.8 (SD 9.2) years, chronically infected with P aeruginosa, and 10 healthy controls, 26.5 (8.7) years, participated. Viable P aeruginosa were detected in cough aerosols from all patients with CF, but not from controls; travelling 4 m in 17/18 (94%) and persisting for 45 min in 14/18 (78%) of the CF group. Marked inter-subject heterogeneity of P aeruginosa aerosol colony counts was seen and correlated strongly (r=0.73-0.90) with sputum bacterial loads. Modelling decay of viable P aeruginosa in a clinic room suggested that at the recommended ventilation rate of two air changes per hour almost 50 min were required for 90% to be removed after an infected patient left the room.

Conclusions: Viable P aeruginosa in cough aerosols travel further and last longer than recognised previously, providing additional evidence of airborne transmission between patients with CF.

Burkholderia cepacia complex epidemiology in persons with cystic fibrosis from Australia and New Zealand

The Burkholderia cepacia complex (Bcc) is a group of significant opportunistic respiratory pathogens which affect people with cystic fibrosis. In this study, we sought to ascertain the epidemiology and geographic species distribution of 116 Bcc isolates collected from people with CF in Australia and New Zealand. We performed a combination of recA-based PCR, amplified rDNA restriction analysis (ARDRA), pulsed-field gel electrophoresis and repetitive extragenic palindromic PCR on each isolate. Each Burkholderia cenocepacia isolate was also screened by PCR for the presence of the B. cepacia epidemic strain marker. One hundred and fourteen isolates were assigned to a species using recA-based PCR and ARDRA. B. cenocepacia, B. multivorans and B. cepacia accounted for 45.7%, 29.3% and 11.2% of the isolates, respectively. Strain analysis of B. cenocepacia revealed that 85.3% of the isolates were unrelated. One related B. cenocepacia strain was identified amongst 15 people. Whilst full details of person-to-person contact was not available, all patients attended CF centres in Queensland (Qld) and New South Wales (NSW). Although person-to-person transmission of B. cenocepacia strains has occurred in Australia, the majority of CF-related Bcc infections in Australia and New Zealand are most likely acquired from the environment.

Burkholderia pseudomallei:another emerging pathogen in cystic fibrosis

BACKGROUND: Burkholderia pseudomallei is an important cause of acute fulminant pneumonia and septicaemia in tropical regions of northern Australia and south east Asia. Subacute and chronic forms of the disease also occur. There have been three recent reports of adults with cystic fibrosis (CF) who presumably acquired B pseudomallei infection during extended vacations or residence in either Thailand or northern Australia.

METHODS: The clinical course, molecular characteristics, serology and response to treatment are described in four adult CF patients infected with B pseudomallei. Polymerase chain reaction (PCR) based methods were used to confirm B pseudomallei and exclude B cepacia complex. Genotyping was performed using randomly amplified polymorphic DNA (RAPD) PCR and pulsed field gel electrophoresis (PFGE).

RESULTS: Four patients are described with a mean duration of infection of 32 months. All but one patient lived in tropical Queensland. Two patients (with the longest duration of infection) deteriorated clinically and one subsequently died of respiratory failure. Both responded to intravenous treatment specifically targeting B pseudomallei. Another patient suffered two severe episodes of acute bronchopneumonia following acquisition of B pseudomallei. Eradication of the organism was not possible in any of the cases. PFGE of a sample isolate from each patient revealed the strains to be unique and RAPD analysis showed retention of the same strain within an individual over time.

CONCLUSIONS: These findings support a potential pathogenic role for B pseudomallei in CF lung disease, producing both chronic infection and possibly acute bronchopneumonia. Identical isolates are retained over time and are unique, consistent with likely environmental acquisition and not person to person spread. B pseudomallei is emerging as a significant pathogen for patients with CF residing and holidaying in the tropics.

Increases in energy, protein and fat intake following the addition of sauce to an older person's meal

Energy intake in 15-20% of the UK older population is currently thought to be inadequate for health. Based on the suggestion that increases in food pleasantness and familiarity can increase intake, this study investigated the impact of the addition of sauce to an older person's meal on subsequent intake. Twenty-eight older people consumed two meals with sauce and the same two meals without sauce on different occasions, and amount consumed in terms of weight, energy and energy consumed from carbohydrate, fat and protein were compared. Pre-meal hunger and desire to eat, post-meal pleasantness and familiarity and participants' expectations of the effects of sauces were also measured. Compared to meals without sauce, meals with sauce were found to result in greater intakes of energy, energy consumed from protein and energy consumed from fat (smallest t(27)=2.13, p=0.04). No differences between conditions were found in measures of pre-meal hunger and desire to eat, or post-meal pleasantness and familiarity (largest t(27) = 1.47, p = 0.15). Similar effects were also found when participant expectations were taken into account, and no differences between participants who expected sauces to affect intake vs. those who did not expect sauces to affect intake were found (largest F(1, 26) = 1.70, p=0.20). These findings suggest that the addition of sauce to an older person's meal can result in increases in intake and may be beneficial for preventing or treating under-nutrition in these individuals, although the mechanisms by which sauces can increase intake are unlikely to be related to pleasantness and familiarity. (c) 2008 Elsevier Ltd. All rights reserved.

Lacustrine flow (divers, side scan sonar, hydrogeology, water penetrating radar) used to understand the location of a drowned person

An unusual application of hydrological understanding to a police search is described. The lacustrine search for a missing person provided reports of bottom-water currents in the lake and contradictory indications from cadaver dogs. A hydrological model of the area was developed using pre-existing information from side scan sonar, a desktop hydrogeological study and deployment of water penetrating radar (WPR). These provided a hydrological theory for the initial search involving subaqueous groundwater flow, focused on an area of bedrock surrounded by sediment, on the lake floor. The work shows the value a hydrological explanation has to a police search operation (equally to search and rescue). With hindsight, the desktop study should have preceded the search, allowing better understanding of water conditions. The ultimate reason for lacustrine flow in this location is still not proven, but the hydrological model explained the problems encountered in the initial search.

First-order characteristics of the person-to-vehicle channel at 5.8 GHz

In this paper we investigate the first order characteristics of the radio channel between a moving vehicle and a stationary person positioned by the side of a road at 5.8 GHz. The experiments considered a transmitter positioned at different locations on both the body and receivers positioned on the vehicle. The transmitter was alternated between positions on the central chest region, back and the wrist (facing the roadside) of the body, with the receivers placed on the outside roof, the outside rear window and the inside dashboard of the vehicle. The Rice fading model was applied to the measurement data to assess its suitability for characterizing this emerging type of wireless channel. The Ricean K factors calculated from the data suggest that a significant dominant component existed in the majority of the channels considered in this study.

Plasma Homocysteine Is Not Subject to Seasonal Variation.

Background: Studies investigating the relationship between plasma total homocysteine (tHcy) and vascular disease usually rely on a single measurement. Little information is available, however, on the seasonal variability of plasma tHcy. The aim of this study was to investigate the seasonal variation in fasting plasma tHcy and related B-vitamin intake and status in a group of people who did not consume fortified foods or take B-vitamin supplements. Methods: In this longitudinal study, a group of 22 healthy people were followed for 1 year. A fasting blood sample and dietary information were collected from each individual every 3 months, i.e., at the end of each season. Results: There was no significant seasonal variation in plasma tHcy or in B-vitamin intake or status with the exception of red cell folate (significantly lower in spring compared with autumn or winter) and serum folate (significantly lower in spring compared with the other seasons). Although the between-person variation in plasma tHcy was high (47%), the within-person variation was low (11%). This low variation, combined with the low methodologic imprecision of 3.8%, yielded a high reliability coefficient for plasma tHcy (0.97). Conclusions: Although there was a small seasonal variation in folate status, there was no corresponding seasonal variation in plasma tHcy. The high reliability coefficient for plasma tHcy suggests that a single measurement is reflective of an individual’s average plasma tHcy concentration, thus indicating its usefulness as a potential predictor of disease. This, however, needs to be confirmed in different subgroups of the population.

Towards a person-centred ‘culture’: the use of community development approaches in the Independent Youth Counselling Service in West Belfast

This paper is drawn from a qualitative study of clients, counsellors and the supervisors views of the value and impact of the Independent Youth Counselling Service (IYCS) in West Belfast. Data collection combined semi-structured interviews, focus groups and an open-ended questionnaire. The findings indicate the significance of factors above and beyond the person-centred counselling experience, in maximising the potential for growth and development for clients and counsellors. This holistic approach to counselling service provision employs a body of community development processes, which collectively combine to embed the counselling service in a complementary principled approach. This paper explores how these community development features bolster the counselling experience to promote a culture of person-centeredness, thereby increasing the empowerment of the client.

A Method from the 'Lifeworld': Some Possibilities for Person Centred Planning for Children in Care

This paper describes a method for working with chldren who are the subjects of care planning and review under the Children Act 1989. The person centred planning model, as it is termed, has been well established in working with adults with special needs but can be extrapolated to encounters with children. It focuses on three fundamental areas: relationship, meaning and narrative. In underscoring these areas, the method restrains the bureaucracy and experience of stigma that is often present for those residing in State care.