Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014

Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted.

Application of cuckoo search for design optimization of heat exchangers

A wide variety of evolutionary optimization algorithms have been used by researcher for optimal design of shell and tube heat exchangers (STHX). The purpose of optimization is to minimize capital and operational costs subject to efficiency constraints. This paper comprehensively examines performance of genetic algorithm (GA) and cuckoo search (CS) for solving STHX design optimization. While GA has been widely adopted in the last decade for STHX optimal design, there is no report on application of CS method for this purpose. Simulation results in this paper demonstrate that CS greatly outperforms GA in terms of finding admissible and optimal configurations for STHX. It is also found that CS method not only has a lower computational requirement, but also generates the most consistent results.

A critical ethnography of communication processes involving the management of oral chemotherapeutic agents by patients with a primary diagnosis of colorectal cancer: study protocol.

AIM: To describe the protocol used to examine the processes of communication between health professionals, patients and informal carers during the management of oral chemotherapeutic medicines to identify factors that promote or inhibit medicine concordance. BACKGROUND: Ideally communication practices about oral medicines should incorporate shared decision-making, two-way dialogue and an equality of role between practitioner and patient. While there is evidence that healthcare professionals are adopting these concordant elements in general practice there are still some patients who have a passive role during consultations. Considering oral chemotherapeutic medications, there is a paucity of research about communication practices which is surprising given the high risk of toxicity associated with chemotherapy. DESIGN: A critical ethnographic design will be used, incorporating non-participant observations, individual semi-structured and focus-group interviews as several collecting methods. METHODS: Observations will be carried out on the interactions between healthcare professionals (physicians, nurses and pharmacists) and patients in the outpatient departments where prescriptions are explained and supplied and on follow-up consultations where treatment regimens are monitored. Interviews will be conducted with patients and their informal carers. Focus-groups will be carried out with healthcare professionals at the conclusion of the study. These several will be analysed using thematic analysis. This research is funded by the Department for Employment and Learning in Northern Ireland (Awarded February 2012). DISCUSSION: Dissemination of these findings will contribute to the understanding of issues involved when communicating with people about oral chemotherapy. It is anticipated that findings will inform education, practice and policy.

Towards the optimization of performance of Atlantic salmon reared at different water temperatures via the manipulation of dietary ARA/EPA ratio

In recent years, aquaculture has been facing a series of new issues, including the necessary replacement of fish oil and fish meal because of their limited supply and sub-optimal water temperature conditions. Higher water temperatures are increasingly encountered as the result of climate change related phenomena and/or the practice of farming of species in areas with environmental characteristics outside their optimal physiological range, such as the case of Atlantic salmon (. Salmo salar) farming in Australia during the summer season. Previous studies in teleost fish have shown that when fish are exposed at higher environmental temperatures, fish had a preferential increased dietary intake for arachidonic acid (20:4n - 6, ARA). This observation suggests that, given the several metabolic roles of ARA, its dietary provision may play an important role in fish for adapting at sub-optimal high water temperatures. The objective of this study was therefore to evaluate the effects of different dietary ARA/EPA ratios in juvenile Atlantic salmon as affected by time of exposition to the diet and water temperatures, with particular focus to fish performance and possible resulting modifications of tissue fatty acid composition. The study showed that independently from dietary treatments, fish held at the higher temperatures had an increased ARA accumulation, primarily in the liver and this ARA accumulation increased over time. It was also shown that the combined dietary inclusion of ARA and EPA significantly improved fish performance, compared with diets either richer in ARA or EPA. A general trend toward higher content of n - 3 LC-PUFA at lower temperatures was also quite clear, especially in the liver. Therefore, and assuming that the trends in tissue fatty acid composition could be taken as a clue of the optimal fatty acid requirements of fish, the n - 6 requirement (and in particular ARA) clearly appears to be greater for Atlantic salmon raised at high water temperatures. Protein accumulation was higher in the diet with the combined dietary inclusion of ARA and EPA for fish held at high water temperature (20. °C), with a concomitant lipid reduction. This study shows the importance of dietary ARA for maximal growth in Atlantic salmon, particularly during the period of the year when high water temperatures are often encountered. Further studies specifically looking at optimal dietary ARA/EPA ratio and roles of ARA on myogenesis, stress physiology and immune status of cultured fish are warranted. Statement of relevance: Given the current high level of fish oil replacement in aquafeed, and the often encountered sub-optimal environmental temperatures, we believe that this study could be considered as timely and highly pertinent for the aquaculture industry and associated R&D sector.

Prediction interval-based modelling and control of nonlinear processes

 Novel computational intelligence-based methods have been investigated to quantify uncertainties prevalent in the operation of chemical plants. A new family of predication interval-based controlling algorithms is proposed and successfully applied to chemical reactors in order to minimise energy consumption and operational cost.

Joint optimization of rule placement and traffic engineering for QoS provisioning in software defined network

Software-Defined Network (SDN) is a promising network paradigm that separates the control plane and data plane in the network. It has shown great advantages in simplifying network management such that new functions can be easily supported without physical access to the network switches. However, Ternary Content Addressable Memory (TCAM), as a critical hardware storing rules for high-speed packet processing in SDN-enabled devices, can be supplied to each device with very limited quantity because it is expensive and energy-consuming. To efficiently use TCAM resources, we propose a rule multiplexing scheme, in which the same set of rules deployed on each node apply to the whole flow of a session going through but towards different paths. Based on this scheme, we study the rule placement problem with the objective of minimizing rule space occupation for multiple unicast sessions under QoS constraints. We formulate the optimization problem jointly considering routing engineering and rule placement under both existing and our rule multiplexing schemes. Via an extensive review of the state-of-the-art work, to the best of our knowledge, we are the first to study the non-routing-rule placement problem. Finally, extensive simulations are conducted to show that our proposals significantly outperform existing solutions.