Post-discharge surveillance : can patients reliably diagnose surgical wound infections?

Post-discharge surgical wound infection surveillance is an important part of many infection control programs. It is frequently undertaken by patient self-assessment, prompted either by a telephone or postal questionnaire. To assess the reliability of this method, 290 patients were followed for six weeks postoperatively. Their wounds were photographed and also covertly assessed for signs of infection by two experienced infection control nurses (ICNs). Patients also responded to a postal questionnaire seeking evidence of infection at both week four and week six post-surgery. Correlation between the patient's assessment of their wound and the ICNs diagnosis was poor (r=0.37) with a low positive predictive value (28.7%), although negative predictive value was high (98.2%). Assessment of photos for signs of infection by two experienced clinicians also correlated poorly with the ICNs diagnosis of infection (r=0.54). The patient's recall of prescription of an antibiotic by their general practitioner (GP) for wound infection during the postoperative period correlated best with the ICNs diagnosis (r=0.76). This latter measure, particularly when confirmed by the GP in those patients reporting an infection, appears to provide the most valid and resource efficient marker of post-discharge surgical wound infection.

Quantifying the roles of cell motility and cell proliferation in a circular barrier assay

Moving fronts of cells are essential features of embryonic development, wound repair and cancer metastasis. This paper describes a set of experiments to investigate the roles of random motility and proliferation in driving the spread of an initially confined cell population. The experiments include an analysis of cell spreading when proliferation was inhibited. Our data have been analysed using two mathematical models: a lattice-based discrete model and a related continuum partial differential equation model. We obtain independent estimates of the random motility parameter, D, and the intrinsic proliferation rate, λ, and we confirm that these estimates lead to accurate modelling predictions of the position of the leading edge of the moving front as well as the evolution of the cell density profiles. Previous work suggests that systems with a high λ/D ratio will be characterized by steep fronts, whereas systems with a low λ/D ratio will lead to shallow diffuse fronts and this is confirmed in the present study. Our results provide evidence that continuum models, based on the Fisher–Kolmogorov equation, are a reliable platform upon which we can interpret and predict such experimental observations.

The largest eruptions in Earth's history

Large igneous provinces (LIPs) host the most frequently recurring, largest volume basaltic & silicic eruptions on Earth. The largest volume (>1000 km^3 DRE) and magnitude (>M8) eruptions produce areally extensive (10^4-10^5 km^2) basaltic flow fields and sills, and silicic ignimbrites that are the main LIP building blocks. Basaltic and silicic eruptions have comparable magnitudes, but silicic ignimbrite volumes may be significantly underestimated due to unrecognized and correlated, but voluminous co-ignimbrite ash deposits. Magma composition is no barrier to individual eruption volume. Despite similar magnitudes, flood basaltic and silicic eruptions are very different in eruption mechanism, duration, intensity, vent configuration, and emplacement style. Flood basalts are dominantly effusive Hawaiian-Strombolian, with magma discharge rates of ~10^7-10^8 kg s^-1, and produce dominantly compound pahoehoe flow fields over eruption durations most likely >10 yrs. Most silicic eruptions are moderately to highly explosive, producing cocurrent pyroclastic fountains (rarely Plinian) and suggested to be of short-duration (hours to days) and high intensity (~10^11 kg s^-1). Eruption frequencies are elevated for largemagnitude eruptions of both magma types during LIP formation. In basalt-dominated provinces, large magnitude (>M8) eruptions have much shorter recurrence intervals (10^3-10^4 years) than similar magnitude silicic eruptions (~10^5 years). The huge volumes of magma erupted rapidly in LIPs raises several unresolved issues in terms of locus of magma generation and storage (if any) in the crust prior to eruption, the paths and rates of ascent from magma reservoirs to the surface, and relative aerosol contributions to the stratosphere from the flood basaltic and rhyolitic eruptions.

Improving the hydrogen gas sensing performance of Pt/MoO3 nanoplatelets using a nano thick layer of La2O3

In this paper, we present how a thin RF sputtered layer of lanthanum oxide (La2O3) can alter electrical and improve hydrogen gas sensing characteristics of Pt/molybdenum oxide (MoO3) nanostructures Schottky diodes. We derived the barrier height, ideality factor and dielectric constant from the measured I–V characteristics at operating temperatures in the range of 25–300 ◦C. The dynamic response, response and recovery times were obtained upon exposure to hydrogen gas at different concentrations. Analysis of the results indicated a substantial improvement to the voltage shift sensitivity of the sensors incorporating the La2O3 layer. We associate this enhancement to the formation of numerous trap states due to the presence of the La2O3 thin film on the MoO3 nanoplatelets. These trap states increase the intensity of the dipolar charges at the metal–semiconductor interface, which induce greater bending of the energy bands. However, results also indicate that the presence of La2O3 trap states also increases response and recover times as electrons trapping and de-trapping processes occur before they can pass through this thin dielectric layer.

The decline in activities of daily living at discharge (DADLD) index : stratifying patients at lower and higher risk

Background: Decreased ability to perform Activities of Daily Living (ADLs) during hospitalisation has negative consequences for patients and health service delivery. Objective: To develop an Index to stratify patients at lower and higher risk of a significant decline in ability to perform ADLs at discharge. Design: Prospective two cohort study comprising a derivation (n=389; mean age 82.3 years; SD� 7.1) and a validation cohort (n=153; mean age 81.5 years; SD� 6.1). Patients and setting: General medical patients aged = 70 years admitted to three university-affiliated acute care hospitals in Brisbane, Australia. Measurement and main results: The short ADL Scale was used to identify a significant decline in ability to perform ADLs from premorbid to discharge. In the derivation cohort, 77 patients (19.8%) experienced a significant decline. Four significant factors were identified for patients independent at baseline: 'requiring moderate assistance to being totally dependent on others with bathing'; 'difficulty understanding others (frequently or all the time)'; 'requiring moderate assistance to being totally dependent on others with performing housework'; a 'history of experiencing at least one fall in the previous 90 days prior to hospital admission' in addition to 'independent at baseline', which was protective against decline at discharge. 'Difficulty understanding others (frequently or all the time)' and 'requiring moderate assistance to being totally dependent on others with performing housework' were also predictors for patients dependent in ADLs at baseline. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of the DADLD dichotomised risk scores were: 83.1% (95% CI 72.8; 90.7); 60.5% (95% CI 54.8; 65.9); 34.2% (95% CI 27.5; 41.5); 93.5% (95% CI 89.2; 96.5). In the validation cohort, 47 patients (30.7%) experienced a significant decline. Sensitivity, specificity, PPV and NPV of the DADLD were: 78.7% (95% CI 64.3; 89.3); 69.8% (95% CI 60.1, 78.3); 53.6% (95% CI 41.2; 65.7); 88.1% (95% CI 79.2; 94.1). Conclusions: The DADLD Index is a useful tool for identifying patients at higher risk of decline in ability to perform ADLs at discharge.

Image-based flow visualisation (IBFV) to enhance interpretation of complex flow patterns within a shallow tidal barrier estuary

We applied a texture-based flow visualisation technique to a numerical hydrodynamic model of the Pumicestone Passage in southeast Queensland, Australia. The quality of the visualisations using our flow visualisation tool, are compared with animations generated using more traditional drogue release plot and velocity contour and vector techniques. The texture-based method is found to be far more effective in visualising advective flow within the model domain. In some instances, it also makes it easier for the researcher to identify specific hydrodynamic features within the complex flow regimes of this shallow tidal barrier estuary as compared with the direct and geometric based methods.

A water-dielectric capacitor using hydrated graphene oxide film

Despite the widespread use of paper, plastic or ceramics in dielectric capacitors, water has not been commonly used as a dielectric due to its tendency to become conductive as it easily leaches ions from the environment. We show here that when water is confined between graphene oxide sheets, it can retain its insulating nature and behave as a dielectric. A hydrated graphene oxide film was used as a dielectric spacer to construct a prototype water-dielectric capacitor. The capacitance depends on the water content of the hydrated GO film as well as the voltage applied to the device. Our results show that the capacitance per unit area of the GO film is in the range of 100–800 mF cm �2, which is 5–40 times that of the double layer capacitance per surface area of activated carbon.

Enlarged stopping distance to improve vehicle discharge at urban signalised intersections

Normally, vehicles queued at an intersection reach maximum flow rate after the fourth vehicle and results in a start-up lost time. This research demonstrated that the Enlarged Stopping Distance (ESD) concept could assist in reducing the start-up time and therefore increase traffic flow capacity at signalised intersections. In essence ESD gives sufficient space for a queuing vehicle to accelerate simultaneously without having to wait for the front vehicle to depart, hence reducing start-up lost time. In practice, the ESD concept would be most effective when enlarged stopping distance between the first and second vehicle allowing faster clearance of the intersection.

Safety enhancement of water-filled road safety barrier using interaction of composite materials

Road safety barriers are used to redirect traffic at roadside work-zones. When filled with water, these barriers are able to withstand low to moderate impact speeds up to 50kmh-1. Despite this feature, Portable Water-filled barriers (PWFB) face challenges such as large lateral displacements, tearing and breakage during impact; especially at higher speeds. This study explores the use of composite action to enhance the crashworthiness of PWFBs and enable their usage at higher speeds. Initially, energy absorption capability of water in PWFB is investigated. Then, composite action of the PWFB with the introduction of steel frame is considered to evaluate its enhanced impact performance. Findings of the study show that the initial height of the impact must be lower than the free surface level of water in a PWFB in order for the water to provide significant crash energy absorption. In general, an impact of a road barrier with 80% filled is a good estimation. Furthermore, the addition of a composite structure greatly reduces the probability of tearing by decreasing the strain and impact energy transferred to the shell container. This allows the water to remain longer in the barrier to absorb energy via inertial displacements and sloshing response. Information from this research will aid in the design of new generation roadside safety structures aimed to increase safety in modern roadways.

How long does it take for aquifer recharge or aquifer discharge processes to reach steady state?

Groundwater flow models are usually characterized as being either transient flow models or steady state flow models. Given that steady state groundwater flow conditions arise as a long time asymptotic limit of a particular transient response, it is natural for us to seek a finite estimate of the amount of time required for a particular transient flow problem to effectively reach steady state. Here, we introduce the concept of mean action time (MAT) to address a fundamental question: How long does it take for a groundwater recharge process or discharge processes to effectively reach steady state? This concept relies on identifying a cumulative distribution function, $F(t;x)$, which varies from $F(0;x)=0$ to $F(t;x) \to \infty$ as $t\to \infty$, thereby providing us with a measurement of the progress of the system towards steady state. The MAT corresponds to the mean of the associated probability density function $f(t;x) = \dfrac{dF}{dt}$, and we demonstrate that this framework provides useful analytical insight by explicitly showing how the MAT depends on the parameters in the model and the geometry of the problem. Additional theoretical results relating to the variance of $f(t;x)$, known as the variance of action time (VAT), are also presented. To test our theoretical predictions we include measurements from a laboratory–scale experiment describing flow through a homogeneous porous medium. The laboratory data confirms that the theoretical MAT predictions are in good agreement with measurements from the physical model.

Safety enhancement of water-filled road safety barrier using interaction of composite materials

Road safety barriers are used to redirect traffic at roadside work-zones. When filled with water, these barriers are able to withstand low to moderate impact speeds up to 50kmh-1. Despite this feature, there are challenges when using portable water-filled barriers (PWFBs) such as large lateral displacements as well as tearing and breakage during impact, especially at higher speeds. In this study, the authors explore the use of composite action to enhance the crashworthiness of PWFBs and enable their use at higher speeds. Initially, we investigated the energy absorption capability of water in PWFB. Then, we considered the composite action of a PWFB with the introduction of a steel frame to evaluate its impact on performance. Findings of the study show that the initial height of impact must be lower than the free surface level of water in a PWFB for the water to provide significant crash energy absorption. In general, impact of a road barrier that is 80% filled is a good estimation. Furthermore, the addition of a composite structure greatly reduces the probability of tearing by decreasing the strain and impact energy transferred to the shell container. This allows the water to remain longer in the barrier to absorb energy via inertial displacement and sloshing response. Information from this research will aid in the design of next generation roadside safety structures aimed to increase safety on modern roadways.

Experimental impact and finite element analysis of a composite, portable road safety barrier

This thesis provides an experimental and computational platform for investigating the performance and behaviour of water filled, plastic portable road safety barriers in an isolated impact scenario. A schedule of experimental impact tests were conducted assessing the impact response of an existing design of road safety barrier utilising a novel horizontal impact testing system. A coupled finite element and smooth particle hydrodynamic model of the barrier system was developed and validated against the results of the experimental tests. The validated model was subsequently used to assess the effect of certain composite materials on the impact performance of the water filled, portable road safety barrier system.