Mediators of gram-positive septic shock

Septic shock can occur as a result of Gram-negative or Gram-positive infection and involves a complex interaction between bacterial factors and the host immune system producing a systemic inflammatory state that may progress to multiple organ failure and death. Gram-positive bacteria are increasingly becoming more prevalent especially Staphylococcus epidermidis in association with indwelling devices. Lipopolysaccaride (LPS) is the key Gram-negative component involved in this process, but it is not clear which components of Gram-positive bacteria are responsible for progression of this often fatal disease. The aim of this thesis was to investigate the effect of bacterial components on the immune systems. Lipid S, a short chain form of lipoteichoic acid (LTA) found to be excreted from bacteria during growth in culture medium was examined along with other Gram-positive cell wall components: LTA, peptidoglycan (PG) and wall teichoic acids (WTA) and LPS from Gram-negative bacteria. Lipid S, LTA, PG and LPS but not WTA all stimulated murine macrophages and cell lines to produce significant amounts of NO, TNF-a, IL-6 and IL-1 and would induce fever and tissue damage seen in inflammatory diseases. Lipid S proved to be the most potent out of the Gram-positive samples tested. IgG antibodies in patients serum were found to bind to and cross react with lipid S and LTA. Anti-inflammatory antibiotics, platelet activating factor (PAF), PAF receptor antagonists and monoclonal antibodies (mAbs) directed to LTA, CD14 and toll-like receptors were utilised to modulate cytokine and NO production. In cell culture the anti-LTA and the anti-CD14 mAbs failed to markedly attenuate the production of NO, TNF-a, IL-6 or IL-1, the anti-TLR4 antibody did greatly inhibit the ability of LPS to stimulate cytokine production but not lipid S. The tetracyclines proved to be the most effective compounds, many were active at low concentrations and showed efficacy to inhibit both lipid S and LPS stimulated macrophages to produce NO.

The Study of Sonar for Imaging of the Solid-Liquid Interface Inside Large Tanks

Retrieval, treatment, and disposal of high-level radioactive waste (HLW) is expected to cost between 100 and 300 billion dollars. The risk to workers, public health, and the environment are also a major area of concern for HLW. Visualization of the interface between settled solids and the optically opaque liquid is needed for retrieval of the waste from underground storage tanks. A Profiling sonar selected for this research generates 2-D image of the interface. Multiple experiments were performed to demonstrate the effectiveness of sonar in real-time monitoring the interface inside HLW tanks. First set of experiments demonstrated that objects shapes could be identified even when 30% of solids entrained in liquid, thereby mapping the interface. Simulation of sonar system validated these results. Second set of experiments confirmed the sonar’s ability in detecting the solids with density similar to the immersed liquid. Third set of experiments determined the affects of near by objects on image resolution. Final set of experiments proved the functional and chemical capabilities of sonar in caustic solution.

Evaluation of semi-passive treatment technologies for septic lagoon capacity expansion

In Canada, increases in rural development has led to a growing need to effectively manage the resulting municipal and city sewage without the addition of significant cost- and energy- expending infrastructure. Storring Septic Service Limited is a family-owned, licensed wastewater treatment facility located in eastern Ontario. It makes use of a passive waste stabilization pond system to treat and dispose of waste and wastewater in an environmentally responsible manner. Storring Septic, like many other similar small-scale wastewater treatment facilities across Canada, has the potential to act as a sustainable eco-engineered facility that municipalities and service providers could utilize to manage and dispose of their wastewater. However, it is of concern that the substantial inclusion of third party material could be detrimental to the stability and robustness of the pond system. In order to augment the capacity of the current facility, and ensure it remains a self-sustaining system with the capacity to safely accept septage from other sewage haulers, it was hypothesized that pond effluent treatment could be further enhanced through the incorporation of one of three different technology solutions, which would allow the reduction of wastewater quality parameters below existing regulatory effluent discharge limits put in place by Ontario’s Ministry of the Environment and Climate Change (MOECC). Two of these solutions make use of biofilm technologies in order to enhance the removal of wastewater parameters of interest, and the third utilizes the natural water filtration capabilities of zebra mussels. Pilot-scale testing investigated the effects of each of these technologies on treatment performance under both cold and warm weather operation. This research aimed to understand the important mechanisms behind biological filtration methods in order to choose and optimize the best treatment strategy for full-scale testing and implementation. In doing so, a recommendation matrix was elaborated provided with the potential to be used as a universal operational strategy for wastewater treatment facilities located in environments of similar climate and ecology.

Culturing the African lungfish in Uganda: effects of exogenous fish feed on growth performance in tanks

The availability of African lungfish (Protopterus aethiopicus) in many communities in Uganda is declining. Indigenous efforts to culture this fish usually produce poor yields and depend on feeding fish fry, minced meat, and leftover food. This study evaluates three formulated diets (diet-1, diet-2, diet-3) fed to wild caught lungfish fingerlings reared in indoor tanks for 77 days. Experimental fish gradually accepted sinking pellets, and marginal increases in average body weight were observed. Mean (± SE) final weight (15.86 ± 0.80 g) for fish fed on diet-3 was significantly higher (p < 0.05) than fish fed diet-1 and diet-2. Specific growth rates (SGR) for diet- 3 were significantly higher (p < 0.05) than diet-1, and marginally more than diet-2 (0.37 ± 0.04 %/ d). Feed conversions were similar (p >0.05), ranging from 1.61 ± 0.26 to 2.07 ± 0.11. Survivals after an 11-week culture were relatively low (< 60%), but generally increased (R2 = 0.667, P = 0.007) with increasing dietary proteins. Diet-3 had a significant higher survival rate (p< 0.05) than diet-1 and diet-2. Significant growth performance was attained with diet-3. This study demonstrated that sinking fish feed pellets can be used to culture wild-caught African fingerlings in captivity.

Sternoclavicular Septic Arthritis Caused by Acupuncture over the Posterior Neck

Acupuncture has been used therapeutically for thousands of years and is considered a relatively safe procedure. Sternoclavicular joint (SCJ) arthritis is a rare joint infection and has never been reported as an adverse event of acupuncture. We report the case of a 50-year-old woman who presented with progressive left neck, shoulder and upper chest pain after acupuncture. A computerized tomography (CT) scan revealed septic arthritis over the left sternoclavicular joint (SCJ) and methicillin-sensitive Staphylococcus aureus bacteraemia was noted. The patient was discharged uneventfully after intravenous antibiotic treatment. SCJ septic arthritis should be considered if unilateral neck and upper chest pain occurs after acupuncture.

Septic Shock Sera Containing Circulating Histones Induce Dendritic Cell–Regulated Necrosis in Fatal Septic Shock Patients

International audience

Water quality and zooplankton in tanks with larvae of Brycon Orbignyanus (Valenciennes, 1949)

Devido à importância das condições das variáveis da água e do alimento disponível no desenvolvimento e sobrevivência das larvas de peixes, o objetivo deste estudo foi avaliar o efeito do uso de dois tratamentos alimentares (ração + zooplâncton e somente zooplâncton) e a qualidade da água, em tanques de larvicultura de Brycon orbignyanus. A transparência total da água (45 cm) esteve associada principalmente ao curto tempo de residência, fluxo contínuo e baixa profundidade. As concentrações de oxigênio dissolvido variaram de 1,32 a 7,00 mg.L-1 no tratamento contendo ração + zooplâncton, e de 1,82 a 7,60 mg.L-1 no tratamento contendo somente zooplâncton. Os nutrientes foram diretamente influenciados pela adição de ração no meio com exceção do nitrito. Rotifera apresentou a maior densidade, variando ao longo do período experimental de 8,7 x 10(5) a 1,3 x 10(6) org.m-3 entre os quatro tanques estudados, num total de dez espécies. A menor densidade foi observada para Cladocera, variando de 4,7 x 10(4) a 2,1 x 10(5) org.m-3 num total de seis espécies encontradas, sendo Diaphanosoma birgei a única espécie classificada como muito freqüente. O uso de ração junto com zooplâncton proporcionou melhor rendimento para larvas de B. orbignyanus.

Dynamics of some limnological characteristics in pacu (Piaractus mesopotamicus) culture tanks as function of handling

Visando obter subsídios para um estudo da qualidade da água em tanques de piscicultura, realizou-se um experimento de 166 dias com uma espécie nativa, pacu (Piaractus mesopotamicus). Nos tanques foram testados dois níveis diferentes de proteína na dieta (16% e 34% de proteína bruta) e três densidades de estocagem (0,25; 0,50 e 0,77 peixes/m²). Dos resultados obtidos foi observado que a interação entre a densidade de estocagem e a duração do experimento interferiram nas variáveis bicarbonato e alcalinidade e a interação entre a densidade de estocagem e a porcentagem de proteína interferiram nas concentrações de CO2 livre e total, condutividade e pH (P < 0,05). A temperatura da água nos tanques variou significativamente ao longo do período estudado (P < 0,05), diminuindo gradativamente do verão para o inverno. Não houve diferença significativa no tempo de residência da água nos tanques (P > 0,05) durante a duração do experimento. Os demais parâmetros não sofreram interferência dos tratamentos ao longo do período de estudo.

Radiological aspects of petroleum exploration and production in the sultanate of Oman

This thesis is a study of naturally occurring radioactive materials (NORM) activity concentration, gamma dose rate and radon (222Rn) exhalation from the waste streams of large-scale onshore petroleum operations. Types of activities covered included; sludge recovery from separation tanks, sludge farming, NORM storage, scaling in oil tubulars, scaling in gas production and sedimentation in produced water evaporation ponds. Field work was conducted in the arid desert terrain of an operational oil exploration and production region in the Sultanate of Oman. The main radionuclides found were 226Ra and 210Pb (238U - series), 228Ra and 228Th (232Th - series), and 227Ac (235U - series), along with 40K. All activity concentrations were higher than the ambient soil level and varied over several orders of magnitude. The range of gamma dose rates at a 1 m height above ground for the farm treated sludge had a range of 0.06 0.43 µSv h 1, and an average close to the ambient soil mean of 0.086 ± 0.014 µSv h 1, whereas the untreated sludge gamma dose rates had a range of 0.07 1.78 µSv h 1, and a mean of 0.456 ± 0.303 µSv h 1. The geometric mean of ambient soil 222Rn exhalation rate for area surrounding the sludge was mBq m 2 s 1. Radon exhalation rates reported in oil waste products were all higher than the ambient soil value and varied over three orders of magnitude. This study resulted in some unique findings including: (i) detection of radiotoxic 227Ac in the oil scales and sludge, (ii) need of a new empirical relation between petroleum sludge activity concentrations and gamma dose rates, and (iii) assessment of exhalation of 222Rn from oil sludge. Additionally the study investigated a method to determine oil scale and sludge age by the use of inherent behaviour of radionuclides as 228Ra:226Ra and 228Th:228Ra activity ratios.

The well-being of older job-seekers : implications for the labour force participation agenda

Throughout the developed world demographic trends and their forecast consequences are attracting the attention of governments, academics, think tanks and the popular press alike. Population aging, in particular, is the focus of many and has generated extensive debate. Approaches commonly advocated in the literature include a mix of ‘population', ‘participation’ and ‘productivity’ measures. Immigration and population policy alongside industry reform and related productivity initiatives are also being pursued. Participation, however, remains a key element of the demographic change policy response. Evidence suggests however, that these approaches are unlikely to deliver the necessary labour force volumes. This has prompted a shift in the participation agenda to also include a stronger focus on skilled and experienced older workers. The literature suggests, however, that the current suite of practices are less than effective for the long-term unemployed, previously long-tenured older workers with specialised skills and trade-displaced workers. Adverse health and human capital outcomes often associated with social disadvantage are complicating factors. This reminds of the complexity of the challenge in seeking to deliver social equity to the disadvantaged and suggests a need for an alternative policy architecture. By integrating the three concepts of health capital, human capital and social capital we show how policy has to change if the older age cohorts of jobseekers are to be assisted to remain employable. This review includes an examination of current policy, a consolidation of the literature and original data.

Continuous infusion of ticarcillin-clavulanate for home treatment of serious infections : clinical efficacy, safety, pharmacokinetics and pharmacodynamics

Continuous infusion (CI) ticarcillin–clavulanate is a potential therapeutic improvement over conventional intermittent dosing because the major pharmacodynamic (PD) predictor of efficacy of β-lactams is the time that free drug levels exceed the MIC. This study incorporated a 6-year retrospective arm evaluating efficacy and safety of CI ticarcillin–clavulanate in the home treatment of serious infections and a prospective arm additionally evaluating pharmacokinetics (PK) and PD. In the prospective arm, steady-state serum ticarcillin and clavulanate levels and MIC testing of significant pathogens were performed. One hundred and twelve patients (median age, 56 years) were treated with a CI dose of 9.3–12.4 g/day and mean CI duration of 18.0 days. Infections treated included osteomyelitis (50 patients), septic arthritis (6), cellulitis (17), pulmonary infections (12), febrile neutropenia (7), vascular infections (7), intra-abdominal infections (2), and Gram-negative endocarditis (2); 91/112 (81%) of patients were cured, 14 (13%) had partial response and 7 (6%) failed therapy. Nine patients had PICC line complications and five patients had drug adverse events. Eighteen patients had prospective PK/PD assessment although only four patients had sufficient data for a full PK/PD evaluation (both serum steady-state drug levels and ticarcillin and clavulanate MICs from a bacteriological isolate), as this was difficult to obtain in home-based patients, particularly as serum clavulanate levels were found to deteriorate rapidly on storage. Three of four patients with matched PK/PD assessment had free drug levels exceeding the MIC of the pathogen. Home CI of ticarcillin–clavulanate is a safe, effective, convenient and practical therapy and is a therapeutic advance over traditional intermittent dosing when used in the home setting.

Implications of faecal indicator bacteria for the microbiological assessment of roof harvested rainwater quality in Southeast Queensland, Australia

The study aimed to evaluate the suitability of Escherichia coli, enterococci and C. perfringens to assess the microbiological quality of roof harvested rainwater, and to assess whether the concentrations of these faecal indicators can be used to predict the presence or absence of specific zoonotic bacterial or protozoan pathogens. From a total of 100 samples tested, respectively 58%, 83% and 46% of samples were found to be positive for E. coli, enterococci and C. perfringens spores, as determined by traditional culture based methods. Additionally, in the samples tested, 7%, 19%, 1%, 8%, 17%, and 15% were PCR positive for A. hydrophila lip, C. coli ceuE, C. jejuni mapA, L. pneumophila mip, Salmonella invA, and G. lamblia β-giardin genes. However, none of the samples was positive for E. coli O157 LPS, VT1, VT2 and C. parvum COWP genes. The presence or absence of these potential pathogens did not correlate with any of the faecal indicator bacterial concentrations as determined by a binary logistic regression model. The roof-harvested rainwater samples tested in this study appear to be of poor microbiological quality and no significant correlation was found between the concentration of faecal indicators and pathogenic microorganisms. The use of faecal indicator bacteria raises questions regarding their reliability in assessing the microbiological quality of water and particularly their poor correlation with pathogenic microorganisms. The presence of one or more zoonotic pathogens suggests that the microbiological analysis of water should be performed, and appropriate treatment measures should be undertaken especially in tanks where the water is used for drinking.

Axisymmetric shell structures for multi-use

Shell structures find use in many fields of engineering, notably structural, mechanical, aerospace and nuclear-reactor disciplines. Axisymmetric shell structures are used as dome type of roofs, hyperbolic cooling towers, silos for storage of grain, oil and industrial chemicals and water tanks. Despite their thin walls, strength is derived due to the curvature. The generally high strength-to-weight ratio of the shell form, combined with its inherent stiffness, has formed the basis of this vast application. With the advent in computation technology, the finite element method and optimisation techniques, structural engineers have extremely versatile tools for the optimum design of such structures. Optimisation of shell structures can result not only in improved designs, but also in a large saving of material. The finite element method being a general numerical procedure that could be used to treat any shell problem to any desired degree of accuracy, requires several runs in order to obtain a complete picture of the effect of one parameter on the shell structure. This redesign I re-analysis cycle has been achieved via structural optimisation in the present research, and MSC/NASTRAN (a commercially available finite element code) has been used in this context for volume optimisation of axisymmetric shell structures under axisymmetric and non-axisymmetric loading conditions. The parametric study of different axisymmetric shell structures has revealed that the hyperbolic shape is the most economical solution of shells of revolution. To establish this, axisymmetric loading; self-weight and hydrostatic pressure, and non-axisymmetric loading; wind pressure and earthquake dynamic forces have been modelled on graphical pre and post processor (PATRAN) and analysis has been performed on two finite element codes (ABAQUS and NASTRAN), numerical model verification studies are performed, and optimum material volume required in the walls of cylindrical, conical, parabolic and hyperbolic forms of axisymmetric shell structures are evaluated and reviewed. Free vibration and transient earthquake analysis of hyperbolic shells have been performed once it was established that hyperbolic shape is the most economical under all possible loading conditions. Effect of important parameters of hyperbolic shell structures; shell wall thickness, height and curvature, have been evaluated and empirical relationships have been developed to estimate an approximate value of the lowest (first) natural frequency of vibration. The outcome of this thesis has been the generation of new research information on performance characteristics of axisymmetric shell structures that will facilitate improved designs of shells with better choice of shapes and enhanced levels of economy and performance. Key words; Axisymmetric shell structures, Finite element analysis, Volume Optimisation_ Free vibration_ Transient response.

Health risk from the use of roof-harvested rainwater in Southeast Queensland, Australia, as potable or nonpotable water, determined using quantitative microbial risk assessment

A total of 214 rainwater samples from 82 tanks were collected in urban Southeast Queensland (SEQ) in Australia and analysed for the zoonotic bacterial and protozoan pathogen using real-time binary PCR and quantitative PCR (qPCR). Quantitative Microbial Risk Assessment (QMRA) analysis was used to quantify the risk of infection associated with the exposure to potential pathogens from potable and non-potable uses of roof-harvested rainwater. Of the 214 samples tested, 10.7%, 9.8%, and 5.6%, and 0.4% samples were positive for Salmonella invA, Giardia lamblia β-giardin , Legionella pneumophila mip, and Campylobacter jejuni mapA genes. Cryptosporidium parvum could not be detected. The estimated numbers of viable Salmonella spp., G. lamblia β-giradin, and L. pneumophila genes ranged from 1.6 × 101 to 9.5 × 101 cells, 1.4 × 10-1 to 9.0 × 10-1 cysts, and 1.5 × 101 to 4.3 × 101 per 1000 ml of water, respectively. Six risk scenarios were considered from exposure to Salmonella spp., G. lamblia and L. pneumophila. For Salmonella spp., and G. lamblia, these scenarios were: (1) liquid ingestion due to drinking of rainwater on a daily basis (2) accidental liquid ingestion due to garden hosing twice a week (3) aerosol ingestion due to showering on a daily basis, and (4) aerosol ingestion due to hosing twice a week. For L. pneumophila, these scenarios were: (5) aerosol inhalation due to showering on a daily basis, and (6) aerosol inhalation due to hosing twice a week. The risk of infection from Salmonella spp., G. lamblia, and L. pneumophila associated with the use of rainwater for showering and garden hosing was calculated to be well below the threshold value of one extra infection per 10,000 persons per year in urban SEQ. However, the risk of infection from ingesting Salmonella spp. and G. lamblia via drinking exceeds this threshold value, and indicates that if undisinfected rainwater were ingested by drinking, then the gastrointestinal diseases of Salmonellosis and Giardiasis is expected to range from 5.0 × 100 to 2.8 × 101 (Salmonellosis) and 1.0 × 101 to 6.4 × 101 (Giardiasis) cases per 10,000 persons per year, respectively. Since this health risk seems higher than that expected from the reported incidences of gastroenteritis, the assumptions used to estimate these infection risks are critically examined. Nonetheless, it would seem prudent to disinfect rainwater for potable use.