The source, cost and prevention of central venous catheter-related infection

Central venous catheters have become an integral part of patient management however they are associated with many complications including infection. Despite efforts being made to reduce the incidence of such infect ions the problem continues to increase and has resource implications for the Health Service. Studies relating to the source of microorganisms causing CVC-associated infection, the cost of such infections and the efficacy of an antimicrobial catheter have been undertaken. Thirty patients who required a CVC as part of their medical management and underwent cardiac surgery had the distal tips of their catheters sampled whilst in situ. Sampling took place within 1 h of catheter placement. Bacteria were isolated from 16% of the catheter distal tips sampled in situ. The guidewires used to insert the devices were also contaminated (50%). When CVC were inserted via a protective sheath, avoiding contact with the skin. the incidence of microbial contamination was reduced. These findings suggest that despite rigorous skin disinfection and strict aseptic technique, viable microorganisms are impacted onto the distal tip of CVC during the insertion procedure. Needleless intravascular access devices have been introduced in order to reduce the incidence of need1estick injury. However, it was unclear whether such connectors would act as a portal of entry for microorganisms to CVC. The efficacy of these devices was investigated. Within the controlled laboratory environment it was demonstrated that needleless devices, when challenged with microorganisms, did not allow the passage of microbes when flu id was injected. This therefore suggested that the devices should not increase the risk of catheter colonisation. When used in clinical practice however microbial contamination of the needleless connectors was 55 % in comparison to the routinely used luer connectors (23%). The cost of infections associated with CVC was determined. Twenty patients catheterised with a CVC designed for long term use who were admitted to hospital with a presumptive diagnosis of catheter-related infection were studied. The treatment given specifically for this infection was costed. The mean cost of such an infection was £ 1781.81. Throughout the UK this may amount to £1.565.906 per annum. The cost of infections associated with CVC designed for short term use was estimated to be between 5 and 7 million pounds per annum in the UK. In an attempt to reduce both the incidence and cost of catheter- related infection antimicrobial CVC have been developed. The efficacy of a novel polyurethane CVC impregnated on both the internal and external catheter surface with the quaternary ammonium compound benzalkonium chloride was investigated. Eighty eight patients received an antimicrobial catheter and 78 patients a conventional polyurethane CVC. The anti-microbial CVC resulted in a reduction in microbial colonisation of the external and internal polymer surfaces as compared to the control device. The observed reduction in microbial colonisation with the anti-microbial CVC may decrease the likelihood of subsequent infection offering a useful approach to the prevention of catheter-related infections.

Solar thermal collectors for use in hybrid solar-biomass power plants in India

This thesis examined solar thermal collectors for use in alternative hybrid solar-biomass power plant applications in Gujarat, India. Following a preliminary review, the cost-effective selection and design of the solar thermal field were identified as critical factors underlying the success of hybrid plants. Consequently, the existing solar thermal technologies were reviewed and ranked for use in India by means of a multi-criteria decision-making method, the Analytical Hierarchy Process (AHP). Informed by the outcome of the AHP, the thesis went on to pursue the Linear Fresnel Reflector (LFR), the design of which was optimised with the help of ray-tracing. To further enhance collector performance, LFR concepts incorporating novel mirror spacing and drive mechanisms were evaluated. Subsequently, a new variant, termed the Elevation Linear Fresnel Reflector (ELFR) was designed, constructed and tested at Aston University, UK, therefore allowing theoretical models for the performance of a solar thermal field to be verified. Based on the resulting characteristics of the LFR, and data gathered for the other hybrid system components, models of hybrid LFR- and ELFR-biomass power plants were developed and analysed in TRNSYS®. The techno-economic and environmental consequences of varying the size of the solar field in relation to the total plant capacity were modelled for a series of case studies to evaluate different applications: tri-generation (electricity, ice and heat), electricity-only generation, and process heat. The case studies also encompassed varying site locations, capacities, operational conditions and financial situations. In the case of a hybrid tri-generation plant in Gujarat, it was recommended to use an LFR solar thermal field of 14,000 m2 aperture with a 3 tonne biomass boiler, generating 815 MWh per annum of electricity for nearby villages and 12,450 tonnes of ice per annum for local fisheries and food industries. However, at the expense of a 0.3 ¢/kWh increase in levelised energy costs, the ELFR increased saving of biomass (100 t/a) and land (9 ha/a). For solar thermal applications in areas with high land cost, the ELFR reduced levelised energy costs. It was determined that off-grid hybrid plants for tri-generation were the most feasible application in India. Whereas biomass-only plants were found to be more economically viable, it was concluded that hybrid systems will soon become cost competitive and can considerably improve current energy security and biomass supply chain issues in India.

An interdisciplinary approach to designing and evaluating a hybrid solar-biomass power plant

Purpose: Energy security is a major concern for India and many rural areas remain un-electrified. Thus, innovations in sustainable technologies to provide energy services are required. Biomass and solar energy in particular are resources that are widely available and underutilised in India. This paper aims to provide an overview of a methodology that was developed for designing and assessing the feasibility of a hybrid solar-biomass power plant in Gujarat. Design/methodology/approach: The methodology described is a combination of engineering and business management studies used to evaluate and design solar thermal collectors for specific applications and locations. For the scenario of a hybrid plant, the methodology involved: the analytical hierarchy process, for solar thermal technology selection; a cost-exergy approach, for design optimisation; quality function deployment, for designing and evaluating a novel collector - termed the elevation linear Fresnel reflector (ELFR); and case study simulations, for analysing alternative hybrid plant configurations. Findings: The paper recommended that for a hybrid plant in Gujarat, a linear Fresnel reflector of 14,000 m2 aperture is integrated with a 3 tonne per hour biomass boiler, generating 815 MWh per annum of electricity for nearby villages and 12,450 tonnes of ice per annum for local fisheries and food industries. However, at the expense of a 0.3 ¢/kWh increase in levelised energy costs, the ELFR can increase savings of biomass (100 t/a) and land (9 ha/a). Research limitations/implications: The research reviewed in this paper is primarily theoretical and further work will need to be undertaken to specify plant details such as piping layout, pump sizing and structure, and assess plant performance during real operational conditions. Originality/value: The paper considers the methodology adopted proved to be a powerful tool for integrating technology selection, optimisation, design and evaluation and promotes interdisciplinary methods for improving sustainable engineering design and energy management. © Emerald Group Publishing Limited.

The pupillary light reflex in migraine

The literature suggests that there may be pupil size and response abnormalities in migraine headache sufferers. We used an infra-red pupillometer to measure dynamic pupil responses to light in 20 migraine sufferers (during non-headache periods) and 16 non-migraine age and gender matched controls. There was a significant increase in the absolute inter-ocular difference of the latency of the pupil light response in the migraine group compared with the controls (0.062 s vs 0.025 s, p = 0.014). There was also a significant correlation between anisocoria and lateralisation of headache such that migraine sufferers with a habitual head pain side have more anisocoria (r= 0.59, p < 0.01), but this was not related to headache laterally. The pupil changes were not correlated with the interval since the last migraine headache, the severity of migraine headache or the number of migraine headaches per annum. We conclude that subtle sympathetic and parasympathetic pupil abnormalities persist in the inter-ictal phase of migraine. © 2005 The College of Optometrists.

Does patenting help high-tech start-ups?

Abstract: Using data on all high- and medium-tech start-ups in the UK in 2000, this paper assesses the effect associated with a firm's decision to patent on a firm's subsequent growth between 2001 and 2005. We propose a new approach to addressing well known issues challenging identification of any patent effect: firm heterogeneity, simultaneity between firm performance and patenting, and sample selection. Our findings suggest that patentees have higher asset growth than non-patentees of between 8% and 27% per annum. © 2011 Elsevier B.V. All rights reserved.

Location and ages of terrestrial peatlands located on continental shelves and in coastal sediments

This synthesis dataset contains records of freshwater peat and lake sediments from continental shelves and coastal areas. Information included is site location (when available), thickness and description of terrestrial sediments as well as underlying and overlying sediments, dates (when available), and references.

System operational costs reduction with non-conventional reactive power sources

Wind energy installations are increasing in power systems worldwide and wind generation capacity tends to be located some distance from load centers. A conflict may arise at times of high wind generation when it becomes necessary to curtail wind energy in order to maintain conventional generators on-line for the provision of voltage control support at load centers. Using the island of Ireland as a case study and presenting commercially available reactive power support devices as possible solutions to the voltage control problems in urban areas, this paper explores the reduction in total generation costs resulting from the relaxation of the operational constraints requiring conventional generators to be kept on-line near load centers for reactive power support. The paper shows that by 2020 there will be possible savings of 87€m per annum and a reduction in wind curtailment of more than a percentage point if measures are taken to relax these constraints.

Pollen from 50 lake surface samples in Brandenburg, Germany, in 2009

Past changes in plant and landscape diversity can be evaluated through pollen analysis, however, pollen based diversity indexes are potentially biased by differential pollen production and deposition. Studies examining the relationship between pollen and landscape diversity are therefore needed. The aim of this study is to evaluate how different pollen based indexes capture aspects of landscape diversity. Pollen counts were obtained from surface samples of 50 small to medium sized lakes in Brandenburg (Northeast Germany) and compiled into two sets, with one containing all pollen counts from terrestrial plants and the second restricted to wind-pollinated taxa. Both sets were adjusted for the pollen production/dispersal bias using the REVEALS model. A high resolution biotope map was used to extract the density of total biotopes and different biotopes per area as parameters describing landscape diversity. In addition tree species diversity was obtained from forest inventory data. The Shannon index and the number of taxa in a sample of 10 pollen grains are highly correlated and provide a useful measure of pollen type diversity which corresponds best to landscape diversity within one km of the lake and the proportion of non-forested area within seven km. Adjustments of the pollen production/dispersal bias only slightly improve the relationships between pollen diversity and landscape diversity for the restricted dataset as well as for the forest inventory data and corresponding pollen types. Using rarefaction analysis, we propose the following convention: pollen type diversity is represented by the number of types in a small sample (low count e.g. 10), pollen type richness is the number of types in a large sample (high count e.g. 500) and pollen sample evenness is characterized by the ratio of the two. Synthesis. Pollen type diversity is a robust index that captures vegetation structure and landscape diversity. It is ideally suited for between site comparisons as it does not require high pollen counts. In concert with pollen type richness and evenness, it helps evaluating the effect of climate change and human land use on vegetation structure on long timescales.

Performance and prospects of smaller UK regional airports

This paper investigates the traffic and financial performance of smaller UK regional airports between 2001 and 2014. Fourteen airports that typically serve less than 5 million passengers per annum were selected for the analysis. A period of strong growth in passenger demand was experienced from 2001 to 2007, driven largely by low cost carriers. The period from 2007 to 2014 was characterised by declining demand, resulting in significant losses for many of the airports. Airline strategies, such as the use of an increased unit fleet size and average sector length, may further limit future prospects for smaller UK regional airports in favour of larger ones with greater local demand. The relationship between traffic throughput and the generation of aeronautical revenues seems to vary at airports. There is generally a strong and significant relationship between traffic throughput and the generation of commercial revenues and total operating costs at airports serving 3–5 million passengers, but the situation for airports serving fewer than 3 million is less certain.

Los emigrantes en las áreas mineras y las ciudades de Hispania: religión, identidades y difusión cultural

En el presente artículo analizamos los desplazamientos de cultos indígenas hispanos desde distintas áreas de la Península Ibérica hacia los principales lugares de inmigración en Hispania: las áreas mineras y las ciudades. Proponemos que estos grupos de emigrantes rendían culto en su nueva residencia a las deidades que veneraban en sus regiones de procedencia como un medio de preservar su cohesión social y su identidad cultural. La dureza de la vida laboral en las áreas mineras reforzaba la necesidad de fortalecer los lazos culturales.

Sepsis: the LightCycler SeptiFast Test MGRADE®, SepsiTest™ and IRIDICA BAC BSI assay for rapidly identifying bloodstream bacteria and fungi – a systematic review and economic evaluation

Background: Sepsis can lead to multiple organ failure and death. Timely and appropriate treatment can reduce in-hospital mortality and morbidity. Objectives: To determine the clinical effectiveness and cost-effectiveness of three tests [LightCycler SeptiFast Test MGRADE® (Roche Diagnostics, Risch-Rotkreuz, Switzerland); SepsiTest™ (Molzym Molecular Diagnostics, Bremen, Germany); and the IRIDICA BAC BSI assay (Abbott Diagnostics, Lake Forest, IL, USA)] for the rapid identification of bloodstream bacteria and fungi in patients with suspected sepsis compared with standard practice (blood culture with or without matrix-absorbed laser desorption/ionisation time-offlight mass spectrometry). Data sources: Thirteen electronic databases (including MEDLINE, EMBASE and The Cochrane Library) were searched from January 2006 to May 2015 and supplemented by hand-searching relevant articles. Review methods: A systematic review and meta-analysis of effectiveness studies were conducted. A review of published economic analyses was undertaken and a de novo health economic model was constructed. A decision tree was used to estimate the costs and quality-adjusted life-years (QALYs) associated with each test; all other parameters were estimated from published sources. The model was populated with evidence from the systematic review or individual studies, if this was considered more appropriate (base case 1). In a secondary analysis, estimates (based on experience and opinion) from seven clinicians regarding the benefits of earlier test results were sought (base case 2). A NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Scenario analyses were used to assess uncertainty. Results: For the review of diagnostic test accuracy, 62 studies of varying methodological quality were included. A meta-analysis of 54 studies comparing SeptiFast with blood culture found that SeptiFast had an estimated summary specificity of 0.86 [95% credible interval (CrI) 0.84 to 0.89] and sensitivity of 0.65 (95% CrI 0.60 to 0.71). Four studies comparing SepsiTest with blood culture found that SepsiTest had an estimated summary specificity of 0.86 (95% CrI 0.78 to 0.92) and sensitivity of 0.48 (95% CrI 0.21 to 0.74), and four studies comparing IRIDICA with blood culture found that IRIDICA had an estimated summary specificity of 0.84 (95% CrI 0.71 to 0.92) and sensitivity of 0.81 (95% CrI 0.69 to 0.90). Owing to the deficiencies in study quality for all interventions, diagnostic accuracy data should be treated with caution. No randomised clinical trial evidence was identified that indicated that any of the tests significantly improved key patient outcomes, such as mortality or duration in an intensive care unit or hospital. Base case 1 estimated that none of the three tests provided a benefit to patients compared with standard practice and thus all tests were dominated. In contrast, in base case 2 it was estimated that all cost per QALY-gained values were below £20,000; the IRIDICA BAC BSI assay had the highest estimated incremental net benefit, but results from base case 2 should be treated with caution as these are not evidence based. Limitations: Robust data to accurately assess the clinical effectiveness and cost-effectiveness of the interventions are currently unavailable. Conclusions: The clinical effectiveness and cost-effectiveness of the interventions cannot be reliably determined with the current evidence base. Appropriate studies, which allow information from the tests to be implemented in clinical practice, are required.

Exploring the potential of cassava in promoting agricultural growth in Nigeria

Cassava is one of the major food crops in Nigeria, with multiple uses from human consumption to industrial applications. This study explores the potential of cassava in Nigerian agriculture based on a review of cassava development policies; performs a trend analysis of the cultivation area, production, productivity, and real price of cassava and other competing crops for the period 1961–2013; identifies the sources of growth in production; and examines the production constraints at the local level based on a survey of 315 farmers/processors and 105 marketers from Delta State. The results revealed that several policies and programmes were implemented to develop the cassava sector with mixed outcomes. Although cassava productivity grew at 1.5% per annum (p.a.) during the post-structural adjustment programme period (1993–2013), its real price declined at a rate of 3.5% p.a. The effect of yield is the main source of growth in production, contributing 76.4% of the total growth followed by the area effect (28.2%). The cassava sector is constrained by inadequate market infrastructure, processing facilities, and lack of information and unstable prices at the local level. The widespread diffusion of improved tropical manioc selection technologies and investments in market and marketing infrastructure, processing technologies, irrigation/water provision and information dissemination are recommended to enhance the potential of the cassava sector to support agricultural growth in Nigeria.

Calidad fisiológica de semillas de berenjena, morrón y tomate tratadas con tiametoxam, un producto bioactivador

Considerando la escasa información referente al efecto del bioactivador tiametoxam y los potenciales beneficios que este compuesto puede proporcionar en producción de semillas, el objetivo de este estudio fue evaluar la influencia del producto en el desempeño fisiológico de semillas de berenjena, morrón y tomate. Semillas de tres lotes de cada una de las especies fueron tratadas con seis dosis crecientes de tiametoxam (0; 0,2; 0,4; 0,6; 0,8 y 1,0 mL del producto por cada mil semillas) y sometidas a germinación, primer conteo de germinación, test de frío, test de envejecimiento acelerado, longitud total de las plántulas y emergencia de plántulas en invernadero. El bioactivador tuvo efecto positivo sobre los parámetros analizados, estimulando el desarrollo fisiológico de las semillas, con intensidades variables de acuerdo con el lote. En berenjena, el aumento medio porcentual de la germinación en el primer conteo tuvo un incremento de aproximadamente 11 %, en morrón de 13 % y para los lotes de tomate aproximadamente de 17 %. La dosis de 0,6 mL cada mil semillas resultó ser la más efectiva para aumentar el vigor de las semillas de las tres especies.

Innovating a consumer awareness of sweetpotato: industry, research and consumer adoption issues

In Australia, sweetpotato production has grown remarkably (1700%) in the last 16 years. Growers currently market 75 000 t per annum, worth $80-90 million at farm gate. The orange-fleshed cultivars are the most familiar to consumers, but other cultivars with varying flesh colour and properties also have potential for the consumer market. Given that Australian sweetpotato growers desire alternative cultivars to promote market demand, it is important to articulate the characteristics of sweetpotatoes that are most and least desirable for consumers. Research indicates that consumer acceptability of the new cultivar 'Evangeline' may assist sweetpotato growers and marketers in understanding the impact of both sensory properties, such as colour and the importance of flavour and texture of sweetpotatoes, and an awareness of the potential health benefits of sweetpotato consumption. In addition, whilst consumer preferences (regarding size, colour, texture, skin tone) and nutritional knowledge of sweet potato (regarding glycaemic index) is increasing, there is limited research investigating consumers understanding of health messages of sweetpotato attributes. This industry and consumer research review highlights the potential for promoting innovative strategies to improve adoption of new cultivars in the marketplace.

Low-Volatility Anomaly in Helsinki Stock Exchange

International research shows that low-volatility stocks have beaten high-volatility stocks in terms of returns for decades on multiple markets. This abbreviation from traditional risk-return framework is known as low-volatility anomaly. This study focuses on explaining the anomaly and finding how strongly it appears in NASDAQ OMX Helsinki stock exchange. Data consists of all listed companies starting from 2001 and ending close to 2015. Methodology follows closely Baker and Haugen (2012) by sorting companies into deciles according to 3-month volatility and then calculating monthly returns for these different volatility groups. Annualized return for the lowest volatility decile is 8.85 %, while highest volatility decile destroys wealth at rate of -19.96 % per annum. Results are parallel also in quintiles that represent larger amount of companies and thus dilute outliers. Observation period captures financial crisis of 2007-2008 and European debt crisis, which embodies as low main index annual return of 1 %, but at the same time proves the success of low-volatility strategy. Low-volatility anomaly is driven by multiple reasons such as leverage constrained trading and managerial incentives which both prompt to invest in risky assets, but behavioral matters also have major weight in maintaining the anomaly.