Procalcitonin Biomarker Kinetics to Predict Multiorgan Dysfunction Syndrome in Children With Sepsis and Systemic Inflammatory Response Syndrome

Background: Procalcitonin (PCT) kinetics is a good prognosis marker in infectious diseases, but few studies of children sepsis have been performed. Objectives: The aim of our study was to examine kinetics of procalcitonin, to evaluate its relationship with severity and to analyze its usefulness in the prediction of multiorgan dysfunction syndrome (MODS). Patients and Methods: Prospective observational study in an 8-bed pediatric intensive care unit of a university hospital. Sixty-two children aged 0-19 years with systemic inflammatory response syndrome or septic states. The degree of severity was evaluated according pediatric logistic organ dysfunction (PELOD) score. Blood tests to determine levels of PCT were taken if the patients had the criteria of systemic inflammatory response syndrome or sepsis. The serum to determine levels of PCT in control group has been taken from patients undergoing elective surgery. Results: Higher values of PCT were identified in patients with PELOD score 12 and more compared to those with PELOD < 12 (P = 0.016). Similarly, higher PCT values were found in patients who developed MODS in contrast to those without MODS (P = 0.011). According to ROC analysis cut-off value of 4.05 ng/mL was found to best discriminate patients with PELOD < 12 and PELOD ≥ 12 with AUC = 0.675 (P = 0.035). Effect of procalcitonin levels on mortality was not demonstrated. Conclusions: Levels of procalcitonin from day 1 to day 5 are related to the severity and multiorgan dysfunction syndrome in children.

A systemic approach to incorporate the highest levels of FHB resistance with agronomic merit and quality in wheat.

2016

Copper as a target for prostate cancer therapeutics: copper-ionophore pharmacology and altering systemic copper distribution

Copper-ionophores that elevate intracellular bioavailable copper display significant therapeutic utility against prostate cancer cells in vitro and in TRAMP (Transgenic Adenocarcinoma of Mouse Prostate) mice. However, the pharmacological basis for their anticancer activity remains unclear, despite impending clinical trails. Herein we show that intracellular copper levels in prostate cancer, evaluated in vitro and across disease progression in TRAMP mice, were not correlative with copper-ionophore activity and mirrored the normal levels observed in patient prostatectomy tissues (Gleason Score 7 & 9). TRAMP adenocarcinoma cells harbored markedly elevated oxidative stress and diminished glutathione (GSH)-mediated antioxidant capacity, which together conferred selective sensitivity to prooxidant ionophoric copper. Copper-ionophore treatments [CuII(gtsm), disulfiram & clioquinol] generated toxic levels of reactive oxygen species (ROS) in TRAMP adenocarcinoma cells, but not in normal mouse prostate epithelial cells (PrECs). Our results provide a basis for the pharmacological activity of copper-ionophores and suggest they are amendable for treatment of patients with prostate cancer. Additionally, recent in vitro and mouse xenograft studies have suggested an increased copper requirement by prostate cancer cells. We demonstrated that prostate adenocarcinoma development in TRAMP mice requires a functional supply of copper and is significantly impeded by altered systemic copper distribution. The presence of a mutant copper-transporting Atp7b protein (tx mutation: A4066G/Met1356Val) in TRAMP mice changed copper-integration into serum and caused a remarkable reduction in prostate cancer burden (64% reduction) and disease severity (grade), abrogating adenocarcinoma development. Implications for current clinical trials are discussed.

Inhibition of nitro-oxidative stress attenuates pulmonary and systemic injury induced by high-tidal volume mechanical ventilation

Mechanisms contributing to pulmonary and systemic injury induced by high tidal volume (VT) mechanical ventilation are not well known. We tested the hypothesis that increased peroxynitrite formation is involved in organ injury and dysfunction induced by mechanical ventilation. Male Sprague-Dawley rats were subject to low- (VT, 9 mL/kg; positive end-expiratory pressure, 5 cmH2O) or high- (VT, 25 mL/kg; positive end-expiratory pressure, 0 cmH2O) VT mechanical ventilation for 120 min, and received 1 of 3 treatments: 3-aminobenzamide (3-AB, 10 mg/kg, intravenous, a poly adenosine diphosphate ribose polymerase [PARP] inhibitor), or the metalloporphyrin manganese(III) tetrakis(1-methyl-4-pyridyl)porphyrin (MnTMPyP, 5 mg/kg intravenous, a peroxynitrite scavenger), or no treatment (control group), 30 min before starting the mechanical ventilation protocol (n = 8 per group, 6 treatment groups). We measured mean arterial pressure, peak inspiratory airway pressure, blood chemistry, and gas exchange. Oxidation (fluorescence for oxidized dihydroethidium), protein nitration (immunofluorescence and Western blot for 3-nitrotyrosine), PARP protein (Western blot) and gene expression of the nitric oxide (NO) synthase (NOS) isoforms (quantitative real-time reverse transcription polymerase chain reaction) were measured in lung and vascular tissue. Lung injury was quantified by light microscopy. High-VT mechanical ventilation was associated with hypotension, increased peak inspiratory airway pressure, worsened oxygenation; oxidation and protein nitration in lung and aortic tissue; increased PARP protein in lung; up-regulation of NOS isoforms in lung tissue; signs of diffuse alveolar damage at histological examination. Treatment with 3AB or MnTMPyP attenuated the high-VT mechanical ventilation-induced changes in pulmonary and cardiovascular function; down-regulated the expression of NOS1, NOS2, and NOS3; decreased oxidation and nitration in lung and aortic tissue; and attenuated histological changes. Increased peroxynitrite formation is involved in mechanical ventilation-induced pulmonary and vascular dysfunction.

Mode of oral iron administration and the amount of iron habitually consumed do not affect iron absorption, systemic iron utilisation or zinc absorption in iron-sufficient infants: a randomised trial

Different metabolic pathways of supplemental and fortification Fe, or inhibition of Zn absorption by Fe, may explain adverse effects of supplemental Fe in Fe-sufficient infants. We determined whether the mode of oral Fe administration or the amount habitually consumed affects Fe absorption and systemic Fe utilisation in infants, and assessed the effects of these interventions on Zn absorption, Fe and Zn status, and growth. Fe-sufficient 6-month-old infants (n 72) were randomly assigned to receive 6·6 mg Fe/d from a high-Fe formula, 1·3 mg Fe/d from a low-Fe formula or 6·6 mg Fe/d from Fe drops and a formula with no added Fe for 45 d. Fractional Fe absorption, Fe utilisation and fractional Zn absorption were measured with oral (⁵⁷Fe and ⁶⁷Zn) and intravenous (⁵⁸Fe and ⁷⁰Zn) isotopes. Fe and Zn status, infection and growth were measured. At 45 d, Hb was 6·3 g/l higher in the high-Fe formula group compared with the Fe drops group, whereas serum ferritin was 34 and 35 % higher, respectively, and serum transferrin 0·1 g/l lower in the high-Fe formula and Fe drops groups compared with the low-Fe formula group (all P<0·05). No intervention effects were observed on Fe absorption, Fe utilisation, Zn absorption, other Fe status indices, plasma Zn or growth. We concluded that neither supplemental or fortification Fe nor the amount of Fe habitually consumed altered Fe absorption, Fe utilisation, Zn absorption, Zn status or growth in Fe-sufficient infants. Consumption of low-Fe formula as the only source of Fe was insufficient to maintain Fe stores.

Typography and the branding of culture: a systemic functional analysis of typography’s performance in branding cultural festivals in Australia

This paper offers a social semiotic analysis of logotypes used to brand cultural festivals in 21st century Australia. A contemporary method is explored that suits the significant role typography performs within this context and offers a contribution to design research and the festival scape that not only engages with the artefacts of design but with the conceptualization of designed meaning in visual culture. Branding is a vital part of the festival space and relies on typography to establish the symbolic values and representations of urban freedoms; rich histories, cultured places, playfulness and stimulation that seek to subvert our daily existence while performing the task of engaging local, national, and international visitors and participants. However, professional practices demonstrated in the design, media and arts industries have far outpaced the extent to which this phenomenon has been written about in the academic or public realm. This paper addresses this shortfall and offers the foundation for a systemic functional method in the decoding of typography in visual culture

Production Diseases in European Organic Dairy Farms – Current Status and Identification of Drivers for Improvement by Means of a Systemic Approach

The aims of this thesis were to determine the animal health status in organic dairy farms in Europe and to identify drivers for improving the current situation by means of a systemic approach. Prevalences of production diseases were determined in 192 herds in Germany, France, Spain, and Sweden (Paper I), and stakeholder consultations were performed to investigate potential drivers to improve animal health on the sector level (ibid.). Interactions between farm variables were assessed through impact analysis and evaluated to identify general system behaviour and classify components according to their outgoing and incoming impacts (Paper II-III). The mean values and variances of prevalences indicate that the common rules of organic dairy farming in Europe do not result in consistently low levels of production diseases. Stakeholders deemed it necessary to improve the current status and were generally in favour of establishing thresholds for the prevalence of production diseases in organic dairy herds as well as taking actions to improve farms below that threshold. In order to close the gap between the organic principle of health and the organic farming practice, there is the need to formulate a common objective of good animal health and to install instruments to ensure and prove that the aim is followed by all dairy farmers in Europe who sell their products under the organic label. Regular monitoring and evaluation of herd health performance based on reference values are considered preconditions for identifying farms not reaching the target and thus in need of improvement. Graph-based impact analysis was shown to be a suitable method for modeling and evaluating the manifold interactions between farm factors and for identifying the most influential components on the farm level taking into account direct and indirect impacts as well as impact strengths. Variables likely to affect the system as a whole, and the prevalence of production diseases in particular, varied largely between farms despite some general tendencies. This finding reflects the diversity of farm systems and underlines the importance of applying systemic approaches in health management. Reducing the complexity of farm systems and indicating farm-specific drivers, i.e. areas in a farm, where changes will have a large impact, the presented approach has the potential to complement and enrich current advisory practice and to support farmers’ decision-making in terms of animal health.

Biochemical characterization of systemic bacteria in bananas, sensitivity to antibiotics and plant phytotoxicity during shoot proliferation.

2016

Moderation as judgement practice: Reconciling system level accountability and local level practice

Internationally, recognition of the role of assessment to inform the learning process has received much attention in recent years. Assessment for learning, not just of learning is being supported by an increasing body of literature providing strategies that teachers and their students can incorporate to support the learning process (Assessment Reform Group, 2002; Broadfoot & Black, 2004; James, 2006). Concurrently there has been an increase internationally in systemic accountability requirements of schools in terms of student results. The convergence of these two movements has resulted in some education systems promoting standards-driven reform involving authentic assessment and a re-examination of the relationship between the teacher and the student in the learning process. In this context standards are intended to be used as the basis for judgements of student achievement; while the results from assessment tasks are meant to both inform the teaching/learning process, and to report and track student progress. In such system, the role and reliability of teacher judgement takes centre stage.

A framework for analyzing system intelligence of the building control system : a study of the integrated building management system

The lack of satisfactory consensus for characterizing the system intelligence and structured analytical decision models has inhibited the developers and practitioners to understand and configure optimum intelligent building systems in a fully informed manner. So far, little research has been conducted in this aspect. This research is designed to identify the key intelligent indicators, and develop analytical models for computing the system intelligence score of smart building system in the intelligent building. The integrated building management system (IBMS) was used as an illustrative example to present a framework. The models presented in this study applied the system intelligence theory, and the conceptual analytical framework. A total of 16 key intelligent indicators were first identified from a general survey. Then, two multi-criteria decision making (MCDM) approaches, the analytic hierarchy process (AHP) and analytic network process (ANP), were employed to develop the system intelligence analytical models. Top intelligence indicators of IBMS include: self-diagnostic of operation deviations; adaptive limiting control algorithm; and, year-round time schedule performance. The developed conceptual framework was then transformed to the practical model. The effectiveness of the practical model was evaluated by means of expert validation. The main contribution of this research is to promote understanding of the intelligent indicators, and to set the foundation for a systemic framework that provide developers and building stakeholders a consolidated inclusive tool for the system intelligence evaluation of the proposed components design configurations.

Predication and propagation : a method for analyzing evaluative meanings in technology policy

In this article I outline and demonstrate a synthesis of the methods developed by Lemke (1998) and Martin (2000) for analyzing evaluations in English. I demonstrate the synthesis using examples from a 1.3-million-word technology policy corpus drawn from institutions at the local, state, national, and supranational levels. Lemke's (1998) critical model is organized around the broad 'evaluative dimensions' that are deployed to evaluate propositions and proposals in English. Martin's (2000) model is organized with a more overtly systemic-functional orientation around the concept of 'encoded feeling'. In applying both these models at different times, whilst recognizing their individual usefulness and complementarity, I found specific limitations that led me to work towards a synthesis of the two approaches. I also argue for the need to consider genre, media, and institutional aspects more explicitly when claiming intertextual and heteroglossic relations as the basis for inferred evaluations. A basic assertion made in this article is that the perceived Desirability of a process, person, circumstance, or thing is identical to its 'value'. But the Desirability of anything is a socially and thus historically conditioned attribution that requires significant amounts of institutional inculcation of other 'types' of value-appropriateness, importance, beauty, power, and so on. I therefore propose a method informed by critical discourse analysis (CDA) that sees evaluation as happening on at least four interdependent levels of abstraction.

Look before you leap : the epistemic violence that sometimes hides behind the word "inclusion"

This paper demonstrates how Indigenous Studies is controlled in some Australian universities in ways that continue the marginalisation, denigration and exploitation of Indigenous peoples. Moreover, it shows how the engagement of white notions of “inclusion” can result in the maintenance of racism, systemic marginalisation, white race privilege and radicalised subjectivity. A case study will be utilised which draws from the experience of two Indigenous scholars who were invited to be part of a panel to review one Australian university’s plan and courses in Indigenous studies. The case study offers the opportunity to destabilise the relationships between oppression and privilege and the epistemology that maintains them. The paper argues for the need to examine exactly what is being offered when universities provide opportunities for “inclusion”.

The epistemology that maintains white race privilege, power and control of Indigenous Studies and Indigenous peoples' participation in universities

This paper represents my attempt to turn the gaze and demonstrate how Indigenous Studies is controlled in some Australian universities in ways that witness Indigenous peoples being further marginalised, denigrated and exploited. I have endeavoured to do this through sharing an experience as a case study. I have opted to write about it as a way of exposing the problematic nature of racism, systemic marginalisation, white race privilege and radicalised subjectivity played out within an Australian higher education institution and because I am dissatisfied with the on-going status quo. In bringing forth analysis to this case study, I reveal the relationships between oppression, white race privilege and institutional privilege and the epistemology that maintains them. In moving from the position of being silent on this experience to speaking about it, I am able to move from the position of object to subject and to gain a form of liberated voice (hooks 1989:9). Furthermore, I am hopeful that it will encourage others to examine their own practices within universities and to challenge the domination that continues to subjugate Indigenous peoples.

The critical competences needed for innovative organizational inter-firm and intra-firm integration

In today's highly challenging business environment, an innovative and systemic approach is imperative to survival and growth. Organisational integration and technological integration, are often seen as a catalyst of change that could lead to significant improvements in organisations. The levels of improvement in inter and intra firm integration should arise from a detailed understanding and development of competences within and between organisations. Preliminary findings suggest that lack of trust across organisational cultures within the firms has a negative influence on the development of the capabilities to integrate and align technological innovations and hinders implementation and the effectiveness of the operations. Additionally, poor communication and conflict effects customer satisfaction. Firms need to transfer the competences that support cooperative integration, developed through interaction with supply chain partners, to their relationship arrangements with other supply chain partners, as these are key to ensuring low operational costs.

Termination of a minor’s pregnancy : critical issues for consent and the criminal law

The recent Supreme Court decision of Queensland v B [2008] 2 Qd R 562 has significant implications for the law that governs consent and abortions. The judgment purports to extend the ratio of Secretary, Department of Health and Community Services (NT) v JWB and SMB (1991) 175 CLR 218 (Marion’s Case) and impose a requirement of court approval for terminations of pregnancy for minors who are not Gillick-competent. This article argues against the imposition of this requirement on the ground that such an approach is an unjustifiable extension of the reasoning in Marion’s Case. The decision, which is the first judicial consideration in Queensland of the position of medical terminations, also reveals systemic problems with the criminal law in that State. In concluding that the traditional legal excuse for abortions will not apply to those which are performed medically, Queensland v B provides further support for calls to reform this area of law.