Failure of normal glycaemic regulation in a patient with severe hypothermia

This report describes the case of an 88-year-old non-diabetic female who presented to the emergency department following a presumed hypoijtycaemic collapse due to self-neglect. Subsequent rewarming and resuscitation demonstrated a number of the significant consequences of severe hypothermia, including apparent secondary impairment of glycaemic autoregulation. The phenomenon of reversible inhibition of insulin secretion due to severe hypothermia has been documented previously in the field of cardiac surgery. The hyperglycaemia was not treated with any antihyperglycaernic agent, and her recovery was uneventful. Subsequent blood sugar level monitoring was normal. If insulin is administered to the hypothermic patient, intensive monitoring of blood glucose is essential due to the increase in endogenous insulin secretion on rewarming. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Effects of care pathways on stroke care practices at regional hospitals

Background: Our previous work identified deficiencies in stroke care practices at regional hospitals in comparison to standards suggested by published stroke care guidelines. These deficiencies might be improved by the implementation of clinical pathways. The aim of this study was to assess changes in acute stroke care practices following the implementation of stroke care pathways at four regional Queensland hospitals. Methods: The medical records of two cohorts of 120 patients with a discharge diagnosis of stroke or transient ischaemic attack were retrospectively audited before and after implementation of stroke care pathways to identify differences in the use of acute interventions, investigations and secondary prevention strategies. Results: Following pathway implementation there were clinically important, but not statistically significant, increases in the rates of swallow assessment, allied health assessment (significant for occupational therapy, P = 0.04) and use of deep vein thrombosis prevention strategies (also significant, P = 0.006). Fewer patients were discharged on no anti-thrombotic therapy (statistically significant in the subgroup of patients with atrial fibrillation, P = 0.02). Only 37% of the patients audited were actually enrolled on the pathway. Among this subgroup there were significant increases in the rates of swallow assessment (first 24 h, P = 0.01; any time during admission, P = 0.0001), allied health assessments (all P < 0.05), estimation of blood glucose level (P = 0.0015) and the use of deep vein thrombosis prevention strategies (P = 0.0003). Conclusion: Stroke care pathways appear to improve the process of care. Whether this influences outcomes such as mortality, functional and neurological recovery, the incidence of complications, length of stay or the cost of care was beyond the scope of this study and will require further examination.

The availability of nitrogen from sugarcane trash on contrasting soils in the wet tropics of North Queensland

Sugarcane crop residues ('trash') have the potential to supply nitrogen (N) to crops when they are retained on the soil surface after harvest. Farmers should account for the contribution of this N to crop requirements in order to avoid over-fertilisation. In very wet tropical locations, the climate may increase the rate of trash decomposition as well as the amount of N lost from the soil-plant system due to leaching or denitrification. A field experiment was conducted on Hydrosol and Ferrosol soils in the wet tropics of northern Australia using N-15-labelled trash either applied to the soil surface or incorporated. Labelled urea fertiliser was also applied with unlabelled surface trash. The objective of the experiment was to investigate the contribution of trash to crop N nutrition in wet tropical climates, the timing of N mineralisation from trash, and the retention of trash N in contrasting soils. Less than 6% of the N in trash was recovered in the first crop and the recovery was not affected by trash incorporation. Around 6% of the N in fertiliser was also recovered in the first crop, which was less than previously measured in temperate areas (20-40%). Leaf samples taken at the end of the second crop contined 2-3% of N from trash and fertilizer applied at the beginning of the experiment. Although most N was recovered in the 0-1.5 m soil layer there was some evidence of movement of N below this depth. The results showed that trash supplies N slowly and in small amounts to the succeeding crop in wet tropics sugarcane growing areas regardless of trash placement (on the soil surface or incorporated) or soil type, and so N mineralisation from a single trash blanket is not important for sugarcane production in the wet tropics.

PENTECOSTAIS, POLÍTICAS PÚBLICAS E MEIO AMBIENTE: Estudo Socioambiental em Rio Grande da Serra, periferia urbana no Grande ABC Paulista

O tema central de nossa pesquisa são as interações dos pentecostais com as questões socioambientais. Portanto, trata-se do estudo do grau de envolvimento dos pentecostais com as políticas públicas ambientais e o meio ambiente em periferia urbana - Rio Grande da Serra - Grande ABC Paulista. A intensa presença dos pentecostais nos bairros mais periféricos da cidade permitiu-nos indagar sobre as relações que esses mantêm com a expansão urbana nas áreas a serem protegidas, com os impactos ambientais, com consumo e pós-consumo na região, na participação de políticas públicas, bem como, os discursos e práticas religiosas interferem no comportamento dos religiosos frente a todas essas questões, uma vez que, a cidade está inserida em Área de Proteção e Recuperação de Mananciais, imbricada em um dos biomas terrestres mais ameaçados de extinção - o Bioma da Mata Atlântica. Como procedimentos metodológicos servimo-nos das observações empíricas, registro dos aspectos e impactos ambientais, aplicação de formulários e entrevistas com roteiro semiestruturado, elementos que constituíram uma tríade instrumental analítica. Concluímos que os pentecostais embora sejam atuantes em questões sociais, todavia, não o são quanto às questões ambientais na cidade, pois, não participam de maneira mais efetiva nas políticas públicas ambientais. Entretanto, os pentecostais demonstram uma potencialidade em participar do planejamento urbano participativo e dos processos de gestão urbana a médio e longos prazos, desde que sejam estimulados, primando dessa maneira, pela proteção, defesa e justiça ambiental nessas áreas de vulnerabilidade socioambiental.

A comparison of high-content screening versus manual analysis to assay the effects of mesenchymal stem cell-conditioned medium on neurite outgrowth in vitro

Bone marrow mesenchymal stem cells (MSCs) promote nerve growth and functional recovery in animal models of spinal cord injury (SCI) to varying levels. The authors have tested high-content screening to examine the effects of MSC-conditioned medium (MSC-CM) on neurite outgrowth from the human neuroblastoma cell line SH-SY5Y and from explants of chick dorsal root ganglia (DRG). These analyses were compared to previously published methods that involved hand-tracing individual neurites. Both methods demonstrated that MSC-CM promoted neurite outgrowth. Each showed the proportion of SH-SY5Y cells with neurites increased by ~200% in MSC-CM within 48 h, and the number of neurites/SH-SY5Y cells was significantly increased in MSC-CM compared with control medium. For high-content screening, the analysis was performed within minutes, testing multiple samples of MSC-CM and in each case measuring >15,000 SH-SY5Y cells. In contrast, the manual measurement of neurite outgrowth from >200 SH-SY5Y cells in a single sample of MSC-CM took at least 1 h. High-content analysis provided additional measures of increased neurite branching in MSC-CM compared with control medium. MSC-CM was also found to stimulate neurite outgrowth in DRG explants using either method. The application of the high-content analysis was less well optimized for measuring neurite outgrowth from DRG explants than from SH-SY5Y cells.

Doing business in... Indonesia

Indonesia's long stability of over three decades came to a sudden end after the regional economic crisis of 1997–1998. The economic crisis not only shattered the Indonesian economy but also resulted in political turmoil. The national leadership has changed three times over the last five years. In such conditions, the confidence of foreign investors is very low. The present government has initiated a number of steps to restore political stability and economic recovery. This article provides useful information on the complex business environment, aimed to help foreign investors to develop a good understanding on key background knowledge for being successful in Indonesia. It reviews Indonesian historical development, political structure and climate, regional relations, and economy and foreign trade. Indonesia's infrastructure, legal framework, sociocultural setup, as well as market structure and potential, are also analyzed.

Articulating wider smartphone emerging security issues in the case of M-government in Turkey

For the last several years, mobile devices and platform security threats, including wireless networking technology, have been top security issues. A departure has occurred from automatic anti-virus software based on traditional PC defense: risk management (authentication and encryption), compliance, and disaster recovery following polymorphic viruses and malware as the primary activities within many organizations and government services alike. This chapter covers research in Turkey as a reflection of the current market – e-government started officially in 2008. This situation in an emerging country presents the current situation and resistances encountered while engaging with mobile and e-government interfaces. The authors contend that research is needed to understand more precisely security threats and most of all potential solutions for sustainable future intention to use m-government services. Finally, beyond m-government initiatives' success or failure, the mechanisms related to public administration mobile technical capacity building and security issues are discussed.

Ablative pyrolysis of biomass

The primary objectives of this work were to design, construct, test and operate a novel ablative pyrolysis reactor and product recovery system. Other key objectives included the development of an ablative pyrolysis reactor design methodology, mathematical modelling of the ablation process and measurement of empirical ablation rate data at 500°C. The constructed reactor utilised a rotating blade approach to achieve particle ablation in a 258mm internal diameter reactor. By fulfilling the key requirements of high relative motion and high contact pressure, pine wood particles of maximum size 6.35 mm were successfully ablated.Sixteen experiments were carried out: five initial commissioning experiments were used to test the rotating blade concept and to solve char separation problems. Mass balances were obtained for the other eleven experiments with good closures. Based on ablatively pyrolysed dry wood, a maximum organic liquid yield of 65.9 wt% was achieved with corresponding yields of 12.4 wt% char, 11.5 wt% water and 9.2 wt% non-condensable gas. Reactor throughputs of 2 kg/h dry ablated wood were achieved at 600°C. The theoretical ablative pyrolysis reactor design methodology was simplified and improved based upon empirical data derived from wood rod ablation experiments. Yields of chemicals were qualitatively similar to those of other fast pyrolysis processes.The product recovery system, comprising hot char removal, liquids collection in two ice-cooled condensers followed by gas filtration and drying, gave good mass balance closures. The most significant problem was char separation and removal from the reactor. This was solved by using a nitrogen blow line. In general, the reactor and product collection systems performed well.Future development of the reactor would involve modification of the reactor feed tube to allow the reactor residence time to be reduced and testing of the rotating blade approach with different blade angles, configurations and numbers of blades.

Global non-dynamic refinement of radial orbit error for altimetric earth satellites

The accuracy of altimetrically derived oceanographic and geophysical information is limited by the precision of the radial component of the satellite ephemeris. A non-dynamic technique is proposed as a method of reducing the global radial orbit error of altimetric satellites. This involves the recovery of each coefficient of an analytically derived radial error correction through a refinement of crossover difference residuals. The crossover data is supplemented by absolute height measurements to permit the retrieval of otherwise unobservable geographically correlated and linearly combined parameters. The feasibility of the radial reduction procedure is established upon application to the three day repeat orbit of SEASAT. The concept of arc aggregates is devised as a means of extending the method to incorporate longer durations, such as the 35 day repeat period of ERS-1. A continuous orbit is effectively created by including the radial misclosure between consecutive long arcs as an infallible observation. The arc aggregate procedure is validated using a combination of three successive SEASAT ephemerides. A complete simulation of the 501 revolution per 35 day repeat orbit of ERS-1 is derived and the recovery of the global radial orbit error over the full repeat period is successfully accomplished. The radial reduction is dependent upon the geographical locations of the supplementary direct height data. Investigations into the respective influences of various sites proposed for the tracking of ERS-1 by ground-based transponders are carried out. The potential effectiveness on the radial orbital accuracy of locating future tracking sites in regions of high latitudinal magnitude is demonstrated.

The development of a new compiler-compiler front-end

The increasing cost of developing complex software systems has created a need for tools which aid software construction. One area in which significant progress has been made is with the so-called Compiler Writing Tools (CWTs); these aim at automated generation of various components of a compiler and hence at expediting the construction of complete programming language translators. A number of CWTs are already in quite general use, but investigation reveals significant drawbacks with current CWTs, such as lex and yacc. The effective use of a CWT typically requires a detailed technical understanding of its operation and involves tedious and error-prone input preparation. Moreover, CWTs such as lex and yacc address only a limited aspect of the compilation process; for example, actions necessary to perform lexical symbol valuation and abstract syntax tree construction must be explicitly coded by the user. This thesis presents a new CWT called CORGI (COmpiler-compiler from Reference Grammar Input) which deals with the entire `front-end' component of a compiler; this includes the provision of necessary data structures and routines to manipulate them, both generated from a single input specification. Compared with earlier CWTs, CORGI has a higher-level and hence more convenient user interface, operating on a specification derived directly from a `reference manual' grammar for the source language. Rather than developing a compiler-compiler from first principles, CORGI has been implemented by building a further shell around two existing compiler construction tools, namely lex and yacc. CORGI has been demonstrated to perform efficiently in realistic tests, both in terms of speed and the effectiveness of its user interface and error-recovery mechanisms.

Time-division-multiplexing using pulse position locking for 100 Gb/s applications

Recently, there is a great interest in pushing communication technologies to 100 Gb/s. However, there are still many challenges to perform high speed (> 40 Gb/s) clock and data recovery, and data time-division-multiplexing (TDM). Here, we propose and numerically analyze an asynchronous optical packet retimer using parabolic or sinusoidal phase modulation and linear dispersion. This scheme is named pulse position locking (PPL). Numerical simulation shows that this scheme can effectively resynchronize input signals with arbitrary delays to the local clock, and reduce input jitter. The scheme can also be applied to TDM 10 Gb/s and 40 Gb/s signals to over 100 Gb/s.

The scope to improve the efficiency of solar-powered reverse osmosis

The aim of this paper is to identify and evaluate potential areas of technical improvement to solar-powered desalination systems that use reverse osmosis (RO). We compare ideal with real specific energy consumption (SEC) to pinpoint the causes of inefficiency. The ideal SEC is compared among different configurations including a batch system driven by a piston, and continuous systems with single or multiple stages with or without energy recovery in each case. For example, to desalinate 1 m3 of freshwater from normal seawater (osmotic pressure 27 bar) will require at least 0.94 kWh of solar energy; thus in a sunny coastal location, up to 1850 m3 of water per year per m2 (m3/m2) of land covered by solar collectors could theoretically be desalinated. For brackish water (osmotic pressure 3 bar), 11570 m3/m2 of fresh water could theoretically be obtained under the same conditions. These ideal values are compared with practically achieved values reported in the literature. The practical energy consumption is found to be typically 40-200 times higher depending on feed water composition, system configuration and energy recovery. For state-of-the-art systems, energy losses at the various steps in the conversion process are quantified and presented with the help of Sankey diagrams. Improvements that could reduce the losses are discussed. Consequently, recommendations for areas of R&D are highlighted with particular reference to emerging technologies. It is concluded that there is considerable scope to improve the efficiency of solar-powered RO system.

Advanced techniques for the improvement of optical transmission systems

This thesis presents the experimental investigation into two novel techniques which can be incorporated into current optical systems. These techniques have the capability to improve the performance of transmission and the recovery of the transmitted signal at the receiver. The experimental objectives are described and the results for each technique are presented in two sections: The first experimental section is on work related to Ultra-long Raman Fibre lasers (ULRFLs). The fibre lasers have become an important research topic in recent years due to the significant improvement they give over lumped Raman amplification and their potential use in the development of system with large bandwidths and very low losses. The experiments involved the use of ASK and DPSK modulation types over a distance of 240km and DPSK over a distance of 320km. These results are compared to the current state of-the-art and against other types of ultra-long transmission amplification techniques. The second technique investigated involves asymmetrical, or offset, filtering. This technique is important because it deals with the strong filtering regimes that are a part of optical systems and networks in modern high-speed communications. It allows the improvement of the received signal by offsetting the central frequency of a filter after the output of a Delay Line Interferometer (DLI), which induces significant improvement in BER and/or Qvalues at the receiver and therefore an increase in signal quality. The experimental results are then concluded against the objectives of the experimental work and potential future work discussed.

Pharmaceutical process optimisation of bulk lyophilisates:implications of powder handling

Lyophilisation or freeze drying is the preferred dehydrating method for pharmaceuticals liable to thermal degradation. Most biologics are unstable in aqueous solution and may use freeze drying to prolong their shelf life. Lyophilisation is however expensive and has seen lots of work aimed at reducing cost. This thesis is motivated by the potential cost savings foreseen with the adoption of a cost efficient bulk drying approach for large and small molecules. Initial studies identified ideal formulations that adapted well to bulk drying and further powder handling requirements downstream in production. Low cost techniques were used to disrupt large dried cakes into powder while the effects of carrier agent concentration were investigated for powder flowability using standard pharmacopoeia methods. This revealed superiority of crystalline mannitol over amorphous sucrose matrices and established that the cohesive and very poor flow nature of freeze dried powders were potential barriers to success. Studies from powder characterisation showed increased powder densification was mainly responsible for significant improvements in flow behaviour and an initial bulking agent concentration of 10-15 %w/v was recommended. Further optimisation studies evaluated the effects of freezing rates and thermal treatment on powder flow behaviour. Slow cooling (0.2 °C/min) with a -25°C annealing hold (2hrs) provided adequate mechanical strength and densification at 0.5-1 M mannitol concentrations. Stable bulk powders require powder transfer into either final vials or intermediate storage closures. The targeted dosing of powder formulations using volumetric and gravimetric powder dispensing systems where evaluated using Immunoglobulin G (IgG), Lactate Dehydrogenase (LDH) and Beta Galactosidase models. Final protein content uniformity in dosed vials was assessed using activity and protein recovery assays to draw conclusions from deviations and pharmacopeia acceptance values. A correlation between very poor flowability (p<0.05), solute concentration, dosing time and accuracy was revealed. LDH and IgG lyophilised in 0.5 M and 1 M mannitol passed Pharmacopeia acceptance values criteria with 0.1-4 while formulations with micro collapse showed the best dose accuracy (0.32-0.4% deviation). Bulk mannitol content above 0.5 M provided no additional benefits to dosing accuracy or content uniformity of dosed units. This study identified considerations which included the type of protein, annealing, cake disruption process, physical form of the phases present, humidity control and recommended gravimetric transfer as optimal for dispensing powder. Dosing lyophilised powders from bulk was demonstrated as practical, time efficient, economical and met regulatory requirements in cases. Finally the use of a new non-destructive technique, X-ray microcomputer tomography (MCT), was explored for cake and particle characterisation. Studies demonstrated good correlation with traditional gas porosimetry (R2 = 0.93) and morphology studies using microscopy. Flow characterisation from sample sizes of less than 1 mL was demonstrated using three dimensional X-ray quantitative image analyses. A platinum-mannitol dispersion model used revealed a relationship between freezing rate, ice nucleation sites and variations in homogeneity within the top to bottom segments of a formulation.

Spinal motor neurite outgrowth over glial scar inhibitors is enhanced by coculture with bone marrow stromal cells

Background context Transplantation of bone marrow cells into spinal cord lesions promotes functional recovery in animal models, and recent clinical trials suggest possible recovery also in humans. The mechanisms responsible for these improvements are still unclear. Purpose To characterize spinal cord motor neurite interactions with human bone marrow stromal cells (MSCs) in an in vitro model of spinal cord injury (SCI). Study design/setting Previously, we have reported that human MSCs promote the growth of extending sensory neurites from dorsal root ganglia (DRG), in the presence of some of the molecules present in the glial scar, which are attributed with inhibiting axonal regeneration after SCI. We have adapted and optimized this system replacing the DRG with a spinal cord culture to produce a central nervous system (CNS) model, which is more relevant to the SCI situation. Methods We have developed and characterized a novel spinal cord culture system. Human MSCs were cocultured with spinal motor neurites in substrate choice assays containing glial scar-associated inhibitors of nerve growth. In separate experiments, MSC-conditioned media were analyzed and added to spinal motor neurites in substrate choice assays. Results As has been reported previously with DRG, substrate-bound neurocan and Nogo-A repelled spinal neuronal adhesion and neurite outgrowth, but these inhibitory effects were abrogated in MSC/spinal cord cocultures. However, unlike DRG, spinal neuronal bodies and neurites showed no inhibition to substrates of myelin-associated glycoprotein. In addition, the MSC secretome contained numerous neurotrophic factors that stimulated spinal neurite outgrowth, but these were not sufficient stimuli to promote spinal neurite extension over inhibitory concentrations of neurocan or Nogo-A. Conclusions These findings provide novel insight into how MSC transplantation may promote regeneration and functional recovery in animal models of SCI and in the clinic, especially in the chronic situation in which glial scars (and associated neural inhibitors) are well established. In addition, we have confirmed that this CNS model predominantly comprises motor neurons via immunocytochemical characterization. We hope that this model may be used in future research to test various other potential interventions for spinal injury or disease states. © 2014 Elsevier Inc. All rights reserved.