IMPOSE (IMProving Outcomes after Sepsis)—the effect of a multidisciplinary follow-up service on health-related quality of life in patients postsepsis syndromes—a double-blinded randomised controlled trial: protocol

Introduction Patients post sepsis syndromes have a poor quality of life and a high rate of recurring illness or mortality. Follow-up clinics have been instituted for patients postgeneral intensive care but evidence is sparse, and there has been no clinic specifically for survivors of sepsis. The aim of this trial is to investigate if targeted screening and appropriate intervention to these patients can result in an improved quality of life (Short Form 36 health survey (SF36V.2)), decreased mortality in the first 12 months, decreased readmission to hospital and/or decreased use of health resources. Methods and analysis 204 patients postsepsis syndromes will be randomised to one of the two groups. The intervention group will attend an outpatient clinic two monthly for 6 months and receive screening and targeted intervention. The usual care group will remain under the care of their physician. To analyse the results, a baseline comparison will be carried out between each group. Generalised estimating equations will compare the SF36 domain scores between groups and across time points. Mortality will be compared between groups using a Cox proportional hazards (time until death) analysis. Time to first readmission will be compared between groups by a survival analysis. Healthcare costs will be compared between groups using a generalised linear model. Economic (health resource) evaluation will be a within-trial incremental cost utility analysis with a societal perspective. Ethics and dissemination Ethical approval has been granted by the Royal Brisbane and Women’s Hospital Human Research Ethics Committee (HREC; HREC/13/QRBW/17), The University of Queensland HREC (2013000543), Griffith University (RHS/08/14/HREC) and the Australian Government Department of Health (26/2013). The results of this study will be submitted to peer-reviewed intensive care journals and presented at national and international intensive care and/or rehabilitation conferences.

Functional limitations and quality of life in schizophrenia and other psychotic disorders

There is substantial evidence of the decreased functional capacity, especially everyday functioning, of people with psychotic disorder in clinical settings, but little research about it in the general population. The aim of the present study was to provide information on the magnitude of functional capacity problems in persons with psychotic disorder compared with the general population. It estimated the prevalence and severity of limitations in vision, mobility, everyday functioning and quality of life of persons with psychotic disorder in the Finnish population and determined the factors affecting them. This study is based on the Health 2000 Survey, which is a nationally representative survey of 8028 Finns aged 30 and older. The psychotic diagnoses of the participants were assessed in the Psychoses of Finland survey, a substudy of Health 2000. The everyday functioning of people with schizophrenia is studied widely, but one important factor, mobility has been neglected. Persons with schizophrenia and other non-affective psychotic disorders, but not affective psychoses had a significantly increased risk of having both self-reported and test-based mobility limitations as well as weak handgrip strength. Schizophrenia was associated independently with mobility limitations even after controlling for lifestyle-related factors and chronic medical conditions. Another significant factor associated with problems in everyday functioning in participants with schizophrenia was reduced visual acuity. Their vision was examined significantly less often during the five years before the visual acuity measurement than the general population. In general, persons with schizophrenia and other non-affective psychotic disorder had significantly more limitations in everyday functioning, deficits in verbal fluency and in memory than the general population. More severe negative symptoms, depression, older age, verbal memory deficits, worse expressive speech and reduced distance vision were associated with limitations in everyday functioning. Of all the psychotic disorders, schizoaffective disorder was associated with the largest losses of quality of life, and bipolar I disorder with equal or smaller losses than schizophrenia. However, the subjective loss of qualify of life associated with psychotic disorders may be smaller than objective disability, which warrants attention. Depressive symptoms were the most important determinant of poor quality of life in all psychotic disorders. In conclusion, subjects with psychotic disorders need regular somatic health monitoring. Also, health care workers should evaluate the overall quality of life and depression of subjects with psychotic disorders in order to provide them with the basic necessities of life.

Molecular profiling of indoor microbial communities in moisture damaged and non-damaged buildings

Epidemiological studies have shown an elevation in the incidence of asthma, allergic symptoms and respiratory infections among people living or working in buildings with moisture and mould problems. Microbial growth is suspected to have a key role, since the severity of microbial contamination and symptoms show a positive correlation, while the removal of contaminated materials relieves the symptoms. However, the cause-and-effect relationship has not been well established and knowledge of the causative agents is incomplete. The present consensus of indoor microbes relies on culture-based methods. Microbial cultivation and identification is known to provide qualitatively and quantitatively biased results, which is suspected to be one of the reasons behind the often inconsistent findings between objectively measured microbiological attributes and health. In the present study the indoor microbial communities were assessed using culture-independent, DNA based methods. Fungal and bacterial diversity was determined by amplifying and sequencing the nucITS- and16S-gene regions, correspondingly. In addition, the cell equivalent numbers of 69 mould species or groups were determined by quantitative PCR (qPCR). The results from molecular analyses were compared with results obtained using traditional plate cultivation for fungi. Using DNA-based tools, the indoor microbial diversity was found to be consistently higher and taxonomically wider than viable diversity. The dominant sequence types of fungi, and also of bacteria were mainly affiliated with well-known microbial species. However, in each building they were accompanied by various rare, uncultivable and unknown species. In both moisture-damaged and undamaged buildings the dominant fungal sequence phylotypes were affiliated with the classes Dothideomycetes (mould-like filamentous ascomycetes); Agaricomycetes (mushroom- and polypore-like filamentous basidiomycetes); Urediniomycetes (rust-like basidiomycetes); Tremellomycetes and the family Malasseziales (both yeast-like basidiomycetes). The most probable source for the majority of fungal types was the outdoor environment. In contrast, the dominant bacterial phylotypes in both damaged and undamaged buildings were affiliated with human-associated members within the phyla Actinobacteria and Firmicutes. Indications of elevated fungal diversity within potentially moisture-damage-associated fungal groups were recorded in two of the damaged buildings, while one of the buildings was characterized by an abundance of members of the Penicillium chrysogenum and P. commune species complexes. However, due to the small sample number and strong normal variation firm conclusions concerning the effect of moisture damage on the species diversity could not be made. The fungal communities in dust samples showed seasonal variation, which reflected the seasonal fluctuation of outdoor fungi. Seasonal variation of bacterial communities was less clear but to some extent attributable to the outdoor sources as well. The comparison of methods showed that clone library sequencing was a feasible method for describing the total microbial diversity, indicated a moderate quantitative correlation between sequencing and qPCR results and confirmed that culture based methods give both a qualitative and quantitative underestimate of microbial diversity in the indoor environment. However, certain important indoor fungi such as Penicillium spp. were clearly underrepresented in the sequence material, probably due to their physiological and genetic properties. Species specific qPCR was a more efficient and sensitive method for detecting and quantitating individual species than sequencing, but in order to exploit the full advantage of the method in building investigations more information is needed about the microbial species growing on damaged materials. In the present study, a new method was also developed for enhanced screening of the marker gene clone libraries. The suitability of the screening method to different kinds of microbial environments including biowaste compost material and indoor settled dusts was evaluated. The usability was found to be restricted to environments that support the growth and subsequent dominance of a small number microbial species, such as compost material.

Prediction of Fatigue Life in Plain Concrete Using Entropy Production

An energy approach within the framework of thermodynamics is used to model the fatigue process in plain concrete. Fatigue crack growth is an irreversible process associated with an irreversible entropy gain. A closed-form expression for entropy generated during fatigue in terms of energy dissipated is derived using principles of dimensional analysis and self-similarity. An increase in compliance is considered as a measure of damage accumulated during fatigue. The entropy at final fatigue failure is shown to be independent of loading and geometry and is proposed as a material property. A relationship between energy dissipated and number of cycles of fatigue loading is obtained. (C) 2015 American Society of Civil Engineers.

Marine life in the North Pacific Ocean: the known, unknown, and unknowable

Bacterioplankton [pdf] Phytoplankton [pdf] Zooplankton [pdf] Non-exploited fish and invertebrates [pdf] Commercially-important fish and invertebrates [pdf] Marine birds [pdf] Mammals [pdf] Supplemental table of Unknowns [html] (Document pdf contains 48 pages)

Marine life in the North Pacific: the known, unknown, and unknowable

Special Publication 2 On-line version On-line version includes links to the following files (these files are not included into publication): Bacterioplankton [pdf] Phytoplankton [pdf] Zooplankton [pdf] Non-exploited fish and invertebrates [pdf] Commercially-important fish and invertebrates [pdf] Marine birds [pdf] Mammals [pdf] Supplemental table of Unknowns [html]

Comparative Microbial Dynamics in Crassostrea virginica and Crassostrea ariakensis

Considerations to introduce the Suminoe or Asian oyster Crassostrea ariakensis along the East Coast have raised many questions regarding ecology, economics, and human health. To date, research has focused primarily on the ecological and socioeconomic implications of this initiative, yet few studies have assessed its potential impact on public health. Our work compares the rates of bioaccumulation, depuration and post harvest decay of indicator organisms (such as E. coli) and Vibrio sp. between Crassostrea virginica and Crassostrea ariakensis in the laboratory. Preliminary results suggest that the rates of bioaccumulation of E. coli in Crassostrea ariakensis were significantly lower than those for Crassostrea virginica, depuration of E. coli was variable between the two species, and Crassostrea ariakensis post harvest decay rates of Vibrio sp. were significantly lower than Crassostrea virginica. This research provides coastal managers with insight into the response of Crassostrea ariakensis to bacteria, an important consideration for determining appropriate management strategies for this species. Further field-based studies will be necessary to elucidate the mechanisms responsible for the differences in rates of bioaccumulation and depuration. (PDF contains 40 pages)

From lakes to lungs : assessing microbial activity in diverse environments

All major geochemical cycles on the Earth’s surface are mediated by microorganisms. Our understanding of how these microbes have interacted with their environments (and vice versa) throughout Earth's history, and how they will respond to changes in the future, is primarily based on studying their activity in different environments today. The overarching questions that motivate the research presented in the two parts of this thesis -- how do microorganisms shape their environment (and vice versa)? and how can we best study microbial activity in situ? -- have arisen from the ultimate goal of being able to predict microbial activity in response to changes within their environments both past and future.

Part one focuses on work related to microbial processes in iron-rich Lake Matano and, more broadly, microbial interactions with the biogeochemical cycling of iron. Primarily, we find that the chelation of ferrous iron by organic ligands can affect the role of iron in anoxic environmental systems, enabling photomixotrophic growth of anoxygenic microorganisms with ferrous iron, as well as catalyzing the oxidation of ferrous iron by denitrification intermediates. These results imply that the ability to grow photomixotrophically on ferrous iron might be more widespread than previously assumed, and that the co-occurrence of chemical and biological processes involved in the coupled biogeochemical cycling of iron and nitrogen likely dominate organic-rich environmental systems.

Part two switches focus to in situ measurements of growth activity and comprises work related to microbial processes in the Cystic Fibrosis lung, and more broadly, the physiology of slow growth. We introduce stable isotope labeling of microbial membrane fatty acids and whole cells with heavy water as a new technique to measure microbial activity in a wide range of environments, demonstrate its application in continuous culture in the laboratory at the population and single cell level, and apply the tool to measure the in situ activity of the opportunistic pathogen Staphylococcus aureus within the environment of expectorated mucus from cystic fibrosis patients. We find that the average in situ growth rates of S. aureus fall into a range of generation times between ~12 hours and ~4 days, with substantial heterogeneity at the single-cell level. These data illustrate the use of heavy water as a universal environmental tracer for microbial activity, and highlight the crucial importance of studying the physiology of slow growth in representative laboratory systems in order to understand the role of these microorganisms in their native environments.

Island life in the Cretaceous - faunal composition, biogeography, evolution, and extinction of land-living vertebrates on the Late Cretaceous European archipelago

The Late Cretaceous was a time of tremendous global change, as the final stages of the Age of Dinosaurs were shaped by climate and sea level fluctuations and witness to marked paleogeographic and faunal changes, before the end-Cretaceous bolide impact. The terrestrial fossil record of Late Cretaceous Europe is becoming increasingly better understood, based largely on intensive fieldwork over the past two decades, promising new insights into latest Cretaceous faunal evolution. We review the terrestrial Late Cretaceous record from Europe and discuss its importance for understanding the paleogeography, ecology, evolution, and extinction of land-dwelling vertebrates. We review the major Late Cretaceous faunas from Austria, Hungary, France, Spain, Portugal, and Romania, as well as more fragmentary records from elsewhere in Europe. We discuss the paleogeographic background and history of assembly of these faunas, and argue that they are comprised of an endemic 'core' supplemented with various immigration waves. These faunas lived on an island archipelago, and we describe how this insular setting led to ecological peculiarities such as low diversity, a preponderance of primitive taxa, and marked changes in morphology (particularly body size dwarfing). We conclude by discussing the importance of the European record in understanding the end-Cretaceous extinction and show that there is no clear evidence that dinosaurs or other groups were undergoing long-term declines in Europe prior to the bolide impact.

Promotion of substrate based microbial biofilm in ponds: a low cost technology to boost fish production

Microbial biofilms have been found to increase fish production in ponds by increasing heterotrophic production through periphyton proliferation on available substrates. In this paper, the role of substrate based microbial biofilm in the production of Cyprinus carpio and Labeo rohita grown in ponds is investigated, using an easily available and biodegradable agricultural waste product (sugarcane bagasse) as substrate.

Studies of microbial abundances in mangrove habitat along the Karachi coast

Three species of bacteria, 8 species of fungi and 3 species of VAM-fungi were isolated from the soil substrata supporting Avicennia marina which comprises the majority of mangrove vegetation along the Karachi coast. The species abundances for fungi and bacteria were greater at one site (Sandspit) supporting healthy mangrove growth with soil pH 7.8, EC 16.2mmhos/cm², TSS 2.57% and available phosphorus 0.008% than at the other site (Korangi creek) with stunted growth of mangrove where the soil samples showed pH 7.9, EC 18.8mmhos/cm², TSS 1.45% and available phosphorus 0.001%. Symbiotic association by vasicular-arbuscular mycorrhizal (VAM) fungi in the roots of mangrove plants was also observed on a small scale at Korangi creek where the substratum was undergoing microbial degradation.

Effect of microbial biofilm in the nursery phase of mrigal, Cirrhinus mrigala

The experiment was conducted for 35 days in nine cement tubs (1 x 1 x 1 m) having 15 cm sandy-loam soil base with three treatments in triplicate, viz., cow dung alone at the rate of 1 kg/tub (T sub(1)), cow dung at 1 kg/tub and feed at 10% body wt/d in two meals (T sub(2)), and cow dung at 1 kg and paddy straw at 200 g/tub (T sub(3)). Both manure and substrate were added on dry weight basis. All the tubs were stocked with 10 fry each mrigal (100,000/ha) of average weight of 0.09 g, seven days after the addition of manure and substrate. The total plate count of bacteria in water did not vary much between the treatments and the mean values were 5.13, 5.49 and 5.85 (CFU x 10 super(4)/ml) in T sub(1) T sub(2) and T sub(3) respectively. The number of phytoplankters and zooplankters in water differed significantly between the treatments. The average number of attached algae (no./cm³) and fish food organisms (no./cm³) recorded on the substrate were 145.28 and 70.67, respectively. The mean final weight of mrigal differed significantly (P < 0.05) between the treatments with T sub(3) registering the highest value of 6.93 g followed by T sub(2) (5.01 g) and T sub(1) (3.37 g). The specific growth rate and growth increment of fish also followed the same trend as that of weight recorded in the different treatments. Survival was higher in T sub(2) (83.33%), followed by T sub(3) (80.00%) and T sub(1) (76.67%). The study demonstrates that by the introduction of biodegradable substrates like paddy straw into the culture systems, significantly higher growth and survival can be obtained in the nursery rearing of mrigal.