The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections : a case-control study

Objectives Hospital-acquired bloodstream infections are known to increase the risk of death and prolong hospital stay, but precise estimates of these two important outcomes from well-designed studies are rare, particularly for non-intensive care unit (ICU) patients. We aimed to calculate accurate estimates, which are vital for estimating the economic costs of hospital-acquired bloodstream infections.

Proof of concept : A bioinformatic and serological screening method for identifying new peptide antigens for Chlamydia trachomatis related sequelae in women

This study aimed to identify new peptide antigens from Chlamydia (C.) trachomatis in a proof of concept approach which could be used to develop an epitope-based serological diagnostic for C. trachomatis related infertility in women. A bioinformatics analysis was conducted examining several immunodominant proteins from C. trachomatis to identify predicted immunoglobulin epitopes unique to C. trachomatis. A peptide array of these epitopes was screened against participant sera. The participants (all female) were categorized into the following cohorts based on their infection and gynecological history; acute (single treated infection with C. trachomatis), multiple (more than one C. trachomatis infection, all treated), sequelae (PID or tubal infertility with a history of C. trachomatis infection), and infertile (no history of C. trachomatis infection and no detected tubal damage). The bioinformatics strategy identified several promising epitopes. Participants who reacted positively in the peptide 11 ELISA were found to have an increased likelihood of being in the sequelae cohort compared to the infertile cohort with an odds ratio of 16.3 (95% c.i. 1.65 – 160), with 95% specificity and 46% sensitivity (0.19-0.74). The peptide 11 ELISA has the potential to be further developed as a screening tool for use during the early IVF work up and provides proof of concept that there may be further peptide antigens which could be identified using bioinformatics and screening approaches.

Fluid-structure interaction analysis of full scale vehicle-barrier impact using coupled SPH-FEA

Portable water-filled barriers (PWFB) are roadside structures used to separate moving traffic from work-zones. Numerical PWFB modelling is preferred in the design stages prior to actual testing. This paper aims to study the fluid-structure interaction of PWFB under vehicular impact using several methods. The strategy to treat water as non-structural mass was proposed and the errors were investigated. It was found that water can be treated with the FEA-NSM model for velocities higher than 80kmh-1. However, full SPH/FEA model is still the best treatment for water and necessary for lower impact velocities. The findings in this paper can be used as guidelines for modelling and designing PWFB.

Osteogenic differentiation of bone marrow MSCs by β-tricalcium phosphate stimulating macrophages via BMP2 signalling pathway

Immune reactions play important roles in determining the in vivo fate of bone substitute materials, either in new bone formation or inflammatory fibrous tissue encapsulation. The paradigm for the development of bone substitute materials has been shifted from inert to immunomodulatory materials, emphasizing the importance of immune cells in the material evaluation. Macrophages, the major effector cells in the immune reaction to implants, are indispensable for osteogenesis and their heterogeneity and plasticity render macrophages a primer target for immune system modulation. However, there are very few reports about the effects of macrophages on biomaterial-regulated osteogenesis. In this study, we used b-tricalcium phosphate (b-TCP) as a model biomaterial to investigate the role of macrophages on the material stimulated osteogenesis. The macrophage phenotype switched to M2 extreme in response to b-TCP extracts, which was related to the activation of calcium-sensing receptor (CaSR) pathway. Bone morphogenetic protein 2 (BMP2) was also significantly upregulated by the b-TCP stimulation, indicating that macrophage may participate in the b-TCP stimulated osteogenesis. Interestingly, when macrophageconditioned b-TCP extracts were applied to bone marrow mesenchymal stem cells (BMSCs), the osteogenic differentiation of BMSCs was significantly enhanced, indicating the important role of macrophages in biomaterial-induced osteogenesis. These findings provided valuable insights into the mechanism of material-stimulated osteogenesis, and a strategy to optimize the evaluation system for the in vitro osteogenesis capacity of bone substitute materials.

Impact of extracellular matrix derived from osteoarthritis subchondral bone osteoblasts on osteocytes : role of integrinβ1 and focal adhesion kinase signaling cues

INTRODUCTION: Our recent study indicated that subchondral bone pathogenesis in osteoarthritis (OA) is associated with osteocyte morphology and phenotypic abnormalities. However, the mechanism underlying this abnormality needs to be identified. In this study we investigated the effect of extracellular matrix (ECM) produced from normal and OA bone on osteocytic cells function. METHODS: De-cellularized matrices, resembling the bone provisional ECM secreted from primary human subchondral bone osteoblasts (SBOs) of normal and OA patients were used as a model to study the effect on osteocytic cells. Osteocytic cells (MLOY4 osteocyte cell line) cultured on normal and OA derived ECMs were analyzed by confocal microscopy, scanning electron microscopy (SEM), cell attachment assays, zymography, apoptosis assays, qRT-PCR and western blotting. The role of integrinβ1 and focal adhesion kinase (FAK) signaling pathways during these interactions were monitored using appropriate blocking antibodies. RESULTS: The ECM produced by OA SBOs contained less mineral content, showed altered organization of matrix proteins and matrix structure compared with the matrices produced by normal SBOs. Culture of osteocytic cells on these defective OA ECM resulted in a decrease of integrinβ1 expression and the de-activation of FAK cell signaling pathway, which subsequently affected the initial osteocytic cell's attachment and functions including morphological abnormalities of cytoskeletal structures, focal adhesions, increased apoptosis, altered osteocyte specific gene expression and increased Matrix metalloproteinases (MMP-2) and -9 expression. CONCLUSION: This study provides new insights in understanding how altered OA bone matrix can lead to the abnormal osteocyte phenotypic changes, which is typical in OA pathogenesis.

Torsional properties of bamboo-like structured Cu nanowires

Recently, researchers reported that nanowires (NWs) are often polycrystalline, which contain grain or twin boundaries that transect the whole NW normal to its axial direction into a bamboo like structure. In this work, large-scale molecular dynamics simulation is employed to investigate the torsional behaviours of bamboo-like structured Cu NWs. The existence of grain boundaries is found to induce a considerably large reduction to the critical angle, and the more of grain boundaries the less reduction appears, whereas, the presence of twin boundaries only results in a relatively smaller reduction to the critical angle. The introduction of grain boundaries reduces the torsional rigidity of the NW, whereas, the twin boundaries exert insignificant influence to the torsional rigidity. NWs with grain boundaries are inclined to produce a local HCP structure during loading, and the plastic deformation is usually evenly distributed along the axial axis of the NW. The plastic deformation of both perfect NW and NWs with twin boundaries is dominated by the nucleation and propagation of parallel intrinsic stacking faults. This study will enrich the current understanding of the mechanical properties of NWs, which will eventually shed lights on their applications.

Two-dimensional graphene heterojunctions: The tunable mechanical properties

We report the mechanical properties of different two-dimensional carbon heterojunctions (HJs) made from graphene and various stable graphene allotropes, including α-, β-, γ- and 6612-graphyne (GY), and graphdiyne (GDY). It is found that all HJs exhibit a brittle behaviour except the one with α-GY, which however shows a hardening process due to the formation of triple carbon rings. Such hardening process has greatly deferred the failure of the structure. The yielding of the HJs is usually initiated at the interface between graphene and graphene allotropes, and monoatomic carbon rings are normally formed after yielding. By varying the locations of graphene (either in the middle or at the two ends of the HJs), similar mechanical properties have been obtained, suggesting insignificant impacts from location of graphene allotropes. Whereas, changing the types and percentages of the graphene allotropes, the HJs exhibit vastly different mechanical properties. In general, with the increasing graphene percentage, the yield strain decreases and the effective Young’s modulus increases. Meanwhile, the yield stress appears irrelevant with the graphene percentage. This study provides a fundamental understanding of the tensile properties of the heterojunctions that are crucial for the design and engineering of their mechanical properties, in order to facilitate their emerging future applications in nanoscale devices, such as flexible/stretchable electronics.

Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis

Quantity and timing of protein ingestion are major factors regulating myofibrillar protein synthesis (MPS). However, the effect of specific ingestion patterns on MPS throughout a 12 h period is unknown. We determined how different distributions of protein feeding during 12 h recovery after resistance exercise affects anabolic responses in skeletal muscle. Twenty-four healthy trained males were assigned to three groups (n = 8/group) and undertook a bout of resistance exercise followed by ingestion of 80 g of whey protein throughout 12 h recovery in one of the following protocols: 8 × 10 g every 1.5 h (PULSE); 4 × 20 g every 3 h (intermediate: INT); or 2 × 40 g every 6 h (BOLUS). Muscle biopsies were obtained at rest and after 1, 4, 6, 7 and 12 h post exercise. Resting and post-exercise MPS (l-[ring-(13)C6] phenylalanine), and muscle mRNA abundance and cell signalling were assessed. All ingestion protocols increased MPS above rest throughout 1-12 h recovery (88-148%, P < 0.02), but INT elicited greater MPS than PULSE and BOLUS (31-48%, P < 0.02). In general signalling showed a BOLUS>INT>PULSE hierarchy in magnitude of phosphorylation. MuRF-1 and SLC38A2 mRNA were differentially expressed with BOLUS. In conclusion, 20 g of whey protein consumed every 3 h was superior to either PULSE or BOLUS feeding patterns for stimulating MPS throughout the day. This study provides novel information on the effect of modulating the distribution of protein intake on anabolic responses in skeletal muscle and has the potential to maximize outcomes of resistance training for attaining peak muscle mass.

Daytime pattern of post-exercise protein intake affects whole-body protein turnover in resistance-trained males

Background The pattern of protein intake following exercise may impact whole-body protein turnover and net protein retention. We determined the effects of different protein feeding strategies on protein metabolism in resistance-trained young men. Methods: Participants were randomly assigned to ingest either 80g of whey protein as 8x10g every 1.5h (PULSE; n=8), 4x20g every 3h (intermediate, INT; n=7), or 2x40g every 6h (BOLUS; n=8) after an acute bout of bilateral knee extension exercise (4x10 repetitions at 80% maximal strength). Whole-body protein turnover (Q), synthesis (S), breakdown (B), and net balance (NB) were measured throughout 12h of recovery by a bolus ingestion of [ 15N]glycine with urinary [15N]ammonia enrichment as the collected end-product. Results PULSE Q rates were greater than BOLUS (?19%, P<0.05) with a trend towards being greater than INT (?9%, P=0.08). Rates of S were 32% and 19% greater and rates of B were 51% and 57% greater for PULSE as compared to INT and BOLUS, respectively (P<0.05), with no difference between INT and BOLUS. There were no statistical differences in NB between groups (P=0.23); however, magnitude-based inferential statistics revealed likely small (mean effect90%CI; 0.590.87) and moderate (0.800.91) increases in NB for PULSE and INT compared to BOLUS and possible small increase (0.421.00) for INT vs. PULSE. Conclusion We conclude that the pattern of ingested protein, and not only the total daily amount, can impact whole-body protein metabolism. Individuals aiming to maximize NB would likely benefit from repeated ingestion of moderate amounts of protein (?20g) at regular intervals (?3h) throughout the day.

Geographic remoteness, area-level socioeconomic disadvantage and inequalities in colorectal cancer survival in Queensland : a multilevel analysis

Background To explore the impact of geographical remoteness and area-level socioeconomic disadvantage on colorectal cancer (CRC) survival. Methods Multilevel logistic regression and Markov chain Monte Carlo simulations were used to analyze geographical variations in five-year all-cause and CRC-specific survival across 478 regions in Queensland Australia for 22,727 CRC cases aged 20–84 years diagnosed from 1997–2007. Results Area-level disadvantage and geographic remoteness were independently associated with CRC survival. After full multivariate adjustment (both levels), patients from remote (odds Ratio [OR]: 1.24, 95%CrI: 1.07-1.42) and more disadvantaged quintiles (OR = 1.12, 1.15, 1.20, 1.23 for Quintiles 4, 3, 2 and 1 respectively) had lower CRC-specific survival than major cities and least disadvantaged areas. Similar associations were found for all-cause survival. Area disadvantage accounted for a substantial amount of the all-cause variation between areas. Conclusions We have demonstrated that the area-level inequalities in survival of colorectal cancer patients cannot be explained by the measured individual-level characteristics of the patients or their cancer and remain after adjusting for cancer stage. Further research is urgently needed to clarify the factors that underlie the survival differences, including the importance of geographical differences in clinical management of CRC.

"You’ve modelled and now what?" : Exploring determinants of process model re-use

Business process modelling as a practice and research field has received great attention over recent years. Organizations invest significantly into process modelling in terms of training, tools, capabilities and resources. The return on this investment is a function of process model re-use, which we define as the recurring use of process models to support organizational work tasks. While prior research has examined re-use as a design principle, we explore re-use as a behaviour, because evidence suggest that analysts’ re-use of process models is indeed limited. In this paper we develop a two-stage conceptualization of the key object-, behaviour- and socioorganization-centric factors explaining process model re-use behaviour. We propose a theoretical model and detail implications for its operationalization and measurement. Our study can provide significant benefits to our understanding of process modelling and process model use as key practices in analysis and design.

Multi-wall carbon nanotube coating of fluorine-doped tin oxide as an electrode surface modifier for polymer solar cells

A controlled layer of multi-wall carbon nanotubes (MWCNT) was grown directly on top of fluorine-doped tin oxide (FTO) glass electrodes as a surface modifier for improving the performance of polymer solar cells. By using low-temperature chemical vapor deposition with short synthesis times, very short MWCNTs were grown, these uniformly decorating the FTO surface. The chemical vapor deposition parameters were carefully refined to balance the tube size and density, while minimizing the decrease in conductivity and light harvesting of the electrode. As created FTO/CNT electrodes were applied to bulk-heterojunction polymer solar cells, both in direct and inverted architecture. Thanks to the inclusion of MWCNT and the consequent nano-structuring of the electrode surface, we observe an increase in external quantum efficiency in the wavelength range from 550 to 650 nm. Overall, polymer solar cells realized with these FTO/CNT electrodes attain power conversion efficiency higher than 2%, outclassing reference cells based on standard FTO electrodes.

Engineering based problem solving in the middle school : design and construction with simple machines

Incorporating engineering concepts into middle school curriculum is seen as an effective way to improve students’ problem-solving skills. A selection of findings is reported from a science, technology, engineering and mathematics (STEM)-based unit in which students in the second year (grade 8) of a three-year longitudinal study explored engineering concepts and principles pertaining to the functioning of simple machines. The culminating activity, the focus of this paper, required the students to design, construct, test, and evaluate a trebuchet catapult. We consider findings from one of the schools, a co-educational school, where we traced the design process developments of four student groups from two classes. The students’ descriptions and explanations of the simple machines used in their catapult design are examined, together with how they rated various aspects of their engineering designs. Included in the findings are students’ understanding of how their simple machines were simulated by the resources supplied and how the machines interacted in forming a complex machine. An ability to link physical materials with abstract concepts and an awareness of design constraints on their constructions were apparent, although a desire to create a ‘‘perfect’’ catapult despite limitations in the physical materials rather than a prototype for testing concepts was evident. Feedback from teacher interviews added further insights into the students’ developments as well as the teachers’ professional learning. An evolving framework for introducing engineering education in the pre-secondary years is proposed.

Folk opera : stories crossing borders in Papua New Guinea

The Life Drama project is a drama-based sexual health promotion project, developed by a cross-cultural research team in Papua New Guinea (PNG) over the past four years. Recognising the limitations of established theatre-in-education and theatre-for-development approaches when working across cultures, the research team explored ways of tapping into the everyday performativity of PNG participants and their communities in order to communicate more powerfully about the personal and social issues involved in sexual health. Through the Folk Opera form, developed by PNG theatre company Raun Raun Theatre around the time of national Independence, the research explored the importance of "story" in identity formation, maintenance and change, the communication of meaning, and the transmission of tacit local knowledges. In a highly diverse and rapidly-changing country like PNG, enacted stories inherently compel the exchange and exploration of different knowledges, and promote the dialogue and ownership that drives social change. The paper will present and unpack the Folk Opera form as developed in the Life Drama program, drawing conclusions which may apply to other programs which to promote health and social justice across cultures.

Peripheral refraction patterns out to large field angles

Purpose To investigate hyperopic shifts and the oblique (or 45-degree/135-degree) component of astigmatism at large angles in the horizontal visual field using the Hartmann-Shack technique. Methods The adult participants consisted of 6 hypermetropes, 13 emmetropes and 11 myopes. Measurements were made with a modified COAS-HD Hartmann-Shack aberrometer across T60 degrees along the horizontal visual field in 5-degree steps. Eyes were dilated with 1% cyclopentolate. Peripheral refraction was estimated as mean spherical (or spherical equivalent) refraction, with/against the rule of astigmatism and oblique astigmatism components, and as horizontal and vertical refraction components based on 3-mm major diameter elliptical pupils. Results Thirty percent of eyes showed a pattern that was a combination of type IV and type I patterns of Rempt et al. (Rempt F, Hoogerheide J, Hoogenboom WP. Peripheral retinoscopy and the skiagram. Ophthalmologica 1971;162:1Y10), which shows the characteristics of type IV (relative hypermetropia along the vertical meridian and relative myopia along the horizontal meridian) out to an angle of between 40 and 50 degrees before behaving like type I (both meridians show relative hypermetropia). We classified this pattern as type IV/I. Seven of 13 emmetropes had this pattern. As a group, there was no significant variation of the oblique component of astigmatism with angle, but about one-half of the eyes showed significant positive slopes (more positive or less negative values in the nasal field than in the temporal field) and one-fourth showed significant negative slopes. Conclusions It is often considered that a pattern of relative peripheral hypermetropia predisposes to the development of myopia. In this context, the finding of a considerable portion of emmetropes with the IV/I pattern suggests that it is unlikely that refraction at visual field angles beyond 40 degrees from fixation contributes to myopia development.