Molecular epidemiology of pneumococci obtained from Gambian children aged 2-29 months with invasive pneumococcal disease during a trial of a 9-valent pneumococcal conjugate vaccine.

BACKGROUND: The study describes the molecular epidemiology of Streptococcus pneumoniae causing invasive disease in Gambian children METHODS: One hundred and thirty-two S. pneumoniae isolates were recovered from children aged 2-29 months during the course of a pneumococcal conjugate vaccine trial conducted in The Gambia of which 131 were characterized by serotyping, antibiotic susceptibility, BOX-PCR and MLST. RESULTS: Twenty-nine different serotypes were identified; serotypes 14, 19A, 12F, 5, 23F, and 1 were common and accounted for 58.3% of all serotypes overall. MLST analysis showed 72 sequence types (STs) of which 46 are novel. eBURST analysis using the stringent 6/7 identical loci definition, grouped the isolates into 17 clonal complexes and 32 singletons. The population structure of the 8 serotype 1 isolates obtained from 4 vaccinated and 2 unvaccinated children were the same (ST 618) except that one (ST3336) of the isolates from an unvaccinated child had a novel ST which is a single locus variant of ST 618. CONCLUSION: We provide the first background data on the genetic structure of S. pneumoniae causing IPD prior to PC7V use in The Gambia. This data will be important for assessing the impact of PC7V in post-vaccine surveillance from The Gambia

AN ASSESSMENT OF KNOWLEDGE AND ATTITUDES OF GENETIC COUNSELING SERVICES IN U.S. HTCs

Hemophilia is a hereditary bleeding disorder which requires lifelong specialized care. A network of Hemophilia Treatment Centers (HTCs) exists to meet the medical needs of patients affected by hemophilia. Genetic counseling services are an integral part of the HTC model of care; however, many HTCs do not have genetic counselors on staff. As a result, the duty to provide these services must fall to other healthcare providers within the HTC. To assess the knowledge and attitudes of these providers we developed a 49 question survey that was distributed electronically to hematologists and nurses at U.S. HTCs. The survey consisted of a three sections: demographic information, knowledge of hemophilia genetics, and attitudes towards genetic services. A total of 111 complete responses were received and analyzed. The average knowledge score among all participants was 74.8% with a total of 81 participants receiving a passing score of 70% or above. Thirty participants scored below 70% in the knowledge section. In general, attitude scores were high indicating that the majority of hematologists and nurses in HTCs feel confident in their ability to provide genetic counseling services. Over 90% of participants reported that they have some form of access to genetic counseling services at their center. Hematologists and nurses practicing in U.S. HTCs demonstrate sufficient knowledge of the genetics of hemophilia, and they generally feel confident in their ability to provide genetic counseling services to their patients. While their knowledge is sufficient, the average knowledge score was lower than 75%. Certain questions covering new genetic technologies and testing practices were more commonly missed than questions asking about more basic aspects of hemophilia genetics, such as inheritance and carrier testing. Finally, many clinics report having access to a counselor, but it is oftentimes a hematologist or nurse who is providing genetic counseling services to patients. Given the inconsistency in knowledge among providers coupled with the high confidence in one’s ability to counsel patients, it leaves room to question whether information about the genetics of hemophilia is being communicated to patients in the most appropriate and accurate manner

Sintering of calcium phosphates with a femtosecond pulsed laser for hard tissue engineering

The authors acknowledge support from the sponsors of this work; the EPSRC LUMIN (EP/K020234/1) and EU-Marie-Curie-IAPP LUSTRE (324538) projects.Direct laser sintering on hard tissues is likely to open new pathways for personalised medicine. To minimise irradiation damage of the surrounding soft tissues, lasers operating at wavelengths that are ‘safe’ for the tissues and biomaterials with improved optical properties are required. In this work laser sintering is demonstrated with the use of an ultrafast, femtosecond (100 fs) pulsed laser operating at a wavelength of 1045 nm and two existing calcium phosphate minerals (brushite and hydroxyapatite) which have been improved after doping with iron (10 mol%). Femtosecond laser irradiation caused transformation of the Fe3+-doped brushite and Fe3+-doped HAp samples into β-calcium pyrophosphate and calcium-iron-phosphate, respectively, with simultaneous evidence for microstructural sintering and densification. After estimating the temperature profile at the surface of the samples we suggest that soft tissues over 500 μm from the irradiated zone would be safe from thermal damage. This novel laser processing provides a means to control the phase constitution and the morphology of the finished surfaces. The porous structure of β-pyrophosphate might be suitable for applications in bone regeneration by supporting osteogenic cell activity while, the densified Fe3+-rich calcium-iron-phosphate may be promising for applications like dental enamel restoration.PostprintPeer reviewe

Innovative learning at The University of Edinburgh

The activities available to civil engineering students during the University of Edinburgh's innovative learning week in 2012 were examined. The academic staff proposed a wide range of possible activities and student participation was optional. Popular activities were those with a ‘hands-on’ element: making or doing something. The practical activities offered included designing and building trebuchets, relaying railway permanent way on a heritage railway, practical workshops on engineering in international development and learning to juggle. These activities suggested that heuristic learning by trial and error was likely to enhance the visualisation skills that contribute to good engineering design. Further, the linking of achievement to purposeful practice rather than innate talent could inform teaching methods in the future. They also showed that in some cases safety culture messages were still not fully assimilated by students

Synergistic Antibacterial Effects of Metallic Nanoparticle Combinations

© The Author(s) 2019.Metallic nanoparticles have unique antimicrobial properties that make them suitable for use within medical and pharmaceutical devices to prevent the spread of infection in healthcare. The use of nanoparticles in healthcare is on the increase with silver being used in many devices. However, not all metallic nanoparticles can target and kill all disease-causing bacteria. To overcome this, a combination of several different metallic nanoparticles were used in this study to compare effects of multiple metallic nanoparticles when in combination than when used singly, as single elemental nanoparticles (SENPs), against two common hospital acquired pathogens (Staphylococcus aureus and Pseudomonas. aeruginosa). Flow cytometry LIVE/DEAD assay was used to determine rates of cell death within a bacterial population when exposed to the nanoparticles. Results were analysed using linear models to compare effectiveness of three different metallic nanoparticles, tungsten carbide (WC), silver (Ag) and copper (Cu), in combination and separately. Results show that when the nanoparticles are placed in combination (NPCs), antimicrobial effects significantly increase than when compared with SENPs (P < 0.01). This study demonstrates that certain metallic nanoparticles can be used in combination to improve the antimicrobial efficiency in destroying morphologically distinct pathogens within the healthcare and pharmaceutical industry.Peer reviewe

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

The images of psychiatry scale: development, factor structure, and reliability.

BACKGROUND: This analysis is based on a survey questionnaire designed to describe medical educators' views of psychiatry and psychiatrists. Our goals in this paper were to assess the psychometric properties of the survey questions by (a) using exploratory factor analysis to identify the basic factor structure underlying 37 survey items; (b) testing the resulting factor structure using confirmatory factor analysis; and (c) assessing the internal reliability of each identified factor. To our knowledge, this is the first attempt to use these techniques to psychometrically assess a scale measuring the strength of stigma that medical educators attached to psychiatry. METHODS: Survey data were collected from a random sample of 1,059 teaching faculty in 23 academic teaching sites in 15 countries. We conducted exploratory and confirmatory factor analysis to identify the scale structure and Cronbach's alpha to assess internal consistency of the resulting scales. RESULTS: Results showed that a two-factor solution was the best fit for the data. Following exploratory factor analysis, we conducted confirmatory factor analysis on a split half of the sample. Results highlighted several items with low loadings. Excluding factors with low correlations and allowing for several correlated variances resulted in a good fitting model explaining 95% of the variance in the data. CONCLUSIONS: We identified two unidimensional scales. The Images Scale contained 11 items measuring stereotypic content concerning psychiatry and psychiatrists. The Efficacy of Psychiatry Scale contained 5 items addressing perceptions of the challenges and effectiveness of psychiatry as a discipline

The SERRATE protein is involved in alternative splicing in <em>Arabidopsis thaliana</em>

Howalternative splicing (AS) is regulated in plants has not yet been elucidated. Previously, we have shown that the nuclear cap-binding protein complex (AtCBC) is involved in AS in Arabidopsis thaliana. Here we show that both subunits of AtCBC (AtCBP20 and AtCBP80) interact with SERRATE (AtSE), a protein involved in the microRNA biogenesis pathway. Moreover, using a high-resolution reverse transcript-ase-polymerase chain reaction AS system we have found that AtSE influences AS in a similar way to the cap-binding complex (CBC), preferentially affecting selection of 50 splice site of first introns. The AtSE protein acts in cooperation with AtCBC: many changes observed in the mutant lacking the correct SERRATE activity were common to those observed in the cbp mutants. Interestingly, significant changes in AS of some genes were also observed in other mutants of plant microRNA biogenesis pathway, hyl1-2 and dcl1-7, but a majority of them did not cor-respond to the changes observed in the se-1mutant. Thus, the role of SERRATE in AS regulation is distinct from that of HYL1andDCL1, and is similar to the regu-lation of AS in which CBC is involved

Helping Business Schools Engage with Real Problems: The Contribution of Critical Realism and Systems Thinking

The world faces major problems, not least climate change and the financial crisis, and business schools have been criticised for their failure to help address these issues and, in the case of the financial meltdown, for being causally implicated in it. In this paper we begin by describing the extent of what has been called the rigour/relevance debate. We then diagnose the nature of the problem in terms of historical, structural and contextual mechanisms that initiated and now sustain an inability of business schools to engage with real-world issues. We then propose a combination of measures, which mutually reinforce each other, that are necessary to break into this vicious circle – critical realism as an underpinning philosophy that supports and embodies the next points; holism and transdisciplinarity; multimethodology (mixed-methods research); and a critical and ethical-committed stance. OR and management science have much to contribute in terms of both powerful analytical methods and problem structuring methods