Fish and habitat community assessments on North Carolina shipwrecks: potential sites for detecting climate change in the graveyard of the Atlantic

The Monitor National Marine Sanctuary (MNMS) was the nation’s first sanctuary, originally established in 1975 to protect the famous civil war ironclad shipwreck, the USS Monitor. Since 2008, sanctuary sponsored archeological research has branched out to include historically significant U-boats and World War II shipwrecks within the larger Graveyard of the Atlantic off the coast of North Carolina. These shipwrecks are not only important for their cultural value, but also as habitat for a wide diversity of fishes, invertebrates and algal species. Additionally, due to their unique location within an important area for biological productivity, the sanctuary and other culturally valuable shipwrecks within the Graveyard of the Atlantic are potential sites for examining community change. For this reason, from June 8-30, 2010, biological and ecological investigations were conducted at four World War II shipwrecks (Keshena, City of Atlanta, Dixie Arrow, EM Clark), as part of the MNMS 2010 Battle of the Atlantic (BOTA) research project. At each shipwreck site, fish community surveys were conducted and benthic photo-quadrats were collected to characterize the mobile conspicuous fish, smaller prey fish, and sessile invertebrate and algal communities. In addition, temperature sensors were placed at all four shipwrecks previously mentioned, as well as an additional shipwreck, the Manuela. The data, which establishes a baseline condition to use in future assessments, suggest strong differences in both the fish and benthic communities among the surveyed shipwrecks based on the oceanographic zone (depth). In order to establish these shipwrecks as sites for detecting community change it is suggested that a subset of locations across the shelf be selected and repeatedly sampled over time. In order to reduce variability within sites for both the benthic and fish communities, a significant number of surveys should be conducted at each location. This sampling strategy will account for the natural differences in community structure that exist across the shelf due to the oceanographic regime, and allow robust statistical analyses of community differences over time

Measuring and optimising the efficiency of community hospital inpatient care for older people: the MoCHA mixed-methods study

Background: Community hospitals are small hospitals providing local inpatient and outpatient services. National surveys report that inpatient rehabilitation for older people is a core function but there are large differences in key performance measures. We have investigated these variations in community hospital ward performance. Objectives: (1) To measure the relative performance of community hospital wards (studies 1 and 2); (2) to identify characteristics of community hospital wards that optimise performance (studies 1 and 3); (3) to develop a web-based interactive toolkit that supports operational changes to optimise ward performance (study 4); (4) to investigate the impact of community hospital wards on secondary care use (study 5); and (5) to investigate associations between short-term community (intermediate care) services and secondary care utilisation (study 5). Methods: Study 1 – we used national data to conduct econometric estimations using stochastic frontier analysis in which a cost function was modelled using significant predictors of community hospital ward costs. Study 2 – a national postal survey was developed to collect data from a larger sample of community hospitals. Study 3 – three ethnographic case studies were performed to provide insight into less tangible aspects of community hospital ward care. Study 4 – a web-based interactive toolkit was developed by integrating the econometrics (study 1) and case study (study 3) findings. Study 5 – regression analyses were conducted using data from the Atlas of Variation Map 61 (rate of emergency admissions to hospital for people aged ≥ 75 years with a length of stay of < 24 hours) and the National Audit of Intermediate Care. Results: Community hospital ward efficiency is comparable with the NHS acute hospital sector (mean cost efficiency 0.83, range 0.72–0.92). The rank order of community hospital ward efficiencies was distinguished to facilitate learning across the sector. On average, if all community hospital wards were operating in line with the highest cost efficiency, savings of 17% (or £47M per year) could be achieved (price year 2013/14) for our sample of 101 wards. Significant economies of scale were found: a 1% rise in output was associated with an average 0.85% increase in costs. We were unable to obtain a larger community hospital sample because of the low response rate to our national survey. The case studies identified how rehabilitation was delivered through collaborative, interdisciplinary working; interprofessional communication; and meaningful patient and family engagement. We also developed insight into patients’ recovery trajectories and care transitions. The web-based interactive toolkit was established [http://mocha. nhsbenchmarking.nhs.uk/ (accessed 9 September 2019)]. The crisis response team type of intermediate care, but not community hospitals, had a statistically significant negative association with emergency admissions. Limitations: The econometric analyses were based on cross-sectional data and were also limited by missing data. The low response rate to our national survey means that we cannot extrapolate reliably from our community hospital sample. Conclusions: The results suggest that significant community hospital ward savings may be realised by improving modifiable performance factors that might be augmented further by economies of scale. Future work: How less efficient hospitals might reduce costs and sustain quality requires further research

Application of phage display to high throughput antibody generation and characterization.

We have created a high quality phage display library containing over 1010 human antibodies and describe its use in the generation of antibodies on an unprecedented scale. We have selected, screened and sequenced over 38,000 recombinant antibodies to 292 antigens, yielding over 7,200 unique clones. 4,400 antibodies were characterized by specificity testing and detailed sequence analysis and the data/clones are available online. Sensitive detection was demonstrated in a bead based flow cytometry assay. Furthermore, positive staining by immunohistochemistry on tissue microarrays was found for 37% (143/381) of antibodies. Thus, we have demonstrated the potential of and illuminated the issues associated with genome-wide monoclonal antibody generation.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are