146 research outputs found

    A Modified SIR Model Equivalent to a Generalized Logistic Model, with Standard Logistic Approximations

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    https://knowledgeconnection.mainehealth.org/lambrew-retreat-2021/1000/thumbnail.jp

    Outcomes following oesophagectomy in patients with oesophageal cancer: a secondary analysis of the ICNARC Case Mix Programme Database

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    Introduction: This report describes the case mix and outcomes of patients with oesophageal cancer admitted to adult critical care units following elective oesophageal surgery in England, Wales and Northern Ireland. Methods: Admissions to critical care following elective oesophageal surgery for malignancy were identified using data from the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme Database. Information on admissions between December 1995 and September 2007 were extracted and the association between in-hospital mortality and patient characteristics on admission to critical care was assessed using multiple logistic regression analysis. The performance of three prognostic models (Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II and the ICNARC physiology score) was also evaluated. Results: Between 1995 and 2007, there were 7227 admissions to 181 critical care units following oesophageal surgery for malignancy. Overall mortality in critical care was 4.4% and in-hospital mortality was 11%, although both declined steadily over time. Eight hundred and seventy-three (12.2%) patients were readmitted to critical care, most commonly for respiratory complications (49%) and surgical complications (25%). Readmitted patients had a critical care unit mortality of 24.7% and in-hospital mortality of 33.9%. Overall in-hospital mortality was associated with patient age, and various physiological measurements on admission to critical care (partial pressure of arterial oxygen (PaO2):fraction of inspired oxygen (FiO2) ratio, lowest arterial pH, mechanical ventilation, serum albumin, urea and creatinine). The three prognostic models evaluated performed poorly in measures of discrimination, calibration and goodness of fit. Conclusions: Surgery for oesophageal malignancy continues to be associated with significant morbidity and mortality. Age and organ dysfunction in the early postoperative period are associated with an increased risk of death. Postoperative serum albumin is confirmed as an additional prognostic factor. More work is required to determine how this knowledge may improve clinical management

    Effect of Concurrent Partnerships and Sex-Act Rate on Gonorrhea Prevalence

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    The disease gonorrhea (GC) is a major public health problem in the United States, and the dynamics of the spread of GC through popula tions are complicated and not well understood. Studies have drawn attention to the effect of concurrent sexual partnerships as an influen tial factor for determining disease prevalence. However, little has been done to date to quantify the combined effects of concurrency and within-partnership sex-act rates on the prevalence of GC. This simulation study examines this issue with a simplified model of GC transmission in closed human populations that include concurrent partnerships. Two models of within-partnership sex-act rate are compared; one is a fixed sex-act rate per partnership, and the other is perhaps more realistic in that the rate depends on the number of concurrent partners. After controlling for total number of sex acts, pseudo-equilibrium prevalence is higher with the fixed sex-act rate than under the concurrency-adjusted rate in all the modeled partnership formation conditions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68414/2/10.1177_003754979807100404.pd

    An Architecture for an Integrated Fire Emergency Response System for the Built Environment

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    Peer-reviewed article published in the Proceedings of the 9th International Symposium on Fire Safety Science, Karlsruhe, 2008.FireGrid is a modern concept that aims to leverage a number of modern technologies to aid fire emergency response. In this paper we provide a brief introduction to the FireGrid project. A number of different technologies such as wireless sensor networks, grid-enabled High Performance Computing (HPC) implementation of fire models, and artificial intelligence tools need to be integrated to build up a modern fire emergency response system. We propose a system architecture that provides the framework for integration of the various technologies. We describe the components of the generic FireGrid system architecture in detail. Finally we present a small-scale demonstration experiment which has been completed to highlight the concept and application of the FireGrid system to an actual fire. Although our proposed system architecture provides a versatile framework for integration, a number of new and interesting research problems need to be solved before actual deployment of the system. We outline some of the challenges involved which require significant interdisciplinary collaborations

    A shared population of epidemic methicillin-resistant Staphylococcus aureus 15 circulates in humans and companion animals.

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    UNLABELLED: Methicillin-resistant Staphylococcus aureus (MRSA) is a global human health problem causing infections in both hospitals and the community. Companion animals, such as cats, dogs, and horses, are also frequently colonized by MRSA and can become infected. We sequenced the genomes of 46 multilocus sequence type (ST) 22 MRSA isolates from cats and dogs in the United Kingdom and compared these to an extensive population framework of human isolates from the same lineage. Phylogenomic analyses showed that all companion animal isolates were interspersed throughout the epidemic MRSA-15 (EMRSA-15) pandemic clade and clustered with human isolates from the United Kingdom, with human isolates basal to those from companion animals, suggesting a human source for isolates infecting companion animals. A number of isolates from the same veterinary hospital clustered together, suggesting that as in human hospitals, EMRSA-15 isolates are readily transmitted in the veterinary hospital setting. Genome-wide association analysis did not identify any host-specific single nucleotide polymorphisms (SNPs) or virulence factors. However, isolates from companion animals were significantly less likely to harbor a plasmid encoding erythromycin resistance. When this plasmid was present in animal-associated isolates, it was more likely to contain mutations mediating resistance to clindamycin. This finding is consistent with the low levels of erythromycin and high levels of clindamycin used in veterinary medicine in the United Kingdom. This study furthers the "one health" view of infectious diseases that the pathogen pool of human and animal populations are intrinsically linked and provides evidence that antibiotic usage in animal medicine is shaping the population of a major human pathogen. IMPORTANCE: Methicillin-resistant Staphylococcus aureus (MRSA) is major problem in human medicine. Companion animals, such as cats, dogs, and horses, can also become colonized and infected by MRSA. Here, we demonstrate that a shared population of an important and globally disseminated lineage of MRSA can infect both humans and companion animals without undergoing host adaptation. This suggests that companion animals might act as a reservoir for human infections. We also show that the isolates from companion animals have differences in the presence of certain antibiotic resistance genes. This study furthers the "one health" view of infectious diseases by demonstrating that the pool of MRSA isolates in the human and animal populations are shared and highlights how different antibiotic usage patterns between human and veterinary medicine can shape the population of bacterial pathogens.This work was supported by a Medical Research Council Partnership grant (G1001787/1) held between the Department of Veterinary Medicine, University of Cambridge (M.A.H.), the School of Clinical Medicine, University of Cambridge (S.J.P.), the Moredun Research Institute, and the Wellcome Trust Sanger Institute (J.P. and S.J.P). S.J.P. receives support from the NIHR Cambridge Biomedical Research Centre. M.T.G.H., S.R.H. and J.P. were funded by Wellcome Trust grant no. 098051.This is the final published version distributed under a Creative Commons Attribution License 2.0, which can also be found on the publisher's website at: http://mbio.asm.org/content/5/3/e00985-13.full.pdf+htm

    Coronin Promotes the Rapid Assembly and Cross-linking of Actin Filaments and May Link the Actin and Microtubule Cytoskeletons in Yeast

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    Coronin is a highly conserved actin-associated protein that until now has had unknown biochemical activities. Using microtubule affinity chromatography, we coisolated actin and a homologue of coronin, Crn1p, from Saccharomyces cerevisiae cell extracts. Crn1p is an abundant component of the cortical actin cytoskeleton and binds to F-actin with high affinity (Kd 6 × 10−9 M). Crn1p promotes the rapid barbed-end assembly of actin filaments and cross-links filaments into bundles and more complex networks, but does not stabilize them. Genetic analyses with a crn1Δ deletion mutation also are consistent with Crn1p regulating filament assembly rather than stability. Filament cross-linking depends on the coiled coil domain of Crn1p, suggesting a requirement for Crn1p dimerization. Assembly-promoting activity is independent of cross-linking and could be due to nucleation and/or accelerated polymerization. Crn1p also binds to microtubules in vitro, and microtubule binding is enhanced by the presence of actin filaments. Microtubule binding is mediated by a region of Crn1p that contains sequences (not found in other coronins) homologous to the microtubule binding region of MAP1B. These activities, considered with microtubule defects observed in crn1Δ cells and in cells overexpressing Crn1p, suggest that Crn1p may provide a functional link between the actin and microtubule cytoskeletons in yeast

    FireGrid: An e-infrastructure for next-generation emergency response support

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    Peer reviewed paper published in Journal of Parallel and Distributed Computing.The FireGrid project aims to harness the potential of advanced forms of computation to support the response to large-scale emergencies (with an initial focus on the response to fires in the built environment). Computational models of physical phenomena are developed, and then deployed and computed on High Performance Computing resources to infer incident conditions by assimilating live sensor data from an emergency in real time–or, in the case of predictive models, faster-than-real time. The results of these models are then interpreted by a knowledge-based reasoning scheme to provide decision support information in appropriate terms for the emergency responder. These models are accessed over a Grid from an agent-based system, of which the human responders form an integral part. This paper proposes a novel FireGrid architecture, and describes the rationale behind this architecture and the research results of its application to a large-scale fire experiment.Emergency response, Grid, High performance computing, Multi-agent system, Knowledge-based reasoning, Fire simulation mode

    Temporal signal in structured molecular data

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    'Dated-tip' methods of molecular dating use DNA sequences sampled at different times, to estimate the age of their most recent common ancestor. Several tests of 'temporal signal' are available to determine whether data sets are suitable for such analysis. However, it remains unclear whether these tests are reliable.We investigate the performance of several tests of temporal signal, including some recently suggested modifications. We use simulated data (where the true evolutionary history is known), and whole genomes of methicillin-resistant Staphylococcus aureus (to show how particular problems arise with real-world data sets).We show that all of the standard tests of temporal signal are seriously misleading for data where temporal and genetic structures are confounded (i.e. where closely related sequences are more likely to have been sampled at similar times). This is not an artefact of genetic structure or tree shape per se, and can arise even when sequences have measurably evolved during the sampling period. More positively, we show that a 'clustered permutation' approach introduced by DuchĂȘne et al. (Molecular Biology and Evolution, 32, 2015, 1895) can successfully correct for this artefact in all cases and introduce techniques for implementing this method with real data sets.The confounding of temporal and genetic structures may be difficult to avoid in practice, particularly for outbreaks of infectious disease, or when using ancient DNA. Therefore, we recommend the use of 'clustered permutation' for all analyses. The failure of the standard tests may explain why different methods of dating pathogen origins have reached such wildly different conclusions.GGRM is supported by a Medical Research Council studentship. JJW was supported by the Issac Newton Trust and Wellcome Trust ISSF. AEM and SRH are supported by Wellcome Trust grant 098051.This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1111/2041-210X.1246
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