Fish and freshwater crayfish in streams in the Cape Naturaliste region and Wilyabrup Brook

No abstract availabl

Establishing links between organizational climate, employee well-being and historical patient outcomes

This research undertaken in collaboration with Queensland Health analysed the links between dimensions of workplace climate/employee well-being contained in a number of Queensland Health databases, including the Patient Satisfaction Survey, the Clinical Incident database, the compliments and complaints database, the Variable Life Adjusted Display (VLAD) Database and the Better Workplaces Staff Opinion Survey database. Queensland Health sought to identify in what ways workplace climate is related to patient outcomes using existing datasets collected within the Queensland Health Centre for Healthcare Improvement. The process of establishing links involved matching aggregated data for specific facilities (where possible), or failing that, larger facilities (e.g. Hospital), or the Health Service District. Once the datasets had been matched on location or facility, correlations were calculated between the aggregated scores. The results demonstrated links between the data sets. These links showed that a better workplace climate is associated with greater reported numbers of clinical incidents, especially “no harm” clinical incidents. There was also a link between workplace climate and patient compliments/complaints which show that unsolicited compliments received from patients and their families are clearly related to a number of positive aspects of workplace climate (workplace morale, role clarity, and appraisal and recognition) and individual morale. The results linking workplace climate and patient satisfaction showed that there is a strong positive relationship between overall patient satisfaction and role clarity, and a negative relationship between overall patient satisfaction and both workplace distress and excessive work demands. While these results relate to historical data and therefore should not be construed to reflect the current state of operation within Queensland Health, they are still indicative of some very important relationships. This is the first study to demonstrate that more positive clinical management practices, better perceptions of the workplace climate and better employee well-being are a reflection of a better incident reporting and learning culture in a health care organization, ultimately resulting in improved patient outcomes

The fractional integrated bi- parameter smooth transition autoregressive model

This paper introduces the fractionally integrated Bi-parameter smooth transition autoregressive model (FI-BSTAR model) as an extension of BSTAR model proposed by Siliverstovs (2005) and the fractionally integrated STAR model (FI-STAR model) proposed by van Dijk et al. (2002). Our FI-BSTAR model is able to simultaneously describe persistence and asymmetric smooth structural change in time series. An empirical application using monthly growth rates of the American producer price index is provided.Long Memory, Nonlinearity, Asymmetry, STAR models.

Use of groundwater lifetime expectancy for the performance assessment of a deep geologic waste repository: 1. Theory, illustrations, and implications

Long-term solutions for the disposal of toxic wastes usually involve isolation of the wastes in a deep subsurface geologic environment. In the case of spent nuclear fuel, if radionuclide leakage occurs from the engineered barrier, the geological medium represents the ultimate barrier that is relied upon to ensure safety. Consequently, an evaluation of radionuclide travel times from a repository to the biosphere is critically important in a performance assessment analysis. In this study, we develop a travel time framework based on the concept of groundwater lifetime expectancy as a safety indicator. Lifetime expectancy characterizes the time that radionuclides will spend in the subsurface after their release from the repository and prior to discharging into the biosphere. The probability density function of lifetime expectancy is computed throughout the host rock by solving the backward-in-time solute transport adjoint equation subject to a properly posed set of boundary conditions. It can then be used to define optimal repository locations. The risk associated with selected sites can be evaluated by simulating an appropriate contaminant release history. The utility of the method is illustrated by means of analytical and numerical examples, which focus on the effect of fracture networks on the uncertainty of evaluated lifetime expectancy.Comment: 11 pages, 8 figures; Water Resources Research, Vol. 44, 200

Diffusive transport of light in two-dimensional granular materials

We study photon diffusion in a two-dimensional random packing of monodisperse disks as a simple model of granular material. We apply ray optics approximation to set up a persistent random walk for the photons. We employ Fresnel's intensity reflectance with its rich dependence on the incidence angle and polarization state of the light. We present an analytic expression for the transport-mean-free path in terms of the refractive indices of grains and host medium, grain radius, and packing fraction. We perform numerical simulations to examine our analytical result.Comment: 9 pages, 3 figure

Metabolomics defines complex patterns of dyslipidaemia in juvenile-sle patients associated with inflammation and potential cardiovascular disease risk

Cardiovascular disease (CVD) is a leading cause of mortality in patients with juvenile-onset systemic lupus erythematosus (JSLE) associated with atherosclerosis. The interplay between dyslipidaemia and inflammation—mechanisms that drive atherosclerosis—were investigated retro-spectively in adolescent JSLE patients using lipoprotein-based serum metabolomics in patients with active and inactive disease, compared to healthy controls (HCs). Data was analysed using machine learning, logistic regression, and linear regression. Dyslipidaemia in JSLE patients was characterised by lower levels of small atheroprotective high-density lipoprotein subsets compared to HCs. These changes were exacerbated by active disease and additionally associated with significantly higher atherogenic very-low-density lipoproteins (VLDL) compared to patients with low disease activity. Atherogenic lipoprotein subset expression correlated positively with clinical and serological markers of JSLE disease activity/inflammation and was associated with disturbed liver function, and elevated expression of T-cell and B-cell lipid rafts (cell signalling platforms mediating immune cell activa-tion). Finally, exposing VLDL/LDL from patients with active disease to HC lymphocytes induced a significant increase in lymphocyte lipid raft activation compared to VLDL/LDL from inactive patients. Thus, metabolomic analysis identified complex patterns of atherogenic dyslipidaemia in JSLE patients associated with inflammation. This could inform lipid-targeted therapies in JSLE to improve cardiovascular outcomes

A Cellular Automata Model with Probability Infection and Spatial Dispersion

In this article, we have proposed an epidemic model by using probability cellular automata theory. The essential mathematical features are analyzed with the help of stability theory. We have given an alternative modelling approach for the spatiotemporal system which is more realistic and satisfactory from the practical point of view. A discrete and spatiotemporal approach are shown by using cellular automata theory. It is interesting to note that both size of the endemic equilibrium and density of the individual increase with the increasing of the neighborhood size and infection rate, but the infections decrease with the increasing of the recovery rate. The stability of the system around the positive interior equilibrium have been shown by using suitable Lyapunov function. Finally experimental data simulation for SARS disease in China and a brief discussion conclude the paper

DAS28(3)CRP is a reliable measure of disease activity in pregnant women with rheumatoid arthritis

OBJECTIVES: The disease activity of rheumatoid arthritis (RA) in pregnancy is most commonly assessed with the modified Disease Activity Score (DAS)-28, the DAS28(3)CRP. However, the performance of the DAS28(3)CRP in pregnancy has not been compared to musculoskeletal ultrasound (MSK-US) as a gold standard. We performed a prospective pilot study to test the hypothesis that pregnancy-related factors limit the reliability of the DAS28(3)CRP. METHODS: Pregnant women with RA were recruited from an Obstetric Rheumatology clinic and assessed during pregnancy (second (T2) and third (T3) trimesters) and postpartum with DAS28(3)CRP and MSK-US scores, with quantification of power Doppler (PD) signal in small joints (hands and feet). Age-matched non-pregnant women with RA underwent equivalent assessments. PD scores were calculated as mean scores of all joints scanned. RESULTS: We recruited 27 pregnant and 20 non-pregnant women with RA. DAS28(3)CRP was sensitive and specific for active RA in pregnancy and postpartum as defined by positive PD signal, but not in non-pregnancy. There were significant correlations between DAS28(3)CRP and PD scores throughout pregnancy (T2, r=0.82 (95% CI [0.42, 0.95], p<0.01); T3, r=0.68 (95% CI [0.38, 0.86], p<0.01)) and postpartum, r=0.84 (95% CI [0.60, 0.94], p<0.01), while this correlation in non-pregnancy was weaker (r=0.47 (95% CI [0, 0.77], p<0.05). CONCLUSIONS: This pilot study found that DAS28(3)CRP is a reliable measure of disease activity in pregnant women with RA. Based on these data, pregnancy does not appear to confound clinical evaluation of the tender and/or swollen joint counts

Normalizing glycosphingolipids restores function in CD4+ T cells from lupus patients

Patients with the autoimmune rheumatic disease systemic lupus erythematosus (SLE) have multiple defects in lymphocyte signaling and function that contribute to disease pathogenesis. Such defects could be attributed to alterations in metabolic processes, including abnormal control of lipid biosynthesis pathways. Here, we reveal that CD4+ T cells from SLE patients displayed an altered profile of lipid raft–associated glycosphingolipids (GSLs) compared with that of healthy controls. In particular, lactosylceramide, globotriaosylceramide (Gb3), and monosialotetrahexosylganglioside (GM1) levels were markedly increased. Elevated GSLs in SLE patients were associated with increased expression of liver X receptor β (LXRβ), a nuclear receptor that controls cellular lipid metabolism and trafficking and influences acquired immune responses. Stimulation of CD4+ T cells isolated from healthy donors with synthetic and endogenous LXR agonists promoted GSL expression, which was blocked by an LXR antagonist. Increased GSL expression in CD4+ T cells was associated with intracellular accumulation and accelerated trafficking of GSL, reminiscent of cells from patients with glycolipid storage diseases. Inhibition of GSL biosynthesis in vitro with a clinically approved inhibitor (N-butyldeoxynojirimycin) normalized GSL metabolism, corrected CD4+ T cell signaling and functional defects, and decreased anti-dsDNA antibody production by autologous B cells in SLE patients. Our data demonstrate that lipid metabolism defects contribute to SLE pathogenesis and suggest that targeting GSL biosynthesis restores T cell function in SLE

Impact of immunogenicity on clinical efficacy and toxicity profile of biologic agents used for treatment of inflammatory arthritis in children compared to adults

The treatment of inflammatory arthritis has been revolutionised by the introduction of biologic treatments. Many biologic agents are currently licensed for use in both paediatric and adult patients with inflammatory arthritis and contribute to improved disease outcomes compared with the pre-biologic era. However, immunogenicity to biologic agents, characterised by an immune reaction leading to the production of anti-drug antibodies (ADAs), can negatively impact the therapeutic efficacy of biologic drugs and induce side effects to treatment. This review explores for the first time the impact of immunogenicity against all licensed biologic treatments currently used in inflammatory arthritis across age, and will examine any significant differences between ADA prevalence, titres and timing of development, as well as ADA impact on therapeutic drug levels, clinical efficacy and side effects between paediatric and adult patients. In addition, we will investigate factors associated with differences in immunogenicity across biologic agents used in inflammatory arthritis, and their potential therapeutic implications