Fasciola hepatica calcium-binding protein FhCaBP2: structure of the dynein light chain-like domain

The common liver fluke Fasciola hepatica causes an increasing burden on human and animal health, partly because of the spread of drug-resistant isolates. As a consequence, there is considerable interest in developing new drugs to combat liver fluke infections. A group of potential targets is a family of calcium-binding proteins which combine an N-terminal domain with two EF-hand motifs and a C-terminal domain with predicted similarity to dynein light chains (DLC-like domain)

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Delivering exceptionally safe transitions of care to older people : a qualitative study of multidisciplinary staff perspectives

Background Transitions of care are often risky, particularly for older people, and shorter hospital stays mean that patients can go home with ongoing care needs. Most previous research has focused on fundamental system flaws, however, care generally goes right far more often than it goes wrong. We explored staff perceptions of how high performing general practice and hospital specialty teams deliver safe transitional care to older people as they transition from hospital to home. Methods We conducted a qualitative study in six general practices and four hospital specialties that demonstrated exceptionally low or reducing readmission rates over time. Data were also collected across four community teams that worked into or with these high-performing teams. In total, 157 multidisciplinary staff participated in semi-structured focus groups or interviews and 9 meetings relating to discharge were observed. A pen portrait approach was used to explore how teams across a variety of different contexts support successful transitions and overcome challenges faced in their daily roles. Results Across healthcare contexts, staff perceived three key themes to facilitate safe transitions of care: knowing the patient, knowing each other, and bridging gaps in the system. Transitions appeared to be safest when all three themes were in place. However, staff faced various challenges in doing these three things particularly when crossing boundaries between settings. Due to pressures and constraints, staff generally felt they were only able to attempt to overcome these challenges when delivering care to patients with particularly complex transitional care needs. Conclusions It is hypothesised that exceptionally safe transitions of care may be delivered to patients who have particularly complex health and/or social care needs. In these situations, staff attempt to know the patient, they exploit existing relationships across care settings, and act to bridge gaps in the system. Systematically reinforcing such enablers may improve the delivery of safe transitional care to a wider range of patients. Trial registration The study was registered on the UK Clinical Research Network Study Portfolio (references 35272 and 36174)

Ecoacoustics and multispecies semiosis: naming, semantics, semiotic characteristics, and competencies

Biosemiotics to date has focused on the exchange of signals between organisms, in line with bioacoustics; consideration of the wider acoustic environment as a semiotic medium is under-developed. The nascent discipline of ecoacoustics, that investigates the role of environmental sound in ecological processes and dynamics, fills this gap. In this paper we introduce key ecoacoustic terminology and concepts in order to highlight the value of ecoacoustics as a discipline in which to conceptualise and study intra- and interspecies semiosis. We stress the inherently subjective nature of all sensory scapes (vivo-, land-, vibro- and soundscapes) and propose that they should always bear an organismic attribution. Key terms to describe the sources (geophony, biophony, anthropophony, technophony) and scales (sonotopes, soundtopes, sonotones) of soundscapes are described. We introduce epithets for soundscapes to point to the degree to which the global environment is implicated in semiosis (latent, sensed and interpreted soundscapes); terms for describing key ecological structures and processes (acoustic community, acoustic habitat, ecoacoustic events) and examples of ecoacoustic events (choruses and noise) are described. The acoustic eco-field is recognized as the semiotic model that enables soniferous species to intercept core resources like food, safety and roosting places. We note that whilst ecoacoustics to date has focused on the critical task of the development of metrics for application in conservation and biodiversity assessment, these can be enriched by advancing conceptual and theoretical foundations. Finally, the mutual value of integrating ecoacoustic and biosemiotics perspectives is considered

Chloride penetration resistance of concrete sealer and coating systems

This study investigated the chloride penetration resistance of a silane-based sealer (SS1), an acrylic-based coating (AC1), and two cementitious coatings (CC1 and CC2) when applied on concrete surface. Concrete powder samples were collected from 15, 30 and 45 mm depths of sealer and coating treated concrete prism specimens, which were exposed to H2O and de-icing solutions of NaCl, Geomelt S30, MgCl2 and CaCl2 for 100 freeze-thaw cycles followed by 25 wet-dry cycles. Chloride analysis was carried out to determine the total water-soluble chlorides of concrete. Test results revealed that the chloride penetration for exposure to the de-icing chemicals occurred at a depth of 15 mm from the concrete surface. The highest chloride penetration occurred for the non-treated concrete. The sealer ‘SS1’ exhibited good performance except with exposure to NaCl solution. Among the three different coating products, the acrylic-based coating ‘AC1’ was the best-performing coating, whereas the cementitious coating ‘CC1’ had the worst performance. The amount of penetrated water-soluble chlorides was greater than the maximum recommended value of 0.025% (by concrete weight) at 15 mm depth for the sealer ‘SS1’ when exposed to NaCl de-icing solution, and for the coating ‘CC1’ when exposed to NaCl, CaCl2 and MgCl2 solutions

CHLORIDE PENETRATION RESISTANCE OF CONCRETE SEALER AND COATING SYSTEMS

This study investigated the chloride penetration resistance of a silane-based sealer (SS1), an acrylic-based coating (AC1), and two cementitious coatings (CC1 and CC2) when applied on concrete surface. Concrete powder samples were collected from 15, 30 and 45 mm depths of sealer and coating treated concrete prism specimens, which were exposed to H2O and de-icing solutions of NaCl, Geomelt S30, MgCl2 and CaCl2 for 100 freeze-thaw cycles followed by 25 wet-dry cycles. Chloride analysis was carried out to determine the total water-soluble chlorides of concrete. Test results revealed that the chloride penetration for exposure to the de-icing chemicals occurred at a depth of 15 mm from the concrete surface. The highest chloride penetration occurred for the non-treated concrete. The sealer ‘SS1’ exhibited good performance except with exposure to NaCl solution. Among the three different coating products, the acrylic-based coating ‘AC1’ was the best-performing coating, whereas the cementitious coating ‘CC1’ had the worst performance. The amount of penetrated water-soluble chlorides was greater than the maximum recommended value of 0.025% (by concrete weight) at 15 mm depth for the sealer ‘SS1’ when exposed to NaCl de-icing solution, and for the coating ‘CC1’ when exposed to NaCl, CaCl2 and MgCl2 solutions