Outcomes and costs of blunt trauma in England and Wales

Background Trauma represents an important public health concern in the United Kingdom, yet the acute costs of blunt trauma injury have not been documented and analysed in detail. Knowledge of the overall costs of trauma care, and the drivers of these costs, is a prerequisite for a cost-conscious approach to improvement in standards of trauma care, including evaluation of the cost-effectiveness of new healthcare technologies. Methods Using the Trauma Audit Research Network database, we examined patient records for persons aged 18 years and older hospitalised for blunt trauma between January 2000 and December 2005. Patients were stratified by the Injury Severity Score (ISS). Results A total of 35,564 patients were identified; 60% with an ISS of 0 to 9, 17% with an ISS of 10 to 16, 12% with an ISS of 17 to 25, and 11% with an ISS of 26 to 75. The median age was 46 years and 63% of patients were men. Falls were the most common cause of injury (50%), followed by road traffic collisions (33%). Twenty-nine percent of patients were admitted to critical care for a median length of stay of 4 days. The median total hospital length of stay was 9 days, and 69% of patients underwent at least one surgical procedure. Seven percent of the patients died before discharge, with the highest proportion of deaths among those in the ISS 26–75 group (32%). The mean hospital cost per person was £9,530 (± 11,872). Costs varied significantly by Glasgow Coma Score, ISS, age, cause of injury, type of injury, hospital mortality, grade and specialty of doctor seen in the accident and emergency department, and year of admission. Conclusion The acute treatment costs of blunt trauma in England and Wales vary significantly by injury severity and survival, and public health initiatives that aim to reduce both the incidence and severity of blunt trauma are likely to produce significant savings in acute trauma care. The largest component of acute hospital cost is determined by the length of stay, and measures designed to reduce length of admissions are likely to be the most effective in reducing the costs of blunt trauma care

Electromagnetic Actuated stirring in Microbioreactors enabling easier multiplexing & flexible device design

This paper was presented at the 4th Micro and Nano Flows Conference (MNF2014), which was held at University College, London, UK. The conference was organised by Brunel University and supported by the Italian Union of Thermofluiddynamics, IPEM, the Process Intensification Network, the Institution of Mechanical Engineers, the Heat Transfer Society, HEXAG - the Heat Exchange Action Group, and the Energy Institute, ASME Press, LCN London Centre for Nanotechnology, UCL University College London, UCL Engineering, the International NanoScience Community, www.nanopaprika.eu.The development of a novel electromagnetically (EM) actuated stirring method, for use in microbioreactors, is reported. Mixing in microbioreactors is critical to ensure even distribution of nutrients to microorganisms and cells. Magnetically driven stirrer bars or peristaltic mixing are the most commonly utilised mixing methods employed in completely liquid-filled microbioreactors. However the circular reactor shape required for mixing with a stirrer bar and frequently used for peristaltically mixed microbioreactors presents difficulties for bubble-free priming in a microfluidic bioreactor. Moreover the circular shape and the hardware required for both types of mixing reduces the potential packing density of multiplexed reactors. We present a new method of mixing, displaying design flexibility by demonstrating mixing in circular and diamond-shaped reactors and a duplex diamond reactor and fermentation of the gram-positive bacteria S. carnosus in a diamond-shaped microbioreactor system. The results of the optimisation of this mixing method for performing fermentations alongside both batch and continuous culture fermentations are presented

Kohlenwasserstoffverbrückte Komplexe, XXV

Hydrocarbon-Bridged Complexes, XXV. - C-C Coupling of Anionic Tricarbonyl Manganese Complexes of Cyclic Polyenes with Cationic Tropylium Metal Compounds; Preparation and Structure of (OC)3Mn(-5:6-C7H8-C7H7)M(CO)3, (OC)3Mn(-5:6-C8H10-C7H7)M(CO)3, and (OC)3Mn(-5:5-C8H8-C7H7)M(CO)3 (M = Cr, Mo, W)[Note ] The addition of the anionic complexes [(4-C7H8)Mn(CO)3]-, [(4-C8H10)Mn(CO)3]- and [(4-C8H8)Mn(CO)3]- to the cations [(7-C7H7)M(CO)3]+ (M = Cr, Mo, W) gives the hydrocarbon-bridged complexes (OC)3Mn(-5:6-C7H8-C7H7)M(CO)3, (OC)3Mn(-5:6-C8H10-C7H7)M(CO)3, and (OC)3Mn(-5:6-C8H8-C7H7)M(CO)3 (M = Cr, Mo, W). The structures of 4b and 6a have been determined by X-ray diffraction

Succinct Data Structures for Families of Interval Graphs

We consider the problem of designing succinct data structures for interval graphs with $n$ vertices while supporting degree, adjacency, neighborhood and shortest path queries in optimal time in the $\Theta(\log n)$-bit word RAM model. The degree query reports the number of incident edges to a given vertex in constant time, the adjacency query returns true if there is an edge between two vertices in constant time, the neighborhood query reports the set of all adjacent vertices in time proportional to the degree of the queried vertex, and the shortest path query returns a shortest path in time proportional to its length, thus the running times of these queries are optimal. Towards showing succinctness, we first show that at least $n\log{n} - 2n\log\log n - O(n)$ bits are necessary to represent any unlabeled interval graph $G$ with $n$ vertices, answering an open problem of Yang and Pippenger [Proc. Amer. Math. Soc. 2017]. This is augmented by a data structure of size $n\log{n} +O(n)$ bits while supporting not only the aforementioned queries optimally but also capable of executing various combinatorial algorithms (like proper coloring, maximum independent set etc.) on the input interval graph efficiently. Finally, we extend our ideas to other variants of interval graphs, for example, proper/unit interval graphs, k-proper and k-improper interval graphs, and circular-arc graphs, and design succinct/compact data structures for these graph classes as well along with supporting queries on them efficiently

The Energy Landscape, Folding Pathways and the Kinetics of a Knotted Protein

The folding pathway and rate coefficients of the folding of a knotted protein are calculated for a potential energy function with minimal energetic frustration. A kinetic transition network is constructed using the discrete path sampling approach, and the resulting potential energy surface is visualized by constructing disconnectivity graphs. Owing to topological constraints, the low-lying portion of the landscape consists of three distinct regions, corresponding to the native knotted state and to configurations where either the N- or C-terminus is not yet folded into the knot. The fastest folding pathways from denatured states exhibit early formation of the N-terminus portion of the knot and a rate-determining step where the C-terminus is incorporated. The low-lying minima with the N-terminus knotted and the C-terminus free therefore constitute an off-pathway intermediate for this model. The insertion of both the N- and C-termini into the knot occur late in the folding process, creating large energy barriers that are the rate limiting steps in the folding process. When compared to other protein folding proteins of a similar length, this system folds over six orders of magnitude more slowly.Comment: 19 page

A Conceptual Framework Based on Maturana’s Ontology of the Observer to Explore the Checkland’s Soft Systems Methodology

© 2019, Springer Science+Business Media, LLC, part of Springer Nature. This paper explores Checkland’s Soft Systems Methodology (SSM) through the lenses of a theoretical framework that incorporates key concepts from Maturana’s Ontology of the Observer (OoO) with the view of complementing Checkland’s SSM application process. We outline and examine paradigmatic compatibility between: Checkland’s ontological position (reality is problematic/chaotic) together with his interpretivist epistemology (multiple perceptions enrich the ever-changing reality); and Maturana’s OoO (we are immersed in the praxis of living in an ontological multi-universe). We argue that OoO resonates with key SSM theoretical underpinnings. After establishing compatibility between these two influential systems thinkers, we advance a conceptual framework in which Checkland’s SSM learning process is re-visited through a the framework grounded on Maturana’s OoO. The proposed framework illustrates how key ideas drawn from Maturana’s OoO can shed light into the way in which some of the main SSM devices (i.e.: Root definitions, Conceptual model) are used in the SSM process. By doing that, SSM is enriched and becomes more flexible as the stakeholders involved are placed within the domain of constitutive ontologies from which, a deeper dialogue can be promoted in a domain of coexistence in mutual acceptance. We argue that this is a suitable way to have more flexible and holistic views for a SSM intervention in particular to promote the learning process and debating proposed changes amongst the stakeholders involved. The proposed framework, when applied, may enhance the power of SSM learning process and when adopted can have substantial implications to complement the SSM process

Synthesis of 1-Substituted Carbazolyl-1,2,3,4-tetrahydro- and Carbazolyl-3,4-dihydro-β-carboline Analogs as Potential Antitumor Agents

A series of 1-substituted carbazolyl-1,2,3,4-tetrahydro- and carbazolyl-3,4-dihydro-β-carboline analogs have been synthesized and evaluated for antitumor activity against human tumor cells including KB, DLD, NCI-H661, Hepa, and HepG2/A2 cell lines. Among these, compounds 2, 6, 7, and 9 exhibited the most potent and selective activity against the tested tumor cells. As for inhibition of topoisomerase II, compounds 1–14 and 18 showed better activity than etoposide. Among them, compounds 3, 4, 7, 9, and 10 exhibited potent activity. The structure and activity relationship (SAR) study revealed correlation between carbon numbers of the side chain and biological activities. The molecular complex with DNA for compound 2 was proposed

Protein Pattern Formation

Protein pattern formation is essential for the spatial organization of many intracellular processes like cell division, flagellum positioning, and chemotaxis. A prominent example of intracellular patterns are the oscillatory pole-to-pole oscillations of Min proteins in \textit{E. coli} whose biological function is to ensure precise cell division. Cell polarization, a prerequisite for processes such as stem cell differentiation and cell polarity in yeast, is also mediated by a diffusion-reaction process. More generally, these functional modules of cells serve as model systems for self-organization, one of the core principles of life. Under which conditions spatio-temporal patterns emerge, and how these patterns are regulated by biochemical and geometrical factors are major aspects of current research. Here we review recent theoretical and experimental advances in the field of intracellular pattern formation, focusing on general design principles and fundamental physical mechanisms.Comment: 17 pages, 14 figures, review articl

Maternal iron deficiency perturbs embryonic cardiovascular development in mice.

Congenital heart disease (CHD) is the most common class of human birth defects, with a prevalence of 0.9% of births. However, two-thirds of cases have an unknown cause, and many of these are thought to be caused by in utero exposure to environmental teratogens. Here we identify a potential teratogen causing CHD in mice: maternal iron deficiency (ID). We show that maternal ID in mice causes severe cardiovascular defects in the offspring. These defects likely arise from increased retinoic acid signalling in ID embryos. The defects can be prevented by iron administration in early pregnancy. It has also been proposed that teratogen exposure may potentiate the effects of genetic predisposition to CHD through gene-environment interaction. Here we show that maternal ID increases the severity of heart and craniofacial defects in a mouse model of Down syndrome. It will be important to understand if the effects of maternal ID seen here in mice may have clinical implications for women