Biofilm monitoring coupon system and method of use

An apparatus and method is disclosed for biofilm monitoring of a water distribution system which includes the mounting of at least one fitting in a wall port of a manifold in the water distribution system with a passage through the fitting in communication. The insertion of a biofilm sampling member is through the fitting with planar sampling surfaces of different surface treatment provided on linearly arrayed sample coupons of the sampling member disposed in the flow stream in edge-on parallel relation to the direction of the flow stream of the manifold under fluid-tight sealed conditions. The sampling member is adapted to be aseptically removed from or inserted in the fitting and manifold under a positive pressure condition and the fitting passage sealed immediately thereafter by appropriate closure means so as to preclude contamination of the water distribution system through the fitting. The apparatus includes means for clamping the sampling member and for establishing electrical continuity between the sampling surfaces and the system for minimizing electropotential effects. The apparatus may also include a plurality of fittings and sampling members mounted on the manifold to permit extraction of the sampling members in a timed sequence throughout the monitoring period

New York City mayor-elect Bill de Blasio’s plans for the city show that he is much more Clintonista than Sandinista

In November, Bill de Blasio won the New York Mayoral election and on January 1st, he will become the first Democrat to fill the position in nearly 20 years. Richard Flanagan takes a close look at de Blasio’s vision for New York, praising his plans to improve police-community relations, implement universal pre-kindergarten for city schools and to settle municipal labor contracts. He also writes that, despite accusations to the contrary, de Blasio is much more of a liberal pragmatist than progressive ideologue

Probe Brane Dynamics and the Cosmological Constant

Recently a brane world perspective on the cosmological constant and the hierarchy problems was presented. Here, we elaborate on some aspects of that particular scenario and discuss the stability of the stationary brane solution and the dynamics of a probe brane. Even though the brane is unstable under a small perturbation from its stationary position, such instability is harmless when the 4-D cosmological constant is very small, as is the case of our universe. One may also introduce radion stabilizing potentials in a more realistic scenario.Comment: 13 pages, 1 figure, REVTE

Functional interaction between BMPR-II and Tctex-1, a light chain of Dynein, is isoform-specific and disrupted by mutations underlying primary pulmonary hypertension

Diverse heterozygous mutations of bone morphogenetic receptor type II (BMPR-II) underlie the inherited form of the vascular disorder primary pulmonary hypertension (PPH). As yet, the molecular detail of how such defects contribute to the pathogenesis of PPH remains unclear. BMPR-II is a member of the transforming growth factor-beta cell signalling superfamily. Ligand binding induces cell surface receptor complex formation and activates a cascade of phosphorylation events of intracellular intermediaries termed Smads, which initiate transcriptional regulation. Some 30% of PPH-causing mutations localize to exon 12, which may be spliced out forming an isoform depleted of the unusually long BMPR-II cytoplasmic tail. To further elucidate the consequences of BMPR2 mutation, we sought to characterize aspects of the cytoplasmic domain function by seeking intracellular binding partners. We now report that Tctex-1, a light chain of the motor complex dynein, interacts with the cytoplasmic domain of BMPR-II and demonstrate that Tctex-1 is phosphorylated by BMPR-II, a function disrupted by PPH disease causing mutations within exon 12. Finally we show that BMPR-II and Tctex-1 co-localize to endothelium and smooth muscle within the media of pulmonary arterioles, key sites of vascular remodelling in PPH. Taken together, these data demonstrate a discrete function for the cytoplasmic domain of BMPR-II and justify further investigation of whether the interaction with and phosphorylation of Tctex-1 contributes to the pathogenesis of PPH

Improvement of Intraoperative Antibiotic Prophylaxis in Prolonged Cardiac Surgery by Automated Alerts in the Operating Room

Abstract Objective: To assess the impact of an automated intraoperative alert to redose prophylactic antibiotics in prolonged cardiac operations. Design: Randomized, controlled, evaluator-blinded trial. Setting: University-affiliated hospital. Patients: Patients undergoing cardiac surgery that lasted more than 4 hours after the preoperative administration of cefazolin, unless they were receiving therapeutic antibiotics at the time of surgery. Intervention: Randomization to an audible and visual reminder on the operating room computer console at 225 minutes after the administration of preoperative antibiotics (reminder group, n = 137) or control (n = 136). After another 30 minutes, the circulating nurse was required to indicate whether a follow-up dose of antibiotics had been administered. Results: Intraoperative redosing was significantly more frequent in the reminder group (93 of 137; 68%) than in the control group (55 of 136; 40%) (adjusted odds ratio, 3.31; 95% confidence interval, 1.97 to 5.56; P < .0001). The impact of the reminder was even greater when compared with the 6 months preceding the study period (129 of 480; 27%; P < .001), suggesting some spillover effect on the control group. Redosing was formally declined for 19 of the 44 patients in the reminder group without redosing. The rate of surgical-site infection in the reminder group (5 of 137; 4%) was similar to that in the control group (8 of 136; 6%; P = .42), but significantly lower than that in the pre-study period (48 of 480; 10%; P = .02). Conclusion: The use of an automatic reminder system in the operating room improved compliance with guidelines on perioperative antibiotic prophylaxi

Intersession Reliability and Within-Session Stability of a Novel Perception-Action Coupling Task

BACKGROUND: The perception-action coupling task (PACT) was designed as a more ecologically valid measure of alertness/reaction times compared to currently used measures by aerospace researchers. The purpose of this study was to assess the reliability, within-subject variability, and systematic bias associated with the PACT. METHODS: There were 16 subjects (men/women = 9/7; age = 27.8 +/- 3.6 yr) who completed 4 identical testing sessions. The PACT requires subjects to make judgements on whether a virtual ball could fit into an aperture. For each session, subjects completed nine cycles of the PACT, with each cycle lasting 5 min. Judgement accuracy and reaction time parameters were calculated for each cycle. Systematic bias was assessed with repeated-measures ANOVA, reliability with intraclass correlation coefficients (ICC), and within-subject variability with coefficients of variation (CVTE). RESULTS: Initiation time (Mean = 0.1065 s) showed the largest systematic bias, requiring the elimination of three cycles to reduce bias, with all other variables requiring, at the most, one. All variables showed acceptable reliability (ICC > 0.70) and within-subject variability (CVTE <20%) with only one cycle after elimination of the first three cycles. CONCLUSIONS: With a three-cycle familiarization period, the PACT was found to be reliable and stable

“Anybody on this list that you're more worried about?” Qualitative analysis exploring the functions of questions during end of shift handoffs

Background Shift change handoffs are known to be a point of vulnerability in the quality, safety and outcomes of healthcare. Despite numerous efforts to improve handoff reliability, few interventions have produced lasting change. Although the opportunity to ask questions during patient handoff has been required by some regulatory bodies, the function of questions during handoff has been less well explored and understood. Objective To investigate questions and the functions they serve in nursing and medicine handoffs. Research design Qualitative thematic analysis based on audio recordings of nurse-to-nurse, medical resident-to-resident and surgical intern-to-intern handoffs. Subjects Twenty-seven nurse handoff dyads and 18 medical resident and surgical intern handoff dyads at one VA Medical Center. Results Our analysis revealed that the vast majority of questions were asked by the Incoming Providers. Although topics varied widely, the bulk of Incoming Provider questions requested information that would best help them understand individual patient conditions and plan accordingly. Other question types sought consensus on clinical reasoning or framing and alignment between the two professionals. Conclusions Handoffs are a type of socially constructed work. Questions emerge with some frequency in virtually all handoffs but not in a linear or predictable way. Instead, they arise in the moment, as necessary, and without preplanning. A checklist cannot model this process element because it is a static memory aid and questions occur in a relational context that is emergent. Studying the different functions of questions during end of shift handoffs provides insights into the interface between the technical context in which information is transferred and the social context in which meaning is created

Thermal Converter Devices, Systems and Control Methods

A system is provided for reducing exhaust emissions. The system can comprise a series of chambers, an injector head, and a controller. The controller can maintain desired temperature zones and chemical environments inside the series of chambers, and the chambers and structures inside the system 10 can provide a desired travel path for the air, fuel, and untreated exhaust mixture inside

Arsenic in tube well water in Bangladesh: health and economic impacts and implications for arsenic mitigation

A national drinking water quality survey conducted in 2009 furnished data that were used to make an updated estimate of chronic arsenic exposure in Bangladesh. About 20 million and 45 million people were found to be exposed to concentrations above the national standard of 50 μg/L and the World Health Organization’s guideline value of 10 μg/L, respectively. From the updated exposure data and all-cause mortality hazard ratios based on local epidemiological studies, it was estimated that arsenic exposures to concentrations > 50 μg/L and 10–50 μg/L account for an annual 24 000 and perhaps as many as 19 000 adult deaths in the country, respectively. Exposure varies widely in the 64 districts; among adults, arsenic-related deaths account for 0–15% of all deaths. An arsenic-related mortality rate of 1 in every 18 adult deaths could represent an economic burden of 13 billion United States dollars (US$) in lost productivity alone over the next 20 years. Arsenic mitigation should follow a two-tiered approach: (i) prioritizing provision of safe water to an estimated 5 million people exposed to > 200 μg/L arsenic, and (ii) building local arsenic testing capacity. The effectiveness of such an approach was demonstrated during the United Nations Children’s Fund 2006–2011 country programme, which provided safe water to arsenic-contaminated areas at a cost of US$ 11 per capita. National scale-up of such an approach would cost a few hundred million US dollars but would improve the health and productivity of the population, especially in future generations