The epidemiological type identification of Serratia marcescens from outbreaks of infection in hospitals

A study of serological, bacteriocine and phage typing of Serratia marcescens was made. Specific O-antisera of adequate titre were relatively simple to prepare but H-antisera exhibited many heterologous agglutination reactions amongst the type strains. Most of these cross-reactions were not reproduced when immobilization tests with H-sera were performed. Direct haemagglutination tests were used to establish the presence of fimbriae amongst the H-type strains and the results of agglutination tests with non-fimbriate variants of strains indicated that fimbrial antibody in high titre was present in some sera. Replicate typing of 100 pairs of cultures by the phage-typing method indicated that small variations in pattern were common and that larger variations occurred occasionally. Therefore differences in pattern of less than two strong reactions should not be taken as evidence that strains can be distinguished. Cultures of S. marcescens, 273 in total, from six outbreaks of infection in British and European hospitals were typed by O-serology, H agglutination and immobilization tests, phage typing and bacteriocine susceptibility by a cross-streaking method. The typability of strains by each method was high but the results suggested that no single method was sufficiently discriminating to be used alone for typing. Comparison of the H-type and typing patterns of members of the same O serogroup from incidents of infection showed that reliable results were obtained by H-typing or by phage and bacteriocine typing after the application of the appropriate ‘difference' rule. The greatest discrimination between strains of the same 0-group was obtained by the use of H-typing or phage typin

Observation of enhanced rate coefficients in the H2+_2^+ + H2_2 →\rightarrow H3+_3^+ + H reaction at low collision energies

The energy dependence of the rate coefficient of the H$_2^+\ + {\rm H}_2 \rightarrow {\rm H}_3^+ + {\rm H}$ reaction has been measured in the range of collision energies between $k_\mathrm{B}\cdot 10$ K and $k_\mathrm{B}\cdot 300$ mK. A clear deviation of the rate coefficient from the value expected on the basis of the classical Langevin-capture behavior has been observed at collision energies below $k_\mathrm{B}\cdot 1$ K, which is attributed to the joint effects of the ion-quadrupole and Coriolis interactions in collisions involving ortho-H$_2$ molecules in the $j = 1$ rotational level, which make up 75% of the population of the neutral H$_2$ molecules in the experiments. The experimental results are compared to very recent predictions by Dashevskaya, Litvin, Nikitin and Troe (J. Chem. Phys., in press), with which they are in agreement.Comment: 14 pages, 3 figure

Artificial intelligence, bias and clinical safety

This is the final version. Available on open access from BMJ Publishing group via the DOI in this recordEngineering and Physical Sciences Research Council (EPSRC

An Automatic System to Evaluate Bait Station Visitation by Brown Treesnakes and Mongooses

Understanding the temporal, spatial, and behavioral patterns of the free-ranging target species in response to candidate baits and baiting strategies is important to ensure control success. This information can also assist in the development and deployment of feeding stations and can exclude non-target species while constituting effective bait delivery and control strategies for certain invasive animals, especially at environmentally sensitive sites. We used passive integrated transponder (PIT) tags in conjunction with very-high frequency radio-telemetry to remotely record bait station visitations and evaluate bait attractiveness in separate field research studies of brown treesnakes (Boiga irregularis) on Andersen Air Force Base, Guam, Northern Mariana Islands, between 1999 and 2000 and in 2007, for small Indian mongooses (Urva auropunctata: Syn. Herpestes auropunctatus) on Hilo, Hawaiʻi Island, Hawaiʻi. USA. This system allowed us to document visitation rates to bait stations by brown treesnakes and mongooses. In Guam, we determined that 75% of medium to large brown treesnakes (\u3e850 mm snout-vent length [SVL]) attracted to the bait stations consumed toxic bait, while smaller snakes (SVL) were not attracted to the bait stations. On Hawai‘i Island, we learned mongooses foraged over large areas (range = 6.0–70.2 ha), traveled up to 598 m to select baits, had restricted centers of activity, and displayed fidelity to newly discovered food sources. We recorded discrete group feeding activity not previously documented for mongooses. We found that anterior and posterior double-PIT tagging improved detectability of both target species. The complimentary monitoring system we used can be easily adapted for monitoring small mammals, birds, reptiles, or amphibian species and various activities of interest

Facilitating Patient‐Centric Thinking in Hospital Facility Management: A Case of Pharmaceutical Inventory

Conventional hospital facility management (FM) focuses on reasonably allocating various resources to support core healthcare services from the perspectives of the FM department and hos-pital. However, since patients are the main service targets of hospitals, the patients’ demographic and hospitalization information can be integrated to support the patient‐centric facility manage-ment, aiming at a higher level of patient satisfaction with respect to the hospital environment and services. Taking the pharmaceutical services in hospital inpatient departments as the case, forecasting the pharmaceutical demands based on the admitted patients’ information contributes to not only better logistics management and cost containment, but also to securing the medical require-ments of individual patients. In patient‐centric facility management, the pharmacy inventory is re-garded as the combination of medical resources that are reserved and allocated to each admitted patient. Two forecasting models are trained to predict the inpatients’ total medical requirement at the beginning of the hospitalization and rectify the patients’ length of stay after early treatment. Specifically, once a patient is admitted to the hospital, certain amounts of medical resources are reserved, according to the inpatient’s gender, age, diagnosis, and their preliminary expected days in the hospital. The allocated inventory is updated after the early treatment by rectifying the inpa-tient’s estimated length of stay. The proposed procedure is validated using medical data from eight-een hospitals in a Chinese city. This study facilitates the integration of patient‐related information with the conventional FM processes and demonstrates the potential improvement in patients’ satisfaction with better hospital logistics and pharmaceutical services

Measurement of the vector analyzing power in elastic electron-proton scattering as a probe of double photon exchange amplitudes

We report the first measurement of the vector analyzing power in inclusive transversely polarized elastic electron-proton scattering at Q^2 = 0.1 (GeV/c)^2 and large scattering angles. This quantity should vanish in the single virtual photon exchange, plane wave impulse approximation for this reaction, and can therefore provide information on double photon exchange amplitudes for electromagnetic interactions with hadronic systems. We find a non-zero value of A=-15.4+/-5.4 ppm. No calculations of this observable for nuclei other than spin 0 have been carried out in these kinematics, and the calculation using the spin orbit interaction from a charged point nucleus of spin 0 cannot describe these data.Comment: 4 pages, 2 figures, submitted to Phys. Rev. Let

Going places

Journeys. We all make them. Often they take us to exotic places. Sometimes they take us even further. They might take us through time. Or they might take us into a new way of life. There are times too, when we go all over the world and back again only to find that home is, after all, where it’s all happening. This book contains stories about many different types of journey. We hope you will enjoy travelling into it and finding a world that suits you

Personhood, consciousness, and god : how to be a proper pantheist

© Springer Nature B.V. 2018In this paper I develop a theory of personhood which leaves open the possibility of construing the universe as a person. If successful, it removes one bar to endorsing pantheism. I do this by examining a rising school of thought on personhood, on which persons, or selves, are understood as identical to episodes of consciousness. Through a critique of this experiential approach to personhood, I develop a theory of self as constituted of qualitative mental contents, but where these contents are also capable of unconscious existence. On this theory, though we can be conscious of our selves, consciousness turns out to be inessential to personhood. This move, I then argue, provides resources for responding to the pantheist’s problem of God’s person.Peer reviewedFinal Accepted Versio

Factors influencing digital review of pathology test results in an inpatient setting: a cross-sectional study

This is the final version. Available from Oxford University Press via the DOI in this record.Availability of data and material: The datasets generated and/or analysed during the current study are not publicly available due to the remote possibility of targeted patient re-identification through a linkage attack. Limited data may be available from the corresponding author on reasonable request, and review by the information governance and ethics teams.BACKGROUND: Delay or failure to view test results in a hospital setting can lead to delayed diagnosis, risk of patient harm, and represents inefficiency. Factors influencing this were investigated to identify how timeliness and completeness of test review could be improved through an evidence based redesign of the use of clinical test review software. METHODS: A cross section of all abnormal haematology and biochemistry results which were published on a digital test review platform over a three year period were investigated. The time it took for clinicians to view these results, and the results that were not viewed within 30 days, were analysed relative to time of the week, the detailed type of test, and an indicator of patient record data quality. RESULTS: The majority of results were viewed within 90 minutes, and 93.9% of these results viewed on the digital platform within 30 days. There was significant variation in results review throughout the week, shown to be due to an interplay between technical and clinical workflow factors. Routine results were less likely to be reviewed, as were those with patient record data quality issues . CONCLUSION: The evidence suggests that test result review would be improved by stream-lining access to the result platform, differentiating between urgent and routine results, improving handover of responsibility for result review, and improving search for temporary patient records. Altering the timing of phlebotomy rounds, and a review of the appropriateness of routine test requests at the weekend may also improve result review rates.Engineering and Physical Sciences Research Council (EPSRC)NHS EnglandAlan Turing Institut