1,612 research outputs found

    Appendicitis. A plea for early operation

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    A New Method for tackling Asymmetric Decision Problems

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    Chain Event Graphs are probabilistic graphical models designed especially for the analysis of discrete statistical problems which do not admit a natural product space structure. We show here how they can be used for decision analysis through designation of some nodes as decision nodes, and the addition of utilities. We provide a local propagation algorithm for finding an optimal decision strategy and maximising expected utility. We also compare CEGs with Influence diagrams, Valuation Networks, Sequential decision diagrams, Sequential influence diagrams and Decision circuits for the representation and analysis of asymmetric decision problems

    Effect of blade geometry on the aerodynamic loads produced by vertical-axis wind turbines

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    Accurate aerodynamic modelling of vertical-axis wind turbines poses a significant challenge. The rotation of the turbine induces large variations in the angle of attack of its blades that can manifest as dynamic stall. In addition, interactions between the blades of the turbine and the wake that they produce can result in impulsive changes to the aerodynamic loading. The Vorticity Transport Model has been used to simulate the aerodynamic performance and wake dynamics of three different vertical-axis wind turbine configurations. It is known that vertical-axis turbines with either straight or curved blades deliver torque to their shaft that fluctuates at the blade passage frequency of the rotor. In contrast, a turbine with helically twisted blades delivers a relatively steady torque to the shaft. In this article, the interactions between helically twisted blades and the vortices within their wake are shown to result in localized perturbations to the aerodynamic loading on the rotor that can disrupt the otherwise relatively smooth power output that is predicted by simplistic aerodynamic tools that do not model the wake to sufficient fidelity. Furthermore, vertical-axis wind turbines with curved blades are shown to be somewhat more susceptible to local dynamic stall than turbines with straight blades

    Taurine uptake across the human intestinal brush-border membrane is via two transporters: H+-coupled PAT1 (SLC36A1) and Na+- and Cl−-dependent TauT (SLC6A6)

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    Taurine is an essential amino acid in some mammals and is conditionally essential in humans. Taurine is an abundant component of meat and fish-based foods and has been used as an oral supplement in the treatment of disorders such as cystic fibrosis and hypertension. The purpose of this investigation was to identity the relative contributions of the solute trans-porters involved in taurine uptake across the luminalmembrane of human enterocytes. Distinct transport characteristics were revealed following expression of the candidate solute trans-porters in Xenopus laevis oocytes: PAT1 (SLC36A1) is a H+-coupled, pH-dependent, Na+-and Cl−-independent, low-affinity, high-capacity transporter for taurine and β-alanine; TauT (SLC6A6) is a Na+- and Cl−-dependent, high-affinity, low-capacity transporter of taurine and β-alanine; ATB0,+ (SLC6A14) is a Na+- and Cl−-dependent, high-affinity, low-capacity transporter which accepts β-alanine but not taurine. Taurine uptake across the brush-border membrane of human intestinal Caco-2 cell monolayers showed characteristics of both PAT1-and TauT-mediated transport. Under physiological conditions, Cl−-dependent TauT-mediated uptake predominates at low taurine concentrations, whereas at higher concentrations typical of diet, Cl−-independent PAT1-mediated uptake is the major absorptive mechanism. Real-tim

    Screening fungi isolated from historic Discovery Hut on Ross Island, Antarctica for cellulose degradation

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    To survive in Antarctica, early explorers of Antarctica's Heroic Age erected wooden buildings and brought in large quantities of supplies. The introduction of wood and other organic materials may have provided new nutrient sources for fungi that were indigenous to Antarctica or were brought in with the materials. From 30 samples taken from Discovery Hut, 156 filamentous fungi were isolated on selective media. Of these, 108 were screened for hydrolytic activity on carboxymethyl cellulose, of which 29 demonstrated activities. Endo-1, 4-β-glucanase activity was confirmed in the extracellular supernatant from seven isolates when grown at 4°C, and also when they were grown at 15°C. Cladosporium oxysporum and Geomyces sp. were shown to grow on a variety of synthetic cellulose substrates and to use cellulose as a nutrient source at temperate and cold temperatures. The research findings from the present study demonstrate that Antarctic filamentous fungi isolated from a variety of substrates (wood, straw, and food stuffs) are capable of cellulose degradation and can grow well at low temperatures

    Whole-genome sequencing shows that patient-to-patient transmission rarely accounts for acquisition of Staphylococcus aureus in an intensive care unit

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    BACKGROUND  Strategies to prevent Staphylococcus aureus infection in hospitals focus on patient-to-patient transmission. We used whole-genome sequencing to investigate the role of colonized patients as the source of new S. aureus acquisitions, and the reliability of identifying patient-to-patient transmission using the conventional approach of spa typing and overlapping patient stay. METHODS Over 14 months, all unselected patients admitted to an adult intensive care unit (ICU) were serially screened for S. aureus. All available isolates (n = 275) were spa typed and underwent whole-genome sequencing to investigate their relatedness at high resolution. RESULTS Staphylococcus aureus was carried by 185 of 1109 patients sampled within 24 hours of ICU admission (16.7%); 59 (5.3%) patients carried methicillin-resistant S. aureus (MRSA). Forty-four S. aureus (22 MRSA) acquisitions while on ICU were detected. Isolates were available for genetic analysis from 37 acquisitions. Whole-genome sequencing indicated that 7 of these 37 (18.9%) were transmissions from other colonized patients. Conventional methods (spa typing combined with overlapping patient stay) falsely identified 3 patient-to-patient transmissions (all MRSA) and failed to detect 2 acquisitions and 4 transmissions (2 MRSA). CONCLUSIONS Only a minority of S. aureus acquisitions can be explained by patient-to-patient transmission. Whole-genome sequencing provides the resolution to disprove transmission events indicated by conventional methods and also to reveal otherwise unsuspected transmission events. Whole-genome sequencing should replace conventional methods for detection of nosocomial S. aureus transmission

    The management of tetanus in adults in an intensive care unit in Southern Vietnam

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    Background: Tetanus remains common in many low- and middle-income countries (LMICs) yet the evidence base guiding management of this disease is extremely limited, particularly with respect to contemporary management options. Sharing knowledge about practice may facilitate improvement in outcomes elsewhere. Methods: We describe clinical interventions and outcomes of 180 adult patients ≥16 years-old with tetanus enrolled in prospective observational studies at a specialist infectious diseases hospital in Southern Vietnam. Patients were treated according to a holistic management protocol encompassing wound-care, antitoxin, antibiotics, symptom control, airway management, nutrition and de-escalation criteria. Results: Mortality rate in our cohort was 2.8%, with 90 (50%) patients requiring mechanical ventilation for a median 16 [IQR 12-24] days. Median [IQR] duration of ICU stay was 15 [8-23] days. Autonomic nervous system dysfunction occurred in 45 (25%) patients. Hospital acquired infections occurred in 77 (43%) of patients. Conclusion: We report favourable outcomes for patients with tetanus in a single centre LMIC ICU, treated according to a holistic protocol. Nevertheless, many patients required prolonged intensive care support and hospital acquired infections were common

    Tonotopic representation of loudness in the human cortex

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    A prominent feature of the auditory system is that neurons show tuning to audio frequency; each neuron has a characteristic frequency (CF) to which it is most sensitive. Furthermore, there is an orderly mapping of CF to position, which is called tonotopic organization and which is observed at many levels of the auditory system. In a previous study (Thwaites et al., 2016) we examined cortical entrainment to two auditory transforms predicted by a model of loudness, instantaneous loudness and short-term loudness, using speech as the input signal. The model is based on the assumption that neural activity is combined across CFs (i.e. across frequency channels) before the transform to short-term loudness. However, it is also possible that short-term loudness is determined on a channel-specific basis. Here we tested these possibilities by assessing neural entrainment to the overall and channel-specific instantaneous loudness and the overall and channel-specific short-term loudness. The results showed entrainment to channel-specific instantaneous loudness at latencies of 45 and 100 ms (bilaterally, in and around Heschl's gyrus). There was entrainment to overall instantaneous loudness at 165 ms in dorso-lateral sulcus (DLS). Entrainment to overall short-term loudness occurred primarily at 275 ms, bilaterally in DLS and superior temporal sulcus. There was only weak evidence for entrainment to channel-specific short-term loudness.This work was supported by an ERC Advanced Grant (230570, ‘Neurolex’) to WMW, by MRC Cognition and Brain Sciences Unit (CBU) funding to WMW (U.1055.04.002.00001.01), and by EPSRC grant RG78536 to JS and BM

    Effect of dynamic stall on the aerodynamics of vertical-axis wind turbines

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    Accurate simulations of the aerodynamic performance of vertical-axis wind turbines pose a significant challenge for computational fluid dynamics methods. The aerodynamic interaction between the blades of the rotor and the wake that is produced by the blades requires a high-fidelity representation of the convection of vorticity within the wake. In addition, the cyclic motion of the blades induces large variations in the angle of attack on the blades that can manifest as dynamic stall. The present paper describes the application of a numerical model that is based on the vorticity transport formulation of the Navier–Stokes equations, to the prediction of the aerodynamics of a verticalaxis wind turbine that consists of three curved rotor blades that are twisted helically around the rotational axis of the rotor. The predicted variation of the power coefficient with tip speed ratio compares very favorably with experimental measurements. It is demonstrated that helical blade twist reduces the oscillation of the power coefficient that is an inherent feature of turbines with non-twisted blade configurations
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