382 research outputs found

    319 Vitamin K monitoring in adult CF patients

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    Si-metasomatism in serpentinized peridotite: The effects of talc-alteration on strontium and boron isotopes in abyssal serpentinites from Hole 1268a, ODP Leg 209

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    Ultramafic rocks recovered from Hole 1268a, Ocean Drilling Program Leg 209, to the south of the 15°20′N Fracture Zone on the Mid-Atlantic ridge have experienced a complex history of melt depletion and subsequent interaction with a series of fluids under varying temperature and pH conditions. After intense melt depletion, varying degrees of serpentinization at 100–200 °C took place, initially under seawater-like pH conditions. Subsequently, interaction with a higher temperature (300–350 °C) fluid with low (4–5) pH and low MgO/SiO2 resulted in the heterogeneous alteration of these serpentinites to talc-bearing ultramafic lithologies. The proximity of the currently active, high temperature Logatchev hydrothermal field, located on the opposite flank of the Mid-Atlantic ridge, suggests that unlike more distal localities sampled during ODP Leg 209, Hole 1268a has experienced Si-metasomatism (i.e. talc-alteration) by a Logatchev-like hydrothermal fluid. Serpentinite strontium isotope ratios were not materially shifted by interaction with the subsequent high-T fluid, despite the likelihood that this fluid had locally interacted with mid-ocean ridge gabbro. 87Sr/86Sr in the ultramafic lithologies of Hole 1268a are close to that of seawater (c.0.709) and even acid leached serpentinites retain 87Sr/86Sr in excess of 0.707, indistinguishable from Logatchev hydrothermal fluid. On the other hand, boron isotope ratios appear to have been shifted from seawater-like values in the serpentinites (δ11B = c.+40‰) to much lighter values in talc-altered serpentinites (δ11B = +9 to +20‰). This is likely a consequence of the effects of changing ambient pH and temperature during the mineralogical transition from serpentine to talc. Heterogeneous boron isotope systematics have consequences for the composition of ultramafic portions of the lithosphere returned to the convecting mantle by subduction. Inhomogeneities in δ11B, [B] and mineralogy introduce significant uncertainties in the prediction of the composition of slab fluids released during the early- to mid-stages of subduction

    Prognosis and clinical features of adult diagnosis CF

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    A Distributed Multilevel Force-directed Algorithm

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    The wide availability of powerful and inexpensive cloud computing services naturally motivates the study of distributed graph layout algorithms, able to scale to very large graphs. Nowadays, to process Big Data, companies are increasingly relying on PaaS infrastructures rather than buying and maintaining complex and expensive hardware. So far, only a few examples of basic force-directed algorithms that work in a distributed environment have been described. Instead, the design of a distributed multilevel force-directed algorithm is a much more challenging task, not yet addressed. We present the first multilevel force-directed algorithm based on a distributed vertex-centric paradigm, and its implementation on Giraph, a popular platform for distributed graph algorithms. Experiments show the effectiveness and the scalability of the approach. Using an inexpensive cloud computing service of Amazon, we draw graphs with ten million edges in about 60 minutes.Comment: Appears in the Proceedings of the 24th International Symposium on Graph Drawing and Network Visualization (GD 2016

    Transmission and lineage displacement drive rapid population genomic flux in cystic fibrosis airway infections of a Pseudomonas aeruginosa epidemic strain

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    Pseudomonas aeruginosa chronic infections of cystic fibrosis (CF) airways are a paradigm for within-host evolution with abundant evidence for rapid evolutionary adaptation and diversification. Recently emerged transmissible strains have spread globally, with the Liverpool Epidemic Strain (LES) the most common strain infecting the UK CF population. Previously we have shown that highly divergent lineages of LES can be found within a single infection, consistent with super-infection among a cross-sectional cohort of patients. However, despite its clinical importance, little is known about the impact of transmission on the genetic structure of these infections over time. To characterize this, we longitudinally sampled a meta-population of 15 genetic lineages within the LES over 13 months among seven chronically infected CF patients by genome sequencing. Comparative genome analyses of P. aeruginosa populations revealed that the presence of coexisting lineages contributed more to genetic diversity within an infection than diversification in situ. We observed rapid and substantial shifts in the relative abundance of lineages and replacement of dominant lineages, likely to represent super-infection by repeated transmissions. Lineage dynamics within patients led to rapid changes in the frequencies of mutations across suites of linked loci carried by each lineage. Many loci were associated with important infection phenotypes such as antibiotic resistance, mucoidy and quorum sensing, and were repeatedly mutated in different lineages. These findings suggest that transmission leads to rapid shifts in the genetic structure of CF infections, including in clinically important phenotypes such as antimicrobial resistance, and is likely to impede accurate diagnosis and treatment

    The Crystal Hotel: A Microfluidic Approach to Biomimetic Crystallization

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    A “crystal hotel” microfluidic device that allows crystal growth in confined volumes to be studied in situ is used to produce large calcite single crystals with predefined crystallographic orientation, microstructure, and shape by control of the detailed physical environment, flow, and surface chemistry. This general approach can be extended to form technologically important, nanopatterned single crystals

    Lack of regional pathways impact on surgical delay: Analysis of the Orthopaedic Trauma Hospital Outcomes-Patient Operative Delays (ORTHOPOD) study.

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    INTRODUCTION: Current practice following injury within the United Kingdom is to receive surgery, at the institution of first contact regardless of ability to provide timely intervention and inconsiderate of neighbouring hospital resource and capacity. This can lead to a mismatch of demand and capacity, delayed surgery and stress within hospital systems, particularly with regards to elective services. We demonstrate through a multicentre, multinational study, the impact of this at scale. METHODOLOGY: ORTHOPOD data collection period was between 22/08/2022 and 16/10/2022 and consisted of two arms. Arm 1 captured orthopaedic trauma caseload and capacity in terms of sessions available per centre and patients awaiting surgery per centre per given week. Arm 2 recorded patient and injury demographics, time of decision making, outpatient and inpatient timeframes as well as time to surgery. Hand and spine cases were excluded. For this regional comparison, regional trauma networks with a minimum of four centres enroled onto the ORTHOPOD study were exclusively analysed. RESULTS: Following analysis of 11,202 patient episodes across 30 hospitals we found no movement of any patient between hospitals to enable prompt surgery. There is no current system to move patients, between regional centres despite clear discrepancies in workload per capacity across the United Kingdom. Many patients wait for days for surgery when simple transfer to a neighbouring hospital (within 10 miles in many instances) would result in prompt care within national guidelines. CONCLUSION: Most trauma patients in the United Kingdom are managed exclusively at the place of first presentation, with no consideration of alternative pathways to local hospitals that may, at that time, offer increased operative capacity and a shorter waiting time. There is no oversight of trauma workload per capacity at neighbouring hospitals within a regional trauma network. This leads to a marked disparity in waiting time to surgery, and subsequently it can be inferred but not proven, poorer patient experience and outcomes. This inevitably leads to a strain on the overall trauma system and across several centres can impact on elective surgery recovery. We propose the consideration of inter-regional network collaboration, aligned with the Major Trauma System

    Recent Advances in Graph Partitioning

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    We survey recent trends in practical algorithms for balanced graph partitioning together with applications and future research directions
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