Attitudes to Ageing and to Geriatric Medicine

The ageing of populations across the developed and developing world is a consequence of success (better nutrition and sanitation, improved medical care, greater choice about whether and when to have children) but older people are not always viewed or portrayed in a positive light, either in the hospital setting or in wider society. Similarly, geriatric medicine is a low prestige specialty, facing problems with recruitment. Even the British Geriatrics Society debates changing its name since "geriatrics" has "acquired negative connotations". Here, we briefly review the attitudes to geriatric medicine among medical professionals, including physicians, medical students and nurses. Societal attitudes to ageing are explored from different eras and across cultural perspectives. We consider how older people's own attitudes to their health may impact both their recovery from illness and life expectancy. We conclude that it is essential to consider the broader cultural milieu of medical schools, as this may have a greater influence than the formal curriculum on physicians' personality and conduct. Positive forces such as governmental edicts to abolish ageist practices may be undermined by what medical students hear and see on the wards. With the ageing of the inpatient population, it is critical that all physicians and nursing staff respect the ageing process and provide dignified and appropriate care to vulnerable older people

A System Dynamics Approach to Improve Visibility and Performance in a Supply Chain System

This research takes an in-depth look into the supply chain system of a semiconductor company. It utilizes a system dynamics tool to detect demand indications and simulate the pipeline inventory. The semiconductor company has been practicing a lot of management principles especially postponement strategies and supply chain management (SCM). The overall performance of the supply chain system has never been measured thoroughly, thus the company is not sure about the effectiveness of its decisions. It is also concerned about the effective implementation of some of the company's policies. Using a system dynamics approach to simulation modeling, this research aims to build a complete system dynamics model for internal supply chain events (from order to ship-out). The simulation model allows for the investigation and identification of discrepancies between the business policy and actual practice of key events in order to achieve supply chain optimization. The simulation model also allows for comparison and measurement of the effectiveness of various supply chain strategies implemented by the semiconductor company. This research provides a platform into studies of supply chain systems of semiconductor industry. Its success adds a unique case study on assessing the dynamic relationships of supply chain events in the semiconductor industry using system dynamics technique. The simulation model provides empirical evidence on the effective implementation of various supply chain strategies. System dynamics approach to modeling a supply chain system is shown to be able to try out alternative practices that have high level of complexity

Global Genome Comparative Analysis Reveals Insights of Resistome and Life-Style Adaptation of Pseudomonas putida

Most Pseudomonas putida strains are environmental microorganisms exhibiting a wide range of metabolic capability but certain strains have been reported as rare opportunistic pathogens and some emerged as multidrug resistant P. putida. This study aimed to assess the drug resistance profile of, via whole genome analysis, P. putida strain T2-2 isolated from oral cavity. At the same time, we also compared the nonenvironmental strain with environmentally isolated P. putida. In silico comparative genome analysis with available reference strains of P. putida shows that T2-2 has lesser gene counts on carbohydrate and aromatic compounds metabolisms, which suggested its little versatility. The detection of its edd gene also suggested T2-2’s catabolism of glucose via ED pathway instead of EMP pathway. On the other hand, its drug resistance profile was observed via in silico gene prediction and most of the genes found were in agreement with drug-susceptibility testing in laboratory by automated VITEK 2. In addition, the finding of putative genes of multidrug resistance efflux pump and ATP-binding cassette transporters in this strain suggests a multidrug resistant phenotype. In summary, it is believed that multiple metabolic characteristics and drug resistance in P. putida strain T2-2 helped in its survival in human oral cavity

Unravelling the genome of long chain N-acylhomoserine lactone-producing Acinetobacter sp. strain GG2 and identification of its quorum sensing synthase gene

Myriad proteobacteria use N-acyl homoserine lactone (AHL) molecules as quorum-sensing (QS) signals to regulate different physiological functions, including virulence, antibiotic production and biofilm formation. Many of these proteobacteria possess LuxI/LuxR system as the QS mechanism. Recently, we reported the 3.89 Mb genome of Acinetobacter sp. strain GG2. In this work, the genome of this long chain AHL-producing bacterium was unravelled which led to the molecular characterization of luxI homlogue, designated as aciI. This 552 bp gene was cloned and overexpressed in Escherichia coli BL21(DE3). The purified protein was approximately 20.5 kDa and is highly similar to several autoinducer proteins of LuxI family among Acinetobacter species. To verify the AHL synthesis activity of this protein, high resolution liquid chromatography-mass spectrometry analysis revealed the production of 3-oxo-dodecanoyl homoserine lactone and 3-hydroxy dodecanoyl homoserine lactone from induced E.coli harboring the recombinant AciI. Our data show for the first time, the cloning and characterization of the luxI homologue from Acinetobacter sp. strain GG2, and confirmation of its AHLs production. These data are of great significance as the annotated genome of strain GG2 has provided a valuable insight in the study of autoinducer molecules and its roles in QS mechanism of the bacterium

Complete genome sequence of Planococcus donghaensis JH1T, a pectin-degrading bacterium

The type strain Planococcus donghaensis JH1T is a psychrotolerant and halotolerant bacterium with starch-degrading ability. Here, we determine the carbon utilization profile of P. donghaensis JH1T and report the first complete genome of the strain. This study revealed the strain’s ability to utilize pectin and d-galacturonic acid, and identified genes responsible for degradation of the polysaccharides. The genomic information provided may serve as a fundamental resource for full exploration of the biotechnological potential of P. donghaensis JH1T

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Short-term effect of sulphate attack on concrete

The concrete structures subject to aggressive environment under sulphate attack is of key importance to the service life of the structures. Previous studies have considered the full immersion method to evaluate the concrete resistance to sulphate attack. However, the integration of dry-wet cycles under short-term exposure of external sulphate attack as representing environmental factors in the service conditions was not fully explored in literature. The purpose of this study is to evaluate the properties of concrete under external sulphate attack and drying-wetting cycles for short-term exposure. The dry-wet cycle in this study was defined as immersion of concrete specimens in 5% and 10% sodium sulphate solutions for 6 days and placing at oven at 60oC for 21 hours, followed by 3 hours at room temperature for drying purpose as representing environment factors in the service conditions. The drying process was conducted at the end of 7, 14, 21, 28, 35, 42, 49, 56, 63, 70, 77 and 84 days. Twelve drying-wetting cycles were conducted with regards to the actual weather conditions in Malaysia and each drying-wetting cycle was lasted for 7 days. Changes on properties over time in term of visual observation, change in mass, ultrasonic pulse velocity (UPV) and residual compressive strength of the concrete under different exposure conditions were performed. Concentration of sulphate ions (SO42-) across the depth of specimens was measured by Ion Chromatography instrument. Microstructure study of the concrete degradation were observed under Field-Emission Scanning Electron Microscopy (FE-SEM) with Energy Dispersive X-ray Spectroscopy (EDX) analysis and X-ray Diffraction (XRD). From all the tests carried out, it was found the sulphate attack in 10% concentration after 84 days of drying-wetting cycles have a noticeable impact on the degradation of concrete. The results reported that exposing concrete to higher concentration of 10% sodium sulphate after 84 days of drying-wetting cycle, leading to higher mass loss at 0.75%, 9.55% reduction in UPV, 5.30% reduction in compressive strength and sulphate ions penetrated into concrete by reaching depth at 20 to 25 mm within 56 days of drying-wetting cycle. Gypsum, ettringite and calcite are the identified phases after 84 days drying-wetting cycles. Under repetitive drying-wetting cycles, such physical process can significantly accelerate the sulphate attack when high concentration of sodium sulphate travel through the concrete and get deposited at the surface, causing it to scale physically. Therefore, concrete would experience more severe deterioration when drying and wetting process existed in the environments with a higher sulphate content

Corporate governance and firm profitability

The objective of this study is to investigate how closely Singapore companies from various sectors follow corporate governance guidelines set out by the OECD and the Committee on the Financial Aspects of Corporate Governance and whether there is a relationship between firm profitability and corporate governance