Moderately-rapid assessment of alkaline desiccation environmental systems

A moderately-rapid assessment tool was developed to analyze the waterless desiccation compost toilet investigated in a rural Mexican setting. Over 100 social factors were identified along with the applicable technical factors that influenced the low acceptability of the toilets. A 4-point rating scale was developed to increase the ability and speed of analyzing both the social and technical data. The treatment process was an alkaline-desiccation process with mean pH values of 8.2 ± sd 1.1 and water content of 18.3% ± sd 9.9, which resulted in mean fecal coliform values of 15.0 MPN/g ± sd 31.8, drastically lower than the 1000 MPN/g United States Environmental Protection Agency (USEPA) limit. Alkalinity, not pH, was determined to be the limiting factor in some waste samples, resulting in the need to dilute the waste with local soils. Designs were developed to reduce the unnecessarily long detention times between 0.75 to 4.4 years and improve other features, especially additive use and waste handling. Solvita® test kits were used to assess compost characteristics. Modifications, made to kit procedures to enable their use, included adjusting pH values and extending the pre-test acclimation period. With low macro-nutrient concentrations, a mean carbon/nitrogen ratio of 14.0 ± sd 6.1, and a mean volatile solids value of 15.9 ± sd 6.9 indicative of low organic matter, the finished waste had limited agricultural value, however, the treatment process did efficiently remove nitrogen in many samples and eliminate the pathogens in all of them. Mean Specific Oxygen Uptake Rate (SOUR) values of 1.4 ± sd 1.1 mg O2 / gram total solids were substantially close with the USEPA standard of 1.5. The SOUR on a volatile solids basis was not applicable. A socially and technically useful ASH/VS (inorganic/organic solids) ratio was discovered with mean concentration values of 6.8 ± sd 4.2 with most values falling within an easily explainable socially-valuable ten-point scale. The introduction of two other dry batch composting toilets created a competitive situation in the community where comparative analysis was being performed with the preferred pour-flush water toilet. If water shortages continue, the desiccation toilet’s acceptability may increase again

Comprehensive computerised primary care records are an essential component of any national health information strategy: report from an international consensus conference

In many countries, primary care informatics has developed to the point that it is recognised as an important enabler of quality improvement; this has not occurred to date in the United States. With this conference, we aimed to build an international consensus as to whether primary care has unique characteristics that require an informatics subspecialty; and, if so, to establish the role of an international audience of 53 health informaticians, mostly working in primary care. There was consensus among the participants that primary care has many unique characteristics that justify the existence of an informatics subspecialty: primary care informatics (PCI). The conference identified principles and practical examples of: (1) the effective deployment of information technology to underpin the provision of records, communication and access to information; (2) the need to harness the extensive knowledge base about the practice of PCI; and (3) the contribution of the primary care informatics in improving patient care, and to enable its recognition in the national strategy. The conference was organised by the primary care informatics working groups of AMIA, EFMI, IMIA and Wonca and took place at Medinfo 2004 in San Francisco. It consisted of two plenary lectures, two small-group work sessions and a panel discussion to summarise the day. It was attended by experimental work and theory that underpins the science of PCI. These principles and examples of their practical application were largely derived from the extensive knowledge base which has been built up in countries that have developed PCI over the last one to two decades

Iron and Erythropoietin to Heal and Recover after Intensive Care (ITHRIVE):A pilot RCT

AbstractObjectiveTo determine the feasibility of a pivotal randomised clinical trial of intravenous (IV) iron and erythropoietin in adult survivors of critical illness with anaemia requiring treatment in the intensive care unit.DesignAn investigator-initiated, parallel group, placebo-controlled, randomised, feasibility trial.SettingA tertiary intensive care unit (ICU) in Perth, Western Australia. ParticipantsAdults with anaemia (haemoglobin <100g/L), requiring ICU-level care for more than 48 hours and likely to be ready for ICU discharge within 24 hours.InterventionsA single dose of IV ferric carboxymaltose and Epoetin alfa (active group), or an equal volume of 0.9% saline (placebo group).Main outcome measuresStudy feasibility was considered met if the pilot achieved a recruitment rate of ≥2 participants per site per month, ≥ 90% of participants received their allocated study treatment, and≥ 90% of participants were followed up for the proposed pivotal trial primary outcome - days alive and at home to Day 90 (DAH90).ResultsThe 40-participant planned sample size included twenty in each group and were enrolled between 1/9/2021 and 2/3/2022. Participants spent a median of 3.4 days (interquartile range 2.8-5.1) in ICU prior to enrolment and had a mean baseline haemoglobin of 83.7g/L (standard deviation 6.7). The recruitment rate was 6.7 participants per month [95% confidence interval (CI) 4.8-9.0], DAH90 follow up was 100% (95% CI 91.2%-100%), and 39 (97.5%, 95% CI 86.8%-99.9%) participants received the allocated study intervention. No serious adverse events were reported. ConclusionThe ITHRIVE pilot demonstrated feasibility based on predefined participant recruitment, study drug administration and follow up thresholds

A Comparative Study of the Arabidopsis thaliana Guard-Cell Transcriptome and Its Modulation by Sucrose

Microarray analysis was performed on RNA isolated from guard cells that were manually dissected from leaves of Arabidopsis. By pooling our data with those of two earlier studies on Arabidopsis guard cell protoplasts, we provide a robust view of the guard-cell transcriptome, which is rich in transcripts for transcription factors, signaling proteins, transporters, and carbohydrate-modifying enzymes. To test the hypothesis that photosynthesis-derived sugar signals guard cells to adjust stomatal opening, we determined the profile of genes expressed in guard cells from leaves that had been treated with sucrose. The results revealed that expression of 440 genes changed in guard cells in response to sucrose. Consistent with this hypothesis, these genes encoded cellular functions for photosynthesis and transport of sugars, water, amino acids, and ions. Plants of T-DNA insertion lines for 50 genes highly responsive to sucrose were examined for defects in guard cell function. Twelve genes not previously known to function in guard cells were shown to be important in leaf conductance, water-use efficiency, and/or stomate development. Of these, three are of particular interest, having shown effects in nearly every test of stomatal function without a change in stomatal density: TPS5 (At4g17770), a TRAF domain-containing protein (At1g65370), and a WD repeat–containing protein (At1g15440)

Acute exercise induces distinct quantitative and phenotypical T cell profiles in men with prostate cancer

BackgroundReduced testosterone levels can influence immune system function, particularly T cells. Exercise during cancer reduces treatment-related side effects and provide a stimulus to mobilize and redistribute immune cells. However, it is unclear how conventional and unconventional T cells (UTC) respond to acute exercise in prostate cancer survivors compared to healthy controls.MethodsAge-matched prostate cancer survivors on androgen deprivation therapy (ADT) and those without ADT (PCa) along with non-cancer controls (CON) completed ∼45 min of intermittent cycling with 3 min at 60% of peak power interspersed by 1.5 min of rest. Fresh, unstimulated immune cell populations and intracellular perforin were assessed before (baseline), immediately following (0 h), 2 h, and 24 h post-exercise.ResultsAt 0 h, conventional T cell counts increased by 45%–64% with no differences between groups. T cell frequency decreased by −3.5% for CD3+ and −4.5% for CD4+ cells relative to base at 0 h with CD8+ cells experiencing a delayed decrease of −4.5% at 2 h with no group differences. Compared to CON, the frequency of CD8+CD57+ cells was −18.1% lower in ADT. Despite a potential decrease in maturity, ADT increased CD8+perforin+ GMFI. CD3+Vα7.2+CD161+ counts, but not frequencies, increased by 69% post-exercise while CD3+CD56+ cell counts increased by 127% and were preferentially mobilized (+1.7%) immediately following the acute cycling bout. There were no UTC group differences. Cell counts and frequencies returned to baseline by 24 h.ConclusionFollowing acute exercise, prostate cancer survivors demonstrate normal T cell and UTC responses that were comparable to CON. Independent of exercise, ADT is associated with lower CD8+ cell maturity (CD57) and perforin frequency that suggests a less mature phenotype. However, higher perforin GMFI may attenuate these changes, with the functional implications of this yet to be determined

Inhibition of microbial biofuel production in drought-stressed switchgrass hydrolysate

Additional file 2. Maps of significant gene ontology terms for chemical genomics data. Untreated biomass composition. Detailed hydrolysate composition

Electronic prescribing systems in hospitals to improve medication safety: a multimethods research programme.

Electronic prescribing (ePrescribing) systems allow health-care professionals to enter prescriptions and manage medicines using a computer. We set out to find out how these ePrescribing systems are chosen, set up and used in English hospitals. Given that these systems are designed to improve medication safety, we looked at whether or not these systems affected the number of prescribing errors made (mistakes such as ordering the wrong dose of medication). We also tried to see whether or not the systems were good value for money (or more cost-effective). Finally, we made recommendations to help hospitals choose, set up and use ePrescribing systems. We found that setting up ePrescribing systems was very difficult because there is a need to take into consideration how different pharmacists, nurses and doctors work, and the different work that needs to be carried out for different diseases and medical conditions. We recorded a link between the implementation of ePrescribing systems and a reduction in some high-risk prescribing errors in two out of three study sites. Given that the error reductions corresponded to the warnings triggered by the system, we concluded that the system is likely to have caused the error reduction. Prescribing errors may lead to adverse events that lead to death, impaired quality of life and longer hospital stays. The cost of an ePrescribing system increased in proportion to reduced errors, reaching £4.31 per patient per year for the site that experienced the greatest reduction in prescribing errors (i.e. site S). This estimate is based on assumptions in the model and how much a health service is willing to pay for a unit of health benefit. To help professionals choose, set up and use ePrescribing systems in the future, we produced an online ePrescribing Toolkit (www.eprescribingtoolkit.com/; accessed 21 December 2019) that, with support from NHS England, is becoming widely used internationally