Novel Antimicrobial Plasma Deposited Films

Bacterial infection is a growing concern in hospital and community settings, where the issue of biofilms is a major problem. Most current methods of preventing microbial attachment and biofilm formation are limited due to application, process or inherent flaws. It was proposed that thin films containing an organometallic element could be deposited using plasma, a quick, clean surface modification technique; to create antimicrobial films which could then be applied to a range of substrates. Several novel antimicrobial monomer systems were synthesised and characterised based on silver, copper and zinc as the active constituent with phosphines, phosphites, maleimide and a novel Schiff base among the ligand systems. All monomers were found to greatly inhibit the growth of P. aeruginosa and S. aureus in solution and on solid media. Successful monomers were deposited onto suitable substrates (glass, gold, plastics, non-woven polypropylene) using continuous wave and pulse plasma, with the films characterised and low levels of active metal found in analysis using XPS and SIMS. Films were tested against solutions of pathogenic bacteria using a number of traditional and modern microbiological techniques and found to inhibit growth under a range of conditions, potentially due to the synergistic action of metal and ligand on bacterial cells. Effective control of bacteria was exhibited at times varying from 1h to 24h+. Highly volatile compounds were produced which allowed quick deposition of plasma films, which showed excellent activity against bacteria (99.9%+ growth reduction), indicating viability for potential application. All films tested showed no inhibition or toxicity to eukaryotic cells.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Cost-effectiveness of community-based strategies for blood pressure control in a low-income developing country: findings from a cluster-randomized, factorial-controlled trial.

BACKGROUND: Evidence on economically efficient strategies to lower blood pressure (BP) from low- and middle-income countries remains scarce. The Control of Blood Pressure and Risk Attenuation (COBRA) trial randomized 1341 hypertensive subjects in 12 randomly selected communities in Karachi, Pakistan, to 3 intervention programs: (1) combined home health education (HHE) plus trained general practitioner (GP); (2) HHE only; and (3) trained GP only. The comparator was no intervention (or usual care). The reduction in BP was most pronounced in the combined group. The present study examined the cost-effectiveness of these strategies. METHODS AND RESULTS: Total costs were assessed at baseline and 2 years to estimate incremental cost-effectiveness ratios based on (1) intervention cost; (2) cost of physician consultation, medications, diagnostics, changes in lifestyle, and productivity loss; and (3) change in systolic BP. Precision of the incremental cost-effectiveness ratio estimates was assessed by 1000 bootstrapping replications. Bayesian probabilistic sensitivity analysis was also performed. The annual costs per participant associated with the combined HHE plus trained GP, HHE alone, and trained GP alone were $3.99,$3.34, and $0.65, respectively. HHE plus trained GP was the most cost-effective intervention, with an incremental cost-effectiveness ratio of$23 (95 confidence interval, 6-99) per mm Hg reduction in systolic BP compared with usual care, and remained so in 97.7 of 1000 bootstrapped replications. CONCLUSIONS: The combined intervention of HHE plus trained GP is potentially affordable and more cost-effective for BP control than usual care or either strategy alone in some communities in Pakistan, and possibly other countries in Indochina with similar healthcare infrastructure

May measurement month 2017: An analysis of the blood pressure screening campaign results in Pakistan-south Asia

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. Hypertension is a global health concern for developing countries. In Pakistan, apart from few population-based studies which evaluated the prevalence of hypertension, there is no current nationally representative study (the latest nationwide survey was conducted more than two decades ago). Pakistan Hypertension League, in accordance with the International Society of Hypertension directive under the banner of the May Measurement Month 2017 (MMM17) campaign, carried out a nationwide cross-sectional survey of volunteers aged ≥18 in May 2017 through its 14 regional chapters. Blood pressure measurement recorded through digital apparatus, the definition of hypertension (≥140/90 mmHg or being on BP-lowering treatment) and statistical analysis followed the standard MMM protocol. A total of 5333 individuals were screened during the MMM17 campaign with mean age 45.0 (11.6). Males had a higher rate (66.3%, n = 3536) in those screened than females (33.0%, n = 1757). A total of 55.2% (n = 2943) people had hypertension. This result shows very high rates of hypertension in Pakistani people. Therefore, there is an urgent need for federal implementation of BP screening as well as awareness programs across the nation

Comparing Tree‐Ring and Permanent Plot Estimates of Aboveground Net Primary Production in Three Eastern U.S. Forests

Forests account for a large portion of sequestered carbon, much of which is stored as wood in trees. The rate of carbon accumulation in aboveground plant material, or aboveground net primary productivity (aNPP), quantifies annual to decadal variations in forest carbon sequestration. Permanent plots are often used to estimate aNPP but are usually not annually resolved and take many years to develop a long data set. Tree rings are a unique and infrequently used source for measuring aNPP, and benefit from fine spatial (individual trees) and temporal (annual) resolution. Because of this precision, tree rings are complementary to permanent plots and the suite of tools used to study forest productivity. Here we evaluate whether annual estimates of aNPP developed from tree rings approximate estimates derived from colocated permanent plots. We studied a lowland evergreen (Howland, Maine), mixed deciduous (Harvard Forest, Massachusetts), and mixed mesophytic (Fernow, West Virginia) forest in the eastern United States. Permanent plots at the sites cover an area of 2–3 ha, and we use these areas as benchmarks indicative of the forest stand. We simulate random draws of permanent plot subsets to describe the distribution of aNPP estimates given a sampling area size equivalent to the tree-ring plots. Though mean tree-ring aNPP underestimates permanent plot aNPP slightly at Howland and Fernow and overestimates at Harvard Forest when compared with the entire permanent plot, it is within the 95% confidence interval of the random draws of equal-sized sampling area at all sites. To investigate whether tree-ring aNPP can be upscaled to the stand, we conducted a second random draw of permanent plot subsets simulating a twofold increase in sampling area. aNPP estimates from this distribution were not significantly different from results of the initial sampling area, though variance decreased as sampling area approaches stand area. Despite several concerns to consider when using tree rings to reconstruct aNPP (e.g., upscaling, allometric, and sampling uncertainties), the benefits are apparent, and we call for the continued application of tree rings in carbon cycle studies across a broader range of species diversity, productivity, and disturbance histories to fully develop this potential

Comparing Tree-Ring And Permanent Plot Estimates Of Aboveground Net Primary Production In Three Eastern U.S. Forests

Forests account for a large portion of sequestered carbon, much of which is stored as wood in trees. The rate of carbon accumulation in aboveground plant material, or aboveground net primary productivity (aNPP), quantifies annual to decadal variations in forest carbon sequestration. Permanent plots are often used to estimate aNPP but are usually not annually resolved and take many years to develop a long data set. Tree rings are a unique and infrequently used source for measuring aNPP, and benefit from fine spatial (individual trees) and temporal (annual) resolution. Because of this precision, tree rings are complementary to permanent plots and the suite of tools used to study forest productivity. Here we evaluate whether annual estimates of aNPP developed from tree rings approximate estimates derived from colocated permanent plots. We studied a lowland evergreen (Howland, Maine), mixed deciduous (Harvard Forest, Massachusetts), and mixed mesophytic (Fernow, West Virginia) forest in the eastern United States. Permanent plots at the sites cover an area of 2-3 ha, and we use these areas as benchmarks indicative of the forest stand. We simulate random draws of permanent plot subsets to describe the distribution of aNPP estimates given a sampling area size equivalent to the tree-ring plots. Though mean tree-ring aNPP underestimates permanent plot aNPP slightly at Howland and Fernow and overestimates at Harvard Forest when compared with the entire permanent plot, it is within the 95% confidence interval of the random draws of equal-sized sampling area at all sites. To investigate whether tree-ring aNPP can be upscaled to the stand, we conducted a second random draw of permanent plot subsets simulating a twofold increase in sampling area. aNPP estimates from this distribution were not significantly different from results of the initial sampling area, though variance decreased as sampling area approaches stand area. Despite several concerns to consider when using tree rings to reconstruct aNPP (e.g., upscaling, allometric, and sampling uncertainties), the benefits are apparent, and we call for the continued application of tree rings in carbon cycle studies across a broader range of species diversity, productivity, and disturbance histories to fully develop this potential

Liraglutide and renal outcomes in type 2 diabetes

In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown

Is it time to reappraise blood pressure thresholds and targets? Statement from the international society of hypertension - a global perspective

No abstract available

An adaptable analysis workflow for characterization of platelet spreading and morphology

The assessment of platelet spreading through light microscopy, and the subsequent quantification of parameters such as surface area and circularity, is a key assay for many platelet biologists. Here we present an analysis workflow which robustly segments individual platelets to facilitate the analysis of large numbers of cells while minimizing user bias. Image segmentation is performed by interactive learning and touching platelets are separated with an efficient semi-automated protocol. We also use machine learning methods to robustly automate the classification of platelets into different subtypes. These adaptable and reproducible workflows are made freely available and are implemented using the open-source software KNIME and ilastik