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Background Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional ‘high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment. Methods We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ. Hospital- and ward-level data were collected, including bed numbers, tertiary services offered, presence of an emergency department, ward staffing levels, and the availability of critical care facilities. Results We received responses from 257 UK (response rate: 97.7%), 35 Australian (response rate: 32.7%), and 17 NZ (response rate: 94.4%) hospitals (total 309). Of these hospitals, 91.6% reported on-site ICU or HDU facilities. UK hospitals reported fewer critical care beds per 100 hospital beds (median=2.7) compared with Australia (median=3.7) and NZ (median=3.5). Additionally, 31.1% of hospitals reported having high-acuity beds to which high-risk patients were admitted for postoperative management, in addition to standard ICU/HDU facilities. The estimated numbers of critical care beds per 100 000 population were 9.3, 14.1, and 9.1 in the UK, Australia, and NZ, respectively. The estimated per capita high-acuity bed capacities per 100 000 population were 1.2, 3.8, and 6.4 in the UK, Australia, and NZ, respectively. Conclusions Postoperative critical care resources differ in the UK, Australia, and NZ. High-acuity beds may have developed to augment the capacity to deliver postoperative critical care.

Antimicrobial resistance (AMR) is a major public health threat that will cause an estimated 10 million deaths worldwide by 2050. Because antimicrobial use drives selection and transmission of AMR, there is an urgent need to continue to develop, evaluate, and implement effective, evidence-based antimicrobial stewardship (AMS) interventions that safely reduce antimicrobial use in both primary and secondary healthcare.

Background Previous studies have demonstrated that analysing whisker movements and locomotion allows us to quantify the behavioural consequences of sensory, motor and cognitive deficits in rodents. Independent whisker and feet trackers exist but there is no fully-automated, open-source software and hardware solution, that measures both whisker movements and gait. New method We present the LocoWhisk arena and new accompanying software (ARTv2) that allows the automatic detection and measurement of both whisker and gait information from high-speed video footage. Results We demonstrate the new whisker and foot detector algorithms on high-speed video footage of freely moving small mammals, and show that whisker movement and gait measurements collected in the LocoWhisk arena are similar to previously reported values in the literature. Comparison with existing method(s) We demonstrate that the whisker and foot detector algorithms, are comparable in accuracy, and in some cases significantly better, than readily available software and manual trackers. Conclusion The LocoWhisk system enables the collection of quantitative data from whisker movements and locomotion in freely behaving rodents. The software automatically records both whisker and gait information and provides added statistical tools to analyse the data. We hope the LocoWhisk system and software will serve as a solid foundation from which to support future research in whisker and gait analysis.

Background Cognitive impairment is associated with poorer quality of life, risk for hospitalization, and mortality. Cognitive impairment is common in people with end-stage kidney disease treated with hemodialysis, yet the severity and specific cognitive deficits are uncertain. Study Design Systematic review and meta-analysis. Setting & Population Adults receiving hemodialysis compared with the general population, people with non−dialysis-dependent chronic kidney disease (NDD-CKD), people receiving peritoneal dialysis, or people with nondialyzed chronic kidney failure. Selection Criteria for Studies Randomized controlled trials, cohort or cross-sectional studies without language restriction. Index Tests Validated neuropsychological tests of cognition. Outcomes Cognitive test scores, aggregated by cognitive domain: orientation and attention, perception, memory, language, construction and motor performance, concept formation and reasoning, and executive functions. Results 42 studies of 3,522 participants. Studies were of high or uncertain risk of bias, assessed by the Newcastle-Ottawa Scale. People treated with hemodialysis had worse cognition than the general population, particularly in attention (n=22; standardized mean difference [SMD], −0.93; 95% CI, −1.18 to −0.68). Hemodialysis patients performed better than nondialyzed patients with chronic kidney failure in attention (n=6; SMD, 0.70; 95% CI, 0.45 to 0.96) and memory (n=6; SMD, 0.36; 95% CI, 0.08 to 0.63), but had poorer memory than the general population (n=16; SMD, −0.41; 95% CI, −0.91 to 0.09) and people with NDD-CKD (n=5; SMD, −0.40; 95% CI, −0.60 to −0.21). There were insufficient data to show other differences among people receiving hemodialysis and those receiving peritoneal dialysis or with NDD-CKD. Limitations Potentially biased studies, not wholly adjusted for education. High heterogeneity, mainly due to the large variety of tests used to assess cognition. Conclusions People treated with hemodialysis have impaired cognitive function compared to the general population, particularly in the domains of orientation and attention and executive function. Cognitive deficits in specific domains should be further explored in this population and should be considered when approaching education and chronic disease management.

Intersecting cooling holes allow very high density heat exchangers to be implemented in the cooling systems of gas turbine blades. The pressure loss and heat transfer characteristics caused by the highly turbulent flow at intersections are poorly understood. These are characterised experimentally and numerically for a single intersection of two equal diameter holes at 90 ∘ or 60 ∘ /120 ∘ angles of intersection, 0%, 10%, 49% and 88% offset. Large variations in pressure loss occur for a given intersection geometry; dependent on the mass flow splits, and the level of offset. Pressure losses range from 4 to more than 30 inlet dynamic heads. This allows the flow distribution in an engine application to be tuned, allowing for manufacturing uncertainties. Heat transfer coefficient (HTC) distributions measured in single intersections are reported. These show clear enhancement associated with stripping the fluid boundary layer and mixing of the bulk flow. High local heat transfer gradients were observed at the intersections and circumferentially averaged Nusselt number enhancement of up to 5 found where the degree of pipe intersection is significant. The HTC distributions allow the required packing of hole intersections while controlling the pressure margin. The experimental data are replicated in CFD studies which show good agreement within experimental uncertainty. Thus more detailed numerical models can be relied on for a full range of intersection angles and offsets. Extending the modelling to include multiple linked intersections confirmed that data measured in single intersections are applicable to a matrix of multiply intersecting holes.

This paper surveys the history of literary adaptation in Russian and Soviet film, then examines the issue of translation of a literary text into another language through film adaptation. It focuses on two recent English language adaptations of Lev Tolstoy's novel Анна Каренина by Bernard Rose (1997) with the French actress Sophie Marceau, and Joe Wright's recent version (2012) starring Keira Knightley. The paper will focus on the representation of Anna by French and British actresses, examining to what extent their interpretation of the role of a nineteenth century Russian literary heroine is informed by modern feminist readings of the novel. The central issue is: how successful can a literary work be translated into another language, and how successful can literature be embedded into a different culture.

The objective of the research is to define some of the typical features of communicative tactics of creating headlines in British newspapers. We have used structural and linguistic approaches in defining three typical communicative tactics and analyzed numerous samples of headlines from quality papers and tabloids. The analysis shows that communicative tactics of headlines from a range of quality papers are more informative and persuasive, they form opinions, judgments of readers and in tabloids they are mostly advertising and entertaining, they capture readers’ attention to trivial events and awake a keen interest in private life of celebrities.

The context for the present study was a cluster-randomized controlled trial of a group-based anger-management intervention, delivered by day-service staff. We aimed to develop a scale to measure the fidelity of manualized cognitive-behavioural therapy (CBT) delivered to adults with intellectual disabilities in group-based settings. A 30-item monitoring instrument (the MAnualized Group Intervention Check: MAGIC) was adapted from an existing fidelity-monitor instrument for individual CBT. Two sessions for 27 groups were observed by pairs of monitors who had no other contact with the intervention. 16 observers participated, in 15 unique pairings. Observers recorded high levels of inter-rater reliability and the scale had good internal consistency. Fidelity ratings predicted two key outcomes of the intervention, and were themselves predicted by the therapists' clinical supervisors.

For in-depth analyses of polyolefin microstructures, we have installed the MW-specific light scattering (LS) and viscosity detectors into a home-built hybrid GPC–TREF instrument. Data processing capabilities were developed for this triple-detector system to determine (1) polymer long chain branching (LCB) distribution across the GPC-determined molecular weight distribution (MWD) curve, (2) the GPC-Mz and higher-order MW averages with greatly improved precision to complement the rheological results, and (3) the dependence of polymer MW across the TREF-determined short chain branching (SCB) distribution curve. A ‘polymer microstructure plot’ is created from the combined overlays of triple-detector GPC–TREF chromatograms to provide a quick view of detecting subtle sample differences in polymer MW, MWD, SCB or LCB. These results can do much more than the use of only the MI and density values for product development or trouble shooting of polymer end-use properties.

mRNA and protein expression of the Th2 cytokines IL-4 and IL-5 from human lung were examined during the first 4 hr following IgE-mediated triggering, a time representative of the evolving late-phase reaction (LPR). Lung explants were incubated for 16 hr at 37 degrees C in culture media alone or with added dexamethasone (10(-6) M), washed, and then challenged with buffer or anti-IgE (3 micrograms/ml). Using RNase protection assays, in 16/16 individual lungs IL-5 mRNA expression was observed at 4 hr following anti-IgE and at no points following buffer challenge. Fragments released 1129 +/- 499 ng of IL-5/g wet wt over a 24-hr period (mean +/- SEM, n = 5). Neither IL-4 transcripts nor protein were detected in any anti-IgE challenges. Both the IgE-mediated IL-5 mRNA and protein responses were below the limits of detection following dexamethasone preincubation, suggesting a mechanism for the potent inhibitory effects of these agents observed in the LPR.

We have synthesized a novel heteropolymer double-stranded RNA (dsRNA) molecule of defined length and strandedness (dsRNA309) and evaluated its ability to induce cytokine gene expression, activate dsRNA-dependent enzymes, and inhibit both tumor cell growth and virus replication. Unlike the conventionally studied synthetic homopolymer dsRNAs, polyinosinic acid:polycytidylic acid (poly(I-C)) and its mismatched analogue polyinosinic:polycytidylic, uridylic acid (poly(I-C12,U), dsRNA309 possessed restricted biological activity. dsRNA309 was unable to inhibit tumor cell growth or efficiently induce cytokine (i.e. interferon-beta and interleukin-1 alpha) gene expression. However, dsRNA309 was able to inhibit virus replication and activate dsRNA-dependent intracellular enzymes, 2'-5' oligoadenylate synthetase (2'-5' A synthetase) and the dsRNA-activated inhibitor kinase in in vitro assay systems. Overall, dsRNA309 provided a means for examining the mechanisms governing the dsRNA-regulated antiviral and antiproliferative responses, and studies with dsRNA309 demonstrated that the ability of a synthetic dsRNA to activate dsRNA-dependent intracellular enzymes does not necessarily predict the same gene inducing capacity.

Mismatched double-stranded RNA (Ampligen) has broad spectrum antiviral and immunomodulatory activities. These activities generate stabilization or improvement in three important surrogate markers of HIV disease progression. Patients with HIV disease treated with Ampligen do not become positive for p24 antigen, in contrast to patients treated with AZT or placebo. Viral burden can also be decreased in patients receiving Ampligen/AZT therapy. In vitro studiies indicate that both AZT sensitive and AZT resistant viruses can be inhibited by Ampligen alone and are synergistically inhibited by Ampligen in combination with AZT. The immunomodulatory effects of Ampligen are manifested as a stabilization of CD4 counts. When Ampligen is combined with AZT, an increase in CD4 count is seen. Furthermore, a return or increase in delayed type hypersensitivity to mumps, Candida, and trichophyton was seen in approximately 70% of patients treated with Ampligen. The activity of Ampligen in HIV disease is due to its multifunctional activity as an antiviral and immune stimulating agent. The antiviral effect directly inhibits HIV-infection and other viruses which have been implicated in HIV disease acceleration and progression. The immunomodulatory activity can stabilize, increase, or restore immune function. This enhanced immune function can also lead to the further inhibition of additional infections associated with disease progression. Thus, Ampligen has multiple mechanisms of action against HIV disease.

Molecular basis of hybridization and effect of different conditions, such as probe size, salt concentration, temperature, detergent concentration, time of washing, sample preparation and sample purity, on hybridization is discussed. Different formats of hybridization such as in solution hybridization, solid phase hybridization, and methods for probe preparation are presented. Polymerase chain reaction for the amplification of target and alternative methods for signal amplification are introduced in this review.

INTRODUCTION: Preventable hospital readmissions is a vitally imprortant issue in health care policy, and practice reform is vital to reducing cost, and improving quality of care. Care for patients with IBD is a substantial portion of hospital care in patients with gastrointestinal illnesses. The aim of this study was to explore factors associated with readmissions in IBD patients within an inpatient tertiary referral center. METHODS: 912 readmissions to CCF from September 1, 2008 to September 1, 2010, were extracted into a database from our Outcomes Review System. Index admissions were to the inpatient gastroenterology service, and readmission was defined as admission to any service within 30 days from index admission discharge date. Patients who carried a diagnosis of Irritable Bowel Disease were included (n=106) regardless of admission diagnosis. Chart review of all readmissions was inputted into a RedCap database. Variables included initial admission and readmission data (reason for hospitalization, length of stay, time to follow-up appointments in Gastroenterology clinic (FU), whether FU was scheduled and made, whether a nutrition plan or discharge care was provided to the patient). Student t-tests and Pearson's chi-square tests were used to analyze the data RESULTS: Of the 106 IBD patients, 78 had 1 readmission, and 28 had >1 readmission. Ninety-three patients (88%) were readmitted before FU. Of these 60% never had a scheduled appointment, 5% had a scheduled appointment within 7 days, 9% within 8-14 days, 7% within 15-21 days and 17% after 22 days. Contrarily, only 13 were readmitted after FU. 67% of patients where readmitted within 2 weeks of initial discharge. Subjects readmitted within 2 weeks were more likely to have not been given any plan for pain control (34% vs. 14%; p=0.034) and prescription of oral non-narcotic medications was significantly less common (44% vs. 69%; p=0.016).Use of central IV access during initial admission was less common in patients who were readmitted within 2-weeks (7% vs. 20%; p=0.058). Obstruction/SBO/pseudo-obstruction/Ogilvie's, and use of medications other than narcotics and benzodiazepines during initial admission were associated with multiple readmissions (p

Phosphoproteins of control and IFN-β treated human bladder carcinoma cells (RT4) were labelled in vitro with [ 32 P]-ATP and analyzed by polyacrylamide gel electrophoresis. Cells treated with antiproliferative doses of IFN had reduced levels of phosphorylated 60 Kd and 40 Kd proteins. IFN also induced within 24 hours the modification of a low molecular weight phosphoprotein doublet in the 22–24,000 molecular weight range. The ability to phosphorylate high molecular weight proteins by the in vitro procedures was generally depressed by IFN treatment. There was a dramatic shift in the phosphorylation of alkali stable phosphoamino acids associated with proteins in the 43–50,000 molecular weight range in IFN-treated cells. Preliminary studies indicate that at least some of the IFN-induced modifications of cellular phosphoproteins may result from transcriptional control of specific oncogenes.

A set of probes was designed for the quantitation of HIV-1 RNA in infected cells by a molecular hybridization procedure called reversible target capture. Reversible target capture is analogous to sandwich hybridization, except that the link between hybrid complexes and the affinity support was reversible, allowing for repeated capture of hybrids on, and release from, fresh affinity support. Repeated cycles of capture resulted in a high degree of purification of hybrids from unreacted probe, thereby greatly reducing assay noise and increasing assay sensitivity. Probes against the HIV-1 pol gene were chosen because their target sequences were highly conserved among HIV-1 isolates, while being divergent enough to provide discrimination from other human T cell tropic viruses. Subpicogram quantities of HIV-1 pol gene RNA were measured with signal:noise ratios of over 10. Hybridization signal increased with increasing target RNA with a proportionality constant of 1.

A procedure for quantitatively binding covalently closed circular DNA to nitrocellulose is detailed. The procedure involves making DNA saturated with respect to Nat at 25 degrees C, denaturing the DNA by heating to 80-100 degrees C, then passing the DNA-NaI solution through a nitrocellulose membrane at 50-60 degrees C. Form I DNA remains denatured throughout the loading procedure and is quantitatively deposited on the membrane as denatured DNA. The mechanism of binding DNA to nitrocellulose in NaI appears to be different from the binding promoted by NaCl.

DNA synthesis is supported by small particles from platelets of patients with myeloproliferative disorders. In vitro synthesis consists of the addition of a few deoxynucleotides to a low molecular weight RNA primer. Specific bases are preferred in the first 10 nucleotides and oligodeoxynucleotides of defined length are synthesized. A reverse transcription mechanism for this activity is suggested.

A seven-year-old male gibbon ape (Hylobates lar) with malignant lymphoma and leukemia was obtained from a colony in Bermuda. Tissues obtained at necropsy were infiltrated with tumor cells to varying degrees, the most extensively involved being the kidneys, ureters, liver, lymph nodes, heart, salivary glands, and mesentery. These cells showed typical lymphoblast morphology. Type-C virus particles were abundant in the plasma and were detectable in all tissues tested. Intracytoplasmic virus was seen in some nonleukemic parenchymal cells. However, budding virus particles were observed only from the leukemic peripheral blood lymphoblasts. Tissue extracts contained viral p30, reverse transcriptase, viral RNA, and proviral DNA in amounts which generally correlated with the degree of leukemic cell infiltration. Viral markers were particularly abundant in tissue from the region of the oral cavity. Proviral DNA was found in all tissues except muscle and brain, which contained little or no leukemic cell infiltration. Replicating virus was transmitted to heterologous cells in tissue culture from many tissues, including muscle and brain. This virus, called GaLVH was classified as a member of the gibbon ape leukemia virus-simian sarcoma (simian sarcoma-associated) virus group by comparative tests of the antigenic relatedness of p30 and reverse transcriptase, and by nucleotide sequence homology of RNA from this virus and from other members of this group. These results: (a) highlight the extraordinary replication of this type of virus in gibbons; (b) further implicate this virus group in the etiology of spontaneous gibbon ape leukemia; (c) suggest that the oral route is a likely mode of virus transmission; and (d) fail to provide evidence for a genetic reservoir of virus outside of the tumor cells.

Synthesis of coat protein of bacteriophage f2 in infected cells, as well as in the cell-free system, is initiated with an amino-terminal formyl-methionine. The formyl-methionine is removed when the nascent chain is 40 to 60 amino acids long.

An improved method for the formation of DNA—RNA hybrids is described. The procedure involves immobilizing denatured DNA on nitrocellulose membrane filters, hybridizing complementary RNA to the membrane-fixed DNA, and eliminating RNA “noise”. Denatured DNA and hybridized RNA remain on the filter throughout the procedure. Unpaired RNA is removed by washing, and RNA complexed over short regions is eliminated by RNase treatment. Many samples can be easily handled, permitting kinetic and saturation studies. Large amounts-of DNA can be loaded on a filter without interfering with the efficiency of the annealing reaction. Moreover, the “noise” can be depressed to a level (0·003% of the input RNA) permitting the identification of small regions of DNA complementary to a given RNA species. The results are quantitatively more certain than annealing in liquid, since the competing DNA renaturation reaction is suppressed.

Two cases of congenital absence of the right pulmonary artery and one case of probably acquired obstruction of the right pulmonary artery are discussed. Patients with congenital absence of the right pulmonary artery frequently present with pulmonary hypertension during infancy, particularly if there is an associated patent ductus arteriosus. Adults with absent right pulmonary artery may be asymptomatic. The diagnosis may be suspected from the chest roentgenogram and confirmed by pulmonary angiography. Aortography is essential for the recognition of the not infrequent anomalous origin of the right pulmonary artery. Previous surgical results and possible therapeutic approaches to the problem of absent right pulmonary artery are discussed.

A rate-controlled partial-equilibrium method for treating reacting gas mixtures has been developed that is very much simpler than the usual technique of integrating the full set of rate equations. The method is based on the observation that a rate-controlling reaction is equivalent to a “passive constraint” on the gas, so that the corresponding partial-equilibrium state can be calculated by minimizing the appropriate free energy function. An example illustrating the application of the method to the “freezing” of threebody reactions in an internal combustion engine is given.