A procedure for assessing the functional reliability of hospital systems

An effective reliability-based procedure is presented to assess the capability of hospitals to be functional after a seismic event of a given intensity. Every major function in a hospital depends on the joint action of various cooperating services, which in turn are made up from a certain number of sub-services. Such a complex organization is described in terms of a logical scheme and subsequently reduced to a minimal cut-set representation. For each sub-service a collapse criterion is defined, by which the strength is compared to the action load, both represented as random variables. Strengths are evaluated through assessment analyses based on design drawings. Loads are evaluated from 3-D linear dynamic analyses under seismic input. This is given by the Eurocode 8 elastic response spectrum, scaled at a given peak ground acceleration and account for the position of the sub-service within the building. By calculating the failure probability of each service by FORM (First Order Reliability Method) or SORM (Second Order Reliability Methods), the probability of functional interruption is obtained in terms of Didevsen bounds, conditional on a given earthquake intensity. The method helps to single out weak elements and potential sources of damage (structural, non-structural, equipment) within the hospital. This allows: (a) to investigate quantitatively the effectiveness of different upgrading criteria, (b) to select rationally intervention hypotheses, both in the retrofitting and rehabilitation of existing hospitals and in the design optimization of new ones, and (c) to evaluate different investment options for seismic vulnerability mitigation. As an example, an application to a case study hospital is presented.     

Attribution and alcohol-mediated aggression.

48 males participated in an aggression task after receiving either alcoholic or placebo beverages and after being told that they had received either a high or a low dose of alcohol. All Ss in the alcohol group actually received the same dose. Measures of aggression were the intensity and duration of shock given to a bogus partner in a RT-pain perception task and a score on a posttask attitude questionnaire. Blood alcohol readings were taken 3 times during the session, and a locus of control scale was administered before and after drinking. For Ss in the alcohol conditions, blood alcohol levels averaged .079% before the task and .085% afterwards. Alcohol resulted in higher aggression scores only on the questionnaire measure, and an interaction between drug and attribution was found for the measure of shock duration. Attribution alone resulted in greater aggression on the measure of shock intensity. Ss in groups where the attribution was discrepant with the drug condition were the most aggressive on the measures of shock intensity and duration. These Ss became more external, reflecting a high correlation between their aggression and a stimulus tone. Results suggest that a person's increased aggressiveness when intoxicated results from an interaction between alcohol and an altered responsivity to provoking stimuli. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of CHROMagar Salmonella medium and hektoen enteric agar for isolation of salmonellae from stool samples

CHROMagar Salmonella (CAS), a new chromogenic medium, was retrospectively compared to Hektoen enteric agar (HEA) with 501 Salmonella stock isolates and was then prospectively compared to HEA for the detection and presumptive identification of Salmonella spp. with 508 stool samples before and after enrichment. All stock cultures (100%), including cultures of H2S-negative isolates, yielded typical mauve colonies on CAS, while 497 (99%) isolates produced typical lactose-negative, black-centered colonies on HEA. Following overnight incubation at 37 degreesC, a total of 20 Salmonella strains were isolated from the 508 clinical samples. Sensitivities for primary plating and after enrichment were 95% (19 isolates) and 100% (20 isolates), respectively, for CAS and 80% (16 isolates) and 100% (20 isolates), respectively, for HEA. The specificity of CAS (88.9%) was significantly higher than that of HEA (78.5%; P < 0.0001). On the basis of its good sensitivity and specificity, CAS medium can be recommended for use for primary plating when human stool samples are screened for Salmonella spp.     

The complete amino acid sequence of a trypsin inhibitor from Bauhinia variegata var. candida seeds

Trypsin inhibitors of two varieties of Bauhinia variegata seeds have been isolated and characterized. Bauhinia variegata candida trypsin inhibitor (BvcTI) and B. variegata lilac trypsin inhibitor (BvlTI) are proteins with Mr of about 20,000 without free sulfhydryl groups. Amino acid analysis shows a high content of aspartic acid, glutamic acid, serine, and glycine, and a low content of histidine, tyrosine, methionine, and lysine in both inhibitors. Isoelectric focusing for both varieties detected three isoforms (pI 4.85, 5.00, and 5.15), which were resolved by HPLC procedure. The trypsin inhibitors show Ki values of 6.9 and 1.2 nM for BvcTI and BvlTI, respectively. The N-terminal sequences of the three trypsin inhibitor isoforms from both varieties of Bauhinia variegata and the complete amino acid sequence of B. variegata var. candida L. trypsin inhibitor isoform 3 (BvcTI-3) are presented. The sequences have been determined by automated Edman degradation of the reduced and carboxymethylated proteins of the peptides resulting from Staphylococcus aureus protease and trypsin digestion. BvcTI-3 is composed of 167 residues and has a calculated molecular mass of 18,529. Homology studies with other trypsin inhibitors show that BvcTI-3 belongs to the Kunitz family. The putative active site encompasses Arg (63)-Ile (64).     

Adaptation as a genome-wide autoregulatory principle in the stress response of yeast

The gene expression response of yeast to various types of stresses/perturbations shows a common functional and dynamical pattern for the vast majority of genes, characterised by a quick transient peak (affecting primarily short genes) followed by a return to the pre-stimulus level. Kinetically, this process of adaptation following the transient excursion can be modelled using a genome-wide autoregulatory mechanism by means of which yeast aims at maintaining a preferential concentration in its mRNA levels. The resulting feedback system explains well the different time constants observable in the transient response, while being in agreement with all the known experimental dynamical features. For example, it suggests that a very rapid transient can be induced also by a slowly varying concentration of the gene products.     

The role of teat skin contamination in the epidemiology of Staphylococcus aureus intramammary infections

Knowledge of the epidemiological pattern and the potential sources of infections is important to control Staphylococcus aureus in dairy herds. This paper reports the results of a study applying both pulse field gel electrophoresis (PGFE) and the assessment of a selected number of virulence genes to investigate the role of teat skin on Staph. aureus transmission among cows and on the contamination of milk. Overall 61 isolates were considered, 23 from teat skin, 33 from milk samples and 5 from curd samples. Teat swabs were taken in five herds, but in only three of them could Staph. aureus be isolated. Curd was sampled in three herds, but Staph. aureus could be isolated in only two herds. The distribution of isolates among herds confirmed the presence of herd-specific Staph. aureus strain in most of the herds. The same pattern was observed in teat skin samples, in quarter milk samples, and in the curd samples. Our findings are consistent with other studies showing the role of teat skin as a potential reservoir. Moreover, Staph. aureus was isolated from teat skin of confirmed Staph. aureus-negative cows that were segregated from infected ones. Our findings also suggest that some strains have higher chances to survive on teat skin and therefore to increase the risk for contamination of milk and milk products due to the persistence of intramammary infections.