Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Calculation of the expected output spectrum for a mid-infrared supercontinuum source based on As ₂ S₃ chalcogenide photonic crystal fibers

We computationally investigate supercontinuum generation in an As ₂ S₃ solid core photonic crystal fiber (PCF) with a hexagonal cladding of air holes. With a goal of obtaining a supercontinuum output spectrum that can predict what might be seen in an experiment, we investigate the spectral and statistical behavior of a mid-infrared supercontinuum source using a large ensemble average of 10⁶ realizations, in which the input pulse duration and energy vary. The output spectrum is sensitive to small changes (0.1%) in these pulse parameters. We show that the spectrum can be divided into three regions with distinct characteristics: a short-wavelength region with high correlation, a middle-wavelength region with minimal correlation, and a long-wavelength region where the behavior is dominated by a few rare large-bandwidth events. We show that statistically significant fluctuations exist in the experimentally expected output spectrum and that we can reproduce an excellent match to that spectrum with a converged shape and bandwidth using 5000 realizations.

Guided entropy mode Rayleigh scattering in optical fibers

Rayleigh scattering in optical fibers has the potential to degrade the performance of low-noise opto-electronic systems. In this Letter, we measure the Rayleigh gain spectrum of optical fibers. Our data show the gain bandwidth and the offset frequency of the Rayleigh gain peak. Both the gain bandwidth and the peak frequency are 3 orders of magnitude lower than the corresponding values for bulk silica. Our data suggest that the narrower gain bandwidth and frequency shift that we observe are due to guided entropy modes in the fiber. This effect is fundamental and will be present in any medium in which light is guided so that transverse intensity gradients exist.

Pure chiral optical fibres

We investigate the properties of optical fibres made from chiral materials, in which a contrast in optical activity forms the waveguide, rather than a contrast in the refractive index; we refer to such structures as pure chiral fibres. We present a mathematical formulation for solving the modes of circularly symmetric examples of such fibres and examine the guidance and polarisation properties of pure chiral step-index, Bragg and photonic crystal fibre designs. Their behaviour is shown to differ for left- and right-hand circular polarisation, allowing circular polarisations to be isolated and/or guided by different mechanisms, as well as differing from equivalent non-chiral fibres. The strength of optical activity required in each case is quantified.

Calculation of the expected bandwidth for a mid-infrared supercontinuum source based on As(2)S(3) chalcogenide photonic crystal fibers

We computationally investigate supercontinuum generation in an As(2)S(3) solid core photonic crystal fiber (PCF) with a hexagonal cladding of air holes. We study the effect of varying the system (fiber and input pulse) parameters on the output bandwidth. We find that there is significant variation of the measured bandwidth with small changes in the system parameters due to the complex structure of the supercontinuum spectral output. This variation implies that one cannot accurately calculate the experimentally-expected bandwidth from a single numerical simulation. We propose the use of a smoothed and ensemble-averaged bandwidth that is expected to be a better predictor of the bandwidth of the supercontinuum spectra that would be produced in experimental systems. We show that the fluctuations are considerably reduced, allowing us to calculate the bandwidth more accurately. Using this smoothed and ensemble averaged bandwidth, we maximize the output bandwidth with a pump wavelength of 2.8 μm and obtain a supercontinuum spectrum that extends from 2.5 μm to 6.2 μm with an uncertainty of ± 0.5 μm. The optimized bandwidth is consistent with prior work, but with a significantly increased accuracy..

Non-invasive treatment of ST elevation myocardial infarction

There is good evidence that timely restoration of coronary blood flow in obstructed infarct related arteries is a significant determinant of both short and long term mortality and morbidity. This is irrespective of whether it is achieved using fibrinolytic therapy or percutaneous coronary intervention (PCI). Despite the clear advantages of primary PCI, it is thrombolysis that remains the main reperfusion strategy in the UK. Recent data have highlighted mortality benefits when antiplatelet treatment and anticoagulation are used as adjuncts to thrombolysis. Moreover, of those who receive thrombolysis, 60% proceed to coronary arteriography within 6 months of their index event. Recent studies have been published clarifying the timing of coronary arteriography in patients who receive thrombolysis as reperfusion therapy.

Improving child protection: a systematic review of training and procedural interventions

AIM

To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals.

METHODS

Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour.

RESULTS

Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions (such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of one-group pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process.

CONCLUSION

Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective.

Cryoprecipitate prepared from plasma treated with methylene blue plus light: increasing the fibrinogen concentration

When cryoprecipitate is prepared from plasma which has been treated with methylene blue plus light (MB) for the purpose of virus inactivation, clottable fibrinogen content is 40% lower compared with units prepared from untreated plasma. Initial studies showed that when frozen MB plasma units were removed to +2 to +6 degrees C for 4 h and then returned to -40 degrees C prior to cryoprecipitation, fibrinogen recoveries increased from 24 to 42%. Although fibrinogen yield improved when plasma units were stored at +2 to +6 degrees C for varying lengths of time, FVIII levels decreased with increasing time. Conditioning for 8 h was studied in more detail. Groups of two plasma units were mixed together, divided into two equal units, frozen/thawed and treated with MB. One of each pair was stored continually at -40 degrees C, whereas the other was removed to +2 to +6 degrees C for 8 h. Samples were assayed for fibrinogen, FVIII, VWF:Ristocetin cofactor activity (RCo), VWF:Ag and VWF:Collagen binding (CB). The cryoprecipitate fibrinogen content increased to a mean of 207 mg unit(-1). VWF:Ag, VWF:RCo and VWF:CB recoveries also increased. FVIII recovery decreased from 50 to 45% (mean 124 iu unit(-1)). Conditioning has been validated for routine production of cryoprecipitate from imported plasma.

A potentially improved approach to methylene blue virus inactivation of plasma: the Maco Pharma Maco-Tronic system

Plasma was subjected to methylene blue (MB) photochemical virus inactivation using the Maco Pharma Maco-Tronic system which allows three units to be illuminated together, thus reducing processing time. The plasma bag system used incorporates an integral membrane plasma filter and a dry MB pill which dissolves in the plasma to give a 1-microM concentration. There is computer-controlled processing and datalogging. In an assessment of 10 pools of Group A plasma, the losses of coagulation factors, following MB/light treatment, were 23% fibrinogen, 10% FV, 26% FVIII, 11% FIX and 13% FXI. Group O, Group B and Group AB plasmas were not tested. Von Willebrand factor (vWf) multimers showed no substantial change when treated with MB, and no losses were seen for antithrombin III (ATIII), protein C and vWf:Ag. Measurements of C3a, C5a, prothrombin fragment 1+2 and FXIIa indicated that there was no activation as a result of filtration.

Serum metalloproteinases and their inhibitors: markers for malignant potential

Death from cancer results from the development of metastases or local progression of tumour. Metastasis and local progression may result from the inappropriate activity of metalloproteinases released by tumour cells or of their regulatory peptides. We have developed quantitative assays for interstitial collagenase, stromelysin 1 and tissue inhibitors of metalloproteinase (TIMP) 1 and 2, which have allowed the study of serum levels of these proteins. Sera from 40 patients with prostatic cancer, stored prior to and after 6 and 12 months' treatment with a gonadotrophin-releasing hormone agonist and an anti-androgen were analysed. Levels were compared with two control groups, comprising 21 patients with active rheumatoid arthritis and 56 age-matched hospital attenders without arthritis or cancer. Contrasting levels have been found in patients with prostatic cancer as compared with hospital controls without cancer and patients with rheumatoid arthritis. Patients with prostatic cancer had higher levels of TIMP-1 and collagenase (P = 0.0001) and lower levels of TIMP-2 (P = 0.003) than controls. Patients with metastatic cancer had significantly higher levels of collagenase than those without metastases (P = 0.02). Patients with rheumatoid arthritis had significantly higher levels of stromelysin than either controls (P = 0.002) or patients with cancer (P = 0.008). Serum tissue inhibitor of metalloproteinase 1 in combination with collagenase levels was as sensitive as prostate-specific antigen as a marker of metastatic disease. These findings provide a basis for the investigation of the role of metalloproteinases and their inhibitors in other malignancies.

Human progelatinase A can be activated by matrilysin

The activation of human progelatinase A by other matrix metalloproteinases was studied by following both the loss of its N-terminal propeptide and the accompanying increase in the rate of hydrolysis of a synthetic substrate. Activated stromelysin 1 was unable to cause any activation of progelatinase A beyond that slowly occurring by autolysis, but an 8 h incubation with activated matrilysin was able to produce 64% of the activity generated by incubation with (4-aminophenylmercuric)acetate (APMA). Wild-type progelatinase A and a mutant proenzyme that cannot become active were both cleaved by matrilysin to a lower molecular weight species that had lost the propeptide. This shows that matrilysin activates progelatinase A by removing the propeptide in a process that does not require any autolytic cleavages.

Crystallization and preliminary X-ray analysis of a truncated tissue metalloproteinase inhibitor delta 128-194 TIMP-2

Crystals of an active truncated form of a human tissue metallproteinase inhibitor (delta 128-194 TIMP-2), a protein implicated in a number of diseases of the connective tissues, have been grown in a form suitable for study by X-ray diffraction analysis. Crystals grow using polyethylene glycol 600 as a precipitant and are in space group P2(1)2(1)2, with cell dimensions a = 75.28 A, b = 100.77 A, c = 31.45 A. The asymmetric unit appears to contain two molecules of delta TIMP-2 with a Vm value of 2.3 A3/dalton. The crystals diffract to Bragg-spacings beyond 2.5 A. Native data to 3.2 A have been collected and a search for heavy-metal derivatives is in progress.

Neonatal infection in premature infants and use of human immunoglobulin

In an open study 120 consecutively admitted premature babies of 32 weeks' gestation or less, were randomised to receive weekly intramuscular injections of human normal immunoglobulin (50 mg/kg). There was no significant difference between the number of babies in the treated and untreated groups who had at least one episode of infection, but the total number of infective episodes was substantially less in the treated group (n = 22) compared with 40 in the non-treated group. Three babies died from overwhelming infection and three babies developed necrotising enterocolitis, all in the group that had not been treated. Serum IgG concentrations were significantly higher in the treated group by the age of 2 weeks but remained consistently below those of full term babies of similar postnatal age. Administration of human immunoglobulin may decrease the severity of infection in premature babies, but alternative regimens may be more successful.

Tetracycline resistance genes from Bacillus plasmid pAB124 confer decreased accumulation of the antibiotic in Bacillus subtilis but not in Escherichia coli

Expression of tetracycline resistance by genes originating in the Bacillus plasmid pAB124 was examined in both Bacillus subtilis and Escherichia coli host cells. Expression of resistance in B. subtilis by genes from pAB124 was inducible and associated with decreased accumulation of the antibiotic. A fragment of pAB124 carrying the genes coding for tetracycline resistance was cloned into the E. coli plasmid RSF2124. The cloned fragment conferred a low level of resistance in E. coli, but this was not associated with decreased uptake of tetracycline and was not inducible.

Naturally occurring macrolide-lincosamide-streptogramin B resistance in Bacillus licheniformis

Resistance to the macrolide-lincosamide-streptogramin B (MLS) group of antibiotics is widespread and of clinical importance. B. Weisblum and his coworkers have demonstrated that this resistance is associated with methylation of the 23S ribosomal ribonucleic acid of the large ribosomal subunit which results in a diminished affinity of this organelle for these antibiotics (Lai et al, J. Mol. Biol. 74:67-72, 1973). We report that 10 of 15 natural isolates of Bacillus licheniformis, a common soil organism, are resistant to the MLS antibiotics. The properties of this resistance (high level of tolerance for erythromycin, broad cross-resistance spectrum, and inducibility) suggest that resistance is conferred as described above. The resistance determinant from one of these strains was cloned onto a B. subtilis plasmid vector, and the resulting hybrid plasmid (pBD90) was used to prepare radioactive probe deoxyribonucleic acid for hybridization studies. All of the resistance B. licheniformis strains studied exhibited homology with the pBD90 insert. Plasmid pBD90 showed no homology to the following staphylococcal and streptococcal MLS-resistance plasmids: pE194, pE5, pAM77, pI258. Plasmids pE194 and pE5, on the other hand, carry homologous MLS genes but showed no detectable homology to one another in their replication genes. pBD90 specified a 35,000-dalton erythromycin-inducible protein, detectable in minicells, which therefore appears different from the 29,000-dalton inducible resistance protein specified by pE194. We conclude that there are at least three distinct MLS resistance determinants to be found among gram-positive bacteria.