Transcriptional profiling of the human fibrillin/LTBP gene family, key regulators of mesenchymal cell functions.

The fibrillins and latent transforming growth factor binding proteins (LTBPs) form a superfamily of extracellular matrix (ECM) proteins characterized by the presence of a unique domain, the 8-cysteine transforming growth factor beta (TGFβ) binding domain. These proteins are involved in the structure of the extracellular matrix and controlling the bioavailability of TGFβ family members. Genes encoding these proteins show differential expression in mesenchymal cell types which synthesize the extracellular matrix.

Full de-steam ahead for Yeovil facility.

Keen to address one of the major priorities on its backlog maintenance list, and, in the process, to significantly reduce both its carbon footprint and energy bills, Yeovil District Hospital NHS Foundation Trust has recently entered into a 15-year Energy Performance Contract (EPC) with Cynergin which involves the conversion of the existing steam-based heating and hot water infrastructure at Yeovil District Hospital to a considerably more economical, efficient, and future-proof, low temperature hot water (LTHW) system which should also provide added resilience.

A promoter-level mammalian expression atlas.

Regulated transcription controls the diversity, developmental pathways and spatial organization of the hundreds of cell types that make up a mammal. Using single-molecule cDNA sequencing, we mapped transcription start sites (TSSs) and their usage in human and mouse primary cells, cell lines and tissues to produce a comprehensive overview of mammalian gene expression across the human body. We find that few genes are truly 'housekeeping', whereas many mammalian promoters are composite entities composed of several closely separated TSSs, with independent cell-type-specific expression profiles.

An atlas of active enhancers across human cell types and tissues.

Enhancers control the correct temporal and cell-type-specific activation of gene expression in multicellular eukaryotes. Knowing their properties, regulatory activity and targets is crucial to understand the regulation of differentiation and homeostasis. Here we use the FANTOM5 panel of samples, covering the majority of human tissues and cell types, to produce an atlas of active, in vivo-transcribed enhancers.

'Don't blame the middle man': an exploratory qualitative study to explore the experiences of translators breaking bad news.

Background: Healthcare professionals find breaking bad news difficult and upsetting. Increasing cultural diversity has led to a greater number of patients whose first language differs to that of the healthcare provider, with more patients requiring a translator to facilitate communication. Hospitals often ask non-clinical translators to facilitate breaking bad news.

Dementia-friendly design resource.

Although estimates suggest that, on average, some 30 per cent of all patients in general acute medical wards may have some form of dementia, Stirling University's Dementia Services Development Centre (DSDC), one of the leading international knowledge centres working to improve the lives of dementia sufferers, says progress in designing healthcare facilities that address such patients' needs has been 'patchy at best'. With the number of individuals living with dementia expected to double in the next 25 years, the DSDC has recently worked with Edinburgh-based architects, Burnett Pollock Associates, to develop an online resource that clearly illustrates, via 15 simulated 'dementia-friendly' healthcare 'spaces', some of the key principles to consider when designing effectively for this fast-growing group. HEJ editor, Jonathan Baillie, attended the launch of the so-called 'Virtual Hospital'.

Total pancreatectomy and islet autotransplantation in chronic pancreatitis: recommendations from PancreasFest.

Description: Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical procedure used to treat severe complications of chronic pancreatitis or very high risk of pancreatic cancer while reducing the risk of severe diabetes mellitus. However, clear guidance on indications, contraindications, evaluation, timing, and follow-up are lacking.

Methods: A working group reviewed the medical, psychological, and surgical options and supporting literature related to TPIAT for a consensus meeting during PancreasFest.

Heteroresistance at the single-cell level: adapting to antibiotic stress through a population-based strategy and growth-controlled interphenotypic coordination.

Unlabelled: Heteroresistance refers to phenotypic heterogeneity of microbial clonal populations under antibiotic stress, and it has been thought to be an allocation of a subset of "resistant" cells for surviving in higher concentrations of antibiotic. The assumption fits the so-called bet-hedging strategy, where a bacterial population "hedges" its "bet" on different phenotypes to be selected by unpredicted environment stresses. To test this hypothesis, we constructed a heteroresistance model by introducing a blaCTX-M-14 gene (coding for a cephalosporin hydrolase) into a sensitive Escherichia coli strain.

Veteran's vision on 45 years' change.

Even for a company where many employees have contributed long service, with 45 years under his belt at commercial washroom and showering system manufacturer, Kohler Mira, the company's commercial marketing manager on the Rada brand, Roy Minett, has seen his share of change. HEJ editor, Jonathan Baillie, recently met with the acknowledged expert on water hygiene and safety issues for a look around the company's Cheltenham headquarters, where the 'voice of Rada' was happy to share some of the changes he has seen during an extremely varied career, explain some of the innovations incorporated into washroom and showering products targeted at healthcare applications under the Rada brand name, and offer his thoughts on future trends.

Pseudomonas--an opportunistic foe.

An honest account of some of the lessons learned in how to protect patients, staff, and visitors, against waterborne Pseudomonas aeruginosa by effectively monitoring a large healthcare facility's water supply, identifying potential 'trigger points', harnessing the expertise of a multidisciplinary team, encouraging all staff to 'go the extra mile' preventatively, and above all, 'going beyond compliance', was provided by George McCracken, head of Estates Risk and Environment at the Belfast Health and Social Care Trust--in whose Royal Jubilee Maternity Hospital three young babies died after an outbreak of the bacteraemia in early 2012--at a recent Water Management Society conference. HEJ editor, Jonathan Baillie, reports.

Wireless world widens nurse call options.

With wireless technology now an integral part of all our lives, and miniaturisation of computing power having made even hand-held portable devices such as mobile phones powerful tools in their own right, HEJ editor, Jonathan Baillie, spoke to specialist in wireless nurse call systems, Courtney-Thorne, to discuss some of its key recent product innovations, and see what impact it feels developments such as 'cloud' technology will have on the bringing of more technology into the nurse call sector as 'nurse and carer tools'.

Reducing costs via standardisation.

Speaking in a presentation at October's Healthcare Estates 2013, senior representatives from a number of Principal Supply Chain Partners (PSCPs) within the ProCure21 + National Framework explained their ongoing work to develop designs for standardised and repeatable rooms, along with a range of associated standard components--from flooring to air-handling units--all intended to reduce NHS capital building costs in line with the Government Construction Strategy. HEJ editor, Jonathan Baillie, reports.

Taking a responsible and holistic approach.

With good fire safety strategy, and, for instance, ensuring that staff are properly trained in, and familiar with, the correct procedures should a major fire necessitate evacuation, being a key priority for healthcare facilities of all kinds, HEJ editor, Jonathan Baillie, spoke to Adair Lewis, technical manager at the Fire Protection Association, for a run-down of some of the most important things for those responsible to consider.

Examining the global challenges ahead.

A quartet of speakers at a London seminar that looked ahead to the challenges facing the sector to 2020 and beyond, held in early November to mark IHEEM's 70th Anniversary, addressed subjects including how the global healthcare community will tackle a significant future increase in demand for care, the growing pressure to reduce energy consumption, and the predicted migration of much of the care currently provided in large acute hospitals to community healthcare settings and patients' homes. The seminar, entitled 'Healthcare Estates 2020', was held at the Institution of Civil Engineers just off Parliament Square, and was followed by a celebratory lunch in an impressive riverside setting at the Houses of Parliament. HEJ editor, Jonathan Baillie, reports.

Network analysis reveals distinct clinical syndromes underlying acute mountain sickness.

Acute mountain sickness (AMS) is a common problem among visitors at high altitude, and may progress to life-threatening pulmonary and cerebral oedema in a minority of cases. International consensus defines AMS as a constellation of subjective, non-specific symptoms. Specifically, headache, sleep disturbance, fatigue and dizziness are given equal diagnostic weighting.

Changing times, similar challenges.

With IHEEM celebrating its 70th Anniversary this month, HEJ editor, Jonathan Baillie, recently met the Institute's oldest surviving Past-President, Lawrence Turner OBE, who, having in 1964 established a small engineering business producing some of the NHS's earliest nurse call systems from the basement of his three-storey West Midlands home, has since seen the company, Static Systems Group, grow to become one of the U.K. market-leaders in its field.

Winning the battle for greater efficiency.

The keynote speeches at this year's Healthcare Estates conference, which was themed 'Putting positive energy into healthcare', included a rousing address by former Welsh Guardsman, and Falklands War veteran, Simon Weston, describing his extraordinary recovery after suffering extensive burns when his troop ship was hit by an Argentinian bomb in June 1982, as well three estates and facilities-orientated presentations from senior sector players, on topics ranging from public sector energy procurement, to how those English NHS Trusts still seeking Foundation Trust status can 'raise the bar' sufficiently to achieve this. HEJ editor, Jonathan Baillie reports.

Global patterns of freshwater species diversity, threat and endemism.

Aim: Global-scale studies are required to identify broad-scale patterns in the distributions of species, to evaluate the processes that determine diversity and to determine how similar or different these patterns and processes are among different groups of freshwater species. Broad-scale patterns of spatial variation in species distribution are central to many fundamental questions in macroecology and conservation biology. We aimed to evaluate how congruent three commonly used metrics of diversity were among taxa for six groups of freshwater species.

Off-site build speeds mortuary completion.

A new mortuary and bereavement facility at one of North Wales's largest acute hospitals, the Ysbyty Glan Clwyd near Rhyl, formed from 16 steel-framed modules that were manufactured off site, and subsequently craned into position to greatly speed project completion, was delivered 'well below original cost budget, four weeks ahead of schedule', by turnkey construction specialist, MTX Contracts. As HEJ editor, Jonathan Baillie, reports, this is MTX's second substantial project in the past two years at Glan Clwyd, reporting to the principal contractor on a major redevelopment programme currently ongoing at the hospital, Laing O'Rourke.

A vision for better healthcare in India.

Ian Hinitt, until the Summer of 2012 deputy director of Estates at Bradford Teaching Hospitals NHS Foundation Trust, is spearheading an ambitious joint-venture project between Apex 4D, he and his business partner, Balbir Panesar's recently established Bradford-based outsourced FM company, and Leeds-headquartered architectural practice, Bowman Riley, which the project partners hope will initiate the construction of a new generation of modular buildings to improve healthcare provision throughout India, and, in the process, generate significant reciprocal trade opportunities for both UK and Indian suppliers to the sector. HEJ editor, Jonathan Baillie, reports.