This could explain why the RhoH-overexpressing transgenic mice did not exhibit a strong phenotype

biased towards “well” patients. A power calculation, based on a presumed exposure of 20% and outcome incidence of HAP of 10% in unexposed at 80% PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19770275 power and the 0.05 significance level suggested that recruiting 200 patients would be able to detect a 20% difference in the incidence of HAP between colonised and uncolonised persons. An exposure of 20% was based on two previous papers, and the incidence of HAP was based on 9% incidence found by Roche et al.. Ethics statement Ethical approval was granted by the Newcastle and North Tyneside 2 research ethics committee, which had a special interest in adults lacking capacity. The research was conducted as per the Mental Capacity Act 2005 guidelines, and every effort was made to include all persons with cognitive impairment because these are the very people that hospital acquired pneumonia affect. To exclude these persons would mean that the research outcomes would be less useful when applying results to real life populations. In addition, the taking of oral swabs was deemed minimally intrusive and wholly without risk to participants. Written patient consent was obtained. Where there were concerns regarding capacity, a capacity assessment was undertaken by VE. All efforts were made to allow patients to make their own decision, including repeating information, visits at different times and finding visual or hearing aids. If the patient was found not to have capacity, then a relative was sought and invited to provide written consent on the patient’s behalf, taking into account what they knew of their relative’s beliefs, wishes and condition. If the patient had no relatives then a professional independent of the study was sought, and invited to provide written consent, again taking into account the patient’s condition. According to the PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19768759 Act, a researcher may nominate another individual who is not connected to the project according to local guidelines to act on the participant’s behalf. In this study, one patient fell into this category, and a qualified nurse who had been caring for that patient acted on their behalf. No power of attorney was assigned. The nurse was unconnected with the study and its personnel, and had not previously worked together. If any patient showed any signs of not wishing to take part in the study they were immediately withdrawn, even if written consent had been provided on their behalf. Routine Care All patients received peri-operative antibiotics. All patients received 4500 international units of tinzaparin subcutaneously, unless already anticoagulated on warfarin. Routine postoperative analgesia was cocodamol 30/500mg four times daily. Patients were routinely screened for MRSA and decolonised with chlorhexidine mouthwash and antibacterial toothpaste if found positive. No specific oral hygiene policy was in operation at the time of the study and the study team did not undertake any oral hygiene intervention. Patients relied on nursing staff helping with oral hygiene and bringing equipment to their beds if unable to mobilise, and leaving equipment within their reach. Patients with dentures were given denture pots if these were available, but these did not necessarily contain fluid. 4 / 23 Dental/Microbiological Risk Factors for Hospital-Acquired Pneumonia Recording of demographic variables We recorded demographic data including age, residence, gender, weight, comorbidity, and prescribed drugs. We calculated functional scores, including the Barthel index , the MedChemExpress Mertansine Clinical Frailty