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Knowledge of local antibiotic resistance data, provided by antibiograms (a cumulative summary of in vitro-antimicrobial-susceptibility-test results), can aid prescribing of appropriate empirical antibiotics. This study aimed to explore the feasibility of antibiogram development for residential aged care facilities (RACFs).
Design:
Retrospective observational study of culture and sensitivity data.
Setting:
Nine RACFs in Queensland, Australia.
Method:
Available antimicrobial susceptibility results were collected retrospectively for all residents of recruited RACFs from January 1, 2020, to December 31, 2022. Data were managed and analyzed with WHONET software®, and antibiograms were developed in accordance with the CLSI-M39 guidelines. Antibiogram data beyond the standard 12-months and pooling of data from geographically similar RACFs were explored as options to improve feasibility and validity of the antibiograms.
Results:
The most prevalent bacteria in the RACFs were Escherichia coli and Staphylococcus aureus. Due to the low number of positive cultures (less than 30) for individual RACFs, an annual antibiogram was not feasible. Extending the time-period to three years improved feasibility of antibiograms for E.coli in seven RACFs and S.aureus in five RACFs. Combining the data from closely located RACFs allowed for sufficient urinary and skin swab isolates to produce annual pooled antibiograms for all three years.
Conclusion:
Use of extended time period antibiograms can provide RACF specific urinary and skin/soft tissue resistance data without the necessity of private pathology provider input. However, pooled syndromic antibiograms can be made available on an annual basis, which may be the preferred option.
Members of the genus Scaphanocephalus mature in accipitrids, particularly osprey, Pandion haliaetus, with metacercaria causing Black Spot Syndrome in reef fishes. In most of the world, only the type species, Scaphanocephalus expansus (Creplin, 1842) has been reported. Recent molecular studies in the Western Atlantic, Mediterranean and Persian Gulf reveal multiple species of Scaphanocephalus, but have relied on 28S rDNA, mainly from metacercariae, which limits both morphological identification and resolution of closely related species. Here we combine nuclear rDNA with mitochondrial sequences from adult worms collected in osprey across North America and the Caribbean to describe species and elucidate life cycles in Scaphanocephalus. A new species described herein can be distinguished from S. expansus based on overall body shape and size. Phylogenetic analysis of the whole mitochondrial genome of Scaphanocephalus indicates a close relationship with Cryptocotyle. We conclude that at least 3 species of Scaphanocephalus are present in the Americas and 2 others are in the Old World. Specimens in the Americas have similar or identical 28S to those in the Mediterranean and Persian Gulf, but amphi-Atlantic species are unlikely in light of divergence in cytochrome c oxidase I and the lack of amphi-Atlantic avian and fish hosts. Our results provide insight into the geographic distribution and taxonomy of a little-studied trematode recently linked to an emerging pathology in ecologically important reef fishes.
Multiple Sclerosis (MS) affects up to 500,000 adults in the United States, with cognitive impairment present in 45%-65% of people. Studies showed hippocampal atrophy in MS, but the underlying mechanisms remain unknown. Inflammation has been proposed to play a significant role, and associations between systemic inflammatory biomarkers and hippocampal atrophy have been shown in other neurological conditions. However, research exploring serum biomarker and volumetric associations in MS are lacking. Given that conventional imaging methods lack resolution for hippocampal internal architecture (HIA), new protocols were developed. We used the High-Resolution Multiple Image Co-Registration and Averaging (HR-MICRA) method to visualize the HIA subfields. We investigated the relationship between subfield volumes generated from HR-MICRA scans and systemic serum biomarkers in MS.
Participants and Methods:
Patients with MS were recruited (N= 34, mean age= 54.6, 35.3% Black) underwent Magnetic Resonance Imaging (MRI), and serum biomarkers were obtained, specifically chosen for their potential role in MS. Inflammatory biomarkers included; granulocyte colony stimulating factor (G-CSF), interleukin-10 (IL-10), matrix metalloproteinase-9 (MMP-9), tumor necrosis factor- a (TNF- a), and growth factors; vascular endothelial growth factor (VEGF); insulin-like growth factor-1 (IGF-1), and brain derived growth factor (BDNF). Imaging was performed in a Siemens Prisma 3T scanner with a 64-channel head coil using the HR-MICRA method. Hippocampal subfields were calculated using the Automated Segmentation of Hippocampal Subfields (ASHS) package. We used the Magdeburg Young Adult 7T Atlas for sub-hippocampal structures and Penn Temporal Lobe Epilepsy T1-MRI Whole Hippocampus ASHS Atlas for general hippocampal structure and segmentation. Pearson's product-moment analyses provided correlations between biomarkers and hippocampal subfield volumes for each cerebral hemisphere. A statistical significance level of p < 0.05 was used for all analyses.
Results:
Correlations emerged between left hemisphere Cornu Ammonis (CA) 2 and G-CSF (r = -.384; p = .025); IL-10 (r = -.342; p = .048); VEGF (r = -.371; p= .031); and CA3 with IL-10 (r = -.488, p = .003); G-CSF (r = -.386; p= .024); VEGF (r = -.352; p= .041). Dentate gyrus correlated with MMP-9 (r =.416; p=.014); IL-10 (r = -.365; p =.034). BDNF was correlated with right hemisphere CA1 (r = -.417, p = .014), CA2 (r = -.497; p= .003) and CA3 (r = -.451; p=.007).
Conclusions:
In our sample of persons with MS, left hemisphere hippocampal subfield volumes were negatively correlated with inflammatory biomarkers, supporting previous reports linking inflammation to reduced brain volumes in other neurological conditions. In the right hemisphere, we found negative correlations between HIA and BDNF, suggesting a neuroprotective function for BDNF in this neurodegenerative disease. These findings in a representative sample of patients with MS highlight the need for further research exploring the relationship between HIA and systemic serum biomarkers in MS.
To investigate the relationship between systematic inflammatory biomarkers and cognition in patients with Multiple Sclerosis (MS).
Participants and Methods:
We recruited 36 patients diagnosed with MS (31 with relapsing-remitting and 5 with progressive) who presented for treatment at the University of Alabama at Birmingham (UAB). Patients underwent a comprehensive neuropsychological battery, and serum blood samples were collected. Cognitive data was divided into an overall Cognitive Composite score and seven cognitive domains (i.e., Attention, Verbal Memory, Visual Memory, Visuospatial Ability, Language, Processing Speed, and Executive Function) using z-score averages. Pearson's product-moment correlations were conducted to determine the relationship between cognitive performance and 14 inflammatory biomarkers specifically chosen for their potential role in MS.
Results:
Granulocyte Colony Stimulating Factor (G-CSF) was significantly correlated with Executive Function (r= -.355; p=.039) and Processing Speed (r= -.528; p= .001) scores. Additionally, Interleukin-10 (IL-10) was significantly correlated with Visual Memory (r= -.346; p= .041) scores. Finally, Tumor Necrosis Factor (TNF-a) was significantly correlated with Visual Memory (r= -.347; p= .041).
Conclusions:
Studies investigating associations between inflammation and cognition in MS are lacking. In our sample of persons with Multiple Sclerosis, G-CSF biomarkers were negatively correlated with Executive Function as well as Processing Speed. In addition, IL-10 and TNF-a biomarkers were negatively correlated with Visual Memory scores. These findings in a representative sample of patients with MS highlight the need for further research exploring the relationship between systematic inflammatory biomarkers and cognition in MS.
Disasters of all varieties have been steadily increasing in frequency. Simultaneously, “big data” has seen explosive growth as a tool in business and private industries while opportunities for robust implementation in disaster management remain nascent. To more explicitly ascertain the current status of big data as applied to disaster recovery, we conducted an integrative literature review.
Methods:
Eleven databases were searched using iteratively developed keywords to target big data in a disaster recovery context. All studies were dual-screened by title and abstract followed by dual full-text review to determine if they met inclusion criteria. Articles were included if they focused on big data in a disaster recovery setting and were published in the English-language peer-reviewed literature.
Results:
After removing duplicates, 25,417 articles were originally identified. Following dual title/abstract review and full-text review, 18 studies were included in the final analysis. Among those, 44% were United States-based and 39% focused on hurricane recovery. Qualitative themes emerged surrounding geographic information systems (GIS), social media, and mental health.
Conclusions:
Big data is an evolving tool for recovery from disasters. More research, particularly in real-time applied disaster recovery settings, is needed to further expand the knowledge base for future applications.
Many species of marine sponges on tropical reefs host abundant and diverse symbiont communities capable of varied metabolic pathways. While such communities may confer a nutritional benefit to some hosts (termed High Microbial Abundance (HMA) sponges), other sympatric species host only sparse symbiont communities (termed Low Microbial Abundance (LMA) sponges) and obtain a majority of their C and N from local sources. Sponge communities are widespread across large latitudinal gradients, however, and recent evidence suggests that these symbioses may also extend beyond the tropics. We investigated the role that symbionts play in the ecology of sponges from the temperate, hard-bottom reefs of Gray's Reef National Marine Sanctuary by calculating the niche size (as standard ellipse area (SEAc)) and assessing the relative placement of five HMA and four LMA sponge species within bivariate (δ13C and δ15N) isotopic space. Although photosymbiont abundance was low across most of these species, sponges were widespread across isotopic niche space, implying that microbial metabolism confers an ecological benefit to temperate sponges by expanding host metabolic capability. To examine how these associations vary across a latitudinal gradient, we also compared the relative placement of temperate and tropical conspecifics within isotopic space. Surprisingly, shifts in sponge δ13C and δ15N values between these regions suggest a reduced reliance on symbiont-derived nutrients in temperate sponges compared with their tropical conspecifics. Despite this, symbiotic sponges in temperate systems likely have a competitive advantage, allowing them to grow and compete for space within these habitats.
The incredible variety of galaxy shapes cannot be summarized by human defined discrete classes of shapes without causing a possibly large loss of information. Dictionary learning and sparse coding allow us to reduce the high dimensional space of shapes into a manageable low dimensional continuous vector space. Statistical inference can be done in the reduced space via probability distribution estimation and manifold estimation.
EarSketch is an all-in-one approach to supporting a holistic introductory course to computer music as an artistic pursuit and a research practice. Targeted to the high school and undergraduate levels, EarSketch enables students to acquire a strong foundation in electroacoustic composition, computer music research and computer science. It integrates a Python programming environment with a commercial digital audio workstation program (Cockos’ Reaper) to provide a unified environment within which students can use programmatic techniques in tandem with more traditional music production strategies to compose music. In this paper we discuss the context and goals of EarSketch, its design and implementation, and its use in a pilot summer camp for high school students.
As we have seen in earlier chapters, the concept ‘National System of Innovation’ may be used in two senses: in a broad sense it encompasses all institutions which affect the introduction and diffusion of new products, processes and systems in a national economy; and in a narrow sense it encompasses that set of institutions which are more directly concerned with scientific and technical activities. This book is mainly concerned with national systems in the broad sense and has stressed the importance of the interactions between the production system, the users and innovation. In this chapter, however, we focus more on the narrower set of formal institutions and attempt to outline some major stages in the evolution of these institutions.
Chapter 1 has pointed out that flexibility in the economy does not only derive from market institutions. This chapter shows that the capacity to adapt to major changes in technology has depended historically on the development of a network of scientific and technical institutions, both in the public and private sectors. Whereas chapter 7 has focused mainly on the role of the public sector as user of innovation, this chapter concentrates more on its role as producer.
In the early days of the industrial revolution contact between science and industry was certainly already important (Musson and Robinson, 1969) but it was largely on an individual basis and not on a systematic, continuous basis. Firms were very small and science was largely the province of individual enthusiasts, loosely linked in scientific societies and in national academies.
It seems probable that Schumpeter thought of ‘Business Cycles’, at least before publication, as his magnum opus. It was, of course, immediately recognized, at least in the United States, as a major contribution to business cycle theory and economic theory more generally, and was accorded a major review article by Kuznets (1940) in the American Economic Review. Yet, half a century later it cannot be said that Business Cycles occupies a place in the history of economic thought comparable to the major works of Marx, Keynes or Ricardo, or even other works of Schumpeter himself.
The ambitious scope of the book is evident from the full title: Business Cycles: A Theoretical, Historical and Statistical Analysis of the Capitalist Process and its two volumes, comprising more than a thousand pages, bear further witness to the magnitude of the enterprise. Schumpeter always regarded business cycles not as a sideline or a speciality, but as a major manifestation of his theory of economic development and growth in capitalist economies. Already in the Theory of Economic Development he included a chapter on business cycles that foreshadowed his later work. Moreover, although he greatly admired Marx's intellectual achievement and gave him credit for being one of the first theorists to recognize cycles and address these problems, he nevertheless chided Marx (Schumpeter 1943, 36–39) for supposedly failing to develop any systematic theoretical explanation of crises and for holding an eclectic view embracing many possible causes.
Action potentials were recorded from rat retinal ganglion cell fibers in the presence of a uniform field, and the maintained discharge pattern was characterized. Spike trains recorded under ketamine–xylazine anesthesia were generally stationary, while those recorded under urethane anesthesia often showed slow, undriven, quasiperiodic fluctuations in firing rate. In light of these nonstationarities, interspike interval distributions and power spectral densities are reported for data collected primarily under ketamine–xylazine. The majority of cells had multimodal interval distributions, with the first peak in the range of 25.0–38.5 ms and the subsequent peaks occurring at integer multiples of the first peak. Cells with unimodal distributions were fit well by a gamma distribution function. Interval and spike count statistics showed that ON cells tended to fire faster than OFF cells and that cells with higher rates fired in a more regular manner, with the coefficient of variation covering a wide range of values across all cells (0.43–0.97). Both ON and OFF cells show serial correlations between adjacent interspike intervals, while ON cells also showed second-order correlations. Cells with multimodal interval distribution showed a strong peak at high frequencies in the power spectra in the range of 28.9–41.4 Hz. Oscillations were present under both anesthetic conditions and persisted in the dark at a slightly lower frequency, implying that the oscillations are generated independent of any light stimulus but can be modulated by light level. The oscillation frequency varied slightly between cells of the same type and in the same eye, suggesting that multiple oscillatory generating mechanisms exist within the retina. Cells with high-frequency oscillations were described well by an integrate-and-fire model with the input consisting of Gaussian noise plus a sinusoid where the phase was jittered randomly to account for the bandwidth present in the oscillations.
The first use of electricity in resuscitation was described in 1774 by the Royal Humane Society in London for a near-drowned child. In the late nineteenth century, treatment of ventricular fibrillation was described in animals with the use of electricity. In 1947, successful termination of ventricular fibrillation was described using AC current in humans. In the 1960s, direct current cardioversion was described and this ultimately became the standard for modern-day cardioversion. Cardioversion techniques have been modified and developed during the past 50 years with different waveforms, amplitudes, and timing for delivering safe and effective cardioversion.
The ideal agents and methods to provide procedural sedation and analgesia (PSA) during the cardioversion procedure have been less well investigated. Few studies have evaluated the use of PSA in the emergency department (ED) for electrical cardioversion. Additionally, studies that have addressed this unique problem in the ED setting have been limited by small sample sizes. As a consequence, there is a large variation of clinical practice for PSA during ED cardioversion.
Despite a lack of a uniform approach to PSA during ED cardioversion, it is clear that electrical cardioversion as an ED-based procedure is becoming more commonplace. This is largely due to an aging population with elevated risk for arrhythmias.
The largest cohort of ED patients with stable arrhythmias that are candidates for cardioversion is the new-onset atrial fibrillation and flutter group. Atrial fibrillation is the most common arrhythmia seen in the ED and afflicts approximately 0.4% of the population.
It is now almost 10 yr since radiocarbon dating of cremated bone was first developed using the small carbonate component contained within the hydroxyapatite-based inorganic fraction. Currently, a significant number of 14C laboratories date cremated bone as part of their routine dating service. As a general investigation of cremated bone dating since this initial development, a small, cremated bone intercomparison study took place in 2005, involving 6 laboratories. Six cremated bone samples (including 2 sets of duplicates), with ages spanning approximately 1500–2800 BP, were sent to the laboratories. The results, which showed relatively good agreement amongst the laboratories and between the duplicate samples, are discussed in detail.
The tensile strengths of Nextel™ 720 fibers as well as tows and minicomposites made of these fibers were measured to study the effects of monazite coating at room temperature (RT) and 1200°C (HT). Tests were conducted on as-received materials (called unsoaked) as well as materials that had been thermally soaked at HT for 100 hours. Weibull analysis of fiber strength data shows close agreement between the Weibull modulus obtained from the statistical fracture distribution and the modulus obtained from a study of the gage length dependence of strength. The monazite coating does not change the RT strength of unsoaked single fibers, but has a beneficial effect in terms of strength retention under HT testing. This beneficial effect of the coating disappears for soaked samples. The results for tows and minicomposites also indicate that for the unsoaked condition, tensile failure appears to be driven by fiber surface flaws and the presence of the monazite coatings clearly improves both RT and HT strength of fibers, tows and minicomposites. However, the beneficial effects of the coating disappear after long term exposure to HT.
Little is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care in the UK.
Method
Patients meeting criteria for DSM–III major depressive disorder were randomly allocated to one of four treatments each lasting 16 weeks, then followed up for 18 months. Assessments were made of depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks.
Results
The prevalence of personality disorder (PD) in the sample of 113 patients was 26%. Patients with a PD were significantly younger and rated more depressed at entry than patients with no personality disorder (NoPD). On completion of treatment patients with a PD were significantly more depressed and had poorer social functioning than the NoPD group. After 18 months there were no differences in ratings of depression or social functioning between the groups.
Conclusions
There was substantial improvement in both the PD and NoPD groups. The presence of personality pathology delays recovery from major depressive illness.
Clinicians who deal with patients with anorexia nervosa are well acquainted with their patients' inability to recognise their emaciation. The patients' insistence that they are normal weight or even overweight, against clear evidence to the contrary, led Bruch (1962) to state that the misperception reaches “delusional proportions”. Studies of body size perception in anorexia nervosa that have used the ‘body part’ method have invariably found that the patients overestimate their body size (Slade & Russell, 1973; Crisp & Kalucy, 1974; Pierloot & Houben, 1978; Garner et al, 1976; Button et al, 1977; Fries, 1977; Casper et al, 1979) but the majority have not found any significant difference in size estimation between patients and controls (Slade, 1985).