We present three cases of epidural abscess, all in patients in whom an epidural catheter had been inserted for postoperative pain management. In all three cases the infecting organism was ...Staphylococcus aureus and two patients had diabetes. The diagnosis was made within 3 days of epidural catheter removal in two cases, but in one the abscess did not present until after the patient had been discharged from hospital. We have retrospectively calculated the incidence of epidural abscess in our hospital over the 5‐yr period 1993–98 to be 1 in 800 (0.12%). We emphasize the importance of using techniques that minimize the risk of bacterial contamination during both catheter placement and the management of infusion, and seek to raise awareness of this relatively rare but significant condition. Br J Anaesth 2002; 89: 778–82
The Minimal Gene Complement of Mycoplasma genitalium Fraser, Claire M.; Gocayne, Jeannine D.; White, Owen ...
Science (American Association for the Advancement of Science),
10/1995, Letnik:
270, Številka:
5235
Journal Article
Recenzirano
The complete nucleotide sequence (580,070 base pairs) of the Mycoplasma genitalium genome, the smallest known genome of any free-living organism, has been determined by whole-genome random sequencing ...and assembly. A total of only 470 predicted coding regions were identified that include genes required for DNA replication, transcription and translation, DNA repair, cellular transport, and energy metabolism. Comparison of this genome to that of Haemophilus influenzae suggests that differences in genome content are reflected as profound differences in physiology and metabolic capacity between these two organisms.
Atomistic models based on quantum-chemical calculations are combined with time-resolved spectroscopic investigations to explore the migration of electronic excitations along ...oligophenylenevinylene-based chiral stacks. It is found that the usual Pauli master equation (PME) approach relying on uncoherent transport between individual chromophores underestimates the excitation diffusion dynamics, monitored here by the time decay of the transient polarization anisotropy. A better agreement to experiment is achieved when accounting for excitation delocalization among acceptor molecules, as implemented in a modified version of the PME model. The same models are applied to study light harvesting and trapping in guest−host systems built from oligomers of different lengths.
Negotiating a resource package as a potential new department chair is common practice in academic medicine. The foundations for this negotiation include the historical presence of the department in ...relation to the broader institution, projections for future growth, accounting for mission/vision, resource needs (space, personnel, finances, etc), faculty and staff development, and external partnerships within and outside the institution. Despite similarities in this process across departments, many nuances influence the development of a specific new chair package, such as, department size; desires, perspectives and talents of the incoming chair, the department faculty, the medical school and dean; prevailing agendas and mission imperatives; and the overall priorities of the institution. With strategy and forethought, a new chair package can promote a successful chair tenure and departmental growth. Assembled through the Association of Departments of Family Medicine with input from several dozen department chairs and senior leaders, this is intended to serve as a practical guide to new chair packages for chair candidates.
Introduction
In settings where both daily and event‐driven pre‐exposure prophylaxis (PrEP) are offered to men who have sex with men (MSM), a clear understanding of the motives to choose between the ...different dosing‐regimens can facilitate more effective PrEP implementation. We therefore studied the motives for choosing for, switching between, and stopping daily or event‐driven PrEP.
Methods
We used data (August 2015‐June 2017) from the prospective, longitudinal, open‐label Amsterdam PrEP demonstration study, in which daily (dPrEP) and event‐driven PrEP (edPrEP) were offered to 374 HIV‐negative MSM and two transgender persons. Participants self‐selected the preferred PrEP‐regimen at baseline and could switch regimens at three‐monthly follow‐up visits. We measured motives for choosing PrEP‐regimen at baseline and for switching and stopping PrEP at follow‐up visits. Open‐ and closed‐end items were combined and qualitatively analysed.
Results
Choices of PrEP‐regimens were determined by personal and contextual factors, involving the perceived self‐efficacy concerning adherence, the risk‐context, and the anticipated impact of PrEP on physical and sexual wellbeing. dPrEP was preferred because of the anticipated better adherence and the fear of side‐effects relating to edPrEP re‐initiations. Moreover, dPrEP was perceived to be more effective than edPrEP. Motives to choose edPrEP were the expected physical burden of dPrEP, anticipated side‐effects of dPrEP, and fear to forget daily doses. Regarding the risk‐context: dPrEP was preferred for unplanned and/or frequent sex, while edPrEP was chosen when risk was predictable and/or less frequent. While some chose for dPrEP to gain more sexual freedom, others chose for edPrEP to minimize sexual risk episodes. Changes in the above factors, such as changing risk patterns, changing relationships or changing physical conditions, resulted in switching regimens. Choices to stop PrEP were related to lower sexual risk, adherence issues and side‐effects.
Conclusions
The great diversity of motives illustrates the importance of offering a choice of PrEP‐regimens. In counselling of MSM starting PrEP, choices for PrEP‐regimens may be addressed as a continuum of flexible and changeable options over time. This may help individuals choose the PrEP‐regimen that best fits their current sexual context, priorities and personal capabilities and therefore will be more easily adhered to.
Western Australia July to December 2017 Phillips, Harry C.J.; Kerr, Liz
The Australian journal of politics and history,
June 2018, 2018-06-00, 20180601, Letnik:
64, Številka:
2
Journal Article
Western Australia July to December 2018 Phillips, Harry C.J.; Kerr, Liz
The Australian journal of politics and history,
June 2019, 2019-06-00, 20190601, Letnik:
65, Številka:
2
Journal Article
Abstract
We report the discovery of an enigmatic large-amplitude (
mag) transient event in near-IR data obtained by the VISTA Variables in the Via Lactea (VVV) ESO Public Survey. The object ...(designated VVV-WIT-06) is located at R.A. = 17:07:18.917, decl. = −39:06:26.45 (J2000), corresponding to Galactic coordinates
l
= 347.14539,
b
= 0.88522. It exhibits a clear eruption, peaking at
Ks
= 9 mag during 2013 July and fading to
in 2017. Our late near-IR spectra show post-outburst emission lines, including some broad emission lines (upward of
km s
−1
). We estimate a total extinction of
mag in the surrounding field, and no progenitor was observed in
ZYJHKs
images obtained during 2010–2012 (down to
mag). Subsequent deep near-IR imaging and spectroscopy, in concert with the available multiband photometry, indicate that VVV-WIT-06 may be either: (i) the closest Type I SN observed in about 400 years, (ii) an exotic high-amplitude nova that would extend the known realm of such objects, or (iii) a stellar merger. In all of these cases, VVV-WIT-06 is a fascinating and curious astrophysical target under any of the scenarios considered.
Despite the widely recognized incidence of homoplasy characterizing this region, the hypervariable region I (HVRI) of the mitochondrial control region is one of the most frequently used genetic ...markers for population genetic and phylogeographic studies. We present an evolutionary analysis of HVRI and cytochrome b sequences from a range‐wide survey of 1031 Steller sea lions, Eumetopias jubatus, to quantify homoplasy and substitution rate at HVRI. Variation in HVRI was distributed across 41 variable sites in the 238‐bp segment examined. All variants at HVR1 were found to be transitions. However, our analyses suggest that a minimum of 101 changes have actually occurred within HVRI with as many as 18 substitutions occurring at a single site. By including this hidden variation into our analyses, several instances of apparent long‐range dispersal were resolved to be homoplasies and 8.5–12% of observed HVRI haplotypes were found to have geographic distributions descriptive of convergent molecular evolution rather than identity by descent. We estimate the rate of substitution at HVRI in Steller sea lions to be ∼24 times that of cytochrome b with an absolute rate of HVRI substitution estimated at 27.45% per million years. These findings have direct implications regarding the utility of HVRI data to generate a variety of evolutionary genetic hypotheses.
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