Background. Whether echinocandins could be used to treat candidemia of a urinary tract source (CUTS) is unknown. We aimed to provide current epidemiological information of CUTS and to compare ...echinocandin to fluconazole treatment on CUTS outcomes. Methods. A multicenter study of adult patients with candidemia was conducted in 9 hospitals. CUTS was defined as a candidemia with concomitant candiduria by the same organism associated with significant urological comorbidity. The primary outcome assessed was clinical failure (defined by 7-day mortality or persistent candidemia) in patients treated with either an echinocandin or fluconazole. A propensity score was calculated and then entered into a regression model. Results. Of 2176 episodes of candidemia, 128 were CUTS (5.88%). Most CUTS cases were caused by Candida albicans (52.7%), followed by Candida glabrata (25.6%) and Candida tropicalis (16.3%). Clinical failure occurred in 7 patients (20%) treated with an echinocandin and in 15 (17.1%) treated with fluconazole (P = .730). Acute renal failure (adjusted odds ratio AOR, 3.01; 95% confidence interval CI, 1.01–8.91; P = .047) was the only independent factor associated with clinical failure, whereas early urinary tract drainage procedures (surgical, percutaneous, or endoscopic) were identified as protective (AOR, 0.08; 95% CI, .02–.31; P < .001). Neither univariate nor multivariate analysis showed that echinocandin therapy altered the risk of clinical failure. Conclusions. Initial echinocandin therapy was not associated with clinical failure in patients with CUTS. Notably, acute renal failure predicted worse outcomes and performing an early urologic procedure was a protective measure.
Quantifying space use and segregation, as well as the extrinsic and intrinsic factors affecting them, is crucial to increase our knowledge of species-specific movement ecology and to design effective ...management and conservation measures. This is particularly relevant in the case of species that are highly mobile and dependent on sparse and unpredictable trophic resources, such as vultures. Here, we used the GPS-tagged data of 127 adult Griffon Vultures
captured at five different breeding regions in Spain to describe the movement patterns (home-range size and fidelity, and monthly cumulative distance). We also examined how individual sex, season, and breeding region determined the cumulative distance traveled and the size and overlap between consecutive monthly home-ranges. Overall, Griffon Vultures exhibited very large annual home-range sizes of 5027 ± 2123 km
, mean monthly cumulative distances of 1776 ± 1497 km, and showed a monthly home-range fidelity of 67.8 ± 25.5%. However, individuals from northern breeding regions showed smaller home-ranges and traveled shorter monthly distances than those from southern ones. In all cases, home-ranges were larger in spring and summer than in winter and autumn, which could be related to difference in flying conditions and food requirements associated with reproduction. Moreover, females showed larger home-ranges and less monthly fidelity than males, indicating that the latter tended to use the similar areas throughout the year. Overall, our results indicate that both extrinsic and intrinsic factors modulate the home-range of the Griffon Vulture and that spatial segregation depends on sex and season at the individual level, without relevant differences between breeding regions in individual site fidelity. These results have important implications for conservation, such as identifying key threat factors necessary to improve management actions and policy decisions.
Objective To describe the times associated with the morphological changes that occur in the embryo during preimplantation development based on the largest sample size described with time lapse. ...Design Cohort study. Setting University-affiliated private center. Patient(s) A total of 9,530 embryos from 1,806 intracytoplasmic sperm injection (ICSI) cycles. Intervention(s) None. Main Outcome Measure(s) Using a time-lapse system, embryo images were acquired for at least 68 hours, in some cases reaching 120–130 hours. Embryo cleavage time points up to 8-cell-stage (t2–t8) as well as morulae (tM) and blastocyst formation (tB) were registered in hours after ICSI. Additionally, duration of the cell cycle (cc) and synchrony (s) of the second and third cell cycles were defined. Finally, four subgroups of embryos were considered: the “regular divisions” group excluded embryos with a direct cleavage from 1 to 3 or 2 to 5 cells, and the “viable 8-cell,” the “viable blastocyst,” and “implanted embryos” groups included only embryos viable to the 8-cell stage, blastocyst stage, or transferred and successfully implanted, respectively. Result(s) Averages of times in the general population were: t2 = 27.9 hours, t3 = 38.2 hours, t4 = 40.7 hours, t5 = 51.0 hours, t6 = 54.1 hours, t7 = 56.7 hours, t8 = 59.1 hours, tM = 86.6 hours, tB = 104.1 hours, cc2 = 10.3 hours, cc3 = 12.8 hours, s2 = 2.7 hours, and s3 = 9.9 hours. Comparison between groups showed significant differences between regular divisions and viable 8 cells for t2, t3, t5, cc2, cc3, s2, and s3; between 8 cells and blastocyst for t5, t8, tM, cc3, and s2; and between blastocyst and implanted embryos for t8, tM, tB, and s2. Differences in timing related to morphology of cleavage- and blastocyst-stage embryos were detected. Conclusion(s) A time-lapse monitoring system applied to embryology allows accuracy and objectivity when defining the basis of embryo development within a clinic. The sample size is the largest ever described that provides consistent information about the normal distribution of embryo developmental timings.
•Effectiveness of maternal pertussis vaccination (VE) is 88.0%.•Pertussis vaccination in pregnancy is very effective.•Vaccination before and after the 32nd week of pregnancy are equally effective.
...The objective was to estimate the effectiveness of maternal pertussis vaccination in protecting infants aged < 2 months.
We performed a case-control study. Laboratory-confirmed cases aged <8 weeks at disease onset were identified and 2–4 matched-controls born within ± 15 days of the case were included. Information was obtained from healthcare providers and maternal interviews. Odds ratios (OR) were calculated using multivariable conditional logistic regression. Vaccine effectiveness (VE) was estimated as (1 – OR) × 100%.
47 cases and 124 controls were studied. The mean age (in days) (39.8 ± 12.7 vs. 40.8 ± 13.2), weeks of gestation (38.8 vs. 39.1, p = 0.43) and mean birth weight (3.309 vs. 3.253 kg, p = 0.55) were comparable between cases and controls. Mothers of cases were less frequently vaccinated in the third trimester (59.6% vs. 83.9%, p <0.001). The VE of maternal vaccination in pregnancy was 88.0% (95%CI 53.8% -96.5%), and was slightly higher in those vaccinated before the 32nd week of gestation (88.5% vs 87.8%).
Pertussis vaccination in pregnancy is very effective in reducing pertussis in children aged < 2 months. Vaccination before and after the 32nd week of pregnancy are equally effective in reducing the risk of pertussis.
Objective To evaluate the usefulness of preimplantation genetic screening (PGS) using fluorescence in situ hybridization (FISH) for two different indications: repetitive implantation failure (RIF) ...and advanced maternal age (AMA). Design Two prospective, randomized controlled trials with patients allocated in two arms: blastocyst transfer on day 5 (group A) or PGS with transfer on day 5 (group B). Setting University-affiliated private clinics. Patient(s) The RIF study included women <40 years with three or more failed IVF cycles without other known causal factors (91 patients). The AMA study included intracytoplasmic sperm injection patients aged between 41 and 44 (183 patients). Intervention(s) In the PGS group, single-cell day 3 biopsy was performed with aneuploidy screening for chromosomes 13, 15, 16, 17, 18, 21, 22, X, and Y. In both the blastocyst transfer group and the PGS group, ET was performed on day 5. Main Outcome Measure(s) Live-birth rate per patient and per started cycle. Result(s) A significant increase in live-birth rates per patient was found in the PGS group compared with the blastocyst group for the AMA study (30/93 patients 32.3% vs. 14/90 patients 15.5%; odds ratio, 2.585; confidence interval, 1.262–5.295). In the RIF study no significant differences were observed (23/48 patients 47.9% vs. 12/43 patients 27.9%). Conclusion(s) PGS with FISH was shown to be beneficial for the AMA group.
This paper describes the study of two Nasrid polychrome wooden ceilings from the Alhambra monumental ensemble using vibrational spectroscopic techniques. The study is focused on the identification of ...the constituent materials and execution techniques used employing non‐invasive and non‐destructive scientific investigation methods. Information about both inorganic (pigments) and organic (binders and coatings) materials has been obtained without the need for time‐consuming procedures. A complex stratigraphy involving the use of a protective priming layer of red lead covered with animal glue and white lead was revealed. The identification of Raman signatures of different lead oxide compounds, including lead‐tin oxide (Pb2SnO4), in the priming layer, allowed us to hypothesize the synthesis of red lead (Pb3O4) from litharge (α‐PbO), a common by‐product of the cupellation process used since antiquity for silver production. Furthermore, the pigments employed in hidden drawings found in the reverse of the wood pieces of one of the ceilings were also studied and compared with those found in the visible external face.
The characterization of two typical polychrome wood ceilings (alfarje) of the Alhambra monumental ensemble has been carried out employing non‐destructive analytical techniques. An elaborated painting technique has been found. Lead speciation in the priming layer revealed an alternative synthesis process of red lead from litharge.
A 3D-printed phased array consisting of four H-Sectorial horn antennas of 200 g weight with an ultra-wideband rectangular-waveguide-to-microstrip-line transition operating over the whole LMDS and K ...bands (24.25–29.5 GHz) is presented. The transition is based on exciting three overlapped transversal patches that radiate into the waveguide. The transition provides very low insertion losses, ranging from 0.30 dB to 0.67 dB over the whole band of operation (23.5–30.4 GHz). The measured fractional bandwidth of the phased array including the transition was 20.8% (24.75–30.3 GHz). The antenna was measured for six different scanning angles corresponding to six different progressive phases α, ranging from 0° to 140° at the central frequency band of operation of 26.5 GHz. The maximum gain was found in the broadside direction α = 0°, with 15.2 dB and efficiency η = 78.5%, while the minimum was found for α = 140°, with 13.7 dB and η = 91.2%.
The quality of the coffee beverage is related to the chemical, physical, and sensory attributes of the coffee beans that vary with the geographic location of the crop, genetic factors, and ...post‐harvest processing. So, the objective of this study was to evaluate the genetic divergence of 27 genotypes of Coffea canephora using the volatile compounds and sensory attributes profile to select genotypes that produce a coffee beverage with high sensory quality. This genetic diversity was estimated from the Euclidean distance matrix using non‐standard data and the Unweighted Pair‐Group Method Using Arithmetic Averages (UPGMA). The 2‐furyl‐methanol, 4‐ethenyl‐2‐methoxyphenol, furfural, 5‐methylfurfural, methylpyrazine, and 2,6‐dimethylpyrazine were predominating volatile compounds in the genotypes. The sensory attributes had a positive Pearson's correlation with the total score. The volatile compounds had a different relative contribution to the genetic divergence between the genotypes of C. canephora. The 4‐ethenyl‐2‐methoxyphenol, 2‐furyl‐methanol, and furfural were volatile compounds that most contributed to the formation of the groups in the UPGMA dendrogram. The relative contribution of sensory attributes to dissimilarity among genotypes was 6.42% to 20.20%. Therefore, this study verified the relative contribution of volatile compounds, in specially 4‐ethenyl‐2‐methoxyphenol, 2‐furyl‐methanol, and furfural, and sensory attributes (flavor, mouthfeel, and bitterness/sweetness) to the genetic divergence between the genotypes of the three clonal varieties. Thus, this work points out compounds that positively contribute to the sensory quality of the Conilon coffee beverage.
The spectrum of COVID-19 infection includes acute respiratory distress syndrome (ARDS) and macrophage activation syndrome (MAS), although the histological basis for these disorders has not been ...thoroughly explored. Post-mortem pulmonary and bone marrow biopsies were performed in 33 patients. Samples were studied with a combination of morphological and immunohistochemical techniques. Bone marrow studies were also performed in three living patients. Bone marrow post-mortem studies showed striking lesions of histiocytic hyperplasia with hemophagocytosis (HHH) in most (16/17) cases. This was also observed in three alive patients, where it mimicked the changes observed in hemophagocytic histiocytosis. Pulmonary changes included a combination of diffuse alveolar damage with fibrinous microthrombi predominantly involving small vessels, in particular the alveolar capillary. These findings were associated with the analytical and clinical symptoms, which helps us understand the respiratory insufficiency and reveal the histological substrate for the macrophage activation syndrome-like exhibited by these patients. Our results confirm that COVID-19 infection triggers a systemic immune-inflammatory disease and allow specific therapies to be proposed.
The power of death Blanco, Maria-Jose; Vidal, Ricarda
2014., 20141015, 2014, 2014-10-01
eBook
The social and cultural changes of the last century have transformed death from an everyday fact to something hidden from view. Shifting between the practical and the theoretical, the professional ...and the intimate, the real and the fictitious, this collection of essays explores the continued power of death over our lives. It examines the idea and experience of death from an interdisciplinary perspective, including studies of changing burial customs throughout Europe; an account of a"dying party" in the Netherlands; examinations of the fascination with violent death in crime fiction and the phenomenon of serial killer art; analyses of death and bereavement in poetry, fiction, and autobiography; and a look at audience reactions to depictions of death on screen. By studying and considering how death is thought about in the contemporary era, we might restore the natural place it has in our lives.
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