Culture of percutaneous central venous line (PCVL) segments may assist the diagnosis of line colonisation and catheter-related sepsis (CRS). The authors aimed to determine if the diagnosis of CRS and ...colonisation of PCVLs in neonates is improved by the culture of the proximal and middle segments of the line in addition to the tip.
In a prospective study, proximal, middle and tip segments of PCVLs indwelling for more than 24 h in term and preterm infants were sent for culture at line removal. Definite CRS was considered as a positive peripheral blood culture plus any line segment growing the same organism in an infant with clinical signs of sepsis.
189 lines were removed from 143 neonates: 142 (75%) were from well infants and 47 (25%) were from neonates with suspected clinical sepsis. The overall CRS rate was 7.9% (15 of 189 line episodes). In well infants, bacterial colonisation rates were significantly higher for proximal segments than for tips (p=0.004). Comparative rates of segmental culture positivity and their positive predictive values for definite CRS were similar for all segments. The diagnosis of CRS was not improved beyond a sole line tip culture by additional middle or proximal segmental cultures or by combinations of the three segments.
In well infants, the proximal segments of PCVLs were more often colonised than line tips, but in clinically septic infants preferential culture of proximal or middle segments or combinations of the three segments did not permit better prediction of definite CRS than the culture of the line tip alone. Further studies prior to antibiotic therapy are indicated in babies with suspected CRS.
To compare the efficacy and safety of volume-controlled (VC) ventilation to time-cycled pressure-limited (TCPL) ventilation in very low birth weight infants with respiratory distress syndrome (RDS).
...Newborns weighing between 600 and 1500 g and with a gestational age of 24 to 31 weeks who had RDS were randomized to receive either VC or TCPL ventilation and treated with a standardized protocol. The 2 modalities were compared by determining the time required to achieve a predetermined success criterion, on the basis of either the alveolar-arterial oxygen gradient <100 mm Hg or the mean airway pressure <8 cm H
2O. Secondary outcomes included mortality, duration of mechanical ventilation, and complications commonly associated with ventilation.
The mean time to reach the success criterion was 23 hours in the VC group versus 33 hours in the TCPL group (
P = .15). This difference was more striking in babies weighing <1000g (21 versus 58 hours;
P = .03). Mean duration of ventilation with VC was 255 hours versus 327 hours with TCPL (
P = .60). There were 5 deaths in the VC group and 10 deaths in the TCPL group (
P = .10). The incidence of other complications was similar.
VC ventilation is safe and efficacious in very low birth weight infants and may have advantages when compared with TCPL, especially in smaller infants.
In most Canadian jurisdictions, high school athletics are still governed by outdated and sexist views about participation. The author argues that the current approach is discriminatory and violates ...human rights laws. In addition, a careful analysis of the jurisprudence reveals a host of specious arguments that keeps athletically talented female athletes from competing with the males. A more progressive response to the current situation is required that embraces an ethic of inclusion and excellence.
In most Canadian jurisdictions, high school athletics are still governed by outdated and sexist views about participation. The author argues that the current approach is discriminatory and violates ...human rights laws. In addition, a careful analysis of the jurisprudence reveals a host of specious arguments that keeps athletically talented female athletes from competing with the males. A more progressive response to the current situation is required that embraces an ethic of inclusion and excellence.
It was more than a decade ago that I first explored the notion of a "learning community". Whilst the overall goal remains the same, there are now important new ecological insights that can be added ...to our earlier understanding, which heighten the urgency for a more radical consideration of learning community to ensure that practice is both educationally sound and ecologically sustainable within such a community. This paper serves as reference to some of this new thinking. To provide a context, it will refer to the earlier work and indicate the limitations and breakthroughs of the earlier work which, with the benefit of retrospect, have become apparent. The paper is structured around four themes that I continue to draw upon as the basis of my own learning--themes of practicalities, guidance, radicalism and transition. The paper concludes with the first formulation of a framework for sustainable learning community based upon these and earlier observations and insights. (Contains 3 figures, 3 tables, and 2 notes.)
Recent years have witnessed a deliberate effort in literary studies to expand temporal possibilities beyond traditional narratives of linear and continuous time. The thesis is positioned alongside ...such studies by exploring how the inherent queerness of time is revealed in the material forms of books. Although notions of queer temporalities have often been problematized through the human body, rarely have these same questions been extended in explicit terms to the body of the book. Yet as objects that repeatedly travel through space and time, at fluctuating speeds and rhythms, books are ideal carriers of such nonmodern temporalities.The thesis takes a discrete selection of editions of the medieval author Giovanni Boccaccio (1313-75) as the subject of inquiry, in different media formats. His texts were copied, edited, and re-made very extensively in the early modern period, and in this way, he emerges as a paradigmatic case study for material approaches to literary studies. The thesis develops a model that deliberately fuses together the literary and the material by framing each chapter through an analysis of time and materiality in the works of Boccaccio. In this way, it is possible to consider some of his lesser-studied, Latin works (De montibus; De Canaria; and Testamentum) alongside his more widely studied, vernacular corpus (Elegia di madonna Fiammetta and Filocolo).The discrete analysis of the material artefacts of Boccaccio is framed as a story of increasing scale. In practice, this means that the thesis begins with the composition of two of his works in manuscript and moves in the subsequent chapters to look at progressively larger collections and subsets of objects. A range of material forms is analyzed, including his autograph manuscripts, examples of fifteenth- and sixteenth-century print production, and instances of photographic reproduction. By interrogating literary systems at scale, beginning with the medieval author working at his desk and culminating with a digital, bibliographic universe, the thesis aims to provide a model for the ways in which a single, iconic author can be read in different materially-inflected ways. In what remains a conservative and often under-theorized field, this approach not only increases our knowledge and understanding of a major world author, but also develops a new paradigm for the study of early modern book production.
Ran GTPase has multiple functions during the cell division cycle, including nucleocytoplasmic transport, mitotic spindle assembly and nuclear envelope formation. The activity of Ran is determined by ...both its guanine nucleotide-bound state and its subcellular localization.
Here, we have characterised the localisation and mobility of Ran coupled to green fluorescent protein (GFP) during the cell cycle in live human cells. Ran-GFP is nuclear during interphase and is dispersed throughout the cell during mitosis. GFP-RanQ69L, a mutant locked in the GTP-bound state, is less highly concentrated in the nucleus and associates with nuclear pore complexes within the nuclear envelope. During mitosis, GFP-RanQ69L is excluded from chromosomes and localizes to the spindle. By contrast, GFP-RanT24N, a mutant with low affinity for nucleotides, interacts relatively stably with chromatin throughout the cell cycle and is highly concentrated on mitotic chromosomes.
These results show that Ran interacts dynamically with chromatin, nuclear pore complexes and the mitotic spindle during the cell cycle. These interactions are dependent on the nucleotide-bound state of the protein. Our data indicate that Ran-GTP generated at chromatin is highly mobile and interacts dynamically with distal structures that are involved in nuclear transport and mitotic spindle assembly.
Ran is a small GTPase that has been implicated in a variety of nuclear processes, including the maintainance of nuclear structure, protein import, mRNA processing and export, and cell cycle ...regulation. There has been significant progress in determining the role of Ran in nuclear protein import. However, it has been unclear whether this role is sufficient to account for the diverse effects of disrupting Ran functions. Recently, several proteins have been identified that bind specifically to Ran and are, therefore, possible effectors. Other experiments using dominant mutants of Ran that block its GTP/GDP cycle have suggested that Ran may have multiple roles. Here, these results are summarised and discussed with respect to the action of Ran.
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