Escherichia coli is the leading pathogen of community-acquired urinary tract infections. Gepotidacin is a novel, bactericidal, first-in-class triazaacenaphthylene oral antibiotic that inhibits ...bacterial DNA replication by a distinct mechanism of action that confers activity against most strains of target pathogens, such as E. coli, Staphylococcus saprophyticus and Neisseria gonorrhoeae, including those resistant to other antibiotics.
This study assessed the in vitro activity of gepotidacin in comparison with ciprofloxacin and other oral standard-of-care antibiotics using a large collection of urine isolates of E. coli obtained from outpatients in Germany.
Four hundred and sixty E. coli collected from 23 laboratories during a surveillance study in 2019/2020 were tested. Forty-six isolates (10.0%) produced an ESBL of the CTX-M family, half of which belonged to MDR clonal subgroups of E. coli ST131. Antibiotic susceptibilities were tested at a reference laboratory by broth microdilution according to the standard ISO 20776-1.
Fifty-three (11.5%) isolates were ciprofloxacin resistant, 25 (47.2%) of which also produced an ESBL. Overall, MIC50/90 values for gepotidacin were 2/4 mg/L (MIC range 0.125-16 mg/L), with no differences in activity between ciprofloxacin-susceptible and ciprofloxacin-resistant isolates, ESBL-producing and non-ESBL isolates, O25b-ST131 isolates, and isolates susceptible or resistant to fosfomycin, mecillinam or nitrofurantoin.
Gepotidacin showed promising in vitro activity against urine isolates of E. coli, including ciprofloxacin-resistant isolates, ESBL-producing isolates and isolates resistant to oral standard-of-care antibiotics.
Flow under variable-density conditions is widespread, occurring in geothermal reservoirs, at waste disposal sites or due to saltwater intrusion. The migration of dense plumes typically results in the ...formation of vertical plume fingers which are known to be triggered by material heterogeneity or by variations in source concentration that causes the density variation. Using a numerical groundwater model, six perturbation methods are tested under saturated and unsaturated flow conditions to mimic heterogeneity and concentration variations on the pore scale in order to realistically generate dense fingers. A laboratory-scale sand tank experiment is numerically simulated, and the perturbation methods are evaluated by comparing plume fingers obtained from the laboratory experiment with numerically simulated fingers. Dense plume fingering for saturated flow can best be reproduced with a spatially random, time-constant perturbation of the solute source. For unsaturated flow, a spatially and temporally random noise of solute concentration or a random conductivity field adequately simulate plume fingering.
•We numerically simulate variable-density flow in a lab-scale sand tank experiment.•We introduce pore-scale heterogeneity by small perturbations in the numerical model.•Existing and new perturbation mechanisms are applied to variable-density flow.•Quality of results is evaluated by comparison with those from a physical experiment.•Application of perturbation mechanisms improved results of the numerical model.
Congenital cytomegalovirus infection (cCMV) may lead to symptoms at birth and long-term consequences. We present a nationwide, retrospective cohort study on the outcome of cCMV up to age 6 years. For ...this study we identified cCMV, using polymerase chain reaction, by analysing dried blood spots, which are taken shortly after birth for neonatal screening. The group of children with cCMV were compared to a group of children who were cCMV negative at birth. Data were collected about their health and development up to age 6 years. Parents of 73 693 children were invited to participate, and 32 486 (44·1%) gave informed consent for testing of their child's dried blood spot for CMV. Of the 31 484 dried blood spots tested, 156 (0·5%) were positive for cCMV. Of these, four (2·6%) children had been diagnosed with cCMV prior to this study. This unique retrospective nationwide study permits the estimation of long-term sequelae of cCMV up to the age of 6 years. The birth prevalence of cCMV in this study was 0·5%, which is in line with prior estimates. Most (97·4%) children with cCMV had not been diagnosed earlier, indicating under-diagnosis of cCMV.
Aim
A small percentage of complicated infantile haemangiomas need early, safe and effective treatment, and the option of off‐label systemic propranolol treatment has been in existence since 2008. The ...aim of this study was to provide greater insight into the drug's efficacy and side effects.
Methods
We report our retrospective experiences of 207 paediatric patients treated with systemic propranolol for complicated infantile haemangiomas, which were photographed and analysed with a specific haemangioma score.
Results
Systemic treatment was successful in 99.5% of the patients. The haemangioma score before treatment was 8.3 ± 3.3 and the score at the end of the treatment was 1.5 ± 1.4. The reduction in the haemangiomas was significant and did not show any differences when distributed according to different localisations or to the patients' ages. Relevant side effects that may have made it necessary to discontinue the treatment were not observed. However, there was a statistically significant reduction in heart rate during the first six in‐hospital drug applications.
Conclusion
Our study demonstrates that systemic propranolol treatment is a highly effective treatment that is nearly always safe. These findings are a milestone for particularly complicated haemangiomas and provide highly valuable information on this drug treatment.
Aortenklappe in Bewegung Cremer, J.
Zeitschrift für Herz-, Thorax- und Gefässchirurgie,
6/2013, Volume:
27, Issue:
3
Journal Article
Open access
Die enorm hohe Eingriffszahl von mehr als 9000 Transkatheter-Aortenklappenimplantationen („transcatheter aortic valve implantation“, TAVI) 2012 in Deutschland hat eine lebhafte Diskussion zur ...wissenschaftlichen Evidenzlage der Ergebnisse von katheterbasierten Prozeduren im Vergleich zum konventionellen herzchirurgischen Aortenklappenersatz angestoßen. Sie dürfen dabei nicht erwarten, dass die aufgezeigte Diskussion sich gleichermaßen in der detaillierten interdisziplinären Leitlinie der European Association of Cardiothoracic Surgery und der European Society of Cardiology in dieser Form wiederfinden, weder im Volltext noch in der „pocket guideline“. Die ersten Analysen zur „In-hospital“-Letalität (Annual Meeting of the European Society of Cardiology 2012) und zum Einjahres-Outcome (Annual Meeting of the American College of Cardiology 2013) sind präsentiert und zur Publikation eingereicht.
While overall opioid prescribing has been decreasing in the United States, the rates of prescribing at the county level have been variable. Previous studies show that social determinants of health ...(the social and economic conditions in which we live) may play a role in opioid prescribing; however, researchers have not examined this relationship across US counties. This cross-sectional study seeks to determine whether county-level sociodemographic characteristics (e.g., economic, housing, social environment, healthcare environment, and population characteristics) are associated with county level differences in opioid dispensing.
Data from 2,881 counties in the United States from 2017 to 2018 were used for this study. Opioid dispensing was measured using morphine milligram equivalents (MME) per capita. Spatial error models were used to measure the association between county-level sociodemographic characteristics and MME per capita while adjusting for spatial correlation between neighboring counties.
In the adjusted model, counties with a higher percentage of people below the poverty line, with less than a 4-year college degree, and without health insurance were associated with higher MME dispensed per capita, as were counties with higher percentages of families headed by a single parent, persons separated or divorced, and those with disabilities. Conversely, minority race/ethnicity and rural population were associated with lower opioid dispensing.
County-level sociodemographics can differ in their association with opioid dispensing, hence examining which county-level factors help in improving opioid prescribing, and implementing overdose prevention strategies that tackle these factors is important.
The vadose zone is subject to dynamic boundary conditions in the form of infiltration and evaporation. A better understanding of implications for flow and solute transport, arising from these dynamic ...boundary conditions in combination with heterogeneous structure, will help to improve the prediction of the fate of solutes. We present laboratory experiments and numerical simulations of heterogeneous porous media under unsaturated conditions where controlled, temporally varying precipitation and evaporation are applied to study the effect of dynamic boundary conditions on solute transport in the presence of material interfaces. Dye tracers Eosine Y and Brilliant Blue FCF are utilized to visualize solute transport and analyze redistribution processes in a flow cell. Water and solute fluxes in and out of the flow cell are quantified. While in dynamic experiments application of small infiltration rates (significantly below the saturated hydraulic conductivities of the materials) led to a reversal of transport paths between infiltration and succeeding evaporation, larger infiltration rates altered downward transport such that flow and transport paths differed from those observed during evaporation. Differences in transport paths ultimately led to a redistribution and trapping of solute in one material which manifested as pronounced tailing in breakthrough curves. Trapping was induced not by the formation of a stagnant zone as result of large parameter contrast but by an interplay of dynamic boundary conditions and material heterogeneity. This study thereby highlights the importance to consider dynamic boundary conditions in predictions of solute leaching.
Key Points
Laboratory studies of solute transport in heterogeneous porous media under dynamic boundary conditions are conducted
Combination of dynamic boundary conditions and material heterogeneity affects solute leaching in experiments and can induce strong tailing
Study highlights importance of consideration of dynamic boundary conditions in predictions of solute leaching
•We describe the virus situation in Australia’s largest winter tomato production area.•Alternative hosts for vectors and viruses in the region were discovered.•Local management options were ...successfully trialled under high virus pressure.•Introduction of dual resistant tomato hybrids allow continued production in the area.
The Bowen region of Northern Queensland is an important winter production area for tomatoes in Australia. There are three economically important viruses in the region that affect tomato, Tomato yellow leaf curl virus (TYLCV), Tomato spotted wilt virus (TSWV) and Potato leafroll virus (PLRV), which are vectored by whiteflies, thrips and aphids, respectively. An area wide management approach is required to lower the primary inoculum throughout the district. To this end, we undertook investigations into the virus incidence and alternative hosts for the virus and vectors in different cropping regions throughout the district, as well as local management options such as insecticide application and possible non-host cover crops for the wet-season break in production. The initial incidence of Potato leafroll virus was very high, most probably due to abnormal weather patterns for the district, and has ceased to be a problem. Tomato yellow leaf curl virus is a continual problem even at the beginning of the season, indicating large reservoir host(s) in the environment. Only four alternative hosts have been identified: Stachytarpheta jamaicensis (TSWV), Solanum americanum (PLRV and TYLCV) Trianthema portulacastrum (TYLCV), and Amaranthus viridis(TLYCV). Different insecticide and application options were trialled for protection against Tomato yellow leaf curl virus, with the best possible option yielding marketable fruit more than ninety percent of a resistant hybrid. A trial of yield vs time of infection of TYLCV found that whitefly exclusion for 6 weeks post-transplant yielded an average increase of nearly three kilograms of marketable fruit per plant. A number of pulse crops have been confirmed as non-hosts of tomato yellow leaf curl for use as cover crops in the wet-season break. Most of the production has moved to dual resistant TYLCV/TSWV hybrids, though an area wide management program still needs to be established to reduce the primary inoculum throughout the district, giving growers more varietal options, especially early in the season.
The franciscana is endemic to subtropical coastal waters of Brazil, Uruguay, and Argentina, and is the only living species of the family Pontoporiidae. It is regarded as the most endangered cetacean ...in the western South Atlantic. Five management units are recognized (Franciscana Management Areas, FMAs – sensu
Secchi et al., 2003a
), with abundance estimates ranging from a few hundred to around 15,000 dolphins. Low reproductive potential and short life span make this species highly susceptible to current non-natural removal rates. Bycatch in gillnet fisheries occurs in high levels since the 1960s in Uruguay and 1980s in Brazil and Argentina. Although other threats exist, such as habitat degradation that includes physical (noise) and chemical pollution, depletion of fish stocks and climate change, incidental mortality in gillnets is currently the greatest threat to franciscanas. Fishing-related mortality ranges from approximately 100, in FMA I, to more than 1,000 in FMA III, and exceed from near two (in FMA IV) to more than five times (in FMA III) the maximum allowed sustainable mortality rate, based on potential biological removal (PBR) approach. These numbers indicate that the species is unlikely to cope with the current levels of bycatch and that urgent and extreme reduction on fishing practice and effort are required to avoid collapse of the franciscana and to lower its risk of extinction. Current mortality levels and projected declines resulted in the listing of the franciscana as “Vulnerable” in the IUCN Red List. Recent fisheries regulations were implemented in areas with extensive bycatch in Brazil and were expected to improve the species’ conservation status. There is evidence, however, that this regulation is insufficient to reduce fishing-related mortality to sustainable levels due to either or both lack of compliance and inadequate regulation strategies. Here we provide a comprehensive review on the franciscana ecology and threats and discuss perspectives for its conservation.
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