Despite the prominence of the concept of the information ecosystem (hereafter IE) in information literacy documents and literature, it is under‐theorized. This article proposes a general definition ...of IE for information literacy. After reviewing the current use of the IE concept in the Association of College and Research Libraries (ACRL) Framework for Information Literacy and other information literacy sources, existing definitions of IE and similar concepts (e.g., “evidence ecosystems”) will be examined from other fields. These will form the basis of the definition of IE proposed in the article for the field of information literacy: “all structures, entities, and agents related to the flow of semantic information relevant to a research domain, as well as the information itself.”
Introduction
Emergency operations for perforations and anastomotic leakage of the upper gastrointestinal tract are associated with a high overall morbidity and mortality rate. An endoscopic vacuum ...therapy (EVT) has been established successfully for anastomotic leakage after rectal resection but only limited data exist for EVT of the upper GI tract.
Methods
We report on a series of nine patients treated with EVT for defects of the upper intestinal tract between March 2011 and May 2012. In four patients, initial endoscopic sponge placement was performed in combination with open surgical revision. Median follow-up was 189 (range, 51–366) days.
Results
In total, 52 vacuum sponges were placed in upper GI defects of nine patients. Indication for EVT were anastomotic leakage after esophageal resection or gastrectomy (
n
= 5) and iatrogenic or spontaneous esophageal perforations (
n
= 4). The mean number of sponge insertions was six (range, 1–13) with a mean changing interval of 3.5 days (range, 2–5). A successful vacuum therapy for upper intestinal defects was achieved in eight of nine patients (89 %).
Conclusion
EVT is a promising approach for postoperative, iatrogenic, or spontaneous lesions of the upper GI tract. If necessary the endoscopic procedure can be combined with operative revision for better control of the local septic focus.
Isocitrate dehydrogenase 1 (IDH1) is a key metabolic enzyme for maintaining cytosolic levels of α-ketoglutarate (AKG) and preserving the redox environment of the cytosol. Wild-type (WT) IDH1 converts ...isocitrate to AKG; however, mutant IDH1-R132H that is recurrent in human cancers catalyzes the neomorphic production of the oncometabolite d-2-hydroxyglutrate (D-2HG) from AKG. Recent work suggests that production of l-2-hydroxyglutarte in cancer cells can be regulated by environmental changes, including hypoxia and intracellular pH (pHi). However, it is unknown whether and how pHi affects the activity of IDH1-R132H. Here, we show that in cells IDH1-R132H can produce D-2HG in a pH-dependent manner with increased production at lower pHi. We also identify a molecular mechanism by which this pH sensitivity is achieved. We show that pH-dependent production of D-2HG is mediated by pH-dependent heterodimer formation between IDH1-WT and IDH1-R132H. In contrast, neither IDH1-WT nor IDH1-R132H homodimer formation is affected by pH. Our results demonstrate that robust production of D-2HG by IDH1-R132H relies on the coincidence of (1) the ability to form heterodimers with IDH1-WT and (2) low pHi or highly abundant AKG substrate. These data suggest cancer-associated IDH1-R132H may be sensitive to physiological or microenvironmental cues that lower pH, such as hypoxia or metabolic reprogramming. This work reveals new molecular considerations for targeted therapeutics and suggests potential synergistic effects of using catalytic IDH1 inhibitors targeting D-2HG production in combination with drugs targeting the tumor microenvironment.
Objectives: To assess the use of computed tomography (CT) in the diagnosis of chronic nasal disease in dogs.
Methods: A retrospective study of 85 dogs with chronic nasal discharge due to primary ...nasal disease, which had undergone CT and biopsy, was carried out. Medical records were reviewed signalment, clinical signs, CT findings, endoscopic findings and histopathology. The results obtained via CT were correlated with nasal histopathology and gross anatomical observations were recorded at the time of rhinoscopy.
Results: Neoplasia was diagnosed in 37 dogs for which CT typically revealed a soft tissue density associated with extensive turbinate destruction. Inflammatory rhinitis was diagnosed in 40 dogs. CT disclosed either normal turbinate structures or mild to moderate turbinate destruction, with or without the presence of soft tissue densities (mucopus) within the nasal passages. Fungal rhinitis was diagnosed in seven dogs for which CT disclosed extensive turbinate destruction with hyperlucency of the nasal passages. One dog had normal CT and histopathology findings.
Clinical Significance: CT greatly enhanced the ability to diagnose chronic nasal disease in dogs, providing detailed information regarding the extent of the disease, accurate discrimination of neoplastic versus non‐neoplastic diseases, and identification of areas of the nose to examine rhinoscopically and suspicious regions to target for biopsy.
A measurement of the absolute fluorescence yield of the 337 nm nitrogen band, relevant to ultra-high energy cosmic ray (UHECR) detectors, is reported. Two independent calibrations of the fluorescence ...emission induced by a 120 GeV proton beam were employed: Cherenkov light from the beam particle and calibrated light from a nitrogen laser. The fluorescence yield in air at a pressure of 1013 hPa and temperature of 293 K was found to be Y 337 = 5.61 +/- 0.06 stat +/- 0.22 syst photons/MeV. When compared to the fluorescence yield currently used by UHECR experiments, this measurement improves the uncertainty by a factor of three, and has a significant impact on the determination of the energy scale of the cosmic ray spectrum.
The Bloomsbury Dictionary of Eighteenth-Century German Philosophers is a landmark work. Covering one of the most innovative centuries for philosophical investigation, it features more than 650 ...entries on the eighteenth-century philosophers, theologians, jurists, physicians, scholars, writers, literary critics and historians whose work has had lasting philosophical significance.Alongside well-known German philosophers of that era-Gottfried Wilhelm Leibniz, Immanuel Kant, and Georg Wilhelm Friedrich Hegel-the Dictionary provides rare insights into the lives and minds of lesser-known individuals who influenced the shape of philosophy. Each entry discusses a particular philosopher's life, contributions to the world of thought, and later influences, focusing not only on their most important published writings, but on relevant minor works as well. Bibliographical references to primary and secondary source material are included at the end of entries to encourage further reading, while extensive cross-referencing allows comparisons to be easily made between different thinkers' ideas and practices. For anyone looking to understand more about the century when enlightenment thinking arrived in Germany and established conceits were challenged, The Bloomsbury Dictionary of Eighteenth-Century German Philosophers is a valuable, unparalleled resource.
Procalcitonin (PCT)-guided antibiotic stewardship is a successful strategy to decrease antibiotic use. We assessed if clinical judgement affected compliance with a PCT-algorithm for antibiotic ...prescribing in a multicenter surveillance of patients with lower respiratory tract infections (LRTI).
Initiation and duration of antibiotic therapy, adherence to a PCT algorithm and outcome were monitored in consecutive adults with LRTI who were enrolled in a prospective observational quality control. We correlated initial clinical judgment of the treating physician with algorithm compliance and assessed the influence of PCT on the final decision to initiate antibiotic therapy.
PCT levels correlated with physicians’ estimates of the likelihood of bacterial infection (
p
for trend <0.02). PCT influenced the post-test probability of antibiotic initiation with a greater effect in patients with non-pneumonia LRTI (e.g., for bronchitis: −23 % if PCT ≤ 0.25 μg/L and +31 % if PCT > 0.25 μg/L), in European centers (e.g., in France −22 % if PCT ≤ 0.25 μg/L and +13 % if PCT > 0.25 μg/L) and in centers, which had previous experience with the PCT-algorithm (−16 % if PCT ≤ 0.25 μg/L and +19 % if PCT > 0.25 μg/L). Algorithm non-compliance, i.e. antibiotic prescribing despite low PCT-levels, was independently predicted by the likelihood of a bacterial infection as judged by the treating physician. Compliance was significantly associated with identification of a bacterial etiology (
p
= 0.01).
Compliance with PCT-guided antibiotic stewardship was affected by geographically and culturally-influenced subjective clinical judgment. Initiation of antibiotic therapy was altered by PCT levels. Differential compliance with antibiotic stewardship efforts contributes to geographical differences in antibiotic prescribing habits and potentially influences antibiotic resistance rates.
Summary
Background: Cholinesterase inhibitors form the mainstay of treatment for persons with mild‐to‐moderate Alzheimer’s disease (AD). The rivastigmine patch may increase compliance and the ...proportion of patients maintaining an efficacious dose compared with oral cholinesterase inhibitors.
Objective: To investigate the proportion of patients who reached and maintained the target rivastigmine patch dose compared with the target rivastigmine capsule dose reported in clinical trials.
Methods: This was a multicentre, 24‐week, open‐label study in persons with probable AD and a Mini‐Mental State Examination (MMSE) score of ≥ 10 and ≤ 26. The primary outcome was the proportion of patients (ITT population) treated with 9.5 mg/24 h rivastigmine patch for at least 8 weeks at week 24. Secondary outcomes included week 24 MMSE, Alzheimer’s Disease Cooperative Study–Clinical Global Impression of Change (ADCS‐CGIC), Trail Making Test Part A (TMT‐A) and Alzheimer’s Disease Cooperative Study–Activities of Daily Living (ADCS‐ADL) scores.
Results: Overall, 208 participants received treatment and 155 (74.5%) completed the study. Within the ITT population, 147/182 patients (80.8%; 95% CI 75.0–86.5%) were treated for at least 8 weeks with the 9.5 mg/24 h rivastigmine patch; 135/182 patients (74.2%; 95% CI 67.8–80.5%) were treated for at least 8 weeks and completed the study. The most common adverse events were nausea (10.1% of patients), erythema (8.7%), pruritus (8.2%) and vomiting (7.2%). At week 24, patients treated with the rivastigmine patch showed improvements on MMSE, ADCS‐ADL, ADCS‐CGIC and TMT‐A scores. Caregivers reported acceptance, preference and satisfaction with the patch.
Conclusion: Transdermal delivery may allow more patients to reach and maintain therapeutic doses of rivastigmine compared with oral rivastigmine.
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