Systematic review of antimicrobial drug prescribing in hospitals.

Prudent antibiotic prescribing to hospital inpatients has the potential to reduce the incidences of antimicrobial resistance and healthcare-associated infection. We reviewed the literature from January 1980 to November 2003 to identify rigorous evaluations of interventions to improve hospital antibiotic prescribing. We identified 66 studies with interpretable data of which 16 reported 20 microbiological outcomes: Gram negative resistant bacteria (GNRB), 10 studies; Clostridium difficile associated diarrhoea (CDAD), 5 studies; vancomycin resistant enterococci (VRE), 3 studies and methicillin resistant Staphylococcus aureus (MRSA), 2 studies. Four studies provide good evidence that the intervention changed microbial outcomes with low risk of alternative explanations, eight studies provide less convincing evidence and four studies were negative. The strongest and most consistent evidence was for CDAD but we were able to analyse only the immediate impact of interventions because of nonstandardised durations of follow up. The ability to compare results of studies could be substantially improved by standardising methodology and reporting

Pilot-scale ceramic membrane filtration of skim milk for the production of a 'humanised' protein base ingredient for infant milk formula

The protein composition of bovine skim milk was modified using pilot scale membrane filtration to produce a whey protein-dominant ingredient with a casein profile closer to human milk. Bovine skim milk was processed at low (8.9 °C) or high (50 °C) temperature using ceramic microfiltration (MF) membranes (0.1 μm mean pore diameter). The resulting permeate stream was concentrated using polyethersulfone ultrafiltration (UF) membranes (10 kDa cut-off). The protein profile of MF and UF retentate streams were determined using reversed phase-high performance liquid chromatography and polyacrylamide gel electrophoresis. Permeate from the cold MF process (8.9 °C) had a casein:whey protein ratio of ∼35:65 with no αS- or κ-casein present, compared with a casein:whey protein ratio of ∼10:90 at 50 °C. This study has demonstrated the application of cold membrane filtration (8.9 °C) at pilot scale to produce a dairy ingredient with a protein profile closer to that of human milk

Reducing Versatile Bat Wing Conformations to a 1-DoF Machine

Recent works have shown success in mimicking the flapping flight of bats on the robotic platform Bat Bot (B2). This robot has only five actuators but retains the ability to flap and fold-unfold its wings in flight. However, this bat-like robot has been unable to perform folding-unfolding of its wings within the period of a wingbeat cycle, about 100 ms. The DC motors operating the spindle mechanisms cannot attain this folding speed. Biological bats rely on this periodic folding of their wings during the upstroke of the wingbeat cycle. It reduces the moment of inertia of the wings and limits the negative lift generated during the upstroke. Thus, we consider it important to achieve wing folding during the upstroke. A mechanism was designed to couple the flapping cycle to the folding cycle of the robot. We then use biological data to further optimize the mechanism such that the kinematic synergies of the robot best match those of a biological bat. This ensures that folding is performed at the correct point in the wingbeat cycle

Impact of corticosteroids on late growth of radiofrequency lesions in infant pigs: histopathological and electroanatomical findings

Aims Corticosteroids attenuate late growth of radiofrequency (RF) lesions in the thigh muscle of infant rats. We sought to assess the impact of these drugs on the late growth of RF lesions in immature swine myocardium and to determine the electroanatomical mapping (EAM) characteristics of these lesions.Methods and results Radiofrequency (60 degrees C; 60 s) lesions were created in the right atrium (n = 2) and ventricle (n = 2) of 14 piglets (age 65 days; weight 5 kg) and 3 adults. Piglets were divided into: controls (n 7) and treated (n 7), receiving hydrocortisone (10 mg/kg iv after RF) and prednisone (1 mg/kg/day) for 29 days. After 8 months, animals were sacrificed for histological analysis. in four piglets, endocardial and epicardial voltage EAM were performed.In infant groups, the dimensions of atrial (11 +/- 5 vs. 13 +/- 7 mm) and ventricular (12 +/- 3 vs. 11 +/- 3 mm) lesions were similar. in adults, atrial (6 +/- 1 mm) and ventricular (6 +/- 1 mm) lesions were smaller. in controls, ventricular lesions depicted dense fibrosis and multiple strands of fibrous tissue extending from the lesion into normal muscle. Treated piglets revealed scars exhibiting less dense fibrosis with predominance of fibroadipose tissue and less collagen proliferation. Large atrial and ventricular low-voltage areas corresponding to the macroscopic lesions were identified in all animals.Conclusion Radiofrequency lesions in infant pigs reveal late growth and invasion of normal muscle by intense collagen proliferation. Corticosteroids do not prevent late enlargement of the lesions but modulate the fibrotic proliferation. the expressive growth of the lesion may generate low-voltage areas detectable by EAM.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Discipline Cardiol, Paulista Sch Med, BR-04039030 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pathol, Paulista Sch Med, BR-04039030 São Paulo, BrazilUniversidade Federal de São Paulo, Discipline Cardiol, Paulista Sch Med, BR-04039030 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pathol, Paulista Sch Med, BR-04039030 São Paulo, BrazilWeb of Scienc

A rapid and multi-element method for the analysis of major nutrients in grass (Lolium perenne) using energy-dispersive X-ray fluorescence spectroscopy

peer-reviewedElemental analysis of grass (Lolium perenne) is essential in agriculture to ensure grass quality and animal health. Energy-dispersive X-ray fluorescence (EDXRF) spectroscopy is a rapid, multi-element alternative to current methods using acid digestion and inductively coupled plasma optical emission spectrometry (ICP-OES). Percentage phosphorus (P), potassium (K), magnesium (Mg) and calcium (Ca), determined from grass samples using EDXRF, were within 0.035, 0.319, 0.025 and 0.061, respectively, of ICP-OES values. Concordance correlation coefficients computed using agreement statistics ranged from 0.4379 to 0.9669 (values close to one indicate excellent agreement); however, the level of agreement for each element depended on the calibrations used in EDXRF. Empirical calibrations gave excellent agreement for percentage P, K and Ca, but moderate agreement for percentage Mg due to a weaker correlation between standards and intensities. Standardless calibration using the fundamental parameters (FP) approach exhibited bias, with consistently lower values reported for percentage P and Mg, when compared with ICP-OES methods. The relationship between the methods was plotted as scatter plots with the line of equality included, and although correlation coefficients indicated strong relationships, these statistics masked the effects of consistent bias in the data for percentage P and Mg. These results highlight the importance of distinguishing agreement from correlation when using statistical methods to compare methods of analysis. Agreement estimates improved when a matching library of grass samples was added to the FP method. EDXRF is a comparable alternative to conventional methods for grass analysis when samples of similar matrix type are used as empirical standards or as a matching library

A closed loop brain-machine interface for epilepsy control using dorsal column electrical stimulation

Although electrical neurostimulation has been proposed as an alternative treatment for drug-resistant cases of epilepsy, current procedures such as deep brain stimulation, vagus, and trigeminal nerve stimulation are effective only in a fraction of the patients. Here we demonstrate a closed loop brain-machine interface that delivers electrical stimulation to the dorsal column (DCS) of the spinal cord to suppress epileptic seizures. Rats were implanted with cortical recording microelectrodes and spinal cord stimulating electrodes, and then injected with pentylenetetrazole to induce seizures. Seizures were detected in real time from cortical local field potentials, after which DCS was applied. This method decreased seizure episode frequency by 44% and seizure duration by 38%. We argue that the therapeutic effect of DCS is related to modulation of cortical theta waves, and propose that this closed-loop interface has the potential to become an effective and semi-invasive treatment for refractory epilepsy and other neurological disorders.We are grateful for the assistance from Jim Meloy for the design and production of the multielectrode arrays as well as setup development and maintenance, Laura Oliveira, Terry Jones, and Susan Halkiotis for administrative assistance and preparation of the manuscript. This work was funded by a grant from The Hartwell Foundation.info:eu-repo/semantics/publishedVersio

Factors associated with milk processing characteristics predicted by mid-infrared spectroscopy in a large database of dairy cows

Despite milk processing characteristics being important quality traits, little is known about the factors underlying their variability, due primarily to the resources required to measure these characteristics in a sufficiently large population. Cow milk coagulation properties (rennet coagulation time, curd-firming time, curd firmness 30 and 60 min after rennet addition), heat coagulation time, casein micelle size, and pH were generated from available mid-infrared spectroscopy prediction models. The prediction models were applied to 136,807 spectra collected from 9,824 Irish dairy cows from research and commercial herds. Sources of variation were investigated using linear mixed models that included the fixed effects of calendar month of test; milking time in the day; linear regressions on the proportion of Friesian, Jersey, Montb\ue9liarde, Norwegian Red, and \u201cother\u201d breeds in the cow; coefficients of heterosis and of recombination loss; parity; stage of lactation; and the 2-way interaction parity 7 stage of lactation. Withinand across-parity cow effects, contemporary group, and a residual term were also included as random effects in the model. Supplementary analyses considered the inclusion of either test-day milk yield or milk protein concentration as fixed-effects covariates in the multiple regression models. Milk coagulation properties were most favorable (i.e., short rennet coagulation time and strong curd firmness) for cheese manufacturing in early lactation, concurrent with the lowest values of both pH and casein micelle size. Milk coagulation properties and pH deteriorated in mid lactation but improved toward the end of lactation. In direct contrast, heat coagulation time was more favorable in mid lactation and less suitable (i.e., shorter) for high temperature treatments in both early and late lactation. Relative to multiparous cows, primiparous cows, on average, yielded milk with shorter rennet coagulation time and longer heat coagulation time. Milk from the evening milking session had shorter rennet coagulation time and greater curd firmness, as well as lower heat coagulation time and lower pH compared with milk from the morning session. Jersey cows, on average, yielded milk more suitable for cheese production rather than for milk powder production. When protein concentration was included in the model, the improvement of milk coagulation properties toward the end of lactation was no longer apparent. Results from the present study may aid in decisionmaking for milk manufacturing, especially in countries characterized by a seasonal supply of fresh milk

Novas Idéias Sobre os Mecanismos Eletrofisiológicos da Fibrilaçao Atrial suas Implicaçoes Terapêuticas

A fibrilaçao atrial (FA) é a arritmia cardíaca sustentada mais frequente na prática clínica e está associada a morbidade e mortalidade significativas. Nos últimos anos, houve grandes progressos no entendimento dos vários mecanismos eletrofisiológicos envolvidos na gênese e perpetuaçao dessa arritmia. Observou-se que a FA pode ser desencadeada por mecanismos focais, localizados principalmente nas veias pulmonares. Evidências experimentais e clínicas sugerem que a FA promove alteraçoes anatômicas e elétricas nos átrios que favorecem a sua perpetuaçao. Esses novos conceitos têm redirecionado a abordagem terapêutica dos pacientes com FA. Vários métodos nao farmacológicos para o tratamento da FA estao em desenvolvimento, incluindo ablaçao por cateter com radiofrequência, marcapassos com dupla estimulaçao atrial e desfibriladores atriais implantáveis. Apesar de promissores, o valor e a aplicabilidade clínica desses métodos ainda nao foram definidos. A associaçao de modalidades terapêuticas com o objetivo de obter um efeito sinérgico pode contribuir favoravelmente para o tratamento da FA. Este artigo revisa os novos conceitos fisiopatológicos da FA e analisa o impacto desses avanços na abordagem terapêutica de pacientes com essa arritmia

DGCR8 HITS-CLIP reveals novel functions for the Microprocessor

The Drosha-DGCR8 complex (Microprocessor) is required for microRNA (miRNA) biogenesis. DGCR8 recognizes the RNA substrate, whereas Drosha functions as the endonuclease. High-throughput sequencing and crosslinking immunoprecipitation (HITS-CLIP) was used to identify RNA targets of DGCR8 in human cells. Unexpectedly, miRNAs were not the most abundant targets. DGCR8-bound RNAs also comprised several hundred mRNAs as well as snoRNAs and long non-coding RNAs. We found that the Microprocessor controls the abundance of several mRNAs as well as of MALAT-1. By contrast, DGCR8-mediated cleavage of snoRNAs is independent of Drosha, suggesting the involvement of DGCR8 in cellular complexes with other endonucleases. Interestingly, binding of DGCR8 to cassette exons, acts as a novel mechanism to regulate the relative abundance of alternatively spliced isoforms. Collectively, these data provide new insights in the complex role of DGCR8 in controlling the fate of several classes of RNAs