Mycotic aneurysm of the inferior gluteal artery caused by non-typhi Salmonella in a man infected with HIV: a case report

<p>Abstract</p> <p>Introduction</p> <p>Non-typhi <it>Salmonellae </it>infections represent major opportunistic pathogens affecting human immunodeficiency virus-infected individuals residing in sub-Saharan Africa. To the best of our knowledge, we report the first documented case in the medical literature of a <it>Salmonella</it>-induced mycotic aneurysm involving an artery supplying the gluteal region.</p> <p>Case presentation</p> <p>A 37-year-old black, Kenyan man, infected with human immunodeficiency virus with a CD4 count of 132 cells per microliter presented with a pulsatile gluteal mass and debilitating pain progressing over one week. He was receiving prophylaxis with trimethoprim-sulfamethoxazole. Aspiration of the mass yielded gross blood. An ultrasound examination revealed a 37 ml vascular structure with an intra-luminal clot. Upon exploration, a true aneurysm of the inferior gluteal artery was identified and successfully resected. A culture of the aspirate grew a non-typhi <it>Salmonellae </it>species. Following resection, he was treated with oral ciprofloxacin for 10 weeks. He later began anti-retroviral therapy. Forty-two months after the initial diagnosis, he remained alive and well.</p> <p>Conclusions</p> <p>Clinicians caring for patients infected with human immunodeficiency virus in Africa and other resource-limited settings should be aware of the invasive nature of <it>Salmonella </it>infections and the potential for aneurysm formation in unlikely anatomical locations. Rapid initiation of appropriate anti-microbial chemotherapy and surgical referral is needed. Use of trimethoprim-sulfamethoxazole prophylaxis does not routinely prevent invasive <it>Salmonella </it>infections.</p

Video summarisation: A conceptual framework and survey of the state of the art

This is the post-print (final draft post-refereeing) version of the article. Copyright @ 2007 Elsevier Inc.Video summaries provide condensed and succinct representations of the content of a video stream through a combination of still images, video segments, graphical representations and textual descriptors. This paper presents a conceptual framework for video summarisation derived from the research literature and used as a means for surveying the research literature. The framework distinguishes between video summarisation techniques (the methods used to process content from a source video stream to achieve a summarisation of that stream) and video summaries (outputs of video summarisation techniques). Video summarisation techniques are considered within three broad categories: internal (analyse information sourced directly from the video stream), external (analyse information not sourced directly from the video stream) and hybrid (analyse a combination of internal and external information). Video summaries are considered as a function of the type of content they are derived from (object, event, perception or feature based) and the functionality offered to the user for their consumption (interactive or static, personalised or generic). It is argued that video summarisation would benefit from greater incorporation of external information, particularly user based information that is unobtrusively sourced, in order to overcome longstanding challenges such as the semantic gap and providing video summaries that have greater relevance to individual users

Examination Of The Influence Of Service Quality On Membership Renewal In Fitness Centers In San Francisco Bay Area

Corporations have to learn how to satisfy their customers&rsquo; various demands as the era of interactivity with customers has emerged (Pepper &amp; Rogers, 1999). For fitness center, customers&rsquo; demands are increasing and diversified. Therefore, service quality is an index of quality assessment from customers for service-producing industries. Furthermore, the concept of corporate expansion and customer relationship has become the foundation of service-providers for higher profitability through customers&rsquo; renewal of membership. The main purpose of this study is to evaluate the impact of service quality on the renewal willingness of fitness center membership. Customers from four fitness centers in the San Francisco Bay Area, USA, were randomly selected for this survey. A total of 50 subjects participated in this survey. The data was analyzed by multiple regression and stepwise regression. The result indicated that the service quality has positive influence on the renewal willingness of membership

UUnderstanding Program Engagement and Attrition in Child Abuse Prevention

Engaging and retaining families is a common challenge when serving families at high risk. McCurdy and Daro’s (2001) Integrated Theory of Parental Involvement (ITPI) proposes factors that impact engagement and retention in services. While several studies have found varying family demographic and risk factors to be associated with family engagement in home-based services, (withheld citation for purpose of review) identified program and provider characteristics that predicted engagement and retention (withheld citation for purpose of review). Specifically, SafeCare (SC) had greater enrollment (4 times) and retention (8.5 times) rates than services as usual (SAU), likely due to SC’s skill-based approach targeting desired topics. As a follow-up to this quantitative study, we conducted separate focus groups with parents who engaged and who failed to engage in SC (N= 16) and SAU (N=18). Provider characteristics (e.g., caring, experienced with children, nonjudgmental) was the strongest themes for engagement across groups. Program and provider flexibility and providers’ persistent support for parents despite life chaos facilitated retention. Results suggest that provider characteristics and program approach are key in engagement of families in home-based services. These results suggest expansion of the ITPI to address social context. Results suggestfocusing on specific provider characteristics and program approach for work force and program development to increase program engagement and decrease attrition

Investing in Turbulent Times: The Investment Behavior of Polish Firms in the Transition

We examine the investment behavior of a sample of Polish industrial firms over the period 1991-1993 by means of a model that views investment flows as part of the firm's effort to adjust its assets and liabilities so as to maximize the returns to the firm. We argue that the application of neo-classical models of investment is only appropriate in cases where net investment is positive. If firms are seeking to reduce their capital stock, then the major constraints are not financial but rather set by the level of depreciation. This paper examines the adjustments undertaken by Polish firms and shows that firms that did make positive net investments in this period were influenced by their capital intensity, profitability and by their cost of and returns to financial assets. The explanatory power of the model is relatively high when compared to previous studies of the investment behavior of firms in transition economies.http://deepblue.lib.umich.edu/bitstream/2027.42/39617/3/wp231.pd

Evaluation of pericoronary adipose tissue attenuation on CT

Pericoronary adipose tissue (PCAT) is the fat deposit surrounding coronary arteries. Although PCAT is part of the larger epicardial adipose tissue (EAT) depot, it has different pathophysiological features and roles in the atherosclerosis process. While EAT evaluation has been studied for years, PCAT evaluation is a relatively new concept. PCAT, especially the mean attenuation derived from CT images may be used to evaluate the inflammatory status of coronary arteries non-invasively. The most commonly used measure, PCATMA, is the mean attenuation of adipose tissue of 3 mm thickness around the proximal right coronary artery with a length of 40 mm. PCATMA can be analyzed on a per-lesion, per-vessel or per-patient basis. Apart from PCATMA, other measures for PCAT have been studied, such as thickness, and volume. Studies have shown associations between PCATMA and anatomical and functional severity of coronary artery disease. PCATMA is associated with plaque components and high-risk plaque features, and can discriminate patients with flow obstructing stenosis and myocardial infarction. Whether PCATMA has value on an individual patient basis remains to be determined. Furthermore, CT imaging settings, such as kV levels and clinical factors such as age and sex affect PCATMA measurements, which complicate implementation in clinical practice. For PCATMA to be widely implemented, a standardized methodology is needed. This review gives an overview of reported PCAT methodologies used in current literature and the potential use cases in clinical practice.</p