Pediatric Blood Culture Isolates and Antibiotic Sensitivity Pattern in a Nigerian Tertiary Hospital

Introduction: There is a significant variation in the bacterial pathogens implicated in childhood septicemia and their antibiotic sensitivity patternfrom place to place. Sustained monitoring of this dynamics is therefore critical to rational antibiotic use. Materials and Methods: This study was thus conducted to determine the etiology of childhood septicemia and their antibiotic sensitivity pattern. Blood culture results (contaminants excluded), age, and sex of all pediatric patients with suspected septicemia between January 2013 and December 2014 were retrieved. Data were analyzed using SPSS version 20. Results: Over a 2‑year period, a total of 3680 blood samples were processed. Pathogenic bacteria were isolated in 701 samples (19%).    Staphylococcus aureus was the most common isolate (41.4%) and was most sensitive to ampicillin‑sulbactam (89%). Klebsiella species (21.7%),  coagulase‑negative Staphylococcus (14.7%), and Pseudomonas aeruginosa (11%) were other common organisms isolated. Virtually, all the isolates demonstrated a reliable susceptibility to ciprofloxacin except for S. aureus and Klebsiella species which were most sensitive to ampicillin‑sulbactam and imipenem, respectively. Conclusion: In conclusions, S. aureus is the leading cause of childhood septicemia in this locale. The significant rate of isolation of the supposedly less virulent organisms calls for an urgent review of potential risk factors and an appraisal of the hospital infection control policies and structures. Keywords: Antibiotics, isolates, paediatri

The effect of neoadjuvant therapy on PD-L1 expression and CD8+lymphocyte density in non-small cell lung cancer.

PD-L1 expression is the routine clinical biomarker for the selection of patients to receive immunotherapy in non-small cell lung cancer (NSCLC). However, the application and best timing of immunotherapy in the resectable setting is still under investigation. We aimed to study the effect of chemotherapy on PD-L1 expression and tumor infiltrating lymphocytes (TILs), which is to date still poorly understood. Our retrospective, single-centre neoadjuvant cohort comprised 96 consecutive patients with NSCLC resected 2000-2016 after neoadjuvant therapy, including paired diagnostic chemo-naïve specimens in 53 cases. A biologically matched surgical cohort of 114 primary resected cases was included. PD-L1 expression, CD8 + TILs density and tertiary lymphoid structures were assessed on whole slides and correlated with clinico-pathological characteristics and survival. Seven/53 and 12/53 cases had lower respectively higher PD-L1 expressions after neoadjuvant therapy. Most cases (n = 34) showed no changes in PD-L1 expression, the majority of these harboring PD-L1 < 1% in both samples (21/34 [61.8%]). Although CD8 + TILs density was significantly higher after chemotherapy (p = 0.031) in resections compared to diagnostic biopsies, this might be due to sampling and statistical bias. No difference in PD-L1 expression or CD8 + TILs density was detected when comparing the neoadjuvant and surgical cohort. In univariable analyses, higher CD8 + TILs density, higher numbers of tertiary lymphoid structures but not PD-L1 expression were significantly associated with longer survival. Increased PD-L1 expression after neoadjuvant chemotherapy was not significantly associated with shorter 5-year survival, but the number of cases was very low. In multivariable analysis, only pT category and age remained independent prognostic factors. In summary, PD-L1 expression was mostly unchanged after neoadjuvant chemotherapy compared to diagnostic biopsies. The sample size of cases with changed PD-L1 expression was too small to draw conclusions on any prognostic value

A prognostic score for non-small cell lung cancer resected after neoadjuvant therapy in comparison with the tumor-node-metastases classification and major pathological response.

Studies validating the prognostic accuracy of the tumor-node-metastases (TNM) classification in patients with lung cancer treated by neoadjuvant therapy are scarce. Tumor regression, particularly major pathological response (MPR), is an acknowledged prognostic factor in this setting. We aimed to validate a novel combined prognostic score. This retrospective single-center study was conducted on 117 consecutive patients with non-small cell lung cancer resected after neoadjuvant treatment at a Swiss University Cancer Center between 2000 and 2016. All cases were clinicopathologically re-evaluated. We assessed the prognostic performance of a novel prognostic score (PRSC) combining T-category, lymph node status, and MPR, in comparison with the eighth edition of the TNM classification (TNM8), the size adapted TNM8 as proposed by the International Association for the Study of Lung Cancer (IASLC) and MPR alone. The isolated ypT-category and the combined TNM8 stages accurately differentiated overall survival (OS, stage p = 0.004) and disease-free survival (DFS, stage p = 0.018). Tumor regression had a prognostic impact. Optimal cut-offs for MPR emerged as 65% for adenocarcinoma and 10% for non-adenocarcinoma and were statistically significant for survival (OS p = 0.006, DFS p < 0.001). The PRSC differentiated between three prognostic groups (OS and DFS p < 0.001), and was superior compared to the stratification using MPR alone or the TNM8 systems, visualized by lower Akaike (AIC) and Bayesian information criterion (BIC) values. In the multivariate analyses, stage III tumors (HR 4.956, p = 0.003), tumors without MPR (HR 2.432, p = 0.015), and PRSC high-risk tumors (HR 5.692, p < 0.001) had significantly increased risks of occurring death. In conclusion, we support 65% as the optimal cut-off for MPR in adenocarcinomas. TNM8 and MPR were comparable regarding their prognostic significance. The novel prognostic score performed distinctly better regarding OS and DFS

Cornerstones of Sampling of Operator Theory

This paper reviews some results on the identifiability of classes of operators whose Kohn-Nirenberg symbols are band-limited (called band-limited operators), which we refer to as sampling of operators. We trace the motivation and history of the subject back to the original work of the third-named author in the late 1950s and early 1960s, and to the innovations in spread-spectrum communications that preceded that work. We give a brief overview of the NOMAC (Noise Modulation and Correlation) and Rake receivers, which were early implementations of spread-spectrum multi-path wireless communication systems. We examine in detail the original proof of the third-named author characterizing identifiability of channels in terms of the maximum time and Doppler spread of the channel, and do the same for the subsequent generalization of that work by Bello. The mathematical limitations inherent in the proofs of Bello and the third author are removed by using mathematical tools unavailable at the time. We survey more recent advances in sampling of operators and discuss the implications of the use of periodically-weighted delta-trains as identifiers for operator classes that satisfy Bello's criterion for identifiability, leading to new insights into the theory of finite-dimensional Gabor systems. We present novel results on operator sampling in higher dimensions, and review implications and generalizations of the results to stochastic operators, MIMO systems, and operators with unknown spreading domains

Effect of olive oil in dairy cow diets on the fatty acid profile and sensory characteristics of cheese

The effect of dietary unrefined olive oil (OO) residues and hydrogenated vegetable oil (HVO) on the fatty acid profiles of milk and cheese and the sensory characteristics of cheeses was determined. For 9 weeks, animals were fed a control diet with no added lipid (n = 5 cows), or fat-supplemented diets containing OO or HVO (in both cases n = 5 cows; 30 g kg-1 dry matter). Compared with control and HVO, OO increased C18:1 cis-9, and C18:3 cis-9, cis-12, cis-15 fatty acids in milk; and also increased C18:1 trans-10, C18:1 trans-11, C18:1 cis-9, C18:2 cis-9, trans-11 and C18:3 cis-9, cis-12, cis-15 fatty acids in cheeses. OO reduced the number of holes, overall odour and acidity of cheeses, whereas HVO increased the cow milk odour, bitterness and acidity of cheeses. Overall, OO can improve the cheese fatty acid profile, but with adverse effects on sensory attributes