Seeking Clarity within Cloudy Effluents: Differentiating Fungal from Bacterial Peritonitis in Peritoneal Dialysis Patients

Fungal peritonitis is a serious complication of peritoneal dialysis (PD) therapy with the majority of patients ceasing PD permanently. The aims of this study were to identify risk factors and clinical associations that may discriminate between fungal from bacterial peritonitis.We retrospectively identified episodes of fungal peritonitis from 2001-2010 in PD patients at Liverpool and Westmead Hospitals (Australia). Fungal peritonitis cases were matched in a 1:2 ratio with patients with bacterial peritonitis from each institution's dialysis registry, occurring closest in time to the fungal episode. Patient demographic, clinical and outcome data were obtained from the medical records.Thirty-nine episodes of fungal peritonitis (rate of 0.02 episodes per patient-year of dialysis) were matched with 78 episodes of bacterial peritonitis. Candida species were the commonest pathogens (35/39; 90% episodes) with Candida albicans (37%), Candida parapsilosis (32%) and Candida glabrata (13%) the most frequently isolated species. Compared to bacterial peritonitis, fungal peritonitis patients had received PD for significantly longer (1133 vs. 775 catheter-days; p = 0.016), were more likely to have had previous episodes of bacterial peritonitis (51% vs. 10%; p = 0.01), and to have received prior antibacterial therapy (51% vs. 10%; p = 0.01). Patients with fungal peritonitis were less likely to have fever and abdominal pain on presentation, but had higher rates of PD catheter removal (79% vs. 22%; p<0.005), and permanent transfer to haemodialysis (87% vs. 24%; p<0.005). Hospital length of stay was significantly longer in patients with fungal peritonitis (26.1 days vs. 12.6 days; p = 0.017), but the all-cause 30-day mortality rate was similar in both groups. Fluconazole was a suitable empiric antifungal agent; with no Candida resistance detected.Prompt recognition of clinical risk factors, initiation of antifungal therapy and removal of PD catheters are key considerations in optimising outcomes

Few-body resonances in light nuclei

We have localized several few-body resonances in light nuclei, using methods which can properly handle two- or three-body resonant states. Among other results, we predict the existence of a three-neutron resonance, small spin-orbit splittings between the low-lying states in He-5 and Li-5, the nonexistence of the soft dipole resonance in He-6, new 1+ states in Li-8 and B-8, and the presence of a nonlinear amplification phenomenon in the 0+_2 state of C-12

Gut microbiota functions: metabolism of nutrients and other food components

The diverse microbial community that inhabits the human gut has an extensive metabolic repertoire that is distinct from, but complements the activity of mammalian enzymes in the liver and gut mucosa and includes functions essential for host digestion. As such, the gut microbiota is a key factor in shaping the biochemical profile of the diet and, therefore, its impact on host health and disease. The important role that the gut microbiota appears to play in human metabolism and health has stimulated research into the identification of specific microorganisms involved in different processes, and the elucidation of metabolic pathways, particularly those associated with metabolism of dietary components and some host-generated substances. In the first part of the review, we discuss the main gut microorganisms, particularly bacteria, and microbial pathways associated with the metabolism of dietary carbohydrates (to short chain fatty acids and gases), proteins, plant polyphenols, bile acids, and vitamins. The second part of the review focuses on the methodologies, existing and novel, that can be employed to explore gut microbial pathways of metabolism. These include mathematical models, omics techniques, isolated microbes, and enzyme assays

A Program for At-Risk High School Students Informed by Evolutionary Science

Improving the academic performance of at-risk high school students has proven difficult, often calling for an extended day, extended school year, and other expensive measures. Here we report the results of a program for at-risk 9th and 10th graders in Binghamton, New York, called the Regents Academy that takes place during the normal school day and year. The design of the program is informed by the evolutionary dynamics of cooperation and learning, in general and for our species as a unique product of biocultural evolution. Not only did the Regents Academy students outperform their comparison group in a randomized control design, but they performed on a par with the average high school student in Binghamton on state-mandated exams. All students can benefit from the social environment provided for at-risk students at the Regents Academy, which is within the reach of most public school districts

The emerging modern face of mood disorders: a didactic editorial with a detailed presentation of data and definitions

The present work represents a detailed description of our current understanding and knowledge of the epidemiology, etiopathogenesis and clinical manifestations of mood disorders, their comorbidity and overlap, and the effect of variables such as gender and age. This review article is largely based on the 'Mood disorders' chapter of the Wikibooks Textbook of Psychiatry http://en.wikibooks.org/wiki/Textbook_of_Psychiatry/Mood_Disorders

Een tankgracht van de Vordere Wasserstellung in plangebied Halte Waddinxveen Triangel Gemeente Waddinxveen Archeologisch onderzoek: een begeleiding

Langs de spoorlijn Alphen aan den Rijn-Gouda komt een nieuw station (Halte Waddinxveen Triangel), inclusief een nieuwe onderdoorgang onder de spoorbaan. Deze onderdoorgang komt op de locatie waar sporen van een tankgracht uit de Tweede Wereldoorlog worden verwacht (Wijnen, 2012). Deze tankgracht is na de oorlog deels gedempt en deels nog aanwezig als de bestaande spoorsloot aan de oostzijde van de spoorbaan. Door de aanleg van de onderdoorgang zullen aanwezige resten van de tankgracht op deze locatie volledig worden vergraven, over een breedte van circa 10 m. Aangezien de tankgracht een lineaire structuur betreft, blijven resten van de tankgracht buiten het plangebied behouden. De adviseur archeologie van de gemeente Waddinxveen heeft aangegeven dat het vanuit archeologisch oogpunt wenselijk is om deze sloot/tankgracht te onderzoeken

Munitiedepot De Eese

Op advies van de gemeente Steenwijkerland heeft RAAP in opdracht van KWS Infra BV op 30 november en 2 december 2016 waarnemingen gedaan aan enkele structuren die waren aangetroffen tijdens explosievenopsporing op landgoed De Eese, gemeente Steenwijkerland. Op het landgoed is in de Tweede Wereldoorlog door de Duitse bezetter een munitiedepot ingericht ten behoeve van het nabijgelegen vliegveld Havelte. Tijdens de explosievenopsporing is geen archeologische begeleiding uitgevoerd. KWS Infra BV heeft overeenkomstig de afspraken met de gemeente Steenwijkerland melding gemaakt van het aantreffen van enkele structuren tijdens hun werkzaamheden. Naar aanleiding van deze melding heeft RAAP de aangetroffen structuren gedocumenteerd

Impact of sulfate deprivation and H₂S exposure on the metabolites of the activated methyl cycle in Chinese cabbage

The activated methyl cycle is a central metabolic pathway used to generate (and recycle) several important sulfur-containing metabolites including methionine, S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) and enable methylation. We have developed a precise and sensitive method for the simultaneous measurement of several sulfur metabolites based on liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) and 34S-metabolic labeling of sulfur-containing metabolites including glutathione and the metabolites of the activated methyl cycle. Sulfate deprivation resulted in a decreased biomass production and content of glutathione, methionine, SAH of both shoot and root, and SAM of the root of Chinese cabbage. Foliarly absorbed H2S may able to replace sulfate taken up by the root as sulfur source for growth and an atmospheric concentration of 0.2 μl l-1 alleviated the decrease in the content of sulfur metabolites. The SAM content of the shoot was hardly affected upon sulfate-deprivation, resulting an increase in the SAM/SAH ratio, indicating a potential higher methylation capacity under this condition