Optimal management of urinary tract infections in older people

Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials

Space Climate Manifestation in Earth Prices - from Medieval England Up to Modern Usa

In this study we continue to search for possible manifestations of space weather influence on prices of agricultural products and consumables. We note that the connection between solar activity and prices is based on the causal chain that includes several nonlinear transition elements. These non-linear elements are characterized by threshold sensitivity to external parameters and lead to very inhomogeneous local sensitivity of the price to space weather conditions. It is noted that "soft type" models are the most adequate for description of this class of connections. Two main observational effects suitable for testing causal connections of this type of sensitivity are considered: burst-like price reactions on changes in solar activity and price asymmetry for selected phases of the sunspot cycle. The connection, discovered earlier for wheat prices of Medieval England, is examined in this work on the basis of another 700-year data set of consumable prices in England. Using the same technique as in the previous part of our work (Pistilnik and Yom Din 2004) we show that statistical parameters of the interval distributions for price bursts of consumables basket and for sunspot minimum states are similar one to another, like it was reported earlier for wheat price bursts. Possible sources of these consistencies between three different multiyear samples are discussed. For search of possible manifestations of the "space weather - wheat market" connection in modern time, we analyze dynamics of wheat prices in the USA in the twentieth century. We show that the wheat prices revealed a maximum/minimum price asymmetry consistent with the phases of the sunspot cycle. We discuss possible explanations of this observed asymmetry, unexpected under conditions of globalization of the modern wheat market.Comment: First International Symposium on Space Climate: Direct and Indirect Observations of Long-Term Solar Activity, 20-23 June 2004, Oulu, Finlan

Ion mobility mass spectrometry uncovers the impact of the patterning of oppositely charged residues on the conformational distributions of intrinsically disordered proteins

The global dimensions and amplitudes of conformational fluctuations of intrinsically disordered proteins are governed, in part, by the linear segregation versus clustering of oppositely charged residues within the primary sequence. Ion mobility-mass spectrometry (IM-MS) affords unique advantages for probing the conformational consequences of the linear patterning of oppositely charged residues because it measures and separates proteins electrosprayed from solution on the basis of charge and shape. Here, we use IM-MS to measure the conformational consequences of charge patterning on the C-terminal intrinsically disordered region (p27 IDR) of the cell cycle inhibitory protein p27Kip1. We report the range of charge states and accompanying collisional cross section distributions for wild-type p27 IDR and two variants with identical amino acid compositions, κ14 and κ56, distinguished by the extent of linear mixing versus segregation of oppositely charged residues. Wild-type p27 IDR (κ31) and κ14, where the oppositely charged residues are more evenly distributed, exhibit a broad distribution of charge states. This is concordant with high degrees of conformational heterogeneity in solution. By contrast, κ56 with linear segregation of oppositely charged residues leads to limited conformational heterogeneity and a narrow distribution of charged states. Gas-phase molecular dynamics simulations demonstrate that the interplay between chain solvation and intrachain interactions (self-solvation) leads to conformational distributions that are modulated by salt concentration, with the wild-type sequence showing the most sensitivity to changes in salt concentration. These results suggest that the charge patterning within the wild-type p27 IDR may be optimized to sample both highly solvated and self-solvated conformational states

Cryogenic and room temperature strength of sapphire jointed by hydroxide-catalysis bonding

Hydroxide-catalysis bonding is a precision technique used for jointing components in opto-mechanical systems and has been implemented in the construction of quasi-monolithic silica suspensions in gravitational wave detectors. Future detectors are likely to operate at cryogenic temperatures which will lead to a change in test mass and suspension material. One candidate material is mono-crystalline sapphire. Here results are presented showing the influence of various bonding solutions on the strength of the hydroxide-catalysis bonds formed between sapphire samples, measured both at room temperature and at 77 K, and it is demonstrated that sodium silicate solution is the most promising in terms of strength, producing bonds with a mean strength of 63 MPa. In addition the results show that the strengths of bonds were undiminished when tested at cryogenic temperatures

Muon Catalyzed Fusion in 3 K Solid Deuterium

Muon catalyzed fusion in deuterium has traditionally been studied in gaseous and liquid targets. The TRIUMF solid-hydrogen-layer target system has been used to study the fusion reaction rates in the solid phase of D_2 at a target temperature of 3 K. Products of two distinct branches of the reaction were observed; neutrons by a liquid organic scintillator, and protons by a silicon detector located inside the target system. The effective molecular formation rate from the upper hyperfine state of $\mu d$ and the hyperfine transition rate have been measured: $\tilde{\lambda}_(3/2)=2.71(7)_{stat.}(32)_{syst.} \mu/s$, and $\tilde{\lambda}_{(3/2)(1/2)} =34.2(8)_{stat.}(1)_{syst.} \mu /s$. The molecular formation rate is consistent with other recent measurements, but not with the theory for isolated molecules. The discrepancy may be due to incomplete thermalization, an effect which was investigated by Monte Carlo calculations. Information on branching ratio parameters for the s and p wave d+d nuclear interaction has been extracted.Comment: 19 pages, 11 figures, submitted to PRA Feb 20, 199

Resonant Formation of dμtd\mu t Molecules in Deuterium: An Atomic Beam Measurement of Muon Catalyzed dt Fusion

Resonant formation of $d\mu t$ molecules in collisions of muonic tritium ($\mu t$) on D$_2$ was investigated using a beam of $\mu t$ atoms, demonstrating a new direct approach in muon catalyzed fusion studies. Strong epithermal resonances in $d\mu t$ formation were directly revealed for the first time. From the time-of-flight analysis of $2036\pm 116$ $dt$ fusion events, a formation rate consistent with $0.73\pm (0.16)_{meas} \pm (0.09)_{model}$ times the theoretical prediction was obtained. For the largest peak at a resonance energy of $0.423 \pm 0.037$ eV, this corresponds to a rate of $(7.1 \pm 1.8) \times 10^9$ s$^{-1}$, more than an order of magnitude larger than those at low energies.Comment: To appear in Phys. Rev. Let