Late-onset pulmonary arterial hypertension after successful early arterial switch surgery for simple transposition of the great arteries

Pulmonary arterial hypertension rarely develops in patients with simple transposition of the great arteries who undergo neonatal surgical correction. We describe a young male patient who was diagnosed with severe pulmonary arterial hypertension 14 years after neonatal arterial switch surgery. The relevant literature is briefly reviewed. Clinicians should be aware of this rare, late, and potentially life-threatening condition. Continued long-term follow up of these patients should be provided. Early diagnosis and treatment with combination therapy may improve outcome

The world’s first human-to-human heart transplant at Groote Schuur Hospital: 50 years later

No Abstrac

On the Relationship between the Evolution of Technological Firms and Their Knowledge Development Regimes

Abstract Differences in knowledge regimes and growth dynamics amongst four ideal types of knowledge based firms are analyzed. Two aspects of technological knowledge, technological opportunity and appropriability are traditionally seen as vital to understand the incentives for research and development activities in firms. However, they do not fully define the technology regimes, when one asks how the knowledge based firm competes. Therefore, the dynamic nature of firm capabilities and knowledge development in terms of expansion and in terms of deepening are also discussed. These two additional aspects of knowledge implies that even if all firms in an industry can be considered to be knowledge intensive these firms do also differ. Using cases of entrepreneurial start-up firms in Sweden, we illustrate whether our conceptual ideas of knowledge development help us understand the diversity and contradictions of firm evolution. Our finding is that firm evolution and capability development is dependent upon both the potential for expanding knowledge, such as by innovations, and by deepening the understanding within established knowledge, such as by learning. This implies that the shaping of a science based industry must be seen in relation both to the value of current knowledge and capabilities together with the sometimes only limited and temporarily advantages of radical innovations

Antimicrobial susceptibility profile of selected bacteraemic pathogens from private institutions in South Africa

Objectives. The National Antimicrobial Surveillance Forum is a continuous  surveillance organisation comprising all academic/ public and private   sector  laboratories in South Africa.Methods. The antibiotic susceptibility of blood culture isolates of  Escherichia  coli, Klebsiella pneumoniae, Enterobacter species,   Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus  aureus from patients in private hospitals in five major centres were  investigated. Antimicrobial susceptibility tests were performed by 12  participating laboratories  according to the Clinical and Laboratory Standards Institute (CLSI)  guidelines. Extended-spectrum 13-lactamase (ESBL)  production was  determined in selected species of Enterobacteriaceae  irrespective of source.Results. The overall prevalence of ampicillin resistance in blood culture isolates of E. coli (N = 471) was 84%, and 20% were resistant to the  fluoroquinolones. Considerable geographical differences were noted   between the centres with regard to the K. pneumoniae (N = 636) resistance rates for ceftriaxone and/ or cefotaxime (39- 87%). The most active   agents in the Enterobacter spp. (N = 244) were imipenem/meropenem, ertapenem, ciprofloxacin, levofloxacin and cefepime, with 100%,94%, 88%, 87% and 80% susceptibility, respectively. Carbapenem resistance in P. aeruginosa (N = 382) varied between 42% and 45%, and in the case of A. baumannii (N= 190) resistance varied between 32% and 33% for   meropenem and imipenem respectively. The nationwide incidence of  oxacillin resistance in S. aureus (N = 629) was 36%. Overall, the  prevalence of ESBL production among all isolates of K. pneumoniae was 26% (N = 7 514), while in Enterobacter spp. it was 12% (N = 4 031) and in E. coli 5% (N = 28 412).Conclusions. The data highlight the widespread problem of antibiotic  resistance among important bacteraemic pathogens in private institutions in South Africa. Continued surveillance is vital to guide appropriate  empirical therapy for invasive infections

11,000 h of chemical-looping combustion operation—Where are we and where do we want to go?

A key for chemical-looping combustion (CLC) is the oxygen carrier. The ultimate test is obviously the actual operation, which reveals if it turns to dust, agglomerates or loses its reactivity or oxygen carrier capacity. The CLC process has been operated in 46 smaller chemical-looping combustors, for a total of more than 11,000 h. The operation involves both manufactured oxygen carriers, with 70% of the total time of operation, and less costly materials, i.e. natural ores or waste materials. Among manufactured materials, the most popular materials are based on NiO with 29% of the operational time, Fe2O3 with 16% and CuO with 13%. Among the monometallic oxides there are also Mn3O4 with 1%, and CoO with 2%. The manufactured materials also include a number of combined oxides with 11% of operation, mostly calcium manganites and other combined manganese oxides. Finally, the natural ores and waste materials include ilmenite, FeTiO3 with 13%, iron ore/waste with 9% and manganese ore with 6%. In the last years a shift towards more focus on CuO, combined oxides and natural ores has been seen. The operational experience shows a large variation in performance depending on pilot design, operational conditions, solids inventory, oxygen carrier and fuel. However, there is at present no experience of the process at commercial or semi-commercial scale, although oxygen-carrier materials have been successfully used in commercial fluidized-bed boilers for Oxygen-Carrier Aided Combustion (OCAC) during more than 12,000 h of operation. The paper discusses strategies for upscaling as well as the use of biomass for negative emissions. A key question is how scaling-up will affect the performance, which again will determine the costs for purification of CO2 through e.g. oxy-polishing. Unfortunately, the conditions in the small-scale pilots do not allow for any safe conclusions with respect to performance in full scale. Nevertheless, the experiences from pilot operation shows that the process works and can be expected to work in the large scale and gives important information, for instance on the usefulness of various oxygen-carriers. Because further research is not likely to improve our understanding of the performance that can be achieved in full scale, there is little sense in waiting with the scale-up. A major difficulty with the scaling-up of a novel process is in the risk. First-of-its-kind large-scale projects include risks of technical mistakes and unforeseen obstacles, leading to added costs or, in the worst case, failure. One way of addressing these risks is to focus on the heart of the process and build it with maximum flexibility for future use. A concept for maximum flexibility is the Multipurpose Dual Fluidized Bed (MDFB). Another is to find a suitable existing plant, e.g. a dual fluidized-bed thermal gasifier. With present emissions the global CO2 budget associated with a maximum temperature of 2 \ub0C may be spent in around 20–25 years, whereas the CO2 budget for 1.5 \ub0C is may be exhausted in 10 years. Thus, the need for both CO2 neutral fuels and negative emissions will become increasingly urgent as we are nearing or transgressing the maximum amount of CO2 that can be emitted without compromising the global climate agreement in Paris saying we must keep “well below” 2 \ub0C and aim for a maximum of 1.5 \ub0C. Thus, biomass may turn out to be a key fuel for Carbon Capture and Storage (CCS), because CO2-free power does not necessarily need CCS, but negative emissions will definitely need Bio-CCS

(N-Benzoyl-N′-phenyl­thio­urea-κS)chlorido(η4-1,5-cyclo­octa­diene)rhodium(I)

The title compound, [RhCl(C8H12)(C14H12N2OS)], is a rhodium(I) derivative with a functionalized thio­urea ligand. Despite the presence of several heteroatoms, the thio­urea ligand coordinates only in a monodentate fashion via the S atom. The geometry of the coordination sphere is approximately square planar about the RhI atom, with two bonds to the π-electrons of the 1,5-cyclo­octa­diene ligand, one bond to the Cl− ligand and one bond to the S atom of the thio­urea ligand. The mol­ecular structure is stabilized by intra­molecular N—H⋯O and N—H⋯Cl hydrogen bonding. Inter­molecular N—H⋯O hydrogen-bonding inter­actions lead to the formation of layers extending parallel to (011)