Identification of a suspect before being charged: legitimate freedom of speech or a threat to a fair trial?

Identification of a person suspected of a heinous crime before being charged risks prejudicing a fair trial. Present laws place this type of publicity outside the reach of sub judice contempt. This thesis argues there should be a change in the law of sub judice contempt making it an offence for the media to publish the fact that a person is under investigation until the person has been charged

In situ mixing of organic matter decreases hydraulic conductivity of denitrification walls in sand aquifers

In a previous study, a denitrification wall was constructed in a sand aquifer using sawdust as the carbon substrate. Ground water bypassed around this sawdust wall due to reduced hydraulic conductivity. We investigated potential reasons for this by testing two new walls and conducting laboratory studies. The first wall was constructed by mixing aquifer material in situ without substrate addition to investigate the effects of the construction technique (mixed wall). A second, biochip wall, was constructed using coarse wood chips to determine the effect of size of the particles in the amendment on hydraulic conductivity. The aquifer hydraulic conductivity was 35.4 m/d, while in the mixed wall it was 2.8 m/d and in the biochip wall 3.4 m/d. This indicated that the mixing of the aquifer sands below the water table allowed the particles to re-sort themselves into a matrix with a significantly lower hydraulic conductivity than the process that originally formed the aquifer. The addition of a coarser substrate in the biochip wall significantly increased total porosity and decreased bulk density, but hydraulic conductivity remained low compared to the aquifer. Laboratory cores of aquifer sand mixed under dry and wet conditions mimicked the reduction in hydraulic conductivity observed in the field within the mixed wall. The addition of sawdust to the laboratory cores resulted in a significantly higher hydraulic conductivity when mixed dry compared to cores mixed wet. This reduction in the hydraulic conductivity of the sand/sawdust cores mixed under saturated conditions repeated what occurred in the field in the original sawdust wall. This indicated that laboratory investigations can be a useful tool to highlight potential reductions in field hydraulic conductivities that may occur when differing materials are mixed under field conditions

Digital responses by small businesses during COVID-19: the role of entrepreneurial success factors

Small businesses’ revenues worldwide were affected drastically when governments introduced lockdowns to mitigate the effects of the COVID-19 pandemic. As a response, many small businesses introduced digital technology initiatives. This article examines digital responses introduced by 68 small businesses that have been sourced from Google News. The news stories were analysed according to how small businesses behaved across different phases of their pandemic response (initial impact, digital response and evaluation of the response). The results, which used entrepreneurial success factors as an analytical lens, suggested that success factors were front of mind for small business owners throughout all phases of their responses. These involved traditional measures of financial success (such as measures of turnover or profit) and owner/managers’ personally oriented measures (such as wanting to assist the local community and taking care of employees and customers during the pandemic). The paper proposes new entrepreneurial success measures

A review of studies on information systems and SMEs in high ranked IS journals (2000-2014)

This paper identifies novel approaches to future small and medium enterprise (SME) research from a review of articles, and then introduces the papers in this AJIS special section which evidence these approaches. More specifically, the paper makes an important contribution by reviewing 61 articles in high ranked IS journals (2000-2014) and introducing three new facets which are used to analyse research on SME adoption/use of IS (units of analysis, SME sizes and SME types) not considered in previous literature review studies. These facets provide thebasis for proposing various future research opportunities. The editorial then introduces the four papers in this special section covering the research theme on SMEs, and highlights the contributions they make using the three facets

Nephrotoxicity in Patients With or Without Cystic Fibrosis Treated With Polymyxin B Compared to Colistin

Nephrotoxicity is the primary adverse effect of the polymyxins. The relative rates of toxicity of polymyxin B and colistin have not been fully elucidated, especially in patients with cystic fibrosis (CF). A retrospective cohort study of adults treated with polymyxin B or colistin for at least 48 h was conducted. The primary endpoint was the incidence of kidney injury assessed by RIFLE (i.e., risk, injury, failure, loss, end-stage renal disease) criteria. Risk factors for kidney injury were evaluated using multivariate Cox regression. A total of 414 patients were evaluated, 220 of whom had CF. In patients without CF, there was no difference in kidney injury with polymyxin B and colistin (42.9% versus 50.3%, P = 0.46). Loop diuretic exposure was a risk factor for kidney injury (adjusted hazard ratio [aHR], 1.82; 95% confidence interval [CI], 1.16 to 2.83) in this population. In patients with CF, polymyxin B and colistin were associated with similar rates of kidney injury (34.5% versus 29.8%, P = 0.77). Diabetes (aHR, 2.68; 95% CI, 1.01 to 7.11), loop diuretics (aHR, 3.02; 95% CI, 1.36 to 6.73), and progressive care unit admission (aHR, 8.21; 95% CI, 2.55 to 26.46) were risk factors for kidney injury, while higher baseline serum creatinine levels (per 1 mg/dl) were protective (aHR, 0.08; 95% CI, 0.01 to 0.48). Total unadjusted kidney injury in polymyxin-treated patients was less frequent in those who had CF (30.5% versus 48.5%, P \u3c 0.001). Polymyxin B and colistin are associated with a high incidence of kidney injury; cystic fibrosis may be protective against polymyxin nephrotoxicity, but further investigation is needed to confirm this conjecture

Nephrotoxicity During Vancomycin Therapy in Combination with Piperacillin-Tazobactam or Cefepime

Recent reports have demonstrated that vancomycin (VAN) may lead to an increase in the incidence of acute kidney injury (AKI) when it is combined with antipseudomonal beta-lactams. This study compared the incidence of AKI associated with VAN plus piperacillin-tazobactam (TZP) or cefepime (FEP). This was a retrospective, matched cohort study that was conducted at an academic medical center between September 2010 and September 2014 and that included adult patients without severe chronic or structural kidney disease, dialysis, pregnancy, cystic fibrosis, or a hospital transfer receiving TZP-VAN or FEP-VAN for at least 48 h. The primary outcome was the difference in the AKI incidence between the TZP-VAN and FEP-VAN groups, evaluated using the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) criteria. Patients in the two groups were matched on the basis of age, sex, severity of illness, baseline creatinine clearance, hypotension, number of nephrotoxicity risk factors, and intravenous contrast exposure. In total, 4,193 patients met all inclusion criteria (3,605 received TZP-VAN and 588 received FEP-VAN). The unadjusted AKI incidence was 21.4% in patients receiving TZP-VAN, whereas it was 12.6% in patients receiving FEP-VAN (P \u3c 0.001). After the patients were matched, 1,633 patients receiving TZP-VAN and 578 patients receiving FEP-VAN were evaluated. The AKI incidence remained higher in patients receiving TZP-VAN than in those receiving FEP-VAN (21.4% versus 12.5%, P \u3c 0.0001). This trend remained true for all classifications of the RIFLE criteria. After controlling for remaining confounders, TZP-VAN therapy was associated with 2.18 times the odds of AKI than FEP-VAN therapy (95% confidence interval, 1.64 to 2.94 times) in logistic regression. AKI was significantly more common in patients receiving vancomycin in combination with piperacillin-tazobactam than in those receiving vancomycin in combination with cefepime. This finding reinforces the need for the judicious use of combination empirical antimicrobial therapy

Utilizing Monte Carlo Simulations to Optimize Institutional Empiric Antipseudomonal Therapy

Pseudomonas aeruginosa is a common pathogen implicated in nosocomial infections with increasing resistance to a limited arsenal of antibiotics. Monte Carlo simulation provides antimicrobial stewardship teams with an additional tool to guide empiric therapy. We modeled empiric therapies with antipseudomonal β-lactam antibiotic regimens to determine which were most likely to achieve probability of target attainment (PTA) of ≥90%. Microbiological data for P. aeruginosa was reviewed for 2012. Antibiotics modeled for intermittent and prolonged infusion were aztreonam, cefepime, meropenem, and piperacillin/tazobactam. Using minimum inhibitory concentrations (MICs) from institution-specific isolates, and pharmacokinetic and pharmacodynamic parameters from previously published studies, a 10,000-subject Monte Carlo simulation was performed for each regimen to determine PTA. MICs from 272 isolates were included in this analysis. No intermittent infusion regimens achieved PTA ≥90%. Prolonged infusions of cefepime 2000 mg Q8 h, meropenem 1000 mg Q8 h, and meropenem 2000 mg Q8 h demonstrated PTA of 93%, 92%, and 100%, respectively. Prolonged infusions of piperacillin/tazobactam 4.5 g Q6 h and aztreonam 2 g Q8 h failed to achieved PTA ≥90% but demonstrated PTA of 81% and 73%, respectively. Standard doses of β-lactam antibiotics as intermittent infusion did not achieve 90% PTA against P. aeruginosa isolated at our institution; however, some prolonged infusions were able to achieve these targets

Structures of smooth muscle myosin and heavy meromyosin in the folded, shutdown state

Remodelling of the contractile apparatus within smooth muscle cells is an essential process that allows effective contractile activity over a wide range of cell lengths. The thick filaments may be redistributed via depolymerisation into inactive myosin monomers that have been detected in vitro, in which the long tail has a folded conformation. The structure of this folded molecule has been controversial. Using negative stain electron microscopy of individual folded molecules from turkey gizzard we show they are more compact than previously described, with heads and the three segments of the folded tail closely packed. Smooth muscle heavy meromyosin (HMM), which lacks two-thirds of the tail, closely resembles the equivalent parts of whole myosin. Image processing reveals a characteristic head region morphology for both HMM and myosin whose features are identifiable by comparison with less compact molecules. The two heads associate asymmetrically: the tip of one motor domain touches the base of the other, resembling the blocked and free heads of this HMM when it forms 2-D crystals on lipid. The tail of HMM lies between the heads, contacting the blocked motor domain, unlike in the 2-D crystal. The tail of the intact myosin is bent sharply and consistently at two positions close to residues 1175 and 1535. The first bend position correlates with a skip in the coiled coil sequence, the second does not. The first segment runs between the heads from the head-tail junction. Unexpectedly, the other segments associate only with the blocked head rather than both heads, such that the second bend lies at a specific position near the C-lobe of the blocked head regulatory light chain. Quantitative analysis of tail flexibility shows that the single coiled coil of HMM has an apparent Young’s modulus of about 0.5 GPa. The folded tail of the intact molecule is less flexible indicating interactions between the segments. The folded tail does not modify the compact head arrangement but stabilises it, indicating a structural mechanism for the very low ATPase activity of the folded molecule