Impact of time to appropriate therapy on mortality in patients with vancomycin-intermediate Staphylococcus aureus infection

Despite the increasing incidence of vancomycin-intermediate Staphylococcus aureus (VISA) infections, few studies have examined the impact of delay in receipt of appropriate antimicrobial therapy on outcomes in VISA patients. We examined the effects of timing of appropriate antimicrobial therapy in a cohort of patients with sterile-site methicillin-resistant S. aureus (MRSA) and VISA infections. In this single-center, retrospective cohort study, we identified all patients with MRSA or VISA sterile-site infections from June 2009 to February 2015. Clinical outcomes were compared according to MRSA/VISA classification, demographics, comorbidities, and antimicrobial treatment. Thirty-day all-cause mortality was modeled with Kaplan-Meier curves. Multivariate logistic regression analysis (MVLRA) was used to determine odds ratios for mortality. We identified 354 patients with MRSA (n = 267) or VISA (n = 87) sterile-site infection. Fifty-five patients (15.5%) were nonsurvivors. Factors associated with mortality in MVLRA included pneumonia, unknown source of infection, acute physiology and chronic health evaluation (APACHE) II score, solid-organ malignancy, and admission from skilled care facilities. Time to appropriate antimicrobial therapy was not significantly associated with outcome. Presence of a VISA infection compared to that of a non-VISA S. aureus infection did not result in excess mortality. Linezolid use was a risk for mortality in patients with APACHE II scores of ≥14. Our results suggest that empirical vancomycin use in patients with VISA infections does not result in excess mortality. Future studies should (i) include larger numbers of patients with VISA infections to confirm the findings presented here and (ii) determine the optimal antibiotic therapy for critically ill patients with MRSA and VISA infections

Improved understanding and control of Mg-doped GaN by plasma assisted molecular beam epitaxy

By an improved understanding of Mg-doped GaN through an exhaustive review of current limitations, increased control over the material was achieved by addressing several of these issues. To address the issues of the memory effect, low sticking coefficient and high vapor pressure of Mg, a new Mg dopant source was implemented, characterized and modeled for p-type doping of GaN. The device enhanced the sticking coefficient of Mg by energizing the outgoing Mg flux, and also allowed the first reported demonstration of an abrupt junction between two non-zero Mg concentrations and a graded Mg-doped GaN film. The significant compensation of Mg acceptors at high dopant concentrations was used advantageously to develop a new ex situ resistivity analysis technique using the energy distributions of SIMS to characterize doping of buried layers. The new technique was used to identify the barrier between conductive and resistive Mg doping for increased Mg concentration, which was then used to optimize Mg-doped GaN. Because Mg doping exhibits a dependence upon the growth regime, a new growth and regime characterization technique was developed using specific RHEED intensity responses to repeat growth conditions. During the development of this technique, a new surface kinetics growth model for III-nitrides was discovered based on DMS observations, which suggests preferential buildup of the metal bilayer before growth begins with an unfamiliar cation-anion exchange process initially upon metal shutter opening. Using the new RHEED growth and regime characterization technique, a new growth technique called metal modulated epitaxy (MME) was developed to increase repeatability, uniformity and smoothness. The MME technique was enhanced with a closed-loop control using real-time feedback from RHEED transients to control shutter transitions. This enhancement, called smart shuttering, led to improved growth rate and further improvement of surface roughness and grain size, which were repeatable within low percentages. Effects of smart-shuttering MME were observed with Si, Mg and In during GaN growths. Repeatable Mg-doped GaN was achieved with a variation of less than 8%, and a peak hole carrier concentration of 4.7E18 cm^-3.Ph.D.Committee Chair: Doolittle, W. Alan; Committee Member: Carter, W. Brent; Committee Member: Cressler, John D.; Committee Member: Dorsey, John F.; Committee Member: Ferguson, Ian T

Practical Pullet and Breeder Nutrition

Modern meat chicken breeding stock have been selected for extremely efficient conversion of feed into protein and rapid growth. As a result, it has become increasingly more difficult to rear pullets and breeders to achieve the healthy chick numbers needed to supply the ever-expanding poultry meat market. There are many factors involved in producing a healthy pullet and breeder chicken. These include; housing, lighting, temperature and air control, health, animal husbandry, feed management and nutrition. This presentation is titled, Practical Pullet and Breeder Nutrition. Feed nutrient composition is important, but feed management is critical to make the nutrition effective. The nutritionist’s job is to establish the correct balance of nutrients in the feed and then to work with breeder managers to ensure that each bird receives the required daily intake of nutrients for age

Risky business

Rupert Read and David Burnham on what philosophy can tell us about dealing with uncertainty, systemic risk, and potential catastroph

Billiards and Brains: Cognitive Ability and Behavior in a p-Beauty Contest

"Beauty contests" are well-studied, dominance-solvable games that generate two interesting results. First, most behavior does not conform to the unique Nash equilibrium. Second, there is considerable unexplained heterogeneity in behavior. In this work, we evaluate the relationship between beauty contest behavior and cognitive ability. We find that subjects with high cognitive ability exhibit behavior that is closer to the Nash equlibrium. We examine this finding through the prism of economic and biological theory.beauty contest; rationality; cognitive ability; Nash equlibrium

Luciano Jaramillo

A Luciano Jaramillo, lo he considerado siempre un pintor distinto, un pintor para situar un día en su verdadero lugar: siempre en entrega honrada y definitiva a un arte casi "underground", desde un voluntarioso retraimiento, desde un deliberado ostracismo, haciendo sabotaje al conformismo estético

Modelling of optical traps for aerosols

Experimental observations suggest that there are differences between the behavior of particles optically trapped in air and trapped in a liquid phase. We present a modified version of Mie Debye Spherical Aberration theory to numerically simulate such optical system in attempt to explain and predict these effects. The model incorporates Mie scattering and focussing of the trapping beam through media of stratified refractive index. Our results show a geometrical optics approach cannot correctly describe our system and that spherical aberration must be included. We successfully qualitatively explain the observed phenomena and those of other authors, before discussing the limits of our experimental techniques and methods to improve it. We draw the important conclusion that when optically trapping aerosols the system does not behave as a true `optical tweezers', varying between levitation and single beam gradient force trapping depending on particle and beam parameters

Atomic Resonance and Scattering

Contains reports on one research projects.U. S. Navy (Office of Naval Research) under Contract N00014-67-A-0204-0006Joint Services Electronics Programs (U. S. Army, U. S. Navy, and U. S. Air Force) under Contract DA28-043-AMC-02536(E