Risk factors for failure of outpatient parenteral antibiotic therapy (OPAT) in infective endocarditis

Objectives: To identify risk factors for failure of outpatient antibiotic therapy (OPAT) in infective endocarditis (IE). Patients and methods: We identified IE cases managed at a single centre over 12 years from a prospectively maintained database. ‘OPAT failure’ was defined as unplanned readmission or antibiotic switch due to adverse drug reaction or antibiotic resistance. We analysed patient and disease-related risk factors for OPAT failure by univariate and multivariate logistic regression. We also retrospectively collected follow-up data on adverse disease outcome (defined as IE-related death or relapse) and performed Kaplan–Meier survival analysis up to 36 months following OPAT. Results: We identified 80 episodes of OPAT in IE. Failure occurred in 25/80 episodes (31.3%). On multivariate analysis, cardiac or renal failure [pooled OR 7.39 (95% CI 1.84–29.66), P = 0.005] and teicoplanin therapy [OR 8.69 (95% CI 2.01–37.47), P = 0.004] were independently associated with increased OPAT failure. OPAT failure with teicoplanin occurred despite therapeutic plasma levels. OPAT failure predicted adverse disease outcome up to 36 months (P = 0.016 log-rank test). Conclusions: These data caution against selecting patients with endocarditis for OPAT in the presence of cardiac or renal failure and suggest teicoplanin therapy may be associated with suboptimal OPAT outcomes. Alternative regimens to teicoplanin in the OPAT setting should be further investigated

Effect of Increasing Levels of Condensed Corn Distillers Solubles on Performance of Finishing Steers

A trial was conducted as a randomized block design to assess the effects of condensed corn distillers solubles (CCDS) on performance and carcass merit of yearling steers (n = 21 6) fed 90% concentrate finishing diets. CCDS was included at 0 (MSBM), 5 (5CCDS1, 10 (IOCCDS), or 20% (20CCDS) of diet DM, replacing soybean meal, molasses, and corn. Average daily gain increased (PC .051 for steers fed CCDS but, along with a numerical trend (P= .14) of increasing DMI, resulted in no improvement in FIG (P\u3e.20). Steers were harvested on day 108. Carcass weight and dressing percent for steers fed CCDS were greater than control steers (P\u3c .01). Other carcass characteristics did not differ by treatment (P \u3e .20). Ruminal fluid was collected by stomach tube from steers (n = 72) at -.5, + 1, +4, and + 7 hours from feeding. Values reported are means across sampling times. Ruminal fluid pH was higher for CCDS fed cattle than MSBM (P\u3c.05). Butyrate increased with increasing CCDS level (PC .05). Differences in acetate, propionate, and NH3N were not significant (P\u3e .20). The CCDS was an effective protein and energy source in 90% concentrate corn-based finishing diets. Based on performance, maximum inclusion rate is at least 20% of diet DM

Spectroscopic Constants, Abundances, and Opacities of the TiH Molecule

Using previous measurements and quantum chemical calculations to derive the molecular properties of the TiH molecule, we obtain new values for its ro-vibrational constants, thermochemical data, spectral line lists, line strengths, and absorption opacities. Furthermore, we calculate the abundance of TiH in M and L dwarf atmospheres and conclude that it is much higher than previously thought. We find that the TiH/TiO ratio increases strongly with decreasing metallicity, and at high temperatures can exceed unity. We suggest that, particularly for subdwarf L and M dwarfs, spectral features of TiH near $\sim$0.52 \mic, 0.94 \mic, and in the $H$ band may be more easily measureable than heretofore thought. The recent possible identification in the L subdwarf 2MASS J0532 of the 0.94 \mic feature of TiH is in keeping with this expectation. We speculate that looking for TiH in other dwarfs and subdwarfs will shed light on the distinctive titanium chemistry of the atmospheres of substellar-mass objects and the dimmest stars.Comment: 37 pages, including 4 figures and 13 tables, accepted to the Astrophysical Journa

Neuronal synchrony: peculiarity and generality

Synchronization in neuronal systems is a new and intriguing application of dynamical systems theory. Why are neuronal systems different as a subject for synchronization? (1) Neurons in themselves are multidimensional nonlinear systems that are able to exhibit a wide variety of different activity patterns. Their “dynamical repertoire” includes regular or chaotic spiking, regular or chaotic bursting, multistability, and complex transient regimes. (2) Usually, neuronal oscillations are the result of the cooperative activity of many synaptically connected neurons (a neuronal circuit). Thus, it is necessary to consider synchronization between different neuronal circuits as well. (3) The synapses that implement the coupling between neurons are also dynamical elements and their intrinsic dynamics influences the process of synchronization or entrainment significantly. In this review we will focus on four new problems: (i) the synchronization in minimal neuronal networks with plastic synapses (synchronization with activity dependent coupling), (ii) synchronization of bursts that are generated by a group of nonsymmetrically coupled inhibitory neurons (heteroclinic synchronization), (iii) the coordination of activities of two coupled neuronal networks (partial synchronization of small composite structures), and (iv) coarse grained synchronization in larger systems (synchronization on a mesoscopic scale

Onset of Phase Synchronization in Neurons Conneted via Chemical Synapses

We study the onset of synchronous states in realistic chaotic neurons coupled by mutually inhibitory chemical synapses. For the realistic parameters, namely the synaptic strength and the intrinsic current, this synapse introduces non-coherences in the neuronal dynamics, yet allowing for chaotic phase synchronization in a large range of parameters. As we increase the synaptic strength, the neurons undergo to a periodic state, and no chaotic complete synchronization is found.Comment: to appear in Int. J. Bif. Chao

Characteristics and capacities of the NASA Lewis Research Center high precision 6.7- by 6.7-m planar near-field scanner

A very precise 6.7- by 6.7-m planar near-field scanner has recently become operational at the NASA Lewis Research Center. The scanner acquires amplitude and phase data at discrete points over a vertical rectangular grid. During the design phase for this scanner, special emphasis was given to the dimensional stability of the structures and the ease of adjustment of the rails that determine the accuracy of the scan plane. A laser measurement system is used for rail alignment and probe positioning. This has resulted in very repeatable horizontal and vertical motion of the probe cart and hence precise positioning in the plane described by the probe tip. The resulting accuracy will support near-field measurements at 60 GHz without corrections. Subsystem design including laser, electronic and mechanical and their performance is described. Summary data are presented on the scan plane flatness and environmental temperature stability. Representative near-field data and calculated far-field test results are presented. Prospective scanner improvements to increase test capability are also discussed