Incidence, risk factors and outcomes of Escherichia coli bloodstream infections in a large Canadian region

ABSTRACTAlthough Escherichia coli is the most common cause of bloodstream infection, its epidemiology has not been well defined in non-selected populations. We sought to describe the incidence of risk factors for, and outcomes associated with, E. coli bacteraemia. Population-based surveillance for E. coli bacteraemia was conducted in the Calgary Health Region (population 1.2 million) during the period 2000–2006. In total, 2368 episodes of E. coli bacteraemia were identified for an overall annual population incidence of 30.3/100 000; 15% were nosocomial, 32% were healthcare-associated community-onset and 53% were community-acquired bacteraemias. The very young and the elderly were at highest risk for E. coli bacteraemia. Sixty per cent of the episodes occurred in females (relative risk 1.5; 95% CI 1.4–1.6). Dialysis, solid organ transplantation and neoplastic disease were the most important risk factors for acquiring E. coli bacteraemia. Rates of resistance to ampicillin, trimethoprim–sulphamethoxazole, gentamicin, ciprofloxacin, cefazolin and ceftriaxone increased significantly during the period 2000–2006. The case-fatality rate was 11% and the annual population mortality rate was 2.9/100 000. Increasing age, ciprofloxacin resistance, non-urinary focus and a number of comorbid illnesses were independently associated with an increased risk of death, and community acquisition and urinary focus were associated with a lower risk of death. This study documents the major burden of illness associated with E. coli bacteraemia and identifies groups at increased risk for acquiring and dying from these infections. The emergence of ciprofloxacin resistance and its adverse effect on patient outcome is a major concern

Molecular evolution of Klebsiella pneumoniae ST278 harboring blaNDM-7 involved in nosocomial transmission

During 2013, ST278 Klebsiella pneumoniae with blaNDM-7 was isolated from the urine (KpN01) and rectum (KpN02) of a patient in Calgary, Canada. The same strain (KpN04) was subsequently isolated from another patient in the same unit. Interestingly, a carbapenem-susceptible ST278 (KpN06) was obtained one month later from the blood of the second patient. Next generation sequencing (NGS) revealed that the loss of carbapenem-resistance in KpN06 was due to a 5-kb deletion on the blaNDM-7-harboring IncX3 plasmid. In addition, an IncFIB plasmid in KpN06 had a 27 kb deletion that removed genes encoding for heavy metal resistance. Phylogenetic analysis showed that the ST278 K. pneumoniae from patient 2 were likely descendants of KpN02 and that KpN06 was a close progenitor of an environmental ST278. It is unclear whether KpN06 lost the blaNDM-7 gene in vivo. This study detailed the remarkable plasticity and speed of evolutionary changes in multidrug resistance K. pneumoniae demonstrating the highly recombinant nature of this species. It also highlights the ability of NGS to clarify molecular micro-evolutionary events within antibiotic-resistant organisms.This work was supported in part by a research grant from the Calgary Laboratory Services (#10009392) and grants from the National Institutes of Health (1R01AI090155 to B.N.K, and R21AI117338 to L.C).http://jid.oxfordjournals.org2017-06-30hb2016Medical Microbiolog

Jet disc coupling in black hole binaries

In the last decade multi-wavelength observations have demonstrated the importance of jets in the energy output of accreting black hole binaries. The observed correlations between the presence of a jet and the state of the accretion flow provide important information on the coupling between accretion and ejection processes. After a brief review of the properties of black hole binaries, I illustrate the connection between accretion and ejection through two particularly interesting examples. First, an INTEGRAL observation of Cygnus X-1 during a 'mini-' state transition reveals disc jet coupling on time scales of orders of hours. Second, the black hole XTEJ1118+480 shows complex correlations between the X-ray and optical emission. Those correlations are interpreted in terms of coupling between disc and jet on time scales of seconds or less. Those observations are discussed in the framework of current models.Comment: Invited talk at the Fifth Stromlo Symposium: Disks, Winds & Jets - from Planets to Quasars. Accepted for publication in Astrophysics & Space Scienc

Inflation Physics from the Cosmic Microwave Background and Large Scale Structure

Fluctuations in the intensity and polarization of the cosmic microwave background (CMB) and the large-scale distribution of matter in the universe each contain clues about the nature of the earliest moments of time. The next generation of CMB and large-scale structure (LSS) experiments are poised to test the leading paradigm for these earliest moments---the theory of cosmic inflation---and to detect the imprints of the inflationary epoch, thereby dramatically increasing our understanding of fundamental physics and the early universe. A future CMB experiment with sufficient angular resolution and frequency coverage that surveys at least 1 of the sky to a depth of 1 uK-arcmin can deliver a constraint on the tensor-to-scalar ratio that will either result in a 5-sigma measurement of the energy scale of inflation or rule out all large-field inflation models, even in the presence of foregrounds and the gravitational lensing B-mode signal. LSS experiments, particularly spectroscopic surveys such as the Dark Energy Spectroscopic Instrument, will complement the CMB effort by improving current constraints on running of the spectral index by up to a factor of four, improving constraints on curvature by a factor of ten, and providing non-Gaussianity constraints that are competitive with the current CMB bounds

Thermomechanical erosion modelling of Baydaratskaya Bay, Russia with COSMOS

Rapid coastal erosion threatens Arctic coastal infrastructure, including communities and industrial installations. Erosion of permafrost depends on numerous processes, including thermal and mechanical behaviour of frozen and unfrozen soil, nearshore hydrodynamics, atmospheric forcing, and the presence of sea ice. The quantification and numerical modelling of these processes is essential to predicting Arctic coastal erosion. This paper presents a case study of Baydaratskaya Bay, Russia, using the COSMOS numerical model to predict thermal-mechanical erosion. In particular, this study focuses on thermoabrasional rather than thermodenudational processes. A field dataset of onshore thermal and mechanical soil characteristics was supplemented by sources from the literature to serve as input for the model. A detailed sensitivity analysis has been conducted to determine the influence of key parameters on coastal erosion rates at the study site. This case study highlights the need for expanded data collection on Arctic coastlines and provides direction for future investigations

Long-term Atmospheric Mercury Wet Deposition at Underhill, Vermont

Section 112(m) of the 1990 Clean Air Act Amendments, referred to as the Great Waters Program, mandated an assessment of atmospheric deposition of hazardous air pollutants (HAPs) to Lake Champlain. Mercury (Hg) was listed as a priority HAP and has continued to be a high priority for a number of national and international programs. An assessment of the magnitude and seasonal variation of atmospheric Hg levels and deposition in the Lake Champlain basin was initiated in December 1992 which included event precipitation collection, as well as collection of vapor and particle phase Hg in ambient air. Sampling was performed at the Proctor Maple Research Center in Underhill Center, VT. The range in the annual volume-weighted mean concentration for Hg in precipitation was 7.8–10.5 ng/l for the 11-year sampling period and the average amount of Hg deposited with each precipitation event was 0.10 μg/m 2 . The average amount of Hg deposited through precipitation each year from 1993 to 2003 was 9.7 μg/m 2 /yr. A seasonal pattern for Hg in precipitation is clearly evident, with increased Hg concentrations and deposition observed during spring and summer months. While a clear trend in the 11-year event deposition record at Underhill was not observed, a significant decrease in the event max-to-monthly ratio was observed suggesting that a major source influence was controlled over time. Discrete precipitation events were responsible for significant fractions of the monthly and annual loading of Hg to the forested ecosystem in Vermont. Monthly-averaged temperatures were found to be moderately correlated with monthly volume-weighted mean Hg concentrations ( r 2 =0.61) and Hg deposition ( r 2 =0.67) recorded at the Vermont site. Meteorological analysis indicated the highest levels of Hg in precipitation were associated with regional transport from the west, southwest, and south during the warmer months.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44444/1/10646_2004_Article_6260.pd

New Strategies in Sport Nutrition to Increase Exercise Performance.

Despite over 50 years of research, the field of sports nutrition continues to grow at a rapid rate. Whilst the traditional research focus was one that centred on strategies to maximize competition performance, emerging data in the last decade has demonstrated how both macronutrient and micronutrient availability can play a prominent role in regulating those cell signalling pathways that modulate skeletal muscle adaptations to endurance and resistance training. Nonetheless, in the context of exercise performance, it is clear that carbohydrate (but not fat) still remains king and that carefully chosen ergogenic aids (e.g. caffeine, creatine, sodium bicarbonate, beta-alanine, nitrates) can all promote performance in the correct exercise setting. In relation to exercise training, however, it is now thought that strategic periods of reduced carbohydrate and elevated dietary protein intake may enhance training adaptations whereas high carbohydrate availability and antioxidant supplementation may actually attenuate training adaptation. Emerging evidence also suggests that vitamin D may play a regulatory role in muscle regeneration and subsequent hypertrophy following damaging forms of exercise. Finally, novel compounds (albeit largely examined in rodent models) such as epicatechins, nicotinamide riboside, resveratrol, β-hydroxy β-methylbutyrate, phosphatidic acid and ursolic acid may also promote or attenuate skeletal muscle adaptations to endurance and strength training. When taken together, it is clear that sports nutrition is very much at the heart of the Olympic motto, Citius, Altius, Fortius (faster, higher, stronger)

Planck early results. VI. The High Frequency Instrument data processing

We describe the processing of the 336 billion raw data samples from the High Frequency Instrument (HFI) which we performed to produce six temperature maps from the first 295 days of Planck-HFI survey data. These maps provide an accurate rendition of the sky emission at 100, 143, 217, 353, 545 and 857GHz with an angular resolution ranging from 9.9 to 4.4 . The white noise level is around 1.5 μK degree or less in the 3 main CMB channels (100–217 GHz). The photometric accuracy is better than 2% at frequencies between 100 and 353 GHz and around 7% at the two highest frequencies. The maps created by the HFI Data Processing Centre reach our goals in terms of sensitivity, resolution, and photometric accuracy. They are already sufficiently accurate and well-characterised to allow scientific analyses which are presented in an accompanying series of early papers. At this stage, HFI data appears to be of high quality and we expect that with further refinements of the data processing we should be able to achieve, or exceed, the science goals of the Planck project