Preliminary Remarks Regarding the Prevalence of ESBL-Producing Strains of E. coli and K. Pneumoniae, Isolated from Cows with Clinical Endometritis

ESBL-producing organisms pose unique challenges to clinical microbiologists, clinicians, infection control professionals and antibacterial-discovery scientists. Although the prevalence of ESBLs is not known, it is clearly increasing, and in many parts of the world, 10-40% of strains of E. coli and K. pneumoniae express ESBLs (Rupp and Fey, 2003).The aim of this study was to assess the prevalence of ESBL-positive strains of E. coli and K. pneumoniae in cows with clinical signs of endometritis that were treated exclusively with Oxytetracicline for both diseases of the genital area as well as other bacterial infectious diseases.The study population included 35 Romanian Black Pied cows with clinical signs of endometritis within a farm in North Eastern of Romania. The samples were harvested using sterile cotton swabs that have been further microbiologically processed. For the phenotypic confirmation of the isolated ESBL strains, were used the combined disk test (CLSI, 2014) and the Oxoid Brilliance chromogenic ESBL Agar medium. The taxonomic classification of the isolated colonies was carried out by testing some minimal biochemical characteristics by using the MIU and TSI tests.A total of 47 bacterial strains were isolated from uterine secretions, derived from the 35 cows included in this trial. From the total of 47 isolated bacterial strains, 17 belonged to E. coli and K. pneumoniae species, from which, 6 of them were confirmed as being ESBL-positive.In this preliminary study, by phenotypic methods was confirmed a prevalence of 35.3% for the ESBL strains of E. coli and K. pneumoniae, which requires further research to confirm by molecular biology the identification of ESBL resistance genes, but also for the plasmids encoding these gene transmission

Food product design : chocolate formulas with addition of brewer's yeast powder

The purpose of this study was to use the beer yeast as a substitute for cocoa powder in the chocolate manufacturing recipe with high antioxidant properties. It is known that beer yeast is rich in high antioxidant compounds. To preserve these properties, the beer yeast has been conditioned at a moderate temperature (65°C) to ensure its stability. Then, chocolate formulas, simple and with addition of beer yeast powder in different percentages, was obtaining. The total antioxidant capacity was measured by FRAP assay and to assess the total polyphenol content was used the Folin–Ciocalteu method. By incorporating the beer yeast powder into the chocolate recipe, an increase in the total phenolic content and total antioxidant capacity has been recorded compared to the control sample. Therefore, the total polyphenol content vary from 2.71 mM GAE/100 g DM in the control sample to 6.05 mM GAE/100 g DM in the chocolate formula with 40% yeast. Based on the results obtained from this study, we can affirm that the beer yeast can be used as an ingredient with high added value for designing innovative food products; in this case the chocolate with a more intense taste and flavor

Smart homes for older people involved in rehabilitation activities - reality or dream, acceptance or rejection?

Introduction Recent statistics show an increase in the prevalence of the elderly population. The year 2012 was declared European Year for Active Ageing and Solidarity between Generations, and the European Commission launched campaigns like The Active and Assisted Living Joint Program (AAL JP). Rehabilitation in the elderly is a desideratum, but the problems of rehabilitation in the elderly are numerous. The aim of the study was to evaluate degree of acceptance/implementation of different technologies in Romania, of monitoring in the rehabilitation activity conducted at home. Material and methods the study comprised 154 persons with a mean age of 73.37 ± 7.33 years, of which 64 (41.6%) male and 90 (58.4%) female. All subjects completed a questionnaire regarding the living conditions and health status, about the degree of acceptance of intelligent technologies for monitoring current health status/reporting acute events. Results 18.2% used the Internet frequently, and the rest used it almost never or rarely. 71.9 % of patients agreed to wear a portable sensor (p=0.07 between men and women), 33.1% accepted videocam, 47.4% accepted a screen, 41.3% accepted living room monitoring, 68% sensor in the room on the wall and 69.1% accepted fall detection sensor. No significant differences were found regarding the acceptance vs rejection of personal sensors, living room monitoring, sensors in the room, fall detection sensors depending on the gender, income level, type of caregiving. Using of videocam and screen was influenced by type of care giving and income (p=0.002, p<0.001, respectively for screen p=0.032 and p=0.003). In conclusion, Romanian old people are not keen on using intelligent devices for health status related to acute event monitoring. More programs and measures are needed for device implementation in real life

Comparison of heavy-ion transport simulations: Collision integral with pions and Δ resonances in a box

We compare ten transport codes for a system confined in a box, aiming at improved handling of the production of $\Delta$ resonances and pions, which is indispensable for constraining high-density symmetry energy from observables such as the $\pi^-/\pi^+$ yield ratio in heavy-ion collisions. The system in a box is initialized with nucleons at saturation density and at 60 MeV temperature. The reactions $NN\leftrightarrow N\Delta$ and $\Delta\leftrightarrow N\pi$ are implemented, but the Pauli blocking and the mean-field potential are deactivated in the present comparison. Results are compared to those from the two reference cases of a chemically equilibrated ideal gas mixture and of the rate equation. In the results of the numbers of $\Delta$ and $\pi$, deviations from the reference values are observed in many codes, and they depend significantly on the size of the time step. These deviations are tied to different ways in ordering the sequence of collisions and decays, that take place in the same time step. Better agreements are seen in the reaction rates and the number ratios among the isospin species of $\Delta$ and $\pi$. These are, however, affected by the correlations, which are absent in the Boltzmann equation, but are induced by the way particle scatterings are treated in transport calculations. The uncertainty in the transport-code predictions of the $\pi^-/\pi^+$ ratio for the system initialized at n/p = 1.5, after letting the existing $\Delta$ resonances decay, is found to be within a few percent, which is sufficiently small so that it does not strongly impact constraining the high-density symmetry energy from heavy-ion collisions. Most of the sources of uncertainties have been understood, and individual codes may be further improved. This investigation will be extended in the future to heavy-ion collisions to ensure the problems identified here remain under control.Comment: 36 pages, 27 figures; a new Fig. 21 and revised results from some codes, achieving improved and consistent understandin

Comparison of heavy-ion transport simulations: Collision integral in a box

Simulations by transport codes are indispensable to extract valuable physical information from heavy-ion collisions. In order to understand the origins of discrepancies among different widely used transport codes, we compare 15 such codes under controlled conditions of a system confined to a box with periodic boundary, initialized with Fermi-Dirac distributions at saturation density and temperatures of either 0 or 5 MeV. In such calculations, one is able to check separately the different ingredients of a transport code. In this second publication of the code evaluation project, we only consider the two-body collision term; i.e., we perform cascade calculations. When the Pauli blocking is artificially suppressed, the collision rates are found to be consistent for most codes (to within 1 % or better) with analytical results, or completely controlled results of a basic cascade code. In orderto reach that goal, it was necessary to eliminate correlations within the same pair of colliding particles that can be present depending on the adopted collision prescription. In calculations with active Pauli blocking, the blocking probability was found to deviate from the expected reference values. The reason is found in substantial phase-space fluctuations and smearing tied to numerical algorithms and model assumptions in the representation of phase space. This results in the reduction of the blocking probability in most transport codes, so that the simulated system gradually evolves away from the Fermi-Dirac toward a Boltzmann distribution. Since the numerical fluctuations are weaker in the Boltzmann-Uehling-Uhlenbeck codes, the Fermi-Dirac statistics is maintained there for a longer time than in the quantum molecular dynamics codes. As a result of this investigation, we are able to make judgements about the most effective strategies in transport simulations for determining the collision probabilities and the Pauli blocking. Investigation in a similar vein of other ingredients in transport calculations, like the mean-field propagation or the production of nucleon resonances and mesons, will be discussed in the future publications

A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURO bservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry

Aims: Given the advances in atrial fibrillation (AF) management and the availability of new European Society of Cardiology (ESC) guidelines, there is a need for the systematic collection of contemporary data regarding the management and treatment of AF in ESC member countries. Methods and results: We conducted a registry of consecutive in- and outpatients with AF presenting to cardiologists in nine participating ESC countries. All patients with an ECG-documented diagnosis of AF confirmed in the year prior to enrolment were eligible. We enroled a total of 3119 patients from February 2012 to March 2013, with full data on clinical subtype available for 3049 patients (40.4% female; mean age 68.8 years). Common comorbidities were hypertension, coronary disease, and heart failure. Lone AF was present in only 3.9% (122 patients). Asymptomatic AF was common, particularly among those with permanent AF. Amiodarone was the most common antiarrhythmic agent used (~20%), while beta-blockers and digoxin were the most used rate control drugs. Oral anticoagulants (OACs) were used in 80% overall, most often vitamin K antagonists (71.6%), with novel OACs being used in 8.4%. Other antithrombotics (mostly antiplatelet therapy, especially aspirin) were still used in one-third of the patients, and no antithrombotic treatment in only 4.8%. Oral anticoagulants were used in 56.4% of CHA 2DS2-VASc = 0, with 26.3% having no antithrombotic therapy. A high HAS-BLED score was not used to exclude OAC use, but there was a trend towards more aspirin use in the presence of a high HAS-BLED score. Conclusion: The EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot Registry has provided systematic collection of contemporary data regarding the management and treatment of AF by cardiologists in ESC member countries. Oral anticoagulant use has increased, but novel OAC use was still low. Compliance with the treatment guidelines for patients with the lowest and higher stroke risk scores remains suboptimal. © The Author 2013

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P &lt;.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p&nbsp;&lt;.001. Over 24&nbsp;months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10&nbsp;ml/min/1.73&nbsp;m2 decrease), that was most notable in patients with eGFR &lt;30&nbsp;ml/min/1.73&nbsp;m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90&nbsp;ml/min/1.73&nbsp;m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF