Toll-like receptors in inflammatory bowel diseases: A decade later

Differential alteration of Toll-like receptor (TLR) expression in inflammatory bowel disease (IBD) was first described 10 years ago. Since then, studies from many groups have led to the current concept that TLRs represent key mediators of innate host defense in the intestine, involved in maintaining mucosal as well as commensal homeostasis. Recent findings in diverse murine models of colitis have helped to reveal the mechanistic importance of TLR dysfunction in IBD pathogenesis. It has become evident that environment, genetics, and host immunity form a multidimensional and highly interactive regulatory triad that controls TLR function in the intestinal mucosa. Imbalanced relationships within this triad may promote aberrant TLR signaling, critically contributing to acute and chronic intestinal inflammatory processes in IBD colitis and associated cancer. (Inflamm Bowel Dis 2010

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Virginia dare.

Gift of Dr. Mary Jane Esplen.Piano vocal [instrumentation]E flat major [key]Marcia [tempo]Popular song [form/genre]Woman, men [illustration]Albert Alex Smith [engraver]Publisher's advertisement on back cover [note

Gram negative bacteria related urinary tract infections: spectrum of antimicrobial resistance over 9 years in a University tertiary referral Hospital

Objective: Overuse of antibiotics has led to an increase in antimicrobial resistance (AMR) worldwide, with a negative impact on the healthcare system and the patients. In this context, our study aims to assess the current AMR patterns of urinary tract infections (UTIs) associated to Gram-negative bacteria. Thus, we provide useful information for doctors dealing with prophylactic and therapeutic empiric therapies. Materials and methods: We retrospectively analysed more than 650,000 urine cultures collected in the Microbiology Department of a referral University Hospital of Southern England from January 2014 to December 2022. Results: AMR spectra for 164,059 Gram-negative associated (UTIs) were analysed. The lowest percentage of resistance was found for Amikacin (2.30%), Gentamicin (5.89%) and Co-Amoxiclav (10.49%). Over a 9-year time, there was no significant change in resistance to Amikacin (2.04% in 2014 compared to 2.18% in 2022; p  = 0.602) and to Fosfomycin (11.50% in 2014 versus 16.65% in 2022; p  = 0.577). Overall, the trend of AMR significantly rose for Cefalexin (17.96–18.42%; p  < 0.0001), Co-amoxiclav (9.46–12.69%; p  < 0.0001), Nitrofurantoin (10.20–14.18%; p  < 0.0001) and Piperacillin/Tazobactam (14.52–18.96%; p  < 0.0001). Gram-negative resistance spectrum towards Ciprofloxacin (11.83–9.01%; p  < 0.0001), Gentamicin (6.29–5.26%; p  < 0.0001), Pivmecillinam (26.88–11.02%; p  < 0.0001), Trimethoprim (36.72–29.23%; p  < 0.0001) and Ampicillin/Amoxicillin (65.20–57.99%; p  < 0.0001) significantly decreased. Conclusion: Despite the application of national and international guidelines for prophylaxis and treatment of UTIs, the spectrum of resistance for the most common antibiotics is still changing. Clinicians in primary and secondary care must keep that in mind when prescribing antibiotics for suspected UTI and sepsis associated with Gram-negative infections Up-to-date therapeutic strategies can help implement treatment of UTI, reducing selection of multi-resistant pathogens and providing more accurate care for patients. Future studies will be required to help clinicians and keep the guidelines updated

Shag Rock - Sunbleached girl

'Sunbleached Girl' was released by Brisbane-based band Shag Rock in mid 2017. It was written by Jacob Reed, Alex Wilson, Nick Cavdarski, and Max Beech. The song was engineered by Yanto Browning, produced by Ian Haug, and mixed by Nick DiDia.'Sunbleached Girl' was certified as a Gold record by APRA in June 2021, with the song passing the 6 million mark on streaming platforms

100 Songs Project 2011

The Independent Music Project is centred around the development and creation of new music, and includes research into copyright, business models of the future, new technologies, and new audiences. The music industry is undergoing the most radical changes it has faced in almost a century. New digital technologies have made the production, distribution, and promotion of recorded music accessible to anyone with a personal computer. People can now make high-quality digital copies of music and distribute them globally within minutes. Even bastions of the established industries, such as EMI and Columbia, are struggling to make sense of the new industry terrain. The whole employment picture has changed just as radically for people who wish to make a living from music. In Australia, many of the avenues that provided employment for musicians have either disappeared or dramatically shrunk. The advertising industry no longer provides the level of employment it used to prior to the Federal deregulation of the industry in 1992. In many places, new legislative pressures on inner-city and suburban venues have diminished the number of performance spaces that musicians can work in. Just as quickly, new sectors have opened to professional musicians: computer games, ringtones, sound-enabled toys and web advertising all present new opportunities to the enterprising musician. The opportunity to distribute music internationally without being signed to a major label is very attractive to many aspiring and established professionals. No doubt the music industry will face many more challenges as technologies continue to change, as global communication gets easier and faster, and as the challenges to copyright proliferate and change. These challenges cannot be successfully met on a single front. They require research and expertise from all sectors being affected, and this is why the independent music project (IMP) exists