447 research outputs found
The effect of boundary conditions on resonant ultrasonic spherical chains
The response of a resonant chain of spheres to changes in holder material and pre-compression is studied at ultrasonic frequencies. The system is found to be very sensitive to these parameters, with the creation of impulsive waveforms from a narrow bandwidth input seen only for certain chain lengths and holder materials. In addition, careful experiments were performed using known amounts of pre-compression force, using a calibrated stylus arrangement. At negligible pre-compression levels, impulses were generated within the chain, which were then suppressed by increased pre-compression. This was accompanied by large changes in propagation velocity as the system gradually changes from being strongly nonlinear to being more linear. Simulations using a discrete model for the motion of each sphere agree well with experimental data
High frequency sound in superfluid 3He-B
We present measurements of the absolute phase velocity of transverse and
longitudinal sound in superfluid 3He-B at low temperature, extending from the
imaginary squashing mode to near pair-breaking. Changes in the transverse phase
velocity near pair-breaking have been explained in terms of an order parameter
collective mode that arises from f-wave pairing interactions, the so-called
J=4- mode. Using these measurements, we establish lower bounds on the energy
gap in the B-phase. Measurement of attenuation of longitudinal sound at low
temperature and energies far above the pair-breaking threshold, are in
agreement with the lower bounds set on pair-breaking. Finally, we discuss our
estimations for the strength of the f-wave pairing interactions and the Fermi
liquid parameter, F4s.Comment: 15 pages, 8 figures, accepted to J. Low Temp. Phy
Current perspectives on recurrent pituitary adenoma: the role and timing of surgery vs adjuvant treatment
The clinical course of pituitary adenoma can be highly variable. Aggressive pituitary tumours may require multimodal therapy with multiple operations. Even standard pituitary adenomas exhibit relatively high longâterm recurrence rates and delayed intervention is often required. The indications for revision surgery in the endoscopic era are expanding for both functioning and nonfunctioning tumours, including access to the cavernous sinus and intracranial compartments. Although revision surgery can be challenging, it has been demonstrated to be both safe and effective. The question of the use of early radiotherapy in pituitary adenoma remains controversial. Our increasing understanding of pituitary tumour biology facilitates individualized treatment and surveillance protocols, with early intervention in highârisk adenoma subtypes. In this review, we discuss the treatment options for recurring pituitary tumours and focus on the role of revision surgery
CASSETTEâclindamycin adjunctive therapy for severe Staphylococcus aureus treatment evaluation: Study protocol for a randomised controlled trial
Background
Exotoxins are important virulence factors in Staphylococcus aureus. Clindamycin, a protein synthesis inhibitor antibiotic, is thought to limit exotoxin production and improve outcomes in severe S. aureus infections. However, randomised prospective data to support this are lacking.
Methods
An open-label, multicentre, randomised controlled trial (RCT) will compare outcome differences in severe S. aureus infection between standard treatment (flucloxacillin/cefazolin in methicillin-susceptible S. aureus; and vancomycin/daptomycin in methicillin-resistant S. aureus) and standard treatment plus an additional clindamycin given for 7âdays. We will include a minimum of 60 participants (both adult and children) in the pilot study. Participants will be enrolled within 72âh of an index culture. Severe infections will include septic shock, necrotising pneumonia, or multifocal and non-contiguous skin and soft tissue/osteoarticular infections. Individuals who are immunosuppressed, moribund, with current severe diarrhoea or Clostridiodes difficile infection, pregnant, and those with anaphylaxis to ÎČ-lactams or lincosamides will be excluded.
The primary outcomes measure is the number of days alive and free (1 or 0) of systemic inflammatory response syndrome (SIRS) within the first 14âdays post randomisation. The secondary outcomes measure will include all-cause mortality at 14, 42, and 90âdays, time to resolution of SIRS, proportion with microbiological treatment failure, and rate of change of C-reactive protein over time. Impacts of inducible clindamycin resistance, strain types, methicillin susceptibility, and presence of various exotoxins will also be analysed.
Discussion
This study will assess the effect of adjunctive clindamycin on patient-centred outcomes in severe, toxin-mediated S. aureus infections. The pilot study will provide feasibility for a much larger RCT.
Trial registration
Australian New Zealand Clinical Trials Registry, ACTRN12617001416381p. Registered on 6 October 2017
Clindamycin adjunctive therapy for severe Staphylococcus aureus treatment evaluation (CASSETTE)âan open-labelled pilot randomized controlled trial
Background
Combination antibiotic therapy with an antitoxin agent, such as clindamycin, is included in some guidelines for severe, toxin-mediated Staphylococcus aureus infections. The evidence to support this practice is currently limited to in vitro, animal and observational human case-series data, with no previous randomized controlled trials (RCTs).
Objectives
This pilot RCT aimed to determine the feasibility of conducting a clinical trial to examine if adjunctive clindamycin with standard therapy has greater efficacy than standard therapy alone for S. aureus infections.
Methods
We performed an investigator-initiated, open-label, multicentre, pilot RCT (ACTRN12617001416381p) in adults and children with severe S. aureus infections, randomized to standard antibiotic therapy with or without clindamycin for 7â
days.
Results
Over 28â
months, across nine sites, 127 individuals were screened and 34 randomized, including 11 children (32%). The primary outcomeânumber of days alive and free of systemic inflammatory response syndrome â€14â
daysâwas similar between groups: clindamycin (3â
days [IQR 1â6]) versus standard therapy (4â
days [IQR 0â8]). The 90â
day mortality was 0% (0/17) in the clindamycin group versus 24% (4/17) in the standard therapy group. Secondary outcomesâmicrobiological relapse, treatment failure or diarrhoeaâwere similar between groups.
Conclusions
As the first clinical trial assessing adjunctive clindamycin for S. aureus infections, this study indicates feasibility and that adults and children can be incorporated into one trial using harmonized endpoints, and there were no safety concerns. The CASSETTE trial will inform the definitive S. aureus Network Adaptive Platform (SNAP) trial, which includes an adjunctive clindamycin domain and participants with non-severe disease
Observing Supermassive Black Holes across cosmic time: from phenomenology to physics
In the last decade, a combination of high sensitivity, high spatial
resolution observations and of coordinated multi-wavelength surveys has
revolutionized our view of extra-galactic black hole (BH) astrophysics. We now
know that supermassive black holes reside in the nuclei of almost every galaxy,
grow over cosmological times by accreting matter, interact and merge with each
other, and in the process liberate enormous amounts of energy that influence
dramatically the evolution of the surrounding gas and stars, providing a
powerful self-regulatory mechanism for galaxy formation. The different
energetic phenomena associated to growing black holes and Active Galactic
Nuclei (AGN), their cosmological evolution and the observational techniques
used to unveil them, are the subject of this chapter. In particular, I will
focus my attention on the connection between the theory of high-energy
astrophysical processes giving rise to the observed emission in AGN, the
observable imprints they leave at different wavelengths, and the methods used
to uncover them in a statistically robust way. I will show how such a combined
effort of theorists and observers have led us to unveil most of the SMBH growth
over a large fraction of the age of the Universe, but that nagging
uncertainties remain, preventing us from fully understating the exact role of
black holes in the complex process of galaxy and large-scale structure
formation, assembly and evolution.Comment: 46 pages, 21 figures. This review article appears as a chapter in the
book: "Astrophysical Black Holes", Haardt, F., Gorini, V., Moschella, U and
Treves A. (Eds), 2015, Springer International Publishing AG, Cha
Production and Decay of D_1(2420)^0 and D_2^*(2460)^0
We have investigated and final states and
observed the two established charmed mesons, the with mass
MeV/c and width MeV/c and
the with mass MeV/c and width
MeV/c. Properties of these final states, including
their decay angular distributions and spin-parity assignments, have been
studied. We identify these two mesons as the doublet predicted
by HQET. We also obtain constraints on {\footnotesize } as a function of the cosine of the relative phase of the two
amplitudes in the decay.Comment: 15 pages in REVTEX format. hardcopies with figures can be obtained by
sending mail to: [email protected]
Organizational and Leadership Implications for Transformational Development
Transformational development is a concept of change that originated in the Christian context but has now become generally used in the work of both secular and faith-based organizations. The growing use of the concept by organizations that are fundamentally different has naturally led to some confusion about what the concept means and what it takes to effectively implement it. In this article, we describe the key features of the concept and how they are important in determining the organizational requirements for its effective implementation. Drawing on a few cases, the paper highlights the centrality of faith in transformational development work
Measurement of the branching fraction for
We have studied the leptonic decay of the resonance into tau
pairs using the CLEO II detector. A clean sample of tau pair events is
identified via events containing two charged particles where exactly one of the
particles is an identified electron. We find . The result is consistent with
expectations from lepton universality.Comment: 9 pages, RevTeX, two Postscript figures available upon request, CLNS
94/1297, CLEO 94-20 (submitted to Physics Letters B
Measurement of the Decay Asymmetry Parameters in and
We have measured the weak decay asymmetry parameters (\aLC ) for two \LC\
decay modes. Our measurements are \aLC = -0.94^{+0.21+0.12}_{-0.06-0.06} for
the decay mode and \aLC = -0.45\pm 0.31 \pm
0.06 for the decay mode . By combining these
measurements with the previously measured decay rates, we have extracted the
parity-violating and parity-conserving amplitudes. These amplitudes are used to
test models of nonleptonic charmed baryon decay.Comment: 11 pages including the figures. Uses REVTEX and psfig macros. Figures
as uuencoded postscript. Also available as
http://w4.lns.cornell.edu/public/CLNS/1995/CLNS95-1319.p
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