Note and Comment

Epithetical Jurisprudence and the Annexation of Fixtures - If we begin with all the facts of a controversy and proceed inductively to determine the rights of the parties litigant, we thus arrive at a jurisprudence of rights, whereas, if we reason deductively from a rule, a definition, or a maxim of law to its application in the facts of our case, we can at best attain only a jurisprudence of rules, which has been so aptly characterized as an epithetical jurisprudence. The subject of fixtures is one in which we have great difficulty in applying the inductive method because the courts have been slower in approaching the subject scientifically in this field of the law than in others

Relationships among HIV infection, metabolic risk factors, and left ventricular structure and function

Our objective was to determine if the presence of metabolic complications (MC) conveyed an additional risk for left ventricular (LV) dysfunction in people with HIV. HIV(+) and HIV(−) men and women were categorized into four groups: (1) HIV(+) with MC (43±7 years, n=64), (2) HIV(+) without MC (42±7 years, n=59), (3) HIV(−) with MC (44±8 years, n=37), or (4) HIV(−) controls without MC (42±8 years, n=41). All participants underwent two-dimensional (2-D), Doppler, and tissue Doppler echocardiography. Overall, the prevalence of systolic dysfunction (15 vs. 4%, p=0.02) and LV hypertrophy (9 vs. 1%, p=0.03) was greater in HIV(+) than in HIV(−) participants. Participants with MC had a greater prevalence of LV hypertrophy (10% vs. 1%). Early mitral annular velocity during diastole was significantly (p<0.005) lower in groups with MC (HIV(+)/MC(+): 11.6±2.3, HIV(−)/MC(+): 12.0±2.3 vs. HIV(+)/MC(−): 12.4±2.3, HIV(−)/MC(−): 13.1±2.4 cm/s) and tended to be lower in groups with HIV (p=0.10). However, there was no interaction effect of HIV and MC for any systolic or diastolic variable. Regardless of HIV status, participants with MC had reduced LV diastolic function. Although both the presence of MC and HIV infection were associated with lower diastolic function, there was no additive negative effect of HIV on diastolic function beyond the effect of MC. Also, HIV was independently associated with lower systolic function. Clinical monitoring of LV function in individuals with metabolic risk factors, regardless of HIV status, is warranted

Arritmias no idoso: avaliaçao através da eletrocardiografia dinâmica de 24 horas

Alteraçoes do ritmo cardíaco podem ser encontradas normalmente em indivíduos saudáveis; o avançar da idade, entretanto, aumenta sua prevalência. Para identificar a freqüência de arritmias em idosos sadios e naqueles portadores de doenças cardiovasculares, foram analisados os resultados dos exames de Eletrocardiografia Dinâmica de 24 horas realizados em 288 indivíduos, sendo 159 (55,2%) do sexo feminino e 129 (44,8%) do sexo masculino, com idade mínima de 60 anos (máxima de 97 e média de 70 anos). Tais pacientes foram divididos em seis grupos, de acordo com os seus diagnósticos: 1) sem cardiopatia aparente, 2) com hipertensao arterial sistêmica, 3) com doença arterial coronária, 4) com prolapso de valva mitral, 5) com miocardiopatias e 6) com valvulopatias. As arritmias supraventriculares estiveram presentes em 55,6% dos pacientes estudados (extrassístoles em 38%, taquicardia atrial em 8,7% e ritmos ectópicos em 4,9%) e as arritmias ventriculares ocorreram em 31 % (extrassístoles em 29,6% e taquicardia nao-sustentada em 1,4%). Bradiarritmias foram registradas em 6,9% dos casos. Dos 191 que apresentaram arritmias, 67,5% nao relatavam quaisquer sintomas, enquanto que dos 32,5% que os referiram, em apenas 3,2% os mesmos estavam associados às arritmias. Os resultados do estudo confirmaram que as alteraçoes do ritmo cardíaco no idoso sao comuns e freqüentemente assintomáticas, nao havendo diferença significativa em relaçao à presença ou nao de doença cardiovascular

Arritmias no idoso: avaliaçao através da eletrocardiografia dinâmica de 24 horas

Alteraçoes do ritmo cardíaco podem ser encontradas normalmente em indivíduos saudáveis; o avançar da idade, entretanto, aumenta sua prevalência. Para identificar a freqüência de arritmias em idosos sadios e naqueles portadores de doenças cardiovasculares, foram analisados os resultados dos exames de Eletrocardiografia Dinâmica de 24 horas realizados em 288 indivíduos, sendo 159 (55,2%) do sexo feminino e 129 (44,8%) do sexo masculino, com idade mínima de 60 anos (máxima de 97 e média de 70 anos). Tais pacientes foram divididos em seis grupos, de acordo com os seus diagnósticos: 1) sem cardiopatia aparente, 2) com hipertensao arterial sistêmica, 3) com doença arterial coronária, 4) com prolapso de valva mitral, 5) com miocardiopatias e 6) com valvulopatias. As arritmias supraventriculares estiveram presentes em 55,6% dos pacientes estudados (extrassístoles em 38%, taquicardia atrial em 8,7% e ritmos ectópicos em 4,9%) e as arritmias ventriculares ocorreram em 31 % (extrassístoles em 29,6% e taquicardia nao-sustentada em 1,4%). Bradiarritmias foram registradas em 6,9% dos casos. Dos 191 que apresentaram arritmias, 67,5% nao relatavam quaisquer sintomas, enquanto que dos 32,5% que os referiram, em apenas 3,2% os mesmos estavam associados às arritmias. Os resultados do estudo confirmaram que as alteraçoes do ritmo cardíaco no idoso sao comuns e freqüentemente assintomáticas, nao havendo diferença significativa em relaçao à presença ou nao de doença cardiovascular

Analysis of circulating tumor and cancer stem cells provides new opportunities in diagnosis and treatment of small cell lung cancer

Current methods for diagnosis and treatment of small cell lung cancer (SCLC) have only a modest efficacy. In this pilot study, we analyzed circulating tumor cells (CTCs) and cancer stem cells (CSCs) in patients with SCLC to search for new diagnostic and prognostic markers and novel approaches to improve the treatment of the disease. In other forms of lung cancer, we showed a heterogeneity of blood CTCs and CSCs populations, as well as changes in other cell populations (ALDH+, CD87+CD276+, and EGF+Axl+) in smokers. A number of CTCs and CSCs in patients with SCLC have been shown to be resistant to chemotherapy (CT). High cytotoxic activity and resistance to apoptosis of reprogrammed CD3+CD8+ T-lymphocytes (rTcells) in relation to naive CD3+CD8+ T-lymphocytes was demonstrated in a smoking patient with SCLC (Patient G) in vitro. The target for rTcells was patient G’s blood CSCs. Reprogramming of CD3+CD8+ T-lymphocytes was carried out with the MEK1/2 inhibitor and PD-1/PD-L1 pathway blocker nivolumab. The training procedure was performed with a suspension of dead CTCs and CSCs obtained from patient’s G blood. The presented data show a new avenue for personalized SCLC diagnosis and targeted improvement of chemotherapy based on the use of both CTCs and CSCs

Portable Rabies Virus Sequencing in Canine Rabies Endemic Countries Using the Oxford Nanopore MinION

As countries with endemic canine rabies progress towards elimination by 2030, it will become necessary to employ techniques to help plan, monitor, and confirm canine rabies elimination. Sequencing can provide critical information to inform control and vaccination strategies by identifying genetically distinct virus variants that may have different host reservoir species or geographic distributions. However, many rabies testing laboratories lack the resources or expertise for sequencing, especially in remote or rural areas where human rabies deaths are highest. We developed a low-cost, high throughput rabies virus sequencing method using the Oxford Nanopore MinION portable sequencer. A total of 259 sequences were generated from diverse rabies virus isolates in public health laboratories lacking rabies virus sequencing capacity in Guatemala, India, Kenya, and Vietnam. Phylogenetic analysis provided valuable insight into rabies virus diversity and distribution in these countries and identified a new rabies virus lineage in Kenya, the first published canine rabies virus sequence from Guatemala, evidence of rabies spread across an international border in Vietnam, and importation of a rabid dog into a state working to become rabies-free in India. Taken together, our evaluation highlights the MinION’s potential for low-cost, high volume sequencing of pathogens in locations with limited resources

Man of Letters, Literary Lady, Journalist or Reporter?

The enormous changes wrought in the British newspaper industry during the late nineteenth and early twentieth centuries brought about a revolution in newspaper reading habits, financing and influence, all aspects of which have been well-documented by historians of the press. But what of the contributor, particularly the freelance whose millions of words formed, mostly anonymously, the content of the new mass market press? How did writers negotiate changes in the literary marketplace during this time as editors demanded more ‘news’ and less in the way of whimsical paragraphing, and sketches, the traditional newspaper output of the professional man, or woman, of letters? Through the study of memoirs, correspondence and the fictional output of contributors to the press during this time, it is possible to discern the often fraught relations between writers and their most lucrative market

Investigating effects of parasite infection on body condition of the Kafue lechwe (Kobus leche kafuensis) in the Kafue basin

<p>Abstract</p> <p>Background</p> <p>The Kafue lechwe (<it>Kobus leche Kafuensis</it>), a medium-sized semi-aquatic antelope, is endemic to the Kafue basin of Zambia. The population of the Kafue lechwe has significantly dropped in the last decades leading to its subsequent inclusion on the red list of endangered species. In order to save the remaining population from extinction, it has become increasingly important that the impact of parasite infection and infestation on the Kafue lechwe is investigated.</p> <p>Findings</p> <p>Endoparasites accounted for the majority of parasites observed from a study of 40 Kafue lechwe occurring in the the Kafue basin. <it>Amphistoma spp. </it>were present in all animals examined, while <it>Fasciola gigantica </it>had a prevalence rate of 0.525 (95% CI: 0.36 to 0.69) and species of <it>Schistosoma </it>0.3 (95% CI: 0.15 to 0.45). Among the ectoparasites, <it>Strobiloestrous vanzyli</it>, had a prevalence rate of 0.15 (95% CI: 0.03 to 0.27), while <it>Rhipicephalus appendiculatus </it>had a prevalence of 0.075 (3/40). Our findings indicate that body condition was not influenced by the parasitic infestation in Kafue lechwe. There was no association between sex and parasitic burden (odds ratio = 0.3, 95% CI: 0.8-1.3). However, an association between age and parasitic burden was observed as older animals above 15 years were more likely to get parasite infections than those aged between 1-5 years (odds ratio = 1.5, 95% CI: 1.1-2.4).</p> <p>Conclusion</p> <p>Overall, there was no evidence that parasitic infections and infestations adversely affected the lechwe population on the Kafue basin. These findings indicate that ecto- and endo-parasite infestation might not play a significant role in reducing the Kafue lechwe population on the Kafue basin.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London