Employable knowledge: benchmarking education about standardization in the UK

For academics and students in the United Kingdom the main source of standards is via British Standards Institution (BSI). The research demonstrates that British, European and International Standards play a key role in many areas of education. In some disciplines their inclusion in the course is mandatory, e.g. in building construction and performing risk assessments of equipment. Where not a requirement, other courses successfully encourage students to understand and apply specific standards and principles from them, to their design and project work, in topic areas such as quality management and user-computer interface design. Assessment practice is a key part of learning and academics have indicated how this fitted into the learning activity, e.g. by expecting students to develop an understanding of standards and reference them in all assessed work. Likewise, students taking part in the survey also suggest that they were actively engaged with one or more standards and that their understanding was measured through an assessed activity. However, students also emphasised the importance of additional support, e.g. introduction to standards in the workplace or as part of work placements, by library staff as an information resource, and by presentations from BSI experts. Employers have also indicated the importance of students’ knowledge, understanding and appreciation of relevant standards in the right context, emphasising their desire for standards to be included more widely in the curriculum. The draft recommendations from this study were subject to International review and comment, the results from this review served to strengthen the recommendations of this work. This research was commissioned by British Standards Institution (BSI). This research was produced in association with the Department for Business, Innovation and Skills as part of its ongoing programme of support for standardization. Grateful thanks are due to all those who filled in the questionnaire or who attended the workshops

Urine culture doubtful in determining etiology of diffuse symptoms among elderly individuals: a cross-sectional study of 32 nursing homes

Background: The high prevalence of bacteriuria in elderly individuals makes it difficult to know if a new symptom is related to bacteria in the urine. There are different views concerning this relationship and bacteriuria often leads to antibiotic treatments. The aim of this study was to investigate the relationship between bacteria in the urine and new or increased restlessness, fatigue, confusion, aggressiveness, not being herself/himself, dysuria, urgency and fever in individuals at nursing homes for elderly when statistically considering the high prevalence of asymptomatic bacteriuria in this population.\ud \ud Methods: In this cross-sectional study symptoms were registered and voided urine specimens were collected for urinary cultures from 651 elderly individuals. Logistic regressions were performed to evaluate the statistical correlation between bacteriuria and presence of a symptom at group level. To estimate the clinical relevance of statistical correlations at group level positive and negative etiological predictive values (EPV) were calculated.\ud \ud Results: Logistic regression indicated some correlations at group level. Aside from Escherichia coli in the urine and not being herself/himself existing at least one month, but less than three months, EPV indicated no clinically useful correlation between any symptoms in this study and findings of bacteriuria.\ud \ud Conclusions: Urinary cultures provide little or no useful information when evaluating diffuse symptoms among elderly residents of nursing homes. Either common urinary tract pathogens are irrelevant, or urine culture is an inappropriate test

A phase 3 multicenter, prospective, open-label efficacy and safety study of immune globulin (human) 10% caprylate/chromatography purified in patients with myasthenia gravis exacerbations

Background: Myasthenia gravis (MG) is an autoimmune disorder affecting neuromuscular transmission. Exacerbations may involve increasing bulbar weakness and/or sudden respiratory failure, both of which can be critically disabling. Management of MG exacerbations includes plasma exchange and intravenous immunoglobulin (IVIG); they are equally effective, but patients experience fewer side effects with IVIG. The objective of this study was to assess the efficacy and safety of immune globulin caprylate/chromatography purified (IGIV-C) in subjects with MG exacerbations. Methods: This prospective, open-label, non-controlled 28-day clinical trial was conducted in adults with MG Foundation of America class IVb or V status. Subjects received IGIV-C 2 g/kg over 2 consecutive days (1 g/kg/day) and were assessed for efficacy/safety on Days 7, 14, 21, and 28. The primary efficacy endpoint was the change from Baseline in quantitative MG (QMG) score to Day 14. Secondary endpoints of clinical response, Baseline to Day 14, included at least a 3-point decrease in QMG and MG Composite and a 2-point decrease in MG-activities of daily living (MG-ADL). Results: Forty-nine subjects enrolled. The change in QMG score at Day 14 was significant (p < 0.001) in the Evaluable (-6.4, n = 43) and Safety (-6.7, n = 49) populations. Among evaluable subjects, Day 14 response rates were 77, 86, and 88% for QMG, MG Composite, and MG-ADL, respectively. IGIV-C showed good tolerability with no serious adverse events. Conclusions: The results of this study show that IGIV-C was effective, safe, and well tolerated in the treatment of MG exacerbations

Plastic strain arrangement in copper single crystals in sliding

Deformation of tribologically loaded contact zone is one of the wear mechanisms in spite of the fact that no mass loss may occur during this process. Generation of optimal crystallographic orientations of the grains in a polycrystalline materials (texturing) may cause hardening and reducing the deformation wear. To reveal the orientation dependence of an individual gain and simplify the task we use copper single crystals with the orientations of the compression axis along [11 1] and [110]. The plastic deformation was investigated by means of optical, scanning electron microscopy and EBSD techniques. It was established that at least four different zones were generated in the course of sliding test, such as non-deformed base metal, plastic deformation layer sliding, crystalline lattice reorientation layer and subsurface grain structure layer. The maximum plastic strain penetration depth was observed on [110]-single crystals. The minimum stability of [11 1]-crystals with respect to rotation deformation mode as well as activation of shear in the sliding contact plane provide for rotation deformation localization below the worn surface. The high-rate accumulation of misorientations and less strain penetration depth was observed on [11 1]-crystals as compared to those of [110]-oriented ones

Gestação de alto risco de paciente portadora de Tumor Pancreático, Nefropatia Membranosa, Hipertensão Arterial Crônica, Diabetes mellitus 2, Dislipidemia, Esteatose Hepática e Infecção Urinária de repetição: relato de caso: High-risk pregnancy of patient with Pancreatic Tumor, Membranous Nephropathy, Chronic Arterial Hypertension, Diabetes mellitus 2, Dyslipidemia, Hepatic Steatosis recurrent Urinary tract Infection: case report

Numerosas condições patológicas associadas à gestação, constituem fatores de risco que podem resultar em possíveis complicações materno-fetais. Nesse contexto, o presente estudo observacional descritivo, apresenta o caso de uma paciente de 24 anos G1P1C1A0, portadora de tumor pancreático, nefropatia membranosa, hipertensão arterial crônica, diabetes mellitus 2, dislipidemia, esteatose hepática e infecção urinária de repetição. Os dados relacionados ao presente estudo foram coletados por meio de análise de prontuários e dos exames laboratoriais e de imagem, após autorização do Comitê de Ética (CAAE:&nbsp;59909122.4.0000.5076). Com ajuste da terapêutica farmacológica e orientações sobre a alimentação adequada e atividades físicas, a gestação cursou sem complicações até a 36ª semana e 1 dia, quando a paciente deu entrada na emergência obstétrica da Santa Casa de Misericórdia de Anápolis-GO em iminência de eclâmpsia. Na ocasião fora realizado o parto cesáreo sem intercorrências. O recém-nascido do sexo feminino, classificado como pré-termo tardio, apresentou peso de adequado à idade gestacional, valores de APGAR de 7 (1º minuto) e 8 (5 º minuto), sem malformações aparentes. Portanto, nota-se que a implementação de práticas oportunas e adequadas, baseadas em evidências, permite a redução da mortalidade materna e fetal

UniCarb-DB: a database resource for glycomic discovery

Summary: Glycosylation is one of the most important post-translational modifications of proteins, known to be involved in pathogen recognition, innate immune response and protection of epithelial membranes. However, when compared to the tools and databases available for the processing of high-throughput proteomic data, the glycomic domain is severely lacking. While tools to assist the analysis of mass spectrometry (MS) and HPLC are continuously improving, there are few resources available to support liquid chromatography (LC)-MS/MS techniques for glycan structure profiling. Here, we present a platform for presenting oligosaccharide structures and fragment data characterized by LC-MS/MS strategies. The database is annotated with high-quality datasets and is designed to extend and reinforce those standards and ontologies developed by existing glycomics databases. Availability: http://www.unicarb-db.org Contact: [email protected]

Unnecessary use of fluoroquinolone antibiotics in hospitalized patients

<p>Abstract</p> <p>Background</p> <p>Fluoroquinolones are among the most commonly prescribed antimicrobials and are an important risk factor for colonization and infection with fluoroquinolone-resistant gram-negative bacilli and for <it>Clostridium difficile </it>infection (CDI). In this study, our aim was to determine current patterns of inappropriate fluoroquinolone prescribing among hospitalized patients, and to test the hypothesis that longer than necessary treatment durations account for a significant proportion of unnecessary fluoroquinolone use.</p> <p>Methods</p> <p>We conducted a 6-week prospective, observational study to determine the frequency of, reasons for, and adverse effects associated with unnecessary fluoroquinolone use in a tertiary-care academic medical center. For randomly-selected adult inpatients receiving fluoroquinolones, therapy was determined to be necessary or unnecessary based on published guidelines or standard principles of infectious diseases. Adverse effects were determined based on chart review 6 weeks after completion of therapy.</p> <p>Results</p> <p>Of 1,773 days of fluoroquinolone therapy, 690 (39%) were deemed unnecessary. The most common reasons for unnecessary therapy included administration of antimicrobials for non-infectious or non-bacterial syndromes (292 days-of-therapy) and administration of antimicrobials for longer than necessary durations (234 days-of-therapy). The most common syndrome associated with unnecessary therapy was urinary tract infection or asymptomatic bacteriuria (30% of all unnecessary days-of-therapy). Twenty-seven percent (60/227) of regimens were associated with adverse effects possibly attributable to therapy, including gastrointestinal adverse effects (14% of regimens), colonization by resistant pathogens (8% of regimens), and CDI (4% of regimens).</p> <p>Conclusions</p> <p>In our institution, 39% of all days of fluoroquinolone therapy were unnecessary. Interventions that focus on improving adherence with current guidelines for duration of antimicrobial therapy and for management of urinary syndromes could significantly reduce overuse of fluoroquinolones.</p

GlycoDigest: a tool for the targeted use of exoglycosidase digestions in glycan structure determination

Summary: Sequencing oligosaccharides by exoglycosidases, either sequentially or in an array format, is a powerful tool to unambiguously determine the structure of complex N- and O-link glycans. Here, we introduce GlycoDigest, a tool that simulates exoglycosidase digestion, based on controlled rules acquired from expert knowledge and experimental evidence available in GlycoBase. The tool allows the targeted design of glycosidase enzyme mixtures by allowing researchers to model the action of exoglycosidases, thereby validating and improving the efficiency and accuracy of glycan analysis. Availability and implementation: http://www.glycodigest.org. Contact: [email protected] or [email protected]

Family Medicine needs assessment: Studying the clinical work of general practitioners in Ethiopia

Background and Objective: Some universities in sub-Saharan Africa have initiated Family Medicine (FM) residency programs. This study was conducted by FM colleagues at Addis Ababa University (AAU) in Ethiopia and the University of Toronto, Canada to inform the FM residency curriculum at AAU. It was designed to determine the clinical problems that family physicians in Ethiopia may encounter.Methods: We used a mixed methods approach: Modified time-motion study and brief interviews. We observed 46 general practitioners (GPs) across ten sites in Ethiopia. Trained observers recorded time-motion data while GPs conducted their daily work. This data was supplemented by brief interviews with the GPs.Findings: Clinical encounters occupied 82% of GP work. The common symptoms were digestive-abdominal pain (21% visits), respiratory-cough (16%), and general-fever and chills (16%). The common diagnoses were infectious (22% visits), genitourinary (12%), circulatory (10%), and endocrine (10%). Challenges identified were lack of clinical resources (57% of GPs), difficulties in communication (48%) and excessive workload (33%). Most common requests were for information technology (78%) and HIV (46%) training.Conclusion: The profile of common symptoms and diagnoses indicated the competencies family physicians in the regions should have. This information will be used to develop an appropriate FM curriculum at AAU