Antecedent use of fluoroquinolones is associated with resistance to moxifloxacin in Clostridium difficile

ObjectiveMoxifloxacin is characterized by high activity against Gram-positive cocci and some Gram-positive and -negative anaerobes, including Clostridium difficile. This study investigates the role of prior quinolone use in relation to patterns of susceptibility of C. difficile to moxifloxacin.MethodsSixty-three clinical isolates of C. difficile were investigated for toxigenicity, susceptibility to moxifloxacin, and mutations in the DNA gyrase gene. The medical histories for 50 of these patients were available and used to identify previous fluoroquinolone use.ResultsThirty-three (52.4%) strains showed resistance to moxifloxacin (MICs ≥ 16 mg/L). All moxifloxacin-resistant strains harbored a mutation at amino acid codon Ser-83 of gyrA. Forty-five isolates (71.4%) were toxigenic; all moxifloxacin-resistant strains were in this group. Resistance to moxifloxacin was associated with prior use of fluoroquinolones (P-value 0.009, chi-square).ConclusionsAlthough the use of moxifloxacin to treat C. difficile-associated diarrhea is not likely to be common, these data show a relationship between antecedent fluoroquinolone use and resistance to moxifloxacin in C. difficile isolates, and raise questions regarding selection pressure for resistance placed on colonizing bacteria exposed to fluoroquinolones. Mutations in gyrA are involved in moxifloxacin resistance

Nonlinear analysis of a simple model of temperature evolution in a satellite

We analyse a simple model of the heat transfer to and from a small satellite orbiting round a solar system planet. Our approach considers the satellite isothermal, with external heat input from the environment and from internal energy dissipation, and output to the environment as black-body radiation. The resulting nonlinear ordinary differential equation for the satellite's temperature is analysed by qualitative, perturbation and numerical methods, which show that the temperature approaches a periodic pattern (attracting limit cycle). This approach can occur in two ways, according to the values of the parameters: (i) a slow decay towards the limit cycle over a time longer than the period, or (ii) a fast decay towards the limit cycle over a time shorter than the period. In the first case, an exactly soluble average equation is valid. We discuss the consequences of our model for the thermal stability of satellites.Comment: 13 pages, 4 figures (5 EPS files

Background Rejection in the DMTPC Dark Matter Search Using Charge Signals

The Dark Matter Time Projection Chamber (DMTPC) collaboration is developing low-pressure gas TPC detectors for measuring WIMP-nucleon interactions. Optical readout with CCD cameras allows for the detection for the daily modulation in the direction of the dark matter wind, while several charge readout channels allow for the measurement of additional recoil properties. In this article, we show that the addition of the charge readout analysis to the CCD allows us too obtain a statistics-limited 90% C.L. upper limit on the $e^-$ rejection factor of $5.6\times10^{-6}$ for recoils with energies between 40 and 200 keV$_{\mathrm{ee}}$. In addition, requiring coincidence between charge signals and light in the CCD reduces CCD-specific backgrounds by more than two orders of magnitude.Comment: 8 pages, 6 figures. For proceedings of DPF 2011 conferenc

Creating a potential diagnostic for prostate cancer risk stratification (InformMDx™) by translating novel scientific discoveries concerning cAMP degrading phosphodiesterase-4D7 (PDE4D7)

Increased PSA-based screening for prostate cancer has resulted in a growing number of diagnosed cases. However, around half of these are ‘indolent’, neither metastasizing nor leading to disease specific death. Treating non-progressing tumours with invasive therapies is currently regarded as unnecessary over-treatment with patients being considered for conservative regimens, such as active surveillance (AS). However, this raises both compliance and protocol issues. Great clinical benefit could accrue from a biomarker able to predict long-term patient outcome accurately at the time of biopsy and initial diagnosis. Here we delineate the translation of a laboratory discovery through to the precision development of a clinically validated, novel prognostic biomarker assay (InformMDx™). This centres on determining transcript levels for phosphodiesterase-4D7 (PDE4D7), an enzyme that breaks down cyclic AMP, a signalling molecule intimately connected with proliferation and androgen receptor function. Quantifiable detection of PDE4D7 mRNA transcripts informs on the longitudinal outcome of post-surgical disease progression. The risk of post-surgical progression increases steeply for patients with very low ‘PDE4D7 scores’, while risk decreases markedly for those patients with very high ‘PDE4D7 scores’. Combining clinical risk variables, such as the Gleason or CAPRA (Cancer of the Prostate Risk Assessment) score, with the ‘PDE4D7 score’ further enhances the prognostic power of this personalized, precision assessment. Thus the ‘PDE4D7 score’ has the potential to define, more effectively, appropriate medical intervention/AS strategies for individual prostate cancer patients

Optimized random phase approximations for arbitrary reference systems: extremum conditions and thermodynamic consistence

The optimized random phase approximation (ORPA) for classical liquids is re-examined in the framework of the generating functional approach to the integral equations. We show that the two main variants of the approximation correspond to the addition of the same correction to two different first order approximations of the homogeneous liquid free energy. Furthermore, we show that it is possible to consistently use the ORPA with arbitrary reference systems described by continuous potentials and that the same approximation is equivalent to a particular extremum condition for the corresponding generating functional. Finally, it is possible to enforce the thermodynamic consistence between the thermal and the virial route to the equation of state by requiring the global extremum condition on the generating functional.Comment: 8 pages, RevTe

Small-Scale Vertical Movements of Summer Flounder Relative to Diurnal, Tidal, and Temperature Changes

Observation of animal movements on small spatial scales provides a means to understand how large-scale species distributions are established from individual behavioral decisions. Small-scale vertical movements of 14 Summer Flounder Paralichthys dentatus residing in Chesapeake Bay were observed by using depth data collected with archival tags. A generalized linear mixed model was employed to examine the relationship between these vertical movements and environmental covariates such as tidal state, time of day, lunar phase, and temperature. Vertical movements increased with warming water temperatures, and this pattern was most apparent at night and during rising and falling tides. Fish generally exhibited greater vertical movements at night, but the difference between vertical movements in the day and those at night decreased as fish increased in size. Results from this study fill a void in understanding the small-scale movements of Summer Flounder and could be incorporated into individual-based models to investigate how species distributions develop in response to environmental conditions

Pre-existing virus-specific CD8+ T-cells provide protection against pneumovirus-induced disease in mice

Pneumoviruses such as pneumonia virus of mice (PVM), bovine respiratory syncytial virus (bRSV) or human (h)RSV are closely related pneumoviruses that cause severe respiratory disease in their respective hosts. It is well-known that T-cell responses are essential in pneumovirus clearance, but pneumovirus-specific T-cell responses also are important mediators of severe immunopathology. In this study we determined whether memory- or pre-existing, transferred virus-specific CD8 + T-cells provide protection against PVM-induced disease. We show that during infection with a sublethal dose of PVM, both natural killer (NK) cells and CD8 + T-cells expand relatively late. Induction of CD8 + T-cell memory against a single CD8 + T-cell epitope, by dendritic cell (DC)-peptide immunization, leads to partial protection against PVM challenge and prevents Th2 differentiation of PVM-induced CD4 T-cells. In addition, adoptively transferred PVM-specific CD8 + T-cells, covering the entire PVM-specific CD8 + T-cell repertoire, provide partial protection from PVM-induced disease. From these data we infer that antigen-specific memory CD8 + T-cells offer significant protection to PVM-induced disease. Thus, CD8 + T-cells, despite being a major cause of PVM-associated pathology during primary infection, may offer promising targets of a protective pneumovirus vaccine

Long‐term mortality of patients admitted to an intensive care unit with seizures: a population‐based study

No abstract available

Reaching across continents : engaging students through virtual collaborations

Business schools have the responsibility of preparing students for work in multicultural organizations and global markets. This paper examines a situated learning experience for undergraduates through a virtual collaboration between a UK university and a Brazilian university. This facilitated remote communication using social media and smart devices, allowing students from both institutions to enhance their cross-cultural management competencies. A qualitative approach was used for the research, drawing on the reflections of the tutors from both institutions, and feedback received from students in the UK and Brazil. This paper provides empirical observations regarding the use of this innovative pedagogic approach, generating discussion of the implications for teaching, thus contributing to the literature on international collaborations in cross-cultural management education