The burden of clostridium difficile infection in patients with liver cirrhosis

Clostridium Difficile Infection (CDI) has registered a dramatically increasing incidence in the general population over the past decades. Nowadays, Clostridium Difficile is the leading cause of hospital-acquired diarrhea in Europe and North America. Liver cirrhosis is the final stage of any chronic liver disease (CLD). The most common causes are chronic hepatitis C or B and viral co-infections, alcohol misuse, and nonalcoholic fatty liver disease (NAFLD). CLD and cirrhosis are listed among the ten leading causes of death in the US. Cirrhosis due to any etiology disrupts the homeostatic role of the liver in the body. Cirrhosis-associated immune dysfunction (CAID) leads to alterations in both inherited and acquired systemic and local liver immunity. CAID is caused by increased systemic inflammation and immunodeficiency and it is responsible for 30% of mortality rates all over the world. Clostridium Difficile infection frequently affects patients suffering from liver cirrhosis because of the high number of prolonged hospitalizations, regular use of antibiotics for the prevention or treatment of SBP, proton pump inhibitor (PPI) use, and an overall immunocompromised state. Clostridium Difficile is a Gram-positive bacterium responsible for the high morbidity and mortality rates in patients with cirrhosis, with an essential increase in a 30-day mortality

Effect of anisotropy in ground movements caused by tunnelling

This paper presents closed-form analytical solutions for estimating far-field ground deformations caused by shallow tunnelling in a linear elastic soil mass with cross-anisotropic stiffness properties. The solutions describe two-dimensional ground deformations for uniform convergence (u [subscript ε]) and ovalisation (u [subscript δ]) modes of a circular tunnel cavity, based on the complex formulation of planar elasticity and superposition of fundamental singularity solutions. The analyses are used to interpret measurements of ground deformations caused by open-face shield construction of a Jubilee Line Extension (JLE) tunnel in London Clay at a well-instrumented site in St James's Park. Anisotropic stiffness parameters are estimated from hollow-cylinder tests on intact block samples of London Clay (from the Heathrow Airport Terminal 5 project), and the selection of the two input parameters is based on a least-squares optimisation using measurements of ground deformations. The results show consistent agreement with the measured distributions of surface and subsurface, vertical and horizontal displacement components, and anisotropic stiffness properties appear to have little effect on the pattern of ground movements. The results provide an interesting counterpoint to prior studies using finite-element analyses that have reported difficulties in predicting the distribution of ground movements for the instrumented section of the JLE tunnel.George and Marie Vergottis FellowshipGoldberg-Zoino Fellowshi

Dust-scattering rings of GRB 221009A as seen by the Neil Gehrels Swift satellite: can we count them all?

We present the first results for the dust-scattering rings of GRB 221009A, coined as the GRB of the century, as observed by the Neil Gehrels Swift satellite. We perform analysis of both time resolved observations and stacked data. The former approach enable us to study the expansion of the most prominent rings, associate their origin with the prompt X-ray emission of the GRB and determine the location of the dust layers. The stacked radial profiles increase the signal-to-noise ratio of the data and allows detection of fainter and overlapping peaks in the angular profile. We find a total of 16 dust concentrations (with hints of even more) that span about 15 kpc in depth and could be responsible for the highly structured X-ray angular profiles. By comparing the relative scattered fluxes of the five most prominent rings we show that the layer with the largest amount of dust is located at about 0.44 kpc away from us. We finally compare the location of the dust layers with results from experiments that study the 3D structure of our Galaxy via extinction or CO radio observations, and highlight the complementarity of dust X-ray tomography to these approaches.Comment: 12 pages, 10 figures, accepted for publication in MNRAS. New version contains updated tables/figures after correction of a numerical erro