Laboratory diagnosis of Lyme neuroborreliosis: a comparison of three CSF anti-Borrelia antibody assays

The diagnosis of Lyme neuroborreliosis (LNB) requires the detection of intrathecal synthesis of Borrelia-specific antibodies, but in very early disease, the sensitivity may be low. We compared the performance of the second-generation IDEIA Lyme Neuroborreliosis test (Oxoid), based on purified native flagellum antigen, with two newly developed tests based on several recombinant antigens for the diagnosis of LNB. Patients investigated for LNB during 2003 through 2007 were included (n = 175); 52 with definite LNB, four with possible LNB and 119 non-LNB patients. Serum and cerebrospinal fluid (CSF) were analysed with the IDEIA Lyme Neuroborreliosis (Oxoid), VIDAS Lyme IgG (bioMérieux) and recomBead Borrelia IgM and IgG (Mikrogen) assays. Intrathecal antibody indices (AIs) were calculated according to the manufacturers’ protocols. The IDEIA test performed with an overall sensitivity (IgM and IgG AIs taken together) of 88 % and a specificity of 99 %. The VIDAS test showed a sensitivity of 86 % and a specificity of 97 %. An overall sensitivity of 100 % and a specificity of 97 % were achieved by the recomBead test. We conclude that the three assays performed equally well regarding specificity, but our data suggest an improved diagnostic sensitivity with the recomBead Borrelia test

A recommendation to perform a blood culture before the administration of intravenous antibiotics increased the detection of Staphylococcus aureus bacteremia

In 2004, the Surviving Sepsis Campaign was launched to increase awareness and improve the outcome of severe sepsis. Accordingly, in Jönköping County, Sweden, a strong recommendation to perform a blood culture before the start of intravenous antibiotic treatment was introduced in 2007. Moreover, a reminder was included in the laboratory report to consult an infectious disease specialist when Staphylococcus aureus was isolated from a blood culture. Retrospectively, patients with at least one blood culture growing S. aureus during 2002 through 2003 (pre intervention n = 58) or during 2008 through 2009 (post intervention n = 100) were included. Medical records were evaluated regarding clinical data and outcome. Blood culture isolates were characterized by antibiotic susceptibility testing (AST) and S. aureus protein A (spa) gene typing. The annual incidence of S. aureus bacteremia (SAB) increased from 28 per 100,000 inhabitants at the pre intervention period to 45 per 100,000 at the post intervention period (p = 0.046). During post intervention, the SAB incidence was significantly higher in men (p = 0.009). The mortality rate during hospital stay was 14 % during pre intervention and 18 % during post intervention (p = 0.47). The most common spa types were t012 and t084. The Surviving Sepsis Campaign resulted in an increased number of detected cases of SAB. The mortality rate was the same before and after the intervention, and no spa type correlated to certain clinical manifestations or mortality

Computing the gauge-invariant bubble nucleation rate in finite temperature effective field theory

A gauge-invariant framework for computing bubble nucleation rates at finite temperature in the presence of radiative barriers was presented and advocated for model-building and phenomenological studies in an accompanying article [1]. Here, we detail this computation using the Abelian Higgs Model as an illustrative example. Subsequently, we recast this approach in the dimensionally-reduced high-temperature effective field theory for nucleation. This allows for including several higher order thermal resummations and furthermore delineate clearly the approach's limits of validity. This approach provides for robust perturbative treatments of bubble nucleation during possible first-order cosmic phase transitions, with implications for electroweak baryogenesis and production of a stochastic gravitational wave background. Furthermore, it yields a sound comparison between results of perturbative and non-perturbative computations.Peer reviewe

Computing the gauge-invariant bubble nucleation rate in finite temperature effective field theory

A gauge-invariant framework for computing bubble nucleation rates at finite temperature in the presence of radiative barriers was presented and advocated for model-building and phenomenological studies in an accompanying article [1]. Here, we detail this computation using the Abelian Higgs Model as an illustrative example. Subsequently, we recast this approach in the dimensionally-reduced high-temperature effective field theory for nucleation. This allows for including several higher order thermal resummations and furthermore delineate clearly the approach's limits of validity. This approach provides for robust perturbative treatments of bubble nucleation during possible first-order cosmic phase transitions, with implications for electroweak baryogenesis and production of a stochastic gravitational wave background. Furthermore, it yields a sound comparison between results of perturbative and non-perturbative computations.Peer reviewe

Analog Computer Research

Contains reports on three research projects

Interprofessional education in a student-led emergency department : a realist evaluation

This paper reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations and questionnaires to study what worked, for whom and under what circumstances in this specific interprofessional setting. The study participants were medical, nursing and physiotherapy students, their supervisors and two members of the emergency department’s management staff. The data analysis indicated that the emergency ward provided an excellent environment for interprofessional education (IPE), as attested by the students, supervisors and the clinical managers. An essential prerequisite is that the students have obtained adequate skills to work independently. Exemplary conditions for IPE to work well in an emergency department demand the continuity of effective and encouraging supervision throughout the training period and supervisors who are knowledgeable about developing a team

Does Culture Impact Preferred Employee attributes in Complaint Handling Encounters?

Recently, Gruber et al.’s (2011) Kano study revealed that complaining customers in Saudi Arabia are less difficult to delight than UK customers. The present study investigates whether these differences are caused by different service sector development stages, as suggested in their study, or by cultural differences instead. Data were collected using Kano questionnaires from 151 respondents with complaining experience in Singapore. This country was chosen as it has a highly developed service economy (like the UK) but also a collectivistic culture (like Saudi Arabia). The analysis reveals that Singaporean customers show the same preferences as those in the UK. We consider this as a strong indicator for the suggested impact of the stage of service sector development rather than cultural differences on complaining customers’ preferences of frontline employee attributes. Our results support the findings by Gruber et al. (2011). By doing so, they surprisingly refute previous research which concluded that national culture plays a significant role in shaping customer expectations during complaint handling encounters. Our study especially corroborates the notion of a life cycle of quality attributes that had been found for goods and services and the preferred attributes of frontline employees dealing with customer complaints