B-Nodes: A Proposed New Technique for Database Design and Implementation

There exist a wide range of methods that can be used for the analysis and design of IT systems. However a survey of a wide range of methods and a detailed analysis of one structured method indicated the lack of a simple method for modeling hardware. The ORACLE database provides detailed guidelines regarding the minimum platform to run the database and how to derive table spaces (system, user, applications, rollback etc) size of shared pool buffer, Redo log buffer pool etc.that can be used to define hard disc capacity. The system can then be optimised. However little guidance is given regarding the performance of other devices (microprocessor, RAM, bus structures etc). This paper evaluates the new B-Node modeling technique as a possible standard technique in structured systems analysis and design for evaluating hardware performance

Antibacterial susceptibility patterns of blood stream isolates in patients investigated at the Aga Khan University Hospital, Nairobi

Background: Microbial invasion of the blood stream can have serious immediate consequences and are a threat to every organ in the body. Timely detection and treatment is vital and necessitates hospital admission and immediate intervention.Objectives: To investigate aetiology and anti-microbial resistance patterns of bacterial isolates in blood stream infections.Design: A retrospective clinical-laboratory study carried over a five year period January 2003 to April 2008.Setting: The Aga Khan University Hospital, Nairobi, Department of Pathology, Division of Microbiology.Subjects: All blood culture specimens received from both in and out-patients’ at the Aga Khan University Hospital’s laboratory.Results: Rates of oxacillin resistance for Staphylococcus aureus were 21%. Streptococci were generally susceptible to beta-lactams. High-level gentamicin resistance was seen in 12% of Enterococci. Vancomycin resistance was conspicuously absent. Resistance rates of Pseudomonas aeruginosa to ciprofloxacin, gentamicin, amikacin, imipenem were between 11% and 23%. Salmonella spp. showed multiple resistant patterns toco-trimoxazole, chloramphenicol and ampicillin with resistance rates of greater than 35%. One hundred and twenty three patients (11%) tested positive for HlV. Unlike in HlV negative individuals, Cryptococcus neoformans was an important isolate, positive in 5%. A number of HlV positive patients had Staphylococcus aureus and coagulase negative staphylococcus isolates in their blood cultures. In such clinical circumstances it is difficult to determine the clinical significance of these isolates. Conclusion: Antimicrobial susceptibility patterns revealed high level resistance among the gram positive organisms and also amongst extended spectrum beta lactamase (ESBL) producing E.coli and Klebsiella spp. This study highlights the challenges of deriving empiric drug regimens in the current clinical scenario. However, we do know it is important to cover adequately for gram positive organisms

Development of a quantitative PCR assay for the detection and enumeration of a potentially ciguatoxin-producing dinoflagellate, Gambierdiscus lapillus (Gonyaulacales, Dinophyceae)

© 2019 Public Library of Science. All rights reserved. Ciguatera fish poisoning (CFP) is an illness contracted through the ingestion of seafood containing ciguatoxins. It is prevalent in tropical regions worldwide, including in Australia. Ciguatoxins are produced by some species of Gambierdiscus. Therefore, screening of Gambierdiscus species identification through quantitative PCR (qPCR), along with the determination of species toxicity, can be useful in monitoring potential ciguatera risk in these regions. In Australia, CFP is prevalent in tropical Queensland and increasingly in sub-tropical regions of Australia, but has a report rate of approximately 10%. Yet the identity, distribution and abundance of ciguatoxin producing Gambierdiscus spp. is largely unknown. In this study, we developed a rapid qPCR assay to quantify the presence and abundance of Gambierdiscus lapillus, a likely ciguatoxic species first described from Australia. We assessed the specificity and efficiency of the qPCR assay. The assay was tested on 25 environmental samples from the Heron Island reef in the southern Great Barrier Reef, a ciguatera endemic region, to determine the presence and patchiness of this species across samples from Chnoospora sp., Padina sp. and Sargassum sp. macroalgal hosts

Protracted tuberculous empyema necessitans following intercostal drainage tube insertion

Empyema necessitans (EN) is a rare long-term sequela of poorly or untreated empyema thoracis, characterized by the dissection of pus through the soft tissues and skin of the chest wall, ultimately forming a fistula between skin and pleural cavity. We herein present a male patient in his late 30s, a known case of tuberculosis (TB) on anti-tubercular therapy (ATT) under directly observed treatment short-course (DOTS), who recently came with complaints of backache for 3 days. Chest X-ray showed a massive pleural effusion, in view of which an intercostal drainage tube (ICD) was inserted and 1.5 L of pleural fluid was drained. An ultrasound (USG) back done revealed subcutaneous collection with communication to pleural space, which resolved after pleural fluid drainage. As there was a persistent communication between pleural space and right-sided subcutaneous plane with a massive effusion i.e., EN, he was advised to undergo thoracotomy with decortication and resection of communication which he underwent successfully. This case is presented for its rarity with atypical presentation

Biomimetic surface functionalization of clinically relevant metals used as orthopaedic and dental implants

Titanium and its alloys or tantalum (Ta) are materials used in orthopaedic and dental implants due to their excellent mechanical properties and biocompatibility. However, their bioactivity and osteoconductivity is low. With a view to improving the bioactivity of these materials we hypothesised that the surface of Ta and TiAl6V4 can be functionalised with biomimetic, amorphous nano-sized calcium phosphate (CaP) apatite-like deposits, instead of creating uniform coatings, which can lead to flaking, delamination and poor adherence. We used Ta and TiAl6V4 metal discs with smooth and rough surfaces. Amorphous CaP apatite-like particles were deposited on the different surfaces by a biomimetic rapid two-step soaking method using concentrated simulated body fluid (SBF) solutions without a pre-treatment of the metal surfaces to induce CaP deposition. Immersion times in the second SBF solution of 48 and 18 h for Ta and TiAl6V4 respectively produced CaP deposits composed of amorphous globular nano-sized particles that also contained Mg, C and O. Longer immersion times produced more uniform coatings as well as an undesired calcite mineral phase. Prediction of in vivo behaviour by immersion in regular SBF showed that the obtained CaP deposits would act as a catalyst to rapidly form a Ca deficient CaP layer that also incorporates Mg. The amorphous CaP apatite-like deposits promoted initial attachment, proliferation and osteogenic differentiation of bone marrow derived mesenchymal stem cells. Finally, we used our method to functionalise 3D porous structures of titanium alloy made by selective laser sintering. Our study uses a novel and cost-effective approach to functionalise clinically relevant metal surfaces in order to increase the bioactivity of these materials, which could improve their clinical performance

Humoral Response Induced by Prime-Boost Vaccination with the ChAdOx1 nCoV-19 and mRNA BNT162b2 Vaccines in a Teriflunomide-Treated Multiple Sclerosis Patient.

Patients with multiple sclerosis (MS) are treated with drugs that may impact immune responses to SARS-CoV-2 vaccination. Evaluation of "prime-boost" (heterologous) vaccination regimens including a first administration of a viral vector-based vaccine and a second one of an mRNA-based vaccine in such patients has not yet been completed. Here, we present the anti-spike protein S humoral response, including the neutralizing antibody response, in a 54-year-old MS patient who had been treated with teriflunomide for the past 2 years and who received a heterologous ChAdOx1 nCoV-19/ BNT162b2 vaccination regimen. The results showed a very strong anti-S IgG response and a good neutralizing antibody response. These results show that teriflunomide did not prevent the development of a satisfactory humoral response in this MS patient after vaccination with a ChAdOx1 nCoV-19/ BNT162b2 prime-boost protocol

Partial empty Sella syndrome in women-the significance of obstetric and lactational history

Empty Sella syndrome is an uncommon condition characterized by the shrinking or flattening of the pituitary gland, resulting in the filling of the Sella turcica with cerebrospinal fluid rather than the normal pituitary gland. In this report, we present a case of undiagnosed partial empty Sella syndrome, which was found to be caused by pituitary hypophysitis with an idiopathic etiology. The patient, a middle-aged individual, presented atypically with acute adrenal insufficiency induced by a lower respiratory tract infection. The diagnosis was made following an investigative work-up that took into consideration the presence of hypotension, electrolyte imbalances, and a history of two post-partum lactational failures. Hormonal supplements were used to manage the patient conservatively, and no significant complications were observed

Development of Integrated Decision-Making Support Systems: A Practical Approach

Integrated Decision-Making Support Systems (IDMSS), are specialized Computer Based Information Systems designed to support all phases of the Decision- Making Process. Full integration of stand-alone components was proposed in the early 90´s and, despite substantial reported benefits above less integrated systems, few of the fully integrated systems have been implemented in practice. We believe that this “implementation paradox” is caused by the lack of a process-oriented perspective to guide the implementation of IDMSS. This tutorial has the goal of offering such a process-oriented approach