Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs

Direct photon elliptic flow in Pb-Pb collisions at root s(NN)=2.76 TeV

The elliptic flow of inclusive and direct photons was measured at mid-rapidity in two centrality classes 0-20% and 20-40% in Pb-Pb collisions at root s(NN) = 2.76 TeV by ALICE. Photons were detected with the highly segmented electromagnetic calorimeter PHOS and via conversions in the detector material with the e(broken vertical bar)e pairs reconstructed in the central tracking system. The results of the two methods were combined and the direct-photon elliptic flow was extracted in the transverse momentum range 0.9 < p(T) < 6.2 GeV/c. A comparison to RHIC data shows a similar magnitude of the measured direct-photon elliptic flow. Hydrodynamic and transport model calculations are systematically lower than the data, but are found to be compatible. (C) 2018 The Author. Published by Elsevier B.V.Peer reviewe

Increasing the Astrophysical Reach of the Advanced Virgo Detector via the Application of Squeezed Vacuum States of Light

Current interferometric gravitational-wave detectors are limited by quantum noise over a wide range of their measurement bandwidth. One method to overcome the quantum limit is the injection of squeezed vacuum states of light into the interferometer’s dark port. Here, we report on the successful application of this quantum technology to improve the shot noise limited sensitivity of the Advanced Virgo gravitational-wave detector. A sensitivity enhancement of up to 3.2±0.1  dB beyond the shot noise limit is achieved. This nonclassical improvement corresponds to a 5%–8% increase of the binary neutron star horizon. The squeezing injection was fully automated and over the first 5 months of the third joint LIGO-Virgo observation run O3 squeezing was applied for more than 99% of the science time. During this period several gravitational-wave candidates have been recorded

Wses Jerusalem Guidelines For Diagnosis And Treatment Of Acute Appendicitis

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.1

Life in a warm deep sea: routine activity and burst swimming performance of the shrimp Acanthephyra eximia in the abyssal Mediterranean

Measurements of routine swimming speed, "tail-flip'' escape responses, and oxygen consumptions were made of the deep-sea shrimp Acanthephyra eximia using autonomous landers in the Rhodos Basin at depths of up to 4,400 m and temperatures of 13 - 14.5 degrees C. Routine swimming speeds at 4,200 m averaged 0.18 m s(-1) or 3.09 body lengths s(-1), approximately double those of functionally similar oceanic scavengers. During escape responses peak accelerations of 23 m s(-2) or 630.6 body lengths s(-2) were recorded, with animals reaching speeds of 1.61 m s(-1) or 34.8 body lengths s(-2). When compared to shallow-water decapods at similar temperatures these values are low for a lightly calcified shrimp such as A. eximia despite a maximum muscle mass specific power output of 90.0 W kg(-1). A preliminary oxygen consumption measurement indicated similar rates to those of oceanic crustacean scavengers and shallower-living Mediterranean crustaceans once size and temperature had been taken into account. These animals appear to have high routine swimming speeds but low burst muscle performances. This suite of traits can be accounted for by high competition for limited resources in the eastern Mediterranean, but low selective pressure for burst swimming due to reductions in predator pressure

Study of B Meson Production in p plus Pb Collisions at root s(NN)=5.02 TeV Using Exclusive Hadronic Decays

Peer reviewe

Variable coordination of amine functionalised N-heterocyclic carbene ligands to Ru, Rh and Rr: C-H and N-H activation and catalytic transfer hydrogenation

Chelating amine and amido complexes of late transition metals are highly valuable bifunctional catalysts in organic synthesis, but complexes of bidentate amine–NHC and amido–NHC ligands are scarce. Hence, we report the reactions of a secondary-amine functionalised imidazolium salt 2a and a primary-amine functionalised imidazolium salt 2b with [( p -cymene)RuCl 2 ] 2 and [Cp*MCl 2 ] 2 (M = Rh, Ir). Treating 2a with [Cp*MCl 2 ] 2 and NaOAc gave the cyclometallated compounds Cp*M(C,C)I (M = Rh, 3 ;M = Ir, 4 ), resulting from aromatic C–H activation. In contrast, treating 2b with [( p -cymene)RuCl 2 ] 2 ,Ag 2 O and KI gave the amine–NHC complex [( p -cymene)Ru(C,NH 2 )I]I ( 5 ). The reaction of 2b with [Cp*MCl 2 ] 2 (M = Rh, Ir), NaO t Bu and KI gave the amine–NHC complex [Cp*Rh(NH 2 )I]I ( 6 ) or the amido–NHC complex Cp*Ir(C,NH)I ( 7 ); both protonation states of the Ir complex could be accessed: treating 7 with trifluoroacetic acid gave the amine–NHC complex [Cp*Ir(C,NH 2 )I][CF 3 CO 2 ]( 8 ). These are the first primary amine– or amido–NHC complexes of Rh and Ir. Solid-state structures of the complexes 3–8 have been determined by single crystal X-ray diffraction. Complexes 5 , 6 and 7 are pre-catalysts for the catalytic transfer hydrogenation of acetophenone to 1-phenylethanol, with ruthenium complex 5 demonstrating especially high reactivity

Measuring (KSK +/-)-K-0 interactions using pp collisions at root s=7 TeV

We present the first measurements of femtoscopic correlations between the K-S(0) and K-+/- particles in pp collisions at root s = 7 TeV measured by the ALICE experiment. The observed femtoscopic correlations are consistent with final-state interactions proceeding solely via the a(0)(980) resonance. The extracted kaon source radius and correlation strength parameters for (KSK-)-K-0 are found to be equal within the experimental uncertainties to those for (KSK+)-K-0. Results of the present study are compared with those from identical-kaon femtoscopic studies also performed with pp collisions at root s = 7 TeV by ALICE and with a (KSK +/-)-K-0 measurement in Pb-Pb collisions at root s(NN) = 2.76 TeV. Combined with the Pb-Pb results, our pp analysis is found to be compatible with the interpretation of the a (980) having a tetraquark structure instead of that of a diquark. (C) 2018 Published by Elsevier B.V.Peer reviewe

A Framework for M-Commerce Implementation in Nigeria

The Internet has brought about the concept of grobalilation, which has revolutionized the way business is transacted all over the world. The E-comnterce is of particular interest, though widely used but still has some security challenges in terms of transparency and confidentiality of transactiorts. This papei focuses on M-contnrcrce as an extensiott to E-commerce hnplementatiott with the Bankiltg industry proposed as core implementation consideration in ortler to guarantee high level security. We have reviewed some cqses of onlilrc frauds and eliscussed tlte emerging critical issues afficting software development of M-cornmerce applicatiotts. Afranrcworkfor M-commerce implementationis therefore,proposed for countries such as Nigeria, Romania and Indonesia where cases of online scam are alanning

Targeting Macrophages and Synoviocytes Intracellular Milieu to Augment Anti?Inflammatory Drug Potency

Using a preclinical in vivo model of arthritis and the gold standard disease-modifying anti-rheumatic drug, methotrexate, pH-responsive phosphorylcholine polymersomes, elicit both anti-inflammatory and anti-arthritic therapeutic efficacy, while drastically minimizing off-target toxicity. First, the selective accumulation of polymersomes within synovium of inflamed joints. Second, the polymersomes targeting ability toward activated macrophages and synoviocytes, via scavenger receptors, allow their uptake via endocytosis. And third, the polymersomes pH-responsiveness enables the drug escape from early endosomes and hence its intracellular milieu delivery. On-site augment of methotrexate loaded polymersomes enable the complete abrogation of synovial inflammation and prevent the disease progression and severity. Overall, in vitro and in vivo investigations reveal the potential of polymersomes as a promising nanotherapy for treating arthritic inflammation