Elements of design: the knowledge on which we build

ABSTRACTThe time the free drug serum concentration of antibiotic remains above the pathogen MIC (T > MIC) determines bacteriological efficacy and emergence or selection of resistance for penicillin and amoxicillin with or without clavulanate. Multiple studies in animal and in‐vitro models now support this conclusion. The size of the T > MIC (the pharmacokinetic/‐dynamic target) is > 40–50% to maximise antibacterial effect and pathogen eradication for Streptococcus pneumoniae and probably also Haemophilus influenzae. The size of the T > MIC for optimal antibacterial effect is changed by host immune status but not by bacterial inoculum or mechanism of resistance. There is good animal evidence to support the prediction that, as long as the target T > MIC is achieved, strains of S. pneumoniae with amoxicillin MICs of 0.016 mg/L will respond to amoxicillin in the same way as those with MICs of 1–2 mg/L. Emergence of resistance to amoxicillin/clavulanate in S. pneumoniae is related to low T > MIC (< 20%) and also to the degree of population heterogeneity to amoxicillin. Selection of resistant strains of S. pneumoniae is also related to T > MIC. Monte Carlo simulations based on the pharmacokinetics of amoxicillin with or without clavulanate in humans are needed to best predict the likely efficacy of different amoxicillin dosing regimens. This approach adequately allows the considerable pharmacokinetic variability in amoxicillin handling by infected patients to be accounted for as well as differences in pathogen β‐lactam susceptibility

The Long-Term Effects of ACL Reconstruction on Bilateral Limb Asymmetry in Elite Alpine Skiers

Research on the causation and prevention of anterior cruciate ligament (ACL)injuries in elite alpine skiers has been conducted for numerous years yet the incidenceof ACL injuries remains high for both female and male skiers. High rates of re-injuryare also prominent due to the internal muscular forces and external environmentalforces combined with known neuromuscular changes following ACL reconstruction(ACL-R). The objective of this study was to characterize long-term bilateral asymmetryin thigh volume and multi-joint movements in elite national alpine skiers. Seven femalenational skiers, 3 with ACL-R and 12 males, 4 with ACL-R performed two dynamicmulti-joint closed-chained movements: squat jumps (SJ) and countermovement jumps(CMJ). Vertical ground reaction forces of both legs was measured simultaneously via aPasco Passport 2-Axis Force Platform Model PS2142 at a sampling frequency of 500Hz. Five consecutive jumps were performed and the best trial was analyzed. DEXAscans measuring thigh muscle volume were also performed. The results showed thatACL-R skiers displayed a significant bilateral asymmetry in the final ascent phaseof jumping for both the SJ (p=0.0002) and CMJ (p=0.0007). The ACL-R skiers alsodisplayed a significantly greater bilateral asymmetry in thigh muscle volume (p=0.002).In conclusion ACL-R skiers exhibit long-term bilateral asymmetries despite long postoperativeperiods, rehabilitation and full return to sport. The mechanism underlyingthese asymmetries is unclear although future research should include attention onneural factors

Hoosier Farmland Wildlife Notes: Enhancing Your Farm for Northern Bobwhite Quail

Northern bobwhite quail (Colinus virginianus) are a nonmigratory, small game bird found throughout Indiana and the eastern United States. Once very common throughout the agricultural landscape, recent population indices of this native species continue to be at or near historical lows in Indiana (Figure 1). Loss of habitat is most likely responsible for the declines in bobwhite quail over the past half century. A shift in agricultural practices during this time is the primary cause. When quail populations in Indiana and the Midwest were much higher in the 1950s, farming practices were different than today. Farms were generally divided into smaller parcels, field sizes were smaller and divided by fencerows, and production was more evenly distributed among row crops, small grains, and pastures. Today, clean farming dominates the agricultural landscape (Figure 2)

Hoosier Farmland Wildlife Notes: Warm Season Grasses, Why All the Fuss?

Many wildlife professionals are encouraging landowners to include planting warm season grasses in their wildlife management plans. The purpose of this publication is to describe the many benefits of warm season grasses, especially their benefits to wildlife

By chance or by design: structures of opportunity for college-bound African Americans

Thesis (Ed.D.)--Boston UniversityThis exploratory qualitative study investigated the college choice processes of 25 African American college students. Individual interviews that asked the students to look back on their college choice processes during high school provided the data for the study. The goals of the study were to (1) identify the difficulties that these students encountered when searching for and applying to colleges, (2) identify the factors that helped them succeed in gaining acceptance to college, and (3) develop a model of the college choice process based on the identified factors. The findings provide understandings of the positive and negative factors that African American students may encounter in the college choice process and provide a model of the optimal process. This model is designed to help counselors in high schools and colleges change organizational arrangements and procedures, both within and between institutions, to better assist African American high school students in the transition to higher education. Other wider societal and political changes that may assist students in the transition to higher education are identified and discussed