A review of antibiotic synergy in carbapenemase-producing bacteria

The problem of antibiotic resistance has garnered too much attention over the last few decades for posing a global hazard to the clinical handling and the inhibition of several deadly infections caused by bacteria. It burdens the world not only clinically but also economically... Antibiotic agents known as carbapenems are a very effective and  typically designated for the treatment of multidrug-resistant (MDR) bacterial infections. To identify a suitable antibiotic combination to be used in vivo, one must be able to determine the synergism between the antibiotics in vitro. Several methods, such as the checkerboard method, multiple-combination bactericidal test, time-kill and E-test, have been used for this purpose. However, the lack of proper standardization procedures, types of bacterial agents, bacterial load, stage of infection and other factors make it very difficult to reproduce or correlate the results with other methods.Carbapenem-destroying lactases, which have recently emerged as mechanisms of resistance, are increasing in number and decreasing the treatment alternatives available. These infections are treated with colistin and tigecycline, but monotherapy may result in clinical breakdown because of a variety of factors. To control these infections, clinicians often choose combinations of drugs over monotherapy. There is an extreme lack of information on synergistic antibiotic combinations accounting for the diverse mechanisms of GNB resistance commonly encountered. The incidence of carbapenem-resistant GNB in Indian articles is also unknown. Therefore, we anticipate that this study may provide methodology for the selection of an appropriate antibiotic combination

Journey towards tiny perceptual super-resolution

Recent works in single-image perceptual super-resolution (SR) have demonstrated unprecedented performance in generating realistic textures by means of deep convolutional networks. However, these convolutional models are excessively large and expensive, hindering their effective deployment to end devices. In this work, we propose a neural architecture search (NAS) approach that integrates NAS and generative adversarial networks (GANs) with recent advances in perceptual SR and pushes the efficiency of small perceptual SR models to facilitate on-device execution. Specifically, we search over the architectures of both the generator and the discriminator sequentially, highlighting the unique challenges and key observations of searching for an SR-optimized discriminator and comparing them with existing discriminator architectures in the literature. Our tiny perceptual SR (TPSR) models outperform SRGAN and EnhanceNet on both full-reference perceptual metric (LPIPS) and distortion metric (PSNR) while being up to 26.4 × more memory efficient and 33.6 × more compute efficient respectively

Do absorption and realistic distraction influence performance of component task surgical procedure?

Background. Surgeons perform complex tasks while exposed to multiple distracting sources that may increase stress in the operating room (e.g., music, conversation, and unadapted use of sophisticated technologies). This study aimed to examine whether such realistic social and technological distracting conditions may influence surgical performance. Methods. Twelve medical interns performed a laparoscopic cholecystectomy task with the Xitact LC 3.0 virtual reality simulator under distracting conditions (exposure to music, conversation, and nonoptimal handling of the laparoscope) versus nondistracting conditions (control condition) as part of a 2 x 2 within-subject experimental design. Results. Under distracting conditions, the medical interns showed a significant decline in task performance (overall task score, task errors, and operating time) and significantly increased levels of irritation toward both the assistant handling the laparoscope in a nonoptimal way and the sources of social distraction. Furthermore, individual differences in cognitive style (i.e., cognitive absorption and need for cognition) significantly influenced the levels of irritation experienced by the medical interns. Conclusion. The results suggest careful evaluation of the social and technological sources of distraction in the operation room to reduce irritation for the surgeon and provision of proper preclinical laparoscope navigation training to increase security for the patient.Industrial DesignIndustrial Design Engineerin

Churn, Baby, Churn: Strategic Dynamics Among Dominant and Fringe Firms in a Segmented Industry

This paper integrates and extends the literatures on industry evolution and dominant firms to develop a dynamic theory of dominant and fringe competitive interaction in a segmented industry. It argues that a dominant firm, seeing contraction of growth in its current segment(s), enters new segments in which it can exploit its technological strengths, but that are sufficiently distant to avoid cannibalization. The dominant firm acts as a low-cost Stackelberg leader, driving down prices and triggering a sales takeoff in the new segment. We identify a “churn” effect associated with dominant firm entry: fringe firms that precede the dominant firm into the segment tend to exit the segment, while new fringe firms enter, causing a net increase in the number of firms in the segment. As the segment matures and sales decline in the segment, the process repeats itself. We examine the predictions of the theory with a study of price, quantity, entry, and exit across 24 product classes in the desktop laser printer industry from 1984 to 1996. Using descriptive statistics, hazard rate models, and panel data methods, we find empirical support for the theoretical predictions

Systematic review of studies generating individual participant data on the efficacy of drugs for treating soil-transmitted helminthiases and the case for data-sharing

Preventive chemotherapy and transmission control (PCT) by mass drug administration is the cornerstone of the World Health Organization (WHO)’s policy to control soil-transmitted helminthiases (STHs) caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm) and hookworm species (Necator americanus and Ancylostama duodenale) which affect over 1 billion people globally. Despite consensus that drug efficacies should be monitored for signs of decline that could jeopardise the effectiveness of PCT, systematic monitoring and evaluation is seldom implemented. Drug trials mostly report aggregate efficacies in groups of participants, but heterogeneities in design complicate classical meta-analyses of these data. Individual participant data (IPD) permit more detailed analysis of drug efficacies, offering increased sensitivity to identify atypical responses potentially caused by emerging drug resistance

Results from evaluations of models and cost-effectiveness tools to support introduction decisions for new vaccines need critical appraisal

The World Health Organization (WHO) recommends that the cost-effectiveness (CE) of introducing new vaccines be considered before such a programme is implemented. However, in low- and middle-income countries (LMICs), it is often challenging to perform and interpret the results of model-based economic appraisals of vaccines that benefit from locally relevant data. As a result, WHO embarked on a series of consultations to assess economic analytical tools to support vaccine introduction decisions for pneumococcal, rotavirus and human papillomavirus vaccines. The objectives of these assessments are to provide decision makers with a menu of existing CE tools for vaccines and their characteristics rather than to endorse the use of a single tool. The outcome will provide policy makers in LMICs with information about the feasibility of applying these models to inform their own decision making. We argue that if models and CE analyses are used to inform decisions, they ought to be critically appraised beforehand, including a transparent evaluation of their structure, assumptions and data sources (in isolation or in comparison to similar tools), so that decision makers can use them while being fully aware of their robustness and limitations

Stellar populations of bulges at low redshift

This chapter summarizes our current understanding of the stellar population properties of bulges and outlines important future research directions.Comment: Review article to appear in "Galactic Bulges", Editors: Laurikainen E., Peletier R., Gadotti D., Springer Publishing. 34 pages, 12 figure

Astrophysically Motivated Bulge-Disk Decompositions of SDSS Galaxies

We present a set of bulge-disk decompositions for a sample of 71,825 SDSS main-sample galaxies in the redshift range 0.003<z<0.05. We have fit each galaxy with either a de Vaucouleurs ('classical') or an exponential ('pseudo-') bulge and an exponential disk. Two dimensional Sersic fits are performed when the 2-component fits are not statistically significant or when the fits are poor, even in the presence of high signal-to-noise. We study the robustness of our 2-component fits by studying a bright subsample of galaxies and we study the systematics of these fits with decreasing resolution and S/N. Only 30% of our sample have been fit with two-component fits in which both components are non-zero. The g-r and g-i colours of each component for the two-component models are determined using linear templates derived from the r-band model. We attempt a physical classification of types of fits into disk galaxies, pseudo-bulges, classical bulges, and ellipticals. Our classification of galaxies agrees well with previous large B+D decomposed samples. Using our galaxy classifications, we find that Petrosian concentration is a good indicator of B/T, while overall Sersic index is not. Additionally, we find that the majority of green valley galaxies are bulge+disk galaxies. Furthermore, in the transition from green to red B+D galaxies, the total galaxy colour is most strongly correlated with the disk colour.Comment: 28 pages, 34 figures, MNRAS accepte

'IISR Thevam', 'IISR Malabar Excel' and 'IISR Girimunda'- three new black pepper (Piper nigrum L.) clones

Based on 7 years' performance at Valparai (Tamil Nadu) (3000 ft MSL), and 2 years' performance at Peruvannamuzhi (Kerala) and quality evaluation, three black pepper lines namely, Call. 1041, HP-813 and HP-I05 were superior and proposed for release as 'IISR Thevam', 'IISR Malabar Excel' and 'IISR Girimunda', respectively. These lines were superior to at least one of the controls for more than one character at one or both the locations. Trials laid out at farmers' fields in four northern districts of Kerala also indicated the superiority of these lines. Call. 1041 besides out-yielding control, exhibited a high degree of field tolerance to foot rot disease, whereas HP-813 had oleoresin content as high as 12%. &nbsp