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

On the role of pre and post-processing in environmental data mining

The quality of discovered knowledge is highly depending on data quality. Unfortunately real data use to contain noise, uncertainty, errors, redundancies or even irrelevant information. The more complex is the reality to be analyzed, the higher the risk of getting low quality data. Knowledge Discovery from Databases (KDD) offers a global framework to prepare data in the right form to perform correct analyses. On the other hand, the quality of decisions taken upon KDD results, depend not only on the quality of the results themselves, but on the capacity of the system to communicate those results in an understandable form. Environmental systems are particularly complex and environmental users particularly require clarity in their results. In this paper some details about how this can be achieved are provided. The role of the pre and post processing in the whole process of Knowledge Discovery in environmental systems is discussed

A mechanical model for liquid nanolayers

Liquids in contact with solids are submitted to intermolecular forces making liquids heterogeneous and stress tensors are not any more spherical as in homogeneous bulks. The aim of this article is to show that a square-gradient functional representing liquid-vapor interface free energy corrected with a liquid density functional at solid surfaces is a well adapted model to study structures of very thin nanofilms near solid walls. This result makes it possible to study the motions of liquids in nanolayers and to generalize the approximation of lubrication in long wave hypothesis.Comment: 10 page

Quantum properties of atomic-sized conductors

Using remarkably simple experimental techniques it is possible to gently break a metallic contact and thus form conducting nanowires. During the last stages of the pulling a neck-shaped wire connects the two electrodes, the diameter of which is reduced to single atom upon further stretching. For some metals it is even possible to form a chain of individual atoms in this fashion. Although the atomic structure of contacts can be quite complicated, as soon as the weakest point is reduced to just a single atom the complexity is removed. The properties of the contact are then dominantly determined by the nature of this atom. This has allowed for quantitative comparison of theory and experiment for many properties, and atomic contacts have proven to form a rich test-bed for concepts from mesoscopic physics. Properties investigated include multiple Andreev reflection, shot noise, conductance quantization, conductance fluctuations, and dynamical Coulomb blockade. In addition, pronounced quantum effects show up in the mechanical properties of the contacts, as seen in the force and cohesion energy of the nanowires. We review this reseach, which has been performed mainly during the past decade, and we discuss the results in the context of related developments.Comment: Review, 120 pages, 98 figures. In view of the file size figures have been compressed. A higher-resolution version can be found at: http://lions1.leidenuniv.nl/wwwhome/ruitenbe/review/QPASC-hr-ps-v2.zip (5.6MB zip PostScript

Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study

We compared the distribution by wealth of self-reported illness burden (estimated from validated scales, biomarker and reported symptoms) for angina, cataract, depression, diabetes and osteoarthritis, with the distribution of self-reported medical diagnosis and treatment. We aimed to determine if the greater illness burden borne by poorer participants was matched by appropriately higher levels of diagnosis and treatment

N-version Design vs. One Good Version

Evidence indicates that n-version development techniques are more reliable than producing one "good" version-and cost effective in the long run. The author concludes that diverse, independent channels used in parallel are significantly superior to even the current state of the art, especially in situations where cost of failure is high

The end of all niches: the future position of the academic librarian in a modern service industry

A (University) Library is a modern service industry which has to follow the rules of effectiveness, efficiency and productivity. Even academic librarians have to be integrated into the production process of ‘the supply of information’ in such a way that they can deliver optimal results on the basis of their qualifications. In the process, the classic occupational image of the subject indexing lone fighter has dramatically changed into that of a productive performance bearer with great skills in management, social competence and performance. This paper gives an overview of the historical development of the classic academic librarian and the current requirements for a modern information manager. The strictly contrastive approach makes clear what a quantum leap there is between the image of a classic academic librarian, and the modern requirements for an efficient academic employee in the production process of supplying information

Spray characteristics of a multi-hole injector for direct-injection gasoline engines

The sprays from a high-pressure multi-hole nozzle injected into a constant-volume chamber have been visualized and quantified in terms of droplet velocity and diameter with a two-component phase Doppler anemometry (PDA) system at injection pressures up to 200 bar and chamber pressures varying from atmospheric to 12 bar. The flow characteristics within the injection system were quantified by means of a fuel injection equipment (FIE) one-dimensional model, providing the injection rate and the injection velocity in the presence of hole cavitation, by an in-house three-dimensional computational fluid dynamics (CFD) model providing the detailed flow distribution for various combinations of nozzle hole configurations, and by a fuel atomization model giving estimates of the droplet size very near to the nozzle exit. The overall spray angle relative to the axis of the injector was found to be almost independent of injection and chamber pressure, a significant advantage relative to swirl pressure atomizers. Temporal droplet velocities were found to increase sharply at the start of injection and then to remain unchanged during the main part of injection, before decreasing rapidly towards the end of injection. The spatial droplet velocity profiles were jet-like at all axial locations, with the local velocity maximum found at the centre of the jet. Within the measured range, the effect of injection pressure on droplet size was rather small while the increase in chamber pressure from atmospheric to 12 bar resulted in much smaller droplet velocities, by up to four-fold, and larger droplet sizes by up to 40 per cent

The gamma-ray burst monitor for Lobster-ISS

Lobster-ISS is an X-ray all-sky monitor experiment selected by ESA two years ago for a Phase A study (now almost completed) for a future flight (2009) aboard the Columbus Exposed Payload Facility of the International Space Station. The main instrument, based on MCP optics with Lobster-eye geometry, has an energy passband from 0.1 to 3.5 keV, an unprecedented daily sensitivity of 2x10^{-12} erg cm^{-2}s$^{-1}, and it is capable to scan, during each orbit, the entire sky with an angular resolution of 4--6 arcmin. This X-ray telescope is flanked by a Gamma Ray Burst Monitor, with the minimum requirement of recognizing true GRBs from other transient events. In this paper we describe the GRBM. In addition to the minimum requirement, the instrument proposed is capable to roughly localize GRBs which occur in the Lobster FOV (162x22.5 degrees) and to significantly extend the scientific capabilities of the main instrument for the study of GRBs and X-ray transients. The combination of the two instruments will allow an unprecedented spectral coverage (from 0.1 up to 300/700 keV) for a sensitive study of the GRB prompt emission in the passband where GRBs and X-Ray Flashes emit most of their energy. The low-energy spectral band (0.1-10 keV) is of key importance for the study of the GRB environment and the search of transient absorption and emission features from GRBs, both goals being crucial for unveiling the GRB phenomenon. The entire energy band of Lobster-ISS is not covered by either the Swift satellite or other GRB missions foreseen in the next decade.Comment: 6 pages, 4 figures. Paper presented at the COSPAR 2004 General Assembly (Paris), accepted for publication in Advances in Space Research in June 2005 and available on-line at the Journal site (http://www.sciencedirect.com/science/journal/02731177), section "Articles in press