Antimicrobial Treatment of Orthopedic Implant-related Infections with Rifampin Combinations

The purpose of this prospective clinical study is to evaluate the role of combination chemotherapy with rifampin in the treatment of orthopedic device—related infections in which the implant could not be removed. Eleven patients with orthopedic implant-related infections due to staphylococci or streptococci were treated with the implant in situ. Each antimicrobial regimen included rifampin in combination with a β-lactam antibiotic or ciprofloxacin. The median duration of treatment with rifampin was 86 days (range, 15-336 days) with a median follow-up of >;24 months after cessation of therapy. Treatment was successful for 82% of patients. Failures were associated with documented inappropriate treatment. These preliminary clinical data are supported by data from in vitro studies and animal experiments. Combination therapy with rifampin, in particular rifampin and a quinolone, should be considered for patients with orthopedic implant-related infections if the implant cannot be remove

Comparison of post-Newtonian templates for compact binary inspiral signals in gravitational-wave detectors

The two-body dynamics in general relativity has been solved perturbatively using the post-Newtonian (PN) approximation. The evolution of the orbital phase and the emitted gravitational radiation are now known to a rather high order up to O(v^8), v being the characteristic velocity of the binary. The orbital evolution, however, cannot be specified uniquely due to the inherent freedom in the choice of parameter used in the PN expansion as well as the method pursued in solving the relevant differential equations. The goal of this paper is to determine the (dis)agreement between different PN waveform families in the context of initial and advanced gravitational-wave detectors. The waveforms employed in our analysis are those that are currently used by Initial LIGO/Virgo, that is the time-domain PN models TaylorT1, TaylorT2, TaylorT3, TaylorT4 and TaylorEt, the effective one-body (EOB) model, and the Fourier-domain representation TaylorF2. We examine the overlaps of these models with one another and with the prototype effective one-body model (calibrated to numerical relativity simulations, as currently used by initial LIGO) for a number of different binaries at 2PN, 3PN and 3.5PN orders to quantify their differences and to help us decide whether there exist preferred families that are the most appropriate as search templates. We conclude that as long as the total mass remains less than a certain upper limit M_crit, all template families at 3.5PN order (except TaylorT3 and TaylorEt) are equally good for the purpose of detection. The value of M_crit is found to be ~ 12M_Sun for Initial, Enhanced and Advanced LIGO. From a purely computational point of view we recommend that 3.5PN TaylorF2 be used below Mcrit and EOB calibrated to numerical relativity simulations be used for total binary mass M > Mcrit.Comment: 27 pages, 8 figures, 4 tables, submitted to PR

Acute painful diabetic neuropathy: an uncommon, remittent type of acute distal small fibre neuropathy.

INTRODUCTION: Acute painful diabetic neuropathy (APDN) is a distinctive diabetic polyneuropathy and consists of two subtypes: treatment-induced neuropathy (TIN) and diabetic neuropathic cachexia (DNC). The characteristics of APDN are (1.) the small-fibre involvement, (2.) occurrence paradoxically after short-term achievement of good glycaemia control, (3.) intense pain sensation and (4.) eventual recovery. In the face of current recommendations to achieve quickly glycaemic targets, it appears necessary to recognise and understand this neuropathy. METHODS AND RESULTS: Over 2009 to 2012, we reported four cases of APDN. Four patients (three males and one female) were identified and had a mean age at onset of TIN of 47.7 years (±6.99 years). Mean baseline HbA1c was 14.2% (±1.42) and 7.0% (±3.60) after treatment. Mean estimated time to correct HbA1c was 4.5 months (±3.82 months). Three patients presented with a mean time to symptom resolution of 12.7 months (±1.15 months). One patient had an initial normal electroneuromyogram (ENMG) despite the presence of neuropathic symptoms, and a second abnormal ENMG showing axonal and myelin neuropathy. One patient had a peroneal nerve biopsy showing loss of large myelinated fibres as well as unmyelinated fibres, and signs of microangiopathy. CONCLUSIONS: According to the current recommendations of promptly achieving glycaemic targets, it appears necessary to recognise and understand this neuropathy. Based on our observations and data from the literature we propose an algorithmic approach for differential diagnosis and therapeutic management of APDN patients

Self-control in decision-making involves modulation of the vmPFC valuation system

Every day, individuals make dozens of choices between an alternative with higher overall value and a more tempting but ultimately inferior option. Optimal decision-making requires self-control. We propose two hypotheses about the neurobiology of self-control: (i) Goal-directed decisions have their basis in a common value signal encoded in ventromedial prefrontal cortex (vmPFC), and (ii) exercising self-control involves the modulation of this value signal by dorsolateral prefrontal cortex (DLPFC). We used functional magnetic resonance imaging to monitor brain activity while dieters engaged in real decisions about food consumption. Activity in vmPFC was correlated with goal values regardless of the amount of self-control. It incorporated both taste and health in self-controllers but only taste in non–self-controllers. Activity in DLPFC increased when subjects exercised self-control and correlated with activity in vmPFC

Systematic and statistical errors in a Bayesian approach to the estimation of the neutron-star equation of state using advanced gravitational wave detectors

Advanced ground-based gravitational-wave detectors are capable of measuring tidal influences in binary neutron-star systems. In this work, we report on the statistical uncertainties in measuring tidal deformability with a full Bayesian parameter estimation implementation. We show how simultaneous measurements of chirp mass and tidal deformability can be used to constrain the neutron-star equation of state. We also study the effects of waveform modeling bias and individual instances of detector noise on these measurements. We notably find that systematic error between post-Newtonian waveform families can significantly bias the estimation of tidal parameters, thus motivating the continued development of waveform models that are more reliable at high frequencies

Adapting Social Neuroscience Measures for Schizophrenia Clinical Trials, Part 1: Ferrying Paradigms Across Perilous Waters

Social cognitive impairment is prominent in schizophrenia, and it is closely related to functional outcome. Partly for these reasons, it has rapidly become a target for both training and psychopharmacological interventions. However, there is a paucity of reliable and valid social cognitive endpoints that can be used to evaluate treatment response in clinical trials. Also, clinical studies in schizophrenia have benefited rather little from the surge of activity and knowledge in nonclinical social neuroscience. The National Institute of Mental Health-sponsored study, "Social Cognition and Functioning in Schizophrenia" (SCAF), attempted to address this translational challenge by selecting paradigms from social neuroscience that could be adapted for use in schizophrenia. The project also evaluated the psychometric properties and external validity of the tasks to determine their suitability for multisite clinical trials. This first article in the theme section presents the goals, conceptual background, and rationale for the SCAF project

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