Is a two-step glutamate dehyrogenase antigen-cytotoxicity neutralization assay algorithm superior to the premier toxin A and B enzyme immunoassay for laboratory detection of Clostridium difficile? (Journal of Clinical Microbiology (2008) 46, 4, (1523-1525))

A two-step algorithm for the detection of Clostridium difficile by the use of C. Diff Quik Chek (TechLab, Blacksburg, VA) and a tissue culture cytotoxicity neutralization assay was found to be more sensitive than the widely used solid-phase enzyme immunoassay (EIA), the Premier toxin A and B EIA (Meridian Bioscience, Cincinnati, OH), and a newly developed, rapid single-test EIA for C. difficile toxins A and B (Tox A/B Quik Chek; TechLab)

A Cellular Automata Model for Citrus Variagated Chlorosis

A cellular automata model is proposed to analyze the progress of Citrus Variegated Chlorosis epidemics in S\~ao Paulo oranges plantation. In this model epidemiological and environmental features, such as motility of sharpshooter vectors which perform L\'evy flights, hydric and nutritional level of plant stress and seasonal climatic effects, are included. The observed epidemics data were quantitatively reproduced by the proposed model varying the parameters controlling vectors motility, plant stress and initial population of diseased plants.Comment: 10 pages, 10 figures, Scheduled tentatively for the issue of: 01Nov0

Analysis of the empathic concern subscale of the emotional response questionnaire in a study evaluating the impact of a 3D cultural simulation

© 2018 Walter de Gruyter GmbH, Berlin/Boston. Background Empathic concern has been found to decline in health professional students. Few effective educational programs and a lack of validated scales are reported. Previous analysis of the Empathic Concern scale of the Emotional Response Questionnaire has reported both one and two latent constructs. Aim To evaluate the impact of simulation on nursing students' empathic concern and test the psychometric properties of the Empathic Concern scale. Methods The study used a one group pre-test post-test design with a convenience sample of 460 nursing students. Empathic concern was measured pre-post simulation with the Empathic Concern scale. Factor Analysis was undertaken to investigate the structure of the scale. Results There was a statistically significant increase in Empathic Concern scores between pre-simulation 5.57 (SD = 1.04) and post-simulation 6.10 (SD = 0.95). Factor analysis of the Empathic Concern scale identified one latent dimension. Conclusion Immersive simulation may promote empathic concern. The Empathic Concern scale measured a single latent construct in this cohort

Evolution of Testing Algorithms at a University Hospital for Detection of Clostridium difficile Infections

We present the evolution of testing algorithms at our institution in which the C. Diff Quik Chek Complete immunochromatographic cartridge assay determines the presence of both glutamate dehydrogenase and Clostridium difficile toxins A and B as a primary screen for C. difficile infection and indeterminate results (glutamate dehydrogenase positive, toxin A and B negative) are confirmed by the GeneXpert C. difficile PCR assay. This two-step algorithm is a cost-effective method for highly sensitive detection of toxigenic C. difficile

Prevalence of Community-Associated Methicillin-Resistant Staphylococcus aureus in Patients with Cystic Fibrosis

We prospectively determined the prevalence of community-associated Staphylococcus aureus in a large cystic fibrosis (CF) center between October 2005 and October 2007. We found that 2.7% (19/707) of the CF patients who had cultures during the study period were infected with this organism, representing 14% of the total methicillin-resistant Staphylococcus aureus strains (n = 140) recovered from the patient population during the study period

Gender, age and the MBA: An analysis of extrinsic and intrinsic career benefits

Against the background of an earlier UK study, this paper presents the findings of a Canadian based survey of career benefits from the MBA. Results indicate firstly that gender and age interact to influence perceptions of career outcomes (young men gain most in terms of extrinsic benefits of career change and pay), and secondly that both men and women gain intrinsic benefits from the MBA. However, intrinsic benefits vary by gender: men in the study were more likely to say they gained confidence from having a fuller skill set while women were more likely to say they gained confidence from feelings of self worth; men emphasised how they had learned to give up control while women argued that they had gained a ‘voice’ in the organization. The role of the MBA in career self- management and the acquisition of key skills are examined as well as the implications for the design of programmes in meeting the varied need of men and women in different age groups

Parallel processes:Getting it write?

This paper offers a critical reflection on the processes surrounding the writing of a book aimed at foster carers and residential workers. By utilising the concept of parallel process as well as the four modes of reflection identified by Ruch (2000), we explore the ways in which the wider context of both direct works with children and reflective practice have been impacted by the tensions between relationally based, child-centred practice and wider managerialist imperatives. The paper draws parallels between these practice tensions and those currently in play within the academy. By employing a dialogical and reflective analysis of the process and interactions surrounding the writing of a practitioner-targeted book, the paper demonstrates the ways in which critical and process reflection post-event took place, considering the heretofore unexplored parallel processes between writing for practice, and practice. In so doing, it identifies the ways in which the authors mirrored practitioners in relation to the management of anxiety, a sense of constrained autonomy and confidence, and an avoidance of recognising and challenging structural and political context. Implications for the creation of practice literature and for the academy are considered.Output Status: Forthcoming/Available Onlin

The broad phenotypic spectrum of 17α-hydroxylase/17,20-lyase (CYP17A1) deficiency: a case series

CONTEXT: 17α-Hydroxylase/17,20-lyase deficiency (17OHD) caused by mutations in the CYP17A1 gene is a rare form of congenital adrenal hyperplasia typically characterised by cortisol deficiency, mineralocorticoid excess and sex steroid deficiency. OBJECTIVE: To examine the phenotypic spectrum of 17OHD by clinical and biochemical assessment and corresponding in silico and in vitro functional analysis. DESIGN: Case series. PATIENTS AND RESULTS: We assessed eight patients with 17OHD, including four with extreme 17OHD phenotypes: two siblings presented with failure to thrive in early infancy and two with isolated sex steroid deficiency and normal cortisol reserve. Diagnosis was established by mass spectrometry-based urinary steroid profiling and confirmed by genetic CYP17A1 analysis, revealing homozygous and compound heterozygous sequence variants. We found novel (p.Gly111Val, p.Ala398Glu, p.Ile371Thr) and previously described sequence variants (p.Pro409Leu, p.Arg347His, p.Gly436Arg, p.Phe53/54del, p.Tyr60IlefsLys88X). In vitro functional studies employing an overexpression system in HEK293 cells showed that 17,20-lyase activity was invariably decreased while mutant 17α-hydroxylase activity retained up to 14% of WT activity in the two patients with intact cortisol reserve. A ratio of urinary corticosterone over cortisol metabolites reflective of 17α-hydroxylase activity correlated well with clinical phenotype severity. CONCLUSION: Our findings illustrate the broad phenotypic spectrum of 17OHD. Isolated sex steroid deficiency with normal stimulated cortisol has not been reported before. Attenuation of 17α-hydroxylase activity is readily detected by urinary steroid profiling and predicts phenotype severity. SIGNIFICANCE STATEMENT: Here we report, supported by careful phenotyping, genotyping and functional analysis, a prismatic case series of patients with congenital adrenal hyperplasia due to 17α-hydroxylase (CYP17A1) deficiency (17OHD). These range in severity from the abolition of function, presenting in early infancy, and unusually mild with isolated sex steroid deficiency but normal ACTH-stimulated cortisol in adult patients. These findings will guide improved diagnostic detection of CYP17A1 deficiency