The role of carbapenems in initial therapy for serious Gram-negative infections

The treatment of patients with serious Gram-negative infections must be both prompt and correct. Numerous studies have demonstrated that mortality risk is significantly increased when the initial antibiotic regimen does not adequately cover the infecting pathogen. Furthermore, changing to an appropriate regimen once culture results are available does not reduce this risk. Therefore, one must empirically treat serious infections with a regimen that covers likely pathogens. Selecting such a regimen is complicated by the increasing prevalence of resistance to commonly used antibiotics. Moreover, multidrug-resistant pathogens, once limited to hospital-acquired infections, are increasingly being detected in community-acquired infections, especially those involving the urinary and gastrointestinal tracts or in immunocompromised patients. Consequently, the initial antibiotic regimen must have a broad spectrum of activity that includes potential resistant pathogens, as indicated by the local antibiogram. Many multidrug-resistant pathogens remain susceptible to carbapenems despite increasing worldwide antibiotic resistance. This article reviews the role played by carbapenems in the initial treatment of serious Gram-negative infections and the potential effect of emerging resistance on this role

Co-crystal structures of furosemide:urea and carbamazepine:indomethacin determined from powder x-ray diffraction data

Co-crystallization is a promising approach to improving both the solubility and the dissolution rate of active pharmaceutical ingredients. Crystal structure determination from powder diffraction data plays an important role in determining co-crystal structures, especially those generated by mechanochemical means. Here, two new structures of pharmaceutical interest are reported: a 1:1 co‑crystal of furosemide with urea formed by liquid-assisted grinding and a second polymorphic form of a 1:1 co‑crystal of carbamazepine with indomethacin, formed by solvent evaporation. Energy minimization using dispersion-corrected density functional theory was used in finalizing both structures. In the case of carbamazepine:indomethacin, this energy minimization step was essential in obtaining a satisfactory final Rietveld refinement

Phase transitions in a gas of anyons

We continue our numerical Monte Carlo simulation of a gas of closed loops on a 3 dimensional lattice, however now in the presence of a topological term added to the action corresponding to the total linking number between the loops. We compute the linking number using certain notions from knot theory. Adding the topological term converts the particles into anyons. Using the correspondence that the model is an effective theory that describes the 2+1-dimensional Abelian Higgs model in the asymptotic strong coupling regime, the topological linking number simply corresponds to the addition to the action of the Chern-Simons term. We find the following new results. The system continues to exhibit a phase transition as a function of the anyon mass as it becomes small \cite{mnp}, although the phases do not change the manifestation of the symmetry. The Chern-Simons term has no effect on the Wilson loop, but it does affect the {\rm '}t Hooft loop. For a given configuration it adds the linking number of the 't Hooft loop with all of the dynamical vortex loops to the action. We find that both the Wilson loop and the 't Hooft loop exhibit a perimeter law even though there are no massless particles in the theory, which is unexpected.Comment: 6 pages, 5 figure

Replication of Eye-Bars and Measurement of Losses in Cross Section Due to Corrosion

Recent availability of high pressure water blasters made it possible to remove rust accumulated between the eye-bars near pin connections on the Central Bridge (Figure 1) over the Ohio River at Newport. Previously, they had never been thoroughly cleaned. Cleaning of two connections on a trial basis enabled an inspection between the bars. It was apparent then that the deterioration was critical enough to necessitate examination of the several bar groups and to accurately measure their least cross sections. The Research Division undertook the task of replicating and measuring the bars. Figures 2 and 3 show one set of bars before and after cleaning. Considerable difficulty was encountered in making moldings or impressions because the space between the two center bars, referred to here as 1, 2, 3 and 4 (Figure 4), varied between one-quarter and one-half inch. Thin sheet metal forms (Figure 5) were used to fit around each section. These forms were then tied in place (Figure 6) and sealed around the edges with paraffin to prevent liquid leakage. A two-component compound, referred to as Sika-Flex, was used to rill these forms and provide a negative molding. Sika-Flex is a liquid joint filler which hardens into a rubbery type of material after mixing --- thereby retaining the exact shape of the bar sections after removal. Wire mesh was used inside the forms around the bars to prevent stretching or deformation of the Sika-Flex mold. Figures 7 and 8 show the forms installed. The forms were removed after several hours of curing and taken to the laboratory where hydrostone was used to make an exact positive casting of the bar sections (Figure 9). Thereafter, each of these replicates was measured at three or four places where the least section was thought to be. A contour gauge was used to transfer these cross sections onto paper and then the area was measured with a planimeter. This method is believed to be reasonably accurate. The percent loss of section in each bar was calculated in reference to the original section taken from calculations made previously by the Maintenance Division. A key for identifying the bars as listed is provided in Figure 10. Attached are copies of the measured sections of the respective bars listed in Table 1

Hybrid Strategies using Linear and Piecewise-Linear Decision Rules for Multistage Adaptive Linear Optimization

Decision rules offer a rich and tractable framework for solving certain classes of multistage adaptive optimization problems. Recent literature has shown the promise of using linear and nonlinear decision rules in which wait-and-see decisions are represented as functions, whose parameters are decision variables to be optimized, of the underlying uncertain parameters. Despite this growing success, solving real-world stochastic optimization problems can become computationally prohibitive when using nonlinear decision rules, and in some cases, linear ones. Consequently, decision rules that offer a competitive trade-off between solution quality and computational time become more attractive. Whereas the extant research has always used homogeneous decision rules, the major contribution of this paper is a computational exploration of hybrid decision rules. We first verify empirically that having higher uncertainty resolution or more linear pieces in early stages is more significant than having it in late stages in terms of solution quality. Then we conduct a comprehensive computational study for non-increasing (i.e., higher uncertainty resolution in early stages) and non-decreasing (i.e., higher uncertainty resolution in late stages) hybrid decision rules to illustrate the trade-off between solution quality and computational cost. We also demonstrate a case where a linear decision rule is superior to a piecewise-linear decision rule within a simulator environment, which supports the need to assess the quality of decision rules obtained from a look-ahead model within a simulator rather than just using the look-ahead model's objective function value

Supersymmetric Sum Rules for Electromagnetic Multipoles

We derive model independent, non-perturbative supersymmetric sum rules for the magnetic and electric multipole moments of any theory with N=1 supersymmetry. We find that in any irreducible N=1 supermultiplet the diagonal matrix elements of the l-multipole moments are completely fixed in terms of their off-diagonal matrix elements and the diagonal (l-1)-multipole moments.Comment: 10 pages, plain Te

High Efficiency Power Management Unit for Implantable Optical-Electrical Stimulators

Battery-less active implantable devices are of interest because they offer longer life span and eliminate costly battery replacement surgical interventions. This is possible as a result of advances in inductive power transfer and development of power management circuits to maximize the overall power transfer and provide various voltage levels for multi-functional implantable devices. Rehabilitation therapy using optical stimulation of genetically modified peripheral neurons requires high current loads. Standard rectification topologies are inefficient and have associated voltage drops unsuited for miniaturized implants. This paper presents an integrated power management unit (PMU) for an optical-electrical stimulator to be used in the treatment of motor neurone disease. It includes a power-efficient regulating rectifier with a novel body biased high-speed comparator providing 3.3 V for the operation of the stimulator, a 3-stage latch-up charge pump with 12 V output for the input stage of the optical-electrical stimulator, and 1.8 V for digital control logic. The chip was fabricated in a 0.18 μm CMOS process. Measured results show that for a regulated output of 3.3 V delivering 30.3 mW power, the peak power conversion efficiency is 84.2% at 6.78 MHz inductive link tunable frequency reducing to 70.3% at 13.56 MHz. The charge pump with on chip capacitors has 90.9% measured voltage conversion efficiency

All-in-one: a versatile gas sensor based on fiber enhanced Raman spectroscopy for monitoring postharvest fruit conservation and ripening

In today's fruit conservation rooms the ripening of harvested fruit is delayed by precise management of the interior oxygen (O2) and carbon dioxide (CO2) levels. Ethylene (C2H4), a natural plant hormone, is commonly used to trigger fruit ripening shortly before entering the market. Monitoring of these critical process gases, also of the increasingly favored cooling agent ammonia (NH3), is a crucial task in modern postharvest fruit management. The goal of this work was to develop and characterize a gas sensor setup based on fiber enhanced Raman spectroscopy for fast (time resolution of a few minutes) and non-destructive process gas monitoring throughout the complete postharvest production chain encompassing storage and transport in fruit conservation chambers as well as commercial fruit ripening in industrial ripening rooms. Exploiting a micro-structured hollow-core photonic crystal fiber for analyte gas confinement and sensitivity enhancement, the sensor features simultaneous quantification of O2, CO2, NH3 and C2H4 without cross-sensitivity in just one single measurement. Laboratory measurements of typical fruit conservation gas mixtures showed that the sensor is capable of quantifying O2 and CO2 concentration levels with accuracy of 3% or less with respect to reference concentrations. The sensor detected ammonia concentrations, relevant for chemical alarm purposes. Due to the high spectral resolution of the gas sensor, ethylene could be quantified simultaneously with O2 and CO2 in a multi-component mixture. These results indicate that fiber enhanced Raman sensors have a potential to become universally usable on-site gas sensors for controlled atmosphere applications in postharvest fruit management

κ−(BEDT−TTF)2X\kappa-(BEDT-TTF)_2X organic crystals: superconducting versus antiferromagnetic instabilities in an anisotropic triangular lattice Hubbard model

A Hubbard model at half-filling on an anisotropic triangular lattice has been proposed as the minimal model to describe conducting layers of $\kappa-(BEDT-TTF)_2X$ organic materials. The model interpolates between the square lattice and decoupled chains. The $\kappa-(BEDT-TTF)_2X$ materials present many similarities with cuprates, such as the presence of unconventional metallic properties and the close proximity of superconducting and antiferromagnetic phases. As in the cuprates, spin fluctuations are expected to play a crucial role in the onset of superconductivity. We perform a weak-coupling renormalization-group analysis to show that a superconducting instability occurs. Frustration in the antiferromagnetic couplings, which arises from the underlying geometrical arrangement of the lattice, breaks the perfect nesting of the square lattice at half-filling. The spin-wave instability is suppressed and a superconducting instability predominates. For the isotropic triangular lattice, there are again signs of long-range magnetic order, in agreement with studies at strong-coupling.Comment: 4 pages, 5 eps figs, to appear in Can. J. Phys. (proceedings of the Highly Frustrated Magnetism (HFM-2000) conference, Waterloo, Canada, June 2000