Panton-Valentine Leucocidin-Positive Staphylococcus Aureus Gonarthritis in a Healthy Adult Leads To Fulminant Sepsis with Multiple Metastatic Soft Tissue Infection and Necessity of Extracorporeal Membrane Oxygenation

Background: Infections with Panton-Valentine leucocidin (PVL) positive Staphylococcus aureus ( S. aureus ) are often complicated by necrotizing pneumonia, myositis and osteomyelitis. Case Description: We describe a 50 years old, previously healthy male which presented a severe infection with PVL-positive, methicillin- susceptible S. aureus (MSSA) in his left knee after returning from China. He developed a fulminant sepsis with necrotizing pneumonia, acute respiratory distress syndrome (ARDS), acute renal failure and multiple soft tissue abscesses. Extra-corporeal membrane oxygenation (ECMO) was needed for five days. The patient recovered after multiple surgical interventions and long-term antibiotic treatment and eventually returned to work five months after initial admission. Conclusion: While most staphylococcal skin and soft tissue infections (SSTI) show a favorable outcome, SSTI caused by PVL- positive bacteria can lead to fulminant and fatal disease manifestations. Immunocompetent individuals are equally affected as immunocompromised ones. Early suspicion, surgical intervention with debridement and drainage of abscess formations are of key importance in concert with appropriate antibiotic therapy without delay. Imaging should be done to identify clinically silent foci

Induced activation in accelerator components

The residual activity induced in particle accelerators is a serious issue from the point of view of radiation safety as the long-lived radionuclides produced by fast or moderated neutrons and impact protons cause problems of radiation exposure for staff involved in the maintenance work and when decommissioning the facility. This paper presents activation studies of the magnets and collimators in the High Energy Beam Transport line of the European Spallation Source due to the backscattered neutrons from the target and also due to the direct proton interactions and their secondaries. An estimate of the radionuclide inventory and induced activation are predicted using the GEANT4 code

Using ordinal logistic regression to evaluate the performance of laser-Doppler predictions of burn-healing time

Background Laser-Doppler imaging (LDI) of cutaneous blood flow is beginning to be used by burn surgeons to predict the healing time of burn wounds; predicted healing time is used to determine wound treatment as either dressings or surgery. In this paper, we do a statistical analysis of the performance of the technique. Methods We used data from a study carried out by five burn centers: LDI was done once between days 2 to 5 post burn, and healing was assessed at both 14 days and 21 days post burn. Random-effects ordinal logistic regression and other models such as the continuation ratio model were used to model healing-time as a function of the LDI data, and of demographic and wound history variables. Statistical methods were also used to study the false-color palette, which enables the laser-Doppler imager to be used by clinicians as a decision-support tool. Results Overall performance is that diagnoses are over 90% correct. Related questions addressed were what was the best blood flow summary statistic and whether, given the blood flow measurements, demographic and observational variables had any additional predictive power (age, sex, race, % total body surface area burned (%TBSA), site and cause of burn, day of LDI scan, burn center). It was found that mean laser-Doppler flux over a wound area was the best statistic, and that, given the same mean flux, women recover slightly more slowly than men. Further, the likely degradation in predictive performance on moving to a patient group with larger %TBSA than those in the data sample was studied, and shown to be small. Conclusion Modeling healing time is a complex statistical problem, with random effects due to multiple burn areas per individual, and censoring caused by patients missing hospital visits and undergoing surgery. This analysis applies state-of-the art statistical methods such as the bootstrap and permutation tests to a medical problem of topical interest. New medical findings are that age and %TBSA are not important predictors of healing time when the LDI results are known, whereas gender does influence recovery time, even when blood flow is controlled for. The conclusion regarding the palette is that an optimum three-color palette can be chosen 'automatically', but the optimum choice of a 5-color palette cannot be made solely by optimizing the percentage of correct diagnoses

Associações entre heterópteros Emesinae e aranhas em cavernas calcárias de Minas Gerais, sudeste do Brasil

Emesine bugs, within several genera, are recorded from caves around the world, but have been regarded as uncommon in these habitats. Many emesines have ecological relationships with spiders, as kleptoparasites, predators, or both. However, cave emesines are apparently rarely involved in these arachnophilous relationships, and only two examples have been previously documented. Recent studies in limestone caves at Presidente Olegário in northwestern Minas Gerais, Southeastern Brazil revealed the presence of four emesine species, two of which (Emesa mourei Wygodzinsky, 1946 and Phasmatocoris sp.) were associated with spiders, probably as kleptoparasites. The spiders recorded in these associations were Mesabolivar aff. tandilicus (Mello-Leitão, 1940) (Pholcidae) and Loxosceles similis Moenkhaus, 1898 (Sicariidae). The only non-emesine reduviid recorded in Presidente Olegário caves was Zelurus zikani (Costa Lima, 1940). We discuss these rarely recorded associations between cave emesines and spiders and the importance of protecting Presidente Olegário caves.Keywords: Arachnophily, Reduviidae, Pholcidae, Sicariidae, subterranean environment.Emesíneos cavernícolas, pertencentes a vários gêneros, são registrados em cavernas ao redor do mundo, porém são considerados menos abundantes nesse habitat. Muitas espécies possuem relações ecológicas com aranhas, como cleptoparasitas, predadores ou ambos. Entretanto, é aparentemente raro esse tipo de associação com aranhas em cavernas e apenas dois exemplos foram documentados anteriormente. Estudos recentes em cavernas calcárias de Presidente Olegário, no noroeste de Minas Gerais, sudeste do Brasil, revelaram a presença de quatro espécies de Emesinae, sendo que duas delas (Emesa mourei Wygodzinsky, 1946 e Phasmatocoris sp.) estavam associadas com aranhas, provavelmente como cleptoparasitas. As aranhas registradas nessas associações foram Mesabolivar aff. tandilicus (Mello-Leitão, 1940) (Pholcidae) e Loxosceles similis Moenkhaus, 1898 (Sicariidae). O único reduvídeo não Emesinae registrado nas cavernas de Presidente Olegário foi Zelurus zikani (Costa Lima, 1940). Discutem-se brevemente essas raras associações entre emesíneos cavernícolas e aranhas e a importância de se proteger as cavernas de Presidente Olegário.Palavras-chave: Aracnofilia, Reduviidae, Pholcidae, Sicariidae, ambiente subterrâneo

Early and efficient detection of Mycobacterium tuberculosis in sputum by microscopic observation of broth cultures.

Early, efficient and inexpensive methods for the detection of pulmonary tuberculosis are urgently needed for effective patient management as well as to interrupt transmission. These methods to detect M. tuberculosis in a timely and affordable way are not yet widely available in resource-limited settings. In a developing-country setting, we prospectively evaluated two methods for culturing and detecting M. tuberculosis in sputum. Sputum samples were cultured in liquid assay (micro broth culture) in microplate wells and growth was detected by microscopic observation, or in Löwenstein-Jensen (LJ) solid media where growth was detected by visual inspection for colonies. Sputum samples were collected from 321 tuberculosis (TB) suspects attending Bugando Medical Centre, in Mwanza, Tanzania, and were cultured in parallel. Pulmonary tuberculosis cases were diagnosed using the American Thoracic Society diagnostic standards. There were a total of 200 (62.3%) pulmonary tuberculosis cases. Liquid assay with microscopic detection detected a significantly higher proportion of cases than LJ solid culture: 89.0% (95% confidence interval [CI], 84.7% to 93.3%) versus 77.0% (95% CI, 71.2% to 82.8%) (p = 0.0007). The median turn around time to diagnose tuberculosis was significantly shorter for micro broth culture than for the LJ solid culture, 9 days (interquartile range [IQR] 7-13), versus 21 days (IQR 14-28) (p<0.0001). The cost for micro broth culture (labor inclusive) in our study was US $4.56 per sample, versus US$11.35 per sample for the LJ solid culture. The liquid assay (micro broth culture) is an early, feasible, and inexpensive method for detection of pulmonary tuberculosis in resource limited settings

Broadening Participation in Biology Education Research: Engaging Community College Students and Faculty

Nearly half of all undergraduates are enrolled at community colleges (CCs), including the majority of U.S. students who represent groups underserved in the sciences. Yet only a small minority of studies published in discipline-based education research journals address CC biology students, faculty, courses, or authors. This marked underrepresentation of CC biology education research (BER) limits the availability of evidence that could be used to increase CC student success in biology programs. To address this issue, a diverse group of stakeholders convened at the Building Capacity for Biology Education Research at Community Colleges meeting to discuss how to increase the prevalence of CC BER and foster participation of CC faculty as BER collaborators and authors. The group identified characteristics of CCs that make them excellent environments for studying biology teaching and learning, including student diversity and institutional cultures that prioritize teaching, learning, and assessment. The group also identified constraints likely to impede BER at CCs: limited time, resources, support, and incentives, as well as misalignment between doing research and CC faculty identities as teachers. The meeting culminated with proposing strategies for faculty, administrators, journal editors, scientific societies, and funding agencies to better support CC BER

Interpreting LHC SUSY searches in the phenomenological MSSM

We interpret within the phenomenological MSSM (pMSSM) the results of SUSY searches published by the CMS collaboration based on the first ~1 fb^-1 of data taken during the 2011 LHC run at 7 TeV. The pMSSM is a 19-dimensional parametrization of the MSSM that captures most of its phenomenological features. It encompasses, and goes beyond, a broad range of more constrained SUSY models. Performing a global Bayesian analysis, we obtain posterior probability densities of parameters, masses and derived observables. In contrast to constraints derived for particular SUSY breaking schemes, such as the CMSSM, our results provide more generic conclusions on how the current data constrain the MSSM.Comment: 15 pages, 7 figures; minor revision, some references and a comment on prior dependence added; version accepted by JHE