Risk factors for failure of outpatient parenteral antibiotic therapy (OPAT) in infective endocarditis

Objectives: To identify risk factors for failure of outpatient antibiotic therapy (OPAT) in infective endocarditis (IE). Patients and methods: We identified IE cases managed at a single centre over 12 years from a prospectively maintained database. ‘OPAT failure’ was defined as unplanned readmission or antibiotic switch due to adverse drug reaction or antibiotic resistance. We analysed patient and disease-related risk factors for OPAT failure by univariate and multivariate logistic regression. We also retrospectively collected follow-up data on adverse disease outcome (defined as IE-related death or relapse) and performed Kaplan–Meier survival analysis up to 36 months following OPAT. Results: We identified 80 episodes of OPAT in IE. Failure occurred in 25/80 episodes (31.3%). On multivariate analysis, cardiac or renal failure [pooled OR 7.39 (95% CI 1.84–29.66), P = 0.005] and teicoplanin therapy [OR 8.69 (95% CI 2.01–37.47), P = 0.004] were independently associated with increased OPAT failure. OPAT failure with teicoplanin occurred despite therapeutic plasma levels. OPAT failure predicted adverse disease outcome up to 36 months (P = 0.016 log-rank test). Conclusions: These data caution against selecting patients with endocarditis for OPAT in the presence of cardiac or renal failure and suggest teicoplanin therapy may be associated with suboptimal OPAT outcomes. Alternative regimens to teicoplanin in the OPAT setting should be further investigated

Antibiotic Resistance (ABR) in Neonates with Suspected Sepsis admitted to a Medecins Sans Frontieres (MSF) supported Medium Care Unit in Quetta, Pakistan

BACKGROUND: Neonatal Sepsis is a major cause of infant death, especially if associated with ABR. Choice of empirical antibiotics is particularly challenging without access to culture/DST, as in most resource limited settings. MSF care included blood cultures (BCs) since 2015. Here we describe the characteristics of babies, etiologies, ABR, treatment and outcomes

Geometric Interpretation of the Mixed Invariants of the Riemann Spinor

Mixed invariants are used to classify the Riemann spinor in the case of Einstein-Maxwell fields and perfect fluids. In the Einstein-Maxwell case these mixed invariants provide information as to the relative orientation of the gravitational and electromagnetic principal null directions. Consideration of the perfect fluid case leads to some results about the behaviour of the Bel-Robinson tensor regarded as a quartic form on unit timelike vectors.Comment: 31 pages, AMS-LaTe

Lassoing and corraling rooted phylogenetic trees

The construction of a dendogram on a set of individuals is a key component of a genomewide association study. However even with modern sequencing technologies the distances on the individuals required for the construction of such a structure may not always be reliable making it tempting to exclude them from an analysis. This, in turn, results in an input set for dendogram construction that consists of only partial distance information which raises the following fundamental question. For what subset of its leaf set can we reconstruct uniquely the dendogram from the distances that it induces on that subset. By formalizing a dendogram in terms of an edge-weighted, rooted phylogenetic tree on a pre-given finite set X with |X|>2 whose edge-weighting is equidistant and a set of partial distances on X in terms of a set L of 2-subsets of X, we investigate this problem in terms of when such a tree is lassoed, that is, uniquely determined by the elements in L. For this we consider four different formalizations of the idea of "uniquely determining" giving rise to four distinct types of lassos. We present characterizations for all of them in terms of the child-edge graphs of the interior vertices of such a tree. Our characterizations imply in particular that in case the tree in question is binary then all four types of lasso must coincide

A Note on Encodings of Phylogenetic Networks of Bounded Level

Driven by the need for better models that allow one to shed light into the question how life's diversity has evolved, phylogenetic networks have now joined phylogenetic trees in the center of phylogenetics research. Like phylogenetic trees, such networks canonically induce collections of phylogenetic trees, clusters, and triplets, respectively. Thus it is not surprising that many network approaches aim to reconstruct a phylogenetic network from such collections. Related to the well-studied perfect phylogeny problem, the following question is of fundamental importance in this context: When does one of the above collections encode (i.e. uniquely describe) the network that induces it? In this note, we present a complete answer to this question for the special case of a level-1 (phylogenetic) network by characterizing those level-1 networks for which an encoding in terms of one (or equivalently all) of the above collections exists. Given that this type of network forms the first layer of the rich hierarchy of level-k networks, k a non-negative integer, it is natural to wonder whether our arguments could be extended to members of that hierarchy for higher values for k. By giving examples, we show that this is not the case

In-Season Hip Thrust vs. Back Squat Training in Female High School Soccer Players

International Journal of Exercise Science 13(4): 49-61, 2020. The barbell back squat provides a highly effective training stimulus to improve lower body strength, speed, and power, which are considered key components of athletic performance in many sports. The barbell hip thrust exercise utilizes similar musculature, and is popular among practitioners, but has received far less scientific examination. The purpose of this study was to evaluate the effects of an in-season resistance training program with hip thrusts or back squats on physical performance in adolescent female soccer players. Fourteen players completed identical whole-body resistance training twice per week for 6 weeks, except one group used the barbell hip thrust (HT) (n = 6) and the other the back squat (SQ) (n = 8). Improvements were observed for both groups in hip thrust 3RM (HT = 34.0%, SQ = 23.8%), back squat 3RM (HT = 34.6%, SQ = 31.0%), vertical jump (HT = 5.4%, SQ = 4.9%), broad jump (HT = 10.5%, SQ = 8.1%), ball kicking distance (HT = 13.2%, SQ = 8.1%), and pro-agility (HT = -1.5%, SQ = -1.5%; faster), but not 36.6-m dash (HT = 2.9%, SQ = 1.9%; slower) with no significant between-group differences. These data indicate that both the hip thrust and the squat provide an effective stimulus to improve these sport-specific performance measures. Practitioners should consider these findings in combination with other factors (equipment availability, ability to coach the movement, training goals, injuries, etc.) when selecting exercises

On the Heisenberg invariance and the Elliptic Poisson tensors

We study different algebraic and geometric properties of Heisenberg invariant Poisson polynomial quadratic algebras. We show that these algebras are unimodular. The elliptic Sklyanin-Odesskii-Feigin Poisson algebras $q_{n,k}(\mathcal E)$ are the main important example. We classify all quadratic $H-$invariant Poisson tensors on ${\mathbb C}^n$ with $n\leq 6$ and show that for $n\leq 5$ they coincide with the elliptic Sklyanin-Odesskii-Feigin Poisson algebras or with their certain degenerations.Comment: 14 pages, no figures, minor revision, typos correcte

Approximate and exact nodes of fermionic wavefunctions: coordinate transformations and topologies

A study of fermion nodes for spin-polarized states of a few-electron ions and molecules with $s,p,d$ one-particle orbitals is presented. We find exact nodes for some cases of two electron atomic and molecular states and also the first exact node for the three-electron atomic system in $^4S(p^3)$ state using appropriate coordinate maps and wavefunction symmetries. We analyze the cases of nodes for larger number of electrons in the Hartree-Fock approximation and for some cases we find transformations for projecting the high-dimensional node manifolds into 3D space. The node topologies and other properties are studied using these projections. We also propose a general coordinate transformation as an extension of Feynman-Cohen backflow coordinates to both simplify the nodal description and as a new variational freedom for quantum Monte Carlo trial wavefunctions.Comment: 7 pages, 7 figure