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

A note on the index of closed minimal hypersurfaces of flat tori

Generalizing earlier work by Ros in ambient dimension three, we prove an affine lower bound for the Morse index of closed minimal hypersurfaces inside a flat torus in terms of their first Betti number (with purely dimensional coefficients)

Chloroquine-resistant Plasmodium falciparum malaria in the Kavango region of Namibia

The sensitivity to chloroquine of Plasmodium falciparum from the Kavango region of Namibia was determined by a 24-hour test in vitro. Twenty-six Isolates were successfully tested, of which 11 were resistant to a low degree, schizogony being inhibited at 8 pmollwell. The results of the Dill-Glazko test for the presence of 4-amlnoquinolines in urine indicate that chloroquine is not Widely used in the area

Designing blue green infrastructure (BGI) for water management, human health, and wellbeing : summary of evidence and principles for design

This Report has been prepared by researchers from the University of Sheffield for built environment, water, and public health professionals in the UK. It collates and presents evidence about the potential benefits of designing Blue Green Infrastructure (BGI) to enhance mental health, physical health, and wellbeing. We hope it will help professionals to advocate for health-promoting BGI to policymakers; to integrate health-promoting BGI into policy, investment, and master-planning; and to design BGI in a way that maximises health benefits. The Report identifies three key attributes of BGI that provide health-relevant environmental impacts. Firstly, BGI can be used to promote a healthy physical environment: to diminish noise, reduce heat stress, and improve air quality. Secondly, BGI has beneficial aesthetic and sensory qualities: its appearance, sounds, smells, and tactile qualities can have therapeutic potential even where communities are unable to walk through the area directly (e.g. a pocket park on private land). Thirdly, there are benefits to physically accessible BGI spaces, which can promote exercise and social interaction by allowing a wide range of people with varying mobility needs to pass through them. Together, these aspects of BGI mean that well-designed spaces can make a very real difference. As well as helping to improve general health and wellbeing, they can reduce social and health inequalities in the UK. Research suggests that such health inequalities are currently widening, at a time when the impacts of climate change are also disproportionately impacting poorer communities. We show that BGI offers the opportunity to tackle these two problems together, and thus to build a society that is fair and sustainable for future generations. The COVID-19 pandemic has reemphasised the topicality of this focus, as the quality of people’s local environments is an issue that has been at the forefront of public debate during lockdown. Sections 1 and 2 explain the scope of the report, outline key terminology, and summarise methodological issues. Sections 3-8 then review the literature on the contribution that BGI can make across six specific categories of health impact: noise reduction; heat stress reduction; improved air quality; stress reduction and cognitive restoration; decreased loneliness and enhanced social interaction; and increased physical activity. In section 9, evidence about the potential for BGI to address inequalities is considered. Section 10 then presents the evidence that these impacts can lead to improvements across five wider health outcomes: improved mental health and wellbeing; reduced physical illness; reduced mortality; improved birth outcomes; and healthier body weights. Key design findings are summarised in Section 11

Cancer And Premature Mortality In Ireland: An Employer's Perspective Following The Friction Cost Approach.

Cancer is the second leading cause of death in Ireland accounting for approximately 30% of all deaths. Of these, almost a third arise in those of working age. As well as the public health burden, cancer also imposes economic costs on society in general and employers in particular. This study measured the productivity costs associated with cancer-related premature mortality from an employer’s perspective in Ireland

Conspiracy in bacterial genomes

The rank ordered distribution of the codon usage frequencies for 123 bacteriae is best fitted by a three parameters function that is the sum of a constant, an exponential and a linear term in the rank n. The parameters depend (two parabolically) from the total GC content. The rank ordered distribution of the amino acids is fitted by a straight line. The Shannon entropy computed over all the codons is well fitted by a parabola in the GC content, while the partial entropies computed over subsets of the codons show peculiar different behavior, exhibiting therefore a first conspiracy effect. Moreover the sum of the codon usage frequencies over particular sets, e.g. with C and A (respectively G and U) as i-th nucleotide, shows a clear linear dependence from the GC content, exhibiting another conspiracy effect.Comment: revised version: introduction and conclusion enhanced, references added, figures added, some tables remove

Quantifying argonaute proteins in and out of GW/P-bodies: Implications in microRNA activities

MicroRNAs (miRNAs) are a class of ∼22nt non-coding RNAs that regulate the translational potential and stability of mRNAs. Though constituting only 1-4% of human genes, miRNAs are predicted to regulate more than 60% of all mRNAs. The action of miRNAs is mediated through their associations with Argonaute proteins and mRNA targets. Previous studies indicated that though the majority of Argonaute proteins is diffusely distributed in the cytoplasm, a small fraction is consistently observed to be concentrated in a cytoplasmic compartment called GW/P-bodies. In this chapter, we will provide a quantitative and dynamic view of the subcellular localization of miRNA function, followed by a discussion on the possible roles of PBs in miRNA silencing.National Institutes of Health (U.S.) (Grant R01-CA133404)National Cancer Institute (U.S.) (Grant P01-CA42063)National Cancer Institute (U.S.) (Grant P30-CA14051

How actors are (dis)integrating policy agendas for multi-functional blue and green infrastructure projects on the ground

Local governments are increasingly considering blue and green infrastructure (BGI) in order to climate-proof cities. Because BGI can have multiple benefits beyond climate adaptation, policy integration is required. Since drainage services have traditionally been within the remit of a single department, this is new territory for water management. This article provides a dynamic perspective on the messy process of policy integration ‘on the ground’ in two BGI projects in Dordrecht, NL and Bradford, UK. Drawing on interviews with key actors involved in the cases, our research question is: How are ambitions to integrate policies resulting in multi-functional BGI projects? While previous research typically defines organisational structures as barriers for policy integration, our findings demonstrate instances of actors who are successfully navigating these structures as a route towards policy integration. Nevertheless, we found that actors who push for BGI lack resources and authority, so they mainly rely on more voluntary forms of policy integration that involve concerted action over a number of years. Overall, our cases demonstrate that space for policy integration exists and powerful agencies are sympathetic to this, but more support is needed to achieve this mandate

Improved synchronous production of Plasmodium falciparum gametocytes in vitro.

The sexual stages of the Plasmodium falciparum life cycle are attractive targets for vaccines and transmission blocking drugs. Difficulties in culturing and obtaining large amounts of sexual stage P. falciparum parasites, particularly early stages, have often limited research progress in this area. We present a new protocol which simplifies the process of stimulating gametocytogenesis leading to improved synchronous gametocyte production. This new method can be adapted to enrich for early stage gametocytes (I and II) with a higher degree of purity than has previously been achieved, using MACS magnetic affinity columns. The protocol described lends itself to large scale culturing and harvesting of synchronous parasites suitable for biochemical assays, northern blots, flow cytometry, microarrays and proteomic analysis