Carotid Endarterectomy Versus Carotid Stenting in the Prevention of Stroke in Asymptomatic Carotid Artery Disease

Stroke is the leading cause of disability and second most common cause of death worldwide. Ischemic stroke accounts for 80% of all strokes, and are the result of the blood supply to the brain being interrupted abruptly. Atheroembolism, or a cholesterol embolism, is a major contributor to ischemic strokes. Due to this fact, treatment of carotid artery stenosis has been aimed at preventing atheroembolization by controlling plaque buildup in arteries before they have the chance to break off and cause harm. In an attempt to prevent future stroke (O) in adult patients with asymptomatic carotid artery disease (P), will performing a carotid endarterectomy (I) compared to carotid stent placement (C) have lower associated risks (O)

Quaternary pulse position modulation electronics for free-space laser communications

The development of a high data-rate communications electronic subsystem for future application in free-space, direct-detection laser communications is described. The dual channel subsystem uses quaternary pulse position modulation (QPPM) and operates at a throughput of 650 megabits per second. Transmitting functions described include source data multiplexing, channel data multiplexing, and QPPM symbol encoding. Implementation of a prototype version in discrete gallium arsenide logic, radiofrequency components, and microstrip circuitry is presented

Impact of HIV drug resistance on HIV/AIDS associated mortality, new infections and antiretroviral therapy program costs in sub-Saharan Africa

To inform the level of attention to be given by antiretroviral therapy (ART) programs to HIV drug resistance (HIVDR), we used an individual-level model to estimate its impact on future AIDS deaths, HIV-incidence and ART program costs in sub-Saharan Africa (SSA) for a range of program situations. We applied this to SSA through the Spectrum-Goals model. In a situation in which current levels of pre-treatment HIVDR are over 10% (mean 15%), 16% of AIDS deaths (890,000 deaths) , 9% of new infections (450,000) and 8% ($6.5 billion) of ART program costs in SSA in 2016-2030 will be attributable to HIVDR

Irradiation of the secondary star in X-ray Nova Scorpii 1994 (=GRO J1655--40)

We have obtained intermediate resolution optical spectra of the black-hole candidate Nova Sco 1994 in June 1996, when the source was in an X-ray/optical active state (R~15.05). We measure the radial velocity curve of the secondary star and obtain a semi-amplitude of 279+/-10 km/s; a value which is 30 per cent larger than the value obtained when the source is in quiescence. Our large value for K_2 is consistent with 60 +9,-7 per cent of the secondary star's surface being heated; compared to 35 per cent, which is what one would expect if only the inner face of the secondary star were irradiated. Effects such as irradiation-induced flows on the secondary star may be important in explaining the observed large value for K_2.Comment: 5 pages, 2 figures, accepted by MNRA

Assessment of Antimicrobial Pharmacokinetics Curricula Across Schools and Colleges of Pharmacy in the United States

Introduction Advances in technology and understanding of pharmacokinetic/pharmacodynamic relationships have prompted guideline updates and advances in precision dosing, but the role of clinical pharmacokinetics (PK) in pharmacy education remains inconsistent. Previous surveys of pharmacy school PK curricula revealed large variations in content, integration, and teaching tools but did not focus on antimicrobials or details of andragogy used. Objective Identify how antimicrobial PK is taught in pharmacy curricula across the United States, as well as instructor perceptions of current practices. Methods An online survey was distributed to 118 pharmacy programs across the United States in 2018. This 30-minute questionnaire covered curriculum content, teaching strategies, assessment modalities, and perceptions. Results Completed surveys were received from 53 programs (45% response rate) via relevant course coordinators. Among 35 traditional progressive curriculum programs (TPC), antimicrobial PK was taught in basic science (33, 94%), clinical PK (15, 43%), pharmacology (8, 23%), therapeutics (28, 80%), and skills lab courses (21, 65%). Among 18 integrated block curriculum programs (IBC), it was taught in foundations/principles (17, 94%), organ systems (12, 67%), and skills lab courses (9, 50%). On average, TPC programs had more courses with antimicrobial PK than IBC programs. Vancomycin and aminoglycosides were the most common antimicrobials taught (100%), while didactic lecturing was the predominant andragogy. Multiple choice was the primary assessment modality, being frequently used in 64% of TPC and 68% of IBC courses, respectively. Among respondents, 72% believed more time was needed to teach PK and 53% believed students were adequately prepared at the start of APPEs. Conclusion Antimicrobial PK instruction remains highly inconsistent in U.S. pharmacy schools and colleges. IBC programs may provide less opportunity for antimicrobial PK instruction, which conflicts with the desire for more instruction time. As clinical applications of antimicrobial PK change and expand, it is crucial that pharmacy education prioritizes PK education appropriately

An evaluation of metal removal during wastewater treatment: The potential to achieve more stringent final effluent standards

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2011 Taylor & Francis.Metals are of particular importance in relation to water quality, and concern regarding the impact of these contaminants on biodiversity is being encapsulated within the latest water-related legislation such as the Water Framework Directive in Europe and criteria revisions to the Clean Water Act in the United States. This review undertakes an evaluation of the potential of 2-stage wastewater treatment consisting of primary sedimentation and biological treatment in the form of activated sludge processes, to meet more stringent discharge consents that are likely to be introduced as a consequence. The legislation, sources of metals, and mechanisms responsible for their removal are discussed, to elucidate possible pathways by which the performance of conventional processes may be optimized or enhanced. Improvements in effluent quality, achievable by reducing concentrations of suspended solids or biochemical oxygen demand, may also reduce metal concentrations although meeting possible requirements for the removal of copper my be challenging

Expanding the Repertoire of Natural Product-Inspired Ring Pairs for Molecular Recognition of DNA

A furan amino acid, inspired by the recently discovered proximicin natural products, was incorporated into the scaffold of a DNA-binding hairpin polyamide. While unpaired oligomers of 2,4-disubstituted furan amino acids show poor DNA-binding activity, furan (Fn) carboxamides paired with N-methylpyrrole (Py) and N-methylimidazole (Im) rings demonstrate excellent stabilization of duplex DNA as well as discrimination of noncognate sequences, consistent with function as a Py mimic according to the Py/Im polyamide pairing rules