Bacterial meningitis in neonates and children South Africa

Includes bibliographical references.Acute bacterial meningitis is defined as the inflammation of the meninges. It is caused by various bacteria and the specific aetiology is age dependant. In the neonatal period the causative organisms are: Group B streptococci, Gram - negative bacilli (e.g.: E. coli, Klebsiella spp, Enterobacter spp, Salmonella spp) and Listeria monocytogenes. In infants and children up to the age of 5 the most common causative organisms include: Streptococcus pneumoniae, Haemophilus influenzae type B (Hib)and Neiseria meningitidis. The two chief causes of bacterial meningitis in children older than 5 are S. pneumoniae and N. meningitidis. Various studies have been performed to look at the profile of meningitis among the paediatric population. Objective: To investigate the aetiology of acute bacterial meningitis in South African newborns and children from 2005 - 2010

Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)

Background: Due to the poor outcomes achieved in acute myeloid leukaemia (AML) treatment, the Red Cross War Memorial Children's Hospital (RCWMCH) Oncology service changed from a BFM-87 based protocol to one based on MRC-AML15 in 2007. Rationale: This study was designed to assess the outcomes and treatment - related toxicity among children treated with RCWMCH protocol Rx 2071. Methods: This was a retrospective review of AML patients treated with Rx2071 between 2007 and 2012 at RCWMCH. Patients with acute promyelocytic leukaemia (APL) and Down Syndrome were excluded. Risk was assigned by cytogenetics. Good risk patients were those with t(8;21), t(16,16) and inv(16). Poor and standard risk included all other cytogenetics according to MRC-AML15. Data pertaining to toxicity was obtained from patient folders. Results: Thirty five children were treated on Rx 2071 during the study period. Males comprised 51.4% (18/35) and females 48.6% (17/35). Age at diagnosis ranged from 0.33 to 12.51 years with the median being 5.68 years. Follow-up from remission in the patients who survived ranged from 1 year 10 months to 9 years 1 month with a median of 62.5 months. Fifteen patients had favourable cytogenetics. Event free survival (EFS) for the good risk group was 85.6%. Twenty patients presented with standard/poor risk cytogenetics. Five patients were deemed poor risk with one having major karyotype abnormalities and four not achieving remission. The remaining fifteen were deemed standard risk by cytogenetics. EFS in this group was 32.4%. Two standard/poor risk patients were transplanted in first complete remission (CR1) and two patients were transplanted in second complete remission. (CR2) Patients had a median of four neutropaenic fevers, and required a median of eight packed cell and eleven platelet transfusions. There were 39 positive blood cultures. There were no chemotherapy related deaths. Discussion: The EFS for good risk patients is excellent but the EFS for standard/poor risk group is not on par with results being achieved in high income countries. The toxicity is not excessive on Rx2071. The results achieved on this protocol were superior to that of the previous BFM- based protocol. Conclusion: The results of this study support the continued use of Rx2071 at RCWMCH

Design, format, validity and reliability of mutiple choice questions for use in nursing research and education

Multiple choice questions are used extensively in nursing research and education and play a fundamental role in the design of research studies or educational programs. Despite their widespread use, there is a lack of evidence-based guidelines relating to design and use of multiple choice questions. Little is written about their format, structure, validity and reliability of in the context of nursing research and/or education and most of the current literature in this area is based on opinion or consensus. Systematic multiple choice question design and use of valid and reliable multiple choice questions are vital if the results of research or educational testing are to be considered valid. Content and face validity schould be established by expert panel review and construct validity should be established using &lsquo;key check&rsquo;, item discrimination and item difficulty analyses. Reliability measures include internal consistency and equivalence. Internal consistency should be established by determination of internal consistency using reliability coefficients while equivalence should be established using alternate form correlation. This paper reviews literature related to the use of multiple choice questions, current design recommendations and processes to establish reliability and validity, and discusses implications for their use in nursing research and education.<br /

Device-to-Device Aided Multicasting

We consider a device-to-device (D2D) aided multicast channel, where a transmitter wishes to convey a common message to many receivers and these receivers cooperate with each other. We propose a simple computationally efficient scheme requiring only statistical channel knowledge at transmitter. Our analysis in general topologies reveals that, when the number of receivers $K$ grows to infinity, the proposed scheme guarantees a multicast rate of ${1 \over 2} \log_2(1 + \beta \ln K )$ with high probability for any $\beta < \beta^\star$ where $\beta^\star$ depends on the network topology. This scheme undergoes a phase transition at threshold $\beta^\star \ln K$ where transmissions are successful/unsuccessful with high probability when the SNR is above/below this threshold. We also analyze the outage rate of the proposed scheme in the same setting.Comment: Technical report version of a paper submitted to ISIT 201

California High Schools That Beat the Odds in High School Graduation

Based on interviews with principals of schools with better graduation rates, test scores, and dropout rates compared to others of similar student composition, outlines policies and practices that contribute to high graduation rates and academic standards

Writer by Trade: James Ralph’s Claims to Authorship

To the enterprising journalists of early eighteenth-century Great Britain, the refined status of “author” remained elusive. Journalism itself was a nascent occupation formed in the processes of cultural legitimatization, commercialization, and politicization of authorship. In London, James Ralph, an American expatriate and political writer, emerged as a spokesman for journalism. In his Case of Authors by Profession or Trade, a short treatise published in 1758, Ralph argued that “professional” authors included journalists and other non-patroned writers. They deserved respect as an occupational group, and a special role in society. Ralph equated and extended the privileged notions of authorship and the role of the author — essentially, respectability and some limited independence from political and financial pressures — to his fellow journalists. His Case is worth revisiting because it shows how literary culture was being challenged in his era, extended and subverted as it was by his fellow journalists and their more transitory creations

MAMP (microbe-associated molecular pattern) triggered immunity in plants

Plants are sessile organisms that are under constant attack from microbes. They rely on both preformed defenses, and their innate immune system to ward of the microbial pathogens. Preformed defences include for example the cell wall and cuticle, which act as physical barriers to microbial colonization. The plant immune system is composed of surveillance systems that perceive several general microbe elicitors, which allow plants to switch from growth and development into a defense mode, rejecting most potentially harmful microbes. The elicitors are essential structures for pathogen survival and are conserved among pathogens. The conserved microbe-specific molecules, referred to as microbe- or pathogen-associated molecular patterns (MAMPs or PAMPs), are recognized by the plant innate immune systems pattern recognition receptors (PRRs). General elicitors like flagellin (Flg), elongation factor Tu (EF-Tu), peptidoglycan (PGN), lipopolysaccharides (LPS), Ax21 (Activator of XA21-mediated immunity in rice), fungal chitin and β-glucans from oomycetes are recognized by plant surface localized PRRs. Several of the MAMPs and their corresponding PRRs have, in recent years, been identified. This review focuses on the current knowledge regarding important MAMPs from bacteria, fungi and oomycetes, their structure, the plant PRRs that recognizes them, and how they induce MAMP-triggered immunity (MTI) in plants

A General Chemical Method to Regulate Protein Stability in the Mammalian Central Nervous System

SummaryThe ability to make specific perturbations to biological molecules in a cell or organism is a central experimental strategy in modern research biology. We have developed a general technique in which the stability of a specific protein is regulated by a cell-permeable small molecule. Mutants of the Escherichia coli dihydrofolate reductase (ecDHFR) were engineered to be degraded, and, when this destabilizing domain is fused to a protein of interest, its instability is conferred to the fused protein resulting in rapid degradation of the entire fusion protein. A small-molecule ligand trimethoprim (TMP) stabilizes the destabilizing domain in a rapid, reversible, and dose-dependent manner, and protein levels in the absence of TMP are barely detectable. The ability of TMP to cross the blood-brain barrier enables the tunable regulation of proteins expressed in the mammalian central nervous system