Recurrent Klebsiella Meningitis Following Trans-sphenoidal Hypophysectomy for Nelson\u27s Syndrome: Chloramphenicol resistance during relapse

Three episodes of meningitis due to Klebsiella pneumoniae occurred in a young man following cerebral surgery. The patient had the features of Nelson\u27s syndrome, and a chromophobe adenoma was removed by trans-sphenoidal resection. Intravenous chloramphenicol was effective in producing a temporary clinical response during the first episode of meningitis, but the organism became resistant to chloramphenicol during the second episode. Combined parenteral and intralumbar administration of gentamicin resulted in temporary improvement only. Subsequently, the subcutaneous cerebrospinal fluid (CSF) reservoir of Ommaya provided a safe, convenient way to administer prolonged intraventricular therapy which, combined with a definitive procedure to correct the cerbrospinal fluid rhinorrhea, ultimately cured the infection

In Vitro and Clinical Studies of Cefaclor, A New Cephalosporin

In vitro susceptibility studies of 246 clinical isolates demonstrated that this antibiotic was effective against Group A beta hemolytic streptococci, alpha hemolytic streptococci, S. pneumoniae, both penicillinase producing and nonpenicillinase producing Staphylococci, Klebsiella pneumoniae, and Proteus mirabilis. Cephalothin susceptible E. coii were also susceptible to cefaclor. Pseudomonas aeruginosa, Serratia sp., Enterobacter Sp., and Streptococcus faecalis were uniformly resistant to cefaclor. The efficacy and safety of this antibiotic were studied in 27 patients with urinary tract, soft tissue, and respiratory infections. Patients with urinary tract infections became abacteriuric after 48 hours. Patients with soft tissue infections responded well within the first week of therapy, and throat cultures of patients with tonsillitis were negative ten days and six weeks after treatment. The drug was well tolerated, and no significant adverse effect was noted

Soil zinc content, groundwater usage, and prostate cancer incidence in South Carolina

Background Prostate cancer (PrCA) incidence in South Carolina (SC) exceeds the national average, particularly among African Americans (AAs). Though data are limited, low environmental zinc exposures and down-regulation of prostatic zinc transporter proteins among AAs may explain, in part, the racial PrCA disparity. Methods Age-adjusted PrCA rates were calculated by census tract. Demographic data were obtained from the 1990 census. Hazardous waste site locations and soil zinc concentrations were obtained from existing federal and state databases. A geographic information system and Poisson regression were used to test the hypothesis that census tracts with reduced soil zinc concentrations, elevated groundwater use, or more agricultural or hazardous waste sites had elevated PrCA risks. Results Census tracts with high groundwater use and low zinc concentrations had higher PrCA rate ratios (RR: 1.270; 95% confidence interval: 1.079, 1.505). This effect was not more apparent in areas populated primarily by AAs. Conclusion Increased PrCA rates were associated with reduced soil zinc concentrations and elevated groundwater use, although this observation is not likely to contribute to SC’s racial PrCA disparity. Statewide mapping and statistical modeling of relationships between environmental factors, demographics, and cancer incidence can be used to screen hypotheses focusing on novel PrCA risk factors

Scaling tests of the improved Kogut-Susskind quark action

Improved lattice actions for Kogut-Susskind quarks have been shown to improve rotational symmetry and flavor symmetry. In this work we find improved scaling behavior of the rho and nucleon masses expressed in units of a length scale obtained from the static quark potential, and better behavior of the Dirac operator in instanton backgrounds.Comment: 4 pages, 4 figures, Revte

The QCD spectrum with three quark flavors

We present results from a lattice hadron spectrum calculation using three flavors of dynamical quarks - two light and one strange, and quenched simulations for comparison. These simulations were done using a one-loop Symanzik improved gauge action and an improved Kogut-Susskind quark action. The lattice spacings, and hence also the physical volumes, were tuned to be the same in all the runs to better expose differences due to flavor number. Lattice spacings were tuned using the static quark potential, so as a byproduct we obtain updated results for the effect of sea quarks on the static quark potential. We find indications that the full QCD meson spectrum is in better agreement with experiment than the quenched spectrum. For the 0++ (a0) meson we see a coupling to two pseudoscalar mesons, or a meson decay on the lattice.Comment: 38 pages, 20 figures, uses epsf. 5/29/01 revision responds to referee's Comments, changes pion fits and tables, and corrects Fig. 10 and some minor error

Adult meningitis in a setting of high HIV and TB prevalence: findings from 4961 suspected cases

BACKGROUND: The presentation and causes of adult meningitis in South Africa have changed substantially as a result of HIV. Knowledge of aetiology and laboratory findings in patients presenting with meningitis are important in guiding management. We performed a retrospective study to determine these findings in a setting of high HIV and TB prevalence in Cape Town. METHODS: Patients undergoing lumbar punctures between 1st January 2006 and 31st December 2008 at a public sector referral hospital were studied. Cases were classified by microbiological diagnosis, or in the absence of definitive microbiology as 1) normal CSF (neutrophils or =1.5 mmol/L), 2) minor abnormalities (neutrophils 2-5, lymphocytes 6-20, protein 0.51-1.0, glucose 1.0-1.49) or 3) markedly abnormal (neutrophils>5, lymphocytes>20, protein>1.0, glucose<1.0). RESULTS: 5578 LPs were performed on 4549 patients, representing 4961 clinical episodes. Of these, 2293 had normal CSF and 931 had minor abnormalities and no aetiology identified. Of the remaining 1737, microbiological diagnoses were obtained in 820 (47%). Cryptococcus accounted for 63% (514) of microbiological diagnoses, TB for 28% (227), bacterial meningitis for 8% (68). Of the remaining 917 who had marked abnormalities, the majority (59%) had a sterile lymphocytic CSF. Of note 16% (81) patients with confirmed Cryptococcus, 5% (12) with TB and 4% (3) with bacterial meningitis had normal CSF cell-counts and biochemistry. CONCLUSIONS: Cryptococcal and tuberculous meningitis are now the commonest causes of adult meningitis in this setting. TB meningitis is probably underdiagnosed by laboratory investigation, as evidence by the large numbers presenting with sterile lymphocytic markedly abnormal CSFs

Introductory programming: a systematic literature review

As computing becomes a mainstream discipline embedded in the school curriculum and acts as an enabler for an increasing range of academic disciplines in higher education, the literature on introductory programming is growing. Although there have been several reviews that focus on specific aspects of introductory programming, there has been no broad overview of the literature exploring recent trends across the breadth of introductory programming. This paper is the report of an ITiCSE working group that conducted a systematic review in order to gain an overview of the introductory programming literature. Partitioning the literature into papers addressing the student, teaching, the curriculum, and assessment, we explore trends, highlight advances in knowledge over the past 15 years, and indicate possible directions for future research

Report of the 1st Workshop on Generative AI and Law

This report presents the takeaways of the inaugural Workshop on Generative AI and Law (GenLaw), held in July 2023. A cross-disciplinary group of practitioners and scholars from computer science and law convened to discuss the technical, doctrinal, and policy challenges presented by law for Generative AI, and by Generative AI for law, with an emphasis on U.S. law in particular. We begin the report with a high-level statement about why Generative AI is both immensely significant and immensely challenging for law. To meet these challenges, we conclude that there is an essential need for 1) a shared knowledge base that provides a common conceptual language for experts across disciplines; 2) clarification of the distinctive technical capabilities of generative-AI systems, as compared and contrasted to other computer and AI systems; 3) a logical taxonomy of the legal issues these systems raise; and, 4) a concrete research agenda to promote collaboration and knowledge-sharing on emerging issues at the intersection of Generative AI and law. In this report, we synthesize the key takeaways from the GenLaw workshop that begin to address these needs. All of the listed authors contributed to the workshop upon which this report is based, but they and their organizations do not necessarily endorse all of the specific claims in this report

Open access transport models: A leverage point in sustainable transport planning

A large and growing body of evidence suggests fundamental changes are needed in transport systems, to tackle issues such as air pollution, physical inactivity and climate change. Transport models can play a major role in tackling these issues through the transport planning process, but they have historically been focussed on motorised modes (especially cars) and available only to professional transport planners working within the existing paradigm. Building on the principles of open access software, first developed in the context of geographic information systems, this paper develops and discusses the concept of open access transport models, which we define as models that are both developed using open source software and are available to be used by the public without the need for specialist training or the purchase of software licences. We explore the future potential of open access transport models to support the transition away from fossil fuels in the transport sector. We do this with reference to the literature on the use of tools in the planning process, and by exploring an example that is already in use: the ‘Propensity to Cycle Tool’. We conclude that open access transport models can be a leverage point in the planning process due to their ability to provide robust, transparent and actionable evidence that is available to a range of stakeholders, not just professional transport planners. Open access transport models represent a disruptive technology deserving further research and development, by planners, researchers and citizen scientists, including open source software developers and advocacy groups but, in order to fulfil their potential, they will require both financial and policy support from government bodies

Integrated genomic characterization of pancreatic ductal adenocarcinoma

We performed integrated genomic, transcriptomic, and proteomic profiling of 150 pancreatic ductal adenocarcinoma (PDAC) specimens, including samples with characteristic low neoplastic cellularity. Deep whole-exome sequencing revealed recurrent somatic mutations in KRAS, TP53, CDKN2A, SMAD4, RNF43, ARID1A, TGFβR2, GNAS, RREB1, and PBRM1. KRAS wild-type tumors harbored alterations in other oncogenic drivers, including GNAS, BRAF, CTNNB1, and additional RAS pathway genes. A subset of tumors harbored multiple KRAS mutations, with some showing evidence of biallelic mutations. Protein profiling identified a favorable prognosis subset with low epithelial-mesenchymal transition and high MTOR pathway scores. Associations of non-coding RNAs with tumor-specific mRNA subtypes were also identified. Our integrated multi-platform analysis reveals a complex molecular landscape of PDAC and provides a roadmap for precision medicine