Multidrug-Resistant Klebsiella Pneumoniae Meningitis Successfully Treated with Intrathecal Colistin

Background: Multidrug-resistant (MDR) gram negative bacteria meningitis has become a clinical entity with increasing importance in recent years. Intrathecal colistin (ITH) has been used in the treatment of this cases. Aims: To report one case of MDR Klebsiella pneumoniae meningitis and ventriculitis successfully treated with ITH colistin. Case Report: Nine months old boy, born at 28 weeks of gestational age, diagnosed with neonatal meningitis, complicated with tetraventricular hydrocephalus requiring ventriculo-peritoneal shunt (VPS) placement and multiple shunt revisions. Admitted for worsening hydrocephalus. Cerebrospinal fluid (CSF) cultures were positive for extended-spectrum β-lactamase (ESBL) Klebsiella pneumoniae, only sensitive to meropenem and amikacin. Intravenous meropenen was started but CSF cultures remained positive and shunt device could not be removed. Although susceptibility to colistin was not available, on day 24 intrathecal colistin(4mg/day) was started through an external shunt. CSF white blood cell count improved and cultures became negative. Colistin was stopped after 19 days because of CSF pleocitosis and meropenen maintained for a total of 2 months with clinical improvement. Conclusion: In Klebsiella pneumoniae meningitis with ventriculitis, ITH colistin can be considered a safe, effective, and practicable alternative treatment when parental administration fails.info:eu-repo/semantics/publishedVersio

Setting the stage for new ecological indicator species: A holistic case study on the Iberian dolphin freshwater mussel Unio delphinus Spengler, 1793

Supplementary data to this article can be found online at https://doi.org/10.1016/j.ecolind.2019.105987.Due to their sensitivity and dramatic declines, freshwater mussels are prime targets for conservation and environmental monitoring. For this, however, information is needed on life history and ecological traits, which is lacking in many taxa, including threatened species. Species recently described or recognized as valid are of particular concern, due to the shortage of even basic knowledge. A case in point is the recently recognized and Near Threatened dolphin freshwater mussel Unio delphinus Spengler, 1793, which is endemic to the western Iberian Peninsula and has suffered marked population declines. To overcome information gaps for U. delphinus, we carried out a holistic biological study across the species range, aiming to: i) estimate the area of occupancy (AOO) and extent of occurrence (EOO) based on updated distribution data taken from the literature and recent surveys; ii) estimate growth patterns from biometrical (shell dimensions and growth annuli) measurements taken on specimens from seven populations; iii) estimate sex ratios from gonad tissue biopsies collected on specimens from eight populations; iv) estimate gametogenesis and sex ratio through histological examination of gonad and gill tissues collected monthly for a year, from a single population; and v) determine host species from infestation trials of glochidia with co-occurring fish species. We estimated an EOO of 706 km2 and an AOO of 61 km2, which together with data on declines assigns the species to the Endangered category using IUCN criteria. Unio delphinus was found to grow faster and to be shorter-lived (up to 11 years, maturity at around 2 years old) than other European freshwater mussels. Growth and life span are similar across the range in lotic habitats, but different from that in lentic habitats. The larvae of U. delphinus may attach to most co-occurring fish species, but only native species were effective hosts. Native cyprinids, especially those from the genus Squalius, seem to be the primary hosts. Overall, the information provided contributes to a better conservation status assessment, selection of conservation and rehabilitation areas, guidance for the establishment of propagation programs and better timing for specimens’ manipulation including monitoring and possible translocations. The framework presented here highlights the importance of basic biological studies to define good ecological and physiological status.This work was supported by Portuguese FCT – Foundation for Science and Technology, Projects FRESHCO: Multiple implications of invasive species on Freshwater Mussel co-extinction processes (PTDC/AGR-FOR/1627/2014-04/SAICT/2015), MUSSELFLOW: Host-depen dent evolution, ecology and conservation of freshwater mussels under varying hydrological conditions: consequences of climate change (PTDC/BIA-EVL/29199/2017), and ConBiomics: The missing approach for the Conservation of freshwater Bivalves Project N° NORTE-01-0145- FEDER-030286, co-financed by COMPETE 2020, Portugal 2020 and the European Union through the ERDF. FCT also supported MLL under grant (SFRH/BD/115728/2016), CM under grant (SFRH/BD/111133/ 2015) and also through Strategic Funding UID/Multi/04423/2019. PB was supported by EDP Biodiversity Chair

Niche-breadth of freshwater macrophytes occurring in tropical southern African rivers predicts species global latitudinal range

The study tested the hypothesis that measurement, using multivariate Principal Components Analy-sis (PCA), of the niche-breadth of river macrophyte species in southern tropical Africa, may predicttheir larger-scale biogeographical range. Two measures of niche-breadth were calculated for 44 riverinemacrophyte species, from 20 families commonly occurring in Zambia, using an approach based on PCAordination with 16 bio-physico-chemical input variables. These included altitude, stream order, streamflow, pH, conductivity and soluble reactive phosphate concentration (SRP). In the absence of additionalchemical water quality data for Zambian rivers, invertebrate-based measures of general water qualitywere also used. These were benthic macroinvertebrate Average Score per Taxon (ASPT), and individualabundance of nine macroinvertebrate families with differing water quality tolerance, indicated by theirSensitivity Weightings within the Zambian Invertebrate Scoring System (ZISS). Macrophyte large-scalelatitudinal range was derived from world geopositional records held by online databases, and additionalrecords held by the authors. The two niche-breadth metrics divided the species into narrow-niche andintermediate/broad-niche categories, showing significant variation (from one or both of correlation andANOVA test outcomes) in altitude, stream flow, conductivity, SRP, pH and ASPT, but not stream order.Macrophyte alpha-diversity (as a measure of number of individual niches co-existing per habitat) showedno significant relationship with individual species niche-breadth. Narrow-niche species included a higherproportion of Afrotropical endemics than did species with broader niche size. There were significant pre-dictive relationships between macrophyte niche-breadth and latitudinal range of the target species atglobal and Afrotropical scales, but not for the Neotropics.Fil: Kennedy, Michael. University Of Aberdeen; Reino UnidoFil: Lang, Pauline. University of Glasgow; Reino UnidoFil: Tapia Grimaldo, Julissa. University of Glasgow; Reino UnidoFil: Varandas Martins, Sara. University of Glasgow; Reino UnidoFil: Bruce, Alannah. University of Glasgow; Reino UnidoFil: Moore, Isabel. University of Glasgow; Reino UnidoFil: Taubert, Rebeca. University of Glasgow; Reino UnidoFil: Macleod-Nolan, Chantal. University of Glasgow; Reino UnidoFil: McWaters, Stephanie. University of Glasgow; Reino UnidoFil: Briggs, John. University of Glasgow; Reino UnidoFil: Lowe, Steve. University of Glasgow; Reino UnidoFil: Saili, Kochelani. University Of Zambia;Fil: SICHINGABULA, Henry. University Of Zambia;Fil: Dallas, Helen. Nelson Mandela Metropolitan University, Sudafrica; SudáfricaFil: Morrison, Sean. University of Glasgow; Reino UnidoFil: Franceschini, Maria Celeste. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Centro de Ecología Aplicada del Litoral. Universidad Nacional del Nordeste. Centro de Ecología Aplicada del Litoral; ArgentinaFil: Willems, Frank. The Kasanka Trust; ZambiaFil: Bottino, Flavia. Universidad Federal de San Carlos; BrasilFil: MURPHY Kevin. University of Glasgow; Reino Unid

Intrinsic ergodicity beyond specification: beta-shifts, S-gap shifts, and their factors

We give sufficient conditions for a shift space $(\Sigma,\sigma)$ to be intrinsically ergodic, along with sufficient conditions for every subshift factor of $\Sigma$ to be intrinsically ergodic. As an application, we show that every subshift factor of a $\beta$-shift is intrinsically ergodic, which answers an open question included in Mike Boyle's article "Open problems in symbolic dynamics". We obtain the same result for $S$-gap shifts, and describe an application of our conditions to more general coded systems. One novelty of our approach is the introduction of a new version of the specification property that is well adapted to the study of symbolic spaces with a non-uniform structure.Comment: 27 pages, 1 figure, minor changes based on referee's suggestions, in v.3 the result on coded systems has been moved to the introduction, resulting in small changes to numbering (lettering) of result

Compulsory admissions of patients with mental disorders : State of the art on ethical and legislative aspects in 40 European countries

Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.Peer reviewe

A simple method for defining malaria seasonality

BACKGROUND: There is currently no standard way of defining malaria seasonality, resulting in a wide range of definitions reported in the literature. Malaria cases show seasonal peaks in most endemic settings, and the choice and timing for optimal malaria control may vary by seasonality. A simple approach is presented to describe the seasonality of malaria, to aid localized policymaking and targeting of interventions. METHODS: A series of systematic literature reviews were undertaken to identify studies reporting on monthly data for full calendar years on clinical malaria, hospital admission with malaria and entomological inoculation rates (EIR). Sites were defined as having 'marked seasonality' if 75% or more of all episodes occurred in six or less months of the year. A 'concentrated period of malaria' was defined as the six consecutive months with the highest cumulative proportion of cases. A sensitivity analysis was performed based on a variety of cut-offs. RESULTS: Monthly data for full calendar years on clinical malaria, all hospital admissions with malaria, and entomological inoculation rates were available for 13, 18, and 11 sites respectively. Most sites showed year-round transmission with seasonal peaks for both clinical malaria and hospital admissions with malaria, with a few sites fitting the definition of 'marked seasonality'. For these sites, consistent results were observed when more than one outcome or more than one calendar year was available from the same site. The use of monthly EIR data was found to be of limited value when looking at seasonal variations of malaria transmission, particularly at low and medium intensity levels. CONCLUSION: The proposed definition discriminated well between studies with 'marked seasonality' and those with less seasonality. However, a poor fit was observed in sites with two seasonal peaks. Further work is needed to explore the applicability of this definition on a wide-scale, using routine health information system data where possible, to aid appropriate targeting of interventions

Biology and conservation of freshwater bivalves : past, present and future perspectives

Freshwater bivalves have been highly threatened by human activities, and recently their global decline has been causing conservational and social concern. In this paper, we review the most important research events in freshwater bivalve biology calling attention to the main scientific achievements. A great bias exists in the research effort, with much more information available for bivalve species belonging to the Unionida in comparison to other groups. The same is true for the origin of these studies, since the publishing pattern does not always correspond to the hotspots of biodiversity but is concentrated in the northern hemisphere mainly in North America, Europe and Russia, with regions such as Africa and Southeast Asia being quite understudied. We also summarize information about past, present and future perspectives concerning the most important research topics that include taxonomy, systematics, anatomy, physiology, ecology and conservation of freshwater bivalves. Finally, we introduce the articles published in this Hydrobiologia special issue related with the International Meeting on Biology and Conservation of Freshwater Bivalves held in 2012 in Braganc¸a, Portugal.We would like to express our gratitude to our sponsors and institutions, especially to the Polytechnic Institute of Braganca for all the logistic support. We acknowledge all keynote speakers, authors, session chairpersons and especially to all attendees whose contributions were fundamental for the success of this meeting. We would also like to thank all referees of this special issue and to Koen Martens, Editor-in-Chief of Hydrobiologia, for all the valuable comments and suggestions. The chronogram was built with the help of the expert opinion of fellow colleagues Rafael Araujo, Arthur Bogan, Kevin Cummings, Dan Graf, Wendell Haag, Karl-Otto Nagel and David Strayer to whom we are very grateful. The authors acknowledge the support provided by Portuguese Foundation for Science and Technology (FCT) and COMPETE funds-projects CONBI (Contract: PTDC/AAC-AMB/117688/2010) and ECO-IAS (Contract: PTDC/AAC-AMB/116685/2010), and by the European Regional Development Fund (ERDF) through the COMPETE, under the project "PEst-C/MAR/LA0015/2011"

On the mechanisms governing gas penetration into a tokamak plasma during a massive gas injection

A new 1D radial fluid code, IMAGINE, is used to simulate the penetration of gas into a tokamak plasma during a massive gas injection (MGI). The main result is that the gas is in general strongly braked as it reaches the plasma, due to mechanisms related to charge exchange and (to a smaller extent) recombination. As a result, only a fraction of the gas penetrates into the plasma. Also, a shock wave is created in the gas which propagates away from the plasma, braking and compressing the incoming gas. Simulation results are quantitatively consistent, at least in terms of orders of magnitude, with experimental data for a D 2 MGI into a JET Ohmic plasma. Simulations of MGI into the background plasma surrounding a runaway electron beam show that if the background electron density is too high, the gas may not penetrate, suggesting a possible explanation for the recent results of Reux et al in JET (2015 Nucl. Fusion 55 093013)

Velocity-space sensitivity of the time-of-flight neutron spectrometer at JET

The velocity-space sensitivities of fast-ion diagnostics are often described by so-called weight functions. Recently, we formulated weight functions showing the velocity-space sensitivity of the often dominant beam-target part of neutron energy spectra. These weight functions for neutron emission spectrometry (NES) are independent of the particular NES diagnostic. Here we apply these NES weight functions to the time-of-flight spectrometer TOFOR at JET. By taking the instrumental response function of TOFOR into account, we calculate time-of-flight NES weight functions that enable us to directly determine the velocity-space sensitivity of a given part of a measured time-of-flight spectrum from TOFOR