Sepsis caused by bloodstream infection in patients in the intensive care unit: the impact of inactive empiric antimicrobial therapy on outcome

Background: Sepsis is one of the leading causes of death in the UK. Aims: The aims of this study were to identify the rate of inactive antimicrobial therapy (AMT) in the ICU and whether inactive AMT had an effect on in hospital mortality, ICU mortality, 90-day mortality and length of hospital stay. Additionally, we wanted to identify risk factors for receiving inactive AMT. Methods: This was a retrospective observational study conducted at Glasgow Royal Infirmary ICU between January 2010 and December 2013, with 12,000 blood cultures taken over this time period, of which n=127 were deemed clinically significant. Multivariate logistic regression was used to identify risk factors independently associated with mortality. To identify risk factors for receiving inactive AMT a univariable and a subsequent multivariate analysis was constructed. Results: The rate of inactive AMT was 47% (n =60). Our multivariate analysis showed that receiving antibiotics within the first 24 hours of ICU admission led to a reduced mortality (RR 1.70; 95% CI 1.19-2.44.) Furthermore, it showed that severity of illness (as defined by SIRS criteria sepsis vs septic shock) increased mortality (OR 9.87; 95% CI 1.73-55.5). However, inactive AMT did not increase mortality (OR 1.07; 95% CI 0.47-2.41) or length of hospital stay (53.2 vs 69.1 days p=0.348.) We identified fungal bloodstream infection as a risk factor for receiving inactive AMT (OR 5.10;95% CI 1.29-20.14. Conclusion: Mortality from sepsis is influenced by multiple factors. We were unable to demonstrates that inactive AMT had an effect on mortality in sepsis

Effect of Dexamethasone injection at birth on growth performance of pigs from birth to weaning

A total of 82 litters were used in a 21-day study to evaluate the effect of injecting litters of pigs with dexamethasone within 24 hours of birth on growth rate from birth to weaning. Experimental treatments consisted of an injection of 1 mg dexamethasone solution (2mg/mL, Prolab Ltd, St. Joseph, MO) to all pigs within a litter, while pigs in control litters did not receive a dexamethasone injection. There was no difference in growth rate from birth to weaning between pigs injected with dexamethasone and control pigs. Number of pigs weaned per litter and preweaning mortality were not different. In this study no benefit was observed in growth rate from birth to weaning from injecting whole litters of pigs with 1 mg/pig of dexamethasone within 24 hours of birth

Dietary energy density and growing-finishing pig performance and profitability

A retrospective analysis of 25 studies (16 at university and 9 at field research facilities) was conducted to model the response in ADG and F/G to increasing dietary energy density and its effect on profitability. Average daily feed intake in the field studies was approximately 30% lower than in the university studies, and as pigs increase in weight in the university studies they transition to a non-energy dependent phase of growth at a lighter weight than those in the field studies. The percentage response in ADG per percent added fat in the university studies was greater for the first 2.5% added fat than for higher fat levels, indicating a diminishing return. However, the percentage response in ADG was similar for both the 2.5 and 5% added fat levels in the field studies, indicating a linear response to fat additions. As expected the F/G improvement was greater in the field compared to the university studies. A five-year price series was used to determine the impact of fat additions to cornsoybean meal-based diets on profitability. For lighter weight pigs (70 to 120 lb), the net return to added fat is almost always positive, with feed cost per unit of gain being increased and deceased 50% of the time. However, the net return to added fat for heavier weight pigs (230 to 265 lb) fluctuates, with feed cost per unit of gain being increased in most scenarios. Using high energy diets for lighter weight pigs is cost effective and increases profit the majority of the time. The optimal energy density for late finishing pig diets is more dependent on the economic conditions

Pricing Options in Incomplete Equity Markets via the Instantaneous Sharpe Ratio

We use a continuous version of the standard deviation premium principle for pricing in incomplete equity markets by assuming that the investor issuing an unhedgeable derivative security requires compensation for this risk in the form of a pre-specified instantaneous Sharpe ratio. First, we apply our method to price options on non-traded assets for which there is a traded asset that is correlated to the non-traded asset. Our main contribution to this particular problem is to show that our seller/buyer prices are the upper/lower good deal bounds of Cochrane and Sa\'{a}-Requejo (2000) and of Bj\"{o}rk and Slinko (2006) and to determine the analytical properties of these prices. Second, we apply our method to price options in the presence of stochastic volatility. Our main contribution to this problem is to show that the instantaneous Sharpe ratio, an integral ingredient in our methodology, is the negative of the market price of volatility risk, as defined in Fouque, Papanicolaou, and Sircar (2000).Comment: Keywords: Pricing derivative securities, incomplete markets, Sharpe ratio, correlated assets, stochastic volatility, non-linear partial differential equations, good deal bound

Generation of thiocillin ring size variants by prepeptide gene replacement and in vivo processing by Bacillus cereus

The thiocillins from Bacillus cereus ATCC 14579 are natural products from the broader class of thiazolyl peptides. Their biosynthesis proceeds via extensive post-translational modification of a ribosomally encoded precursor peptide. This post-translational tailoring involves a key step formal cycloaddition between two distal serine residues. In the wild-type structure, this cycloaddition forms a major macrocycle circumscribed by 26-atoms (shortest path). Results presented herein demonstrate the promiscuity of this last step by means of a set of "competition" experiments. Cyclization proceeds in many cases to provide altered ring sizes, giving access to several variant rings sizes that have not previously been observed in nature

Reaction mechanisms for weakly-bound, stable nuclei and unstable, halo nuclei on medium-mass targets

An experimental overview of reactions induced by the stable, but weakly-bound nuclei 6Li, 7Li and 9Be, and by the exotic, halo nuclei 6He, 8B, 11Be and 17F on medium-mass targets, such as 58Ni, 59Co or 64Zn, is presented. Existing data on elastic scattering, total reaction cross sections, fusion processes, breakup and transfer channels are discussed in the framework of a CDCC approach taking into account the breakup degree of freedom.Comment: 7 pages, 6 figures, Invited Talk given by C. Beck to the 10th International Conference on Nucleus-Nucleus Collisions, August 16-21, 2009 Beijing, China; Paper submitted to the NN2009 Proceedings, Nuclear Physics A (to be published

Effects of paylean (ractopamine⋅HCl) on finishing pig growth and variation

A total of 336 pigs were used in a 21-day trial to determine the effect of Paylean (9.0 g/ton Ractopamine·HCl) on finishing pig growth and variation. Pigs were allotted based on weight so that all pens had the same initial weight and degree of variation within the pen. Pigs fed Paylean had greater ADG and better feed efficiency than control-fed pigs (P<0.05). However, no differences in pen coefficient of variation were observed (P>0.70). The results suggest that adding Paylean to the diet improves finishing pig growth performance but does not affect weight variation within the pen

Extended T-systems

We use the theory of q-characters to establish a number of short exact sequences in the category of finite-dimensional representations of the quantum affine groups of types A and B. That allows us to introduce a set of 3-term recurrence relations which contains the celebrated T-system as a special case.Comment: 36 pages, latex; v2: version to appear in Selecta Mathematic

Evaluation of hemicell® on growth performance of late nursery pigs

A total of 276 pigs (initially 21.9 lb) was used to determine the effects of added Hemicell® on growth performance. Hemicell® is a patented fermentation product of Bacillus lentus. The active ingredient in the fermentation product is β-mannanase. However, other enzymes such as amylase, xylanase, cellulases, and α-galactosidase also are present. It is claimed that Hemicell® degrades β-mannan in feed, thus, removing its effects as an antinutritive factor in swine diets. Dietary treatments were arranged as a 2 x 3 factorial, with or without 0.05% Hemicell®, in diets with 3 levels of energy density (1,388, 1,488, 1,588 ME, kcal/lb). The 100 kcal increments were achieved by the addition of wheat bran or soy oil to a corn-soybean meal based diet. The addition of Hemicell® to the diets, regardless of energy level, did not lead to an improvement in growth performance in these late nursery pigs. Increasing energy density of the diet, however, resulted in an improved ADG and F/G

Reaction mechanisms in the 6Li+59Co system

The reactions induced by the weakly bound 6Li projectile interacting with the intermediate mass target 59Co were investigated. Light charged particles singles and $\alpha$-$d$ coincidence measurements were performed at the near barrier energies E_lab = 17.4, 21.5, 25.5 and 29.6 MeV. The main contributions of the different competing mechanisms are discussed. A statistical model analysis, Continuum-Discretized Coupled-Channels calculations and two-body kinematics were used as tools to provide information to disentangle the main components of these mechanisms. A significant contribution of the direct breakup was observed through the difference between the experimental sequential breakup cross section and the CDCC prediction for the non-capture breakup cross section.Comment: 30 pages, 8 figure