9,899 research outputs found

    The Tn916/Tn1545 Family of Conjugative Transposon

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    The conjugative transposon Tn916 was first discovered in the late 1970s and is, together with the related conjugative transposon Tn1545, the paradigm of a large family of related conjugative transposons known as the Tn916/Tn1545 family, which are found in an extremely diverse range of bacteria. With the huge increase in bacterial genomic sequence data available, due to the widespread use of next generation sequencing, more putative conjugative transposons belonging to the Tn916/Tn1545 family are being reported. Many of these are capable of excision, integration and conjugation. Nearly all of the Tn916/Tn1545‑like elements discovered to date encode tetracycline resistance however, increasingly resistance to other antimicrobials is being found. Some of the members of the Tn916/Tn1545 family of elements are composite structures which contain smaller mobile genetic elements which are also capable of transposition. Tn916/Tn1545‑like elements themselves are also found within larger and more complex elements. This review will give an overview of the current knowledge of the Tn916/Tn1545 family of conjugative transposons highlighting recently characterized composite elements carrying additional and novel resistance genes

    Relativistic Beaming and the Intrinsic Properties of Extragalactic Radio Jets

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    Relations between the observed quantities for a beamed radio jet, apparent transverse speed and apparent luminosity (beta_app,L), and the intrinsic quantities, Lorentz factor and intrinsic luminosity (gamma,L_o), are investigated. The inversion from measured to intrinsic values is not unique, but approximate limits to gamma and L_o can be found using probability arguments. Roughly half the sources in a flux density--limited, beamed sample have a value of gamma close to the measured beta_app. The methods are applied to observations of 119 AGN jets made with the VLBA at 15 GHz during 1994-2002. The results strongly support the common relativistic beam model for an extragalactic radio jet. The (beta_app,L) data are closely bounded by a theoretical envelope, an aspect curve for gamma=32, L_o= 10^25 W/Hz. This gives limits to the maximum values of gamma and L_o in the sample: gamma_max about 32, and L_o,max ~ 10^26 W/Hz. No sources with both high beta_app and low L are observed. This is not the result of selection effects due to the observing limits, which are flux density S>0.5 Jy, and angular velocity mu<4 mas/yr. Many of the fastest quasars have a pattern Lorentz factor gamma_p close to that of the beam, gamma_b, but some of the slow quasars must have gamma_p<<gamma_b. Three of the 10 galaxies in the sample have a superluminal feature, with speeds up to beta_app about 6. The others are at most mildly relativistic. The galaxies are not off-axis versions of the powerful quasars, but Cygnus A might be an exception.Comment: 12 pages, 9 figures, 1 table, accepted for publication in the Astrophysical Journa

    Improving primary care antimicrobial stewardship by implementing a peer audit and feedback intervention in Cape Town community healthcare centres

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    Background. The increasing prevalence of antibiotic resistance is a major threat to public health. Primary care, where 80% of antibiotics are consumed, is a pivotal setting to direct antimicrobial stewardship (AMS) efforts. However, the ideal model to improve antibiotic prescribing in primary care in low-resource settings is not known.Objective. To implement a multidisciplinary audit and feedback AMS intervention with the aim to improve appropriate antibiotic prescribing at primary care level.Methods. The intervention was implemented and monitored in 10 primary care centres of the Cape Town metropole between July 2017 and June 2019. The primary and secondary outcome measures were monthly adherence to a bundle of antibiotic quality process measures and monthly antibiotic consumption, respectively. Multidisciplinary audit and feedback meetings were initiated and integrated into facility clinical meetings. Two Excel tools were utilised to automatically calculate facility audit scores and consumption. Once a month, 10 antibiotic prescriptions were randomly selected for a peer review audit by the team. The prescriptions were audited for adherence to a bundle of seven antibiotic process measures using the standard treatment guidelines (STG) and Essential Medicines List (EML) as standard. Concurrently, primary care pharmacists monitored monthly antibiotic consumption by calculating defined daily doses (DDDs) per 100 prescriptions dispensed. Adherence and consumption feedback were regularly provided to the facilities. Learning collaboratives involving representative multidisciplinary teams were held twice-yearly. Pre-, baseline and post-intervention periods were defined as 6 months before, first 6 months and last 6 months of the study, respectively.Results. The mean overall adherence increased from 19% (baseline) to 47% (post intervention) (p&lt;0.001). Of the 2 077 prescriptions analysed, 33.7% had an antibiotic prescribed inappropriately. No diagnosis had been captured in patient notes, and the antibiotic chosen was not according to the STG and EML in 30.1% and 31.7% of cases, respectively. Seasonal variation was observed in prescribing adherence, with significantly lower adherence in winter and spring months (adjusted odds ratio 0.60). A reduction of 12.9 DDDs between the pre- and post-intervention periods (p=0.0084) was documented, which represented a 19.3% decrease in antibiotic consumption.Conclusion. The study demonstrated that peer reviewed audit and feedback is an effective AMS intervention to improve antibiotic prescribing in primary care in a low-resource setting. The intervention, utilising existing resources and involving multidisciplinary engagement, may be incorporated into existing quality improvement processes at facility level, to ensure sustainable change

    The Dynamical Cluster Approximation: Non-Local Dynamics of Correlated Electron Systems

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    We recently introduced the dynamical cluster approximation(DCA), a new technique that includes short-ranged dynamical correlations in addition to the local dynamics of the dynamical mean field approximation while preserving causality. The technique is based on an iterative self-consistency scheme on a finite size periodic cluster. The dynamical mean field approximation (exact result) is obtained by taking the cluster to a single site (the thermodynamic limit). Here, we provide details of our method, explicitly show that it is causal, systematic, Φ\Phi-derivable, and that it becomes conserving as the cluster size increases. We demonstrate the DCA by applying it to a Quantum Monte Carlo and Exact Enumeration study of the two-dimensional Falicov-Kimball model. The resulting spectral functions preserve causality, and the spectra and the CDW transition temperature converge quickly and systematically to the thermodynamic limit as the cluster size increases.Comment: 19 pages, 13 postscript figures, revte

    Evidence-b(i)ased psychiatry:research into the evidence for effectiveness and safety of antidepressants in depression and anxiety disorders

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    BACKGROUND: Antidepressants remain controversial, partly due to allegations that disappointing results were buried and because of their modest average efficacy.&lt;br/&gt; AIM: To investigate bias in the antidepressant literature and the possibilities for predicting which patients with depression or anxiety do receive significant benefits from antidepressants.&lt;br/&gt; METHOD: We investigated bias by comparing information from the US Food and Drug Administration with the published literature. To predict response, we used patient data from randomized trials.&lt;br/&gt; RESULTS: Of all studies on depression or anxiety, 50% and 72% were positive, compared to 95% and 96% of all published studies. Safety outcomes were poorly reported in published articles and unpublished studies were often 'bundled' into pooled-trials publications with positive conclusions. We found an association between severity and antidepressant efficacy for some, but not all, anxiety disorders; previous research has found inconsistent evidence for this association for depression. Furthermore, patients with depression that showed early improvement were more likely to attain a good response, irrespective of which symptoms improved.&lt;br/&gt; CONCLUSION: These results demonstrate the severe impact of bias on the antidepressant literature. Severity and early improvement predicted a good response, but more information is needed to improve predictions. The increased accessibility of individual patient data will hopefully soon enable further progress in this area.</p

    The thermal equation of state of FeTiO_3 ilmenite based on in situ X-ray diffraction at high pressures and temperatures

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    We present in situ measurements of the unit-cell volume of a natural terrestrial ilmenite (Jagersfontein mine, South Africa) and a synthetic reduced ilmenite (FeTiO_3) at simultaneous high pressure and high temperature up to 16 GPa and 1273 K. Unit-cell volumes were determined using energy-dispersive synchrotron X-ray diffraction in a multi-anvil press. Mössbauer analyses show that the synthetic sample contained insignificant amounts of Fe^(3+) both before and after the experiment. Results were fit to Birch-Murnaghan thermal equations of state, which reproduce the experimental data to within 0.5 and 0.7 GPa for the synthetic and natural samples, respectively. At ambient conditions, the unit-cell volume of the natural sample [V_0 = 314.75 ± 0.23 (1 ) Å^3] is significantly smaller than that of the synthetic sample [V_0 = 319.12 ± 0.26 Å^3]. The difference can be attributed to the presence of impurities and Fe^(3+) in the natural sample. The 1 bar isothermal bulk moduli K_(T0) for the reduced ilmenite is slightly larger than for the natural ilmenite (181 ± 7 and 165 ± 6 GPa, respectively), with pressure derivatives K_0' = 3 ± 1. Our results, combined with literature data, suggest that the unit-cell volume of reduced ilmenite is significantly larger than that of oxidized ilmenite, whereas their thermoelastic parameters are similar. Our data provide more appropriate input parameters for thermo-chemical models of lunar interior evolution, in which reduced ilmenite plays a critical role

    The relationship between mental disorders and actual and desired subjective social status

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    Mental disorders are associated with lower subjective social status (SSS), but a more nuanced understanding of this relationship is needed. We examined the influence of disorder age of onset and recency on SSS and studied whether mental disorders are also associated with the discrepancy between actual and desired SSS.Method Data are from the baseline and second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2). Mental disorders were assessed with the Composite International Diagnostic Interview (CIDI 3.0), while both actual and desired SSS were assessed with a ten-rung ladder. Linear regression was used to examine the association between mental disorders and SSS.Results Of 5303 participants, 2237 had a lifetime mental disorder at baseline. These participants reported significantly lower actual SSS (6.28) at follow-up than healthy participants (6.66, B = -0.38 [95% CI -0.48 to -0.27], p < 0.001) and a significantly greater actual-desired SSS discrepancy (1.14 v. 1.05 after controlling for actual SSS, B = 0.09 [0.01-0.17], p = 0.024). Lower age of onset of the first mental disorder was marginally significantly associated with lower actual SSS (B = 0.006 [0.000-0.012], p = 0.046). More recent disorders were also associated with lower actual SSS (B = 0.015 [0.005-0.026], p = 0.005), such that participants whose disorder remitted a ≥6 years before baseline were statistically indistinguishable from healthy participants.Conclusions Lifetime mental disorders are associated with lower actual SSS and a slightly greater discrepancy between actual and desired SSS. However, people with mental disorders in (long-term) remission have a similar social status as healthy participants

    Elastic and total reaction cross sections of oxygen isotopes in Glauber theory

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    We systematically calculate the total reaction cross sections of oxygen isotopes, 1524^{15-24}O, on a 12^{12}C target at high energies using the Glauber theory. The oxygen isotopes are described with Slater determinants generated from a phenomenological mean-field potential. The agreement between theory and experiment is generally good, but a sharp increase of the reaction cross sections from ^{21}O to ^{23}O remains unresolved. To examine the sensitivity of the diffraction pattern of elastic scattering to the nuclear surface, we study the differential elastic-scattering cross sections of proton-^{20,21,23}O at the incident energy of 300 MeV by calculating the full Glauber amplitude.Comment: 9 pages, 8 figure
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