33 research outputs found
Release the Kratom: Post-Acute Withdrawal Syndrome in a 70 Year Old Male
Centuries in Eastern medicine.. Kratom has been commonly used for chronic pain and opiate withdrawal symptoms with first reported cases in the United States in the early 2000s. It is a plant that consists of psychoactive alkaloids that target opioid receptors with different affinity. Effects from Kratom are dose-dependent, at lower doses, it acts as a stimulant, while at higher doses produces analgesia and euphoria. Although Kratom is legal and easily accessible over the counter, there have been increasing reports of potential for addiction and toxicity. Cessation of Kratom can result in withdrawal symptoms similar to opiate withdrawal. Here we discuss a case of a 71 year old male with inadvertent Kratom dependence, who had prolonged withdrawal weeks after cessation and required management of dysphoric mood and insomnia symptoms persisting after withdrawal
The Virtues of Osteopathic Manipulative Treatments in Patients with Opioid Use Disorder
As America continues to face the opioid epidemic, numerous people have made great strides in receiving formal treatment for their opioid use disorder (OUD). This research seeks to examine the effects providing OMT along with traditional OUD pharmacological methods in providing results for patients. By utilizing prior research on OMT techniques, we were able to uncover how effective OMT can be in reducing the time and discomfort associated with seeking opioid recovery. OMT in combination with traditional pharmacology was associated with reduction of somatic pain, higher success with MAT, as well as lowered costs. This research also highlights the importance of OMT in the era of COVID social distancing, as well as special considerations to be taken for those with trauma histories associated with their disorder. We argue the benefit of OMT in combination with pharmacological methods at reducing the overall burden of prior opioid use disorders
Brief of Amici Curiae 116 Law Librarians and 5 Law Library Organizations in Support of Respondent
Strategic Planning for Environmental Stewardship at Eastern Kentucky University
The 2006-2010 Strategic Plan for Eastern Kentucky University, under Strategic Direction 5.4, mandates the formulation of a plan to guide the University toward greater environmental stewardship. The creation and implementation of that plan is the charge of the Eastern Committee on Responsible Environmental Stewardship (ECRES), which was formed in September of 2005. On October 27th, 2006, ECRES hosted a Strategic Planning Workshop. This workshop brought together a wide range of paticipants, including elected officials, college and university representatives, and interested citizens. The result was a broad consensus in the identification of environmental goals and objectives toward which EKU should strive
The Lick AGN Monitoring Project: Reverberation Mapping of Optical Hydrogen and Helium Recombination Lines
We have recently completed a 64-night spectroscopic monitoring campaign at
the Lick Observatory 3-m Shane telescope with the aim of measuring the masses
of the black holes in 12 nearby (z < 0.05) Seyfert 1 galaxies with expected
masses in the range ~10^6-10^7M_sun and also the well-studied nearby active
galactic nucleus (AGN) NGC 5548. Nine of the objects in the sample (including
NGC 5548) showed optical variability of sufficient strength during the
monitoring campaign to allow for a time lag to be measured between the
continuum fluctuations and the response to these fluctuations in the broad
Hbeta emission, which we have previously reported. We present here the light
curves for the Halpha, Hgamma, HeII 4686, and HeI 5876 emission lines and the
time lags for the emission-line responses relative to changes in the continuum
flux. Combining each emission-line time lag with the measured width of the line
in the variable part of the spectrum, we determine a virial mass of the central
supermassive black hole from several independent emission lines. We find that
the masses are generally consistent within the uncertainties. The time-lag
response as a function of velocity across the Balmer line profiles is examined
for six of the AGNs. Finally we compare several trends seen in the dataset
against the predictions from photoionization calculations as presented by
Korista & Goad. We confirm several of their predictions, including an increase
in responsivity and a decrease in the mean time lag as the excitation and
ionization level for the species increases. Further confirmation of
photoionization predictions for broad-line gas behavior will require additional
monitoring programs for these AGNs while they are in different luminosity
states. [abridged]Comment: 37 pages, 18 figures and 15 tables, accepted for publication in the
Astrophysical Journa
The Lick AGN Monitoring Project: Broad-Line Region Radii and Black Hole Masses from Reverberation Mapping of Hbeta
We have recently completed a 64-night spectroscopic monitoring campaign at
the Lick Observatory 3-m Shane telescope with the aim of measuring the masses
of the black holes in 12 nearby (z < 0.05) Seyfert 1 galaxies with expected
masses in the range ~10^6-10^7 M_sun and also the well-studied nearby active
galactic nucleus (AGN) NGC 5548. Nine of the objects in the sample (including
NGC 5548) showed optical variability of sufficient strength during the
monitoring campaign to allow for a time lag to be measured between the
continuum fluctuations and the response to these fluctuations in the broad
Hbeta emission. We present here the light curves for the objects in this sample
and the subsequent Hbeta time lags for the nine objects where these
measurements were possible. The Hbeta lag time is directly related to the size
of the broad-line region, and by combining the lag time with the measured width
of the Hbeta emission line in the variable part of the spectrum, we determine
the virial mass of the central supermassive black hole in these nine AGNs. The
absolute calibration of the black hole masses is based on the normalization
derived by Onken et al. We also examine the time lag response as a function of
velocity across the Hbeta line profile for six of the AGNs. The analysis of
four leads to ambiguous results with relatively flat time lags as a function of
velocity. However, SBS 1116+583A exhibits a symmetric time lag response around
the line center reminiscent of simple models for circularly orbiting broad-line
region (BLR) clouds, and Arp 151 shows an asymmetric profile that is most
easily explained by a simple gravitational infall model. Further investigation
will be necessary to fully understand the constraints placed on physical models
of the BLR by the velocity-resolved response in these objects.Comment: 24 pages, 16 figures and 13 tables, submitted to Ap
First Results from the Lick AGN Monitoring Project: The Mass of the Black Hole in Arp 151
We have recently completed a 64-night spectroscopic monitoring campaign at
the Lick Observatory 3-m Shane telescope with the aim of measuring the masses
of the black holes in 13 nearby (z < 0.05) Seyfert 1 galaxies with expected
masses in the range ~10^6-10^7 M_sun. We present here the first results from
this project -- the mass of the central black hole in Arp 151. Strong
variability throughout the campaign led to an exceptionally clean Hbeta lag
measurement in this object of 4.25(+0.68/-0.66) days in the observed frame.
Coupled with the width of the Hbeta emission line in the variable spectrum, we
determine a black hole mass of (7.1 +/- 1.2)x10^6 M_sun, assuming the Onken et
al. normalization for reverberation-based virial masses. We also find
velocity-resolved lag information within the Hbeta emission line which clearly
shows infalling gas in the Hbeta-emitting region. Further detailed analysis may
lead to a full model of the geometry and kinematics of broad line region gas
around the central black hole in Arp 151.Comment: 4 pages, 4 figures and 2 tables, accepted for publication in ApJ
Letter
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Within-host evolution of Staphylococcus aureus during asymptomatic carriage
Background
Staphylococcus aureus is a major cause of healthcare associated mortality, but like many important bacterial pathogens, it is a common constituent of the normal human body flora. Around a third of healthy adults are carriers. Recent evidence suggests that evolution of S. aureus during nasal carriage may be associated with progression to invasive disease. However, a more detailed understanding of within-host evolution under natural conditions is required to appreciate the evolutionary and mechanistic reasons why commensal bacteria such as S. aureus cause disease. Therefore we examined in detail the evolutionary dynamics of normal, asymptomatic carriage. Sequencing a total of 131 genomes across 13 singly colonized hosts using the Illumina platform, we investigated diversity, selection, population dynamics and transmission during the short-term evolution of S. aureus.
Principal Findings
We characterized the processes by which the raw material for evolution is generated: micro-mutation (point mutation and small insertions/deletions), macro-mutation (large insertions/deletions) and the loss or acquisition of mobile elements (plasmids and bacteriophages). Through an analysis of synonymous, non-synonymous and intergenic mutations we discovered a fitness landscape dominated by purifying selection, with rare examples of adaptive change in genes encoding surface-anchored proteins and an enterotoxin. We found evidence for dramatic, hundred-fold fluctuations in the size of the within-host population over time, which we related to the cycle of colonization and clearance. Using a newly-developed population genetics approach to detect recent transmission among hosts, we revealed evidence for recent transmission between some of our subjects, including a husband and wife both carrying populations of methicillin-resistant S. aureus (MRSA).
Significance
This investigation begins to paint a picture of the within-host evolution of an important bacterial pathogen during its prevailing natural state, asymptomatic carriage. These results also have wider significance as a benchmark for future systematic studies of evolution during invasive S. aureus disease
A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)
Meeting abstrac
Robust estimation of bacterial cell count from optical density
Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data