Clinico-epidemiological features of infections caused by CTX-M type extended spectrum beta lactamase-producing Escherichia coli in hospitalised patients

A review of medical records of 45 of 53 hospitalised patients with positive cultures for CTX-M type ESBL-producing Escherichia coli between 01 January and 31 May 2004 was conducted. The mean age of the population studied was 73.1 (+/-14.6) years and the majority (55.6%) had been under the care of the internal medicine or elderly care service. In the majority (77.8%) of instances the isolate was attributed to a clinical infection rather than colonisation and the commonest clinical specimen to yield the organism was urine, which was positive in 57.8% of patients. Acquisition of the organism was categorised as nosocomial in 68.9% of patients; in this subgroup, the median duration of inpatient stay prior to recovery of the organism was 24 (range 3-240) days. Haemodialysis-dependence was the most common of the comorbidities evaluated. The mean number of antibiotics prescribed per patient in the 30 days prior to first isolation of the organism was 1.7 (range 0-4). Furthermore, the mean number of antibiotic-days exposure per patient during this period was 13.9 (range 0-48). The most frequently received class of antibiotic was beta-lactam/beta-lactamase inhibitor combinations. Of 35 infections, 26 (74.2%) were successfully treated. Overall 12 patients with infection died (34.3%); attributable mortality was presumed in seven (20%).

Evaluation of the VITEK 2 AST N-054 test card for the detection of extended-spectrum beta-lactamase production in Escherichia coli with CTX-M phenotypes

A new VITEK 2 antibiotic susceptibility testing (AST) card, AST N-054, was introduced for aerobic gram-negative bacilli in 2007 and has been widely adopted for routine use in the UK. We evaluated its performance for detecting extended-spectrum beta-lactamase (ESBL) production in Escherichia coli.

The impact of antibiotic use on the incidence and resistance pattern of extended-spectrum beta-lactamase-producing bacteria in primary and secondary healthcare settings

Aims: The objective of the present study was to study the relationship between hospital antibiotic use, community antibiotic use and the incidence of extended-spectrum beta-lactamase (ESBL)-producing bacteria in hospitals, while assessing the impact of a fluoroquinolone restriction policy on ESBL-producing bacteria incidence rates. METHODS: The study was retrospective and ecological in design. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate antibiotic use to ESB-producing bacteria incidence rates and resistance patterns over a 5 year period (January 2005-December 2009). Results: Analysis showed that the hospital incidence of ESBLs had a positive relationship with the use of fluoroquinolones in the hospital (coefficient = 0.174, P= 0.02), amoxicillin-clavulanic acid in the community (coefficient = 1.03, P= 0.03) and mean co-morbidity scores for hospitalized patients (coefficient = 2.15, P= 0.03) with various time lags. The fluoroquinolone restriction policy was implemented successfully with the mean use of fluoroquinolones (mainly ciprofloxacin) being reduced from 133 to 17 defined daily doses (DDDs)/1000 bed days (P <0.001) and from 0.65 to 0.54 DDDs/1000 inhabitants/day (P= 0.0007), in both the hospital and its surrounding community, respectively. This was associated with an improved ciprofloxacin susceptibility in both settings [ciprofloxacin susceptibility being improved from 16% to 28% in the community (P <0.001)] and with a statistically significant reduction in ESBL-producing bacteria incidence rates. Discussion: This study supports the value of restricting the use of certain antimicrobial classes to control ESBL, and demonstrates the feasibility of reversing resistance patterns post successful antibiotic restriction. The study also highlights the potential value of the time-series analysis in designing efficient antibiotic stewardship. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

Entanglement Spectrum, Critical Exponents and Order Parameters in Quantum Spin Chains

We investigate the entanglement spectrum near criticality in finite quantum spin chains. Using finite size scaling we show that when approaching a quantum phase transition, the Schmidt gap, i.e., the difference between the two largest eigenvalues of the reduced density matrix ?1, ?2, signals the critical point and scales with universal critical exponents related to the relevant operators of the corresponding perturbed conformal field theory describing the critical point. Such scaling behavior allows us to identify explicitly the Schmidt gap as a local order parameter.

Aldo goes to Primary School: Experiencing school through the lens of the autistic spectrum.

The document draws largely on the results of research carried out by Hugh McNally and Dominic Morris of McNally Morris Architects and Keith McAllister of Queen’s University Belfast between 2012 and 2013. The objective of the study was to obtain a greater understanding of the impact that architecture and the built environment can have on people with autism spectrum disorder (ASD). The investigation into the subject centred on parents of young children with ASD in the belief that they are most likely to have an intimate knowledge of the issues that affect their children and are relatively well positioned to communicate those issues.

The study comprised a number of components.

- Focus Group Discussions with parents of children with ASD
- A Postal Questionnaire completed by parents of children with ASD
- A Comprehensive Desktop study of contemporary research into the relationship between ASD and aspects of the built environment.

Social stories are then used to help illustrate the world of a child with ASD to the reader and identify a series of potential difficulties for the pupil with ASD in a primary school setting. Design considerations and mitigating measures are then proposed for each difficulty.

The intention is that the document will raise awareness of some of the issues affecting primary school children with ASD and generate discourse among those whose task it is to provide an appropriate learning environment for all children. This includes teachers, health professionals, architects, parents, carers, school boards, government bodies and those with ASD themselves.

While this document uses the primary school as a lens through which to view some of the issues associated with ASD, it is the authors’ contention that the school can be seen as a “microcosm” for the wider world and that lessons taken from the learning environment can be applied elsewhere. The authors therefore hope that the document will help raise awareness of the myriad of issues for those with ASD that are embedded in the vast landscape of urban configurations and building types making up the spatial framework of our society.

Detection of magnetic dipole lines of Fe XII in the ultraviolet spectrum of the dwarf star ε Eri

We report observations of the dwarf star e Eri (K2V) made with the Space Telescope Imaging Spectrograph (STIS) on the Hubble Space Telescope. The high sensitivity of the STIS instrument has allowed us to detect the magnetic dipole transitions of Fe XII at 1242.00 and 1349 38 Å for the first time in a star other than the Sun. The width of the stronger line at 1242.00 Å has also been measured; such measurements are not possible for the permitted lines of Fe XII in the extreme-ultraviolet. To within the accuracy of the measurements the N v and the Fe XII lines occur at their rest wavelengths. Electron densities and linewidths have been measured from other transition region lines. Together, these can be used to investigate the non-thermal energy flux in the lower and upper transition regions, which is useful in constraining possible heating processes. The Fe XII lines are also present in archival STIS spectra of other G/K-type dwarfs.

Evidence for relativistic features in the X-ray spectrum of Mrk 335

We present an analysis of hard X-ray features in the spectrum of the bright Sy 1 galaxy Mrk 335 observed by the XMM-Newton satellite. Our analysis confirms the presence of a broad, ionized Fe Ka emission line in the spectrum, first found by Gondoin et al. The broad line can be modelled successfully by relativistic accretion disc reflection models. This interpretation is unusually robust in the case of Mrk 335 because of the lack of any ionized ('warm') absorber and the absence a clear narrow core to the line. Partial covering by neutral gas cannot, however, be ruled out statistically as the origin of the broad residuals. Regardless of the underlying continuum we report, for the first time in this source, the detection of a narrow absorption feature at the rest frame energy of ~5.9 keV. If the feature is identified with a resonance absorption line of iron in a highly ionized medium, the redshift of the line corresponds to an inflow velocity of ~0.11-0.15c. We present a simple model for the inflow, accounting approximately for relativistic and radiation pressure effects, and use Monte Carlo methods to compute synthetic spectra for qualitative comparison with the data. This modelling shows that the absorption feature can plausibly be reproduced by infalling gas providing that the feature is identified with Fe xxvi. We require the inflowing gas to extend over a limited range of radii at a few tens of r to match the observed feature. The mass accretion rate in the flow corresponds to 60 per cent of the Eddington limit, in remarkable agreement with the observed rate. The narrowness of the absorption line tends to argue against a purely gravitational origin for the redshift of the line, but given the current data quality we stress that such an interpretation cannot be ruled out. © 2006 The Authors.

Time-dependent three-dimensional spectrum synthesis for Type Ia supernovae

A Monte Carlo code (artis) for modelling time-dependent three-dimensional spectral synthesis in chemically inhomogeneous models of Type Ia supernova ejecta is presented. Following the propagation of ?-ray photons, emitted by the radioactive decay of the nucleosynthesis products, energy is deposited in the supernova ejecta and the radiative transfer problem is solved self-consistently, enforcing the constraint of energy conservation in the comoving frame. Assuming a photoionization-dominated plasma, the equations of ionization equilibrium are solved together with the thermal balance equation adopting an approximate treatment of excitation. Since we implement a fully general treatment of line formation, there are no free parameters to adjust. Thus, a direct comparison between synthetic spectra and light curves, calculated from hydrodynamic explosion models, and observations is feasible. The code is applied to the well-known W7 explosion model and the results tested against other studies. Finally, the effect of asymmetric ejecta on broad-band light curves and spectra is illustrated using an elliptical toy model. © 2009 RAS.

Interceptive skills in children aged 9-11 years, diagnosed with Autism Spectrum Disorder

Growing evidence suggests that significant motor problems are associated with a diagnosis of Autism Spectrum Disorders (ASD), particularly in catching tasks. Catching is a complex, dynamic skill that involves the ability to synchronise one's own movement to that of a moving target. To successfully complete the task, the participant must pick up and use perceptual information about the moving target to arrive at the catching place at the right time. This study looks at catching ability in children diagnosed with ASD (mean age 10.16 ± 0.9 years) and age-matched non-verbal (9.72 ± 0.79 years) and receptive language (9.51 ± 0.46) control groups. Participants were asked to "catch" a ball as it rolled down a fixed ramp. Two ramp heights provided two levels of task difficulty, whilst the sensory information (audio and visual) specifying ball arrival time was varied. Results showed children with ASD performed significantly worse than both the receptive language (p =.02) and non-verbal (p =.02) control groups in terms of total number of balls caught. A detailed analysis of the movement kinematics showed that difficulties with picking up and using the sensory information to guide the action may be the source of the problem. © 2013 Elsevier Ltd.

Maximum Outage Capacity in Dense Indoor Femtocell Networks with Joint Energy and Spectrum Utilization

We consider a multiple femtocell deployment in a small area which shares spectrum with the underlaid macrocell. We design a joint energy and radio spectrum scheme which aims not only for co-existence with the macrocell, but also for an energy-efficient implementation of the multi-femtocells. Particularly, aggregate energy usage on dense femtocell channels is formulated taking into account the cost of both the spectrum and energy usage. We investigate an energy-and-spectral efficient approach to balance between the two costs by varying the number of active sub-channels and their energy. The proposed scheme is addressed by deriving closed-form expressions for the interference towards the macrocell and the outage capacity. Analytically, discrete regions under which the most promising outage capacity is achieved by the same size of active sub-channels are introduced. Through a joint optimization of the sub-channels and their energy, properties can be found for the maximum outage capacity under realistic constraints. Using asymptotic and numerical analysis, it can be noticed that in a dense femtocell deployment, the optimum utilization of the energy and the spectrum to maximize the outage capacity converges towards a round-robin scheduling approach for a very small outage threshold. This is the inverse of the traditional greedy approach. © 2012 IEEE.

Mutational spectrum of the ZEB1 gene in corneal dystrophies supports a genotype-phenotype correlation

Mutations in ZEB1 have been reported in posterior polymorphous corneal dystrophy (PPCD3; MIM #609141) and Fuchs' endothelial corneal dystrophy (FECD6; MIM #613270). Although PPCD and keratoconus are clinically and pathologically distinct, PPCD has been associated with keratoconus, suggesting a common genetic basis. The purpose of our study was to perform mutational screening of the ZEB1 gene in patients affected with keratoconus or PPCD.

Scaling of the entanglement spectrum near quantum phase transitions

The entanglement spectrum describing quantum correlations in many-body systems has been recently recognized as a key tool to characterize different quantum phases, including topological ones. Here we derive its analytically scaling properties in the vicinity of some integrable quantum phase transitions and extend our studies also to nonintegrable quantum phase transitions in one-dimensional spin models numerically. Our analysis shows that, in all studied cases, the scaling of the difference between the two largest nondegenerate Schmidt eigenvalues yields with good accuracy critical points and mass scaling exponents.

Molecular Validation of the Schizophrenia Spectrum

Background: Early descriptive work and controlled family and adoption studies support the hypothesis that a range of personality and nonschizophrenic psychotic disorders aggregate in families of schizophrenic probands. Can we validate, using molecular polygene scores from genome-wide association studies (GWAS), this schizophrenia spectrum? Methods: The predictive value of polygenic findings reported by the Psychiatric GWAS Consortium (PGC) was applied to 4 groups of relatives from the Irish Study of High-Density Schizophrenia Families (ISHDSF; N = s) differing on their assignment within the schizophrenia spectrum. Genome-wide single nucleotide polymorphism data for affected and unaffected relatives were used to construct per-individual polygene risk scores based on the PGC stage-I results. We compared mean polygene scores in the ISHDSF with mean scores in ethnically matched population controls (N = 929). Results: The schizophrenia polygene score differed significantly across diagnostic categories and was highest in those with narrow schizophrenia spectrum, lowest in those with no psychiatric illness, and in-between in those classified in the intermediate, broad, and very broad schizophrenia spectrum. Relatives of all of these groups of affected subjects, including those with no diagnosis, had schizophrenia polygene scores significantly higher than the control sample. Conclusions: In the relatives of high-density families, the observed pattern of enrichment of molecular indices of schizophrenia risk suggests an underlying, continuous liability distribution and validates, using aggregate common risk alleles, a genetic basis for the schizophrenia spectrum disorders. In addition, as predicted by genetic theory, nonpsychotic members of multiply-affected schizophrenia families are significantly enriched for replicated, polygenic risk variants compared with the general population.