Emergence of CTX-M Group 1-ESBL producing Klebsiella pneumonia from a tertiary care centre in Karachi, Pakistan.

http://www.jidc.org/index.php/journal/article/view/20818098/422 Background: Extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae have been reported previously from Pakistan but the genotypic characteristics of these enzymes is not known. Hence the aim of the study was first to characterise the genotypic content of these beta-lactamases and secondly to assess the clonal relationship of these isolates. Methodology: We analysed 65 non-duplicate ESBL positive, K. pneumoniae isolates prospectively collected based on phenotype as detected using the two-disc method. Isolates were collected from different sources: blood cultures (46.15%; n = 30); tracheal aspirates (24.6%; n = 16); urine (10.7%; n = 7); wound swabs, pus and tissue (18.4%; n = 12). ESBL production was confirmed by the ESBL E-test method and the presence of the blaCTX-M encoding genes was confirmed by polymerase chain reaction. The clonal relationship of clinical isolates was studied by Pulsed Field Gel Electrophoresis. Results: The results showed that 93.84% (n = 61) isolates of K. pneumoniae were positive for the blaCTX-M-1 group. One isolate showed PCR signals for blaCTX-M-25 group. None of our isolates were positive for CTX-M groups 2, 8 and 9. The majority of blaCTX-M positive isolates were genetically unrelated and no epidemic clones were identified. Conclusion: This study reports the emergence of CTX-M groups 1 and 25 producing isolates of K. pneumoniae with genetic diversity in Karachi, Pakistan.

Cybersecurity Test-Bed for IEC 61850 based Smart Substations

With the development and deployment of IEC 61850 based smart substations, cybersecurity vulnerabilities of supervisory control and data acquisition (SCADA) systems are increasingly emerging. In response to the emergence of cybersecurity vulnerabilities in smart substations, a test-bed is indispensable to enable cybersecurity experimentation. In this paper, a comprehensive and realistic cyber-physical test-bed has been built to investigate potential cybersecurity vulnerabilities and the impact of cyber-attacks on IEC 61850 based smart substations. This test-bed is close to a real production type environment, and has the ability to carry out end-to-end testing of cyber-attacks and physical consequences. A fuzz testing approach is proposed for detecting IEC 61850 based intelligent electronic devices (IEDs) and validated in the proposed test-bed.

Emergence of episodic future though in pre-school aged children

Three experiments examined the development of episodic future thinking: the ability to think ahead about novel future situations (Atance & O’Neill, 2001). Each experiment used three novel tasks, similar to the Blow Football task used by Russell, Alexis, and Clayton (2010). In each, there was a different table top with two sides. Children played a game on one side of a table, and then were asked to choose a tool to play with a similar game on the other side of the table the next day. For example, children used a toy fishing rod to catch magnetic fish on one side of the table; playing the same game from the other side of the table required a different type of fishing rod. At test, children chose between 2 or 3 tools: a) the tool they used today, b) the tool suitable for the other side (correct) and c) a distractor tool which was not suitable for either side. In Experiment 1, 24 four-year-olds selected 1 out of 2 tools for tomorrow. Children selected the correct item above chance level in all tasks (p < 0.001). In Experiment 2, in which children were not allowed to look at the apparatus when choosing, 21 three-year olds selected 1 out of 2 tools for tomorrow. This group also selected the right tool above chance level in all tasks (p < 0.001).The results of Experiments 1 and 2 imply that 3- and 4-year olds might indeed show episodic future foresight. However, they could have also selected the right tool by default. To control for this, a third tool distractor was introduced in Experiment 3. This time, 3-4 year olds did not perform above chance levels, suggesting that there is an alternative explanation as to why they performed so well in the previous two experiments.

Belief, Knowledge and Expertise. The emergence of the lay expert in medical sociology

The paper has three main aims. First, to trace – through the pages of the Journal – the changing ways in which lay understandings of health and illness have been represented during the 1979-2002 period. Second, to say something about the limits of lay knowledge (and particularly lay expertise) in matters of health and medicine. Third, to call for a re-assessment of what lay people can offer to a democratised and customer sensitive system of health care and to attempt to draw a boundary around the domain of expertise. In following through on those aims, the author calls upon data derived from three current projects. These latter concern the diagnosis of Alzheimer’s disease in people with Down’s syndrome; the development of an outcome measure for people who have suffered a traumatic brain injury; and a study of why older people might reject annual influenza vaccinations. Key words: Lay health beliefs, lay expertise, Alzheimer’s, Traumatic Brain Injury, Vaccinations