Improving outcome of childhood bacterial meningitis by simplified treatment : Experience from Angola

Background Acute bacterial meningitis (BM) continues to be an important cause of childhood mortality and morbidity, especially in developing countries. Prognostic scales and the identification of risk factors for adverse outcome both aid in assessing disease severity. New antimicrobial agents or adjunctive treatments - except for oral glycerol - have essentially failed to improve BM prognosis. A retrospective observational analysis found paracetamol beneficial in adult bacteraemic patients, and some experts recommend slow β-lactam infusion. We examined these treatments in a prospective, double-blind, placebo-controlled clinical trial. Patients and methods A retrospective analysis included 555 children treated for BM in 2004 in the infectious disease ward of the Paediatric Hospital of Luanda, Angola. Our prospective study randomised 723 children into four groups, to receive a combination of cefotaxime infusion or boluses every 6 hours for the first 24 hours and oral paracetamol or placebo for 48 hours. The primary endpoints were 1) death or severe neurological sequelae (SeNeSe), and 2) deafness. Results In the retrospective study, the mortality of children with blood transfusion was 23% (30 of 128) vs. without blood transfusion 39% (109 of 282; p=0.004). In the prospective study, 272 (38%) of the children died. Of those 451 surviving, 68 (15%) showed SeNeSe, and 12% (45 of 374) were deaf. Whereas no difference between treatment groups was observable in primary endpoints, the early mortality in the infusion-paracetamol group was lower, with the difference (Fisher s exact test) from the other groups at 24, 48, and 72 hours being significant (p=0.041, 0.0005, and 0.005, respectively). Prognostic factors for adverse outcomes were impaired consciousness, dyspnoea, seizures, delayed presentation, and absence of electricity at home (Simple Luanda Scale, SLS); the Bayesian Luanda Scale (BLS) also included abnormally low or high blood glucose. Conclusions New studies concerning the possible beneficial effect of blood transfusion, and concerning longer treatment with cefotaxime infusion and oral paracetamol, and a study to validate our simple prognostic scales are warranted.

H I deficiency in cluster spiral galaxies - Dependence on galaxy size

From the available H I data on spiral galaxies in three rich Abell clusters and the Virgo Cluster, it is shown that galaxies with medium to large optical sizes tend to be more severely deficient in atomic hydrogen than the small galaxies. This is so both in terms of the fractional number of galaxies that are deficient and the amount of gas lost by a galaxy. The fraction of H I-deficient galaxies increases with size over most of the size range, saturating or dropping only for the largest galaxies. A comparative study is made of various currently accepted gas removal mechanisms, namely those which are a result of galaxy-intracluster medium interactions, e.g., ram pressure stripping, as well as those due to galaxy-galaxy interactions, i.e., collisions and tidal interactions. It is shown that, with the exception of tidal interactions, all of these mechanisms would produce a size dependence in H I deficiency that is the opposite of that observed. That is, the gas in the largest galaxies would be the least affected by these mechanisms. However, if there is significant mass segregation, these processes may give the trends observed in the size dependence of H I deficiency.

The Reaction of N4P4Cl8 with Dibenzylamine: Formation of an Unusual Bicyclic Phosphazene, N4P4[N(CH2Ph)2]6(NCH2Ph), by Dealkylation

The reactions of halogenocyclotetraphosphazatetraenes N4P4X8, with nucleophiles have received little attention and only the reactions of the octachloride, N4P4Cl8, with amines have been investigated in any detail.1 Millington and Sowerby2 studied the reaction of N4P4Cl8 with dimethylamine and isolated the derivatives, N4P4Cl8-n (NMe2)n, n = 2,3,4,5,6,8;several N-methylanilino derivatives

A field-consistent and variationally correct representation of transverse shear strains in the nine-noded plate element

We present a biquadratic Lagrangian plate bending element with consistent fields for the constrained transverse shear strain functions. A technique involving expansion of the strain interpolations in terms of Legendre polynomials is used to redistribute the kinematically derived shear strain fields so that the field-consistent forms (i.e. avoiding locking) are also variationally correct (i.e. do not violate the variational norms). Also, a rational method of isoparametric Jacobian transformation is incorporated so that the constrained covariant shear strain fields are always consistent in whatever general quadrilateral form the element may take. Finally the element is compared with another formulation which was recently published. The element is subjected to several robust bench mark tests and is found to pass all the tests efficiently.

Existence Theorems for Generalized Hammerstein Equations

In this paper we obtain existence theorems for generalized Hammerstein-type equations K(u)Nu + u = 0, where for each u in the dual X* of a real reflexive Banach space X, K(u): X -- X* is a bounded linear map and N: X* - X is any map (possibly nonlinear). The method we adopt is totally different from the methods adopted so far in solving these equations. Our results in the reflexive spacegeneralize corresponding results of Petry and Schillings.

Improved Inverted V-Notch or Chimney Weir

This paper is devoted to the improvement of the measuring range of inverted V-notch (IVN) weir, a practical linear sharp-crested weir, designed earlier by the writers. The range of linearity of IVN can be considerably enhanced (by more than 200%) by the addition of a retangular weir of width 0.265W (W = half crest width) at a depth of 0.735d (d = altitude of IVN), above the crest of the weir, which is equivalent to providing at this depth two vertical straight lines to the IVN, resulting in a chimney-shaped profile; hence, the modified weir is named chimney weir. The design parameters of the weir, that is, the linearity range, base flow depth, and datum constant, which fixes the reference plane of the weir, are estimated by solving the nonlinear programming problem using a numerical optimization procedure. For flows through this weir above a depth of 0.22d, the discharges are proportional to the depth of flow measured above a reference plane situated at 0.08d above the weir crest for all heads in the range 0.22d <= h <= 2.43d, within a maximum percentage deviation of ±1.5 from the theoretical discharge. A significant result of the analysis is that the same linear head-discharge relationship governing the flow through the IVN is also valid for the extended chimney weir. Experiments with three different chimney weirs show excellent agreement with the theory by giving a constant average coefficient of discharge for each weir.

Both Surface Proteins (VP4 and VP7) of an Asymptomatic Neonatal Rotavirus Strain (1321) Have High Levels of Sequence Identity with the Homologous Proteins of a Serotype 10 Bovine Rotavirus

The nucleotide sequence of genes 4 and 9, encoding the outer capsid proteins VP4 and VP7 of a serotype 10 tissue culture-adapted strain, 1321, representative of asymptomatic neonatal rotaviruses isolated from neonates in Bangalore, India, were determined. Comparison of nucleotide and deduced amino acid sequences of 1321 VP4 and VP7 with previously published sequences of various serotypes revealed that both genes were highly homologous to the respective genes of serotype 10 bovine rotavirus, B223. The VP4 of 1321 represents a new human P serotype and the 1321 and related strains represent the first description of neonatal rotaviruses that appear to derive both surface proteins from an animal rotavirus.

Observations on transition in plane bubble plumes

Flow visualization studies of plane laminar bubble plumes have been conducted to yield quantitative data on transition height, wavelength and wave velocity of the most unstable disturbance leading to transition. These are believed to be the first results of this kind. Most earlier studies are restricted to turbulent bubble plumes. In the present study, the bubble plumes were generated by electrolysis of water and hence very fine control over bubble size distribution and gas flow rate was possible to enable studies with laminar bubble plumes. Present observations show that (a) the dominant mode of instability in plane bubble plumes is the sinuous mode, (b) transition height and wavelength are related linearly with the proportionality constant being about 4, (c) wave velocity is about 40 % of the mean plume velocity, and (d) normalized transition height data correlate very well with a source Grashof number. Some agreement and some differences in transition characteristics of bubble plumes have been observed compared to those for similar single-phase flows.

High-Q, Ag-doped 123 resonator on unbuffered sapphire substrate

The microwave performance of an Ag-doped YBa2Cu3O7-x, thin-film X-band microstrip resonator on unbuffered sapphire substrate is reported. Q-values of 2400 and 1200 have been obtained al 15R and 77K, respectively, which correspond to R(s) values of 330 mu Omega and 680 mu Omega.

Multifunctional cryogenic sensors from n-BaTiO3 ceramics having strong negative temperature coefficient of resistance

Donor-doped n-BaTiO3 polycrystalline ceramics show a strong negative temperature coefficient of resistivity below the orthorhombic-rhombohedral phase transition point, from 10(2-3) Omega cm af 190 K to 10(10-13) Omega cm at less than or similar to 50 K, with thermal coefficient of resistance alpha = 20-23% K-1. Stable thermal sensors for low-temperature applications are realized therefrom. The negative temperature coefficient of resistivity region can be modified by substituting isovalent ions in the lattice. Highly nonlinear current-voltage (I-V) curves are observed at low temperatures, with a voltage maximum followed by the negative differential resistance. The I-V curves are sensitive to dissipation so that cryogenic sensors can be fabricated for liquid level control, flow rate monitoring, radiation detection or in-rush voltage limitation.

Magneto-structural correlation in (mu-alkoxo/hydroxo)(mu-carboxylato)dicopper(II) systems: Synthesis, X-ray structure and magnetic properties of aquo(mu-hydroxo) (mu-arylcarboxylato)bis(N,N,N ',N '-tetramethylethane-1,2-diamine)dicopper(II) diperchlorate

Asymmetrically dibridged dicopper(II) complexes, [Cu-2(OH)(O2CC6H4-p-Me)(tmen)(2)(H2O)](ClO4)(2) (1) and [Cu-2(OH)(O2CC6H4-p-OMe)(tmen)(2)(H2O)](ClO4)(2) (2) (tmen = N,N,N',N'-tetramethylethane-1,2-diamine), were prepared and structurally characterized. Complex 1 crystallizes in the monoclinic space group P2(1)/a with a = 17.718(2), b = 9.869(1), c = 19.677(2) Angstrom, beta = 115.16(1)degrees, V = 3114.3(6) Angstrom(3) and Z = 4. The structure was refined to R(wR(2)) = 0.067(0.178). Complex 2 crystallizes in the monoclinic space group P2(1)/a with a = 17.695(3), b = 9.574(4), c = 20.104(2) Angstrom, beta = 114.18(1)degrees, V = 3107(1) Angstrom(3) and Z = 4. The final residuals are R(wR(2)) = 0.067(0.182). The complexes have a [Cu-2(mu-OH)(mu-OH)(mu-O2CAr)](2+) core with tmen Ligands occupying the terminal sites of the core. In addition, one copper is axially bound to a water molecule. The Cu ... Cu distances and the Cu-OH Cu angles in the core are 3.394(1) Angstrom, 124.4(2)degrees for 1 and 3.374(1) Angstrom, 123.3(3)degrees for 2. The complexes show axial X-band EPR spectral features in methanol glass at 77 K giving g(perpendicular to) = 2.02, g(parallel to) = 2.3 (A(parallel to) = 165 x 10(-4) cm(-1)) and a visible band near similar to 630 nm in methanol. The complexes are weakly antiferromagnetic. A theoretical fit of the magnetic susceptibility data in the temperature range 40-295 K gives -J = 10 cm(-1), g = 2.05 for 1 and -J = 10 cm(-1), g = 2.0 for 2. Plots of -2J versus the Cu-OH-Cu angle (phi) in this class of asymmetrically dibridged dicopper(II) complexes having d(x2-y2)-d(x2-y2) magnetic orbitals show a linear magneto-structural correlation: -2J(cm(-1)) = 11.48 phi(deg) - 1373.

Critical properties of the double-exchange ferromagnet Nd(0.6)Pb(0.4)MnO(3)

Results of a study of dc magnetization M(T,H), performed on a Nd(0.6)Pb(0.4)MnO(3) single crystal in the temperature range around T(C) (Curie temperature) which embraces the supposed critical region \epsilon\=\T-T(C)\/T(C)less than or equal to0.05 are reported. The magnetic data analyzed in the critical region using the Kouvel-Fisher method give the values for the T(C)=156.47+/-0.06 K and the critical exponents beta=0.374+/-0.006 (from the temperature dependence of magnetization) and gamma=1.329+/-0.003 (from the temperature dependence of initial susceptibility). The critical isotherm M(T(C),H) gives delta=4.54+/-0.10. Thus the scaling law gamma+beta=deltabeta is fulfilled. The critical exponents obey the single scaling equation of state M(H,epsilon)=epsilon(beta)f(+/-)(H/epsilon(beta+gamma)), where f(+) for T>T(C) and f(-) for T

Role of Nonplanar Peptide Unit in Regular Polypeptide Helices - New Model for Pply-Beta-Benzyl-L-Aspartate

The effect of non-planarity of the peptide unit on helical structures stabilized by intrachain hydrogen bonds is discussed. While the present calculations generally agree with those already reported in the literature for right-handed helical structures, it is found that the most stable left-handed structure is a novel helix, called the delta-helix. Its helical parameters are close to these reported for poly-beta-benzyl-L -aspartate. Conformational energy calculations show that poly-beta-benzyl-L -aspartate with the delta-helical structure is considerably more stable than the structure it is generally believed to take up (the omega-helix) by about 15 kcal/mol-residue.