Prophylactic antibiotics for the prevention of cellulitis

Background: Cellulitis of the lower leg accounts for 2-3% of hospital admissions (Cox et al, 1998), with an average length of in-patient stay of nine days. Studies have reported that up to half of these patients suffer further episodes (Cox et al, 1998; Dupuy et al, 1999). Reducing the recurrence of cellulitis could therefore have a significant impact on both patient morbidity and NHS costs. Aims: To assess whether prophylactic antibiotics prescribed after an episode of cellulitis of the leg results in fewer subsequent attacks and reduced health service costs (PATCH prophylactic antibiotics for the treatment of cellulitis at home). Methods: This article describes two related studies in which participants are randomised to receive either 12 months of prophylaxis (PATCH I) or six months of prophylaxis (PATCH II). The PATCH I study recruits only patients with recurrent disease defined as two or more episodes of cellulitis in the last three years. PATCH II has more open criteria and includes patients with a first episode of cellulitis and also participants with recurrent disease. It is expected that 260 patients will be recruited into PATCH I and 400 patients into PATCH II.

The medico-legal importance of establishing human identity by palatal rugoscopy: evaluation of the immutability and individuality of palatal rugae under the influence of ante mortem orthodontic treatment

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Tempo de migração dos macrófagos em matrinxã, Brycon amazonicus, por meio da técnica de inoculação de leveduras Saccharomyces cerevisiae

Na aquicultura são utilizados análises da ativação e incremento da migração de macrófagos, com intuito de verificar a capacidade imunológica inespecífica dos peixes frente a um desafio. Neste sentido, o objetivo deste estudo foi determinar o tempo de migração de monócitos/macrófagos para a cavidade peritoneal em matrinxã, Brycon amazonicus, por meio da técnica de inoculação de leveduras Saccharomyces cerevisiae, e verificar as possíveis alterações dos parâmetros hematológicos após o estímulo. Foram utilizados 30 matrinxãs com peso médio de 101,55 ± 24,50 g e comprimento médio de 19,75 ± 1,72 cm. Os tempos de inoculação utilizados foram 2, 4, 8 e 12 horas, sendo utilizados 6 animais por tempo. Após os períodos de incubação (2, 4, 8 e 12 horas), os exemplares foram anestesiados e alíquotas de sangue foram coletadas por punção do vaso caudal, para a análise: número total de células, contagem diferencial e total dos leucócitos e contagem total de trombócitos, hematócrito, taxa de hemoglobina e índices hematimétricos (VCM, HCM e CHCM). Os resultados mostram que a capacidade fagocítica do macrófago não apresentou diferenças significativas entre os tempos experimentais. Com relação ao índice fagocítico, o tempo de 2 horas representa o tempo em que os macrófagos fagocitaram maior número de leveduras com diferenças significativas em relação aos outros tempos experimentais, indicando que este tempo (2 horas) de incubação foi suficiente para a migração e ativação máxima dos macrófagos da cavidade peritoneal, da espécie estudada. Os valores do número de eritrócitos apresentaram diferenças entre os tempos de incubação. Entretanto, os valores dos outros parâmetros hematológicos não apresentaram diferenças significativas.

Evaluación de tres microdietas en el destete de Lenguado Paralichthys adspersus (Steindachner, 1867) paralichthyidae, en condiciones de laboratorio

El lenguado peruano Paralichthys adspersus es una especie que presenta gran calidad nutricional y alto valor económico, Se distribuye desde Paita (norte de Perú) hasta el golfo de Arauco (Chile). En el Perú el cultivo de lenguado se desarrolla a nivel experimental y comercial (pequeña escala), sin embargo la investigación realizada es escasa. Durante el proceso de producción de semilla, el periodo de destete, etapa durante la cual el alimento vivo es sustituido por microdietas balanceadas, resulta ser un punto crítico debido a la alta mortalidad que genera en comparación a otras etapas del cultivo. El objetivo del presente estudio es evaluar el efecto del uso de 3 microdietas (dos experimentales y una comercial) en el destete de Paralichthys adspersus, evaluando el crecimiento (longitud y peso) y la supervivencia. En el ensayo se utilizó la dieta comercial Otohime, y las experimentales, elaboradas con procesos diferentes, MEM (Micro-Extrusion Marumerization) y PARA (Particle Assisted Rotational Agglomeration) desarrolladas en el Servicio de Investigación Agrícola (ARS) del departamento de Agricultura de los Estados Unidos (USDA) -Fish Technology Center. El ensayo inició con peces de 35 días de edad con un peso seco promedio de 0,96±0,52 mg y una talla promedio de 9,55±0,84 mm, los cuales se distribuyeron en nueve tanques de 150L a razón de 400 individuos T-1. Se seleccionaron al alzar tres tanques por cada tratamiento. Estos se denominaron T1, T2 y T3, en cada uno se utilizó una microdieta (Otohime, MEM y PARA respectivamente) para realizar el destete. Los resultados muestran que para los tratamientos T1, T2 y T3 la longitud promedio final alcanzada fue de 15,9 ± 3,2, 14,3 ± 1,72 y 14,4 ± 2,28 mm y el peso seco promedio alcanzado fue de 8,83 ± 5,37, 5,53 ± 2,85 y 7,10 ± 3,56 mg existiendo diferencias significativas solo entre los tratamientos T1 y T2 (p<0,05). La supervivencia media fue de 18,1, 16,3 y 15,2 % (Tratamientos T1, T2 y T3 respectivamente). Además se evaluó el efecto de las dietas sobre los procesos de pigmentación y metamorfosis, cuantificando para cada caso la cantidad de peces que presentan pigmentación normal y la cantidad de los que alcanzaron a completar la metamorfosis, resultando que no existen diferencias significativas entre los tratamientos (p>0,05).

Evaluación biológica poblacional de macha (Mesodesma donacium, Lamarck 1818) en la provincia de Islay, Arequipa. Febrero 2015

La evaluación se realizó entre el 20 y 26 de febrero 2015, el área de distribución de la macha comprendió la playa entre punta Corio y Sombrero Chico en la provincia de Islay; no se registró entre el Boquerón y La Ensenada. La mayor concentración se observó entre Las Cuevas y El Tablón (área de repoblamiento de Islay). La densidad relativa de las estaciones/transectos varió entre 0 y 20,39 ejem/m2. El área efectiva de distribución se calculó en 1´413.514 m2, se estimó abundancia en 7´722.393 ejemplares y biomasa total 147,58 t. Se analizó biométricamente 2.612 ejemplares, la talla varió entre 26 y 90 mm de longitud valvar (LV), con moda principal en 62 mm y secundaria en 76 mm, la longitud promedio fue 59,17 mm, el 89,43% estuvo debajo de la Talla Mínima de Captura (TCM= 70 mm). Los perfiles medios de playa fueron de pendiente suave que varió entre 1,00° y 1,72°; en el Sector sur (Punta de Bombón) se observó playas intermedias acercándose a los límites de playas disipativas (Ω entre 3,14 y 5,92), en el Sector norte (Dean Valdivia - Mejía) se observaron playas intermedias - disipativas (Ω entre 4,53 y 5,22). La temperatura superficial del mar varió entre 16,4 y 21,0 °C, promedio 18,2±0,02 °C. En el análisis del plancton, entre El Molle y Cardones y El Conto y Mejía, se observó larvas D y umbonadas con características similares a Mesodesma donacium.

Effect of the average soft-segment length on the morphology and properties of segmented polyurethane nanocomposites

Two organically modified layered silicates (with small and large diameters) were incorporated into three segmented polyurethanes with various degrees of microphase separation. Microphase separation increased with the molecular weight of the poly(hexamethylene oxide) soft segment. The molecular weight of the soft segment did not influence the amount of polyurethane intercalating the interlayer spacing. Small-angle neutron scattering and differential scanning calorimetry data indicated that the layered silicates did not affect the microphase morphology of any host polymer, regardless of the particle diameter. The stiffness enhancement on filler addition increased as the microphase separation of the polyurethane decreased, presumably because a greater number of urethane linkages were available to interact with the filler. For comparison, the small nanofiller was introduced into a polyurethane with a poly(tetramethylene oxide) soft segment, and a significant increase in the tensile strength and a sharper upturn in the stress-strain curve resulted. No such improvement occurred in the host polymers with poly(hexamethylene oxide) soft segments. It is proposed that the nanocomposite containing the more hydrophilic and mobile poly(tetramethylene oxide) soft segment is capable of greater secondary bonding between the polyurethane chains and the organosilicate surface, resulting in improved stress transfer to the filler and reduced molecular slippage. (c) 2006 Wiley Periodicals, Inc.

Rehabilitation outcomes for brain injured patients in Australia: functional status, length of stay and discharge destination

This study describes the rehabilitation length of stay (LOS), discharge destination and discharge functional status of 149 patients admitted with traumatic brain injury (TBI) to an Australian hospital over a 5-year period. Hospital charts of patients admitted between 1993-1998 were reviewed. Average LOS over the 5-year time period was 61.8 days and only decreased nominally over this time. Longer LOS was predicted by lower admission motor FIM scores and presence of comorbidities. Mean admission and discharge motor FIM scores were 58 and 79, which represented a gain of 21 points. Higher discharge motor FIM scores were predicted by higher admission motor FIM scores and younger age. FIM gain was predicted by cognitive status and age. Most patients, 88%, were discharged back to the community, with 30% changing their living setting or situation. Changing living status was predicted by living alone and having poorer functional status on admission.

Using data mining for prediction of hospital length of stay: an application of the CRISP-DM Methodology

Hospitals are nowadays collecting vast amounts of data related with patient records. All this data hold valuable knowledge that can be used to improve hospital decision making. Data mining techniques aim precisely at the extraction of useful knowledge from raw data. This work describes an implementation of a medical data mining project approach based on the CRISP-DM methodology. Recent real-world data, from 2000 to 2013, were collected from a Portuguese hospital and related with inpatient hospitalization. The goal was to predict generic hospital Length Of Stay based on indicators that are commonly available at the hospitalization process (e.g., gender, age, episode type, medical specialty). At the data preparation stage, the data were cleaned and variables were selected and transformed, leading to 14 inputs. Next, at the modeling stage, a regression approach was adopted, where six learning methods were compared: Average Prediction, Multiple Regression, Decision Tree, Artificial Neural Network ensemble, Support Vector Machine and Random Forest. The best learning model was obtained by the Random Forest method, which presents a high quality coefficient of determination value (0.81). This model was then opened by using a sensitivity analysis procedure that revealed three influential input attributes: the hospital episode type, the physical service where the patient is hospitalized and the associated medical specialty. Such extracted knowledge confirmed that the obtained predictive model is credible and with potential value for supporting decisions of hospital managers.

The average crossing number of equilateral random polygons.

In this paper, we study the average crossing number of equilateral random walks and polygons. We show that the mean average crossing number ACN of all equilateral random walks of length n is of the form . A similar result holds for equilateral random polygons. These results are confirmed by our numerical studies. Furthermore, our numerical studies indicate that when random polygons of length n are divided into individual knot types, the for each knot type can be described by a function of the form where a, b and c are constants depending on and n0 is the minimal number of segments required to form . The profiles diverge from each other, with more complex knots showing higher than less complex knots. Moreover, the profiles intersect with the ACN profile of all closed walks. These points of intersection define the equilibrium length of , i.e., the chain length at which a statistical ensemble of configurations with given knot type -upon cutting, equilibration and reclosure to a new knot type -does not show a tendency to increase or decrease . This concept of equilibrium length seems to be universal, and applies also to other length-dependent observables for random knots, such as the mean radius of gyration Rg.

Inactivation of L-type calcium channels is determined by the length of the N terminus of mutant beta(1) subunits.

Voltage-dependent calcium channel (Ca(v)) pores are modulated by cytosolic beta subunits. Four beta-subunit genes and their splice variants offer a wide structural array for tissue- or disease-specific biophysical gating phenotypes. For instance, the length of the N terminus of beta(2) subunits has major effects on activation and inactivation rates. We tested whether a similar mechanism principally operates in a beta(1) subunit. Wild-type beta(1a) subunit (N terminus length 60 aa) and its newly generated N-terminal deletion mutants (51, 27 and 18 aa) were examined within recombinant L-type calcium channel complexes (Ca(v)1.2 and alpha(2)delta2) in HEK293 cells at the whole-cell and single-channel level. Whole-cell currents were enhanced by co-transfection of the full-length beta(1a) subunit and by all truncated constructs. Voltage dependence of steady-state activation and inactivation did not depend on N terminus length, but inactivation rate was diminished by N terminus truncation. This was confirmed at the single-channel level, using ensemble average currents. Additionally, gating properties were estimated by Markov modeling. In confirmation of the descriptive analysis, inactivation rate, but none of the other transition rates, was reduced by shortening of the beta(1a) subunit N terminus. Our study shows that the length-dependent mechanism of modulating inactivation kinetics of beta(2) calcium channel subunits can be confirmed and extended to the beta(1) calcium channel subunit.

The average inter-crossing number of equilateral random walks and polygons

In this paper, we study the average inter-crossing number between two random walks and two random polygons in the three-dimensional space. The random walks and polygons in this paper are the so-called equilateral random walks and polygons in which each segment of the walk or polygon is of unit length. We show that the mean average inter-crossing number ICN between two equilateral random walks of the same length n is approximately linear in terms of n and we were able to determine the prefactor of the linear term, which is a = (3 In 2)/(8) approximate to 0.2599. In the case of two random polygons of length n, the mean average inter-crossing number ICN is also linear, but the prefactor of the linear term is different from that of the random walks. These approximations apply when the starting points of the random walks and polygons are of a distance p apart and p is small compared to n. We propose a fitting model that would capture the theoretical asymptotic behaviour of the mean average ICN for large values of p. Our simulation result shows that the model in fact works very well for the entire range of p. We also study the mean ICN between two equilateral random walks and polygons of different lengths. An interesting result is that even if one random walk (polygon) has a fixed length, the mean average ICN between the two random walks (polygons) would still approach infinity if the length of the other random walk (polygon) approached infinity. The data provided by our simulations match our theoretical predictions very well.

Length of activity season drives geographic variation in body size of a widely distributed lizard

Understanding the factors that drive geographic variation in life history is an important challenge in evolutionary ecology. Here, we analyze what predicts geographic variation in life-history traits of the common lizard, Zootoca vivipara, which has the globally largest distribution range of all terrestrial reptile species. Variation in body size was predicted by differences in the length of activity season, while we found no effects of environmental temperature per se. Females experiencing relatively short activity season mature at a larger size and remain larger on average than females in populations with relatively long activity seasons. Interpopulation variation in fecundity was largely explained by mean body size of females and reproductive mode, with viviparous populations having larger clutch size than oviparous populations. Finally, body size-fecundity relationship differs between viviparous and oviparous populations, with relatively lower reproductive investment for a given body size in oviparous populations. While the phylogenetic signal was weak overall, the patterns of variation showed spatial effects, perhaps reflecting genetic divergence or geographic variation in additional biotic and abiotic factors. Our findings emphasize that time constraints imposed by the environment rather than ambient temperature play a major role in shaping life histories in the common lizard. This might be attributed to the fact that lizards can attain their preferred body temperature via behavioral thermoregulation across different thermal environments. Length of activity season, defining the maximum time available for lizards to maintain optimal performance, is thus the main environmental factor constraining growth rate and annual rates of mortality. Our results suggest that this factor may partly explain variation in the extent to which different taxa follow ecogeographic rules.

Length Change of P. C. Concrete Due to Moisture Content, MLR-85-09, 1987

Portland cement concrete is an outstanding structural material but stresses and cracks often occur in large structures due to drying shrinkage. The objective of this research was to determine the change in length due to loss of moisture from placement through complete drying of portland cement concrete. The drying shrinkage was determined for four different combinations of Iowa DOT structural concrete mix proportions and materials. The two mix proportions used were an Iowa DOT D57 (bridge deck mix proportions) and a water reduced modified C4 mix. Three 4"x 4"x 18" beams were made for each mix. After moist curing for three days, all beams were maintained in laboratory dry air and the length and weight were measured at 73°F ± 3°F. The temperature was cycled on alternate days from 73°F to 90°F through four months. From four months through six months, the temperature was cycled one day at 73°F and six days at 130°F. It took approximately six months for the concrete to reach a dry condition with these temperatures. The total drying shrinkage for the four mixes varied from .0106 in. to .0133 in. with an average of .0120 in. The rate of shrinkage was approximately .014% shrinkage per 1% moisture loss for all four mixes. The rate and total shrinkage for all four mixes was very similar and did not seem to depend on the type of coarse aggregate or the use of a retarder.