Report of the Iowa Antibiotic Resistance Task Force, January 24, 2012

On January 29, 1998, a task force was convened by the Iowa Department of Public Health (IDPH) to address the development of bacterial resistance to antibiotics in Iowa. The purpose of this task force was to evaluate and monitor the prevalence of resistance in Iowa, to monitor the status of the problem, and to develop strategies to diminish the risk to the population of Iowa. The goals of the Iowa Antibiotic Resistance Task Force (IARTF) are to facilitate appropriate use of antibiotics, discourage prescribing practices that promote the development of antibiotic resistance, and decrease the spread of antibiotic-resistant organisms with appropriate prevention and control measures. This group has been meeting since 1998 to accomplish these goals.

Iowa Privacy Task Force Final Report, January 22, 2002

In appointing the Iowa Privacy Task Force, Governor Vilsack sought to obtain the opinions of both average Iowa citizens and businesses and professionals that work with health and financial information. The Governor recognized that the free flow of information is essential to the vitality of the Iowa economy. At the same time, he also recognized the legitimate fears and concerns of Iowa citizens with the potential loss of privacy inherent in the vast new information flows in this new economy. In order to obtain broad and balanced input, the Governor appointed half the members of the Task Force to represent average Iowa citizens. The other half of the Task Force was appointed with representatives of the financial services industry, providers of health care and the health insurance industry. The Task Force was further balanced to represent the different geographic regions of the state and gender. A total of 32 members were appointed to the Task Force.

Partial Cricotracheal Resection in Children: Potential Pitfalls and Avoidance of Complications.

OBJECTIVES: To delineate the various factors contributing to failure or delay in decannulation after partial cricotracheal resection (PCTR) in children. STUDY DESIGN: Case series. SETTING: Academic tertiary medical center. SUBJECTS AND METHODS: A retrospective case review of 100 children who underwent PCTR between 1978 and 2008 for severe subglottic stenosis using an ongoing database. RESULTS: Ninety of 100 (90%) patients were decannulated. Six patients needed secondary tracheostomy. The results of the preoperative evaluation showed grade II stenosis in four patients, grade III in 64 patients, and grade IV in 32 patients. The overall decannulation rate was 100 percent in grade II, 95 percent in grade III, and 78 percent in grade IV stenosis. Fourteen (14%) patients required revision open surgery. The most common cause of revision surgery was posterior glottic stenosis. Partial anastomotic dehiscence was seen in four patients. Delayed decannulation (>1 year) occurred in nine patients. Overall mortality rate in the whole series was 6 percent. No deaths were directly related to the surgery. No iatrogenic recurrent laryngeal nerve injury was present in the entire series. CONCLUSION: Comorbidities and associated syndromes should be addressed before PCTR is planned to improve the final postoperative outcome in terms of decannulation. Perioperative morbidity due to anastomotic dehiscence, to a certain extent, can be avoided by intraoperative judgment in the selection of double-stage surgery when more than five tracheal rings need to be resected. Subglottic stenosis with glottic involvement continues to pose a difficult challenge to pediatric otolaryngologists, often necessitating revision procedures.

Parenteral anticoagulants in heart disease: Current status and perspectives (Section II). Position Paper of the ESC Working Group on Thrombosis - Task Force on Anticoagulants in Heart Disease.

Anticoagulants are a mainstay of cardiovascular therapy, and parenteral anticoagulants have widespread use in cardiology, especially in acute situations. Parenteral anticoagulants include unfractionated heparin, low-molecular-weight heparins, the synthetic pentasaccharides fondaparinux, idraparinux and idrabiotaparinux, and parenteral direct thrombin inhibitors. The several shortcomings of unfractionated heparin and of low-molecular-weight heparins have prompted the development of the other newer agents. Here we review the mechanisms of action, pharmacological properties and side effects of parenteral anticoagulants used in the management of coronary heart disease treated with or without percutaneous coronary interventions, cardioversion for atrial fibrillation, and prosthetic heart valves and valve repair. Using an evidence-based approach, we describe the results of completed clinical trials, highlight ongoing research with currently available agents, and recommend therapeutic options for specific heart diseases.

Dispersal and Inbreeding Avoidance.

Using a game-theoretical approach, we investigate the dispersal patterns expected if inbreeding avoidance were the only reason for dispersal. The evolutionary outcome is always complete philopatry by one sex. The rate of dispersal by the other sex depends on patch size and mating system, as well as inbreeding and dispersal costs. If such costs are sex independent, then two stable equilibria coexist (male or female philopatry), with symmetric domains of attraction. Which sex disperses is determined entirely by history, genetic drift, and gene flow. An asymmetry in costs makes one domain of attraction extend at the expense of the other. In such a case, the dispersing sex might also be, paradoxically, the one that incurs the higher dispersal costs. As asymmetry increases, one equilibrium eventually disappears, which may result in a sudden evolutionary shift in the identity of the dispersing sex. Our results underline the necessity to control for phylogenetic relationships (e.g., through the use of independent-comparisons methods) when investigating empirical trends in dispersal. Our model also makes quantitative predictions on the rate of dispersal by the dispersing sex and suggests that inbreeding avoidance may only rarely be the sole reason for dispersal.

Septal lesions impair the acquisition of a cued place navigation task: attentional or memory deficit?

These experiments were designed to analyze how medial septal lesions reducing the cholinergic innervation in the hippocampus might affect place learning. Rats with quisqualic lesions of the medial septal area (MS) were trained in a water maze and on a homing table where the escape position was located at a spatially fixed position and further indicated by a salient cue suspended above it. The lesioned rats were significantly impaired in reaching the cued escape platform during training. In addition rats, did not show any discrimination of the training sector during a probe trial in which no platform or cue was present. This impairment remained significant during further training in the absence of the cue. When the cued escape platform was located at an unpredictable spatial location, the MS-lesioned rats showed no deficit and spent more time under the cue than control rats during the probe trial. On the homing board, with a salient object in close proximity to the escape hole, the MS rats showed no deficit in escape latencies, although a significant reduction in spatial memory was observed. However, this was overcome by additional training in the absence of the cue. Under these conditions, rats with septal lesions were prone to develop a pure guidance strategy, whereas normal rats combined a guidance strategy with a memory of the escape position relative to more distant landmarks. The presence of a salient cue appeared to decrease attention to environmental landmarks, thus reducing spatial memory. These data confirm the general hypothesis that MS lesions reduce the capacity to rely on a representation of the relation between several landmarks with different salience.

Quality of Learners' Time and Learning Performance Beyond Quantitative Time-on-Task

Peer-reviewed

Inhibition of the shade avoidance response by formation of non-DNA binding bHLH heterodimers.

In shade-intolerant plants such as Arabidopsis, a reduction in the red/far-red (R/FR) ratio, indicative of competition from other plants, triggers a suite of responses known as the shade avoidance syndrome (SAS). The phytochrome photoreceptors measure the R/FR ratio and control the SAS. The phytochrome-interacting factors 4 and 5 (PIF4 and PIF5) are stabilized in the shade and are required for a full SAS, whereas the related bHLH factor HFR1 (long hypocotyl in FR light) is transcriptionally induced by shade and inhibits this response. Here we show that HFR1 interacts with PIF4 and PIF5 and limits their capacity to induce the expression of shade marker genes and to promote elongation growth. HFR1 directly inhibits these PIFs by forming non-DNA-binding heterodimers with PIF4 and PIF5. Our data indicate that PIF4 and PIF5 promote SAS by directly binding to G-boxes present in the promoter of shade marker genes, but their action is limited later in the shade when HFR1 accumulates and forms non-DNA-binding heterodimers. This negative feedback loop is important to limit the response of plants to shade.