Emergence of clonal complex 5 (CC5) methicillin-resistant Staphylococcus aureus (MRSA) isolates susceptible to trimethoprim-sulfamethoxazole in a Brazilian hospital

In this study, genotyping techniques including staphylococcal chromosomal cassette mec (SCCmec) typing, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and restriction-modification tests were used to compare the molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered at two times within a 10-year interval (1998 and 2008) from a tertiary Brazilian hospital. In addition, the antimicrobial susceptibility profiles were analyzed. All 48 MRSA isolates from 1998 and 85.7% from 2008 (48/56 isolates) displayed multidrug-resistance phenotypes and SCCmec III. All but one of the 13 representative SCCmec III isolates belonged to CC8 and had PFGE patterns similar to that of the BMB9393 strain (Brazilian epidemic clone of MRSA; BEC). In 2008, we found an increased susceptibility to rifampicin and chloramphenicol among the SCCmec III isolates. In addition, we detected the entrance of diverse international MRSA lineages susceptible to trimethoprim-sulfamethoxazole (SXT), almost all belonging to CC5. These non-SCCmec III isolates were related to the USA 300 (ST8-SCCmec IV; PFGE-type B), USA 800 (ST5-SCCmec IV; subtype D1), USA 100 (ST5-SCCmec II; subtype D2), and EMRSA-3/Cordobes (ST5-SCCmec I, type C) clones. To the best of our knowledge, this is the first report of the emergence of isolates genetically related to the EMRSA-3/Cordobes clone in southeast Brazil. In this regard, these isolates were the most common non-SCCmec III MRSA in our institution, accounting for 8.9% of all isolates recovered in 2008. Thus, despite the supremacy of BEC isolates in our country, significant changes may occur in local MRSA epidemiology, with possible consequences for the rationality of MRSA empiric therapy.

Utility of a novel risk score for prediction of ventricular tachycardia and cardiac death in chronic Chagas disease - the SEARCH-RIO study

The SEARCH-RIO study prospectively investigated electrocardiogram (ECG)-derived variables in chronic Chagas disease (CCD) as predictors of cardiac death and new onset ventricular tachycardia (VT). Cardiac arrhythmia is a major cause of death in CCD, and electrical markers may play a significant role in risk stratification. One hundred clinically stable outpatients with CCD were enrolled in this study. They initially underwent a 12-lead resting ECG, signal-averaged ECG, and 24-h ambulatory ECG. Abnormal Q-waves, filtered QRS duration, intraventricular electrical transients (IVET), 24-h standard deviation of normal RR intervals (SDNN), and VT were assessed. Echocardiograms assessed left ventricular ejection fraction. Predictors of cardiac death and new onset VT were identified in a Cox proportional hazard model. During a mean follow-up of 95.3 months, 36 patients had adverse events: 22 new onset VT (mean±SD, 18.4±4‰/year) and 20 deaths (26.4±1.8‰/year). In multivariate analysis, only Q-wave (hazard ratio, HR=6.7; P<0.001), VT (HR=5.3; P<0.001), SDNN<100 ms (HR=4.0; P=0.006), and IVET+ (HR=3.0; P=0.04) were independent predictors of the composite endpoint of cardiac death and new onset VT. A prognostic score was developed by weighting points proportional to beta coefficients and summing-up: Q-wave=2; VT=2; SDNN<100 ms=1; IVET+=1. Receiver operating characteristic curve analysis optimized the cutoff value at >1. In 10,000 bootstraps, the C-statistic of this novel score was non-inferior to a previously validated (Rassi) score (0.89±0.03 and 0.80±0.05, respectively; test for non-inferiority: P<0.001). In CCD, surface ECG-derived variables are predictors of cardiac death and new onset VT.

Late emergence of A594V and L595W mutations related to ganciclovir resistance in a patient with HCMV retinitis and long-term HIV progression

The emergence of ganciclovir (GCV) resistance during the treatment of human cytomegalovirus (HCMV) infection is a serious clinical challenge, and is associated with high morbidity and mortality. In this case report, we describe the emergence of two consecutive mutations (A594V and L595W) related to GCV resistance in a patient with HCMV retinitis and long-term HIV progression after approximately 240 days of GCV use. Following the diagnosis of retinitis, the introduction of GCV did not result in viral load reduction. The detected mutations appeared late in the treatment, and we propose that other factors (high initial HCMV load, previous GCV exposure, low CD4+ cell count), in addition to the presence of resistance mutations, may have contributed to the treatment failure of HCMV infection in this patient.

HIGH PRESSURE PHASE EQUILIBRIUM: PREDICTION OF ESSENTIAL OIL SOLUBILITY

This work describes a method to predict the solubility of essential oils in supercritical carbon dioxide. The method is based on the formulation proposed in 1979 by Asselineau, Bogdanic and Vidal. The Peng-Robinson and Soave-Redlich-Kwong cubic equations of state were used with the van der Waals mixing rules with two interaction parameters. Method validation was accomplished calculating orange essential oil solubility in pressurized carbon dioxide. The solubility of orange essential oil in carbon dioxide calculated at 308.15 K for pressures of 50 to 70 bar varied from 1.7± 0.1 to 3.6± 0.1 mg/g. For same the range of conditions, experimental solubility varied from 1.7± 0.1 to 3.6± 0.1 mg/g. Predicted values were not very sensitive to initial oil composition.

Application of mathematical models for the prediction of adsorption isotherms in solid mixture for mango powder refreshment

Solid mixtures for refreshment are already totally integrated to the Brazilian consumers' daily routine, because of their quick preparation method, yield and reasonable price - quite lower if compared to 'ready-to-drink' products or products for prompt consumption, what makes them economically more accessible to low-income populations. Within such a context, the aim of this work was to evaluate the physicochemical and mineral composition, as well as the hygroscopic behavior of four different brands of solid mixture for mango refreshment. The BET, GAB, Oswim and Henderson mathematical models were built through the adjustment of experimental data to the isotherms of adsorption. Results from the physiochemical evaluation showed that the solid mixtures for refreshments are considerable sources of ascorbic acid and reductor sugar; and regarding mineral compounds, they are significant sources of calcium, sodium and potassium. It was also verified that the solid mixtures for refreshments of the four studied brands are considered highly hygroscopic.

An artificial neural network model for prediction of quality characteristics of apples during convective dehydration

In this study, the effects of hot-air drying conditions on color, water holding capacity, and total phenolic content of dried apple were investigated using artificial neural network as an intelligent modeling system. After that, a genetic algorithm was used to optimize the drying conditions. Apples were dried at different temperatures (40, 60, and 80 °C) and at three air flow-rates (0.5, 1, and 1.5 m/s). Applying the leave-one-out cross validation methodology, simulated and experimental data were in good agreement presenting an error < 2.4 %. Quality index optimal values were found at 62.9 °C and 1.0 m/s using genetic algorithm.

Artificial neural networks (ANN): prediction of sensory measurements from instrumental data

The objective of this study was to predict by means of Artificial Neural Network (ANN), multilayer perceptrons, the texture attributes of light cheesecurds perceived by trained judges based on instrumental texture measurements. Inputs to the network were the instrumental texture measurements of light cheesecurd (imitative and fundamental parameters). Output variables were the sensory attributes consistency and spreadability. Nine light cheesecurd formulations composed of different combinations of fat and water were evaluated. The measurements obtained by the instrumental and sensory analyses of these formulations constituted the data set used for training and validation of the network. Network training was performed using a back-propagation algorithm. The network architecture selected was composed of 8-3-9-2 neurons in its layers, which quickly and accurately predicted the sensory texture attributes studied, showing a high correlation between the predicted and experimental values for the validation data set and excellent generalization ability, with a validation RMSE of 0.0506.

Vigor and field emergence in "high oleic" sunflower seeds, in southeast of Buenos Aires province

Sunflower crop was based, as yet, on high linoleic cultivars, but in the last years request for oil with higher content of oleic acid has increased, due to their dietary characteristics. At the beginning, high oleic cultivars were used to be sown in warm regions, but then the concern about growing it in temperate areas, as the south-east of Buenos Aires Province, was posed. In this region, early sowings are recommended, so that grain filling matches with a period of appropriate hydric and light conditions, as to result in greater yields. However, early sowings are limited by low soil temperature, that delays seedling emergence, resulting in heterogeneous stand establishment. The aim of this work was to evaluate seed performance of four high oleic cultivars in the southern area of Buenos Aires Province, by means of vigor tests and field trials. Germination, cold, tetrazolium viability, tetrazolium viability with cold, accelerated ageing tests and three field sowings at different soil temperatures were performed. Data were analyzed by Anova using generalised linear models, and tests and cultivars were contrasted among themselves. Similar seedling emergence under optimal and suboptimal temperatures for high oleic and high linoleic cultivars was recorded. The success of seedling establishment does not appear to be related to the acidic composition of seeds.

Assessment of the physiological potential of bell pepper seeds and relationship with seedling emergence

The objective in this study was to verify the efficiency of different procedures for evaluating the physiological potential of bell pepper seed and identify its relationship with germination at different temperatures and with seedling emergence. Five seed lots each of the Reinger and Sentinel hybrids were used. Seed physiological potential was evaluated by germination, saturated salt accelerated aging (48 h/41 °C), seedling emergence (percentage and speed), and tetrazolium tests (preconditioning at 45 °C/3 h and seed staining at 45 °C/2 h). Germination (percentage and speed) on a thermogradient table at 15 °C, 18 °C, 21 °C, 25 °C and 30 °C was also evaluated the saturated salt accelerated aging and tetrazolium tests are suitable for access the physiological potential of bell pepper seeds. It was also confirmed that vigorous seed lots perform better when exposed to different temperatures during germination.

Chemical and biological treatments of castor bean seeds: effects on germination, emergence and associated microorganisms

The effect of chemical and biological treatments on castor bean emergence, seedling vigor, dry matter production, and also the control of microorganisms associated with seeds of the AL Guarany 2002 and Lyra cultivars, was evaluated. The products tested were carbendazim + thiram, carboxin + thiram and a product based on Trichoderma. Total seed and seedling emergence were evaluated at 27 days after sowing whereas dry matter production was verified for plants removed 45 days after sowing. The Guarany 2002 AL cultivar had a higher incidence of microorganisms than the Lyra cultivar. The chemical treatment was 100% effective in controlling fungi but the biological treatment did not reduce microorganism incidence on the seeds. Chemical treatment resulted in plants with more dry matter and the best results were for carbendazim + thiram and carboxin + thiram at doses of 60 g + 140 g and 50 g + 50 g/100 kg of seeds, respectively. The carbendazim + thiram mixture was the only treatment which was statistically higher for total emergence whereas the biological treatment increased emergence only for the Lyra cultivar, thus demonstrating its lower efficiency. The importance of fungicides to control pathogens associated with seeds was discussed.

Critical elements underpinning the emergence of the medical game ecosystem: gamifying traumatic brain injury rehabilitation in Finland

The healthcare sector is currently in the verge of a reform and thus, the medical game research provide an interesting area of research. The aim of this study is to explore the critical elements underpinning the emergence of the medical game ecosystem with three sub-objectives: (1) to seek who are the key actors involved in the medical game ecosystem and identify their needs, (2) to scrutinise what types of resources are required in medical game development and what types of relationships are needed to secure those resources, and (3) to identify the existing institutions (‘the rules of the game’) affecting the emergence of the medical game ecosystem. The theoretical background consists of service ecosystems literature. The empirical study conducted is based on the semi-structured theme interviews of 25 experts in three relevant fields: games and technology, health and funding. The data was analysed through a theoretical framework that was designed based upon service ecosystems literature. The study proposes that the key actors are divided into five groups: medical game companies, customers, funders, regulatory parties and complementors. Their needs are linked to improving patient motivation and enhancing the healthcare processes resulting in lower costs. Several types of resources, especially skills and knowledge, are required to create a medical game. To gain access to those resources, medical game companies need to build complex networks of relationships. Proficiency in managing those value networks is crucial. In addition, the company should take into account the underlying institutions in the healthcare sector affecting the medical game ecosystem. Three crucial institutions were identified: validation, lack of innovation supporting structures in healthcare and the rising consumerisation. Based on the findings, medical games cannot be made in isolation. A developmental trajectory model of the emerging medical game ecosystem was created based on the empirical data. The relevancy of relationships and resources is dependent on the trajectory that the medical game company at that time resides. Furthermore, creating an official and documented database for clinically valdated medical games was proposed to establish the medical game market and ensure an adequate status for the effective medical games. Finally, ecosystems approach provides interesting future opportunities for research on medical game ecosystems.

A service perspective to digital innovation: exploring the emergence of autonomous shipping

Current research describes digital innovation largely similar to product innovation. Digital innovation is seen as an object of coherent activities, however in reality digital innovation results from convergence of variant technologies and those related actors with versatile business goals. To account for the dynamic nature of digital innovation, this study applies a service perspective to digital innovation. The purpose of the study is to understand how digital innovation emerges within a service ecosystem for autonomous shipping. The sub-objectives of this study are to 1) identify what factors motivate and demotivate actors to integrate resources for autonomous shipping, 2) explore the key technology areas to be integrated to realise the autonomous shipping concept, and 3) suggest how the technology areas are combined for mutual value creation within a service eco-system for autonomous shipping. Insights from autonomous driving were also included. This study draws on literatures on service innovation and service-dominant logic. The research was conducted as a qualitative exploratory case study. The data comprise interviews of 18 marine and automotive industry experts, 4 workshops, 4 seminars, and observations as well as various secondary data sources. The findings revealed that the key actors have versatile motivations regarding autonomous shipping. These varied from opportunities for single applications to occupying a central role in an autonomous technology platform. Thus, autonomous shipping can be seen as an umbrella concept comprising multiple levels. In technical terms, the development of the concept of autonomous shipping is largely based on combining existing technology solutions, which are gradually integrated towards more systemic entities comprising areas of the autonomous shipping concept. This study argues that a service perspective embraces the inherently complex and dynamic nature of digital innovation. This is captured in the developed research framework that describes digital innovation emerging on different levels of interaction: 1. strategic relationships for new solutions, 2. new local networks for technology platforms, and 3. global networks for new markets. The framework shows how the business models and motivations of digital innovation actors feed the emergence of digital innovation in overlapping service ecosystems that together comprise an innovation ecosystem for autonomous technologies. Digital innovation managers will benefit from seeing their businesses as part of a larger ecosystem of value co-creating actors. In orchestrating digital innovation within a service ecosystem, it is suggested that managers consider the resources, roles and institutions within the ecosystem. Finally, as autonomous shipping is at its infancy, the topic provides a number of interesting avenues for future research.

Narratives of emergence: rising powers and the end of the Third World?

This article examines recent arguments from development economists, from historians and from international relations specialists that do challenge the continued relevance of the idea of the Third World. It then examines five reasons why these arguments are wrong. We can indeed understand much about emerging powers in terms of how they are seeking to navigate and best position themselves within an existing state-centric, liberal and capitalist order whilst accepting many of the underlying assumptions and values of that order. But the nature of that navigation has been shaped by their historical trajectory and by the developmental, societal and geopolitical context of their emergence.