Targeted nasal vaccination provides antibody-independent protection against Staphylococcus aureus.

Despite showing promise in preclinical models, anti-Staphylococcus aureus vaccines have failed in clinical trials. To date, approaches have focused on neutralizing/opsonizing antibodies; however, vaccines exclusively inducing cellular immunity have not been studied to formally test whether a cellular-only response can protect against infection. We demonstrate that nasal vaccination with targeted nanoparticles loaded with Staphylococcus aureus antigen protects against acute systemic S. aureus infection in the absence of any antigen-specific antibodies. These findings can help inform future developments in staphylococcal vaccine development and studies into the requirements for protective immunity against S. aureus.

Thalamic connectivity in patients with essential tremor treated with MR imaging-guided focused ultrasound: in vivo fiber tracking by using diffusion-tensor MR imaging.

PURPOSE: To use diffusion-tensor (DT) magnetic resonance (MR) imaging in patients with essential tremor who were treated with transcranial MR imaging-guided focused ultrasound lesion inducement to identify the structural connectivity of the ventralis intermedius nucleus of the thalamus and determine how DT imaging changes correlated with tremor changes after lesion inducement. MATERIALS AND METHODS: With institutional review board approval, and with prospective informed consent, 15 patients with medication-refractory essential tremor were enrolled in a HIPAA-compliant pilot study and were treated with transcranial MR imaging-guided focused ultrasound surgery targeting the ventralis intermedius nucleus of the thalamus contralateral to their dominant hand. Fourteen patients were ultimately included. DT MR imaging studies at 3.0 T were performed preoperatively and 24 hours, 1 week, 1 month, and 3 months after the procedure. Fractional anisotropy (FA) maps were calculated from the DT imaging data sets for all time points in all patients. Voxels where FA consistently decreased over time were identified, and FA change in these voxels was correlated with clinical changes in tremor over the same period by using Pearson correlation. RESULTS: Ipsilateral brain structures that showed prespecified negative correlation values of FA over time of -0.5 or less included the pre- and postcentral subcortical white matter in the hand knob area; the region of the corticospinal tract in the centrum semiovale, in the posterior limb of the internal capsule, and in the cerebral peduncle; the thalamus; the region of the red nucleus; the location of the central tegmental tract; and the region of the inferior olive. The contralateral middle cerebellar peduncle and bilateral portions of the superior vermis also showed persistent decrease in FA over time. There was strong correlation between decrease in FA and clinical improvement in hand tremor 3 months after lesion inducement (P < .001). CONCLUSION: DT MR imaging after MR imaging-guided focused ultrasound thalamotomy depicts changes in specific brain structures. The magnitude of the DT imaging changes after thalamic lesion inducement correlates with the degree of clinical improvement in essential tremor.

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2010 Retailers Motor Fuel Gallons Annual Report, April 2011

The Department identified 2,706 potential retail locations at which motor fuel may be sold. Reporting forms were mailed to 1,675 locations identified using Department of Agriculture and Land Stewardship motor fuel license information and to 305 locations identified through the Department of Revenue motor fuel tax database. In addition, 726 locations were identified for four large motor fuel retailers that submitted their annual sales data electronically. The Department received either forms or electronic files representing 2,324 (85.9%) of the locations. Replies for 115 of the locations indicated that no retail sales of any type of motor fuel were made during 2010. 2,209 locations reported retail motor fuel sales. This report’s primary focus is on biofuel sales. Of the reporting retail locations, 2,075 (93.9%) reported selling E10 blend motor fuel, 165 (7.5%) reported selling the E85 blend motor fuel, and 239 (10.8%) reported selling various blends of biodiesel.

Prise en charge actuelle de l'incontinence anale [Current management of anal incontinence]

Even though anal incontinence affects a significant proportion of the population, causing a major burden to both patient and society, it still remains "the last closet issue". Less than a third of patients will share this problem with their physician. Consequently, the incidence of anal incontinence is difficult to determine, varying from 2-50%. Since this disabling condition is often associated with urinary incontinence and/or pelvic organ prolapse, a multidisciplinary team approach is required. A wide range of therapeutic options are available. When dietary, medical and rehabilitative treatments have failed, sacral neuromodulation should be considered in selected cases. More invasive surgery is usually undertaken in the presence of major structural defects. The aim of this article is to suggest a comprehensive way of identifying and treating anal incontinence.

[Illustrations de Description de l'Académie royale des Arts de peinture et de sculpture] / [Non identifié] ; Nicolas Guérin, aut. du texte

Comprend : [ Planche dépliante entre pp. 64-65. ] Elévation des faces des murs du Salon de l'Académie [royale des Arts de peinture et de sculpture. XVIIIè siècle.] [ Cote : BNF C 107129. ] ; [ Planche dépliante entre pp.104-105. ] Plan et élévation de la salle où se tiennent ordinairement les Assemblés. [ Académie royale des Arts de peinture et de sculpture. XVIIIè siècle.] [ Cote : BNF C 107130. ] ; [ Planche dépliante entre pp.164-166. ] Plan et élévation de la troisième salle de l'Académie [royale des Arts de peinture et de sculpture] où sont les vases de Medicis. [XVIIIè siècle.] [ Cote : BNF C 106592. ] ; [ Planche dépliante entre pp.208-209. ] Plan de la salle séparée des autres. [ Une salle de l'Académie royale des Arts de peinture et de sculpture. XVIIIè siècle.] [ Cote : BNF C 107131. ] ; [ Planche dépliante entre pp. 246-247. ] Plan du vestibule par où on entre dans le salon [de l'Académie royale des Arts de peinture et de sculpture. XVIIIè siècle.] [ Cote : BNF C 107132. ] ; [ Planche dépliante entre pp.256-257. ] Plan de l'Ecole du modèle [ à l'Académie royale des Arts de peinture et de sculpture. XVIIIè siècle.] [ Cote : BNF C 107133. ]

Pharmaceutical care in an inpatient pediatric intensive care unit: an international multicentric study

Introduction Pediatric intensive care patient represent a population athigh risk for drug-related problems. Our objective is to describe drugrelated problems and intervention of four decentralized pharmacists inpediatric and cardiac intensive care unit.Materials & Methods Multicentric, descriptive and prospectivestudy over a six-month period (August 1st 2009-January 31st 2010).Drug-related problems and clinical interventions were compiled infour pediatric centers using a tool developed by the Socie´te´ Franc¸aisede Pharmacie Clinique. Data concerning patients, drugs, intervention,documentation, approval (if needed), and estimated impact werecompiled. The four pharmacists participating were from Belgium (B),France (F), Quebec (Q) and Switzerland (S).Results A total of 996 interventions were collected: 129 (13%) in B,238 (24%) in F, 278 (28%) in Q and 351 (35%) in S. These interventionstargeted 269 patients (median 22 month-old, 52% male): 69(26%) in B, 88 (33%) in F, 56 (21%) in Q and in S. These data werecollected during 28 non consecutive days in the clinical unit in B, 59days in F, 42 days in Q and 63 days in S. The main drug-relatedproblems were inappropriate administration technique (293, 29%),untreated indication (254, 25%) and supra therapeutic dosage (106,11%). The pharmacist's interventions concerned mainly administrationmode optimization (223, 22%), dose adjustment (200, 20%) andtherapeutic monitoring (164, 16%). The three major drug classesleading to interventions were anti-infectives for systemic use (233,23%) and alimentary tract and metabolism drugs (218, 22%). Interventionsconcerned mainly residents and all clinical staff (209, 21%).Among the 879 (88%) interventions requiring a physician's approval,731 (83%) were accepted. Interventions were considered as having amoderate (51%) or major (17%) clinical impact. Among the interventionsprovided, 10% were considered to have an economicalpositive impact. Differences and similarities between countries willbe presented at the poster session.Discussion & Conclusion Decentralized pharmacist at patient bedsideis a pre-requisite for pharmaceutical care. There are limitedstudies comparing the activity of clinical pharmacists betweencountries. This descriptive study illustrates the ability of clinicalpharmacist to identify and solve drug-related problems in pediatricintensive care unit in four different francophone countries.

Heb 5.7, Jesus' Prayer on the Mount of Olives and Jewish Christianity: Hearing Early Christian Voices in Canonical and Apocryphal Texts

(Résumé de l'ouvrage) The book of Hebrews has often been the Cinderella of the New Testament, overlooked and marginalized; and yet it is one of the most interesting and theologically significant books in the New Testament. A Cloud of Witness examines the theology of the book in the light of its ancient historical context. There are chapters devoted to the structure of Hebrews, the person of Jesus Christ, Hebrews within the context of Second Temple Judaism and the Greco-Roman empire and the role of Hebrews in early Christian thought.

Phase I study of sorafenib combined with radiation therapy and temozolomide as first-line treatment of high-grade glioma.

BACKGROUND: Sorafenib (Sb) is a multiple kinase inhibitor targeting both tumour cell proliferation and angiogenesis that may further act as a potent radiosensitizer by arresting cells in the most radiosensitive cell cycle phase. This phase I open-label, noncontrolled dose escalation study was performed to determine the safety and maximum tolerated dose (MTD) of Sb in combination with radiation therapy (RT) and temozolomide (TMZ) in 17 patients with newly diagnosed high-grade glioma. METHODS: Patients were treated with RT (60 Gy in 2 Gy fractions) combined with TMZ 75 mg m(-2) daily, and Sb administered at three dose levels (200 mg daily, 200 mg BID, and 400 mg BID) starting on day 8 of RT. Thirty days after the end of RT, patients received monthly TMZ (150-200 mg m(-2) D1-5/28) and Sb (400 mg BID). Pharmacokinetic (PK) analyses were performed on day 8 (TMZ) and on day 21 (TMZ&Sb) (Clinicaltrials ID: NCT00884416). RESULTS: The MTD of Sb was established at 200 mg BID. Dose-limiting toxicities included thrombocytopenia (two patients), diarrhoea (one patient) and hypercholesterolaemia (one patient). Sb administration did not affect the mean area under the curve(0-24) and mean Cmax of TMZ and its metabolite 5-amino-imidazole-4-carboxamide (AIC). Tmax of both TMZ and AIC was delayed from 0.75 (TMZ alone) to 1.5 h (combined TMZ/Sb). The median progression-free survival was 7.9 months (95% confidence interval (CI): 5.4-14.55), and the median overall survival was 17.8 months (95% CI: 14.7-25.6). CONCLUSIONS: Although Sb can be combined with RT and TMZ, significant side effects and moderate outcome results do not support further clinical development in malignant gliomas. The robust PK data of the TMZ/Sb combination could be useful in other cancer settings.

Assessing the Glaucoma Quality of Life-15 (GCL-15) Questionnaire, Goldmann Tonometry and Moorfields Motion Displacement Test in Glaucoma Case Finding

Purpose: To compare the performance Glaucoma Quality of Life-15 (GQL-15) Questionnaire, intraocular pressure measurement (IOP Goldmann tonometry) and a measure of visual field loss using Moorfields Motion Displacement Test (MDT) in detecting glaucomatous eyes from a self referred population. Methods: The GQL-15 has been suggested to correlate with visual disability and psychophysical measures of visual function in glaucoma patients. The Moorfields MDT is a multi location perimetry test with 32 white line stimuli presented on a grey background on a standard laptop computer. Each stimulus is displaced between computer frames to give the illusion of "apparent motion". Participants (N=312, 90% older than 45 years; 20.5% family history of glaucoma) self referred to an advertised World Glaucoma Day (March 2009) Jules Gonin Eye Hospital, Lausanne Switzerland. Participants underwent a clinical exam (IOP, slit lamp, angle and disc examination by a general ophthalmologist), 90% completed a GQL-15 questionnaire and over 50% completed a MDT test in both eyes. Those who were classified as abnormal on one or more of the following (IOP >21 mmHg/ GQL-15 score >20/ MDT score >2/ clinical exam) underwent a follow up clinical examination by a glaucoma specialist including imaging and threshold perimetry. After the second examination subjects were classified as "healthy"(H), "glaucoma suspect" (GS) (ocular hypertension and/or suspicious disc, angle closure with SD) or "glaucomatous" (G). Results: One hundred and ten subjects completed all 4 initial examinations; of these 69 were referred to complete the 2nd examination and were classified as; 8 G, 24 GS, and 37 H. MDT detected 7/8 G, and 7/24 GS, with false referral rate of 3.8%. IOP detected 2/8 G and 8/24 GS, with false referral rate of 8.9%. GQL-15 detected 4/8 G, 16/24 GS with a false referral rate of 42%. Conclusions: In this sample of participants attending a self referral glaucoma detection event, the MDT performed significantly better than the GQL-15 and IOP in discriminating glaucomatous patients from healthy subjects. Further studies are required to assess the potential of the MDT as a glaucoma screening tool.

Decomposição e liberação de N, P e K de esterco bovino e de cama de frango isolados ou misturados

A utilização de resíduos orgânicos de origem animal na adubação das culturas demanda informações sobre a dinâmica de decomposição e mineralização de nutrientes neles contidos. Este trabalho objetivou avaliar a decomposição e a liberação de N, P e K dos resíduos orgânicos esterco bovino e cama de frango isolados ou misturados, em Argissolo Vermelho-Amarelo, da região de Tabuleiros Costeiros paraibanos. O experimento foi conduzido em delineamento experimental de blocos casualizados, utilizando-se o método das sacolas de decomposição (litterbag), com os tratamentos arranjados em esquema fatorial 3 × 2 × 6, referentes a três resíduos orgânicos: esterco bovino (EB), cama de frango (CF) e a mistura desses resíduos na proporção de 1:1, denominada de esterco misto (EM); duas camadas de incorporação (0-10 e 10-20 cm); e seis períodos de avaliação (0, 30, 90, 150, 210 e 270 dias após a aplicação - DAA) com três repetições. Os resultados revelaram que a profundidade de incorporação não influenciou a decomposição dos resíduos EB e EM, que essa foi mais rápida na CF (0,0035 g dia-1), mais lenta no EB (0,0010 g dia-1) e ocorreu numa velocidade intermediária no EM (0,0020 g dia-1). Houve liberação mais rápida de N no EM (0,0011 g dia-1), de P no EB (0,0040 g dia-1) e de K na CF (0,0025 g dia-1), com tendência de aumento na liberação de N na CF e de P em todos os resíduos com a incorporação desses na camada de 10-20 cm. Após 270 DAP, estimou-se que a liberação de nutrientes pelos resíduos EB, CF e EM, em relação ao teor inicial, foi de 5,0; 15,0; e 28,0 %, para N; 80,0; 68,0; e 47,0 %, para P; e 20,0; 53,0; e 32,0 %, para K. Em valores absolutos, esses percentuais representaram, respectivamente, 19,0; 103,5; e 149,5 kg ha-1 de N; 28,0; 18,0; e 15,0 kg ha-1 de P; e 75,0; 493,0; e 209,0 kg ha-1 de K. Os resíduos orgânicos se evidenciaram fontes inadequadas para suprir isoladamente a demanda nutricional de culturas de ciclo curto nesses solos.