Adult native septic arthritis: 10 years in review in order to establish local guidelines on empiric antibiotic therapy.

Objective: Antibiotic stewardship includes development of practice guidelines incorporating local microbiology and resistance patterns. In case of septic arthritis (SA), addition of vancomycin to the empiric therapy and broad-spectrum antibiotherapy in some clinical settings are subjects of discussion. Our objective was to review the local epidemiology of native septic arthritis in adults, in order to establish local guidelines for empiric therapy. Methods: Retrospective study based on positive synovial fluid cultures and hospital discharge diagnoses of SA obtained from 1999 to 2008 in patients _16 years. Medical records were reviewed to assess the diagnosis and complete relevant clinical information. Results: During this ten-year period, we identified 233 SA on native joints in 231 patients. 107 episodes (46%) were obtained through positive synovial fluid cultures, and 126 episodes (54%) through the discharge diagnosis. 147 SA (63%) were large joint infections (LJI). 35 SA (15%) occurred in intravenous drug users. Preexisting arthropathy was present in 51% of cases. 42% of patients with small joint infection (SJI) were diabetic, vs. 23% with LJI (p = 0.003). When available, synovial fluid direct examination was positive in 35% of cases. Etiologic agents are reported in the table. Five of the 11 MRSA SA (45%) occurred in known carriers. SJI were more frequently polymicrobial (24% vs. 1%, p<0.001). For LJI, an empiric treatment with amoxicillin/clavulanate (A/C) would have been appropriate in 85% of cases. MRSA (8 cases) and tuberculous (7 cases) arthritis would have been the most frequently untreated pathogens. Addition of vancomycin to A/C in MRSA carriers would rise the adequacy to 87%. In contrast, A/C would cover only 75% of SJI (82% if restricted to non-diabetic patients). MRSA (3 cases) and P. aeruginosa (9 cases, 7 monomicrobial) would be the main untreated pathogens. An anti-pseudomonal penicillin would have been appropriate in 94% of cases of SJI (P = 0.002 vs. A/C, p = 0.19 if diabetic patients not included). Conclusions: Treatment with A/C seems adequate for empiric coverage of LJI in our setting. Broad-spectrum antibiotherapy was significantly superior for SJI in diabetic patients, due to different causative bacteria. In an area of low MRSA incidence, our results do not justify a systematic empiric therapy for MRSA, which should be considered in a known carrier.

The EU strategy of policy convergence with its neighbours in the area of trade

The objective of this paper is to ascertain whether the EU is seeking policy convergence with its neighbours in the area of trade by means of EU regulations. For each trade- related topic, we carried out a content analysis of the available official documents to identify the model of relations that has been established between the EU and four neighbouring countries (Morocco, Algeria, Ukraine and Georgia). The findings indicate that Europeanization is the EU strategy in most cases. However, adaptation to European regulations is only a long-term aim. When international regulations exist in a specific area, the EU usually demands the internationalization of a country¿s regulations as a first step. When there are no international regulations, the convergence process is established on the basis of bilaterally developed norms. EU strategy also varies depending on the country. Its relations with Algeria are the most particular. We conclude that the EU is promoting policy convergence with its neighbours in the area of trade mainly on the basis of international and bilaterally-developed regulations.

Coverage effects on the magnetism of Fe/MgO(001) ultrathin films

Different aspects of the structure-magnetism and morphology-magnetism correlation in the ultrathin limit are studied in epitaxial Fe films grown on MgO(001). In the initial stages of growth the presence of substrate steps, intrinsically higher than an Fe atomic layer, prevent the connection between Fe islands and hence the formation of large volume magnetic regions. This is proposed as an explanation to the superparamagnetic nature of ultrathin Fe films grown on MgO in addition to the usually considered islanded, or Vollmer-Weber, growth. Using this model, we explain the observed transition from superparamagnetism to ferromagnetism for Fe coverages above 3 monolayers (ML). However, even though ferromagnetism and magnetocrystalline anisotropy are observed for 4 ML, complete coverage of the MgO substrate by the Fe ultrathin films only occurs around 6 ML as determined by polar Kerr spectra and simulations that consider different coverage situations. In annealed 3.5 ML Fe films, shape or configurational anisotropy dominates the intrinsic magnetocrystalline anisotropy, due to an annealing induced continuous to islanded morphological transition. A small interface anisotropy in thicker films is observed, probably due to dislocations observed at the Fe¿MgO(001) interface.

Audit report on America’s Agricultural Industrial Heritage Landscape, Inc., d/b/a Silos and Smokestacks National Heritage Area, in Waterloo, Iowa for the years ended December 31, 2010 and 2009

Audit report on America’s Agricultural Industrial Heritage Landscape, Inc., d/b/a Silos and Smokestacks National Heritage Area, in Waterloo, Iowa for the years ended December 31, 2010 and 2009

The EU strategy of policy convergence with its neighbours in the area of trade

The objective of this paper is to ascertain whether the EU is seeking policy convergence with its neighbours in the area of trade by means of EU regulations. For each trade- related topic, we carried out a content analysis of the available official documents to identify the model of relations that has been established between the EU and four neighbouring countries (Morocco, Algeria, Ukraine and Georgia). The findings indicate that Europeanization is the EU strategy in most cases. However, adaptation to European regulations is only a long-term aim. When international regulations exist in a specific area, the EU usually demands the internationalization of a country¿s regulations as a first step. When there are no international regulations, the convergence process is established on the basis of bilaterally developed norms. EU strategy also varies depending on the country. Its relations with Algeria are the most particular. We conclude that the EU is promoting policy convergence with its neighbours in the area of trade mainly on the basis of international and bilaterally-developed regulations.

Leaf area of common bean genotypes during early pod filling as related to plant adaptation to limited phosphorus supply

Low phosphorus supply markedly limits leaf growth and genotypes able to maintain adequate leaf area at low P could adapt better to limited-P conditions. This work aimed to investigate the relationship between leaf area production of common bean (Phaseolus vulgaris) genotypes during early pod filling and plant adaptation to limited P supply. Twenty-four genotypes, comprised of the four growth habits in the species and two weedy accessions, were grown at two P level applied to the soil (20 and 80 mg kg-1) in 4 kg pots and harvested at two growth stages (pod setting and early pod filling). High P level markedly increased the leaf number and leaf size (leaf area per leaf), slightly increased specific leaf area but did not affect the net assimilation rate. At low P level most genotypic variation for plant dry mass was associated with leaf size, whereas at high P level this variation was associated primarily with the number of leaves and secondarily with leaf size, specific leaf area playing a minor role at both P level. Determinate bush genotypes presented a smaller leaf area, fewer but larger leaves with higher specific leaf area and lower net assimilation rate. Climbing genotypes showed numerous leaves, smaller and thicker leaves with a higher net assimilation rate. Indeterminate bush and indeterminate prostrate genotypes presented the highest leaf area, achieved through intermediate leaf number, leaf size and specific leaf area. The latter groups were better adapted to limited P. It is concluded that improved growth at low P during early pod filling was associated with common bean genotypes able to maintain leaf expansion through leaves with greater individual leaf area.

Structural quality of soils cultivated with coffee and pasture in an environmental protection area

Studies of soils in Environmental Protection Areas (EPAs) are of great importance, because they are an essential component of ecosystems, directly interfering in environmental sustainability. The objective of this study was to evaluate the structural quality of soil cultivated with coffee and used as pasture in the Capituva's River microbasin, which is located in the Environmental Protection Area in Coqueiral, south of the state of Minas Gerais. Uniaxial compression test (preconsolidation test) and soil resistance to penetration were used. Undisturbed samples were taken from the surface layer (0-5 cm) of the soils in the area: a typic dystrophic Red Latosol (LVd - Oxisol), a typic eutrophic Red Argisol (PVe - Ultisol), and a typic dystrophic Haplic Cambisol (CXbd - Inceptisol). A significant linear positive correlation was observed between the results of the preconsolidation test and soil resistance to penetration. Load bearing capacity of soil could be estimated accordingly by means of penetration resistance for LVd, PVe, and CXbd. Cambisol - CXbd showed lower loading support capacity and resistance to penetration than LVd and PVe, due to the better crop management in this soil that resulted in higher physical quality which accounts for higher production and environmental sustainability.

Willigness to pay for long-term care coverage: the role of private information and self-insurance

Both public and private insurance for long-term care is undeveloped in some European countries such as in Spain and empirical evidence is still limited. This paper aims at exmining the determinants of the demand for Long Term Care (LTC) coverage in Spain using contingent valuation techniques. Our findings indicate that only one-fifth of the population is willing to pay to assure coverage decisions are significantly affected by private information asymmetry and housing tenure in giving rise to self-insurance reduces the probability of insurance being hypothetically purchased.

Pedochronology and development of peat bog in the environmental protection area pau-de-fruta - Diamantina, Brazil

In the region of the Serra do Espinhaço Meridional, peat bog is formed in hydromorphic environments developed in sunken areas on the plain surfaces with vegetation adapted to hydromorphic conditions, favoring the accumulation and preservation of organic matter. This pedoenvironment is developed on the regionally predominant quartzite rocks. Peat bog in the Environmental Protection Area - APA Pau-de-Fruta, located in the watershed of Córrego das Pedras, Diamantina,Brazil, was mapped and three representative profiles were morphologically characterized and sampled for physical, chemical and microbiological analyses. The organic matter was fractionated into fulvic acid (FA), humic acids (HA) and humin (H). Two profiles were sampled to determine the radiocarbon age and δ13C. The structural organization of the three profiles is homogeneous. The first two layers consist of fibric, the two subsequent of hemic and the four deepest of sapric peat, showing that organic matter decomposition advances with depth and that the influence of mineral materials in deeper layers is greater. Physical properties were homogeneous in the profiles, but varied in the sampled layers. Chemical properties were similar in the layers, but the Ca content, sum of bases and base saturation differed between profiles. Contents of H predominated in the more soluble organic matter fractions and were accumulated at a higher rate in the surface and deeper layers, while HA levels were higher in the intermediate and FA in the deeper layers. Microbial activity did not vary among profiles and was highest in the surface layers, decreasing with depth. From the results of radiocarbon dating and isotope analysis, it was inferred that bog formation began about 20 thousand years ago and that the vegetation of the area had not changed significantly since then.

Iowa Interstate Rest Area Stabilization Ponds, September 1979

This report is presented in two parts . P a r t I takes a new look at the design of rest area stabilization ponds after nearly 10 years' experience with some of the existing ponds and in the light of new design standards issued by Iowa DEQ. The Iowa DOT is embarking on improvements t o the ponds a t some of the r e s t areas. These improvements may include installation of drainage tile around the ponds to lower the water table below the pond bottom, sealing of the ponds with bentonite clay to reduce the infiltration to limits recently established by Iowa DEQ, and the enlargement of the ponds installation of aeration equipment t o increase the pond capacity. As the Iowa DOT embarks on this improvement program, it behooves them t o make only the improvements that are absolutely necessary to achieve waste water treatment goals. These ponds are subject to an extremely seasonal load and thus the ordinary standards used for pond design are not appropriate. Thus, Part I of the report presents a rationale for design and operation of the ponds which is deemed appropriate for t h e i r unique seasonally loaded character. Part I1 of the report looks a t the feasibility of using wind power for the aeration of the ponds, if and when aeration is deemed necessary.

Decomposição e liberação de nutrientes da parte aérea de plantas de milheto e sorgo

O milheto pode ser usado como planta de cobertura para o solo e recicladora de nutrientes em solos de baixa fertilidade natural. O objetivo deste trabalho foi avaliar a taxa de decomposição e a liberação de nutrientes pela parte aérea de plantas de milheto e sorgo deixada sobre o solo. Os tratamentos consistiram de plantas de milheto, com as cultivares pérola ENA 2 e BRS 1501, e plantas de sorgo do híbrido BRS 310. Após o corte, no final do ciclo, amostras da parte aérea foram acondicionadas em bolsas de decomposição distribuídas na superfície das parcelas. A decomposição da matéria seca e a liberação de nutrientes foram monitoradas por meio de coletas dos resíduos, contidos nas bolsas de decomposição, realizadas aos 10, 20, 30, 60, 90 e 120 dias após o corte das plantas. A massa do milheto ENA 2 apresentou menor velocidade de decomposição, com t½ (tempo de meia-vida) =112 dias, sendo maior que a do BRS 1501 (98 dias) e do sorgo (96 dias). Houve rápida liberação de N pelo sorgo, enquanto nas cultivares de milheto a liberação foi gradativa, sendo o K e o Mg os nutrientes liberados mais rapidamente em todas as plantas de cobertura utilizadas. Os resultados indicam que a cultivar de milheto ENA 2 apresenta maior t½ para matéria seca, sendo mais favorável para uso em áreas de clima tropical, como planta de cobertura e recicladora de nutrientes, com liberação gradativa de N, P e Ca para o solo.

Audit report on the Shelby County Area Solid Waste Agency for the year ended June 30, 2011

Audit report on the Shelby County Area Solid Waste Agency for the year ended June 30, 2011

Audit report on the Rathbun Area Solid Waste Commission for the year ended June 30, 2011

Audit report on the Rathbun Area Solid Waste Commission for the year ended June 30, 2011

Industrial-economic survey of Clinton, Iowa, and the surrounding area,1960.

This is an "Industrial-Economic Survey" of Clinton, Iowa and the surrounding area that was compiled and assembled for the use of any manufacturing of commercial organization which has in interest in setting up operations in the general Clinton area. Facts and statistics are shown to use for location analysis. Numerous photos and maps are included.

Runoff and sediment transport in a degraded area

Gully erosion occurs by the combined action of splash, sheetwash and rill-wash (interrill and rill erosion). These erosion processes have a great capacity for both sediment production and sediment transport. The objectives of this experiment were to evaluate hydrological and sediment transport in a degraded area, severely dissected by gullies; to assess the hydraulic flow characteristics and their aggregate transport capacity; and to measure the initial splash erosion rate. In the study area in Guarapuava, State of Paraná, Brazil (lat 25º 24' S; long 51º24' W; 1034 m asl), the soil was classified as Cambissolo Húmico alumínico, with the following particle-size composition: sand 0.116 kg kg-1; silt 0.180 kg kg-1; and clay 0.704 kg kg-1. The approach of this research was based on microcatchments formed in the ground, to study the hydrological response and sediment transport. A total of eight rill systems were simulated with dry and wet soil. An average rainfall of 33.7 ± 4.0 mm was produced for 35 to 54 min by a rainfall simulator. The equipment was installed, and a trough was placed at the end of the rill to collect sediments and water. During the simulation, the following variables were measured: time to runoff, time to ponding, time of recession, flow velocity, depth, ratio of the initial splash and grain size. The rainsplash of dry topsoil was more than twice as high as under moist conditions (5 g m-2 min-1 and 2 g m-2 min-1, respectively). The characteristics of the flow hydraulics indicate transition from laminar to turbulent flow [Re (Reynolds number) 1000-2000]. In addition, it was observed that a flow velocity of 0.12 m s-1 was the threshold for turbulent flow (Re > 2000), especially at the end of the rainfall simulation. The rill flow tended to be subcritical [Fr (Froude Number) < 1.0]. The variation in hydrological attributes (infiltration and runoff) was lower, while the sediment yield was variable. The erosion in the rill systems was characterized as limited transport, although the degraded area generated an average of 394 g m-2 of sediment in each simulation.