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With the aim to elucidate gonococcal antimicrobial resistance (AMR)–risk factors, we undertook a retrospective analysis of the molecular epidemiology and AMR of 104 Neisseria gonorrhoeae isolates from clinical samples (urethra, rectum, pharynx and cervix) of 94 individuals attending a sexually transmitted infection clinic in Madrid (Spain) from July to October 2016, and explored potential links with socio-demographic, behavioural and clinical factors of patients. Antimicrobial susceptibility was determined by E-tests, and isolates were characterised by N. gonorrhoeae multi-antigen sequence typing. Penicillin resistance was recorded for 15.4% of isolates, and most were susceptible to tetracycline, cefixime and azithromycin; a high incidence of ciprofloxacin resistance (~40%) was found. Isolates were grouped into 51 different sequence types (STs) and 10 genogroups (G), with G2400, ST5441, ST2318, ST12547 and G2992 being the most prevalent. A significant association (P = 0.015) was evident between HIV-positive MSM individuals and having a ciprofloxacin-resistant strain. Likewise, a strong association (P = 0.047) was found between patient age of MSM and carriage of isolates expressing decreased susceptibility to azithromycin. A decrease in the incidence of AMR gonococcal strains and a change in the strain populations previously reported from other parts of Spain were observed. Of note, the prevalent multi-drug resistant genogroup G1407 was represented by only three strains in our study, while the pan-susceptible clones such as ST5441, and ST2318, associated with extragenital body sites were the most prevalent.
To explore whether higher degrees of electrophysiological abnormalities are associated with a more frequent exposure to a more aggressive treatment regimen, we performed a retrospective chart review of patients attending the neuromuscular clinic from June 2012 to December 2015 and included 87 patients. We compared treatment regimens during the follow-up period between patients with high and low jitter and decrement. Myasthenia gravis patients with high jitter or decrement at baseline were more frequently treated with intravenous immunoglobulins (IVIG) and/or plasma exchange (PLEX) during the follow-up period. In patients with mild disease, IVIG or PLEX treatment was associated with high decrement.
There is a long history of exploitation of the South American river turtle Podocnemis expansa. Conservation efforts for this species started in the 1960s but best practices were not established, and population trends and the number of nesting females protected remained unknown. In 2014 we formed a working group to discuss conservation strategies and to compile population data across the species’ range. We analysed the spatial pattern of its abundance in relation to human and natural factors using multiple regression analyses. We found that > 85 conservation programmes are protecting 147,000 nesting females, primarily in Brazil. The top six sites harbour > 100,000 females and should be prioritized for conservation action. Abundance declines with latitude and we found no evidence of human pressure on current turtle abundance patterns. It is presently not possible to estimate the global population trend because the species is not monitored continuously across the Amazon basin. The number of females is increasing at some localities and decreasing at others. However, the current size of the protected population is well below the historical population size estimated from past levels of human consumption, which demonstrates the need for concerted global conservation action. The data and management recommendations compiled here provide the basis for a regional monitoring programme among South American countries.
The generosity of maternity pay has been shown to be an important factor for mothers’ attachment to the labour market. In the UK, we can observe that the generosity of maternity leaves across universities varies greatly: some universities top up the statutory maternity pay with longer and better paid leaves, others are either less generous or only entitle academic women to the legal minimum. We want to understand why this is the case. Therefore, this article examines both theoretically and empirically how higher education employers decide about the generosity of the offered occupational maternity pay. We use a bargaining approach to model the supply and demand side of generous maternity benefits in universities with different characteristics and test the implications with a generalised negative binomial model. We find that universities’ income does not account for this variation while differences in terms of costs and benefits for employers do. Most importantly, our results show that more research intense universities with a higher previous share of female professors provide more generous maternity pay. We offer a range of explanations for these findings.
Immigration federalism scholarship has established that state and local government policies can make federally defined immigration status more or less consequential. Drawing primarily on focus groups and interviews with 184 undocumented students attending the University of California, we suggest that institutional policies work alongside state and local efforts to mediate the consequences of illegality for undocumented students. We find that the Deferred Action for Childhood Arrivals program, state-funded financial aid policies, and university support programs all facilitate the integration of undocumented students by increasing access to higher education and enabling fuller participation. Although federal policies contribute to persistent barriers to academic engagement and professional development, we show that universities can intervene to improve educational experiences and opportunities. Ultimately, we argue that university policies are a key site for intervening in immigration policy and constructing immigrant illegality.
Background: High levels of uric acid (UA) are associated with various peripheral neuropathies. Furthermore, uric acid levels have been found to correlate with both the clinical and electrophysiological severity of diabetic sensorimotor polyneuropathy, mainly with sensory functions. Objectives: To determine whether higher UA levels are associated negatively with nerve function in healthy subjects. Methods: A total of 126 healthy subjects recruited prospectively for another study were included. We extracted demographic data, body mass index (BMI), blood pressure, Toronto Clinical Neuropathy Score (TCNS), electrophysiological findings, vibration perception thresholds (VPT), and laboratory test results including UA, hemoglobin A1c (HbA1c), estimated glomerular filtration rate (eGFR), and lipid levels. Results: The mean age of the cohort was 56 ± 17 years with 56% females. Males had higher UA values compared with females. Univariate beta regression coefficient analysis between UA levels and demographic, clinical, electrophysiological, and laboratory findings showed significant positive correlations with male gender, components of the metabolic syndrome, and with VPT, while an inverse correlation was found with electrophysiological sensory parameters. A multivariate regression model showed positive correlations only with BMI, finger VPT, and triglycerides. Conclusion: Higher UA levels correlate with lower sensory nerve function in healthy subjects, expanding the evidence of possible negative influence of UA on peripheral nerves, although a causative role has not yet established.
The fixed-effects estimator is biased in the presence of dynamic misspecification and omitted within variation correlated with one of the regressors. We argue and demonstrate that fixed-effects estimates can amplify the bias from dynamic misspecification and that with omitted time-invariant variables and dynamic misspecifications, the fixed-effects estimator can be more biased than the ‘naïve’ OLS model. We also demonstrate that the Hausman test does not reliably identify the least biased estimator when time-invariant and time-varying omitted variables or dynamic misspecifications exist. Accordingly, empirical researchers are ill-advised to rely on the Hausman test for model selection or use the fixed-effects model as default unless they can convincingly justify the assumption of correctly specified dynamics. Our findings caution applied researchers to not overlook the potential drawbacks of relying on the fixed-effects estimator as a default. The results presented here also call upon methodologists to study the properties of estimators in the presence of multiple model misspecifications. Our results suggest that scholars ought to devote much more attention to modeling dynamics appropriately instead of relying on a default solution before they control for potentially omitted variables with constant effects using a fixed-effects specification.
Lumbar puncture (LP) performed with the assistance of ultrasound (US) may improve success rate, with fewer puncture attempts and less pain.
To explore the utility of US-assisted LP in a neuromuscular clinic.
We performed a prospective, randomized, open-label study between May 2016 and January 2017. The primary outcome measure was LP success rate, and the secondary outcome measures included procedure time, number of attempts, and the levels of pain, anxiety, and satisfaction.
Lumbar puncture was performed in 40 consecutive patients. Ultrasound-assisted LP had a 100% success rate, compared with 85% (95% confidence interval: 58%-96%) without US assistance, although this difference failed to reach statistical significance. Ultrasound-assisted LP was associated with less pain and, also in patients >60 years of age, with fewer needle insertions. Both groups reported high satisfaction rates, regardless of the use of US.
Ultrasound-assisted LP has a high success rate and less pain than unassisted LP, and can be accomplished easily in the outpatient neuromuscular clinic setting equipped with US.
To study the frequency of laboratory test abnormalities, and electrophysiological correlations, we performed a retrospective chart review of 226 patients with polyneuropathy. The frequency of laboratory test abnormalities, and correlations with electrophysiological findings were explored. Abnormal glucose handling tests were the most common findings (54%), followed by paraproteinemia (21%) and anemia (21%). The frequencies of paraproteinemia and anemia in our cohort were significantly higher than previously reported. In addition, several laboratory abnormalities correlated with electrophysiological findings of median neuropathy at the wrist, expanding current knowledge about the deleterious effects of various metabolic and hematologic derangements at this site.
Radiation environment of near-Earth space is one of the most important factors of space weather. Space Monitoring Data Center of Moscow State University provides operational monitor and forecast of radiation conditions both at Geostationary Orbits (GEO) and at Low Earths Orbits (LEO) of the near-Earth space using data of recent space missions (Vernov, CORONAS series) and current (Lomonosov, Meteor-M, Electro-L) ones. Internet portal of Space Monitoring Data Center of Skobeltsyn Institute of Nuclear Physics of Lomonosov Moscow State University (SINP MSU - [swx.sinp.msu.ru]) provides possibilities to monitor and analyze the space radiation conditions in the real time mode together with the geomagnetic and solar activity including hard X-ray and gamma-emission of solar flares.
It has long been contentious as to whether the presence of bilateral infundibulums, or conuses, is a prerequisite for the diagnosis of double-outlet right ventricle. As the use of such a criterion would abrogate the so-called “morphological method”, which correctly states that one variable entity should not be defined on the basis of another entity that is itself variable, it is now accepted that double outlet can exist in the setting of fibrous continuity between the leaflets of the atrioventricular and arterial valves. Although this debate has now been resolved, there are other contentious areas still requiring clarification in the setting of hearts unified because of the presence of this particular ventriculo-arterial connection – for example, it is questionable whether the channel between the ventricles should be described as a “ventricular septal defect”, whereas it is equally arguable that the mere presence of fibrous continuity between the leaflets of the arterial valves does not necessarily place the channel in a doubly committed location. In this review, we describe a series of autopsied hearts in which the anatomical features serve to illuminate these various topics. We then discuss recent findings regarding cardiac development that point to the individuality of the building blocks of the ventricular outflow tracts, specifically the outlet septum, the inner heart curvature, or ventriculo-infundibular fold, and the septomarginal trabeculation, or septal band.
The aim of this study was to evaluate the oxidative stress in serum and liver and adenosine deaminase (ADA) activity of cattle experimentally infected by Fasciola hepatica. The group A consisted of five healthy animals (uninfected), and the group B was composed of five animals orally infected with 200 metacercariae of F. hepatica. On days 20, 40, 60 and 80 post-infection (PI) serum was collected to measure oxidative stress variables. On day 100 PI, animals were humanely euthanized and liver samples were collected. Infected animals showed lower (P < 0·05) seric ADA activities on days 40 and 60 PI but higher (P < 0·05) in the liver tissue compared with uninfected animals. Seric and hepatic reactive oxygen species (ROS) were higher (P < 0·05) in infected compared with uninfected animals. Hepatic thiobarbituric acid reactive substances were higher (P < 0·05) in infected animals. Catalase and glutathione S-transferase activities were lower in liver tissue of infected animals, while glutathione peroxidase was higher compared with uninfected (P < 0·05). In summary, we conclude that oxidative stress occurs in cattle experimentally infected by F. hepatica, mainly due to excessive ROS production in the course of fasciolosis, contributing to hepatic damage, and that increased in hepatic ADA activity may contribute to the inflammatory process.