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Central nervous system (CNS) infections are not uncommon in the neurocritical care unit (NCCU). This chapter reviews the most common causes of CNS infections and discusses the diagnosis and management of these life-threatening illnesses.
Children exposed to trauma are predisposed to develop a number of mental health syndromes. They are prone to under-treatment with effective psychosocial interventions and over-treatment with high-risk psychotropic medications, especially polypharmacy and the use of antipsychotics for unapproved conditions. We review the evidence for psychosocial and pharmacological treatments for mental health problems associated with high exposure to childhood trauma – identifying those in foster care as an index group – and the frequency of high-risk pharmacological practices. We describe current efforts to reduce over-treatment of children with high-risk psychotropic medications and propose further recommendations to protect and provide effective care for these vulnerable children.
A robust biomedical informatics infrastructure is essential for academic health centers engaged in translational research. There are no templates for what such an infrastructure encompasses or how it is funded. An informatics workgroup within the Clinical and Translational Science Awards network conducted an analysis to identify the scope, governance, and funding of this infrastructure. After we identified the essential components of an informatics infrastructure, we surveyed informatics leaders at network institutions about the governance and sustainability of the different components. Results from 42 survey respondents showed significant variations in governance and sustainability; however, some trends also emerged. Core informatics components such as electronic data capture systems, electronic health records data repositories, and related tools had mixed models of funding including, fee-for-service, extramural grants, and institutional support. Several key components such as regulatory systems (e.g., electronic Institutional Review Board [IRB] systems, grants, and contracts), security systems, data warehouses, and clinical trials management systems were overwhelmingly supported as institutional infrastructure. The findings highlighted in this report are worth noting for academic health centers and funding agencies involved in planning current and future informatics infrastructure, which provides the foundation for a robust, data-driven clinical and translational research program.
Streptococcus pyogenes (or Group A Streptococcus, GAS) is a Gram-positive human pathogen responsible for a diverse array of superficial, invasive and immune-related diseases. GAS infections have historically been diseases of poverty and overcrowding, and remain a significant problem in the developing world and in disadvantaged populations within developed countries. With improved living conditions and access to antibiotics, the rates of GAS diseases in developed societies have gradually declined during the 20th century. However, genetic changes in circulating GAS strains and/or changes in host susceptibility to infection can lead to dramatic increases in the rates of specific diseases. No situations exemplify this more than the global upsurge of invasive GAS disease that originated in the 1980s and the regional increases in scarlet fever in north-east Asia and the UK. In each case, increased disease rates have been associated with the emergence of new GAS strains with increased disease-causing capability. Global surveillance for new GAS strains with increased virulence is important and determining why certain populations suddenly become susceptible to circulating strains remains a research priority. Here, we overview the changing epidemiology of GAS infections and the genetic alterations that accompany the emergence of GAS strains with increased capacity to cause disease.
Shigellosis causes significant morbidity and mortality in developing and developed countries, mostly among infants and young children. The World Health Organization estimates that more than one million people die from Shigellosis every year. In order to evaluate trends in Shigellosis in Israel in the years 2002–2015, we analysed national notifiable disease reporting data. Shigella sonnei was the most commonly identified Shigella species in Israel. Hospitalisation rates due to Shigella flexenri were higher in comparison with other Shigella species. Shigella morbidity was higher among infants and young children (age 0–5 years old). Incidence of Shigella species differed among various ethnic groups, with significantly high rates of S. flexenri among Muslims, in comparison with Jews, Druze and Christians. In order to improve the current Shigellosis clinical diagnosis, we developed machine learning algorithms to predict the Shigella species and whether a patient will be hospitalised or not, based on available demographic and clinical data. The algorithms’ performances yielded an accuracy of 93.2% (Shigella species) and 94.9% (hospitalisation) and may consequently improve the diagnosis and treatment of the disease.
SnO2 doped with Sb and Nb has been investigated for its use as catalyst support materials replacing carbon to enhance PEM fuel cells stability. Nanostructured powders of various doping levels were prepared by flame spray pyrolysis (FSP). The specific requirements of surface area >50 m2g-1 and electronic conductivity >0.01 Scm-1 were obtained, and pore sizes ranging mainly from 10 to 100 nm. Pt particles (9-20 wt.% in loading targeted) of ∼1 nm well dispersed in Sb-doped SnO2 was prepared by a one-step FSP procedure providing microstructures of high interest for further investigations as cathode in PEM fuel cells.
Two Δ14C calibration curves have been produced that allow determination of the statistical average age of coca leaf and cocaine base specimens produced for the time period 1979–2009. These calibration curves are based on field collections of specimens in Bolivia, Colombia, Ecuador, and Peru. The coca leaf F14C and Δ14C calibration curves can be used to predict the ages of botanical tissues collected in tropical South America and possibly extended to other tropical locations. The cocaine F14C and Δ14C calibration curves can be used to predict the ages of seized cocaine specimens. Because the Δ14C of the atmosphere is diminishing, the precision of this approach for age determinations will continue to get less precise over time as atmospheric 14C content continues to decline.
Sir Leonard Woolley found last year at Al Mina in the surface soil an interesting cylinder seal. It is published, but without comment, in J.H.S. 1938, pl. xv. It is now in the British Museum, numbered 126064 (Plate I, 2).
It is of whitish chalcedony, 1½ inches high. The design, which is marred by a chip in the middle, falls into three parts and represents a scene of worship. In the left of the impression is a large figure of a worshipper; in the centre, a kneeling man upholding a winged deity; and on the right, a shrine before which the other two actions are imagined happening. Above are various divine symbols.
Flame spray pyrolysis (FSP) was applied to produce nanopowders of Ti1-xMxO2 and Sn1-xMxO2, where x = 0.05 and M = Nb/Sb, for use as catalyst support materials in PEM fuel cells/ electrolysers. FSP powders in the SnO2-IrO2 system were produced for the same applications. Homogenous particle size distribution (5-20 nm) was demonstrated by TEM, supported by BET and XRD analysis. Whereas two polymorphs were indicated for the Ti-based oxides, the Sb/Nb-doped SnO2 powders were single phase. FSP powders of Mn3O4 intended for supercapacitors were produced and the influence of the precursor/solvent mixtures on the physical and electrochemical properties evaluated.
In 1946 Professor Helmuth Bossert, a distinguished scholar who had already made several remarkable contributions to Anatolian studies and had taken an outstanding part in the decipherment of the Hittite hieroglyphs, in collaboration with an able Turkish colleague, Dr. Bahadir Alkim, published the first account of their discovery of fragments of Old Semitic inscriptions at Karatepe (Aslantaş), in Cilicia. The site is marked by the remains of a small walled enclosure at the top of a hill in the most inaccessible recesses of the Upper Ceyhan River, on its West bank. Opposite Karatepe on the East bank of the river on a hill called Domuztepe, they found remains of a little township, evidently of the late Hittite period. But to return to Karatepe, about which the discoverers furnish further welcome information in their second report; it appears that inside the walled enclosure, there was a series of carved basalt slabs facing East, and forming either the façade of a small temple-palace such as was discovered at Tell Halaf or Sakca-gözü, or the decoration of a gateway, as at Zincirli or Carchemish. Near by, to the South, was a broken gateway-lion, inscribed.
In Vol. XII (1950) of Iraq I published as much as was then available of the results of Rassam and Clayton's excavations at Toprak Kale. I also summarily described the material from the excavations of Lehmann-Haupt and others at the same site. Since then, some items missing in 1950 have come to light in the British Museum, while others not then fit for publication have been cleaned and repaired. In addition, I have now obtained access to Russian publications, with which I was then unacquainted, dealing with the subject.