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Objective: The study explores caregiver perceptions of home programs for clients with acquired brain injury based on current clinical care after transition to the community. Design: A qualitative descriptive study. Setting: Within the community, post inpatient rehabilitation. Participants: A convenience sample of eight caregivers of clients with acquired brain injury from one clinical site. All participants spoke English, were between the ages of 18 and 85 years, had no neurodegenerative disorders, and self-identified as caregivers. Procedures: Two nested semi-structured interviews were completed post-discharge from an inpatient rehabilitation facility. All interviews were audio recorded and transcribed. Qualitative data analysis was performed utilizing MAXQDA© software, consensus coding, and abstraction of themes. Results: Two themes with subsequent subthemes were identified: (1) Systems, Roles, and Responsibilities Influenced Caregivers' Perceptions of Home Program and Recovery Outlook and (2) Caregivers' Home Program Experience. The first theme addresses topics of caregiver roles and responsibilities, system supports and barriers, and their general outlook on recovery. Within the second theme, results provide a chronological description of home program training, use, and modification. Conclusions: A caregiver's outlook on the care receiver's recovery and home program implementation is influenced by the burden of responsibilities, and system-level supports and barriers. The home program experience of the caregivers was reported to involve limited but satisfactory training. Caregivers saw the value in home programs and advised others to engage in them. Future programs should encourage healthcare providers to provide explicit instruction to the caregiver about their intrinsic value to home program implementation and adherence. [ABSTRACT FROM AUTHOR]

Three fragments of a basalt door were retrieved from the excavation at Naṣr ed-Din, which belong to a large group of about 25 stone doors discovered in the city of Tiberias. Such doors are known to have originated in burial contexts, their facades usually adorned in a manner that resembled wooden doors of residences. The door from Bet Ma'on is the first to be found outside Tiberias, and it probably belonged to a contemporary mausoleum mentioned in the Talmud. [ABSTRACT FROM AUTHOR]

Background/objective: The use of natalizumab (NAT) in multiple sclerosis (MS) may be complicated by progressive multifocal leukoencephalopathy (PML), a rare and life-threatening opportunistic brain infection. We aimed to analyze the course of MS after PML recovery together with the long-term outcome of NAT-associated PML (NAT-PML) in Austria. Methods: Retrospective study based on identification of cases in the nationwide Austrian MS treatment registry (AMSTR) and MS centers with review of patient records. The expanded disability status scale (EDSS) was used to measure neurological disability and outcome. Results: As of December 2022, we identified 15 NAT-PML cases in Austria; only 20% occurred after 2016, when increased vigilance commenced. Two patients did not survive acute PML, and an additional patient died five years later, yielding a mortality rate of 20%. Seizures occurred exclusively in patients with pronounced EDSS increase. Gadolinium (Gd)-enhancement on brain magnetic resonance imaging (MRI) on PML suspicion was associated with minor changes of post-PML neurological disability. Long-term follow-up of up to 132 months (median 76 months) was available in 11/15. The overall median EDSS increased from 3.5 at pre-PML to 6.5 at the last assessment. Regarding inflammatory MS-related disease activity during the observation period, one single individual experienced an MS relapse and another patient had two Gd-enhancing brain lesions. Three patients converted to progressive MS within three years from PML and the EDSS further increased in 6/11. Conclusions: The number of NAT-PML cases is decreasing over time. While many patients accumulated severe persistent neurological deficits compared to pre-PML, inflammatory MS-related disease activity after PML recovery was rare. [ABSTRACT FROM AUTHOR]

Background/Aims: Parkinson Wellness Recovery Moves is a functional, large-amplitude exercise programme aimed at reducing the symptoms of Parkinson's disease. To date, evidence supports the use of amplitude training to reduce the symptoms of Parkinson's disease; however, evidence is lacking in the feasibility of using Parkinson Wellness Recovery Moves as an adjunct to occupational therapy within inpatient rehabilitation. The aim of this study was to evaluate the feasibility of implementing the Parkinson Wellness Recovery Moves intervention into the treatment of patients with Parkinson's disease, within an inpatient rehabilitation hospital. Methods: A total of five adults with Parkinson's disease participated in this 11-week quasi-experimental feasibility trial. The use of Parkinson Wellness Recovery Moves was standardised, requiring each participant to engage in at least two occupational therapy sessions that included Parkinson Wellness Recovery Moves. Outcomes collected included fidelity of intervention implementation, and participant-centred outcomes of quality of life satisfaction and function via the Parkinson's Disease Questionnaire-39 and Section GG respectively. Results: Each participant had a positive change in Section GG scores and completed between eight and 13 occupational therapy sessions that included Parkinson Wellness Recovery Moves. Four out of five participants reported higher quality of life at the time of discharge. Conclusions: The use of Parkinson Wellness Recovery Moves was found to be feasible to implement within an inpatient rehabilitation hospital, with increased functional performance and improved quality of life. [ABSTRACT FROM AUTHOR]

More than 100 previously undocumented Hebrew epitaphs (many of them fragmentary) dating from the fifteenth to the seventeenth century were uncovered in the ancient Jewish cemetery of Ẓefat (Safed) through the initiative of the Safed Religious Council. This is by far the largest corpus of ancient Hebrew inscriptions found in one site in Israel. Information gleaned from the engraved names of the deceased attests to a diverse and vibrant Jewish community that existed in the city during these centuries, according with accounts in other historical sources. The study of the epitaphs enriches our knowledge concerning, for example, the existence of certified physicians in Ẓefat and the presence of an unrecorded yeshiva (Talmudic Academy). Interestingly, most of the deceased were honored by the addition of formal titles, such as 'Rabbi,' for men, and 'Dona,' for women. This study describes in detail 28 of the most complete and legible epitaphs, attesting to a wide range of local and foreign Jewish ethnicities. [ABSTRACT FROM AUTHOR]

Aim: Increasing evidence points to the value of coordinated specialty care (CSC) for early intervention in psychotic disorders. This report characterizes clinical and socio‐demographic features of patients at CSC programs in Massachusetts (MA), assessed by a standardized battery incorporated into "real‐world" clinical care. Methods: The MA psychosis network for early treatment developed a pilot battery to coordinate assessments across six CSC clinics. Programs reported baseline, 6‐month, and 12‐month data from a sample of 287 patients with intake dates ranging from April 2015 to December 2020. Results: Patients showed improvements in functioning, emergency service use and several symptom domains at 6 and 12 months. Missing data proved to be a limitation. Conclusions: Patients improved on several meaningful domains within the first year of CSC treatment. Future implementation efforts in cross‐program data collection should consider strategies to circumvent limitations related to heterogeneity between clinics, patient discharge and clinics' capacity for data collection. [ABSTRACT FROM AUTHOR]

Background/aims: Evidence-based inpatient caregiver training may ensure that caregiver needs are met and hospital readmission costs reduced. The aim of this study was to evaluate the feasibility of implementing a caregiver education model, Caring for Our Caregivers, within an inpatient brain injury programme. Methods: A total of 32 adults were admitted to inpatient neurorehabilitation during the 7-week feasibility trial. The three-step Caring for Our Caregivers programme included evidence-based recommendations following a caregiver needs assessment, goal setting and hands-on training. Satisfaction levels and caregiver preparedness were assessed via a survey. Results: The caregiver needs assessment and goal collaboration was completed within 5 days 66% of the time. Results indicated an even distribution of hands-on (47%) and discussion-based (53%) education. Caregivers and staff identified high levels of satisfaction with the programme. Conclusions: Early engagement, collaborative goals and hands-on training of the family caregiver of a client with acquired brain injury during inpatient rehabilitation demonstrated initial feasibility with positive implications for caregiver satisfaction and community discharge. [ABSTRACT FROM AUTHOR]

This article presents an evidence-based strategy to assist academic fieldwork coordinators and capstone coordinators with meeting the Accreditation Council for Occupational Therapy Education standards of experiential learning components in an entry-level doctoral occupational therapy curriculum. The S.E.L.F. approach core methods for pedagogical framework and manual development are based on systems theory and educational learning theories. To optimize fieldwork and capstone delivery, the recommended process should include organizational analysis, program development, manual writing, and implementation of practical learning experience. Objectives of the fieldwork and capstone experiences can effectively connect to the overall curriculum design while addressing integral credentialing standards through an evidence-based approach. The applied learning theories are pertinent for educators to objectively deliver beneficial experiential pedagogical outcomes for student professional growth. This article provides a logical fieldwork and capstone framework for pedagogical and manual development. The S.E.L.F. approach transforms learning to meet objectives of the occupational therapy program, students, and other potential audience stakeholders. [ABSTRACT FROM AUTHOR]

The article offers information on the history of Iron age, Hellenistic, Roman–Byzantine and early Islamic periods in Rosh Pinna (Ja‘una). It mentions the ancient site of Rosh Pinna situated on a limestone spur, that inclines toward the southeast above springs located in the seasonal streambed of Nahal Rosh Pinna to its west and also mentions an ancient structure in the lower, eastern part of the village, which identified as a bathhouse carved in bedrock in 1889.

Copyright of Somnologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Timely characterization of a cancer's evolution is required to predict treatment efficacy and to detect resistance early. High content analysis of single Circulating Tumor Cells (CTCs) enables sequential characterization of genotypic, morphometric and protein expression alterations in real time over the course of cancer treatment. This concept was investigated in a patient with castrate-resistant prostate cancer progressing through both chemotherapy and targeted therapy. In this case study, we integrate across four timepoints 41 genome-wide copy number variation (CNV) profiles plus morphometric parameters and androgen receptor (AR) protein levels. Remarkably, little change was observed in response to standard chemotherapy, evidenced by the fact that a unique clone (A), exhibiting highly rearranged CNV profiles and AR+ phenotype was found circulating before and after treatment. However, clinical response and subsequent progression after targeted therapy was associated with the drastic depletion of clone A, followed by the sequential emergence of two distinct CTC sub-populations that differed in both AR genotype and expression phenotype. While AR- cells with flat or pseudo-diploid CNV profiles (clone B) were identified at the time of response, a new tumor lineage of AR+ cells (clone C) with CNV altered profiles was detected during relapse. We showed that clone C, despite phylogenetically related to clone A, possessed a unique set of somatic CNV alterations, including MYC amplification, an event linked to hormone escape. Interesting, we showed that both clones acquired AR gene amplification by deploying different evolutionary paths. Overall, these data demonstrate the timeframe of tumor evolution in response to therapy and provide a framework for the multi-scale analysis of fluid biopsies to quantify and monitor disease evolution in individual patients. [ABSTRACT FROM AUTHOR]

Genomic analysis provides insights into the role of copy number variation in disease, but most methods are not designed to resolve mixed populations of cells. In tumours, where genetic heterogeneity is common, very important information may be lost that would be useful for reconstructing evolutionary history. Here we show that with flow-sorted nuclei, whole genome amplification and next generation sequencing we can accurately quantify genomic copy number within an individual nucleus. We apply single-nucleus sequencing to investigate tumour population structure and evolution in two human breast cancer cases. Analysis of 100 single cells from a polygenomic tumour revealed three distinct clonal subpopulations that probably represent sequential clonal expansions. Additional analysis of 100 single cells from a monogenomic primary tumour and its liver metastasis indicated that a single clonal expansion formed the primary tumour and seeded the metastasis. In both primary tumours, we also identified an unexpectedly abundant subpopulation of genetically diverse 'pseudodiploid' cells that do not travel to the metastatic site. In contrast to gradual models of tumour progression, our data indicate that tumours grow by punctuated clonal expansions with few persistent intermediates. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was 2-fold: (1) to explore the transfer of responsibility of medical tasks from parent to child during the transition to adolescence, and (2) to examine the associations between family functioning and medical adherence in youth with spina bifida. Methods Seventy families of children with spina bifida participated in this study. Data were collected during family interaction sessions by using questionnaires completed by mothers, fathers, youth, teachers and health professionals. Results Findings suggest that responsibility for medical regimens transfers gradually from parent to child over time. Additionally, family conflict and cohesion were correlated with medical adherence. Finally, family conflict over medical issues was related to a decrease in medical adherence over time. Conclusions Results suggest that as youth take more responsibility over their medical regimens, family conflict regarding medical issues becomes a contributor to their adherence behaviors. Interventions that target family conflict may facilitate adherence behaviors. [ABSTRACT FROM PUBLISHER]

The biosynthesis of histidine (His) in microorganisms, long studied through the isolation and characterization of auxotrophic mutants, has emerged as a paradigm for the regulation of metabolism and gene expression. Much less is known about His biosynthesis in flowering plants. One limiting factor has been the absence of large collections of informative auxotrophs. We describe here the results of a systematic screen for His auxotrophs of Arabidopsis (Arabidopsis thaliana). Ten insertion mutants disrupted in four different biosynthetic genes (HISN2, HISN3, HISN4, HISN6A) were identified through a combination of forward and reverse genetics and were shown to exhibit an embryo-defective phenotype that could be rescued by watering heterozygous plants with His. Male transmission of the mutant allele was in several cases reduced. Knockouts of two re- dundant genes (HISN1B and HISN5A) had no visible phenotype. Another mutant blocked in the final step of His biosynthesis (hisn8) and a double mutant altered in the redundant first step of the pathway (hisn1a hisn1b) exhibited a combination of gametophytic and embryonic lethality in heterozygotes. Homozygous mutant seedlings and callus tissue produced from rescued seeds appeared normal when grown in the presence of His but typically senesced after continued growth in the absence of His. These knockout mutants document the importance of His biosynthesis for plant growth and development, provide valuable insights into amino acid transport and source-sink relationships during seed development, and represent a significant addition to the limited collection of well-characterized auxotrophs in flowering plants. [ABSTRACT FROM AUTHOR]

The study of histidine metabolism has never been at the forefront of interest in plant systems despite the significant role that the analysis of this pathway has played in development of the field of molecular genetics in microbes. With the advent of methods to analyze plant gene function by complementation of microbial auxotrophic mutants and the complete analysis of plant genome sequences, strides have been made in deciphering the histidine pathway in plants. The studies point to a complex evolutionary origin of genes for histidine biosynthesis. Gene regulation studies have indicated novel regulatory networks involving histidine. In addition, physiological studies have indicated novel functions for histidine in plants as chelators and transporters of metal ions. Recent investigations have revealed intriguing connections of histidine in plant reproduction. The exciting new information suggests that the study of plant histidine biosynthesis has finally begun to flower. [ABSTRACT FROM AUTHOR]

Lysine is a nutritionally important essential amino acid, whose synthesis in plants is strongly regulated by the rate of its synthesis. Yet, lysine level in plants is also finely controlled by a super-regulated catabolic pathway that catabolizes lysine into glutamate and acetyl Co-A. The first two enzymes of lysine catabolism are synthesized from a single LKR/SDH gene. Expression of this gene is subject to compound developmental, hormonal and stress-associated regulation. Moreover, the LKR/SDH gene of different plant species encodes up to three distinct polypeptides: (i) a bifunctional enzyme containing the linked lysine-ketoglutarate (LKR) and saccharopine dehydrogenase (SDH) whose LKR activity is regulated by its linked SDH enzyme; (ii) a monofunctional SDH encoded by an internal promoter, which is a part of the coding DNA region of the LKR/SDH gene; and (iii) a monofunctional, highly potent LKR that is formed by polyadenylation within an intron. LKR activity in the bifunctional LKR/SDH polypeptide is also post-translationally regulated by phosphorylation by casein kinase-2 (CK2), but the consequence of this regulation is still unknown. Why is lysine metabolism super-regulated by synthesis and catabolism? A hypothesis addressing this important question is presented, suggesting that lysine may serve as a regulator of plant growth and interaction with the environment. [ABSTRACT FROM AUTHOR]

PURPOSE: The surgical management of complex perianal fistulas is challenging and may be associated with the risk of sphincter injury. Instillation of fibrin glue to the fistula tract is a simple procedure that does not involve any muscle division, and potentially results in healing of the fistula. This study was designed to assess the use of highly concentrated fibrin glue with intra-adhesive antibiotics in the treatment of complex cryptogenic perianal fistulas. METHODS: Patients with complex perianal fistulas of cryptogenic origin were prospectively included in this multicenter study. Injection of the fibrin glue mixed with antibiotics was performed in a uniform fashion. After the procedure, patients were actively examined at fixed time intervals; in cases of recurrent fistula, reinjection of fibrin glue was offered. RESULTS: Sixty patients were enrolled; complete healing of the fistula was achieved in 32 patients (53 percent). Eight of 28 patients (29 percent) who were not completely healed had significant symptomatic improvement. All patients resumed normal daily activity the day after surgery and none had any deterioration in continence related to the procedure. The majority of the 26 (43 percent) adverse events were considered mild and spontaneously resolved; 2 patients (3 percent) with perianal septic complications were successfully treated by drainage. CONCLUSIONS: Injection of fibrin glue for the treatment of perianal fistulas is safe, simple, and associated with early return to normal activity. Although moderately successful, it may preclude extensive surgery in more than one-half of these patients. [ABSTRACT FROM AUTHOR]

Lysine catabolism in plants is initiated by a bifunctional LKR/SDH (lysine-ketoglutarate reductase/saccharopine dehydrogenase) enzyme encoded by a single LKR/SDH gene. Yet, the AtLKR/SDH gene of Arabidopsis also encodes a second gene product, namely a monofunctional SDH. To elucidate the regulation of lysine catabolism in Arabidopsis through these two gene products of the AtLKR/SDH gene, an analysis was carried out on the effects of the hormones, abscisic acid and jasmonate, as well as various metabolic and stress signals, including lysine itself, on their mRNA and protein levels. The response of the two gene products to the various treatments was only partially co-ordinated, but the levels of the monofunctional SDH mRNA and protein were always in excess over their bifunctional LKR/SDH counterparts. These results suggest that lysine catabolism is regulated primarily by the first enzyme LKR, while the excess level of SDH enables efficient flux of lysine catabolism following the LKR step. Analysis of transgenic plants expressing β-glucoronidase fusion constructs with the AtLKR/SDH and monofunctional AtSDH promoters demonstrated that transcriptional regulation contributes to the modulation of expression of the bifunctional LKR/SDH and monofunctional SDH gene products in response to hormonal and metabolic signals. To test whether the enhanced expression of the LKR/SDH gene under various hormonal and metabolic signals is correlated with enhanced lysine catabolism, wild-type Arabidopsis and a knockout mutant lacking lysine catabolism were exposed to abscisic acid and sugar starvation. Free lysine accumulated to significantly higher levels in this knockout mutant than in the wild-type plants. [ABSTRACT FROM PUBLISHER]

In plants, excess cellular lysine (Lys) is catabolized into glutamic acid and acetyl-coenzyme A; yet, it is still not clear whether this pathway has other functions in addition to balancing Lys levels. To address this issue, we examined the effects of stress-related hormones, abscisic acid (ABA), and jasmonate, as well as various metabolic signals on the production of the mRNA and polypeptide of the bifunctional Lys-ketoglutarate reductase (LKR)/saccharopine dehydrogenase (SDH) enzyme, which contains the first two linked enzymes of Lys catabolism. The level of LKR/SDH was strongly enhanced by ABA, jasmonate, and sugar starvation, whereas excess sugars and nitrogen starvation reduced its level; thus this pathway appears to fulfill multiple functions in stress-related and carbon/nitrogen metabolism. Treatments with combination of hormones and/or metabolites, as well as use of ABA mutants in conjunction with the tester sugars mannose and 3-O-methyl-glucose further supported the idea that the hormonal and metabolic signals apparently operate through different signal transduction cascades. The stimulation of LKR/SDH protein expression by ABA is regulated by a signal transduction cascade that contains the ABI1-1 and ABI2-1 protein phosphatases. By contrast, the stimulation of LKR/SDH protein expression by sugar starvation is regulated by the hexokinase-signaling cascade in a similar manner to the repression of many photosynthetic genes by sugars. These findings suggest a metabolic and mechanistic link between Lys catabolism and photosynthesisrelated metabolism in the regulation of carbon/nitrogen partitioning. [ABSTRACT FROM AUTHOR]

Responds to comments on the author's article concerning the intellectual history of psychoanalysis. Relationship between surgical metaphor and ego psychology; Emergence of ego psychology; Development of diagnostic techniques; Implications for psychiatrists and psychoanalysts.

Presents a study that examined the involvement of the central nervous system (CRS) in myasthenia gravis (MG). Background on the disease; Possible mechanisms of CRS involvement in the disease; Benefits of a polysomnographic investigation for the detection of sleep-related breathing disorder in patients with (MG).

Cucumis melo L. (melon) genotypes differ widely in morphological and biochemical traits. Intraspecific classification of such variability has been difficult, and most taxonomists still rely on the work of Naudin (1859). A collection of 54 accessions representing diverse genotypes from 23 countries was surveyed. Morphological traits related to the vegetative and flowering stages and mature fruit morphology and quality parameters, e.g., taste, aroma, sugar composition and pH, were scored. These were used to construct a “botanical-morphological” dendrogram that generally reflected the classification of Cucumis melo into several horticultural varieties. DNA polymorphism among the accessions was assessed using the Inter-SSR-PCR and RAPD techniques that detected abundant DNA polymorphism among melon genotypes. Cluster analysis indicated that the largest divergence was between North American and European cantalupensis and inodorus cultivars as one group, and the more “exotic” varieties: conomon, chito, dudaim, agrestis and momordica, as a second group. The molecular phylogeny agreed, broadly, with the classification of melon into two subspecies, and did not contradict the division into “horticultural varieties”. It was apparent, however, that the infra-specific division is rather loose, molecular variation being distributed continuously between and within cultivar groups. We suggest that despite the morphological diversity, separation between varietal-groups may be based on a too small number of genes to enable unambiguous infra-specific classification based on DNA diversity. [ABSTRACT FROM AUTHOR]

Sugar accumulation is a very important physiological process that determines dessert-melon fruit quality. Considerable variation in the sugar content and composition in the mature flesh of Cucumis melo L. fruits was observed among 56 genotypes which represent the wide range of morphological and horticultural types found in this species. Sucrose accumulation was observed not only among 'dessert melons' of the inodorus and cantalupensis types, but also in representatives of other subgroups of C. melo, including some of the accessions from agrestis and conomon groups. Among the genotypes that accumulate sucrose, the levels of this sugar, and not of the hexoses, were correlated with the total sugar concentration. Hexose levels were correlated with total sugar levels only among low-sugar genotypes that did not accumulate sucrose. Activities of the sucrose hydrolyzing enzymes acid invertase (EC 3.2.1.26) and alkaline invertase (EC 3.2.1.27) were measured in the mature fruit flesh and the results of this survey support the hypothesis that low acid invertase activity is a prerequisite for sucrose accumulation. The sucrose accumulating, high sugar genotypes had less-acidic flesh pH values (pH> 6) than the low-sugar genotypes. The latter were characterized by a broader range of pH values, including acidic (pH< 5.5) fruit flesh. [ABSTRACT FROM AUTHOR]

Focuses on the aspects of the wave-particle duality. Examination of the historical development of quantum mechanics; Comparison of matrix mechanics and wave mechanics; Information on wave-particle duality.

Doxepin and diazepam were evaluated for therapeutic effectiveness in a double blind study carried out with 69 primarily anxious neurotic outpatients attending either a municipal hospital clinic or a general practitioner's office. Doxepin produced more clinical improvement than diazepam in several questionnaire clusters measuring depressive symptomatology, but not in clusters measuring anxious symptomatology. According to several outcome criteria, doxepin tended to produce more clinical improvement in general practice than in clinic patients, while diazepam produced either equal improvement in both populations or slightly more improvement in the clinic. Possibly contributing to the present results are low daily dosage of diazepam, differential pharmacological drug effects, population differences in levels of anxiety and depression, and differences in population characteristics, primarily as related to social class. [ABSTRACT FROM AUTHOR]

The article focuses on the social policies for old people, with the challenges that can be contextualized in Brazil. It mentions that the life expectancy reached 74 years. It mentions that the 1988 Brazilian Federal Constitution integrated Social Security benefits, healthcare and welfare making welfare for people.

Infections caused by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-KP) are on a constant rise and are a noted cause of outbreaks in neonatal intensive care units (NICUs). We used whole genome sequencing (WGS) to investigate the epidemiology of consecutive and overlapping outbreaks caused by ESBL-KP in NICUs in three hospitals in close proximity. Clonality of 43 ESBL-KP isolates from 40 patients was determined by BOX-PCR. Short-read sequencing was performed on representative isolates from each clone. The dominant clones from each NICU were sequenced using long-read sequencing. Bioinformatics methods were used to define multilocus sequence type (MLST), analyze plasmid content, resistomes, and virulence factors. In each NICU, we found a unique dominant clone (ST985, ST37, and ST35), each belonging to a distinct sequence type (ST), as well as satellite clones. A satellite strain in NICU-2 (ST35) was the dominant strain in NICU-3, where it was isolated four weeks later, suggesting transmission. NICU-1- and NICU-2-dominant strains had blaCTX-M-15 carried on a similar transposable element (Tn3-ISEcp1) but at different locations: on a plasmid and on the chromosome, respectively. We concluded that the overlapping ESBL-KP outbreaks were a combination of clonal transmission within NICUs, possible transposable element transmission between NICUs, and repeated importation of ESBL-KP from the community. [ABSTRACT FROM AUTHOR]

Background:In 2008 the Austrian Task Force for Neuromyelitis Optica (NMO) started a nation-wide network for information exchange and multi-centre collaboration. Their aim was to detect all patients with NMO or NMO spectrum disorders (NMO-SD) in Austria and to analyse their disease courses and response to treatment. Methods:(1) As of March 2008, 1957 serum samples (of 1557 patients) have been tested with an established cell based immunofluorescence aquaporin-4 antibody (AQP4-ab) assay with a high sensitivity and specificity (both >95%). All tests were performed in a single reference laboratory (Clinical Dept. of Neurology of the Innsbruck Medical University). (2) A nation-wide survey with several calls for participation (via email newsletters, articles in the official journal of the Austrian Society of Neurology, and workshops) was initiated in 2008. All collected data will be presented in a way that allows that every individual patient can be traced back in order to ensure transparency and to avoid any data distortion in future meta-analyses. The careful and detailed presentation allows the visualization and comparison of the different disease courses in real time span. Failure and response to treatment are made visible at one glance. Database closure was 31 December 2011. All co-operators were offered co-authorship. Results:All 71 NMO- or NMO-SD patients with AQP4-ab positivity (age range 12.3 to 79.6 years) were analysed in detail. Sex ratio (m:f = 1:7) and the proportion of patients without oligoclonal bands in cerebrospinal fluid (86.6%) were in line with previously published results. All identified patients were Caucasians. Conclusions:A nationwide collaboration amongst Austrian neurologists with good network communications made it possible to establish a database of 71 AQP4-ab positive patients with NMO/NMO-SD. This database is presented in detail and provides the basis for further studies and international cooperation in order to investigate this rare disease. [ABSTRACT FROM AUTHOR]

Describes the technical safety categorization in the construction sector. Environmental limit states of a construction; Critical reliability of an object; Numerical intervals of the category factor for the division of structures into various technical safety categories.