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IN THE SUMMER OF 1979, JUST a few years after Jimmy Carter brought the term 'born again' into the mainstream American lexicon and Steve Jobs made the home computer a [...]

GRADUATION WAS APPROACHING, and Northwestern University journalism student Stephanie Choporis faced a tough job market where her choices were few. She could have sought out a spot at a major [...]

In the wake of last year's election season, many of us have been asking difficult questions about our nation and ourselves. Can we restore a sense of shared American identity [...]

The article discusses various topics, including the use of spyware by foreign powers to surveil dissidents, the limitations of public inquiries in holding those in power accountable, campus free speech issues, reforming the House of Lords, addressing climate change, the Old Catholic Churches, the concept of forgiveness in politics, accurate science reporting, the state of the county court system, experiences in prep and public schools, the language used to discuss problems with the UK's water services, and temporary accommodation in the UK. The article also includes several unrelated statistics and facts. [Extracted from the article]

In the run-up to last year's presidential election, Kennady wade found herself challenging her peers on the dubious stories they posted on social media, like links to obscure conservative blogs [...]

Last week I had an epiphany. It was one of those 'Ah-ha' moments that impacts you like a sledgehammer to the chest. The realization was in regard to the question, [...]

Recent observations from U.S. military involvement in major combat operations in Iraq, counterinsurgency in Afghanistan, and humanitarian assistance in the United States, Haiti, and West Africa provide critical lessons for [...]

DAVE PHILIPPS WAS well acquainted with the plight of troubled veterans when he heard about a soldier in the El Paso County jail two years ago. As a reporter at [...]

The difference between involvement and commitment is like ham and eggs. The chicken is involved; the pig is committed.--Business Fable The first time I met Dr. W. Edwards Deming in [...]

JOURNALISTS MAKE CAREERS out of covering the symptoms and causes of bad urban public schools, writing tragedies about students falling through the cracks, scoring scoops from school board investigations, and [...]

IN MARCH, WHEN IT became clear something big was happening in Crimea, Jacob Resneck packed his knapsack with a laptop, sound recorder and camera and boarder a one-way flight in [...]

In 2002, Mark Schleifstein and a team of reporters in New Orleans wrote 'Washing Away,' a five-part series in The Times-Picayune that predicted the devastation of Hurricane Katrina three years [...]

The article explores the growth of the Bible software market on religion and the impact of the shift from printed books to electronic media on the practices of Christians. Topics discussed include establishment of Bible Research Systems by engineers Kent Ochel and Bert Brown, the three shifts in the use of media experienced by Christians, and the role of evangelicals in the production and consumption of digital Bibles.

Background: Outpatient parenteral antimicrobial therapy (OPAT) delivery using peripherally inserted central catheters is associated with a risk of catheter related thrombosis (CRT). Individualised preventative interventions may reduce this occurrence, however patient selection is hampered by a lack of understanding of risk factors. We aimed to identify patient, infection or treatment related risk factors for CRT in the OPAT setting.Methods: Retrospective case control study (1:3 matching) within OPAT services at two tertiary hospitals within Australia.Results: Over a 2 year period, encompassing OPAT delivery to 1803 patients, there were 19 cases of CRT, giving a prevalence of 1.1% and incidence of 0.58/1000 catheter days. Amongst the cases of CRT, there were nine (47%) unplanned readmissions and two (11%) pulmonary emboli. Compared to controls, cases had a higher frequency of malposition of the catheter tip (4/19 (21%) vs 0/57 (0%), p= 0.003) and complicated catheter insertion (3/19 (16%) vs 1/57 (2%), p= 0.046).Conclusions: Although CRTs during OPAT are infrequent, they often have clinically significant sequelae. Identification of modifiable vascular access related predictors of CRT should assist with patient risk stratification and guide risk reduction strategies.

Drug treatment for HIV infection may reduce the amount of virus in semen. Researchers measured HIV RNA in blood and semen samples of 11 HIV-infected men before and after they began treatment with reverse transcriptase inhibitors such as zidovudine. In 82% of the men, levels of HIV in semen dropped after treatment. Five of the men were followed for at least a year and their semen HIV levels continued to be below the level measured before treatment. In much of the world, sexual intercourse is the primary means of HIV transmission.

Graves' orbitopathy can be associated with horizontal, vertical, and torsional diplopia. Of 428 patients treated with transantral orbital decompression, 21 had incycloduction (mean, 12.8 degrees; range, 5 to 20 degrees) and five had excycloduction (mean, 12 degrees; range, 5 to 20 degrees). All 26 patients had had recessions of the medial or inferior rectus muscle (or both) before onset of torsional diplopia. Mean recession was 5.5 mm of (range, 4 to 10 mm) and 5.3 mm (range, 2 to 10 mm) of medial rectus muscle and inferior rectus muscle, respectively. An A pattern was often associated with the condition. Superior oblique tenectomy and inferior oblique myectomy were performed most frequently for incycloduction and excycloduction, respectively. Superior oblique tenectomy induced a mean incycloduction decrease of 7.1 degrees (range, 0 to 12 degrees). Exotropia in downgaze was decreased, and a small ipsilateral hyperdeviation was induced. Bilateral inferior oblique myectomy in one patient decreased excycloduction 10 degrees without inducing new deviation. At follow-up (mean, 63.7 months) after last strabismus operation, 15 patients with incycloduction and two with excycloduction had no diplopia.

To quantify the burden of invasive group A Streptococcus(GAS) disease in Western Australia during 2000–2018. Population‐based data linkage study: Hospital Morbidity Data Collection (HMDC; all WA public and private hospital records), PathWest pathology data (government‐owned pathology services provider), and death registrations. People with invasive GAS disease, defined by an isolate from a normally sterile site (PathWest) or a hospital‐based principal ICD‐10‐AM diagnosis code (HMDC). Incidence of invasive GAS disease; median length of hospital stay; all‐cause mortality. We identified 2237 cases of GAS disease during 2000‒2018; 1283 were in male patients (57%). 1950 cases had been confirmed by GAS isolates from normally sterile tissues (87%; including 1089 from blood [56% of cases] and 750 from tissue [38%]). The age‐standardised incidence increased from 2.0 (95% CI, 1.4–2.7) cases per 100 000 population in 2000 to 9.1 (95% CI, 7.9–10.2) cases per 100 000 in 2017 (by year, adjusted for age group and sex: incidence rate ratio [IRR], 1.09; 95% CI, 1.08–1.10). Incidence was consistently higher among Indigenous than non‐Indigenous Australians (year‐adjusted IRR, 13.1; 95% CI, 11.3–15.1). All‐cause 30‐day mortality was 5% (116 deaths), and 90‐day mortality 7% (156 deaths); 30‐day mortality, adjusted for age group and sex, was not statistically significantly different for cases involving Indigenous or non‐Indigenous patients (adjusted odds ratio, 0.8; 95% CI, 0.6–1.1). The incidence of invasive GAS disease in WA increased between 2000 and 2018, particularly among Indigenous Australians. Mandatory notification of invasive GAS disease would therefore be appropriate. The social determinants of differences in incidence should be addressed, and other relevant host, pathogen, and health system factors investigated.

Prolonged intermittent renal replacement therapy (PIRRT) use has been increasing in critically ill patients with kidney dysfunction. PIRRT can affect the pharmacokinetics of many drugs, although no data is available to guide flucloxacillin dosing in this clinical scenario. Herein, we describe the pharmacokinetics of flucloxacillin, given at 1 g every 4 h during PIRRT, in a 76-year-old, critically ill patient with a methicillin-susceptible Staphylococcus aureus(MSSA) prosthetic joint infection complicated by bacteraemia. Blood samples were taken over 2 days including during a 9-h PIRRT session. A two-compartment model was developed to describe differences in clearance of flucloxacillin during PIRRT and off-PIRRT (9.45 vs. 6.89 L/h). A flucloxacillin dose of 1 g every 4 h during PIRRT therapy appeared to attain adequate exposures for MSSA sepsis in this patient, however higher doses may be required for infection sites with poor drug penetration.

Four patients from the south-eastern coastal region of South Australia near Adelaide are diagnosed with rickettsia spotted fever and all the infections were acquired within the geographic range of Aponomma hydrosauri, tick vector of Rickettsia honei. These patients who had an illness with symptoms of fever, severe malaise, diffuse maculopapular rash and laboratory observations showing acute spotted fever group (SFG) rickettsial infection are described.

The connecting of buyers and sellers that is so much a part of online culture--as well as the rating of each party by the other--has arrived in the world of [...]

Air disc brakes - a technology whose time may finally have come In the 1940s, British novelist Nevil Shute, who was also a respected aircraft designer/engineer, wrote The Breaking Wave, [...]

We examined adherence to antimicrobial stewardship prospective audit and feedback rounds in a rehabilitation service compared with the remainder of the acute hospital, and explored the reasons for this. Between October 2014 and December 2015, we retrospectively assessed the rate of non-adherence to advice from antimicrobial stewardship prospective audit and feedback rounds between the rehabilitation service and the acute hospital, along with the source of the patient referral. Compared with the rehabilitation service, acute hospital medical staff were almost twice as likely to not adhere to advice provided on antimicrobial stewardship prospective audit and feedback rounds (13.8% vs. 7.6%, p < 0.0001, relative risk 1.8 [95% confidence interval 1.3, 2.5]). In the rehabilitation service, referrals were more likely to come from medical staff (61.9% vs. 16.3%, p < 0.0001). These findings may be explained by regular, direct engagement of the antimicrobial stewardship team with the rehabilitation service clinical team, a model potentially applicable to other settings.

Decreased heart rate variability (HRV) is associated with adverse outcomes in cardiovascular diseases and has been observed in patients with systemic lupus erythematosus (SLE). We examined the relationship of HRV with SLE disease activity and selected cytokine pathways. Fifty-three patients from the Oklahoma Lupus Cohort were evaluated at two visits each. Clinical assessments included the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), British Isles Lupus Assessment Group (BILAG) index, physician global assessment (PGA), and Safety of Estrogens in Lupus Erythematosus National Assessment-SLEDAI Flare Index. HRV was assessed with a 5-minute electrocardiogram, and the following HRV parameters were calculated: square root of the mean of the squares of differences between adjacent NN intervals (RMSSD), percentage of pairs of adjacent NN intervals differing by more than 50 milliseconds (pNN50), high-frequency power (HF power), and low frequency to high frequency (LF/HF) ratio, which reflects sympathetic/vagal balance. Plasma cytokine levels were measured with a multiplex, bead-based immunoassay. Serum B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL) were measured with an enzyme-linked immunosorbent assay. Linear regression analysis was applied. Baseline HRV (pNN50, HF power, LF/HF ratio) was inversely related to disease activity (BILAG, PGA) and flare. Changes in RMSSD between visits were inversely related to changes in SLEDAI (p= 0.007). Age, caffeine, tobacco and medication use had no impact on HRV. Plasma soluble tumor necrosis factor receptor II (sTNFRII) and monokine induced by interferon gamma (MIG) were inversely related with all baseline measures of HRV (p= 0.039 to <0.001). Plasma stem cell factor (SCF), interleukin (IL)-1 receptor antagonist (IL-1RA), and IL-15 showed similar inverse relationships with baseline HRV, and weaker trends were observed for interferon (IFN)-α, interferon gamma-induced protein (IP)-10, and serum BLyS. Changes in the LF/HF ratio between visits were also associated with changes in sTNFRII (p= 0.021), MIG (p= 0.003), IFN-α (p= 0.012), SCF (p= 0.001), IL-1RA (p= 0.023), and IL-15 (p= 0.010). On the basis of multivariate linear regression, MIG was an independent predictor of baseline HRV after adjusting for plasma IL-1RA, SCF, IFN-α, IP-10, and serum BLyS. In a similar model, the sTNFRII impact remained significant after adjusting for the same variables. Impaired HRV, particularly the LF/HF ratio, is associated with lupus disease activity and several cytokines related to IFN type II and TNF pathways. The strongest association was with MIG and sTNFRII, expanding previous immune connections of vagal signaling.

Simplified employee pensions (SEPs) were mainly designed so that small businesses can provide qualified retirement plans for their employees. The Tax Reform Act of 1986 made it possible for employees to make pre-tax contributions to an employer-established SEP, though it is only an option for businesses with a maximum of 25 employees and at least half of the employees must participate. An example of a self-designed SEP is presented, showing how to avoid the top-heavy provisions of many such plans.

As we cultivate the skill of scanning screens, many of us find it more difficult to read a book word by word and line by line. We seem to cultivate [...]

Several letters to the editor are presented in response to various articles including the "Editorial" on the issue of housing affordability in Auckland, New Zealand in the June 4, 2016 issue, "Health" column in the May 30, 2016 issue and "Paradise Lost" in the May 28, 2016 issue.

ABSTRACTDried blood spot (DBS) antibiotic assays can facilitate pharmacokinetic (PK)/pharmacodynamic (PD) studies in situations where venous blood sampling is logistically difficult. We sought to develop, validate, and apply a DBS assay for rifampin (RIF), fusidic acid (FUS), and ciprofloxacin (CIP). These antibiotics are considered active against organisms in biofilms and are therefore commonly used for the treatment of infections associated with prosthetic implants. A liquid chromatography-mass spectroscopy DBS assay was developed and validated, including red cell partitioning and thermal stability for each drug and the rifampin metabolite desacetyl rifampin (Des-RIF). Plasma and DBS concentrations in 10 healthy adults were compared, and the concentration-time profiles were incorporated into population PK models. The limits of quantification for RIF, Des-RIF, CIP, and FUS in DBS were 15 μg/liter, 14 μg/liter, 25 μg/liter, and 153 μg/liter, respectively. Adjusting for hematocrit, red cell partitioning, and relative recovery, DBS-predicted plasma concentrations were comparable to measured plasma concentrations for each antibiotic (r> 0.95; P< 0.0001), and Bland-Altman plots showed no significant bias. The final population PK estimates of clearance, volume of distribution, and time above threshold MICs for measured and DBS-predicted plasma concentrations were comparable. These drugs were stable in DBSs for at least 10 days at room temperature and 1 month at 4°C. The present DBS antibiotic assays are robust and can be used as surrogates for plasma concentrations to provide valid PK and PK/PD data in a variety of clinical situations, including therapeutic drug monitoring or studies of implant infections.

Several letters to the editor are presented in response to various articles including "Hope on the horizon" by Dale Bredesen and "Candidates: stand, then deliver" in December 5, 2015 issue; and another on an article related to Islamic State terrorism in November 28, 2015 issue.

I have thoroughly enjoyed reading Air Cargo World for many years. Many times I've wanted to share my opinions, but decided to stay 'on the sidelines.' However something in the [...]

The article evaluates the Dormobile Defender 110 luxury vehicle by Land Rover.

The article discusses developments in journalism as of March 2015, particularly the so called solutions journalism. It cites as example the efforts by "The Seattle Times" and the Solutions Journalism Network to focus on positive news to tackle the issues confronting the education sector in Washington State. Among the positive developments are the in-school suspension program adopted by the Kent School District and the restorative justice policy launched at Big Picture High School.

Several letters to the editor are presented in response to articles in previous issues including "The book that hit like a bomb" by Thomas Piketty in the May 24, 2014 issue, "And the giver is..." in the May 17, 2014 issue, and "Sams, I am" by Paul Thomas in the May 24, 2014 issue.

Several letters to the editor are presented in response to articles in previous issues including "A symbol solution" in the February 15, 2014 issue, "Just one more" by Mark Broatch in the February 8, 2014 issue, and "Health" by Margo White in the February 15, 2014 issue.

Several letters to the editor are presented in response to articles in previous issues including "Brickbats for the NCEA" in the December 7, 2013 issue, "The leaning tower of Pisa" in the December 14, 2013 issue, and "Big bang theories" in the December 7, 2013 issue.