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The distribution of large conjugative Haemophilus influenzae plasmids in the nasopharyngeal haemophili of a group of people and in a large collection of 541 H. influenzae type b (Hib) isolates was studied. A newly developed PCR-based assay was used to detect the plasmids. The target sequences were chosen from sequence analysis of part of p1056, a large multiresistance plasmid isolated from a clinical Hib isolate, 1056. Fifty-nine per cent of people were found to carry β-lactamase-positive (β-lac+), ampicillin-resistant (ampR) haemophili with detectable plasmid sequences. Of these, 83% were in Haemophilus parainfluenzae and 17% were in H. influenzae. In the collection of 541 Hib, antibiotic resistance [β-lac+ampR, β-lac+ampR plus tetracycline resistance (tetR) or tetR] was highly correlated with large plasmids. It was found that 2.3% of the isolates contained large cryptic plasmids (i.e. these isolates were susceptible to antibiotics). The distribution of plasmids between invasive and carried Hib did not differ significantly (25 of 245 and 23 of 276, respectively). Isolates with large plasmids occur at high frequency in the nasopharynx of the normal human population and consist of two populations in Hib, one associated with specific antibiotic resistance traits and the other cryptic. These plasmids do not appear to influence the invasiveness of Hib. [ABSTRACT FROM PUBLISHER]

eSolar provides a low-cost, modular heliostat field solution for tower-based CSP facilities. Industry-leading cost has been achieved via large quantities of small (∼2.2 m2) single-facet, individually-controlled heliostats with simple field installation methods. These modular fields can contain up to 50,000 heliostats (108,000 m2) per receiver and a dozen or more modules may comprise a single plant, presenting a challenge for timely commissioning and calibration with previously existing technology. In response to this challenge, eSolar has developed a fully-automated proprietary calibration system that enables accurate individual heliostat tracking rapidly upon commissioning. The system operates by reflecting light from LEDs located on towers around the field into cameras, which are located on the same towers. The efficacy of this approach is demonstrated at eSolar's Sierra SunTower facility in Lancaster, CA, USA (Fig. 1) where a field of >24,000 heliostats can be calibrated from realistic seed conditions in less than two weeks with resultant pointing error of <1.5 mrad. The calibration system's precise, parallel, and high throughput data collection further enables rapid detection of broken and mis-pointing heliostats, dramatically reducing the Mean Time to Repair (MTTR) from individual heliostat failures, as well as automating the task of discovering such failures. This paper describes the technical solution that eSolar has created and elaborates on the benefits of the system. [ABSTRACT FROM AUTHOR]

The long term success of the concentrating solar power (CSP) industry depends on having accurate and reliable measurements and predictions of performance. Agreed-upon standards for performance characterization are still lacking. This contrasts with more mature technologies such as gas turbine combined cycle power plants, where performance and testing specifications are well established in spite of system complexities. Lack of standardization inevitably results in extra cost and risk to market participants and the spread of misinformation through hidden “apples-to-oranges” comparisons. To cite just one example, there are multiple distinct metrics for characterizing heliostat tracking accuracy, and the differences can easily go unnoticed. Here we propose rigorous and accurate statistical approaches to two key performance analysis problems for tower CSP. We highlight their advantages over previous approaches, and analyze detailed operational data. Further, we demonstrate why they are sufficiently straightforward and general enough for adoption as industry standards. [ABSTRACT FROM AUTHOR]

Abstract: eSolar has been designing small heliostats since the company's founding in 2007. One of the cornerstones of our approach to heliostat design is to deploy many factory-built small heliostats in high density fields. The fields are replicated and thus aggregated into solar plants supporting steam and molten salt electric power, integrated solar combined cycle (ISCC), and process heat applications, such as enhanced oil recovery and desalination. The small heliostat approach has been used in several pilot projects and was previously evolved into a commercially available product presented in 2011 at SolarPACES. In this paper we discuss the ground up redesign of our small heliostat hardware, with a focus of leveraging the proven approach into a higher reliability, globally applicable, more industrial, simple to source and most importantly total installed cost reduced solar collector product. During the redesign we discovered methods to simplify the design and confirmed that small, factory-built, affordable heliostats provide a compelling concentrated solar thermal technology. We discuss details on system optimization, concept selection and prototype development, including some results from design validation testing. Finally, we discuss how this new solar collector system (SCS5) performs and meets economic requirements. eSolar's SCS5 product will be commercially released early in 2014, and is currently available to quote for CSP projects. [Copyright &y& Elsevier]

Presents a study which investigated the incidence of invasive Haemophilus influenzae type b (Hib) disease in Great Britain. Implementation of a routine vaccination campaign for children in 1992 and 1933; Effect of Hib vaccination programs on disease prevalence; Discussion on the role of Hib transmission.

A prospective survey of children in the Oxford region identified 200 cases of systemic Haemophilus influenzae type b disease in the first three and a half years of the study. The annual incidence in children less than 5 years of age was 33.4/100,000. This represents a cumulative incidence of one systemic infection in 600 children before their 5th birthday. The mortality was 5.0%. The risk of H influenzae type b meningitis was one in 850 with a mortality of 5.6%, and substantial morbidity among survivors. From the total live birth rate, about 1300 cases of systemic H influenzae type b disease, over 900 cases of H influenzae type b meningitis, and 65 deaths would be predicted annually in children in the United Kingdom. [ABSTRACT FROM AUTHOR]

For a seven year period (1985-91) clinical and epidemiological data were prospectively collected on children aged < 10 years with microbiologically confirmed invasive Haemophilus influenzae type b infection in the Oxford region to study the epidemiology of the disease and determine the potential impact of early primary immunisation in infants. Computer records of primary immunisations given to these cases were retrospectively analysed and, where necessary, hospital and general practitioner records were searched to determine the immunisation history. Over the seven year period, 416 cases of invasive H influenzae type b disease were reported. Widescale immunisation against H influenzae type b began in 1991 as part of a regional trial. The estimated annual incidence for invasive disease between 1985 and 1990 was 35.5 cases per 100,000 children aged less than 5 years; for H influenzae type b meningitis it was 25.1 per 100,000 children aged less than 5 years. The cumulative risks for invasive disease and meningitis by the fifth birthday were one in 560 and one in 800 respectively. The majority of disease (71%) occurred in children less than 2 years of age with the peak monthly incidences at 6 and 7 months of age. The overall mortality was 4.3% and 50% of these deaths occurred suddenly. Most (91%) of the children had received at least one primary immunisation against diphtheria, tetanus, and pertussis before H influenzae type b infection and there was only one case of parental refusal of immunisation. None had received H influenzae type b immunisation. Given a vaccine uptake of 90% by 5 months of age it is estimated that at least 82% of the H influenzae type b infections could have been prevented. Extrapolated nationally, 1150 cases of infection and 50 deaths could be prevented each year by routine primary immunisation. [ABSTRACT FROM AUTHOR]

The pharyngeal aspirates collected from 400 babies at the time of delivery were examined for the presence of bacteria, especially group B streptococci. Aspirates from 79 babies were found to contain viable bacteria, including 4 with group B streptococci; one of these 4 babies developed streptococcal meningitis within 24 hours. The group B streptococci were seen on a Gram-stained film of the aspirate, and were detectable by coagglutination and countercurrent immunoelectrophoresis within 4 hours and by culture after 24 hours. Examination of pharyngeal aspirates may be of value as a screening test for neonatal sepsis. [ABSTRACT FROM AUTHOR]

Ciprofloxacin is a new antibiotic, related to nalidixic acid, with good in-vitro activity against Gram-negative bacteria including spp. We report the successful treatment with intravenous ciprofloxacin of an infant with ventriculitis caused by a multi-resistant strain. [ABSTRACT FROM PUBLISHER]

Fifty clinical strains of were grown in the presence of cefsulodin and 96% acquired resistance to the antibiotic after 8 serial passages. Cross-resistance was observed between cefsulodin, carbenicillin and ticarcillin and growth of the strains on carbenicillin also induced resistance to the other two antibiotics. The resistant progeny fell into two categories, the first included strains which were indistinguishable phenotypically from the original strain and the second group were atypical in some biochemical tests confirmatory for and were not typable by serology and phage-typing. Neither category reverted to cefsulodin susceptibility after repeated subcultures on antibiotic-free media over a period of 6 months. [ABSTRACT FROM PUBLISHER]

The activity of cefsulodin (CGP 7174/E, SCE 129) a new semi-synthetic cephalosporin, was examined and its interaction with other antimicrobial agents evaluated. Cefsulodin was highly active against but relatively inactive against coliform bacilli. Combinations of cefsulodin and gentamicin were found to have additive or synergistic activity against a third of strains of . Combinations of cefsulodin and cefuroxime were additive rather than synergistic. The potential role of cefsulodin in the therapy of serious Gram-negative infections is discussed. [ABSTRACT FROM PUBLISHER]

Fluoretec, a commercial kit for the rapid diagnosis by immunofluorescence of infections caused by Bacteroides spp was compared with a standard culture method. A total of 1010 specimens were tested for the presence of B fragilis group by Fluoretec F and B melaninogenicus-oralis and asaccharolytic groups by Fluoretec M. Fluoretec F was positive in 123/152 specimens culturing B fragilis group strains. Seventeen specimens were positive by Fluoretec F but negative on culture. Fluoretec M was positive in 21 of 22 specimens from which B melaninogenicus was cultured. The Fluoretec system was convenient in use, results being obtained within one hour of receipt of the specimen. [ABSTRACT FROM PUBLISHER]

Abstract: Cervical weakness is an important cause of late miscarriage and extreme preterm labour. Women have been traditionally offered a cervical cerclage procedure, though studies failed to demonstrate a therapeutic effect. None of these studies has addressed the effect of non-braided to braided suture material on cerclage outcome. Type of suture material is an important determinant of surgical outcomes. This issue is of particular relevance to cerclage because the traditionally braided suture has been associated with increased risk of infection in other surgical procedures. Indeed, infection is an important underlying cause for cerclage failure. It is for this reason that some surgeons use non-braided suture material. Therefore, we hypothesise that the unrealised benefit of cervical cerclage is at least in part due to the type of suture material used. In this article, we present the rationale behind our hypothesis and a proposed way of testing it. [Copyright &y& Elsevier]

Management of chronic pain can require the use of many strategies from multiple domains. When so many strategies from multiple domains are being used, conducting a systematic assessment is difficult. This study describes the development of a pain management profile and illustrates its use with example profiles representing patients using a variety of strategies. The pain management profile was developed by modifying the framework used by Widerstrom-Noga and Turk1 and the universal scoring procedure (i.e. scores are on a single numeric scale regardless of original scale) developed by Robinson-Papp et al.2 Example profiles were developed using data collected from an online survey of the types of multi-domain strategies used by pharmacists who had chronic pain. Xm2 profiles organize management strategies into five domains: medications, medical, physical, psychological, and self-initiated strategies. Specific strategies (e.g. naproxen, rest) used are listed for each domain with a score indicating their associated level of use. The number of strategies reported ranged from two to 24 and the level of use score ranged from two to 72. Example profiles were developed for an individual with average scores who used opioids and an individual who did not use opioids, and for individuals in the lowest and highest 25% level of use. The use of a framework and universal score for level of use resulted in a profile that clearly identified the types of pain management strategies being used from all five domains with level of use. Such a profile could be developed for any individual with pain and may be helpful clinically to identify the most appropriate types and level of use of pain management strategies. (1. Widerstrom-Noga, Spinal Cord, 2003; 2. Robinson-Papp, J Pain Sym Man, 2005). [ABSTRACT FROM AUTHOR]

A case of cholecystitis caused by is reported. Following cholecystectomy a subphrenic abscess due to the same organism developed. [ABSTRACT FROM PUBLISHER]

This paper presents a way of modelling turbulence in multiphase flows within the context of the Reynolds-Stress Model. The model has been implemented in the general-purpose unstructured finite volume code Fluent V6. Two multiphase turbulence approaches were considered: mixture and dispersed models. The mixture model solves the Reynolds-stress transport equations on the mixture level only. The dispersed approach solves the Reynolds-stress transport equations for the continuous phase, while the turbulence closure for the dispersed phases is achieved by an extension of the theory of dispersion of discrete particles by homogeneous turbulence. The dispersed model was used to calculate bubbly flow over a cylindrical back-step and the flow in an unbaffled stirred vessel. The mixture approach was used to calculate an industrially relevant cyclone flow. [ABSTRACT FROM AUTHOR]

An increase in invasive Hib disease incidence in the UK has coincided with the distribution of combination vaccines that contain acellular pertussis (DTaP-Hib). These vaccines have been associated with reduced immunogenicity of the Hib component, although there is little agreement on the clinical relevance of this finding. We retrospectively compared vaccine formulations given to fully vaccinated Hib cases with those administered to fully immunised age-matched controls using conditional logistic regression. More cases than controls received all three doses of their infant primary course as DTaP-Hib, compared with two or three doses of another Hib vaccine (conditional odds ratio 6.77 [95% CI 3.26-14.07]). [ABSTRACT FROM AUTHOR]

Background: Diseases of early childhood associated with Haemophilus influenzae type b (Hib) can now be prevented by vaccination. The rapid implementation of routine infant vaccination with Hib polysaccharide-tetanus protein conjugate (PRP-T) vaccine has allowed us to assess whether an accelerated 2, 3, and 4 month schedule can protect in the longer term without a booster dose and whether carrier priming influences protective efficacy. The degree of protection afforded by a catch-up programme with Hib oligosaccharide conjugate (HbOC) for older children was also assessed.Methods: Paediatricians and microbiologists in the UK were asked to report all cases of invasive H influenzae infection in children who had received at least one dose of Hib-conjugate vaccine. Serum samples from convalescent children were obtained and the isolate was verified. Efficacy was estimated by comparing observed rates of Hib disease in those who had been vaccinated with rates predicted by age adjustment of disease rates from the prevaccine era.Findings: Of 164 reports of invasive infection between Oct 1, 1992, and Oct 1, 1995, 43 were considered true vaccine failures. The estimated overall efficacy for three doses of PRP-T was 98.1% (95% CI 97.3-98.7%). Efficacy in infants aged 5-11 months was 99.1%, 12-23 months 97.3%, and 24-35 months 94.7%. In infants aged 3-11 months, who received their first dose of PRP-T after tetanus toxoid vaccination, disease was unlikely from 1 week after one dose of PRP-T vaccine (88.6% protection in the second to fourth weeks [66.8-97.7%]). The disease rate in vaccinated infants aged 2 months has declined year on year. In children aged 13 months to 2 years given HbOC, as a catch-up vaccine, the estimated efficacy was 94.0% (84.7-98.4%).Interpretation: A high degree of efficacy has been observed with PRP-T vaccine given as a three-dose schedule in infancy and with HbOC as a single dose in older children. Efficacy of PRP-T appears to be enhanced by carrier priming. Although with increasing age there was a small decline in efficacy of PRP-T, Hib disease is now close to being eliminated in the UK, and we suggest that a booster is not necessary in the second year of life. [ABSTRACT FROM AUTHOR]