Search

There is a need for oral antibiotic agents that are effective against multidrug-resistant gram-negative uropathogens. Tebipenem pivoxil hydrobromide is an orally bioavailable carbapenem with activity against uropathogenic Enterobacterales, including extended-spectrum beta-lactamase-producing and fluoroquinolone-resistant strains.In this phase 3, international, double-blind, double-dummy trial, we evaluated the efficacy and safety of orally administered tebipenem pivoxil hydrobromide as compared with intravenous ertapenem in patients with complicated urinary tract infection or acute pyelonephritis. Patients were randomly assigned, in a 1:1 ratio, to receive oral tebipenem pivoxil hydrobromide (at a dose of 600 mg every 8 hours) or intravenous ertapenem (at a dose of 1 g every 24 hours) for 7 to 10 days (or up to 14 days in patients with bacteremia). The primary efficacy end point was overall response (a composite of clinical cure and favorable microbiologic response) at a test-of-cure visit (on day 19, within a ±2-day window) in the microbiologic intention-to-treat population. The noninferiority margin was 12.5%.A total of 1372 hospitalized adult patients were enrolled; 868 patients (63.3%) were included in the microbiologic intention-to-treat population (50.8% of whom had complicated urinary tract infections and 49.2% of whom had pyelonephritis). An overall response was seen in 264 of 449 patients (58.8%) who received tebipenem pivoxil hydrobromide, as compared with 258 of 419 patients (61.6%) who received ertapenem (weighted difference, -3.3 percentage points; 95% confidence interval [CI], -9.7 to 3.2). Clinical cure at the test-of-cure visit was observed in 93.1% of the patients in the microbiologic intention-to-treat population who received tebipenem pivoxil hydrobromide and 93.6% of patients who received ertapenem (weighted difference, -0.6 percentage point; 95% CI, -4.0 to 2.8); the majority of patients with microbiologic response failures at the test-of-cure visit were asymptomatic patients with recurrent bacteriuria. Secondary and subgroup analyses were supportive of the primary analysis. Adverse events were observed in 25.7% of patients who received tebipenem pivoxil hydrobromide and in 25.6% of patients who received ertapenem; the most common adverse events were mild diarrhea and headache.Oral tebipenem pivoxil hydrobromide was noninferior to intravenous ertapenem in the treatment of complicated urinary tract infection and acute pyelonephritis and had a similar safety profile. (Funded by Spero Therapeutics and the Department of Health and Human Services; ADAPT-PO ClinicalTrials.gov number, NCT03788967.).

Nature offers inspiration for developing technologies that integrate the capture, conversion, and storage of solar energy. In this review article, we highlight principles of natural photosynthesis and artificial photosynthesis, drawing comparisons between solar energy transduction in biology and emerging solar-to-fuel technologies. Key features of the biological approach include use of earth-abundant elements and molecular interfaces for driving photoinduced charge separation reactions that power chemical transformations at global scales. For the artificial systems described in this review, emphasis is placed on advancements involving hybrid photocathodes that power fuel-forming reactions using molecular catalysts interfaced with visible-light-absorbing semiconductors.

Lupus anticoagulant (LA) is one of the three criteria antiphospholipid antibodies (aPLs) employed in classification, and by default diagnosis, of antiphospholipid syndrome (APS). Detection of LA is not via calibrated assays but is based on functional behavior of the antibodies in a medley of coagulation assays. A prolonged clotting time in a screening test is followed by demonstration of phospholipid dependence and inhibitory properties in confirmatory and mixing tests, respectively, which are modifications of the parent screening test. Complications arise because no single screening test is sensitive to every LA, and no test is specific for LA, because they are prone to interference by other causes of elevated clotting times. Several screening tests are available but the pairing of dilute Russell's viper venom time (dRVVT) with LA-sensitive activated partial thromboplastin time (aPTT) is widely used and recommended because it is proven to have good detection rates. Nonetheless, judicious use of other assays can improve diagnostic performance, such as dilute prothrombin time to find LA unreactive with dRVVT and aPTT, and the recently validated Taipan snake venom time with ecarin time confirmatory test that are unaffected by vitamin K antagonist and direct factor Xa inhibitor anticoagulation. Expert body guidelines and their updates have improved harmonization of laboratory practices, although some issues continue to attract debate, such as the place of mixing tests in the medley hierarchy, and areas of data manipulation such as assay cut-offs and ratio generation. This article reviews current practices and challenges in the laboratory detection of LA.

Congenital protein C deficiency is an important cause of thrombosis in humans but is not described in dogs. A 4‐year‐old Hungarian Vizsla was presented for investigation of acute onset of ascites. Computed tomography of the chest and abdomen and echocardiography confirmed a large thrombus within the right ventricle. A cause for thrombosis was not initially identified. The clinical signs resolved rapidly and the dog was administered clopidogrel and discharged. Plasma protein C activity measured 2 and 6 weeks later was markedly lower than expected on both occasions. All known causes of acquired protein C deficiency were excluded, and the dog was diagnosed with a congenital protein C deficiency. After diagnosis, the administration of clopidogrel was stopped and administration of rivaroxaban was started. The dog remains well with no evidence of recurrent thrombosis with 6 months of follow‐up.

Long-acting cabotegravir (CAB) extends antiretroviral drug administration from daily to monthly. However, dosing volumes, injection site reactions and health-care oversight are obstacles towards a broad usage. The creation of poloxamer-coated hydrophobic and lipophilic CAB prodrugs with controlled hydrolysis and tissue penetrance can overcome these obstacles. To such ends, fatty acid ester CAB nanocrystal prodrugs with 14, 18 and 22 added carbon chains were encased in biocompatible surfactants named NMCAB, NM2CAB and NM3CAB and tested for drug release, activation, cytotoxicity, antiretroviral activities, pharmacokinetics and biodistribution. Pharmacokinetics studies, performed in mice and rhesus macaques, with the lead 18-carbon ester chain NM2CAB, showed plasma CAB levels above the protein-adjusted 90% inhibitory concentration for up to a year. NM2CAB, compared with NMCAB and NM3CAB, demonstrated a prolonged drug release, plasma circulation time and tissue drug concentrations after a single 45 mg per kg body weight intramuscular injection. These prodrug modifications could substantially improve CAB’s effectiveness. Nanoformulated long-acting cabotegravir prodrugs are shown to be capable of extending the native drug’s antiretroviral activity, biodistribution and pharmacokinetics for up to 12 months in mice and rhesus macaques.

Introduction Life cycle assessment (LCA) has a technical architecture that limits data interoperability, transparency, and automated integration of external data. More advanced information technologies offer promise for increasing the ease with which information can be synthesized within an LCA framework.

Within the aerospace industry there is a growing interest in evaluating and reducing the environmental impacts of products and related risks to business. Consequently, requests from governments, customers, manufacturers, and other interested stakeholders, for environmental information about aerospace products are becoming widespread. Presently, requests are inconsistent and this limits the ability of the aerospace industry to meet the informational needs of various stakeholders and reduce the environmental impacts of their products in a cost-effective manner. Energy consumption is a significant business cost, risk, and a simple proxy value for overall environmental impact. This paper presents the initial research carried out by an academic and industry consortium to develop standardised methods for calculating and reporting the embodied manufacturing energy content of aerospace products. Following an action research approach, three potential methods are identified and applied in a real manufacturing environment. Suitability for use across the aerospace value chain is assessed. The benefits, implementations issues, areas of data uncertainty, and differences in results are outlined. Results show companies could be over/under reporting the embodied manufacturing energy content of parts by a factor of 10. The subsequent business and EU policy implications for industry reporting and evaluating product risks are discussed. The paper concludes the novel research outcomes will be valuable to businesses and other interested stakeholders seeking to report or understand the embodied energy content of aerospace products and associated data uncertainty, as well as inform the development of future industry standards.

The 5000 arthropod genomes initiative (i5k) has tasked itself with coordinating the sequencing of 5000 insect or related arthropod genomes. The resulting influx of data, mostly from small research groups or communities with little bioinformatics experience, will require visualization, dissemination and curation, preferably from a centralized platform. The National Agricultural Library (NAL) has implemented the i5k Workspace@NAL (http://i5k.nal.usda.gov/) to help meet the i5k initiative's genome hosting needs. Any i5k member is encouraged to contact the i5k Workspace with their genome project details. Once submitted, new content will be accessible via organism pages, genome browsers and BLAST search engines, which are implemented via the open-source Tripal framework, a web interface for the underlying Chado database schema. We also implement the Web Apollo software for groups that choose to curate gene models. New content will add to the existing body of 35 arthropod species, which include species relevant for many aspects of arthropod genomic research, including agriculture, invasion biology, systematics, ecology and evolution, and developmental research.

Summary Total knee arthroplasty (TKA) is a fairly common procedure in the United States. Blood loss in the perioperative period is inevitable. Postoperative hematomas and hemarthrosis can develop when bleeding occurs into the knee joint postoperatively, thereby increasing pain and swelling and hindering recovery (Rosenberg, 2007). To minimize the loss of blood intraoperatively, conventional electrocautery is routinely used. However, an alternative approach in preventing blood loss intraoperatively involves the use of a bipolar sealer device designed to seal rather than cauterize blood vessels. Because the bipolar sealer operates at a cooler temperature than the traditional electrocautery method, researchers propose that the bipolar sealer is less traumatizing to tissue and minimizes blood loss in the perioperative period. Therefore, the objective of this study is to assess the effectiveness of the bipolar sealer when compared to the standard electrocautery device in terms of minimizing blood loss and preserving the patient's hemoglobin. A reduced need to transfuse blood could minimize patient risk related to blood transfusion and ultimately reduce hospital length of stay. The research study offers a retrospective collection of demographic, clinical, and outcome data from patients who underwent TKA either with standard electrocautery or bipolar sealer. However, major study design flaws and limitations in this investigation overshadowed the findings which failed to demonstrate a benefit in using the bipolar sealer over the standard electrocautery method. BS

Math proficiency is a prerequisite to the performance of many nursing functions, including medication calculations, but many nursing students have difficulty performing this basic clinical skill. Research has demonstrated that math aptitude alone does not fully explain student outcomes on medication calculation assessments (MCAs), and contextual factors associated with reading and interpreting written medication questions are important for nurse educators to better understand. Reading and English aptitude are proposed as two potential contextual factors that may help explain the nursing student's ability to pass a written MCA. The purpose of this study was to describe the effects of reading and English aptitude on baccalaureate nursing students' ability to pass an MCA taken during the junior year of the nursing curriculum.

Identifying confidence levels and instructional strategies of high school agriculture education teachers when working with students with special needs , Identifying confidence levels and instructional strategies of high school agriculture education teac... , مرکز فناوری اطلاعات و اطلاع رسانی کشاورزی

The purpose of this study was to examine factors related to a graduate student’s decision to take on-line courses in agricultural and extension education and to determine if differences exist in perceptions related to the seven principles of good practice in on-line courses and on-campus courses in a graduate program. The population for this study was all graduate students who had taken at least one on-line course and one on-campus course in an Agricultural and Extension Education graduate program. The theoretical framework for this study was based on Chickering and Ehrmann’s (1996) explanation of technological strategies for the “Seven Principles of Good Practice” for teaching at the university level. Findings suggested that a major factor in students’ decisions to enroll in distance education courses was the “convenience” factor; however, there is a trade off for this convenience. On-line courses do not compare favorably with on-campus courses in regards to the interaction between students and students and professors. On-campus courses were viewed more favorably in regards to the principle “Good Practice Respects Diverse Talents and Ways of Learning.” Students did not perceive distance education courses to be easier than on-campus courses.

This study examined the seriousness with which agriculture teachers view the misbehavior of students enrolled in their agriculture programs today and sought to determine if the level of seriousness of student misbehavior in agricultural education has changed over time. The participants in the study were 165 agricultural education teachers in North Carolina, South Carolina, and Virginia. These teachers rated 77 misbehaviors according to how serious a problem it created for them in their agriculture programs. No misbehaviors received a rating higher than 2.0 on a scale that had 4.0 as the critically disruptive behaviors, indicating that student misbehavior is not a serious problem in agricultural education. The most serious misbehavior manifested by students is a negative attitude toward school. However, there could be cause for concern when one realizes that the number one problem found in previous studies, “exhibiting an ambivalent attitude,” slid to a 20 th place ranking. In this study, teachers perceive that students have finally made up their minds about school - they don't like it. The "love-hate" relationship reported by Burnett and Moore (1988) has essentially developed into a "hate" relationship.

Haemostasis comprises the balanced orchestration of vascular integrity, circulating procoagulant and anticoagulant proteins, and cellular blood components (Moore and Rangarajan, 2009). Disturbances of one or more of these integrated compartments can lead to abnormal bleeding. The main reasons for requiring haemostasis screening tests are preoperative checks, investigation of bleeding or monitoring of anticoagulant therapy.

Members of the Original Equipment Manufacturer Group (OMEG) at National Semiconductor Corporation (NSC) were used to help answer the question of whether empowerment programs, independent of quality improvement programs such as total quality management (TQM), create customer satisfaction. Results of a customer satisfaction survey, administered to a sample of NSC customers prior to implementing an empowerment program and then again one year into the program, provided affirmative support for our research question. Finally, a conceptual model suggesting a process by which empowerment programs create customer satisfaction is proposed to provide direction for future research.

The purpose of this study was to examine the impact of block scheduling on teachers and agricultural education programs in North Carolina. Questionnaires were sent to the senior agricultural instructor in each department in the state. Responses were obtainedfrom 68 percent. Approximately 75% of the NC schools are on block scheduling. Teachers generally have a positive attitude toward block scheduling. Block scheduling has resulted in an substantial increas e in the number of agriculture students while the number of students in the FFA has remained the same .Block scheduling has had little impact on the quality of the instruction a slight negative impact on SAE, and a substantial negative impact on the FFA program. A variety of instructional techniques are needed and eac h class period needs to be broken up into segments .The communications, the entire structure and operating procedures for the FFA may need to be re-examined.

We have measured the drag coefficient on an American football oriented so that its major axis is pointed directly into the wind. The football was suspended from the top of a wind tunnel by bicycle spokes attached to small bearings. The results are similar to the drag coefficients reported by Rouse (1946) for the case of an ellipsoid with major diameter/minor diameter similar to the length/diameter for the football. The drag coefficient for a spinning football is slightly lower than that for a nonspinning football. Both are in the range of 0.05–0.06, about half the value assumed by Brancazio (1985), about one-third that reported by Rae and Streit (2002) and far smaller than that reported by Cunningham and Dowell (1976).

Substituted azaquinazolinones were identified as antagonists of the GHSr-1A receptor for the treatment of type II diabetes and obesity. Optimisation for potency and LogD lead to the identification of orally bioavailable, potent antagonists with improved selectivity over hERG.

The development of Friction Stir Joining as a new class of fastening technologies promises to open new design possibilities. The ability to join large components into a unitized structure or super panels offers the potential of reducing the number of manufacturing processes; leading to reduced build times, all the while achieving weight savings; a natural for reducing aircraft production and operational CO2 footprint.

Formal writing assignments are commonly used in nursing education to develop students' critical thinking skills, as well as to enhance their communication abilities. However, writing apprehension is a common phenomenon among nursing students. It has been suggested that reading and English aptitudes are related to formal writing ability, yet neither the reading nor the English aptitudes of undergraduate nursing students have been described in the literature, and the relationships that reading and English aptitude have with formal writing ability have not been explored. The purpose of this descriptive correlational study was to describe writing apprehension and to assess the relationships among reading and English aptitude and discipline-specific formal writing ability among undergraduate nursing students. The study sample consisted of 146 sophomores from one baccalaureate nursing program. The results indicated that both reading and English aptitude were related to students' formal writing ability.

Dismissal for academic reasons from a baccalaureate nursing (BSN) program is a phenomenon that has rarely been discussed in the literature, and, as a result, little is known about the academic characteristics of the students who are dismissed. Presently, minority students that have been admitted to BSN programs are less likely to graduate from their respective nursing programs than White BSN students are, but whether or not ethnic minority student attrition is due to academic dismissal has not been clearly described. In addition, the antecedent academic characteristics that may identify minority BSN students at high risk for academic dismissal are not fully understood. Thus, the primary purpose of this study was to describe the academic characteristics ofa sample of minority BSN students who experienced academic dismissal. A secondary purpose was to compare ethnic minority BSN students who were dismissed with a sample of ethnic minority BSN students who were academically successful. The results revealed that ethnic minority BSN students who were dismissed for academic reasons tended to have low scholastic and nursing aptitudes, and that nursing aptitudes were higher among ethnic minority BSN students who were academically successful.

The results of the study of residential housing prices of homes located in the proximity of a large toxic chemical waste landfill in the Toledo, Ohio, area for 1986-1990, strongly suggest a distinct negative impact on sale prices for homes located within 2.6 miles of the existing site, and a diminishing impact before a distance of 5.75 miles is reached. Within the 0-2.6 mile range of the Envirosafe Landfill, a $14,200 premium was found for each mile a house was located away from the Landfill. The premium is greater than found in other studies. A second proposed site in 1989, for low-level radioactive wastes, showed a clear, initial negative impact on housing sales prices upon announcement, but the negative effect on prices dissipated soon after extensive public resistance became evident and caused the proposal to be canceled.

A study of Ohio real estate brokers and home buyers finds that a mandatory disclosure requirement had limited success in altering both buyer's perceptions of the role of cooperating real estate salespersons and broker's perceptions of the role they play in the purchase and sales negotiation process between home buyers and sellers.

A wide range of strategies have been put forward to curb the continuing growth of road transport emissions. One aspect of road transportation that has not received much attention is the design philosophy for road structural design. The main topic for this paper deals with applying sustainability principles to high volume urban road structural design. Historically, empirical approaches have been used for flexible pavement design. The accepted life cycle involves periodic routine maintenance and a major rehabilitation treatment every 18 to 25 years. With better analytical techniques and better materials flexible pavements can now be designed and constructed to last 50 years with only minimal maintenance intervention. The benefits of this approach are significant in terms of lower long term life cycle costs, lower greenhouse gas emissions and a better balance of environmental and social impacts. The recently completed Red Hill Valley Parkway project in Hamilton, Ontario, Canada is presented as an example of how the perpetual pavement design strategy can be implemented.