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Objective: To promote antimicrobial stewardship, many institutions have implemented a policy of reflexing to a urine culture based on a positive urinalysis result. The rehabilitation patient population, including individuals with brain and spinal cord injuries, may have atypical presentations of urinary tract infections. The study objective is to determine the effects of implementing a urine culture reflex policy in this specific patient population., Design: In an inpatient rehabilitation unit, 348 urinalyses were analyzed from August 2019 to June 2021. Urinalysis with greater than or equal to 10 white blood cells per high power field was automatically reflexed to a urine culture in this prospective study. Primary outcome was return to acute care related to urinary tract infection. Secondary outcomes included adherence to reflex protocol, antibiotic utilization and appropriateness, adverse outcomes related to antibiotic use, and reduction in urine cultures processed and the associated reduction in healthcare costs., Results: There was no statistically significant difference before and after intervention related to the primary outcome. Urine cultures processed were reduced by 58% after intervention., Conclusions: Urine culture reflex policy is likely an effective intervention to reduce the frequency of urine cultures without significantly affecting the need to transfer patients from inpatient rehabilitation back to the acute care setting., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Faecal or biopsy samples are frequently used to analyse the gut microbiota, but issues remain with the provision and collection of such samples. Rectal swabs are widely-utilised in clinical practice and previous data demonstrate their potential role in microbiota analyses; however, studies to date have been heterogenous, and there are a particular lack of data concerning the utility of swabs for the analysis of the microbiota's functionality and metabolome. We compared paired stool and rectal swab samples from healthy individuals to investigate whether rectal swabs are a reliable proxy for faecal sampling. There were no significant differences in key alpha and beta diversity measures between swab and faecal samples, and inter-subject variability was preserved. Additionally, no significant differences were demonstrated in abundance of major annotated phyla. Inferred gut functionality using Tax4Fun2 showed excellent correlation between the two sampling techniques (Pearson's coefficient r = 0.9217, P < 0.0001). Proton nuclear magnetic resonance ( 1 H NMR) spectroscopy enabled the detection of 20 metabolites, with overall excellent correlation identified between rectal swab and faecal samples for levels all metabolites collectively, although more variable degrees of association between swab and stool for levels of individual metabolites. These data support the utility of rectal swabs in both compositional and functional analyses of the gut microbiota., (© 2023. The Author(s).)

We report two methods to create zinc-sponge electrodes that suppress dendrite formation and shape change for rechargeable zinc batteries. Both methods are characterized by creating a paste made of zinc particles, organic porogen, and viscosity-enhancing agent that is heated under an inert gas and then air. During heating under the inert gas, the zinc particles anneal together, and the porogen decomposes; under air, the zinc fuses and residual organic burns out, yielding an open-cell metal foam or sponge. We tune the mechanical and electrochemical properties of the zinc sponges by varying zinc-to-porogen mass ratio, heating time under inert gas and air, and size and shape of the zinc and porogen particles. An advantage of the reported methods is their ability to finely tune zinc-sponge architecture. The selected size and shape of the zinc and porogen particles influence the morphology of the pore structure. A limitation is that resulting sponges have disordered pore structures that result in low mechanical strength at low volume fractions of zinc (<30%). Applications for these zinc-sponge electrodes include batteries for grid-storage, personal electronics, electric vehicles, and electric aviation. Users can expect zinc-sponge electrodes to cycle up to 40% depth of discharge at technologically relevant rates and areal capacities without the formation of separator-piercing dendrites.

Primary aluminum-air batteries boast high theoretical energy densities, but negative electrode corrosion irreversibly limits their shelf life. Most corrosion mitigation methods are insufficient or compromise power and energy density. We suppressed open-circuit corrosion by displacing electrolyte from the electrode surface with a nonconducting oil during battery standby. High power and energy density are enabled by displacing the oil with electrolyte for battery discharge. The underwater-oleophobic wetting properties of the designed cell surfaces allow for reversible oil displacement. We demonstrate this method in an aluminum-air cell that achieves a 420% increase in usable energy density and 99.99% reduction in corrosion, which lowers self-discharge to a rate of 0.02% a month and enables system energy densities of 700 watt-hours per liter and 900 watt-hours per kilogram., (Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Aicardi syndrome is a sporadic disorder that affects primarily females and is hypothesized to be caused by heterozygous mutations in an X-linked gene. Its main features include of a triad of infantile spasms, agenesis of the corpus callosum, and distinctive chorioretinal lacunae. Additional common findings include moderate to profound mental retardation, gray matter heterotopia, gyral anomalies, and vertebral and rib defects. To date, no consistent facial dysmorphisms have been described. We examined 40 girls with Aicardi syndrome and determined that consistent facial features appeared in over half the study participants and included a prominent premaxilla, upturned nasal tip, decreased angle of the nasal bridge, and sparse lateral eyebrows. Externally apparent microphthalmia was seen in 10/40 (25%). Various skin lesions (including multiple nevi, skin tags, hemangiomas, one giant melanotic nevus, and a history of a previously removed angiosarcoma) were present in 8/40 (20%). Hand abnormalities were seen in 3/40 (7.5%) and included camptodactyly, proximal placement of the thumb and hypoplasia of the fifth finger. This study clearly delineates the existence of a distinctive facial phenotype of Aicardi syndrome not previously described. We recommend that features of a prominent premaxilla with upturned nasal tip and vascular malformations/vascular tumors be added to the modified diagnostic criteria in order to improve the ability of geneticists to diagnose Aicardi syndrome.

A 4-element array of coherently driven dipole microwave antennae produces a hot spot in the central region of the implanted volume and cold spots in the peripheral regions of the implant. Conversely, an incoherently driven array of antennae predominantly heats peripheral (along the antennae) regions of the implant. These two modes of feeding the antennae are complementary in a sense that the cold zones obtained with the coherently driven antennae coincide with the hot zones obtained with the incoherently driven antennae and vice versa. The SAR distributions resulting from mixing these modes of feeding (mixed-mode technique) were studied theoretically and experimentally. A theoretical model that allowed calculation of SAR distributions of a 4-element array of microwave antennae fed coherently, incoherently or using a mixed-mode technique was developed in this work. The goal of the theoretical study was to determine the proper mix of the coherent and incoherent modes of feeding the antennae such that the adequately (enclosed within a 50% isoSAR surface) heated volume was maximized. In experimental studies, the antennae were driven in a cyclical manner with a duty cycle equal to the weight of the coherent mode in the mix. The duty cycle was defined as the ratio of the time the antennae were driven coherently to the total duration of the cycle. To facilitate the periodical change from the coherent to incoherent feeding, a special electromechanical switch was developed. This switch allowed a wide range of variation of the duty cycle and cycle period. Theoretical and experimental studies have demonstrated that, if the relative weight of the coherent feeding in the mix-mode technique was 30% (duty cycle = 0.3), the adequately heated volume was significantly larger and the SAR distribution was more uniform than those obtained with either the coherent or incoherent mode of feeding.

This study examined some of the effects of soldierfish (Gymnapistes marmoratus) venom on the cardiovascular system of rats. Venom (20 microg/ml) produced a biphasic response on rat isolated spontaneously beating atria. This was characterised by a negative, followed by a positive, inotropic and chronotropic action. The increase in force and rate was significantly reduced by propranolol (5 microM) or pretreatment of the rats with reserpine. The decrease in force was significantly inhibited by atropine (0.5 microM). Venom (20-60 microg/ml) produced dose-dependent relaxation in rat isolated endothelium-intact aortae but no response in endothelium-denuded, aortae. Relaxation to venom (30 microg/ml) was significantly inhibited by the nitric oxide synthase inhibitor N(omega)-nitro-L-arginine (NOLA; 0.1 mM) but was unaffected by atropine (0.5 microM). Venom (200 microg/kg, i.v.) produced a biphasic response in anaesthetized rats, consisting of an initial decrease (phase 1) followed by a prolonged increase (phase 2) in mean arterial pressure. Indomethacin (5 mg/kg, i.v.) significantly inhibited phase 1 of the response to venom and significantly potentiated phase 2. NOLA (30 mg/kg, i.v.) significantly inhibited phase 1 of the response to venom and had no significant effect on phase 2. Propranolol (0.5 mg/kg, i.v.) had no significant effect on phase 1 of the response to venom but significantly potentiated phase 2. Neither phase of the response to venom was significantly affected by atropine (2 mg/kg, i.v.), methysergide (2 mg/kg, i.v.) or prazosin (50 microg/kg, i.v.). These results suggest that soldierfish venom acts indirectly at beta-adrenoceptors to produce a positive inotropic and chronotropic effect in atria, and acts at muscarinic receptors to produce a negative inotropic effect. In addition, beta-adrenoceptors mediate a delayed depressor component in vivo that is absent throughout the initial depressor response to the venom and present during, but masked by, the pressor response. Soldierfish venom also appears to stimulate the release of nitric oxide from endothelial cells to produce relaxation of vascular smooth muscle and contribute to the depressor response produced by the venom in anaesthetized rats. The depressor response also appears to be partially mediated by vasodilator prostanoids.

Venoms from the scorpaeniformes Synanceja trachynis and Gymnapistes marmoratus were quantitatively analyzed for enzymic activity. S. trachynis venom displayed significantly higher hyaluronidase activity than G. marmoratus venom, and G. marmoratus venom displayed significantly higher levels of esterase, acid phosphatase, alkaline phosphatase and phosphodiesterase activity. No detectable quantities of phospholipase A2 activity were found in G. marmoratus venom. SDS-polyacrylamide gel electrophoresis of S. trachynis venom indicated the presence of 6 protein bands (20 kDa-295 kDa). G. marmoratus venom displayed 8 protein bands (11 kDa-109 kDa).

The aim of the present study was to commence a characterisation of some of the basic pharmacological properties of venom from the soldierfish (Gymnapistes marmoratus). Soldierfish venom was prepared by extraction into 10% glycerol and centrifugation to remove insoluble material. Protein content was determined and venom concentrations were expressed as microgram venom protein. Soldierfish venom (0.5-15 micrograms/ml) produced concentration-dependent contractile responses in guinea-pig isolated ileum (GPI) and longitudinal smooth muscle (LSM) preparations. The muscarinic receptor antagonist atropine (10 nM) significantly inhibited responses of LSM to soldierfish venom (2.5 micrograms/ml). Responses to soldierfish venom (4-5 micrograms/ml) in GPI were not significantly affected by the ganglion-blocking drug mecamylamine (10 microM) or by incubation with blood cholinesterase. The cyclooxygenase inhibitor indomethacin (2 microM) significantly inhibited responses to soldierfish venom (2.5 micrograms/ml) in LSM. Neither the thromboxane A2/prostaglandin H2 receptor antagonist GR32191B (1 microM) nor the leukotriene receptor antagonist SB205312 (10 nM) significantly affected responses to soldierfish venom (5 micrograms/ml) in GPI. Responses to soldierfish venom (2.5-5 micrograms/ml) were not significantly inhibited by the histamine receptor antagonist mepyramine (0.5 microM), the angiotensin-converting enzyme inhibitor captopril (2 microM) or the neurokinin-1 receptor antagonist CP-99,994 (0.1 microM) in LSM. The angiotensin AT1 receptor antagonist EXP3174 (0.1 microM) also failed to inhibit significantly the responses to soldierfish venom (5 micrograms/ml) in GPI. A fluorometric assay for the detection of 5-hydroxytryptamine (5-HT) and related compounds indicated a level in soldierfish venom of 1.60 +/- 0.01 ng of 5-HT-like substance per microgram venom protein. Soldierfish venom (0.5-10 micrograms/ml) produced concentration-dependent contractile responses in rat isolated stomach fundus strips, and these responses (2.5 micrograms/ml) were significantly inhibited by the 5-HT1/5-HT2 receptor antagonist methysergide (0.1 microM). These results suggest that soldierfish venom may stimulate the release of acetylcholine to act at muscarinic receptors on guinea-pig gastrointestinal smooth muscle. The venom also appears to be causing the release of cyclooxygenase products, such as prostaglandins, and contains 5-HT, or a 5-HT-like substance, that acts directly at 5-HT receptors.

The aim of the present study was to investigate previously suggested adrenergic and tachykinin activity, as well as the cardiovascular effects, of venom from the stonefish (Synanceja trachynis). Stonefish venom (60-120 micrograms/kg, i.v.) produced dose-dependent bronchoconstriction in anaesthetised guinea-pigs. This response (100 micrograms/kg, i.v.) was significantly reduced by the neurokinin 1 (NK1) receptor antagonist CP-99,994 (1 mg/kg, i.v.). Contractile responses to venom (4 micrograms/ml) of guinea-pig isolated ileum (GPI) were significantly inhibited by a combination of the sodium channel blocking drug tetrodotoxin (1 microM) and the ganglion blocking drug mecamylamine (10 microM). However, subsequent administration of CP-99,994 (0.1 microM) did not produce further inhibition. Endogenous tachykinin depletion with capsaicin (1 microM) also significantly attenuated responses to venom (4 micrograms/ml) in GPI. Venom (4 micrograms/ml) produced increases in rate and force of contraction of rat spontaneously beating isolated atria which were significantly inhibited by the beta-adrenoceptor antagonist propranolol (5 microM) but not by noradrenergic transmitter depletion with reserpine (4.5 mg/kg, i.p.). In the presence of the alpha 1-adrenoceptor antagonist prazosin (0.3 microM), venom (6 micrograms/ml) significantly inhibited electrically evoked twitches of prostatic segments of rat vas deferens. The inhibitory effect of venom was significantly reduced by the alpha 2-adrenoceptor antagonist idazoxan (1 microM) but not by propranolol (5 microM) or the neurokinin 2 (NK2) receptor antagonist SR-48,968 (0.1 microM). Venom (60-120 micrograms/kg, i.v.) produced dose-dependent increases in mean arterial blood pressure in anaesthetised rats. This pressor response (60 micrograms/kg, i.v.) was significantly reduced by prazosin (10-50 micrograms/kg, i.v.) and the leukotriene receptor antagonist SB205312 (1 mg/kg, i.v.), significantly increased by propranolol (2 mg/kg, i.v.), but not significantly affected by the cyclo-oxygenase inhibitor indomethacin (10 mg/kg, i.v.) or the thromboxane A2/prostaglandin H2 (TP) receptor antagonist GR32191B (1 mg/kg, i.v.). Pressor responses to venom (100 micrograms/kg, i.v.) were also observed in anaesthetised rabbits. These results suggest that stonefish venom contains a component capable of stimulating the release of endogenous tachykinins with subsequent activity at NK1 receptors. The venom also appears to act via stimulation of sodium channels on sensory nerves. The venom also has activity at alpha 2-adrenoceptors and a direct action at beta-adrenoceptors. The effect of venom on blood pressure of anaesthetised rats appears to include a pressor component that is mediated, in part,by alpha-adrenoceptors and leukotriene receptors, and a depressor component that is mediated by beta-adrenoceptors. However, the pressor response does not involve action at TP receptors, or require the production of cyclo-oxygenase metabolites.

The dosimetry and dose verification for 6-MV X-rays were performed for radiosurgery cones of 5- to 40-mm diameter. The total scatter factors decrease slowly from 0.936 (40-mm cone) to 0.893 (10-mm cone; a variation of 5%), but they fall to 0.83 (7.5-mm cone) and 0.67 (5-mm cone). The dmax increases from about 12.9 (5-mm cone) to 16.3 mm (40-mm cone). The full width half maximum (FWHMs) of the beam profiles, measured at 5 cm depth, agree with the cone diameters within 1 mm. The 10-90% beam penumbra/FWHM ratio is 0.23 +/- 0.03 (> or = 20-mm cones); for the smaller-diameter cones this ratio increases reaching 0.84 (5-mm cone). New tissue maximum ratios (TMRs) are reported for the 5-, 7.5-, 32.5-, and 37.5-mm-diameter cones. TMRs for the other diameter cones are consistent with published data. The measured doses in two verification studies using the 12 cones with diameters > or = 12.5 mm with a single 360 degrees arc agreed to 2% with the planned doses, and to about 10% for the three smaller cones. In a simulated treatment neglecting tissue heterogeneties (skull bone), the measured doses for two five arc studies (22.5-mm cone) were within 4% of the calculated dose to isocenter.

The present study was designed to examine some of the pharmacological properties of venom from the stonefish (Synanceja trachynis), with particular reference to the presence in the venom of pain-producing/enhancing substances. Stonefish venom (1-6 micrograms/ml) produced concentration-dependent contractile responses in guinea-pig isolated ileum. No tachyphylaxis, or reduction in responses with time, was observed to venom (3 micrograms/ml) in ileum. The response to venom (3 micrograms/ml) was not significantly affected by the histamine antagonist mepyramine (0.5 microM), or a preceding anaphylactic response. Mecamylamine, 5HT-desensitization or EXP3174 failed to have any significant effect on responses to venom (3 micrograms/ml). Responses to venom (3 micrograms/ml) were significantly inhibited by the cyclooxygenase inhibitor indomethacin (5 microM), the leukotriene D4 receptor antagonist FLP55712 (1 microM), the thromboxane A2 receptor antagonist GR32191B (1 microM), the muscarinic receptor antagonist atropine (10 nM) and the neurokinin-1 receptor antagonist CP96345 (0.1 microM). Venom (6 micrograms/ml) produced contractile responses in the rat isolated vas deferens which were abolished by the alpha 1-adrenoceptor antagonist prazosin (0.3 microM) and significantly potentiated by the neuronal uptake inhibitor DMI (1 microM). However, noradrenergic transmitter depletion with reserpine (5 mg/kg, i.p.) did not significantly inhibit responses to venom (6 micrograms/ml). Histamine fluorometric and phospholipase A2 assays failed to detect significant quantities of either substance in the venom. These results suggest that stonefish venom may cause the release of acetylcholine, substance P, and cyclooxygenase products, or contain components which act at these receptors. The venom also appears to contain a component which is a substrate for neuronal uptake and has a direct action at alpha 1-adrenoceptors.

The reproductive organs of the male giraffe differ little in morphology and histology from those of other ungulates. There is some indication that gonadal hypertrophy occurs in late fetal life. Spermatogenesis begins at 3-4 years of age and coincides with a rapid increase of testicular weight and seminiferous tubule diameter. In the fetal testis the main hormone is androsteredione (2.73 microgram/g) but in adult testes testosterone is predominant (less than 10.08 microgram/g) and delta' testosterone may also be present.

The hair of rats injected with strontium-90 retains a significant amount of the radionuclide. Although the strontium-90 content of hair is variable in these rats and appears to be subject to a variety of influences, determination of the radionuclide content of hair may offer a nondestructive method of estimating strontium-90 in bone.