1,721,028 research outputs found
Mono vs. combo regimens with novel beta-lactam/beta-lactamase inhibitor combinations for the treatment of infections due to carbapenemase-producing Enterobacterales: insights from the literature
No full textCeftazidime–avibactam (CZA), meropenem–vaborbactam (MVB) and imipenem–relebactam (I–R) are combinations of old ß-lactams with novel non-ß-lactam ß-lactamase inhibitors (BLBLIs) able to inhibit some carbapenemases, such as the KPC-type, thus are becoming the standard for difficult-to-treat carbapenemase-producing Enterobacterales (CPE); a practical question is whether these novel BLBLIs should be used as monotherapy or as part of a combination regimen with other antibiotics, and if so, with which ones, to reduce the emergence of resistant strains and to optimize their efficacy. In this short review, we assessed clinical outcomes in patients with CPE-infections treated with the novel BLBLIs as mono- or combo-regimens, and laboratory studies on the synergistic effects with other antimicrobials. Available evidence on combination therapy is scarce and mainly limited to retrospective studies involving 630 patients treated with CZA: aminoglycosides were used in 39.6% of 336 patients treated with combo-regimens, followed by polymyxin B/colistin (24.4%), tigecycline (24.1%), carbapenems (13.4%) and fosfomycin (5.4%). Aminoglycosides could be useful in case of bloodstream and severe urinary infections. Pneumonia is a risk factor for CZA-resistance emergence: fosfomycin, due to favorable lung pharmacokinetics/pharmacodynamics, could represent an interesting partner; fosfomycin could be added also for osteomyelitis. Tigecycline could be preferred for intrabdominal and skin-soft tissue infections. Due to nephrotoxicity and lack of in vitro synergy, the association CZA/colistin seems not optimal. MVB and I–R were mostly used as monotherapies. Currently, there is no definitive evidence whether combinations are more effective than monotherapies; further studies are warranted, and to date only personal opinions can be provided
AmpC -lactamase-producing Enterobacterales: what a clinician should know
No full textBackgroundEnterobacterales are among the most common causes of bacterial infections in the community and among hospitalized patients, and multidrug-resistant (MDR) strains have emerged as a major threat to human health. Resistance to third-generation cephalosporins is typical of MDRs, being mainly due to the production of extended spectrum -lactamases or AmpC-type -lactamases.ObjectiveThe objective of this paper is to review the epidemiological impact, diagnostic issues and treatment options with AmpC producers.FindingsAmpC enzymes encoded by resident chromosomal genes (cAmpCs) are produced by some species (e.g., Enterobacter spp., Citrobacter freundii, Serratia marcescens), while plasmid-encoded AmpCs (pAmpCs) can be encountered also in species that normally do not produce cAmpCs (e.g., Salmonella enterica, Proteus mirabilis, Klebsiella pneumoniae and Klebsiella oxytoca) or produce them at negligible levels (e.g., Escherichia coli). Production of AmpCs can be either inducible or constitutive, resulting in different resistance phenotypes. Strains producing cAmpCs in an inducible manner (e.g., Enterobacter spp.) usually appear susceptible to third-generation cephalosporins, which are poor inducers, but can easily yield mutants constitutively producing the enzyme which are resistant to these drugs (which are good substrates), resulting in treatment failures. pAmpCs are usually constitutively expressed. Production of pAmpCs is common in community-acquired infections, while cAmpC producers are mainly involved in healthcare-associated infections.ConclusionsTo date, there is no conclusive evidence about the most appropriate treatment for AmpC-producing Enterobacterales. Carbapenems are often the preferred option, especially for severe infections in which adequate source control is not achieved, but cefepime is also supported by substantial clinical evidences as an effective carbapenem-sparing option
Chemical recycling of polyethylene terephthalate (PET) to monomers: Mathematical modeling of the transesterification reaction of bis(2-hydroxyethyl) terephthalate to dimethyl terephthalate
Full text linkThe accumulation of plastic waste in the environment is making recycling a compelling issue, particularly for polyethylene terephthalate (PET), used in products with a short shelf-life. An appealing route to chemical recycling of PET is glycolysis, leading to bis(2-hydroxyethyl) terephthalate (BHET). Its subsequent transesterification with methanol to dimethyl terephthalate (DMT) is crucial for the recovery of polymer-grade monomers. To favor the industrial applicability of this process, this work investigates the influence of three main parameters, i.e. the methanol to ethylene glycol molar ratio, the solvent to oligomers molar ratio and the mass fraction of the catalyst, on the transesterification of BHET to DMT. A kinetic model has been proposed, and the reaction rates evaluated by comparison with the experimental data. The model was used to predict the performances of the process in a wide range of operating conditions, in order to establish the optimal ones for high yield to DMT
Using the CropSyst Model in Continuous Rainfed maize (Zea mais L.) Under Alternative Management Options
No full textBACKGROUND. Simulation models are increasingly being used for describing and predicting soil-crop variables under a wide variety of conditions in view of providing guidelines at farming level. The CropSyst model was regarded as a valuable tool for investigating continuous maize, relatively to crop production and environmental concerns.
METHODS. The CropSyst model was evaluated for its ability to simulate maize biomass and nitrogen uptake, and two soil variables (i.e., water and NO3-N) in response to different types of tillage, nitrogen fertilisation and ground cover at Pisa, Central Italy. Experimental data sampled during the growing seasons 1994 and 1995 were used for this purpose. The most complex hydrological sub-models included in CropSyst were used (Penman-Monteith for evapo-transpiration, finite difference approach for soil water transport). Estimates provided by the model were compared to the state variables measured during the experiment (green area index, above ground biomass, nitrogen uptake at harvest, soil water content, and soil NO3-N in the upper 0.60 m of soil).
RESULTS. CropSyst gave reasonable estimates of crop area index (average modelling efficiency, EF, equal to 0.96) and biomass (EF=0.82) and soil water content (EF=0.75). Even if the model followed the mean trend of nitrates, a few discrepancies between simulations and measurements were observed in some cases (EF=0.23). Some discrepancies were registered for plant nitrogen uptake as well (in particular in the second year of simulation), but the departures were small in many cases.
CONCLUSIONS. A not fully satisfying response observed in nitrogen simulation does not appear as being extremely dramatic, considering the large variability associated to soil NO3-N, due to several casual factors influencing nitrogen variation in the soil profile. In general, the performance was appropriate and the model appeared as a valid tool for predictive purposes under different management applications. After such preliminary results, further investigation over long-term cultivation is required
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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