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DNA analysis of ancient, desiccated feces – termed paleofeces – can unlock insights into the lives of ancient peoples, including through examination of the gut microbiome and identification of specific pathogens and parasites. We collected desiccated feces from the Cave of the Dead Children (La Cueva de Los Muertos Chiquitos) in the Rio Zape Valley in Mexico dated to 725–920 CE, for targeted pathogen analysis. First, we extracted DNA with methods previously optimized for paleofeces. Then, we applied highly sensitive modern molecular tools (i.e., PCR pre-amplification followed by multi-parallel qPCR) to assess the presence of 30 enteric pathogens and gut microbes. We detected ≥1 pathogen or gut microbe associated gene in each of the ten samples and a mean of 3.9 targets per sample. The targets detected included Blastocystis spp. (n = 7), atypical enteropathogenic E. coli (n = 7), Enterobius vermicularis (n = 6), Entamoeba spp. (n = 5), enterotoxigenic E. coli (n = 5), Shigella spp./enteroinvasive E. coli (n = 3), Giardia spp. (n = 2), and E. coli O157:H7 (n = 1). The protozoan pathogens we detected (i.e., Giardia spp. and Entamoeba spp.) have been previously detected in paleofeces via enzyme-linked immunoassay (ELISA), but not via PCR. This work represents the first detection of Blastocystis spp. atypical enteropathogenic E. coli, enterotoxigenic E. coli , Shigella spp./enteroinvasive E. coli , and E. coli O157:H7 in paleofeces. These results suggest that enteric infection may have been common among the Loma San Gabriel people, who lived in the Rio Zape Valley in Mexico during this period.

[...]the store -- located in an 8,000 square-foot repurposed building across St. John Street from the Chapman Cultural Center and the George, with easy access and ample parking -- will fill a void for downtown workers and residents while providing convenience for shoppers from neighborhoods on the east and west sides of the city.

[...]the store -- located in an 8,000 square-foot repurposed building across St. John Street from the Chapman Cultural Center and the George, with easy access and ample parking -- will fill a void for downtown workers and residents while providing convenience for shoppers from neighborhoods on the east and west sides of the city.

The shop will be set up in Hendra, the suburb in Brisbane's northside racing precinct where horses in a trainer's stable were found infected by equine influenza on Monday. That triggered a lockdown at the Doomben and Eagle Farm racecourses and the Albion Park trotting track. Horses have also been infected at a training track in the north Brisbane suburb of Deagon. All racing in Brisbane is expected to be cancelled until February 1 at the earliest.

\"Twenty years I've been doing this and now it's just come to a complete stop,\" he said. \"We'll have to start all over again.\" A lifetime lover of horses, he is torn between hoping his charges do not contract the virus, and hoping they catch it as quickly as possible. \"It's a tough thing to have to say, and you like to do the right thing by the owners of your horses and look after them as best as possible, but the sooner all 500 hundred horses in this area catch the flu, the sooner we can get them back to health and get racing going again.\" Fellow Hendra trainer Robert Heathcote had a more radical solution. \"It may sound draconian,\" he said, \"but if my horses aren't affected, I'm going to go and stick my hand down [Peter Hulpert]'s horses' throats and then give it to my horses.

\"Twenty years I've been doing this and now it's just come to a complete stop,\" he said. \"We'll have to start all over again.\" A lifetime lover of horses, he is torn between hoping his charges do not contract the virus, and hoping they catch it as quickly as possible. \"It's a tough thing to have to say, and you like to do the right thing by the owners of your horses and look after them as best as possible, but the sooner all 500 hundred horses in this area catch the flu, the sooner we can get them back to health and get racing going again.\" Fellow Hendra trainer Robert Heathcote had a more radical solution. \"It may sound draconian,\" he said, \"but if my horses aren't affected, I'm going to go and stick my hand down [Peter Hulpert]'s horses' throats and then give it to my horses.\"

The First Down Initiative is a program bringing the partnership of Ms. Jepsen the ninth grade Academy leader and Mr. Smith, the varsity football coach. Each ninth grade student was nominated by a teacher who believes the student has more to offer than what he has shown in the classroom so far. Forty ninth-grade boys were nominated and each one was accepted to the program. The First Down Initiative meets every Tuesday, Wednesday and Thursday during the athletic study hall, with the football players mentoring the students on academics. As a prodigy of the mentor, the students will be guided in the right aspects of behavior, such as learning respect as well as academics. [Anthony Orbita] is a wide receiver/defensive back is taking all Advanced Placement classes and is also the senior class secretary. He is involved in Meade High at almost every level and is motivating and encouraging according to several of his fellow students.

Advanced colorectal cancer is treated with a combination of cytotoxic drugs and targeted treatments. However, how best to minimise the time spent taking cytotoxic drugs and whether molecular selection can refine this further is unknown. The primary aim of this study was to establish how cetuximab might be safely and effectively added to intermittent chemotherapy. COIN-B was an open-label, multicentre, randomised, exploratory phase 2 trial done at 30 hospitals in the UK and one in Cyprus. We enrolled patients with advanced colorectal cancer who had received no previous chemotherapy for metastases. Randomisation was done centrally (by telephone) by the Medical Research Council Clinical Trials Unit using minimisation with a random element. Treatment allocation was not masked. Patients were assigned (1:1) to intermittent chemotherapy plus intermittent cetuximab or to intermittent chemotherapy plus continuous cetuximab. Chemotherapy was FOLFOX (folinic acid and oxaliplatin followed by bolus and infused fluorouracil). Patients in both groups received FOLFOX and weekly cetuximab for 12 weeks, then either had a planned interruption (those taking intermittent cetuximab) or planned maintenance by continuing on weekly cetuximab (continuous cetuximab). On RECIST progression, FOLFOX plus cetuximab or FOLFOX was recommenced for 12 weeks followed by further interruption or maintenance cetuximab, respectively. The primary outcome was failure-free survival at 10 months. The primary analysis population consisted of patients who completed 12 weeks of treatment without progression, death, or leaving the trial. We tested BRAF and NRAS status retrospectively. The trial was registered, ISRCTN38375681. We registered 401 patients, 226 of whom were enrolled. Results for 169 with KRAS wild-type are reported here, 78 (46%) assigned to intermittent cetuximab and 91 (54%) to continuous cetuximab. 64 patients assigned to intermittent cetuximab and 66 of those assigned to continuous cetuximab were included in the primary analysis. 10-month failure-free survival was 50% (lower bound of 95% CI 39) in the intermittent group versus 52% (lower bound of 95% CI 41) in the continuous group; median failure-free survival was 12·2 months (95% CI 8·8–15·6) and 14·3 months (10·7–20·4), respectively. The most common grade 3–4 adverse events were skin rash (21 [27%] of 77 patients vs 20 [22%] of 92 patients), neutropenia (22 [29%] vs 30 [33%]), diarrhoea (14 [18%] vs 23 [25%]), and lethargy (20 [26%] vs 19 [21%]). Cetuximab was safely incorporated in two first-line intermittent chemotherapy strategies. Maintenance of biological monotherapy, with less cytotoxic chemotherapy within the first 6 months, in molecularly selected patients is promising and should be validated in phase 3 trials. UK Medical Research Council, Merck KGaA.

Background Host-associated microbial communities have important roles in tissue homeostasis and overall health. Severe perturbations can occur within these microbial communities during critical illness due to underlying diseases and clinical interventions, potentially influencing patient outcomes. We sought to profile the microbial composition of critically ill mechanically ventilated patients, and to determine whether microbial diversity is associated with illness severity and mortality. Methods We conducted a prospective, observational study of mechanically ventilated critically ill patients with a high incidence of pneumonia in 2 intensive care units (ICUs) in Hamilton, Canada, nested within a randomized trial for the prevention of healthcare-associated infections. The microbial profiles of specimens from 3 anatomical sites (respiratory, and upper and lower gastrointestinal tracts) were characterized using 16S ribosomal RNA gene sequencing. Results We collected 65 specimens from 34 ICU patients enrolled in the trial (29 endotracheal aspirates, 26 gastric aspirates and 10 stool specimens). Specimens were collected at a median time of 3 days (lower respiratory tract and gastric aspirates; interquartile range [IQR] 2–4) and 6 days (stool; IQR 4.25–6.75) following ICU admission. We observed a loss of biogeographical distinction between the lower respiratory tract and gastrointestinal tract microbiota during critical illness. Moreover, microbial diversity in the respiratory tract was inversely correlated with APACHE II score ( r  = − 0.46, p  = 0.013) and was associated with hospital mortality (Median Shannon index: Discharged alive; 1.964 vs. Deceased; 1.348, p  = 0.045 ) . Conclusions The composition of the host-associated microbial communities is severely perturbed during critical illness. Reduced microbial diversity reflects high illness severity and is associated with mortality. Microbial diversity may be a biomarker of prognostic value in mechanically ventilated patients. Trial registration ClinicalTrials.gov ID NCT01782755 . Registered February 4 2013.

Clinicians' current practice patterns in the management of acute respiratory distress syndrome (ARDS) and refractory hypoxemia are not well described. To describe mechanical ventilation strategies and treatment adjuncts for adults with ARDS, including refractory hypoxemia. This was a prospective cohort study (March 2014-February 2015) of mechanically ventilated adults with moderate-to-severe ARDS requiring an Fi of 0.50 or greater in 24 intensive care units. We enrolled 664 patients: 222 (33%) with moderate and 442 (67%) with severe ARDS. On Study Day 1, mean Vt was 7.5 (SD = 2.1) ml/kg predicted body weight (n = 625); 80% (n = 501) received Vt greater than 6 ml/kg. Mean positive end-expiratory pressure (PEEP) was 10.5 (3.7) cm H O (n = 653); 568 patients (87%) received PEEP less than 15 cm H O. Treatment adjuncts were common (n = 440, 66%): neuromuscular blockers (n = 276, 42%), pulmonary vasodilators (n = 118, 18%), prone positioning (n = 67, 10%), extracorporeal life support (n = 29, 4%), and high-frequency oscillatory ventilation (n = 29, 4%). Refractory hypoxemia, defined as Pa less than 60 mm Hg on Fi of 1.0, occurred in 138 (21%) patients. At onset of refractory hypoxemia, mean Vt was 7.1 (SD = 2.0) ml/kg (n = 124); 95 patients (77%) received Vt greater than 6 ml/kg. Mean PEEP was 12.1 (SD = 4.4) cm H O (n = 133); 99 patients (74%) received PEEP less than 15 cm H O. Among patients with refractory hypoxemia, 91% received treatment adjuncts (126/138), with increased use of neuromuscular blockers (n = 87, 63%), pulmonary vasodilators (n = 57, 41%), and prone positioning (n = 32, 23%). Patients with moderate-to-severe ARDS receive treatment adjuncts frequently, especially with refractory hypoxemia. Paradoxically, therapies with less evidence supporting their use (e.g., pulmonary vasodilators) were over-used, whereas those with more evidence (e.g., prone positioning, neuromuscular blockade) were under-used. Patients received higher Vts and lower PEEP than would be suggested by the evidence.