The impact of earlier intervention by an antimicrobial stewardship team for specific antimicrobials in a single weekly intervention.

OBJECTIVE: The objective of this study was to evaluate the effects of earlier intervention by an antimicrobial stewardship team (AST) on antimicrobial use, antimicrobial resistance rates, and the clinical outcomes, without changing the weekly intervention schedule. METHODS: A retrospective study was conducted at Fukuoka University Hospital between April 2013 and March 2016. The effects were compared among three study periods (SP): SP1 (patients receiving anti-methicillin-resistant Staphylococcus aureus agents and carbapenems for ≥14 days), SP2 (patients receiving specific antimicrobials for ≥14 days), and SP3 (patients receiving specific antimicrobials regardless of the duration of treatment). RESULTS: The timing of AST intervention was shortened from an average of 15.5days after administration in SP1 to 4.2 days in SP3. The antimicrobial use density (AUD) of carbapenems and piperacillin-tazobactam decreased significantly (SP2 vs. SP3, p<0.05), and the costs of specific antimicrobials decreased (SP1, US$ 1080000; SP2, US$ 944000; SP3, US$ 763000). The rates of carbapenem resistance among Pseudomonas aeruginosa isolates showed a significant reduction from 16.2% in SP2 to 8.7% in SP3 (p<0.05). The mortality rate and length of stay did not change during the study period. CONCLUSIONS: Earlier intervention by an AST could contribute to the proper use of antimicrobials without adversely affecting patient outcomes.

The first thin filament layer line decreases in intensity during an isometric contraction of frog skeletal muscle.

During isometric contraction/activation of full-overlap and non-overlap live frog skeletal muscles, the intensity of the first thin filament layer line at the axial spacing of approximately 1/37 nm-1, when separated from the partially overlapping first thick filament layer-line at approximately 1/43 nm-1, remained unchanged in the inner radial region (0.02-0.08 nm-1) where a large intensity increase is observed in the rigor state. The intensity decreased in the outer radial region (0.08-0.18 nm-1) where this layer line is expected to peak in the resting state. The intensity decrease in the outer region became larger with increasing filament overlap; on activation of the non-overlap muscle, it was about half that of the full-overlap muscle. Thus the first thin filament layer line decreases in intensity and any indication of the rigor-like intensification is not observed at all during contraction. This intensity decrease can be attributed to the same structural changes giving rise to the intensity increase of the second thin filament layer line. The results indicate that the configuration of the myosin heads interacting with actin during contraction differs significantly from that of the rigor state. Four-fold rotational symmetry of the thin filament structure as a whole becomes more pronounced during isometric contraction of the overlap muscle.

Dynamic X-ray diffraction of skeletal muscle contraction: structural change of actin filaments.

The X-ray diffraction pattern recorded during contraction shows that the force generation of a muscle proceeds upon interaction of the actin and myosin heads in the incommensurate structural framework of the thin and thick filaments. In this molecular framework the binding of myosin heads to actin filaments is thought to occur on a random basis. Such an actomyosin structure would not produce constructive interference between scattered X-rays from the bound heads and the thin filaments. The characteristic intensity changes of the thin filament layer lines that occur during contraction suggest strongly that the actin structure is varied by interaction with the myosin heads, in a manner that is quite different from that in the rigor state. Variability of the time courses of the intensity changes of the various layer lines indicates that structural change within the thin filament does not take place uniformly and that some different structural processes are involved during contraction At the plateau of isometric contraction, the thin filament structure as a whole assumes a more four-stranded nature due to the changes in the actin structure and tropomyosin position. Our present results imply that the changes of actin structure induced by interaction with myosin heads would be responsible for the regulation as well as force generation in muscle contraction.

Triacetin as food additive in gummy candy and other foodstuffs on the market.

The qualitative and quantitative analytical methods were proposed for the simple and rapid determination of triacetin (TAc) in commercial gummy candies and other foodstuffs by gas chromatography (GC), thin layer chromatography (TLC) and infrared spectroscopy (IR). Each extract from the samples was obtained by pretreatment of the foodstuffs as follows: (A) Gummy candy was dissolved in warm water and the solution was extracted with chloroform. The organic (chloroform) layer was separated. (B) Samples (such as ice cream) containing substantial water were mixed with anhydrous Na2SO4 and stirred to sandy appearance and dried. The residue was homogenized with ether, followed by centrifuging, and the organic (ether) layer was separated. (C) Dried samples (such as chocolate and cookie) were smashed, homogenized with ether, and followed by centrifuging, and the organic (ether) layer was separated. (D) Candy was dissolved in warm water and the solution was extracted with ether. The organic (ether) layer was separated. Each organic layer from (A)-(D) was washed with 10% NaHCO3 and evaporated. The residue containing TAc was dissolved in dichloromethane. The extract obtained was subjected to column chromatography on silica gel. The fractions containing TAc were employed in GC with 25% PEG-20M column, TLC, and IR analyses. Recovery of TAc from gummy candy was 99.1 +/- 3.0% and those from other foodstuffs ranged from was 82.1 to 99.4% by GC. Detection limit by this method was 10 ppm. TAc was found to contain at a level as high as 550 ppm in one domestic gummy candy. On the other hand, one imported gummy candy contained no more than 20 ppm of TAc gummy candy.