The aim of this study was to determine the frequency of carbapenem resistant Klebsiella pneumoniae (CRKP) sequence types (STs) in Iran. Samples were collected from three university hospitals in Sanandaj, Iran, from December 2016 to March 2018. Antibiotic susceptibility testing, phenotypic and genotypic detection of carbapenemases were performed. Common K. pneumoniae capsular types were sought for all isolates. The genetic relatedness of isolates was investigated by multilocus sequence typing (MLST). Plasmids were detected by PCR-based Replicon Typing (PBRT). During the study, 67 K. pneumoniae isolates were identified. Of which, 18 (26.9%) isolates were detected as carbapenem-resistant. The most effective antibacterial agent was tigecycline (97%, 65 isolates) followed by imipenem and ertapenem (73.13%, 49 isolates). PCR showed that 13 isolates (19.4%) had blaNDM-1 gene and 5 (7.5%) harbored blaOXA-48. Examination of common capsular types showed that 2 isolates had K2 and 2 others had K54. REP-PCR revealed 10 clones and 11 singleton strains. MLST analysis of CRKP found ST15 as the most common type (13 isolates, 72.2%), but other STs were also detected namely, ST19, ST117, ST1390, and ST1594. ColE1 and IncL/M plasmids were the carriers of blaNDM-1 and blaOXA-48, respectively. The results showed that CRKP spread in our health centers. Our results, therefore, indicate a worrying trend of resistance to carbapenems in K. pneumoniae.
Previous research has proposed that microdosing, i.e., the repeated use of sub-threshold doses of serotonergic hallucinogens, has an impact on mood by increasing emotional awareness. We propose that increased emotional awareness could translate into higher emodiversity, a balanced experience of emotions in which emotions are experienced with more similarity in intensity and duration. We examine the effect of microdosing, the day after, as well as the cumulative effect of microdosing on overall, positive and negative emodiversity.
We use data collected over a period of 28 days sampled between February to June 2020 from 18 users that already had an active practice of microdosing at the start of the data collection. We assessed emotional states using ESM methods, i.e., signal-contingent sampling with triggers sent 5 times a day. The working dataset has a number of 224 observations days. We used mixed effects models to test our hypotheses.
When taking into account the level of average affect, we found that during microdosing days positive and overall emodiversity were significantly lower. No evidence was found for a mediating role of the level of average affect. Higher cumulative instances of microdosing were not related to any of the emodiversity indexes. Participants experienced more “awe, wonder, or amazement”, “ashamed, humiliated, or disgraced” as well as less “joyful, glad, or happy” emotions during microdosing days.
A microdosing practice may increase the centrality of certain emotions on microdosing days, resulting in a decrease in emotional diversity.
A rapid, stability indicating reverse phase liquid chromatographic method was developed for the determination of purity of Felodipine in active pharmaceutical substance form in the presence of its impurity and its degradation products. To develop the method which is also compatible to liquid chromatographic mass spectroscopic technique. The developed method is also used to determine the assay of Felodipine in bulk drug form. The drug is subjected to various stress conditions like acidic, basic, oxidation, UV light and thermal conditions. Considerable degradation was observed during base hydrolysis. Two degradation products were identified. The Waters Acquity UPLC BEH C18, 2.1 × 100 mm, 1.7 µm Column was used to achieve chromatographic separation. The gradient conditions, diluent and injection volume were optimized to achieve the acceptable resolution between impurities and its degradation products from Felodipine and to get good peak shapes. The masses were determined for main compound and its identified degradation products. Further, the characterization studies for main compound and its degradation products were performed using LCMSMS Q-TOF.
This paper is to analyze the 2007 reform of the higher education system in Portugal (RJIES), which ambitioned fundamental changes in the governance of universities, the option given to higher education institutions (HEIs) to be transformed into public foundations being only one element of the reform. Based on desk research, the key elements of the reform, the process of designing and introducing it and an assessment of its impact are presented. We may conclude that the governance reform has led to more effective management of universities regardless of their legal status, but the new, foundation form has not fulfilled the expectations regarding the more autonomous and flexible operation of the transformed HEIs, due, to a large extent, to the financial restrictions brought about by the global crisis.
The study mediates between two literary thematic fields: the discourse on disasters, with special attention to the comet theme, and the literature about the future or the collapse of the Austro-Hungarian Monarchy. In this context, we ask about the political issue of the comet material or motif. The topic will be explained using the works of Camille Flammarion, Vincenz Chiavacci, Karl Kraus, Hannes Stein and Maurus Jókai as examples.
The presentation of the course of COVID-19-related T-cell responses in the first week of the disease may be a more specific period for adaptive immune response assessment. This study aimed to clarify the relationship between changes in peripheral blood lymphocyte counts and death in patients with COVID-19 pneumonia.
Thirty-three patients (14 females and 19 males) admitted for severe and desaturated COVID-19 pneumonia confirmed by polymerase chain reaction were included. Lymphocyte subsets and CD4+/CD8+ and CD16+/CD56+ rates were measured using flow cytometry from peripheral blood at admission and on the day of death or hospital discharge.
Twenty-eight patients survived and five died. On the day of admission, the CD4+ cell count was significantly higher and the saturation of O2 was significantly lower in the deceased patients compared to the survivors (P < 0.05). The CD16+/CD56+ rate was significantly lower on the day of death in the deceased patients than in discharge day for the survivors (P = 0.013).
CD4+ lymphocyte percentages and O2 saturation in samples taken on the day of admission to the hospital and CD16+/CD56+ ratios taken at the time of discharge from the hospital were found to be associated with the mortality in patients with severe COVID-19.
Virtual exchange practices have been developed at universities for several years; however, the academic importance of VE has grown during the COVID-19 pandemic (Garcés & O'Dowd, 2020; Oswal, Palmer & Koris, 2021). As a result of the restrictions concerning physical mobility, VE has become a ‘first aid kit’ (Reiffenrath, de Louw & Haug, 2020) to continue students' international cooperation. However, at present, there is little research about the nature of students' VE practices during the pandemic COVID-19, particularly in relation to the functions of VE. Thus, the purpose of this study is to understand the characteristics of the special VE actions undertaken during the COVID-19 pandemic and to map out the educational functions and their prevalence through focus group interviews involving students who study at five different universities in Europe.
The article introduces the term ‘emergency-mode’ VE programmes that combine activities of traditional VEs with tailor-made solutions to accommodate the challenges posed by the pandemic. The analysis shows new directions of VE in terms of its educational functions, identifying 1) developmental, 2) social, 3) instrumental, 4) emancipatory, 5) self-reflectional, 6) motivational, as well as 7) occupational functions. The article also presents the prevalence of these functions in the specific learning environments created due to the COVID-19 pandemic.
This article reports on integration challenges that were experienced by nine individuals who attended a three-day legal psilocybin truffle retreat in the Netherlands. The study employed a qualitative phenomenological approach, using semi-structured interviews to gain an understanding of participants' (n = 30) psilocybin experiences and their after-effects. While the study did not actively seek to measure integration issues or unexpected side effects, nine out of thirty participants (30%) spontaneously reported a post-experience integration challenge. These challenges included: mood fluctuations, ‘post-ecstatic blues’, disconnection from community, re-experiencing symptoms, spiritual bypass and perceived lack of support. Integration challenges were transient; they occurred immediately after the psilocybin experience (once the main psychedelic effects had worn off) and in the days and weeks following the retreat, and resolved with time. Integration challenges were also correlated with positive after-effects including long-term remission of significant health conditions. The experiences related in this article align with existing literature that describes the ‘spiritual emergency’ phenomenon; that is, the potential challenges that can arise after ecstatic experiences and how these challenges may be integral to the transformative potential of such experiences. We discuss the implications for psychedelic integration and harm reduction practices and for future psychedelic research.
Although large-scale population studies have linked the use of classic psychedelics (lysergic acid diethylamide, psilocybin, or mescaline) to reduced odds of physical health problems, mental health problems, and criminal behavior, the roughly 35 million adults in the United States who have used classic psychedelics are nonetheless stigmatized in the American job market. Various federal organizations in the United States automatically reject applicants on the sole basis of prior psychedelic use, thereby practicing an open form of legal discrimination against these applicants. The present study investigates whether this discrimination can be justified based on associations between lifetime classic psychedelic use and motivationally-based workplace absenteeism.
Using pooled cross-sectional data from the National Survey on Drug Use and Health (2013–2019) on 193,320 employed adults in the United States, this study tests whether lifetime classic psychedelic use predicts the number of workdays employees skipped in the last month (i.e., motivationally-based workplace absenteeism).
After adjusting for sociodemographics, physical health indicators, and other substance use, no significant association between lifetime classic psychedelic use and motivationally-based workplace absenteeism is found.
This study builds on classic psychedelic research that is just beginning to take work-specific outcomes into account and offers empirical justification for the elimination of arbitrary drug-based recruitment policies in the workplace.
Ketamine and esketamine have garnered interest in both psychiatric research and clinical practice for treatment-resistant depression (TRD). In this review, we examined registered trials investigating the therapeutic use of ketamine or esketamine for TRD, with the aim of characterizing emerging trends and knowledge gaps.
The ClinicalTrials.gov electronic registry and results database was queried from inception to February 5, 2022, adhering to elements of the PRISMA guideline, we evaluated trial eligibility in the qualitative synthesis. Data regarding study design, drug regimens, and measures were subsequently abstracted and descriptively analyzed.
The search returned 86 records, of which 56 trials were included in the final review. The number of trials investigating ketamine and esketamine for TRD increased since 2008, with higher peaks observed in 2015 (n = 9) and 2021 (n = 9). Most trials were Phase 2 (13, 23.2%) or Phase 3 (11, 19.6%), gathering preliminary data on efficacy and/or further data on safety and efficacy with variant dosing and pharmacological approaches. By and large, trials examined ketamine and esketamine as individual versus combination treatments (45% and 25%, respectively). The Montgomery-Asberg Depression Rating Scale (MADRS) was most commonly used to assess clinical outcomes (75%).
There are increasingly large-scale and late-phase trials of esketamine over ketamine for TRD, coupled with efforts to centralize evidence on these medications. Yet several trials do not assess patient characteristics that may affect treatment response, such as age, sex, and race. By understanding these design limitations, scientists and clinicians can avoid research waste and funding bodies can judiciously direct support towards high priority research.