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Infective endocarditis

Infective endocarditis is an infection of the inner surface of the heart the valves. Symptoms may include fever, small areas of bleeding into the skin, heart murmur, feeling tired, low red blood cell count. Complications may include valvular insufficiency, heart failure and kidney failure; the cause is a bacterial infection and less a fungal infection. Risk factors include valvular heart disease including rheumatic disease, congenital heart disease, artificial valves, intravenous drug use, electronic pacemakers; the bacteria most involved are streptococci or staphylococci. Diagnosis is supported by blood cultures or ultrasound. There is a noninfective form of endocarditis; the usefulness of antibiotics following dental procedures for prevention is unclear. Some recommend them in those at high risk. Treatment is with intravenous antibiotics; the choice of antibiotics is based on results of blood cultures. Heart surgery is required; the number of people affected is about 5 per 100,000 per year. Rates, vary between regions of the world.

Males are affected more than females. The risk of death among those infected is about 25%. Without treatment it is universally fatal. Fever occurs in 97% of people. A new or changing heart murmur, weight loss, coughing occurs in 35% of people. Vascular phenomena: septic embolism, Janeway lesions, intracranial hemorrhage, conjunctival hemorrhage, splinter hemorrhages, kidney infarcts, splenic infarcts. Immunologic phenomena: glomerulonephritis which allows for blood and albumin to enter the urine, Osler's nodes, Roth's spots on the retina, positive serum rheumatoid factor Other signs may include night sweats, anemia, spleen enlargement Many microorganisms can cause infective endocarditis; these are isolated by blood culture, where the patient's blood is drawn and any growth is noted and identified. The term bacterial endocarditis is used, reflecting the fact that most cases of IE are due to bacteria. Staphylococcus aureus followed by Streptococci of the viridans group and coagulase negative Staphylococci are the three most common organisms responsible for infective endocarditis.

Other Streptococci and Enterococci are a frequent cause of infective endocarditis. HACEK group of microorganisms and fungi are seen less in North America; the viridians group include S. mitis, S. sanguis, S. gordonii and S. parasanguis. The primary habitats for these organisms are upper respiratory tract; these bacteria are present in the normal oral flora and enter the bloodstream by dental surgical procedures or genitourinary manipulation. In some countries e.g. the USA, high risk patients may be given prophylactic antibiotics such as penicillin or clindamycin for penicillin allergic patients prior to dental procedures. Prophylactics should be bactericidal rather than bacteriostatic; such measures are not taken in certain countries e.g. Scotland due to the fear of antibiotic resistance; because bacteria is the most common cause of infective endocarditis, antibiotics such as penicillin and amoxycillin are used in prophylaxis. Microbiological culture could be used to identify the infecting organism and testing its sensivitiy to different types of antibiotics.

Viridans alpha-hemolytic streptococci, that are present in the mouth, are the most isolated microorganisms when the infection is acquired in a community setting. In contrast, Staphylococcus blood stream infections are acquired in a health care setting where they can enter the blood stream through procedures that cause break in the integrity of skin, such as surgery, catheterisation, or during access of long term indwelling catheters or secondary to intravenous injection of recreational drugs. Enterococcus can enter the bloodstream as a consequence of abnormalities in the gastrointestinal or genitourinary tracts; some organisms, when isolated, give valuable clues to the cause. Pseudomonas species, which are resilient organisms that thrive in water, may contaminate street drugs that have been contaminated with drinking water. P. aeruginosa can infect a child through foot punctures, can cause both endocarditis and septic arthritis. S. bovis and Clostridium septicum, which are part of the natural flora of the bowel, are associated with colonic malignancies.

When they present as the causative agent in endocarditis, it calls for a colonoscopy to be done due to concerns regarding hematogenous spread of bacteria from the colon due to the neoplasm breaking down the barrier between the gut lumen and the blood vessels which drain the bowel. HACEK organisms are a group of bacteria that live on the dental gums, can be seen with IV drug users who contaminate their needles with saliva. Patients may have a history of poor dental hygiene, or pre-existing valvular disease. Less reported bacteria responsible for so called "culture negative endocarditis" include Bartonella, Chlamydia psittaci, Coxiella; such bacteria can be identified by serology, culture of the excised valve tissue, pleural fluid, emboli, by polymerase chain reaction or sequencing of bacterial 16S ribosomal RNA. Multiple case reports of i

Carlo Candida

Carlo Candida was a lieutenant of the Sovereign Order of Malta from 1834 to his death, succeeding Antonio Busca. Carlo Candida was from a noble family of Neapolitan origin. Before his election as lieutenant he was admiral of the Order's naval fleet territorial commander of the Order's lands in Rome and Capua, which had at that time been confiscated from the Order. During his time as lieutenant he succeeded in getting them returned to the Order and implemented the move of the Order's base from Ferrara to Rome, completed on 2 June 1834, putting the Order under direct papal protection at the heart of Christendom. In Rome Candida began setting up a hospital in 1841 in the outbuildings of the church of San Francesco at Ponte Sisto, run by papal officials who were knights of the Order, though this was not long-lasting and closed after a fire in 1844. Under Candida's leadership, the Order rose from its 1798 fall and was able to get help from the other European powers in control of Italy - by a sovereign order of 15 January 1839, Ferdinand I of Austria re-established the Grand Priory of Lombardy and Venice, basing it in a palazzo in Venice next to the civic church of Saint John the Baptist, patron of the Order.

Ferdinand I of the Two Sicilies re-established the Baliaggio di Napoli and the duchies of Modena and Parma reintroduced the Order's commanderies into their territories. The Order established itself in the Kingdom of Piedmont in 1844, under the protection of king Carlo Alberto. On his death in Rome in 1845 Candida was buried in the church of San Francesco and succeeded as lieutenant by Filippo di Colloredo-Mels. Francesco Giuseppe Terrinoni Memorie storiche della resa di Malta ai francesi nel tip. Delle Belle Arti, Roma, 1867

SMART (Northern Ireland Business Grant)

The Small Firms Merit Award for Research and Technology programme in Northern Ireland gives funding and assistance to individuals and small businesses for research in the field of innovation. SMART is one of a range of government–sponsored programmes run by Invest Northern Ireland. Daily business is conducted by an independent Board and overseen by the Government Minister for the Department of Enterprise Trade and Investment. Invest NI is used to implement the government policy of stimulating new businesses in areas of high unemployment like Northern Ireland. SMART spreads the high costs and associated risks of research and development for new, innovation-based businesses, so encourages their start-up. In general, SMART is open to individuals, sole traders, independent companies, or parts of a group that are both based or planning to be based in Northern Ireland and do not exceed certain size criteria; the awards are competitive, but if successful, applicants receive support of up to £45,000 at stage one carry out the research, up to £150,000 at stage two of the programme over a 6-18 month period to help carry out their technical and commercial feasibility studies.

There is a SMART Micro programme, designed for smaller projects. This offers funding of up to £10,000. By 2006, £1m of grants was being given to applicants in Northern Ireland. Adaptive Communication Systems - Testing and debugging complex electronic designs, based at ECIT at the Queen's University of Belfast Giltspur Scientific - Manufacturers of orthopaedic shoes for the treatment of lameness in dairy cows Haemoband Surgical – The ‘Haemoband Multi-Ligator’ for treatment of haemorrhoids InspecVision Ltd. - A manufacturer of computer vision inspection systems Integrated Silicon Systems Ltd Merlin Microwave Ltd Westlink Autogas Economy of Northern Ireland Department of Enterprise Trade and Investment List of Government departments and agencies in Northern Ireland SMART Invest Northern Ireland SMART awards main page Announcement: £1m given in SMART awards from Invest NI, 2006 Northern Irish news article on SMART awards from 2002 Electronics Weekly article on Merlin Microwave Ltd's SMART award Update from InvestNI on Haemoband Surgical, former recipient of a SMART award

Grand Lodge of Michigan

The Grand Lodge of Michigan of Free and Accepted Masons known as Grand Lodge of Michigan, in tandem with the Most Worshipful Prince Hall Grand Lodge of Michigan govern the practice of regular Freemasonry in the state of Michigan. It is uncertain. Though it is known that it was first brought to the area by the French at a time when it was Indian Territory; the earliest documented Lodge west of the Allegheny Mountains was warranted in Detroit on April 27, 1764, by George Harison, Provincial Grand Master of the Provincial Grand Lodge of New York, with Lt. John Christie of the 2nd Battalion, 60th Royal American Foot Regiment as Worshipful Master. By 1772, there were at least three Lodges functioning at Detroit: Lodge No. 1 and two Irish Military Lodges, Nos. 299 and 378, warranted to Masons of the 10th Regiment stationed at Detroit. The next three Lodges warranted for work in Michigan were started by members of the visiting military; these were Harmony Lodge in Detroit, St. Johns Lodge No. 15 on the island of Mackinac and Zion Lodge No. 10 warranted in 1794 for work in Detroit.

In September 1817 Zion Lodge provided much needed support for the newly created University of Michigan. The idea first took shape in the minds of Augustus Woodward, a Mason and the first Judge of the Territorial Supreme Court. On September 15, Zion Lodge met and subscribed the sum of $250 in aid of the University of Michigan, payable in the sum of $50 per year. Of the total amount subscribed to start the University two-thirds came from Zion Lodge and its members; the members of Zion Lodge sponsored and supported additional Lodges in Upper Canada and Michigan including Detroit Lodge No. 337, Oakland Lodge No. 343 in Pontiac, Menomenie Lodge No. 374 in Green Bay and Monroe Lodge No. 375 in Monroe. These five Lodges laid plans for a Grand Lodge in the Territory to handle the growing plans for Masonry in the area, in June 1826 a Grand Lodge for the Territory of Michigan was established in Detroit. There are 274 Lodges in the State of Michigan at the present time. List of past and current Grand Masters of the Grand Lodge of Michigan Detroit Masonic Temple Michigan Masons Share the Secret Michigan Child ID Program Masonic Pathways Senior Living Services Most Worshipful Prince Hall Grand Lodge of Michigan Detroit Masonic Temple

Minuscule 169

Minuscule 169, ε 305, is a Greek minuscule manuscript of the New Testament, on parchment. Palaeographically it has been assigned to the 11th century, it has marginalia. The codex contains a complete text of the four Gospels on 252 parchment leaves; the text is written in 19 lines per page, in light-brown ink. The large initial letters are written in gold; the text is divided according to the κεφαλαια, whose numbers are given at the margin, the τιτλοι at the top of the pages. There is the Ammonian Sections, with references to the Eusebian Canons, it contains Prolegomena, tables of the κεφαλαια before each Gospel, subscriptions at the end of each Gospel, synaxaria and pictures. The Greek text of the codex is a representative of the Byzantine text-type. According to Hermann von Soden it is related to the Byzantine commentated text. Aland placed it in Category V. According to the Claremont Profile Method it represents the textual family Kx in Luke 1 and Luke 20, with some relationship to cluster 1442.

In Luke 10 no profile was made. The pericope Pericope Adulterae is omitted; the manuscript was once in the property of Achilles Statius, as was minuscule 171. It was examined by Bianchini and Scholz. C. R. Gregory saw it in 1886, it is housed at the Biblioteca Vallicelliana, at Rome. List of New Testament minuscules Biblical manuscript Textual criticism G. Bianchini, Evangeliarium quadruplex latinae versionis antiquae, Teil 1, Bd. 2, S.530f

Pilkington Library

The Pilkington Library is the academic library at Loughborough University, situated in the West Park of the university campus at Loughborough, Leicestershire, in the East Midlands of England. It is named after Lord Pilkington. Built to an unusual design on an unusual site in the West Park area of the campus, the library building is adjacent to Village Park; as it is adjacent to the University's more recent Elvyn Richards halls, its Combined Heat and Power plant can be used to cool the library building with otherwise wasted heat. The Pilkington Library opened in 1980 as the main library to the Loughborough University of Technology. At a date this building was closed when the library stock was re-located to the Pilkington Library; the building unusually has the floor with the smallest area at the base of the structure, followed by another larger, these first two floors being known as Level 1 and Level 2 and holding book stock, Level 3 is larger again and contains the entrance, accessed via a link bridge, a café, limited book and periodical stock, a number of administrative offices and Open3 an informal study area.

Level 4 contains the Department of Information Science. The three Library floors amount to 7,777 square metres. For a library designed and built at a time of major change to the criteria used by the University Grants Committee the new library was not affected by the Atkinson Report which set out the UGC's new expectations in terms of size and flexibility; the Librarian, Professor Tony Evans, wrote in an article in the International Association of Technological University Libraries Proceedings that Atkinson's restrictions on collection size were not a problem in an institution with a small book stock and the only difficulties encountered with the UGC arose from the proposal to house the Library School on top of the library building, which were overcome. As a result of a story published in Label Magazine as an April fool there is an ongoing urban myth that the Library building is sinking due to the weight of the books contained within it not having been taken into account at the design stage, although no such errors or movement have occurred.

The library has over 600,000 books and 90,000 journals housed on Levels 1 and 2 of the building, which are organised such that the elements of the collection relevant to the University's science and technology students, 500-699 in the Dewey Decimal Classification system, are housed together on Level 1 and the remaining stock arts, social science and computing are on Level 2. The David Lewis collection is named after Dr David Lewis, Cataloguing Manager in the Library from 1966 to 2004, formed and managed the collection from items acquired by the University and its predecessors since around 1930. Made up of around 3000 books and journals the collection holds items considered in need of secure storage as a result of their age, scarcity, physical condition or other factors. Level 1 of the Library house the University Archives which hold written and other material relating to the university and its predecessor colleges including official minutes, administrative papers, student enrollment records and other publications.

There is a fine series of engineering drawings and photographs dating from the First World War when Loughborough Technical Institute was an Instructional Factory for the Ministry of Munitions. Among material donated by former staff and students, principal collections include those of Norman Swindin, chemical engineer and Honorary Reader in Chemical Engineering. University Library website Pilkington Library on Facebook