Frédéric Le Marcis and Vinh-Kim Nguyen document ebola's ecologies in photos.

Background

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is an emerging global health threat. Surveillance of AMR in N. gonorrhoeae in the Western Pacific Region is important, as resistant strains have typically emerged from this region. There are sparse data regarding antibiotic susceptibility of N. gonorrhoeae from Vietnam. This study aimed to provide updated data on antibiotic susceptibilities in N. gonorrhoeae isolates from Hanoi, Vietnam.

Methods

From 2017 to 2019, 409 N. gonorrhoeae clinical isolates were collected at the National Hospital for Venereology and Dermatology in Hanoi, Vietnam. Antibiotic susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) protocol. The zone diameters of inhibition were recorded and interpreted according to standard CLSI criteria, except for azithromycin, due to the absence of CLSI interpretation. Categorical variables were analyzed by Chi-square and Fisher's exact tests. Linear regression was used to evaluate zones of inhibition by year.

Results

Among the 409 isolates, no isolates were susceptible to penicillin, 98.3% were resistant to ciprofloxacin, and all isolates were susceptible to spectinomycin. There were 122/407 (30.0%) isolates resistant to azithromycin and there was an association between resistance and year (p <  0.01), ranging from 15.3% of isolates in 2017 to 46.7% of the isolates in 2018. Resistance to cefixime was found in 13/406 (3.2%) of isolates and there was no association by year (p = 0.30). Resistance to ceftriaxone occurred in 3/408 (0.7%) of isolates. Linear regression indicated the zone of inhibition diameters decreased by 0.83 mm each year for ceftriaxone (95% CI: - 1.3, - 0.4; p <  0.01) and decreased by 0.83 mm each year (95% CI: - 1.33, - 0.33; p <  0.01) for azithromycin; the association was not significant for cefixime (p = 0.07).

Conclusions

We found decreasing susceptibility of N. gonorrhoeae to ceftriaxone and azithromycin, as well as a high prevalence of resistance to azithromycin, among isolates in Hanoi, Vietnam from 2017 to 2019. The trends of decreasing susceptibility to first-line treatments are concerning and highlight the urgency of addressing antimicrobial resistance in N. gonorrhoeae. Expanded surveillance efforts within the Western Pacific Region are critical to monitoring trends and informing treatment guidelines.

A high-resolution marine proxy for atmospheric pCO2 is needed to clarify the phase lag between pCO2 and marine climate proxies and to provide a record of orbital-scale pCO2 variations before the oldest ice core measurement at 800 ka. Benthic δ13C data should record deep ocean carbon storage and, thus, atmospheric pCO2. This study finds that a modified δ13C gradient between the deep Pacific and intermediate North Atlantic (δ13CP- NA/2 correlates well with pCO2. δ13CP-NA/2 reproduces characteristic differences between pCO2 and ice volume during Late Pleistocene glaciations and indicates that pCO2 usually leads terminations by 0.2-3.7 kyr but lags by 3-10 kyr during two "failed" terminations at 535 and 745 ka. δ13C P- NA/2 gradually transitions from 41- to 100-kyr cyclicity from 1.3-0.7 Ma but has no secular trend in mean or amplitude since 1.5 Ma. The minimum pCO2 of the last 1.5 Myr is estimated to be 155 ppm at ∼920 ka. © 2010 by the American Geophysical Union.

You wake up in a barn, and you must find your way home, a very simple concept with multiple endings. Later you discover that you are in fact in a spaceship, and are given the choice of returning home or doing something more exciting.

The protagonist is stuck in a time loop of his wedding day, you must figure out why he is stuck in this loop

This article uses census data from the 2006–08 American Community Survey to illustrate the range of Asian American entrepreneurial activities in the Los Angeles and the New York City areas and finds that Los Angeles self-employment is characterized by emerging high-skill “professional service” industries while New York continues to be dominated by low-skill traditional “enclave-associated” niches. Within these patterns, there are also notable interethnic and generational differences. I discuss their socioeconomic implications and policy recommendations to facilitate a gradual shift of Asian American entrepreneurship toward more professional service activities that reflect the demographic evolution of the Asian American community and the ongoing dynamics of globalization.