Navigating stormy waters in times of fiscal uncertainty

“Stormy waters ahead”: global emergence of carbapenemases

Carbapenems, once considered the last line of defense against of serious infections with Enterobacteriaceae, are threatened with extinction. The increasing isolation of carbapenem-resistant Gram-negative pathogens is forcing practitioners to rely on uncertain alternatives. As little as 5 years ago, reports of carbapenem resistance in Enterobacteriaceae, common causes of both community and healt...

Navigating uncertainty.

Thought leaders, creative types, and scientists may embrace uncertainty as a route to creativity, discovery, and fulfilment. But uncertainty is often ignored, feared, and hushed up in clinical medicine. Our editorialist Steven Hatch invites clinicians to stop trafficking in certitude, with diagnoses and research results that sound triumphantly final (doi:10.1136/bmj.j2180). If we sound certain ...

Guidance in sepsis management: navigating uncharted waters?

Guidelines can influence physicians to act against their better judgement. For example, while only 47% of surveyed intensivists believed that central venous pressure should guide resuscitation, 86% used it because of the SSC recommendation [2]. Protocols may improve care, but what should one do when audited patient outcomes are already better than those achieved by guideline interventions – suc...

Navigating the Waters of Unconventional Crystalline Hydrates

Elucidating the crystal structures, transformations, and thermodynamics of the two zwitterionic hydrates (Hy2 and HyA) of 3-(4-dibenzo[b,f][1,4]oxepin-11-yl-piperazin-1-yl)-2,2-dimethylpropanoic acid (DB7) rationalizes the complex interplay of temperature, water activity, and pH on the solid form stability and transformation pathways to three neutral anhydrate polymorphs (Forms I, II°, and III)...

Siemens Financial Services Paper: Navigating Uncertain Waters