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Recovery of multidrug-resistant (MDR) Pseudomonas aeruginosa and Klebsiella pneumoniae from a cluster of patients in the medical intensive care unit (MICU) prompted an epidemiologic investigation for a common exposure.
Clinical and microbiologic data from MICU patients were retrospectively reviewed, MICU bronchoscopes underwent culturing and borescopy, and bronchoscope reprocessing procedures were reviewed. Bronchoscope and clinical MDR isolates epidemiologically linked to the cluster underwent molecular typing using pulsed-field gel electrophoresis (PFGE) followed by whole-genome sequencing.
Of the 33 case patients, 23 (70%) were exposed to a common bronchoscope (B1). Both MDR P. aeruginosa and K. pneumonia were recovered from the bronchoscope’s lumen, and borescopy revealed a luminal defect. Molecular testing demonstrated genetic relatedness among case patient and B1 isolates, providing strong evidence for horizontal bacterial transmission. MDR organism (MDRO) recovery in 19 patients was ultimately linked to B1 exposure, and 10 of 19 patients were classified as belonging to an MDRO pseudo-outbreak.
Surveillance of bronchoscope-derived clinical culture data was important for early detection of this outbreak, and whole-genome sequencing was important for the confirmation of findings. Visualization of bronchoscope lumens to confirm integrity should be a critical component of device reprocessing.
Data-centric approaches have become increasingly popular in materials science, also known as informational materials science. Nanostructures often play essential roles in materials properties. Nanoinformatics is an important subset of informational materials science and a powerful tool for characterization and design of nanostructures. It allows discovery of meaningful and useful information and patterns from experimental and theoretical data and databases. This article reviews progress in nanoinformatics and informational materials science. Data-centric approaches for materials property description, construction of interatomic potentials, discovery of new inorganic compounds, efficient characterization of ionic transport and interfacial structures, hyperspectral image data analysis, and design of catalytic nanoparticles are outlined.
Egg-white protein (EWP) is known to reduce lymphatic TAG transport in rats. In this study, we investigated the effects of dietary EWP on body fat mass. Male rats, 4 weeks old, were fed diets containing either 20 % EWP or casein for 28 d. Carcass protein levels and gastrocnemius leg muscle weights in the EWP group were significantly higher than those in the casein group. In addition, carcass TAG levels and abdominal fat weights in the EWP group were significantly lower than those in the casein group; adipocyte size in abdominal fat in the EWP group was smaller than that in the casein group. To identify the involvement of dietary fat levels in the rats, one of two fat levels (5 or 10 %) was added to their diet along with the different protein sources (EWP and casein). Abdominal fat weight and serum and hepatic TAG levels were significantly lower in the EWP group than in the casein group. Moreover, significantly higher values of enzymatic activity related to β-oxidation in the liver were observed in the EWP group compared with the casein group. Finally, abdominal fat weight reduction in the EWP group with the 10 % fat diet was lower than that in the EWP group with the 5 % fat diet. In conclusion, our results indicate that, in addition to the inhibition of dietary TAG absorption reported previously, dietary EWP reduces body fat mass in rats through an increase of body protein mass and the acceleration of β-oxidation in the liver.
Preliminary results are presented from the first validation of geophysical data products (ice concentration, Snow thickness on Sea ice (hs) and ice temperature (TI) from the NASA EOS Aqua AMSR-E Sensor, in East Antarctica (in September–October 2003). The challenge of collecting Sufficient measurements with which to validate the coarse-resolution AMSR-E data products adequately was addressed by means of a hierarchical approach, using detailed in situ measurements, digital aerial photography and other Satellite data. Initial results from a circumnavigation of the experimental Site indicate that, at least under cold conditions with a dry Snow cover, there is a reasonably close agreement between Satellite- and aerial-photo-derived ice concentrations, i.e. 97.2±3.6% for NT2 and 96.5±2.5% for BBA algorithms vs 94.3% for the aerial photos. In general, the AMSR-E concentration represents a Slight overestimate of the actual concentration, with the largest discrepancies occurring in regions containing a relatively high proportion of thin ice. The AMSR-E concentrations from the NT2 and BBA algorithms are Similar on average, although differences of up to 5% occur in places, again related to thin-ice distribution. The AMSR-E ice temperature (TI) product agrees with coincident Surface measurements to approximately 0.5˚C in the limited dataset analyzed. Regarding Snow thickness, the AMSR hs retrieval is a Significant underestimate compared to in situ measurements weighted by the percentage of thin ice (and open water) present. For the case Study analyzed, the underestimate was 46% for the overall average, but 23% compared to Smooth-ice measurements. The Spatial distribution of the AMSR-E hs product follows an expected and consistent Spatial pattern, Suggesting that the observed difference may be an offset (at least under freezing conditions). Areas of discrepancy are identified, and the need for future work using the more extensive dataset is highlighted.
Antarctic coastal polynyas are major areas of intense ocean–atmosphere heat and moisture flux, and associated high Sea-ice production and dense-water formation. Their accurate detection, including an estimate of thin ice thickness, is therefore very important. In this paper, we apply a technique originally developed in the Arctic to an estimation of Sea-ice thickness using Us National Oceanic and Atmospheric Administration (NOAA) Advanced Very High Resolution Radiometer (AVHRR) data and meteorological data in the Vincennes Bay polynya off Wilkes Land, East Antarctica. The method is based upon the heat-flux calculation using Sea-ice Surface temperature estimates from the Satellite thermal-infrared data combined with global objective analysis (European Centre for Medium-Range Weather Forecasts (ECMWF)) data. The validity of this method is assessed by comparing results with independent ice-surface temperature and ice-thickness data obtained during an Australian-led research cruise to the region in 2003. In thin-ice (polynya) regions, ice thicknesses estimated by the heat-flux calculation using AVHRR and ECMWF data Show reasonable agreement with those estimated by (a) applying the heat-flux calculation to in Situ radiation thermometer and meteorological data and (b) in Situ observations. The Standard deviation of the difference between the AVHRR-derived and in Situ data is ∽0.02 m. Comparison of the AVHRR ice-thickness retrievals with coincident Satellite passive-microwave polarization ratio data confirms the potential of the latter as a means of deriving maps of thin Sea-ice thickness on the wider Scale, uninterrupted by darkness and cloud cover.
Pine Island Glacier (PIG), West Antarctica, has been experiencing acceleration in its flow speed and mass loss for nearly two decades, driven in part by an increase in the delivery of relatively warm Circumpolar Deep Water (CDW). However, at present, the configuration of the sub-ice-shelf cavity and bed conditions beneath the PIG ice shelf that dictate such oceanic influences remain poorly understood. Here, we use aerogravity data and ocean bottom depths measured by an autonomous underwater vehicle (AUV) to model the bathymetry and sediment layer thickness beneath the PIG ice shelf. Results reveal that the deep basins, previously found by AUV on both landward and seaward sides of a submarine ridge, extend substantially to the north and south. The water column thickness of the basins reaches 400-550 m on the landward side of the ridge and 500-600 m on the seaward side. The sediment layer covers the whole expanse of the seabed beneath the ice shelf, and the thickness is in the range ∼200-1000 m. The thinnest sediments (<200 m) are found on the seaward slope of the submarine ridge, suggesting that erosion by advancing ice may have been concentrated in the lee of the topographic high.
We analyze the internal stratigraphy in radio-echo sounding data of the northeast Greenland ice stream to infer past and present ice dynamics. In the upper reaches of the ice stream, we propose that shear-margin steady-state folds in internal reflecting horizons (IRHs) form due to the influence of ice flow over spatially varying basal lubrication. IRHs are generally lower in the ice stream than outside, likely because of greater basal melting in the ice stream from enhanced geothermal flux and heat of sliding. Strain-rate modeling of IRHs deposited during the Holocene indicates no recent major changes in ice-stream vigor or extent in this region. Downstream of our survey, IRHs are disrupted as the ice flows into a prominent overdeepening. When combined with additional data from other studies, these data suggest that upstream portions of the ice stream are controlled by variations in basal lubrication whereas downstream portions are confined by basal topography.
We fabricated a novel open-air channel with high efficient capillary-driven system inspired by a coastal animal “wharf roach”. The animal has open-air channels on its legs to transport water spontaneously using by capillary force. We abstracted principles controlling this phenomenon and applied it to artificial open-air channels, aiming at manipulating liquids without external energies. After surface modification for high surface free energy, the inspired open-air channels were able to transport water against gravity as well as the open-air channels of wharf roach by capillary effect of surface microstructures and chemistries. Topographical variation in micrometer-scaled patterns induced transport velocities improvement due to the enhancement of spreading intervals between the microstructure and wettability. Considering topography of micropatterned surfaces, the open-air channels with controllable transport velocity are applicable to capillary-driven microfluidics and lab-on-a-chips.
To determine risk factors for the development of surgical site infections (SSIs) in neurosurgery patients undergoing spinal fusion.
Retrospective case-control study.
Large, academic, quaternary care center.
The study population included all neurosurgery patients who underwent spinal fusion between August 1, 2009, and August 31, 2013. Cases were defined as patients in the study cohort who developed an SSI. Controls were patients in the study cohort who did not develop an SSI.
To achieve 80% power with an ability to detect an odds ratio (OR) of 2, we performed an unmatched case-control study with equal numbers of cases and controls.
During the study period, 5,473 spinal fusion procedures were performed by neurosurgeons in our hospital. With 161 SSIs recorded during the study period, the incidence of SSIs associated with these procedures was 2.94%. While anterior surgical approach was found to be a protective factor (OR, 0.20; 95% confidence interval [CI], 0.08–0.52), duration of procedure (OR, 1.58; 95% CI, 1.29–1.93), American Society of Anesthesiologists score of 3 or 4 (OR, 1.79; 95% CI, 1.00–3.18), and hospitalization within the prior 30 days (OR, 5.8; 95% CI, 1.37–24.57) were found in multivariate analysis to be independent predictors of SSI following spinal fusion. Prior methicillin-resistant Staphylococcus aureus (MRSA) nares colonization was highly associated with odds 20 times higher of SSI following spinal fusion (OR, 20.30; 95% CI, 4.64–8.78).
In additional to nonmodifiable risk factors, prior colonization with MRSA is a modifiable risk factor very strongly associated with development of SSI following spinal fusion.
Dimensional measurements from secondary electron (SE) images were compared with those from backscattered electron (BSE) and low-loss electron (LLE) images. With the commonly used 50% threshold criterion, the lines consistently appeared larger in the SE images. As the images were acquired simultaneously by an instrument with the capability to operate detectors for both signals at the same time, the differences cannot be explained by the assumption that contamination or drift between images affected the SE, BSE, or LLE images differently. Simulations with JMONSEL, an electron microscope simulator, indicate that the nanometer-scale differences observed on this sample can be explained by the different convolution effects of a beam with finite size on signals with different symmetry (the SE signal’s characteristic peak versus the BSE or LLE signal’s characteristic step). This effect is too small to explain the >100 nm discrepancies that were observed in earlier work on different samples. Additional modeling indicates that those discrepancies can be explained by the much larger sidewall angles of the earlier samples, coupled with the different response of SE versus BSE/LLE profiles to such wall angles.