This study extends the extant literature on corporate philanthropy by exploring the indirect effect of physical attractiveness of CEOs on corporate philanthropy under conditional effects of family ownership and control. Recent empirical studies in psychology suggest that egalitarian values are negatively related to physical attractiveness. Based on these findings, we propose that physically attractive CEOs invest less in corporate philanthropic activities than less attractive peers as they have lower egalitarian values. Leveraging upper echelons and stewardship theory, we further consider the moderating impact of family ownership and control on the indirect relationship between the physical attractiveness of a CEO and philanthropy mediated through egalitarianism.

The progressions in the field of wireless technology can be highly attributed to the development of antennas, which can access high data rates, provide significant gain and uniform radiation characteristics. One such antenna called the Vivaldi antenna has attracted the utmost attention of the researchers owing to its high gain, wide bandwidth, low cross-polarization, and stable radiation characteristics. Over the years, different procedures have been proposed by several researchers to improve the performance of the Vivaldi antennas. Some of these different approaches are feeding mechanisms, integration of slots, dielectric substrate selection, and radiator shape. Correspondingly, the performance of a Vivaldi antenna can be increased by including dielectric lens, parasitic patch in between two radiators, corrugations, as well as metamaterials. This paper gives a systematic identification, location, and analysis of a large number of performance enhancement methods of Vivaldi antenna design depicting their concepts, advantages, drawbacks, and applications. The principal emphasis of this article is to offer an outline of the developments in the design of Vivaldi antennas over the last few years, where the most important offerings, mostly from IEEE publications, have been emphasized. This review work aims to reveal a promising path to antenna researchers for its advancement using Vivaldi antennas.

Background: Healthcare-associated infections (HAIs) are a major global threat to patient safety. Systematic surveillance is crucial for understanding HAI rates and antimicrobial resistance trends and to guide infection prevention and control (IPC) activities based on local epidemiology. In India, no standardized national HAI surveillance system was in place before 2017. Methods: Public and private hospitals from across 21 states in India were recruited to participate in an HAI surveillance network. Baseline assessments followed by trainings ensured that basic microbiology and IPC implementation capacity existed at all sites. Standardized surveillance protocols for central-line–associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) were modified from the NHSN for the Indian context. IPC nurses were trained to implement surveillance protocols. Data were reported through a locally developed web portal. Standardized external data quality checks were performed to assure data quality. Results: Between May 2017 and April 2019, 109 ICUs from 37 hospitals (29 public and 8 private) enrolled in the network, of which 33 were teaching hospitals with >500 beds. The network recorded 679,109 patient days, 212,081 central-line days, and 387,092 urinary catheter days. Overall, 4,301 bloodstream infection (BSI) events and 1,402 urinary tract infection (UTI) events were reported. The network CLABSI rate was 9.4 per 1,000 central-line days and the CAUTI rate was 3.4 per 1,000 catheter days. The central-line utilization ratio was 0.31 and the urinary catheter utilization ratio was 0.57. Moreover, 3,542 (73%) of 4,742 pathogens reported from BSIs and 868 (53%) of 1,644 pathogens reported from UTIs were gram negative. Also, 1,680 (26.3%) of all 6,386 pathogens reported were Enterobacteriaceae. Of 1,486 Enterobacteriaceae with complete antibiotic susceptibility testing data reported, 832 (57%) were carbapenem resistant. Of 951 Enterobacteriaceae subjected to colistin broth microdilution testing, 62 (7%) were colistin resistant. The surveillance platform identified 2 separate hospital-level HAI outbreaks; one caused by colistin-resistant K. pneumoniae and another due to Burkholderia cepacia. Phased expansion of surveillance to additional hospitals continues. Conclusions: HAI surveillance was successfully implemented across a national network of diverse hospitals using modified NHSN protocols. Surveillance data are being used to understand HAI burden and trends at the facility and national levels, to inform public policy, and to direct efforts to implement effective hospital IPC activities. This network approach to HAI surveillance may provide lessons to other countries or contexts with limited surveillance capacity.

Funding: None

Disclosures: None

Background: The multidrug-resistant fungus Candida auris is emerging as a major cause of healthcare-associated infection globally. Understanding the epidemiology of these infections in vulnerable groups such as cancer patients is important for hospital infection control and their effective management. In this report we present diagnostic, clinical, antifungal resistance and outcome data of 11 cases of C. auris infection from an oncology center in India. Methods:C. auris strains were identified by Sanger-based DNA sequencing of the internal transcriber spacer (ITS) gene. Antifungal susceptibility testing (AFST) was performed using the broth dilution method. Identification and AFST were checked by the WHO Collaborating Center for Reference & Research on Fungi of Medical Importance. Patients had both empirical as well as directed therapy with antifungal agents based on AFST results and clinical assessment. Results: Between November 2018 and March 2019, 11 cases of C. auris (8 from patients with solid-organ tumors and 3 from hematological malignancy) were detected. Two distinct genetic clusters were identified by ITS gene sequencing; one of these clusters showed 100% homology with a previously unknown C. auris isolate (GenBank accession no. MK881076) and the other cluster had a 100% identity score with isolates from Japan and South Korea (GenBank accession nos. MH071441, KY657027, and EU884189). All 11 strains were resistant to fluconazole. With voriconazole, 1 isolate was susceptible, 3 were resistant, and 7 showed dose-dependent susceptibility. Two isolates were resistant to amphotericin B. Resistance to caspofungin or anidulafungin was noted in 1 of 11 isolates (9%); most showed intermediate susceptibility (63% to caspofungin). Among all of the patients, 72% were from the intensive care unit (ICU) or the high-dependency unit. The 30-day all-cause mortality was 5 of 11 (45%) in the C. auris group and 4 of 11 (36%) the control group (ie, infections with other Candida spp during same period). Duration of ICU stay in the C. auris group was 12 days and in the control group it was 6 days. The median cost (in terms of hospital bill at the time of discharge or death) for management of Candida auris infection and the primary medical condition was US$10,121 for the C. auris groups and US$8,608 for the control group. Most cases (10 of 11) were detected in wards without isolation rooms, and 8 of the 11 C. auris cases (73%) were detected in patients in the intensive care unit. Conclusions: Morbidity, mortality, ICU stay, and healthcare costs are significant in C. auris infection.

Funding: None

Disclosures: None

Understanding the distribution of wildlife species and their response to diverse anthropogenic pressures is important for conservation planning and management of wildlife space in human-dominated landscapes. Assessments of anthropogenic impacts on mammals of the Indian Himalayan Region have mostly been limited to locations inside protected areas. We studied the occurrence of mammals in an unexplored landscape, the 7,586 km2 Bhagirathi basin, at an altitude of 500–5,200 m. The basin encompasses wilderness areas of various habitat types and protection status that are exposed to a range of anthropogenic pressures. Camera trapping at 209 locations during October 2015–September 2017 confirmed the occurrence of 39 species of mammals, nine of which are categorized as threatened (four Vulnerable, five Endangered) and four as Near Threatened on the IUCN Red List. We recorded five mammal species that were hitherto undocumented in Uttarakhand State: the argali Ovis ammon, Tibetan sand fox Vulpes ferrilata, woolly hare Lepus oiostolus, Eurasian lynx Lynx lynx and woolly flying squirrel Eupetaurus cinereus. In addition, we recorded two Endangered species, the dhole Cuon alpinus and tiger Panthera tigris. Threatened species such as the sambar Rusa unicolor, common leopard Panthera pardus and Asiatic black bear Ursus thibetanus occur in a wide variety of habitats despite anthropogenic disturbance. We recorded the snow leopard Panthera uncia in areas with high livestock density but temporally segregated from human activities. The musk deer Moschus spp. and Himalayan brown bear Ursus arctos isabellinus were recorded in subalpine habitats and appeared to be less affected by human and livestock presence. Our findings highlight the potential of the Bhagirathi basin as a stronghold for conservation of several threatened and rare mammal species.

Despite consistent public health efforts, the burden of viral disease in India remains high. The present study was undertaken to understand the aetiology, frequency and distribution of viral disease outbreaks in the state of Odisha between 2010 and 2019. This was a prospective study conducted at the Virology Research and Diagnostic Laboratory located at ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, wherein all the outbreaks of viral aetiologies were investigated and analysed to provide a comprehensive picture of the state of viral disease outbreaks in the region. A total of 191 suspected viral outbreaks were investigated by the team from VRDL during September 2010 and September 2019 reported from all the 30 districts of Odisha. Annual number of suspected cases ranged from 185 to 1002. The most commonly suspected outbreaks were of viral hepatitis (55 outbreaks; 1223 cases) followed by dengue (45 outbreaks; 1185 cases), chickenpox (30 outbreaks; 421 cases), viral encephalitis (27 outbreaks; 930 cases), measles (23 outbreaks; 464 cases), chikungunya (10 outbreaks; 593 cases) and rubella (1 outbreak; 60). The outbreaks peaked in frequency and intensity during the months of July and September. The epidemiology of viral disease outbreaks in the region is presented in the study. Health system preparedness based on evidence is essential for early detection and adequate response to such viral outbreaks.

Between 11–13 December 2018, local public health authorities in the West Midlands, England were alerted to 34 reports of diarrhoea with abdominal cramps. Symptom onset was ~10 h after diners ate Christmas meals at a restaurant between 7–9 December 2018. A retrospective case-control study, environmental and microbiological investigations were undertaken to determine the source and control the outbreak. An analytical study was undertaken with odds ratios (OR) and 95% confidence intervals (CI). Forty persons were recruited to the analytical study (28/40 cases). Multivariable analysis found that leeks in cheese sauce was the only item associated with illness (aOR 51.1; 95% CI 4.13–2492.1). Environmental investigations identified significant lapses in food safety, including lapses in temperature control during cooking and hot holding, likely cross-contamination between raw and cooked foods and the reuse of leftover cheese sauce for the next day's service. No food samples were taken during the exposure period. Two faecal samples were positive for Clostridium perfringens with one confirming the enterotoxigenic gene. Cheese sauce is an unusual vehicle for the organism and the first time this has been reported in England.