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Understanding the properties of time averaging (age mixing) in a stratigraphic layer is essential for properly interpreting the paleofauna preserved in the geologic record. This work assesses the age and quantifies the scale and structure of time averaging of land snail-rich colluvial sediments from the Madeira Archipelago (Portugal) by dating individual shells using amino acid racemization calibrated with graphite-target and carbonate-target accelerator mass spectrometry radiocarbon methods. Gastropod shells of Actinella nitidiuscula were collected from seven sites on the volcanic islands of Bugio and Deserta Grande (Desertas Islands), where snail shells are abundant and well preserved in Quaternary colluvial deposits. Results show that the shells ranged in age from modern to ~48 cal ka BP (calibrated radiocarbon age), covering the last glacial and present interglacial periods. Snail shells retrieved from two of the colluvial sites exhibit multimillennial age mixing (>6 ka), which significantly exceeds the analytical error from dating methods and calibration. The observed multimillennial mixing of these assemblages should be taking into consideration in upcoming paleoenvironmental and paleoecological studies in the region. The extent of age mixing may also inform about the time span of colluvial deposition, which can be useful in future geomorphological studies. In addition, this study presents the first carbonate-target radiocarbon results for land snail shells and suggests that this novel, rapid, and more affordable dating method offers reliable age estimates for small land snail shells younger than ~20 cal ka BP.
Spectroscopic data from a var iety of analyt ical techniques such as x-ray diffraction (XRD), infrared (IR) and Raman spectroscopies, secondary ion mass spectrometry (SIMS) and energy dispersive X-ray analysis (EDX) can be obtained from small areas of samples (< 1 mm2) through the use of microscope sampling accessories. If provisions are made to scan or translate the sample, then a spectrum that is characteristic of each region of interest can be obtained. Alternatively, selective area detectors eliminate the requirement for scanning the sample. Extract ion of information about a specific energy band from each spectrum allows elucidat ion of the spatial distribution of the feature giving rise to that band. For example, the distribution of a compound could be imaged by extracting the intensity of an IR band or XRD peak due to that compound. Peak posit ion and peak width are other parameters that can be extracted as a function of posit ion. Similarly, elemental distributions could be obtained using SIMS and EDX.
OBJECTIVES/SPECIFIC AIMS: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections (SSTIs) recurrence ranges from 16% to 43% and presents significant challenges to clinicians, patients, and families. This comparative effectiveness research study aims to disseminate, implement and evaluate whether an existing intervention, consisting of decolonization and decontamination procedures, which has been determined to be effective in hospital intensive care unit settings, can be implemented by Community Health Workers (CHWs) or “promotoras” conducting home visits prevent recurrence of CA-MRSA and transmission within their households for patients presenting to primary care with SSTIs. METHODS/STUDY POPULATION: In partnership with 3 Community Health Centers and 4 community hospitals in NYC, this study will recruit patients (n=278) with confirmed MRSA SSTIs and their household members. Participants are randomized to receive either a CHW/Promotora-delivered decolonization-decontamination intervention or usual care, which includes hygiene education. The highly engaged stakeholder team meets monthly to review interim results, identify areas for refinement and new research questions, and develop and implement strategies to improve participant engagement and retention. RESULTS/ANTICIPATED RESULTS: MRSA and MSSA were found in 19% and 21.1% of wound cultures, respectively. 59.5% with MRSA+ wound culture had one or more MRSA+ surveillance culture; 67.8% with MSSA+ wound culture had one or more MSSA+ surveillance culture. The “warm handoff” approach, developed and implemented by the stakeholder team to engage patients from their initial consent to return of lab results and scheduling of the home visits, helped improve completion of baseline home visits by 14%, from 45% to 59% of eligible participants. Home visits have demonstrated that 60% of households had at least one surface contaminated with S. aureus. Of the surfaces that tested positive in the households, nearly 20% were MRSA and 81% were MSSA; 32.5% of household members had at least one surveillance culture positive for S. aureus (MRSA: 7.7%, MSSA: 92.3%). DISCUSSION/SIGNIFICANCE OF IMPACT: This study aims to understand the systems-level, patient-level, and environmental-level factors associated with SSTI recurrence and household transmission, and to examine the interactions between bacterial genotypic and clinical/phenotypic factors on decontamination, decolonization, SSTI recurrence and household transmission. This study will evaluate the barriers and facilitators of implementation of home visits by CHWs in underserved populations, and aims to strengthen the weak evidence base for implementation of strategies to reduce SSTI recurrence and household transmission.
Anomalous Hall effect was observed at room temperature in MOCVD-grown GaGdN from a (TMHD)3Gd source, which can contain oxygen in its organic ligand. GaN, and GaGdN grown using a Cp3Gd precursor which does not contain oxygen only showed the ordinary Hall effect. This indicates that oxygen could have a role in magnetic properties of GaGdN. The relationship between the anomalous Hall conductivity and longitudinal conductivity indicated that metallic conduction, hopping of carriers, and scattering-independent mechanisms are likely responsible for the ferromagnetism. However, this still requires further clarification.
A quantity of Romano-British material was found in the course of excavation and although most of this was from disturbed contexts an attempt was made to define the nature and period of occupation which it represents.
The principal features dated to this period by material from primary positions are a number of long straight ditches, F138, F225, F225a and F255, running roughly north-east to south-west, and an irregular D-shaped enclosure, F170 (Fig 12). It is suggested that the ditches form the boundaries of a fairly large-scale layout of fields. From the discrepancies of alignment in ditches lying close together it appears that the boundaries silted and were re-cut without much exactitude. Very little stratified pottery could be associated with these ditches: a Flavian sherd from F138 and late Roman wares from F255.
The positive effects of shared book reading on vocabulary and reading development are well attested (e.g., Bus, van Ijzendoorn, & Pellegrini, 1995). However, the role of shared book reading in grammatical development remains unclear. In this study, we conducted a construction-based analysis of caregivers’ child-directed speech during shared book reading and toy play and compared the grammatical profile of the child-directed speech generated during the two activities. The findings indicate that (a) the child-directed speech generated by shared book reading contains significantly more grammatically rich constructions than child-directed speech generated by toy play, and (b) the grammatical profile of the book itself affects the grammatical profile of the child-directed speech generated by shared book reading.
An outbreak of mumps within a student population in Scotland was investigated to assess the effect of previous vaccination on infection and clinical presentation, and any genotypic variation. Of the 341 cases, 79% were aged 18–24. Vaccination status was available for 278 cases of whom 84% had received at least one dose of mumps containing vaccine and 62% had received two. The complication rate was 5·3% (mainly orchitis), and 1·2% were admitted to hospital. Genetic sequencing of mumps virus isolated from cases across Scotland classified 97% of the samples as genotype G. Two distinct clusters of genotype G were identified, one circulating before the outbreak and the other thereafter, suggesting the virus that caused this outbreak was genetically different from the previously circulating virus. Whilst the poor vaccine effectiveness we found may be due to waning immunity over time, a contributing factor may be that the current mumps vaccine is less effective against some genotypes. Although the general benefits of the measles–mumps–rubella (MMR) vaccine should continue to be promoted, there may be value in reassessing the UK vaccination schedule and the current mumps component of the MMR vaccine.
OBJECTIVES/SPECIFIC AIMS: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft tissue infections (SSTIs) are commonly seen in primary care, with recurrence rates that range from 16% to 43%, and present significant challenges to clinicians, patients, and families. This comparative effectiveness research study aims to develop and evaluate a home-based intervention implemented by Community Health Workers (CHWs) or “promotoras” to prevent recurrence of CA-MRSA in patients presenting to primary care with SSTIs and transmission within their households. This presentation will examine associations between wound microbiology, clinical presentation, and housing characteristics, including housing density and household surfaces contamination. METHODS/STUDY POPULATION: In partnership with 3 Community Health Centers and 3 community hospitals in NYC, this study will recruit patients (n=278) with confirmed MRSA SSTIs and their household members. Participants will be randomized to receive either a CHW/Promotora-delivered decolonization-decontamination intervention (based on the REDUCE MRSA trial) or usual care. The highly engaged stakeholder team finalized the intervention protocol, developed and implemented CHW and clinician training, and developed an online health portal application for data management and exchange. RESULTS/ANTICIPATED RESULTS: We have collected 923 isolates from 237 individuals, including 240 wound culture isolates and 683 surveillance culture isolates (nares, axilla, groin). MRSA and MSSA were found in 19% and 21.1% of wound cultures, respectively; 59.5% with MRSA+ wound culture had 1 or more MRSA+ surveillance culture; 67.8% with MSSA+ wound culture had 1 or more MSSA+ surveillance culture. Of those with MRSA or MSSA infections, 70% of subjects were male, with an average age of 37.9 (SD=15.9 y). The most frequent sites of infection were the leg (20%), axilla (18%), buttock (17%), and abdomen/torso (12%). There was no association between the location and type of infection (MRSA/MSSA) (p-value=0.09). The kitchen floor (14.05%) and bedroom floor (14%) were the most common surfaces contaminated with MRSA. These were also the most common surfaces contaminated with MSSA, which was recovered from 10.2% and 9.1% of kitchen floors and bedroom floors, respectively. For individuals with an MRSA or MSSA wound infection, there was an average number of 3.2 (SD=1.6) co-residents per household, and 36.5% of household members were colonized with either MRSA or MSSA. There is no association between household density (number of co-residents) and type of infection (MRSA/MSSA) (Fisher’s p-values=0.171 and 0.371, respectively). In households of participants with MSSA wound infections, the number of colonized sites is positively associated with the level of household MSSA contamination (p=0.027). Further analyses will examine the associations between molecular subtypes, wound location, household surface contamination and household member colonization and infection. DISCUSSION/SIGNIFICANCE OF IMPACT: This study aims to understand the patient-level and environmental-level factors associated with SSTI recurrence, surface contamination and household transmission, and to examine the interactions between bacterial genotypic and clinical/phenotypic factors on decontamination, decolonization, SSTI recurrence and household transmission. This study will evaluate the barriers and facilitators to implementation of home visits by CHWs in underserved populations, and aims to strengthen the evidence base for implementation of strategies to identify and reduce household reservoirs and then control SSTI recurrence and household transmission.
3D is a next-generation near-IR spectrometer developed at the MPE which offers, in a single integration, the opportunity to image an 8″ × 8″ field across almost the entire K-band at a simultaneous spatial resolution of 0.″5 wide strips which are then aligned optically on top of each other forming a single long slit. This long slit is then used as the input for a grating spectrometer which images it onto a two dimensional detector array. Each detector row then represents the spectrum of one spatial element of the two dimensional field of view. The central part of the optical system is the image slicer which is made of two complex plane mirror systems consisting of 16 segments each. The detector is a NICMOSIII HgCdTe array with 256 × 256 pixels. In the spectral domain the spectrometer provides a resolving power of R = 1000.
Here we present not only the design of the instrument but also first data obtained during instrument commissioning at the 3.5-m Calar Alto telescope in December, 1993.
We report on observations of Cen A using the SEST telescope (Swedish-ESO Submillimeter Telescope). In a previous paper (Eckart et al. 1990a, hereafter Paper I) we presented a fully sampled map of the 12CO(1-0) distribution in the disk which complements the 12CO(2-1) cuts obtained by Phillips et al. (1987, 1989). From these data we determined that the ISM in the disk of Centaurus A is cold (T<10 K), with densities of the order of the 12CO critical density (∼2 × 104 cm—3). Absorption against the nuclear continuum source has been reported for HI (van Gorkom 1987, van der Hulst et al. 1983, Whiteoak and Gardner 1971) and a number of molecular species, such as OH, H2CO, C3H2, 12CO, and 13CO (Whiteoak and Gardner 1971, Gardner and Whiteoak 1976, Bell and Seaquist 1988, Phillips et al. 1987, Israel et al. 1990). Here we summarize measurements of absorption in the lines of 12CO, 13CO, HCO+, HCN, CN and CS (see Eckart et al. 1990b; hereafter Paper II).
Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators.
A multi-faceted, computerized decision support tool was developed, using a systematic literature and guideline review, expert opinion from an earlier Delphi study, as well as qualitative interviews and focus groups with physicians, caregivers of former drivers with dementia, and transportation administrators. The tool integrates inputs from the physician-user about the patient's clinical and driving history as well as cognitive findings, and it produces a recommendation for reporting to transportation administrators. This recommendation is translated into a customized reporting form for the transportation authority, if applicable, and additional resources are provided for the patient and caregiver.
An innovative approach was needed to develop the DD-DT. The literature and guideline review confirmed the algorithm derived from the earlier Delphi study, and barriers identified in the qualitative research were incorporated into the design of the tool.
In the foothills of the Cumberland Mountains, in central Appalachia (a region that spans 13 states in the US), sits an economically distressed and rural community of the United States. Once a thriving coal-mining area, this region now is reported as one of the hardest places to live in the US. Southeastern Kentucky, located in a remote, rocky, mountainous area surrounded by rivers and valleys and prone to flooding, experienced a major flood in Spring 2013 causing significant damage to homes and critical infrastructure.
Aims of the study were to: (1) identify and better understand the contextual variables compounding the impact of a disaster event that occurred in Spring 2013; (2) identify ways participants managed antecedent circumstances, risk, and protective factors to cope with disaster up to 12 months post-event; and (3) further determine implications for community-focused interventions that may enhance recovery for vulnerable populations to promote greater outcomes of adaptation, wellness, and readiness.
Using an ethnographic mixed-methods approach, an inter-collaborative team conducted face-to-face interviews with (N=12) Appalachian residents about their disaster experience, documented observations and visual assessment of need on an observation tool, and used photography depicting structural and environmental conditions. A Health and Emergency Preparedness Assessment Survey Tool was used to collect demographic, health, housing, environment, and disaster readiness assessment data. Community stakeholders facilitated purposeful sampling through coordination of scheduled home visits.
Triangulation of all data sources provided evidence that the community had unique coping strategies related to faith and spirituality, cultural values and heritage, and social support to manage antecedent circumstances, risk, and protective factors during times of adversity that, in turn, enhanced resilience up to 12 months post-disaster. The community was found to have an innate capacity to persevere and utilize resources to manage and transcend adversity and restore equilibrium, which reflected components of resilience that deserve greater recognition and appreciation.
Resilience is a foundational concept for disaster science. A model of resilience for the rural Appalachia community was developed to visually depict the encompassing element of community-based interventions that may enhance coping strategies, mitigate risk factors, integrate protective factors, and strengthen access. Community-based interventions are recommended to strengthen resilience, yielding improved outcomes of adaptation, health and wellness, and disaster readiness.
BanksLH, DavenportLA, HayesMH, McArthurMA, ToroSN, KingCE, VaziraniHM. Disaster Impact on Impoverished Area of US: An Inter-Professional Mixed Method Study. Prehosp Disaster Med. 2016;31(6):583–592.
With an increasing number of older drivers who are prescribed antidepressants, the potential consequences of antidepressant use on driving skills in an aging population are becoming a pressing issue. We conducted a systematic review using MEDLINE, targeting articles specifically pertaining to antidepressants and driving in a population or subgroup of older adults (≥ 55 years of age). The search yielded 267 references, nine of which pertained to the effects of antidepressants on driving in older adults. The single experimental study found imipramine to have detrimental effects on highway driving, whereas nefazodone did not. Seven of eight population-based studies reported a significant increased risk of involvement in a collision associated with antidepressant use. Although the studies indicated a negative effect of antidepressants on driving, the epidemiological designs cannot exclude the possibility that the underlying illness, generally major depression, is the culprit.
We present a self-consistent, absolute isochronal age scale for young (≲ 200 Myr), nearby (≲ 100 pc) moving groups, which is consistent with recent lithium depletion boundary ages for both the β Pic and Tucana-Horologium moving groups. This age scale was derived using a set of semi-empirical pre-main-sequence model isochrones that incorporate an empirical colour-Teff relation and bolometric corrections based on the observed colours of Pleiades members, with theoretical corrections for the dependence on logg. Absolute ages for young, nearby groups are vital as these regions play a crucial role in our understanding of the early evolution of low- and intermediate-mass stars, as well as providing ideal targets for direct imaging and other measurements of dusty debris discs, substellar objects and, of course, extrasolar planets.
Congenital airway obstruction is rare but potentially fatal. We developed a complex airways interventional delivery team to manage such cases. Antenatal imaging detects airway compromise at an early stage and facilitates the planning of delivery procedures (‘ex utero intrapartum treatment’ and ‘operation on placental support’) which maintain feto-placental circulation whilst an airway is secured.
A retrospective review was performed of cases in which ENT input was required at birth for airway obstruction.
Four neonates were delivered before implementation of the service: two were intubated and another two underwent tracheostomy but died in the peri-natal period. Seven neonates were delivered after implementation of the service: six were intubated and one underwent immediate tracheostomy. Five subsequently underwent tracheostomy (three have since been decannulated). One child with multiple congenital anomalies died due to respiratory failure. Airway obstruction was caused by lymphatic malformation, teratoma, costo-craniomandibular syndrome and choristoma.
In the absence of other anomalies, interventional airway delivery led to reduced mortality and improved outcomes.
Listeria monocytogenes is a foodborne pathogen that can cause bacteraemia, meningitis, and complications during pregnancy. In July 2012, molecular subtyping identified indistinguishable L. monocytogenes isolates from six patients and two samples of different cut and repackaged cheeses. A multistate outbreak investigation was initiated. Initial analyses identified an association between eating soft cheese and outbreak-related illness (odds ratio 17·3, 95% confidence interval 2·0–825·7) but no common brand. Cheese inventory data from locations where patients bought cheese and an additional location where repackaged cheese yielded the outbreak strain were compared to identify cheeses for microbiological sampling. Intact packages of imported ricotta salata yielded the outbreak strain. Fourteen jurisdictions reported 22 cases from March–October 2012, including four deaths and a fetal loss. Six patients ultimately reported eating ricotta salata; another reported eating cheese likely cut with equipment also used for contaminated ricotta salata, and nine more reported eating other cheeses that might also have been cross-contaminated. An FDA import alert and US and international recalls followed. Epidemiology-directed microbiological testing of suspect cheeses helped identify the outbreak source. Cross-contamination of cheese highlights the importance of using validated disinfectant protocols and routine cleaning and sanitizing after cutting each block or wheel.
The yttrium-based metal–organic framework, Y(btc) (btc = 1,3,5-benzenetricarboxylate), shows moderate uptake of methane (0.623 mmol g−1) and molecular oxygen (0.183 mmol g−1) at 1 bar and 308 K. Neutron powder-diffraction data for the guest-free, CD4-, and O2-loaded framework reveal multiple adsorption sites for each gas. Both molecular guests exhibit interactions with the host framework characterised by distances between the framework and guest atoms that range from 2.83 to 4.81 Å, with these distances identifying interaction most commonly between the guest molecule and the carboxylate functional groups of the benzenetricarboxylate bridging ligand of the host.