We established a surveillance program to evaluate persistence of C. auris colonization among hospitalized patients. Overall, 17 patients (34%) had ≥1 negative result followed by a positive test, and 7 (41%) of these patients had ≥2 consecutive negative tests.

The study objective was to determine the prevalence of Staphylococcus aureus colonisation in the nares and oropharynx of healthy persons and identify any risk factors associated with such S. aureus colonisation. In total 263 participants (177 adults and 86 minors) comprising 95 families were enrolled in a year-long prospective cohort study from one urban and one rural county in eastern Iowa, USA, through local newspaper advertisements and email lists and through the Keokuk Rural Health Study. Potential risk factors including demographic factors, medical history, farming and healthcare exposure were assessed. Among the participants, 25.4% of adults and 36.1% minors carried S. aureus in their nares and 37.9% of adults carried it in their oropharynx. The overall prevalence was 44.1% among adults and 36.1% for minors. Having at least one positive environmental site for S. aureus in the family home was associated with colonisation (prevalence ratio: 1.34, 95% CI: 1.07–1.66). The sensitivity of the oropharyngeal cultures was greater than that of the nares cultures (86.1% compared with 58.2%, respectively). In conclusion, the nares and oropharynx are both important colonisation sites for healthy community members and the presence of S. aureus in the home environment is associated with an increased probability of colonisation.

Conjugated linoleic acid (CLA) might regulate the lipid depots in liver and adipose tissue. As there is an association between maternal nutrition, fat depots and risk of offspring chronic disease, the aim was to investigate the effect of maternal CLA consumption on TAG regulation and some inflammatory parameters in adult male rat offspring receiving or not receiving CLA. Female Wistar rats were fed control (C) or CLA-supplemented (1 %, w/w) diets during 4 weeks before and throughout pregnancy and lactation. After weaning, male offspring of CLA rats were fed C or CLA diets (CLA/C and CLA/CLA groups, respectively), whereas C male rat offspring were fed a C diet (C/C group) for 9 weeks. Serum TAG levels were increased in the CLA/CLA and CLA/C groups, associated with a reduction of lipoprotein lipase activity and weights of adipose tissue. The liver TAG levels were decreased in the CLA/CLA group, related to a significant reduction of fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC) and glucose-6-phosphate dehydrogenase enzyme activities, as well as to the mRNA levels of FAS, ACC, stearoyl-CoA desaturase-1 and sterol regulatory element-binding protein-1c. Even though normal TAG levels were found in the liver of CLA/C rats, a reduction of lipogenesis was also observed. Thus, these results demonstrated a programming effect of CLA on the lipid metabolic pathways leading to a preventive effect on the TAG accretion in adipose tissue and the liver of male rat offspring. This knowledge could be important to develop some dietary strategies leading to a reduced incidence of obesity and fatty acid liver disease in humans.

In the last decades, a new awareness on human nutrition has increased and the concept of ‘food’ has changed from ‘source of nutrients for body’s needs’ to ‘health promoter’. Fruits and vegetables have always been considered beneficial for human health. More recent studies have demonstrated that bioactive components are also present in animal-derived foods, such as milk and dairy products. A broader concept of ‘nutritional safety’ implies the knowledge of how the nutrients contained in animal-derived foods positively affect human health, and how to increase their content. The improvement of dairy products fatty acid (FA) composition can involve strategies in animal nutrition. This review aims to discuss the role of FAs supplementation in ameliorating milk fat composition, environmental impact and animal health. In particular, we have focused on the role of n-3 and CLA FAs and how animal nutrition strategies can positively affect both human and animal health. Several studies have demonstrated that through adequate nutritional strategies is possible to manipulate and improve FA composition of milk and derived products (cheese). Moreover, feeding animals with n-3 FAs has proved to reduce emission of methane (CH4), but further nutritional strategies are needed in order to address this crucial environmental issue. In relation to animal health, n-3 FAs have been proved to modulate immune and inflammatory response in dairy ruminants. Recent studies have addressed the potential programming effects of increased maternal n-3 polyunsaturated FAs intake on offspring’s immune functions showing that feeding bioactive FAs to pregnant animals can affect progeny health status.

Introduction: Acute upper gastrointestinal (UGI) bleeding is a relatively common emergency resulting in death in 6 to 8% of cases. UGI endoscopy is the intervention of choice which requires procedural sedation and analgesia (PSA). The Halifax Infirmary emergency department (ED) performs 1000 PSAs annually, performed by advanced care paramedics (ACPs). This has been shown safe for other indications for PSA, such as orthopedic procedures. Considering that UGI endoscopy involves upper airway manipulation, and patients are at an increased risk of massive bleeding, this procedure would be expected to be more complex and have an increased risk of adverse events (AEs). This study aims to compare PSA for UGI endoscopy performed by ACPs to that for orthopedic procedures for AEs, airway intervention and medication use. Methods: This study is a retrospective review of an ACP-performed ED PSA quality control database. A dataset was built matching 64 UGI endoscopy PSAs to 192 orthopedic PSAs by propensity scores calculated using age, gender and ASA classification. Outcomes assessed were hypotension (SBP < 100, or 15% decrease from baseline), hypoxia (SaO2 < 90), apnea (> 30sec), vomiting, arrhythmias and death in the ED. The need for airway intervention and medication use was assessed. Results: The UGI endoscopy group was 4.60 times more likely to suffer hypotension than the orthopedic group (OR=4.6, CI:2.2-9.6), and a fifth as likely to require airway repositioning (OR=0.2, CI:0.1-0.5). One endoscopy patient required endotracheal intubation. No patient died in either group. Compared to the orthopedic group, the UGI endoscopy group was one-third as likely to receive fentanyl (OR=0.3, CI:0.2-0.6). When fentanyl was administered, endoscopy patients received an average 26.7 mcg less than orthopedic patients. The endoscopy group was 15.4 times more likely to receive ketamine (OR=15.4, CI:4.7-66.5), and received 34.4 mg less on average. Four endoscopy patients received phenylephrine compared to none in the orthopedic group. There were no other differences. Conclusion: ED PSA for UGI endoscopy appears to differ significantly from that performed for orthopedic procedures. It was associated with more frequent hypotension and increased use of ketamine as a sedative. Patients undergoing UGI endoscopy were less likely to receive fentanyl and require airway repositioning. Only patients in the endoscopy group required intubation or a vasopressor agent.

Increasing irrigation efficiency is a major goal for fruit production in dry Mediterranean environments. The present study was conducted in three consecutive years (2007–09) under typical Mediterranean conditions and tested the effect of partial rootzone drying (PRD) on yield and fruit quality of two apple cultivars: Gala, with fruit maturing in summer and Fuji, with fruit maturing in autumn. Three irrigation treatments were imposed: conventional irrigation (CI), PRD (0·50 of CI water on one side of the rootzone, which was alternated periodically) and continuous deficit irrigation (DI, 0·50 of CI water on both sides of the rootzone). During the 2008 and 2009 irrigation seasons, DI reduced tree water status, and to some extent soil moisture, compared with CI and PRD. In all the years and both cultivars, DI reduced crop load by 11 and 5% over CI and PRD, respectively. In cvar Fuji, DI reduced production per tree by 9% and yield efficiency by 16% compared with CI. In all years for cvar Gala and in 2 of the 3 years for cvar Fuji, PRD and DI increased fruit soluble solid content by 5–6%, whereas PRD improved peel colour only in cvar Fuji and in 2 of the 3 years. In cvar Gala, DI fruit showed 27% more sorbitol and 55% more sucrose than PRD fruit. In both cultivars, PRD determined greater marketable yield and profit than DI. Irrigation water productivity (IWP) was increased by both PRD and DI, and in Fuji, PRD induced 18% greater IWP than DI. The different responses of the two cultivars to irrigation treatments can be attributed to differences in canopy size, crop load and mostly to the different timing of fruit growth. In particular, undergoing fast fruit growth during the irrigation period seems to induce permanent yield reductions in DI (but not PRD) trees of cvar Fuji, whereas water deficit during late fruit growth and lower crop load may have cancelled the negative effect of DI in the smaller trees of cvar Gala.

The flow through a smooth axisymmetric constriction (a stenosis in medical applications) of 75% restriction in area is measured using stereoscopic and time-resolved particle image velocimetry (PIV) in the Reynolds number range Re ~ 100–1100. At low Reynolds numbers, steady flow results reveal an asymmetry of the flow downstream of the constriction. The jet emanating from the throat of the nozzle is deflected towards the wall causing the formation of a one-sided recirculation region. The asymmetry results from a Coanda-type wall attachment already observed in symmetric planar sudden expansion flows. When the Reynolds number is increased above the critical value of 400, the separation surface cannot remain attached and an unsteady flow regime begins. Low-frequency axial oscillations of the reattachment point are observed along with a slow swirling motion of the jet. The phenomenon is linked to a periodic discharge of the unstable recirculation region inducing alternating laminar and turbulent flow phases. The resulting flow is highly non-stationary and intermittent. Discrete wavelet transforms are used to discriminate between the large-scale motions of the mean flow and the vortical and turbulent fluctuations. Continuous wavelet transforms reveal the spectral structure of flow disturbances. Temporal measurements of the three velocity components in cross-sections are used with the Taylor hypothesis to qualitatively reconstruct the three-dimensional velocity vector fields, which are validated by comparing with two-dimensional PIV measurements in meridional planes. Visualizations of isosurfaces of the swirling strength criterion allow the identification of the topology of the vortices and highlight the formation and evolution of hairpin-like vortex structures in the flow. Finally, with further increase of the Reynolds number, the flow exhibits less intermittency and becomes stationary for Re ~ 900. Linear stochastic estimation identifies the predominance of vortex rings downstream of the stenosis before breakdown to turbulence.

Low-frequency, relativistic, subcycle solitary waves are found in two-dimensional and three-dimensional particle-in-cell (PIC) numerical simulations, as a result of the interaction of ultrashort, high-intensity laser pulses with plasmas. Moreover, nondrifting, subcycle relativistic electromagnetic solitons have been obtained as solutions of the hydrodynamic equations for an electron–ion warm plasma, by assuming the quasi-neutrality character of the plasma response. In addition, the formation of long-living macroscopic soliton-like structures has been experimentally observed by means of the proton imaging diagnostics. Several common features result from these investigations, as, for example, the quasi-neutral plasma response to the soliton radiation, in the long-term evolution of the system, which leads to the almost complete expulsion of the plasma from the region where the electromagnetic radiation is concentrated, even at subrelativistic field intensity. The results of the theoretical investigations are reviewed with special attention to these similarities.

Magnetohydrodynamic simulation results related to the capillary discharge dynamics are presented. The main physical process that should be taken into account is the ablation of the capillary wall material evaporated by the heat flux from the capillary plasma. The possible applications of the capillary discharges related to the physics of the X-ray lasers and the use of the capillary plasma to provide a guiding for ultrashort high-intensity laser pulses over a distance greater than the defocusing length are discussed.

Semiconductor nitrides grown on substrates with a large lattice mismatch typically contain extended and point defects that prevent the full potential of this material system from being attained. Among allthe substrate options explored so far, freestanding GaN templates appear ideal for homoepitaxial growth of GaN films. To this end, hydride vapor-phase epitaxial (HVPE) grown GaN templates with a thickness of more than 200 μm were thermally lifted off from the sapphire substrate and mechanically polished. The defect densityof such a template is expected to be non-uniform in the growth direction, especially near the back surface which was in close vicinity of the sapphire substrate. We, therefore, studied the transport properties of this template before and after the removal of a 30 μm region from the back-side. For as-prepared GaN, Hall mobilities of 1100 cm2/V-s and 6800 cm2/V-s were obtained at 295 K and 50 K, respectively. A simultaneous fitting of mobility and carrier concentration was used to quantify the contribution ofdifferent scattering mechanisms. When the backside was etched by ∼30 μm, Hall mobilities improved to 1200 cm2/V-s at 295 K and 7385 cmsup2/V-s at 48 K, respectively. A numerical solution of the Boltzmann transport equation (BTE) that deals with the inelastic nature of electron scattering by polar optical mode was employed to determine the acceptor concentration. Raman spectroscopy was employed to obtain LO and TO phonon energies, which were then used in the above-mentioned calculations. The best fittings of the mobility and carrier concentration data yield an average acceptor concentration of 4.9×1015 cm-3 and a donor concentration of 2.1×1016 cm-3 for the as-prepared GaN. The average acceptor concentration decreased to 2.4×1015 cm-3 after etching of the backside, which confirms that the etched-away region contained higher density of defects. The donor activation energy is derived to be 25.2 meV. Our analysis demonstrated high quality of the freestanding GaN substrate with the highest reported electron mobility for wurtzite GaN.

Background. Previous research has suggested that several factors may influence the presence of cognitive impairment in human immunodeficiency virus (HIV) infection. The objective of this study was to assess the impact of cognitive reserve capacity and other variables on neuropsychological performance in early HIV infection.

Methods. The neuropsychological performance of 100 HIV-seropositive subjects without AIDS (71 men and 29 women) was compared with that of 63 seronegative controls (51 men and 12 women). Measures included a neuropsychological battery, a medical examination and a psychiatric assessment. Cognitive reserve scores were based on a combination of years in school, a measure of educational achievement, and an estimate of pre-morbid intelligence.

Results. HIV-positive subjects had longer reaction time latencies than HIV-negative subjects. Those in the HIV-positive group with low cerebral reserve scores showed the poorest performance on the neuropsychological tests. The prevalence of cognitive impairment was significantly higher in the HIV-positive group (27%) than in the controls (3·2%). Multiple regression analysis and logistic regression analysis were used to identify factors associated with global neuropsychological performance and cognitive impairment. Older age, lower cerebral reserve scores and not being on zidovudine treatment were associated with lower global neuropsychological scores and with the presence of cognitive impairment.

Conclusions. Our results suggest that although cognitive impairment is not characteristic of early HIV infection, there is a subgroup of subjects who perform more poorly than expected. A lower reserve capacity, older age and not being on zidovudine treatment are factors that lower the threshold for neuropsychological abnormalities in cases of early HIV infection.

A cross-sectional study was conducted in prisons of Cantabria (northern Spain) from June 1992 to December 1994. Inmates were asked to participate in a survey on prevalence and risk factors for monoinfections and coinfections with HIV, HBV and HCV. Crude and multiple odds ratios of risk factors were calculated (by polychotomous logistic regression). Prevalence of coinfections was higher than that of monoinfections. IDU risk factors were the main independent variables associated with monoinfections and coinfections with these agents. The strength of association increased with the degree of coinfection for IDU risk factors and penal status, e.g. duration of injecting drug use for more than 5 years yielded an adjusted OR ranging from 1·3 (95% CI: 0·4–5·1) for HBV monoinfection to 180 (95% CI: 61·0–540·0) for HIV–HBV–HCV coinfection. In comparison, sexual behaviours were less important than IDU risk factors.

The structure of magnetosonic perturbations around a pair of X lines of a toroidal magnetic configuration is analysed in the framework of ideal MHD, by means of a WKB technique. The conditions for wave trapping are investigated. It is shown that the wave equation for the displacement is separable in the vicinity of the X lines. The relevant eigenvalues and the different types of ray trajectories are discussed.