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Healthcare-associated norovirus outbreaks increase later but have a more pronounced seasonality than nonhealthcare norovirus outbreaks. Healthcare-associated norovirus outbreaks had higher correlation with Google Trends activity than nonhealthcare outbreaks (R2=0.68 vs 0.39). Google Trends data may have the potential to supplement existing norovirus surveillance due to its real-time availability.
Intercalated and unmodified TiS2 nanomaterials were synthesized and characterized by UV-Visible-NIR spectroscopy, Powder X-Ray Diffraction, and X-Ray Photoelectron and Ultraviolet Photoelectron Spectroscopy. Photoelectron spectroscopy measurements indicated that CoS and Cu2S appeared to be intercalated between sheets of partially or fully oxidized TiS2, which could be solution processed on conductive oxide substrates. The materials were then applied toward water oxidation and evaluated by cyclic voltammetry, chronoamperometry, and impedance measurements. While unmodified TiS2 was not observed to perform well as an electrocatalyst with overpotentials >3 V in 1 M NaOH electrolyte, CoS intercalation was found to lower the overpotential by ∼1.8–1.44 V at 10 mA/cm2. Conversely, Cu2S intercalation resulted in only a modest increase in performance (>2.3 V overpotential). Impedance measurements indicated that intercalation increased the series resistance in the as-prepared samples but decreased the series resistance in oxidized samples.
We present preliminary results of models of terrestrial planet formation using on the one hand classical numerical integration of hundreds of small bodies on CPUs and on the other hand—for comparison—the results of our GPU code with thousands of small bodies which then merge to larger ones. To be able to determine the outcome of collision events we use our smooth particle hydrodynamics (SPH) code which tracks how water is lost during such events.
VIRAL DISEASES frequently have cutaneous manifestations, most of which are self-limited and of little consequence; however, there are occasions when a viral cutaneous disease may be accompanied by systemic manifesttions that can be life threatening. In general, healthy children and adults are at little risk for these severe complications. Persons at highest risk for systemic involvement include patients who are immunosuppressed, as well as neonates, extremely elderly persons, and the undernourished population. Because many viruses have some form of cutaneous exanthem, almost any virus known to have systemic involvement can be considered a dermatological emergency. This chapter focuses mainly on those viruses in which the cutaneous findings would be likely to prompt dermatological investigation in an emergency situation.
HERPES SIMPLEX VIRUS
Presentation and Clinical Features
Herpes simplex virus (HSV) is not typically associated with life-threatening or emergency situations; rather, HSV is better known as an acute, self-limited infection that may recur in certain individuals. In rare instances, fatal and highly morbid complications can arise. Neonates and immunocompromised persons generally make up the vast majority of patients with these poor outcomes, but in extremely rare cases some immunocompetent patients suffer severe complications.
HSV can be divided into two subgroups (HSV-1 and HSV-2) based on molecular and immunologic characteristics. HSV-1 typically causes lesions in the oral mucosa and produces gingivostomatitis and pharyngitis in primary infections. Primary infections of HSV-2 most commonly cause genital lesions and produce acute vulvovaginitis and progenitalis.
CUTANEOUS SURGICAL INTERVENTIONS are becoming more and more popular as this area of dermatology continues to rapidly expand. Dermatologists are performing progressively more surgical procedures in their private offices. A survey performed by the American Society of Dermatologic Surgery (ASDS) in 2003 revealed that 3.9 million procedures were performed that year by participating ASDS members. These outpatient procedures allow the dermatologist to provide more comprehensive care to the patient and present the patient with a more affordable option, because outpatient procedures under local anesthesia are less expensive than in the hospital setting.
With the upsurge in the number of cutaneous surgeries, an important goal remains to keep patients free of nosocomial and surgical site infections (SSIs). Traditionally, dermatologic procedures and surgeries have benefited from relatively low infection rates, despite varying infection-control practices. Strict adherence to aseptic technique is required to maintain this low rate of infectious complications. In addition to the principles of asepsis, the surgeon must also minimize patient and environmental risk factors, achieve adequate preoperative preparation, decide if antibiotic prophylaxis is necessary, as well as maintain proper surgical suite protocol and surgical technique.
SURGICAL SITE INFECTIONS
Postoperative infections after dermatologic procedures are rare. These surgeries are largely considered either “clean” or “clean-contaminated,” with infection rates of less than 5% and 5%–10%, respectively. Studies examining the rate of infectious complications following dermatologic procedures have indicated an even lower incidence in this field.
Zinc oxide (ZnO) nanowires (NWs) are receiving significant industrial and academic attention for a variety of novel electronic, optoelectronic and MEMS device applications due to their unusual combination of physical properties, including being optically transparent, semiconducting and piezoelectric. Hydrothermal growth is possible at significantly lower temperatures (and hence lower thermal budgets) compared with other NW growth methods, such as chemical vapour deposition. In this context, the hydrothermal growth of ZnO NWs on seeded substrates immersed in equimolar zinc nitrate/HMTA aqueous solution was investigated. NWs were grown on polished silicon (001) substrates, and the solution concentrations, temperatures and growth times were varied. Importantly, the NW diameter was found to depend only on concentration during hydrothermal growth for times up to 4 hours. The average diameter was 14 nm in 0.005 M solution and increased up to a maximum 150 nm at 0.07 M, when the NWs formed a continuous polycrystalline film. Concentration and temperature were all found to affect the axial growth rate of NWs in the  direction. The growth rate was constant up to 4 hours (200 nm hr-1) for constant conditions (81 oC, 0.025 M). The growth rate was found to increase approximately linearly with concentration at a rate of 7840 nm M-1 hr-1 up to 0.06 M (81 oC solution). The growth rate also increased linearly with temperature at a rate of 4.9 nm hr-1 K-1 (0.025 M solution). This indicates that growth takes place close to the equilibrium point, found by linear regression to be 36 oC for 0.025 M solution.
The substitution of piperacillin/tazobactam, ampicillin/sulbactam, or both for third-generation cephalosporins has been associated with reduced vancomycin-resistant enterococci (VRE). However, piperacillin/tazobactam came into widespread use during a period in which the prevalence of VRE increased. We hypothesized that the increasing use of piperacillin/tazobactam and other agents with relatively enhanced anti-enterococcal activity (ie, piperacillin, ampicillin/sulbactam, and ampicillin) has been associated with increased or unchanged rates of VRE in some hospitals.
We retrospectively evaluated the correlation between hospital antibiotic use (defined daily doses per 10,000 patient-days of care) and incidence of stool or non-stool VRE isolation. We assessed whether a high or increasing proportion of use of beta-lactam agents with relatively enhanced versus minimal (ie, third-generation cephalosporins and ticarcillin/clavulanate) anti-enterococcal activity would prevent increased VRE.
Four academic medical centers.
With the increasing use of piperacillin/tazobactam, the use of beta-lactam agents with enhanced activity against enterococci surpassed the combined use of third-generation cephalosporins and ticarcillin/clavulanate in each hospital. In one hospital, the incidence of VRE was positively correlated with the use of piperacillin/tazobactam or beta-lactam agents with enhanced anti-enterococcal activity (P< .0001). The incidence of VRE rose steadily in another hospital despite relatively high use of beta-lactam agents with enhanced versus minimal anti-enterococcal activity. A negative correlation between VRE and piperacillin/tazobactam or beta-lactam agents with enhanced anti-enterococcal activity was observed in one hospital, but this correlation was not statistically significant.
Increasing the hospital use of piperacillin/tazobactam and other beta-lactams with relatively enhanced anti-enterococcal activity may not be an effective control measure for VRE.
We examined the frequency of acquisition of bacterial pathogens on investigators' hands after contacting environmental surfaces near hospitalized patients. Hand imprint cultures were positive for one or more pathogens after contacting surfaces near 34 (53%) of 64 study patients, with Staphylococcus aureus and vancomycin-resistant Enterococcus being the most common isolates.
To test the hypothesis that patients colonized with vancomycin-resistant Enterococcus (VRE) have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE.
A rectal swab culture survey was conducted to determine the point-prevalence of stool colonization with ceftazidime-resistant gram-negative bacilli in hospitalized patients with or without VRE stool colonization. For a 6-month period, the frequency of Clostridium difficile diarrhea and isolation of antibiotic-resistant (ie, ceftazidime-, piperacillin/tazobactam-, levofloxacin-, or trimethoprim/sulfamethoxazole-resistant) gram-negative bacilli, methicillin-resistant Staphylococcus aureus (MRSA), and non-albicans Candida species from clinical specimens other than stool was examined.
A Department of Veterans Affairs medical center.
All patients hospitalized in the acute care facility and one nursing home unit during a 1-week period in February 2001.
VRE-colonized patients had a higher point-prevalence of rectal colonization with ceftazidime-resistant gram-negative bacilli than did patients not colonized with VRE (17% vs 4%; P = .026). During a 6-month period, the VRE-colonized patients were more likely to have Clostridium difficile–associated diarrhea (26% vs 2%; P = .001), MRSA infection (17% vs 4%; P = .017), or colonization or infection with gram-negative bacilli resistant to 4 different antibiotics.
VRE-colonized patients in our institution have a higher frequency of colonization or infection with other nosocomial pathogens than do patients who are not colonized with VRE. This suggests that isolation measures implemented to control VRE could help limit the dissemination of other, coexisting pathogens.
Femtosecond modelocked lasers using new ytterbium-doped borate crystals (Yb:Sr3Y(BO3)3,
Yb:Ca4GdO(BO3)3 and Yb:Ca4YO(BO3)3) are demonstrated. Pulse duration as short as 69 fs
has been obtained. To modelock such lasers, fast saturable absorbers need to be used. Two
different types of fast saturable absorbers have been studied: low-temperature-grown
semiconductor mirrors (SESAM) and high-energy-ion-implanted semiconductor Bragg
reflectors (SBR). We demonstrated, for the first time to our knowledge, that ion-implanted
SBR can be used to modelock oscillators using Yb-doped materials.
Observations of slab-avalanche releases in alpine terrain have led to the hypothesis that rocky outcrops can influence the spatial distributions of temperature and heal flow in dry alpine snow covers and Unis control the local distribution of depth hoar. We investigate the effects of terrain on crystal growth by using a two-dimensional finite-clemcnl model of heal How coupled with a model of crystal growth from vapor. We used the model to examine the influence of snow properties, terrain geometry and snow depth on this phenomenon. The efleel is stronger in the early winter than in the late winter, because the rock has then had time to cool. In all cases, we found that depth-hoar growth occurs preferentially over the rock. This suggests that snow-pit investigations made over soil can he misleading if rocky outcrops are present.
A consensus conference on the reasons for the undertreatment of depression was organized by the National Depressive and Manic Depressive Association (NDMDA) on January 17–18,1996. The target audience included health policymakers, clinicians, patients and their families, and the public at large. Six key questions were addressed: (1) Is depression undertreated in the community and in the clinic? (2) What is the economic cost to society of depression? (3) What have been the efforts in the past to redress undertreatment and how successful have they been? (4) What are the reasons for the gap between our knowledge of the diagnosis and treatment of depression and actual treatment received in this country? (5) What can we do to narrow this gap? (6) What can we do immediately to narrow this gap?
Let 𝒳 be a complex Banach space, with open unit ball B. We consider the algebra of analytic functions on B that are weakly continuous and that are uniformly continuous with respect to the norm. We show these are precisely the analytic functions on B that extend to be weak-star continuous on the closed unit ball of 𝒳**. If 𝒳* has the approximation property, then any such function is approximable uniformly on B by finite polynomials in elements of 𝒳*. On the other hand, there exist Banach spaces for which these finite-type polynomials fail to approximate. We consider also the approximation of entire functions by finite-type polynomials. Assuming 𝒳* has the approximation property, we show that entire functions are approximable uniformly on bounded sets if and only if the spectrum of the algebra of entire functions coincides (as a point set) with 𝒳**.
We summarize the discussion of the current status and future prospects of space and astrophysical plasma research prepared by the Panel on Space and Astrophysical plasmas, a part of the study on Physics administered by the National Research Council of the National Academy of Sciences. The Study on Physics is chaired by W. Brinkman of Bell Laboratories and will be completed in 1984.
Cognitive functions of psychiatric patients with and without tardive dyskinesia were evaluated using the Wechsler Adult Intelligence Scale, Wechsler Memory Scale and Rey Auditory Verbal Learning Test. Schizophrenic patients with and without tardive dyskinesia did not differ in their performance on the administered psychological tests. However, affective disorder patients with tardive dyskinesia showed significantly more impairment on the Wechsler Memory Scale and Rey Auditory Verbal Learning Test than affective disorder patients without tardive dyskinesia. These findings suggest that affective disorder patients who develop tardive dyskinesia may have some predisposing brain damage or that tardive dyskinesia in these patients represents both a motor and a dementing disorder.