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To update current estimates of non–device-associated urinary tract infection (ND-UTI) rates and their frequency relative to catheter-associated UTIs (CA-UTIs) and to identify risk factors for ND-UTIs.
Academic teaching hospital.
All adult hospitalizations between 2013 and 2017 were included. UTIs (device and non-device associated) were captured through comprehensive, hospital-wide active surveillance using Centers for Disease Control and Prevention case definitions and methodology.
From 2013 to 2017 there were 163,386 hospitalizations (97,485 unique patients) and 1,273 UTIs (715 ND-UTIs and 558 CA-UTIs). The rate of ND-UTIs remained stable, decreasing slightly from 6.14 to 5.57 ND-UTIs per 10,000 hospitalization days during the study period (P = .15). However, the proportion of UTIs that were non–device related increased from 52% to 72% (P < .0001). Female sex (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.50–2.50) and increasing age were associated with increased ND-UTI risk. Additionally, the following conditions were associated with increased risk: peptic ulcer disease (HR, 2.25; 95% CI, 1.04–4.86), immunosuppression (HR, 1.48; 95% CI, 1.15–1.91), trauma admissions (HR, 1.36; 95% CI, 1.02–1.81), total parenteral nutrition (HR, 1.99; 95% CI, 1.35–2.94) and opioid use (HR, 1.62; 95% CI, 1.10–2.32). Urinary retention (HR, 1.41; 95% CI, 0.96–2.07), suprapubic catheterization (HR, 2.28; 95% CI, 0.88–5.91), and nephrostomy tubes (HR, 2.02; 95% CI, 0.83–4.93) may also increase risk, but estimates were imprecise.
Greater than 70% of UTIs are now non–device associated. Current targeted surveillance practices should be reconsidered in light of this changing landscape. We identified several modifiable risk factors for ND-UTIs, and future research should explore the impact of prevention strategies that target these factors.
Gut cell losses contribute to overall feed efficiency due to the energy requirement for cell replenishment. Intestinal epithelial cells are sloughed into the intestinal lumen as digesta passes through the gastrointestinal tract, where cells are degraded by endonucleases. This leads to fragmented DNA being present in faeces, which may be an indicator of gut cell loss. Therefore, measuring host faecal DNA content could have potential as a non-invasive marker of gut cell loss and result in a novel technique for the assessment of how different feed ingredients impact upon gut health. Faecal calprotectin (CALP) is a marker of intestinal inflammation. This was a pilot study designed to test a methodology for extracting and quantifying DNA from pig faeces, and to assess whether any differences in host faecal DNA and CALP could be detected. An additional aim was to determine whether any differences in the above measures were related to the pig performance response to dietary yeast-enriched protein concentrate (YPC). Newly weaned (∼26.5 days of age) Large White × Landrace × Pietrain piglets (8.37 kg ±1.10, n = 180) were assigned to one of four treatment groups (nine replicates of five pigs), differing in dietary YPC content: 0% (control), 2.5%, 5% and 7.5% (w/w). Pooled faecal samples were collected on days 14 and 28 of the 36-day trial. Deoxyribonucleic acid was extracted and quantitative PCR was used to assess DNA composition. Pig genomic DNA was detected using primers specific for the pig cytochrome b (CYTB) gene, and bacterial DNA was detected using universal 16S primers. A pig CALP ELISA was used to assess gut inflammation. Dietary YPC significantly reduced feed conversion ratio (FCR) from weaning to day 14 (P<0.001), but not from day 14 to day 28 (P = 0.220). Pig faecal CYTB DNA content was significantly (P = 0.008) reduced in YPC-treated pigs, with no effect of time, whereas total faecal bacterial DNA content was unaffected by diet or time (P>0.05). Faecal CALP levels were significantly higher at day 14 compared with day 28, but there was no effect of YPC inclusion and no relationship with FCR. In conclusion, YPC reduced faecal CYTB DNA content and this correlated positively with FCR, but was unrelated to gut inflammation, suggesting that it could be a non-invasive marker of gut cell loss. However, further validation experiments by an independent method are required to verify the origin of pig faecal CYTB DNA as being from sloughed intestinal epithelial cells.
Todays demand for rapid trace element analysis in pollution control and resource materials has led to the development of a completely automatic, very sensitive and stable Si(Li) X-ray analyzer. The key element, a transmission target tube, which has inherently a very clean monochromatic X-ray output, has been studied in view of efficiency, sensitivity and stability. The transmission target tube requires different operating criteria than conventional X-ray tubes. An analysis was made to “explain” these differences using fundamental X-ray physics. Studies included various experiments directly applied to practical problems in analysis of pollutants and mineral resource materials.
This paper reports and discusses the results of a computer modeling study on powder diffraction profile analysis for crystallite size and strain of polycrystalline materials. The results of this computer modeling show that if the spans of diffraction profiles in reciprocal space (1/d) are not carefully chosen, an overestimation on size and an underestimation on strain may result in analysis by both the Warren-Averbach and the Hall-Williamson methods. A general way to eliminate such errors based on profile fitting and regeneration is presented and discussed in this paper.
Energy dispersive X-ray spectrometry has the potential for making very rapid analyses of multi-element samples. In order to fully exploit this capability several studies have been carried out with the goal of improving performance at high input count rates. A refined amplifier permits operation at input count rates up to 80000 per second with minimal peak shift and distortion. Optimum choice of tube parameters and filters permits utilization of a single Mo transmission target tube to analyze a broad range of elements in minimum time. Use of a pulsed tube further reduces the time required for analysis without sacrifice of precision or resolution. Dead time necessarily increases with increasing input count rate. It can be reduced by selecting a short amplifier time constant, but only with a loss of resolution. Digital processing permits recovery of the lost resolution. Some illustrations are given of spectra that have been processed on-line using a computer based multi-channel analyzer.
Aeroacoustic measurements and analysis have been made for an unshrouded rotor partially immersed in a planar equilibrium turbulent boundary layer at low Mach number. This configuration provides an idealized model of inflow distortion effects seen when a rotor is mounted adjacent to the hull or fuselage of a vehicle. At low and moderate thrust conditions, the rotor produces broadband noise organized into haystacks produced by large eddies of the ingested turbulence being cut multiple times by successive rotor blades. At high thrust, however, the acoustic signature changes and becomes louder and more tonal. This change is accompanied by separation of the boundary layer from the wall in the vicinity of the rotor blade disk. The separation region is highly unsteady and populated by intense vortex structures. Acoustic analysis suggests that blade–vortex interactions with these structures are the source of the additional tonal noise at high thrust.
Dietary protein is the main source of nitrous oxide and nitrates, harmful pollutants which are produced in pig units. So reducing the level of protein in the diet may be environmentally friendly. But will this compromise performance? This study compared three ‘nutritional strategies’ providing different protein and energy levels as pigs of two breeds grew from 40 to 120kg live weight.
In commercial practice, the mixing of pigs often occurs on more than one occasion. This can be very stressful for the pig, as new dominance hierarchies have to be formed at each mixing. Mixing piglets pre-weaning has been used as a method of removing the stress of mixing from the point of weaning (Allen et al., 2000; North & Stewart, 2000) but the effects of mixing at different ages on pre-weaning behaviour needs to be determined. The aim of this study was to determine if mixing piglets pre-weaning affects their sucking and social behaviour.
With the proposed ban on antibiotic growth promoters it is becoming increasingly important to provide diets to young pigs which enhance the long term health. Alternative strategies to promote health include organic acids, herbal products and natural antioxidants. These products have various proposed modes of action including improved liver function, removal of reactive oxygen species and the enhancement of the immune function. The objective of this experiment was to measure the effect of a commercial herbal mixture and Lycopene on the performance and immune function of weaned pigs.
The stress caused by weaning piglets is known to have a serious detrimental effect causing a growth check, increased aggression leading to skin lesions and reducing future performance potential. Previous work (Allen et al., 2000) has shown that mixing piglets pre-weaning can improve post-weaning performance and reduce skin lesions caused by fighting without detrimental affects on pre-weaning performance and behaviour. The aim of this experiment was to assess the effect of changing the post-weaning environment on piglet performance.
The current use of antibiotics in weaner pig diets is likely to be banned from 2006, and alternatives are sought to improve growth and health status of weaner pigs. Hops (Humulus lupulus L.) are mainly known from the brewing industry, but they are also known for their antimicrobial activity and antioxidant properties (Stevens et al., 1998). Hops may be a suitable alternative to antimicrobial growth promoters, particularly when pigs are not able to maximise their growth potential, for example when fed low density rations. The objective of the trial was to investigate the effects of hops on newly weaned piglets on growth performance, liver function and microbiology in diets of different nutrient density.
Mixing piglets pre-weaning at 14 days of age has been shown to improve post-weaning performance and reduce skin lesions caused by fighting without any detrimental affects on pre-weaning performance and behaviour (Allen et al., 2000). The stress associated with weaning has been shown to alter immune function of piglets and increase their susceptibility to infections. The aim of this experiment was to assess the effect of mixing piglets pre-weaning on their humoral and cell-mediated immune responses post-weaning.
Radiocarbon ages were measured on replicate samples of burnt grain and 5 mollusk species collected from a single sealed layer at an archaeological site (Hornish Point) on the west coast of South Uist, Scotland. The aim was to examine the impact of using different mollusk species on ΔR determinations that are calculated using the paired terrestrial/marine sample approach. The mollusk species examined inhabit a range of environments and utilize a variety of food sources within the intertidal zone. Several authors have suggested that these factors may be responsible for observed variations in the 14C activity of mollusk shells that were contemporaneous in a single location. This study found no significant variation in the 14C ages of the mollusk species, and consequently, no significant variation in calculated values of ΔR. The implication is that in an area where there are no carboniferous rocks or significant local inputs of freshwater to the surface ocean, any of a range of marine mollusk species can be used in combination with short-lived terrestrial material from the same secure archaeological context to accurately determine a ΔR value for a particular geographic location and period in time.
Previous neuroimaging studies indicate abnormalities in cortico-limbic circuitry in mood disorder. Here we employ prospective longitudinal voxel-based morphometry to examine the trajectory of these abnormalities during early stages of illness development.
Unaffected individuals (16–25 years) at high and low familial risk of mood disorder underwent structural brain imaging on two occasions 2 years apart. Further clinical assessment was conducted 2 years after the second scan (time 3). Clinical outcome data at time 3 was used to categorize individuals: (i) healthy controls (‘low risk’, n = 48); (ii) high-risk individuals who remained well (HR well, n = 53); and (iii) high-risk individuals who developed a major depressive disorder (HR MDD, n = 30). Groups were compared using longitudinal voxel-based morphometry. We also examined whether progress to illness was associated with changes in other potential risk markers (personality traits, symptoms scores and baseline measures of childhood trauma), and whether any changes in brain structure could be indexed using these measures.
Significant decreases in right amygdala grey matter were found in HR MDD v. controls (p = 0.001) and v. HR well (p = 0.005). This structural change was not related to measures of childhood trauma, symptom severity or measures of sub-diagnostic anxiety, neuroticism or extraversion, although cross-sectionally these measures significantly differentiated the groups at baseline.
These longitudinal findings implicate structural amygdala changes in the neurobiology of mood disorder. They also provide a potential biomarker for risk stratification capturing additional information beyond clinically ascertained measures.
A circular letter was sent out to all members of the Commission in December 1937, to which the majority have replied. While work is going on steadily in the Observatories where meridian observations are carried out, comparatively few catalogues have been published since 1935. In view of the very full report made three years ago it is only necessary to draw attention to the progress which has been made in the interval.
The Joint European X-Ray Telescope, JET-X, is one of the core instruments of the scientific payload of the USSR SPECTRUM-X astrophysics mission due for launch in 1993. The JET-X instrument concept is described and its scientific performance and capability discussed.
To determine if total lifetime physical activity (PA) is associated with better cognitive functioning with aging and if cerebrovascular function mediates this association. A sample of 226 (52.2% female) community dwelling middle-aged and older adults (66.5±6.4 years) in the Brain in Motion Study, completed the Lifetime Total Physical Activity Questionnaire and underwent neuropsychological and cerebrovascular blood flow testing. Multiple robust linear regressions were used to model the associations between lifetime PA and global cognition after adjusting for age, sex, North American Adult Reading Test results (i.e., an estimate of premorbid intellectual ability), maximal aerobic capacity, body mass index and interactions between age, sex, and lifetime PA. Mediation analysis assessed the effect of cerebrovascular measures on the association between lifetime PA and global cognition. Post hoc analyses assessed past year PA and current fitness levels relation to global cognition and cerebrovascular measures. Better global cognitive performance was associated with higher lifetime PA (p=.045), recreational PA (p=.021), and vigorous intensity PA (p=.004), PA between the ages of 0 and 20 years (p=.036), and between the ages of 21 and 35 years (p<.0001). Cerebrovascular measures did not mediate the association between PA and global cognition scores (p>.5), but partially mediated the relation between current fitness and global cognition. This study revealed significant associations between higher levels of PA (i.e., total lifetime, recreational, vigorous PA, and past year) and better cognitive function in later life. Current fitness levels relation to cognitive function may be partially mediated through current cerebrovascular function. (JINS, 2015, 21, 816–830)