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Surgical site infections (SSIs) are among the most common healthcare-associated infections in low- and middle-income countries. To encourage establishment of actionable and standardized SSI surveillance in these countries, we propose simplified surveillance case definitions. Here, we use NHSN reports to explore concordance of these simplified definitions to NHSN as ‘reference standard.’
Inefficiencies in the national clinical research infrastructure have been apparent for decades. The National Center for Advancing Translational Science—sponsored Clinical and Translational Science Award (CTSA) program is able to address such inefficiencies. The Trial Innovation Network (TIN) is a collaborative initiative with the CTSA program and other National Institutes of Health (NIH) Institutes and Centers that addresses critical roadblocks to accelerate the translation of novel interventions to clinical practice. The TIN’s mission is to execute high-quality trials in a quick, cost-efficient manner. The TIN awardees are composed of 3 Trial Innovation Centers, the Recruitment Innovation Center, and the individual CTSA institutions that have identified TIN Liaison units. The TIN has launched a national scale single (central) Institutional Review Board system, master contracting agreements, quality-by-design approaches, novel recruitment support methods, and applies evidence-based strategies to recruitment and patient engagement. The TIN has received 113 submissions from 39 different CTSA institutions and 8 non-CTSA Institutions, with projects associated with 12 different NIH Institutes and Centers across a wide range of clinical/disease areas. Already more than 150 unique health systems/organizations are involved as sites in TIN-related multisite studies. The TIN will begin to capture data and metrics that quantify increased efficiency and quality improvement during operations.
This research aims to explore the submerged landscapes of the Pilbara of western Australia, using predictive archaeological modelling, airborne LiDAR, marine acoustics, coring and diver survey. It includes excavation and geophysical investigation of a submerged shell midden in Denmark to establish guidelines for the underwater discovery of such sites elsewhere.
We report the results of a field experiment conducted in New York City during the 2013 election cycle, examining the impact of nonpartisan messages on donations from small contributors. Using information from voter registration and campaign finance records, we built a forecasting model to identify voters with an above-average probability of donating. A random sample of these voters received one of four messages asking them to donate to a candidate of their choice. Half of these treatments reminded voters that New York City's campaign finance program matches small donations with public funds. Candidates’ financial disclosures to the city's Campaign Finance Board reveal that only the message mentioning policy (in generic terms) increased donations. Surprisingly, reminding voters that matching funds multiplied the value of their contribution had no effect. Our experiment sheds light on the motivations of donors and represents the first attempt to assess nonpartisan appeals to contribute.
The Greenland ice sheet is experiencing dramatic melt that is likely to continue with rapid Arctic warming. However, the proportion of meltwater stored before reaching the global ocean remains difficult to quantify. We use NASA MODIS surface reflectance data to estimate river discharge from two West Greenland rivers – the Watson River near Kangerlussuaq and the Naujat Kuat River near Nuuk – over the summers of 2000–12. By comparison with in situ river discharge observations, ‘inundation–discharge’ relations were constructed for both rivers. MODIS-based total annual discharges agree well with total discharge estimated from in situ observations (86% of summer discharge in 2009 to 96% in 2011 at the Watson River, and 106% of total discharge in 2011 to 104% in 2012 at the Naujat Kuat River). We find, however, that a time-lapse camera, deployed at the Watson River in summer 2012, better captures the variations in observed discharge, benefiting from fewer data gaps due to clouds. The MODIS-derived estimates indicate that summer discharge has not significantly increased over the last decade, despite a strong warming trend. Also, meltwater runoff estimates derived from the regional climate model RACMO2/GR for the drainage basins are higher than our reconstructions of river discharge. These results provide indirect evidence for a considerable component of water storage within the glacio-hydrological system.
Here we provide comprehensive guidelines for the assessment and treatment of violence and aggression of various etiologies, including psychotic aggression and impulsive aggression due to schizophrenia, mood disorders, ADHD, or trauma, and predatory aggression due to psychopathy and other personality disorders. These guidelines have been developed from a collection of prescribing recommendations, clinical trial results, and years of clinical experience in treating patients who are persistently violent or aggressive in the California Department of State Hospital System. Many of the recommendations provided in these guidelines employ off-label prescribing practices; thus, sound clinical judgment based on individual patient needs and according to institution formularies must be considered when applying these guidelines in clinical practice.
The design principles and radiation performances of Mikaelian lens antennas are presented. The ways to manufacture gradient index lenses are briefly reviewed. An innovative technique based on the variation of the foam density is described and applied to the Mikaelian lenses. This yields low cost and lightweight gradient index lenses. The focusing properties of Mikaelian lenses are compared numerically to Luneburg lenses. A foam-based planar Mikaelian lens antenna is manufactured and its radiation performances are characterized at 60 GHz. With its flat shape in contact to the primary source, the cylindrical Mikaelian lens turns out to be, for focusing purposes, an interesting alternative to the well-known Luneburg lens.
Obstructing commercialization of Proton Exchange Membrane Fuel Cells (PEMFC) is the soaring cost of platinum and other catalysts used to increase membrane efficiency. The goal of this investigation is to find a relatively inexpensive catalyst for coating the membrane and enhancing the efficiency of the PEMFC. Graphene oxide was reduced using NaBH4 in the presence of metal salts, primarily KAuCl4 and K2PtCl4, to synthesize metal-nanoparticle/reduced graphene oxide (RGO). FTIR indicated the successful synthesis of RGO, while Transmission Electron Microscopy displayed the presence of nanoparticles on RGO sheets. Nafion® membranes were coated with metal-nanoparticle/RGO and tested in an experimental PEMFC alongside bare Nafion®, Gold (Au) nanoparticles, and RGO. The metal-nanoparticle/RGO composites enhanced the PEMFC compared to bare Nafion®. Au-RGO, the best catalyst composite, increased the efficiency up to 150% better than nanoparticles or RGO alone while using only 1% of the concentration of Au nanoparticles. Theoretical power output of the Au-RGO synergy could increase fuel cell efficiency up to 18 times more than the Au-nanoparticles themselves by altering concentrations of Au nanoparticles in Au-RGO. The Au nanoparticles changed the structure and catalytic ability of graphene in the Au-RGO, offering a promising future for PEM fuel cell technology.