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Massive use of antibiotics has led to increased bacterial resistance to these drugs, making infections more difficult to treat. Few studies have assessed the overall antimicrobial resistance (AMR) burden, and there is a paucity of comprehensive data to inform health policies. This study aims to assess the overall annual incident number of hospitalised patients with AMR infection in France, using the National Hospital Discharge database. All incident hospitalisations with acute infections in 2016 were extracted. Infections which could be linked with an infecting microorganism were first analysed. Then, an extrapolation of bacterial species and resistance status was performed, according to age class, gender and infection site to estimate the total number of AMR cases. Resistant bacteria caused 139 105 (95% CI 127 920–150 289) infections, resulting in a 12.3% (95% CI 11.3–13.2) resistance rate. ESBL-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus were the most common resistant bacteria (>50%), causing respectively 49 692 (95% CI 47 223–52 142) and 19 493 (95% CI 15 237–23 747) infections. Although assumptions are needed to provide national estimates, information from PMSI is comprehensive, covering all acute bacterial infections and a wide variety of microorganisms.
Digitaria exilis is an important indigenous cereal in West Africa. The first fonio reference transcriptome was released and became a key tool for developing new molecular markers contributing to a better understanding of its genetic diversity. A total of 126 new putative primer pairs were successfully designed in 37,327 unigenes from the D. exilis transcriptome. Thirty-seven primer pairs were randomly selected and tested for their ability to cross-amplify to related species. Clear amplification patterns were observed on 24 primer pairs. Of these, 71, 74 and 35% showed polymorphism in three species: D. exilis, D. longiflora and D. iburua. The transferability from D. exilis was 96% to D. longiflora and 71% to D. iburua. The new SSR markers confirmed the close genetic proximity of D. exilis with D. longiflora and its stronger genetic difference of D. exilis from D. iburua. These markers will be valuable for completing future knowledge on Digitaria evolutionary history, and for testing gene flows between related species.
Gold has been a major economic asset for Suriname for more than a century. The long history of gold mining, concentrated in large parts of a greenstone belt in the northeast of the country, began with small-scale artisanal extraction activities and has recently seen the development of major open-pit operations. Despite the range of mining activities, Suriname's gold deposits and occurrences are under-explored from a scientific point of view. Primary gold mineralisations in the greenstone belt occur in multiple forms, and although their origin is commonly related to the Palaeoproterozoic Trans-Amazonian orogeny, the controls of ore formation in specific cases often remain obscure. This contribution presents an abridged overview of currently available information on the geological setting and characteristics for some of the main deposits where gold is extracted. In view of the consistent link between gold metallogeny and granitoid–greenstone belts in the northern Guiana Shield, the mineralised settings in Suriname are discussed in a regional context.
The new facility Artemis was installed in 2003 in Saclay, France. This 3MV NEC Pelletron is dedicated to high-precision radiocarbon measurements for French 14C laboratories. We will present information on Artemis along with our sample preparation methods. Results from measurements on some intercalibration samples will be given along with the values of measured blanks. Finally, we report on some problems we have encountered when measuring sputter cathodes with high CH− outputs.
Poly(acrylamide-co-2-hydroxyethyl methacrylate), hydrogel microparticles were prepared by free radical copolymerization of acrylamide (AAm) and 2-hydroxyethyl methacrylate (2-HEMA) using an inverse emulsion polymerization technique, employing ethylene glycol dimethylacrylate (EGDMA) as crosslinker in the presence of w/o emulsifiers span-80 and span-85 (sorbitol mono-oleate) above the lower critical solution temperature. Water absorption capacity and characteristics of the hydrogel microparticles were analyzed by Optical Microscopy (OM), Scanning Electron Microscopy (SEM), Fourier Transform Infrared Spectroscopy (FTIR) and Thermogravimetric Analysis (TGA). Thus, microparticles were submitted to a gravimetric study on their ability to absorb and to retain distilled water at 25°C. One gram of microparticles absorbed at least 15 g of water. By varying the relative ratio between the continuous phase (hexane and emulsifiers) and the dispersed phase (monomers, initiator and crosslinker), non-agglomerated dispersed particles with nearly spherical shape were obtained having a narrow size distribution in the range from 10 to 20 µm. At a constant value of the emulsifier, and as a result of increasing the stirring rate, a particle size reduction was observed from 13 to 7 µm. The PAAm and PHEMA structures of synthesized hydrogel were confirmed using FTIR analysis. Additionally, through thermal analysis the P(AAm-HEMA) hydrogel showed an increase of water retention and thermal stability due to PAAm addition.
Anthropogenic habitat alteration has probably contributed significantly to the decrease of raptor populations in West African savannas. To evaluate the impact of habitat degradation on foraging by sedentary Afrotropical raptors, we investigated the differences in microhabitat selection, foraging effort and energy returns between Dark-chanting Goshawks Melierax metabates inhabiting natural and transformed savannas in Cameroon. We expected that the agro-ecosystems in the transformed savannas have become unprofitable for Dark-chanting Goshawks due to scarcity of food resources. In both savanna types we radio-tracked six mated, adult males during the non-breeding season and determined foraging effort, by time spent at each perch and distance covered between perches, and energy intake through estimation of the energy value of prey items. Goshawks in natural habitats had smaller home-ranges and exploited their range more intensively than Goshawks in transformed habitats. In both natural and transformed habitats, Goshawks selected foraging patches with comparatively tall trees, underlining their importance to foraging Goshawks. The extent of shrub and herbaceous layer cover, agriculture cover, and tree density were other important predictors of foraging patch use, but their importance differed between habitats. The extent of shrub, herbaceous layer and agriculture cover were positively associated with foraging patch use in transformed habitats, suggesting that cultivated fields and ground vegetation support important prey resources for Goshawks in agro-ecosystems. The composition of broad prey categories to the diet, foraging effort and returns were comparable between habitats. However, we found indications that the proportion of heavy-bodied lizard species among reptile prey items was higher in natural than transformed habitats, whereas on average smaller lizards were more commonly caught in the latter. Mean herbaceous layer height and tree density within home ranges, both higher in natural habitat, were negatively related to prey capture rates. Tree clearance and livestock grazing thus favored greater prey capture rates in transformed habitat, offsetting a lower meal energy value compared to natural habitat. We conclude that foraging Dark-chanting Goshawks may cope with moderate land transformation, but practices focused on conservation of tall trees and ground vegetation cover would be beneficial by maintaining important prey resources and their exploitability under growing land pressure.
This study examined how nursing home facility ownership and organizational characteristics relate to emergency department (ED) transfer rates. The sample included a retrospective cohort of nursing home residents in the Vancouver Coastal Health region (n = 13,140). Rates of ED transfers were compared between nursing home ownership types. Administrative data were further linked to survey-derived data of facility organizational characteristics for exploratory analysis. Crude ED transfer rates (transfers/100 resident years) were 69, 70, and 51, respectively, in for-profit, non-profit, and publicly owned facilities. Controlling for sex and age, public ownership was associated with lower ED transfer rates compared to for-profit and non-profit ownership. Results showed that higher total direct-care nursing hours per resident day, and presence of allied health staff – disproportionately present in publicly owned facilities – were associated with lower transfer rates. A number of other facility organizational characteristics – unrelated to ownership – were also associated with transfer rates.
This article describes British Columbia’s regulatory model for assisted living and used time series analysis to examine individuals’ use of health care services before and after moving to assisted living. The 4,219 assisted living residents studied were older and predominantly female, with 73 per cent having one or more major chronic conditions. Use of health care services tended to increase before the move to assisted living, drop at the time of the move (most notably for general practitioners, medical specialists, and acute care), and remain low for the 12-month follow-up period. These apparent positive effects are not trivial; the cohort of 1,894 assisted living residents used 18,000 fewer acute care days in the year after, compared to the year before, their move. Future research should address whether and how assisted living affects longer-term pathways of care for older adults and ultimately their function and quality of life.
L’acquisition du mouvement est de plus en plus souvent
effectuée pour améliorer la balistique des traitements en radiothérapie
externe. Cependant, elle est source d’une exposition supplémentaire
pour le patient. Le développement de la plate-forme de simulation
numérique NEMOSIS (NEural NEtwork MOtion SImulation System)
ouvre la voie à l’optimisation de la dose en imagerie. Elle permet
de générer un mouvement pulmonaire localisé et personnalisé à partir
du modèle 3D du patient. Pour 3 patients test, 5 à 6 points anatomiques
ont été simulés puis comparés aux tracés du radiothérapeute. Dans
le cas le plus défavorable, les résultats ont montré une précision
moyennée sur l’ensemble des points d’un patient et sur toutes les
phases d’environ 3 mm avec une incertitude élargie de tracé égale
à 1,5 mm (intervalle de confiance de 95 %) et une incertitude maximale
de phase atteignant 6,53 mm. Une autre étude comparant les GTV (
Gross Tumor Volume) d’un radiothérapeute et ceux
calculés par NEMOSIS a été également menée. Un indice de Dice stipulant une
correspondance minimale de 0,80 a été calculé entre les deux types
de volumes. Ces résultats font de NEMOSIS un outil très prometteur
en tant qu’alternative aux imageries irradiantes.
Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with better care quality. Accordingly, we conducted a cross-sectional survey of nursing home directors of care in Vancouver Coastal Health, a large health region in British Columbia. The survey addressed staffing levels and organization, physician access, end-of-life care, and factors influencing facility-to-hospital transfers. Many of the modifiable organizational characteristics associated in the literature with potentially avoidable hospital transfers and better care quality are present in nursing homes in British Columbia. However, their presence is not universal, and some features, especially the organization of physician care and end-of-life planning and services, are particularly lacking.
Mass casualty triage is the process of prioritizing multiple victims when resources are not sufficient to treat everyone immediately. No national guideline for mass casualty triage exists in the United States. The lack of a national guideline has resulted in variability in triage processes, tags, and nomenclature. This variability has the potential to inject confusion and miscommunication into the disaster incident, particularly when multiple jurisdictions are involved. The Model Uniform Core Criteria for Mass Casualty Triage were developed to be a national guideline for mass casualty triage to ensure interoperability and standardization when responding to a mass casualty incident. The Core Criteria consist of 4 categories: general considerations, global sorting, lifesaving interventions, and individual assessment of triage category. The criteria within each of these categories were developed by a workgroup of experts representing national stakeholder organizations who used the best available science and, when necessary, consensus opinion. This article describes how the Model Uniform Core Criteria for Mass Casualty Triage were developed.
(Disaster Med Public Health Preparedness. 2011;5:129-137)
The temperature and concentration dependence of the electron paramagnetic resonance spectra of YBa2(Cu1−xZnx)3O7 has been measured for 0≤x≤0.16. Zn substituted on the Cu-site cause a rapid nearly linear depression of the superconducting transition temperature Tc with Tc going to zero in the vicinity of x=0.10. Only weak EPR spectra due to ≤1% of the Cu-ions are seen in the superconducting phase of YBa2Cu3O7. These spectra are most likely attributed to Cu-ions in the vicinity of grain boundaries and do not represent a bulk response. However, a strong asymmetric resonance is observed in the Zn-substituted samples with x>0.1. The EPR results obtained for YBa2(Cu1−xZnx)3O7 are discussed in terms of a possible localization of d-electrons.
We have studied methods of improving glow-discharge-deposited a-Si1−x Gex :H alloys deposited using silane and germane gas mixtures. Material processing methods studied include (1) varying the substrate temperature from 170° to 280°C, (2) varying the process gas composition and pressure, (3) dilution of the feed gas by hydrogen, argon, or helium, (4) enhancing etching during deposition by adding small amounts of XeF2 vapor into the process gas, and (5) postdeposition annealing and/or hydrogenation.