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To evaluate the effect of the burden of Staphylococcus aureus colonization of nursing home residents on the risk of S. aureus transmission to healthcare worker (HCW) gowns and gloves.
Multicenter prospective cohort study.
Setting and participants:
Residents and HCWs from 13 community-based nursing homes in Maryland and Michigan.
Residents were cultured for S. aureus at the anterior nares and perianal skin. The S. aureus burden was estimated by quantitative polymerase chain reaction detecting the nuc gene. HCWs wore gowns and gloves during usual care activities; gowns and gloves were swabbed and then cultured for the presence of S. aureus.
In total, 403 residents were enrolled; 169 were colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA) and comprised the study population; 232 were not colonized and thus were excluded from this analysis; and 2 were withdrawn prior to being swabbed. After multivariable analysis, perianal colonization with S. aureus conferred the greatest odds for transmission to HCW gowns and gloves, and the odds increased with increasing burden of colonization: adjusted odds ratio (aOR), 2.1 (95% CI, 1.3–3.5) for low-level colonization and aOR 5.2 (95% CI, 3.1–8.7) for high level colonization.
Among nursing home patients colonized with S. aureus, the risk of transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. Our findings inform future infection control practices for both MRSA and MSSA in nursing homes.
No studies have investigated the associations between established plant-based diet indices and metabolic syndrome (MetS). We evaluated the associations between an overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), unhealthy plant-based diet index (uPDI), and MetS in a nationally representative sample using data from 14,450 Korean adults (≥19y) in the Korea National Health and Nutrition Examination Survey 2012-2016. Dietary intakes were assessed by a semi-quantitative food frequency questionnaire. In the PDI, all plant foods received positive scores. In the hPDI, only healthy plant foods received positive scores. In the uPDI, only unhealthy plant foods received positive scores. All indices reverse scored animal food intake. Multivariable logistic regression models were used to examine the associations between three PDIs and MetS by sex, adjusting for potential risk factors. A total of 23.3% of Korean adults had MetS. In the overall population, individuals in the highest quintile of uPDI had greater odds (odds ratio: 1.54, 95% confidence interval: 1.28, 1.86, P-trend<0.001) of MetS than those in the lowest quintile. Higher uPDI score was associated with higher odds of hypertriglyceridemia in men, and abdominal obesity, high fasting glucose, and hypertriglyceridemia in women. No significant associations were observed between PDI, hPDI, and MetS. Greater adherence to unhealthy plant-based diets was associated with greater odds of MetS and its components suggesting the importance of the quality of plant-based diet in South Korean adults. Sex difference may be considered when recommending plant-based diets for prevention and management of metabolic diseases.
Geological, geomorphological and soil maps provide important information on the substrate as well as on the past and present physical landscape. For the intensely studied Netherlands coastal plain and Rhine–Meuse delta, many such map datasets have been compiled over the last two centuries. These mapping materials comprise older and younger legacy datasets, often fragmented over regions. They have been compiled within various research traditions and by various parties, involving geologists, soil scientists, geomorphologists and landscape archaeologists. The maps and datasets summarise overwhelming amounts of underlying data accumulated over the last few centuries, and are therefore valuable for reconstructing past landscapes.
Digital-infrastructure developments have enhanced possibilities for recombining existing and new data over the last few decades, e.g. through GIS solutions such as palaeogeographical base maps, from which multiple derived map products can be generated. Integration of thematic information from various source maps and underlying data is needed to use the accumulated data diversity to its full potential and to answer applied and fundamental scientific questions. Using diverse information to compile or update maps, however, requires awareness of legacy surveying strategies and the state of knowledge at the time the original data and maps were produced. This paper reviews the soil, geological and geomorphological mapping traditions. We evaluate their products, underlying data and the reasoning behind their compilation, focusing on their use in conventional and digital palaeogeographical mapping. This helps get the most out of large quantities of legacy and modern data, a major challenge for surface and substrate digital mapping in the big-data era.
The co-occurrence of the 2020 Atlantic hurricane season and the ongoing coronavirus disease 2019 (COVID-19) pandemic creates complex dilemmas for protecting populations from these intersecting threats. Climate change is likely contributing to stronger, wetter, slower-moving, and more dangerous hurricanes. Climate-driven hazards underscore the imperative for timely warning, evacuation, and sheltering of storm-threatened populations – proven life-saving protective measures that gather evacuees together inside durable, enclosed spaces when a hurricane approaches. Meanwhile, the rapid acquisition of scientific knowledge regarding how COVID-19 spreads has guided mass anti-contagion strategies, including lockdowns, sheltering at home, physical distancing, donning personal protective equipment, conscientious handwashing, and hygiene practices. These life-saving strategies, credited with preventing millions of COVID-19 cases, separate and move people apart. Enforcement coupled with fear of contracting COVID-19 have motivated high levels of adherence to these stringent regulations. How will populations react when warned to shelter from an oncoming Atlantic hurricane while COVID-19 is actively circulating in the community? Emergency managers, health care providers, and public health preparedness professionals must create viable solutions to confront these potential scenarios: elevated rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19, and the resurgence of COVID-19 cases among hurricane evacuees who shelter together.
What are the consequences of being the victim of crime for political participation? Previous studies report mixed results with respect to voter turnout, in contrast to the positive effects found for other indicators of political engagement. However, previous turnout studies have failed to differentiate between violent and non-violent crime, and have relied on cross-sectional survey data that is prone to measurement biases and selection effects. This article addresses these shortcomings via a panel analysis of official registry data from Denmark recording individual-level turnout in two municipal elections (in 2009 and 2013) and victimization from violent and non-violent crime. It identifies the effect of victimization by comparing changes in turnout between the two elections for victims and two different counterfactual groups: non-victims in the general population, and individuals who were victimized after the 2013 election. The results show that victimization from violent crime increases turnout by 2 to 3 percentage points. The study further demonstrates a large negative between-individual effect of victimization, suggesting that previous studies have been marred by severe selection bias.
To examine longitudinal patterns of child introduction to foods and drinks targeted for restriction by parents and associations between child intake frequency, mother’s own liking, child early exposure and child liking for restricted foods and drinks at 5 years old.
The study involved secondary analyses of longitudinal data from mothers and children participating in the NOURISH randomised controlled trial. Patterns of descriptive data were examined, and a binary logistic regression model tested for prediction of child liking of a selection of restricted foods and drinks.
Brisbane and Adelaide, Australia.
Two hundred and eleven mothers and their first born 5-year-old children.
The proportion of children who had tried the selected restricted foods and drinks progressively increased from 14 months to 5 years old. Mothers’ own high liking for both sweet and savoury restricted foods and drinks predicted child high liking for the same items at 5 years old. Child high intake frequency at 5 years old also predicted child high liking for sweet foods and drinks, but child early exposure did not predict child liking for the restricted items examined.
These results challenge the belief that limiting children’s intake of foods high in sugar, fat and/or salt will increase their liking for them. Findings instead suggest that restricting children’s access to such foods may be beneficial. While further research is required, mothers should be made aware that their own food preferences may inadvertently influence their child’s liking for the very foods they are trying to restrict.
This paper investigates and questions the relevance of product-centric circularity indicators in a product design context. To do so, reviews of eco-design tools and critical analyses of circularity indicators at the micro level of circular economy implementation are combined with a new workshop experimenting four of these indicators with the aim to improve the circularity performance of an industrial product. On this basis, the four tool-based circularity indicators tested are mapped on the engineering design and development process, and are positioned among the pool of main eco-design tools.
Sleep plays a role in the consolidation of various aspects of language learning. In this study, we investigated the extent to which sleep-dependent memory consolidation contributes to second language (L2) rule generalization and enhancement of L2 explicit knowledge. One hundred native English speakers were engaged in a meaning-focused training of two German grammar rules. Participants were trained either in the morning or in the evening and tested after a retention interval that was either filled with wakefulness or sleep. During the test, we used a grammaticality judgment test to measure grammatical learning and retrospective verbal reports and source attributions to measure awareness. We found that sleep consolidated learning only for learners who reported awareness of syntactic rules prior to sleep. However, performance based on explicit sources did not differ after a period of sleep and after a period of wakefulness. These findings suggest that sleep may benefit L2 rule generalization only for learners who are aware of the L2 rules before sleep but may not consolidate L2 explicit knowledge.
OBJECTIVES/GOALS: To develop feasible screening methods for activity of the enzyme Glucose-6-phosphate dehydrogenase (G6PD) with point of care applicability. METHODS/STUDY POPULATION: Current knowledge establishes the relevance of G6PD as a critical therapeutic determinant for effective antimalarial therapy due to the occurrence of mutations that lead to post-treatment severe adverse effects. We present our findings on development of cost effective point-of-care screening methodologies to ascertain G6PD deficiency. RESULTS/ANTICIPATED RESULTS: Using Patient Cohort Explorer and data from the Department of Pathology, we established the prevalence of G6PD deficiency at the University of Mississippi Medical Center, Jackson, MS as high as 11.8% (African-American males in all population, n = 2518). Next, for selection of potential target groups, we set up a protocol for recruitment of volunteers based on ethnic background, parental ethnicity, and medical history. G6PD activity was evaluated using point of care methods [Trinity Biotech test or CareSTART Biosensor], and Gold Standard quantitative spectrophotometric assay (LabCorp). Determinations in >20 subjects have showed comparable concordance. If used with a conservative interpretation of the signal, the Trinity Biotech test showed superior potential for use in the field relative to the CareSTART Biosensor. DISCUSSION/SIGNIFICANCE OF IMPACT: We established the prevalence of G6PD deficiency in our medical center. We have also setup tests for point-of-care assessment of G6PD. Pending evaluation of the relative tests performance, we will be in position to screen individuals and select them for a prospective clinical trial to evaluate the safety of antimalarial agents on scope of G6PD deficiency.
In 2014, a Nutrition Report Card (NRC) was developed as a sustainable, low-cost framework to assess the healthfulness of children’s food environments and highlight action to support healthy eating. We summarise our experiences in producing, disseminating, evaluating and refining an annual NRC in a Canadian province from 2015 to 2019.
To produce the NRC, children’s food environment indicator data are collected, analyzed and compiled for consensus grading by an Expert Working Group of researchers and practitioners. Knowledge translation activities are tailored annually to the needs of target audiences: researchers, practitioners, policymakers and the public. Evaluation of reach is conducted through diverse strategies, including tracking media coverage and website traffic. Assessment of impact on diets and health outcomes is planned.
The grading process has facilitated refining the NRC to enhance its relevance and utility as a tool for its target audiences. Its public release consistently captures media interest and policymakers’ attention. The importance of partnerships in revealing data sources and in strategising to enhance policy approaches to improve food environments is apparent. The NRC has benchmarked progress and stimulated dialogue regarding healthy food environments for children.
The NRC may help to foster a supportive climate for improving the quality of children’s food environments. As an engaging and accessible document, the NRC represents a key mechanism for collating data related to children’s food environments and ensuring it reaches the audiences best positioned to use it. Efforts are underway to expand the NRC across Canada.
Although trauma-focused cognitive behavior therapy (TF-CBT) is the frontline treatment for post-traumatic stress disorder (PTSD), one-third of patients are treatment non-responders. To identify neural markers of treatment response to TF-CBT when participants are reappraising aversive material.
This study assessed PTSD patients (n = 37) prior to TF-CBT during functional magnetic brain resonance imaging (fMRI) when they reappraised or watched traumatic images. Patients then underwent nine sessions of TF-CBT, and were then assessed for symptom severity on the Clinician-Administered PTSD Scale. FMRI responses for cognitive reappraisal and emotional reactivity contrasts of traumatic images were correlated with the reduction of PTSD severity from pretreatment to post-treatment.
Symptom improvement was associated with decreased activation of the left amygdala during reappraisal, but increased activation of bilateral amygdala and hippocampus during emotional reactivity prior to treatment. Lower connectivity of the left amygdala to the subgenual anterior cingulate cortex, pregenual anterior cingulate cortex, and right insula, and that between the left hippocampus and right amygdala were also associated with symptom improvement.
These findings provide evidence that optimal treatment response to TF-CBT involves the capacity to engage emotional networks during emotional processing, and also to reduce the engagement of these networks when down-regulating emotions.
Introduction: Many cardiac arrest survivors die later due to hemorrhage or thromboembolism, thought to be caused by acquired coagulopathy in post-cardiac arrest syndrome (PCAS) from shock and reperfusion injury. Understanding PCAS is a priority identified by the AHA for the prevention of complications in cardiac arrest survivors. Shock dysregulates both coagulation and fibrinolysis. The key effector enzyme thrombin (Th), is responsible for both up- and down-regulating coagulation and fibrinolysis. Measuring early Th activity may allow for predicting PCAS coagulopathy, and early medical intervention in the ED. Therefore, we aimed to characterize the time-course profile of early coagulation using an established pig model of cardiac arrest. Methods: Yorkshire pigs were anaesthetised and intubated, had VF-arrest induced by pacing, and were resuscitated per ACLS. Rotational thromboelastometry (ROTEM) was performed on whole blood at four times: baseline, intra-arrest, post-arrest, and death, using the fibrin-based test with tissue factor to initiate clotting in the presence of a platelet inhibitor cytochalasin D (FIBTEM). Clot time (CT), clot formation time (CFT), alpha-angle during clot formation (Alpha), clot amplitude at 10 min (A10), maximum clot firmness (MCF), and maximum lysis as total percentage (ML%) were quantified. The primary outcome is the overall coagulation initiation measured by CFT, while secondary outcomes include ROTEM parameters reflecting Th activity. Parameters are compared over time in SPSS using repeated measures ANOVA and Bonferroni correction. Results: Pilot data from one experiment show that cardiac arrest causes immediate early changes to coagulation that subsequently normalized with ROSC (Figure 1). CFT was impaired immediately upon cardiac arrest (2.3-fold increase), normalized with ROSC, and impaired again at death when compared with baseline. Consistent with clotting impairment, A10, Alpha, and MCF were all reduced with cardiac arrest, normalized with ROSC, and impaired again at death. Conclusion: Higher initial indices of coagulopathy in patients with cardiac arrest appear to correlate with death and thromboembolism. In this pilot, CFT is acutely modified by cardiac arrest. Since CFT is affected by overall Th activity, early Th dysregulation may be a critical driver of coagulopathy. Th may therefore be a lead target that is modifiable in the emergency post-arrest setting to decrease morbidity and mortality from PCAS in cardiac arrest survivors.
Our understanding of ice algal responses to the recent changes in Arctic sea ice is impeded by limited field observations. In the present study, environmental characteristics of the landfast sea-ice zone as well as primary production and macromolecular composition of ice algae and phytoplankton were studied in the Kitikmeot Sea near Cambridge Bay in spring 2017. Averaged total chlorophyll-a (Chl-a) concentration was within the lower range reported previously for the same region, while daily carbon uptake rates of bottom-ice algae were significantly lower in this study than previously reported for the Arctic. Based on various indicators, the region's low nutrient concentrations appear to limit carbon uptake rates and associated accumulation of bottom-ice algal biomass. Furthermore, the lipids-dominant biochemical composition of bottom-ice algae suggests strong nutrient limitation relative to the distinctly different carbohydrates-dominant composition of phytoplankton. Together, the results confirm strong nitrate limitation of the local marine system.
Study of the clinical features in the group of somatoform and psychosomatic disorders.
The results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8) are presented.
inventory for clinical-anamnestic behavior sign of adaptation form of disease of patients with comorbid phenomenon and standard scales for value of anxiety and depressions were used.
The homogeneous group of disorders in which somatic as well as psychical symptoms are equivalent 6,7 (P< 0,05).The phenomenon of comorbidity as the independent clinical adaptive mechanism was revealed 8,3 (P< 0,05). In the research group the positive response for the psychotropic therapy was registered 5,3 (P< 0,05).
The phenomenon of comorbidity in practice area reduces to new understanding of the coexistence of the psychic and somatic register, illustrates the possibility of the valuation of indicator of quality of manifestation of symptom and syndrome in context of social functioning. The social functioning is the indicator of quality and optimization of the diagnostic and therapeutic processes, which are demanding independent culturally dependent diagnostic directives from existing classifications (ICD-10, DSM-IV). The somatic symptom is the integral part of psychopathologic syndromes.
The aim of this study was to examine whether the presence of risk alleles of the norepinephrine transporter gene (SLC6A2) polymorphisms is associated with differences in regional cerebral blood flow (rCBF) measured by 99mTc-HMPAO single photon emission computerized tomography in a Korean sample of ADHD.
The present study included 24 children with ADHD (9.5±2.4 years), consisting of 20 boys and 4 girls, aged 6-16 years. We investigated the G1287A and -3081(A/T) polymorphisms of the SLC6A2. The rCBF was compared between the ADHD subjects with and without risk alleles at the G1287A polymorphism and at the -3081(A/T) polymorphism. Image analyses were performed with voxelwise t-statistics using SPM2.
1) The ADHD subjects with the A allele (risk allele) at the G1287A polymorphism showed reduced perfusion in the left middle frontal gyrus, left inferior parietal lobule, precuneus, right superior frontal gyrus, and right superior parietal lobule as compared with ADHD subjects without the A allele (p< 0.001).
2) The ADHD subjects with the A allele at the G1287A polymorphism showed increased perfusion in the right middle frontal gyrus, right middle temporal gyrus, right superior temporal gyrus, right fusiform gyrus, right precentral gyrus, and right anterior lobe of cerebellum as compared with ADHD subjects without the A allele (p< 0.001).
3) No significant perfusion differences were found between ADHD subjects with and without the T allele (risk allele) at the -3081(A/T) polymorphism.
Our findings suggest that the SLC6A2 G1287A polymorphism might exert differential effects on rCBF in children with ADHD.
The frequency of organ somatization in multimedical network was the object of study.
The results of clinical and epidemiological study of 2181 patients (average age-54 ± 0.8) are presented.
Inventory for clinical-anamnestic behavior sign of adaptation form of disease of patients with comorbid phenomenon and standard scales for value of anxiety and depressions were used.
Patients with somatoform pain more complicated in pharmacologic treatment, have complex diagnostic procedures, sometimes surgical interventions, were are often cases of analgesic dependence 5,8 (P< 0,05). The patient with idiopathic pain (antidepressant therapy's reply 4,2 (P< 0,05) and cognitive therapy's 2,8(P< 0,05)) and organ somatizations (analgesic dependence 3,5 (P< 0,05), antidepressant therapy's effect 4,3 (P< 0,05) and the cognitive therapy's reply 3,4(P< 0,05)) almost never has decided the idea about the mental nature of agonizing somatic sensations, seldom collaborate with psychiatrists.
The phenomenon of somatization is a group of disorders in the base of which mechanisms of the psychical adaptation and behavior are. The admission of axial somatization's symptoms as mechanisms of the psychical adaptation and behavior and additional, forming by the purposeful interview of the patient, is appearing to be reasons, that is making actual questions of the effective competent communication for the optimization of therapeutic interventions. Thereby, the phenomenon of the somatization as mechanisms of the psychical adaptation and behavior is axial symptoms and cultural dependent features forming in the structure of the purposeful interview and the doctor's clinical estimation of the patient - are additional.
Schizophrenia is highly familial neuropsychiatric disorder with heritability estimated at 60-90%. Even unaffected first-degree relatives of schizophrenia manifested some neuropsychological abnormalities as well as neurologic soft sign and morphologic anomalies. the aim of this study was to evaluate personality profile in first-degree relatives of schizophrenia compared to their schizophrenia probands and healthy controls and whether personality profile might be endophenotype of schizophrenia.
The subjects were 97 first-degree relatives of schizophrenia, 48 their schizophrenia probands, and 106 healthy controls, who completed Temperament and Character Inventory (TCI) scale. Relatives were further divided into presumed carriers and pesumed non-carriers by schizophrenia genetic loading. Group difference in TCI scores were compared by general linear model using age and gender as covariates.
1. There were significant group differences in HA scores between healthy controls, relatives, and probands after controlling age and gender, in that HA scores were increased by healthy controls, relatives, and probands in order.
2. Presumed carriers have higher HA scores than presumed non-carriers and healthy controls.
3. Proband group showed significantly lower RD and lower P in temperament dimension and lower SD, lower C, and higher ST in character dimension compared to other groups.
We found that HA scores of first-degree relatives of schizophrenia is intermediate level between schizophrenia probands and healthy controls. Considering increase of HA with schizophrenia genetic loading, HA may be potential endophenotype of schizophrenia. Further research with longitudinal follow up is needed to elucidate the clinical implication of high HA observed in schizophrenia family.
There are two major forms of long-term depression (LTD) of synaptic transmission in the central nervous system, which require activation of either N-methyl-D-aspartate receptors (NMDARs) or metabotropic glutamate receptors (mGluRs). In synapses in the perirhinal cortex we have directly compared the Ca2+ signalling mechanisms involved in NMDAR-LTD and mGluR-LTD. Whilst both forms of LTD involve Ca2+ release from intracellular stores the Ca2+ sensors involved are different; NMDAR-LTD involves calmodulin, whilst mGluR-LTD involves the neuronal Ca2+ sensor (NCS) protein NCS-1. In addition, there is a specific requirement for IP3 and PKC as well as protein interacting with C-kinase (PICK-1) in mGluR-LTD. NCS-1 binds directly to PICK1, via its BAR domain, in a Ca2+-dependent manner. Furthermore, the NCS-1-PICK1 association is stimulated by activation of mGluRs, but not NMDARs, and introduction of a PICK1 BAR domain fusion protein specifically blocks mGluR-LTD. Thus, NCS-1 is a component of a novel mechanism involved in mGluR-LTD.
There have been many changes in the treatment of bipolar disorder.
It is necessary to develop guidelines that can more aptly respond to cultural issues and specifics in different countries.
The Korean Medication Algorithm for Bipolar Disorder (KMAP-BP) was firstly published in 2002, with updates in 2006 and 2010. This third update reviewed the experts' consensus of opinion on the pharmacological treatments of bipolar disorder.
The newly revised questionnaire composed of 55 key questions about clinical situations including 223 sub-items was sent to the experts.
Combination of mood stabilizer (MS) and atypical antipsychotic (AAP) was the first-line treatment option in acute mania. For the management of severe psychotic bipolar depression, combination of MS and AAP, combination of AAP and LTG, combination of MS, AAP and AD or LTG, combination of AAP and AD, and combination of AAP, AD and LTG was the first-line treatments. Combination of MS and AAP was the treatment of choice for management of mixed features. Combination of MS and AAP, MS or AAP monotherapy was the first-line options for management of maintenance phase after manic episode. For maintenance treatment after bipolar I depression, combination of MS and AAP, combination of MS and LTG, combination of AAP and LTG, MS or LTG monotherapy, and combination of MS, AAP and LTG were the first-line options.
Despite the limitations of expert consensus guideline, KMAP-BP 2014 may reflect the current patterns of clinical practice and recent researches.