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We examined Clostridioides difficile infection (CDI) prevention practices and their relationship with hospital-onset healthcare facility-associated CDI rates (CDI rates) in Veterans Affairs (VA) acute-care facilities.
From January 2017 to February 2017, we conducted an electronic survey of CDI prevention practices and hospital characteristics in the VA. We linked survey data with CDI rate data for the period January 2015 to December 2016. We stratified facilities according to whether their overall CDI rate per 10,000 bed days of care was above or below the national VA mean CDI rate. We examined whether specific CDI prevention practices were associated with an increased risk of a CDI rate above the national VA mean CDI rate.
All 126 facilities responded (100% response rate). Since implementing CDI prevention practices in July 2012, 60 of 123 facilities (49%) reported a decrease in CDI rates; 22 of 123 facilities (18%) reported an increase, and 41 of 123 (33%) reported no change. Facilities reporting an increase in the CDI rate (vs those reporting a decrease) after implementing prevention practices were 2.54 times more likely to have CDI rates that were above the national mean CDI rate. Whether a facility’s CDI rates were above or below the national mean CDI rate was not associated with self-reported cleaning practices, duration of contact precautions, availability of private rooms, or certification of infection preventionists in infection prevention.
We found considerable variation in CDI rates. We were unable to identify which particular CDI prevention practices (i.e., bundle components) were associated with lower CDI rates.
To systematically review studies from Irish prisons that estimate the prevalence of major mental illness, alcohol and substance misuse, and homelessness at the time of committal.
Healthcare databases were searched for studies quantifying the point prevalence for each outcome of interest. Searches were augmented by scanning of bibliographies and searches of governmental and non-governmental websites. Proportional meta-analyses were completed for each outcome.
We found eight, six and five studies quantifying the point prevalence of major mental illness, substance misuse, and homelessness respectively. Considerable heterogeneity was found for each subgroup (except psychosis where substantial heterogeneity was observed) and random effects models were used to calculate pooled percentages. The pooled percentage for psychotic disorder was 3.6% [95% confidence interval (CI) 3.0–4.2%], for affective disorder 4.3% (95% CI 2.1–7.1%), for alcohol use disorder 28.3% (95% CI 19.9–37.4%), for substance use disorder 50.9% (95% CI 37.6–64.2%) and for those who were homeless on committal 17.4% (95% CI 8.7–28.4%).
Estimates for the prevalence of psychotic illness and substance abuse amongst Irish prisoners are in keeping with international estimates of morbidity in prisons, whilst those for affective disorders are lower. The prevalence of homelessness in committal to Irish prisons is higher than some international estimates. Rates for psychoses, alcohol and substance misuse as well as homelessness in Irish prisons are significantly higher than the general population prevalence of these vulnerabilities. A need for service development is discussed.
In 2011 the Incidence Assay Critical Path Working Group reviewed the current state of HIV incidence assays and helped to determine a critical path to the introduction of an HIV incidence assay. At that time the Consortium for Evaluation and Performance of HIV Incidence Assays (CEPHIA) was formed to spur progress and raise standards among assay developers, scientists and laboratories involved in HIV incidence measurement and to structure and conduct a direct independent comparative evaluation of the performance of 10 existing HIV incidence assays, to be considered singly and in combinations as recent infection test algorithms. In this paper we report on a new framework for HIV incidence assay evaluation that has emerged from this effort over the past 5 years, which includes a preliminary target product profile for an incidence assay, a consensus around key performance metrics along with analytical tools and deployment of a standardized approach for incidence assay evaluation. The specimen panels for this evaluation have been collected in large volumes, characterized using a novel approach for infection dating rules and assembled into panels designed to assess the impact of important sources of measurement error with incidence assays such as viral subtype, elite host control of viraemia and antiretroviral treatment. We present the specific rationale for several of these innovations, and discuss important resources for assay developers and researchers that have recently become available. Finally, we summarize the key remaining steps on the path to development and implementation of reliable assays for monitoring HIV incidence at a population level.
This paper summarizes a search for radio-wavelength counterparts to candidate gravitational-wave events. The identification of an electromagnetic counterpart could provide a more complete understanding of a gravitational-wave event, including such characteristics as the location and the nature of the progenitor. We used the Expanded Very Large Array (EVLA) to search six galaxies which were identified as potential hosts for two candidate gravitational-wave events. We summarize our procedures and discuss preliminary results.
Anisotropic, noble metal nanoparticles have been synthesized using a template synthesis strategy. In short, metallic salts are reduced in the nanometer scale pores of either an alumina or polycarbonate membrane. The particles can then been released from the template to form suspensions of anisotropic nanoparticles. These nanoparticles have been modified with deoxyribonucleic acid (DNA) oligomers of varying length using several different attachment chemistries. The thermodynamics and kinetics of modifying these particles with DNA has been explored. DNA has also been used to assemble the particles on planar Au surfaces as well as lithographically defined Au pads on Si wafers. In addition to surface assembly, DNA has been used to assemble the nanowires into simple, yet deterministic structures in solution.
Histidine is an amino acid present in proteins involved in biosilica formation and often found in peptides identified during phage display studies but its role(s) and the extent of its involvement in the silica precipitation process is not fully understood. In this contribution we describe results from an in vitro silicification study conducted using poly-histidine (P-His) and a series of different molecular weight synthetic polymers containing the imidazole functionality (polyvinylimidazole, PVI) for comparison. We show that the presence of imidazole from PVI or P-His is able to catalyze silicic acid condensation; the effect being greater for P-His. The catalytic mechanism is proposed to involve the dual features of the imidazole group—its ability to form hydrogen bonds with silicic acid and electrostatic attraction toward oligomeric silicic acid species.
Many studies have used negative mood induction techniques to investigate the effect of emotional state on cognitive performance but positive mood induction paradigms have been used less frequently. The objective of this study was to investigate the effect of positive mood induction on emotional processing in euthymic individuals with bipolar disorder (BD) and controls.
Previously, we reported that positive mood induction using a novel technique based on feedback produced a longer-lasting effect in euthymic individuals with BD than controls (Farmer et al.2006). Here we report the effect of mood induction on two tests of emotional processing, the Affective Go/No-go test (AGNG) and the Cambridge Gamble task (CGT), on which BD patients in the manic phase differ in their performance from controls.
Following positive mood induction, bipolar cases exhibited a positive emotional bias on the AGNG and performed more slowly than controls on the CGT, particularly when making more difficult decisions.
These data confirm that positive mood induction is more effective in individuals with BD than controls. They also suggest that alterations in decision making and attentional biases occur even with transient and subtle changes in mood in bipolar disorder.
We give a new heuristic for all of the main terms in the integral moments of various families of primitive $L$-functions. The results agree with previous conjectures for the leading order terms. Our conjectures also have an almost identical form to exact expressions for the corresponding moments of the characteristic polynomials of either unitary, orthogonal, or symplectic matrices, where the moments are defined by the appropriate group averages. This lends support to the idea that arithmetical $L$-functions have a spectral interpretation, and that their value distributions can be modelled using Random Matrix Theory. Numerical examples show good agreement with our conjectures.
Adipose tissue levels of linoleic acid were determined from biopsies of subcutaneous abdominal fat of normal healthy controls (n 40) and from two patient groups with endoscopically evaluated non-ulcer dyspepsia (n 40) or peptic ulcer disease (n 38). The level (g/100 g) of adipose tissue linoleic acid in the normal healthy controls (15·0 (sd 4·1)) was significantly (P < 0·05) greater than that in patients with non-ulcer dyspepsia (12·8 (sd 3·5)) and in patients with peptic ulcer disease (11·7 (sd 2·7)). A dietary history revealed a lower intake of linoleic acid and a significantly (P < 0·05) lower intake of dietary fibre (g/d) for both the non-ulcer dyspepsia (15·9 (sd 6·2)) and peptic ulcer disease (15·2 (sd 7·8)) patients compared with normal healthy controls (20·2 (sd 11·2)). Adipose tissue linoleic acid tended to increase with indices of increasing socioeconomic status, although the differences between patient and controls were not confounded by socioeconomic status. Patients with dyspepsia reported more foods causing symptoms (onion, fried foods, alcohol, citrus fruits and spices) and more foods giving relief (milk, bread) compared with control orthopaedic patients.
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