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Hospital environmental surfaces are frequently contaminated by microorganisms. However, the causal mechanism of bacterial contamination of the environment as a source of transmission is still debated. This prospective study was performed to characterize the nature of multidrug-resistant organism (MDRO) transmission between the environment and patients using standard microbiological and molecular techniques.
Prospective cohort study at 2 academic medical centers.
A prospective multicenter study to characterize the nature of bacterial transfer events between patients and environmental surfaces in rooms that previously housed patients with 1 of 4 ‘marker’ MDROs: methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, and MDR Acinetobacter baumannii. Environmental and patient microbiological samples were obtained on admission into a freshly disinfected inpatient room. Repeat samples from room surfaces and patients were taken on days 3 and 7 and each week the patient stayed in the same room. The bacterial identity, antibiotic susceptibility, and molecular sequences were compared between organisms found in the environment samples and patient sources.
We enrolled 80 patient–room admissions; 9 of these patients (11.3%) were asymptomatically colonized with MDROs at study entry. Hospital room surfaces were contaminated with MDROs despite terminal disinfection in 44 cases (55%). Microbiological Bacterial Transfer events either to the patient, the environment, or both occurred in 12 patient encounters (18.5%) from the microbiologically evaluable cohort.
Microbiological Bacterial Transfer events between patients and the environment were observed in 18.5% of patient encounters and occurred early in the admission. This study suggests that research on prevention methods beyond the standard practice of room disinfection at the end of a patient’s stay is needed to better prevent acquisition of MDROs through the environment.
To investigate the effects of soybean isoflavone (SI) on immunity in infectious bursal disease virus (IBDV)-infected broilers, chicks were fed the same basal diet supplemented with 0 (non-infected control), 0 (infected control), 10, 20 or 40 mg/kg SI for 44 days. At 21 days old, chickens were inoculated with bursal infectious dose causing 50% morbidity of the IBDV BC 6/85 strain by the eye-drop and nasal route (except for non-infected controls). Results showed that, over 1–23 days post-infection (dpi), there was a significant interaction between SI supplementation level and time: high-level SI supplementation increased peripheral T lymphocyte proliferation, percentages of CD3+, CD4+ and CD8+ T lymphocytes, CD4+ to CD8+ ratio, serum concentrations of IgA, IgM and IgG, and IBDV antibody titres. Except for serum IgA and IgM, these variables increased over time with far higher values at 23 dpi than earlier. Compared with non-infected controls, IBDV inoculation decreased peripheral T lymphocyte proliferation at 3 dpi, percentages of CD3+, CD4+ and CD8+ T lymphocytes, and serum IgG, IgM concentration at 23 dpi, and increased IBDV antibody titres at 7, 15 and 23 dpi. Supplemental SI quadratically increased peripheral T lymphocyte proliferation, CD4+ to CD8+ ratio and serum IgA concentration at 3 dpi, percentages of CD3+, CD4+ and CD8+ T lymphocytes at 3 and 23 dpi, and serum IgM concentration and IBDV antibody titres at 23 dpi. These results indicate that dietary SI improved cellular and humoral immunity of IBDV-infected birds and may enhance resistance of Yellow-feathered broilers to infectious diseases.
In this prospective study, we monitored 4 epidemiologically important pathogens (EIPs): methicillin-resistane Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant (MDR) Acinetobacter to assess the effectiveness of 3 enhanced disinfection strategies for terminal room disinfection against standard practice. Our data demonstrated that a decrease in room contamination with EIPs of 94% was associated with a 35% decrease in subsequent patient colonization and/or infection.
Wave loading on marine structures is the major external force to be considered in the design of such structures. The accurate prediction of the nonlinear high-order components of the wave loading has been an unresolved challenging problem. In this paper, the nonlinear harmonic components of hydrodynamic forces on a bottom-mounted vertical cylinder are investigated experimentally. A large number of experiments were conducted in the Danish Hydraulic Institute shallow water wave basin on the cylinder, both on a flat bed and a sloping bed, as part of a European collaborative research project. High-quality data sets for focused wave groups have been collected for a wide range of wave conditions. The high-order harmonic force components are separated by applying the ‘phase-inversion’ method to the measured force time histories for a crest focused wave group and the same wave group inverted. This separation method is found to work well even for locally violent nearly-breaking waves formed from bidirectional wave pairs. It is also found that the
th-harmonic force scales with the
th power of the envelope of both the linear undisturbed free-surface elevation and the linear force component in both time variation and amplitude. This allows estimation of the higher-order harmonic shapes and time histories from knowledge of the linear component alone. The experiments also show that the harmonic structure of the wave loading on the cylinder is virtually unaltered by the introduction of a sloping bed, depending only on the local wave properties at the cylinder. Furthermore, our new experimental results reveal that for certain wave cases the linear loading is actually less than 40 % of the total wave loading and the high-order harmonics contribute more than 60 % of the loading. The significance of this striking new result is that it reveals the importance of high-order nonlinear wave loading on offshore structures and means that such loading should be considered in their design.
With the rapid development of telescopes, both temporal cadence and the spatial resolution of observations are increasing. This in turn generates vast amount of data, which can be efficiently searched only with automated detections in order to derive the features of interest in the observations. A number of automated detection methods and algorithms have been developed for solar activities, based on the image processing and machine learning techniques. In this paper, after briefly reviewing some automated detection methods, we describe our efficient and versatile automated detection method for solar filaments. It is able not only to recognize filaments, determine the features such as the position, area, spine, and other relevant parameters, but also to trace the daily evolution of the filaments. It is applied to process the full disk Hα data observed in nearly three solar cycles, and some statistic results are presented.
To summarize and discuss logistic and administrative challenges we encountered during the Benefits of Enhanced Terminal Room (BETR) Disinfection Study and lessons learned that are pertinent to future utilization of ultraviolet (UV) disinfection devices in other hospitals
Multicenter cluster randomized trial
SETTING AND PARTICIPANTS
Nine hospitals in the southeastern United States
All participating hospitals developed systems to implement 4 different strategies for terminal room disinfection. We measured compliance with disinfection strategy, barriers to implementation, and perceptions from nurse managers and environmental services (EVS) supervisors throughout the 28-month trial.
Implementation of enhanced terminal disinfection with UV disinfection devices provides unique challenges, including time pressures from bed control personnel, efficient room identification, negative perceptions from nurse managers, and discharge volume. In the course of the BETR Disinfection Study, we utilized several strategies to overcome these barriers: (1) establishing safety as the priority; (2) improving communication between EVS, bed control, and hospital administration; (3) ensuring availability of necessary resources; and (4) tracking and providing feedback on compliance. Using these strategies, we deployed ultraviolet (UV) disinfection devices in 16,220 (88%) of 18,411 eligible rooms during our trial (median per hospital, 89%; IQR, 86%–92%).
Implementation of enhanced terminal room disinfection strategies using UV devices requires recognition and mitigation of 2 key barriers: (1) timely and accurate identification of rooms that would benefit from enhanced terminal disinfection and (2) overcoming time constraints to allow EVS cleaning staff sufficient time to properly employ enhanced terminal disinfection methods.
The quality of prenatal maternal mental health, from psychological stress and depressive symptoms to anxiety and other nonpsychotic mental disorders, profoundly affects fetal neurodevelopment. Despite the evidence for the influence of positive mental well-being on health, there is, to our knowledge, no research examining the possible effects of positive antenatal mental health on the development of the offspring. Using exploratory bifactor analysis, this prospective study (n = 1,066) demonstrated the feasibility of using common psychiatric screening tools to examine the effect of positive maternal mental health. Antenatal mental health was assessed during 26th week of pregnancy. The effects on offspring were assessed when the child was 12, 18, and 24 months old. Results showed that positive antenatal mental health was uniquely associated with the offspring's cognitive, language and parentally rated competences. This study shows that the effects of positive maternal mental health are likely to be specific and distinct from the sheer absence of symptoms of depression or anxiety.
Honeybee foraging can transfer exogenous genes from genetically modified (GM) oilseed rape (Brassica napus L.) to closely related plants, which not only induces potential ecological risks but also contaminates non-GM seeds or honey products with GM ingredients. These events may lead to international trade disputes. Chinese honeybees (Apis cerana cerana Fabricius) and a herbicide (glufosinate)-resistant GM strain of B. napus (Z7B10) were studied to examine the effects of honeybee short-range foraging on oilseed rape gene flow and honey ingredients. Results showed variable frequencies of gene flow between GM and non-GM oilseed rape cultivars, with the highest frequency under nylon net isolation with artificially stocked honeybees, the lowest frequency under nylon net isolation alone, and an intermediate frequency under natural pollination, suggesting the important role of honeybee foraging in gene flow frequency. Additionally, GM pollen grains were found in honey collected from honeybees foraging on both GM and non-GM oilseed rape cultivars. The phosphinothricin acetyltransferase protein was also detected in both unbroken pollen-containing and pollen-free honey by protein testing strips, suggesting that honeybee foraging on GM oilseed rape could lead to contamination with GM ingredients. Overall, the results provide a direct scientific basis for the ecological risk assessment and safety management of GM oilseed rape.
An 8-cm optical telescope is constructed for use at the south pole. It is designed to make photoelectric observations of selected stars continuously through an austral winter. The automated operation is controlled by a computer. The aim is to study the variability of the star γ2 Velorum as well as the condition of the polar sky and the performance of the instrument.
Converting coastal waters to farmed production of seafood may generate conflicts with other resource users. This study explores the impact of marine aquaculture development on coastal homeowners. Using single-family home sales from 2012–2014 and spatial data on coastal aquaculture activity, we employ hedonics to assess the impacts of mariculture development in three study areas of Maine, USA. Our results suggest modest impacts on residential property values with significant spatial variation across study areas. This spatial variation represents a challenge for managers and highlights the potential benefits from coordinating the development of aquaculture to balance resource users' objectives with industry growth.
In this study, the biomass of winter wheat was estimated by using hyperspectral data obtained from a hyperspectral camera on an Unmanned Aerial Vehicle (UAV). Every two bands from the hyperspectral data were selected to calculate two kinds of vegetation indexes: the Normalized Difference Vegetation Index (NDVI) and Ratio Vegetation Index (RVI). Linear models were established between winter wheat biomass and those indexes, and coefficient of determination R2 was used to draw the two-dimensional distribution of R2 values. The comparison between NDVI and RVI for pixel covered by soil and wheat showed that RVI is more efficient to mask the influence from soil than NDVI. For calculating the NDVI, optimal bands are located mainly around 820 nm and 725 nm to 750 nm. For assessing RVI, the wavelength range from 820 to 832 nm, 794 to 808 nm, 770 to 788 nm, 725 nm to 750 nm and 890 nm for RVI are most suitable. Those optimal bands can achieve a coefficient of determination R2 higher than 0.88 by using the linear regression model in the study.
Recent observations on strength and deformation of small metals containing microstructures, including dislocation patterns, grain boundaries, and second-phase precipitates are reviewed. These microstructures impose an internal length scale that may interplay with the extrinsic length scale due to the specimen size to affect strength and deformation in an intricate manner. For micro-crystals containing pre-existing dislocations, Taylor work-hardening may dictate the dependence of strength on specimen size. The presence of grain boundaries in a small specimen may lead to effects far from the conventional Hall–Petch behavior. Precipitate–dislocation interactions in a small specimen may lead to an interesting weakest-size behavior.
Models of products and design processes are key to interacting with engineering designs and managing the processes by which they are developed. In practice, companies maintain networks of many interrelated models which need to be synthesised in the minds of their users when considering issues that cut across them. This article considers how information from product and design process models can be integrated with a view to help manage these complex interrelationships. A framework highlighting key issues surrounding model integration is introduced and terminology for describing these issues is developed. To illustrate the framework and terminology, selected modelling approaches that integrate product and process information are discussed and organised according to their levels and forms of integration. Opportunities for further work to advance integrated modelling in engineering design research and practice are discussed.
Longan County is considered a highly endemic area for hepatitis B virus (HBV). The plasma-derived vaccine has been used in newborns in this area since 1987. A cross-sectional survey was conducted to evaluate the long-term effectiveness of this vaccine. In total, 1634 participants born during 1987–1993 and who had received a series of plasma-derived HB vaccinations at ages 0, 1, and 6 months were enrolled. Serological HBV markers were detected and compared with previous survey data. Overall the prevalence of hepatitis B surface antigen (HBsAg) in all participants was 3·79%; 3·47% of subjects who had received the first dose within 24 h were HBsAg positive, and 8·41% of subjects who had received a delayed first dose were also HBsAg positive. There were 1527 subjects identified who had received the first dose within 24 h and whose HBsAg and anti-HBc prevalence increased yearly after immunization, while the anti-HBs-positive rate and vaccine effectiveness declined. The geometric mean concentration of antibody in the anti-HB-positive participants was 55·13 mIU/ml and this declined after immunization. Fewer than 2·0% of participants had anti-HB levels ⩾1000 mIU/ml. The data show that the protective efficacy of the plasma-derived vaccinations declined and administration of HB vaccine within 24 h of birth was very important. To reduce the risk of HBV infection in this highly endemic area, a booster dose might be necessary if anti-HBs levels fall below 10 mIU/ml after age 18 years. Furthermore, studies on the immune memory induced by plasma-derived HB vaccine are needed.
We carried out a pivot experiment to select distant luminous late-type stars on the basis on their 2MASS and GLIMPSE photometry. Low-resolution infrared spectra enabled us to measure the equivalent widths (EWs) of their CO band-heads at 2.293 μm, and to confirm an extraordinarily high detection rate of red supergiants (RSGs), i.e. 61% (Messineo et al. (2016)).