In order to maximize the utility of future studies of trilobite ontogeny, we propose a set of standard practices that relate to the collection, nomenclature, description, depiction, and interpretation of ontogenetic series inferred from articulated specimens belonging to individual species. In some cases, these suggestions may also apply to ontogenetic studies of other fossilized taxa.

Background: Since 2015, the CDC has supported the development and implementation of healthcare-associated infection (HAI) surveillance in resource-limited settings through technical support of case definitions and methods that are feasible with existing surveillance capacity and integration with clinical care to maximize sustainability and data use for action. Methods: Surveillance initiatives included facility-level implementation programs in Kenya, Sierra Leone, Thailand, and Georgia; larger national or regional network-level projects in India and Vietnam were also supported. For assessment and planning, surveillance capacities were grouped into 3 domains: staff, informatics, and diagnostic capacities. Based on these capacities, simplified case definitions surveillance methodologies were devised to balance resources and effort with the anticipated value and use of findings. Results: There was broad understanding of the importance of HAI surveillance; however, the required resources and other challenges (eg, training, staffing, quality of available data) were underappreciated. Staff capacities were often influenced by a lack of dedicated surveillance staff and limited experience in systematic data collection and analysis. Informatics capacities were generally limited by the lack of digital data management, nonstandardized clinical data collection and storage, and the inability to assign and maintain unique patient identifiers. We found that capacity for diagnostics, a critical component of traditional HAI surveillance systems, was limited by its availability, frequency of use, and inconsistent rationale in clinical care. We found that successful surveillance strategies were generally simple, matched existing capacities, and targeted specific HAI priorities identified by clinical teams. For example, in Kenya and Sierra Leone, participating facilities established, with minimal external support, simplified SSI surveillance among post–caesarean-delivery patients. These initiatives improved integration of surveillance with clinical care through encouraging participation of the clinical team in surveillance and planning. Furthermore, these models directly linked surveillance activities to improved patient care (eg, combined clinical checklists with surveillance data collection forms). Discussion: In resource-limited settings, the local cost and effort required to establish and sustain the necessary infrastructure for HAI surveillance can be substantial. Establishing actionable and sustainable HAI surveillance can be achieved through simplifying HAI surveillance to match existing capacities and can result in valuable surveillance programs, even in very resource-limited settings.

Funding: None

Disclosures: None

Background: Estimating the burden of intestinal colonization with antibiotic-resistant gram-negative bacteria (AR-GNB) is critical to understanding their global epidemiology and spread. We aimed to determine the prevalence of, and risk factors for, intestinal colonization due to AR-GNB in population-based hospital and community settings in Chile. Methods: Between December 2018 and May 2019, we enrolled randomly selected hospitalized adults in 4 tertiary-care public hospitals (Antofagasta, Santiago, Curico and Puerto Montt), and adults residing in a community-based cohort in the rural town of Molina. Following informed consent, we collected rectal swabs and epidemiological information through a standardized questionnaire. Swabs were plated onto MacConkey agar with 2 µg/mL ciprofloxacin or ceftazidime. All recovered morphotypes were identified, and antibiotic susceptibility testing was performed via disk diffusion. The primary outcome was the prevalence of colonization with fluoroquinolone (FQ)- or third-generation cephalosporin (3GC)–resistant GNB. The secondary outcome was the prevalence of colonization with multidrug-resistant (MDR) GNB, defined as GNB resistant to ≥3 antibiotic classes. Categories were not mutually exclusive. Bivariate and multivariate analyses were performed to describe risk factors for colonization with these categories. Results: In total, 775 hospitalized adults and 357 community participants were enrolled, with a median age of 60 years (IQR, 42–72) and 55 years (IQR, 48–62) years, respectively. Among hospitalized participants, the prevalence of colonization with FQ- or 3GC-resistant GNB was 47% (95% CI, 43%–50%) and 41% (95% CI, 38%–45%), respectively, whereas the prevalence of MDR-GNB colonization was 27% (95% CI, 24%–31%). In the community setting, the prevalence of colonization with either FQ-, 3GC-resistant GNB, or MDR-GNB was 40% (95% CI, 34%–45%), 29% (95% CI, 24%– 34%), and 5% (95% CI, 3%–8%), respectively. Independent risk factors for hospital MDR-GNB colonization included the hospital of admission, unit of hospitalization (intensive care units carried the highest risk), in-hospital antimicrobial exposure, comorbidities (Charlson index), and length of stay. In the community setting, recent antibiotic exposure (<3 months) predicted colonization with either FQ- or 3GC-resistant GNB, and alcohol consumption was inversely associated with MDR GNB colonization. Conclusions: A high burden of colonization with AR-GNB was observed in this sample of hospitalized and community-dwelling adults in Chile. The high burden of colonization with GNB resistant to commonly used antibiotics such as FQ and 3GC found in community dwellers, suggests that the community may be a relevant source of antibiotic resistance. Efforts to understand relatedness between resistant strains circulating in the community and the hospital are needed.

Funding: None

Disclosures: None

This article reviews the advancements and prospects of liquid cell transmission electron microscopy (TEM) imaging and analysis methods in understanding the nucleation, growth, etching, and assembly dynamics of nanocrystals. The bonding of atoms into nanoscale crystallites produces materials with nonadditive properties unique to their size and geometry. The recent application of in situ liquid cell TEM to nanocrystal development has initiated a paradigm shift, (1) from trial-and-error synthesis to a mechanistic understanding of the “synthetic reactions” responsible for the emergence of crystallites from a disordered soup of reactive species (e.g., ions, atoms, molecules) and shape-defined growth or etching; and (2) from post-processing characterization of the nanocrystals’ superlattice assemblies to in situ imaging and mapping of the fundamental interactions and energy landscape governing their collective phase behaviors. Imaging nanocrystal formation and assembly processes on the single-particle level in solution immediately impacts many existing fields, including materials science, nanochemistry, colloidal science, biology, environmental science, electrochemistry, mineralization, soft condensed-matter physics, and device fabrication.

Gac is a dioecious tropical and perennial climber. The fruit is a rich source of carotenoids and is used in traditional cuisine and medicine. Improving propagation methods using simple techniques would increase production and improve conservation in regional areas. This study evaluated temperature requirements for seed germination, the use of rooting hormones to strike female cuttings and the grafting of female scions onto seedling rootstock. Seed germination was optimised between 25 and 35 °C, with a maximum germination percentage of 91% at 30 °C. However, increasing storage time from 6 to 18 months under laboratory conditions (21 ± 1°C and 60% relative humidity) reduced germination and this was associated with seed weight loss, highlighting the need to develop storage guidelines, particularly for the higher temperature and humidity conditions where Gac is grown. Survival of softwood cuttings was improved from 53 to 77% with indole-3-butyric acid (IBA) (3–5 g/L) and semi-hardwood cuttings did not require IBA treatment. Both splice and wedge grafting techniques achieved a survival rate > 53% and with the youngest rootstock (4 and 8 weeks) this increased to > 85%. Further work could investigate the production potential of crops using cuttings and grafted plants.

The stably stratified Taylor–Couette flow is investigated experimentally and numerically through linear stability analysis. In the experiments, the stability threshold and flow regimes have been mapped over the ranges of outer and inner Reynolds numbers: $-2000<Re_{o}<2000$ and $0<Re_{i}<3000$ , for the radius ratio $r_{i}/r_{o}=0.9$ and the Brunt–Väisälä frequency $N\approx 3.2~\text{rad}~\text{s}^{-1}$ . The corresponding Froude numbers $F_{o}$ and $F_{i}$ are always much smaller than unity. Depending on $Re_{o}$ (or equivalently on the angular velocity ratio $\unicode[STIX]{x1D707}=\unicode[STIX]{x1D6FA}_{o}/\unicode[STIX]{x1D6FA}_{i}$ ), three different regimes have been identified above instability onset: a weakly non-axisymmetric mode with low azimuthal wavenumber $m=O(1)$ is observed for $Re_{o}<0$ ( $\unicode[STIX]{x1D707}<0$ ), a highly non-axisymmetric mode with $m\sim 12$ occurs for $Re_{o}>840$ ( $\unicode[STIX]{x1D707}>0.57$ ) while both modes are present simultaneously in the lower and upper parts of the flow for $0\leqslant Re_{o}\leqslant 840$ ( $0\leqslant \unicode[STIX]{x1D707}\leqslant 0.57$ ). The destabilization of these primary modes and the transition to turbulence as $Re_{i}$ increases have been also studied. The linear stability analysis proves that the weakly non-axisymmetric mode is due to the centrifugal instability while the highly non-axisymmetric mode comes from the strato-rotational instability. These two instabilities can be clearly distinguished because of their distinct dominant azimuthal wavenumber and frequency, in agreement with the recent results of Park et al. (J. Fluid Mech., vol. 822, 2017, pp. 80–108). The stability threshold and the characteristics of the primary modes observed in the experiments are in very good agreement with the numerical predictions. Moreover, we show that the centrifugal and strato-rotational instabilities are observed simultaneously for $0\leqslant Re_{o}\leqslant 840$ in the lower and upper parts of the flow, respectively, because of the variations of the local Reynolds numbers along the vertical due to the salinity gradient.

We examined norovirus contamination on hands of ill patients during 12 norovirus outbreaks in 12 long-term care facilities (LTCFs). The higher frequency and norovirus titers on hands of residents compared to hands of heathcare workers highlights the importance of adhering to appropriate hand hygiene practices during norovirus outbreaks in LTCFs.

Infect Control Hosp Epidemiol 2018;39:219–221

Since the AD 775 and AD 994 Δ14C peak (henceforth M12) was first measured by Miyake et al. (2012, 2013), several possible production mechanisms for these spike have been suggested, but the work of Mekhaldi et al. (2015) shows that a very soft energy spectrum was involved, implying that a strong solar energetic particle (SEP) event (or series of events) was responsible. Here we present Δ14C values from AD 721–820 Sequoiadendron giganteum annual tree-ring samples from Sequoia National Park in California, USA, together with Δ14C in German oak from 650–670 BC. The AD 721–820 measurements confirm that a sharp Δ14C peak exists at AD 775, with a peak height of approximately 15‰ and show that this spike was preceded by several decades of rapidly decreasing Δ14C. A sharp peak is also present at 660 BC, with a peak height of about 10‰, and published data (Reimer et al. 2013) indicate that it too was preceded by a multi-decadal Δ14C decrease, suggesting that solar activity was very strong just prior to both Δ14C peaks and may be causally related. During periods of strong solar activity there is increased probability for coronal mass ejection (CME) events that can subject the Earth’s atmosphere to high fluencies of solar energetic particles (SEPs). Periods of high solar activity (such as one in October–November 2003) can also often include many large, fast CMEs increasing the probability of geomagnetic storms. In this paper we suggest that the combination of large SEP events and elevated geomagnetic activity can lead to enhanced production of 14C and other cosmogenic isotopes by increasing the area of the atmosphere that is irradiated by high solar energetic particles.

The stability of the Taylor–Couette flow is analysed when there is a stable density stratification along the axial direction and when the flow is centrifugally unstable, i.e. in the Rayleigh-unstable regime. It is shown that not only the centrifugal instability but also the strato-rotational instability can occur. These two instabilities can be explained and well described by means of a Wentzel–Kramers–Brillouin–Jeffreys asymptotic analysis for large axial wavenumbers in inviscid and non-diffusive limits. In the presence of viscosity and diffusion, numerical results reveal that the strato-rotational instability becomes dominant over the centrifugal instability at the onset of instability when the axial density stratification is sufficiently strong. Linear transient energy growth is next investigated for counter-rotating cylinders in the stable regime of the Froude number–Reynolds number parameter space. We show that there exist two types of transient growth mechanism analogous to the lift up and the Orr mechanisms in homogeneous fluids but with the additional effect of density perturbations. The dominant mechanism depends on the stratification: when the stratification is strong, non-axisymmetric three-dimensional perturbations achieve the optimal energy growth through the Orr mechanism while for moderate stratification, axisymmetric perturbations lead to the optimal transient growth by a lift-up mechanism involving internal waves.