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Determining infectious cross-transmission events in healthcare settings involves manual surveillance of case clusters by infection control personnel, followed by strain typing of clinical/environmental isolates suspected in said clusters. Recent advances in genomic sequencing and cloud computing now allow for the rapid molecular typing of infecting isolates.
To facilitate rapid recognition of transmission clusters, we aimed to assess infection control surveillance using whole-genome sequencing (WGS) of microbial pathogens to identify cross-transmission events for epidemiologic review.
Clinical isolates of Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, and Klebsiella pneumoniae were obtained prospectively at an academic medical center, from September 1, 2016, to September 30, 2017. Isolate genomes were sequenced, followed by single-nucleotide variant analysis; a cloud-computing platform was used for whole-genome sequence analysis and cluster identification.
Most strains of the 4 studied pathogens were unrelated, and 34 potential transmission clusters were present. The characteristics of the potential clusters were complex and likely not identifiable by traditional surveillance alone. Notably, only 1 cluster had been suspected by routine manual surveillance.
Our work supports the assertion that integration of genomic and clinical epidemiologic data can augment infection control surveillance for both the identification of cross-transmission events and the inclusion of missed and exclusion of misidentified outbreaks (ie, false alarms). The integration of clinical data is essential to prioritize suspect clusters for investigation, and for existing infections, a timely review of both the clinical and WGS results can hold promise to reduce HAIs. A richer understanding of cross-transmission events within healthcare settings will require the expansion of current surveillance approaches.
Current developments in the recently introduced method of HgI2 crystal platelet growth by polymer assisted vapor transport are described. Crystal parameters are evaluated by making electrical measurements on x-ray detectors fabricated from HgI2 platelets, Selection for detector fabrication is on the basis of size and apparent crystalline perfection. Detectors have been fabricated with active areas averaging 2 to 3 mm2 and thicknesses ranging from 20 to 400 µm. Values of electron mobility and mobility-lifetime product measured for HgI2 platelet material are among the highest ever observed for HgI2.
The combination of low leakage current and good electron transport makes HgI2 platelets suitable for room-temperature x-ray spectrometry. An energy resolution of 370 eV (FWHM) for the 5.9 KeV Mn Kα line has been obtained, and representative low-energy x-ray fluorescence spectra are presented.
Genetic progress in poultry species for meat production has contributed to the consistent growth in world production of poultry meat. The poultry species have a number of advantages over the larger species used for meat production. It is possible to maintain large pedigreed populations and use their high reproductive rates to transfer genetic progress to the production generations in less than five years. These populations continue to maintain high heritabilities despite, in some cases, prolonged selection. The history of selection progress in broiler chickens (Gallus gallus domesticus) is reviewed and compared with rates of progress in the duck (Anas platyrhyncos) and the turkey (Meleagris gallopavo).
The rates of genetic change for production traits such as growth, feed efficiency and yield have changed the physiology of the birds. Changes in selection criteria have been made to improve the robustness of the production stock. This allows them to perform well in a wider range of environments. These have been combined with improved definitions of the optimum environments for the birds to minimise any impact on welfare and health. This paper describes examples of selection in the broiler chicken aimed at improving skeletal quality and resistance to ascites. A number of the factors influencing future selection criteria are discussed. Breeding programmes have adapted to respond quickly to adverse genetic correlated responses. The need to combine selection for a large number of traits requires that the programmes are very efficient and use the best statistical techniques available for multivariate breeding value estimation.
Nurses are critical to the research enterprise. However all nurses are not prepared to participate as members of the research team since education and training in clinical research nursing and nurse-specific Good Clinical Practice are not consistently included in nursing curricula. The lack of nurse education and training in clinical research and Good Clinical Practice leaves research participants vulnerable with a nursing workforce that is not prepared to balance fidelity to protocol and patient quality care and safety.
A collaborative network of nurses within Clinical and Translational Science Awards and beyond was established to address this education and training need. Over a 2-year period, using expert opinion, Delphi methods, and measures of validity and reliability the team constructed curriculum and knowledge test items.
A pilot modular electronic curriculum, including knowledge pretest and post-tests, in clinical research nursing and nurse-specific Good Clinical Practice competencies was developed.
As the scope and setting of clinical research changes, it is likely that all practicing nurses, regardless of their practice setting or specialty, will care for patients on research protocol, making all nurses, in essence, clinical research nurses. The curriculum developed by this protocol will address that workforce education and training need.
Dynamic surficial changes and changes in the position of the firn line and the areal extent of Hofsjökull ice cap, Iceland, were studied through analysis of a time series (1973–98) of synthetic-aperture radar (SAR) and Landsat data. A digital elevation model of Hofsjökull, which was constructed using SAR interferometry, was used to plot the SAR backscatter coefficient (σ°) vs elevation and air temperature along transects across the ice cap. Seasonal and daily σ° patterns are caused by freezing or thawing of the ice-cap surface, and abrupt changes in σ° are noted when the air temperature ranges from ∼−5° to 0°C. Late-summer 1997 σ° (SAR) and reflectance (Landsat) boundaries agree and appear to be coincident with the firn line and a SAR σ° boundary that can be seen in the January 1998 SAR image. In January 1994 through 1998, the elevation of this σ° boundary on the ice cap was quite stable, ranging from 1000 to 1300 m, while the equilibrium-line altitude, as measured on the ground, varied considerably. Thus the equilibrium line may be obscured by firn from previous years. Techniques are established to measure long-term changes in the elevation of the firn line and changes in the position of the ice margin.
This paper describes the early stages in the development and testing of a spatio-temporal rule-based model of snow transport by wind over complex terrain. The model uses a cell-based approach and takes into account a range of meteorological, snow-pack and topographic variables. Simple rules are used to determine movement of material from cell-to-cell within the model.
A geographic information system is utilized in modelling wind vectors and the influence of topography upon those vectors, and creating the resulting pattern of snow accumulation at a resolution of 50 m. These patterns of accumulation have been compared with empirical work in the field and, although field data were limited, a good qualitative correlation has been found; for example, modelled accumulations correlate with known areas of accumulation such as gullies and hollows.
We describe a versatile infrared camera/spectrograph, IRIS, designed and constructed at the Anglo-Australian Observatory for use on the Anglo-Australian Telescope. A variety of optical configurations can be selected under remote control to provide several direct image scales and a few low-resolution spectroscopic formats. Two cross-dispersed transmission echelles are of novel design, as is the use of a modified Bowen-Burch system to provide a fast f/ratio in the widest-field option. The drive electronics includes a choice of readout schemes for versatility, and continuous display when the array is not taking data, to facilitate field acquisition and focusing.
The linearity of the detector has been studied in detail. Although outwardly good, slight nonlinearities prevent removal of fixed-pattern noise from the data without application of a cubic linearising function.
Specific control and data-reduction software has been written. We describe also a scanning mode developed for spectroscopic imaging.
Both maternal 25-hydroxyvitamin D (25(OH)D) concentrations during pregnancy and
placental amino acid transporter gene expression have been associated with
development of the offspring in terms of body composition and bone structure.
Several amino acid transporter genes have vitamin D response elements in their
promoters suggesting the possible linkage of these two mechanisms. We aimed to
establish whether maternal 25(OH)D and vitamin D-binding protein (VDBP) levels
relate to expression of placental amino acid transporters. RNA was extracted
from 102 placental samples collected in the Southampton Women's Survey,
and gene expression was analysed using quantitative real-time PCR. Gene
expression data were normalised to the geometric mean of three housekeeping
genes, and related to maternal factors and childhood body composition. Maternal
serum 25(OH)D and VDBP levels were measured by radioimmunoassay. Maternal
25(OH)D and VDBP levels were positively associated with placental expression of
specific genes involved in amino acid transport. Maternal 25(OH)D and VDBP
concentrations were correlated with the expression of specific placental amino
acid transporters, and thus may be involved in the regulation of amino acid
transfer to the fetus. The positive correlation of VDBP levels and placental
transporter expression suggests that delivery of vitamin D to the placenta may
be important. This exploratory study identifies placental amino acid
transporters which may be altered in response to modifiable maternal factors and
provides a basis for further studies.
On 23 May 2011, CDC identified a multistate cluster of Salmonella Heidelberg infections and two multidrug-resistant (MDR) isolates from ground turkey retail samples with indistinguishable pulsed-field gel electrophoresis patterns. We defined cases as isolation of outbreak strains in persons with illness onset between 27 February 2011 and 10 November 2011. Investigators collected hypothesis-generating questionnaires and shopper-card information. Food samples from homes and retail outlets were collected and cultured. We identified 136 cases of S. Heidelberg infection in 34 states. Shopper-card information, leftover ground turkey from a patient's home containing the outbreak strain and identical antimicrobial resistance profiles of clinical and retail samples pointed to plant A as the source. On 3 August, plant A recalled 36 million pounds of ground turkey. This outbreak increased consumer interest in MDR Salmonella infections acquired through United States-produced poultry and played a vital role in strengthening food safety policies related to Salmonella and raw ground poultry.
Human salmonellosis linked to contact with live poultry is an increasing public health concern. In 2012, eight unrelated outbreaks of human salmonellosis linked to live poultry contact resulted in 517 illnesses. In July 2012, PulseNet, a national molecular surveillance network, reported a multistate cluster of a rare strain of Salmonella Braenderup infections which we investigated. We defined a case as infection with the outbreak strain, determined by pulsed-field gel electrophoresis, with illness onset from 25 July 2012–27 February 2013. Ill persons and mail-order hatchery (MOH) owners were interviewed using standardized questionnaires. Traceback and environmental investigations were conducted. We identified 48 cases in 24 states. Twenty-six (81%) of 32 ill persons reported live poultry contact in the week before illness; case-patients named 12 different MOHs from eight states. The investigation identified hatchery D as the ultimate poultry source. Sampling at hatchery D yielded the outbreak strain. Hatchery D improved sanitation procedures and pest control; subsequent sampling failed to yield Salmonella. This outbreak highlights the interconnectedness of humans, animals, and the environment and the importance of industry knowledge and involvement in solving complex outbreaks. Preventing these infections requires a ‘One Health’ approach that leverages expertise in human, animal, and environmental health.
Significant new opportunities for astrophysics and cosmology have been identified at low radio frequencies. The Murchison Widefield Array is the first telescope in the southern hemisphere designed specifically to explore the low-frequency astronomical sky between 80 and 300 MHz with arcminute angular resolution and high survey efficiency. The telescope will enable new advances along four key science themes, including searching for redshifted 21-cm emission from the EoR in the early Universe; Galactic and extragalactic all-sky southern hemisphere surveys; time-domain astrophysics; and solar, heliospheric, and ionospheric science and space weather. The Murchison Widefield Array is located in Western Australia at the site of the planned Square Kilometre Array (SKA) low-band telescope and is the only low-frequency SKA precursor facility. In this paper, we review the performance properties of the Murchison Widefield Array and describe its primary scientific objectives.
In November 2009, we initiated a multistate investigation of Salmonella Montevideo infections with pulsed-field gel electrophoresis pattern JIXX01.0011. We identified 272 cases in 44 states with illness onset dates ranging from 1 July 2009 to 14 April 2010. To help generate hypotheses, warehouse store membership card information was collected to identify products consumed by cases. These records identified 19 ill persons who purchased company A salami products before onset of illness. A case-control study was conducted. Ready-to-eat salami consumption was significantly associated with illness (matched odds ratio 8·5, 95% confidence interval 2·1–75·9). The outbreak strain was isolated from company A salami products from an environmental sample from one manufacturing plant, and sealed containers of black and red pepper at the facility. This outbreak illustrates the importance of using membership card information to assist in identifying suspect vehicles, the potential for spices to contaminate ready-to-eat products, and preventing raw ingredient contamination of these products.