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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.
The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)–pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D–pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (Prace difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (Prace difference=0·56). Among EA, the 25(OH)D–FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.
Investigation of Lake Quinault in western Washington, including a reflection seismic survey, analysis of piston cores, and preliminary mapping in the steep, landslide-prone Quinault River catchment upstream of the lake, reveals evidence for three episodes of earthquake disturbance in the past 3000 yr. These earthquakes triggered failures on the lake’s underwater slopes and delta front, as well as subaerial landsliding, partial channel blockage, and forced fluvial sediment aggradation. The ages of the three Lake Quinault disturbance events overlap with those of coseismically subsided, coastal marsh soils nearby in southwest Washington that are interpreted to record ruptures of the Cascadia megathrust. Absent from Lake Quinault, however, are signals of obvious disturbance from five additional subduction earthquakes inferred to have occurred during the period of record. The lack of evidence for these events may reflect the limitations of the data set derived from the detrital, river-dominated lake stratigraphy but may also have bearing on debates about segmentation and the distribution of slip along the Cascadia subduction zone during prior earthquakes.
Abdominal aortic aneurysm is a multifactorial disease that is a leading cause of death in developed countries. Matrix-metalloproteases (MMPs) are part of the disease process, however, assessing their role in disease initiation and progression has been difficult and animal models have become essential. Combining Förster resonance energy transfer (FRET) proteolytic beacons activated in the presence of MMPs with 2-photon microscopy allows for a novel method of evaluating MMP activity within the extracellular matrix (ECM). Single and 2-photon spectra for proteolytic beacons were determined in vitro. Ex vivo experiments using the apolipoprotein E knockout angiotensin II-infused mouse model of aneurysm imaged ECM architecture simultaneously with the MMP-activated FRET beacons. 2-photon spectra of the two-color proteolytic beacons showed peaks for the individual fluorophores that enable imaging of MMP activity through proteolytic cleavage. Ex vivo imaging of the beacons within the ECM revealed both microstructure and MMP activity. 2-photon imaging of the beacons in aneurysmal tissue showed an increase in proteolytic cleavage within the ECM (p<0.001), thus indicating an increase in MMP activity. Our data suggest that FRET-based proteolytic beacons show promise in assessing MMP activity within the ECM and will therefore allow future studies to identify the heterogeneous distribution of simultaneous ECM remodeling and protease activity in aneurysmal disease.
Electrochemical reactions at both positive and negative electrodes in a nickel metal hydride (Ni-MH) battery during charge have been investigated by in situ neutron powder diffraction. Commercially available β-Ni(OH)2 and LaNi5-based powders were used in this experiment as positive and negative electrodes, respectively. Exchange of hydrogen by deuterium for the β-Ni(OH)2 electrode was achieved by ex situ cycling of the cell prior to in situ measurements. Neutron diffraction data collected in situ show that the largest amount of deuterium contained at the positive electrode is de-intercalated from the electrode with no phase transformation involved up to ∼100 mA h/g and, in addition, the 110 peak width for the positive electrode increases on charge. The negative electrode of composition MmNi3.6Al0.4Mn0.3Co0.7, where Mm = Mischmetal, exhibits a phase transformation to an intermediate hydride γ phase first and then to the β phase on charge. Unit cell dimensions and phase fractions have been investigated by Rietveld refinement of the crystal structure.
The business context of growth in emerging markets has considerable implications for talent-management strategies. There is a changing balance of economic power from developed to developing countries, accompanied by a new geographical demography that is giving rise to enormous talent pools in the emerging markets of Asia, Africa, and Latin America. In particular, China and India have emerged as the two most dynamic of the BRIC economies (Brazil, Russia, India, and China). These giant labor and consumer markets have attracted large shares of foreign investment, have developed strong indigenous industrial and service sectors, and have experienced rapid market growth, resource acquisition, and deployment. Both countries have served as springboards for the growth of emerging market multinationals, as large heretofore domestic companies globalize. This chapter has three objectives. First, it addresses the need for talent management in the Indian and Chinese context and the challenges associated with talent management in those regions. Second, it considers the state of talent-management practices in China and India and how they have evolved in recent years. Third, it explores the implications of that evolution for management practice and research and our understanding of talent practices generally in the next wave of emerging markets economies.
Economic development in both China and India has led to a focus on those factors that enable growth such as the availability of natural resources, investment funding, favorable regulatory policies, and a supportive infrastructure. China and India are the world’s most populous countries. They have sustained the highest annual GDP growth rates over the past decade among all major economies – 9% for China and 6 to 7% for India. Both have exerted strong influence and leverage among the ten emerging-market countries in the G-20. China is the world’s largest source of net capital outflows and India is the world’s largest recipient of foreign outsourcing of computer-based services. China and India are each heavily dependent on imported oil. They are the second and fourth largest importers, respectively. These two countries are by far the most important emerging markets in terms of economic and demographics factors.
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.