Background: Colorectal surgery is associated with a high risk of surgical site infections (SSIs), with an incidence ranging from 16.9% to 20%, and SSIs are associated with significant morbidity and mortality, prolonged length of hospitalization, and increased health care costs. Staphylococcal decolonization is an attempt to alter the microbiome to prevent staphylococcal and other skin flora from accessing the surgical site, and This practice effectively reduces SSIs in orthopedic, neurologic, and cardiac surgeries. A staphylococcal decolonization protocol was enacted in colorectal surgeries at our institution beginning in October 2016. We compared patient outcomes between patients who did and did not undergo preoperative staphylococcal decolonization. Methods: All patients undergoing nonemergent NHSN-defined colorectal procedures from July 2015 until June 2019 at a tertiary-care medical center were included in this retrospective study. Staphylococcal decolonization was performed using chlorhexidine 2% body wash solution, mupirocin nasal ointment, and chlorhexidine 0.12% oral rinse all twice daily for 5 days prior to surgery. All SSIs were defined by NSHN criteria. The primary outcome was SSI, and secondary outcomes were superficial wound infection (SIP) and organ-space infection (IAB). Predictive variables included decolonization status (yes or no), age, gender, body mass index, procedure duration, American Society of Anesthesiologists (ASA) score, diabetes, smoking, and surgical oncology service. Surgical antimicrobial prophylaxis with cefazolin and metronidazole OR cefoxitin, and chlorhexidine skin preparation were standard throughout the study period. Univariate analysis was performed using a χ2 or t test. Multivariable logistic regression was performed to control for all clinically important variables above. All statistical analyses were done using SAS version 9.4 software (Cary, NC). Results: In total, 1,139 patients underwent nonemergent colorectal surgery from July 2015 to June 2019. There were 74 SSIs: 42 IABs and 32 SIPs. Decolonization was performed in 332 of 1,139 cases (29%). There was no difference in overall SSIs between those decolonized and not decolonized (P = .50). However, SIPs were reduced in the group receiving decolonization: 1.2% (4 of 332) versus 3.5% (28 of 807) (P = .04. When controlling for known SSI risk factors, those not receiving decolonization remained at increased risk of SIPs (OR, 3.79; 95% CI, 1.14–12.61; P = .03. Conclusions: Staphylococcal decolonization may prevent a subset of SSIs in patients undergoing colorectal surgery.

Funding: None

Disclosures: Michelle Doll reports a research Grant from Molnlycke Healthcare.

We assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.

We investigated the impact of discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus infected or colonized patients on central-line associated bloodstream infection rates at an academic children’s hospital. Discontinuation of contact precautions with a bundled horizontal infection prevention platform resulted in no adverse impact on CLABSI rates.

This study investigated the reciprocal relationship between parental caregiving and labour force participation to determine whether (1) caregiving related to subsequent employment; (2) employment related to subsequent caregiving; (3) caregiving and labour force participation had a reciprocal relationship across time; and (4) gender differences existed in these relationships. A cross-lagged panel design was applied with structural equation modeling. The study sample included adult children aged 51 or older with living parents or parents-in-law. No reciprocal relationship was found between caregiving and labour force participation, but gender differences were evident. Women caregivers in 2006 were less likely to be working in 2008, whereas employment status was not related to subsequent caregiving. In contrast, men working in 2008 were less likely to be caregiving in 2010, whereas caregiving was not related to subsequent employment status. Findings suggest that gender plays an important role in the relationship between caregiving and labour force participation.

The real-time electronic performance of a gallium nitride nanowire-based field effect transistor was investigated at five-minute intervals over thirty minutes of continuous irradiation by Xenon-124 relativistic heavy ions. An initial current surge that resulted in device improvement rather than device failure was observed. The current surge, and subsequent electronic behavior, was modeled using a combined thermionic emission-tunnelling approach, leading to information about barrier height, carrier concentrations, expected temperature behavior, and tunnelling.

Background: Subthreshold depressive symptoms are common in older adults. The threshold for the clinical significance of such symptoms is unclear. Mechanisms linking depressed mood to increased risk of disability need further investigation.

Methods: Among older adults who did not meet criteria for depression, respondents reporting no anhedonia and dysphoria over the past two weeks were compared to respondents reporting occasional symptoms with respect to self-reported disability and cognitive, psychomotor, and physical performance tests.

Results: Of 312 community-resident participants without dementia, 35.3% (n = 110) reported one or both of the two depressive symptoms at mild severity (no more than “several days” in the past two weeks). Older adults with mild depressive symptoms reported more physician-diagnosed medical conditions (2.2 vs. 1.8, p < 0.01) and mobility problems (3.0 vs. 1.8, 0–7 scale, p < 0.001), and were slower in gait (0.80 vs. 0.73 m/sec, p < 0.01) and speed of cognitive processing (Trail B, 166.1 vs. 184.7 sec, p < 0.001). In regression models that adjusted for sociodemographic and medical status, subthreshold symptoms were not a significant correlate of slowing in gait speed or cognitive performance. However, subthreshold depressive symptoms were associated with self-reported mobility limitation in models that adjusted for observed performance.

Conclusions: Mild depressive symptoms in this sample were not an independent correlate of slowed performance. However, the presence of mild depressive symptoms was associated with poorer appraisal of mobility after adjustment for objective measures of mobility.

The year 2009 marks 20 years since the Environmental Management program was first established in the Department of Energy. At that time, nearly 50 years of nuclear activity had left a legacy that included nuclear waste and environmental contamination at more than 100 sites across the United States. The extent of the risk to our citizens and communities was unknown, and certainly many of the processes and technologies to reduce that risk had not yet been invented. Since then, the Department of Energy has closed 86 of 108 sites originally assigned to the program nationwide. The Department of Energy has packaged and safely stored the nation’s entire excess plutonium inventory. The Department has pioneered new technologies that have allowed progress in retrieving millions of liters of tank waste and safely disposing of tens of thousands of cubic meters of transuranic waste. In Fiscal years 2006 and 2007 alone, the Department of Energy demolished approximately 500 buildings (nuclear, radioactive, and industrial) as part of our decontamination and decommissioning projects. Finally, there have been great strides in restoring groundwater contaminated with radionuclides using innovative treatment systems. In August 2005, a rigorous project management system was instituted. This Department of Energy program was built on the principle of prioritizing risk reduction supported by our four guiding tenets of safety, performance, clean-up, and closure. The mission activities at our clean-up sites are targeted at our highest risk activities. In planning its environmental clean-up efforts and developing the budget for those activities, the Department seeks to focus on work that will produce the greatest environmental benefit and the largest amount of risk reduction.

A coupled hydro-chemical-mechanical constitutive law for the Belgian Eurobitum bituminized waste is being developed by the International Centre for Numerical Methods and Engineering (Polytechnical University of Cataluña, Spain) to contribute to the study of the compatibility of Eurobitum with Boom Clay as a geological disposal environment. A large experimental programme is ongoing at SCK•CEN to support the development of a constitutive law for Eurobitum. Water uptake tests are being performed under different conditions to obtain insights in the parameters that influence the water uptake behaviour of Eurobitum. Furthermore, Environmental Scanning Electron Microscopy and microfocus X-ray Computer Tomography are used to characterize hydrated samples in order to improve the understanding of the water uptake processes.

The salt content, the distribution of the salt crystals, and the membrane efficiency in the Eurobitum samples affect the swelling and pressure increase rate. High membrane efficiencies and a large amount of hygroscopic salts inside the Eurobitum samples result in very high pressures when almost no swelling is allowed. The pressure in small inactive samples with 28 wt.% NaNO3has risen to ∼19 MPa after ∼3 years of hydration in nearly constant volume conditions. Slower pressure increase rates are being measured for samples with 6, 12, 18, and 33 wt.% NaNO3.

IQ and Global Inequality is a sequel to the authors' earlier IQ and the Wealth of Nations wherein they argued that “… national differences in intelligence are an important factor contributing to differences in national wealth and rates of economic growth” (p. 2). Or, later more precisely stated, that “… national IQ is the single most powerful explanatory variable, but because the explained part of the variation does not rise higher than 40–60 percent, this explanation leaves room for other explanatory factors”(p. 13). Not surprisingly, even so qualified, this thesis triggered a “mixed reception.” As the authors relate with refreshing candor, some of the reviewers denounced them for “jumping to conclusions,” took issue with their “relatively weak statistical evidence and dubious presumptions,” found the study “neither methodologically nor theoretically convincing,” and dismissed the evidence as “virtually meaningless” (p. 3).