Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) are drug-resistant pathogens causing high mortality rates with limited treatment options. Understanding the incidence of these organisms and laboratory knowledge of testing protocols is important for controlling their spread in healthcare settings. This project assessed how often Veterans Affairs (VA) healthcare facilities identify CRAB and CRPA and testing practices used. Method: An electronic survey was distributed to 126 VA acute care facilities September-October 2023. The survey focused on CRAB and CRPA incidence, testing and identification, and availability of testing resources. Responses were analyzed by complexity of patients treated at VA facilities (High, Medium, Low) using Fisher’s exact tests. Result: 77 (61.1%) facilities responded, most in urban settings (85.4%). Most respondents were lead or supervisory laboratory technologists (84.2%) from high complexity facilities (69.0%). Few facilities detected CRAB ≥ once/month (4.4%), with most reporting that they have not seen CRAB at their facility (55.0%). CRPA was detected more frequently: 19% of facilities with isolates ≥ once/month, 29.2% a few times per year, and 26.9% reporting had not seen the organism. No differences in CRAB or CRPA incidence was found by facility complexity. Nearly all facilities, regardless of complexity, utilize the recommended methods of MIC or disk diffusion to identify CRAB or CRPA (91.9%) with remaining facilities reporting that testing is done off-site (7.8%). More high complexity facilities perform on-site testing compared to low complexity facilities (32.0% vs 2.7%, p=0.04). 83% of laboratories test for Carbapenemase production, with one-fourth using off-site reference labs. One-fourth of facilities perform additional antibiotic susceptibility testing for CRAB and CRPA isolates, most of which test for susceptibility to combination antibiotics; no differences between complexities were found. Agreement that sufficient laboratory and equipment resources were available was higher in high complexity than in medium complexity facilities (70.7% vs 33.3%, p=0.01), but not low complexity facilities (43.8%). Conclusion: Having timely and accurate testing protocols for CRAB and CRPA are important to quickly control spread and reduce associated mortality. This study shows that most VA protocols follow recommended testing and identification guidelines. Interestingly, there was no difference in CRAB or CRPA incidence for facilities providing higher vs lower complexity of care. While high and low complexity facilities generally reported sufficient resources for CRAB and CRPA evaluation, some medium-complexity labs, who may feel more compelled than low-complexity labs to bring testing in house, reported that additional resources would be required.

Racism has become more covert in post-civil rights America. Yet, measures to combat it are hindered by inadequate general knowledge on what “colorblind” race talk says and does and what makes it effective. We deepen understanding of covert racism by investigating one type of discourse – racial code words, which are (1) indirect signifiers of racial or ethnic groups that contain (2) at least one positive or negative value judgment and (3) contextually implied or salient meanings. Through a thematic analysis of 734 racial code words from 97 scholarly texts, we develop an interpretive framework that explains their tropes, linguistic mechanisms and unique roles in perpetuating racism, drawing from race, linguistic and cultural studies. Racial code words promote tropes of White people’s respectability and privilege and Racial/Ethnic Minorities’ pathology and inferiority in efficient, adaptable, plausibly deniable and almost always racially stratifying ways, often through euphemism, metonymy and othering. They construct a “colorblind” discursivity and propel both “epistemic racism” (racism in knowledge) and systemic racism (racism in action). We further strengthen applications of Critical Race Theory in sociolegal studies of race by presenting a “racial meaning decoding tool” to assist legal and societal measures to detect coded racism.

The modification of montmorillonite with metallic species affects directly its crystalline structure, texture, porosity, and surface. The interaction of the metallic molecules with the clay matrix, derived from the modification pathway and the characteristics of the adsorbate, modifies the physicochemical properties of montmorillonite, enabling the creation of materials with varied characteristics to be used both as catalysts and adsorbents. Small amounts of metallic species can confer various structural and physicochemical characteristics on the same montmorillonite matrix, depending on the metal incorporated. The objective of the present study was to create an acid-base catalyst based on montmorillonite K10 (K10 Mnt), modified with Ti, Ce, and Ni, for the catalytic esterification of acetic acid and penta-1-ol. K10-Mnt was modified using particles of Ti and of Ti modified with Ce and Ni. The effect of the inclusion of Ti and modified Ti species on the transformation of the physicochemical properties of the K10 Mnt and their contributions to the catalytic esterification syntheses were investigated. Samples were characterized by scanning electron microscopy coupled to an energy-dispersive X-ray spectroscopy system (SEM-EDS), powder X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), physisorption of N2 at 77 K (BET and BJH), and thermogravimetric analysis (TGA-DTGA). Finally, the original and modified K10 Mnt samples were tested for their catalytic esterification of acetic acid and penta-1-ol in the liquid phase.

Objectives: To address the importation of multi-drug-resistant organisms (MDROs) when a colonized or infected patient is transferred from another VA facility, the Veterans Health Administration (VHA) launched the Inpatient Pathogen Tracker (IPT) in 2020. IPT tracks MDRO-infected/colonized patients and alerts MDRO Program Coordinators (MPCs) and Infection Preventionists (IPs) when such patients are admitted to their facility to facilitate rapid identification and isolation of infected/colonized patients. IPT usage has been low during initial rollout (32.5%). The VHA and the CARRIAGE QUERI Program developed targeted implementation strategies to increase utilization of IPT’s second iteration, VA Bug Alert (VABA). Methods: Familiarity with IPT was assessed via pre-education survey (3/2022). All sites received standard VABA implementation including: 1) adaptation of VABA features based on end-user feedback (completed 4/2022), 2) development and delivery of an educational module regarding the revised tool (completed 4/2022), and 3) internal facilitation from the VHA MDRO Program Office (ongoing) (see Figure for all key timepoints). Intent to register for VABA was assessed via post-education survey (4-5/2022). Sites (125 eligible) not registered for VABA by 6/1/2022 were randomly assigned to receive one of two conditions from 6/2022–8/2022: continued standard implementation alone or enhanced implementation. Enhanced implementation added the following to standard implementation: 1) audit and feedback reports and 2) external facilitation, including interviews and education about VABA. We compared the number of sites with ≥1 MPC/IP registered for VABA to-date between implementation conditions. Results: Pre-education survey. 168 MPC/IPs across 117 sites responded (94% of eligible sites). Among respondents, 25% had used IPT, 35.1% were familiar with but had not used IPT, and 39.9% were unfamiliar with IPT. Post-education survey. 93 MPC/IPs across 80 sites responded (59% of eligible sites). Of these, 81.7% said they planned to register for VABA, 4.3% said they would not register, and 14.0% said they were unsure. Post-6/1/2022 Registrations. By 6/1/2022, 71% of sites had ≥1 registered VABA user. Of the 28 unregistered sites eligible for enhanced implementation, thirteen were assigned to receive enhanced implementation, and fifteen were assigned to receive continued standard implementation. Eight sites in the enhanced implementation condition (61.5%) registered for VABA. Seven standard-implementation-only sites (46.7%) registered. The number of registered sites did not significantly differ by implementation condition (Fisher’s exact p=0.476). Conclusions: Standard and enhanced implementation were equally effective at encouraging VABA registration, suggesting that allocating resources to enhanced implementation may not be necessary.

Disclosures: None.

Companies are increasingly struggling to manage their complex product portfolios. Since they do not fully understand the complexity, intelligent solutions are required. Emerging technologies and tools offer new ways to deal with existing problems. With the help of clustering, similarities between product variants can be identified automatically, and complexity can be systematically reduced. This article aims to develop a methodological approach to identify correlations between product variants in complex product portfolios automatically by using clustering algorithms. The approach includes the systematic cleaning and transformation of product portfolio data. In addition, a guide for algorithm selection and evaluation of clustering results is presented. As the last step, the results are systematically analysed and visualised. To validate the methodical approach, it is applied to a real-world data set of a commercial vehicle manufacturer and the usefulness of the results is confirmed in an expert workshop.

Machines and mechanisms realize processes, from the shaping process of a milling machine and the motion process of an automotive system to the trajectory realization of a robot. The dynamics of a machine generated by a properly chosen set of constraints in combination with an appropriate drive system is designed to meet the prescribed requirements of the process, which is done by projecting the machine equations of motion on the process dynamics. We get a set of nonlinear relations, which represent the machine motion in terms of the required process motion. A well-known example is the projection of arbitrary many robot degrees of freedom (DOFs) on a given path resulting in a set of nonlinear equations with one DOF only, the path coordinate s. Application of this idea can be used to construct a mobility space $(\ddot{s}, \dot{s}, s)$ for any combination of coordinates and constraints. The paper presents a corresponding approach for n-link robots by applying multibody system theory. Method might be interesting for layout of machines and mechanisms. Practical aspects are discussed, and an example is given.

We provide an overview of diagnostic stewardship with key concepts that include the diagnostic pathway and the multiple points where interventions can be implemented, strategies for interventions, the importance of multidisciplinary collaboration, and key microbiologic diagnostic tests that should be considered for diagnostic stewardship. The document focuses on microbiologic laboratory testing for adult and pediatric patients and is intended for a target audience of healthcare workers involved in diagnostic stewardship interventions and all workers affected by any step of the diagnostic pathway (ie, ordering, collecting, processing, reporting, and interpreting results of a diagnostic test). This document was developed by the Society for Healthcare Epidemiology of America Diagnostic Stewardship Taskforce.

The objective of this retrospective cohort study was to determine the factors affecting the time until adoption of dogs re-homed by Dogs Trust, a UK charity. There were 13,338 records included in the study, representing 11,663 dogs. Data were extracted from the Dogs Trust's database between February 2001 and June 2004 representing all re-homing centres in the UK using the database during this time period. A survival analysis was conducted using Kaplan-Meier plots and multivariable Cox regression. The results of the study showed that the median time till adoption for all dogs was 28 days (95% CI 28-29 days). The variables which affected the time till adoption were breed, purebred status, size, sex, neuter status on arrival at a centre, age, coat colour, veterinary history and re-homing centre. It was suggested that temperament could be an important risk factor but this variable had to be excluded from the multivariable analysis. Dogs from the gundog and utility breed groups and purebred dogs were re-homed at the fastest rate.

The damage caused by ear tags used for sheep identification was investigated in a two-part study. In Part I, ear tags classified as metal loop, golf-tee, single flex or lambtag were inserted into the ears of 62 ewes. The severity of ewe ear lesions was monitored until 20 weeks after ear tag insertion. In Part II, 351 lambs had tags classified as metal loop, plastic loop, golf-tee, double flex, single flap, lambtag and electronic, inserted in their ears. The behaviour of the lambs was observed for 30s after insertion of the ear tag. The severity of lamb ear lesions was monitored until 5 weeks after ear tag insertion. In both ewes and lambs there was a significantly greater risk of severe and persistent ear lesions following the use of metal loop tags as compared with the other types of ear tag (P < 0.001). The single flap tag was difficult to insert in a greater proportion of lambs (P < 0.001), and more lambs haemorrhaged (P < 0.001), vocalized (P = 0.002) and shook their heads (P = 0.004) with it, than with the other types of ear tags. All ear tags resulted in an inflammatory reaction and required correct positioning to minimize the severity of ear lesions.

Crowdwork conducted via digital platforms is a young form of work, but a growing part of the gig economy. Typical for crowdwork is low pay, volatile income streams and no social security benefits. Also, crowdworkers have few possibilities for social comparison or negotiation because they work outside of company organisations. This article examines the question of whether these conditions mean that crowdworkers’ expectations about justice in crowdwork arrangements differ in comparison to their expectations regarding justice in conventional employment relationships. This question is addressed empirically on the basis of 36 qualitative interviews and a survey of 230 crowdworkers. The justice expectations of crowdworkers involved in different types of crowdworking platforms in German-speaking countries were examined. In our sample, crowd work typically serves to supplement – not replace – conventional employment. This explorative research shows that crowdworkers use similar standards of justice regarding work performance in their evaluations of work mediated via crowdwork platforms and conventional employment. It shows that crowdworkers perceive injustices in four specific areas: planning insecurity, lack of transparency in performance evaluation, lack of clarity in task briefings and low remuneration. These areas correspond to the theoretical dimensions of distributive and procedural justice on Colquitt’s (2001) organisational justice scale. These findings have implications for future efforts to regulate crowdwork.

In response to the recession brought about by the COVID-19 pandemic, EU-wide macroeconomic policy has launched an unprecedented coordinated fiscal expansion across the EU (Next Generation EU or NGEU), financed by issuing common debt. Given NGEU’s nature, it is essential to take fiscal spillovers into consideration when assessing the overall macroeconomic effects of this fiscal expansion. We quantify the effects of the additional public investment for all Member States in a rich macro-model with a trade structure. Our model suggests that, on average, GDP effects are around one-third larger when explicitly accounting for the spillover effects from individual-country measures. For small open economies with smaller NGEU allocations, spillover effects account for the bulk of the GDP impact. We also quantify key transmission channels.

Welfare is traditionally understood as social security decommodifying labour markets or as social investment policies. In the domain of housing, however, welfare for homeowners is largely hidden in the tax codes’ fiscal exemptions. Based on a content analysis of legislation, this article introduces a novel yearly database of 37 countries between 1901 and 2020 to uncover the “hidden welfare state” of taxes on imputed rent, deductibility of mortgage payments, housing capital gains tax, and value-added tax on newly built dwellings. Summary indices of homeownership attractiveness and neutrality of the tax code show that fiscal homeownership policies have been in decline until the 1980s and risen ever since. They are in place where finance is liberally and labour restrictively regulated. Contrary to the classical welfare state, they are not associated with an economic logic of industrialism or left-wing governments. They rather are an alternative to rent regulation used by Common-law jurisdictions or smaller countries. As welfare for property owners, the logic of fiscal homeownership welfare diverges from the classical welfare for the labouring classes.

In this note, we give a classification of the maximal order Abelian subgroups of finite irreducible Coxeter groups. We also prove a Weyl group analog of Cartan’s theorem that all maximal tori in a connected compact Lie group are conjugate.