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Starting in 2016, we initiated a pilot tele-antibiotic stewardship program at 2 rural Veterans Affairs medical centers (VAMCs). Antibiotic days of therapy decreased significantly (P < .05) in the acute and long-term care units at both intervention sites, suggesting that tele-stewardship can effectively support antibiotic stewardship practices in rural VAMCs.
Forest ecosystems are rich in biodiversity and provide valuable ecosystem services, but are declining worldwide. Malus niedzwetzkyana, an Endangered wild relative of domesticated apples, is an important component of the walnut–fruit forests of Central Asia. Its iconic pink blossom and genetic properties give it special cultural and scientific significance, but livestock grazing and firewood collection threaten its survival. The conservation of the species and its native forest ecosystem is critical and urgent. This study provides information on the ecology and population of M. niedzwetzkyana and the threats affecting its habitat, improving our understanding of its distribution and proposing measures to reduce threats. We collected ecological data and assessed population structure and threats at four forest sites in southern Kyrgyzstan. We mapped 149 individuals, creating the largest known dataset for this species. We developed species distribution models for M. niedzwetzkyana to identify climatically suitable regions and potential areas for restoration. Sary-Chelek Biosphere Reserve contained the largest expanse of pristine forest and the most stable M. niedzwetzkyana population, followed by Kara-Alma Forestry Unit. Forests in the Gava Forestry Unit and Dashman Reserve were most extensively damaged by humans and livestock. The wild apple's favoured habitat was south-west facing slopes with a gradient < 30° and a relatively open canopy. Overall, the study population was vulnerable to extinction with limited regeneration potential. We recommend short-term population enhancement through planting projects and increased protection of individuals in pristine sites. Community-based conservation initiatives should be prioritized in extensively damaged sites, and larger-scale reforestation of these forests needs to be considered.
Thirteen bryozoan species are described from the Brewer Dock (Hickory Corners) Member of the Reynales Formation (lower Silurian, Aeronian) at the locality Hickory Corners in western New York, USA. Three species are new: trepostomes Homotrypa niagarensis n. sp. and Leioclema adsuetum n. sp. and the rhabdomesine cryptostome Moyerella parva n. sp. Only one species, Hennigopora apta Perry and Hattin, 1960, developed obligatory encrusting colonies whereas the others produced erect ramose colonies of various thicknesses and shapes: cylindrical, branched, and lenticular. Bryozoans display high abundance and richness within the rock. This fauna is characteristic of a moderately agitated environment with a stable substrate. The identified species reveal paleobiogeographic connections to other Silurian localities of New York as well as Ohio and Indiana (USA) and Anticosti (Canada).
To determine the impact of an environmental disinfection intervention on the incidence of healthcare-associated Clostridium difficile infection (CDI).
A multicenter randomized trial.
In total,16 acute-care hospitals in northeastern Ohio participated in the study.
We conducted a 12-month randomized trial to compare standard cleaning to enhanced cleaning that included monitoring of environmental services (EVS) personnel performance with feedback to EVS and infection control staff. We assessed the thoroughness of cleaning based on fluorescent marker removal from high-touch surfaces and the effectiveness of disinfection based on environmental cultures for C. difficile. A linear mixed model was used to compare CDI rates in the intervention and postintervention periods for control and intervention hospitals. The primary outcome was the incidence of healthcare-associated CDI.
Overall, 7 intervention hospitals and 8 control hospitals completed the study. The intervention resulted in significantly increased fluorescent marker removal in CDI and non-CDI rooms and decreased recovery of C. difficile from high-touch surfaces in CDI rooms. However, no reduction was observed in the incidence of healthcare-associated CDI in the intervention hospitals during the intervention and postintervention periods. Moreover, there was no correlation between the percentage of positive cultures after cleaning of CDI or non-CDI rooms and the incidence of healthcare-associated CDI.
An environmental disinfection intervention improved the thoroughness and effectiveness of cleaning but did not reduce the incidence of healthcare-associated CDI. Thus, interventions that focus only on improving cleaning may not be sufficient to control healthcare-associated CDI.
This article examines modernist-nationalist thought on Sufi lodges during the late Ottoman Empire and early Turkish Republic via the controversial novel Nur Baba (1922) by Yakup Kadri Karaosmanoğlu. Widely translated and the basis of the first-ever Turkish motion picture, Nur Baba depicts a debauched Sufi lodge in turn-of-the-century Istanbul where drug use, alcoholism, and illicit amorous liaisons run amok. The novel played an important role in shaping public perceptions of Sufi lodges in the twilight years of the Ottoman Empire. This piece explores the novel's place among early 20th-century critiques of Sufism, its approach to national history, its historical setting (during the reign of Sultan Abdülhamid II), and its close relationship to the intellectual concerns of the Second Constitutional Period (1908–18). It argues for a revised understanding of the novel's historical setting and contends that the novel employs a combination of moralistic critique and romantic nostalgia that is central to modernist-nationalist treatments of Sufism that instrumentalize Sufi culture for nation-building purposes.
Understanding the nutritional demands on serving military personnel is critical to inform training schedules and dietary provision. Troops deployed to Afghanistan face austere living and working environments. Observations from the military and those reported in the British and US media indicated possible physical degradation of personnel deployed to Afghanistan. Therefore, the present study aimed to investigate the changes in body composition and nutritional status of military personnel deployed to Afghanistan and how these were related to physical fitness. In a cohort of British Royal Marines (n 249) deployed to Afghanistan for 6 months, body size and body composition were estimated from body mass, height, girth and skinfold measurements. Energy intake (EI) was estimated from food diaries and energy expenditure measured using the doubly labelled water method in a representative subgroup. Strength and aerobic fitness were assessed. The mean body mass of volunteers decreased over the first half of the deployment ( − 4·6 (sd 3·7) %), predominately reflecting fat loss. Body mass partially recovered (mean +2·2 (sd 2·9) %) between the mid- and post-deployment periods (P< 0·05). Daily EI (mean 10 590 (sd 3339) kJ) was significantly lower than the estimated daily energy expenditure (mean 15 167 (sd 1883) kJ) measured in a subgroup of volunteers. However, despite the body mass loss, aerobic fitness and strength were well maintained. Nutritional provision for British military personnel in Afghanistan appeared sufficient to maintain physical capability and micronutrient status, but providing appropriate nutrition in harsh operational environments must remain a priority.
The debut of Turkish-language translations of the Qurʾan in the newly founded Republic of Turkey sparked lively debates over whether Qurʾan translation was possible or desirable, who should engage in interpretation of the text, and what characteristics a Turkish-language rendering of the Qurʾan should have. Whereas the abolition of the Islamic caliphate, closure of the medreses, and prohibition of the Sufi orders have received considerable attention in histories of early republican Turkey, the state-sponsored translation of the Qurʾan into Turkish remains both neglected and misunderstood. Muhammad Rashid Rida, who was highly influential in shaping opinion in the Muslim world, portrayed the state-sponsored project as a long-term plot to displace the Arabic Qurʾan. Other accounts misrepresent the involvement of President Mustafa Kemal (Atatürk) in the promotion of Qurʾan translation by anachronistically suggesting that he sparked the initiative and led a “campaign” in support of it. Mustafa Kemal had no hand in the composition of Turkish Qurʾan translations published in 1924, other than helping create the political context in which they could be published. Their composition began well before the foundation of the Turkish republic, and their inspiration emerged from the intellectual milieu of the late Ottoman public sphere.
In 1925, the Turkish parliament commissioned a translation of the Qurʾan from Arabic to Turkish as well as a Turkish-language Qurʾanic commentary. This project is commonly misunderstood as an initiative engineered by Mustafa Kemal (Atatürk) and linked to the radical institutional reforms of 1924: abolition of the Islamic caliphate, prohibition of the Sufi orders, and closure of the medreses. In fact, parliament's support of a Qurʾan translation was not a radical nationalist reform but an initiative supported and executed by devout intellectuals who opposed other facets of Islamic reform in the early years of the Turkish republic.
A theoretical examination of the FeAl/Al2O3 fiber intermetallic matrix composite (IMC) system was coupled with experimental results to determine optimum processing conditions for maximum FeAl adhesion to A12O3 fibers and minimum attraction of FeAl and A12O3 fibers to themselves. Optimizing the processing conditions leads to a more uniform green composite without matrix or reinforcement rich zones. The theoretical examination consisted of applying a model developed using traditional colloidal approaches to suspensions while accounting for the complexities of a multicomponent composite system. The model uses the suspension properties of the individual materials such as size and surface potential along with the processing conditions for the system as the basis for calculation. This model describes the interaction potentials between components of the suspension and the stability of and between various components of the system in terms of a stability ratio, W. The optimum processing conditions were found by determining the conditions under which the calculated values of W are ideal. Experimental results utilizing the model predictions have been examined and include verification of the FeAl particle adhesion to the A12O3 fiber and preliminary consolidation studies.
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