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To assess Connecticut medical providers’ concordance (2018–2019) with the 2017 Clostridioides difficile infection (CDI) treatment update by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). The effect of guideline concordance on CDI recurrence risk was also assessed.
Prospective, population-based study.
New Haven County, Connecticut, from January 1, 2017, to December 31, 2019.
CDI incident case (no positive tests in the prior 8 weeks), not limited by care setting.
Using data from the Emerging Infections Program’s CDI surveillance, severity and concordance were defined. Presence of megacolon and/or ileus defined fulminant disease; absence defined nonsevere/severe disease. Using 2017 treatment as baseline, 2018–2019 concordance was defined as receiving the recommended first-line antibiotic (ie, vancomycin or fidaxomicin for adult patients, vancomycin or metronidazole for pediatric patients) for exactly 10 days. For all analyses, significance was P < .05.
Among 990 cases, concordance increased from 24.8% in 2018 to 37.0% in 2019. First-line antibiotic concordance increased from 61.2% in 2018 to 79.9% in 2019. Recurrence risk was significantly associated with patients aged ≥65 years and was highest for those aged 75–84 years, but this factor was not significantly associated with concordance.
From 2018 through 2019, CDI treatment in New Haven County increasingly was concordant with the 2017 treatment update but remained low in 2019. Although concordance with treatment guidelines did not affect recurrence risk, close attention should be paid by medical providers to patients aged ≥65 years, specifically those aged 75–84 years because they are at an increased risk for recurrence.
Develop strong network of science teachers interested in promoting scientific research to their students.
Place students in an immersive summer research internship that, when possible, matches their career interests.
Expose students to the numerous career paths within the STEM field.
The program recruits socio-economically disadvantaged students and provides them a stipend, and also accepts students who can participate unpaid.
Local school teachers are engaged in a summer fellowship to learn biotechnologies and research. In Spring these teachers help recruit students and during the subsequent Fall help students with college and scholarship applications.
Students are placed in a variety of laboratories within the Schools of Medicine, Science, Dentistry, Public Health, Informatics, Health and Human Sciences, Engineering and Technology, especially in biomedical engineering. Students are also placed in industry laboratories such as Eli Lilly and the Indiana Bioscience Research Institute.
Long-term program follow-up is done through post-internship surveys to assess impact on graduate and professional school admission.
Since the Indiana CTSI was established in 2008, 872 students have participated in the summer internship.
71% of past interns are underrepresented minorities in science or classified as disadvantaged by NIH criteria.
17% of students interned during grade 10, 72% during grade 11, and 11% during grade 12.
21% of students engage in the program for more than one year.
100% of past interns are currently enrolled in or have graduated college.
Over 60% of those with a bachelors degree proceed to graduate and professional schools and over 80% stay in STEM related fields. These rates are equal for interns from underrepresented minorities or those classified as disadvantaged by NIH criteria.
DISCUSSION/SIGNIFICANCE OF IMPACT:
Students engaged in the Indiana CTSI STEM program are progressing through the translational science pipeline based on their graduating from college and remaining in the STEM field.
The crystal structure of Na(NH4)Mo3O10·H2O has been solved by parallel tempering using the FOX software package with synchrotron powder diffraction data obtained from beamline 08B1-1 at the Canadian Light Source. Rietveld refinement, performed with the software package GSAS, yielded orthorhombic lattice parameters of a = 13.549 82(10), b = 7.618 50(6), and c = 9.302 74(7) Å (Z = 4, space group Pnma). The structure is composed of molybdate chains running parallel to the b-axis. The Rietveld refinement results were compared with density functional theory calculations performed with CRYSTAL14, and show excellent agreement with the calculated structure.
Just as scientific discoveries enable the development of new technology, novel technologies can drive scientific progress. Similar to the adoption of PCR as a mainstream laboratory technique in the 1990s, the ability to readily sequence whole genomes today has opened up new areas of biology and fundamentally changed the way people work in existing fields.
The most obvious feature of so-called ‘next generation’ sequencing (NGS) technologies (a misnomer that includes a wide array of platforms developed over the past decade) is the enormous increase in throughput of sequence data, resulting in an unprecedented reduction in cost. A single sequencing ‘run’ of a high-end platform can generate up to 5 billion reads and determine the sequence of 1500 billion bp of DNA – the equivalent of 500 human genomes – in 3 to 4 days. The US National Human Genome Research Institute has tracked the changing price of DNA sequencing they fund from about $5000 per Mb to 5 cents per Mb over the last 15 years: a 100 000-fold drop (see Fig 1). At the time of writing (2015) the sequencing equipment market is dominated by Illumina, and a relative lack of competition and the maturity of the current technology has at least temporarily slowed the fall in price. However, the development of newer sequencing platforms is expected to soon spark another era of rapidly declining prices and rising throughput.
This enormous technological progress has been a boon for many areas of biology, but the change in technology has also required researchers to change the way they do science and has led to changes in the types of questions people can ask. Traditional sequencing required massive amplification of specific, targeted DNA sequences by PCR prior to sequencing. While it is possible to sequence PCR amplicons with high-throughput sequencing technology (and PCR is used in the sequencing process), the enormous throughput and short sequencing reads typically mean that the most cost-effective way of collecting even limited amounts of data of interest is by shotgun sequencing.
This untargeted approach opens up new kinds of science. For example, it is now possible – indeed, often technically easier – to assay entire genomes rather than investigate candidate genes.
We live in an age of ubiquitous genomics. Next generation sequencing (NGS) technology, both widely adopted and advancing at pace, has transformed the data landscape, opening up an enormous source of heritable characters to the comparative biologist. Its impact on systematics, like many other fields of biology, has been felt throughout its breadth: from defining species boundaries to estimating their evolutionary histories. This volume examines the broad range of ways in which NGS data are being used in systematics and in the fields that it underpins, from biodiversity prospecting to evo-devo. Experts in their fields draw on contemporary case studies to demonstrate state-of-the-art applications of NGS data. These, along with novel analyses, comprehensive reviews and lively perspectives, are combined to produce an authoritative account of contemporary issues in systematics that have been impacted by the adoption of NGS.
In this paper we consider the relationship between the Assouad and box-counting dimension and how both behave under the operation of taking products. We introduce the notion of ‘equi-homogeneity’ of a set, which requires a uniformity in the cardinality of local covers at all length-scales and at all points, and we show that a large class of homogeneous Moran sets have this property. We prove that the Assouad and box-counting dimensions coincide for sets that have equal upper and lower box-counting dimensions provided that the set ‘attains’ these dimensions (analogous to ‘s-sets’ when considering the Hausdorff dimension), and the set is equi-homogeneous. Using this fact we show that for any α ∈ (0, 1) and any β, γ ∈ (0, 1) such that β + γ ⩾ 1 we can construct two generalised Cantor sets C and D such that dimBC = αβ, dimBD = α γ, and dimAC = dimAD = dimA (C × D) = dimB (C × D) = α.
Photo-excitation of high surface area semiconductor nanorods decorated with surface catalyst particles are investigated. DFT-based simulation is applied to the charge transfer dynamics at the interface of the supported nanocatalyst by modeling dynamics of photo-excitations. The modeling is performed by reduced density matrix method in the basis of Kohn-Sham orbitals. The energy of photo-excitation is dissipating due to interaction with lattice vibrations, treated through non-adiabatic coupling as the electron/hole pair relaxes to the conduction / valence band edges. The methodology is applied to TiO2 nanorod modeled as a periodic anatase (100) slab functionalized by minimalistic nano-clusters or doping. Simulations of these models demonstrate the formation of charge transfer state in both time and frequency domain. Computed charge dynamics leads to creation of positively charged areas on the nanorod surface that is an important prerequisite for oxidation catalysis. Our computation identifies optimal composition and morphology of nanocatalyst for such applications as water splitting for hydrogen production or solar cells.
Religious participation is positively associated with mental health, but attendance at worship services declines during serious illness. This study assessed whether home visits by clergy or laity provide benefits to seriously ill patients who may have difficulty attending religious services.
A cross-sectional study design nested in an observational epidemiologic cohort study was used. The regionally representative sample of patients had metastatic lung, colorectal, breast, and prostate cancer (n = 70); Class III and IV congestive heart failure (n = 70); or chronic obstructive pulmonary disease with hypercapnea (n = 70) and were observed regarding clergy–laity support in their natural environments. Dependent variable: 10-item Center for Epidemiologic Studies – Depression Scale. Independent variable: A one-item question measuring how much helpful support patients received from clergy or other persons from church, temple, synagogue, or mosque. Covariates: demographic, health, social support, religiousness.
Depressed mood was negatively associated with clergy–laity support in a non-linear pattern. Depressed mood was also positively associated with functional deficits and a lifetime history of difficulties related to religious involvement.
Significance of results:
In lieu of worship attendance when people are sick, home visits by members of a patient's religious community may bolster mood by providing continuity of instrumental, emotional, and spiritual support.