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We compared the rates of hospital-onset secondary bacterial infections in patients with coronavirus disease 2019 (COVID-19) with rates in patients with influenza and controls, and we investigated reports of increased incidence of Enterococcus infections in patients with COVID-19.
Retrospective cohort study.
An academic quaternary-care hospital in San Francisco, California.
Patients admitted between October 1, 2019, and October 1, 2020, with a positive SARS-CoV-2 PCR (N = 314) or influenza PCR (N = 82) within 2 weeks of admission were compared with inpatients without positive SARS-CoV-2 or influenza tests during the study period (N = 14,332).
National Healthcare Safety Network definitions were used to identify infection-related ventilator-associated complications (IVACs), probable ventilator-associated pneumonia (PVAP), bloodstream infections (BSIs), and catheter-associated urinary tract infections (CAUTIs). A multiple logistic regression model was used to control for likely confounders.
COVID-19 patients had significantly higher rates of IVAC and PVAP compared to controls, with adjusted odds ratios of 4.7 (95% confidence interval [CI], 1.7–13.9) and 10.4 (95 % CI, 2.1–52.1), respectively. COVID-19 patients had higher incidence of BSI due to Enterococcus but not BSI generally, and whole-genome sequencing of Enterococcus isolates demonstrated that nosocomial transmission did not explain the increased rate. Subanalyses of patients admitted to the intensive care unit and patients who required mechanical ventilation revealed similar findings.
COVID-19 is associated with an increased risk of IVAC, PVAP, and Enterococcus BSI compared with hospitalized controls, which is not fully explained by factors such as immunosuppressive treatments and duration of mechanical ventilation. The mechanism underlying increased rates of Enterococcus BSI in COVID-19 patients requires further investigation.
A cognitive–behavioural therapy (CBT) programme designed for
post-traumatic stress disorder (PTSD) in people with severe mental
illness, including breathing retraining, education and cognitive
restructuring, was shown to be more effective than usual services.
To evaluate the incremental benefit of adding cognitive restructuring to
the breathing retraining and education components of the CBT programme
(trial registration: clinicaltrials.gov identifier: NCT00494650).
In all, 201 people with severe mental illness and PTSD were randomised to
12- to 16-session CBT or a 3-session brief treatment programme (breathing
retraining and education). The primary outcome was PTSD symptom severity.
Secondary outcomes were PTSD diagnosis, other symptoms, functioning and
quality of life.
There was greater improvement in PTSD symptoms and functioning in the CBT
group than in the brief treatment group, with both groups improving on
other outcomes and effects maintained 1-year post-treatment.
Cognitive restructuring has a significant impact beyond breathing
retraining and education in the CBT programme, reducing PTSD symptoms and
improving functioning in people with severe mental illness.
We compared contamination rates of blood cultures obtained either from newly inserted intravenous catheters or via venipuncture. Of 2,431 blood cultures, the overall contamination rate was 2.7% (intravenous catheter, 3.4%; venipuncture, 2.0%; P=.043). The site of lowest contamination was the antecubital fossa, making this the optimal choice for blood-culture sampling.
Ambangulu Forest is one of the few remaining tracts of natural forest between 800 and 1200 m in the West Usambara Mountains of Tanzania. It may be the biologically richest area in the region but it is threatened by illegal felling of timber trees, wind damage, grazing and browsing livestock, and collection of fuel-wood and building poles. A proposed project aims to protect the forest and benefit local people at the same time.
Nearly single-phase thin films of three different Pt–Ga intermetallic compounds have been grown on GaAs(001) by co-deposition of Pt and Ga. The resultant films have been annealed at various temperatures and then characterized using x-ray two-theta diffractometry (XRD), Auger electron spectroscopy (AES), and x-ray photoemission spectroscopy (XPS). The XRD results showed that PtGa2 and PtGa thin films are chemically stable on GaAs under one atmosphere of N2 up to 800 °C and 600 °C, respectively, but thin films of Pt2Ga react with GaAs at temperatures as low as 200 °C to form phases with higher Ga concentration PtAs2. The XRD patterns also revealed that the crystallite orientation and texture of the films were dependent on annealing temperature. Segregation of Ga to the surfaces of the films upon annealing was also observed by both AES and XPS. The results demonstrated that the as-deposited films of PtGa2 and PtGa were kinetically stabilized with respect to possible chemical reactions with the GaAs substrates that evolve gaseous As species during open system annealing.
Epitaxial thin films of three different Pt-Ga intermetallic compounds have been grown on GaAs by molecular beam epitaxy (MBE). The resultant films have been annealed at various temperatures and then examined using X-ray two-theta diffraction. Both PtGa2 and PtGa thin films are chemically stable on GaAs under 1 atmosphere of N2 up to 450°C and 600°C, respectively. Thin films of Pt2Ga react with GaAs at temperatures as low as 200°C to form phases with higher Ga concentration.
The first epitaxial platinum gallium two (PtGa2) films have been grown on gallium arsenide (GaAs) (100) by co-evaporation of the elements under ultra-high vacuum conditions. An electron beam evaporator and a Knudsen cell were used to produce the platinum and gallium beams, respectively. The resulting films and bulk PtGa2 have been characterized by x-ray diffraction, Auger electron spectroscopy, and x-ray photoelectron spectroscopy. The data confirm the PtGa2 stoichiometry and crystal structure of the films, and demonstrate their chemical stability on GaAs (100). This study supports the contention that PtGa2 can be a suitable, temperature stable contact material on GaAs substrates.
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