Compliance of Healthcare Workers with Hand Hygiene Practices in the Northeast of Iran: an Overt Observation

Hand hygiene (HH) is one of the most effective methods to prevent transmission and spread of microorganisms from one patient to another, also, it used to reduce the spread of pathogens in clinical settings and to help control outbreaks but compliance is usually poor. The purpose of this study was to analyze the compliance of hand hygiene and affecting factors among healthcare workers (HCWs) of northeast hospitals in Iran. This study was conducted based on observation method for the compliance of hand hygiene according to the World Health Organization (WHO) guidelines. HCWs were observed during routine patient care in different shifts, also the technique of hand hygiene was assessed through hand washing with alcohol-based disinfectant. Data were collected during 1 year, from June 2014 to July 2015 by the infection control teams in the northeast hospital of Iran. By direct observation, we evaluated a total of 92518 hand hygiene opportunities from 29 hospitals in the northeast of Iran during 1 year, with overall compliance rates in these hospitals were 43.42%. Compliance rates differed by role: nurses43%, doctors 19 % and other health workers 29%. In this observational study, we identified that adherence to hand hygiene practice and use of alcohol-based disinfectant was very low in this hospitals, so effective intervention programs to promote adherence to hand hygiene and use of disinfectants could be effective to increase compliance

The logic of recurrent circuits in the primary visual cortex

Recurrent cortical activity sculpts visual perception by refining, amplifying or suppressing visual input. However, the rules that govern the influence of recurrent activity remain enigmatic. We used ensemble-specific two-photon optogenetics in the mouse visual cortex to isolate the impact of recurrent activity from external visual input. We found that the spatial arrangement and the visual feature preference of the stimulated ensemble and the neighboring neurons jointly determine the net effect of recurrent activity. Photoactivation of these ensembles drives suppression in all cells beyond 30 µm but uniformly drives activation in closer similarly tuned cells. In nonsimilarly tuned cells, compact, cotuned ensembles drive net suppression, while diffuse, cotuned ensembles drive activation. Computational modeling suggests that highly local recurrent excitatory connectivity and selective convergence onto inhibitory neurons explain these effects. Our findings reveal a straightforward logic in which space and feature preference of cortical ensembles determine their impact on local recurrent activity

Exploring Model Complexity in Machine Learned Potentials for Simulated Properties

Machine learning (ML) enables the development of interatomic potentials that promise the accuracy of first principles methods while retaining the low cost and parallel efficiency of empirical potentials. While ML potentials traditionally use atom-centered descriptors as inputs, different models such as linear regression and neural networks can map these descriptors to atomic energies and forces. This begs the question: what is the improvement in accuracy due to model complexity irrespective of choice of descriptors? We curate three datasets to investigate this question in terms of ab initio energy and force errors: (1) solid and liquid silicon, (2) gallium nitride, and (3) the superionic conductor LGPS. We further investigate how these errors affect simulated properties with these models and verify if the improvement in fitting errors corresponds to measurable improvement in property prediction. Since linear and nonlinear regression models have different advantages and disadvantages, the results presented herein help researchers choose models for their particular application. By assessing different models, we observe correlations between fitting quantity (e.g. atomic force) error and simulated property error with respect to ab initio values. Such observations can be repeated by other researchers to determine the level of accuracy, and hence model complexity, needed for their particular systems of interest

How to Better Understand the Influence of Host Genetics on Developing an Effective Immune Response to Thoracic Cancers

Thoracic cancers pose a significant global health burden. Immune checkpoint blockade therapies have improved treatment outcomes, but durable responses remain limited. Understanding how the host immune system interacts with a developing tumor is essential for the rational development of improved treatments for thoracic malignancies. Recent technical advances have improved our understanding of the mutational burden of cancer cells and changes in cancer-specific gene expression, providing a detailed understanding of the complex biology underpinning tumor-host interactions. While there has been much focus on the genetic alterations associated with cancer cells and how they may impact treatment outcomes, how host genetics affects cancer development is also critical and will greatly determine treatment response. Genome-wide association studies (GWAS) have identified genetic variants associated with cancer predisposition. This approach has successfully identified host genetic risk factors associated with common thoracic cancers like lung cancer, but is less effective for rare cancers like malignant mesothelioma. To assess how host genetics impacts rare thoracic cancers, we used the Collaborative Cross (CC); a powerful murine genetic resource designed to maximize genetic diversity and rapidly identify genes associated with any biological trait. We are using the CC in conjunction with our asbestos-induced MexTAg mouse model, to identify host genes associated with mesothelioma development. Once genes that moderate tumor development and progression are known, human homologues can be identified and human datasets interrogated to validate their association with disease outcome. Furthermore, our CC−MexTAg animal model enables in-depth study of the tumor microenvironment, allowing the correlation of immune cell infiltration and gene expression signatures with disease development. This strategy provides a detailed picture of the underlying biological pathways associated with mesothelioma susceptibility and progression; knowledge that is crucial for the rational development of new diagnostic and therapeutic strategies. Here we discuss the influence of host genetics on developing an effective immune response to thoracic cancers. We highlight current knowledge gaps, and with a focus on mesothelioma, describe the development and application of the CC-MexTAg to overcome limitations and illustrate how the knowledge gained from this unique study will inform the rational design of future treatments of mesothelioma

Does an interactive trust-enhanced electronic consent improve patient experiences when asked to share their health records for research? A randomized trial

Objective In the context of patient broad consent for future research uses of their identifiable health record data, we compare the effectiveness of interactive trust-enhanced e-consent, interactive-only e-consent, and standard e-consent (no interactivity, no trust enhancement). Materials and Methods A randomized trial was conducted involving adult participants making a scheduled primary care visit. Participants were randomized into 1 of the 3 e-consent conditions. Primary outcomes were patient-reported satisfaction with and subjective understanding of the e-consent. Secondary outcomes were objective knowledge, perceived voluntariness, trust in medical researchers, consent decision, and time spent using the application. Outcomes were assessed immediately after use of the e-consent and at 1-week follow-up. Results Across all conditions, participants (N = 734) reported moderate-to-high satisfaction with consent (mean 4.3 of 5) and subjective understanding (79.1 of 100). Over 94% agreed to share their health record data. No statistically significant differences in outcomes were observed between conditions. Irrespective of condition, black participants and those with lower education reported lower satisfaction, subjective understanding, knowledge, perceived voluntariness, and trust in medical researchers, as well as spent more time consenting. Conclusions A large majority of patients were willing to share their identifiable health records for research, and they reported positive consent experiences. However, incorporating optional additional information and messages designed to enhance trust in the research process did not improve consent experiences. To improve poorer consent experiences of racial and ethnic minority participants and those with lower education, other novel consent technologies and processes may be valuable

A High Throughput Configurable SDR Detector for Multi-user MIMO Wireless Systems

Spatial division multiplexing (SDM) in MIMO technology significantly increases the spectral efficiency, and hence capacity, of a wireless communication system: it is a core component of the next generation wireless systems, e.g. WiMAX, 3GPP LTE and other OFDM-based communication schemes. Moreover, spatial division multiple access (SDMA) is one of the widely used techniques for sharing the wireless medium between different mobile devices. Sphere detection is a prominent method of simplifying the detection complexity in both SDM and SDMA systems while maintaining BER performance comparable with the optimum maximum-likelihood (ML) detection. On the other hand, with different standards supporting different system parameters, it is crucial for both base station and handset devices to be configurable and seamlessly switch between different modes without the need for separate dedicated hardware units. This challenge emphasizes the need for SDR designs that target the handset devices. In this paper, we propose the architecture and FPGA realization of a configurable sort-free sphere detector, Flex-Sphere, that supports 4, 16, 64-QAM modulations as well as a combination of 2, 3 and 4 antenna/user configuration for handsets. The detector provides a data rate of up to 857.1 Mbps that fits well within the requirements of any of the next generation wireless standards. The algorithmic optimizations employed to produce an FPGA friendly realization are discussed.Xilinx Inc.National Science Foundatio

Preliminary Jitter Stability Results for the Large UV/Optical/Infrared (LUVOIR) Surveyor Concept Using a Non-Contact Vibration Isolation and Precision Pointing System

The need for high payload dynamic stability and ultra-stable mechanical systems is an overarching technology need for large space telescopes such as the Large Ultraviolet / Optical / Infrared (LUVOIR) Surveyor concept. The LUVOIR concept includes a 15-meter-diameter segmented-aperture telescope with a suite of serviceable instruments operating over a range of wavelengths between 100nm to 2.5 um. Wavefront error (WFE) stability of less than 10 picometers RMS of uncorrected system WFE per wavefront control step represents a drastic performance improvement over current space-based telescopes being fielded. Through the utilization of an isolation architecture that involves no mechanical contact between the telescope and the host spacecraft structure, a system design is realized that maximizes the telescope dynamic stability performance without driving stringent technology requirements on spacecraft structure, sensors or actuators. Through analysis of the LUVOIR finite element model and linear optical model, the wavefront error and Line-Of-Sight (LOS) jitter performance is discussed in this paper when using the Vibration Isolation and Precision Pointing System (VIPPS) being developed cooperatively with Lockheed Martin in addition to a multi-loop control architecture. The multi-loop control architecture consists of the spacecraft Attitude Control System (ACS), VIPPS, and a Fast Steering Mirror on the instrument. While the baseline attitude control device for LUVOIR is a set of Control Moment Gyroscopes (CMGs), Reaction Wheel Assembly (RWA) disturbance contribution to wavefront error stability and LOS stability are presented to give preliminary results in this paper. CMG disturbance will be explored in further work to be completed

Astrocytic Abnormalities in Schizophrenia

Astrocytes are glial cells in the central nervous system (CNS), which contribute to CNS health and disease by participating in homeostatic, structural, and metabolic processes that play an essential role in facilitating synaptic transmission between neurons. Schizophrenia (SCZ) is a neuropsychiatric disorder associated with various positive and negative behaviors and interruption of executive function and cognition thought to be due partly to aberrations in signaling within neural networks. Recent research has demonstrated that astrocytes play a role in SCZ through various effects, including influencing immune system function, altering white matter, and mediating changes in neurotransmitters. Astrocytes are also known to play a role in inducing SCZ-associated changes in neuroplasticity, which includes alterations in synaptic strength and neurogenesis. Also, astrocyte abnormalities are linked to neurobehavioral impairments seen at the clinical level. The present chapter details general information on SCZ. It highlights the role of astrocytes in SCZ at molecular and behavioral levels, including neural changes seen in the disease, and the therapeutic implications of targeting astrocytes in SCZ

Associations of statins and diabetes with diagnosis of ulcerated cutaneous melanoma

Ulcerated primary melanomas are associated with an inflammatory tumor microenvironment. We hypothesized that systemic proinflammatory states and anti-inflammatory medications are also associated with a diagnosis of ulcerated melanoma. In a cross-sectional study of 787 patients with newly diagnosed clinical stage IB or II melanoma, we estimated odds ratios for the association of proinflammatory factors (high body mass index, diabetes, cardiovascular disease, hypertension, and smoking) or the use of anti-inflammatory medications (statins, aspirin, corticosteroids, and nonsteroidal anti-inflammatory drugs), with ulcerated primary melanoma using regression models and subgroup analyses to control for melanoma thickness and mitotic rate. On the basis of information from 194 patients with ulcerated and 593 patients with nonulcerated primary melanomas, regular statin users had lower likelihood of a diagnosis of ulcerated primary melanoma (odds ratio 0.67, 95% confidence interval 0.45-0.99), and this association remained after adjusting for age, sex, thickness, and mitosis. When analysis was limited to melanomas that wer

Pathogen Specific, IRF3-Dependent Signaling and Innate Resistance to Human Kidney Infection

The mucosal immune system identifies and fights invading pathogens, while allowing non-pathogenic organisms to persist. Mechanisms of pathogen/non-pathogen discrimination are poorly understood, as is the contribution of human genetic variation in disease susceptibility. We describe here a new, IRF3-dependent signaling pathway that is critical for distinguishing pathogens from normal flora at the mucosal barrier. Following uropathogenic E. coli infection, Irf3−/− mice showed a pathogen-specific increase in acute mortality, bacterial burden, abscess formation and renal damage compared to wild type mice. TLR4 signaling was initiated after ceramide release from glycosphingolipid receptors, through TRAM, CREB, Fos and Jun phosphorylation and p38 MAPK-dependent mechanisms, resulting in nuclear translocation of IRF3 and activation of IRF3/IFNβ-dependent antibacterial effector mechanisms. This TLR4/IRF3 pathway of pathogen discrimination was activated by ceramide and by P-fimbriated E. coli, which use ceramide-anchored glycosphingolipid receptors. Relevance of this pathway for human disease was supported by polymorphic IRF3 promoter sequences, differing between children with severe, symptomatic kidney infection and children who were asymptomatic bacterial carriers. IRF3 promoter activity was reduced by the disease-associated genotype, consistent with the pathology in Irf3−/− mice. Host susceptibility to common infections like UTI may thus be strongly influenced by single gene modifications affecting the innate immune response