52 research outputs found

    Removing Racially Biased Algorithms in Policing

    Get PDF
    Local police departments use algorithm-based programs to do police work and predict crime. Technology has created the police tactic of predictive crime prevention. Police work, however, requires social skills, assessment of the environment, and most importantly human interaction. Automated policing lacks these characteristics. Moreover, the algorithms used to make crime predictions and risk assessments have disproportionately affected minorities

    Evaluation of a Rapid Biological Spore Test for Dental Instrument Sterilization

    Get PDF
    Aim: This study evaluated the reliability of a new rapid biological spore test (BST) for determining the sterilization efficacy of dental steam autoclaves within 20 minutes, as compared to a conventional BST requiring 2 days of incubation after autoclave exposure.Materials and methods: A total of 177 pairs of BST, each composed of a rapid test (Celerity™ 20 Steam Biologic Indicator, Steris) and a conventional BST (Attest™ 1262 Biological Indicator, 3M), both containing Geobacillus stearothermophilus spores, were placed into steam autoclaves loaded with instruments, and subjected to either sterilizing (157 pairs) or non-sterilizing conditions (20 pairs). Celerity™ BST was then incubated for 20 minutes at 57°C, with the growth medium evaluated spectrophotometrically for fluorescent α-glucosidase signal changes (no change with successful sterilization; increased fluorescence after failed sterilization). Attest™ BST was incubated for 48 hours at 57°C, after which a pH-based color change in the culture broth was visually assessed (no change in purple color with successful sterilization; change to yellow color with failed sterilization).Results: Celerity™ and Attest™ BST both accurately identified successful sterilization, with no G. stearothermophilus spore growth from either BST after exposure to sterilizing steam autoclave conditions (100% agreement between 157 pairs of each BST). Both BST also accurately detected unsuccessful sterilization, with all tested ampoules positive for G. stearothermophilus spore germination after non-sterilizing steam autoclave time periods. Both BST exhibited 100% sensitivity, specificity, and accuracy for detection of sterilizing steam autoclave conditions.Conclusion: Celerity™ BST, after only 20 minutes incubation, performed equally as well as a BST requiring 48 hours incubation in determining the sterilization efficacy of dental steam autoclaves.Clinical significance: Rapid BST offer earlier detection of sterilization failure before potentially contaminated dental instruments are used in clinical patient care.</p

    Impact of Combined Low-Level Mupirocin and Genotypic Chlorhexidine Resistance on Persistent Methicillin-Resistant Staphylococcus aureus Carriage After Decolonization Therapy: A Case-control Study

    Get PDF
    The clinical significance of low-level mupirocin and genotypic chlorhexidine resistance remains unclear. This case-control study demonstrates that combined low-level mupirocin and genotypic chlorhexidine resistance significantly increases the risk of persistent MRSA carriage after decolonization therapy (OR 3.4, 95% CI 1.5-7.8

    Rheumatoid leptomeningitis presenting with an acute neuropsychiatric disorder

    Get PDF
    Leptomeningitis is a rare central nervous system manifestation of rheumatoid arthritis, generally in patients with established chronic rheumatoid disease. We report a 41-year-old man without previous rheumatoid arthritis or psychiatric disorder who presented with an acute neuropsychiatric disturbance and polyarthralgia. His MR scan of brain showed asymmetric bifrontal leptomeningitis, confirmed on (18F)-fluoro-D-glucose-positron emission tomography. Other investigations showed highly positive serum and cerebrospinal fluid anti-cyclic citrullinated peptide. A leptomeningeal biopsy showed necrotising leptomeningeal inflammation with ill-defined granulomas and lymphoplasmacytic infiltrate without organisms. Prolonged high-dose corticosteroids and then rituximab resulted in recovery. Chronic leptomeningitis can present with an acute neuropsychiatric disorder. We highlight that early rheumatoid disease can, rarely, cause a chronic leptomeningitis, reversible with immunotherapy

    Concert recording 2013-11-16b

    Get PDF
    [Track 01]. Brushstrokes on a simple field / Jeff Payne ; edited by Jacob Lee -- [Track 02]. Song among hills ; [Track 03]. Mythos unbound ; [Track 04]. Sketches on an autumn day / Jeff Payne

    Evaluation of phytochemicals and antioxidant potential of a new polyherbal formulation TC-16: additive, synergistic or antagonistic?

    Get PDF
    Background Scientific literature has demonstrated the association of free radicals in the etiology of various chronic diseases. Hence, the identification of potent antioxidants remains a useful task. The combination of multiple herbs in polyherbal formulations (PHF) is often associated with greater therapeutic efficacy due to synergistic interactions. However, antagonism can occur in natural product mixtures and the resultant antioxidant potential might not always be the additive value of the antioxidant properties of each component. In this study, we aimed to evaluate the phytochemicals, antioxidative potential and interaction among the herbs in TC-16, a new PHF comprising Curcuma longa L., Zingiber officinal var. Bentong, Piper nigrum L., Citrofortunella microcarpa (Bunge) Wijnands and Apis dorsata honey. Methods TC-16 was screened for phytochemicals. Phenolic and flavonoid contents of TC-16 and its individual ingredients were determined, followed by assessment of antioxidant properties using in vitro assays including 2,2’-azinobis(3-ethylbenzothiazoline-6-sulfonate) (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP), oxygen radical absorbance capacity (ORAC) and β-carotene bleaching (BCB) assays. Interactions among the herbs were also investigated by calculating the difference in antioxidant activity and combination index. Results Alkaloids, flavonoids, terpenoids, saponins and glycosides were present in TC-16. TC-16 possessed the highest phenolic (46.14±1.40 mg GAE/g) and flavonoid (132.69±1.43 mg CE/g) contents following C. longa. Synergistic antioxidant activity among the herbs was evident in ORAC and BCB assays which uses mainly hydrogen atom transfer-based antioxidant mechanisms. Conclusions TC-16 demonstrated roles in combating free radicals. In a PHF, synergistic interaction among the herbs is observed in some but not all mechanisms. Mechanisms showing synergistic interactions should be highlighted to maximize the beneficial property of the PHF

    Comparison of strategies to reduce meticillin-resistant Staphylococcus aureus rates in surgical patients: a controlled multicentre intervention trial.

    Get PDF
    Objective: To compare the effect of two strategies (enhanced hand hygiene vs meticillin-resistant Staphylococcus aureus (MRSA) screening and decolonisation) alone and in combination on MRSA rates in surgical wards. Design: Prospective, controlled, interventional cohort study, with 6-month baseline, 12-month intervention and 6-month washout phases. Setting: 33 surgical wards of 10 hospitals in nine countries in Europe and Israel. Participants: All patients admitted to the enrolled wards for more than 24 h. Interventions: The two strategies compared were (1) enhanced hand hygiene promotion and (2) universal MRSA screening with contact precautions and decolonisation (intranasal mupirocin and chlorhexidine bathing) of MRSA carriers. Four hospitals were assigned to each intervention and two hospitals combined both strategies, using targeted MRSA screening. Outcome measures: Monthly rates of MRSA clinical cultures per 100 susceptible patients (primary outcome) and MRSA infections per 100 admissions (secondary outcome). Planned subgroup analysis for clean surgery wards was performed. Results: After adjusting for clustering and potential confounders, neither strategy when used alone was associated with significant changes in MRSA rates. Combining both strategies was associated with a reduction in the rate of MRSA clinical cultures of 12% per month (adjusted incidence rate ratios (aIRR) 0.88, 95% CI 0.79 to 0.98). In clean surgery wards, strategy 2 (MRSA screening, contact precautions and decolonisation) was associated with decreasing rates of MRSA clinical cultures (15% monthly decrease, aIRR 0.85, 95% CI 0.74 to 0.97) and MRSA infections (17% monthly decrease, aIRR 0.83, 95% CI 0.69 to 0.99). Conclusions: In surgical wards with relatively low MRSA prevalence, a combination of enhanced standard and MRSA-specific infection control approaches was required to reduce MRSA rates. Implementation of single interventions was not effective, except in clean surgery wards where MRSA screening coupled with contact precautions and decolonisation was associated with significant reductions in MRSA clinical culture and infection rates. Trial registration clinicaltrials.gov identifier: NCT0068586

    Variable performance of models for predicting methicillin-resistant Staphylococcus aureus carriage in European surgical wards

    Get PDF
    BACKGROUND: Predictive models to identify unknown methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission may optimise targeted MRSA screening and efficient use of resources. However, common approaches to model selection can result in overconfident estimates and poor predictive performance. We aimed to compare the performance of various models to predict previously unknown MRSA carriage on admission to surgical wards. METHODS: The study analysed data collected during a prospective cohort study which enrolled consecutive adult patients admitted to 13 surgical wards in 4 European hospitals. The participating hospitals were located in Athens (Greece), Barcelona (Spain), Cremona (Italy) and Paris (France). Universal admission MRSA screening was performed in the surgical wards. Data regarding demographic characteristics and potential risk factors for MRSA carriage were prospectively collected during the study period. Four logistic regression models were used to predict probabilities of unknown MRSA carriage using risk factor data: 'Stepwise' (variables selected by backward elimination); 'Best BMA' (model with highest posterior probability using Bayesian model averaging which accounts for uncertainty in model choice); 'BMA' (average of all models selected with BMA); and 'Simple' (model including variables selected >50% of the time by both Stepwise and BMA approaches applied to repeated random sub-samples of 50% of the data). To assess model performance, cross-validation against data not used for model fitting was conducted and net reclassification improvement (NRI) was calculated. RESULTS: Of 2,901 patients enrolled, 111 (3.8%) were newly identified MRSA carriers. Recent hospitalisation and presence of a wound/ulcer were significantly associated with MRSA carriage in all models. While all models demonstrated limited predictive ability (mean c-statistics <0.7) the Simple model consistently detected more MRSA-positive individuals despite screening fewer patients than the Stepwise model. Moreover, the Simple model improved reclassification of patients into appropriate risk strata compared with the Stepwise model (NRI 6.6%, P = .07). CONCLUSIONS: Though commonly used, models developed using stepwise variable selection can have relatively poor predictive value. When developing MRSA risk indices, simpler models, which account for uncertainty in model selection, may better stratify patients' risk of unknown MRSA carriage

    City of Ivanhoe Comprehensive Plan 2018-2038

    Get PDF
    the City of Ivanhoe is located in Tyler County, which is in southeastern Texas near the Louisiana border. The land is gently rolling, with an elevation ranging from 100 to 400 feet above sea level. Texas Target Communities developed this document in partnership with the City of Ivanhoe. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies. The project aimed to enhance community-wide discussion through a public participatory process, resulting in developing a comprehensive plan to help guide the future growth of the County and City. A representative task force of community members engaged in a participatory planning process, including visioning, goal setting, alternative scenario exploration, and strategies for implementation. Using courses on campus, TAMU urban planning students were exposed to the planning process and explored innovative ideas. The result of this collaboration is this document, which provides strategies for the community’s growth utilizing the natural resource and the assets of the City.The Ivanhoe Comprehensive Plan 2017-2037 provides guidance for the future development of the city. In the summer of 2016, Tyler County and the City of Ivanhoe collaborated with Texas Target Communities to assess current community conditions and explore future development strategies., which resulted in this comprehensive plan document.Texas Target Communitie
    • …
    corecore