Assessing the conversion of electronic medical record data into antibiotic stewardship indicators.

BACKGROUND Measuring the appropriateness of antibiotic use is crucial for antibiotic stewardship (ABS) programmes to identify targets for interventions. OBJECTIVES To assess the technical feasibility of converting electronic medical record (EMR) data into ABS indicators. METHODS In this observational feasibility study covering a period of 2 years, the EMRs of patients hospitalized at a large non-university hospital network and receiving at least one dose of a systemic antibiotic were included. ABS indicators measuring steps in the process of antibiotic prescription proposed by the literature were collected and rephrased or defined more specifically to be calculable if needed. Algorithms were programmed in R to convert EMR data into ABS indicators. The indicators were visualized in an interactive dashboard and the plausibility of each output value was assessed. RESULTS In total, data from 25 337 hospitalizations from 20 723 individual patients were analysed and visualized in an interactive dashboard. Algorithms could be programmed to compute 89% (25/28) of all pre-selected indicators assessing treatment decisions automatically out of EMR data, with good data quality for 46% (13/28) of these indicators. According to the data quality observed, the most important issues were (i) missing or meaningless information on indication (e.g. 'mild infection') and (ii) data processing issues such as insufficiently categorized metadata. CONCLUSIONS The calculation of indicators assessing treatment decisions from EMRs was feasible. However, better data structure and processing within EMR systems are crucial for improving the validity of the results

The axonally secreted protein axonin-1 is a potent substratum for neurite growth

Axonin-1 is a neuronal glycoprotein occurring both as a membrane-bound and a secreted form. Membrane-bound axonin-1 is predominantly located in membranes of developing nerve fiber tracts and has recently been characterized as a cell adhesion molecule; the soluble form is secreted from axons and accumulates in the cerebrospinal fluid and the vitreous fluid of the eye. In the present study, we addressed the question as to whether secreted axonin-1 was released in a functionally competent form and we found that it strongly promotes neurite outgrowth when presented to neurons as an immobilized substratum. Neurite lengths elaborated by embryonic dorsal root ganglia neurons on axonin-1 were similar to those on the established neurite-promoting substrata L1 and laminin. Fab fragments of axonin-1 antibodies completely inhibited neurite growth on axonin-1, but not on other substrata. In soluble form, axonin-1 had an anti-adhesive effect, as revealed by perturbation of neurite fasciculation. In view of their structural similarity, we conclude that secreted and membrane-bound axonin-1 interact with the same growth-promoting neuritic receptor. The fact that secreted axonin-1 is functionally active, together with our previous findings that it is secreted from an internal cellular pool, suggests a functional dualism between membrane-bound and secreted axonin-1 at the site of secretion, which is most likely the growth cone. The secretion of adhesion molecules could represent a powerful and rapidly acting regulatory element of growth cone-neurite interactions in the control of neurite elongation, pathway selection, and possibly target recognition

Masses and widths of scalar-isoscalar multi-channel resonances from data analysis

Peculiarities of obtaining parameters for broad multi-channel resonances from data are discussed analyzing the experimental data on processes $\pi\pi\to\pi\pi,K\bar{K}$ in the $I^GJ^{PC}=0^+0^{++}$ channel in a model-independent approach based on analyticity and unitarity and using an uniformization procedure. We show that it is possible to obtain a good description of the $\pi\pi$ scattering data from the threshold to 1.89 GeV with parameters of resonances cited in the PDG tables as preferred. However, in this case, first, representation of the $\pi\pi$ background is unsatisfactory; second, the data on the coupled process $\pi\pi\to K\bar{K}$ are not well described even qualitatively above 1.15 GeV when using the resonance parameters from the only $\pi\pi$ scattering analysis. The combined analysis of these coupled processes is needed, which is carried out satisfactorily. Then both above-indicated flaws, related to the analysis of solely the $\pi\pi$-scattering, are cured. The most remarkable change of parameters with respect to the values of only $\pi\pi$ scattering analysis appears for the mass of the $f_0 (600)$ which is now in some accordance with the Weinberg prediction on the basis of mended symmetry and with an analysis using the large-$N_c$ consistency conditions between the unitarization and resonance saturation. The obtained $\pi\pi$-scattering length $a_0^0$ in case when we restrict to the analysis of the $\pi\pi$ scattering or consider so-called A-solution (with a lower mass and width of $f_0(600)$ meson) agrees well with prediction of chiral perturbation theory (ChPT) and with data extracted at CERN by the NA48/2 Collaboration from the analysis of the $K_{e4}$ decay and by the DIRAC Collaboration from the measurement of the $\pi^+\pi^-$ lifetime.Comment: 21 pages, 3 figures, 6 table

Picosecond Time-Resolved Cathodoluminescence to Probe Exciton Dynamics in α-Plane (Al,Ga)N/GaN Quantum Wells

Extended abstract of a paper presented at Microscopy and Microanalysis 2011 in Nashville, Tennessee, USA, August 7-August 11, 201

Time-resolved cathodoluminescence of InGaAs/AlGaAs tetrahedral pyramidal quantum structures

An original time resolved cathodoluminescence set up has been used to investigate the optical properties and the carrier transport in quantum structures located in InGaAs/AlGaAs tetrahedral pyramids. An InGaAs quantum dot formed just below the top of the pyramid is connected to four types of low-dimensional barriers: InGaAs quantum wires on the edges of the pyramid, InGaAs quantum wells on the (111)A facets and segregated AlGaAs vertical quantum wire and AlGaAs vertical quantum wells formed at the centre and at the pyramid edges. Experiments were performed at a temperature of 92K, an accelerating voltage of 10kV and a beam probe current of 10pA. The cathodoluminescence spectrum shows five luminescence peaks. Rise and decay times for the different emission wavelengths provide a clear confirmation of the peak attribution (previously done with other techniques) to the different nanostructures grown in a pyramid. Moreover, experimental results suggest a scenario where carriers diffuse from the lateral quantum structures towards the central structures (the InGaAs quantum dot and the segregated AlGaAs vertical quantum wire) via the InGaAs quantum wires on the edges of the pyramid. According to this hypothesis, we have modeled the carrier diffusion along these quantum wires. An ambipolar carrier mobility of 1400cm2/V s allows to obtain a good fit to all temporal dependence

Baryonic Effect on chi_cJ Suppression in Au+Au Collisions at RHIC Energies

We predict that initially produced chi_cJ mesons at low transverse momentum in the central rapidity region are almost dissociated by nucleons and antinucleons in hadronic matter produced in central Au+Au collisions at RHIC energies sqrt {s_{NN}}= 130 and 200 GeV. In calculations the nucleon and antinucleon distributions in hadronic matter are results of evolution from their freeze-out distributions which well fit the experimental p_T spectra of proton and antiproton. Any measured chi_cJ mesons at low p_T are generated from deconfined matter and give an explicit proof of regeneration mechanism (recombination mechanism).Comment: 10 pages, 3 figures, Latex, a discussion added to the referenc

Defining freshwater as a natural resource: a framework linking water use to the area of protection natural resources

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: While many examples have shown unsustainable use of freshwater resources, existing LCIA methods for water use do not comprehensively address impacts to natural resources for future generations. This framework aims to (1) define freshwater resource as an item to protect within the Area of Protection (AoP) natural resources, (2) identify relevant impact pathways affecting freshwater resources, and (3) outline methodological choices for impact characterization model development. Methods: Considering the current scope of the AoP natural resources, the complex nature of freshwater resources and its important dimensions to safeguard safe future supply, a definition of freshwater resource is proposed, including water quality aspects. In order to clearly define what is to be protected, the freshwater resource is put in perspective through the lens of the three main safeguard subjects defined by Dewulf et al. (2015). In addition, an extensive literature review identifies a wide range of possible impact pathways to freshwater resources, establishing the link between different inventory elementary flows (water consumption, emissions, and land use) and their potential to cause long-term freshwater depletion or degradation. Results and discussion: Freshwater as a resource has a particular status in LCA resource assessment. First, it exists in the form of three types of resources: flow, fund, or stock. Then, in addition to being a resource for human economic activities (e.g., hydropower), it is above all a non-substitutable support for life that can be affected by both consumption (source function) and pollution (sink function). Therefore, both types of elementary flows (water consumption and emissions) should be linked to a damage indicator for freshwater as a resource. Land use is also identified as a potential stressor to freshwater resources by altering runoff, infiltration, and erosion processes as well as evapotranspiration. It is suggested to use the concept of recovery period to operationalize this framework: when the recovery period lasts longer than a given period of time, impacts are considered to be irreversible and fall into the concern of freshwater resources protection (i.e., affecting future generations), while short-term impacts effect the AoP ecosystem quality and human health directly. It is shown that it is relevant to include this concept in the impact assessment stage in order to discriminate the long-term from the short-term impacts, as some dynamic fate models already do. Conclusions: This framework provides a solid basis for the consistent development of future LCIA methods for freshwater resources, thereby capturing the potential long-term impacts that could warn decision makers about potential safe water supply issues in the future

Different Transport Pathways of Individual Precursor Proteins in Mitochondria

Transport of mitochondrial precursor proteins into mitochondria of Neurospora crassa was studied in a cellfree reconstituted system. Precursors were synthesized in a reticulocyte lysate programmed with Neurospora mRNA and transported into isolated mitochondria in the absence of protein synthesis. Uptake of the following precursors was investigated: apocytochrome c, ADP/ATP carrier and subunit 9 of the oligomycin-sensitive ATPase. Addition of high concentrations of unlabelled chemically prepared apocytochrome c (1–10 μM) inhibited the appearance in the mitochondrial of labelled cytochrome c synthesized in vitro because the unlabelled protein dilutes the labelled one and because the translocation system has a limited capacity [apparent V is 1–3 pmol × min−1× (mg mitochondrial protein)−1]. Concentrations of added apocytochrome c exceeding the concentrations of precursor proteins synthesized in vitro by a factor of about 104 did not inhibit the transfer of ADP/ATP carrier or ATPase subunit 9 into mitochondria. Carbonylcyanide m-chlorophenylhydrazone, an uncoupler of oxidative phosphorylation, inhibited transfer in vitro of ADP/ATP carrier and of ATPase subunit 9, but not of cytochrome c. These findings suggest that cytochrome c and the other two proteins have different import pathways into mitochondria. It can be inferred from the data presented that different 'receptors' on the mitochondrial surface mediate the specific recognition of precursor proteins by mitochondria as a first step in the transport process

Biosynthesis of Mitochondrial Porin and Insertion into the Outer Mitochondrial Membrane of Neuruspora crassa

Mitochondrial porin, the major protein of the outer mitochondrial membrane is synthesized by free cytoplasmic polysomes. The apparent molecular weight of the porin synthesized in homologous or heterologous cell-free systems is the same as that of the mature porin. Transfer in vitro of mitochondrial porin from the cytosolic fraction into the outer membrane of mitochondria could be demonstrated. Before membrane insertion, mitochondrial porin is highly sensitive to added proteinase; afterwards it is strongly protected. Binding of the precursor form to mitochondria occurs at 4°C and appears to precede insertion into the membrane. Unlike transfer of many precursor proteins into or across the inner mitochondrial membrane, assembly of the porin is not dependent on an electrical potential across the inner membrane