Time to blood culture positivity as a predictor of clinical outcome of Staphylococcus aureus bloodstream infection

Few studies have assessed the time to blood culture positivity as a predictor of clinical outcome in bloodstream infections (BSIs). the purpose of this study was to evaluate the time to positivity (TTP) of blood cultures in patients with Staphylococcus aureus BSIs and to assess its impact on clinical outcome. We performed a historical cohort study with 91 adult patients with S. aureus BSIs. TTP was defined as the time between the start of incubation and the time that the automated alert signal indicating growth. in the culture bottle sounded. Patients with BSIs and TTPs of culture of 12 h (n = 47) were compared. Septic shock occurred in 13.6% of patients with TTPs of 12 h (P = 0.51). A central venous catheter source was more common with a BSI TTP of :512 h (P = 0.010). Univariate analysis revealed that a Charlson score of >= 3, the failure of at least one organ (respiratory, cardiovascular, renal, hematologic, or hepatic), infection with methicillin-resistant S. aureus, and TTPs of = 20 at BSI onset, inadequate empirical antibiotic therapy, hospital-acquired bacteremia, and endocarditis were not associated with mortality. Multivariate analysis revealed that independent predictors of hospital mortality were a Charlson score of >= 3 (odds ratio [OR], 14.4; 95% confidence interval [CI], 2.24 to 92.55), infection with methicillin-resistant S. aureus (OR, 9.3; 95% CI, 1.45 to 59.23), and TTPs of <= 12 h (OR, 6.9; 95% Cl, 1.07 to 44.66). in this historical cohort study of BSIs due to S. aureus, a TTP of :512 h was a predictor of the clinical outcome.Universidade Federal de São Paulo, Dept Infect Dis, São Paulo, BrazilVirginia Commonwealth Univ, Med Coll Virginia, Sch Med, Dept Internal Med, Richmond, VA 23298 USAVirginia Commonwealth Univ, Med Coll Virginia, Sch Med, Dept Pathol, Richmond, VA 23298 USAUniversidade Federal de São Paulo, Dept Infect Dis, São Paulo, BrazilWeb of Scienc

Age-Related Changes in Myelin of Axons of the Corpus Callosum and Cognitive Decline in Common Marmosets

Executive control is a higher‐level cognitive function that involves a range of different processes that are involved in the planning, coordination, execution, and inhibition of responses. Many of the processes associated with executive control, such as response inhibition and mental flexibility, decline with age. Degeneration of white matter architecture is considered to be the one of the key factors underlying cognitive decline associated with aging. Here we investigated how white matter changes of the corpus callosum were related to cognitive aging in common marmosets (Callithrix jacchus). We hypothesized that reduction in myelin thickness, myelin density, and myelin fraction of axonal fibers in the corpus callosum would be associated with performance on a task of executive function in a small sample of geriatric marmosets (n = 4) and young adult marmosets (n = 2). Our results indicated declines in myelin thickness, density, and myelin fraction with age. Considerable variability was detected on these characteristics of myelin and cognitive performance assessed via the detoured reach task. Age‐related changes in myelin in Region II of the corpus callosum were predictive of cognitive performance on the detoured reach task. Thus the detoured reach task appears to also measure aspects of corticostriatal function in addition to prefrontal cortical function

Application of the random encounter model in citizen science projects to monitor animal densities

Abundance and density are vital metrics for assessing a species’ conservation status and for developing effective management strategies. Remote-sensing cameras are being used increasingly as part of citizen science projects to monitor wildlife, but current methodologies to monitor densities pose challenges when animals are not individually recognisable. We investigate the use of camera traps and the Random Encounter Model (REM) for estimating the density of West European hedgehogs (Erinaceus europaeus) within a citizen science framework. We evaluate the use of a simplified version of the REM in terms of the parameters’ estimation (averaged versus survey-specific) and asses it’s potential application as part of a large-scale, long-term citizen science project. We compare averaged REM estimates to those obtained via Spatial Capture-Recapture (SCR) using data from nocturnal spotlight surveys. There was a high degree of concordance in REM-derived density estimates from averaged parameters versus those derived from survey-specific parameters. Averaged REM density estimates were also comparable to those produced by SCR at 8 out of 9 sites; hedgehog density was 7.5 times higher in urban (32.3 km-2) versus rural (4.3 km2) sites. Power analyses indicated that the averaged REM approach would be able to detect a 25% change in hedgehog density in both habitats with >90% power. Furthermore, despite the high start-up costs associated with the REM method, it would be cost-effective in the long term. The averaged REM approach is a promising solution to the challenge of large-scale and long-term species monitoring. We suggest including the REM as part of a citizen science monitoring project, where participants collect data and researchers verify and implement the required analysis

Network 'small-world-ness': a quantitative method for determining canonical network equivalence

Background: Many technological, biological, social, and information networks fall into the broad class of 'small-world' networks: they have tightly interconnected clusters of nodes, and a shortest mean path length that is similar to a matched random graph (same number of nodes and edges). This semi-quantitative definition leads to a categorical distinction ('small/not-small') rather than a quantitative, continuous grading of networks, and can lead to uncertainty about a network's small-world status. Moreover, systems described by small-world networks are often studied using an equivalent canonical network model-the Watts-Strogatz (WS) model. However, the process of establishing an equivalent WS model is imprecise and there is a pressing need to discover ways in which this equivalence may be quantified. Methodology/Principal Findings: We defined a precise measure of 'small-world-ness' S based on the trade off between high local clustering and short path length. A network is now deemed a 'small-world' if S. 1-an assertion which may be tested statistically. We then examined the behavior of S on a large data-set of real-world systems. We found that all these systems were linked by a linear relationship between their S values and the network size n. Moreover, we show a method for assigning a unique Watts-Strogatz (WS) model to any real-world network, and show analytically that the WS models associated with our sample of networks also show linearity between S and n. Linearity between S and n is not, however, inevitable, and neither is S maximal for an arbitrary network of given size. Linearity may, however, be explained by a common limiting growth process. Conclusions/Significance: We have shown how the notion of a small-world network may be quantified. Several key properties of the metric are described and the use of WS canonical models is placed on a more secure footing

LES-based Study of the Roughness Effects on the Wake of a Circular Cylinder from Subcritical to Transcritical Reynolds Numbers

This paper investigates the effects of surface roughness on the flow past a circular cylinder at subcritical to transcritical Reynolds numbers. Large eddy simulations of the flow for sand grain roughness of size k/D = 0.02 are performed (D is the cylinder diameter). Results show that surface roughness triggers the transition to turbulence in the boundary layer at all Reynolds numbers, thus leading to an early separation caused by the increased momentum deficit, especially at transcritical Reynolds numbers. Even at subcritical Reynolds numbers, boundary layer instabilities are triggered in the roughness sublayer and eventually lead to the transition to turbulence. The early separation at transcritical Reynolds numbers leads to a wake topology similar to that of the subcritical regime, resulting in an increased drag coefficient and lower Strouhal number. Turbulent statistics in the wake are also affected by roughness; the Reynolds stresses are larger due to the increased turbulent kinetic energy production in the boundary layer and separated shear layers close to the cylinder shoulders.We acknowledge “Red Española de Surpercomputación” (RES) for awarding us access to the MareNostrum III machine based in Barcelona, Spain (Ref. FI-2015-2-0026 and FI-2015-3-0011). We also acknowledge PRACE for awarding us access to Fermi and Marconi Supercomputers at Cineca, Italy (Ref. 2015133120). Oriol Lehmkuhl acknowledges a PDJ 2014 Grant by AGAUR (Generalitat de Catalunya). Ugo Piomelli acknowledges the support of the Natural Sciences and Engineering Research Council (NSERC) of Canada under the Discovery Grant Programme (Grant No. RGPIN-2016-04391). Ricard Borrell acknowledges a Juan de la Cierva postdoctoral grant (IJCI-2014-21034). Ivette Rodriguez, Oriol Lehmkuhl, Ricard Borrell and Assensi Oliva acknowledge Ministerio de Economía y Competitividad, Secretaría de Estado de Investigación, Desarrollo e Innovación, Spain (ref. ENE2014-60577-R).Peer ReviewedPostprint (author's final draft

The Conundrum of Low Achievement and Feedback for Learning

The literature on improving student engagement with assessment and feedback has a tendency to treat all students as if they are the same. Students with lower levels of attainment are generally underrepresented within empirical studies and their feedback behaviours are less well understood. The recent drive to improve student assessment and feedback literacy and the move from ‘feedback’ being information about a task to being a process of understanding and using performance information is a larger conceptual leap for some students than others. In this paper, we consider issues surrounding the transition to new modes of feedback, focusing on what is needed for those who find study difficult and persistently are disappointed by their levels of attainment, to benefit from and take advantage of our feedback pedagogies. We examine literature advocating strategies such as increasing agency, using praise, developing feedback literacy and cultivating a growth mind-set. We argue that students who underachieve may benefit from strong relationships with educators and peers; exposure to feedback rich, low stakes environments, which permit repeated integrations of practice and feedback and building feedback literacy through peer assessment activities

iSchools and archival studies

Whispers and rumors about the iSchool movement lead some to fear that this represents yet another shift away from the valued traditions of library schools, threatening something far different than what library science pioneers ever envisioned. Predating the iSchool movement, however, were other programmatic shifts such as those that led to the formalization of graduate archival education. This essay argues that such evolution is essential to our future, as iSchools tackle the increasingly complex issues confronting a digital society. We consider the mission and history of iSchools and of archival studies, the basic elements and concepts of archival studies that are critical to iSchools, and the relationship between iSchools and the changing nature of personal and institutional archives. © 2009 Springer Science+Business Media B.V

Transfusion of red cells in hematopoietic stem cell transplantation (TRIST): study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Insight regarding transfusion practices in Hematopoietic Stem cell Transplantation (HSCT) are lacking and the impact of red cell transfusion in this high risk group on outcomes following HSCT are not well appreciated. Red blood cell transfusion can be life-saving, however, liberal use of transfusion in critically ill patients failed to demonstrate significant clinical benefit. A large number of other observational studies have also demonstrated an association between red blood cell transfusions and increased morbidity such as infections and multi organ failure as well as increased mortality. The role of red cell transfusion on the clinical outcomes observed in patients undergoing HSCT remains poorly understood and a prospective randomized study of transfusion is required to gain insight and knowledge on best transfusion practices in this high risk population.</p> <p>Methods</p> <p>This report describes the design and methodological issues of a randomized pilot study evaluating red cell transfusion triggers in the setting of Hematopoietic Stem Cell Transplantation. This study has been funded by a peer review grant from the Canadian Blood Services and is registered on Clinicaltrials.gov NCT01237639.</p> <p>Results</p> <p>In 3 Canadian centres, 100 patients undergoing Hematopoietic Stem Cell Transplantation will be randomized to either a restrictive (target hemoglobin of 70-90 g/L) or liberal (target hemoglobin of 90-110 g/L) red cell transfusion strategy, based daily hemoglobin values up to 100 days post-transplant. The study will stratify participants by centre and type of transplant. The primary goal is to demonstrate study feasibility and we will collect clinical outcomes on 1) Transfusion Requirements, 2) Transplant Related Mortality, 3) Maximum grade of acute Graft versus Host Disease, 4) Veno-occlusive Disease, 5) Serious Infections, 6) Bearman Toxicity Score, 7) Bleeding, 8) Quality of Life, 9) Number of Hospitalizations and 10) Number of Intensive Care Unit (ICU) Admissions.</p> <p>Conclusion</p> <p>Upon completion, this pilot trial will provide preliminary insight into red cell transfusion practice and its influence in hematopoietic stem cell transplant outcomes. The results of this trial will inform the conduct of a larger study.</p

An evidence-based review of creative problem solving tools: a practitioner’s resource

Creative problem solving (CPS) requires solutions to be useful and original. Typically, its operations span problem finding, idea generation and critical evaluation. The benefits of training CPS have been extolled in education, industry and government with evidence showing it can enhance performance. However, while such training schemes work, less is known about the specific tools used. Knowing whether a particular tool works or not would provide practitioners with a valuable resource, leading to more effective training schemes, and a better understanding of the processes involved. A comprehensive review was undertaken examining the empirical support of tools used within CPS. Despite the surprising lack of research focusing on the use and success of specific tools some evidence exists to support the effectiveness of a small set. Such findings present practitioners with a potential resource that could be used in a stand-alone setting or possibly combined to create more effective training programmes