An Examination of LEED Certification’s Utility as Evidence for Superior On-Property Environmental Sustainability in Hotels

This study explores the potential misalignment between LEED certification\u27s prescriptive scorecard and hotel real estate\u27s operationally complex nature. This study revealed that LEED hotels generally outperform their non-LEED counterparts on a per square foot basis for carbon footprint, energy use, and water use metrics, but perform worse on a per occupied room basis. However, the large amount of variance in the data sample that is inherent in hotel industry data renders definitive conclusions about the utility of LEED as evidence for superior on-property environmental sustainability in hotels difficult to make. Any variance between LEED and non-LEED data groupings was generally not found to be statistically significant. These results demonstrate that further analysis is needed before LEED certification can be tied to levels of environmental sustainability between hotels in a meaningful way. Also, the true impact of hotel LEED certification is extremely difficult to find with any method besides direct comparison of hotel metrics before and after LEED certification

Staphylococcus Aureus Bacteriuria as a Predictor of In-Hospital Mortality in Patients with Staphylococcus Aureus Bacteremia. Results of a Retrospective Cohort Study

Staphylococcus aureus bloodstream infection (SA-BSI) is an infection with increasing morbidity and mortality. Concomitant Staphylococcus aureus bacteriuria (SABU) frequently occurs in patients with SA-BSI. It is considered as either a sign of exacerbation of SA-BSI or a primary source in terms of urosepsis. The clinical implications are still under investigation. In this study, we investigated the role of SABU in patients with SA-BSI and its effect on the patients' mortality. We performed a retrospective cohort study that included all patients in our university hospital (Charité Universitätsmedizin Berlin) between 1 January 2014 and 31 March 2017. We included all patients with positive blood cultures for Staphylococcus aureus who had a urine culture 48 h before or after the first positive blood culture. We identified cases while using the microbiology database and collected additional demographic and clinical parameters, retrospectively, from patient files and charts. We conducted univariate analyses and multivariable Cox regression analysis to evaluate the risk factors for in-hospital mortality. 202 patients met the eligibility criteria. Overall, 55 patients (27.5%) died during their hospital stay. Cox regression showed SABU (OR 2.3), Pitt Bacteremia Score (OR 1.2), as well as moderate to severe liver disease (OR 2.1) to be independent risk factors for in-hospital mortality. Our data indicates that SABU in patients with concurrent SA-BSI is a prognostic marker for in-hospital death. Further studies are needed for evaluating implications for therapeutic optimization