Prevalence of qacA/B genes and mupirocin resistance among methicillin-resistant Staphylococcus aureus (MRSA) isolates in the setting of chlorhexidine bathing without mupirocin

OBJECTIVE: We aimed to determine the frequency of qacA/B chlorhexidine tolerance genes and high-level mupirocin resistance among MRSA isolates before and after the introduction of a chlorhexidine (CHG) daily bathing intervention in a surgical intensive care unit (SICU). DESIGN: Retrospective cohort study (2005–2012) SETTING: A large tertiary-care center PATIENTS: Patients admitted to SICU who had MRSA surveillance cultures of the anterior nares METHODS: A random sample of banked MRSA anterior nares isolates recovered during (2005) and after (2006–2012) implementation of a daily CHG bathing protocol was examined for qacA/B genes and high-level mupirocin resistance. Staphylococcal cassette chromosome mec (SCCmec) typing was also performed. RESULTS: Of the 504 randomly selected isolates (63 per year), 36 (7.1%) were qacA/B positive ( + ) and 35 (6.9%) were mupirocin resistant. Of these, 184 (36.5%) isolates were SCCmec type IV. There was a significant trend for increasing qacA/B (P= .02; highest prevalence, 16.9% in 2009 and 2010) and SCCmec type IV (P< .001; highest prevalence, 52.4% in 2012) during the study period. qacA/B( + ) MRSA isolates were more likely to be mupirocin resistant (9 of 36 [25%] qacA/B( + ) vs 26 of 468 [5.6%] qacA/B(−); P= .003). CONCLUSIONS: A long-term, daily CHG bathing protocol was associated with a change in the frequency of qacA/B genes in MRSA isolates recovered from the anterior nares over an 8-year period. This change in the frequency of qacA/B genes is most likely due to patients in those years being exposed in prior admissions. Future studies need to further evaluate the implications of universal CHG daily bathing on MRSA qacA/B genes among hospitalized patients

Demersal fish biomass declines with temperature across productive shelf seas

Aim: Theory predicts fish community biomass to decline with increasing temperature due to higher metabolic losses resulting in less efficient energy transfer in warm-water food webs. However, whether these metabolic predictions explain observed macroecological patterns in fish community biomass is virtually unknown. Here, we test these predictions by examining the variation in demersal fish biomass across productive shelf regions. Location: Twenty one continental shelf regions in the North Atlantic and Northeast Pacific. Time Period: 1980-2015. Methods: We compiled high-resolution bottom trawl survey data of fish biomass containing 166,000 unique tows and corrected biomass for differences in sampling area and trawl gear catchability. We examined whether relationships between net primary production and demersal fish community biomass are mediated by temperature, food-web structure and the level of fishing exploitation, as well as the choice of spatial scale of the analysis. Subsequently, we examined if temperature explains regional changes in fish biomass over time under recent warming. Results: We find that biomass per km2 varies 40-fold across regions and is highest in cold waters and areas with low fishing exploitation. We find no evidence that temperature change has impacted biomass within marine regions over the time period considered. The biomass variation is best explained by an elementary trophodynamic model that accounts for temperature-dependent trophic efficiency. Main Conclusions: Our study supports the hypothesis that temperature is a main driver of large-scale cross-regional variation in fish community biomass. The cross-regional pattern suggests that long-term impacts of warming will be negative on biomass. These results provide an empirical basis for predicting future changes in fish community biomass and its associated services for human wellbeing that is food provisioning, under global climate change

Substituting a copper atom modifies the melting of aluminum clusters

Producción CientíficaHeat capacities have been measured for Al(n−1)Cu− clusters (n = 49–62) and compared with results for pure Aln+ clusters. Al(n−1)Cu− and Aln+ have the same number of atoms and the same number of valence electrons (excluding the copper d electrons). Both clusters show peaks in their heat capacities that can be attributed to melting transitions; however, substitution of an aluminum atom by a copper atom causes significant changes in the melting behavior. The sharp drop in the melting temperature that occurs between n = 55 and 56 for pure aluminum clusters does not occur for the Al(n−1)Cu− analogs. First-principles density-functional theory has been used to locate the global minimum energy structures of the doped clusters. The results show that the copper atom substitutes for an interior aluminum atom, preferably one with a local face-centered-cubic environment. Substitution does not substantially change the electronic or geometric structures of the host cluster unless there are several Aln+ isomers close to the ground state. The main structural effect is a contraction of the bond lengths around the copper impurity, which induces both a contraction of the whole cluster and a stress redistribution between the Al–Al bonds. The size dependence of the substitution energy is correlated with the change in the latent heat of melting on substitution

RTOG 0518: Randomized Phase III Trial to Evaluate Zoledronic Acid for Prevention of Osteoporosis and Associated Fractures in Prostate Cancer Patients

Background: RTOG 0518 evaluated the potential benefit of zoledronic acid therapy in preventing bone fractures for patients with high grade and/or locally advanced, non-metastatic prostate adenocarcinoma receiving luteinizing hormone-releasing hormone (LHRH) agonist and radiotherapy (RT). Methods: Eligible patients with T-scores of the hip ( −2.5 vs. > −1.0) and negative bone scans were prospectively randomized to either zoledronic acid, 4 mg, concurrently with the start of RT and then every six months for a total of 6 infusions (Arm 1) or observation (Arm 2). Vitamin D and calcium supplements were given to all patients. Secondary objectives included quality of life (QOL) and bone mineral density (BMD) changes over a period of three years. Results: Of 109 patients accrued before early closure, 96 were eligible. Median follow-up was 36.3 months for Arm I and 34.8 months for Arm 2. Only two patients experienced a bone fracture (1 in each arm) resulting in no difference in freedom from any bone fracture (p=0.95), nor in QOL. BMD percent changes from baseline to 36 months were statistically improved with the use of zoledronic acid compared to observation for the lumbar spine (6% vs. −5%, p<0.0001), left total hip (1% vs. −8%, p=0.0002), and left femoral neck (3% vs. −8%, p=0.0007). Conclusions: For patients with advanced, non-metastatic prostate cancer receiving LHRH agonist and RT, the use of zoledronic acid was associated with statistically improved BMD percent changes. The small number of accrued patients resulted in decreased statistical power to detect any differences in the incidence of bone fractures or QOL

A Keck/HIRES Study of Kinematics of the Cold Interstellar Medium in Dwarf Starburst Galaxies

We have obtained high resolution Echelle spectra (R = 30,000-50,000) of the Na D absorption doublet (5890A, 5896A) for six dwarf starburst galaxies and two more luminous starbursts: M82 and NGC 1614. The absorption features were separated into multiple components and separated into stellar and interstellar parts based on kinematics. We find that three of the dwarfs show outflows, with an average blueshift of 27 km/s. This is small compared to the highest velocity components in NGC 1614 and M82 (blueshifted by 150 km/s and 91 km/s, respectively); these two brighter galaxies also show more complex absorption profiles than the dwarfs. None of the outflow speeds clearly exceed the escape velocity of the host galaxy. Sightlines in NGC 2363 and NGC4214 apparently intersect expanding shells. We compare the shocked gas velocity (v_NaD) to the ionized gas velocity (v_Halpha) and interpret the velocity difference as either a trapped ionization front (NGC 4214) or a leaky HII region (NGC 2363). The dwarfs show N(NaD) = 10^(11.8-13.7) cm^-2, while the Na D columns in M82 and NGC 1614 are 10^13.7 cm^-2 and 10^14.0 cm^-2, respectively. The mass of expelled gas is highly sensitive to outflow geometry, dust depletion, and ionization fraction, but with a simple shell model we estimate neutral outflow gas masses from ~10^6 M_solar to ~10^10 M_solar.Comment: 36 pages, including 9 figures. Accepted for publication in Astrophys.

DSG3 As a Biomarker for the Ultrasensitive Detection of Cccult Lymph Node Metastasis in Oral Cancer Using Nanostructured Immunoarrays

OBJECTIVES: The diagnosis of cervical lymph node metastasis in head and neck squamous cell carcinoma (HNSCC) patients constitutes an essential requirement for clinical staging and treatment selection. However, clinical assessment by physical examination and different imaging modalities, as well as by histological examination of routine lymph node cryosections can miss micrometastases, while false positives may lead to unnecessary elective lymph node neck resections. Here, we explored the feasibility of developing a sensitive assay system for desmoglein 3 (DSG3) as a predictive biomarker for lymph node metastasis in HNSCC. MATERIALS AND METHODS: DSG3 expression was determined in multiple general cancer- and HNSCC-tissue microarrays (TMAs), in negative and positive HNSCC metastatic cervical lymph nodes, and in a variety of HNSCC and control cell lines. A nanostructured immunoarray system was developed for the ultrasensitive detection of DSG3 in lymph node tissue lysates. RESULTS: We demonstrate that DSG3 is highly expressed in all HNSCC lesions and their metastatic cervical lymph nodes, but absent in non-invaded lymph nodes. We show that DSG3 can be rapidly detected with high sensitivity using a simple microfluidic immunoarray platform, even in human tissue sections including very few HNSCC invading cells, hence distinguishing between positive and negative lymph nodes. CONCLUSION: We provide a proof of principle supporting that ultrasensitive nanostructured assay systems for DSG3 can be exploited to detect micrometastatic HNSCC lesions in lymph nodes, which can improve the diagnosis and guide in the selection of appropriate therapeutic intervention modalities for HNSCC patients

Voices Obscured in Complex Environmental Settings (VOICES) corpus

This paper introduces the Voices Obscured In Complex Environmental Settings (VOICES) corpus, a freely available dataset under Creative Commons BY 4.0. This dataset will promote speech and signal processing research of speech recorded by far-field microphones in noisy room conditions. Publicly available speech corpora are mostly composed of isolated speech at close-range microphony. A typical approach to better represent realistic scenarios, is to convolve clean speech with noise and simulated room response for model training. Despite these efforts, model performance degrades when tested against uncurated speech in natural conditions. For this corpus, audio was recorded in furnished rooms with background noise played in conjunction with foreground speech selected from the LibriSpeech corpus. Multiple sessions were recorded in each room to accommodate for all foreground speech-background noise combinations. Audio was recorded using twelve microphones placed throughout the room, resulting in 120 hours of audio per microphone. This work is a multi-organizational effort led by SRI International and Lab41 with the intent to push forward state-of-the-art distant microphone approaches in signal processing and speech recognition.Comment: Submitted to Interspeech 201

A Network-Individual-Resource Model for HIV Prevention

HIV is transmitted through dyadic exchanges of individuals linked in transitory or permanent networks of varying sizes. A theoretical perspective that bridges key individual level elements with important network elements can be a complementary foundation for developing and implementing HIV interventions with outcomes that are more sustainable over time and have greater dissemination potential. Toward that end, we introduce a Network-Individual-Resource (NIR) model for HIV prevention that recognizes how exchanges of resources between individuals and their networks underlies and sustains HIV-risk behaviors. Individual behavior change for HIV prevention, then, may be dependent on increasing the supportiveness of that individual’s relevant networks for such change. Among other implications, an NIR model predicts that the success of prevention efforts depends on whether the prevention efforts (1) prompt behavior changes that can be sustained by the resources the individual or their networks possess; (2) meet individual and network needs and are consistent with the individual’s current situation/developmental stage; (3) are trusted and valued; and (4) target high HIV-prevalence networks

Chandra Observations of the Anomalous X-ray Pulsar 4U 0142+61

We present X-ray imaging, timing, and phase resolved spectroscopy of the anomalous X-ray pulsar 4U 0142+61 using the Chandra X-ray Observatory. The spectrum is well described by a power law plus blackbody model with power law index = 3.35(2), kT_BB=0.458(3) keV, and N_H=0.91(2) x 10^{22} cm^{-2}$; we find no significant evidence for spectral features (0.5-7.0 keV). Time resolved X-ray spectroscopy shows evidence for evolution in phase in either index, or KT_BB, or some combination thereof as a function of pulse phase. We derive a precise X-ray position for the source and determine its spin period, P=8.68866(30) s. We have detected emission beyond 4 arcsec from the central source and extending beyond 100 arcsec, likely due to dust scattering in the interstellar medium.Comment: 15 pages, accepted for publication in Ap

Development of the Ketamine Side Effect Tool (KSET)

Background: Currently, no specific, systematic assessment tool for the monitoring and reporting of ketamine-related side effects exists. Our aim was to develop a comprehensive Ketamine Side Effect Tool (KSET) to capture acute and longer-term side effects associated with repeated ketamine treatments. Methods: Informed by systematic review data and clinical research, we drafted a list of the most commonly reported side effects. Face and content validation were obtained via feedback from collaborators with expertise in psychiatry and anaesthetics, clinical trial piloting and a modified Delphi Technique involving ten international experts. Results: The final version consisted of four forms that collect information at time points: screening, baseline, immediately after a single treatment, and longer-term follow-up. Instructions were developed to guide users and promote consistent utilisation. Limitations: Further evaluation of feasibility, construct validity and reliability is required, and is planned across multiple international sites. Conclusions: The structured Ketamine Side Effect Tool (KSET) was developed, with confirmation of content and face validity via a Delphi consensus process. This tool is timely, given the paucity of data regarding ketamine's safety, tolerability and abuse potential over the longer term, and its recent adoption internationally as a clinical treatment for depression. Although based on data from depression studies, the KSET has potential applicability for ketamine (or derivatives) used in other medical disorders, including chronic pain. We recommend its utilisation for both research and clinical scenarios, including data registries