Staphylococcus aureus breast implant infection isolates display recalcitrance to antibiotic pocket irrigants

Breast implant-associated infections (BIAIs) are the primary complication following placement of breast prostheses in breast cancer reconstruction. Given the prevalence of breast cancer, reconstructive failure due to infection results in significant patient distress and health care expenditures. Thus, effective BIAI prevention strategies are urgently needed. This study tests the efficacy of one infection prevention strategy: the use of a triple antibiotic pocket irrigant (TAPI) against Staphylococcus aureus, the most common cause of BIAIs. TAPI, which consists of 50,000 U bacitracin, 1 g cefazolin, and 80 mg gentamicin diluted in 500 mL of saline, is used to irrigate the breast implant pocket during surgery. We use

Semi-quantitative assay to measure urease activity by urinary catheter-associated uropathogens

Catheter-associated urinary tract infections (CAUTIs) are one of the most common healthcare-associated infections in the US, accounting for over 1 million cases annually and totaling 450 million USD. CAUTIs have high morbidity and mortality rates and can be caused by a wide range of pathogens, making empiric treatment difficult. Furthermore, when urease-producing uropathogens cause symptomatic CAUTI or asymptomatic catheter colonization, the risk of catheter failure due to blockage increases. The enzyme urease promotes catheter blockage by hydrolyzing urea in urine into ammonia and carbon dioxide, which results in the formation of crystals that coat the catheter surface. If CAUTI is left untreated, the crystals can grow until they block the urinary catheter. Catheter blockage and subsequent failure reduces the quality of life for the chronically catheterized, as it requires frequent catheter exchanges and can promote more severe disease, including dissemination of the infection to the kidneys or bloodstream. Thus, understanding how urease contributes to catheter blockages and/or more severe disease among the broad range of urease-producing microbes may provide insights into better prevention or treatment strategies. However, clinical assays that detect urease production among clinical isolates are qualitative and prioritize the detection of urease fro

A Prospective Randomized Clinical Trial to Assess Antibiotic Pocket Irrigation on Tissue Expander Breast Reconstruction

Bacterial infection is the most common complication following staged post-mastectomy breast reconstruction initiated with a tissue expander (TE). to limit bacterial infection, antibiotic irrigation of the surgical site is commonly performed despite little high-quality data to support this practice. We performed a prospective randomized control trial to compare the impact of saline irrigation alone to a triple antibiotic irrigation regimen (1 g cefazolin, 80 mg gentamicin, and 50,000 units of bacitracin in 500 mL of saline) for breast implant surgery. The microbiome in breasts with cancer

WHO World Mental Health Surveys International College Student Project: Prevalence and Distribution of Mental Disorders

Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol use disorder, and substance use disorder. We focus on the 13,984 respondents who were full-time students: 35% of whom screened positive for at least one of the common lifetime disorders assessed and 31% screened positive for at least one 12-month disorder. Syndromes typically had onsets in early to middle adolescence and persisted into the year of the survey. Although relatively modest, the strongest correlates of screening positive were older age, female sex, unmarried-deceased parents, no religious affiliation, nonheterosexual identification and behavior, low secondary school ranking, and extrinsic motivation for college enrollment. The weakness of these associations means that the syndromes considered are widely distributed with respect to these variables in the student population. Although the extent to which cost-effective treatment would reduce these risks is unclear, the high level of need for mental health services implied by these results represents a major challenge to institutions of higher education and governments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).status: publishe

Study on multi-ELVES in the Pierre Auger Observatory

Since 2013, the four sites of the Fluorescence Detector (FD) of the Pierre Auger Observatory record ELVES with a dedicated trigger. These UV light emissions are correlated to distant lightning strikes. The length of recorded traces has been increased from 100 μs (2013), to 300 μs (2014-16), to 900 μs (2017-present), to progressively extend the observation of the light emission towards the vertical of the causative lightning and beyond. A large fraction of the observed events shows double ELVES within the time window, and, in some cases, even more complex structures are observed. The nature of the multi-ELVES is not completely understood but may be related to the different types of lightning in which they are originated. For example, it is known that Narrow Bipolar Events can produce double ELVES, and Energetic In-cloud Pulses, occurring between the main negative and upper positive charge layer of clouds, can induce double and even quadruple ELVES in the ionosphere. This report shows the seasonal and daily dependence of the time gap, amplitude ratio, and correlation between the pulse widths of the peaks in a sample of 1000+ multi-ELVES events recorded during the period 2014-20. The events have been compared with data from other satellite and ground-based sensing devices to study the correlation of their properties with lightning observables such as altitude and polarity

Status and performance of the underground muon detector of the Pierre Auger Observatory

The Auger Muons and Infill for the Ground Array (AMIGA) is an enhancement of the Pierre Auger Observatory, whose purpose is to lower the energy threshold of the observatory down to 1016.5 eV, and to measure the muonic content of air showers directly. These measurements will significantly contribute to the determination of primary particle masses in the range between the second knee and the ankle, to the study of hadronic interaction models with air showers, and, in turn, to the understanding of the muon puzzle. The underground muon detector of AMIGA is concomitant to two triangular grids of water-Cherenkov stations with spacings of 433 and 750 m; each grid position is equipped with a 30 m2 plastic scintillator buried at 2.3 m depth. After the engineering array completion in early 2018 and general improvements to the design, the production phase commenced. In this work, we report on the status of the underground muon detector, the progress of its deployment, and the performance achieved after two years of operation. The detector construction is foreseen to finish by mid-2022

Deep-learning based reconstruction of the shower maximum Xmax using the water-Cherenkov detectors of the Pierre Auger Observatory

The atmospheric depth of the air shower maximum Xmax is an observable commonly used for the determination of the nuclear mass composition of ultra-high energy cosmic rays. Direct measurements of Xmax are performed using observations of the longitudinal shower development with fluorescence telescopes. At the same time, several methods have been proposed for an indirect estimation of Xmax from the characteristics of the shower particles registered with surface detector arrays. In this paper, we present a deep neural network (DNN) for the estimation of Xmax. The reconstruction relies on the signals induced by shower particles in the ground based water-Cherenkov detectors of the Pierre Auger Observatory. The network architecture features recurrent long short-term memory layers to process the temporal structure of signals and hexagonal convolutions to exploit the symmetry of the surface detector array. We evaluate the performance of the network using air showers simulated with three different hadronic interaction models. Thereafter, we account for long-term detector effects and calibrate the reconstructed Xmax using fluorescence measurements. Finally, we show that the event-by-event resolution in the reconstruction of the shower maximum improves with increasing shower energy and reaches less than 25 g/cm2 at energies above 2×1019 eV

A combined fit of energy spectrum, shower depth distribution and arrival directions to constrain astrophysical models of UHECR sources

The combined fit of the measured energy spectrum and distribution of depths of shower maximum of ultra-high-energy cosmic rays is known to constrain the parameters of astrophysical scenarios with homogeneous source distributions. Further measurements show that the cosmic-ray arrival directions agree better with the directions and fluxes of catalogs of starburst galaxies and active galactic nuclei than with isotropy. Here, we present a novel combination of both analyses. For that, a three-dimensional universe model containing a nearby source population and a homogeneous background source distribution is built, and its parameters are adapted using a combined fit of the energy spectrum, depth of shower maximum distribution and energy-dependent arrival directions. The model takes into account a symmetric magnetic field blurring, source evolution and interactions during propagation. We use simulated data, which resemble measurements of the Pierre Auger Observatory, to evaluate the method’s sensitivity. With this, we are able to verify that the source parameters as well as the fraction of events from the nearby source population and the size of the magnetic field blurring are determined correctly, and that the data is described by the fitted model including the catalog sources with their respective fluxes and three-dimensional positions. We demonstrate that by combining all three measurements we reach the sensitivity necessary to discriminate between the catalogs of starburst galaxies and active galactic nuclei

Search for upward-going showers with the Fluorescence Detector of the Pierre Auger Observatory

Given its operation time and wide field of view, the Fluorescence Detector (FD) of the Pierre Auger Observatory is sufficiently sensitive to detect upward-going events when used in monocular mode. Upward-going air showers are a possible interpretation of the recent events reported by the ANITA Collaboration in the energy range above 1017 eV. The Pierre Auger FD data can be used to support or constrain this interpretation. If confirmed, it would require either new phenomena or significant modifications to the standard model of particle physics. To prepare this search, a set of quality selection criteria was defined by using 10% of the available FD data from 14 years of operation. This subset was mainly used to clean the data from improperly labelled laser events that had been used to monitor the quality of the atmosphere. The potential background for this search consists of cosmic-ray induced air showers with specific geometric configurations which, in a monocular reconstruction, can be reconstructed erroneously as upward-going events. To distinguish candidates from these false positives, to calculate the exposure, and to estimate the expected background, dedicated simulations for signal (upward-going events) and background (downward-going events) have been performed. The detector exposure is large enough to strongly constrain the interpretation of ANITA anomalous events. Preliminary results of the analysis after unblinding the data set are presented