The impact of hospital-acquired bloodstream infections.

Nosocomial bloodstream infections are a leading cause of death in the United States. If we assume a nosocomial infection rate of 5%, of which 10% are bloodstream infections, and an attributable mortality rate of 15%, bloodstream infections would represent the eighth leading cause of death in the United States. Because most risk factors for dying after bacteremia or fungemia may not be changeable, prevention efforts must focus on new infection-control technology and techniques

Measuring overlaps in mesoscopic spin glasses via conductance fluctuations

We consider the electonic transport in a mesoscopic metallic spin glasses. We show that the distribution of overlaps between spin configurations can be inferred from the reduction of the conductance fluctuations by the magnetic impurities. Using this property, we propose new experimental protocols to probe spin glasses directly through their overlaps

Barriers in physical access to maternal health services in rural Ethiopia.

BACKGROUND: Identifying women with poor access to health services may inform strategies for improving maternal and child health outcomes. The aim of this study was to explore risk factors associated with access to health facilities (in terms of physical distance) among women of reproductive age (15-49 years) in Dabat district, a rural area of north-western Ethiopia. METHODS: A randomly selected cross sectional survey of 1,456 rural households was conducted. Data were collected during home visits. Data on household assets and socio-demographic data (including age, education level, occupation, religion and ethnicity) were collected on 1,420 women. A geographic information system (GIS) was used to map locations of all households, the district health centre and the smaller health posts. Travel time from households to health facilities was estimated, incorporating information on the topography and terrain of the area. The primary outcomes were: 1) travel time from household to nearest health post 2) travel time from household to health centre. Analysis was conducted using multiple linear regression models and likelihood ratio tests. RESULTS: This study found evidence that educated women lived closer to health centres than uneducated women (adjusted mean difference (adj MD) travel time -41 min (95% CI: -50,-31)) in this community. Woman's age was also associated with distance to the health centre. Women aged 15-20 years were more likely to live in a poor access area compared with women aged 21-30 years (adj MD travel time -11 min (95% CI: -23, 0)), and with women aged 31-49 years (adj MD travel time -32 min (95% CI: -47,-17)). There was no evidence to suggest that travel time to the health centre was associated with household wealth. CONCLUSIONS: Our main aim was to address the almost total lack of research evidence on what socio-demographic characteristics of women of reproductive age influence access to health facilities (in terms of physical distance). We have done so by reporting that our study found an association that women with no education and women who are younger live, on average, further away from a health facility in this rural Ethiopian community. While we have generated this valuable information to those who are responsible for providing maternal and child health services locally, to fully understand access in health care and to promote equitable access to health care, our study could thus be extended to other components of access and explore how our findings fit into the wider context of other factors influencing maternal health outcomes and utilisation of maternal health services such as antenatal care or delivery at health facility

Modeling Adaptation with Klaim

In recent years, it has been argued that systems and applications, in order to deal with their increasing complexity, should be able to adapt their behavior according to new requirements or environment conditions. In this paper, we present an investigation aiming at studying how coordination languages and formal methods can contribute to a better understanding, implementation and use of the mechanisms and techniques for adaptation currently proposed in the literature. Our study relies on the formal coordination language Klaim as a common framework for modeling some well-known adaptation techniques: the IBM MAPE-K loop, the Accord component-based framework for architectural adaptation, and the aspect- and context-oriented programming paradigms. We illustrate our approach through a simple example concerning a data repository equipped with an automated cache mechanism

Utility of surveillance blood cultures in patients undergoing hematopoietic stem cell transplantation

Background Surveillance blood cultures are often obtained in hematopoietic stem cell transplant (HSCT) patients for detection of bloodstream infection. The major aims of this retrospective cohort study were to determine the utility of the practice of obtaining surveillance blood cultures from asymptomatic patients during the first 100 post-transplant days and to determine if obtaining more than one positive blood culture helps in the diagnosis of bloodstream infection. Methods We conducted a 17-month retrospective analysis of all blood cultures obtained for patients admitted to the hospital for HSCT from January 2010 to June 2011. Each patient’s clinical course, vital signs, diagnostic testing, treatment, and response to treatment were reviewed. The association between number of positive blood cultures and the final diagnosis was analyzed. Results Blood culture results for 205 patients were reviewed. Cultures obtained when symptoms of infection were present (clinical cultures) accounted for 1,033 culture sets, whereas 2,474 culture sets were classified as surveillance cultures (no symptoms of infection were present). The total number of positive blood cultures was 185 sets (5.3% of cultures obtained) and accounted for 84 positive culture episodes. Incidence of infection in autologous, related allogeneic and unrelated allogeneic transplants was 8.3%, 20.0%, and 28.6% respectively. Coagulase-negative staphylococci were the most common organisms isolated. Based on our application of predefined criteria there were 29 infections and 55 episodes of positive blood cultures that were not infections. None of the patients who developed infection were diagnosed by surveillance blood cultures. None of the uninfected patients with positive blood cultures showed any clinical changes after receiving antibiotics. There was a significant difference between the incidence of BSI in the first and second 50-day periods post-HSCT. There was no association between the number of positive blood cultures and the final diagnosis. Conclusion Surveillance blood cultures in patients who have undergone HSCT do not identify bloodstream infections. The number of positive blood cultures was not helpful in determining which patients had infection. Patients are at higher risk of infection in the first 50 days post-transplant period

The flail mitral valve: Echocardiographic findings by precordial and transesophageal imaging and doppler color flow mapping

AbstractTo determine the echocardiographic and Doppler characteristics of mitral regurgitation associated with a flail mitral valve, precordial and transesophageal echocardiography with pulsed wave and Doppler color flow mapping was performed in 17 patients with a flail mitral valve leaflet due to ruptured chordae tendineae (Group I) and 22 patients with moderate or severe mitral regurgitation due to other causes (Group II). Echocardiograms were performed before or during cardiac surgery; cardiac catheterization was also performed in 28 patients (72%). Mitral valve disease was confirmed at cardiac surgery in all patients.By echocardiography, the presence of a flail mitral valve leaflet was defined by the presence of abnormal mitral leaflet ccaptation or ruptured chordae. Using these criteria, transesophageal imaging showed a trend toward greater sensitivity and specificity than precordial imaging in the diagnosis of flail mitral valve leaflet. By Doppler color flow mapping, a flail mitral valve leaflet was also characterized by an eccentric, peripheral, circular mitral regurgitant jet that closely adhered to the walls of the left atrium. The direction of flow of the eccentric jet in the left atrium distinguished a flail anterior from a flail posterior leaflet. By transesophageal echocardiography with Doppler color flow mapping, the ratio of mitral regurgitant jet arc length to radius of curvature was significantly higher in Group I than Group II patients (5.0 ± 2.3 versus 0.7 ± 0.6, p < 0.001); all of the Group I patients and none of the Group II patients had a ratio >2.5.Thus, transesophageal imaging with Doppler color flow mapping of mitral regurgitation is complementary to precordial echocardiography in the diagnosis and localization of flail mitral valve leaflet due to ruptured chordae tendineae

Single-top-squark production via R-parity-violating supersymmetric couplings in hadron collisions

Single-top-squark production via q q' -> \bar{\tilde{t_1}} probes R-parity-violating extensions of the minimal supersymmetric standard model though the \lambda''_{3ij} couplings. For masses in the range 180-325 GeV, and \lambda''_{3ij} > 0.02-0.06, we show that discovery of the top squark is possible with 2 fb^{-1} of integrated luminosity at run II of the Fermilab Tevatron. The bound on \lambda''_{3ij}$ can be reduced by up to an order of magnitude with existing data from run I, and by two orders of magnitude at run II if the top squark is not found.Comment: To appear in Phys. Rev. Lett., minor changes, 4 pages, RevTeX, 5 eps fig

Superconducting instability in 3 band metallic nanotubes

Motivated by recent experiments on small radius nanotubes, we study the superconducting instabilities of cylindrical (5,0) nanotubes. According to band structure calculations, thesenanotubes possess three bands at the Fermi energy. Using a fermionic renormalization group approach and a careful bosonization treatment,we consider the effect of different attractive interactions, mediated by phonons, within the Luttinger Liquid framework. We particularly focus on a superconducting instability specific to the three bands model we consider for the description of these (5,0) cylindrical nanotubes.Comment: RevTeX 4, 17 pages, 10 EPS figure

Digital storytelling and Co-creative Media: The role of community arts and media in propagating and coordinating population-wide creative practice

How is creative expression and communication extended among whole populations? What is the social and cultural value of this activity? What roles do formal agencies, community-based organisations and content producer networks play? Specifically, how do participatory media and arts projects and networks contribute to building this capacity in the contemporary communications environment

Production of a Prompt Photon in Association with Charm at Next-to-Leading Order in QCD

A second order, $O(\alpha ^2_s)$, calculation in perturbative quantum chromodynamics of the two particle inclusive cross section is presented for the reaction $p +\bar{p}\rightarrow \gamma + c + X$ for large values of the transverse momentum of the prompt photon and charm quark. The combination of analytic and Monte Carlo integration methods used here to perform phase-space integrations facilitates imposition of photon isolation restrictions and other selections of relevance in experiments. Differential distributions are provided for various observables. Positive correlations in rapidity are predicted.Comment: 27 pages in RevTex plus 14 figures in one compressed PS fil