Multidrug-resistant and methicillin-resistant Staphylococcus aureus (MRSA) in hog slaughter and processing plant workers and their community in North Carolina (USA)

Background: Use of antimicrobials in industrial food-animal production is associated with the presence of antimicrobial resistant Staphylococcus aureus among animals and humans. Hog slaughter/processing plants process large numbers of animals from industrial animal operations, and are environments conducive to the exchange of bacteria between animals and workers. Objectives: To compare the prevalence of methicillin-resistant S. aureus (MRSA) and multidrug resistant S. aureus(MDRSA) carriage between processing plant workers, their household members, and community residents. Methods: We conducted a cross-sectional study of hog slaughter/processing plant workers, their household members, and community residents in North Carolina. Participants responded to a questionnaire and provided a nasal swab. Swabs were tested for S. aureus, and isolates tested for antimicrobial susceptibility and subjected to multilocus sequence typing. Results: The prevalence of S. aureus was 21.6%, 30.2%, and 22.5% among 162 workers, 63 household members, and 111 community residents, respectively. The overall prevalence of MRSA and MDRSA tested by disk diffusion was 4.8% and 6.9%, respectively. The adjusted prevalence of MDRSA among workers was 1.96 times (95% CI: 0.71, 5.45) the prevalence in community residents. The adjusted average number of antimicrobial classes to which S. aureus isolates from workers were resistant was 2.54 times (95% CI: 1.16, 5.56) the number among isolates from community residents. One MRSA isolate and two MDRSA isolates from workers were identified as sequence type 398, a type associated with exposure to livestock. Conclusions: Although the prevalence of S. aureus and MRSA was similar in hog slaughter/processing plant workers and their household and community members, S. aureus isolates from workers were resistant to a greater number of antimicrobial classes. These findings may be related to the non-therapeutic use of antimicrobials in food-animal production

Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service?

Background Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. Methods We evaluated changes in the trends for each procedure after its inclusion in the EBI’s first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. Results Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. Conclusions The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours

Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service?

Background: Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. Methods: We evaluated changes in the trends for each procedure after its inclusion in the EBI’s first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. Results: Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. Conclusions: The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours

Multidrug-Resistant and Methicillin-Resistant Staphylococcus aureus (MRSA) in Hog Slaughter and Processing Plant Workers and Their Community in North Carolina (USA)

Background: Use of antimicrobials in industrial food-animal production is associated with the presence of antimicrobial-resistant Staphylococcus aureus (S. aureus) among animals and humans. Hog slaughter/processing plants process large numbers of animals from industrial animal operations and are environments conducive to the exchange of bacteria between animals and workers

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Inspired by Eisenman: ArchiDNA, a creative shape generative system

Form making is an important and creative act in design. Architects often draw shapes to find design solutions and solve problems. Shape Grammar systems provide automatic shape generation following designer defined rules. Research in Shape Grammar has focused on analyzing existing designs and generating new design patterns (Stiny 1972, Flemming 1990). In this paper, we describe our creative multi-user shape-generative system called ArchiDNA. We built ArchiDNA for designers to specify design style and form generating rules to produce automatically spatial configurations. ArchiDNA is inspired by Peter Eisenman’s design of Biocentrum (Eisenman 1999), an example of form generation from abstract design concepts (Figure 1). Eisenman developed the building form with the concepts of DNA (Figure 2). A DNA chain is composed of four initial shapes A, T, C, and G (2 interlocking pairs) (Figure 3). Observing Eisenman’s design (Figure 4), we found that his principles of form generation are (1): replication of the source forms, (2) rotation of the generative form, (3) rescaling of the generative form to fit the width of the selected form