A Cross-Sectional Survey of the Knowledge, Attitudes, and Practices of Antimicrobial Users and Providers in an Area of High-Density Livestock-Human Population in Western Kenya.

Background: Antimicrobial resistance (AMR) is one of the most important global health crises in recent times and is driven primarily by antimicrobial consumption. In East Africa, there is a paucity of data regarding the knowledge, attitudes, and practices (KAP) related to antimicrobial use (AMU). We investigate the ways in which antimicrobial users in the veterinary sector accessed veterinary antimicrobials, and common behaviors of veterinary antimicrobial users and prescribers associated with AMU and AMR. Methods: In total, 70 farmers, staff at 49 agricultural-veterinary antimicrobial shops (agrovet staff) and 28 veterinary animal healthcare workers or veterinary surgeons (veterinary professionals) were interviewed in Busia county, western Kenya in 2016 using a standard questionnaire as a framework for structured interviews. Data recorded included participant demographics, level of education, access to and sources of veterinary antimicrobials, prescribing patterns, and knowledge of AMR and antimicrobial withdrawal periods. Results: The majority of antimicrobials were accessed through informal means, purchased from agroveterinary shops; more than half of staff did not hold nationally mandated qualifications to advise on or sell veterinary antimicrobials. Approximately 40% of veterinary antimicrobials were sold without a prescription and it was noted that both price and customer preference were important factors when selling antimicrobials in almost all agrovet shops. Knowledge of the dangers associated with AMR and AMU were mostly superficial. Treatment failure occurred often, and there was a lack of differentiation between AMR and simply treatment failure. Conclusion: In this study area in East Africa with high-density human and livestock populations, AMU was primarily for maintenance of livestock health. These findings have highlighted several aspects surrounding inappropriate access to antimicrobials, and as such require attention from policy makers concerned with AMR in both livestock and human medicine sectors. Improving prescribing practices and ensuring a minimum level of general education and awareness of prescribers, as well as expanding the role of agrovet staff in antimicrobial stewardship programmes, may help begin to mitigate the maintenance and transmission of AMR, particularly amongst livestock

Evaluation of a New Global Precipitation Analysis at the US Air Force 557th Weather Wing

No abstract availabl

Laboratory and Clinical Studies of Cardiac Transplantation

Cardiac transplantation was carried out on four patients at the Medical College of Virginia between May and October of 1968, in an effort to salvage them from the terminal stages of otherwise uncorrectable heart disease. Despite a strikingly good early recovery from operation in each case, three of the patients died of acute homograft rejection in one to three weeks; our second case is living and well, ten months after operation, and is at this writing the world\u27s third longest survivor. The world experience to June of 1969 includes about 130 cardiac transplants. Of the first 100 patients operated on over six months ago, 20 are surviving, and the majority of these have returned to a productive existence, demonstrating the feasibility of complete rehabilitation of at least some terminal patients after cardiac transplantation. The high mortality rate--significantly higher than was anticipated--has resulted from acute and chronic homograft rejection and from the equally difficult problem of infection. Certain lessons have been learned from our own experience and from the world experience with this procedure, and these will be reviewed in an attempt to establish the current status and future potential of cardiac transplantation

In vivo construction of recombinant molecules within the Caenorhabditis elegans germ line using short regions of terminal homology

Homologous recombination provides a means for the in vivo construction of recombinant DNA molecules that may be problematic to assemble in vitro. We have investigated the efficiency of recombination within the Caenorhabditis elegans germ line as a function of the length of homology between recombining molecules. Our findings indicate that recombination can occur between molecules that share only 10 bp of terminal homology, and that 25 bp is sufficient to mediate relatively high levels of recombination. Recombination occurs with lower efficiency when the location of the homologous segment is subterminal or internal. As in yeast, recombination can also be mediated by either single- or double-stranded bridging oligonucleotides. We find that ligation between cohesive ends is highly efficient and does not require that the ends be phosphorylated; furthermore, precise intermolecular ligation between injected molecules that have blunt ends can also occur within the germ line

Performance Characteristics of Beamline 6.3.1 from 200 eV to 2000 eV at the Advanced Light Source

Bend magnet beamline 6.3.1 at the Advanced Light Source operates from 200 eV to 2000 eV, primarily used for x-ray absorption fine structure investigations. The beamline optics consist of a compact, entrance-slitless, Hettrick-Underwood type variable-line-spacing plane-grating monochromator and refocusing mirrors to provide a 25 μm × 500 μm spot at the focal point in the reflectometer end station. Wavelength is scanned by the simple rotation of the grating and illuminates a fixed exit slit. The LabView based beamline control and data acquisition computer code has been implemented to provide a convenient interface to the user. The dedicated end station is a reflectometer that is isolated from the beamline by a differential ion pump. The reflectometer can position samples to within 4 μm with an angular position of 0.002°, has total electron and fluorescence yield detectors, and pumps down in about 30 minutes. External end stations can be mounted downstream of the reflectometer as well. The versatility and simplicity of beamline 6.3.1 have made it useful for a wide range of applications such as the characterization of optical components, reflective coatings, and the investigation of a diverse range of materials in both the solid state and in solution

Data Assimilation Enhancements to Air Force Weathers Land Information System

The United States Air Force (USAF) has a proud and storied tradition of enabling significant advancements in the area of characterizing and modeling land state information. 557th Weather Wing (557 WW; DoDs Executive Agent for Land Information) provides routine geospatial intelligence information to warfighters, planners, and decision makers at all echelons and services of the U.S. military, government and intelligence community. 557 WW and its predecessors have been home to the DoDs only operational regional and global land data analysis systems since January 1958. As a trusted partner since 2005, Air Force Weather (AFW) has relied on the Hydrological Sciences Laboratory at NASA/GSFC to lead the interagency scientific collaboration known as the Land Information System (LIS). LIS is an advanced software framework for high performance land surface modeling and data assimilation of geospatial intelligence (GEOINT) information

Effects of Resolution and Spectral Nudging in Simulation the Effects of Wintertime Atmospheric River Landfalls in the Western US

Landfalling atmospheric rivers (ARs) play a crucial role in the climate of the US Pacific coast region as they are frequently related with heavy precipitation and flash flooding events. Thus, the capability of climate models to accurately simulate AR landfalls and their key hydrologic effects is an important practical concern for WUS, from flood forecasting to future water resources projections. In order to examine the effects of model configuration, including the resolution and spectral nudging, in simulating the climatology of key weather events in the conterminous US, a NASA team has performed a hindcast experiment using the GEOS5 global and the NU-WRF regional models for Nov 1999 - Oct 2010. This study examines the skill of these hindcasts, with different models and their configurations, in simulating key footprints of landfalling ARs in the WUS region. Using an AR-landfall chronology based on the vertically-integrated water vapor flux calculated from the MERRA2 reanalysis, we have analyzed the observed and simulated precipitation and temperature anomalies associated with wintertime AR landfalls along the US Pacific coast. Model skill is measured using metrics including regional means, a skill score based on correlations and mean-square errors, and Taylor diagrams in four WUS Bukovsky regions. Results show that the AR-related anomalies of precipitation is more reliable than of surface temperatures. Model skill also varies according to regions. The AR temperature anomalies are well simulated in most of the WUS region except PNW. For precipitation, simulations with finer spatial resolution tend to generate larger spatial variability and agree better with the PRISM data in most regions. Such a resolution dependence of spatial variability is not found for temperatures; e.g., the MERRA2 reanalysis often outperforms, with similar spatial variability and higher pattern correlations with the PRISM data, finer-resolution NU-WRF runs in simulating temperature variations within subregions. Results from this study will be summarized to assist future (regional) climate experiments for climate change impact assessments and developing adaptationmitigation strategies, the key elements of the National Climate Assessment

Allocation mechanisms, incentives, and endemic institutional externalities

Whether an economic agent’s decision creates an externality often depends on the institutional context in which the decision was made. Indeed, in orthodox economics, a technological or exogenous externality occurs just in case one agent’s economic welfare or production possibilities are directly affected by the market decisions of other agents. A pecuniary externality occurs just in case one consumer’s economic welfare or producer’s profit is affected indirectly by price changes caused by changes in other agents’ decisions. Similarly, an institutional or endogenous externality may arise whenever allocations are determined by a mechanism that is not strategy proof for some agent. Then even a resource balance constraint creates an institutional externality except in special cases such as when no individual agent’s action can affect market clearing prices — i.e., there are no pecuniary externalities

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin