Attributable costs of surgical site infection and endometritis after low transverse cesarean delivery

BACKGROUND: Accurate data on costs attributable to hospital-acquired infections are needed in order to determine their economic impact and the cost-benefit of potential preventive strategies. OBJECTIVE: Determine the attributable costs of surgical site infection (SSI) and endometritis (EMM) after cesarean section using two different methods. DESIGN: Retrospective cohort. SETTING: Barnes-Jewish Hospital, a 1250-bed academic tertiary care hospital. PATIENTS: 1,605 women who underwent low transverse cesarean section from 7/1999 – 6/2001. METHODS: Attributable costs of SSI and EMM were determined by generalized least squares (GLS) and propensity score matched-pairs using administrative claims data to define underlying comorbidities and procedures. For the matched-pairs analyses, uninfected control patients were matched to patients with SSI or with EMM based on their propensity to develop infection, and the median difference in costs calculated. RESULTS: The attributable total hospital cost of SSI calculated by GLS was $3,529 and by propensity score matched-pairs was$2,852. The attributable total hospital cost of EMM calculated by GLS was $3,956 and by propensity score matched-pairs was$3,842. The majority of excess costs were associated with room and board and pharmacy costs. CONCLUSIONS: The costs of SSI and EMM were lower than SSI costs reported after more extensive operations. The attributable costs of EMM calculated using the two methods were very similar, while the costs of SSI calculated using propensity score matched-pairs were lower than the costs calculated by GLS. The difference in costs determined by the two methods needs to be considered by investigators performing cost analyses of hospital-acquired infections

Large Momentum Transfer Measurements of the Deuteron Elastic Structure Function A(Q^2) at Jefferson Laboratory

The deuteron elastic structure function A(Q^2) has been extracted in the Q^2 range 0.7 to 6.0 (GeV/c)^2 from cross section measurements of elastic electron-deuteron scattering in coincidence using the Hall A Facility of Jefferson Laboratory. The data are compared to theoretical models based on the impulse approximation with inclusion of meson-exchange currents, and to predictions of quark dimensional scaling and perturbative quantum chromodynamicsComment: Submitted to Physical Review Letter

The deuteron: structure and form factors

A brief review of the history of the discovery of the deuteron in provided. The current status of both experiment and theory for the elastic electron scattering is then presented.Comment: 80 pages, 33 figures, submited to Advances in Nuclear Physic

Time-resolved transcriptome and proteome landscape of human regulatory T cell (Treg) differentiation reveals novel regulators of FOXP3

Background: Regulatory T cells (Tregs) expressing the transcription factor FOXP3 are crucial mediators of self-tolerance, preventing autoimmune diseases but possibly hampering tumor rejection. Clinical manipulation of Tregs is of great interest, and first-in-man trials of Treg transfer have achieved promising outcomes. Yet, the mechanisms governing induced Treg (iTreg) differentiation and the regulation of FOXP3 are incompletely understood.Results: To gain a comprehensive and unbiased molecular understanding of FOXP3 induction, we performed time-series RNA sequencing (RNA-Seq) and proteomics profiling on the same samples during human iTreg differentiation. To enable the broad analysis of universal FOXP3-inducing pathways, we used five differentiation protocols in parallel. Integrative analysis of the transcriptome and proteome confirmed involvement of specific molecular processes, as well as overlap of a novel iTreg subnetwork with known Treg regulators and autoimmunity-associated genes. Importantly, we propose 37 novel molecules putatively involved in iTreg differentiation. Their relevance was validated by a targeted shRNA screen confirming a functional role in FOXP3 induction, discriminant analyses classifying iTregs accordingly, and comparable expression in an independent novel iTreg RNA-Seq dataset.Conclusion: The data generated by this novel approach facilitates understanding of the molecular mechanisms underlying iTreg generation as well as of the concomitant changes in the transcriptome and proteome. Our results provide a reference map exploitable for future discovery of markers and drug candidates governing control of Tregs, which has important implications for the treatment of cancer, autoimmune, and inflammatory diseases

Co-regulation of a large and rapidly evolving repertoire of odorant receptor genes

The olfactory system meets niche- and species-specific demands by an accelerated evolution of its odorant receptor repertoires. In this review, we describe evolutionary processes that have shaped olfactory and vomeronasal receptor gene families in vertebrate genomes. We emphasize three important periods in the evolution of the olfactory system evident by comparative genomics: the adaptation to land in amphibian ancestors, the decline of olfaction in primates, and the delineation of putative pheromone receptors concurrent with rodent speciation. The rapid evolution of odorant receptor genes, the sheer size of the repertoire, as well as their wide distribution in the genome, presents a developmental challenge: how are these ever-changing odorant receptor repertoires coordinated within the olfactory system? A central organizing principle in olfaction is the specialization of sensory neurons resulting from each sensory neuron expressing only ~one odorant receptor allele. In this review, we also discuss this mutually exclusive expression of odorant receptor genes. We have considered several models to account for co-regulation of odorant receptor repertoires, as well as discussed a new hypothesis that invokes important epigenetic properties of the system