Effective antibiotic conservation by emergency antimicrobial stewardship during a drug shortage

We present the first description of an antimicrobial stewardship program (ASP) used to successfully manage a multi-antimicrobial drug shortage. Without resorting to formulary restriction, meropenem utilization decreased by 69% and piperacillin-tazobactam by 73%. During the shortage period, hospital mortality decreased (P=.03), while hospital length of stay remained unchanged.Infect Control Hosp Epidemiol 2017;38:356–359</jats:p

J Am Dent Assoc

BackgroundAntibiotic prescribing practices among dentists and dental specialists in the United States (US) remains poorly understood. The purpose of our study is to compare prescribing practices between dental specialties, evaluate the duration of antibiotics prescribed by dentists, and determine variation in antibiotic selection among dentists.MethodsWe performed a retrospective cross-sectional analysis of dental provider specialties linked to de-identified antibiotic claims data from a large pharmacy benefits manager during the 2015 calendar year.ResultsAs a group, general dentists and dental specialists were responsible for over 2.7 million antibiotic prescriptions, higher than several other medical and allied health provider specialties. Antibiotic treatment duration was generally prolonged and commonly included broad-spectrum agents, such as amoxicillin-clavulanate and clindamycin. Although amoxicillin was the most commonly prescribed antibiotic among all dental specialties, there was significant variation among other antibiotics selected by each specialty. The most common antibiotic treatment durations were for 7 and 10 days.ConclusionsThis study demonstrates that dentists frequently prescribe antibiotics for prolonged periods of time and often use broad-spectrum antibiotics. Further studies are necessary to evaluate the appropriateness of these antibiotic prescribing patterns.Practical ImplicationsThe significant variation in antibiotic selection and treatment duration identified among all dental specialties in this study population implies that further research and guidance into the treatment of dental infections is necessary to improve and standardize antibiotic prescribing practices.KL2 TR002346/TR/NCATS NIH HHS/United StatesUL1 TR000448/TR/NCATS NIH HHS/United StatesU54 CK000482/CK/NCEZID CDC HHS/United StatesUL1 TR002345/TR/NCATS NIH HHS/United StatesKL2 TR000450/TR/NCATS NIH HHS/United StatesU54 CK000482/CK/NCEZID CDC HHS/United States2018-12-01T00:00:00Z28941554PMC57055696517vault:2526

The influence of toughening-particles in CFRPs on low velocity impact damage resistance performance

The role of particle-toughening for increasing impact damage resistance in carbon fibre reinforced polymer (CFRP) composites was investigated. Five carbon fibre reinforced systems consisting of four particle-toughened matrices and one system containing no toughening particles were subjected to low velocity impacts ranging from 25 J to 50 J to establish the impact damage resistance of each material system. Synchrotron radiation computed tomography (SRCT) enabled a novel approach for damage assessment and quantification. Toughening mechanisms were detected in the particle-toughened systems consisting of particle–resin debonding, crack-deflection and crack-bridging. Quantification of the bridging behaviour, increase in crack path length and roughness was undertaken. Out of the three toughening mechanisms measured, particle systems exhibited a larger extent of bridging suggesting a significant contribution of this toughening mechanism compared to the system with no particle

A Case of Bowen’s Disease and Small-Cell Lung Carcinoma: Long-Term Consequences of Chronic Arsenic Exposure in Chinese Traditional Medicine

Chronic arsenic toxicity occurs primarily through inadvertent ingestion of contaminated water and food or occupational exposure, but it can also occur through medicinal ingestion. This case features a 53-year-old lifetime nonsmoker with chronic asthma treated for 10 years in childhood with Chinese traditional medicine containing arsenic. The patient was diagnosed with Bowen’s disease and developed extensive-stage small-cell carcinoma of the lung 10 years and 47 years, respectively, after the onset of arsenic exposure. Although it has a long history as a medicinal agent, arsenic is a carcinogen associated with many malignancies including those of skin and lung. It is more commonly associated with non–small-cell lung cancer, but the temporal association with Bowen’s disease in the absence of other chemical or occupational exposure strongly points to a causal role for arsenic in this case of small-cell lung cancer. Individuals with documented arsenic-induced Bowen’s disease should be considered for more aggressive screening for long-term complications, especially the development of subsequent malignancies

A Study on the Growth and Formation of Single Person Households and Their Housing Decisions in Taiwan

The number of single person households has dramatically increased in Taiwan in the past several decades as it has elsewhere in the world, but this phenomenon has been largely neglected in the literature. This research explores the factors that affect the formation of single person households and their housing decisions. Taiwan¡¦s population census data for 1980, 1990 and 2000 are used. Some interesting trends can be found. First of all, people who are married or cohabiting have exhibited an increasing tendency to live alone census by census. This shows the increasing need in a modern society for the husband and wife to live separately due to employment or other reasons. Secondly, unmarried and widowed elderly persons have had an increasing probability of living alone over the decades. Thirdly, the number of female single person households has been increasing rapidly, and there is a higher probability that they are homeowners and also occupying a larger living space than their male counterparts. To sum up, the results of this study show that the demand for housing among single person households will continue to increase as their numbers increase. Their demand for homeownership and living space are also increasing.Single person household formation; Tenure choice; Living space; Binary probit model; Sample selection model

Accommodation: How You See It, How You Don’t

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87060/1/j.1600-6143.2011.03648.x.pd

Semileptonic decay constants of octet baryons in the chiral quark-soliton model

Based on the recent study of the magnetic moments and axial constants within the framework of the chiral quark-soliton model, we investigate the baryon semileptonic decay constants $(f_1,f_2)$ and $(g_1, g_2)$. Employing the relations between the diagonal transition matrix elements and off-diagonal ones in the vector and axial-vector channels, we obtain the ratios of baryon semileptonic decay constants $f_2/f_1$ and $g_1/f_1$. The $F/D$ ratio is also discussed and found that the value predicted by the present model naturally lies between that of the Skyrme model and that of the nonrelativistic quark model. The singlet axial constant $g^{(0)}_A$ can be expressed in terms of the $F/D$ ratio and $g^{(3)}_A$ in the present model and turns out to be small. The results are compared with available experimental data and found to be in good agreement with them. In addition, the induced pseudotensor coupling constants $g_2/f_1$ are calculated, the SU(3) symmetry breaking being considered. The results indicate that the effect of SU(3) symmetry breaking might play an important role for some decay modes in hyperon semileptonic decay.Comment: 16 pages, RevTeX is used. No figure. Accepted for publication in Phys. Rev.