The expert panel report to Texas health resources leadership on the 2014 ebola events

Full text attached hereThis report is the work of an Expert Panel convened by Texas Health Resources (THR) Chief Executive Officer Barclay Berdan, with the authorization and support of the THR and Texas Health Presbyterian Hospital Dallas (THD) Board of Trustees, following the Ebola Virus Disease (EVD) events of 2014. Under the leadership of Dr. Denis Cortese, the Expert Panel—including Patricia Abbott RN PhD, Mark Chassin, MD, Marshall Lyon MD, andWayne Riley MD—were charged with reviewing the fact pattern associated with events surrounding the care and ultimate death of Mr. Thomas Eric Duncan from EVD and the transmission of the virus to two nurses. This report outlines recommendations to the Board and to THR and Texas Health Presbyterian Dallas (THD) leadership for improving the hospital’s and health system’s performance and preparation for similar unforeseen, novel and rare but significant future events.While specifically directed toward the future operations of THD and Texas Health Resources, these recommendations also present an opportunity for other hospitals and health systems to review and learn so that they also may prepare for unanticipated and potentially catastrophic events. It is critically important that healthcare providers with the primary role of caring for patients work as a cohesive team. It is equally important that hospitals and health systems understand clearly how to plan and work with local, state, and federal government agencies as well as public health partners at all levels to ensure that each health facility across the U.S. healthcare system is prepared for novel events such as the nation experienced last fall when the first Ebola patient was diagnosed in the United States.Texas Health Resourceshttps://deepblue.lib.umich.edu/bitstream/2027.42/145616/1/Expert_Panel_Report_to_THR_on_EVD_response.pdfDescription of Expert_Panel_Report_to_THR_on_EVD_response.pdf : Ebola Report from Blue Ribbon Pane

Beyond the security paradox:Ten criteria for a socially informed security policy

This article is based on a research that has been funded by the EU project “SurPriSe: Surveillance, Privacy and Security: A large scale participatory assessment of criteria and factors determining acceptability and acceptance of security technologies in Europe”, which received funding from the FP7 program, under the grant number: 285492.This article investigates the normative and procedural criteria adopted by European citizens to assess the acceptability of surveillance-oriented security technologies. It draws on qualitative data gathered at 12 citizen summits in nine European countries. The analysis identifies 10 criteria, generated by citizens themselves, for a socially informed security policy. These criteria not only reveal the conditions, purposes and operation rules that would make current European security policies and technologies more consistent with citizens’ priorities. They also cast light on an interesting paradox: although people feel safe in their daily lives, they believe security could, and should, be improved.PostprintPeer reviewe

The epidemiology and outcomes of invasive \u3ci\u3eCandida\u3c/i\u3e infections among organ transplant recipients in the United States: results of the Transplant-Associated Infection Surveillance Network (TRANSNET)

Background: Invasive candidiasis (IC) is a common cause of mortality in solid organ transplant recipients (OTRs), but knowledge of epidemiology in this population is limited. Method: The present analysis describes data from 15 US centers that prospectively identified IC from nearly 17 000 OTRs. Analyses were undertaken to determine predictors of infection and mortality. Results: A total of 639 cases of IC were identified. The most common species was Candida albicans (46.3%), followed by Candida glabrata (24.4%) and Candida parapsilosis (8.1%). In 68 cases \u3e1 species was identified. The most common infection site was bloodstream (44%), followed by intra-abdominal (14%). The most frequently affected allograft groups were liver (41.1%) and kidney (35.3%). All-cause mortality at 90 days was 26.5% for all species and was highest for Candida tropicalis (44%) and C. parapsilosis (35.2%). Non-white race and female gender were more commonly associated with non-albicans species. A high rate of breakthrough IC was seen in patients receiving antifungal prophylaxis (39%). Factors associated with mortality include organ dysfunction, lung transplant, and treatment with a polyene antifungal. The only modifiable factor identified was choice of antifungal drug class based upon infecting Candida species. Conclusion: These data highlight the common and distinct features of IC in OTRs

Ebola Virus Persistence in Semen of Male Survivors

We investigated the duration of Ebola virus (EBOV) RNA and infectious EBOV in semen specimens of 5 Ebola virus disease (EVD) survivors. EBOV RNA and infectious EBOV was detected by real-time RT-PCR and virus culture out to 290 days and 70 days, respectively, after EVD onset

A fatal pseudo-tumour: disseminated basidiobolomycosis

BACKGROUND: Basidiobolomycosis is a rare disease caused by the fungus Basidiobolus ranarum, member of the class Zygomycetes, order Entomophthorales, found worldwide. Usually basidiobolomycosis is a subcutaneous infection but rarely gastrointestinal manifestations have been described; 13 adults and 10 children and a few retroperitoneal or pulmonary cases. In gastrointestinal basidiobolomycosis the colon is most frequently involved, usually presenting with subacute mild abdominal pain. In contrast to children only very few described adult patients had hepatic masses. Definitive diagnosis requires culture, serological testing can be helpful. The fungal morphology and the Splendore-Hoeppli phenomenon are characteristic histological features. There are no prominent risk factors. Usually surgery and prolonged antifungal therapy are required. CASE PRESENTATION: A 61 year old man presented with progressive left abdominal pain and constipation since a few months. Colonoscopy showed an obstructing tumour in the descending colon, and a hemicolectomy was performed. Histology showed inflammation, possibly caused by a fungal or parasitic infection, without definite identification of an organism. A few weeks postoperatively a CT scan made because of abdominal discomfort, revealed a livermass (6 cm). Treatment with metronidazole, directed against an amoebic liver abscess, was unsuccessful. He developed a marked eosinophilia (27.7%). A liver biopsy was performed and the patient was referred to a university hospital. A repeated CT scan showed a livermass of 9 cm diameter. Review of colon and liver biopsy samples showed extensive necrosis and histiocytes, multinucleated giant cells and numerous eosinophils. Grocott stained sections contained unusually large hyphae surrounded by strongly eosinophilic material in haematoxylin and eosin stained sections (Splendore-Hoeppli phenomenon). A presumptive diagnosis of Basidiobolus spp. infection was made and treated with amphotericin B (Itraconazol contra-indicated because of renal insufficiency). A few days later the patient died of a septic shock. After autopsy Basidiobolus ranarum was cultured from liver, gallbladder and colon. CONCLUSION: Our patient died of gastrointestinal basidiobolomycosis with an obstructing colon tumour and a large hepatic mass. This was a rare presentation of basidiobolomycosis and the second fatal case described worldwide

Search for Squarks and Gluinos in Events Containing Jets and a Large Imbalance in Transverse Energy

Using data corresponding to an integrated luminosity of 79 pb-1, D0 has searched for events containing multiple jets and large missing transverse energy in pbar-p collisions at sqrt(s)=1.8 TeV at the Fermilab Tevatron collider. Observing no significant excess beyond what is expected from the standard model, we set limits on the masses of squarks and gluinos and on the model parameters m_0 and m_1/2, in the framework of the minimal low-energy supergravity models of supersymmetry. For tan(beta) = 2 and A_0 = 0, with mu < 0, we exclude all models with m_squark < 250 GeV/c^2. For models with equal squark and gluino masses, we exclude m < 260 GeV/c^2.Comment: 10 pages, 3 figures, Submitted to PRL, Fixed typo on page bottom of p. 6 (QCD multijet background is 35.4 events

Measurement of the Top Quark Pair Production Cross Section in the All-jets Decay Channel

We present a measurement of tbar-t production using multijet final states in pbar-p collisions at a center-of-mass energy of 1.8 TeV, with an integrated luminosity of 110.3 pb(-1). The analysis has been optimized using neural networks to achieve the smallest expected fractional uncertainty on the tbar-t production cross section, and yields a cross section of 7.1 +/- 2.8(stat.) +/- 1.5(syst.) pb, assuming a top quark mass of 172.1 GeV/c^(2). Combining this result with previous D0 measurements, where one or both of the W bosons decay leptonically, gives a tbar-t production cross section of 5.9 +/- 1.2(stat) +/- 1.1(syst) pb.Comment: 6 pages, 3 figures; no substative change in revisio

Search for Charged Higgs Bosons in Decays of Top Quark Pairs

We present a search for charged Higgs bosons in decays of pair-produced top quarks using 109.2 +- 5.8 pb^-1 of data recorded from ppbar collisions at sqrt{s} = 1.8 TeV by the D0 detector during 1992-96 at the Fermilab Tevatron. No evidence is found for charged Higgs production, and most parts of the [m(H+),tan(beta)] parameter space where the decay t -> bH+ has a branching fraction close to or larger than that for t -> bW+ are excluded at 95% confidence level. Assuming m(t) = 175 GeV and sigma(ppbar -> ttbar) = 5.5 pb, for m(H+) = 60 GeV, we exclude tan(beta) 40.9.Comment: 11 pages, 3 figures, submitted to PR

Search for Top Squark Pair Production in the Dielectron Channel

This report describes the first search for top squark pair production in the channel stop_1 stopbar_1 -> b bbar chargino_1 chargino_1 -> ee+jets+MEt using 74.9 +- 8.9 pb^-1 of data collected using the D0 detector. A 95% confidence level upper limit on sigma*B is presented. The limit is above the theoretical expectation for sigma*B for this process, but does show the sensitivity of the current D0 data set to a particular topology for new physics.Comment: Five pages, including three figures, submitted to PRD Brief Report

The Azimuthal Decorrelation of Jets Widely Separated in Rapidity

This study reports the first measurement of the azimuthal decorrelation between jets with pseudorapidity separation up to five units. The data were accumulated using the D{\O}detector during the 1992--1993 collider run of the Fermilab Tevatron at $\sqrt{s}=$ 1.8 TeV. These results are compared to next--to--leading order (NLO) QCD predictions and to two leading--log approximations (LLA) where the leading--log terms are resummed to all orders in $\alpha_{\scriptscriptstyle S}$. The final state jets as predicted by NLO QCD show less azimuthal decorrelation than the data. The parton showering LLA Monte Carlo {\small HERWIG} describes the data well; an analytical LLA prediction based on BFKL resummation shows more decorrelation than the data.Comment: 6 pages with 4 figures, all uuencoded and gzippe