Clostridium difficile infection among veterans health administration patients

OBJECTIVETo report on the prevalence and incidence of Clostridium difficile infection (CDI) from 2009 to 2013 among Veterans Healthcare Administration patientsDESIGNA retrospective descriptive analysis of data extracted from a large electronic medical record (EMR) databaseSETTINGData were acquired from VHA healthcare records from 2009 to 2013 that included outpatient clinical visits, long-term care, and hospitalized care as well as pharmacy and laboratory information.RESULTSIn 2009, there were 10,207 CDI episodes, and in 2013, there were 12,143 CDI episodes, an increase of 19.0%. The overall CDI rate increased by 8.4% from 193 episodes per 100,000 patient years in 2009 to 209 episodes per 100,000 patient years in 2013. Of the CDI episodes identified in 2009, 58% were identified during a hospitalization, and 42% were identified in an outpatient setting. In 2013, 44% of the CDI episodes were identified in an outpatient setting.CONCLUSIONThis is one of the largest studies that has utilized timely EMR data to describe the current CDI epidemiology at the VHA. Despite an aging population with greater burden of comorbidity than the general US population, our data show that VHA CDI rates stabilized between 2011 and 2013 following increases likely attributable to the introduction of the more sensitive nucleic acid amplification tests (NAATs). The findings in this report will help establish an accurate benchmark against which both current and future VA CDI prevention initiatives can be measured.Infect. Control Hosp. Epidemiol. 2015;36(9):1038–1045</jats:sec

A Mendelian polymorphism underlying quantitative variations of goat αs1-casein

Using SDS-polyacrylamide gel electrophoresis and rocket immunoelectrophoresis, 3 new alleles, designated αs1-CnB-,αs1-CnF and αs1-Cno, were identified at the goat αs1-Cn locus, in addition to alleles αs1-CnA, αs1-CnB and αs1-CnC previously reported by BOULANGER al. (1984). Alleles αs1-CnA, αs1-CnB and αs1-CnC are associated with a high content of αs1-casein (approximate mean contribution of each allele being 3.6 g/I) compared to αs1-CnF with a low content (0.6 g/I) and αs1-CnB- with an intermediate content (1.6 g/1) ; αs1-Cno appears to be a true null allele. In a sample of 213 Alpine females from 49 flocks in West Central France, the frequencies of the 6 alleles were : αs1-CnA = 0.14 ; αs1-CnB = 0.05 ; αs1-CnC = 0.01 ; αs1-CnB- = 0.34 ; αs1-CnF = 0.41 ; and αs1-Cno = 0.05. In a sample of 159 Saanen females from 52 flocks of the same region, the frequencies were : αs1-CnA = 0.07 ; αs1-CnB = 0.06 ; αs1-CnC = 0 ; αs1-CnB- = 0.41 ; αs1-CnF = 0.43 ; αs1-Cno = 0.03. Additional data confirm that loci αs1-Cn and αs2-Cn are closely linked. Preliminary investigations indicated a significant superiority in casein content of milks from goats possessing the allele αs1-CnA, as compared to that of milks from goats of genotypes αs1-CnF / αs1-CnF and αs1-CnB- /αs1-CnF and, in a large herd (N = 251), a strong correlation was observed between the αs1-casein content and the rennet-casein content of milk (r = 0.68 ; b = 0.64).A l’aide d’électrophorèses en gel de polyacrylamide SDS et d’immuno-électrophorèses « rocket », 3 allèles, appelés αs1-CnB-, αs1-CnF et αs1-Cno ont été identifiées au locus αs1-Cn de la chèvre, en plus des allèles αs1-CnA, αs1-CnB et αs1-CnC déjà détectés par BOULANGER et al. (1984). Les allèles αs1-CnA, αs1-CnB et αs1-CnC sont associés à un taux élevé de caséine αs1 (contribution approximative de chaque allèle : 3,6 g/I), l’allèle αs1-CnF a un taux faible (0,6 g/I) et l’allèle αs1-CnB a un taux intermédiaire (1,6 g/1). Dans un échantillon de 213 femelles Alpine provenant de 49 troupeaux du centre-ouest de la France, les fréquences des 6 allèles actuellement identifiés étaient les suivantes : αs1-CnA = 0,14 ; αs1-CnB = 0,05 ; αs1-CnC = 0,01; αs1-CnB- = 0,34 ; αs1-CnF = 0,41 et αs1-Cno = 0,05. Dans un échantillon de 159 femelles Saanen provenant de 52 troupeaux de la même région, les fréquences étaient : αs1-CnA = 0,07 ; αs1-CnB = 0,06 ; αs1-CnC = 0; αs1-CnB- = 0,41 ; αs1-CnF = 0,43 ; αs1-Cno = 0,03. Des données supplémentaires confirment que les loci αs1-Cn et αs2-Cn sont étroitement liés. Des investigations préliminaires révèlent que le taux de caséine des laits des chèvres possédant l’allèle αs1-CnA est significativement supérieur à celui des laits des chèvres de génotype αs1-CnF / αs1-CnF ou αs1-CnB- /αs1-CnF; parailleurs, dans un grand troupeau (N = 251), une forte corrélation a été observée entre le taux de caséine αs1 et le taux de matières azotées coagulables (r = 0,68 ; b = 0,64)

A survey of front end modularity as an automotive architecture and its ability to deliver value

Thesis (S.M.)--Massachusetts Institute of Technology, System Design and Management Program, 2008.Includes bibliographical references (leaves 116-118).The partitioning of a system can and will dictate the creative space for a designer or engineer. This thesis will analyze how using a new automotive architecture known as a Front End Module (FEM) can affect a limited specific subset of stakeholders. Through the use of interviews of subject matter experts, literature research and the use of System Design Management tools, an in depth analysis will be done on the FEM and how it affects the craftsmanship, damageability and assembly attributes. It will be shown how the craftsmanship attribute can be improved through the strategic use of FEM's to allow for a feed-forward system where build data are incorporated into upcoming FEM builds. Even with this advantage, the FEM architecture will not negatively impact the damageability attribute or assembly attribute if the proper design cues and strategies are followed. The FEM will also be intensely analyzed using the tools from the MIT SDM program where it will be evaluated as an architecture itself through the specific and targeted intent and beneficiary breakdown. The analysis will also include an Object/Process Mapping analysis where it will be proposed that the true customer of the automotive front end is not the individual that purchased the vehicle but rather the visual society as a whole. Finally, a managerial approach will be taken for the analysis of the inherent and inevitable supplier relationship that is required with using this FEM architecture. Interviews were conducted with two suppliers of OEM's and their common road blocks will be analyzed such as lack of holistic thinking or failure to understand the role of the system integrator. Proposed next steps will be laid out to address these barriers in order to open the communication channels between the supply base and the Original Equipment Manufacturers.by Vincent R. Mahé.S.M

Recent Budget of Hydroclimatology and Hydrosedimentology of the Congo River in Central Africa

Although the Congo Basin is still one of the least studied river basins in the world, this paper attempts to provide a multidisciplinary but non-exhaustive synthesis on the general hydrology of the Congo River by highlighting some points of interest and some particular results obtained over a century of surveys and scientific studies. The Congo River is especially marked by its hydrological regularity only interrupted by the wet decade of 1960, which is its major anomaly over nearly 120 years of daily observations. Its interannual flow is 40,500 m3 s−1. This great flow regularity should not hide important spatial variations. As an example, we can cite the Ubangi basin, which is the most northern and the most affected by a reduction in flow, which has been a cause for concern since 1970 and constitutes a serious hindrance for river navigation. With regard to material fluxes, nearly 88 × 106 tonnes of material are exported annually from the Congo Basin to the Atlantic Ocean, composed of 33.6 × 106 tonnes of TSS, 38.1 × 106 tonnes of TDS and 16.2 × 106 tonnes of DOC. In this ancient flat basin, the absence of mountains chains and the extent of its coverage by dense rainforest explains that chemical weathering (10.6 t km−2 year−1 of TDS) slightly predominates physical erosion (9.3 t km−2 year−1 of TSS), followed by organic production (4.5 t km−2 year−1 of DOC). As the interannual mean discharges are similar, it can be assumed that these interannual averages of material fluxes, calculated over the longest period (2006–2017) of monthly monitoring of its sedimentology and bio-physical-chemistry, are therefore representative of the flow record available since 1902 (with the exception of the wet decade of 1960). Spatial heterogeneity within the Congo Basin has made it possible to establish an original hydrological classification of right bank tributaries, which takes into account vegetation cover and lithology to explain their hydrological regimes. Those of the Batéké plateau present a hydroclimatic paradox with hydrological regimes that are among the most stable on the planet, but also with some of the most pristine waters as a result of the intense drainage of an immense sandy-sandstone aquifer. This aquifer contributes to the regularity of the Congo River flows, as does the buffer role of the mysterious “Cuvette Centrale”. As the study of this last one sector can only be done indirectly, this paper presents its first hydrological regime calculated by inter-gauging station water balance. Without neglecting the indispensable in situ work, the contributions of remote sensing and numerical modelling should be increasingly used to try to circumvent the dramatic lack of field data that persists in this basin

Molecular diversity and distribution of marine fungi across 130 European environmental samples.

Journal ArticleEnvironmental DNA and culture-based analyses have suggested that fungi are present in low diversity and in low abundance in many marine environments, especially in the upper water column. Here, we use a dual approach involving high-throughput diversity tag sequencing from both DNA and RNA templates and fluorescent cell counts to evaluate the diversity and relative abundance of fungi across marine samples taken from six European near-shore sites. We removed very rare fungal operational taxonomic units (OTUs) selecting only OTUs recovered from multiple samples for a detailed analysis. This approach identified a set of 71 fungal 'OTU clusters' that account for 66% of all the sequences assigned to the Fungi. Phylogenetic analyses demonstrated that this diversity includes a significant number of chytrid-like lineages that had not been previously described, indicating that the marine environment encompasses a number of zoosporic fungi that are new to taxonomic inventories. Using the sequence datasets, we identified cases where fungal OTUs were sampled across multiple geographical sites and between different sampling depths. This was especially clear in one relatively abundant and diverse phylogroup tentatively named Novel Chytrid-Like-Clade 1 (NCLC1). For comparison, a subset of the water column samples was also investigated using fluorescent microscopy to examine the abundance of eukaryotes with chitin cell walls. Comparisons of relative abundance of RNA-derived fungal tag sequences and chitin cell-wall counts demonstrate that fungi constitute a low fraction of the eukaryotic community in these water column samples. Taken together, these results demonstrate the phylogenetic position and environmental distribution of 71 lineages, improving our understanding of the diversity and abundance of fungi in marine environments.Gordon and Betty Moore FoundationDeutsche ForschungsgemeinschaftMarie Curie International Outgoing FellowshipMarie Curie Intra-European FellowshipEMBO Long-Term fellowshi

Validation of Messenger Ribonucleic Acid Markers Differentiating Among Human Acute Respiratory Distress Syndrome Subgroups in an Ovine Model of Acute Respiratory Distress Syndrome Phenotypes

BACKGROUND: The discovery of biological subphenotypes in acute respiratory distress syndrome (ARDS) might offer a new approach to ARDS in general and possibly targeted treatment, but little is known about the underlying biology yet. To validate our recently described ovine ARDS phenotypes model, we compared a subset of messenger ribonucleic acid (mRNA) markers in leukocytes as reported before to display differential expression between human ARDS subphenotypes to the expression in lung tissue in our ovine ARDS phenotypes model (phenotype 1 (Ph1): hypoinflammatory; phenotype 2 (Ph2): hyperinflammatory). METHODS: We studied 23 anesthetized sheep on mechanical ventilation with observation times between 6 and 24 h. They were randomly allocated to the two phenotypes (n = 14 to Ph1 and n = 9 to Ph2). At study end, lung tissue was harvested and preserved in RNAlater. After tissue homogenization in TRIzol, total RNA was extracted and custom capture and reporter probes designed by NanoString Technologies were used to measure the expression of 14 genes of interest and the 6 housekeeping genes on a nCounter SPRINT profiler. RESULTS: Among the 14 mRNA markers, in all animals over all time points, 13 markers showed the same trend in ovine Ph2/Ph1 as previously reported in the MARS cohort: matrix metalloproteinase 8, olfactomedin 4, resistin, G protein-coupled receptor 84, lipocalin 2, ankyrin repeat domain 22, CD177 molecule, and transcobalamin 1 expression was higher in Ph2 and membrane metalloendopeptidase, adhesion G protein-coupled receptor E3, transforming growth factor beta induced, histidine ammonia-lyase, and sulfatase 2 expression was higher in Ph1. These expression patterns could be found when different sources of mRNA – such as blood leukocytes and lung tissue – were compared. CONCLUSION: In human and ovine ARDS subgroups, similar activated pathways might be involved (e.g., oxidative phosphorylation, NF-κB pathway) that result in specific phenotypes

Assessment of the Cod Stock in NAFO Division 3M

An assessment of the cod stock in NAFO Division 3M is performed. A Bayesian model, as used in the last assessments, was used to perform the analysis. The data set was extend to 1972 and a new tuning survey is used, the Canadian survey during 1978-1985. As there are inconsistencies with total catch of the last two years, a prior was added for 2011 and 2012 catch. Results indicate a fairly substantial increase in SSB, reaching a value well above Blim. The six-years retrospective plots show an underestimation in the recruitment the last two years after several years of underestimation. Three year projections indicate that fishing at the Fstatusquo level should allow SSB to increase slowly in the short term

Measurement of finite-frequency current statistics in a single-electron transistor

Electron transport in nano-scale structures is strongly influenced by the Coulomb interaction which gives rise to correlations in the stream of charges and leaves clear fingerprints in the fluctuations of the electrical current. A complete understanding of the underlying physical processes requires measurements of the electrical fluctuations on all time and frequency scales, but experiments have so far been restricted to fixed frequency ranges as broadband detection of current fluctuations is an inherently difficult experimental procedure. Here we demonstrate that the electrical fluctuations in a single electron transistor (SET) can be accurately measured on all relevant frequencies using a nearby quantum point contact for on-chip real-time detection of the current pulses in the SET. We have directly measured the frequency-dependent current statistics and hereby fully characterized the fundamental tunneling processes in the SET. Our experiment paves the way for future investigations of interaction and coherence induced correlation effects in quantum transport.Comment: 7 pages, 3 figures, published in Nature Communications (open access

Motion-Aware Mosaicing for Confocal Laser Endomicroscopy

Probe-based Confocal Laser Endomicroscopy (pCLE) pro- vides physicians with real-time access to histological information during standard endoscopy procedures, through high-resolution cellular imaging of internal tissues. Earlier work on mosaicing has enhanced the potential of this imaging modality by meeting the need to get a complete representation of the imaged region. However, with approaches, the dynamic information, which may be of clinical interest, is lost. In this study, we propose a new mosaic construction algorithm for pCLE sequences based on a min-cut optimization and gradient-domain composition. Its main advantage is that the motion of some structures within the tissue such as blood cells in capillaries, is taken into account. This allows physicians to get both a sharper static representation and a dynamic representation of the imaged tissue. Results on 16 sequences acquired in vivo on six different organs demonstrate the clinical relevance of our approach