Excess length of hospital stay due to healthcare acquired infections. Methodologies evaluation

BACKGROUND: Healthcare acquired infections (HAI) cause an increase of burden and in particular excess length of hospital stay (LOS) accounts for approximately up to 90% of total costs. Therefore accurate estimation of extra hospital stay due to healthcare acquired infections is very important. METHODS: The authors carried out a review comparing the principal methods internationally used for estimating the excess LOS attributable to healthcare acquired infections. RESULTS: The methods described and analysed are: 1) Implicit physician assessment; 2) appropriateness evaluation protocol; 3) unmatched case-control; 4) matched case-control; 5) regression analysis; 6) multistate model. The various methodologies are described underlining advantages and limits which researchers need to know before starting any economic analysis. CONCLUSIONS: Overall, studies taking into account the time-dependent nature of HAI show to give more precise and reliable results

Developing an Ecological Model of Turnover Intent: Associations Among Child Welfare Caseworkers’ Characteristics, Lived Experience, Professional Attitudes, Agency Culture, and Proclivity to Leave

Almost a quarter of the child welfare workforce leaves their job each year, and despite clarion calls over the decades, our insights into dynamics underlying turnover remain limited. Using survey data from 276 caseworkers in a Midwestern state, this analysis explores an array of personality, stress, attitudinal, and perception measures and their association with three measures of turnover intent: thinking about quitting, intending to search, and intent to leave. Findings indicate that controlling for demographic factors, burnout, and confidence in decision support from agency leadership had consistent and strong associations with all three outcomes (positive for burnout; negative for decision support). In contrast, associations between conscientiousness, open-mindedness, secondary traumatic stress, and attitudes favoring family preservation over child safety varied in their significance, orientation, and strength depending on the outcome in question. Given that the most powerful and consistent predictors of turnover intentions are potentially malleable, these findings indicate that these are two important areas for agencies to consider developing interventions. Moreover, despite the commonalities, the finding that the three outcomes examined were associated with different predictors, suggests they may be distinguishing phases of contemplation and action along a pre-turnover continuum. Future research will explore the relative predictive validity of these scales

Stress testing the ELBA water model

© 2015 © 2015 The Author(s). Published by Taylor & Francis. The ELBA coarse-grained model describes a water molecule as a single-site Lennard-Jones particle embedded with a point dipole. ELBA was previously reported to capture several properties of real water with relatively high accuracy, while being up to two orders of magnitude more computationally efficient than atomistic models. Here, we stress test the ELBA model by investigating the temperature and pressure dependences of two most important water properties, the liquid density and the self-diffusion coefficient. In particular, molecular dynamics simulations are performed spanning temperatures from 268 K up to 378 K and pressures from 1 atm up to 4000 atm. Comparisons are made with literature data from experiments and from simulations of traditional three-site atomistic models. Remarkably, the ELBA results show an overall similar (and sometimes higher) accuracy with respect to the atomistic data. We also calculate a number of additional thermodynamic properties at ambient conditions, namely isothermal compressibility, shear viscosity, isobaric heat capacity, thermal expansion coefficient and melting point. The accuracy of ELBA is relatively good compared to atomistic and other coarse-grained models

Direct measurement of DNA-mediated adhesion between lipid bilayers

Multivalent interactions between deformable mesoscopic units are ubiquitous in biology, where membrane macromolecules mediate the interactions between neighbouring living cells and between cells and solid substrates. Lately, analogous artificial materials have been synthesised by functionalising the outer surface of compliant Brownian units, for example emulsion droplets and lipid vesicles, with selective linkers, in particular short DNA sequences. This development extended the range of applicability of DNA as a selective glue, originally applied to solid nano and colloidal particles. On very deformable lipid vesicles, the coupling between statistical effects of multivalent interactions and mechanical deformation of the membranes gives rise to complex emergent behaviours, as we recently contributed to demonstrate [Parolini et al., Nature Communications, 2015, 6, 5948]. Several aspects of the complex phenomenology observed in these systems still lack a quantitative experimental characterisation and fundamental understanding. Here we focus on the DNA-mediated multivalent interactions of a single liposome adhering to a flat supported bilayer. This simplified geometry enables the estimate of the membrane tension induced by the DNA-mediated adhesive forces acting on the liposome. Our experimental investigation is completed by morphological measurements and the characterisation of the DNA-melting transition, probed by in-situ F\"{o}rster Resonant Energy Transfer spectroscopy. Experimental results are compared with the predictions of an analytical theory that couples the deformation of the vesicle to a full description of the statistical mechanics of mobile linkers. With at most one fitting parameter, our theory is capable of semi-quantitatively matching experimental data, confirming the quality of the underlying assumptions.Comment: 16 pages, 7 figure

Potential of Lactobacillus casei , Culture Permeate, and Lacti Acid To Control Microorganisms in Ready-To-Use Vegetables.

The effects of various treatments (i.e., the addition of a strain of Lactobacillus that produces antimicrobial agents, Lactobacillus casei IMPC LC34, its sterile permeate, and 0.5 or 1% lactic acid) on the growth of microorganisms associated with ready-to-use mixed salad vegetables were compared during refrigerated (8°C) storage. The addition of 3% culture permeate to mixed salads reduced the total mesophilic bacteria counts from 6 to 1 log CFU/g, and suppressed coliforms, enterococci, and Aeromonas hydrophila after 6 days of storage at 8°C. A similar effect was shown when the L. casei culture was inoculated in the vegetables. One percent lactic acid had a bacteriostatic effect on the bacterial groups examined, except for total and fecal coliforms, which were reduced by about 2 and 1 log unit, respectively, while 0.5% lactic acid did not affect the indigenous microflora of the vegetables. The potential of these new hurdles to prevent the growth of spoilage and pathogenic bacteria in ready-to-use salad vegetables is suggested

Photon creation in a spherical oscillating cavity

We study the photon creation inside a perfectly conducting, spherical oscillating cavity. The electromagnetic field inside the cavity is described by means of two scalar fields which satisfy Dirichlet and (generalized) Neumann boundary conditions. As a preliminary step, we analyze the dynamical Casimir effect for both scalar fields. We then consider the full electromagnetic case. The conservation of angular momentum of the electromagnetic field is also discussed, showing that photons inside the cavity are created in singlet states.Comment: 14 pages, no figure

Homopolymeric tracts represent a general regulatory mechanism in prokaryotes

<p>Abstract</p> <p>Background</p> <p>While, traditionally, regulation of gene expression can be grouped into transcriptional, translational, and post-translational mechanisms, some mechanisms of rapid genetic variation can also contribute to regulation of gene expression, e.g., phase variation.</p> <p>Results</p> <p>We show here that prokaryotes evolved to include homopolymeric tracts (HTs) within coding genes as a system that allows for efficient gene inactivation. Analyses of 81 bacterial and 18 archaeal genomes showed that poly(A) and poly(T) HTs are overrepresented in these genomes and preferentially located at the 5' end of coding genes. Location of HTs at the 5' end is not driven by a preferential placement of aminoacids encoded by the AAA and TTT codons at the N-terminal of proteins. The <it>inlA </it>gene of the pathogen <it>L. monocytogenes </it>was used as a model to further study the role of HTs in reversible gene inactivation. In a number of <it>L. monocytogenes </it>strains, <it>inlA </it>harbors a 5' poly(A) HT, which regularly shows frameshift mutation leading to expression of a truncated 8 aa InlA protein. Translational fusions of the <it>inlA </it>5' end allowed us to estimate that the frequency of variation in this HT is about 1,000 fold higher than the estimated average point mutation frequency.</p> <p>Conclusions</p> <p>As frameshift mutations in HTs can occur at high frequencies and enable efficient gene inactivation, hypermutable HTs appear to represent a universal system for regulation of gene expression in prokaryotes. Combined with other studies indicating that HTs also enable rapid diversification of both coding and regulatory genetic sequences in eukaryotes, our data suggest that hypermutable HTs represent a general and rapid evolutionary mechanism facilitating adaptation and gene regulation across diverse organisms.</p