"Cloud" health-care workers.

Certain bacteria dispersed by health-care workers can cause hospital infections. Asymptomatic health-care workers colonized rectally, vaginally, or on the skin with group A streptococci have caused outbreaks of surgical site infection by airborne dispersal. Outbreaks have been associated with skin colonization or viral upper respiratory tract infection in a phenomenon of airborne dispersal of Staphylococcus aureus called the "cloud" phenomenon. This review summarizes the data supporting the existence of cloud health-care workers

Hierarchical Species Sampling Models

This paper introduces a general class of hierarchical nonparametric prior distributions. The random probability measures are constructed by a hierarchy of generalized species sampling processes with possibly non-diffuse base measures. The proposed framework provides a general probabilistic foundation for hierarchical random measures with either atomic or mixed base measures and allows for studying their properties, such as the distribution of the marginal and total number of clusters. We show that hierarchical species sampling models have a Chinese Restaurants Franchise representation and can be used as prior distributions to undertake Bayesian nonparametric inference. We provide a method to sample from the posterior distribution together with some numerical illustrations. Our class of priors includes some new hierarchical mixture priors such as the hierarchical Gnedin measures, and other well-known prior distributions such as the hierarchical Pitman-Yor and the hierarchical normalized random measures

No persistent effect of intravenous immunoglobulins in patients with narcolepsy with cataplexy

We report on four patients with narcolepsy with cataplexy (NC), who were treated with high-dose intravenous immunoglobulins (IVIg). Although in some patients transient effects were seen of both objective (multiple sleep latency test and maintenance of wakefulness test) and subjective symptoms (Epworth Sleepiness Scale and frequency of cataplexy), these effects lasted at the most for a few weeks and did not persist. Our report challenges the recent observations of a favorable and persistent effect of IVIg in NC patient

Kinetic models with randomly perturbed binary collisions

We introduce a class of Kac-like kinetic equations on the real line, with general random collisional rules, which include as particular cases models for wealth redistribution in an agent-based market or models for granular gases with a background heat bath. Conditions on these collisional rules which guarantee both the existence and uniqueness of equilibrium profiles and their main properties are found. We show that the characterization of these stationary solutions is of independent interest, since the same profiles are shown to be solutions of different evolution problems, both in the econophysics context and in the kinetic theory of rarefied gases

Why and when do family firms invest less in talent management? The suppressor effect of risk aversion

none4siThis article explores the complex relationship between family firms and talent management practices. We use an international sample of medium-sized manufacturing firms to show that the relationship between family-owned firms and investment in talent management practices is mediated by the firm’s level of risk aversion, which is, in turn, moderated by industry competition. Risk-averse family-owned firms tend to invest less in talent management practices when industry competition is weak. In contrast, when competition increases, family-owned firms tend to invest in talent as much as non-family-owned firms do.openBasco, Rodrigo; Bassetti, Thomas; Dal Maso, Lorenzo; Lattanzi, NicolaBasco, Rodrigo; Bassetti, Thomas; Dal Maso, Lorenzo; Lattanzi, Nicol

Efficacy and Safety of Meropenem\u2013Vaborbactam Versus Best Available Therapy for the Treatment of Carbapenem-Resistant Enterobacteriaceae Infections in Patients Without Prior Antimicrobial Failure: A Post Hoc Analysis

open5siIntroduction: Infections due to Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae are associated with increased morbidity and high mortality. Meropenem–vaborbactam (MV) is a novel β-lactam/β-lactamase inhibitor combination active against KPC-producing Enterobacteriaceae. The aim of this post hoc analysis of the TANGO-II randomized controlled trial was to assess the efficacy of MV versus best available therapy (BAT) in the subgroup of patients without prior antimicrobial failure. Methods: The primary outcome measure was clinical cure at the test of cure (TOC). Secondary outcome measures included (1) clinical cure at the end of therapy (EOT), (2) microbiological cure at TOC, (3) microbiological cure at EOT, and (4) 28-day all-cause mortality. Results: First-line MV was associated with a 42.9% absolute increase in clinical cure rate at TOC (95% confidence intervals [CI] 13.7–72.1) in comparison with first-line BAT. A 49.3% absolute increase in clinical cure rate at EOT (95% CI 20.8–77.7), a 42.6% absolute increase in microbiological cure rate at EOT (95% CI 13.4–71.8), and a 36.2% absolute increase in microbiologic cure rate at TOC (95% CI 5.9–66.6) were also observed, in addition to a 29.0% absolute reduction in mortality (95% CI − 54.3 to − 3.7). Overall, fewer adverse events were observed in the MV group than in the BAT group. Conclusion: MV was superior to BAT in the subgroup of patients with serious carbapenem-resistant Enterobacteriaceae (CRE) infections and no prior antimicrobial failure, with very high rates of clinical success, and was well tolerated. Post approval and real-world studies remain essential to clearly define the most appropriate population for early, empirical MV coverage, in accordance with antimicrobial stewardship principles. Funding: The Medicines Company.openBassetti M.; Giacobbe D.R.; Patel N.; Tillotson G.; Massey J.Bassetti, M.; Giacobbe, D. R.; Patel, N.; Tillotson, G.; Massey, J

Sleep-wake disturbances 6 months after traumatic brain injury: a prospective study

Sleep-wake disturbances (SWD) are common after traumatic brain injury (TBI). In acute TBI, we recently found decreased CSF levels of hypocretin-1, a wake-promoting neurotransmitter. In the present study, we aimed to delineate the frequency and clinical characteristics of post-traumatic SWD, to assess CSF hypocretin-1 levels 6 months after TBI, and to identify risk factors for posttraumatic SWD. A total of 96 consecutive patients were enrolled within the first 4 days after TBI. Six months later, out of 76 TBI patients, who did not die and who did not move to foreign countries, we included 65 patients (86%, 53 males, mean age 39 years) in our study. Patients were examined using interviews, questionnaires, clinical examinations, computed tomography of the brain, laboratory tests (including CSF hypocretin-1 levels, and HLA typing), conventional polysomnography, maintenance of wakefulness and multiple sleep latency tests (MSLT) and actigraphy. Potential causes of post-traumatic SWD were assessed according to international criteria. New-onset sleep-wake disturbances following TBI were found in 47 patients (72%): subjective excessive daytime sleepiness (EDS; defined by the Epworth Sleepiness Scale ≥10) was found in 18 (28%), objective EDS (as defined by mean sleep latency <5 min on MSLT) in 16 (25%), fatigue (daytime tiredness without signs of subjective or objective EDS) in 11 (17%), post-traumatic hypersomnia ‘sensu strictu' (increased sleep need of ≥2 h per 24 h compared to pre-TBI) in 14 (22%) patients and insomnia in 3 patients (5%). In 28 patients (43% of the study population), we could not identify a specific cause of the post-traumatic SWD other than TBI. Low CSF hypocretin-1 levels were found in 4 of 21 patients 6 months after TBI, as compared to 25 of 27 patients in the first days after TBI. Hypocretin levels 6 months after TBI were significantly lower in patients with post-traumatic EDS. There were no associations between post-traumatic SWD and severity or localization of TBI, general clinical outcome, gender, pathological neurological findings and HLA typing. However, post-traumatic SWD correlated with impaired quality of life. These results suggest that sleep-wake disturbances, particularly EDS, fatigue and hypersomnia are common after TBI, and significantly impair quality of life. In almost one out of two patients, post-traumatic SWD appear to be directly related to the TBI. An involvement of the hypocretin system in the pathophysiology of post-traumatic SWD appears possible. Other risk factors predisposing towards the development of post-traumatic SWD were not identifie