An outbreak of Streptococcus pneumoniae in an Italian nursing home

Streptococcus pneumoniae is the main cause of community-acquired pneumonia worldwide; pneumonia occurs sporadically in most cases, but rare outbreaks have been reported. We  describe an outbreak occurred in a 21-guests nursing home for elders in Aosta (Italy); outbreak occurred in april 2014 over a 2 weeks period, resulting in 12 out 20 guests affected (all with high fever and respiratory symptoms), two deaths (at home), nine patients referred  to Hospital Emergency Room, and eight admissions. Urinary streptococcus antigen was positive in seven out of eight patient tested. None of the nursing home guests were vaccinated against Streptococcus pneumoniae The Hospital Medical Direction and Public Health Service gave support and adopted strategies to contain the outbreak spread. We underline the need for pneumococcal vaccination in nursing homes/ Long-term care facilities; accurate check of hygiene behaviours in those setting is also mandatory. &nbsp

M31 Pixel Lensing PLAN Campaign: MACHO Lensing and Self Lensing Signals

We present the final analysis of the observational campaign carried out by the PLAN (Pixel Lensing Andromeda) collaboration to detect a dark matter signal in form of MACHOs through the microlensing effect. The campaign consists of about 1 month/year observations carried out during 4 years (2007-2010) at the 1.5m Cassini telescope in Loiano ("Astronomical Observatory of BOLOGNA", OAB) plus 10 days of data taken in 2010 at the 2m Himalayan Chandra Telescope (HCT) monitoring the central part of M31 (two fields of about 13'x12.6'). We establish a fully automated pipeline for the search and the characterization of microlensing flux variations: as a result we detect 3 microlensing candidates. We evaluate the expected signal through a full Monte Carlo simulation of the experiment completed by an analysis of the detection efficiency of our pipeline. We consider both "self lensing" and "MACHO lensing" lens populations, given by M31 stars and dark matter halo MACHOs, in the M31 and the Milky Way (MW), respectively. The total number of events is compatible with the expected self-lensing rate. Specifically, we evaluate an expected signal of about 2 self-lensing events. As for MACHO lensing, for full 0.5 (0.01) solar mass MACHO halos, our prediction is for about 4 (7) events. The comparatively small number of expected MACHO versus self lensing events, together with the small number statistics at disposal, do not enable us to put strong constraints on that population. Rather, the hypothesis, suggested by a previous analysis, on the MACHO nature of OAB-07-N2, one of the microlensing candidates, translates into a sizeable lower limit for the halo mass fraction in form of the would be MACHO population, f, of about 15% for 0.5 solar mass MACHOs.Comment: ApJ accepted, 13 pages, 5 figures, 2 table

Correlations between atazanavir Ctrough and hyperbilirubinemia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hyperbilirubinemia is a common side effect of the antiretroviral agent atazanavir but is generally reversible upon discontinuation of treatment. We used therapeutic drug monitoring to investigate the occurrence of hyperbilirubinemia in a 49-year-old Hispanic man infected with HIV, following an overdose of ritonavir in ritonavir-boosted atazanavir therapy.</p> <p>Case presentation</p> <p>A 49-year-old Hispanic man with HIV who had received several highly active antiretroviral therapy regimens over a number of years including atazanavir-containing regimens, was diagnosed with hyperbilirubinemia. An inappropriate doubling of ritonavir boosting resulted in a high atazanavir C_troughand an initial rise in bilirubin plasma levels. Bilirubin levels later decreased, probably as a consequence of enzyme induction, while atazanavir plasma concentrations remained elevated.</p> <p>Conclusion</p> <p>This article describes an occurrence of hyperbilirubinemia in a man infected with HIV and supports the importance of therapeutic drug monitoring in investigations of hyperbilirubinemia among patients receiving antiretroviral agents. That the patient tolerated exceptionally high atazanavir levels further strengthens the tolerability profile of this drug.</p

KELT-21b: A Hot Jupiter Transiting the Rapidly Rotating Metal-poor Late-A Primary of a Likely Hierarchical Triple System

We present the discovery of KELT-21b, a hot Jupiter transiting the V = 10.5 A8V star HD 332124. The planet has an orbital period of P = 3.6127647 ± 0.0000033 days and a radius of 1.586-0.040+0.039 RJ. We set an upper limit on the planetary mass of at confidence. We confirmed the planetary nature of the transiting companion using this mass limit and Doppler tomographic observations to verify that the companion transits HD 332124. These data also demonstrate that the planetary orbit is well-aligned with the stellar spin, with a sky-projected spin-orbit misalignment of λ = -5.6-1.91.7. The star has Teff = 7598-8481 K, Mz.ast; = 1.458-0.028+0.029 M⊙, Rz.ast; = 1.638 ± 0.034 R⊙ and v sin I∗ = 146 km s-1, the highest projected rotation velocity of any star known to host a transiting hot Jupiter. The star also appears to be somewhat metal poor and α-enhanced, with [Fe/H] = -405-0.033+0.032 and [α/Fe] = 0.145 ± 0.053; these abundances are unusual, but not extraordinary, for a young star with thin-disk kinematics like KELT-21. High-resolution imaging observations revealed the presence of a pair of stellar companions to KELT-21, located at a separation of 1.″2 and with a combined contrast of ΔKs = 6.39 ± 0.06 with respect to the primary. Although these companions are most likely physically associated with KELT-21, we cannot confirm this with our current data. If associated, the candidate companions KELT-21 B and C would each have masses of ∼0.12 M⊙, a projected mutual separation of ∼20 au, and a projected separation of ∼500 au from KELT-21. KELT-21b may be one of only a handful of known transiting planets in hierarchical triple stellar systems

KELT-12b: A P ∼ 5 day, Highly Inflated Hot Jupiter Transiting a Mildly Evolved Hot Star

We announce the discovery of KELT-12b, a highly inflated Jupiter-mass planet transiting the mildly evolved, V = 10.64 host star TYC 2619-1057-1. We followed up the initial transit signal in the KELT-North survey data with precise ground-based photometry, high-resolution spectroscopy, precise radial velocity measurements, and high-resolution adaptive optics imaging. Our preferred best-fit model indicates that the host star has = 6279 ±51 K, = 3.89 ±0.05, [Fe/H] = 0.19+0.08-0.09, = M∗ = 1.59+0.070.09M, and R ∗= 2.37 ±0.17 . The planetary companion has Mp= 0.95 ±0.14 MJ, RP = 1.78+0.17-0.16 RJ, log gP = 2.87+0.9-0.09 and density pp 0.210.070.05= g cm-3, making it one of the most inflated giant planets known. Furthermore, for future follow-up, we report a high-precision time of inferior conjunction in BJDTDB of 2,457,083.660459 ±0.000894 and period of P = 5.0316216 ± 0.000032days. Despite the relatively large separation of ∼0.07 au implied by its ∼5.03-day orbital period, KELT-12b receives significant flux of 2.38+0.32-0.29 × 109 erg s-1 cm-2 from its host. We compare the radii and insolations of transiting gas giant planets around hot (Teff 6250 K) and cool stars, noting that the observed paucity of known transiting giants around hot stars with low insolation is likely due to selection effects. We underscore the significance of long-term ground-based monitoring of hot stars and space-based targeting of hot stars with the Transiting Exoplanet Survey Satellite to search for inflated gas giants in longer-period orbits

Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale

© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design: Instrument development and cross-sectional study for psychometric testing. Methods: A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results: Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50–1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third-year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second-year students

<i>Spitzer</i> Microlensing Parallax Reveals Two Isolated Stars in the Galactic Bulge

We report the mass and distance measurements of two single-lens events from the 2017 $\textit {Spitzer}$ microlensing campaign. The ground-based observations yield the detection of finite-source effects, and the microlens parallaxes are derived from the joint analysis of ground-based observations and $\textit {Spitzer}$ observations. We find that the lens of OGLE-2017-BLG-1254 is a 0.60 ± 0.03 M ⊙ star with D LS = 0.53 ± 0.11 kpc, where D LS is the distance between the lens and the source. The second event, OGLE-2017-BLG-1161, is subject to the known satellite parallax degeneracy, and thus is either a ${0.51}_{-0.10}^{+0.12}\,{M}_{\odot }$ star with D LS = 0.40 ± 0.12 kpc or a ${0.38}_{-0.12}^{+0.13}\,{M}_{\odot }$ star with D LS = 0.53 ± 0.19 kpc. Both of the lenses are therefore isolated stars in the Galactic bulge. By comparing the mass and distance distributions of the eight published $\textit {Spitzer}$ finite-source events with the expectations from a Galactic model, we find that the $\textit {Spitzer}$ sample is in agreement with the probability of finite-source effects occurring in single-lens events

KELT-16b: A Highly Irradiated, Ultra-short Period Hot Jupiter Nearing Tidal Disruption

We announce the discovery of KELT-16b, a highly irradiated, ultra-short period hot Jupiter transiting the relatively bright ($V = 11.7$) star TYC 2688-1839-1. A global analysis of the system shows KELT-16 to be an F7V star with $T_\textrm{eff} = 6236\pm54$ K, $\log{g_\star} = 4.253_{-0.036}^{+0.031}$, [Fe/H] = -0.002$_{-0.085}^{+0.086}$, $M_\star = 1.211_{-0.046}^{+0.043} M_\odot$, and $R_\star = 1.360_{-0.053}^{+0.064} R_\odot$. The planet is a relatively high mass inflated gas giant with $M_\textrm{P} = 2.75_{-0.15}^{+0.16} M_\textrm{J}$, $R_\textrm{P} = 1.415_{-0.067}^{+0.084} R_\textrm{J}$, density $\rho_\textrm{P} = 1.20\pm0.18$ g cm$^{-3}$, surface gravity $\log{g_\textrm{P}} = 3.530_{-0.049}^{+0.042}$, and $T_\textrm{eq} = 2453_{-47}^{+55}$ K. The best-fitting linear ephemeris is $T_\textrm{C} = 2457247.24791\pm0.00019$ BJD$_{tdb}$ and $P = 0.9689951 \pm 0.0000024$ d. KELT-16b joins WASP-18b, -19b, -43b, -103b, and HATS-18b as the only giant transiting planets with $P < 1$ day. Its ultra-short period and high irradiation make it a benchmark target for atmospheric studies by HST, Spitzer, and eventually JWST. For example, as a hotter, higher mass analog of WASP-43b, KELT-16b may feature an atmospheric temperature-pressure inversion and day-to-night temperature swing extreme enough for TiO to rain out at the terminator. KELT-16b could also join WASP-43b in extending tests of the observed mass-metallicity relation of the Solar System gas giants to higher masses. KELT-16b currently orbits at a mere $\sim$ 1.7 Roche radii from its host star, and could be tidally disrupted in as little as a few $\times 10^{5}$ years (for a stellar tidal quality factor of $Q_*' = 10^5$). Finally, the likely existence of a widely separated bound stellar companion in the KELT-16 system makes it possible that Kozai-Lidov oscillations played a role in driving KELT-16b inward to its current precarious orbit.Comment: 16 pages, 18 Figures, 7 Tables, Accepted for publication in A