Épilogue

Les pistes de recherche dessinées par cette enquête sur le don d\u27archives se sont révélées fécondes : plusieurs étudiants des masters Archives et Bibliothèques qui participent aux séminaires de l’équipe ALMA du CERHIO se sont emparés de cette thématique, soit comme objet direct de leur recherche, soit pour éclairer et nourrir un travail sur un sujet connexe, apportant à notre dossier des éléments complémentaires et un regard neuf. Un résumé de ces mémoires est proposé dans cet épilogue.

Antibiotic stewardship implementation and patient-level antibiotic use at hospitals with and without on-site Infectious Disease specialists.

Many US hospitals lack Infectious Disease (ID) specialists, which may hinder antibiotic stewardship efforts. We sought to compare patient-level antibiotic exposure at Veterans Health Administration (VHA) hospitals with and without an on-site ID specialist, defined as an ID physician and/or ID pharmacist. This retrospective VHA cohort included all acute-care patient-admissions during 2016. A mandatory survey was used to identify hospitals' antibiotic stewardship processes and their access to an on-site ID specialist. Antibiotic use was quantified as days of therapy (DOT) per days-present and categorized based on National Healthcare Safety Network definitions. A negative binomial regression model with risk adjustment was used to determine the association between presence of an on-site ID specialist and antibiotic use at the level of patient-admissions. Eighteen of 122 (14.8%) hospitals lacked an on-site ID specialist; there were 525,451 (95.8%) admissions at ID hospitals and 23,007 (4.2%) at non-ID sites. In the adjusted analysis, presence of an ID specialist was associated with lower total inpatient antibacterial use [OR 0.92, (95% CI, 0.85-0.99)]. Presence of an ID specialist was also associated with lower use of broad-spectrum antibacterials [OR 0.61 (95% CI, 0.54-0.70)] and higher narrow-spectrum beta-lactam use [OR 1.43 (95% CI, 1.22-1.67)]. Total antibacterial exposure (inpatient plus post-discharge) was lower among patients at ID versus non-ID sites [OR 0.92 (95% CI, 0.86-0.99)]. Patients at hospitals with an ID specialist received antibiotics in a way more consistent with stewardship principles. The presence of an ID specialist may be important to effective antibiotic stewardship

Antibiotic Stewardship Implementation and Antibiotic Use at Hospitals With and Without On-site Infectious Disease Specialists.

BackgroundMany US hospitals lack infectious disease (ID) specialists, which may hinder antibiotic stewardship efforts. We sought to compare patient-level antibiotic exposure at Veterans Health Administration (VHA) hospitals with and without an on-site ID specialist, defined as an ID physician and/or ID pharmacist.MethodsThis retrospective VHA cohort included all acute-care patient admissions during 2016. A mandatory survey was used to identify hospitals' antibiotic stewardship processes and their access to an on-site ID specialist. Antibiotic use was quantified as days of therapy per days present and categorized based on National Healthcare Safety Network definitions. A negative binomial regression model with risk adjustment was used to determine the association between presence of an on-site ID specialist and antibiotic use at the level of patient admissions.ResultsEighteen of 122 (14.8%) hospitals lacked an on-site ID specialist; there were 525 451 (95.8%) admissions at ID hospitals and 23 007 (4.2%) at non-ID sites. In the adjusted analysis, presence of an ID specialist was associated with lower total inpatient antibacterial use (odds ratio, 0.92; 95% confidence interval, .85-.99). Presence of an ID specialist was also associated with lower use of broad-spectrum antibacterials (0.61; .54-.70) and higher narrow-spectrum β-lactam use (1.43; 1.22-1.67). Total antibacterial exposure (inpatient plus postdischarge) was lower among patients at ID versus non-ID sites (0.92; .86-.99).ConclusionsPatients at hospitals with an ID specialist received antibiotics in a way more consistent with stewardship principles. The presence of an ID specialist may be important to effective antibiotic stewardship

Les dons d’archives et de bibliothèques. De l’intention à la contrepartie

Ni manuel ni encyclopédie du don patrimonial, cet ouvrage a l’ambition de replacer le geste du don de documents dans le contexte plus général du don comme créateur de lien social, de l’envisager dans sa dynamique de circulation dans la société et de s’interroger sur la nature symbolique de la relation qui se noue entre donateurs et donataires. Dépouillé de ses habits juridiques, le don d’archives ou de bibliothèques se révèle partiellement singulier. Le donateur s’y défait d’un bien en faveur d’un bénéficiaire collectif et anonyme ; l’établissement bénéficiaire est réellement le médiateur du don, lieu de conservation et de transmission de l’objet donné vers son destinataire réel, le public

Probing neutron-hidden neutron transitions with the MURMUR experiment

MURMUR is a new passing-through-walls neutron experiment designed to constrain neutron/hidden neutron transitions allowed in the context of braneworld scenarios or mirror matter models. A nuclear reactor can act as a hidden neutron source, such that neutrons travel through a hidden world or sector. Hidden neutrons can propagate out of the nuclear core and far beyond the biological shielding. However, hidden neutrons can weakly interact with usual matter, making possible for their detection in the context of low-noise measurements. In the present work, the novelty rests on a better background discrimination and the use of a mass of a material - here lead - able to enhance regeneration of hidden neutrons into visible ones to improve detection. The input of this new setup is studied using both modelizations and experiments, thanks to tests currently performed with the experiment at the BR2 research nuclear reactor (SCK$\cdot$CEN, Mol, Belgium). A new limit on the neutron swapping probability p has been derived thanks to the measurements taken during the BR2 Cycle 02/2019A: $p < 4.0 \ \times 10^{-10}$ at 95% CL. This constraint is better than the bound from the previous passing-through-wall neutron experiment made at ILL in 2015, despite BR2 is less efficient to generate hidden neutrons by a factor 7.4, thus raising the interest of such experiment using regenerating materials.Comment: 15 pages, 8 figures, final version, accepted for publication in European Physical Journal

Automation technology and sense of control: a window on human agency.

Previous studies have shown that the perceived times of voluntary actions and their effects are perceived as shifted towards each other, so that the interval between action and outcome seems shortened. This has been referred to as 'intentional binding' (IB). However, the generality of this effect remains unclear. Here we demonstrate that Intentional Binding also occurs in complex control situations. Using an aircraft supervision task with different autopilot settings, our results first indicated a strong relation between measures of IB and different levels of system automation. Second, measures of IB were related to explicit agency judgement in this applied setting. We discuss the implications for the underlying mechanisms, and for sense of agency in automated environments

Comparison of bulk milk antibody and youngstock serology screens for determining herd status for Bovine Viral Diarrhoea Virus

BACKGROUND: This paper examines the use of Bulk Milk antibody (BM Ab), Youngstock (YS) serology (Check Tests) and Bulk Milk PCR (BM PCR) for determining the presence or absence of animals persistently infected (PI) with Bovine Viral Diarrhoea Virus (BVDV) within a herd. Data is presented from 26 herds where average herd sizes were 343 and 98 animals for dairy and beef units respectively. Seventeen herds had sufficient data to analyse using Receiver Operating Characteristic (ROC) and probability curves enabling calculation of the sensitivity and specificity of BM Ab and YS Check tests for determining the presence of PI animals within herds in this dataset. RESULTS: Using BM Ab to screen a herd for the presence of PI animals, achieved a herd level sensitivity and specificity of 80.00 % (44.39–97.48 %) and 85.71 % (42.13–99.64 %) respectively (95 % confidence intervals quoted). Sensitivity and specificity of YS Check Tests at a cut off of 3/10 Ab positive YS were 81.82 % (48.22–97.72 %) and 66.67 % (22.28–95.67 %) respectively (95 % confidence interval). These results were achieved by comparing the screening tests to whole herd PI searches that took place 1–19 months after the initial screen with a mean interval of 8 months. Removal of this delay by taking BM samples on the day of a whole herd test and simulating a YS Check Test from the herd test data produced improvements in the reliability of the Check Tests. BM Ab sensitivity and specificity remained unchanged. However, the Check Test sensitivity and specificity improved to 90.9 % (58.72–99.77 %) and 100 % (54.07–100 %) respectively (95 % confidence interval) at a cut of off 2.5/10 Ab positive animals. Our limited BM PCR results identified 5/23 dairy farms with a positive BM PCR result; two contained milking PIs, two had non-milking PIs and another had no PIs identified. CONCLUSIONS: Delaying a PI search following an initial herd screen decreased the diagnostic accuracy and relevance of our results. With careful interpretation, longitudinal surveillance using a combination of the techniques discussed can successfully determine farm status and therefore allow changes in BVDV status to be detected early, thus enabling prompt action in the event of a BVDV incursion