The Character, Mission, and Future of Lutheran Higher Education

This article looks at the history of Lutheran higher education in the United States, discusses what Lutheran institutions of higher education must do to remain vital centers of learning, and examines questions that face American higher education in general

Determination of measurement uncertainty by Monte Carlo simulation

Modern coordinate measurement machines (CMM) are universal tools to measure geometric features of complex three-dimensional workpieces. To use them as reliable means of quality control, the suitability of the device for the specific measurement task has to be proven. Therefore, the ISO 14253 standard requires, knowledge of the measurement uncertainty and, that it is in reasonable relation with the specified tolerances. Hence, the determination of the measurement uncertainty, which is a complex and also costly task, is of utmost importance. The measurement uncertainty is usually influenced by several contributions of various sources. Among those of the machine itself, e.g., guideway errors and the influence of the probe and styli play an important role. Furthermore, several properties of the workpiece, such as its form deviations and surface roughness, have to be considered. Also the environmental conditions, i.e., temperature and its gradients, pressure, relative humidity and others contribute to the overall measurement uncertainty. Currently, there are different approaches to determine task-specific measurement uncertainties. This work reports on recent advancements extending the well-established method of PTB's Virtual Coordinate Measuring Machine (VCMM) to suit present-day needs in industrial applications. The VCMM utilizes numerical simulations to determine the task-specific measurement uncertainty incorporating broad knowledge about the contributions of, e.g., the used CMM, the environment and the workpiece

High Prevalence of Clostridium difficile Colonization among Nursing Home Residents in Hesse, Germany

Clostridium difficile is the most common cause of antibiotic-associated diarrhoea in hospitals and other healthcare facilities. The elderly are particularly susceptible and at increased risk for adverse outcome as a result of C. difficile infection. The aim of this study was to determine the prevalence of C. difficile colonization among residents of nursing homes in Hesse and to compare it with the prevalence in the general population living outside long-term care facilities (LTCF). We assessed possible risk factors for C. difficile colonization and determined the genotype of circulating strains. C. difficile was isolated from 11/240 (4.6%) nursing home residents and 2/249 (0.8%) individuals living outside LTCF (p = 0.02). Ten of 11 (90.9%) isolates from nursing homes and one of two isolates from the population outside LTCF were toxigenic. The prevalence of C. difficile colonization varied from 0% to 10% between different nursing homes. Facilities with known actual or recent CDI cases were more likely to have colonized residents than facilities without known CDI cases. C. difficile PCR-ribotypes 014 and 001 were the most prevalent genotypes and accounted for 30% and 20% of toxigenic isolates in nursing homes, respectively. Interestingly, no individuals carried the epidemic strain PCR-ribotype 027. Our results suggest that residents of nursing homes in Germany are at high risk for colonization by virulent C. difficile strains. The high prevalence of C. difficile colonization in nursing homes underscores the importance of good adherence to standard infection control precautions even in the absence of a diagnosed infection. They also emphasize the need for specific programs to increase the awareness of healthcare professionals in LTCF for CDI

Evidence for West Nile Virus and Usutu Virus Infections in Wild and Resident Birds in Germany, 2017 and 2018

Wild birds play an important role as reservoir hosts and vectors for zoonotic arboviruses and foster their spread. Usutu virus (USUV) has been circulating endemically in Germany since 2011, while West Nile virus (WNV) was first diagnosed in several bird species and horses in 2018. In 2017 and 2018, we screened 1709 live wild and zoo birds with real-time polymerase chain reaction and serological assays. Moreover, organ samples from bird carcasses submitted in 2017 were investigated. Overall, 57 blood samples of the live birds (2017 and 2018), and 100 organ samples of dead birds (2017) were positive for USUV-RNA, while no WNV-RNA-positive sample was found. Phylogenetic analysis revealed the first detection of USUV lineage Europe 2 in Germany and the spread of USUV lineages Europe 3 and Africa 3 towards Northern Germany. USUV antibody prevalence rates were high in Eastern Germany in both years. On the contrary, in Northern Germany, high seroprevalence rates were first detected in 2018, with the first emergence of USUV in this region. Interestingly, high WNV-specific neutralizing antibody titers were observed in resident and short-distance migratory birds in Eastern Germany in 2018, indicating the first signs of a local WNV circulation