Hospital-Level Variations in Rates of Inpatient Urinary Tract Infections in Stroke.

Background and purpose: Urinary tract infection (UTI) is one of the most common complications following stroke and has prognostic significance. UTI rates have been shown to vary between hospitals, but it is unclear whether this is due to case-mix differences or heterogeneities in care among hospitals. Methods: A prospective multi-center cohort study of acute stroke patients admitted to eight National Health Service (NHS) acute hospital trusts within the Anglia Stroke & Heart Clinical Network between 2009 and 2011 was conducted. We modeled the association between hospital (as a fixed-effect) and inpatient UTI using a multivariable logistic regression model, adjusting for established patient-level risk factors. We graphically and descriptively analyzed heterogeneities in hospital-level characteristics. Results: We included 2,241 stroke admissions in our analysis; 171 (7.6%) acquired UTI as an inpatient. UTI rates varied significantly between the eight hospitals, ranging from 3 to 11%. The hospital that had the lowest odds of UTI [odds ratio (OR) = 0.50 (95% confidence interval (CI) 0.22-.11)] in adjusted analysis, had the highest number of junior doctors and occupational therapists per five beds of all hospitals. The hospital with the highest adjusted UTI rate [OR=2.69 (1.56-4.64)] was tertiary, the largest and had the highest volume of stroke patients, lowest number of stroke unit beds per 100 admissions, and the highest number of hospital beds per CT scanner. Conclusions: There is hospital-level variation in post-stroke UTI. Our results suggest the potential influence of service characteristics independently of patient-level factors which may be amenable to be addressed to improve the ultimate stroke outcome

Collaborative International Research in Clinical and Longitudinal Experience Study in NMOSD.

Objective: To develop a resource of systematically collected, longitudinal clinical data and biospecimens for assisting in the investigation into neuromyelitis optica spectrum disorder (NMOSD) epidemiology, pathogenesis, and treatment. Methods: To illustrate its research-enabling purpose, epidemiologic patterns and disease phenotypes were assessed among enrolled subjects, including age at disease onset, annualized relapse rate (ARR), and time between the first and second attacks. Results: As of December 2017, the Collaborative International Research in Clinical and Longitudinal Experience Study (CIRCLES) had enrolled more than 1,000 participants, of whom 77.5% of the NMOSD cases and 71.7% of the controls continue in active follow-up. Consanguineous relatives of patients with NMOSD represented 43.6% of the control cohort. Of the 599 active cases with complete data, 84% were female, and 76% were anti-AQP4 seropositive. The majority were white/Caucasian (52.6%), whereas blacks/African Americans accounted for 23.5%, Hispanics/Latinos 12.4%, and Asians accounted for 9.0%. The median age at disease onset was 38.4 years, with a median ARR of 0.5. Seropositive cases were older at disease onset, more likely to be black/African American or Hispanic/Latino, and more likely to be female. Conclusions: Collectively, the CIRCLES experience to date demonstrates this study to be a useful and readily accessible resource to facilitate accelerating solutions for patients with NMOSD

Narcissism: a factor behind the selective sharing of news online

The current study examined the extent to which narcissism influences the social network users’ intention to share positive and negative life events with (close or unknown) online contacts. Using an online survey, small vignettes and a cross-sectional convenience sample of 119 participants, the results showed that narcissism positively predicted sharing intention of positive and negative life events with strangers. However, individuals rating higher in narcissism were less likely to share negative news with family. The research findings suggest that personality traits such as narcissism, the type of contacts online, and the nature of the news may shape what information is shared by online users. The type of news presented may therefore be a function of who is posting the content, their personality, and the kind of social network contacts they have online

Design of a Human-Powered Roll Stabilization Attachment for Utilitarian Two-Wheeled Vehicles

Copyright © 2019 ASME. This paper describes the motivation and development of a human-powered roll stabilization attachment for utilitarian two-wheeled vehicles. The proposed design has been built and tested by the authors in both on- and off-road conditions. It provides balance by providing a rolling platform underneath the two-wheeled vehicle (motorcycle) for the user to push against with their feet. This platform is placed under the driver’s sitting position and is towed from a three degree-of-freedom joint behind the front axle (i.e. one of the implementations uses a ball hitch joint). Fifty eight percent of the world’s motorcycles are in Asia Pacific, and Southern and Eastern Asia. In most of those countries, motorcycles greatly outnumber cars and many of these motorcycles function as utility vehicles. The uses of motorcycles include transportation of goods on the bike frame, transportation of goods on a trailer, and even pulling agricultural implements in farms. If no modifications are made to the motorcycle, at slow speeds operators of motorcycles must drag their feet on the ground and lightly push upwards as needed to retain balance. Attaching conventional outrigger wheels, similar to a motorcycle side-car, can negate some of the advantages of motorcycles that users value by: (A) preventing leaning into turns when rigid outriggers arms are used, (B) significantly increasing complexity and mass when outrigger arms mounted on suspension systems are used, and (C) increasing the vehicle’s width such that it can no longer travel between car lanes or between rows of growing crop. An additional design consideration for balancing motorcycles is the user’s need for quick conversion between a statically balanced vehicle and a vehicle can lean dynamically in turns, for example for someone who wishes to operate a motorcycle on farms but also travel quickly between agricultural fields. This conversion convenience is affected not only by the ease of attaching and detaching the balancing system but also by the ability to comfortably carry on the balancing system on the motorcycle even when it is not being used, such that it can be deployed when it is needed. This paper describes a design for a human-powered roll stabilization attachment that address these concerns and other identified user needs. It also provides with general equations to design similar human-powered roll stabilization systems for motorcycles

Patrons de réponse des diatomées en environnements contaminés par les métaux

International audienceDiatoms play a key role in the functioning of streams, and their sensitivity to many environmental factors has led to the development of numerous diatom-based indices used in water quality assessment. Although diatom-based monitoring of metal contamination is not currently included in water quality monitoring programs, the effects of metals on diatom communities have been studied in many polluted watersheds as well as in laboratory experiments, underlying their high potential for metal contamination assessment. Here, we built large database of river diatoms (comprising more than 600 taxa) that were exposed to various loads of heavy metals in the water was investigated. The samples were collected during field surveys carried out in 6 different countries (France, Spain, Switzerland, Canada, Vietnam, China). After taxonomy harmonization, the patterns in diatom community structure were investigated for 202 samples, all collected from hard substrates in rivers with circumneutral water pH. As the sites were contaminated by a mixture of different metals (mainly Al, As, Cd, Cr, Cu, Fe, Hg, Ni, Pb, Zn) with various loads, metal concentrations were converted into a single score after Clements et al. (2000) in order to classify sites according to potential metal toxicity. Metal contamination proved to be a strong driver of the community structure, and enabled for the identification of tolerant species like Eolimna minima, Surirella angusta, Cocconeis placentula var. euglypta or Pinnularia parvulissima. Traits were also tested: diatom cell size and the occurrence of diatom deformities were found to be good indicators of high metal contamination. This work provides a basis for further use of diatoms as indicators of metal pollution Clements WH, Carlisle DM, Lazorchak JM, Johnson PC, 2000. Heavy metals structure benthic communities in Colorado mountain streams