The role of stethoscopes in the transmission of hospital infections

Stethoscopes are one of the most commonly used medical devices and have been reported to be potential sources of hospital acquired infections. In this study, we aimed to find out the bacterial contamination of stethoscopes used by health-care staff. Swab samples were taken from the surface of the diaphragm of the stethoscopes used by health personnel in four hospitals including three secondline and one third-line health care institution in Turkey. The samples were inoculated onto bacteriological and mycological media. For identification of the microorganisms, conventional methods and Vitek2 (Biomérieux) were performed. Swab samples were taken from 121 stethoscopes. We found bacterial and fungal contamination on 92 (76%) of the stethoscopes. 15 out 90 (16.3%) had potential pathogens including methicillin susceptible Staphylococcus aureus (5), methicillin resistance Staphylococcus aureus (4), Escherichia coli (3), Acinetobacter baumannii, Acinetobacter haemolyticus and Enterococcus spp. Of the 121 health-care persons, only 61 regularly cleaned their stethoscopes by various disinfectants. The statistical difference between the two groups in terms of pathogen and microorganism isolation was not determined (p>0.05). Although stethoscopes are uncritical medical devices, they could contain pathogen microorganisms and they might be a potential source of hospital acquired infections.Key words: Stethoscopes, hospital infections, Staphylococcus aureus

Investigation of nasal colonization of health care workers by methicillin-resistant Staphylococcus aureus with using new generation real-time PCR assay: Discussing of risks

Methicillin-resistant Staphylococcus aureus (MRSA) is a nasal infectious pathogen which is becoming of significant importance year by year. Mortality, morbidity and treatment costs of MRSA infectionshave all increased. The most effective preventative tool is rapid confirmation of MRSA existence, followed by efficient execution of the required infection control measures. This study was performedwith the aim of evaluating MRSA colonization in health care staff from intensive care units (internal and surgical intensive care units) (ICUs) and how certain risk factors affect their colonization status. The study was conducted prospectively using samples obtained from nasal swabs of health-care staffs working in different missions in the intensive care unit of Gaziantep University Training Hospital in southeast of Turkey. The nasal swab samples were processed using a real-time PCR method platformcalled GeneXpert (Cepheid). Our PCR screen revealed the presence of MRSA in 14 of 98 health-care staffs. Of these 14 health-care staffs carrying nasal MRSA, 10 were male, 8 were assistant health-care personnel and 11 have been working for over one year in the intensive care unit. Our data showed that male gender and an employment during of more than one year served as significant risk factors for nasal MRSA colonization

Galactic-Centre Gamma Rays in CMSSM Dark Matter Scenarios

We study the production of gamma rays via LSP annihilations in the core of the Galaxy as a possible experimental signature of the constrained minimal supersymmetric extension of the Standard Model (CMSSM), in which supersymmetry-breaking parameters are assumed to be universal at the GUT scale, assuming also that the LSP is the lightest neutralino chi. The part of the CMSSM parameter space that is compatible with the measured astrophysical density of cold dark matter is known to include a stau_1 - chi coannihilation strip, a focus-point strip where chi has an enhanced Higgsino component, and a funnel at large tanb where the annihilation rate is enhanced by the poles of nearby heavy MSSM Higgs bosons, A/H. We calculate the total annihilation rates, the fractions of annihilations into different Standard Model final states and the resulting fluxes of gamma rays for CMSSM scenarios along these strips. We observe that typical annihilation rates are much smaller in the coannihilation strip for tanb = 10 than along the focus-point strip or for tanb = 55, and that the annihilation branching ratios differ greatly between the different dark matter strips. Whereas the current Fermi-LAT data are not sensitive to any of the CMSSM scenarios studied, and the calculated gamma-ray fluxes are probably unobservably low along the coannihilation strip for tanb = 10, we find that substantial portions of the focus-point strips and rapid-annihilation funnel regions could be pressured by several more years of Fermi-LAT data, if understanding of the astrophysical background and/or systematic uncertainties can be improved in parallel.Comment: 33 pages, 12 figures, comments and references added, version to appear in JCA

KRAS-mutation incidence and prognostic value are metastatic site-specific in lung adenocarcinoma: poor prognosis in patients with KRAS-mutation and bone metastasis

Current guidelines lack comprehensive information on the metastatic site-specific role of KRAS mutation in lung adenocarcinoma (LADC). We investigated the effect of KRAS mutation on overall survival (OS) in this setting. In our retrospective study, 500 consecutive Caucasian metastatic LADC patients with known KRAS mutational status were analyzed after excluding 32 patients with EGFR mutations. KRAS mutation incidence was 28.6%. The most frequent metastatic sites were lung (45.6%), bone (26.2%), adrenal gland (17.4%), brain (16.8%), pleura (15.6%) and liver (11%). Patients with intrapulmonary metastasis had significantly increased KRAS mutation frequency compared to those with extrapulmonary metastases (35% vs 26.5%, p=0.0125). In contrast, pleural dissemination and liver involvement were associated with significantly decreased KRAS mutation incidence (vs all other metastatic sites; 17% (p<0.001) and 16% (p=0.02) vs 33%, respectively). Strikingly, we found a significant prognostic effect of KRAS status only in the bone metastatic subcohort (KRAS-wild-type vs KRAS-mutant; median OS 9.7v 3.7 months; HR, 0.49; 95% CI, 0.31 to 0.79; p =0.003). Our study suggests that KRAS mutation frequency in LADC patients shows a metastatic site dependent variation and, moreover, that the presence of KRAS mutation is associated with significantly worse outcome in bone metastatic cases.(VLID)469049

Measurement of the diffractive structure function in deep inelastic scattering at HERA

This paper presents an analysis of the inclusive properties of diffractive deep inelastic scattering events produced in $ep$ interactions at HERA. The events are characterised by a rapidity gap between the outgoing proton system and the remaining hadronic system. Inclusive distributions are presented and compared with Monte Carlo models for diffractive processes. The data are consistent with models where the pomeron structure function has a hard and a soft contribution. The diffractive structure function is measured as a function of \xpom, the momentum fraction lost by the proton, of $\beta$, the momentum fraction of the struck quark with respect to \xpom, and of $Q^2$. The \xpom dependence is consistent with the form \xpoma where $a~=~1.30~\pm~0.08~(stat)~^{+~0.08}_{-~0.14}~(sys)$ in all bins of $\beta$ and $Q^2$. In the measured $Q^2$ range, the diffractive structure function approximately scales with $Q^2$ at fixed $\beta$. In an Ingelman-Schlein type model, where commonly used pomeron flux factor normalisations are assumed, it is found that the quarks within the pomeron do not saturate the momentum sum rule.Comment: 36 pages, latex, 11 figures appended as uuencoded fil

Colour reconnection in e+e- -> W+W- at sqrt(s) = 189 - 209 GeV

The effects of the final state interaction phenomenon known as colour reconnection are investigated at centre-of-mass energies in the range sqrt(s) ~ 189-209 GeV using the OPAL detector at LEP. Colour reconnection is expected to affect observables based on charged particles in hadronic decays of W+W-. Measurements of inclusive charged particle multiplicities, and of their angular distribution with respect to the four jet axes of the events, are used to test models of colour reconnection. The data are found to exclude extreme scenarios of the Sjostrand-Khoze Type I (SK-I) model and are compatible with other models, both with and without colour reconnection effects. In the context of the SK-I model, the best agreement with data is obtained for a reconnection probability of 37%. Assuming no colour reconnection, the charged particle multiplicity in hadronically decaying W bosons is measured to be (nqqch) = 19.38+-0.05(stat.)+-0.08 (syst.).Comment: 30 pages, 9 figures, Submitted to Euro. Phys. J.

Determination of alpha_s using Jet Rates at LEP with the OPAL detector

Hadronic events produced in e+e- collisions by the LEP collider and recorded by the OPAL detector were used to form distributions based on the number of reconstructed jets. The data were collected between 1995 and 2000 and correspond to energies of 91 GeV, 130-136 GeV and 161-209 GeV. The jet rates were determined using four different jet-finding algorithms (Cone, JADE, Durham and Cambridge). The differential two-jet rate and the average jet rate with the Durham and Cambridge algorithms were used to measure alpha(s) in the LEP energy range by fitting an expression in which order alpah_2s calculations were matched to a NLLA prediction and fitted to the data. Combining the measurements at different centre-of-mass energies, the value of alpha_s (Mz) was determined to be alpha(s)(Mz)=0.1177+-0.0006(stat.)+-0.0012$(expt.)+-0.0010(had.)+-0.0032(theo.) \.Comment: 40 pages, 17 figures, Submitted to Euro. Phys. J.

Scaling violations of quark and gluon jet fragmentation functions in e+e- annihilations at sqrt(s) = 91.2 and 183-209 GeV

Flavour inclusive, udsc and b fragmentation functions in unbiased jets, and flavour inclusive, udsc, b and gluon fragmentation functions in biased jets are measured in e+e- annihilations from data collected at centre-of-mass energies of 91.2, and 183-209 GeV with the OPAL detector at LEP. The unbiased jets are defined by hemispheres of inclusive hadronic events, while the biased jet measurements are based on three-jet events selected with jet algorithms. Several methods are employed to extract the fragmentation functions over a wide range of scales. Possible biases are studied in the results are obtained. The fragmentation functions are compared to results from lower energy e+e- experiments and with earlier LEP measurements and are found to be consistent. Scaling violations are observed and are found to be stronger for the fragmentation functions of gluon jets than for those of quarks. The measured fragmentation functions are compared to three recent theoretical next-to-leading order calculations and to the predictions of three Monte Carlo event generators. While the Monte Carlo models are in good agreement with the data, the theoretical predictions fail to describe the full set of results, in particular the b and gluon jet measurements.Comment: 46 pages, 17 figures, Submitted to Eur. Phys J.

Tests of model of color reconnection and a search for glueballs using gluon jets with a rapidity gap

Gluon jets with a mean energy of 22 GeV and purity of 95% are selected from hadronic Z0 decay events produced in e+e- annihilations. A subsample of these jets is identified which exhibits a large gap in the rapidity distribution of particles within the jet. After imposing the requirement of a rapidity gap, the gluon jet purity is 86%. These jets are observed to demonstrate a high degree of sensitivity to the presence of color reconnection, i.e. higher order QCD processes affecting the underlying color structure. We use our data to test three QCD models which include a simulation of color reconnection: one in the Ariadne Monte Carlo, one in the Herwig Monte Carlo, and the other by Rathsman in the Pythia Monte Carlo. We find the Rathsman and Ariadne color reconnection models can describe our gluon jet measurements only if very large values are used for the cutoff parameters which serve to terminate the parton showers, and that the description of inclusive Z0 data is significantly degraded in this case. We conclude that color reconnection as implemented by these two models is disfavored. The signal from the Herwig color reconnection model is less clear and we do not obtain a definite conclusion concerning this model. In a separate study, we follow recent theoretical suggestions and search for glueball-like objects in the leading part of the gluon jets. No clear evidence is observed for these objects.Comment: 42 pages, 18 figure

W Boson Polarisation at LEP2

Elements of the spin density matrix for W bosons in e+e- -> W+W- -> qqln events are measured from data recorded by the OPAL detector at LEP. This information is used calculate polarised differential cross-sections and to search for CP-violating effects. Results are presented for W bosons produced in e+e- collisions with centre-of-mass energies between 183 GeV and 209 GeV. The average fraction of W bosons that are longitudinally polarised is found to be (23.9 +- 2.1 +- 1.1)% compared to a Standard Model prediction of (23.9 +- 0.1)%. All results are consistent with CP conservation.Comment: 20 pages, 3 figures, Submitted to Phys. Letts.