Results from the third Scottish National Prevalence Survey: is a population health approach now needed to prevent healthcare-associated infections?

Summary Background Healthcare associated infections (HAI) are a major public health concern and a significant cause of morbidity and mortality. A robust and current evidence base that is specific to local, national and Europe-wide settings is necessary to inform the development of strategies to reduce HAI and contain antimicrobial resistance (AMR). Aim To measure the prevalence of HAI and antimicrobial prescribing and identify key priority areas for interventions to reduce the burden of infection. Methods A national rolling PPS in National Health Service (NHS) acute, NHS non-acute, NHS paediatric and independent hospitals was carried out between September and November 2016 using the European Centre for Disease Prevention and Control protocol designed for the European PPS. Findings The prevalence of HAI was 4.6%, 2.7% and 3.2% in acute adults, paediatric and non-acute patient groups, respectively. The most common HAI types reported in adult patients were urinary tract infection and pneumonia. The prevalence of antimicrobial prescribing was 35.7%, 29.3% and 13.8% in acute adults, paediatric and non-acute patient groups, respectively. Respiratory, skin and soft tissue, gastrointestinal and urinary tract infections were the most common infections being treated at the time of survey. Conclusion HAI continues to be a public health concern in Scotland. UTI and pneumonia continue to place a significant burden on patients and on healthcare delivery, including those that develop in the community and require hospital admission. A broader population health approach which focuses on reducing the risk of infection upstream would reduce these infections in both community and hospital settings

Aspects of Common Eider Nesting Ecology in Labrador

The status, distribution, and nesting ecology of common eiders (Somateria mollissima) breeding in Labrador are not well known. This study is an initial effort to improve understanding of the nesting ecology of eiders on the Labrador coast, a zone of intergradation between the northern (S. m. borealis) and American (S. m. dresseri) subspecies of common eider. During 1998 and 1999, 187 islands were surveyed for nesting eiders at four sites (from north to south: Nain, Hopedale, Makkovik, St. Peter’s Bay) along 750 km of the coast. Nest initiation dates (calculated by candling eggs) ranged over a four- to five-week period and were positively associated with latitude: the earliest mean initiation date (5 June) was in St. Peter’s Bay in the south and the latest (27 June) at Nain in the north. Mean clutch size ranged from 3.5 to 4.2 and varied by area and year; eiders nesting in Nain had the smallest clutches. In 1999, the highest nest density (49.8 nests/ha) was observed in Nain and the lowest (3.9 nests/ha) in Makkovik. In some cases, we used boat surveys to assess eider presence and absence and found it to be a reliable method; this search technique could be beneficial to researchers working in remote locations where operational costs are high.On connaît mal le statut, la distribution et l’écologie de nidification de l’eider à duvet (Somateria mollissima) qui se reproduit au Labrador. Cette étude représente un premier pas vers une meilleure compréhension de l’écologie de nidification de l’eider sur la côte du Labrador, une zone de chevauchement entre la sous-espèce du nord (S. m. borealis) et celle américaine (S. m. dresseri) de l’eider à duvet. Durant 1998 et 1999, on a cherché des eiders nicheurs dans 187 îlots à quatre endroits (du nord au sud: Nain, Hopedale, Makkovik, baie de St. Peter’s) répartis sur 750 km de rivage. Les dates du début de la couvaison (calculées en mirant les oeufs) s’étalaient sur une période de quatre à cinq semaines et étaient associées positivement à la latitude: c’est dans la baie de St. Peter’s dans le sud qu’on a observé la date moyenne du début de la couvaison la plus précoce (5 juin), et à Nain dans le nord, la plus tardive (27 juin). La taille moyenne de la couvée allait de 3,5 à 4,2 et variait selon l’endroit et l’année; les eiders qui nichaient à Nain avaient les plus petites couvées. En 1999, la plus forte densité de nids (49,8 nids/ha) a été observée à Nain et la plus faible (3,9 nids/ha), à Makkovik. Dans certains cas, on a utilisé des relevés effectués à partir d’embarcations pour établir la présence et l’absence d’eiders, méthode qui s’est avérée fiable; cette technique de recherche pourrait être bénéfique aux chercheurs travaillant dans des lieux éloignés où les coûts d’opération sont élevés

Reverse doming of the anterior mitral leaflet with severe aortic regurgitation

The normal anatomic relation of the anterior mitral leaflet to the left ventricular outflow tract suggests that significant aortic regurgitation should have a predictable hemodynamic effect on the motion and configuration of the leaflet, an effect that should be seen by two-dimensional echocardiography. Previous reports have identified an abnormality of mitral opening in the short-axis view that was quite specific but not sensitive. This study was undertaken to evaluate mitral valve motion and configuration in aortic insufficiency using two-dimensional echocardiography. A characteristic pattern of anterior leaflet motion was found in patients with moderately severe and severe aortic regurgitation. This pattern, termed “reverse doming,” was seen in the apical and long-axis views in 19 of 22 such patients. The previously described “diastolic indentation” in the short-axis view was found in 16 of these 22 patients. Only 2 of 16 patients with lesser degrees of insufficiency had reverse doming. The sign was not seen in normal subjects nor in 16 patients with cardiomyopathy. For each of the few false positive and false negative findings, there is a seemingly logical hemodynamic explanation.It is concluded that reverse doming of the anterior mitral leaflet appears to be a sensitive and specific sign for moderately severe and severe aortic regurgitation

Insular nestling growth and its relationship to parental care effort in Silvereyes, Zosterops lateralis

The rate at which avian offspring grow can have consequences for survival and reproductive output as an adult and is known to vary widely among and within species. This variation is thought to be an adaptive response to cope with environmental variation. The principal environmental factors affecting growth are food availability and predation risk, predominantly acting as constraints on parental care. Islands pose an interesting system to explore growth rate dynamics, because the characteristic insular features of high population densities and depauperate predator diversity translate into a potentially food limited environment with low predation risk. Insular environments typically produce populations with slower life history strategies and larger body size in small-bodied species, features that are likely to be mediated by growth rate. We describe the nestling growth of an insular population of Silvereyes and how it relates to parental size and parental care. Neither parental size nor parental care explained insular nestling growth rate, even though food acquisition is thought to underpin avian growth rates. This could be due to a mismatch between acquisition and allocation of resources by nestlings. Compared to a small number of mainland nestlings, the island growth curve asymptotes were significantly larger and inflection points much later, but insular growth rates were only marginally slower. This is in line with proposed insular adaptations required to produce larger body size on islands, however understanding the mechanism underlying this pattern will require data on the relationship between food quality and acquisition, and physiological allocation of resources within individuals

One-pot silyl ketene imine formation-nucleophilic addition reactions of acetonitrile with acetals and nitrones

Trimethylsilyl trifluoromethanesulfonate (TMSOTf) and a trialkylamine base promote the conversion of acetonitrile to its silyl ketene imine in situ when acetonitrile is employed as solvent. Residual TMSOTf acts as a Lewis acid catalyst to activate acetals and nitrones in the reaction mixture, yielding β-methoxynitriles and β-(silyloxy)aminonitriles, respectively. Some reaction products undergo elimination under the reaction conditions to provide the α,β-unsaturated nitrile directly

Vps27-Hse1 and ESCRT-I complexes cooperate to increase efficiency of sorting ubiquitinated proteins at the endosome

Ubiquitin (Ub) attachment to cell surface proteins causes their lysosomal degradation by incorporating them into lumenal membranes of multivesicular bodies (MVBs). Two yeast endosomal protein complexes have been proposed as Ub-sorting “receptors,” the Vps27-Hse1 complex and the ESCRT-I complex. We used NMR spectroscopy and mutagenesis studies to map the Ub-binding surface for Vps27 and Vps23. Mutations in Ub that ablate only Vps27 binding or Vps23 binding blocked the ability of Ub to serve as an MVB sorting signal, supporting the idea that both the Vps27-Hse1 and ESCRT-I complexes interact with ubiquitinated cargo. Vps27 also bound Vps23 directly via two PSDP motifs present within the Vps27 COOH terminus. Loss of Vps27-Vps23 association led to less efficient sorting into the endosomal lumen. However, sorting of vacuolar proteases or the overall biogenesis of the MVB were not grossly affected. In contrast, disrupting interaction between Vps27 and Hse1 caused severe defects in carboxy peptidase Y sorting and MVB formation. These results indicate that both Ub-sorting complexes are coupled for efficient recognition of ubiquitinated cargo

Abraham Lincoln & Family

Colored lithograph; Abraham Lincoln & Family ; Also, at bottom: Respectfully Dedicated to the People of the United Stateshttps://scholarsjunction.msstate.edu/fvw-artifacts/1053/thumbnail.jp

Correspondence to Elizabeth ( Bessie ) McCaw Boggs Taylor, September 7, 1879 - May 22, 1887

Correspondence to Elizabeth ( Bessie ) McCaw Boggs Taylor, September 7, 1879 - May 22, 1887. Box 2, Folder 4.https://digitalcommons.wofford.edu/littlejohnboggs/1014/thumbnail.jp