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National validation of the Centers for Medicare & Medicaid Services strategy for identifying potential surgical-site infections following colon surgery and abdominal hysterectomy
- Michael S. Calderwood, Ken Kleinman, Christina B. Bruce, Lauren Shimelman, Rebecca E. Kaganov, Richard Platt, Susan S. Huang
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 2 / February 2024
- Published online by Cambridge University Press:
- 07 September 2023, pp. 167-173
- Print publication:
- February 2024
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Objective:
National validation of claims-based surveillance for surgical-site infections (SSIs) following colon surgery and abdominal hysterectomy.
Design:Retrospective cohort study.
Setting:US hospitals selected for data validation by Centers for Medicare & Medicaid Services (CMS).
Participants:The study included 550 hospitals performing colon surgery and 458 hospitals performing abdominal hysterectomy in federal fiscal year 2013.
Methods:We requested 1,200 medical records from hospitals selected for validation as part of the CMS Hospital Inpatient Quality Reporting program. For colon surgery, we sampled 60% with a billing code suggestive of SSI during their index admission and/or readmission within 30 days and 40% who were readmitted without one of these codes. For abdominal hysterectomy, we included all patients with an SSI code during their index admission, all patients readmitted within 30 days, and a sample of those with a prolonged surgical admission (length of stay > 7 days). We calculated sensitivity and positive predictive value for the different groups.
Results:We identified 142 colon-surgery SSIs (46 superficial SSIs and 96 deep and organ-space SSIs) and 127 abdominal-hysterectomy SSIs (58 superficial SSIs and 69 deep and organ-space SSIs). Extrapolating to the full CMS data validation cohort, we estimated an SSI rate of 8.3% for colon surgery and 3.0% for abdominal hysterectomy. Our colon-surgery surveillance codes identified 93% of SSIs, with 1 SSI identified for every 2.6 patients reviewed. Our abdominal-hysterectomy surveillance codes identified 73% of SSIs, with 1 SSI identified for every 1.6 patients reviewed.
Conclusions:Using claims to target record review for SSI validation performed well in a national sample.
Homogenizing fluid transport in stratified porous media using an elastic flow instability
- Christopher A. Browne, Richard B. Huang, Callie W. Zheng, Sujit S. Datta
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- Journal:
- Journal of Fluid Mechanics / Volume 963 / 25 May 2023
- Published online by Cambridge University Press:
- 19 May 2023, A30
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Many key environmental, industrial and energy processes rely on controlling fluid transport within subsurface porous media. These media are typically structurally heterogeneous, often with vertically layered strata of distinct permeabilities – leading to uneven partitioning of flow across strata, which can be undesirable. Here, using direct in situ visualization, we demonstrate that polymer additives can homogenize this flow by inducing a purely elastic flow instability that generates random spatio-temporal fluctuations and excess flow resistance in individual strata. In particular, we find that this instability arises at smaller imposed flow rates in higher-permeability strata, diverting flow towards lower-permeability strata and helping to homogenize the flow. Guided by the experiments, we develop a parallel-resistor model that quantitatively predicts the flow rate at which this homogenization is optimized for a given stratified medium. Thus, our work provides a new approach to homogenizing fluid and passive scalar transport in heterogeneous porous media.
First fossil jacobsoniid beetle (Coleoptera): Derolathrus groehni n. sp. from Eocene Baltic amber
- Chenyang Cai, Richard A. B. Leschen, Ye Liu, Diying Huang
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- Journal:
- Journal of Paleontology / Volume 89 / Issue 5 / September 2015
- Published online by Cambridge University Press:
- 28 March 2016, pp. 762-767
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Jacobsoniidae, comprising a small group of small-to-minute polyphagan beetles, is a family presently placed within Derodontiformia. No fossil jacobsoniid has been described to date. Here, we describe the first fossil jacobsoniid, Derolathrus groehni n. sp., based on two well-preserved individuals in middle Eocene Baltic amber. Micro–computed tomography (micro-CT) was used to reveal many diagnostic characters of the Recent genus Derolathrus Sharp. Derolathrus groehni is compared with modern Derolathrus species and is noteworthy for the well-developed eyes and elongate prothorax.
Cost Savings of Universal Decolonization to Prevent Intensive Care Unit Infection: Implications of the REDUCE MRSA Trial
- Susan S. Huang, Edward Septimus, Taliser R. Avery, Grace M. Lee, Jason Hickok, Robert A. Weinstein, Julia Moody, Mary K. Hayden, Jonathan B. Perlin, Richard Platt, G. Thomas Ray
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue S3 / October 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. S23-S31
- Print publication:
- October 2014
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Objective.
To estimate and compare the impact on healthcare costs of 3 alternative strategies for reducing bloodstream infections in the intensive care unit (ICU): methicillin-resistant Staphylococcus aureus (MRSA) nares screening and isolation, targeted decolonization (ie, screening, isolation, and decolonization of MRSA carriers or infections), and universal decolonization (ie, no screening and decolonization of all ICU patients).
Design.Cost analysis using decision modeling.
Methods.We developed a decision-analysis model to estimate the health care costs of targeted decolonization and universal decolonization strategies compared with a strategy of MRSA nares screening and isolation. Effectiveness estimates were derived from a recent randomized trial of the 3 strategies, and cost estimates were derived from the literature.
Results.In the base case, universal decolonization was the dominant strategy and was estimated to have both lower intervention costs and lower total ICU costs than either screening and isolation or targeted decolonization. Compared with screening and isolation, universal decolonization was estimated to save $171,000 and prevent 9 additional bloodstream infections for every 1,000 ICU admissions. The dominance of universal decolonization persisted under a wide range of cost and effectiveness assumptions.
Conclusions.A strategy of universal decolonization for patients admitted to the ICU would both reduce bloodstream infections and likely reduce healthcare costs compared with strategies of MRSA nares screening and isolation or screening and isolation coupled with targeted decolonization.
Does Chlorhexidine Bathing in Adult Intensive Care Units Reduce Blood Culture Contamination? A Pragmatic Cluster-Randomized Trial
- Edward J. Septimus, Mary K. Hayden, Ken Kleinman, Taliser R. Avery, Julia Moody, Robert A. Weinstein, Jason Hickok, Julie Lankiewicz, Adrijana Gombosev, Katherine Haffenreffer, Rebecca E. Kaganov, John A. Jernigan, Jonathan B. Perlin, Richard Piatt, Susan S. Huang
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 35 / Issue S3 / October 2014
- Published online by Cambridge University Press:
- 10 May 2016, pp. S17-S22
- Print publication:
- October 2014
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Objective.
To determine rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization.
Design.Pragmatic cluster-randomized trial.
Setting.Forty-three hospitals with 74 ICUs; 42 of 43 were community hospitals.
Patients.Patients admitted to adult ICUs from July 1, 2009, to September 30, 2011.
Methods.After a 6-month baseline period, hospitals were randomly assigned to 1 of 3 strategies, with all participating adult ICUs in a given hospital assigned to the same strategy. Arm 1 implemented methicillin-resistant Staphylococcus aureus (MRSA) nares screening and isolation, arm 2 targeted decolonization (screening, isolation, and decolonization of MRSA carriers), and arm 3 conducted no screening but universal decolonization of all patients with mupirocin and chlorhexidine (CHG) bathing. Blood culture contamination rates in the intervention period were compared to the baseline period across all 3 arms.
Results.During the 6-month baseline period, 7,926 blood cultures were collected from 3,399 unique patients: 1,099 sets in arm 1, 928 in arm 2, and 1,372 in arm 3. During the 18-month intervention period, 22,761 blood cultures were collected from 9,878 unique patients: 3,055 sets in arm 1, 3,213 in arm 2, and 3,610 in arm 3. Among all individual draws, for arms 1,2, and 3, the contamination rates were 4.1%, 3.9%, and 3.8% for the baseline period and 3.3%, 3.2%, and 2.4% for the intervention period, respectively. When we evaluated sets of blood cultures rather than individual draws, the contamination rate in arm 1 (screening and isolation) was 9.8% (N = 108 sets) in the baseline period and 7.5% (N = 228) in the intervention period. For arm 2 (targeted decolonization), the baseline rate was 8.4% (N = 78) compared to 7.5% (N = 241) in the intervention period. Arm 3 (universal decolonization) had the greatest decrease in contamination rate, with a decrease from 8.7% (N = 119) contaminated blood cultures during the baseline period to 5.1% (N = 184) during the intervention period. Logistic regression models demonstrated a significant difference across the arms when comparing the reduction in contamination between baseline and intervention periods in both unadjusted (P = .02) and adjusted (P = .02) analyses. Arm 3 resulted in the greatest reduction in blood culture contamination rates, with an unadjusted odds ratio (OR) of 0.56 (95% confidence interval [CI], 0.044-0.71) and an adjusted OR of 0.55 (95% CI, 0.43-0.71).
Conclusion.In this large cluster-randomized trial, we demonstrated that universal decolonization with CHG bathing resulted in a significant reduction in blood culture contamination.
Use of Medicare Claims to Identify US Hospitals with a High Rate of Surgical Site Infection after Hip Arthroplasty
- Michael S. Calderwood, Ken Kleinman, Dale W. Bratzler, Allen Ma, Christina B. Bruce, Rebecca E. Kaganov, Claire Canning, Richard Piatt, Susan S. Huang, Centers for Disease Control and Prevention Epicenters Program and the Oklahoma Foundation for Medical Quality
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 34 / Issue 1 / January 2013
- Published online by Cambridge University Press:
- 02 January 2015, pp. 31-39
- Print publication:
- January 2013
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Objective.
To assess the ability of Medicare claims to identify US hospitals with high rates of surgical site infection (SSI) after hip arthroplasty.
Design.Retrospective cohort study.
Setting.Acute care US hospitals.
Participants.Fee-for-service Medicare patients 65 years of age and older who underwent hip arthroplasty in US hospitals from 2005 through 2007.
Methods.Hospital rankings were derived from claims codes suggestive of SSI, adjusted for age, sex, and comorbidities, while using generalized linear mixed models to account for hospital volume. Medical records were obtained for validation of infection on a random sample of patients from hospitals ranked in the best and worst deciles of performance. We then calculated the risk-adjusted odds of developing a chart-confirmed SSI after hip arthroplasty in hospitals ranked by claims into worst- versus best-performing deciles.
Results.Among 524,892 eligible Medicare patients who underwent hip arthroplasty at 3,296 US hospitals, a patient who underwent surgery in a hospital ranked in the worst-performing decile based on claims-based evidence of SSI had 2.9-fold higher odds of developing a chart-confirmed SSI relative to a patient with the same age, sex, and comorbidities in a hospital ranked in the best-performing decile (95% confidence interval, 2.2-3.7).
Conclusions.Medicare claims successfully distinguished between hospitals with high and low SSI rates following hip arthroplasty. These claims can identify potential outlier hospitals that merit further evaluation. This strategy can also be used to validate the completeness of public reporting of SSI.
Optimizing Thermoelectric Efficiency of La3-xTe4 with Calcium Metal Substitution
- Samantha M. Clarke, James M. Ma, C.-K. Huang, Paul A. von Allmen, Trinh Vo, Richard B. Kaner, Sabah K. Bux, Jean-Pierre Fleurial
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1490 / 2013
- Published online by Cambridge University Press:
- 18 January 2013, pp. 83-88
- Print publication:
- 2013
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La3-xTe4 is a state-of-the-art high temperature n-type thermoelectric material with a previously reported maximum zT∼1.1 at 1273 K. Computational modeling suggests the La atoms play a crucial role in defining the density of states for La3-xTe4 in the conduction band. In addition to controlling charge carrier concentration, substitution with Ca2+ atoms on the La3+ site is explored as a potential means to tune the density of states and result in larger Seebeck coefficients. High purity, oxide-free samples are produced by ball milling of the elements and consolidated by spark plasma sintering. Powder XRD and electron microprobe analysis are used to characterize the material. High temperature thermoelectric properties are reported and compared with La3-xTe4 compositions. A maximum zT of 1.3 is reached at 1273 K for the composition La2.22Ca0.775Te4.
The 3D solar minimum with differential emission measure tomography
- Alberto M. Vásquez, Richard A. Frazin, Zhenguang Huang, Ward B. Manchester IV, Paul Shearer
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- Journal:
- Proceedings of the International Astronomical Union / Volume 7 / Issue S286 / October 2011
- Published online by Cambridge University Press:
- 05 July 2012, pp. 123-133
- Print publication:
- October 2011
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Differential emission measure tomography (DEMT) makes use of extreme ultraviolet (EUV) image series to deliver two products: a) the three-dimensional (3D) reconstruction of the coronal emissivity in the instrumental bands, and b) the 3D distribution of the local differential emission measure (LDEM). The LDEM allows, in turn, construction of 3D maps of the electron density and temperature distribution. DEMT is being currently applied to the space-based EUV imagers, allowing reconstruction of the inner corona in the height range 1.00 to 1.25 R⊙. In this work we applied DEMT to different Carrington Rotations corresponding to the last two solar Cycle minima. To reconstruct the 2008 minimum we used data taken by the Extreme UltraViolet Imager (EUVI), on board the Solar TErrestrial RElations Observatory (STEREO) spacecraft, and to reconstruct the 1996 minimum we used data taken by the Extreme ultraviolet Imaging Telescope (EIT), on board the Solar and Heliospheric Observatory (SOHO). We show here comparative results, discussing the observed 3D density and temperature distributions in the context of global potential magnetic field extrapolations. We also compare the DEMT results with other observational and modeling efforts of the same periods.
The 3D solar corona Cycle 24 rising phase from SDO/AIA tomography
- Federico A. Nuevo, Alberto M. Vásquez, Richard A. Frazin, Zhenguang Huang, Ward B. Manchester IV
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- Journal:
- Proceedings of the International Astronomical Union / Volume 7 / Issue S286 / October 2011
- Published online by Cambridge University Press:
- 05 July 2012, pp. 238-241
- Print publication:
- October 2011
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We recently extended the differential emission measure tomography (DEMT) technique to be applied to the six iron bands of the Atmospheric Imaging Assembly (AIA) instrument aboard the Solar Dynamics Observatory (SDO). DEMT products are the 3D reconstruction of the coronal emissivity in the instrument's bands, and the 3D distribution of the local differential emission measure, in the height range 1.0 to 1.25 R⊙. We show here derived maps of the electron density and temperature of the inner solar corona during the rising phase of solar Cycle 24. We discuss the distribution of our results in the context of open/closed magnetic regions, as derived from a global potential field source surface (PFSS) model of the same period. We also compare the results derived with SDO/AIA to those derived with the Extreme UltraViolet Imager (EUVI) instrument aboard the Solar TErrestrial RElations Observatory (STEREO).
Contributors
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- By Gregory H. Adkisson, Ozan Akça, Nawar Al-Rawas, John T. Anderson, Richard M. Bednarski, Francesca Bernabè, David G. Bjoraker, Lluis Blanch, Stephan H. Böhm, Edwin A. Bowe, Philip G. Boysen, Justin C. Cahill, Ira M. Cheifetz, David C. Cone, Nancy Craig, Daniel P. Davis, John B. Downs, Ronald Dueck, Jay L. Falk, Roger Fletcher, Michael A. Frakes, Andrea Gabrielli, Thomas J. Gallagher, Geoff Gilmartin, J. S. Gravenstein, Antonino Gullo, Donna Hamel, John W. Huang, Amy V. Isenberg, Michael B. Jaffe, Michael C. K. Khoo, Robert R. Kirby, E. F. Klein, A. Joseph Layon, Umberto Lucangelo, Emilio Maldonado, Paul E. Marik, Alicia E. Meuret, Timothy E. Morey, William Muir, Joseph A. Orr, Mehmet S. Ozcan, Lucía Isabel Passoni, David A. Paulus, Yong G. Peng, Carl W. Peters, George A. Ralls, Adriana G. Scandurra, Peter W. Scherer, Gerd Schmalisch, Adam Seiver, Salvatore Silvestri, Bob Smalhout, Fernando Suarez-Sipmann, Daniel E. Supkis, John Thompson, Patrick Troy, Jonathon D. Truwit, Gerardo Tusman, Joseph Varon, Ajeet G. Vinayak, Kevin R. Ward, Marvin A. Wayne, Charles Weissman, Dafna Willner, Kai Zhao, Christian C. Zuver
- Edited by J. S. Gravenstein, University of Florida, Michael B. Jaffe, Nikolaus Gravenstein, University of Florida, David A. Paulus, University of Florida
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- Capnography
- Published online:
- 05 August 2011
- Print publication:
- 17 March 2011, pp ix-xii
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Impact of an Environmental Cleaning Intervention on the Presence of Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci on Surfaces in Intensive Care Unit Rooms
- Eric R. Goodman, Richard Piatt, Richard Bass, Andrew B. Onderdonk, Deborah S. Yokoe, Susan S. Huang
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 29 / Issue 7 / July 2008
- Published online by Cambridge University Press:
- 02 January 2015, pp. 593-599
- Print publication:
- July 2008
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Objectives.
To evaluate the adequacy of discharge room cleaning and the impact of a cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) on environmental surfaces in intensive care unit (ICU) rooms.
Design.Prospective environmental study.
Setting and sample.Convenience sample of ICU rooms in an academic hospital.
Methods and intervention.The intervention consisted of (1) a change from the use of pour bottles to bucket immersion for applying disinfectant to cleaning cloths, (2) an educational campaign, and (3) feedback regarding adequacy of discharge cleaning. Cleaning of 15 surfaces was evaluated by inspecting for removal of a preapplied mark, visible only with an ultraviolet lamp (“black light”). Six surfaces were cultured for MRSA or VRE contamination. Outcomes of mark removal and culture positivity were evaluated by X2 testing and generalized linear mixed models, clustering by room.
Results.The black-light mark was removed from 44% of surfaces at baseline, compared with 71 % during the intervention (P < .001). The intervention increased the likelihood of removal of black-light marks after discharge cleaning (odds ratio, 4.4; P < .001), controlling for ICU type (medical vs surgical) and type of surface. The intervention reduced the likelihood of an environmental culture positive for MRSA or VRE (proportion of cultures positive, 45% at baseline vs 27% during the intervention; adjusted odds ratio, 0.4; P = .02). Broad, flat surfaces were more likely to be cleaned than were doorknobs and sink or toilet handles.
Conclusions.Increasing the volume of disinfectant applied to environmental surfaces, providing education for Environmental Services staff, and instituting feedback with a black-light marker improved cleaning and reduced the frequency of MRSA and VRE contamination.
Contributors
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- By Robert S. Agnew, Lara M. Belliston, Daniel M. Blonigen, Michel Boivin, Jeanne Brooks‐Gunn, Andrew Canastar, Noel A. Card, Emil F. Coccaro, Nicki R. Crick, Linda L. Dahlberg, Garth Davies, Scott H. Decker, Kenneth A. Dodge, Dorothy L. Espelage, Jeffrey Fagan, Albert D. Farrell, David P. Farrington, Daniel J. Flannery, Mark S. Fleisher, Vangie A. Foshee, Holly Foster, Richard J. Gelles, Denise C. Gottfredson, Gary D. Gottfredson, Michael R. Gottfredson, Richard E. Heyman, James C. (Buddy) Howell, Megan Q. Howell, Li Huang, L. Rowell Huesmann, Cynthia Irvin, Gary F. Jensen, Yoshito Kawabata, Lucyna Kirwil, Jeff M. Kretschmar, Robert F. Krueger, Markus J. P. Kruesi, Benjamin B. Lahey, Royce Lee, Scott O. Lilienfeld, Todd D. Little, Anne Martin, Rebecca A. Matthew, Stephen C. Maxson, Jacquelyn Mize, Terrie E. Moffitt, Daniel S. Nagin, Jamie M. Ostrov, Christopher J. Patrick, Bowen Paulle, Gregory S. Pettit, Adrian Raine, Soo Hyun Rhee, Angela Scarpa, Jean R. Séguin, Michelle R. Sherrill, Mark I. Singer, Amy M. Smith Slep, Kevin J. Strom, Patrick Sylvers, Patrick H. Tolan, Elizabeth Trejos‐Castillo, Richard E. Tremblay, Manfred van Dulmen, Johan van Wilsem, Alexander T. Vazsonyi, Edelyn Verona, Frank Vitaro, Monique Vulin‐Reynolds, Irwin D. Waldman, Mark Warr, Stanley Wasserman, Deanna L. Wilkinson
- Edited by Daniel J. Flannery, Kent State University, Ohio, Alexander T. Vazsonyi, Auburn University, Alabama, Irwin D. Waldman, Emory University, Atlanta
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- Book:
- The Cambridge Handbook of Violent Behavior and Aggression
- Published online:
- 05 June 2012
- Print publication:
- 03 September 2007, pp xi-xviii
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The transcription factor Nr2e3 functions in retinal progenitors to suppress cone cell generation
- NEENA B. HAIDER, PAUL DEMARCO, ARNE M. NYSTUEN, XIAONA HUANG, RICHARD S. SMITH, MAUREEN A. MCCALL, JÜRGEN K. NAGGERT, PATSY M. NISHINA
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- Journal:
- Visual Neuroscience / Volume 23 / Issue 6 / November 2006
- Published online by Cambridge University Press:
- 30 January 2007, pp. 917-929
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The transcription factor Nr2e3 is an essential component for development and specification of rod and cone photoreceptors; however, the mechanism through which it acts is not well understood. In this study, we use Nr2e3rd7/rd7 mice that harbor a mutation in Nr2e3, to serve as a model for the human retinal disease Enhanced S Cone Syndrome. Our studies reveal that NR2E3 is expressed in late retinal progenitors and differentiating photoreceptors of the developing retina and localized to the cell bodies of mature rods and cones. In particular, we demonstrate that the abnormal increase in cone photoreceptors observed in Nr2e3rd7/rd7 mice arise from ectopic mitotic progenitor cells that are present in the outer nuclear layer of the mature Nr2e3rd7/rd7 retina. A prolonged phase of proliferation is observed followed by abnormal retinal lamination with fragmented and disorganized photoreceptor synapses that result in a progressive loss of rod and cone function. An extended and pronounced wave of apoptosis is also detected at P30 and temporally correlates with the phase of prolonged proliferation. Approximately twice as many apoptotic cells were detected compared to proliferating cells. This wave of apoptosis appears to affect both rod and cone cells and thus may account for the concurrent loss of rod and cone function. We further show that Nr2e3rd7/rd7 cones do not express rod specific genes and Nr2e3rd7/rd7 rods do not express cone specific genes. Our studies suggest that, based on its temporal and spatial expression, NR2E3 acts simultaneously in different cell types: in late mitotic progenitors, newly differentiating post mitotic cells, and mature rods and cones. In particular, this study reveals the function of NR2E3 in mitotic progenitors is to repress the cone generation program. NR2E3 is thus one of the few genes known to influence the competency of retinal progenitors while simultaneously directing the rod and cone differentiation.