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Novel method of calculating adjusted antibiotic use by microbiological burden
- Hana R. Winders, Majdi N. Al-Hasan, Bruce M. Jones, Darrell T. Childress, Kayla R. Stover, Benjamin B. Britt, Elias B. Chahine, Suetping Lau, Pamela D. Andrews, Shauna Jacobson Junco, Rebekah H. Wrenn, Brad J. Crane, Jordan R. Wong, Megan M. Seddon, Christopher M. Bland, Shawn H. MacVane, Geneen M. Gibson, P. Brandon Bookstaver
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 42 / Issue 6 / June 2021
- Published online by Cambridge University Press:
- 28 January 2021, pp. 688-693
- Print publication:
- June 2021
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Objective:
To determine the usefulness of adjusting antibiotic use (AU) by prevalence of bacterial isolates as an alternative method for risk adjustment beyond hospital characteristics.
Design:Retrospective, observational, cross-sectional study.
Setting:Hospitals in the southeastern United States.
Methods:AU in days of therapy per 1,000 patient days and microbiologic data from 2015 and 2016 were collected from 26 hospitals. The prevalences of Pseudomonas aeruginosa, extended-spectrum β-lactamase (ESBL)–producing bacteria, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) were calculated and compared to the average prevalence of all hospitals in the network. This proportion was used to calculate the adjusted AU (a-AU) for various categories of antimicrobials. For example, a-AU of antipseudomonal β-lactams (APBL) was the AU of APBL divided by (prevalence of P. aeruginosa at that hospital divided by the average prevalence of P. aeruginosa). Hospitals were categorized by bed size and ranked by AU and a-AU, and the rankings were compared.
Results:Most hospitals in 2015 and 2016, respectively, moved ≥2 positions in the ranking using a-AU of APBL (15 of 24, 63%; 22 of 26, 85%), carbapenems (14 of 23, 61%; 22 of 25; 88%), anti-MRSA agents (13 of 23, 57%; 18 of 26, 69%), and anti-VRE agents (18 of 24, 75%; 15 of 26, 58%). Use of a-AU resulted in a shift in quartile of hospital ranking for 50% of APBL agents, 57% of carbapenems, 35% of anti-MRSA agents, and 75% of anti-VRE agents in 2015 and 50% of APBL agents, 28% of carbapenems, 50% of anti-MRSA agents, and 58% of anti-VRE agents in 2016.
Conclusions:The a-AU considerably changes how hospitals compare among each other within a network. Adjusting AU by microbiological burden allows for a more balanced comparison among hospitals with variable baseline rates of resistant bacteria.
Effect of Selected Pesticides on Survival of Colletotrichum gloeosporioides f. sp. malvae, a Bioherbicide for Round-leaved Mallow (Malva pusilla)
- Nelson T. Grant, Elizabeth Prusinkiewicz, Roberte M. D. Makowski, Britt Holmstrom-Ruddick, Knud Mortensen
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- Journal:
- Weed Technology / Volume 4 / Issue 4 / December 1990
- Published online by Cambridge University Press:
- 12 June 2017, pp. 701-715
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Commercial formulations of 33 herbicides, 12 fungicides, and 16 adjuvants were evaluated for their toxic effects on germination of Colletotrichum gloeosporioides f. sp. malvae (C.g.m.) spores. At the recommended rates, none of the herbicides for grass weed control (diclofop, difenzoquat, fenoxaprop-ethyl, flamprop-methyl, and sethoxydim) or formulated herbicides registered for both broadleaf and grass weed control [diclofop plus bromoxynil (23:8), propanil, and propanil plus MCPA (7:2)] were compatible with C.g.m. spores. C.g.m. spore germination and appressorial formation recorded 24 h after exposure were totally inhibited by these herbicides. At recommended rates, herbicides for broadleaf weed control (2,4-D ester, 2,4-D amine, benazolin, bentazon, clopyralid, cyanazine, cyanazine plus MCPA (1:2), dicamba, dicamba plus MCPA (1:4), dicamba plus mecoprop plus MCPA (1:1:4.4), dicamba plus 2,4-D plus mecoprop (4.2:11:3), MCPA amine, MCPA-K, MCPA-Na, and metribuzin), caused no more than a 20% reduction in C.g.m. spore germination, and appressorial formation was not significantly reduced except by benazolin and metribuzin. Cyanazine and dicamba at recommended rates increased appressorial formation without reducing germination compared to the control. At lower concentrations, the other herbicides recommended for broadleaf weed control (2,4-DB, bromoxynil, bromoxynil plus MCPA (1:1), dichlorprop plus 2,4-D (1:1), imazethapyr, linuron, and picloram) were less toxic to C.g.m. spores. The fungicide triadimefon at recommended rate had no effect on C.g.m. spores. Dicloran reduced germination more than 50% at recommended rate and growth was distorted. At recommended rates, spore germination was inhibited by more than 90% with benomyl, carbathiin, chlorothalonil, iprodione, mancozeb, and thiophanate-methyl although germination increased as concentration declined. Spore germination was totally inhibited at all concentrations with ferbam, thiram, and captan. Exposure to the adjuvants—Agral 90, Alkasurf-0P-10, Atplus-555, Citowett Plus, Enhance, Renex 36, Triton XR, and X-77–inhibited C.g.m. spore germination and reduced spore production compared to the control. Spore germination was significantly higher in suspensions containing ammonium sulfate, Assist, Bio-veg, CD-407, and Tween 20, as well as with starch, sucrose, and water (control) than with the other adjuvants. Spore production was higher in suspensions containing starch and Bio-veg than in those with water and the other adjuvants.
Contributors
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- By Ainsworth Shaaron, Ayres Paul, Azevedo Roger, Bediou Benoit, Britt Anne, Kirsten R. Butcher, Chen Fei, Michelene T. H. Chi, Richard E. Clark, Ruth Colvin Clark, Sharon J. Derry, David F. Feldon, Fiorella Logan, J. D. Fletcher, Arthur C. Graesser, Hegarty Mary, HU Xiangen, Allison J. Jaeger, Janssen Jeroen, Cheryl I. Johnson, Ton De Jong, Kalyuga Slava, Kester Liesbeth, Kirschner Femke, Paul A. Kirschner, Susanne P. Lajoie, Ard W. Lazonder, Leutner Detlev, Low Renae, Richard K. Lowe, Richard E. Mayer, Benjamin D. Nye, Paas Fred, Pilegard Celeste, Jan L. Plass, Heather A. Priest, Renkl Alexander, Rouet Jean-FranÇois, Christopher A. Sanchez, Scheiter Katharina, Schmeck Annett, Schnotz Wolfgang, Ruth N. Schwartz, Bruce L. Sherin, Miriam Gamoran Sherin, Sweller John, Tobias Sigmund, Tamara Van Gog, Jeroen J. G. Van MerriËNboer, Jennifer Wiley, Alexander P. Wind, Ruth Wylie
- Edited by Richard E. Mayer, University of California, Santa Barbara
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- Book:
- The Cambridge Handbook of Multimedia Learning
- Published online:
- 05 August 2014
- Print publication:
- 28 July 2014, pp ix-x
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The Deep Space 1 Encounter With Comet 19P/Borrelly
- Diane H. Wooden, L. A. Soderblom, D. T. Britt, R. H. Brown, B. R. Sandel, R. V. Yelle, B. J. Buratti, M. D. Hicks, R. M. Nelson, M. D. Rayman, J. Oberst, N. Thomas
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- Journal:
- International Astronomical Union Colloquium/ Volume 186 /
- pp. 301-324
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NASA's Deep Space 1 (DSl) spacecraft successfully encountered comet 19P/Borrelly near perihelion and the Miniature Integrated Camera and Spectrometer (MICAS) imaging system onboard DS1 returned the first high-resolution images of a Jupiter-family comet nucleus and surrounding environment. The images span solar phase angles from 88° to 52°, providing stereoscopic coverage of the dust coma and nucleus. Numerous surface features are revealed on the 8-km long nucleus in the highest resolution images (47-58 m/pixel). A smooth, broad basin containing brighter regions and mesa-like structures is present in the central part of the nucleus that seems to be the source of jet-like dust features seen in the coma. High ridges seen along the jagged terminator lead to rugged terrain on both ends of the nucleus containing dark patches and smaller series of parallel grooves. No evidence of impact craters with diameters larger than about 200-m are present, indicating a young and active surface. The nucleus is very dark with albedo variations from 0.007 to 0.035. Short-wavelength, infrared spectra from 1.3 to 2.6 μm revealed a hot, dry surface consistent with less than about 10% actively sublimating. Two types of dust features are seen: broad fans and highly collimated “jets” in the sunward hemisphere that can be traced to the surface. The source region of the main jet feature, which resolved into at least three smaller “jets” near the surface, is consistent with an area around the rotation pole that is constantly illuminated by the sun during the encounter. Within a few nuclear radii, entrained dust is rapidly accelerated and fragmented and geometrical effects caused from extended source regions are present, as evidenced in radial intensity profiles centered on the jet features that show an increase in source strength with increasing cometocentric distance. Asymmetries in the dust from dayside to nightside are pronounced and may show evidence of lateral flow transporting dust to structures observed in the nightside coma. A summary of the initial results of the Deep Space 1 Mission is provided, highlighting the new knowledge that has been gained thus far.
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