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Prior reports of healthcare-associated respiratory syncytial virus (RSV) have been limited to cases diagnosed after the third day of hospitalization. The omission of other healthcare settings where RSV transmission may occur underestimates the true incidence of healthcare-associated RSV.
Design:
Retrospective cross-sectional study.
Setting:
United States RSV Hospitalization Surveillance Network (RSV-NET) during 2016–2017 through 2018–2019 seasons.
Patients:
Laboratory-confirmed RSV-related hospitalizations in an eight-county catchment area in Tennessee.
Methods:
Surveillance data from RSV-NET were used to evaluate the population-level burden of healthcare-associated RSV. The incidence of healthcare-associated RSV was determined using the traditional definition (i.e., positive RSV test after hospital day 3) in addition to often under-recognized cases associated with recent post-acute care facility admission or a recent acute care hospitalization for a non-RSV illness in the preceding 7 days.
Results:
Among the 900 laboratory-confirmed RSV-related hospitalizations, 41 (4.6%) had traditionally defined healthcare-associated RSV. Including patients with a positive RSV test obtained in the first 3 days of hospitalization and who were either transferred to the hospital directly from a post-acute care facility or who were recently discharged from an acute care facility for a non-RSV illness in the preceding 7 days identified an additional 95 cases (10.6% of all RSV-related hospitalizations).
Conclusions:
RSV is an often under-recognized healthcare-associated infection. Capturing other healthcare exposures that may serve as the initial site of viral transmission may provide more comprehensive estimates of the burden of healthcare-associated RSV and inform improved infection prevention strategies and vaccination efforts.
Compassion is the emotion that motivates people to relieve the physical, emotional, or mental pains of others. Engaging in compassionate behaviour has been found to enhance psychological wellness and resilience. However, constant displays of compassionate behaviour can lead to burnout particularly for healthcare workers who inherently practise compassion day to day. This burnout can be relieved by Compassion focused meditation. The aim of this review is to identify neuroplastic changes in the brain associated with meditation, with a focus on compassion and compassion related meditation.
Methods:
Based on PRISMA guidelines, we conducted a scoping review of studies which described neuroplastic effects of meditation, focusing on compassion-based training. Studies were excluded if they (i) included multiple meditation practices or (ii) included participant populations with psychiatric/neuropsychiatric history (except anxiety or depression) or (iii) included exclusively ageing populations.
Results:
The results of the reviewed studies showed various neurological changes in regions of the brain as a result of compassion based training. These regions include amygdala, the anterior insula, medial prefrontal cortex, medial orbitofrontal cortex and structures within the dopamine system.
Conclusion:
This review highlights that compassion-based training could lead to neuroplastic changes which interconnect to enhance overall well-being, resilience and compassionate care among health-care professionals. However, further work is required to establish conclusive evidence of its sustained benefit and cost-effectiveness, as well as its utility in a healthcare setting.
Drawing on students' experiences of structural racism in the UK higher education institutions, this book offers an informed analysis on the barriers to Black student progression. It documents success stories and provides key recommendations for the sector on how to eliminate discrimination and achieve positive results for Black students.
Palmer amaranth with resistance to dicamba, glufosinate, and protoporphyrinogen oxidase inhibitors has been documented in several southern states. With extensive use of these and other herbicides in South Carolina, a survey was initiated in fall 2020 and repeated in fall 2021 and 2022 to determine the relative response of Palmer amaranth accessions to selected preemergence and postemergence herbicides. A greenhouse screening experiment was conducted in which accessions were treated with three preemergence (atrazine, S-metolachlor, and isoxaflutole) and six postemergence (glyphosate, thifensulfuron-methyl, fomesafen, glufosinate, dicamba, and 2,4-D) herbicides at the 1× and 2× use rates. Herbicides were applied shortly after planting (preemergence) or at the 2- to 4-leaf growth stage (postemergence). Percent survival was evaluated 5 to 14 d after application depending on herbicide activity. Sensitivity to atrazine preemergence was lower for 49 and 33 accessions out of 115 to atrazine applied preemergence at the 1× and 2× rate, respectively. Most of the accessions (90%) were controlled by isoxaflutole applied preemergence at the 1× rate. Response to S-metolachlor applied preemergence indicated that 34% of the Palmer amaranth accessions survived the 1× rate (>60% survival). Eleven accessions exhibited reduced sensitivity to fomesafen applied postemergence; however, these percentages were not different from the 0% survivor group. Glyphosate applied postemergence at the 1× rate did not control most accessions (79%). Palmer amaranth response to thifensulfuron-methyl applied postemergence varied across the accessions, with only 36% and 28% controlled at the 1× rate and 2× rate, respectively. All accessions were controlled by 2,4-D, dicamba, or glufosinate when they were applied postemergence. Palmer amaranth accessions from this survey exhibited reduced susceptibility to several herbicides commonly used in agronomic crops in South Carolina. Therefore, growers should use multiple management tactics to minimize the evolution of herbicide resistance in Palmer amaranth in South Carolina.
We present the Sydney Radio Star Catalogue, a new catalogue of stars detected at megahertz to gigahertz radio frequencies. It consists of 839 unique stars with 3 405 radio detections, more than doubling the previously known number of radio stars. We have included stars from large area searches for radio stars found using circular polarisation searches, cross-matching, variability searches, and proper motion searches as well as presenting hundreds of newly detected stars from our search of Australian SKA Pathfinder observations. The focus of this first version of the catalogue is on objects detected in surveys using SKA precursor and pathfinder instruments; however, we will expand this scope in future versions. The 839 objects in the Sydney Radio Star Catalogue are distributed across the whole sky and range from ultracool dwarfs to Wolf-Rayet stars. We demonstrate that the radio luminosities of cool dwarfs are lower than the radio luminosities of more evolved sub-giant and giant stars. We use X-ray detections of 530 radio stars by the eROSITA soft X-ray instrument onboard the Spectrum Roentgen Gamma spacecraft to show that almost all of the radio stars in the catalogue are over-luminous in the radio, indicating that the majority of stars at these radio frequencies are coherent radio emitters. The Sydney Radio Star Catalogue can be found in Vizier or at https://radiostars.org.
Background: Asymptomatic bacteriuria (ASB) is often treated with antibiotics despite recommendations against screening for and treating ASB in most populations. Some providers cite concern for progression of ASB to a symptomatic urinary tract infection (UTI) as the jultification for antibiotic use. While the 2019 Infectious Diseases Society of America (IDSA) ASB guidelines refute this concern, most evidence is derived from studies done in females, potentially limiting external validity. The purpose of this study is to compare the outcomes of patients with ASB who received antibiotic treatment versus those who did not in a primarily male population. Methods: This is a multi-center, retrospective, cohort study conducted by the 5 sites within the Veterans Affairs MidSouth Healthcare Network. Patients with a positive urine culture (defined as cultures with a colony forming unit count >100,000) collected from January 1, 2021 through December 31, 2021 were identified. ASB was determined via chart review using pre-determined criteria (positive culture in the absence of reported or documented signs or symptoms attributable to UTI as defined by the 2019 IDSA ASB guidelines). Additional data collected included antibiotic use, clinic visits and hospital admissions related to UTI or sepsis from a UTI. The primary outcome was the comparison of UTI incidence at 30 days, 6 months, and 1 year in those untreated versus treated with antibiotics. Secondary outcomes included a comparison of admissions with sepsis from UTI and adverse drug reactions (ADRs) between the cohorts. Continuous data were analyzed using a Student’s t-test. Discrete data were analyzed using either a Chi-squared or Fisher’s exact test. Results: The study population was primarily elderly (73 years, range 27-99 years) and male (79.7%). Of the 281 patients with ASB, 127 (45.2%) and 154 (54.8%) were untreated and treated, respectively. The incidence of UTI was 3% versus 1% (p = 0.41) at 30 days, 10% versus 12% (p = 0.61) at 6 months and 11% versus 12% (p = 0.94) at 12 months in the untreated and treated cohorts, respectively. There was no difference in admissions for UTI, sepsis from UTI or ADRs at 30 days. Conclusion: This study found no difference in the development of symptomatic UTI in veterans with untreated ASB compared to those treated with antibiotics. These findings align with current ASB guideline recommendations and support avoidance of unnecessary antibiotic use in the veteran population.
A significant proportion of the forested production area in South Carolina is managed using aerial applications of imazapyr. Cotton injury from off-target movement of imazapyr has been observed in South Carolina. Field experiments were conducted twice at the Edisto Research and Education Center (EREC) in 2021 and 2022, and once at the Pee Dee Research and Education Center (PDREC) in 2022, to evaluate the response of cotton at two growth stages to imazapyr at 0.1×, 0.05×, 0.025×, 0.0125×, and 0.00625× of the normal use rate of 0.84 kg ae ha−1. Injury to cotton at the vegetative stage was 86% and 74% at 0.1× and 0.05× imazapyr rates 28 d after application (DAA). Cotton height ranged from 23 to 93 cm at all three locations. Yield at the EREC location in 2021 was reduced by 79%, 48%, and 31% at the 0.1×, 0.05×, and 0.025× rates of imazapyr, respectively. Similar reductions from imazapyr were observed at both EREC and PDREC in 2022. Injury to cotton at the reproductive stage based on visual estimates at 28 DAA ranged from 95% to 64% for the 0.1× to 0.0125× rates, respectively. Cotton height at the reproductive stage was reduced to 59% of the untreated control 28 DAA when the 0.1× rate of imazapyr was applied. Seed cotton (which included both seed and lint) yield ranged from 0 to 2,880 kg ha−1 at the three locations in both years. Seed cotton yield was lowest when imazapyr was applied at the 0.1× to 0.025× rates. Cotton exposure to imazapyr at the vegetative and reproductive growth stages resulted in plant injury, height, and yield reductions, especially at the higher rates of imazapyr. The greatest reduction in cotton growth and yield was observed after exposure at the reproductive growth stage regardless of imazapyr rate. In summary, the magnitude of cotton response to imazapyr depends on crop growth stage and imazapyr concentration at the time of exposure with the greatest impact occurring at the reproductive growth stage.
Schizophrenia (SCZ) is a neuropsychiatric disorder with strong genetic heritability and predicted genetic heterogeneity, but limited knowledge regarding the underlying genetic risk variants. Classification into phenotype-driven subgroups or endophenotypes is expected to facilitate genetic analysis. Here, we report a teen boy with chronic psychosis and cerebellar hypoplasia (CBLH) and analyze data on 16 reported individuals with SCZ or chronic psychosis not otherwise specified associated with cerebellar hypoplasia to look for shared features.
Participants and Methods:
We evaluated an 18-year-old boy with neurodevelopmental deficits from early childhood and onset of hallucinations and other features of SCZ at 10 years who had mild vermis-predominant CBLH on brain imaging. This prompted us to review prior reports of chronic psychosis or SCZ with cerebellar malformations using paired search terms including (1) cerebellar hypoplasia, Dandy-Walker malformation, Dandy-Walker variant, or mega-cisterna magna with (2) psychosis or SCZ. We found reports of 16 affected individuals from 13 reports. We reviewed clinical features focusing on demographic information, prenatal-perinatal history and neuropsychiatric and neurodevelopmental phenotypes, and independently reviewed brain imaging features.
Results:
All 17 individuals had classic psychiatric features of SCZ or chronic psychosis as well as shared neurodevelopmental features not previously highlighted including a downward shift in IQ of about 20 points, memory impairment, speech-language deficits, attention deficits and sleep disturbances. The brain imaging findings among these individuals consistently showed posterior vermis predominant CBLH with variable cerebellar hemisphere hypoplasia and enlarged posterior fossa (a.k.a. mega-cisterna magna). None had features of classic DWM.
Conclusions:
In 17 individuals with chronic psychosis or SCZ and cerebellar malformation, we found a high frequency of neurodevelopmental disorders, a consistent brain malformation consisting of posterior vermis-predominant (and usually symmetric) CBLH, and no evidence of prenatal risk factors. The consistent phenotype and lack of prenatal risk factors for CBLH leads us to hypothesize that psychosis or schizophrenia associated with vermis predominant CBLH comprises a homogeneous subgroup of individuals with chronic psychosis/schizophrenia that is likely to have an underlying genetic basis. No comprehensive targeted gene panel for CBLH has yet been defined, leading us to recommend trio-based exome sequencing for individuals who present with this combination of features.
Field amputations are a low-frequency, high-risk procedure. Many prehospital personnel utilize the reciprocating saw. This study compares the efficiency, speed, and degree of tissue damage of different reciprocating saw blades found commercially.
Methods:
Amputations were performed on two human cadavers at different levels of the upper and lower extremities. Four different blades were used, each with a different teeth-per-inch (TPI) design. The amputations were timed, blade temperature was recorded, subjective operator effort was obtained, amount of splatter was evaluated, and an orthopedic physician evaluated the extent of tissue damage and operating room repair difficulty.
Results:
The blade with fourteen TPI was superior in overall speed to complete the amputations at 1.07 seconds per one centimeter of tissue (SD = 0.49 seconds) and had the lowest fail rate (0/8 amputations). The three TPI, six TPI, and ten TPI blades all required a “rescue” technique and were slower. The blade with fourteen TPI caused the least amount of tissue damage and was deemed the easiest to repair. Secondary outcomes demonstrated the fourteen TPI blade had generated the least amount of heat and produced the least amount of splatter. All blades had a perceived effort of “easy” to complete the amputation.
Conclusion:
While all blades were able to achieve an amputation, the overall recommendation is use of a fourteen TPI blade. It did not require any rescue techniques, provided the most straightforward amputation to repair, had the least amount of biohazard splatter and temperature increase, and was the fastest blade overall.