Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

The current emphasis in aerospace component development is on creating safe, reliable and cost-effective technologies. However, the intricate design of stage separation systems renders component reliability a critical factor in determining mission success or failure. One of the technical challenges involves the development of various aerospace mechanisms, such as payload separation, heavy propulsion system separation, ejection of auxiliary components and detachment of rigid components. These stage separation mechanisms commonly employ pyrotechnic devices, which, by their operational nature, impart shock to the spacecraft, potentially causing damage or adverse effects on flight instruments. Therefore, it is imperative to explore multiple viable concepts aimed at reducing shock and experimentally ascertain the impact of shock using diverse shock attenuation techniques. While existing literature primarily addresses shock attenuation with distance from the shock source, limited attention has been given to diminishing shock at the location of the shock-generating element. This study employed various shock-attenuating devices, including dampers, metallic foam structures, viscous materials and dampeners, to assess the effectiveness of shock reduction. Furthermore, the study investigated shock reduction resulting from the elimination of rigid connections, such as bolted joints, from pyro-actuated mechanisms. Through a series of experiments, a conclusive analysis was conducted to determine the approach for achieving a substantial reduction in pyro shock.

This paper offers a new methodology for analyzing individual differences in preference judgments with regard to a set of stimuli prespecified in a multidimensional attribute space. The individual is modelled as possessing an “ideal point” denoting his most preferred stimulus location in this space and a set of weights which reveal the relative saliences of the attributes. He prefers those stimuli which are “closer” to his ideal point (in terms of a weighted Euclidean distance measure). A linear programming model is proposed for “external analysis” i.e., estimation of the coordinates of his ideal point and the weights (involved in the Euclidean distance measure) by analyzing his paired comparison preference judgments on a set of stimuli, prespecified by their coordinate locations in the multidimensional space. A measure of “poorness of fit” is developed and the linear programming model minimizes this measure over all possible solutions. The approach is fully nonmetric, extremely flexible, and uses paired comparison judgments directly. The weights can either be constrained nonnegative or left unconstrained. Generalizations of the model to consider ordinal or interval preference data and to allow an orthogonal transformation of the attribute space are discussed. The methodology is extended to perform “internal analysis,”i.e., to determine the stimuli locations in addition to weights and ideal points by analyzing the preference judgments of all subjects simultaneously. Computational results show that the methodology for external analysis is “unbiased”—i.e., on an average it recovers the “true” ideal point and weights. These studies also indicate that the technique performs satisfactorily even when about 20 percent of the paired comparison judgments are incorrectly specified.

This paper presents a new methodology for estimating the weights or saliences of subcriteria (attributes) in a composite criterion measure. The inputs to the estimation procedure consist of (i) a set of stimuli or objects with each stimulus defined by its subcriteria profile (set of attribute values) and (ii) the set of paired comparison dominance (e.g., preference) judgments on the stimuli made by a single judge (expert) in terms of the global criterion. A criterion of fit is developed and its optimization via linear programming is illustrated with an example. The procedure is generalized to estimate a common set of weights when the pairwise judgments on the stimuli are made by more than one judge. The procedure is computationally efficient and has been applied in developing a composite criterion of managerial success yielding high concurrent validity.

This methodology can also be used to perform ordinal multiple regression—i.e., multiple regression with an ordinally scaled dependent variable and a set of intervally scaled predictor variables. The approach is further extended to “internal analysis” (unfolding) using the vector model of preference and to the additive model of “conjoint measurement.”

Background: With the emergence of antibiotic resistant threats and the need for appropriate antibiotic use, laboratory microbiology information is important to guide clinical decision making in nursing homes, where access to such data can be limited. Susceptibility data are necessary to inform antibiotic selection and to monitor changes in resistance patterns over time. To contribute to existing data that describe antibiotic resistance among nursing home residents, we summarized antibiotic susceptibility data from organisms commonly isolated from urine cultures collected as part of the CDC multistate, Emerging Infections Program (EIP) nursing home prevalence survey. Methods: In 2017, urine culture and antibiotic susceptibility data for selected organisms were retrospectively collected from nursing home residents’ medical records by trained EIP staff. Urine culture results reported as negative (no growth) or contaminated were excluded. Susceptibility results were recorded as susceptible, non-susceptible (resistant or intermediate), or not tested. The pooled mean percentage tested and percentage non-susceptible were calculated for selected antibiotic agents and classes using available data. Susceptibility data were analyzed for organisms with ≥20 isolates. The definition for multidrug-resistance (MDR) was based on the CDC and European Centre for Disease Prevention and Control’s interim standard definitions. Data were analyzed using SAS v 9.4 software. Results: Among 161 participating nursing homes and 15,276 residents, 300 residents (2.0%) had documentation of a urine culture at the time of the survey, and 229 (76.3%) were positive. Escherichia coli, Proteus mirabilis, Klebsiella spp, and Enterococcus spp represented 73.0% of all urine isolates (N = 278). There were 215 (77.3%) isolates with reported susceptibility data (Fig. 1). Of these, data were analyzed for 187 (87.0%) (Fig. 2). All isolates tested for carbapenems were susceptible. Fluoroquinolone non-susceptibility was most prevalent among E. coli (42.9%) and P. mirabilis (55.9%). Among Klebsiella spp, the highest percentages of non-susceptibility were observed for extended-spectrum cephalosporins and folate pathway inhibitors (25.0% each). Glycopeptide non-susceptibility was 10.0% for Enterococcus spp. The percentage of isolates classified as MDR ranged from 10.1% for E. coli to 14.7% for P. mirabilis. Conclusions: Substantial levels of non-susceptibility were observed for nursing home residents’ urine isolates, with 10% to 56% reported as non-susceptible to the antibiotics assessed. Non-susceptibility was highest for fluoroquinolones, an antibiotic class commonly used in nursing homes, and ≥ 10% of selected isolates were MDR. Our findings reinforce the importance of nursing homes using susceptibility data from laboratory service providers to guide antibiotic prescribing and to monitor levels of resistance.

Disclosures: None

Funding: None

Background: Antibiotics are among the most commonly prescribed drugs in nursing homes; urinary tract infections (UTIs) are a frequent indication. Although there is no gold standard for the diagnosis of UTIs, various criteria have been developed to inform and standardize nursing home prescribing decisions, with the goal of reducing unnecessary antibiotic prescribing. Using different published criteria designed to guide decisions on initiating treatment of UTIs (ie, symptomatic, catheter-associated, and uncomplicated cystitis), our objective was to assess the appropriateness of antibiotic prescribing among NH residents. Methods: In 2017, the CDC Emerging Infections Program (EIP) performed a prevalence survey of healthcare-associated infections and antibiotic use in 161 nursing homes from 10 states: California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee. EIP staff reviewed resident medical records to collect demographic and clinical information, infection signs, symptoms, and diagnostic testing documented on the day an antibiotic was initiated and 6 days prior. We applied 4 criteria to determine whether initiation of treatment for UTI was supported: (1) the Loeb minimum clinical criteria (Loeb); (2) the Suspected UTI Situation, Background, Assessment, and Recommendation tool (UTI SBAR tool); (3) adaptation of Infectious Diseases Society of America UTI treatment guidelines for nursing home residents (Crnich & Drinka); and (4) diagnostic criteria for uncomplicated cystitis (cystitis consensus) (Fig. 1). We calculated the percentage of residents for whom initiating UTI treatment was appropriate by these criteria. Results: Of 248 residents for whom UTI treatment was initiated in the nursing home, the median age was 79 years [IQR, 19], 63% were female, and 35% were admitted for postacute care. There was substantial variability in the percentage of residents with antibiotic initiation classified as appropriate by each of the criteria, ranging from 8% for the cystitis consensus, to 27% for Loeb, to 33% for the UTI SBAR tool, to 51% for Crnich and Drinka (Fig. 2). Conclusions: Appropriate initiation of UTI treatment among nursing home residents remained low regardless of criteria used. At best only half of antibiotic treatment met published prescribing criteria. Although insufficient documentation of infection signs, symptoms and testing may have contributed to the low percentages observed, adequate documentation in the medical record to support prescribing should be standard practice, as outlined in the CDC Core Elements of Antibiotic Stewardship for nursing homes. Standardized UTI prescribing criteria should be incorporated into nursing home stewardship activities to improve the assessment and documentation of symptomatic UTI and to reduce inappropriate antibiotic use.

Funding: None

Disclosures: None

This report is on the synthesis by electrospinning of multiferroic core-shell nanofibers of strontium hexaferrite and lead zirconate titanate or barium titanate and studies on magneto-electric (ME) coupling. Fibers with well-defined core–shell structures showed the order parameters in agreement with values for nanostructures. The strength of ME coupling measured by the magnetic field-induced polarization showed the fractional change in the remnant polarization as high as 21%. The ME voltage coefficient in H-assembled films showed the strong ME response for the zero magnetic bias field. Follow-up studies and potential avenues for enhancing the strength of ME coupling in the core–shell nanofibers are discussed.

Canonical models of costly signaling in international relations (IR) tend to assume costly signals speak for themselves: a signal's costliness is typically understood to be a function of the signal, not the perceptions of the recipient. Integrating the study of signaling in IR with research on motivated skepticism and asymmetric updating from political psychology, we show that individuals’ tendencies to embrace information consistent with their overarching belief systems (and dismiss information inconsistent with it) has important implications for how signals are interpreted. We test our theory in the context of the 2015 Joint Comprehensive Plan of Action (JCPOA) on Iran, combining two survey experiments fielded on members of the American mass public. We find patterns consistent with motivated skepticism: the individuals most likely to update their beliefs are those who need reassurance the least, such that costly signals cause polarization rather than convergence. Successful signaling therefore requires knowing something about the orientations of the signal's recipient.

We study a DevOps software development process for a Product-Service System (PSS) using a design structure matrix (DSM) representation. We find unique features such as nested, planned iterations at differing rates which are not evident in conventional engineering development projects. We describe the impact of integrating ongoing operations into a development process and identify some of the enablers that lead to adoption of a DevOps process. We conclude by discussing the implications of our findings and raise questions for further research.

Vegetable and grain amaranths represent a vital source of micronutrients and protein in Asia and Africa. However, various foliar lepidopteran pests and stem-mining weevils hinder amaranth production. Insect-resistant cultivars can enhance the productivity of this crop. Here, we report on the performances of amaranth varieties screened for their resistance to insect pests under the field conditions at The World Vegetable Center stations in Asia and sub-Saharan Africa. We conducted two preliminary screening trials with a total of 263 entries from around the world in Taiwan and a third preliminary screening trial with 49 African-indigenous entries in Tanzania. Promising entries from these preliminary trials were collectively evaluated in an advanced screening trial in Tanzania, to identify lines resistant to foliar and stem-boring pests in East Africa. Four entries exhibited moderate resistance to foliar pests: TZ51 and TZ53 (Amaranthus cruentus), TZ34 (A. dubius) and TZ39 (Amaranthus sp.). Five entries showed moderate resistance to stem weevils: TZ06 and TZ27 (A. cruentus), TZ52 (A. graecizans), TZ59 (A. palmeri) and TZ07 (Amaranthus sp.). Lepidopteran pests affecting leaves were reared to adulthood and identified as Spoladea recurvalis (Crambidae), Spodoptera exigua (Noctuidae) and Spodoptera littoralis (Noctuidae). Stem weevil larvae were also reared and identified as: Neocleonus sannio Herbst, Gasteroclisus pr. rhomboidalis Boheman, Hypolixus pr. haerens Boheman and Baradine sp. (Curculionidae). These results highlight key amaranth pests in East Africa and identify insect-resistant entries that will be useful in breeding programmes and resistance studies.

Documentation of antibiotic indication provides helpful information for antimicrobial stewardship, but accuracy is not understood. Review of 396 antibiotic orders in a pediatric ICU and adult medicine step-down unit found 90% agreement between provider-selected indication and independent review. Prompts to enter antibiotic indication during order entry provide largely accurate information.

Infect Control Hosp Epidemiol 2018;39:111–113

Even at small angles of incidence, the flow separates from the sharp leading edges of a slender wing. These flow separations usually lead to the formation of two free vortex layers, joined to the leading edges of the wing and rolling up to form spiral-shaped vortex sheets above the upper surface of the wing. This vortex formation is illustrated schematically in Fig. 1. The streamlines on the vortex sheet follow helical paths. Smoke injected near the wing apex for flow visualisation remains concentrated close to the axis of the core of the vortex sheet.