Intravesical Bacillus Calmette-Guérin (BCG) is a standard therapy for non–muscle-invasive bladder cancer used in urology clinics and inpatient settings. We present a review of infection risks to patients receiving intravesical BCG, healthcare personnel who prepare and administer BCG, and other patients treated in facilities where BCG is prepared and administered. Knowledge of these risks and relevant regulations informs appropriate infection prevention measures.

Background: The use of personal protective equipment (PPE) is a critical intervention in preventing the spread of transmission-based infections in healthcare settings. However, contamination of the skin and clothing of healthcare personnel (HCP) frequently occurs during the doffing of PPE. In fact, nearly 40% of HCP make errors while doffing their PPE, causing them to contaminate themselves. PPE monitors are staff that help to promote their colleagues’ safety by guiding them through the PPE donning and doffing processes. With the advent of the COVID-19 pandemic in early 2020, the UNC Medical Center chose to incorporate PPE monitors as part of its comprehensive COVID-19 prevention strategy, using them in inpatient areas (including COVID-19 containment units and all other units with known or suspected SARS-CoV-2–positive patients), procedural areas, and outpatient clinics. Methods: Infection prevention and nursing developed a PPE monitoring team using redeployed staff from outpatient clinics and inpatient areas temporarily closed because of the pandemic. Employee training took place online and included fundamentals of disease transmission, hand hygiene basics, COVID-19 policies and signage, and videos on proper donning and doffing, including coaching tips. The monitors’ first shifts were supervised by experienced monitors to continue in-place training. Employees had competency sheets signed off by a supervisor. Results: The Medical Center’s nursing house supervisors took over management and deployment of the PPE monitoring team, and infection prevention staff continued to train new members. Eventually, as closed clinics and areas reopened and these PPE monitors returned to their regular positions, areas used their own staff to perform the role of PPE monitor. In the fall of 2020, a facility-wide survey was sent to all inpatient staff to assess their perceptions of the Medical Center’s efforts to protect them from acquiring COVID-19. It included a question asking how much staff agreed or disagreed that PPE monitors “play an important role in keeping our staff who care for COVID-19 patients safe.” Of the 626 staff who answered this question, 67.6% agreed or strongly agreed that PPE monitors played an important role in keeping staff safe. Thus far, there has been no direct transmission or clusters of COVID-19 involving HCP in COVID-19 containment units with PPE monitors. Conclusions: PPE monitors are an important part of a comprehensive COVID-19 prevention strategy. In early 2021, the UNC Medical Center posted and hired paid PPE monitor positions to continue this critical work in a sustainable way.

Funding: No

Disclosures: None

Background: Infection prevention efforts are complex, and sustaining reductions is even more challenging. At the UNC Medical Center, multidisciplinary hospital-wide work groups implement quality improvement initiatives to prevent healthcare-associated infections. The first and most successful initiative has been our catheter-associated urinary tract infection (CAUTI) prevention effort, which started in 2014. The program led to initial dramatic reductions, with continued reductions in CAUTI rates each year since then. Methods: A multidisciplinary workgroup formed in 2014 developed an evidence-based CAUTI prevention bundle and partnered with the nursing staff in 2015–2016 to implement practice changes as part of our hospital’s quality improvement “Spread of Innovations” model. These changes included (1) creation of a 2-person catheter-insertion checklist; (2) insertion skills validation for all nursing staff and nursing assistants; (3) standardization of a maintenance protocol and subsequent education and skills validation with nurses and nurse assistants; and (4) peer audits of urinary catheter maintenance. Additional initiatives implemented over the past 5 years include (1) routine resident education on CAUTI prevention; (2) annual nurse competencies to reinforce skills around CAUTI prevention; (3) introduction of products (eg, PureWick) as alternatives to indwelling catheters; (4) diagnostic stewardship efforts; (5) revisions to the electronic medical record; and (6) efforts to encourage removal of unnecessary catheters such as the “nurse-driven conversation” and Trial of Void. Results: Our CAUTI rates decreased 65% from 2.94 per 1,000 catheter days in the baseline period of 2014 to 1.02 in 2018. In our ICUs (excluding the neonatal ICU), the rate dropped 75% from 4.30 in 2014 to 1.08 per 1,000 catheter days in 2018. Conclusions: We attribute our continued reductions and successful sustainment of low CAUTI rates to several factors. First, the use of a multidisciplinary team was critical to obtaining buy-in from key stakeholders including nursing, nurse assistants, physicians, pharmacists, performance improvement specialists, and administration. Second, continuation of the maintenance peer audits outside the initial project year has provided an important framework for this project, giving regular opportunities for frontline staff to evaluate patients’ catheter condition and to give feedback to colleagues or “just in time education.” These activities potentially prevent infections in real time. Third, with the many competing priorities demanding clinicians’ attention, it has been important for the CAUTI workgroup to continue to evaluate the problem, to determine where opportunities for improvement remain, and to tailor initiatives to meet those needs. In this way, new work can focus on priorities identified by staff, and CAUTI prevention initiatives remain relevant.

Funding: None

Disclosures: None

Conventional wisdom pervades presidential politics, and there is no doubt that this will again be true in 2016. First among “old politicians’ tales” is that a political party’s placement of a national convention in a specific state can affect presidential voting there, swinging or flipping it to its presidential candidate. Second, the selection of a vice-presidential candidate as a favorite son (or daughter) will deliver a state’s electoral votes to a presidential ticket. Is either of these pearls of wisdom true? This article tests the truth of both the convention location and favorite-son claims and finds little evidence of their efficacy.

When speakers engage in conversation, acoustic features of their utterances sometimes converge. We examined how the speech rate of participants changed when a confederate spoke at fast or slow rates during readings of scripted dialogues. A beat-tracking algorithm extracted the periodic relations between stressed syllables (beats) from acoustic recordings. The mean interbeat interval (IBI) between successive stressed syllables was compared across speech rates. Participants’ IBIs were smaller in the fast condition than in the slow condition; the difference between participants’ and the confederate's IBIs decreased across utterances. Cross-correlational analyses demonstrated mutual influences between speakers, with greater impact of the confederate on participants’ beat rates than vice versa. Beat rates converged in scripted conversations, suggesting speakers mutually entrain to one another's beat.

The cherry scallop shell moth, Hydria prunivorata (Ferguson), is a colonial feeder on black cherry, Prunus serotina Ehrh. Pupae overwinter in the litter and adult emergence occurs from May through September. Eggs are laid on the foliage in pyramidal-shaped masses 23–26 days after adult emergence. Eggs begin to hatch 4 days following oviposition and each of the four larval stages lasts 4–6 days. There is one generation per year in New York. The egg parasite Telenomus sp. is the principal mortality factor occurring in populations that have remained at outbreak levels for 2 or more years. The life stages of H. prunivorata are described and control recommendations discussed. The peach bark beetle, Phloeotribus liminaris (Harris), may kill black cherry trees that are stressed by heavy defoliation.

Some seaweeds exert antioxidant and hypocholesterolaemic properties. The effects of diets including restructured meats (RM) containing Wakame (W) or Nori (N) algae on arylesterase (AE) activity and lipoprotein concentration and composition were tested. In the present study, six groups of ten male growing Wistar rats each were fed a mix of 85 % AIN-93M diet and 15 % freeze-dried RM for 35 d. The control group (C) consumed control RM, the W and N groups consumed RM with 5 % W and 5 % N, respectively. The cholesterol-enriched C (CC), W (CW) and N (CN) groups consumed their corresponding basal diets with supplementary cholesterol (2·43 %) and cholic acid (0·49 %). Cholesterol in the diet induced lower (P < 0·001) growth ratios. Both W and N diets significantly increased AE activity. VLDL-cholesterol values were lower in N rats than in W rats. AE activity increased (P < 0·001) in CC and CW rats but not in CN rats compared with their corresponding counterparts. AE was lower (P < 0·05) in the CN group than in the CC and CW groups. The CN diet partially blocked (P < 0·001) the hypercholesterolaemic induction observed in CC and CW diets and reduced TAG levels (at least P < 0·05) with respect to those of CC rats. Although dietary cholesterol supplementation increased total cholesterol, VLDL-cholesterol and (intermediate-density lipoprotein+LDL)-cholesterol (all P < 0·001) in all rats, the CN diet moderately improved the lipoprotein profile of hypercholesterolaemic rats. Changes in AE activity and plasma cholesterol in CN rats but not in CW rats suggest a possible relationship between the two parameters. It is concluded that inclusion of RM enriched with N may be used in hypercholesterolaemic diets to improve lipoprotein metabolism.

The rate of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing in neonatal intensive care units. We determined the economic impact of isolating and cohorting MRSA-colonized neonates on total hospital cost at a 49-bed, level III-IV neonatal intensive care unit.

On-farm research in remote areas demands methods that keep down costs and reduce the need for subsequent research and extension inputs and yet that still produce useful and sustainable recommendations. An important part of the process is to identify existing resource user groups and use them, rather than individual farmers, as a starting point for on-farm research. This approach is discussed in the context of farming systems research in the eastern hills of Nepal.

The NASA Discovery mission EPOXI, utilizing the Deep Impact flyby spacecraft, comprises two phases: EPOCh (Extrasolar Planet Observation and Characterization) and DIXI (Deep Impact eXtended Investigation). With EPOCh, we use the 30-cm high resolution visible imager to obtain ultraprecise photometric light curves of known transiting planet systems. We will analyze these data for evidence of additional planets, via transit timing variations or transits; for planetary moons or rings; for detection of secondary eclipses and the constraint of geometric planetary albedos; and for refinement of the system parameters. Over a period of four months, EPOCh observed four known transiting planet systems, with each system observed continuously for several weeks. Here we present an overview of EPOCh, including the spacecraft and science goals, and preliminary photometry results.

EPOXI (EPOCh + DIXI) is a NASA Discovery Program Mission of Opportunity using the Deep Impact flyby spacecraft. The EPOCh (Extrasolar Planet Observation and Characterization) Science Investigation will gather photometric time series of known transiting exoplanet systems from January through August 2008. Here we describe the steps in the photometric extraction of the time series and present preliminary results of the first four EPOCh targets.