36 research outputs found
Geotechnical uncertainties and reliability-based assessments of dykes
No full textThis thesis utilises the random finite element method (RFEM) to provide practical guidance and tools for geotechnical engineers to account for the influence of soil spatial variability. This has involved: (a) practical insight and guidance on the choice of characteristic soil property values and scales of fluctuation; (b) a robust approach to reliability assessment and design that obviates the need for explicit calculation of characteristic values; and (c) the benchmarking and improving of simpler analysis tools.Geo-engineerin
Persistence of Ebola virus in ocular fluid during convalescence
No full textPlease note: A correction to the original article has been published. “From New England Journal of Medicine, Jay B. Varkey,
Jessica G. Shantha, Ian Crozier, Colleen S. Kraft, G.
Marshall Lyon, Aneesh K. Mehta, Gokul Kumar, Justine
R. Smith, Markus H. Kainulainen, Shannon Whitmer,
Ute Ströher, Timothy M. Uyeki, Bruce S. Ribner, and
Steven Yeh, Persistence of Ebola Virus in Ocular Fluid
during Convalescence, 2015; 372:2423-2427. Copyright © (2015) Massachusetts Medical Society. Reprinted with permission.Among the survivors of Ebola virus disease (EVD), complications that include uveitis can develop during convalescence, although the incidence and pathogenesis of EVD-associated uveitis are unknown. We describe a patient who recovered from EVD and was subsequently found to have severe unilateral uveitis during convalescence. Viable Zaire ebolavirus (EBOV) was detected in aqueous humor 14 weeks after the onset of EVD and 9 weeks after the clearance of viremia.Supported by a grant from the National Center for Advancing Translational Sciences of the National Institutes of Health (UL1TR000454, to the Atlanta Clinical and Translational Science Institute), an unrestricted grant from Research to Prevent Blindness and a grant from the National Eye Institute (P30-EY06360, to the Department of Ophthalmology, Emory University School of Medicine), and a fellowship grant from the Australian Research Council (FT130101648, to Dr. Smith). Favipiravir was provided by the Department of Defense Joint Project Manager Medical Countermeasure Systems
Infect Control Hosp Epidemiol
No full textObjective:To determine the effect of an electronic medical record (EMR) nudge at reducing total and inappropriate orders testing for hospital-onset Clostridioides difficile infection (HO-CDI).Design:An interrupted time series analysis of HO-CDI orders two years before and two years after the implementation of an EMR intervention designed to reduce inappropriate HO-CDI testing. Orders for C. difficile testing were considered inappropriate if the patient received a laxative or stool softener in the previous 24 hours.Setting:Four hospitals in an academic healthcare network.Patients:All patients with a C. difficile order after hospital day three.Intervention:C. difficile orders in patients administered a laxative or stool softener in <24 hours triggered an EMR alert defaulting to order cancellation (\u201cnudge\u201d).Results:Of the 17,694 HO-CDI orders, 7% were inappropriate (8% pre- vs. 6% post-intervention, p < 0.001). Monthly HO-CDI orders decreased by 21% post-intervention (level change rate ratio [RR]: 0.79; 95% confidence interval [CI] 0.73\u20130.86) and the rate continued to decrease (post-intervention trend change RR: 0.99; 95% CI 0.98\u20131.00). The intervention was not associated with a level change in inappropriate HO-CDI orders (RR: 0.80; 95% CI 0.61\u20131.05), but the post-intervention inappropriate order rate decreased over time (RR: 0.95; 95% CI 0.93\u20130.97).Conclusion:An EMR nudge targeted to minimize inappropriate ordering for C. difficile was effective at reducing HO-CDI orders, and likely contributed to decreasing the post-intervention inappropriate HO-CDI order rate.TL1 TR002382/TR/NCATS NIH HHS/United StatesU54 CK000164/CK/NCEZID CDC HHS/United StatesUL1 TR002378/TR/NCATS NIH HHS/United States2021-04-01T00:00:00Z32036798PMC79096149379vault:3663
Detection of Bartonella species in the blood of veterinarians and veterinary technicians: a newly recognized occupational hazard?
No full textBACKGROUND: Bartonella species are important emerging pathogens in human and veterinary medicine. In the context of their daily activities, veterinary professionals have frequent animal contact and arthropod exposures. Detection of Bartonella spp. using traditional culture methods has been limited by poor sensitivity, making it difficult to determine the prevalence of infection in this population. We have developed a detection method combining enrichment culture and molecular amplification, which increases testing sensitivity. METHODS: We performed a cross-sectional study to determine the prevalence of detectable Bartonella spp. in the blood of veterinary personnel and nonveterinary control subjects. Bartonella was detected by enrichment blood culture with conventional PCR followed by DNA sequencing. RESULTS were correlated with epidemiological variables and symptoms. RESULTS: We detected DNA from at least one Bartonella species in 32 (28%) of the 114 veterinary subjects. After DNA sequencing, the Bartonella species could be determined for 27 of the 32 infected subjects, including B. henselae in 15 (56%), B. vinsonii subsp. berkhoffii in seven (26%), B. koehlerae in six (22%), and a B. volans-like sequence in one (4%). Seventy percent of Bartonella-positive subjects described headache compared with 40% of uninfected veterinarians (p=0.009). Irritability was also reported more commonly by infected subjects (68% vs. 43%, p=0.04). CONCLUSIONS: Our study supports an emerging body of evidence that cryptic Bartonella bloodstream infection may be more frequent in humans than previously recognized and may induce symptoms. Longitudinal studies are needed to determine the natural course and clinical features of Bartonella infection
Temporal Dynamics of Host Molecular Responses Differentiate Symptomatic and Asymptomatic Influenza A Infection.
No full textExposure to influenza viruses is necessary, but not sufficient, for healthy human hosts to develop symptomatic illness. The host response is an important determinant of disease progression. In order to delineate host molecular responses that differentiate symptomatic and asymptomatic Influenza A infection, we inoculated 17 healthy adults with live influenza (H3N2/Wisconsin) and examined changes in host peripheral blood gene expression at 16 timepoints over 132 hours. Here we present distinct transcriptional dynamics of host responses unique to asymptomatic and symptomatic infections. We show that symptomatic hosts invoke, simultaneously, multiple pattern recognition receptors-mediated antiviral and inflammatory responses that may relate to virus-induced oxidative stress. In contrast, asymptomatic subjects tightly regulate these responses and exhibit elevated expression of genes that function in antioxidant responses and cell-mediated responses. We reveal an ab initio molecular signature that strongly correlates to symptomatic clinical disease and biomarkers whose expression patterns best discriminate early from late phases of infection. Our results establish a temporal pattern of host molecular responses that differentiates symptomatic from asymptomatic infections and reveals an asymptomatic host-unique non-passive response signature, suggesting novel putative molecular targets for both prognostic assessment and ameliorative therapeutic intervention in seasonal and pandemic influenza
Analysis of two- and three-year trends in antimicrobial resistance in intensive care units using unit-specific antibiograms
No full textData_Sheet_3_Infants on the move: bibliometric analyses of observational vs. digital means of screening infant development.zip
No full textNeurodevelopmental disorders are on the rise, yet their average diagnosis is after 4.5 years old. This delay is partly due to reliance on social-communication criteria, which require longer maturation than scaffolding elements of neuromotor control. Much earlier criteria could include reflexes, monitoring of the quality of spontaneous movements from central pattern generators and maturation of intentional movements and their overall sensation. General Movement Assessment (GMA) studies these features using observational means, but the last two decades have seen a surge in digital tools that enable non-invasive, continuous tracking of infants’ spontaneous movements. Despite their importance, these tools are not yet broadly used. In this work, using CiteSpace, VOSViewer and SciMAT software, we investigate the evolution of the literature on GMA and the methods in use today, to estimate how digital techniques are being adopted. To that end, we created maps of key word co-occurrence networks, co-author networks, document co-citation analysis and strategic diagrams of 295 publications based on a search in the Web of Science, Dimensions and SCOPUS databases for: ‘general movement assessment’ OR ‘general movements assessment’. The nodes on the maps were categorized by size, cluster groups and year of publication. We found that the state-of-the-art methodology to diagnose neurodevelopmental disorders still relies heavily on observation. Several groups in classical GMA research have branched out to incorporate new techniques, but few groups have adopted digital means. We report on additional analyses of methods and biosensors usage and propose that combining traditional clinical observation criteria with digital means may allow earlier diagnoses and interventional therapies for infants.</p
Infants on the move: bibliometric analyses of observational vs. digital means of screening infant development
No full textNeurodevelopmental disorders are on the rise, yet their average diagnosis is after 4.5 years old. This delay is partly due to reliance on social-communication criteria, which require longer maturation than scaffolding elements of neuromotor control. Much earlier criteria could include reflexes, monitoring of the quality of spontaneous movements from central pattern generators and maturation of intentional movements and their overall sensation. General Movement Assessment (GMA) studies these features using observational means, but the last two decades have seen a surge in digital tools that enable non-invasive, continuous tracking of infants’ spontaneous movements. Despite their importance, these tools are not yet broadly used. In this work, using CiteSpace, VOSViewer and SciMAT software, we investigate the evolution of the literature on GMA and the methods in use today, to estimate how digital techniques are being adopted. To that end, we created maps of key word co-occurrence networks, co-author networks, document co-citation analysis and strategic diagrams of 295 publications based on a search in the Web of Science, Dimensions and SCOPUS databases for: ‘general movement assessment’ OR ‘general movements assessment’. The nodes on the maps were categorized by size, cluster groups and year of publication. We found that the state-of-the-art methodology to diagnose neurodevelopmental disorders still relies heavily on observation. Several groups in classical GMA research have branched out to incorporate new techniques, but few groups have adopted digital means. We report on additional analyses of methods and biosensors usage and propose that combining traditional clinical observation criteria with digital means may allow earlier diagnoses and interventional therapies for infants
