The dramatic changes in the epidemiology of Clostridium difficile infection (CDI) during recent years, with increases in incidence and severity of disease in several countries, have made CDI a global ...public health challenge. Increases in CDI incidence have been largely attributed to the emergence of a previously rare and more virulent strain, BI/NAP1/027. Increased toxin production and high-level resistance to fluoroquinolones have made this strain a very successful pathogen in healthcare settings. In addition, populations previously thought to be at low risk are now being identified as having severe CDI. Recent genetic analysis suggests that C. difficile has a highly fluid genome with multiple mechanisms to modify its content and functionality, which can make C. difficile adaptable to environmental changes and potentially lead to the emergence of more virulent strains. In the face of these changes in the epidemiology and microbiology of CDI, surveillance systems are necessary to monitor trends and inform public health actions.
Clostridioides difficile
infection is a major cause of nosocomial and community illness. In this report from the Emerging Infections Program, associated with the U.S. CDC, the national burden of
C. ...difficile
infection is estimated from 2011 through 2017. In 2017, an estimated 462,100 cases of
C. difficile
infection occurred.
Minimum Entropy Deconvolution (MED) has been applied successfully to rotating machine fault detection from vibration data, however this method has limitations. A convolution adjustment to the MED ...definition and solution is proposed in this paper to address the discontinuity at the start of the signal – in some cases causing spurious impulses to be erroneously deconvolved. A problem with the MED solution is that it is an iterative selection process, and will not necessarily design an optimal filter for the posed problem. Additionally, the problem goal in MED prefers to deconvolve a single-impulse, while in rotating machine faults we expect one impulse-like vibration source per rotational period of the faulty element. Maximum Correlated Kurtosis Deconvolution was proposed to address some of these problems, and although it solves the target goal of multiple periodic impulses, it is still an iterative non-optimal solution to the posed problem and only solves for a limited set of impulses in a row. Ideally, the problem goal should target an impulse train as the output goal, and should directly solve for the optimal filter in a non-iterative manner. To meet these goals, we propose a non-iterative deconvolution approach called Multipoint Optimal Minimum Entropy Deconvolution Adjusted (MOMEDA). MOMEDA proposes a deconvolution problem with an infinite impulse train as the goal and the optimal filter solution can be solved for directly. From experimental data on a gearbox with and without a gear tooth chip, we show that MOMEDA and its deconvolution spectrums according to the period between the impulses can be used to detect faults and study the health of rotating machine elements effectively.
•Vibration from rotating machines with impulse-like fault sources are studied.•MED convolution fix is proposed to remove discontinuity-related spurious impulses.•MOMEDA is proposed as a non-iterative deconvolution problem to deconvolve impulses controlled by a target vector.•Spectrums of impulse train targets can be solved simultaneously to study the fault level according to the fault period.•On our setup, results show that AR model preprocessing before deconvolutions had no significant effect on fault detection result.
Every day, biologists in parkas, raincoats, and rubber boots go into the field to capture and mark a variety of animal species. Back in the office, statisticians create analytical models for the ...field biologists' data. But many times, representatives of the two professions do not fully understand one another's roles. This book bridges this gap by helping biologists understand state-of-the-art statistical methods for analyzing capture-recapture data. In so doing, statisticians will also become more familiar with the design of field studies and with the real-life issues facing biologists.
Reliable outcomes of capture-recapture studies are vital to answering key ecological questions. Is the population increasing or decreasing? Do more or fewer animals have a particular characteristic? In answering these questions, biologists cannot hope to capture and mark entire populations. And frequently, the populations change unpredictably during a study. Thus, increasingly sophisticated models have been employed to convert data into answers to ecological questions. This book, by experts in capture-recapture analysis, introduces the most up-to-date methods for data analysis while explaining the theory behind those methods. Thorough, concise, and portable, it will be immensely useful to biologists, biometricians, and statisticians, students in both fields, and anyone else engaged in the capture-recapture process.
This article provides U.S. national estimates for six common nosocomial pathogens. The incidence of infection decreased for four (MRSA, vancomycin-resistant enterococcus, carbapenem-resistant ...acinetobacter species, and multidrug-resistant
P. aeruginosa
), was constant for one (carbapenem-resistant Enterobacteriaceae), and increased for one (ESBL-producing Enterobacteriaceae).
Clostridium difficile
is an important cause of hospital-associated diarrhea. In this report from the CDC, the U.S. burden of
C. difficile
infection is estimated at nearly 500,000 cases and 30,000 ...deaths in 2011, with an increasing burden among nonhospitalized persons.
Changes in the epidemiology of
Clostridium difficile
infections have occurred since the emergence of the North American pulsed-field gel electrophoresis type 1 (NAP1) strain, which has been responsible for geographically dispersed hospital-associated outbreaks.
1
–
3
In the United States, hospitalizations for
C. difficile
infection among nonpregnant adults doubled from 2000 through 2010 and were projected to continue to increase in 2011 and 2012, especially as laboratories transition to more sensitive
C. difficile
assays, such as the nucleic acid amplification test (NAAT).
4
–
6
On the basis of data from U.S. death certificates,
C. difficile
infection is the leading cause of gastroenteritis-associated death . . .
This presentataion outlines the development of a post-membership masterclass programme in Perinatal Psychiatry, funded by Health Education England and delivered through the Royal College of ...Psychiatrists. The masterclass programme renges from 5-15 days and there are separate programmes for consultants, SAS doctors and senior trainees in psychiatry. The course is delivered by experts in the area and contains a mix of didactic teaching and small group work. The programme was developed to meet the workforce needs of rapidly expanding perinatal mental services throughout England. The programme also helps facilitate the needs of perinatal psychiatrists from Ireland and from the devolved nations of the UK (Scotland, Wales and Northern Ireland).
Disclosure
No significant relationships.
Anxiety disorders are common in pregnancy and in the post-natal period. This presentation will focus on how anxiety disorders may present in the perinatal period, the need for accurate and timely ...diagnosis, and barriers to diagnosis and barriers for women in accessing appropriate care and treatment.
Disclosure
No significant relationships.
Background. Globally, gastroenteritis is recognized as an important contributor to mortality among children, but population-based data on gastroenteritis deaths among adults and the contributions of ...specific pathogens are limited. We aimed to describe trends in gastroenteritis deaths across all ages in the United States and specifically estimate the contributions of Clostridium difficile and norovirus. Methods. Gastroenteritis-associated deaths in the United States during 1999-2007 were identified from the National Center for Health Statistics multiple-cause-of-death mortality data. All deaths in which the underlying cause or any of the contributing causes listed gastroenteritis were included. Time-series regression models were used to identify cause-unspecified gastroenteritis deaths that were probably due to specific causes; seasonality of model residuals was analyzed to estimate norovirus-associated deaths. Results. Gastroenteritis mortality averaged 39/1 000 000 person-years (11 255 deaths per year) during the study period, increasing from 25/1 000 000 person-years in 1999-2000 to 57/1 000 000 person-years in 2006-2007 (P < .001). Adults aged ≥65 years accounted for 83% of gastroenteritis deaths (258/1 000 000 person-years). C. difficile mortality increased 5-fold from 10/1 000 000 person-years in 1999-2000 to 48/1 000 000 person-years in 2006-2007 (P (P < .001). Norovirus contributed to an estimated 797 deaths annually (3/1 000 000 person-years), with surges by up to 50% during epidemic seasons associated with emergent viral strains. Conclusions. Gastroenteritis-associated mortality has more than doubled during the past decade, primarily affecting the elderly. C. difficile is the main contributor to gastroenteritis-associated deaths, largely accounting for the increasing trend, and norovirus is probably the second leading infectious cause. These findings can help guide appropriate clinical management strategies and vaccine development.
Since publication of the Society for Healthcare Epidemiology of America position paper on Clostridium difficile infection in 1995, significant changes have occurred in the epidemiology and treatment ...of this infection. C. difficile remains the most important cause of healthcare-associated diarrhea and is increasingly important as a community pathogen. A more virulent strain of C. difficile has been identified and has been responsible for more-severe cases of disease worldwide. Data reporting the decreased effectiveness of metronidazole in the treatment of severe disease have been published. Despite the increasing quantity of data available, areas of controversy still exist. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management.
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