Currently, contact precautions are recommended for patients colonized or infected with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE). Recent studies have challenged this ...strategy. This study aimed to assess the rate of ESBL-PE faecal carriage among hospitalized patients according to type of hospital ward, and to identify risk factors associated with carriage.
A point prevalence study was conducted in five different types of hospital ward medical, surgical, intensive care unit (ICU), after care and rehabilitation, and geriatric in eight French hospitals. All patients included in the study provided a fresh stool sample.
In total, 554 patients were included in the study, with a median age of 73 years (range 60–82 years). The overall faecal carriage rate of ESBL-PE was 17.7%. The most frequently encountered species among ESBL-PE was Escherichia coli (71.4%), followed by Klebsiella pneumoniae (14.3%). Risk factors associated with ESBL-PE faecal carriage on univariate analysis were: living in the Paris region (P<0.01) and hospitalization on a geriatric ward (P<0.01). Interestingly, the cumulative duration of hospital stay before screening was not associated with a significantly higher prevalence of ESBL-PE carriage, regardless of ward type. The ESBL-PE colonization rate was much higher for patients hospitalized on geriatric wards (28.1%) and ICUs (21.7%) compared with those for patients hospitalized on surgical wards (14.8%), medical wards (12.8%) or aftercare and rehabilitation (11.2%).
The overall prevalence of ESBL-PE faecal carriage was 17.7%, with only 21% of patients identified previously as carriers. The delay between admission and screening was not associated with an increase in ESBL-PE faecal carriage.
Asymptomatic faecal carriage of Clostridioides difficile has been widely evaluated, but its prevalence across a wide range of clinical departments and related risk factors are not well described. The ...objectives of the PORTADIFF study were to evaluate the prevalence and identifying risk factors leading to asymptomatic carriage of both toxigenic and non-toxigenic C. difficile.
The PORTADIFF study was a 1-day prevalence study carried out in 10 different French hospitals. Adult patients, who agreed to participate, were included in this study and provided a fresh stool sample. C. difficile strains isolated from carriage were characterized by polymerase chain reaction (PCR) detection of tcdA, tcdB, cdtA and cdtB, and PCR ribotyping.
In total, 721 patients were included in this study. The median age was 73 years (range 18–101 years) and the male/female ratio was 1.06. C. difficile (either toxigenic or non-toxigenic strains) was isolated from 79 (11%) patients; 42 (5.8%) strains were toxigenic. The prevalence rates of asymptomatic carriage ranged from 5% on surgical wards to 19% on long-term care wards. The main risk factors associated with asymptomatic carriage were antibiotic treatment within the preceding 3 months (81.8% vs 53.7%; P<0.01), hospitalization within the preceding 2 months (55.8% vs 33%; P<0.01), cumulative duration of hospital stay before study inclusion (mean 50.1 vs 34.5 days; P<0.047), and hospitalization on a ward with high global incidence of C. difficile infection.
Eleven percent of hospitalized patients were asymptomatic carriers of toxigenic or non-toxigenic C. difficile, and may constitute a potential reservoir of C. difficile strains.
Acute lymphoblastic leukemia (ALL) in the elderly is characterized by its ominous prognosis. On the other hand, imatinib has demonstrated remarkable, although transient, activity in relapsed and ...refractory Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL), which prompted us to assess the use of imatinib in previously untreated elderly patients. ALL patients aged 55 years or older were given steroids during 1 week. Ph+ve cases were then offered a chemotherapy-based induction followed by a consolidation phase with imatinib and steroids during 2 months. Patients in complete response (CR) after consolidation were given 10 maintenance blocks of alternating chemotherapy, including two additional 2-month blocks of imatinib. Thirty patients were included in this study and are compared with 21 historical controls. Out of 29 assessable patients, 21 (72%, confidence interval (CI): 53-87%) were in CR after induction chemotherapy vs 6/21 (29%, CI: 11-52%) in controls (P=0.003). Five additional CRs were obtained after salvage with imatinib and four after salvage with additional chemotherapy in the control group. Overall survival (OS) is 66% at 1 year vs 43% in the control group (P=0.005). The 1-year relapse-free survival is 58 vs 11% (P=0.0003). The use of imatinib in elderly patients with Ph+ ALL is very likely to improve outcome, including OS.
1
The NK, tachykinin receptor agonists, septide, Sar9, Met(O2)11SP and Pro9SP produced locomotor hyperactivity (10–20 min) when injected intracerebroventricularly (i.c.v.) in the guinea‐pig. ...Producedlocomotor The most potent in eliciting this hyperactivity was septide (from 0.63 to 5 μg), compared to Sar9, Met(O2)11SP, which was active at 2.5 and 5 μg and Pro9SP which induced a non‐significant increase even at 10 μg.
2
Wet‐dog shakes were elicited by septide, Sar9, Met(O2)11SP and Pro9SP injected by the i.c.v. route in the guinea‐pig. Sar9, Met(O2)11SP, active from 0.16 to 2.5 μg was more potent than septide (active at 1.25 μg) and Pro9SP (active at 0.63 μg) in eliciting such behaviour. To a lesser extent, grooming was also observed after injection of these agonists.
3
The NK2 tachykinin receptor agonist, Lys5, MeLeu9, Nle10NKA(4–10), up to the dose of 10 μg i.c.v. had no effect in the guinea‐pig. It neither modified locomotor activity nor induced a characteristic behavioural response. At higher doses (20μg), some toxic effects were noted.
4
The NK3 tachykinin receptor agonist, senktide, contrasts with the NK1 receptor agonists in that it elicited only wet‐dog shakes, at doses ranging from 0.32 to 1.25 μg. It neither modified locomotor activity (1 pg) nor induced grooming (up to 5 μg) in the guinea‐pig.
5
To our knowledge, these results are the first demonstration that the guinea‐pig could be useful to differentiate tachykinin agonists on the basis of their behavioural profile, distinct from those obtained in mice and rats.
The NK sub(1) tachykinin receptor agonists, septide, Sar super(9),Met(O sub(2)) super(11)SP and Pro super(9)SP produced locomotor hyperactivity (10-20 min) when injected intracerebroventricularly ...(i.c.v.) in the guinea-pig. The most potent in eliciting this hyperactivity was septide (from 0.63 to 5 mu g), compared to Sar super(9),Met(O sub(2)) super(11)SP, which was active at 2.5 and 5 mu g and Pro super(9)SP which induced a non-significant increase even at 10 mu g. Wet-dog shakes were elicited by septide, Sar super(9),Met(O sub(2)) super(11)SP and Pro super(9)SP injected by the i.c.v. route in the guinea-pig. Sar super(9),Met(O sub(2)) super(11)SP, active from 0.16 to 2.5 mu g was more potent than septide (active at 1.25 mu g) and Pro super(9)SP (active at 0.63 mu g) in eliciting such behaviour. To a lesser extent, grooming was also observed after injection of these agonists. The NK sub(2) tachykinin receptor agonist, Lys super(5), MeLeu super(9), Nle super(10)NKA(4-10), up to the dose of 10 mu g i.c.v. had no effect in the guinea-pig. It neither modified locomotor activity nor induced a characteristic behavioural response. At higher doses (20 mu g), some toxic effects were noted. The NK sub(3) tachykinin receptor agonist, senktide, contrasts with the NK sub(1) receptor agonists in that it elicited only wet-dog shakes, at doses ranging from 0.32 to 1.25 mu g. It neither modified locomotor activity (1 mu g) nor induced grooming (up to 5 mu g) in the guinea-pig. To our knowledge, these results are the first demonstration that the guinea-pig could be useful to differentiate tachykinin agonists on the basis of their behavioural profile, distinct from those obtained in mice and rats.
Growth hormones are proteins produced by the anterior pituitary gland responsible for bone and tissue growth through their effects on carbohydrates, lipids and proteins metabolisms. Despite strict ...regulations banning the use of recombinant equine growth hormone, this substance is suspected to be misused to improve the horse physical performances. In order to check whether the regulation is fulfilled or not, controls are organized and a new analytical screening tool potentially able to detect such abuse was investigated in this paper. An untargeted metabolomics approach, based on liquid chromatography coupled to high resolution mass spectrometry, was developed and applied to characterize and compare horse urinary and plasmatic metabolic profiles upon reGH administrations. After minimal sample preparation, biological fluids were analyzed by LC-ESI(+/-)-Q-TOF. Data processing was performed by XCMS software and multivariate data analysis applied to the generated data set allowed building OPLS models to discriminate control versus treated populations. Results demonstrated significant metabolic modifications consecutively to the reGH treatment. A comparative study between urinary and plasmatic signatures was performed to evaluate the resulting metabolomic models and to asses their respective interests in the scope of real application for screening reGH administration.
Growth hormones are proteins produced by the anterior pituitary gland responsible for bone and tissue growth through their effects on carbohydrates, lipids and proteins metabolisms. Despite strict ...regulations banning the use of recombinant equine growth hormone, this substance is suspected to be misused to improve the horse physical performances. In order to check whether the regulation is fulfilled or not, controls are organized and a new analytical screening tool potentially able to detect such abuse was investigated in this paper. An untargeted metabolomics approach, based on liquid chromatography coupled to high resolution mass spectrometry, was developed and applied to characterize and compare horse urinary and plasmatic metabolic profiles upon reGH administrations. After minimal sample preparation, biological fluids were analyzed by LC-ESI(+/-)-Q-TOF. Data processing was performed by XCMS software and multivariate data analysis applied to the generated data set allowed building OPLS models to discriminate control versus treated populations. Results demonstrated significant metabolic modifications consecutively to the reGH treatment. A comparative study between urinary and plasmatic signatures was performed to evaluate the resulting metabolomic models and to asses their respective interests in the scope of real application for screening reGH administration.
A
bstract
In contrast to massless spinning particles, scalars are not heavily constrained by unitarity and locality. Off-shell, no gauge symmetries are required to write down manifestly local ...theories, while on-shell consistent factorisation is trivial. Instead a useful classification scheme for scalars is based on the symmetries they can non-linearly realise. Motivated by the breaking of Lorentz boosts in cosmology, in this paper we classify the possible symmetries of a shift-symmetric scalar that is assumed to non-linearly realise Lorentz boosts as, for example, in the EFT of inflation. Our classification method is algebraic; guided by the coset construction and inverse Higgs constraints. We rediscover some known phonon theories within the superfluid and galileid classes, and discover a new galileid theory which we call the
extended galileid
. Generic galileids correspond to the broken phase of galileon scalar EFTs and our extended galileids correspond to special subsets where each galileon coupling is fixed by an additional symmetry. We discuss the broken phase of theories that also admit a perturbation theory around Poincaré invariant vacua and we show that the so-called exceptional EFTs, the DBI scalar and special galileon, do not admit such a broken phase. Concentrating on DBI we provide a detailed account of this showing that the scattering amplitudes are secretly Poincaré invariant when the theory is expanded around the superfluid background used in the EFT of inflation. We point out that DBI is an exception to the common lore that the residue of the total energy pole of cosmological correlators is proportional to the amplitude. We also discuss the inevitability of poles in 2
→
2 scattering amplitudes when boost are spontaneously broken meaning that such theories do not admit Adler zeros and generalisations even in the presence of a shift symmetry.
•The case of gradual degradation with unknown parameters is considered.•Remaining lifetime and a preventive threshold are combined with different options.•The long run maintenance cost is derived for ...unknown degradation parameters.•A Bayesian framework is used for deterioration model update after inspections.•A dynamic procedure for update of decision variables is proposed and assessed.
With the development of monitoring equipment, research on condition-based maintenance (CBM) is rapidly growing. CBM optimization aims to find an optimal CBM policy which minimizes the average cost of the system over a specified duration of time. This paper proposes a dynamic auto-adaptive predictive maintenance policy for single-unit systems whose gradual deterioration is governed by an increasing stochastic process. The parameters of the degradation process are assumed to be unknown and Bayes’ theorem is used to update the prior information. The time interval between two successive inspections is scheduled based on the remaining useful life (RUL) of the system and is updated along with the degradation parameters. A procedure is proposed to dynamically adapt the maintenance decision variables accordingly. Finally, different possible maintenance policies are considered and compared to illustrate their performance.
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