Attitudes and beliefs of Canadian infection control decision-makers towards 'borderline' methicillin-resistant Staphylococcus aureus

'Borderline' methicillin-resistant Staphylococcus aureus (MRSA) strains are inhibited by drug concentrations of 2 to 8 micrograms/mL. This type of resistance is usually mediated by 'hyper beta-lactamase' production which is detectable in vitro by susceptibility to combinations of a beta-lactam and a beta-lactamase inhibitor (ie, amoxicillin and clavulanic acid). A survey of Canadian infection control experts was performed to assess the knowledge, attitudes and beliefs regarding the containment requirements for borderline MRSA strains in acute health care facilities. Twenty-three of 38 Canadian infection control experts (61%) (members of the Canadian Hospital Epidemiology Committee [CHEC] or the Society for Healthcare Epidemiology of American [SHEA]) returned a questionnaire about a fictional patient with a postoperative wound infection with such a strain. Eleven respondents (48%) considered the isolate as an MRSA, 11 did not and one was unsure. All who did not believe the strain to be MRSA would not have isolated or cohorted the patient. Four in the latter group would have isolated the patient if he or she were on a neurosurgery or cardiovascular surgery unit, indicating a desire to restrict spread of this isolate on those units. Seven of the 12 individuals who had managed at least one patient with a borderline MRSA did not advocate patient isolation or cohorting, and five did. This survey has supported the belief that there are discrepancies among infection control decision-makers in Canada regarding the approach, precautions and therapy of patients infected with borderline strains of MRSA. Further data on virulence of and effective therapy for these isolates are needed to assess whether the additional cost is warranted in controlling the nosocomial spread of these isolates.     

Diffusion induced grain boundary migration and recrystallization during oxidation of a Ni- 48.5 Pet Cu alloy

Diffusion induced grain boundary migration (DIGM) was observed to occur in a Ni-48.5 wt pct Cu alloy during oxidation at 450 °C, 500 °C, 600 °C, and 707 °C in air. The DIGM zones are Cu enriched. A Ni depleted zone, consisting of small recrystallized grains, formed in the matrix beneath the metal-oxide interface during oxidation at 600 °C and 707 °C. This process is referred to as oxidation-induced recrystallization (OIR). Growth of the small OIR grains was observed to be associated with Cu-rich DIGM. No Cu-rich DIGM was found in the same alloy when annealed in Ar at 707 °C. Oxidation of this alloy in air resulted in the formation of a duplex oxide: an inner NiO layer and an outer CuO layer. The NiO layer was observed to grow at a faster rate than the CuO layer. The occurrence of Cu-rich DIGM is interpreted in terms of this preferential oxidation of Ni.     

Analysis of an antijam FH acquisition scheme

An easily implemented matched filter scheme for acquiring hopping code synchronization of incoming frequency-hopping (FH) signals is analyzed, and its performance is evaluated for two types of jamming: partial-band noise jamming and partial-band multitone jamming. The system is designed to reduce jammer-induced false alarms. The system's matched filter output is compared to an adaptive threshold that is derived from a measurement of the number of acquisition channels being jammed. Example performance calculations are given for the frequency coverage of the jamming either fixed over the entire acquisition period or hopped, that is, changed for each acquisition pulse. It is shown that the jammer's optimum strategy (the worst case) is to maximize the false alarm probability without regard for the effect on detection probability, for both partial-band noise and multitone jamming. It is also shown that a significantly lower probability of false acquisition results from using an adaptive matched filter threshold, demonstrating that the strategy studied here is superior to conventional nonadaptive threshold schemes     

Spontaneous platelet activation and aggregation during obstructive sleep apnea and its response to therapy with nasal continuous positive airway pressure. A preliminary investigation

STUDY OBJECTIVE: To determine whether alterations of platelet reactivity occur during obstructive sleep apnea (OSA) and, if so, whether therapy with nasal-continuous positive airway pressure (N-CPAP) alters this reactivity. DESIGN: Patients with suspected moderate to severe OSA had blood drawn for spontaneous platelet aggregation (sAGG) and activation (sACT) measurements at hourly intervals during diagnostic polysomnography (PSG) and, in those with confirmed OSA, on a separate night during which N-CPAP was applied. SETTING: Tertiary care center sleep laboratory. PATIENTS: Six patients with OSA had matched blood samples drawn on both diagnostic and N-CPAP treatment nights. Five patients without confirmed OSA served as controls. INTERVENTIONS: N-CPAP was applied to those patients with OSA and pressures adjusted with goals of eliminating apneas; N-CPAP was then maintained through the night. MEASUREMENTS AND RESULTS: sACT and sAGG were measured using flow cytometric determination of P-selectin expression using a monoclonal antibody. Platelet aggregation was assessed by measuring the proportion of platelets larger than resting platelets by light scatter techniques. Mean values for sACT and sAGG were higher on the diagnostic night compared with treatment night (p = 0.001 and p = 0.003, analysis of variance, respectively). The mean baseline supine sACT compared with completion supine sACT for both diagnostic and N-CPAP nights also revealed significant differences (mean = 16.6 +/- 3.5% vs 36.9 +/- 7.5%, p = 0.04; and 11.9 +/- 3% vs 39.5 +/- 9.1%, p = 0.04). Platelet activation during sleep in five subjects without OSA resembles that found in patients with OSA during N-CPAP. CONCLUSIONS: Increased platelet sACT and sAGG occur during sleep in patients with OSA. This effect is greatly reduced by N-CPAP.     

Modulation of human CACO-2 intestinal epithelial cell phenotype by protein kinase C inhibitors

Protein kinase C (PKC) isoforms are altered in colon tumors and upon exposure of intestinal mucosa to nutrients. We evaluated the effects of the PKC inhibitors staurosporine and calphostin C on human Caco-2 intestinal epithelial proliferation, motility, and differentiation. Motility was quantitated by monolayer expansion and the brush border enzymes dipeptidyl dipeptidase (DPDD) and alkaline phosphatase (AP) by synthetic substrate digestion. Staurosporine (0.03-1.0 ng/ml) and calphostin C (10(-12) M-10(-4) M) dose-dependently inhibited monolayer expansion and AP but stimulated DPDD. Proliferation was also inhibited but the effects of each inhibitor on motility, AP, and DPDD were preserved after mitomycin C proliferative blockade, suggesting that these effects were proliferation-independent. PKC inhibitors independently inhibit motility, AP and proliferation in human intestinal Caco-2 epithelial cells, but selectively stimulate the small intestinal differentiation marker DPDD. PKC may regulate small intestinal epithelial differentiation.     

Response of dairy cows to high doses of a sustained-release bovine somatotropin administered during two lactations. 2. Health and reproduction.

Eighty-two lactating Holstein cows in their first, second, or third lactation received either one, three, or five concurrent i.m. injections of a unit dose (.6 g) of zinc methionyl bST (sometribove) or five doses of the vehicle. Injections were given at 14-d intervals from 60 +/- 3 d postpartum until the end of lactation or necropsy. Thirty-eight animals were continued on treatment for a 2nd yr. Sometribove did not affect the incidence of ketosis, milk fever, tetany, or pneumonia. Digestive disorders, primarily cows going off feed, were increased by bST during yr 1 only. The incidence of lameness was increased by bST in some time frames because of an increase in the 3.0-g bST group. Lameness was not associated with treatment-specific histopathologic changes or with abnormalities in cartilage or bone. Reproductive health generally was unaffected by treatment, but delayed conception and increased incidence of abortion were noted. Incidence of cystic ovaries was unaffected by bST. Pregnancy rates were decreased during the 100-d breeding interval of yr 1 but not during the 215-d interval of yr 2. The incidence of clinical mastitis was increased by bST, primarily at the 3.0-g dose. During the 2-yr study, 0, 3, 3, and 2 cows died or became moribund on 0, .6, 1.8, and 3.0 g of bST, respectively. Health issues identified for further evaluation included lameness and clinical mastitis for the 3.0-g group and early removal from the herd and decreased reproductive performance for all bST groups. Bovine somatotropin caused no treatment-specific toxic effects in dairy cows even at 3.0 g every 14 d.     

Self-aligning planarization and passivation for integration applications in III-V semiconductor devices

This work reports an easy planarization and passivation approach for the integration of III-V semiconductor devices. Vertically etched III-V semiconductor devices typically require sidewall passivation to suppress leakage currents and planarization of the passivation material for metal interconnection and device integration. It is, however, challenging to planarize all devices at once. This technique offers wafer-scale passivation and planarization that is automatically leveled to the device top in the 1-3-/spl mu/m vicinity surrounding each device. In this method, a dielectric hard mask is used to define the device area. An undercut structure is intentionally created below the hard mask, which is retained during the subsequent polymer spinning and anisotropic polymer etch back. The spin-on polymer that fills in the undercut seals the sidewalls for all the devices across the wafer. After the polymer etch back, the dielectric mask is removed leaving the polymer surrounding each device level with its device top to atomic scale flatness. This integration method is robust and is insensitive to spin-on polymer thickness, polymer etch nonuniformity, and device height difference. It prevents the polymer under the hard mask from etch-induced damage and creates a polymer-free device surface for metallization upon removal of the dielectric mask. We applied this integration technique in fabricating an InP-based photonic switch that consists of a mesa photodiode and a quantum-well waveguide modulator using benzocyclobutene (BCB) polymer. We demonstrated functional integrated photonic switches with high process yield of >90%, high breakdown voltage of >25 V, and low ohmic contact resistance of /spl sim/10 /spl Omega/. To the best of our knowledge, such an integration of a surface-normal photodiode and a lumped electroabsorption modulator with the use of BCB is the first to be implemented on a single substrate.