bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stool Colonization of Healthcare Workers With Selected Resistant Bacteria
Authors: Carmeli Yehuda , Venkataraman Lata , DeGirolami Paola C. , Lichtenberg Deborah A. , Karchmer Adolf W. , Samore Matthew H. 
Published: September 2009

AbstractWe examined the carriage of selected resistant bacteria in the stools of healthcare workers who provided direct patient care. Neither vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus, nor Clostridium difficile was recovered from the 55 stool specimens collected. A ceftazidime-resistant Citrobacter freundii was isolated from one specimen. We conclude that the stool of healthcare workers is colonized infrequently with these resistant organisms
Medical-Resource Use for Suspected Tuberculosis in a New York City Hospital
Authors: Griffiths Robert I. , Hyman Charles L. , McFarlane Samy I. , Saurina Guillermo R. , Anderson Jane E. , O'Brien Theodore , Popper Caroline , McGrath Margaret M. , Herbert Robert J. , Sierra Marcelino F. 
Published: September 2009

AbstractObjective:To compare resource use by diagnostic outcome among hospital admissions during which tuberculosis (TB) was suspected.Design:Retrospective study based on chart review and microbiology laboratory data.Setting:The department of medicine in a municipal hospital serving central Brooklyn, New York.Participants:We identified all adult admissions in 1993 during which TB was suspected. We assigned each admission to one of four mutually exclusive groups defined by the results of microbiological tests (acid-fast bacilli [AFB] smear and culture): culture-positive and smear-positive (C + S +); culture-positive and smear-negative (C + S−); culture-negative and smear-positive (C−S+); or culture-negative and smear-negative (C−S−). Each admission was divided into two separate periods to which the utilization of medical resources was assigned: the diagnostic and the postdiagnostic periods, which were separated by the date of receipt of the first definitive culture report.Results:Data on 519 admissions (93 C+S+; 57 C+S−; 30 C−S+; and 339 C−S−) were analyzed. Although C+S+ were more likely than other groups to have an admitting diagnosis of TB, approximately one quarter of the admissions without TB (C−S+, C−S−) were admitted with the principal diagnosis of TB. For the four groups, C+S+, C+S−, C−S+, and C−S−, the respective rates of TB isolation and anti-TB treatment, and median lengths of isolation were 98%, 87%, and 34 days; 74%, 74%, and 7 days; 83%, 83%, and 15 days; and 44%, 29%, and 0 days. During the diagnostic period, the rate and length of isolation were similar in the AFB-smear—positive groups (C+S+ and C−S+). We estimated that admissions without culture-proven TB (C−S+ and C−S−) accounted for 3,174 (36%) of the 8,712 days of TB isolation expended and for 65% of the 16,671 days of anti-TB treatment. The vast majority of this resource consumption (2,737 [86%] of 3,174 days of isolation) occurred during the diagnostic period before a definitive culture result was known.Conclusions:Our results suggest that prolonged diagnostic uncertainty and misclassification of cases due to false-positive and false-negative smears are associated with substantial medical-resource consumption. New diagnostic modalities that reduce the period of diagnostic uncertainty could reduce the utilization of resources later found to be unnecessary
An Observational Study of Hand Washing and Infection Control Practices by Healthcare Workers
Authors: Watanakunakorn Chatrchai , Wang Catherine , Hazy John 
Published: September 2009

AbstractDuring a 6-week period, a medical student conducted an observational study of hand washing and infection control practices in a community teaching hospital. There was no difference in the prevalence of handwashing practices among the three work shifts. The prevalence of hand washing was higher in surgical (56.4%) and medical intensive-care units (39.2%) than in intermediate (30.0%) or general units (22.8%).
A Software Program to Calculate Goodman and Kruskal's Gamma: A Method to Monitor Surgical-Site Infection Rates
Authors: Wasser Thomas E. 
Published: September 2009

AbstractSeveral studies have described a need for a valid statistical methodology to facilitate interhospital and intrahospital infection rates for their operative procedures. Physician awareness of postoperative surgical-site infection rates has been demonstrated as an effective means to reduce infection rates in both high- and low-risk surgical patients. This article presents a new software program that allows for simple data entry and provides results including the gamma statistic, sample size, variance, standard error, and Z value and P value of the gamma result. This software also provides a data interpretation table, allowing infectious disease department physicians or staff to determine if a significant relation exists between operative procedure infection rates and patient risk factors.
A Viral Gastroenteritis Outbreak Associated with Person-to-Person Spread Among Hospital Staff
Authors: Cáceres Victor M. , Kim David K. , Bresee Joseph S. , Horan John , Noel Jacqueline S. , Ando Tamie , Steed Connie J. , Weems J. John , Monroe Stephan S. , Gibson James J. 
Published: September 2009

AbstractObjective:To identify the etiologic agent and risk factors associated with a hospital ward outbreak of gastroenteritis.Setting:A regional referral hospital in upstate South Carolina.Methods:We reviewed patient charts, surveyed staff, and tested stool from acutely ill persons. A case was defined as diarrhea and vomiting in a staff member or patient from January 5 to 13, 1996.Results:The initial case occurred on January 5 in a staff nurse who subsequently was hospitalized on the ward and visited by many staff colleagues. The staff were at a significantly greater risk for gastroenteritis than were patients (28/89 [31%] vs 10/91 [11%]; relative risk [RR], 2.9; 95% confidence interval [CI95], 1.5-5.5). All 10 case-patients had been exposed to case-nurses (assigned nurses who were primary caretakers), and eight had documented exposure to case-nurses 1 to 2 days before their illness. Patients exposed to case-nurses had a significantly increased risk of illness (8/57 [14%] vs 0/32; RR, >4.5; CI95, undefined). Neither staff nor patients had significantly increased risk from food, water, ice, or exposure to case-patients. Electron microscopy identified small round-structured viruses (SRSVs) in nine of nine stool samples.Conclusion:This nosocomial outbreak of gastroenteritis was likely caused by SRSVs introduced by a staff member and spread via person-to-person transmission from and among staff. The potential for spread of SRSV-associated gastroenteritis from and among staff should be considered in developing strategies to prevent similar outbreaks in hospital settings
Influenza Immunization: Improving Compliance of Healthcare Workers
Authors: Harbarth Stephan , Siegrist Claire-Anne , Schira Jean-Claude , Wunderli Werner , Pittet Didier 
Published: September 2009

ABSTRACTOBJECTIVE: In spite of yearly recalls, influenza immunization rates of healthcare workers (HCWs) remained low (10%) at the University Hospitals of Geneva. This study was conducted to identify HCWs' reasons for rejection of immunization, to design specific intervention methods based on these reasons, and to evaluate the impact of such interventions.METHODS: Three departments with high-risk patients (geriatrics, obstetrics, and pediatrics) were selected as main targets. Questionnaires were distributed in these units. Based on HCWs' perceptions, different intervention methods were designed and used either in these departments only (educational conferences, on-site availability of a vaccination nurse) or in the whole institution (posters, personal letters). Immunization rates were collected throughout the institution.RESULTS: 797 completed questionnaires from 1,092 HCWs (73%) were returned. Major reasons for immunization rejection were confidence that their bodies' self-defense mechanisms would ward off infection (32%), perception of low exposure risk (23%), and doubts concerning vaccine efficacy (19%). The use of intervention methods designed to address these factors increased influenza immunization rates in the three targeted departments from 13% (95% confidence interval [CI95], 11.4-15.6) in 1995 and 1996 to 37% (CI95, 34.5-40.3) in the following season (P<.001). In all other departments, immunization rates rose from 9% (CI95, 8.5-10.3) to 23%% (CI95, 21.6-24.1; P<.001). Nurses were, and remained, more reluctant to be immunized compared to other HCWs.CONCLUSIONS: Influenza immunization rates can be increased significantly by specific interventions based on local concerns of HCWs, among which educational conferences and the on-site availability of a vaccination nurse appeared important
Evidence for Person-to-Person Transmission of Candida lusitaniae in a Neonatal Intensive-Care Unit
Authors: Fowler Sandra L. , Rhoton Beth , Springer Shelley C. , Messer S.A. , Hollis Richard J. , Pfaller Michael A. 
Published: September 2009

ABSTRACTCandida lusitaniae is an increasingly important nosocomial bloodstream pathogen. Epidemiological investigation and molecular typing techniques identified three neonates infected with identical strains of C lusitaniae that were distinguished readily from epidemiologically unrelated strains from other locations in the hospital. The results of this study provide evidence for nosocomial transmission of C lusitaniae in a neonatal intensive-care unit and suggest that these infants are at increased risk for infection with this agent
Evaluating the Control of Tuberculosis Among Healthcare Workers: Adherence to CDC Guidelines of Three Urban Hospitals in California
Authors: Sutton Patrice M. , Nicas Mark , Reinisch Florence , Harrison Robert J. 
Published: September 2009

AbstractOBJECTIVE:To evaluate adherence to components of the Centers for Disease Control and Prevention (CDC) guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities.DESIGN:Multihospital study using direct observation and a standardized questionnaire.SETTING:Three urban hospitals (two county hospitals and one private community hospital) in counties in California with a high number and incidence rate of tuberculosis (TB) cases.MEASUREMENTS:The ventilation performance of treatment and TB-patient isolation rooms was assessed. Questionnaire data regarding TB control policy and procedures were obtained through interviews with the person(s) responsible for each program component; review of written TB control plans, training, and educational materials; and attendance at hospital TB control meetings and trainings.RESULTS:Twenty-eight percent of isolation rooms tested (7/25) were under positive pressure; 83% of rooms tested (20/24) had six or more nominal air changes per hour (ACH), but supply air did not mix rapidly with room air. Therefore, the nominal ACH likely overestimated the effective ACH and the subsequent protection provided. In virtually all rooms tested (26/27), air potentially containing M tuberculosis aerosol moved toward, rather than away from likely worker locations. None of the hospitals regularly checked the performance of engineering controls. Only one hospital adhered to the CDC minimum requirements for respiratory protection. Training of healthcare workers generally was underutilized as a TB prevention measure. Hospitals did not provide comprehensive counseling regarding the need for healthcare workers to know their immune status and the risks associated with M tuberculosis infection in an immunocompromised individual. Employee representatives did not have a voice in TB-related decision making.CONCLUSIONS:Important aspects of day-to-day TB control practice did not conform to the written TB control policy. Subsequent to the identification of TB patients, healthcare workers at all three hospitals were potentially exposed to M tuberculosis aerosol due to breaches in negative-pressure isolation, the limitations of dilution ventilation, and the failure to maintain engineering controls and to implement respiratory protection controls fully These findings lend support to the Occupational Safety and Health Administration's policy presumption that, absent clear evidence to the contrary, newly acquired healthcare-worker M tuberculosis infections are work-related.
Cross-Contamination with Mycobacterium tuberculosis: An Epidemiological and Laboratory Investigation
Authors: Nivin Beth , Fujiwara Paula I. , Hannifin John , Kreiswirth Barry N. 
Published: September 2009

AbstractOBJECTIVE:To investigate possible cross-contamination of laboratory specimens, as suggested by an increased incidence of newly diagnosed patients with tuberculosis, many of whom had all negative smears for acid-fast bacilli and only one positive Mycobacterium tuberculosis culture referred to as “negative smears, one positive“ or NSOP.METHODS:Medical-record reviews were performed for all patients with NSOP results diagnosed at this facility within a 9-month period. Laboratory logbooks were reviewed for all isolates processed; DNA fingerprinting was performed on available isolates.RESULTS:Of 80 patients with NSOP results, 45 (56%) were found to have false-positive cultures resulting from laboratory contamination with H37Ra, an avirulent stock strain of Mycobacterium tuberculosis.CONCLUSION:Laboratory cross-contamination resulted in the false diagnosis of tuberculosis in at least 45 individuals. Use of the Mycobacteria Growth Indicator Tube may have contributed to these contamination incidents by detecting small numbers of contaminating mycobacteria that may not have been detected with less sensitive media.
Central Venous Catheters as a Source of Hemodialysis-Related Bacteremia
Authors: Taylor Geoffrey D. , McKenzie Margaret , Buchanan-Chell Maureen , Caballo Louise , Chui Linda , Kowalewska-Grochowska Kinga 
Published: September 2009

AbstractObjective:To describe investigations into an increase in hemodialysis-related bacteremia that occurred in our hospital in the first 6 months of 1996.Setting:Hemodialysis unit in a tertiary-care medical center.Methods:Prospective surveillance for hemodialysis bacteremia has been performed for several years. Cases that occurred in 1995 were compared to cases in the first 6 months of 1996. Unit data on dialysis runs and method of dialysis access were used to calculate rates. Nested polymerase chain reaction (PCR) was used to type 18 Staphylococcus aureus isolates from 1996. A case-control study comparing 80 randomly selected hemodialysis patients from 1995 and 1996 was performed to examine infection risk factors.Results:The hemodialysis bacteremia rate was 1.2 per 1,000 runs in 1995 and 2.8 per 1,000 in the first 6 months of 1996 (P=.0009). The 25 cases in 1995 and 32 in the first half of 1996 were similar in age, gender, means of vascular access, and micro-bial etiology. Central venous catheter (CVC) access accounted for >90% of cases in both time periods. S aureus was the most common microbial etiology (53% of the 1996 cases). PCR typing of S aureus isolates from 1996 demonstrated five different strains, the most common having six isolates. The use of CVCs as a means of vascular access abruptly increased in the unit in January 1996, from <30% of dialysis runs in 1995 to >40% in 1996 (P<.001), associated with structural changes in healthcare delivery in the region resulting in delays in performing surgical procedures, such as creation of vascular grafts and fistulae.Conclusion:A marked increase in hemodialysis bacteremia occurred in 1996, associated with increased reliance on CVCs for vascular access in hemodialysis patients during a period of healthcare restructuring.
Global Changes in the Transcript and Metabolic Profiles during Symbiotic Nitrogen Fixation in Phosphorus-Stressed Common Bean Plants
Authors: Hernández Georgina , Valdés-López Oswaldo , Ramírez Mario , Goffard Nicolas , Weiller Georg , Aparicio-Fabre Rosaura , Fuentes Sara Isabel , Erban Alexander , Kopka Joachim , Udvardi Michael K. , Vance Carroll P. 
Published: September 2009

AbstractPhosphorus (P) deficiency is widespread in regions where the common bean (Phaseolus vulgaris), the most important legume for human consumption, is produced, and it is perhaps the factor that most limits nitrogen fixation. Global gene expression and metabolome approaches were used to investigate the responses of nodules from common bean plants inoculated with Rhizobium tropici CIAT899 grown under P-deficient and P-sufficient conditions. P-deficient inoculated plants showed drastic reduction in nodulation and nitrogenase activity as determined by acetylene reduction assay. Nodule transcript profiling was performed through hybridization of nylon filter arrays spotted with cDNAs, approximately 4,000 unigene set, from the nodule and P-deficient root library. A total of 459 genes, representing different biological processes according to updated annotation using the UniProt Knowledgebase database, showed significant differential expression in response to P: 59% of these were induced in P-deficient nodules. The expression platform for transcription factor genes based in quantitative reverse transcriptase-polymerase chain reaction revealed that 37 transcription factor genes were differentially expressed in P-deficient nodules and only one gene was repressed. Data from nontargeted metabolic profiles indicated that amino acids and other nitrogen metabolites were decreased, while organic and polyhydroxy acids were accumulated, in P-deficient nodules. Bioinformatics analyses using MapMan and PathExpress software tools, customized to common bean, were utilized for the analysis of global changes in gene expression that affected overall metabolism. Glycolysis and glycerolipid metabolism, and starch and Suc metabolism, were identified among the pathways significantly induced or repressed in P-deficient nodules, respectively.
Large-Scale Analysis of Putative Soybean Regulatory Gene Expression Identifies a Myb Gene Involved in Soybean Nodule Development
Authors: Libault Marc , Joshi Trupti , Takahashi Kaori , Hurley-Sommer Andrea , Puricelli Kari , Blake Sean , Finger Richard E. , Taylor Christopher G. , Xu Dong , Nguyen Henry T. , Stacey Gary 
Published: September 2009

Abstract
Nodulation is the result of a symbiosis between legumes and rhizobial bacteria in soil. This symbiosis is mutually beneficial, with the bacteria providing a source of nitrogen to the host while the plant supplies carbon to the symbiont. Nodule development is a complex process that is tightly regulated in the host plant cell through networks of gene expression. In order to examine this regulation in detail, a library of quantitative reverse transcription-polymerase chain reaction primer sets was developed for a large number of soybean (Glycine max) putative regulatory genes available in the current expressed sequence tag collection. This library contained primers specific to soybean transcription factor genes as well as genes involved in chromatin modification and translational regulation. Using this library, we analyzed the expression of this gene set during nodule development. A large number of genes were found to be differentially expressed, especially at the later stages of nodule development when active nitrogen fixation was occurring. Expression of these putative regulatory genes was also analyzed in response to the addition of nitrate as a nitrogen source. This comparative analysis identified genes that may be specifically involved in nitrogen assimilation, metabolism, and the maintenance of active nodules. To address this possibility, the expression of one such candidate was studied in more detail by expressing in soybean roots promoter β-glucuronidase and green fluorescent protein fusions. This gene, named Control of Nodule Development (CND), encoded a Myb transcription factor gene. When the CND gene was silenced, nodulation was reduced. These results, associated with a strong expression of the CND gene in the vascular tissues, suggest a role for CND in controlling soybean nodulation.
RNA interference‐mediated knock‐down of Bla g 1 in the German cockroach, Blattella germanica L., implicates this allergen‐encoding gene in digestion and nutrient absorption
Authors: Suazo A. , Gore C. , Schal C. 
Published: September 2009

AbstractWe used RNA interference (RNAi) to silence the expression of a gene encoding Bla g 1, a human allergen produced by the German cockroach, Blattella germanica L., to study its function in cockroach physiology. Females injected with 1 µg of double‐stranded RNA contained 64% less Bla g 1 protein and Bla g 1 mRNA abundance was reduced by 91.4% compared to sham‐injected females. Bla g 1 knockdown slowed the pace of weight gain, midgut growth, and colleterial gland and basal oocyte maturation, resulting in delayed egg case formation and lower fecundity. Exogenous juvenile hormone treatments rescued reproduction in RNAi‐treated females, suggesting that Bla g 1 silencing lowered endogenous juvenile hormone, probably by reducing food intake and nutrient absorption.
Correlates of recent and regular mammography screening among Asian‐American women
Authors: Wu Tsu‐Yin , Ronis David 
Published: September 2009

AbstractTitle.  Correlates of recent and regular mammography screening among Asian‐American women. Aim.  This paper is a report of a study of the health beliefs, knowledge and selected demographic variables that influence mammography utilization among Asian‐American women.Background.  Breast cancer is the most frequently occurring cancer in Asian‐American women and its incidence is increasing at a greater rate than for other racial and ethnic groups in the United States of America (USA). Compared to White women, breast cancer also is more likely to be diagnosed at a later stage with larger tumours in Asian‐Americans.Method.  A self‐administered questionnaire was used with Asian‐American women residing in the USA. Data were collected in 2005 and 315 women participated in the study.Results.  Fifty‐five per cent of participants reported having their last mammogram within the past 13 months, and 33% reported having annual mammograms in each of the past 5 years. Based on multivariate logistic regression analyses, clinical breast examination, barriers and knowledge of recommendations of the frequency of mammography screening were associated with both recent and regular mammography practice after controlling for all other demographic, psychosocial and behavioural variables in the model.Conclusion. Intervention strategies tailored to knowledge, language and cultural factors associated with mammography use should target at‐risk subgroups, particularly those who are recent immigrants and those with limited English language ability. Culturally appropriate strategies should be developed to promote lifelong mammography screening for this rapidly growing and diverse population.