Community-Level Social Vulnerability and Hip and Knee Joint Replacement Surgery Receipt Among Medicare Enrollees With Arthritis.

Objectives: (1) Explore associations between county minority health social vulnerability index (MH-SVI) and total joint replacement (TJR), and (2) assess associations by individual-level race/ethnicity.

Background: An expanded understanding of relevant social determinants of health is essential to inform policies and practices that promote equitable access to hip and knee TJR.

Methods: Retrospective cohort study of Medicare enrollees.

Measuring the Direct Medical Costs of Hospital-Onset Infections Using an Analogy Costing Framework.

Background: The majority of recent estimates on the direct medical cost attributable to hospital-onset infections (HOIs) has focused on device- or procedure-associated HOIs. The attributable costs of HOIs that are not associated with device use or procedures have not been extensively studied.

Objective: We developed simulation models of attributable cost for 16 HOIs and estimated the total direct medical cost, including nondevice-related HOIs in the USA for 2011 and 2015.

Transfusion-related errors and associated adverse reactions and blood product wastage as reported to the National Healthcare Safety Network Hemovigilance Module, 2014-2022.

Background: Transfusion-related errors are largely preventable but may lead to blood product wastage and adverse reactions, resulting in patient harm. In the United States, the incidence of transfusion-related errors is poorly understood nationally. We used data from the National Healthcare Safety Network (NHSN) Hemovigilance Module to describe and quantify transfusion-related errors, as well as associated transfusion-related adverse reactions and blood product wastage.

Length of antibiotic therapy among adults hospitalized with uncomplicated community-acquired pneumonia, 2013-2020.

Objective: The 2014 US National Strategy for Combating Antibiotic-Resistant Bacteria (CARB) aimed to reduce inappropriate inpatient antibiotic use by 20% for monitored conditions, such as community-acquired pneumonia (CAP), by 2020. We evaluated annual trends in length of therapy (LOT) in adults hospitalized with uncomplicated CAP from 2013 through 2020.

Methods: We conducted a retrospective cohort study among adults with a primary diagnosis of bacterial or unspecified pneumonia using codes in MarketScan and the Centers for Medicare & Medicaid Services databases.

How Coronavirus Restrictions Adopted by Governments Affected World Religious Groups: A Review.

The coronavirus pandemic has significantly affected the operation of the world's faith communities. The first reaction of different confessions to the introduction of corresponding restrictive measures was quite variable-it ranged from understanding and assisting the authorities to disobedience and deliberate violation of the quarantine regime. Today, religious precepts, values, and attitudes continue to exert an enormous influence on the behavioral patterns and public perception of the imposed COVID-19-related restrictions.

A spectrum of BRCA1 and BRCA2 germline deleterious variants in ovarian cancer in Russia.

Purpose: Pathogenic variants (PVs) in BRCA1 and BRCA2 genes are essential biomarkers of an increased breast and ovarian cancer risk and tumor sensitivity to poly ADP ribose polymerase inhibitors. In Russia, eight PVs were thought to be the most common, among which BRCA1 c.5266dup is the most frequently identified one.

Declines in the utilization of hospital-based care during COVID-19 pandemic.

The disruptions of the coronavirus disease 2019 (COVID-19) pandemic impacted the delivery and utilization of healthcare services with potential long-term implications for population health and the hospital workforce. Using electronic health record data from over 700 US acute care hospitals, we documented changes in admissions to hospital service areas (inpatient, observation, emergency room [ER], and same-day surgery) during 2019-2020 and examined whether surges of COVID-19 hospitalizations corresponded with increased inpatient disease severity and death rate. We found that in 2020, hospitalizations declined by 50% in April, with greatest declines occurring in same-day surgery (-73%).

Trends in facility-level rates of infections in US hospitals, 2019-2020.

Objectives: The coronavirus disease 2019 pandemic caused substantial changes to healthcare delivery and antibiotic prescribing beginning in March 2020. To assess pandemic impact on infection (CDI) rates, we described patients and trends in facility-level incidence, testing rates, and percent positivity during 2019-2020 in a large cohort of US hospitals.

Methods: We estimated and compared rates of community-onset CDI (CO-CDI) per 10,000 discharges, hospital-onset CDI (HO-CDI) per 10,000 patient days, and testing rates per 10,000 discharges in 2019 and 2020.

Associations of facility-level antibiotic use and hospital-onset infection in US acute-care hospitals, 2012-2018.

Previously reported associations between hospital-level antibiotic use and hospital-onset infection (HO-CDI) were reexamined using 2012-2018 data from a new cohort of US acute-care hospitals. This analysis revealed significant positive associations between total, third-generation, and fourth-generation cephalosporin, fluoroquinolone, carbapenem, and piperacillin-tazobactam use and HO-CDI rates, confirming previous findings.

Vascular Access and Risk of Bloodstream Infection Among Older Incident Hemodialysis Patients.

Rationale & Objective: Most new patients with end-stage renal disease (ESRD) initiate hemodialysis (HD) with a central venous catheter (CVC) and later transition to a permanent vascular access with lower infection risk. The benefit of early fistula use in preventing severe infections is incompletely understood. We examined patients' first access and subsequent transitions between accesses during the first year of HD to estimate the risk for bloodstream infection (BSI) associated with incident and time-dependent use of HD access.

Effect of Surfagon on Open Field and Elevated Plus Maze Behavior of Gonadectomized and Non-Gonadectomized Male Rats.

We studied the effect of gonadotropin-releasing hormone agonist surfagon (2 μg/kg, once, intraperitoneally) on anxious behavior of adult gonadectomized and non-gonadectomized male rats. It was shown that surfagon significantly increased anxiety of both gonadectomized and non-gonadectomized rats in the open-field test and in elevated plus maze.

Surgical site infection risk following cesarean deliveries covered by Medicaid or private insurance.

Objective: To compare risk of surgical site infection (SSI) following cesarean delivery between women covered by Medicaid and private health insurance.

Study Design: Retrospective cohort.

Study Population: Cesarean deliveries covered by Medicaid or private insurance and reported to the National Healthcare Safety Network (NHSN) and state inpatient discharge databases by hospitals in California (2011-2013).

Association Between Antibiotic Use and Hospital-onset Clostridioides difficile Infection in US Acute Care Hospitals, 2006-2012: An Ecologic Analysis.

Background: Unnecessary antibiotic use (AU) contributes to increased rates of Clostridioides difficile infection (CDI). The impact of antibiotic restriction on hospital-onset CDI (HO-CDI) has not been assessed in a large group of US acute care hospitals (ACHs).

Methods: We examined cross-sectional and temporal associations between rates of hospital-level AU and HO-CDI using data from 549 ACHs.

Players' expertise and competition with others shape the satisfaction of competence needs, gaming gratifications, and contingent self-esteem in a gaming context.

The current study explores how competition and gaming expertise affect the satisfaction of competence needs and gaming gratifications. We demonstrate that competition moderates the effect of gaming expertise on the satisfaction of competence needs, which in turn affects game enjoyment and replay intention. Gaming expertise predicted players' need satisfaction, game enjoyment, and replay intention significantly better in a competitive compared to a noncompetitive context.

Pho regulon promoter-mediated transcription of the key pathway gene aroGFbr improves the performance of an L-phenylalanine-producing Escherichia coli strain.

DAHP synthase (EC 4.1.2.

Construction of an L-phenylalanine-producing tyrosine-prototrophic Escherichia coli strain using tyrA ssrA-like tagged alleles.

To construct a Phe-producing Tyr(+) Escherichia coli strain, TyrA (chorismate mutase/prephenate dehydrogenase) activity was varied by engineering a proteolytically unstable protein. The tyrA in the E. coli BW25113 was altered to include ssrA-like tags.

Aromatic amino acid auxotrophs constructed by recombinant marker exchange in Methylophilus methylotrophus AS1 cells expressing the aroP-encoded transporter of Escherichia coli.

The isolation of auxotrophic mutants, which is a prerequisite for a substantial genetic analysis and metabolic engineering of obligate methylotrophs, remains a rather complicated task. We describe a novel method of constructing mutants of the bacterium Methylophilus methylotrophus AS1 that are auxotrophic for aromatic amino acids. The procedure begins with the Mu-driven integration of the Escherichia coli gene aroP, which encodes the common aromatic amino acid transporter, into the genome of M.

[Comparative analysis of the effects of estrogens and tamoxifen on the brain higher functions].

At present, it is commonly accepted that estrogens modulate both cognitive and psycho-emotional status. Induced or natural hypoestrogeny is frequently accompanied by a complex of pathological states including suppressed state, anxiety, and weeping, sometimes with the development of depression. It is established that a substituting hormonal therapy in some cases favors restoration of the cognitive function and provides correction of affective disorders.

[Effect of tamoxifen on anxiety in ovariectomized and intact female rats].

The effect of tamoxifen (estrogen receptor modulator) administered in a daily dose of 10 mg/kg (i.p.) over 14 days on the behavioral state of female rats has been studied in various phase of the sexual cycle and in the state of estrogen deficiency.

A multistate outbreak of Serratia marcescens bloodstream infection associated with contaminated intravenous magnesium sulfate from a compounding pharmacy.

Background: In contrast to pharmaceutical manufacturers, compounding pharmacies adhere to different quality-control standards, which may increase the likelihood of undetected outbreaks. In 2005, the Centers for Disease Control and Prevention received reports of cases of Serratia marcescens bloodstream infection occurring in patients who underwent cardiac surgical procedures in Los Angeles, California, and in New Jersey. An investigation was initiated to determine whether there was a common underlying cause.

A hospital outbreak of diarrhea due to an emerging epidemic strain of Clostridium difficile.

Background: Increased Clostridium difficile-associated disease (CDAD) in a hospital and an affiliated long-term care facility continued despite infection control measures. We investigated this outbreak to determine risk factors and transmission settings.

Methods: The CDAD cases were compared according to where the disease was likely acquired based on health care exposure and characterization of isolates from case patients, asymptomatic carriers, and the environment.

An epidemic, toxin gene-variant strain of Clostridium difficile.

Background: Recent reports suggest that the rate and severity of Clostridium difficile-associated disease in the United States are increasing and that the increase may be associated with the emergence of a new strain of C. difficile with increased virulence, resistance, or both.

Methods: A total of 187 C.

[Efficiency of encefabol use in patients with dyscirculatory encephalopathy].

The article presents the findings of the Encefabol treatment of 50 patients aged 56-68 yy with vascular encephalopathy at the I-III stage, caused by atherosclerotic and high blood pressure pathological processes. The individual dose prescription of the medication to patients with vascular encephalopathy was substantiated in the article. The importance of psychodiagnostic tests in assessment of Encefabol treatment efficiency of the disease was shown in the article.

An analysis of administrative data found that proximate clinical event ratios provided a systematic approach to identifying possible iatrogenic risk factors or complications.

Objective: A method to generate hypotheses about iatrogenic risk factors and complications from administrative data was developed and tested using hospitalization of the elderly for depression as a model.

Study Design And Setting: Hospital claims were selected for 30,998 elderly inpatients admitted for the first time for depression. Common principal diagnoses and procedures in hospitalizations within 90 days of the index depression admission were tallied.