Epidemiology of carbapenem-resistant organisms in Alameda County, California, 2019-2021.

Objective: Carbapenem-resistant organisms (CROs) are an urgent health threat. Since 2017, Alameda County Health Public Health Department (ACPHD) mandates reporting of carbapenem-resistant Enterobacterales (CRE) and encourages voluntary reporting of non-CRE CROs including carbapenem-resistant (CRAB) and carbapenem-resistant (CRPA). Surveillance data from ACPHD were analyzed to describe the epidemiology of CROs and target public health interventions.

Simulated ventilation of two patients with a single ventilator in a pandemic setting.

Simultaneous ventilation of two patients may lead to hypoventilation in one patient and hyperinflation in the other patient. In a simulation of ventilation in two patients using artificial lungs, we voluntarily directed gas flow to one patient by using three-dimensional-printed Y-adapters and stenosis adapters during volume- and pressure-controlled ventilation in the first set up. We continuously modified the model using a special one-way valve on the flow-limited side and measured it in pressure-controlled ventilation with the flow sensor of the ventilator adjusted on both sides in a second and third setup.

[The evolution of the Critical Incident Reporting System in an Austrian university hospital].

Background: Critical Incident Reporting Systems (CIRS) are an important tool to identify potential hazards in healthcare. However, in Europe CIR systems are differently used with respect to whether its use is voluntary or mandatory. The aim of the present paper was to describe the development of the recently implemented CIRS in the University Hospital Graz.

[New ways to evaluate patient safety relevant topics: Patient-safety feedback].

Background: Patient safety has become a hot topic, and there are numerous initiatives ongoing to improve patient-relevant processes. But how can both the effectiveness and sustainability of these initiatives be evaluated? The aim of the present paper was to describe the development of an instrument to assess patient safety aspects which can be used for normal hospital ward and intensive care unit rounds or in the operating room.

Methodology: All relevant patient safety guidelines and checklists of the University Hospital Graz were screened.

The Gap between Individual Perception and Compliance: A Qualitative Follow-Up Study of the Surgical Safety Checklist Application.

Background: "The Surgical Safety Checklist (SSC) is important, but we don't use it adequately" is a well-suited statement that reflects the SSC's application in hospitals. Our aim was to follow up on our initial study on compliance (2014) by analysing differences between individual perception and compliance with the SSC.

Methods: We conducted a follow-up online survey to assess healthcare professionals' individual perception of, as well as satisfaction and compliance with the SSC three years following its thorough implementation.

Implementation of a surgical safety checklist: interventions to optimize the process and hints to increase compliance.

Background: A surgical safety checklist (SSC) was implemented and routinely evaluated within our hospital. The purpose of this study was to analyze compliance, knowledge of and satisfaction with the SSC to determine further improvements.

Methods: The implementation of the SSC was observed in a pilot unit.

Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers.

Background: For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identification, analysis, and management of potential risks.

Fidelity decay for local perturbations: microwave evidence for oscillating decay exponents.

We study fidelity decay in classically chaotic microwave billiards for a local, pistonlike boundary perturbation. We experimentally verify a predicted nonmonotonic crossover from the Fermi golden rule to the escape-rate regime of the Loschmidt echo decay with increasing local boundary perturbation. In particular, we observe pronounced oscillations of the decay rate as a function of the piston position which quantitatively agree with corresponding theoretical results based on a refined semiclassical approach for local boundary perturbations.

Microwave fidelity studies by varying antenna coupling.

The fidelity decay in a microwave billiard is considered, where the coupling to an attached antenna is varied. The resulting quantity, coupling fidelity, is experimentally studied for three different terminators of the varied antenna: a hard-wall reflection, an open wall reflection, and a 50 Ω load, corresponding to a totally open channel. The model description in terms of an effective Hamiltonian with a complex coupling constant is given.

Stable lead isotope compositions in selected coals from around the world and implications for present day aerosol source tracing.

The phasing out of leaded gasoline in many countries around the world at the end of the last millennium has resulted in a complex mixture of lead sources in the atmosphere. Recent studies suggest that coal combustion has become an important source of Pb in aerosols in urban and remote areas. Here, we report lead concentration and isotopic composition for 59 coal samples representing major coal deposits worldwide in an attempt to characterize this potential source.

Two high resolution terrestrial records of atmospheric Pb deposition from New Brunswick, Canada, and Loch Laxford, Scotland.

Environmental archives like peat deposits allow for the reconstruction of both naturally and anthropogenically forced changes in the biogeochemical cycle of Pb as well as the quantification of past and present atmospheric Pb pollution. However, records of atmospheric Pb deposition from pre-industrial times are lacking. In a publication by Weiss et al.

Anaphylactic reaction after systemic application of aprotinin triggered by aprotinin-containing fibrin sealant.

We report a 67-yr-old male after multiple surgical procedures for treatment of arterial occlusive disease who suffered an anaphylactic reaction after administration of aprotinin (Trasylol) prior to urgent coronary artery bypass surgery. The patient had been treated with aprotinin-containing fibrin sealant in 2004 and in 2007, 2 wk before coronary artery bypass surgery. The postoperative serologic screening revealed positive results for qualitative aprotinin-specific IgG, highly elevated quantitative aprotinin-specific IgG and moderately elevated aprotinin-specific IgE antibodies.

A rapid and reliable method for Pb isotopic analysis of peat and lichens by laser ablation-quadrupole-inductively coupled plasma-mass spectrometry for biomonitoring and sample screening.

An analytical protocol for rapid and reliable laser ablation-quadrupole (LA-Q)- and multi-collector (MC-) inductively coupled plasma-mass spectrometry (ICP-MS) analysis of Pb isotope ratios ((207)Pb/(206)Pb and (208)Pb/(206)Pb) in peats and lichens is developed. This technique is applicable to source tracing atmospheric Pb deposition in biomonitoring studies and sample screening. Reference materials and environmental samples were dry ashed and pressed into pellets for introduction by laser ablation.

Identifying the sources and timing of ancient and medieval atmospheric lead pollution in England using a peat profile from Lindow bog, Manchester.

A peat core from Lindow bog near Manchester, England, was precisely cut into 2 cm slices to provide a high-resolution reconstruction of atmospheric Pb deposition. Radiocarbon and (210)Pb age dates show that the peat core represents the period ca. 2000 BC to AD 1800.

Usefulness of tumor volumetry as a prognostic factor of survival in head and neck cancer.

Background: The TNM classification system of tumor stage does not always reflect the actual tumor mass present at diagnosis. This study aimed at evaluating the prognostic value of volumetric data regarding survival in head and neck cancer patients being treated with either cisplatin or carboplatin administered concomitantly with radiotherapy.

Patients And Methods: We retrospectively analyzed 107 patients suffering from squamous cell carcinoma of the head and neck in a Greek-German cooperative study (see Table 1).

[Long term results of total skin electron beam therapy (TSEBT) in the treatment of mycosis fungoides].

Background And Objective: Total skin electron beam therapy (TSEBT) is an important therapeutic option for the treatment of mycosis fungoides. The aim of this study was to find out long term results in 10 patients with the clinical and histological diagnosis of mycosis fungoides.

Patients And Methods: Between 1982 and 1997 we performed a total skin electron beam therapy in 10 patients.

Dosimetry of rotational partial-skin electron irradiation.

Background And Purpose: Often, the most appropriate treatment for superficially and extensively spreading tumors of the skin is to use electron irradiation at enlarged distances. Rotational skin electron irradiation is a proven method for the treatment of the entire skin surface. We here report modifications of this technique in the set-up of partial-skin electron irradiation and the results of dosimetric examinations with regard to optimal shielding, dose profiles and depth dose curves under various irradiation conditions.

A simple and reliable method to simulate multileaf-plans.

To combine conformity of the irradiation with time effectiveness during treatment, the use of multileaf collimators has become more and more common. However, the simulation of the leaf positions is rather difficult compared with metal blocks. We developed a new method, utilizing an acrylic template in which the contour produced by the leaves is machined in the form of a 1 mm groove by a computerized numerically controlled milling machine.

[A multileaf collimator: additional quality assurance in a GE linear accelerator].

Background: In comparison to a conventional collimator, a multileaf collimator demands a great deal of quality assurance procedures due to its large number of leaves. A concept for daily quality assurance is presented, mainly concerning the positioning accuracy of the leaves.

Material And Methods: Two leaf configurations including maximal opening as well as overtravel of single leaves, at a maximal opening of the jaws, are transmitted online in daily exchange from our record- and verify system to the linac.

Comparison of calibration procedures for 192Ir high-dose-rate brachytherapy sources.

Purpose: To compare the efficacy of different calibration procedures for 192Ir high-dose-rate (HDR) brachytherapy sources and to determine their suitability in clinical practice. In addition the manufacturer's calibration is compared with our experimental measurements so that the accuracy of the source strength on the manufacturer certificate which is supplied with each new 192Ir source can be accessed.

Methods And Materials: We compared three types of calibration system: well-type chambers (HDR-1000 and SDS), cylindrical phantom, and plate phantom.

[A quality assurance program of simulators in radiation therapy. 2. Extent and results of long-term quality assurance test on a therapy simulator].

Background: Since 1990 we follow a quality assurance program with periodical tests of functional performance values of a 16-year-old simulator.

Material And Method: For this purpose we adopted and modified German standards for quality assurance on linear accelerators and international standards elaborated for simulators (International Electrotechnical Commission). The tests are subdivided into daily visual checks (light field indication, optical distance indicator, isocentre-indicating devices, indication of gantry and collimator angles) and monthly and annually tests of relevant simulator parameters.

Paclitaxel and simultaneous radiation in locally advanced stage IIIA/B non-small cell lung cancer: a clinical phase I study.

Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) is one of the most active single agents for the treatment of non-small cell lung cancer, with response rates of 21% to 24%. We present a phase I study with paclitaxel and simultaneous radiation in previously untreated, locally advanced, inoperable, stage IIIA/B non-small cell lung cancer. The aims of the study were to determine the maximum tolerated dose, define the safety and toxicity, and obtain preliminary data about the activity of the combined modality.