Incidence of health care-associated extended-spectrum β-lactamase-positive patients before and after discontinuation of contact precautions.

Background: Isolation of patients with multidrug-resistant organisms has been recommended in several guidelines. Recent evidence has suggested potential negative effects of isolation on patient well-being and facility throughput. Published literature shows a difference in transmission risk of extended-spectrum β-lactamase (ESBL)-producing organisms, suggesting that contact precautions may not be necessary for all ESBL-positive organisms.

Water impacts of U.S. biofuels: Insights from an assessment combining economic and biophysical models.

Biofuels policies induce land use changes (LUC), including cropland expansion and crop switching, and this in turn alters water and soil management practices. Policies differ in the extent and type of land use changes they induce and therefore in their impact on water resources. We quantify and compare the spatially varying water impacts of biofuel crops stemming from LUC induced by two different biofuels policies by coupling a biophysical model with an economic model to simulate the economically viable mix of crops, land uses, and crop management choices under alternative policy scenarios.

Assessment of operating room airflow using air particle counts and direct observation of door openings.

Background: The role of the operating room (OR) environment has been thought to contribute to surgical site infection rates. The quality of OR air, disruption of airflow, and other factors may increase contamination risks. We measured air particulate counts (APCs) to determine if they increased in relation to traffic, door opening, and other common activities.

Assessment of Endoscope Reprocessing Using Peer-to-Peer Assessment Through a Clinical Community.

Background: Cleaning, disinfection, and sterilization (CDS) of medical devices are intended to help prevent health care-associated infections (HAIs), a significant cause of mortality and morbidity. In February 2013 the Johns Hopkins Health System (JHHS; Baltimore) formed a clinical community of experts and stakeholders--physicians, nurses, administrators, infection control practitioners, risk managers, and regulatory staff--to assess CDS practices across facilities.

Methods: A survey administered to leadership indicated endoscopy areas of risk.

Recent Trends in Water Use and Production for California Oil Production.

Recent droughts and concerns about water use for petroleum extraction renew the need to inventory water use for oil production. We quantified water volumes used and produced by conventional oil production and hydraulic fracturing (HF) in California. Despite a 25% decrease in conventional oil production from 1999 to 2012, total water use increased by 30% though much of that increase was derived from reuse of produced water.

Hand hygiene in emergency medical services.

Background: Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009).

Long-term shifts in life-cycle energy efficiency and carbon intensity.

The quantity of primary energy needed to support global human activity is in large part determined by how efficiently that energy is converted to a useful form. We estimate the system-level life-cycle energy efficiency (EF) and carbon intensity (CI) across primary resources for 2005-2100. Our results underscore that although technological improvements at each energy conversion process will improve technology efficiency and lead to important reductions in primary energy use, market mediated effects and structural shifts toward less efficient pathways and pathways with multiple stages of conversion will dampen these efficiency gains.

Low propensity of conventional antiepileptic drugs for interaction with felbamate against maximal electroshock-induced seizures in mice.

The objective of this study was to evaluate an interaction of the novel antiepileptic drug felbamate (2-phenyl-1,3-propanediol dicarbamate) with conventional antiepileptic drugs against maximal electroshock-induced convulsions in mice. Electroconvulsions were produced by means of an alternating current (ear-clip electrodes, 0.2-s stimulus duration, tonic hindlimb extension taken as the endpoint).

[Mastopathy and endometrial hyperplasia--coexistence, relationships].

Samples of endometrium were examined histologically in 161 female patients with endometrial hyperplasia or mastopathy. Moreover, LH, FSH, prolactin, testosterone, and dehydroepiandrosterone sulphate levels were assayed in 51 patients. Mastopathy was found in 36.

Neuromyopathy in venous insufficiency.

Since July, 1985, the authors have studied 23 patients with history and physical findings of venous insufficiency syndrome (VIS) confirmed by venous pressure, muscle biopsy, ascending and descending venography, electromyography, and nerve conduction velocity studies. Clinically, swelling appears to be the most important symptom, along with high venous pressure, particularly ambulatory venous pressure, correlated with venography findings. Muscle atrophy was present in 18 cases.