S.aureus bacteraemia surveillance quarterly report: October - December 2012

This quarterly report provides epidemiological data on�S. aureus�in Northern Ireland, including overall infection�figures as well as those specific to MRSA and MSSA. The report highlights key points, rates, trends and statistical process control charts. The report also provides information on surveillance methods and data for each hospital and Health and Social Care Trust in Northern Ireland

S. aureus bacteraemia surveillance quarterly report: October-December 2010

This quarterly report provides epidemiological data on�S. aureus�in Northern Ireland, including overall infection�figures as well as those specific to MRSA and MSSA. The report highlights key points, rates, trends and statistical process control charts. The report also provides information on surveillance methods and data for each hospital and Health and Social Care Trust in Northern Ireland.

C. difficile surveillance quarterly report: October-December 2010

This quarterly report provides epidemiological data on C. difficile in Northern Ireland, and includes key points, a comprehensive�overview of all C. diff infections, rates, trends, age-specific information�and statistical process control charts. The report also provides information on surveillance methods and data for each hospital and Health and Social Care Trust in Northern Ireland.

C. difficile and S.aureus bacteraemia surveillance quarterly reports

Quarterly reports provide epidemiological data on�C. difficile and S. aureus�in Northern Ireland. The report highlights key points, rates, trends and statistical process control charts. The report also provides information on surveillance methods and data for each hospital and Health and Social Care Trust in Northern Ireland.Click here to see the latest reports

C. difficle surveillance quarterly report: July-September 2015

This quarterly report provides epidemiological data on�C. difficile�in Northern Ireland, and includes key points, a comprehensive�overview of all�C. diff�infections, rates, trends, age-specific information�and statistical process control charts.

A compositional data analysis package for R providing multiple approaches

”compositions” is a new R-package for the analysis of compositional and positive data.It contains four classes corresponding to the four different types of compositional andpositive geometry (including the Aitchison geometry). It provides means for computation,plotting and high-level multivariate statistical analysis in all four geometries.These geometries are treated in an fully analogous way, based on the principle of workingin coordinates, and the object-oriented programming paradigm of R. In this way,called functions automatically select the most appropriate type of analysis as a functionof the geometry. The graphical capabilities include ternary diagrams and tetrahedrons,various compositional plots (boxplots, barplots, piecharts) and extensive graphical toolsfor principal components. Afterwards, ortion and proportion lines, straight lines andellipses in all geometries can be added to plots. The package is accompanied by ahands-on-introduction, documentation for every function, demos of the graphical capabilitiesand plenty of usage examples. It allows direct and parallel computation inall four vector spaces and provides the beginner with a copy-and-paste style of dataanalysis, while letting advanced users keep the functionality and customizability theydemand of R, as well as all necessary tools to add own analysis routines. A completeexample is included in the appendix

Compositional hypotheses of subcompositional stability and specific perturbation change and their testing

In standard multivariate statistical analysis common hypotheses of interest concern changes in mean vectors and subvectors. In compositional data analysis it is now well established that compositional change is most readily described in terms of the simplicial operation of perturbation and that subcompositions replace the marginal concept of subvectors. To motivate the statistical developments of this paper we present two challenging compositional problems from food production processes.Against this background the relevance of perturbations and subcompositions can beclearly seen. Moreover we can identify a number of hypotheses of interest involvingthe specification of particular perturbations or differences between perturbations and also hypotheses of subcompositional stability. We identify the two problems as being the counterpart of the analysis of paired comparison or split plot experiments and of separate sample comparative experiments in the jargon of standard multivariate analysis. We then develop appropriate estimation and testing procedures for a complete lattice of relevant compositional hypotheses

Interacting software-agents to support a kind of expert supervision systems

Expert supervision systems are software applications specially designed to automate process monitoring. The goal is to reduce the dependency on human operators to assure the correct operation of a process including faulty situations. Construction of this kind of application involves an important task of design and development in order to represent and to manipulate process data and behaviour at different degrees of abstraction for interfacing with data acquisition systems connected to the process. This is an open problem that becomes more complex with the number of variables, parameters and relations to account for the complexity of the process. Multiple specialised modules tuned to solve simpler tasks that operate under a co-ordination provide a solution. A modular architecture based on concepts of software agents, taking advantage of the integration of diverse knowledge-based techniques, is proposed for this purpose. The components (software agents, communication mechanisms and perception/action mechanisms) are based on ICa (Intelligent Control architecture), software middleware supporting the build-up of applications with software agent features

"The 3/3 strategy": a successful multifaceted hospital wide hand hygiene intervention based on WHO and continuous quality improvement methodology.

BACKGROUND Only multifaceted hospital wide interventions have been successful in achieving sustained improvements in hand hygiene (HH) compliance. METHODOLOGY/PRINCIPAL FINDINGS Pre-post intervention study of HH performance at baseline (October 2007-December 2009) and during intervention, which included two phases. Phase 1 (2010) included multimodal WHO approach. Phase 2 (2011) added Continuous Quality Improvement (CQI) tools and was based on: a) Increase of alcohol hand rub (AHR) solution placement (from 0.57 dispensers/bed to 1.56); b) Increase in frequency of audits (three days every three weeks: "3/3 strategy"); c) Implementation of a standardized register form of HH corrective actions; d) Statistical Process Control (SPC) as time series analysis methodology through appropriate control charts. During the intervention period we performed 819 scheduled direct observation audits which provided data from 11,714 HH opportunities. The most remarkable findings were: a) significant improvements in HH compliance with respect to baseline (25% mean increase); b) sustained high level (82%) of HH compliance during intervention; c) significant increase in AHRs consumption over time; c) significant decrease in the rate of healthcare-acquired MRSA; d) small but significant improvements in HH compliance when comparing phase 2 to phase 1 [79.5% (95% CI: 78.2-80.7) vs 84.6% (95% CI:83.8-85.4), p<0.05]; e) successful use of control charts to identify significant negative and positive deviations (special causes) related to the HH compliance process over time ("positive": 90.1% as highest HH compliance coinciding with the "World hygiene day"; and "negative":73.7% as lowest HH compliance coinciding with a statutory lay-off proceeding). CONCLUSIONS/SIGNIFICANCE CQI tools may be a key addition to WHO strategy to maintain a good HH performance over time. In addition, SPC has shown to be a powerful methodology to detect special causes in HH performance (positive and negative) and to help establishing adequate feedback to healthcare workers.

Unusual voltage sag event detection in power systems

Three multivariate statistical tools (principal component analysis, factor analysis, analysis discriminant) have been tested to characterize and model the sags registered in distribution substations. Those models use several features to represent the magnitude, duration and unbalanced grade of sags. They have been obtained from voltage and current waveforms. The techniques are tested and compared using 69 registers of sags. The advantages and drawbacks of each technique are listed

Bloodstream infections related to totally implantable venous access port: What is the situation in our hospital?

Port-a-Cath© (PAC) are totally implantable devices that offer an easy and long term access to venous circulation. They have been extensively used for intravenous therapy administration and are particularly well suited for chemotherapy in oncologic patients. Previous comparative studies have shown that these devices have the lowest catheter-related bloodstream infection rates among all intravascular access systems. However, bloodstream infection (BSI) still remains a major issue of port use and epidemiology data for PAC-associated BSI (PABSI) rates differ strongly depending on studies. Also, current literature about PABSI risk factors is scarce and sometimes controversial. Such heterogeneity may depend on type of studied population and local factors. Therefore, the aim of this study was to describe local epidemiology and risk factors for PABSI in adult patients in our tertiary- care university hospital. We conducted a retrospective cohort study in order to describe local epidemiology. We also performed a nested case-control study to identify local risk factors of PABSI. We analyzed medical files of adult patients who had a PAC implanted between January 1st, 2008 and December 31st, 2009 and looked for PABSI occurrence before May 1st, 2011 to define cases. Thirty nine PABSI occurred in this population with an attack rate of 5.8%. We estimated an incidence rate of 0.08/1000 PAC-days using the case-control study. PABSI causative agents were mainly Gram positive cocci (62%). We identified three predictive factors of PABSI by multivariate statistical analysis: neutropenia on outcome date (Odds Ratio [OR]: 4.05; 95% confidence interval [CI]:1.05- 15.66; p=0.042), diabetes (OR: 11.53; 95% CI: 1.07-124.70; p=0.044) and having another infection than PABSI on outcome date (OR: 6.35; 95% CI: 1.50-26.86; p=0.012). Patients suffering from acute or renal failure (OR: 4.26; 95% CI: 0.94-19.21; p=0.059) or wearing another invasive device (OR: 2.99; 95%CI:0.96-9.31; p=0.059) did not have a statistically increased risk for developing a PABSI according to classical threshold (p<0.05) but nevertheless remained close to significance. Our study demonstrated that local epidemiology and microbiology of PABSI in our institution was similar to previous reports. A larger prospective study is required to confirm our results or to test preventive measures.

Morphological studies on castes of Protopolybia chartergoides (Hymenoptera, Vespidae, Epiponini) observed in colonies during male production stage

Social wasps are important for the study of social behavior evolution because their colonies present different degrees of caste differentiation, from morphologically similar to highly conspicuous, associated with the occasional presence of intermediate females, which bears developed ovaries but no insemination. In the Polistinae, depending on the taxon, such differentiation can be discreet or conspicuous. This work intended to study morphological and physiological differences between castes in Protopolybia chartergoides by using morphometric analyses associated with multivariate statistical analyses and physiological evaluations from females' ovarian development. Results evidence low morphological and physiological differences among the castes in P. chartergoides, indicating three groups of females: queens, workers and intermediates. In this way, it was possible to suggest that Protopolybia chartergoides presents post-imaginal caste differentiation (or a very subtle form of pre-imaginal determination).

Dinámica espacio temporal en la ecología trófica de la anchoveta (Engraulis ringens Jenyns, 1842; pisces: engraulide) en el mar peruano

El objetivo de este trabajo es estudiar las variaciones ontogénicas, espaciales y nictemerales en la dieta de la anchoveta peruana (Engraulis ringens). El trabajo se basa en el análisis de contenido estomacal de 13 430 anchovetas (peces de 4 a 19,5 cm) muestreados durante 22 cruceros de investigación realizados a bordo de las embarcaciones científicas del Instituto del Mar del Perú durante el período 1996-2003. Previo a los análisis estadísticos la contribución de cada grupo de presa fue convertido a carbonó. Los datos fueron procesados por medio de estadística uni y multivariada en función de la talla de la anchoveta, la latitud, la distancia de la costa, la distancia del borde de la plataforma continental y el período nictemeral. Los resultados enseñan que la anchoveta se alimenta mayormente de zooplancton cualquier sea su tamaño o su distribución espaciotemporal. La anchoveta cambio gradualmente su dieta a lo largo de su ciclo de vida. Así, los individuos mas pequeños han ingerido mayormente copépodos calanoideos (68.0%) y eufausidos (23.3%), mientras que los individuos mas grandes ingirieron mayormente eufausidos (84.9%) y copépodos calanoideos (11.5%). Latitudinalmente, la mayor contribución de los copépodos calanoideos se observó en las zonas de afloramiento de Chicama y San Juan, con el 52.3% y 47.5%, respectivamente. Hasta los 160 km de distancia de la costa, no se ha observado un patrón regular en la contribución de las principales presas, mientras que por fuera, se insinúa un patrón caracterizado por el predominio de los eufausidos (>84%) y la menor contribución de copépodos calanoideos (<14,1%). En la plataforma continental los eufausidos contribuyeron con el 55.6% y los copépodos calanoideos con el 36.9%; mientras que por fuera de esa zona, los eufausidos se incrementaron al 75.3% y los copépodos calanoideos disminuyeron al 20.1%. Al considerar el período nictemeral, el ítem presa predominante durante el día fueron los eufausidos (52.7%) seguido de los copépodos calanoideos (40.9%); mientras que durante la noche, los eufausidos se incrementaron al 80.2% y los copépodos calanoideos disminuyeron al 15.7%. Estos resultados contradicen lo que se conocía acerca de la variabilidad de la dieta de la anchoveta, desestimándose: (i) que en el norte es fitoplanctívora y en el sur es zooplanctívora; (ii) que la fracción zooplanctónica es mayor en la zona oceánica. Asimismo, se ha demostrado que: (i) la anchoveta es principalmente zooplanctófaga durante su ciclo de vida, con modificaciones que corresponden a la mayor ingesta de presas pequeñas cuando son juveniles y de presas grandes cuando son adultas, (ii) en la zona de influencia de la plataforma continental consume aproximadamente el doble de copépodos calanoideos que en la zona oceánica, y aproximadamente una tercera parte menos de eufausidos en la zona interna que en la zona oceánica, y (iii) durante la noche y el día ingiere principalmente eufausidos pero la contribución de los copépodos calanoideos sube al 40%.

A new blood-based screening test for colorectal cancer: a pilot study

Background: Colorectal cancer (CRC) can be cured when diagnosed in its early or precancerous (adenoma) stages. Mostly due to poor compliance towards invasive screening procedures, detection rates for adenoma and early CRCs are still low. Available non-invasive screening tests have unfortunately low sensitivity and specificity performances. Therefore, there is a large unmet need calling for a cost-effective, reliable and non-invasive test to screen for early neoplastic and pre-neoplastic lesions. Objective: To develop a routine screening test based on a nucleic acids multi-gene assay performed on peripheral blood mononuclear cells (PBMCs) that can detect early CRCs and adenomas. Methods: 116 patients (mean age: 55 years; range: 18 to 74 years; female/male ration 0.98) were included in this pilot, nonblinded, colonoscopy-controlled study. Colonoscopy revealed 21 patients with CRC, 30 patients with adenoma bigger than 1 cm, 24 patients with inflammatory bowel disease (IBD) and 41 patients had no neoplastic or inflammatory lesions. Blood samples were taken from each patient the day of the colonoscopy and PBMCs were purified. Total RNA was extracted following standard procedures. Multiplex RT-qPCR was applied on 92 different candidate biomarkers. Different univariate and multivariate statistical methods were applied on these candidates, and among them, 57 biomarkers with significant p values (<0.01, Wilcoxon test) were selected, including ADAMTS1, MMP9, CXCL10, CXCR4, VEGFA and CDH1. Two distinct biomarker signatures are used to separate patients without neoplastic lesion from those with cancer (named COLOX 1 test), respectively from those with adenoma (named COLOX 2 test). Result: COLOX 1 and 2 tests have successfully separated patients without neoplastic lesion from those with CRC (sensitivity 70%, specificity 90%, AUC 0.88), respectively from those with adenoma bigger than 1cm (sensitivity 61%, specificity 80%, AUC 0.80). 6/24 patients in the IBD group have a positive COLOX 1 test. Conclusion: These two COLOX tests demonstrated an acceptable sensitivity and a high specificity to detect the presence of CRCs and adenomas bigger than 1 cm. The false positives COLOX 1 test in IBD patients could possibly be due to the chronic inflammatory state. A prospective, multicenter, pivotal study is underway in order to confirm these promising results in a larger cohort.

Adenocarcinoma of the pancreas: Comparative single centre analysis between ductal and mucinous type.

1. Background¦Adenocarcinomas of the pancreas are exocrine tumors, originate from ductal system, including two morphologically distinct entities: the ductal adenocarcinoma and mucinous adenocarcinoma. Ductal adenocarcinoma is by far the most frequent malignant tumor in the pancreas, representing at least about 90% of all pancreas cancers. It is associated with very poor prognosis, due to the fact that actually there are no any biological markers or diagnostic tools for identification of the disease at an early stage. Most of the time the disease is extensive with vascular and nerves involvement or with metastatic spread at the time of diagnosis (1). The median survival is less than 5% at 5 years, placing it, at the fifth leading cause of death by cancer in the world (2). The mucinous form of pancreatic adenocarcinoma is less frequent, and seems to have a better prognosis with about 57% survival at 5 years (1)(3)(4).¦Each morphologic type of pancreatic adenocarcinoma is associated with particular preneoplastic lesions. Two types of preneoplastic lesions are described: firstly, pancreatic intra-epithelial neoplasia (PanIN) which affects the small and peripheral pancreatic ducts, and the intraductal papillary-mucinous neoplasm (IPMN) interested the main pancreatic ducts and its principal branches. Both of preneoplastic lesions lead by different mechanisms to the pancreatic adenocarcinoma (1)(2)(3)(4)(5)(6)(7)(8)(9)(10).¦The purpose of our study consists in a retrospective analysis of various clinical and histo-morphological parameters in order to assess a difference in survival between these two morphological types of pancreatic adenocarcinomas.¦1.2 Material and methods¦We conducted a retrospective analysis including 35 patients, (20 men and 15 women), beneficed the surgical treatment for pancreas adenocarcinoma at the Surgical Department of University Hospital in Lausanne. The patients involved in our study have been treated between 2003 and 2008, permitting at least 5-years mean follow up. For each patient the following parameters were analysed: age, gender, type of operation, type of preneoplastic lesions, TNM stage, histological grade of the tumor, vascular invasion, lymphatic and perineural invasion, resection margins, and adjuvant treatment.¦The results from these observations were included in a univariate and multivariate statistical analysis and compared with overall survival, as well as specific survival for each morphologic subtype of adenocarcinoma.¦As a low number of mucinous adenocarcinomas (n=5) was insufficient to conduct a pertinent statistical analysis, we compared the data obtained from adenocarcinomas developed on PanIN with adenocarcinomas developed on IPMN including both, ductal or mucinous types.¦1.3 Result¦Our results show that adenocarcinomas developed on pre-existing IPMN including both morphologic types (ductal and mucinous form) are associated with a better survival and prognosis than adenocarciomas developed on PanIN.¦1.4 Conclusion¦This study reflects that the most relevant parameter in survival in pancreatic adenocarcinoma seems to be the type of preneoplastic lesion. The significant difference in survival was noted between adenocarcinomas developing on PanIN as compared to adenocarcinomas developed on IPMN precursor lesions. Ductal adenocarcinomas developped on IPMN present significantly longer survival than those developed on PanIN lesions (P value= 0,01). Therefore we can suggest that the histological type of preneoplastic lesion rather than the histological type of adenocarcinoma should be the determinant prognosis factor in survival of pancreatic adenocarcinoma.