The Stealthy Superbug: the Role of Asymptomatic Enteric Carriage in Maintaining a Long-Term Hospital Outbreak of ST228 Methicillin-Resistant Staphylococcus aureus.

UNLABELLED: Whole-genome sequencing (WGS) of 228 isolates was used to elucidate the origin and dynamics of a long-term outbreak of methicillin-resistant Staphylococcus aureus (MRSA) sequence type 228 (ST228) SCCmec I that involved 1,600 patients in a tertiary care hospital between 2008 and 2012. Combining of the sequence data with detailed metadata on patient admission and movement confirmed that the outbreak was due to the transmission of a single clonal variant of ST228, rather than repeated introductions of this clone into the hospital. We note that this clone is significantly more frequently recovered from groin and rectal swabs than other clones (P < 0.0001) and is also significantly more transmissible between roommates (P < 0.01). Unrecognized MRSA carriers, together with movements of patients within the hospital, also seem to have played a major role. These atypical colonization and transmission dynamics can help explain how the outbreak was maintained over the long term. This "stealthy" asymptomatic colonization of the gut, combined with heightened transmissibility (potentially reflecting a role for environmental reservoirs), means the dynamics of this outbreak share some properties with enteric pathogens such as vancomycin-resistant enterococci or Clostridium difficile. IMPORTANCE: Using whole-genome sequencing, we showed that a large and prolonged outbreak of methicillin-resistant Staphylococcus aureus was due to the clonal spread of a specific strain with genetic elements adapted to the hospital environment. Unrecognized MRSA carriers, the movement of patients within the hospital, and the low detection with clinical specimens were also factors that played a role in this occurrence. The atypical colonization of the gut means the dynamics of this outbreak may share some properties with enteric pathogens.

Observatorio de competitividad : Percepción de los ejecutivos latinoamericanos sobre las mejores ciudades para hacer negocios 2003 - 2004. N. 3. Abril de 2005

Gestión del conocimiento

The Effect of Functional Electrically Stimulated Ambulation Training on Locomotor Function and Quality of Life in Individuals With Incomplete Spinal Cord Injury

The purpose of this study was to investigate the effects of a 12-week FES-ambulation program on locomotor function and quality of life after incomplete spinal cord injury. Six individuals with incomplete SCI participated in the study. Over-ground walking endurance (6MWT), speed (10MWT), independence (WISCI II) and body-weight support were assessed. Quality of life was assessed via the SF-36, WHOQOL-BREF, Perceived Stress Scale, Center of Epidemiological Studies for Depression scale, and task self-efficacy. Participants experienced significant improvements in walking endurance (223.6±141.5m to 297.3±164.5m; p=0.03), body-weight support (55.3±12.6% to 14.7±23.2%; p= 0.005) and four of the six participants showed improvements on the WISCI II scale (1-4 points). In addition, there was a significant reduction in reported bodily pain (6.5±1.2 to 5.0±1.7; p=0.04). Therefore, FES-ambulation is an effective means for enhancing over-ground locomotor function in individuals with incomplete SCI. It may also be an effective method for reducing pain in individuals with SCI.

L’exercice du métier policier en opération de paix : quelles pratiques? quelles retombées?

La participation des organisations policières à des opérations de paix des Nations Unies est un phénomène datant de quelques décennies, mais qui suscite de plus en plus d’intérêt dans la communauté scientifique ainsi que chez les organisations contributrices. À titre indicatif, en 2010, près de 13 000 policiers étaient déployés dans 13 opérations de paix des Nations Unies, ce qui représente une augmentation de 810 % par rapport aux 1 600 policiers qui étaient déployés en 1995 . Cette augmentation marquée de la participation policière à ce type d’opération à l’étranger remet en question les conceptions traditionnelles que les chercheurs avaient de l’institution policière. Bel exemple de la transnationalisation des organisations policières, la participation des policiers à des opérations de paix soulève toutefois de nombreux questionnements. Alors que la majorité des recherches se sont penchées sur les problématiques opérationnelles reliées à l’envoi de policiers dans ces zones en sortie de guerre, peu d’entre elles se sont penchées sur les questions reliées au post-déploiement, c'est-à-dire à la réintégration des policiers dans leur société d’origine. Puisque la contribution des services de police québécois aux missions de paix des Nations Unies semble maintenant faire partie intégrante de la mission de certaines de ces organisations, il serait intéressant de valider quelles sont les retombées organisationnelles de cette participation. C’est précisément dans cette lignée que le présent mémoire prend tout son sens. Plus précisément, la présente recherche a pour objectif d’étudier la relation entre la participation d’un policier à ce type de mission et la modification de ses habitudes et méthodes de travail lors de sa réintégration dans son unité d’origine. La perspective organisationnelle utilisée dans ce mémoire est novatrice au sens où elle permet de questionner l’utilité et les retombées de ces missions, non pas sur les sociétés bénéficiaires de l’aide internationale, mais plutôt sur les acteurs contribuant à la mise en place de ces missions. De tels questionnements sont pertinents si l’on veut mesurer les retombées que peuvent avoir les opérations de paix sur les policiers eux-mêmes, sur les organisations policières participantes, mais aussi sur les services fournis aux citoyens par ces mêmes organisations. Les données qui nous permettront de répondre à ces questions proviennent de dix-neuf entretiens semi-directifs réalisés auprès de policiers de la Sûreté du Québec qui ont participé à une mission de paix en Haïti entre 2005 et 2010. En somme, il est possible d’affirmer que les méthodes de travail d’un policier revenant de mission peuvent être modifiées positivement ou négativement par différents facteurs tels que l’acquisition de compétences, la modification des traits de personnalité ou encore par un changement au niveau de la perception qu’on ces policiers de leur travail.

Building a Canadian Virtual Health Library Database / Création de la Bibliothèque virtuelle canadienne de santé

Introduction: Avec l’abondance d’information gratuite disponible en ligne, la tâche de trouver, de trier et d’acheminer de l’information pertinente à l’auditoire approprié peut s’avérer laborieuse. En décembre 2010, la Bibliothèque virtuelle canadienne de santé / Canadian Virtual Health Library (BVCS) a formé un comité d’experts afin d’identifier, d’évaluer, de sélectionner et d’organiser des ressources d’intérêt pour les professionnels de la santé. Méthodes: Cette affiche identifiera les décisions techniques du comité d’experts, incluant le système de gestion de contenus retenu, l’utilisation des éléments Dublin Core et des descripteurs Medical Subject Headings pour la description des ressources, et le développement et l’adaptation de taxonomies à partir de la classification MeSH. La traduction française des descripteurs MeSH à l’aide du portail CISMeF sera également abordée. Résultats: Au mois de mai 2011, le comité a lancé la base de données BVCS de ressources en ligne gratuites sur la santé, regroupant plus de 1600 sites web et ressources. Une variété de types de contenus sont représentés, incluant des articles et rapports, des bases de données interactives et des outils de pratique clinique. Discussion: Les bénéfices et défis d’une collaboration pancanadienne virtuelle seront présentés, ainsi que l’inclusion cruciale d’un membre francophone pour composer avec la nature bilingue de la base de données. En lien avec cet aspect du projet, l’affiche sera présentée en français et en anglais. Introduction: With the abundance of freely available online information, the task of finding, filtering and fitting relevant information to the appropriate audience, is daunting. In December 2010 the Canadian Virtual Health Library / Bibliothèque virtuelle canadienne de santé (CVHL) formed an expert committee to identify, evaluate, select and organize resources relevant to health professionals. Methods: This poster will identify the key technical decisions of the expert committee including the content management system used to manage the data, the use of Dublin Core elements and Medical Subject Headings to describe the resources, and the development and adaptation of taxonomies from MeSH classification to catalog resources. The translation of MeSH terms to French using the CiSMeF portal will also be discussed. Results: In May 2010, the committee launched the CVHL database of free web-based health resources. Content ranged from online articles and reports to videos, interactive databases and clinical practice tools, and included more than 1,600 websites and resources. Discussion: The benefits and challenges of a virtual, pan-Canadian collaboration, and the critical inclusion of a Francophone member to address the bilingual nature of the database, will be presented. In keeping with the nature of the project, the poster will be presented in French and English.

Factores de riesgo para evento coronario asociado a cirugias no cardiacas en mayores de 65 años

Objetivo: Determinar si la presencia de hipertensión arterial severa, rangos de edad diferentes, sexo masculino, dislipidemia en tratamiento, obesidad o múltiples predictores clínicos de riesgo, se asocian a mayor probabilidad de desarrollar falla cardiaca aguda, infarto agudo de miocardio no fatal o muerte de origen cardiovascular, en pacientes mayores de 65 años llevados a un procedimiento quirúrgico no cardiaco. Materiales y Métodos. Se realizó un estudio de cohorte retrospectivo de los pacientes llevados a cirugías no cardiacas en la Fundación Cardioinfantil entre el 1ro de enero de 2003 y el 31 de diciembre de 2005. Por análisis bivariado, prueba T student y CHI2 se determino la significancia estadística, con posterior regresión logística. Resultados: De 1.600 eventos analizados, el 9,2% presentaron complicaciones cardiovasculares, de las cuales el 40,1% fueron mortales. El tabaquismo, hipertensión arterial severa y un mayor número de predictores clínicos de riesgo, se asocian con desenlaces mortales y no mortales, con un riesgo relativo de 5,3 (IC 95%, 3,7-7,69), 4,27 (IC 95%; 2,56-7,11) y hasta 18,86 (IC 95%; 9,59-37,1) respectivamente. La dislipidemia, sexo masculino y edad avanzada se asocian con eventos no mortales, con un RR de 3,1 (IC 95%; 1,97-4,87), 1,67 (95%; 1,06-2,62) y 2,49 (IC 95%; 1,03-6,05) respectivamente. Conclusiones: los factores de riesgo para enfermedad coronaria de la población general son también factores de riesgo para complicaciones cardiovasculares perioperatorias en cirugías no cardiacas.

Decadal Prediction. Can It Be Skillful?

A new field of study, “decadal prediction,” is emerging in climate science. Decadal prediction lies between seasonal/interannual forecasting and longer-term climate change projections, and focuses on time-evolving regional climate conditions over the next 10–30 yr. Numerous assessments of climate information user needs have identified this time scale as being important to infrastructure planners, water resource managers, and many others. It is central to the information portfolio required to adapt effectively to and through climatic changes. At least three factors influence time-evolving regional climate at the decadal time scale: 1) climate change commitment (further warming as the coupled climate system comes into adjustment with increases of greenhouse gases that have already occurred), 2) external forcing, particularly from future increases of greenhouse gases and recovery of the ozone hole, and 3) internally generated variability. Some decadal prediction skill has been demonstrated to arise from the first two of these factors, and there is evidence that initialized coupled climate models can capture mechanisms of internally generated decadal climate variations, thus increasing predictive skill globally and particularly regionally. Several methods have been proposed for initializing global coupled climate models for decadal predictions, all of which involve global time-evolving three-dimensional ocean data, including temperature and salinity. An experimental framework to address decadal predictability/prediction is described in this paper and has been incorporated into the coordinated Coupled Model Intercomparison Model, phase 5 (CMIP5) experiments, some of which will be assessed for the IPCC Fifth Assessment Report (AR5). These experiments will likely guide work in this emerging field over the next 5 yr.

Geomorphological Map of Ribbed Moraines on the Dubawnt Lake Palaeo-Ice Stream Bed: A Signature of Ice Stream Shut-down?

The beds of active ice streams in Greenland and Antarctica are largely inaccessible, hindering a full understanding of the processes that initiate, sustain and inhibit fast ice flow in ice sheets. Detailed mapping of the glacial geomorphology of palaeo-ice stream tracks is, therefore, a valuable tool for exploring the basal processes that control their behaviour. In this paper we present a map that shows detailed glacial geomorphology from a part of the Dubawnt Lake Palaeo-Ice Stream bed on the north-western Canadian Shield (Northwest Territories), which operated at the end of the last glacial cycle. The map (centred on 63 degrees 55 '' 42'N, 102 degrees 29 '' 11'W, approximate scale 1:90,000) was compiled from digital Landsat Enhanced Thematic Mapper Plus satellite imagery and digital and hard-copy stereo-aerial photographs. The ice stream bed is dominated by parallel mega-scale glacial lineations (MGSL), whose lengths exceed several kilometres but the map also reveals that they have, in places, been superimposed with transverse ridges known as ribbed moraines. The ribbed moraines lie on top of the MSGL and appear to have segmented the individual lineaments. This indicates that formation of the ribbed moraines post-date the formation of the MSGL. The presence of ribbed moraine in the onset zone of another palaeo-ice stream has been linked to oscillations between cold and warm-based ice and/or a patchwork of cold-based areas which led to acceleration and deceleration of ice velocity. Our hypothesis is that the ribbed moraines on the Dubawnt Lake Ice Stream bed are a manifestation of the process that led to ice stream shut-down and may be associated with the process of basal freeze-on. The precise formation of ribbed moraines, however, remains open to debate and field observation of their structure will provide valuable data for formal testing of models of their formation.

Soils and their distribution on Bambouto volcanic mountain, West Cameroon highland, Central Africa

Morphological, physical and chemical studies were carried out on soils of Mount Bambouto, a volcanic mountain of the West Cameroon highland. These studies show that the soils of this region can be divided into seven groups according to Soils Taxonomy USA [Soil taxonomy: a basic system of soil classification for making and interpreting soils surveys: USDA Agriculture Handbook 436: Washington, DC, US Government Pronting Office, 1975, 754]: lithic dystrandept soils, typical dystrandept soils, oxic dystrandept soils, typical haplohumox soils, typical kandiudox soils, tropopsamment soils and umbriaquox soils. A soils map of this region at scale 1:50,000 has been drawn up, using the seven soils groups above as soil cartography units. These soils are organised into of three main categories: soils with andic characteristics in the upper region of the mountain (lithic dystrandept soils, typical dystrandept soils and oxic dystrandept soils); ferrallitic soils in the lower part of the mountain (typical haplohumox soils and typical kandiudox soils) and imperfectly developed soils (tropopsamment soils and umbraquox soils).

Kinetics of high pressure facilitated starch gelatinisation in Thai glutinous rice

The combined effect of pressure and temperature on the rate of gelatinisation of starch present in Thai glutinous rice was investigated. Pressure was found to initiate gelatinisation when its value exceeded 200 MPa at ambient temperature. On the other hand, complete gelatinisation was observed at 500 and 600 MPa at 70 degrees C, when the rice was soaked in water under these conditions for 120 min. A first-order kinetic model describing the rate of gelatinisation was developed to estimate the values of the rate constants as a function of pressure and temperature in the range: 0.1-600 MPa and 20-70 degrees C. The model, based on the well-known Arrhenius and Eyring equations, assumed the form [GRAPHICS] The constants k(0), E-a, and Delta V were found to take values: 31.19 s(-1), 37.89 kJ mol(-1) and -9.98 cm(3) mol(-1), respectively. It was further noted that the extent of gelatinisation occurring at any time, temperature and pressure, could be exclusively correlated with the grain moisture content. (c) 2006 Elsevier Ltd. All rights reserved.

Prediction of coagulation properties, titratable acidity and pH of bovine milk using mid-infrared spectroscopy

This study investigated the potential application of mid-infrared spectroscopy (MIR 4,000–900 cm−1) for the determination of milk coagulation properties (MCP), titratable acidity (TA), and pH in Brown Swiss milk samples (n = 1,064). Because MCP directly influence the efficiency of the cheese-making process, there is strong industrial interest in developing a rapid method for their assessment. Currently, the determination of MCP involves time-consuming laboratory-based measurements, and it is not feasible to carry out these measurements on the large numbers of milk samples associated with milk recording programs. Mid-infrared spectroscopy is an objective and nondestructive technique providing rapid real-time analysis of food compositional and quality parameters. Analysis of milk rennet coagulation time (RCT, min), curd firmness (a30, mm), TA (SH°/50 mL; SH° = Soxhlet-Henkel degree), and pH was carried out, and MIR data were recorded over the spectral range of 4,000 to 900 cm−1. Models were developed by partial least squares regression using untreated and pretreated spectra. The MCP, TA, and pH prediction models were improved by using the combined spectral ranges of 1,600 to 900 cm−1, 3,040 to 1,700 cm−1, and 4,000 to 3,470 cm−1. The root mean square errors of cross-validation for the developed models were 2.36 min (RCT, range 24.9 min), 6.86 mm (a30, range 58 mm), 0.25 SH°/50 mL (TA, range 3.58 SH°/50 mL), and 0.07 (pH, range 1.15). The most successfully predicted attributes were TA, RCT, and pH. The model for the prediction of TA provided approximate prediction (R2 = 0.66), whereas the predictive models developed for RCT and pH could discriminate between high and low values (R2 = 0.59 to 0.62). It was concluded that, although the models require further development to improve their accuracy before their application in industry, MIR spectroscopy has potential application for the assessment of RCT, TA, and pH during routine milk analysis in the dairy industry. The implementation of such models could be a means of improving MCP through phenotypic-based selection programs and to amend milk payment systems to incorporate MCP into their payment criteria.

The art of shooting the moving goal - explorative study of EA pilot

Enterprise Architecture (EA) has been recognised as an important tool in modern business management for closing the gap between strategy and its execution. The current literature implies that for EA to be successful, it should have clearly defined goals. However, the goals of different stakeholders are found to be different, even contradictory. In our explorative research, we seek an answer to the questions: What kind of goals are set for the EA implementation? How do the goals evolve during the time? Are the goals different among stakeholders? How do they affect the success of EA? We analysed an EA pilot conducted among eleven Finnish Higher Education Institutions (HEIs) in 2011. The goals of the pilot were gathered from three different stages of the pilot: before the pilot, during the pilot, and after the pilot, by means of a project plan, interviews during the pilot and a questionnaire after the pilot. The data was analysed using qualitative and quantitative methods. Eight distinct goals were recognised by the coding: Adopt EA Method, Build Information Systems, Business Development, Improve Reporting, Process Improvement, Quality Assurance, Reduce Complexity, and Understand the Big Picture. The success of the pilot was analysed statistically using the scale 1-5. Results revealed that goals set before the pilot were very different from those mentioned during the pilot, or after the pilot. Goals before the pilot were mostly related to expected benefits from the pilot, whereas the most important result was to adopt the EA method. Results can be explained by possibly different roles of respondents, which in turn were most likely caused by poor communication. Interestingly, goals mentioned by different stakeholders were not limited to their traditional areas of responsibility. For example, in some cases Chief Information Officers' goals were Quality Assurance and Process Improvement, whereas managers’ goals were Build Information Systems and Adopt EA Method. This could be a result of a good understanding of the meaning of EA, or stakeholders do not regard EA as their concern at all. It is also interesting to notice that regardless of the different perceptions of goals among stakeholders, all HEIs felt the pilot to be successful. Thus the research does not provide support to confirm the link between clear goals and success.

Relações crescentes entre treonina e lisina digestível a partir de l-treonina e farelo de soja para frangos de corte

Foi realizado um experimento com o objetivo de avaliar relações crescentes de treonina para lisina digestível em dietas formuladas com base no conceito de proteína ideal. Para tal, alojou-se 1.600 frangos de corte machos Ross x Ross 308 em arranjo fatorial com 3 relações entre treonina e lisina digestível (0,635; 0,660 e 0,685) e 2 fontes de treonina suplementar (Farelo de Soja (FS) e L-Treonina sintética (L-Thr)) com dois tratamentos controle (positivo e negativo). Assim, o experimento contou com oito tratamentos e oito repetições de 25 aves. Os tratamentos com as respectivas relações treonina:lisina digestível (TLD) e fontes de treonina foram: T1 (controle positivo) com relação TLD de 0,700 (FS+L-Thr); T2 (controle negativo) com relação 0,610 (FS); T3 com relação 0,635 (FS+L-Thr); T4 com relação 0,660 (FS+LThr); T5 com relação 0,685 (FS+L-Thr); T6 com relação 0,635 (FS); T7 com relação 0,660 (FS) e T8 com relação TLD 0,685 (FS). Todas as dietas foram formuladas para apresentarem o mesmo nível mínimo de nutrientes e energia sem restrição para o nível de proteína bruta. Não houve efeito da suplementação de treonina sobre as características avaliadas. Conversão alimentar (P=0,0095) e consumo de água (P=0,0113) foram significativamente melhores para a proteína intacta (FS) comparativamente às dietas com suplementação dos 3 primeiros AA limitantes (L-Thr). Contudo, a característica rendimento de peito apresentou resultado superior (P=0,0351) para as dietas suplementadas com treonina sintética. Não foi observado efeito dos tratamentos sobre as demais respostas estudadas. Desta forma, a menor relação entre treonina e lisina digestível estudada, ou seja, 0,610, foi suficiente para atender as exigências para ótimo desempenho dos frangos de corte dos 15 aos 37 dias de idade. Todavia, para a característica rendimento de peito recomenda-se a relação TLD mínima de 0,635. Em virtude de as melhores respostas terem sido obtidas com as dietas cuja fonte de treonina foi exclusivamente o FS, atribui-se estas respostas ao maior conteúdo de aminoácidos menos limitantes e aminoácidos não-essenciais contidos nas referidas dietas.

"Comida di buteco" : o botequim, um pedaço da alma carioca, em uma iniciativa de construção de comunidade virtual de marca

O botequim é um estabelecimento que serve comida caseira, em porções generosas e a baixo custo, também servindo petiscos típicos e bebidas, isto num ambiente informal, com arquitetura e decoração típicas. Durante muito tempo teve sua imagem associada ao ócio e ao vício, ao ponto dos proprietários rejeitarem a associação dos seus estabelecimentos ao termo botequim. Esta visão mudou com a recente valorização do termo botequim, através do lançamento de guias como o “Rio Botequim”, “Guia Veja Comer & Beber”, das colunas “Pé-limpo” e “Pé-sujo”, ambas publicadas no caderno “Rio Show” do jornal O Globo, e do concurso “Comida di Buteco”. Apesar de haver em todo território brasileiro 297.000 estabelecimentos semelhantes que ocupam em torno de 1.600.000, não são facilmente encontrados estudos que abordem o botequim de um ponto de vista empresarial. Objeto deste estudo o concurso “Comida di Buteco” foi criado em 2000 e atualmente acontece em 16 cidades de 8 estados brasileiros e conta com mais de 370 estabelecimentos concorrentes. O presente estudo tem por objetivo apresentar de que maneira os organizadores do concurso incentivam através de sua página no Facebook a formação de uma comunidade virtual de marca em torno do concurso e se esta se estende aos botequins participantes. Para a realização deste objetivo esta pesquisa se apoia em um referencial teórico mapeado dentro da literatura disponível sobre: o botequim; o concurso “Comida di Buteco”; marca e a criação de seus significados; comunidade de marca e comunidade virtual de marca. Optou-se por abordar o fenômeno de forma qualitativa usando-se a etnografia como metodologia para a coleta de dados e no tratamento destes aplicou-se a análise de discurso mediado por computador. O resultado da análise é confrontado com o referencial teórico e conclui-se que a organização do concurso “Comida di Buteco” incentiva a formação de uma comunidade virtual de marca em torno do concurso, através da troca de informações e opiniões, da divulgação do concurso e estabelecimentos, do incentivo a autoconsciência de grupo. Não foi possível comprovar se esta comunidade se estende aos estabelecimentos concorrentes, porém verificou-se que estes tiram proveito da divulgação de suas marcas pelo concurso.

O mercado de opções de Petrobras é eficiente? Um estudo a partir da estratégia delta-gama-neutra

This study aims to verify if the Petrobras options market is efficient in the semi-strong form, that is, if all public information is reflected in these derivative prices. For this purpose, this work tries to achieve profit systematically through the Delta-GammaNeutral strategy using the company's stock and options. In order to simulate the strategy exactly as it would be used in the real world, we built the order books every five minutes considering all buying and selling orders sent to the underlying asset and to the options. We apply the strategy when distortions between implied volatilities extracted from the options are detected. The results show that the Petrobras options market is not efficient, since in 371 day trade strategies, which have an average investment of R$81,000 and average duration of one hour and thirteen minutes, the average return was 0.49% - which corresponds to more than 1,600% of the 1-day risk free interest rate - and 85% of strategies were profitable.