Survey of <i>C. difficile</i>-Specific Infection Control Policies in Local Long-Term Care Facilities

Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. Infection control policies are crucial for controlling CDI, but there are currently no regulatory guidelines in the United States. Therefore, we evaluated infection control policies in local LTCFs to define the CDI-specific policies and the administrative and staff understanding of CDI, so as to identify perceived barriers for compliance. Methods: IRB approval was sought and exemption granted, all 8 local LTCFs were asked to participate. Each facility was visited by study personnel who interviewed the administrative Infection Control Practitioner (ICP) and 3-4 Licensed Practical Nurses (LPNs) with distinct survey format. Infection control policies were then compared to the SHEA recommendations for CDI in LTCFs. Results: Of the eligible facilities, 75% (n = 6) participated. ICP (n = 6) and LPNs (n = 21) were interviewed. All facilities accept residents with active CDI and 2 had written CDI-specific infection control policies. All facilities had hand hygiene or glove use policies and 2 had policies for the use of sporicidal environmental cleaning. No facility restricted antibiotic use. Each facility has a policy to instruct their staff through in-services, either annually or upon new hire, but 33% (n = 7) LPNs reported no facility-based CDI training. While 80% (n = 17) of LPNs felt comfortable with the facility CDI policies, only 11 accurately restated it. ICPs felt the most relevant barrier to staff compliance was time constraints (n = 4, 67%), however, LPNs felt it was limited knowledge (n = 10, 48%) and poor communication (n = 2, 10%). Discussion and Conclusions: With the increasing incidence and severity of CDI in LCTF, few of the facilities surveyed had CDI-specific policies. Despite CDI-specific training, there is a perceived knowledge and communication gap for staff caring for residents with CDI.

Statistical Transformation Indicators of Short-Term to Long-Term Using Flood Regional Coefficients (Case Study: East Azarbaijan Province, Iran)

Changing contexts in a long-term and short-term perspective should be managed within an integrated risk management framework that accounts for both temporary management strategies and permanent preventive measures to reduce the impact of natural hazard processes. In this study, statistical transformation indicators of short-term (20 year) to long-term (30 year) used flood regional coefficients. After the tests of data validation and the reconstruction of missing and outlier data, the data of 18 hydrometric stations were completed for 30 years (1985 to 2014). In the next phase, the return period values were prepared for 20-year and 30-year statistical periods (1985 to 2004 and 1985 to 2014) using the HYFA software. Thus the 20-year to 30-year ratio for various return period discharges obtained and these dimensionless values were plotted for the return periods of 2, 5, 10, 20, 50 and 100 years, also fitted the logarithmic trend line and the values of coefficients of the relationship were obtained. The statistics including average, standard deviation, coefficient of variation (CV), skewness coefficient (CS) and Kurtosis coefficient (CK) were calculated for 20-year data period for each station and we identified the statistics as independent parameters and the coefficients of A and B as dependent parameter, thus analyzed using linear multivariate regression, and regional factors were obtained. In the hydrometric station with 17-027 code, the discharge using the regional factors was calculated and compared with the discharge values of 30 years data. The results showed that there is little difference between the observed and estimated values from regional factors thus this method can be used in projects that require at least 30 years of data.

Short-term and long-term risk factors in gastric cance

While in chronic diseases, such as diabetes, mortalityrates slowly increases with age, in oncological seriesmortality usually changes dramatically during thefollow-up, often in an unpredictable pattern. Forinstance, in gastric cancer mortality peaks in thefirst two years of follow-up and declines thereafter.Also several risk factors, such as TNM stage, largelyaffect mortality in the first years after surgery, whileafterward their effect tends to fade. Temporal trendsin mortality were compared between a gastric cancerseries and a cohort of type 2 diabetic patients. Forthis purpose, 937 patients, undergoing curativegastrectomy with D1/D2/D3 lymphadenectomy forgastric cancer in three GIRCG （Gruppo Italiano RicercaCancro Gastrico = Italian Research Group for GastricCancer） centers, were compared with 7148 type 2diabetic patients from the Verona Diabetes Study. Inthe early/advanced gastric cancer series, mortality fromrecurrence peaked to 200 deaths per 1000 personyears1 year after gastrectomy and then declined,becoming lower than 40 deaths per 1000 person-yearsafter 5 years and lower than 20 deaths after 8 years.Mortality peak occurred earlier in more advanced Tand N tiers. At variance, in the Verona diabetic cohort overall mortality slowly increased during a 10-yearfollow-up, with ageing of the type 2 diabetic patients.Seasonal oscillations were also recorded, mortalitybeing higher during winter than during summer. Alsothe most important prognostic factors presented adifferent temporal pattern in the two diseases： whilethe prognostic significance of T and N stage markedlydecrease over time, differences in survival amongpatients treated with diet, oral hypoglycemic drugsor insulin were consistent throughout the follow-up.Time variations in prognostic significance of main riskfactors, their impact on survival analysis and possiblesolutions were evaluated in another GIRCG series of568 patients with advanced gastric cancer, undergoingcurative gastrectomy with D2/D3 lymphadenectomy.Survival curves in the two different histotypes （intestinaland mixed/diffuse） were superimposed in the first threeyears of follow-up and diverged thereafter. Likewise,survival curves as a function of site （fundus vs body/antrum） started to diverge after the first year. On thecontrary, survival curves differed among age classesfrom the very beginning, due to different post-operativemortality, which increased from 0.5% in patients aged65-74 years to 9.9% in patients aged 75-91 years;this discrepancy later disappeared. Accordingly, theproportional hazards assumption of the Cox modelwas violated, as regards age, site and histology. Tocope with this problem, multivariable survival analysiswas performed by separately considering either thefirst two years of follow-up or subsequent years.Histology and site were significant predictors only aftertwo years, while T and N, although significant bothin the short-term and in the long-term, became lessimportant in the second part of follow-up. Increasingage was associated with higher mortality in the firsttwo years, but not thereafter. Splitting survival timewhen performing survival analysis allows to distinguishbetween short-term and long-term risk factors.Alternative statistical solutions could be to excludepost-operative mortality, to introduce in the modeltime-dependent covariates or to stratify on variablesviolating proportionality assumption.

Short-Term and Long-Term Price Forecasting Models for the Future Exchange of Mongolian Natural Sea Buckthorn Market

Sea buckthorn market floated uncertainly within a narrow range. The market situation provided upward pressure on prices, and producer and consumer interest were poor, coupled with weak prices in the regional markets. The objectives of the study are: 1) to estimate the relationship between wild Sea buckthorn (SB) price and Supply, Demand, while some other factors of crude oil price and exchange rate by using simultaneous Supply-Demand and Price system equation and Vector Error Correction Method (VECM);2) to forecast the short-term and long-term SB price;3) to compare and evaluate the price forecasting models. Firstly, the data was analyzed by Ferris and Engle-Granger’s procedure;secondly, both price forecasting methodologies were tested by Pindyck-Rubinfeld and Makridakis’s procedure. The result shows that the VECM model is more efficient using yearly data;a short-term price forecast decreases, and a long-term price forecast is predicted to increase the Mongolian Sea buckthorn market.

Trends of Inequalities in the Use of Long-Term Reversible Contraceptives in Burkina Faso between 2010 and 2015

Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.

Video caching and scheduling with edge cooperation

In this paper,we explore a distributed collaborative caching and computing model to support the distribution of adaptive bit rate video streaming.The aim is to reduce the average initial buffer delay and improve the quality of user experience.Considering the difference between global and local video popularities and the time-varying characteristics of video popularity,a two-stage caching scheme is proposed to push popular videos closer to users and minimize the average initial buffer delay.Based on both long-term content popularity and short-term content popularity,the proposed caching solution is decouple into the proactive cache stage and the cache update stage.In the proactive cache stage,we develop a proactive cache placement algorithm that can be executed in an off-peak period.In the cache update stage,we propose a reactive cache update algorithm to update the existing cache policy to minimize the buffer delay.Simulation results verify that the proposed caching algorithms can reduce the initial buffer delay efficiently.

Comparison of short- with long-term regeneration results after digital nerve reconstruction with musclein-vein conduits

Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits. Static and moving two-point discriminations and Semmes-Weinstein Monofilaments were used to evaluate sensory recovery 6–12 months and 14–35 months after repair of digital nerves with muscle-in-vein in 7 cases. Both follow-ups were performed after clinical signs of progressing regeneration disappeared. In 4 of 7 cases, a further recovery of both two-point discriminations and in another case of only the static two-point discrimination of 1–3 mm could be found between the short-term and long-term follow-up examination. Moreover, a late recovery of both two-point discriminations was demonstrated in another case. Four of 7 cases showed a sensory improvement by one Semmes-Weinstein Monofilaments. This pilot study suggests that sensory recovery still takes place even when clinical signs of progressing regeneration disappear.

Long-term care policy simulation of disabled elderly

With the accelerating process of population aging in our country, the physical function of the elderly will decline, the possibility of suffering from acute and chronic diseases will increase, and the occurrence of disability will become more common and normal. The potential demand for elderly care is rapidly increasing. With the growth, the care of the disabled elderly has become increasingly acute. At the same time, due to the intensification of family miniaturization and population migration, the traditional family-based long-term care has been difficult to sustain. How to incorporate long-term care into our social security system as soon as possible has become the focus of the whole society. The thesis through the combination of public policy simulation methods and the research data, the long-term care insurance system implemented at the beginning of 2018 in Shanghai is a policy blueprint. It uses statistical software SPSS, MATLAB, etc. to achieve data collation, analysis and prediction, and at the same time integrates the pilot of the long-term care insurance system. The implementation of policies in cities such as Qingdao and Nantong has been simulated. Finally, on the basis of simulation results, suggestions have been made for the future development of China＇s long-term care insurance system.

Measuring moisture content of dead fine fuels based on the fusion of spectrum meteorological data

Dead fine fuel moisture content(DFFMC)is a key factor affecting the spread of forest fires,which plays an important role in evaluation of forest fire risk.In order to achieve high-precision real-time measurement of DFFMC,this study established a long short-term memory(LSTM)network based on particle swarm optimization(PSO)algorithm as a measurement model.A multi-point surface monitoring scheme combining near-infrared measurement method and meteorological measurement method is proposed.The near-infrared spectral information of dead fine fuels and the meteorological factors in the region are processed by data fusion technology to construct a spectral-meteorological data set.The surface fine dead fuel of Mongolian oak(Quercus mongolica Fisch.ex Ledeb.),white birch(Betula platyphylla Suk.),larch(Larix gmelinii(Rupr.)Kuzen.),and Manchurian walnut(Juglans mandshurica Maxim.)in the maoershan experimental forest farm of the Northeast Forestry University were investigated.We used the PSO-LSTM model for moisture content to compare the near-infrared spectroscopy,meteorological,and spectral meteorological fusion methods.The results show that the mean absolute error of the DFFMC of the four stands by spectral meteorological fusion method were 1.1%for Mongolian oak,1.3%for white birch,1.4%for larch,and 1.8%for Manchurian walnut,and these values were lower than those of the near-infrared method and the meteorological method.The spectral meteorological fusion method provides a new way for high-precision measurement of moisture content of fine dead fuel.

Initial Labor Market Conditions and Individual Employability

Initial labor market conditions affect how individuals build their human capital and look for jobs and thus can have long-term effects on their income levels,work performance,and career development.Based on data from the Urban Household Survey(UHS)of urban households in China from 1986 to 2009,we perform an empirical test of how initial labor market conditions affect the employability of individuals.Our research shows that people’s future incomes suffer if they start out in an adverse job market.Each percentage point of increase in the unemployment rate at an individual’s entry into the labor market is associated with a two-percentage-point drop in his or her average annual income.Even after looking at different parts of the job market and sample groups,this conclusion still holds.In the context of global economic instability,our findings may assist government policymakers in addressing adverse labor market conditions.

The Function of Oxytocin in Memory —A General Review of Oxytocin’s Effect on Memory

Introduction: While oxytocin (OT) is widely recognized for its pivotal role in reproductive behavior and the formation of social bonds, there remains a significant gap in our understanding of its potential influence on learning and memory processes, encompassing both social and non-social aspects. Thus this paper serves as an attempt to investigate the comprehensive role of OT in Physiological, Cognitive, and Behavioral processes. Method: A comprehensive literature review was conducted to assemble evidence related to the influence of OT on learning and memory. Studies encompassing both social and non-social memory were incorporated into the analysis. Additionally, molecular mechanisms through which OT could potentially impact neuronal activity in the hippocampus and amygdala, consequently affecting learning and memory, were also investigated. Results: Our review reveals a spectrum of evidence that both supports and contradicts the theory that OT plays a significant role in social and non-social memory. While certain studies suggest a positive impact of OT on memory, others present findings that argue otherwise. However, multiple potential molecular mechanisms were discovered that may elucidate OT’s effects on learning and memory, particularly its potential to modulate neuronal activity in the hippocampus and amygdala. Conclusion: Despite the mixed evidence, OT might have a significant role in both social and non-social memory. Identified molecular mechanisms propose potential ways in which OT could influence learning and memory. The key role appears to be the modulation of neuronal activity in the hippocampus and amygdala by OT. Furthermore, it is plausible that OT’s function in memory is crucial for the social behaviors previously associated with it. Future research is necessitated to fully unravel the exact mechanisms and implications of OT’s role in learning and memory.

Radical resection of pancreatic cancer

BACKGROUND: Pancreatic adenocarcinoma (PCa) is a disease with dismal prognosis, and the only possibility of cure, albeit small, is based on the combination of complete resection with negative histopathological margins (R0 resection) with adjuvant treatment. Therefore, a lot of effort has been made during the last decade to assess the role of extensive surgery in both local recurrence and survival of patients with PCa. DATA SOURCES: Medline search and manual cross- referencing were utilized to identify published evidence- based data for PCa surgery between 1973 and 2006, with emphasis to feasibility, efficacy, long-term survival, disease free survival, recurrence rates, pain relief and quality of life. RESULTS: Extended surgery is safe and feasible in high volume surgical centers with comparable short-term results. Organ preserving surgery is a main goal because of quality of life reasons and is performed whenever possible from the tumor extent. Concerning long-term survival major vein resection does not adversely affect outcome. To date, there are no changes in long-term survival attributed to the extended lymph node dissection. However, there is a benefit in locoregional control with fewer local recurrences and extended lymphadenectomy allows better staging for the disease. CONCLUSIONS: Extended PCa surgery is safe and feasible despite the inconclusive results in patient’s survival benefit. In the future, appropriately powered randomized trials of standard vs. extended resections may show improved outcomes for PCa patients.

Discussion on the parameters of design waves

In order to respond the discredit on the design wave standard and to recommend new consideration on design wave parameters, based on the long-term distribution of statistic characteristics of waves and the short-term probability properties of sea state defined by giving the return period, the calculation of the return period, the height, the period, and the oceanic wave parameters of the design wave and the forecasting methods are discussed in this paper. To provide references for the operation reliability of floating structures in the extreme sea state, the method of determining the design wave parameters is resurveyed. A proposal is recommended that the design wave, which can be either significant wave with 500-year of the return period, or the maximum wave with 1/N of exceeding probability, 100-year of the return period, can be applied in the engineering design practice.

The detrimental effects of lipopolysaccharideinduced neuroinflammation on adult hippocampal neurogenesis depend on the duration of the pro-inflammatory response

Adult hippocampal neurogenesis is a finely tuned process regulated by extrinsic factors. Neuroinflammation is a hallmark of several pathological conditions underlying dysregulation of neurogenesis. In animal models, lipopolysaccharide(LPS)-induced neuroinflammation leads to a neurogenic decrease mainly associated to the early inflammatory response. However, it is not well understood how the neuroinflammatory response progresses over time and if neurogenesis continues to be diminished during the late neuroinflammatory response. Moreover, it is unknown if repeated intermittent administration of LPS along time induces a greater reduction in neurogenesis. We administered one single intraperitoneal injection of LPS or saline or four repeated injections(one per week) of LPS or saline to young-adult mice. A cohort of new cells was labeled with three 5-bromo-2-deoxyuridine injections(one per day) 4 days after the last LPS injection. We evaluated systemic and neuroinflammation-associated parameters and compared the effects of the late neuroinflammatory response on neurogenesis induced by each protocol. Our results show that 1) a single LPS injection leads to a late pro-inflammatory response characterized by microglial activation, moderate astrocytic reaction and increased interleukin-6 levels. This response correlates in time with decreased neurogenesis and 2) a repeated intermittent injection of LPS does not elicit a late pro-inflammatory response although activated microglia persists. The latter profile is not accompanied by a continued longterm hippocampal neurogenic decrease. Hereby, we provide evidence that the neuroinflammatory response is a dynamic process that progresses in a milieu-dependent manner and does not necessarily lead to a neurogenic decrease, highlighting the complex interaction between the immune system and neurogenesis.

Voltage-dependent plasticity and image Boolean operations realized in a WOx-based memristive synapse

The development of electronic devices that possess the functionality of biological synapses is a crucial step towards neuromorphic computing.In this work,we present a WOx-based memristive device that can emulate voltage-dependent synaptic plasticity.By adjusting the amplitude of the applied voltage,we were able to reproduce short-term plasticity(STP)and the transition from STP to long-term potentiation.The stimulation with high intensity induced long-term enhancement of conductance without any decay process,thus representing a permanent memory behavior.Moreover,the image Boolean operations(including intersection,subtraction,and union)were also demonstrated in the memristive synapse array based on the above voltage-dependent plasticity.The experimental achievements of this study provide a new insight into the successful mimicry of essential characteristics of synaptic behaviors.

A Lightweight Temporal Convolutional Network for Human Motion Prediction

A lightweight multi-layer residual temporal convolutional network model(RTCN)is proposed to target the highly complex kinematics and temporal correlation of human motion.RTCN uses 1-D convolution to efficiently obtain the spatial structure information of human motion and extract the correlation in the time series of human motion.The residual structure is applied to the proposed network model to alleviate the problem of gradient disappearance in the deep network.Experiments on the Human 3.6M dataset demonstrate that the proposed method effectively reduces the errors of motion prediction compared with previous methods,especially of long-term prediction.

A Hybrid Handover Forecasting Mechanism Based on Fuzzy Forecasting Model in Cellular Networks

As the increasing demand for mobile communications and the shrinking of the coverage of cells, handover mechanism will play an important role in future wireless networks to provide users with seamless mobile communication services. In order to guarantee the user experience, the handover decision should be made timely and reasonably. To achieve this goal, this paper presents a hybrid handover forecasting mechanism, which contains long-term and short-term forecasting models. The proposed mechanism could cooperate with the standard mechanisms, and improve the performance of standard handover decision mechanisms. Since most of the parameters involved are imprecise, fuzzy forecasting model is applied for dealing with predictions of them. The numerical results indicate that the mechanism could significantly decrease the rate of ping-pong handover and the rate of handover failure.

Response-based Analysis for Tension Leg Platform

The typical industry practice for Tension Leg Platform （TLP） design focuses on a conventional short-term design recipe, which assumes that an N-year design environment leads to an N-year response. In the response-based design method, the TLP is designed to withstand N-year responses rather than respond to N-year environmental conditions. In this paper, we present an overview and a general procedure for the response-based design method and use a case study to compare the critical TLP responses between the two methods. The results of our comparison show that the conventional short-term design method often contains an element of conservatism and that the response-based design method can reduce the design conditions and thereby achieve cost savings.

Biomarkers for detection of alcohol consumption in liver transplantation

Alcoholic liver disease is an established, yet controversial, indication for liver transplantation. Although an abstinence period of up to 6 mo prior to transplantation is mandatory, alcohol relapse after transplantation is a common event. In case of recurrence of heavy drinking, graft survival is significantly impaired. Guidelines on detection and surveillance of alcohol consumption in this patient cohort are lacking. This review summarizes the challenge of patient selection as well as the current knowledge on established and novel alcohol biomarkers with special focus on liver transplant candidates and recipients.

Fractal and chaotic laws on seismic dissipated energy in an energy system of enginering structures

Fractal and chaotic laws of engineering structures are discussed in this paper, it means that the intrinsic essences and laws on dynamic systems which are made from seismic dissipated energy intensity E d and intensity of seismic dissipated energy moment I e are analyzed. Based on the intrinsic characters of chaotic and fractal dynamic system of E d and I e, three kinds of approximate dynamic models are rebuilt one by one: index autoregressive model, threshold autoregressive model and local-approximate autoregressive model. The innate laws, essences and systematic error of evolutional behavior I e are explained over all, the short-term behavior predictability and long-term behavior probability of which are analyzed in the end. That may be valuable for earthquake-resistant theory and analysis method in practical engineering structures.