Catheter-Associated Urinary Tract Infection, Clostridioides difficile Colitis, Central Line-Associated Bloodstream Infection, and Methicillin-Resistant Staphylococcus aureus.

Hospital-acquired infections increase cost, morbidity, and mortality for patients across the United States and the world. Principal among these infections are central line-associated bloodstream infection, catheter-associated urinary tract infection, Clostridioides difficile, and methicillin-resistant Staphylococcus aureus colonization and infections. This article provides succinct summaries of the background, epidemiology, diagnosis, and treatment of these conditions. In addition, novel prevention strategies, including those related to recent national interventions, are reviewed.

Physicians' attitudes toward pharmacogenetic testing before and after pharmacogenetic education.

AIM: Our aim was to evaluate physicians' attitudes toward pharmacogenetic testing before and after pharmacogenetic education. METHODS: In total, 12 physicians (˜40% response rate) completed a survey with eight questions on 10-point scales on their attitudes toward pharmacogenetic testing before and after a 1-h grand rounds presentation on pharmacogenetics. Differences in question scores overall, among training levels (resident/fellow/attending), and specific drugs (clopidogrel/simvastatin/warfarin) were assessed using Wilcoxon signed-rank and exact Kruskal-Wallis tests. RESULTS & CONCLUSION: The scores for all eight questions increased, with statistically significant (p < 0.05) increases for four out of eight questions. The scores were similar among training levels, but the postscores for clopidogrel were significantly higher than for simvastatin and warfarin. In conclusion, brief pharmacogenetic education can significantly affect physicians' attitudes toward pharmacogenetic testing.

Energy versus centrality dependence of the jet quenching parameter [Formula: see text] at RHIC and LHC: a new puzzle?

The central goal of jet quenching studies in high-energy nuclear collisions is the characterization of those QCD medium properties that are accessible by these probes. Most of the discussion in the last years has been focused on the determination of the jet quenching parameter, [Formula: see text]. We present here an extraction of this parameter using data of inclusive particle suppression at RHIC and LHC energies for different centralities. Our approach consists in fitting a K factor that quantifies the departure of this parameter from an ideal estimate, [Formula: see text], where [Formula: see text] is determined by the local medium quantities as provided by hydrodynamical calculations. We find that this K factor is larger at RHIC than at the LHC, as obtained already in previous analyses, but, surprisingly, it is almost independent of the centrality of the collision. Taken at face value, the K factor would not depend on the local properties of the medium as energy density or temperature, but on global collision quantities such as the center of mass energy. This is a very intriguing, unexpected possibility for which we cannot yet provide a clear interpretation. We also comment on the limitations of the formalism that may affect this conclusion.

A prospective cohort study of medication reconciliation using pharmacy technicians in the emergency department to reduce medication errors among admitted patients.

BACKGROUND: The collection of a complete, verified medication history is essential to patient safety. The involvement of clinical pharmacists has been shown to improve the completeness and accuracy of medication histories; however, to our knowledge, involvement of pharmacy technicians has not been studied. OBJECTIVE: Our aim was to determine whether verification of medication histories by pharmacy technicians in the emergency department (ED) would result in fewer errors in inpatient medication regimens compared to verification by the admitting physician team. METHODS: We performed a prospective cohort study of adult ED patients admitted for continuing care. In the intervention group, medication reconciliation was performed by pharmacy technicians in the ED before the creation of physician admitting orders. In the control group, pharmacy technicians conducted their history taking later, after admission. Initial admitting orders were then compared to the pharmacy technicians' medication reconciliation taken before admission (intervention group) or after admission (control group). Medication discrepancies were classified and determined to be justified or unjustified. Unjustified discrepancies were rated for harm potential. RESULTS: In our cohort of 113 intervention and 75 control subjects, the mean age was 55 years (standard deviation [SD] 16 years); 96 patients (51%) were male. In the intervention group, 566 changes to home medications were observed on admission; 352 (62%) were unjustified. Among controls, 406 changes to home medications were observed; 228 (56%) were unjustified. This difference was not statistically significant (p = 0.0586). The rate of unjustified medication changes per patient was likewise not significantly different (3.14 [SD 2.98] in interventions vs. 3.17 [SD 2.81] in controls; p = 0.9570). The rate of medical errors did not differ between study groups, nor did severity ratings of unjustified changes. CONCLUSIONS: Medication reconciliation by pharmacy technicians in the ED did not lead to a significant reduction in unjustified medication discrepancies.

Anisotropic flow in event-by-event ideal hydrodynamic simulations of √[s(NN)]=200 GeV Au+Au collisions.

We simulate top-energy Au+Au collisions using ideal hydrodynamics in order to make the first comparison to the complete set of midrapidity flow measurements made by the PHENIX Collaboration. A simultaneous calculation of v(2), v(3), v(4), and the first event-by-event calculation of quadrangular flow defined with respect to the v(2) event plane (v(4){Ψ(2)}) gives good agreement with measured values, including the dependence on both transverse momentum and centrality. This provides confirmation that the collision system is indeed well described as a quark-gluon plasma with an extremely small viscosity and that correlations are dominantly generated from collective effects. In addition, we present a prediction for v(5).

Directed flow at midrapidity in sqrt[S(NN)] = 2.76 TeV Pb + Pb collisions.

We analyze published data from the ALICE Collaboration in order to obtain the first extraction of the recently proposed rapidity-even directed flow observable v(1). An accounting of the correlation due to the conservation of transverse momentum restores the factorization seen by ALICE in all other Fourier harmonics and thus indicates that the remaining correlation gives a reliable measurement of directed flow. We then carry out the first viscous hydrodynamic calculation of directed flow, and show that it is less sensitive to viscosity than higher harmonics. This allows for a direct extraction of the dipole asymmetry of the initial state, providing a strict constraint on the nonequilibrium dynamics of the early-time system. A prediction is then made for v(1) in Au-Au collisions at RHIC.