Prediction of Readmission Following Sepsis Using Social Determinants of Health.

OBJECTIVES: To determine the predictive value of social determinants of health (SDoH) variables on 30-day readmission following a sepsis hospitalization as compared with traditional clinical variables. DESIGN: Multicenter retrospective cohort study using patient-level data, including demographic, clinical, and survey data. SETTINGS: Thirty-five hospitals across the United States from 2017 to 2021. PATIENTS: Two hundred seventy-one thousand four hundred twenty-eight individuals in the AllofUs initiative, of which 8909 had an index sepsis hospitalization. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Unplanned 30-day readmission to the hospital. Multinomial logistic regression models were constructed to account for survival in determination of variables associate with 30-day readmission and are presented as adjusted odds rations (aORs). Of the 8909 sepsis patients in our cohort, 21% had an unplanned hospital readmission within 30 days. Median age (interquartile range) was 54 years (41-65 yr), 4762 (53.4%) were female, and there were self-reported 1612 (18.09%) Black, 2271 (25.49%) Hispanic, and 4642 (52.1%) White individuals. In multinomial logistic regression models accounting for survival, we identified that change to nonphysician provider type due to economic reasons (aOR, 2.55 [2.35-2.74]), delay of receiving medical care due to lack of transportation (aOR, 1.68 [1.62-1.74]), and inability to afford flow-up care (aOR, 1.59 [1.52-1.66]) were strongly and independently associated with a 30-day readmission when adjusting for survival. Patients who lived in a ZIP code with a high percentage of patients in poverty and without health insurance were also more likely to be readmitted within 30 days (aOR, 1.26 [1.22-1.29] and aOR, 1.28 [1.26-1.29], respectively). Finally, we found that having a primary care provider and health insurance were associated with low odds of an unplanned 30-day readmission. CONCLUSIONS: In this multicenter retrospective cohort, several SDoH variables were strongly associated with unplanned 30-day readmission. Models predicting readmission following sepsis hospitalization may benefit from the addition of SDoH factors to traditional clinical variables.

Electronic Spectroscopy of Jet-Cooled NdO.

Chemi-ionization reactions of the type M + O → MO+ + e- (M = Nd or Sm) are currently being investigated as a method to artificially increase the electron density in the ionosphere for control of micro- and radio wave propagation. Experiments involving the release of atomic Nd into the upper atmosphere have resulted in the production of a cloud that, on excitation by solar radiation, emits green light. It has been assumed that NdO was the carrier of this emission, but the existing spectroscopic data needed for this attribution is lacking. While the electronic spectrum of NdO has been well-characterized at wavelengths greater than 590 nm, relatively little spectroscopic data exist for emission wavelengths in the blue-green spectral range. In this study, spectra for jet-cooled NdO were recorded over the range 15,500-21,000 cm-1. Rotationally resolved laser induced fluorescence and vibronically resolved dispersed laser-induced fluorescence spectra were recorded, and nine new electronically excited states were identified. The data indicate that the electronic spectrum of NdO has relatively few allowed transitions in the green spectral range, casting doubt on the assignment of the Nd high-altitude release cloud green emission to NdO.

Awareness and utilization of pre-exposure prophylaxis and HIV prevention services among transgender and non-binary adolescent and young adults.

Introduction: Transgender and gender non-binary (TGNB) individuals are disproportionally affected by HIV and face high rates of discrimination and stigmatization, resulting in limited access to HIV prevention services. Pre-exposure prophylaxis (PrEP) is highly efficacious for reducing the risk of HIV transmission. However, little research is available regarding PrEP awareness and utilization among TGNB adolescents and young adults (AYA). Methods: TGNB AYA ages 15-24 years old were recruited between December 2021 and November 2022 for participation in a one-time, anonymous online survey study to assess PrEP awareness and perceptions, as well as barriers to its use. Participants were recruited from seven academic centers offering gender-affirming care to TGNB AYA across the United States. Results: Of the 156 TGNB AYA individuals who completed the survey, most (67%) were aware of PrEP; however, few (7%) had been prescribed PrEP. Many (60%) had not spoken to a medical provider and, even if the medication was free and obtained confidentially, most participants did not plan to take PrEP due to low perceived HIV risk, lack of PrEP knowledge, and concern about interactions between their hormone therapy and PrEP. Discussion: These findings underscore the need for broad PrEP educational efforts for both TGNB AYA and their providers to improve knowledge, identify potential PrEP candidates among TGNB AYA and improve access by addressing identified barriers.

Electronic Spectroscopy of SmO in the 645 to 670 nm Range.

The associative ionization reaction Sm + O → SmO+ + e- is being investigated as an electron source that could transiently modify high-altitude electron densities via Sm vapor release. Electronic spectra have been obtained from tests where sounding rockets released Sm vapor, but the interpretation of these results has been hampered by the limited laboratory spectral data available for both SmO and SmO+. The present study extends the spectroscopic characterization of SmO in the 645-670 nm range, where the field data show the most prominent molecular emission features. Rotationally resolved excitation spectra, dispersed laser-induced fluorescence spectra, and fluorescence decay lifetimes are reported. The results are consistent with the assignment of a subset of the red-region bands to configurational transitions of the form Sm2+(4f56s)O2- ↔ Sm2+(4f55d)O2-. Analysis of the excited state hyperfine structure supports this configurational description.

Genome Sequence of VanLee, a Singleton Actinobacteriophage That Infects Multiple Gordonia Strains.

VanLee is a singleton phage that was isolated from soil in Florida using Gordonia rubripertincta NRRL B-16540 as the host. The genome is 84,560 bp and has a GC content of 67.8%. VanLee has 164 predicted protein-coding genes and one tRNA. VanLee can infect Gordonia terrae with the same efficiency as G. rubripertincta.

Factores asociados a la infección por Chlamydia trachomatis en mujeres atendidas en dos hospitales provinciales, Matanzas 2010-2012 / Factors associated to Chlamydia trachomatis infection in women attended in two provincial hospitals, Matanzas 2010-2013

Se realizó un estudio observacional analítico transversal, para determinar la frecuencia de Chlamydia trachomatis y factores asociados en 298 mujeres sexualmente activas en los hospitales Comandante Faustino Pérez y Julio Alfonso Medina, de Matanzas, desde junio del 2010 a 2012, seleccionándose no aleatoriamente 149 mujeres de cada hospital. Se diagnosticó clamidiasis por el test-CHLAMY-CHECK-1 y otros gérmenes asociados por exudado vaginal. Se realizó análisis divariado, estimando relación entre clamidiasis y las variables seleccionadas. Se utilizó tablas de contingencias para análisis de riesgo calculándose el Odds ratio, con intervalos de confianza del 95 por ciento. Para la asociación estadística significativa se utilizó el CHI², siendo estadísticamente significativa cuando el valor de P sea menor de 0,05. El 72,5 por ciento de las mujeres estudiadas resultaron infectadas, siendo las menores de 24 años, con un 85,8 por ciento las de mayor incidencia. El inicio de las relaciones sexuales antes de los 18 años predominó, presentándose en el 80,2 por ciento. El 87,1 por ciento de las mujeres tuvieron como factor de riesgo la inestabilidad en la pareja sexual, predominando las parejas con síntomas, para un 94 por ciento de las infectadas. Fue significativo que el 89,3 por ciento de las afectadas tuvieran antecedentes de infección de transmisión sexual; otro factor de riesgo importante fue el no uso del condón en el 73,1 por ciento de las mismas. Presentaron leucorrea el 70 por ciento de los casos.

An observational, cross-sectional, analytical study was carried out to determine the frequency of Chlamydia trachomatis and its associated factors in 298 sexually active women assisting the hospitals Comandante Faustino Pérez y Julio Alfonso Medina, of Matanzas, from June 2010 to June 2012, selecting 149 women from each hospital in a no randomized way. Chlamydiasis was diagnosed by CHLAMY-CHECK-1 test and other associated germs were diagnosed by vaginal exudates. Bivariate analyses were performed, estimating relation between chlamydiasis and selected variables. We used contingency charts to analyze the risk calculating the Odd ration, with a confidence interval of 95 percent. For the significant statistic association we used Chi², being statistically significant when P value was less than 0,05. 72,5 percent of the studied women were infected, being the age group of less than 24 years the one with higher incidence (85,8 percent). Starting having sexual relationships before the age of 18 was predominant, with 80,2 percent. 87,1 percent of the women showed instability in sexual partnership as a risk factor, predominating symptomatic partners in 94 percent of the infected one. It was significant that 89,3 percent of the affected patients had antecedents of sexually transmitted infections; another important risk factor was that 73, 1 percent of them do not use condoms. 70 percent of the cases had leucorrhea(AU)

Factores asociados a la infección por Chlamydia trachomatis en mujeres atendidas en dos hospitales provinciales. Matanzas 2010-2012 / Factors associated to Chlamydia trachomatis infection in women attended in two provincial hospitals. Matanzas 2010-2013

Se realizó un estudio observacional analítico transversal, para determinar la frecuencia de Chlamydia trachomatis y factores asociados en 298 mujeres sexualmente activas en los hospitales Comandante Faustino Pérez y Julio Alfonso Medina, de Matanzas, desde junio del 2010 a 2012, seleccionándose no aleatoriamente 149 mujeres de cada hospital. Se diagnosticó clamidiasis por el test-CHLAMY-CHECK-1 y otros gérmenes asociados por exudado vaginal. Se realizó análisis divariado, estimando relación entre clamidiasis y las variables seleccionadas. Se utilizó tablas de contingencias para análisis de riesgo calculándose el Odds ratio, con intervalos de confianza del 95 %. Para la asociación estadística significativa se utilizó el CHI², siendo estadísticamente significativa cuando el valor de P sea menor de 0,05. El 72,5 % de las mujeres estudiadas resultaron infectadas, siendo las menores de 24 años, con un 85,8 % las de mayor incidencia. El inicio de las relaciones sexuales antes de los 18 años predominó, presentándose en el 80,2 %. El 87,1 % de las mujeres tuvieron como factor de riesgo la inestabilidad en la pareja sexual, predominando las parejas con síntomas, para un 94 % de las infectadas. Fue significativo que el 89,3 % de las afectadas tuvieran antecedentes de infección de transmisión sexual; otro factor de riesgo importante fue el no uso del condón en el 73,1 % de las mismas. Presentaron leucorrea el 70 % de los casos.

An observational, cross-sectional, analytical study was carried out to determine the frequency of Chlamydia trachomatis and its associated factors in 298 sexually active women assisting the hospitals Comandante Faustino Pérez y Julio Alfonso Medina, of Matanzas, from June 2010 to June 2012, selecting 149 women from each hospital in a no randomized way. Chlamydiasis was diagnosed by CHLAMY-CHECK-1 test and other associated germs were diagnosed by vaginal exudates. Bivariate analyses were performed, estimating relation between chlamydiasis and selected variables. We used contingency charts to analyze the risk calculating the Odd ration, with a confidence interval of 95 %. For the significant statistic association we used Chi2, being statistically significant when P value was less than 0,05. 72,5 % of the studied women were infected, being the age group of less than 24 years the one with higher incidence (85, 8 %). Starting having sexual relationships before the age of 18 was predominant, with 80,2 %. 87,1 % of the women showed instability in sexual partnership as a risk factor, predominating symptomatic partners in 94 % of the infected one. It was significant that 89,3 % of the affected patients had antecedents of sexually transmitted infections; another important risk factor was that 73, 1 % of them do not use condoms. 70 % of the cases had leucorrhea.