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We present a custom CMOS IC with a buried double junction (BDJ) photodiode to detect and process the optical signal, eliminating the need for any off-chip optical filters. The on-chip signal processing circuitry improves the desired signal extraction from the optical background noise. Since the IC is manufactured using standard commercial fabrication processes with no post-processing necessary, the system can ultimately be low cost to fabricate. Additionally, because of the CMOS integration, it will consume little power when operating, and even less during stand-by.

Delays often occur between CLSI and FDA revisions of antimicrobial interpretive criteria. Using our Regional Healthcare Ecosystem Analyst (RHEA) simulation model, we found that the 32-month delay in changing carbapenem-resistant Enterobacteriaceae (CRE) breakpoints might have resulted in 1,821 additional carriers in Orange County, CA, an outcome that could have been avoided by identifying CRE and initiating contact precautions. Policy makers should aim to minimize the delay in the adoption of new breakpoints for antimicrobials against emerging pathogens when containment of spread is paramount; delays of

Background Even though human hookworm infection is highly endemic in many countries throughout the world, its global economic and health impact is not well known. Without a better understanding of hookworm’s economic burden worldwide, it is difficult for decision makers such as funders, policy makers, disease control officials, and intervention manufacturers to determine how much time, energy, and resources to invest in hookworm control. Methodology/Principle Findings We developed a computational simulation model to estimate the economic and health burden of hookworm infection in every country, WHO region, and globally, in 2016 from the societal perspective. Globally, hookworm infection resulted in a total 2,126,280 DALYs using 2004 disability weight estimates and 4,087,803 DALYs using 2010 disability weight estimates (excluding cognitive impairment outcomes). Including cognitive impairment did not significantly increase DALYs worldwide. Total productivity losses varied with the probability of anemia and calculation method used, ranging from $7.5 billion to $138.9 billion annually using gross national income per capita as a proxy for annual wages and ranging from $2.5 billion to $43.9 billion using minimum wage as a proxy for annual wages. Conclusion Even though hookworm is classified as a neglected tropical disease, its economic and health burden exceeded published estimates for a number of diseases that have received comparatively more attention than hookworm such as rotavirus. Additionally, certain large countries that are transitioning to higher income countries such as Brazil and China, still face considerable hookworm burden., Author Summary Our work quantifies the economic and health burden associated with hookworm infection by country, WHO region, and worldwide. We also evaluated the burden by age, various costing methodologies, and ran an extensive sensitivity analysis on key and debated parameters to determine the robustness of our model’s resulting estimates. We report the DALYs associated with hookworm infections with consequent health outcomes in 2016 and show the impact that varying disability weights and likelihoods of anemia have on the estimates. Additionally, our study identified potential targets for future studies and data collection. Our results provide important information for decision makers. Without a better understanding of the economic and health burden of hookworm worldwide and in different countries, it is difficult for decision makers such as funders, policy makers, disease control officials, and intervention manufacturers to determine how much time, energy, and resources to invest in hookworm control. Our results can also help decision makers know where hookworm should fall on their priority lists and allocate limited resources.

A recent trial showed that universal decolonization in adult intensive care units (ICUs) resulted in greater reductions in all bloodstream infections and clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) than either targeted decolonization or screening and isolation. Since regional health-care facilities are highly interconnected through patient-sharing, focusing on individual ICUs may miss the broader impact of decolonization. Using our Regional Healthcare Ecosystem Analyst simulation model of all health-care facilities in Orange County, California, we evaluated the impact of chlorhexidine baths and mupirocin on all ICU admissions when universal decolonization was implemented for 25%, 50%, 75%, and 100% of ICU beds countywide (compared with screening and contact precautions). Direct benefits were substantial in ICUs implementing decolonization (a median 60% relative reduction in MRSA prevalence). When 100% of countywide ICU beds were decolonized, there were spillover effects in general wards, long-term acute-care facilities, and nursing homes resulting in median 8.0%, 3.0%, and 1.9% relative MRSA reductions at 1 year, respectively. MRSA prevalence decreased by a relative 3.2% countywide, with similar effects for methicillin-susceptible S. aureus. We showed that a large proportion of decolonization's benefits are missed when accounting only for ICU impact. Approximately 70% of the countywide cases of MRSA carriage averted after 1 year of universal ICU decolonization were outside the ICU.

Background— Radial artery access for coronary angiography and interventions has been promoted for reducing hemostasis time and vascular complications compared with femoral access, yet it can take longer to perform and is not always successful, leading to concerns about its cost. We report a cost–benefit analysis of radial catheterization based on results from a systematic review of published randomized controlled trials. Methods and Results— The systematic review added 5 additional randomized controlled trials to a prior review, for a total of 14 studies. Meta-analyses, following Cochrane procedures, suggested that radial catheterization significantly increased catheterization failure (OR, 4.92; 95% CI, 2.69–8.98), but reduced major complications (OR, 0.32; 95% CI, 0.24–0.42), major bleeding (OR, 0.39; 95% CI, 0.27–0.57), and hematoma (OR, 0.36; 95% CI, 0.27–0.48) compared with femoral catheterization. It added approximately 1.4 minutes to procedure time (95% CI, −0.22 to 2.97) and reduced hemostasis time by approximately 13 minutes (95% CI, −2.30 to −23.90). There were no differences in procedure success rates or major adverse cardiovascular events. A stochastic simulation model of per-case costs took into account procedure and hemostasis time, costs of repeating the catheterization at the alternate site if the first catheterization failed, and the inpatient hospital costs associated with complications from the procedure. Using base-case estimates based on our meta-analysis results, we found the radial approach cost $275 (95% CI, −$374 to −$183) less per patient from the hospital perspective. Radial catheterization was favored over femoral catheterization under all conditions tested. Conclusions— Radial catheterization was favored over femoral catheterization in our cost–benefit analysis.

Staphylococcus aureus infections are a substantial problem for hemodialysis patients. Several vaccine candidates are currently under development, with hemodialysis patients being one possible target population. To determine the potential economic value of a Staphylococcus aureus vaccine among hemodialysis patients, we developed a Markov decision analytic computer simulation model. When Staphylococcus aureus colonization prevalence was 1%, the incremental cost-effectiveness ratio (ICER) of vaccination was ≤$25,217/quality-adjusted life year (QALY). Vaccination became more cost-effective, as colonization prevalence, vaccine efficacy, or vaccine protection duration increased or vaccine cost decreased. Even at 10% colonization prevalence, a 25% efficacious vaccine costing $100 prevented 29 infections, 21 infection-related hospitalizations, and 9 inpatient deaths per 1,000 vaccinated HD patients. Our results suggest that a Staphylococcus aureus vaccine would be cost-effective (i.e., ICERs ≤$50,000/QALY) among hemodialysis patients over a wide range of Staphylococcus aureus prevalence, vaccine costs and efficacies, and vaccine protection durations and delineate potential target parameters for such a vaccine.

Background MDROs can spread between hospitals, nursing homes (NH), and long-term acute care facilities (LTACs) via shared patients. SHIELD OC is a regional decolonization collaborative involving 38 of 104 countywide adult facilities identified by their high degree of direct and indirect patient sharing with one another. We report baseline MDRO prevalence in these facilities. Methods Adult patients in 38 facilities (17 hospitals, 18 NHs, 3 LTACs) underwent point-prevalence screening between September 2016–April 2017 for MRSA, VRE, ESBL, and CRE using nares, skin (axilla/groin), and peri-rectal swabs. In NHs and LTACs, residents were randomly selected until 50 sets of swabs were obtained. Swabbing in hospitals involved all patients in contact precautions. An additional set of swabs were also performed for all LTAC admissions from November 2016–February 2017. Results The overall prevalence of any MDRO among patients was 64% (44%–88%) in NHs, 80% (range 72%–86%) in LTACs, and 64% (54–84%) in hospitals (contact precaution patients) (Table 1). Only 25%, 64%, and 81% of patients were already known to harbor an MDRO in NHs, LTACs, and hospitals, respectively. Known MDRO patients also harbored another MDRO 49%, 63%, and 34% of the time for NHs, LTACs, and hospitals, respectively. In LTACs, MDRO point prevalence was 38% higher than the usual admission prevalence (65% higher for MRSA, 34% higher for VRE, 95% higher for ESBL, and 50% higher for CRE). Conclusion MDRO carriage in highly inter-connected NHs and LTACs was widespread, rivaling that found in hospitalized patients on contact precautions. MRSA, VRE, and ESBL carriage far outnumbered CRE carriage. A history of MDRO was insensitive for identifying MDRO carriers, and many patients carried multiple MDROs. The extensive MDRO burden and transmission in long-term care settings suggests that regional MDRO prevention efforts must include MDRO control in long-term care facilities. Disclosures R. D. Singh, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; J. A. McKinnell, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L. G. Miller, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; K. Kleinman, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L. Heim, Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; T. D. Dutciuc, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; M. Estevez, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; G. Gussin, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; L’Oreal: Consultant, Consulting fee; J. Chang, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; E. M. Peterson, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; B. Y. Lee, GSK: Consultant, Consulting fee; R. A. Weinstein, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; OpGen Company: Study support, Provided services at no charge; M. K. Hayden, Sage Products: Receipt of contributed product, Sage is contributing product to healthcare facilities participating in a regional collaborative on which I am a co-investigator. Neither I nor my hospital receive product.; Clorox: Receipt of contributed product, Research support; CDC: Grant Investigator and Receipt of contributed product, Research grant; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; OpGen Company: Study support, Provided services at no charge for studies; S. K. Gohil, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Park, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Tam, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; R. Saavedra, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. Yamaguchi, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; H. Custodio, Xttrium Laboratories: Study coordination, Conducting studies in healthcare facilities that are receiving contributed product; Sage Products: Study coordination, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Study coordination, Conducting studies in healthcare facilities that are receiving contributed product; J. Nguyen, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; T. Tjoa, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; J. He, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; 3M: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; M. H. Coady, Sage Products: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; Clorox: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; R. Platt, Sage Products: Receipt of contributed product, Conducting clinical studies in which participating healthcare facilities are receiving contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting clinical studies in which participating healthcare facilities are receiving contributed product; Clorox: Receipt of contributed product, Conducting clinical studies in which participating healthcare facilities are receiving contributed product; receive research funds from Clorox, but Clorox has no role in the design; Molnlycke: Receipt of contributed product, Conducting studies in healthcare facilities that are receiving contributed product; S. S. Huang, Sage Products: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Xttrium Laboratories: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Clorox: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; 3M: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product; Molnlycke: Receipt of contributed product, Conducting studies in which participating healthcare facilities are receiving contributed product (no contribution in submitted abstract), Participating healthcare facilities in my studies received contributed product

An aerosol jet printer is used to precisely control the deposition in 25 nm increments of poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) on an oxygen plasma-treated Ni (O2-Ni) electrode to modify its work function. As revealed by Kelvin probe measurements, the effective work function of the O2-Ni electrode is dependent on the thickness of the PEDOT:PSS coating. By precisely controlling the coating thickness, the effective work function of metal electrodes in polymer-based photodetectors can be tailored for improved device performance. This is verified by demonstrating a threefold increase in the photoresponse of a polymer-based Schottky barrier infrared photodetector.

Background The World Health Organization’s 2020 Goals for Chagas disease include access to antiparasitic treatment and care of all infected/ill patients. Policy makers need to know the economic value of identifying and treating patients earlier. However, the economic value of earlier treatment to cure and prevent the Chagas’ spread remains unknown. Methods We expanded our existing Chagas disease transmission model to include identification and treatment of Chagas disease patients. We linked this to a clinical and economic model that translated chronic Chagas disease cases into health and economic outcomes. We evaluated the impact and economic outcomes (costs, cost-effectiveness, cost-benefit) of identifying and treating different percentages of patients in the acute and indeterminate disease states in a 2,000-person village in Yucatan, Mexico. Results In the absence of early treatment, 50 acute and 22 new chronic cases occurred over 50 years. Identifying and treating patients in the acute stage averted 0.5–5.4 acute cases, 0.6–5.5 chronic cases, and 0.6–10.8 disability-adjusted life years (DALYs), saving $694-$7,419 and $6,976-$79,950 from the third-party payer and societal perspectives, respectively. Treating in the indeterminate stage averted 2.2–4.9 acute cases, 6.1–12.8 chronic cases, and 11.7–31.1 DALYs, saving $7,666-$21,938 from the third-party payer perspective and $90,530-$243,068 from the societal perspective. Treating patients in both stages averted ≤9 acute cases and ≤15 chronic cases. Identifying and treating patients early was always economically dominant compared to no treatment. Identifying and treating patients earlier resulted in a cumulative cost-benefit of $7,273-$224,981 at the current cost of identification and treatment. Conclusions Even when identifying and treating as little as 5% of cases annually, treating Chagas cases in the acute and indeterminate stages reduces transmission and provides economic and health benefits. This supports the need for improved diagnostics and access to safe and effective treatment., Author summary The World Health Organization’s 2020 Goals for Chagas disease include access to antiparasitic treatment and care of all infected/ill patients. Policy makers need to know the economic value of identifying and treating patients earlier and what can be invested. We evaluated the impact and economic outcomes (costs, cost-effectiveness, cost-benefit) of identifying and treating different percentages of Chagas patients in the acute and indeterminate disease states using a transmission model linked to a clinical and economic outcomes model. Identifying and treating Chagas cases in the acute and indeterminate stages could result in up to an 18.0% relative reduction in transmission events as well as a 68.2% relative reduction in new chronic cases over 50 years compared to no treatment and was always economically dominant compared to no treatment. Identifying and treating Chagas disease in its earlier stages would reduce transmission and result in better health outcomes and cost-savings. In fact, the cost-savings would outweigh the cost of treating, meaning that earlier treatment may pay for itself. This supports the need for improved diagnostics and access to effective treatment.

Das Schultereckgelenk ist masgeblich an der Kraftubertragung zwischen oberer Extremitat und Thorax beteiligt. Aufgrund seiner anatomischen Besonderheiten und extremen mechanischen Beanspruchungen unterliegt es fruhzeitigen degenerativen Veranderungen, die zunachst magnetresonanztomographisch, spater auch nativradiologisch erfasst werden konnen. Therapeutisch wegweisend ist daher die klinische Untersuchung, um symptomatische von asymptomatischen Schultereckgelenkarthrosen zu unterscheiden. Differenzialdiagnostisch mussen begleitende Pathologien im Subakromialraum oder Glenohumeralgelenk abgegrenzt werden. Hierzu werden lokale Infiltrationstests angewendet. Scheitern konservative Therapiemasnahmen, ist das Ziel der operativen Behandlung die Entlastung des Gelenks mit Resektion arthrotischer Anteile und Behebung des schmerzhaften Kontakts der knochernen Gelenkpartner unter weitestgehender Aufrechterhaltung der ligamentaren Stabilitat. Hierbei hat sich die arthroskopische Resektion der lateralen Klavikula als ein Standardverfahren etabliert. Der vorliegende Artikel stellt diagnostische Masnahmen, operative Techniken und deren Resultate sowie potenzielle Komplikationen vor.

Background The 2020 Sustainable Development goals call for 100% certified interruption or control of the three main forms of Chagas disease transmission in Latin America. However, how much will achieving these goals to varying degrees control Chagas disease; what is the potential impact of missing these goals and if they are achieved, what may be left? Methods We developed a compartmental simulation model that represents the triatomine, human host, and non-human host populations and vector-borne, congenital, and transfusional T. cruzi transmission between them in the domestic and peridomestic settings to evaluate the impact of limiting transmission in a 2,000 person virtual village in Yucatan, Mexico. Results Interruption of domestic vectorial transmission had the largest impact on T. cruzi transmission and prevalence in all populations. Most of the gains were achieved within the first few years. Controlling vectorial transmission resulted in a 46.1–83.0% relative reduction in the number of new acute Chagas cases for a 50–100% interruption in domestic vector-host contact. Only controlling congenital transmission led to a 2.4–8.1% (30–100% interruption) relative reduction in the total number of new acute cases and reducing only transfusional transmission led to a 0.1–0.3% (30–100% reduction). Stopping all three forms of transmission resulted in 0.5 total transmission events over five years (compared to 5.0 with no interruption); interrupting all forms by 30% resulted in 3.4 events over five years per 2,000 persons. Conclusions While reducing domestic vectorial, congenital, and transfusional transmission can successfully reduce transmission to humans (up to 82% in one year), achieving the 2020 goals would still result in 0.5 new acute cases per 2,000 over five years. Even if the goals are missed, major gains can be achieved within the first few years. Interrupting transmission should be combined with other efforts such as a vaccine or improved access to care, especially for the population of already infected individuals., Author summary While World Health Organization’s (WHO) London Declaration on Neglected Tropical Diseases has proposed 2020 goals of 100% certified interruption or control of the three main forms of Chagas disease transmission (vectorial, congenital, and transfusional) in Latin America, the impact of achieving and/or missing these goals is not known. Policy makers need to know the potential impact of missing these goals on disease incidence and prevalence. If they are achieved, decision makers need to know what may be left to adequately inform policies and the future for controlling Chagas disease. Our compartmental simulation model suggests that achieving the 2020 goals would still result in 25 new acute cases per 100,000 over five years. However, substantial gains could still be garnered within one year by interrupting transmission to varying degrees, so the goals should still be pursued.

GPS (Global Positioning System) technology is widely used for positioning applications. Many of them have high requirements with respect to precision, reliability or fast product delivery, but usually not all at the same time as it is the case for early warning applications. The tasks for the GPS-based components within the GITEWS project (German Indonesian Tsunami Early Warning System, Rudloff et al., 2009) are to support the determination of sea levels (measured onshore and offshore) and to detect co-seismic land mass displacements with the lowest possible latency (design goal: first reliable results after 5 min). The completed system was designed to fulfil these tasks in near real-time, rather than for scientific research requirements. The obtained data products (movements of GPS antennas) are supporting the warning process in different ways. The measurements from GPS instruments on buoys allow the earliest possible detection or confirmation of tsunami waves on the ocean. Onshore GPS measurements are made collocated with tide gauges or seismological stations and give information about co-seismic land mass movements as recorded, e.g., during the great Sumatra-Andaman earthquake of 2004 (Subarya et al., 2006). This information is important to separate tsunami-caused sea height movements from apparent sea height changes at tide gauge locations (sensor station movement) and also as additional information about earthquakes' mechanisms, as this is an essential information to predict a tsunami (Sobolev et al., 2007). This article gives an end-to-end overview of the GITEWS GPS-component system, from the GPS sensors (GPS receiver with GPS antenna and auxiliary systems, either onshore or offshore) to the early warning centre displays. We describe how the GPS sensors have been installed, how they are operated and the methods used to collect, transfer and process the GPS data in near real-time. This includes the sensor system design, the communication system layout with real-time data streaming, the data processing strategy and the final products of the GPS-based early warning system components.

Biopolymers, such as deoxyribonucleic acid-hexadecyltrimethyl ammonium chloride (DNA-CTMA) and bovine serum albumin-polyvinyl alcohol (BSA-PVA), were studied using a novel capacitive test structure. A variety of external electrical stimuli were applied, including a low frequency alternating current signal and a rf/microwave frequency signal combined with a DC bias. The dynamic responses of the DNA-based biopolymer to the external stimuli are presented in this paper. The electrical transport measurements support the space-charge-limited conduction and the low frequency capacitance–voltage (CV) measurements showed large depletion layer capacitance at the Au –biopolymer interface, at 20 Hz, and the capacitance approaching bulk values at 1 MHz. Electric force microscopy (EFM) was utilized for visualization of charge dynamics and to examine the effect of DC bias combined with an AC signal. Ionic charges in the DNA-CTMA system seem to be responsible for the dynamic response to the various external electrical stimuli.

BACKGROUND: Preterm infants with very low birth weight > 1500 g (VLBW) have a higher risk of developmental disorders. In addition to the common estimation of the mean intelligence values, we studied the distribution of intelligence at preschool age in VLBW infants and the risk factors influencing this distribution. PATIENTS AND METHODS: A prospective cohort study of 277 VLBW infants > 32 weeks born in 1991-1995 and treated according to a standardized regimen in one Perinatal Center was carried out, including measurement of intelligence (Kaufman-Assessment Battery for Children) at age 5. Statistical methods employed were: explorative data analysis, correlation, χ 2 - and t-tests; the tested variables were: small for gestational age (> third percentile), perinatal acidemia (umbilical arterial pH > 7.10), perinatal hypoxia (BE > - 10), hypothermia (> 36 °C), hypoglycemia after the first day of life (> 30 mg / dL), bronchopulmonary dysplasia (FiO 2 32 weeks (60 % follow-up rate) was similar to a symmetrical Gaussian bell curve. The intelligence increased very slightly with birth weight (Pearson correlation: 0.172; p = 0.045) and was significantly lower in children with hypoglycemia after the first day of life (- 13.35; 95 % confidence interval: - 20.08 to - 6.63; p = 0.002), hyperexcitability at discharge (- 16.28; 95 % confidence interval: - 25.26 to - 7.31; p = 0.005), and bronchopulmonary dysplasia (- 7.00; 95 % confidence interval - 11.71 to - 2.29; p = 0.039). CONCLUSIONS: At preschool age, the intelligence of VLBW infants is normally distributed and corre-lates only slightly with the very low birth weight. Hypoglycemia after the first day of life and bronchopulmonary dysplasia are risk factors for lower intelligence. Hyperexcitability at discharge seemed to represent a promising prognostic factor for a later intelligence reduction.

A new capacitive test structure, containing a parallel plate capacitor with coplanar waveguide feed lines, was used for microwave characterization of biopolymers for the first time. Microwave dielectric properties were obtained for the biopolymers as a function of dc bias and temperature by performing on-wafer microwave measurements. Dielectric tunability was observed with applied dc bias in the biopolymers tested. © 2007 Wiley Periodicals, Inc. Microwave Opt Technol Lett 49: 1261–1265, 2007; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.22474

Background Although mass drug administration (MDA) has helped reduce morbidity attributed to soil-transmitted helminth infections in children, its limitations for hookworm infection have motivated the development of a human hookworm vaccine to both improve morbidity control and ultimately help block hookworm transmission leading to elimination. However, the potential economic and epidemiologic impact of a preventive vaccine has not been fully evaluated. Methods We developed a dynamic compartment model coupled to a clinical and economics outcomes model representing both the human and hookworm populations in a high transmission region of Brazil. Experiments simulated different implementation scenarios of MDA and vaccination under varying circumstances. Results Considering only intervention costs, both annual MDA and vaccination were highly cost-effective (ICERs ≤$790/DALY averted) compared to no intervention, with vaccination resulting in lower incremental cost-effectiveness ratios (ICERs ≤$444/DALY averted). From the societal perspective, vaccination was economically dominant (i.e., less costly and more effective) versus annual MDA in all tested scenarios, except when vaccination was less efficacious (20% efficacy, 5 year duration) and MDA coverage was 75%. Increasing the vaccine's duration of protection and efficacy, and including a booster injection in adulthood all increased the benefits of vaccination (i.e., resulted in lower hookworm prevalence, averted more disability-adjusted life years, and saved more costs). Assuming its target product profile, a pediatric hookworm vaccine drastically decreased hookworm prevalence in children to 14.6% after 20 years, compared to 57.2% with no intervention and 54.1% with MDA. The addition of a booster in adulthood further reduced the overall prevalence from 68.0% to 36.0% and nearly eliminated hookworm infection in children. Conclusion Using a human hookworm vaccine would be cost-effective and in many cases economically dominant, providing both health benefits and cost-savings. It could become a key technology in effecting control and elimination efforts for hookworm globally.

Background Chagas disease (caused by Trypanosoma cruzi) is the most important neglected tropical disease (NTD) in Latin America, infecting an estimated 5.7 million people in the 21 countries where it is endemic. It is one of the NTDs targeted for control and elimination by the 2020 London Declaration goals, with the first goal being to interrupt intra-domiciliary vector-borne T. cruzi transmission. A key question in domestic T. cruzi transmission is the role that synanthropic animals play in T. cruzi transmission to humans. Here, we ask, (1) do synanthropic animals need to be targeted in Chagas disease prevention policies?, and (2) how does the presence of animals affect the efficacy of vector control? Methods We developed a simple mathematical model to simulate domestic vector-borne T.cruzi transmission and to specifically examine the interaction between the presence of synanthropic animals and effects of vector control. We used the model to explore how the interactions between triatomine bugs, humans and animals impact the number and proportion of T. cruzi-infected bugs and humans. We then examined how T. cruzi dynamics change when control measures targeting vector abundance are introduced into the system. Results We found that the presence of synanthropic animals slows the speed of T. cruzi transmission to humans, and increases the sensitivity of T. cruzi transmission dynamics to vector control measures at comparable triatomine carrying capacities. However, T. cruzi transmission is amplified when triatomine carrying capacity increases with the abundance of syntathoropic hosts. Conclusions Our results suggest that in domestic T. cruzi transmission scenarios where no vector control measures are in place, a reduction in synanthropic animals may slow T. cruzi transmission to humans, but it would not completely eliminate transmission. To reach the 2020 goal of interrupting intra-domiciliary T. cruzi transmission, it is critical to target vector populations. Additionally, where vector control measures are in place, synanthropic animals may be beneficial.

An ultraviolet (UV) photodetector utilizing an inkjet printable , UV photoconducting biopolymer was fabricated and the performance of the photodetector was characterized for varying thickness layers of the biopolymer. The biopolymer was formed of deoxyribonucleic acid (DNA), the Clevios P formulation of poly(3,4-ethylenedioxythiophene)- poly(styrenesulfonate) (PEDOT:PSS), and hexadecyltrimethyl-ammonium chloride (CTMA); this was then combined with phenyl-C61-butyric acid methyl (PCBM) to form the printable, UV photoconducting biopolymer. Using a 260-nm source, the highest measured responsivity of the photodetectors is 1.2 mA/W at 20 V bias.

Ein erster Einstieg in die Suche nach einer genauen Definition von „Klimawandel“ ist recht unkompliziert vollzogen: Umweltveranderungen jedweder Art sind naturwissenschaftlich beobachtbare Erscheinungen, und so lasst sich auch der Klimawandel anhand physikalischer Gesetzmasigkeiten und meteorologischer oder geologischer Forschungserkenntnisse naher beschreiben. Klimatische Veranderungen konnen sich aus Anderungen der Energiebilanz des Planeten Erde unter Einwirkung der Sonne ergeben. Grundsatzlich besteht ein Gleichgewicht zwischen der auf die Erdoberflache einstrahlenden und der von ihr reflektierten Sonnenwarme.

In der geografischen Alltagswahrnehmung der Burger Mitteleuropas konnten die Polarregionen der Erde bisher als „Randerscheinungen“ im wahrsten Sinne des Wortes charakterisiert werden. Dies ist mehr als nur ein Wortspiel: Tatsachlich ist etwa in Deutschland ihre tagespolitische Relevanz im Allgemeinen so gering, dass die Nord- und Sudpolareale auf den Weltkarten der abendlichen Nachrichtensendungen zumeist gar nicht erst verzeichnet sind. Was aber macht die Arktis jenseits der Tatsache, dass sie in der menschlichen Wahrnehmung – wenn uberhaupt – nur als oberer Rand der Weltkarte, oder in bildlicher Vorstellung als lebensfeindliche Eiswuste existiert, geografisch und historisch aus? Bereits ihre exakte Ortsbestimmung ist ein wenig problematisch, da abhangig von der jeweiligen wissenschaftlichen Disziplin gleich mehrere Definitionen moglich sind.

Dieses Buch hatte das Ziel, die Implikationen der derzeitigen Situation in der Arktis fur das Verstandnis des Verhaltnisses von Klimawandel und Sicherheit herauszuarbeiten. Wie eingangs definiert, ist sein Selbstverstandnis dabei ein sicherheitspolitisch fokussiertes. Daher mag es ein wenig uberraschen, an seinem Ende zu dem Schluss zu kommen, dass der behandelte Untersuchungsgegenstand von den beteiligten Akteuren bislang nur in recht begrenztem Ausmas uberhaupt als ein sicherheitspolitisches Problem wahrgenommen wird. In Bezug auf das Konfliktrisiko im Hohen Norden hatte die hiesige Auswertung der Arktisstrategien zunachst den Nebeneffekt, dass die grundsatzliche Unwahrscheinlichkeit einer militarischen Eskalation zwischenstaatlicher arktischer Spannungen, die zuvor bereits andere Autoren betonten, einmal mehr eindeutig bestatigt werden konnte.

Author(s): Slayton, Rachel B; Toth, Damon; Lee, Bruce Y; Tanner, Windy; Bartsch, Sarah M; Khader, Karim; Wong, Kim; Brown, Kevin; McKinnell, James A; Ray, William; Miller, Loren G; Rubin, Michael; Kim, Diane S; Adler, Fred; Cao, Chenghua; Avery, Lacey; Stone, Nathan TB; Kallen, Alexander; Samore, Matthew; Huang, Susan S; Fridkin, Scott; Jernigan, John A | Abstract: BackgroundTreatments for health care-associated infections (HAIs) caused by antibiotic-resistant bacteria and Clostridium difficile are limited, and some patients have developed untreatable infections. Evidence-supported interventions are available, but coordinated approaches to interrupt the spread of HAIs could have a greater impact on reversing the increasing incidence of these infections than independent facility-based program efforts.MethodsData from CDC's National Healthcare Safety Network and Emerging Infections Program were analyzed to project the number of health care-associated infections from antibiotic-resistant bacteria or C. difficile both with and without a large scale national intervention that would include interrupting transmission and improved antibiotic stewardship. As an example, the impact of reducing transmission of one antibiotic-resistant infection (carbapenem-resistant Enterobacteriaceae [CRE]) on cumulative prevalence and number of HAI transmission events within interconnected groups of health care facilities was modeled using two distinct approaches, a large scale and a smaller scale health care network.ResultsImmediate nationwide infection control and antibiotic stewardship interventions, over 5 years, could avert an estimated 619,000 HAIs resulting from CRE, multidrug-resistant Pseudomonas aeruginosa, invasive methicillin-resistant Staphylococcus aureus (MRSA), or C. difficile. Compared with independent efforts, a coordinated response to prevent CRE spread across a group of inter-connected health care facilities resulted in a cumulative 74% reduction in acquisitions over 5 years in a 10-facility network model, and 55% reduction over 15 years in a 102-facility network model.ConclusionsWith effective action now, more than half a million antibiotic-resistant health care-associated infections could be prevented over 5 years. Models representing both large and small groups of interconnected health care facilities illustrate that a coordinated approach to interrupting transmission is more effective than historical independent facilitybased efforts.Implications for public healthPublic health-led coordinated prevention approaches have the potential to more completely address the emergence and dissemination of these antibiotic-resistant organisms and C. difficile than independent facility-based efforts.

OBJECTIVE To explore the economic impact to a hospital of universal methicillin-resistant Staphylococcus aureus (MRSA) screening. METHODS We used a decision tree model to estimate the direct economic impact to an individual hospital of starting universal MRSA screening and contact precautions. Projected costs and benefits were based on literature-derived data. Our model examined outcomes of several strategies including non-nares MRSA screening and comparison of culture versus polymerase chain reaction-based screening. RESULTS Under baseline conditions, the costs of universal MRSA screening and contact precautions outweighed the projected benefits generated by preventing MRSA-related infections, resulting in economic costs of $104,000 per 10,000 admissions (95% CI, $83,000-$126,000). Cost-savings occurred only when the model used estimates at the extremes of our key parameters. Non-nares screening and polymerase chain reaction-based testing, both of which identified more MRSA-colonized persons, resulted in more MRSA infections averted but increased economic costs of the screening program. CONCLUSIONS We found that universal MRSA screening, although providing potential benefit in preventing MRSA infection, is relatively costly and may be economically burdensome for a hospital. Policy makers should consider the economic burden of MRSA screening and contact precautions in relation to other interventions when choosing programs to improve patient safety and outcomes.

The present paper explores whether the shape of long bone shafts can be explained as a mere result of mechano-adapation. A computer simulation study was conducted in order to investigate adaptation processes of bone-like structures under load patterns comparable to those acting on the diaphysis of long bones. The aim of the study was to have a deeper look into the relationship between typical loading patterns and resulting bone shape and structure. The simulations are based on a mechanistic model approach for mechano-transduction and bone transformation. Results of the simulations are that axial torsion around the long axis is important for the evolvement and maintenance of tube-like structures. Of note such structures can form from a variety of starting geometries, provided that axial torsion is present. The selection of the set-point parameter for the regulation of load adapted bone transformation has an impact on the final structure as well. In conclusion, the present study confirms the mechanical environment’s potential to generate shaft-like structures and demonstrates the respective boundary conditions.

Economic and financing studies are particularly important for decision-making when resources are scarce or considerably limited. This is the case for neglected tropical diseases (NTDs). In fact, the definition of NTDs is an economic one. The shortage of resources for NTD control may be due in large part to the fact that the burden of NTDs and economic value of control measures have not been fully characterized. A number of economic study methodologies are available: cost of illness can quantify the extent, magnitude, and change of a problem; cost of intervention studies can outline the feasibility and guide the design of a policy or intervention; and cost-benefit, cost-effectiveness, and return-on-investment studies can determine the potential value of different interventions and policies. NTDs have unique characteristics that require special consideration in such analyses. Hence, approaches used for other diseases may need modifications to capture the full impact of NTDs. While the existing literature has made important findings, there is a need for substantially more work, as many NTDs and their associated interventions and policies require more evaluation. With increasing work in this area, NTDs may not be as 'neglected' in the future as they are now.

As the most recent outbreak of Ebola virus disease (EVD) in West Africa continues to grow since its initial recognition as a Public Health Emergency of International Concern, an unanswered question is what is the cost of a case of Ebola? Understanding this cost will help decision makers better understand the impact of each case of EVD, benchmark this against that of other diseases, prioritize which cases may require response, and begin to estimate the cost of Ebola outbreaks. To date, the scientific literature has not characterized this cost per case. Therefore, we developed a mathematical model to estimate the cost of an EVD case from the provider and societal perspectives in the three most affected countries of Guinea, Liberia, and Sierra Leone. Our model estimates the total societal cost of an EVD case with full recovery ranges from $480 to $912, while that of an EVD case not surviving ranges from $5929 to $18 929, varying by age and country. Therefore, as of 10 December 2014, the estimated total societal costs of all reported EVD cases in these three countries range from $82 to potentially over $356 million.

Die militarische Prasenz der Kustenstaaten in der Arktis hat seit der Jahrtausendwende wieder zugenommen. Verstarkte Prasenz heist aber nicht gleich Aggression. Vier Aspekte relativieren ihre Bedeutung.

Eisruckgang und globale Rohstoffpreise werden weiterhin das Interesse an der Arktis unmittelbar bestimmen. Politisch ist die Region jedoch stabil. Die Institutionen der Arktis sind in der Lage, die menschliche Aktivitat vor Ort friedlich und verbindlich zu regeln. Der Klimawandel wird den arktischen Naturraum tiefgreifend und wahrscheinlich unumkehrbar verandern.

In der Arktis schreitet der Klimawandel doppelt so schnell und doppelt so intensiv wie an anderen Orten der Welt voran. Vermutlich bis zur Mitte des 21. Jahrhunderts wird das Polarmeer im Sommer annahernd eisfrei sein.

Die Arktis ist vermutlich reich an verschiedenen begehrten Ressourcen. Ihre rentable Nutzbarkeit ist jedoch nicht vorprogrammiert, sondern abhangig von weltwirtschaftlichen Entwicklungen. Der hohe Erschliesungsaufwand stimuliert bislang statt etwaiger Konflikte viel eher die Bereitschaft der Interessenten zur Kooperation.

OBJECTIVETo explore the economic impact to a hospital of universal methicillin-resistantStaphylococcus aureus(MRSA) screening.METHODSWe used a decision tree model to estimate the direct economic impact to an individual hospital of starting universal MRSA screening and contact precautions. Projected costs and benefits were based on literature-derived data. Our model examined outcomes of several strategies including non-nares MRSA screening and comparison of culture versus polymerase chain reaction–based screening.RESULTSUnder baseline conditions, the costs of universal MRSA screening and contact precautions outweighed the projected benefits generated by preventing MRSA-related infections, resulting in economic costs of $104,000 per 10,000 admissions (95% CI, $83,000–$126,000). Cost-savings occurred only when the model used estimates at the extremes of our key parameters. Non-nares screening and polymerase chain reaction–based testing, both of which identified more MRSA-colonized persons, resulted in more MRSA infections averted but increased economic costs of the screening program.CONCLUSIONSWe found that universal MRSA screening, although providing potential benefit in preventing MRSA infection, is relatively costly and may be economically burdensome for a hospital. Policy makers should consider the economic burden of MRSA screening and contact precautions in relation to other interventions when choosing programs to improve patient safety and outcomes.Infect Control Hosp Epidemiol 2015;36(1): 2–13

Die tauende Arktis liefert scheinbar besten Stoff fur einen regelrechten Politkrimi. In der offentlichen Wahrnehmung der internationalen Arktispolitik fuhrt dies bisweilen zu Verzerrungen. Vier Fragen zur politischen Zukunft der Region stellen sich.

Seerecht, Arktischer Rat und eine Vielzahl von Einzelabkommen regeln territoriale Anspruche und menschliche Aktivitat in der Arktis verbindlich und bisher erfolgreich.

Die Arktis besteht uberwiegend aus Seegebiet. Ihre Entdeckung und Kartierung dauerte mehrere Jahrhunderte. Acht Staaten sind geografisch arktisch, jedoch nur funf von ihnen haben als Kustenstaaten des Nordpolarmeeres direkten Zugang zur zentralen Arktisregion.

Die russische Arktispolitik vermengt wirtschaftliches Kooperationsbedurfnis mit nationalistischer Symbolpolitik. Die Gefahr einer russischen Aggression in der Arktis ist gleichwohl gering.

Economic and financing studies are particularly important for decision-making when resources are scarce or considerably limited. This is the case for neglected tropical diseases (NTDs). In fact, the definition of NTDs is an economic one. The shortage of resources for NTD control may be due in large part to the fact that the burden of NTDs and economic value of control measures have not been fully characterized. A number of economic study methodologies are available: cost of illness can quantify the extent, magnitude, and change of a problem; cost of intervention studies can outline the feasibility and guide the design of a policy or intervention; and cost-benefit, cost-effectiveness, and return-on-investment studies can determine the potential value of different interventions and policies. NTDs have unique characteristics that require special consideration in such analyses. Hence, approaches used for other diseases may need modifications to capture the full impact of NTDs. While the existing literature has made important findings, there is a need for substantially more work, as many NTDs and their associated interventions and policies require more evaluation. With increasing work in this area, NTDs may not be as 'neglected' in the future as they are now.

The models of dislocation generation during plastic deformation are reviewed. The different types of dislocation generation, i.e. localized Frank–Read sources and multiplication by the double-cross slip mechanism, are observed in ceramic single crystals, semiconductors, metals, intermetallics and quasicrystals during in situ deformation in a high-voltage electron microscope. The results are discussed with respect to the ability of cross slip in different materials.

Icosahedral quasicrystals deform plastically by dislocation motion. The deformation behaviour can be modelled by simple equations of dislocation mobility, the damage of the quasicrystal structure and the kinetics of dislocation evolution, but fundamental questions are still discussed, like the mode of dislocation motion (glide or climb) and the role of phason defects.

Targeted Delivery of Antisense Oligodeoxynucleotides In Vivo by Means of Coated Cationic LipoplexesEarlier we reported on the massive uptake of liposomes surface-modified with negatively charged aconitylated albumin (Aco-HSA) by liver endothelial cells (EC) in vivo. In the present work we apply this principle for in vivo delivery of antisense oligodeoxynucleotides (ODN) to these cells by means of coated cationic lipoplexes (CCL) (). CCL were prepared by complexing ODN with the cationic lipid DOTAP and subsequent coating of the complex by neutral lipids including a lipid-anchored poly(ethylene glycol). Aco-HSA was covalently coupled.The Aco-HSA-CCLs were 160 nm in size, contained 1.03 ± 0.35 nmol ODN and 54 ± 18 µg Aco-HSA per µ mol total lipid. The Aco-HSA-CCLs were rapidly eliminated from plasma, 60% of the injected dose being recovered in the liver after 30 m. Within the liver, the EC accounted for two thirds of total liver uptake. Non-targeted CCLs were eliminated very slowly: after 30 m >90% of the pa...

This manuscript presents the design and fabrication process of an additively manufactured multilayer antenna. The antenna reported herein is an x-band 32 element patch array and is fabricated on a multi-curved surface that is typical of what one might find on an airborne platform. In this design all of the substrate materials and conductive elements (except the ground plane) are fully printed including the via fills. Peak gain for the antenna is greater than 15 dBi at 10.4 GHz and showed close adherence to modeling results.

Mathematical and computational modeling can transform decision making for neglected tropical diseases (NTDs) if the right model is used for the right question. Modeling can help better understand and address the complex systems involved in making decisions for NTD prevention and control. However, all models, modelers, and modeling are not the same. Thus, decision makers need to better understand if a particular model actually fits their needs. Here are a series of questions that a decision maker can ask when determining whether a model is right for him or her.

Objectives The Centers for Disease Control and Prevention considers carbapenem-resistant Enterobacteriaceae (CRE) an urgent public health threat; however, its economic burden is unknown. Methods We developed a CRE clinical and economics outcomes model to determine the cost of CRE infection from the hospital, third-party payer, and societal, perspectives and to evaluate the health and economic burden of CRE to the USA. Results Depending on the infection type, the median cost of a single CRE infection can range from $22 484 to $66 031 for hospitals, $10 440 to $31 621 for third-party payers, and $37 778 to $83 512 for society. An infection incidence of 2.93 per 100 000 population in the USA (9418 infections) would cost hospitals $275 million (95% CR $217–334 million), third-party payers $147 million (95% CR $129–172 million), and society $553 million (95% CR $303–1593 million) with a 25% attributable mortality, and would result in the loss of 8841 (95% CR 5805–12 420) quality-adjusted life years. An incidence of 15 per 100 000 (48 213 infections) would cost hospitals $1.4 billion (95% CR $1.1–1.7 billion), third-party payers $0.8 billion (95% CR $0.6–0.8 billion), and society $2.8 billion (95% CR $1.6–8.2 billion), and result in the loss of 45 261 quality-adjusted life years. Conclusions The cost of CRE is higher than the annual cost of many chronic diseases and of many acute diseases. Costs rise proportionally with the incidence of CRE, increasing by 2.0 times, 3.4 times, and 5.1 times for incidence rates of 6, 10, and 15 per 100 000 persons.

A complex of salmon milt deoxyribonucleic acid (DNA) and the cationic surfactant cetyltrimethylammonium (CTMA) forms an organic-soluble biomaterial that can be readily incorporated within an organically modified silane-based xerogel. The photoluminescence (PL) intensity and excited-state luminescence lifetime of tris(4,7′-diphenyl-1, 10′-phenanathroline) ruthenium(II) [(Ru(dpp)3]2+, a common O2 responsive luminophore, increases in the presence of DNA-CTMA within the xerogel. The increase in the [Ru(dpp)3]2+ excited-state lifetime in the presence of DNA-CTMA arises from DNA intercalation that attenuates one or more non-radiative processes, leading to an increase in the [Ru(dpp)3]2+ excited-state lifetime. Prospects for the use of these materials in an oxygen sensor are demonstrated.