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Direct-digital-synthesis (DDS)- based synthesizers are primarily known as agile frequency sources with low phase noise and excellent spurious performance. In many applications, they offer significant advantages over phase-locked-loop (PLL) synthesis [...]

The article reflects on emergence of globalization and digitalization as a challenge to the U.S. and the European alliance. It highlights the Third World to the geopolitics of Europe and Russia; and strategies related to vision of particularism in the U.S. It also mentions loss of strategic importance of Europe certified by none other than the president of the Council on Foreign Relations Richard Haass.

In this article, the author focuses on the Brexit, which is considered to be a sign of the growing tension between political and economic elites and their voters.

ABSTRACTInmates of Rikers Island jail potentially introduce Staphylococcus aureusinto New York State prisons upon transfer. In this study, methicillin-resistant Staphylococcus aureusisolates (n= 452), collected from infected inmates (2009 to 2013), were characterized. spatype t008 was the predominant clone identified, accounting for 82.3% of the isolates, with no evidence of mupirocin or chlorhexidine resistance.

The article discusses the views of former U.S. Assistant Secretary of State for European Affairs John Kornblum and professor Michael Mandelbaum on the expansion of the North Atlantic Treaty Organization (NATO). Kornblum explains the overall success of NATO enlargement as well as the possible consequences of the failure to expand NATO. On the other hand, Mandelbaum offers a look at the reasons for the hostile relationship between Russia and the West.

AbstractObjective:We describe an effort to reduce transmission of a multidrug-resistant Streptococcus pneumoniae(MDRSP) in a long-term-care facility (LTCF).Design:Longitudinal cross-sectional study.Setting:An LTCF in New York City with ongoing disease due to an MDRSP strain among residents with AIDS since a 1995 outbreak. The MDRSP outbreak strain was susceptible to vancomycin but not to other antimicrobials tested, including fluoroquinolones.Participants:Residents and staff members of the LTCF during 1999 through 2001.Intervention:Implementing standard infection control measures, and developing and implementing "enhanced standard" infection control measures, modified respiratory droplet prevention measures to reduce inter-resident transmission.Results:Before the intervention, nasopharyngeal carriage of the MDRSP outbreak strain was detected in residents with AIDS and residents with tracheostomies who were not dependent on mechanical ventilation. The prevalence of nasopharyngeal carriage of the MDRSP outbreak strain was 7.8% among residents who had AIDS and 14.6% among residents with tracheostomies. After training sessions on standard and enhanced standard infection control measures, the staff appeared to have good knowledge and practice of the infection control measures. After the intervention, new transmission among residents with tracheostomies was prevented; however, these residents were prone to persistent tracheal carriage and needed ongoing enhanced standard infection control measures. Ongoing transmission among residents with AIDS, a socially active group, was documented, although fewer cases of disease due to the outbreak strain occurred.Conclusions:Infection control contributed to less transmission of MDRSP in the LTCF. Additional strategies are needed to reduce transmission and carriage among certain resident populations.

AbstractObjectives:To characterize risk factors associated with pneumococcal disease and asymptomatic colonization during an outbreak of multidrug-resistant Streptococcus pneumoniae(MDRSP) among AIDS patients in a long-term–care facility (LTCF), evaluate the efficacy of antimicrobial prophylaxis in eliminating MDRSP colonization, and describe the emergence of fluoroquinolone resistance in the MDRSP outbreak strain.Design:Epidemiologic investigation based on chart review and characterization of SP strains by antimicrobial susceptibility testing and PFGE and prospective MDRSP surveillance.Setting:An 80-bed AIDS-care unit in an LTCF.Participants:Staff and residents on the unit.Results:From April 1995 through January 1996, 7 cases of MDRSP occurred. A nasopharyngeal (NP) swab survey of all residents (n = 65) and staff (n = 70) detected asymptomatic colonization among 6 residents (9%), but no staff. Isolates were sensitive only to rifampin, ofloxacin, and vancomycin. A 7-day course of rifampin and ofloxacin was given to eliminate colonization among residents: NP swab surveys at 1, 4, and 10 weeks after prophylaxis identified 1 or more colonized residents at each follow-up with isolates showing resistance to one or both treatment drugs. Between 1996 and 1999, an additional 6 patients were diagnosed with fluoroquinolone-resistant (FQ-R) MDRSP infection, with PFGE results demonstrating that the outbreak strain had persisted 3 years after the initial outbreak was recognized.Conclusions:Chemoprophylaxis likely contributed to the development of a FQ-R outbreak strain that continued to be transmitted in the facility through 1999. Long-term control of future MDRSP outbreaks should rely primarily on vaccination and strict infection control measures.

ABSTRACTFrom April 2000 to April 2001, 24 patients in intensive care units at Tisch Hospital, New York, N.Y., were infected or colonized by carbapenem-resistant Klebsiella pneumoniae. Pulsed-field gel electrophoresis identified a predominant outbreak strain, but other resistant strains were also recovered. Three representatives of the outbreak strain from separate patients were studied in detail. All were resistant or had reduced susceptibility to imipenem, meropenem, ceftazidime, piperacillin-tazobactam, and gentamicin but remained fully susceptible to tetracycline. PCR amplified a blaKPCallele encoding a novel variant, KPC-3, with a His(272)→Tyr substitution not found in KPC-2; other carbapenemase genes were absent. In the outbreak strain, KPC-3 was encoded by a 75-kb plasmid, which was transferred in vitro by electroporation and conjugation. The isolates lacked the OmpK35 porin but expressed OmpK36, implying reduced permeability as a cofactor in resistance. This is the third KPC carbapenem-hydrolyzing β-lactamase variant to have been reported in members of the Enterobacteriaceae, with others reported from the East Coast of the United States. Although producers of these enzymes remain rare, the progress of this enzyme group merits monitoring.

ABSTRACTStrains of newly emerging Salmonella entericasubsp. enterica(subspecies I) serotype 4,5,12:i:- causing food-borne infections, including a large food poisoning outbreak (n= 86) characterized by persistent diarrhea (14% bloody), abdominal pain, fever, and headache, were examined. The organisms were found in the stool samples from the patients. The biochemical profile of the organisms is consistent with that of S. entericasubsp. I serotypes, except for decreased dulcitol (13%) and increased inositol (96%) utilization. Twenty-eight percent of the strains showed resistance to streptomycin, sulfonamides, or tetracycline only; all three antimicrobial agents; or these agents either alone or in combination with ampicillin, trimethoprim, and trimethoprim-sulfamethoxazole. None of the serotype 4,5,12:i:- strains showed resistance or decreased susceptibility to chloramphenicol or ciprofloxacin. On pulsed-field gel electrophoresis (PFGE), the strains showed 11 or 12 resolvable genomic fragments with 18 banding patterns and three PFGE profile (PFP) clusters (i.e., PFP/A, PFP/B, and PFP/C). Seventy-five percent of the isolates fingerprinted were closely related (zero to three band differences; similarity [Dice] coefficient, 86 to 100%); 63% of these were indistinguishable from each other (PFP/A1). PFP/A1was common to all strains from the outbreak and 11 hospital sources. Strains from six other hospitals shared clusters PFP/B and PFP/C. PFP/C4, of the environmental isolate, was unrelated to PFP/A and PFP/B. Nine band differences (similarity coefficient, 61%) were noted between PFP/A1and PFP/E of the multidrug-resistant S. entericasubsp. entericaserotype Typhimurium definitive type 104 strains. Whether these emerging Salmonellastrains represent a monophasic, Dul-variant of serotype Typhimurium or S. entericasubsp. entericaserotype Lagos or a distinct serotype of S. entericasubsp. I is not yet known. Some of the phenotypic and genotypic properties of the serotype 4,5,12:i:- strains are described here.