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Background: Inpatient quality indicators (IQIs) were previously developed to assess responsible antibiotic use. Aim: Practice testing of these QIs in the hospital setting. Method: This study was performed within a DutcheBelgian border network of hospitals implementing the Infection Risk Scan (IRIS) point prevalence survey (PPS) as part of the i4-1-Health project. Twenty out of 51 DRIVE-AB IQIs, including 13 structure and seven process IQIs, were tested. Data on structure IQIs were obtained through a web-based questionnaire sent to the hospital medical microbiologists. PPS data from October to December 2018 were used to calculate performance scores for the process QIs. Findings: Nine hospitals participated. Regarding structure IQIs: the lowest performance scores were observed for recommendations for microbiological investigations in the guidelines and the use of an approval system for restricted antibiotics. In addition, most hospitals reported that some antibiotics were out of stock due to shortages. Regarding process IQIs: 697 systemic antibiotic prescriptions were used to calculate performance scores. The lowest score was observed for documentation of an antibiotic plan in the medical file (58.8%). Performance scores for IQIs on guideline compliance varied between 74.1% and 82.3% for different aspects of the antibiotic regimen (duration, choice, route, timing). Conclusion: This multicentre practice testing of IQIs identified improvement targets for stewardship efforts for both structure and process aspects of antibiotic care (approval system for restricted antibiotics, documentation of antibiotic plan). These results can guide the design of future PPS studies and a more extensive evaluation of the clinimetric properties of the IQIs. The i-4-1-Health project was financed by the Interreg V Flanders e The Netherlands programme, the cross-border cooperation programme with financial support from the European Regional Development Fund (ERDF) (0215). Additional financial support was received from the Dutch Ministry of Health, Welfare and Sport (325911), the Dutch Ministry of Economic Affairs (DGNR-RRE/14191181), the Province of Noord-Brabant (PROJ-00715/PROJ-01018/PROJ-00758), the Belgian Department of Agriculture and Fisheries (no reference), the Province of Antwerp (1564470690117/1564470- 610014) and the Province of East-Flanders (E01/subsidie/ VLNL/i-4-1-Health). The authors are free to publish the results from the project without interference from the funding bodies. The authors thank all the stakeholders (infection control practitioners, pharmacists, ID physicians, residents, and microbiologists) for the collection of the epidemiological data. The authors acknowledge the participants to the questionnaire and thank all the members of the i-4-1-Health Study Group (see Supplementary Appendix A).

Perverse schobers are categorifications of perverse sheaves. In prior work we constructed a perverse schober on a partial compactification of the stringy K\"ahler moduli space (SKMS) associated by Halpern-Leistner and Sam to a quasi-symmetric representation of a reductive group. When the group is a torus the SKMS corresponds to the complement of the GKZ discriminant locus (which is a hyperplane arrangement in the quasi-symmetric case shown by Kite). We show here that a suitable variation of the perverse schober we constructed provides a categorification of the associated GKZ hypergeometric system in the case of non-resonant parameters. As an intermediate result we give a description of the monodromy of such "quasi-symmetric" GKZ hypergeometric systems., Comment: 46 pages. v2: expanded Discussion

We report five patients with human immunodeficiency virus-1/acquired immunodeficiency syndrome (HIV-1/AIDS) who developed T-cell large granular lymphocytic proliferation (T-LGLP) or leukemia (T-LGLL). None of the patients fulfilled criteria for diagnosis of diffuse infiltrative lymphocyte syndrome (DILS) or HIV-associated CD8+ lymphocytosis syndrome at the time of diagnosis of LGL. The immunophenotype of malignant T-cells was identical in three patients with co-expression of CD3, CD8, CD57, and T-cell receptor (TCR) alpha/beta. Three out of five patients were also diagnosed with clonal disorders of B-cell origin including diffuse large B-cell lymphoma, Burkitt's lymphoma, and monoclonal gammopathy of undetermined significance (MGUS). Two patients developed cytopenias due to T-LGLL prompting initiation of therapy. Our study suggests that chronic viral infection with HIV can contribute to the evolution of T-LGLP. Clinical and laboratory characteristics of T-LGLP associated with HIV-1/AIDS resemble those of immunocompetent patients.

MBA, North-West University, Potchefstroom Campus, 2018 Universities are under rising pressure from the South African government to limit increasing tuition fees. Driven by external prospects for economic development as well as increased internal demands to generate more income, universities have been rapidly growing their association to become entrepreneurial. Higher education institutions are facing rapid change with successions of multifaceted changes. These changes are essential as a result of vast political, economic, technological and social changes in these applicable environments. These changes bring along new challenges for support staff, especially those who are working in the third-money income stream activities. This specific income stream does not have the same support structures as those from other money streams, but have to deliver according to the new drive to secure additional income. As a result, the support staff from third-money income stream experience and sense feelings of multiple levels of stress, insecurities, and uncertainty regarding their future in the institution. They struggle to understand the multiple changes and how they contribute to the values of the institution. Along with the multiple changes and new need to generate additional income, increased bureaucracy beyond their control leads to additional strain. The lack of a proper migration plan contributes to the anxiety of support staff that has elevated stress levels as result. With the demand to increase revenue, it is important that technological systems contribute positively to reach goals by means of effectiveness and efficiency. The current systems applied for third-money income stream are not adequate to address increased volumes and specific needs as per contractual agreements with external clients. Processes are to be streamlined to ensure faster turnaround time as this is the heart of delivering to clients. The workload for these support staff members has increased and has changed drastically. It is essential to provide autonomy to these sections as relying on departmental resources within the institutions proved to be a burden rather than a support. The objective of this study is to investigate the frustrations experienced by third-income stream support staff and to determine whether these elements contribute to stress and strain. The results of the study exposed that the support staff do experience stress-related strain, which could primarily be recognised in their work relationships, demands, role association, support and job characteristics, correspondingly. The levels of job insecurity were very high and the support from higher-ranking individuals very low. Analyses of different age groups and years in employment had no variable effect on the study. Masters