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This document provides the final text of regulations governing employee protection (retaliation or whistleblower) claims under section 1558 of the Affordable Care Act, which added section 18C to the Fair Labor Standards Act to provide protections to employees who may have been subject to retaliation for seeking assistance under certain affordability assistance provisions (for example, health insurance premium tax credits) or for reporting potential violations of the Affordable Care Act's consumer protections (for example, the prohibition on rescissions)...
October 13, 2016: Federal Register
Viraj Suvarna
Stroke prevention in atrial fibrillation (AF) has reached an exciting phase with a plethora of newer, potentially more efficacious and safer agents being introduced for physicians to select from. Dabigatran belongs to a class of anticoagulants called direct thrombin inhibitors, while rivaroxaban, apixaban, and edoxaban are direct Factor Xa inhibitors. Purely from a therapeutic endpoint perspective-based on the action of anticoagulants in reducing cardioembolic stroke-in clinical trials, one should look at whether a new anticoagulant in patients with AF prevents ischemic stroke...
October 2016: Journal of the Association of Physicians of India
Olubukunola Adesanya, Mubariz Naqvi
We report a rare, but serious, complication of a malpositioned umbilical venous catheter in a term male infant who developed laceration, hematoma, and necrosis of liver, ascites, and left-sided obstructive uropathy secondary to extravasation of total parenteral nutrition. Abdominal paracentesis confirmed the presence of parenteral nutrition in the peritoneal cavity. Although, the umbilical venous catheterization is a common intravenous access used in neonatal intensive care units, judicious continued monitoring of its use should be practiced to avoid serious complications...
2016: Global Pediatric Health
G Odewale, O J Adefioye, J Ojo, F A Adewumi, O A Olowe
Acinetobacter baumannii is a ubiquitous pathogen that has emerged as a major cause of healthcare-associated infections at Ladoke Akintola University Teaching Hospital. Isolates were assayed according to standard protocol. The isolates were subjected to molecular techniques to detect blaOXA, blaTEM, blaCTX-M, and blaSHV genes in strains of the A. baumannii isolates. The prevalence of A. baumannii was 8.5% and was most prevalent among patients in the age group 51-60 (36%); the male patients (63.6%) were more infected than their female counterparts...
September 29, 2016: European Journal of Microbiology & Immunology
Man-Chiu Poon, Adrienne Lee
Prophylaxis is considered optimal care for hemophilia patients to prevent bleeding and to preserve joint function thereby improving quality of life (QoL). The evidence for prophylaxis is irrefutable and is the standard of care in developed nations. Prophylaxis can be further individualized to improve outcomes and cost effectiveness. Individualization is best accomplished taking into account the bleeding phenotype, physical activity/lifestyle, joint status, and pharmacokinetic handling of specific clotting factor concentrates, all of which vary among individuals...
2016: Thrombosis Journal
Hendrik J F Helmerhorst, Derk L Arts, Marcus J Schultz, Peter H J van der Voort, Ameen Abu-Hanna, Evert de Jonge, David J van Westerloo
OBJECTIVE: Emerging evidence has shown the potential risks of arterial hyperoxia, but the lack of a clinical definition and methodologic limitations hamper the interpretation and clinical relevance of previous studies. Our purpose was to evaluate previously used and newly constructed metrics of arterial hyperoxia and systematically assess their association with clinical outcomes in different subgroups in the ICU. DESIGN: Observational cohort study. SETTING: Three large tertiary care ICUs in the Netherlands...
October 19, 2016: Critical Care Medicine
Jeremy S Stultz, Christopher D Doern, Emily Godbout
Urinary tract infections (UTIs) are a common problem in pediatric patients. Resistance to common antibiotic agents appears to be increasing over time, although resistance rates may vary based on geographic region or country. Prior antibiotic exposure is a pertinent risk factor for acquiring resistant organisms during a first UTI and recurrent UTI. Judicious prescribing of antibiotics for common pediatric conditions is needed to prevent additional resistance from occurring. Complex pediatric patients with histories of hospitalizations, prior antibiotic exposure, and recurrent UTIs are also at high risk for acquiring UTIs due to extended spectrum beta-lactamase-producing organisms...
December 2016: Current Infectious Disease Reports
Peter M Chapman
We are facing a dynamic future in the face of multiple stressors acting individually and in combination: climate change; habitat change/loss; overfishing; invasive species; harmful algal blooms/eutrophication; and, chemical contaminants. Historic assessment and management approaches will be inadequate for addressing risks from climate change and other stressors. Wicked problems (non-linear, complex, competing risks and benefits, not easily solvable), will become increasingly common. We are facing irreversible changes to our planetary living conditions...
October 16, 2016: Marine Pollution Bulletin
M Zhao, M Kong, J J Yu, X L He, D H Zhang, X D Teng
Objective: To investigate the clinical and histopathologic characteristics, diagnosis, differential diagnosis and prognostic features of anastomosing hemangioma. Methods: Five cases of anastomosing hemangioma of the kidney and adrenal gland were collected, the clinical and radiologic features, histomorphology, immunophenotype and prognosis were analyzed with review of literature. Results: Three patients were male and two were female with ages ranging from 47 to 77 years; three were located in adrenal gland and 2 originated from the kidney...
October 8, 2016: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Flavia Westphal, Suzete Maria Fustinoni, Vânia Lopes Pinto, Patrícia de Souza Melo, Anelise Riedel Abrahão
Objective: To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination. Methods: This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival...
July 2016: Einstein
Ana Flores-Carrero, Indira Labrador, Alberto Paniz-Mondolfi, David R Peaper, Dana Towle, María Araque
Enterobacter spp. have emerged as an important group of pathogens linked to outbreaks in neonatal intensive care units (NICUs), usually involving strains expressing extended-spectrum β-lactamases (ESBLs). The aim of this study was to describe the first nosocomial bloodstream infection outbreak caused by Enterobacter ludwigii co-harbouring CTX-M-8, SHV-12 and TEM-15 in a NICU in a Venezuelan hospital. Initial bacterial identification was achieved by VITEK(®)2 system and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (VITEK(®) MS) and was subsequently confirmed by nucleotide sequencing of the 16S rDNA gene and hsp60 genotyping...
October 7, 2016: Journal of Global Antimicrobial Resistance
S McDougall, C W R Compton, N Botha
AIMS: To determine the factors associated with the selection of antimicrobials by dairy veterinarians, and the attitudes of those veterinarians and dairy farmers to antimicrobial usage and resistance. METHODS: Facilitated focus groups of dairy farmers (n=22) and an anonymous online survey of dairy cattle veterinarians (n=206 respondents) were used to determine prescribing behaviour, factors affecting prescribing of antimicrobials, and the attitudes of veterinarians and farmers to the use of antimicrobials and the risk of antimicrobial resistance (AMR)...
October 16, 2016: New Zealand Veterinary Journal
Nathaniel Bell, Bo Cai
BACKGROUND: Our objective was to evaluate the reliability and predictability of ten socioeconomic indicators obtained from the 2006-2013 annual and multi-year ACS data cycles for unintentional drowning and submersion injury surveillance. METHODS: Each indicator was evaluated using its margin of error and coefficient of variation. For the multi-year data cycles we calculated the frequency that estimates for the same geographic areas from consecutive surveys were statistically significantly different...
December 2015: Injury Epidemiology
Vidhya Parameswaran, S Anilkumar, S Lylajam, C Rajesh, Vivek Narayan
BACKGROUND AND OBJECTIVES: This in vitro study compared the shade matching abilities of an intraoral spectrophotometer and the conventional visual method using two shade guides. The results of previous investigations between color perceived by human observers and color assessed by instruments have been inconclusive. The objectives were to determine accuracies and interrater agreement of both methods and effectiveness of two shade guides with either method. METHODS: In the visual method, 10 examiners with normal color vision matched target control shade tabs taken from the two shade guides (VITAPAN Classical™ and VITAPAN 3D Master™) with other full sets of the respective shade guides...
October 2016: Journal of Indian Prosthodontic Society
Anna-Sophie Weidner, Nicole C Panarelli, Hanna Rennert, Jose Jessurun, Rhonda K Yantiss
OBJECTIVES: Gastrointestinal infections by cytomegalovirus (CMV) and adenovirus may complicate hematopoietic stem cell transplantation (HSCT). Although CMV and adenovirus produce recognizable cytopathic changes, these changes may be subtle or focal. The value of viral immunohistochemistry in detecting infection in HSCT recipients when cytopathic changes are not identified has not been demonstrated. METHODS: H&E-stained sections from gastrointestinal biopsy specimens were reviewed by three pathologists...
October 15, 2016: American Journal of Clinical Pathology
Kenan Karbeyaz, Mehmet Toygar, Adnan Çelikel
INTRODUCTION: In this study student suicides are classified as a distinct group in Eskisehir-a city located in the western part of our country and famous as a student city. The study aims at describing demographic and suicide specification of cases and compare some important issues between males and females. METHOD: All the judicially deaths in Eskisehir in a 12 year period between 2004 and 2015 have been evaluated. 75 cases that were deemed as suicide cases as a result of criminal investigation have been included in the study...
September 28, 2016: Journal of Forensic and Legal Medicine
Yuri P Springer, Roy Gerona, Erich Scheunemann, Sarah L Shafer, Thomas Lin, Samuel D Banister, Michael P Cooper, Louisa J Castrodale, Michael Levy, Jay C Butler, Joseph B McLaughlin
In July 2015, personnel in the Alaska Division of Public Health's Section of Epidemiology became aware of an increase in the number of patients being treated in Anchorage hospital emergency departments for adverse reactions associated with use of synthetic cannabinoids (SCs). SCs are a chemically diverse class of designer drugs that bind to the same cannabinoid receptors as tetrahydrocannabinol, the main psychoactive component of cannabis. A public health investigation was initiated to describe clinical outcomes, characterize the outbreak, and identify SC chemicals circulating in Anchorage...
October 14, 2016: MMWR. Morbidity and Mortality Weekly Report
Getahun E Agga, John W Schmidt, Terrance M Arthur
: Concerns have been raised that in-feed chlortetracycline (CTC) may increase antimicrobial resistance (AMR), specifically tetracycline-resistant (TET(r)) Escherichia coli, and third-generation cephalosporin-resistant (3GC(r)) E. coli We evaluated the impact of a 5-day in-feed CTC prophylaxis on animal health, TET(r) E. coli, and 3GC(r) E. coli A "control group" of cattle (n = 150) received no CTC, while a "CTC group" (n = 150) received in-feed CTC (10 mg/lb of body weight/day) from the 5th to the 9th day after feedlot arrival...
October 7, 2016: Applied and Environmental Microbiology
Delay in recognizing clinical deterioration in acutely unwell patients often leads to cardiac arrests and unexpected admissions to the Intensive Care Unit. Early Warning Scoring Systems based on vital physiological parameters help in early detection of clinical deterioration. When combined with a system of prompt and appropriate clinical response, they have been shown to improve outcome. A standardised National Early Warning Score has been implemented in the United Kingdom. There is a need to implement an early warning scoring system in hospitals in India in order to ensure effective and judicious utilization of our overburdened acute services and to minimize adverse outcomes...
May 2016: Journal of the Association of Physicians of India
Mohammad J Alhilaly, Megalamane S Bootharaju, Chakra P Joshi, Tabot M D Besong, Abdul-Hamid Emwas, Rosalba Juarez Mosqueda, Sami Kaappa, Sami Malola, Karim Adil, Aleksander Shkurenko, Hannu Häkkinen, Mohamed Eddaoudi, Osman M Bakr
Engineering the surface ligands of metal nanoparticles is critical in designing unique arrangements of metal atoms. Here, we report the synthesis and total structure determination of a large box-shaped Ag67 nanocluster (NC) protected by a mixed shell of thiolate (2,4-dimethylbenzenethiolate, SPhMe2) and phosphine (triphenylphosphine, PPh3) ligands. Single crystal X-ray diffraction (SCXRD) and electrospray ionization mass spectrometry (ESI-MS) revealed the cluster formula to be [Ag67(SPhMe2)32(PPh3)8]3+. The crystal structure shows an Ag23 metal core covered by a layer of Ag44S32P8 arranged in the shape of a box...
October 13, 2016: Journal of the American Chemical Society
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