Geertsenowen6362

4% response) totaling 101,231 beds in the second. Ten of the 11 criteria improved (p less then 0.05), as well as the composite indicator (p=0.001) in all the regions of the country, particularly in the group of hospitals participating at baseline. "Hand-hygiene (HH) infrastructure" reached 100% (baseline 97.9, p=0.001), "HH protocol" 96.9% (baseline 92.9, p=0.001), "HH monitoring" 70% (baseline 60.7, p less then 0.001) and "existence of antimicrobial prescription protocol" 80.7%(baseline 73.2; p less then 0.001), among others. The HAI rates of the participating hospitals decreased after the intervention (p less then 0.05). CONCLUSIONS The QI cycle approach was useful in guiding system-wide interventions for patient safety. External regulation was feasible and effective in promoting internal HAI prevention nationwide. BACKGROUND Methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infection rates have risen steadily in recent years, with a marked decline in the corresponding rates due to methicillin-resistant S. aureus (MRSA). Screening for MSSA carriage is not routinely undertaken and MRSA screening is not universal, so the extent of S. aureus colonisation pressure in nosocomial settings is unknown. METHODS We conducted a prospective, observational study of patients and healthcare workers (HCWs) across nine inpatient wards in a tertiary referral hospital over a two-year period. Participants were screened for MSSA and MRSA using nasal swabs and oral rinses. Environmental surfaces and air were also tested for S. aureus using contact plates and active air sampling. FINDINGS We enrolled 388 patients and 326 HCWs; and took 758 contact plate samples from surfaces and 428 air samples. MSSA was recovered from 24% of patients, 31.3% of HCWs, 16% of air samples and 7.9% of surface samples. MRSA was recovered from 6.4% of patients, 3.7% of HCWs, 2.5% of air samples and 2.2% of surface samples. Inclusion of the oral cavity in addition to the anterior nares in the sampling regimen identified 30 patients and 36 HCWs who exhibited exclusive oral colonisation. CONCLUSIONS The oral cavity comprises a significant nosocomial reservoir for S. aureus that is currently under-appreciated. click here Oral screening should be considered both in terms of the colonisation pressure in a healthcare facility, and on an individual patient level, especially in patients where decolonisation attempts have repeatedly failed and those undergoing high risk procedures. PURPOSE Patients with abscopal regressions of lymphoma after palliative involved-site radiation therapy (ISRT), detected on sequential 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET), were identified by audit. A retrospective analysis was subsequently conducted to estimate the frequency of abscopal regression in follicular lymphoma (FL). METHODS AND MATERIALS Potential cases were identified at multidisciplinary lymphoma meetings and fulfilled these criteria a) Palliative ISRT given for histologically-confirmed lymphoma, b) >2 lesions visualized on FDG-PET c) >1 un-irradiated lesion(s) outside ISRT volume d) no systemic therapy delivered 1 unirradiated lesions. One patient each was identified with mantle cell lymphoma (4Gy in 2 fractions), Hodgkin lymphoma (HL) (20Gy in 3 fractions then 30Gy in 15 fractions to the same volume) and Richter transformation of chronic lymphatic leukemia (30Gy in 10 fractions). The four FL patients received either 4Gy in 2 fractions, (n=3) or 4Gy followed 8 months later by 30Gy in 15 fractions (n=1). During 2016-2018, 29 courses of ISRT were prescribed for multifocal FL, following which 4/29 (13.8%) abscopal responses were detected, including in 4/9 (44.4%) patients with serial PET scans. Two patients, with relapsed disease after initial abscopal responses, experienced durable CMRs with immunotherapies. CONCLUSIONS In 4/7 cases, PET-detected abscopal regression of lymphoma occurred after 4Gy, in 2/7 cases after repeated ISRT to the same volume and in 2/7 was associated with subsequent complete responses to immunotherapy, consistent with an immune basis for the abscopal effect. Abscopal regressions in FL appear to be more common than previously-suspected. PURPOSE This study assessed the safety and tolerability of therapeutic immunization against the HPV viral oncoproteins E6 and E7 in cervical cancer patients following chemoradiation. EXPERIMENTAL DESIGN MEDI0457 (INO-3112) is a DNA-based vaccine targeting E6 and E7 of HPV-16/18 that is co-injected with an IL-12 plasmid followed by electroporation with the CELLECTRA® 5P device. Two to 4 weeks following chemoradiation, patients with newly diagnosed stage IB1-IVA (Cohort 1) or persistent/recurrent (Cohort 2) cervical cancers were treated with four immunizations of MEDI0457 every 4 weeks. The primary endpoints were incidence of adverse events and injection site reactions. Immune responses against HPV antigens were measured by ELISpot for interferon-γ (IFNγ), ELISA for antibody responses and multiplexed immunofluorescence for immune cells in cervical biopsy specimens. RESULTS 10 patients (Cohort 1 n=7; Cohort 2 n=3) with HPV16 (n = 7) or HPV18 (n = 3) cervical cancers received MEDI0457 after chemoradiation. Treatment-related adverse events were all Grade 1, primarily related to the injection site. 8 of 10 patients had detectable cellular and/or humoral immune responses against HPV antigens following chemoradiation and vaccination 6/10 patients generated anti-HPV antibody responses and 6/10 patients generated IFNγ producing T cell responses. At the completion of chemoradiation and vaccination, cervical biopsy specimens had detectable CD8+ T cells and decreased PD-1+CD8+, PD-L1+CD8+ and PD-L1+CD68+ subpopulations. All patients cleared detectable HPV DNA in cervical biopsies by completion of chemoradiation and vaccination. CONCLUSIONS Adjuvant MEDI0457 is safe and well-tolerated after chemoradiation for locally advanced and/or recurrent cervical cancers supporting further investigation into combining tumor-specific vaccines with radiotherapy. To identify non-protein coding as well as truncated or premature RNA sequences expressed and obtain more complete transcriptome information, we combined the MinION direct RNA-sequencing of a conventional poly(A) RNA purification method with poly(A)-tagging of the non-coding RNA (ncRNA) fraction. This approach was applied to transcriptome sequencing of the dicyemid mesozoan, Dicyema misakiense, which has minicircular mitochondrial DNA molecules where each molecule encodes a single gene, as well as the host. Using informatics analysis, we distinguished dicyemid RNAs from those of the host squid. The poly(A) RNAs were assigned to host mitochondrial genes, host nuclear protein-coding genes, Dicyema nuclear protein-coding genes, and Dicyema mitochondrial genes in the decreasing order. Our poly(A)-tailing method recovered significantly more ncRNAs from the host compared with the sequencing of poly(A) RNAs. Furthermore, our method captured various lengths of squid mitochondrial DNA (mtDNA) transcripts at different steps of maturation including a read of 3,500 bp, which covers 21% of the squid mitochondrial genome, possibly a premature host RNA product.