Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Heil G[original query] |
---|
Considerations for long-acting antiretroviral therapy in older persons with HIV
O'Shea JG , Cholli P , Heil EL , Buchacz K . AIDS 2023 37 (15) 2271-2286 People with HIV (PWH) can now enjoy longer, healthier lives due to safe and highly effective antiretroviral therapy (ART), and improved care and prevention strategies. New drug formulations such as long-acting injectables (LAI) may overcome some limitations and issues with oral antiretroviral therapy and strengthen medication adherence. However, challenges and questions remain regarding their use in aging populations. Here, we review unique considerations for LAI-ART for the treatment of HIV in older PWH, including benefits, risks, pharmacological considerations, implementation challenges, knowledge gaps, and identify factors that may facilitate uptake of LA-ART in this population. |
Impact of Statewide Prevention and Reduction of Clostridioides difficile (SPARC), a Maryland public health-academic collaborative: an evaluation of a quality improvement intervention
Rock C , Perlmutter R , Blythe D , Bork J , Claeys K , Cosgrove SE , Dzintars K , Fabre V , Harris AD , Heil E , Hsu YJ , Keller S , Maragakis LL , Milstone AM , Morgan DJ , Dullabh P , Ubri PS , Rotondo C , Brooks R , Leekha S . BMJ Qual Saf 2021 31 (2) 153-162 To evaluate changes in Clostridioides difficile incidence rates for Maryland hospitals that participated in the Statewide Prevention and Reduction of C. difficile (SPARC) collaborative. Pre-post, difference-in-difference analysis of non-randomised intervention using four quarters of preintervention and six quarters of postintervention National Healthcare Safety Network data for SPARC hospitals (April 2017 to March 2020) and 10 quarters for control hospitals (October 2017 to March 2020). Mixed-effects negative binomial models were used to assess changes over time. Process evaluation using hospital intervention implementation plans, assessments and interviews with staff at eight SPARC hospitals. Maryland, USA. All Maryland acute care hospitals; 12 intervention and 36 control hospitals. Participation in SPARC, a public health-academic collaborative made available to Maryland hospitals, with staggered enrolment between June 2018 and August 2019. Hospitals with higher C. difficile rates were recruited via email and phone. SPARC included assessments, feedback reports and ongoing technical assistance. Primary outcomes were C. difficile incidence rate measured as the quarterly number of C. difficile infections per 10 000 patient-days (outcome measure) and SPARC intervention hospitals' experiences participating in the collaborative (process measures). SPARC invited 13 hospitals to participate in the intervention, with 92% (n=12) participating. The 36 hospitals that did not participate served as control hospitals. SPARC hospitals were associated with 45% greater C. difficile reduction as compared with control hospitals (incidence rate ratio=0.55, 95% CI 0.35 to 0.88, p=0.012). Key SPARC activities, including access to trusted external experts, technical assistance, multidisciplinary collaboration, an accountability structure, peer-to-peer learning opportunities and educational resources, were associated with hospitals reporting positive experiences with SPARC. SPARC intervention hospitals experienced 45% greater reduction in C. difficile rates than control hospitals. A public health-academic collaborative might help reduce C. difficile and other hospital-acquired infections in individual hospitals and at state or regional levels. |
Surface dosimetry of ultraviolet germicidal irradiation using a colorimetric technique
Neu DT , Mead KR , McClelland TL , Lindsley WG , Martin SB , Heil G , See M , Feng HA . Ann Work Expo Health 2021 65 (5) 605-611 Ultraviolet germicidal irradiation uses ultraviolet C (UV-C) energy to disinfect surfaces in clinical settings. Verifying that the doses of UV-C energy received by surfaces are adequate for proper disinfection levels can be difficult and expensive. Our study aimed to test commercially available colorimetric labels, sensitive to UV-C energy, and compare their precision with an accepted radiometric technique. The color-changing labels were found to predictably change color in a dose-dependent manner that would allow them to act as a qualitative alternative to radiometry when determining the minimum UV-C energy dosage received at surfaces. If deployed using careful protective techniques to avoid unintentional exposure to sunlight or other light sources, the use of colorimetric labels could provide inexpensive, easy, and accurate verification of effective UV-C dosing in clinical spaces. |
Accuracy of provider-selected indications for antibiotic orders
Heil EL , Pineles L , Mathur P , Morgan DJ , Harris AD , Srinivasan A , Thom KA . Infect Control Hosp Epidemiol 2018 39 (1) 111-113 Documentation of antibiotic indication provides helpful information for antimicrobial stewardship, but accuracy is not understood. Review of 396 antibiotic orders in a pediatric ICU and adult medicine step-down unit found 90% agreement between provider-selected indication and independent review. Prompts to enter antibiotic indication during order entry provide largely accurate information. Infect Control Hosp Epidemiol 2018;39:111-113. |
Evaluation of an improved prototype mini-baghouse to control the release of respirable crystalline silica from sand movers
Alexander BM , Esswein EJ , Gressel MG , Kratzer JL , Feng HA , Miller AL , Cauda E , Heil G . J Occup Environ Hyg 2017 15 (1) 0 The OSHA final rule on respirable crystalline silica (RCS) will require hydraulic fracturing companies to implement engineering controls to limit workers' exposure to RCS. RCS is generated by pneumatic transfer of quartz-containing sand during hydraulic fracturing operations. Chronic inhalation of RCS can lead to serious disease, including silicosis and lung cancer. NIOSH research identified at least seven sources where RCS aerosols were generated at hydraulic fracturing sites. NIOSH researchers developed an engineering control to address one of the largest sources of RCS aerosol generation, RCS escaping from thief hatches on the top of sand movers. The control, the NIOSH Mini-Baghouse Retrofit Assembly (NMBRA), mounts on the thief hatches. Unlike most commercially-available engineering controls, the NMBRA has no moving parts and requires no power source. This article details the results of an evaluation of generation 3 of the NMBRA at a sand mine in Arkansas from May 19 - 21, 2015. During the evaluation, 168 area air samples were collected at 12 locations on and around a sand mover with and without the NMBRA installed. Analytical results for respirable dust and RCS indicated the use of the NMBRA effectively reduced concentrations of both respirable dust and RCS downwind of the thief hatches. Reductions of airborne respirable dust were estimated at 99+%; reductions in airborne RCS ranged from 98-99%. Analysis of bulk samples of the dust showed the likely presence of freshly fractured quartz, a particularly hazardous form of RCS. Use of an improved filter fabric and a larger area of filter cloth led to substantial improvements in filtration and pressures during these trials, as compared to the generation 2 NMBRA. Planned future design enhancements, including a weather cover, will increase the performance and durability of the NMBRA. Future trials are planned to evaluate the long-term operability of the technology. |
Influenza A(H1N1)pdm09 virus among healthy show pigs, United States
Gray GC , Bender JB , Bridges CB , Daly RF , Krueger WS , Male MJ , Heil GL , Friary JA , Derby RB , Cox NJ . Emerg Infect Dis 2012 18 (9) 1519-21 Within 5 months after the earliest detection of human influenza A(H1N1)pdm09 virus, we found molecular and culture evidence of the virus in healthy US show pigs. The mixing of humans and pigs at swine shows possibly could further the geographic and cross-species spread of influenza A viruses. |
MChip, a low density microarray, differentiates among seasonal human H1N1, North American swine H1N1, and the 2009 pandemic H1N1
Heil GL , McCarthy T , Yoon KJ , Liu S , Saad MD , Smith CB , Houck JA , Dawson ED , Rowlen KL , Gray GC . Influenza Other Respir Viruses 2010 4 (6) 411-416 BACKGROUND: The MChip uses data from the hybridization of amplified viral RNA to 15 distinct oligonucleotides that target the influenza A matrix (M) gene segment. An artificial neural network (ANN) automates the interpretation of subtle differences in fluorescence intensity patterns from the microarray. The complete process from clinical specimen to identification including amplification of viral RNA can be completed in <8 hours for under US$10. OBJECTIVES: The work presented here represents an effort to expand and test the capabilities of the MChip to differentiate influenza A/H1N1 of various species origin. METHODS: The MChip ANN was trained to recognize fluorescence image patterns of a variety of known influenza A viruses, including examples of human H1N1, human H3N2, swine H1N1, 2009 pandemic influenza A H1N1, and a wide variety of avian, equine, canine, and swine influenza viruses. Robustness of the MChip ANN was evaluated using 296 blinded isolates. RESULTS: Training of the ANN was expanded by the addition of 71 well-characterized influenza A isolates and yielded relatively high accuracy (little misclassification) in distinguishing unique H1N1 strains: nine human A/H1N1 (88.9% correct), 35 human A/H3N2 (97.1% correct), 31 North American swine A/H1N1 (80.6% correct), 14 2009 pandemic A/H1N1 (87.7% correct), and 23 negative samples (91.3% correct). Genetic diversity among the swine H1N1 isolates may have contributed to the lower success rate for these viruses. CONCLUSIONS: The current study demonstrates the MChip has the capability to differentiate the genetic variations among influenza viruses with appropriate ANN training. Further selective enrichment of the ANN will improve its ability to rapidly and reliably characterize influenza viruses of unknown origin. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 06, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure