University of Washington Suzzallo and Allen Libraries Holding: Kinh tế Việt Nam - Thăng trầm và đột phá

UW Suzzallo and Allen Libraries Holding of title Kinh tế Việt Nam - Thăng trầm và đột phá, published by Hanoi-based National Political Publishing House, Hanoi, Vietnam, in 2009.

Kent and Kleemeier Award Lecture and Presentations

The Robert W. Kleemeier Award lecture will feature an address by the 2020 Kleemeier Award recipient, Matt Kaeberlein, PhD, FGSA, of the University of Washington. The Kleemeier Award is given annually to a member of The Gerontological Society of America in recognition for outstanding research in the field of gerontology. The Donald P. Kent Award lecture will feature an address by the 2020 Kent Award recipient, David Ekerdt, Phd, FGSA, of the University of Kansas. The Kent Award is given annually to a member of The Gerontological Society of America who best exemplifies the highest standards of professional leadership in gerontology through teaching, service, and interpretation of gerontology to the larger society.

The University of Washington Ice–Liquid Discriminator (UWILD) improves single-particle phase classifications of hydrometeors within Southern Ocean clouds using machine learning

Mixed-phase Southern Ocean clouds are challenging to simulate, and their representation in climate models is an important control on climate sensitivity. In particular, the amount of supercooled water and frozen mass that they contain in the present climate is a predictor of their planetary feedback in a warming climate. The recent Southern Ocean Clouds, Radiation, Aerosol Transport Experimental Study (SOCRATES) vastly increased the amount of in situ data available from mixed-phase Southern Ocean clouds useful for model evaluation. Bulk measurements distinguishing liquid and ice water content are not available from SOCRATES, so single-particle phase classifications from the Two-Dimensional Stereo (2D-S) probe are invaluable for quantifying mixed-phase cloud properties. Motivated by the presence of large biases in existing phase discrimination algorithms, we develop a novel technique for single-particle phase classification of binary 2D-S images using a random forest algorithm, which we refer to as the University of Washington Ice–Liquid Discriminator (UWILD). UWILD uses 14 parameters computed from binary image data, as well as particle inter-arrival time, to predict phase. We use liquid-only and ice-dominated time periods within the SOCRATES dataset as training and testing data. This novel approach to model training avoids major pitfalls associated with using manually labeled data, including reduced model generalizability and high labor costs. We find that UWILD is well calibrated and has an overall accuracy of 95 % compared to 72 % and 79 % for two existing phase classification algorithms that we compare it with. UWILD improves classifications of small ice crystals and large liquid drops in particular and has more flexibility than the other algorithms to identify both liquid-dominated and ice-dominated regions within the SOCRATES dataset. UWILD misclassifies a small percentage of large liquid drops as ice. Such misclassified particles are typically associated with model confidence below 75 % and can easily be filtered out of the dataset. UWILD phase classifications show that particles with area-equivalent diameter (Deq) < 0.17 mm are mostly liquid at all temperatures sampled, down to −40 ∘C. Larger particles (Deq>0.17 mm) are predominantly frozen at all temperatures below 0 ∘C. Between 0 and 5 ∘C, there are roughly equal numbers of frozen and liquid mid-sized particles (0.17<Deq<0.33 mm), and larger particles (Deq>0.33 mm) are mostly frozen. We also use UWILD's phase classifications to estimate sub-1 Hz phase heterogeneity, and we show examples of meter-scale cloud phase heterogeneity in the SOCRATES dataset.

Emily C. Donaldson, Working with the Ancestors: Mana and Place in the Marquesas Islands

Emily C. Donaldson, Working with the Ancestors: Mana and Place in the Marquesas Islands (Seattle: University of Washington Press, 2019), 250 pp., $30.00 (pbk), ISBN: 9780295745831.

860. HIV Post-exposure Prophylaxis Availability at Small and Critical Access Hospitals in the Western Region

Background Post-exposure prophylaxis (PEP) is essential to minimize the risk of human immunodeficiency virus (HIV) acquisition following an occupational or nonoccupational exposure to potentially infectious body fluids. PEP is most effective when initiated as soon as possible after HIV exposure. Patients in rural areas may rely on small (&lt; 50 beds) and critical access (&lt; 25 beds) hospitals for access to PEP – especially after-hours and on holidays, when outpatient pharmacies are typically closed. However, PEP medications are costly to maintain on a hospital formulary due to unpredictable use and expiration. We hypothesized that PEP availability may be variable and limited at such hospitals. Methods The University of Washington Tele-Antimicrobial Stewardship Program (UW-TASP) is comprised of 68 hospitals in Washington, Oregon, Arizona, Idaho, and Utah, most of which are rural and critical access. In August 2020, we surveyed UW-TASP participating hospitals and a convenience sample of other networked rural hospitals in Western states using REDCap, a HIPAA-compliant, electronic data management program. Respondents reported all antimicrobials on their hospital formulary and their hospital size. Data were reviewed by physicians and pharmacists trained in infectious diseases. Preferred PEP regimens, defined by the CDC, for adults and adolescents ≥ 13 years, included combination tenofovir disoproxil fumarate-emtricitabine (TDF/FTC) and either raltegravir (RAL) or dolutegravir (DTG). Results Responses from 49 hospitals were received. Six were excluded – one was incomplete and five were excluded due to hospital size ( &gt; 50 beds) (Table 1). The majority of hospitals (40/43, 93.0%) were critical access. Half of the hospitals’ formularies (22/43, 51.2%) contained a preferred PEP regimen. One hospital reported a non-preferred regimen. Most hospitals with a preferred PEP regimen on formulary (18/22, 86.3%) offered TDF/FTC + RAL, and the remainder (4/22, 18.2%) offered TDF/FTC + DTG. Conclusion Many small and critical access hospital formularies do not include antiretroviral agents needed for HIV PEP. Improving urgent access to these critical medications in rural communities is an opportunity for HIV prevention. Disclosures Jehan Budak, MD, Nothing to disclose Chloe Bryson-Cahn, MD, Alaska Airlines (Other Financial or Material Support, Co-Medical Director, position is through the University of Washington)

133. A Review of Antimicrobial Formularies at Rural Hospitals: Stewardship Opportunities Abound

Background Management of a hospital’s antimicrobial formulary is an important aspect of antimicrobial stewardship and cost containment strategies. Ensuring that essential medications for clinical care are available and excluding therapeutic duplicates and unnecessary antimicrobials is time and resource intensive. Comparisons of antimicrobial formularies across multiple rural hospitals have not been evaluated in the literature. We hypothesized that a comprehensive formulary evaluation would reveal important opportunities for antimicrobial stewardship efforts and could help smaller hospitals optimize available medications. Methods The University of Washington Tele-Antimicrobial Stewardship Program (UW-TASP) is comprised of 68 hospitals of varying sizes, most of which are rural and critical access, in Washington, Oregon, Arizona, Idaho, and Utah. We surveyed UW-TASP participating hospitals and other networked rural hospitals in multiple Western states using REDCap, a HIPAA-compliant, electronic data management program. Respondents reported which antimicrobials are on their hospital formulary as well as basic information about hospital size and inpatient units. Data were reviewed by a panel of infectious diseases trained physicians and pharmacists at UW-TASP. Results Surveys from 49 hospitals were received; two were excluded from the data analysis (Table 1) – one submission was incomplete, and one was a large inpatient psychiatric hospital. Select antimicrobials and proportion of hospitals carrying these agents is shown in Table 2. Several antimicrobials are on the formulary at all hospitals, regardless of size. In some critical access hospitals (&lt; 25 beds), empiric first-line bacterial meningitis and viral encephalitis coverage (Table 3) was lacking. Six hospitals (12.7%) lacked ampicillin for Listeria coverage and only one had a suitable alternative agent (meropenem). Seven hospitals (14.9%) lacked intravenous acyclovir, although three had oral valacyclovir. Formulary inclusion of agents for multi-drug resistant organisms was rare. Conclusion In critical access hospitals in the Western USA, lack of essential empiric antimicrobials may be more of a concern than inclusion of agents with unnecessarily broad spectra. Disclosures Chloe Bryson-Cahn, MD, Alaska Airlines (Other Financial or Material Support, Co-Medical Director, position is through the University of Washington)