Potential Cost Savings Associated with Targeted Substitution of Current Guideline-Concordant Inpatient Agents with Omadacycline for the Treatment of Adult Hospitalized Patients with Community-Acquired Bacterial Pneumonia at High Risk for Clostridioides difficile Infections: Results of Healthcare-Decision Analytic Model from the United States Hospital Perspective

Introduction: Approximately 3% of hospitalized patients with community-acquired bacterial pneumonia (CABP) develop healthcare-associated Clostridioides difficile infection (HCA-CDI). The validated Davis risk score (DRS) indicates that patients with a DRS ≥ 6 are at an increased risk of 30-day HCA-CDI. In the phase 3 OPTIC CABP study, 14% of CABP patients with DRS ≥ 6 who received moxifloxacin developed CDI vs. 0% for omadacycline. This study assessed the potential economic impact of substituting current guideline-concordant CABP inpatient treatments with omadacycline in hospitalized CABP patients with a DRS ≥ 6 across US hospitals. Methods: A deterministic healthcare-decision analytic model was developed. The model population was hospitalized adult CABP patients with a DRS ≥ 6 across US hospitals (100,000 patients). In the guideline-concordant arm, 14% of CABP patients with DRS ≥ 6 were assumed to develop an HCA-CDI, each costing USD 20,100. In the omadacycline arm, 5 days of therapy was calculated for the entire model population. Results: The use of omadacycline in place of guideline-concordant CABP inpatient treatments for CABP patients with DRS ≥ 6 was estimated to result in cost savings of USD 55.4 million annually across US hospitals. Conclusion: The findings of this simulated model suggest that prioritizing the use of omadacycline over current CABP treatments in hospitalized CABP with a DRS ≥ 6 may potentially reduce attributable HCA-CDI costs. The findings are not unique to omadacycline and could be applied to any antibiotic that confers a lower risk of HCA-CDI relative to current CABP inpatient treatments.

Penerapan Model Pembelajaran Inquiry untuk Meningkatkan Hasil Belajar Siswa pada Pelajaran Geografi dengan Materi Pokok Dinamika Kependudukan di Indonesia Kelas XI SMAN 10 Kota Jambi

This research aims to determine the effectiveness of student learning outcomes in Geography subjects with the subject of Population Dynamics in Indonesia class XI IPS 1 SMAN 10 Jambi using inquiry learning model. Population and samples in this study were students of class XI IPS 1, amounting to 30 students. The data obtained based on this study Based on the results obtained in the above study between the two cycles it can be obtained data that in cycle 1 the average value of student learning activities in first cycle was 2.6 while the average value in second cycle was obtained. amounted to 3,4. This shows that there is an increase in student learning activities. Based on the results obtained in the above research, between the two cycles, it can be obtained data that in first cycle the average value of teacher activity was 3.4, and the average value insecond cycle was 3.5. This shows that there is an increase in teacher activity. Based on the results obtained in the above research, especially on the subject of Population Dynamics in Indonesia, there are significant results on student learning completeness in first cycle and second cycle was 10%.

Overdispersion in COVID-19 increases the effectiveness of limiting nonrepetitive contacts for transmission control

Increasing evidence indicates that superspreading plays a dominant role in COVID-19 transmission. Recent estimates suggest that the dispersion parameter k for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is on the order of 0.1, which corresponds to about 10% of cases being the source of 80% of infections. To investigate how overdispersion might affect the outcome of various mitigation strategies, we developed an agent-based model with a social network that allows transmission through contact in three sectors: “close” (a small, unchanging group of mutual contacts as might be found in a household), “regular” (a larger, unchanging group as might be found in a workplace or school), and “random” (drawn from the entire model population and not repeated regularly). We assigned individual infectivity from a gamma distribution with dispersion parameter k. We found that when k was low (i.e., greater heterogeneity, more superspreading events), reducing random sector contacts had a far greater impact on the epidemic trajectory than did reducing regular contacts; when k was high (i.e., less heterogeneity, no superspreading events), that difference disappeared. These results suggest that overdispersion of COVID-19 transmission gives the virus an Achilles’ heel: Reducing contacts between people who do not regularly meet would substantially reduce the pandemic, while reducing repeated contacts in defined social groups would be less effective.

Chronic ocean noise and cetacean population models

Recent years have seen rapid development of tools and approaches to model population consequences of disturbance in several marine mammal populations from high-amplitude, acute sound sources. Ocean noise from shipping and other maritime activities is now recognized as a chronic, habitat-level stressor. In order to understand population consequences of chronic ocean noise to whales and their populations, advances are needed in several key areas, which are explored in this review. One tractable way to predict population-level consequences of noise-mediated disruption of feeding, which can include both behavioural responses and foraging opportunities lost due to acoustic masking. Masking may be defined as both the process and the amount by which the threshold of hearing of one sound is raised by the presence of another. Parameterising any such model requires information on sensitivity and vulnerability of large whales to ocean noise, in which sensitivity is the degree to which marine features respond to a stressor (e.g., behavioural responses to noise or proportional reduction in foraging efficiency due to masking), and vulnerability is the probability that whales are exposed noise to which they are sensitive. Efforts are underway to provide much-needed information on hearing sensitivity in baleen whales, the role of acoustic cues in foraging, and deriving links between long-term variability in prey availability and whale demography. As this information becomes available, we expect rapid advancement on modelling population consequences of acoustic masking in baleen whales, because those efforts can leverage substantial investments in statistical methodological approaches to model population consequences of disturbance. Pathways of effects other than via foraging disruption (e.g., stress hormones affecting reproduction or disease) are possible, but we illustrate potential ways to proceed based on this tractable approach, namely noise-mediated impacts on foraging. This report highlights case studies of local, national, international, and inter-governmental efforts to monitor and reduce the contribution of global shipping to ocean ambient noise. The following outlines approaches that can be used to assess the risk to baleen whale recovery of existing levels of ocean noise, and consequently, predict the benefits likely to arise from reducing chronic ocean noise.

Lifelong learning tendencies of trainers in adult education

<span>Life-long learning competencies, skills and attitudes are of having significance for education processes. The study was designed based on the correlational survey model. Population consists of 354 trainers in Public Education Centers in Samsun. In terms gender, there was a significant difference in lack of regulation and lack of curiosity dimension in favour of females in terms of lifelong learning tendencies. It was found that as the age level increases, the tendency to persistence which is the sub-factor of lifelong tendencies increases. It was found that as the level of education increases, persistence level decreases and regulation skill increases. No statistically significant difference was found between the mean scores of lifelong learning tendencies in terms of professional seniority variable and mode of their work. It was seen that the trainers who did not receive pedagodical formation had higher tendency in the fields of motivation and persistence. It was found that there was a significant difference in the sub-dimension of lack of regulation of learning according to the existance of any curriculum related to their field of study in favour of saying “no”.</span>