for Aug 21, 2019
NEW 🔥🔥
— Antibiotic Steward (@ABsteward) August 21, 2019
State of the Art Review @bmj_latest
Clostridioides difficile: diagnosis and treatments. #IDTwitter https://t.co/4SbX2Z7UUu pic.twitter.com/XkXR67tfAO
'This study showed a decreasing trend in the prescribing of antibacterial drugs. Awareness of antimicrobial resistance, reimbursement status changes & pneumococcal & influenza vaccinations are possible reasons for this' #JACNews https://t.co/WHhcTpeoky
— BSAC (@BSACandJAC) August 21, 2019
The U.S. Customs and Border Patrol’s decision to withhold #vaccinations against seasonal #influenza from migrants in border detention facilities is a violation of the most basic principles of public health & human rights.
— IDSA (@IDSAInfo) August 21, 2019
Read our statement: https://t.co/oZFnrptonG @CBP pic.twitter.com/QrBHapPRnX
Impact of Unconscious Bias in Healthcare: How to Recognize and Mitigate It | The Journal of Infectious Diseases | Oxford Academic https://t.co/6J6I1wB6Vn
— Brave Enough MD (@RUBraveEnough) August 21, 2019
"early transition from IV to oral therapy is a feasible & effective strategy in most patients with BSI due to Gram-negative bacteria, obligate anaerobic bacteria and Candida species." https://t.co/wfVGiJRf3D Important for #AMS #AMR #antimicrobialstewardship @raseaton66 @uhbipc
— Abid Hussain (@MicrobLog_me_uk) August 21, 2019
#InfectiousDiseases A-Z: There's a widespread outbreak of #HepatitisA in the U.S. "Hepatitis A is a highly contagious virus that can cause infection and inflammation in the liver," says @DrStaceyRizza. Anyone not vaccinated is at risk of infection. https://t.co/iwvMCqLTaR pic.twitter.com/gjuycPYj0G
— Mayo Clinic (@MayoClinic) August 21, 2019
Make ART. With #BACTERIA. @genspacenyc is hosting a public #AgarArt workshop this Sun, Aug 25 in #Brooklyn : https://t.co/Q4JPe4KDdW. Your #microbialmasterpiece could win $200 in prizes from ASM's Agar Art 2019 Contest! #DIYbio #SciArt #BioArt #NYC
— ASM (@ASMicrobiology) August 21, 2019
The UK has lost its #measles-free status 3 years after the virus was eliminated in the country.
— Microbes&Infection (@MicrobesInfect) August 21, 2019
Cases of the potentially deadly infection have been going up, with too few people being vaccinated.https://t.co/ZhicALrmze pic.twitter.com/mqNGS50FzT
Nutrition, Inflammation, and Immunological Biomarkers in Dengue virus infection - our paper now available as an advance article in the Journal of Infectious Diseases with @FinkelsteinLab @SuzeColt @CornellNutri @CornellCFI @ESPOL https://t.co/9arkHwXIfy
— Mehta Research Group (@MehtaRG) August 21, 2019
The Pfizer Foundation invests in 20 organizations tackling infectious diseases and antimicrobial resistance https://t.co/XpixG9UyeL #onmedic #ehealth #pharma
— onmedic global (@onmedicglobal) August 21, 2019
The first genetic evidence for cytochrome-based extracellular electron transfer in an Archaea, Methanosarcina acetivorans, suggests some parallels to Gram-negative bacterial systems @mbiojournal https://t.co/hxEnaUiJ8E pic.twitter.com/z1A4A9T563
— ASM (@ASMicrobiology) August 21, 2019
Please read the excellent statement from @IDSAInfo @HIVMA @SHEA_Epi @@ASTMH & @PIDSociety opposing the @CBP stance denying flu vaccines to migrants detained at the border. https://t.co/nYH502f5VN via @IDSAInfo
— Carlos del Rio (@CarlosdelRio7) August 21, 2019
New online: Improving the estimation of the global burden of antimicrobial resistant infections https://t.co/8y6uwckdnE #AMR
— The Lancet Infectious Diseases (@TheLancetInfDis) August 21, 2019
Join the @Innovate4AMR student competition to address #AntibioticResistance in low-resource settings. Winners will attend a capacity-building workshop in Geneva organized by ReAct, @IFMSA, @South_Centre
— ReAct Action on ABR (@reactgroup) August 21, 2019
& supported by @WHO Deadline 16 September! https://t.co/6pXkfD2qD1
#KeepAntibioticWorking resources are enroute to community pharmacies ahead of Sept #publichealth #AMRCampaign.
— Diane Ashiru, PhD (@DrDianeAshiru) August 21, 2019
Has your pack arrived?
Find out more via EoE webinar next Thursday 29.08.19. All welcome. Register: https://t.co/cqkXhkGKQp
Resources also available for download pic.twitter.com/mkNoQrUcg2
The Community Antimicrobial Stewardship Program at the @CDCofBC has recently published a study showing the cost-savings that have been achieved in BC since the implementation of the @DoBugsNeedDrugs program. The results are amazing! Read more: https://t.co/p5KKM2JwtD pic.twitter.com/YCPe93Wi2W
— antibioticwise (@antibioticwise) August 21, 2019
Antibiotic stewardship -- ensuring that patients get the right antibiotic at the right dose at the right time and for the right duration – is key to fighting #antibioticresistance https://t.co/AjAucVSwB4
— Save Antibiotics (@saveantibiotics) August 21, 2019
New: Forecasted Size of Measles Outbreaks Associated With Vaccination Exemptions for Schoolchildren https://t.co/l25ulTYPNX #openaccess @JAMANetworkOpen
— 𝙀𝙡𝙞 𝙋𝙚𝙧𝙚𝙣𝙘𝙚𝙫𝙞𝙘𝙝 😷 (@eliowa) August 21, 2019
Finally read @serotavirus @SandySpringerMD @jabarocas
— Joe Cooper (@jdcooperid) August 21, 2019
piece in CID about #addiction and #InfectiousDiseases. Well written. Like the requirement for all graduating fellows to get waivered. Seems like it would be easy to implement. Strong work! #IDTwitter https://t.co/SJxpZeafuE
Student question in #PHRM5880: I'm struggling in terms of determining duration of therapy even through I'm using both your ppt and guidelines to answer questions. Any advice? Yep...much of it has been made up over time. Most data now showing shorter=best https://t.co/rIgpjynyjb
— Chris Bland (@blandman19) August 21, 2019
Importance of Inclusion, Diversity, and Equity to the Future of the Infectious Diseases Society of America https://t.co/ISFlQgCUMU. Past @IDSAInfo President Bill Powderly has been a champion of #IDAEinID. #FacesofID #IDAEinJID
— Carlos del Rio (@CarlosdelRio7) August 21, 2019
Today marks 3 years since the last case of wild #poliovirus was recorded in Nigeria, a milestone as Africa may soon be declared #polio free. https://t.co/ZUlPkzfrcW
— IDSA (@IDSAInfo) August 21, 2019
Today's #shoutout to #WomenInSTEM goes to @IDSAInfo Prez @DrCindySears & @PreetiNMalani for their JID #editorial with @CarlosdelRio on #Inclusion, #Diversity, Access, and Equity for #InfectiousDiseases https://t.co/5Rj61MKqx4
— Dr Steffanie Strathdee, 🗡️Superbug Slayer 🗡️ (@chngin_the_wrld) August 21, 2019
📄 New CID pub... are ID pharmacists out there running into this topic in practice?
— ACCP INFD PRN (@accpinfdprn) August 21, 2019
Any pearls you have about the cross-roads of ID and addiction?https://t.co/Fw2kVSYKU7 #IDtwitter pic.twitter.com/ZTyRe9ulEs
Delighted to see published this #JID supplement dedicated to inclusion, diversity, access and equity in the infectious diseases workforce. I was honored to be a guest editor with @IDSAInfo President Cindy Sears and @PreetiNMalani #FacesofID https://t.co/XBKSjiCC8C
— Carlos del Rio (@CarlosdelRio7) August 21, 2019
Proficiency testing of virus diagnostics based on bioinformatics analysis of simulated in silico high-throughput sequencing data sets @JClinMicro https://t.co/mjrry74P1H pic.twitter.com/RP6cOthxCR
— ASM (@ASMicrobiology) August 21, 2019
Restriction-free antimicrobial stewardship initiative targeting fluoroquinolone reduction across a regional health-system
— IPIP (@IPIP_Open) August 21, 2019
Read it here: https://t.co/1BLEDvjk3i
Call for abstracts for the 19th ICID! #ICID2020 #infectiousdiseases #emergingdiseases #AMR #measles #vaccines #microbiology https://t.co/NfGv8NGPGb pic.twitter.com/kvSg7cUXUB
— ISID (@ISID_org) August 21, 2019
Love the flyer!@GSTTnhs and @EvelinaLondon staff: antibiotic guidelines are on the Infections app
— Dr. Alicia (@aliciad3) August 21, 2019
Android link: https://t.co/u08Npd4hLd
Or search for "infections GSTT" app, make sure to select your hospital site in settings#AntimicrobialResistance #AntimicrobialStewardship https://t.co/kxs09YsGbp
Migrants will face more health risks if a Trump admin plan to hold them in detention facilities indefinitely goes into effect during flu season.
— Nicole Acevedo (@Nicolemarie_A) August 21, 2019
At least 3 children have died of infectious diseases like the flu while in CBP custody.
My latest @NBCNews👇🏼https://t.co/K1Qd1Mu21S
Spectrum of Diversity in Today’s Infectious Diseases Workforce: It’s Much Broader and Brighter Than You Think https://t.co/6ycrwpDEvu Where does the ID workforce stand in respect to #IDAE? Read this article in #JID to find out. #FacesofID #IDAEinJID
— Carlos del Rio (@CarlosdelRio7) August 21, 2019
Interesting. #Rifampin dose recommended in the @IDSAInfo Vertebral Osteo is 600 mg PO q24h based on this paper.
— Monica Mahoney (@mmPharmD) August 21, 2019
Curious if folks are actually using 600mg q24h? Or 300mg q12h ala PJI/endocarditis?https://t.co/P2ZaOQ0hPf
Our new #JInfectDis supplement provides valuable resources to support #diversity in the field of infectious diseases: https://t.co/sd1W6qb2c3 #IDAEinJID #IDSAJournals #FutureofID @CarlosdelRio7 @PreetiNMalani pic.twitter.com/YeNfUAcs3y
— IDSA (@IDSAInfo) August 21, 2019
OPAT - An unfunded/underfunded mandate. “The majority of respondents reported a lack of support in data analysis (80%), information technology (66%), financial assistance (65%), and administrative assistance (60%).” https://t.co/NAT8yO8JIu
— Michael Calderwood (@CalderwoodMD) August 21, 2019
STEWARDSHIP / RESISTANCE SCAN: Improper #antibiotic Rx in UK; Combo drug for urinary infections https://t.co/MC6yWoKRP2 #AMR #AntibioticStewardship
— CIDRAP (@CIDRAP) August 21, 2019
Using Frontline Ownership to deliver sustained improvement in #antibiotic prescribing https://t.co/qzNfsR39Px @mckirrane @AisRafferty @IkeOkafor16 @rosilvergrove @TempleStreetHos @Ampforan @MonaBaker18 @johnfitzsimons9 @davidjvaughan @AMSInSight @astghughes @DundasSteph @sujas15
— Rob Cunney (@robcunney) August 21, 2019
Assessing the “Five Moments of Antimicrobial Prescribing”: (1) escalation, (2) de-escalation, (3) discontinuation, (4) switch, and (5) optimization. https://t.co/l5HpECH48C
— Michael Calderwood (@CalderwoodMD) August 21, 2019
Come be a part of the U! The Helms Lab (@mynhelms1) is looking for a #postdoc interested working on epithelial ion channels (ENaC) and their role in #lung #inflammation and #disease. Apply today! https://t.co/brvmi7mXmP #ECRchat #PhdChat #AcademicTwitter pic.twitter.com/21YfYBIAbx
— UofU3i (@UofU3i) August 21, 2019
HIV vaccine efficacy trials underway: Phase 2b study, Imbokodo, completed enrollment in May 2019 and initial results are anticipated in 2021; Phase 3 study, Mosaico, plans to open enrollment later this year. https://t.co/J7UfLChsLI pic.twitter.com/PNdqH9NxbL
— SIDP (@SIDPharm) August 21, 2019
Hundreds of people continue to be exposed to the #Ebola virus in DR Congo (DRC), raising fears of the disease spreading to neighboring countries and the wider region.@WHO reports 70 to 80 cases a week.https://t.co/tvH0uTzcyh pic.twitter.com/RCrVlHR69v
— Microbes&Infection (@MicrobesInfect) August 21, 2019
Watch our seminar today on the prevalence of infections in remote Indigenous communities and the need for AMS in primary care centres; and antimicrobial prescribing and AMS in aged care homes - https://t.co/YxNNVnVfpB pic.twitter.com/DHOUNAZXmG
— NCAS_Australia (@NCAS_Aus) August 21, 2019
Did you know infectious diseases affect 5-20% of the U.S. population every year? Our new, interactive Building Immunity Table explores the science behind viruses, like influenza and HIV, and the ways scientists fight back. https://t.co/YrG5Muu1Qi pic.twitter.com/GgKjJ3Q9Q9
— LibertyScienceCenter (@LibertySciCtr) August 21, 2019
How are some beef industry farmers able to use fewer antibiotics? Listen and read more here. #Beef #Cattle #Livestock #AMR #AntimicrobialStewardship #AntimicrobialResistance https://t.co/7rTEmiqe2G
— UC Davis Antimicrobial Stewardship (@UCDavisAMR) August 21, 2019
A new study published in @PLOSONE suggests #AMR rates may peak during winter months https://t.co/yp2sImKNVj @AJMC_Journal
— Save Antibiotics (@saveantibiotics) August 21, 2019
NEW in #IDSAJournals: the #IDAEinJID supplement provides resources on supporting inclusion, diversity, access & equity in field of ID. https://t.co/sd1W6qb2c3 #FacesofID
— IDSA (@IDSAInfo) August 21, 2019
Editors: @CarlosdelRio7 @DrCindySears @PreetiNMalani pic.twitter.com/nRUMREPTsK
"Social media to engage, communicate and interact." Article from @ESCMID. https://t.co/cQhLtkWuPC This is for us in #IPC @drmarkgarvey @uhbipc #IPCinAction
— Abid Hussain (@MicrobLog_me_uk) August 21, 2019
What can reduce adverse events & provide real-time clinical decision support for infectious disease surveillance as well as #antimicrobialstewardship? TheraDoc! Now at Alaska VA Healthcare! https://t.co/vCJUScxv7a @VeteransHealth@DeptVetAffairs #InfectionControl pic.twitter.com/EXNxqmZOAz
— DSS, Inc. (@DSSHealthIT) August 21, 2019
Commentary: Science Should Drive Vaccine Policy by @aetiology and @maiamajumder https://t.co/YypxVJtZq0 #openaccess @JAMANetworkOpen https://t.co/6HNaG7jqRj
— 𝙀𝙡𝙞 𝙋𝙚𝙧𝙚𝙣𝙘𝙚𝙫𝙞𝙘𝙝 😷 (@eliowa) August 21, 2019
Pharmacological effects of ginseng on infectious diseases. - PubMed - NCBI https://t.co/FGX2D6m8sI
— DrRPalmquist (@DrPalmquist) August 21, 2019
Urgency for vaccine grows as #AfricanSwineFever ravages Asia's pigs.
— Microbes&Infection (@MicrobesInfect) August 21, 2019
The virus wasn't considered a high priority until it turned up last year in China, likely by way of E. Europe. Since then, it has spread to other Asian countries, killing millions pigs.https://t.co/f2tBKe4mBD pic.twitter.com/pQX4SX6Mnz
Via @IDSAInfo, Infectious Diseases Society of America: "Border Patrol’s decision to withhold #vaccinations against seasonal #influenza from migrants in border detention facilities is a violation of the most basic principles of public health & human rights" https://t.co/Ampn1PZ64T
— Every. Last. One. (@IFTEveryLastOne) August 21, 2019
Yikes: Evaluated against the evidence-based prescribing guidelines for #antibiotic prophylaxis, 80% of the patients in a four-year study were prescribed antibiotics deemed “unnecessary.” That’s roughly 72,000 American patients. https://t.co/rPfTKCAYup #AntibioticResistance
— Battle Superbugs (@battlesuperbugs) August 21, 2019
The structure + functional mechanisms of the multiheme cytochrome OcwA, the terminal reductase of the Gram-positive bacterium Thermincola potens JR found at the cell surface @mbiojournal https://t.co/whSJ8gW9Gp pic.twitter.com/gS0XA1fxwg
— ASM (@ASMicrobiology) August 21, 2019
An umbrella review published this week in the journal Clinical Infectious Diseases, led by academics from ARU in #Cambridge and the Medical University of Vienna, found that people living with HIV have a significantly elevated risk of age-related illness. https://t.co/tDzTUUswmq pic.twitter.com/i1XpFS5Sbx
— ARU (@AngliaRuskin) August 21, 2019
“The single-patient room experience @cusm_muhc has many benefits—privacy, confidentiality, comfort, reduced noise, & improved quality of sleep. Importantly, this study also found that private rooms might help reduce life-threatening infections” https://t.co/WqmHxETlXd
— Battle Superbugs (@battlesuperbugs) August 21, 2019
Antimicrobial use in acute care hospitals: national point prevalence survey on healthcare-associated infections and antimicrobial use, Switzerland, 2017
— Dr. Alicia (@aliciad3) August 21, 2019
by @walterzingg @DidierPittet and teamhttps://t.co/PJQgagTahy
Emergence of Delafloxacin-Resistant Staphylococcus aureus in Brooklyn, NY - Well, that didn’t take long...22% resistance in 2017 https://t.co/D4iPCnZnwq
— Michael Calderwood (@CalderwoodMD) August 21, 2019
From @STCmicrobeblog the marine flatworms Paracatenula suggest a novel twist on symbiosis. Here, symbiotic bacteria do not just provide carbon compounds for their host but actually store them. And they do that also for energy... https://t.co/C72eOCKiSa
— ASM (@ASMicrobiology) August 21, 2019
Immigration officers won't vaccinate migrants, despite three children who have been in US custody who have died after contracting the flu. Do you think these people should be vaccinated for infectious diseases? https://t.co/ksl41jscto
— KRIS 6 News (@KRIS6News) August 21, 2019
Thanks @IDSA and all the co-authors for this important supplement to #JID Inclusion, Diversity, Access, and Equity: Perspectives for Infectious Diseases https://t.co/r6Z4ow0hvP
— Andrew Pavia (@AndrewPaviaMD) August 21, 2019
antibiotic resistance; +122 new citations https://t.co/b6i6e9Kjo0
— AntibioticResistance (@AntibioticResis) August 21, 2019
A Summary of Recent Advances in Ebola Treatment. Great summary by @GlobalVirusNews of the recent advances in treatment of #Ebola @colleenkraftmd https://t.co/FjFHXAm1ZW
— Carlos del Rio (@CarlosdelRio7) August 21, 2019
Staphylococcus aureus colonisation and acquisition of skin and soft tissue infection amongst Royal Marines recruits: a prospective cohort study @unibirm_MDS @IMIBirmingham @DMS_RCDM @uhbtrust @uhbipc https://t.co/omVlEtj4us
— Abid Hussain (@MicrobLog_me_uk) August 21, 2019
Effects of an automatic discontinuation of antibiotics policy: A novel approach to #AntimicrobialStewardshiphttps://t.co/4d6JzQmUbA
— Dr. Alicia (@aliciad3) August 21, 2019
Infectious disease report for Ireland - latest weekly report available now https://t.co/mlk44sB3fr #thisispublichealth #vaccineswork #infectiousdiseases pic.twitter.com/S9au1Vk9P2
— HPSC (@hpscireland) August 21, 2019
More additions to the see saw of risk/benfit for abx use.. our profession's willingness for antimicrobial stewardship cont to be clinically relevant!https://t.co/fIYUiLlwvF
— Ankita Sagar, MD, FACP (@sagar_ankita) August 21, 2019
Perceived Benefits and Challenges of Ebola Preparation Among Hospitals in Developed Countries - “Doubts remain whether preparations resulted in sustained improvements.” https://t.co/v2V2AubmNS
— Michael Calderwood (@CalderwoodMD) August 21, 2019
#BuildTheDamnWall @realDonaldTrump
— Tom Curry @gab.ai (@Tom_Curry) August 21, 2019
Illegal immigrants are bringing dangerous infectious diseases into America, and the CDC is doing nothing about ithttps://t.co/c7ilsXwdTh
.@gardp_amr is hosting a free webinar on advanced and complex in vivo models for infectious disease research on Sept. 10. Register here: https://t.co/Krm2uTd65M
— Save Antibiotics (@saveantibiotics) August 21, 2019
Doctors are experimenting with using fecal transplants to treat antibiotic-resistant C. difficile, but the procedure is not without risks. @HarvardHealth explains: https://t.co/8XGEj1tip9 @hricciot @huebschergolen
— Save Antibiotics (@saveantibiotics) August 21, 2019
Illegal immigrants are bringing dangerous infectious diseases into America, and the CDC is doing nothing about it https://t.co/G4FHWRnr4H via @DCClothesline
— AmericaFirst 🇺🇸👊🇺🇸 ❌ (@danco_1830) August 21, 2019
Kudos to #VigiAwards “Standing Ovation” winner, Katherine Perez from @MethodistHosp. Katherine is being recognized for integrating rapid diagnostics and antimicrobial stewardship to improve patient outcomes. #hospital #healthcare #patientsafety https://t.co/KWGGXZRMHT pic.twitter.com/HcOoEN118g
— VigiLanz (@vigilanzcorp) August 21, 2019
Principles of Inclusion, Diversity, Access, and Equity https://t.co/6dDFm1qqoF Red this article by Tina Tan to understand what #IDAE is all about. #FacesofID #IDAEinJID
— Carlos del Rio (@CarlosdelRio7) August 21, 2019
Fab to meet up today with inaugural members of the UCL UTI in Pregnancy research group! (Catchier names welcome!) So much exciting work to be done - relevant to preterm birth, maternal morbidity, antimicrobial stewardship etc @PrenatalTherapy @JennyRohn @Lkindinger @NatashaLiou
— Jane Currie (@janecurrie) August 21, 2019
Super Bugs and Antimicrobial Stewardship. https://t.co/2vzEMCIvhX
— AntibioticResistance (@AntibioticResis) August 21, 2019
“Arthur Ashe once said, ‘Start where you are. Use what you have. Do what you can.’ Ashe was not referring to [antimicrobial stewardship programs], but he might as well have been”
— Amesh Adalja (@AmeshAA) August 21, 2019
https://t.co/kYFYjIHNjK
7/ For some scientific articles on this:@EpidemiologyLWW Balicer RD. Modeling infectious diseases dissemination through online role-playing games. Epidemiology. 2007 Mar;18(2):260-1.https://t.co/uZUTMONRzz
— Kim Lauper 🇨🇭 🇬🇧 🇪🇺 (@k_lauper) August 21, 2019
And allowing preventable diseases to spread in @realDonaldTrump's concentration camps, endangers all of us, in addition to being barbaric, cruel and unusual punishment. Infectious diseases don't stop at fences, gates, walls. #mumps https://t.co/QEbHRl2SyN
— Gregg Gonsalves (@gregggonsalves) August 21, 2019
Georgia State researchers recently found a link between the timing of a hurricane and the resulting spread of mosquito-borne diseases like #WestNile virus and #Zika. #WorldMosquitoDay https://t.co/M53FGHJR2M pic.twitter.com/uwGZJ6GZ0j
— GSU Research (@GSU_Research) August 21, 2019
How can we speed up the diagnosis of infectious diseases?
— The Pathologist (@pathologistmag) August 21, 2019
Steve Conly recommends automation and integrated informatics to improve outcomes and tackle the ever-present #AMR threat https://t.co/pDobx7HowY#Microbiology
IDSA/PIDS/SHEA/ASTMH joint statement on vaccinations for migrants at border detention facilities—thank you for your leadership on this important public health issue @IDSAInfo @PIDSociety @SHEA_Epi @ASTMH https://t.co/0YEtspwqQ4
— Kevin Messacar, MD (@kmess44) August 21, 2019
Due to popular demand, Abstract submission deadline for #ICC_GCCMID2019 is extended to 27th August. Hurry and submit your Research at https://t.co/Nq3Bt9Ba0K. @ischemo #InfectiousDiseases #Microbiology #ClinicalMicrobiology pic.twitter.com/uUrddqEIlJ
— ICC-GCCMID 2019 (@iccgccmid2019) August 21, 2019
Virginia Tech researchers receive $2.9 million grant with China to study infectious diseases https://t.co/B58FfYRg1Q
— VT Biology (@VT_Biology) August 21, 2019
Created by Cameron Forbes. Last updated August 25, 2019 at 05:13 EST.