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We report here three clinical cases as exemples of our rich and frequent collaboration between the department of psychiatry and the department of medecine, nephrology and hemodialysis. This work can serve as a basis for further reflection in order to improve mutual demands. We based our description on three patients chosen for their homogeneity in demand, rapidity of evaluation, the same clinician who evaluated the demand. Either case: a 42-year-old woman, who was admitted for alteration of general state, severe headaches and chronic addiction to alcohool, 71-year-old woman sufferring from recurrent unipolar depression who came for somatic exploration and severe weight loss or 55-year-old man who was transferred from cardio-pulmonary intensive care unit after a volontary ingestion of neuroleptic- were reevaluated by the psychiatrist and the special follow-up was indicated as the patient was discharded from internal medecine department. We were interested in studying how important to the patient this indication turned to be on time.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
One of the biggest challenges for in situ heating transmission electron microscopy (TEM) and scanning transmission electron microscopy (STEM) is the ability to measure the local temperature of the specimen accurately. Despite technological improvements in the construction of TEM/STEM heating holders, the problem of being able to measure the real sample temperature is still the subject of considerable discussion. In this study, we review the present literature on methodologies for temperature calibration. We analyze calibration methods that require the use of a thermometric material in addition to the specimen under study, as well as methods that can be performed directly on the specimen of interest without the need for a previous calibration. Finally, an overview of the most important characteristics of all the treated techniques, including temperature ranges and uncertainties, is provided in order to provide an accessory database to consult before an in situ TEM/STEM temperature calibration experiment.
We describe elongate, wet, subglacial bedforms in the shear margins of the NE Greenland Ice Stream and place some constraints on their formation. Lateral shear margin moraines have been observed across the previously glaciated landscape, but little is known about the ice-flow conditions necessary to form these bedforms. Here we describe in situ sediment bedforms under the NE Greenland Ice Stream shear margins that are observed in active-source seismic and ground-penetrating radar surveys. We find bedforms in the shear margins that are ~500 m wide, ~50 m tall, and elongated nearly parallel to ice-flow, including what we believe to be the first subglacial observation of a shear margin moraine. Acoustic impedance analysis of the bedforms shows that they are composed of unconsolidated, deformable, water-saturated till. We use these geophysical observations to place constraints on the possible formation mechanism of these subglacial features.
Recent seismic measurements from upper Thwaites Glacier indicate that the bed-type variability is closely related to the along-flow basal topography. In high-relief subglacial highlands, stoss sides of topographic highs have a relatively higher acoustic impedance (‘hard’ bed) with lower acoustic impedance (‘soft’ till) on lee sides. This pattern is similar to observations of many deglaciated terrains. Subglacial hydraulic-potential gradient and its divergence show a tendency for water to diverge over the stoss sides and converge into the lee sides. Convergence favors a thicker or more widespread water system, which can more efficiently decouple ice from the underlying till. Under such circumstances, till deformation does occur but, fluxes are relatively small. Till carried from the lee sides onto stoss sides of downstream bumps should couple to the ice more efficiently, increasing the ability for transport by till deformation. In turn, this suggests that steady-state till transport can be achieved if the stoss-side till layer is thin or discontinuous. In addition, the large basal shear stress generated in the highlands seems too high for a bed lubricated by a continuous although thin deforming till, suggesting till discontinuity, which would allow debris-laden ice to erode bedrock on stoss sides, supplying additional till for transport.
Recovery of multidrug-resistant (MDR) Pseudomonas aeruginosa and Klebsiella pneumoniae from a cluster of patients in the medical intensive care unit (MICU) prompted an epidemiologic investigation for a common exposure.
Clinical and microbiologic data from MICU patients were retrospectively reviewed, MICU bronchoscopes underwent culturing and borescopy, and bronchoscope reprocessing procedures were reviewed. Bronchoscope and clinical MDR isolates epidemiologically linked to the cluster underwent molecular typing using pulsed-field gel electrophoresis (PFGE) followed by whole-genome sequencing.
Of the 33 case patients, 23 (70%) were exposed to a common bronchoscope (B1). Both MDR P. aeruginosa and K. pneumonia were recovered from the bronchoscope’s lumen, and borescopy revealed a luminal defect. Molecular testing demonstrated genetic relatedness among case patient and B1 isolates, providing strong evidence for horizontal bacterial transmission. MDR organism (MDRO) recovery in 19 patients was ultimately linked to B1 exposure, and 10 of 19 patients were classified as belonging to an MDRO pseudo-outbreak.
Surveillance of bronchoscope-derived clinical culture data was important for early detection of this outbreak, and whole-genome sequencing was important for the confirmation of findings. Visualization of bronchoscope lumens to confirm integrity should be a critical component of device reprocessing.
Data-centric approaches have become increasingly popular in materials science, also known as informational materials science. Nanostructures often play essential roles in materials properties. Nanoinformatics is an important subset of informational materials science and a powerful tool for characterization and design of nanostructures. It allows discovery of meaningful and useful information and patterns from experimental and theoretical data and databases. This article reviews progress in nanoinformatics and informational materials science. Data-centric approaches for materials property description, construction of interatomic potentials, discovery of new inorganic compounds, efficient characterization of ionic transport and interfacial structures, hyperspectral image data analysis, and design of catalytic nanoparticles are outlined.
Egg-white protein (EWP) is known to reduce lymphatic TAG transport in rats. In this study, we investigated the effects of dietary EWP on body fat mass. Male rats, 4 weeks old, were fed diets containing either 20 % EWP or casein for 28 d. Carcass protein levels and gastrocnemius leg muscle weights in the EWP group were significantly higher than those in the casein group. In addition, carcass TAG levels and abdominal fat weights in the EWP group were significantly lower than those in the casein group; adipocyte size in abdominal fat in the EWP group was smaller than that in the casein group. To identify the involvement of dietary fat levels in the rats, one of two fat levels (5 or 10 %) was added to their diet along with the different protein sources (EWP and casein). Abdominal fat weight and serum and hepatic TAG levels were significantly lower in the EWP group than in the casein group. Moreover, significantly higher values of enzymatic activity related to β-oxidation in the liver were observed in the EWP group compared with the casein group. Finally, abdominal fat weight reduction in the EWP group with the 10 % fat diet was lower than that in the EWP group with the 5 % fat diet. In conclusion, our results indicate that, in addition to the inhibition of dietary TAG absorption reported previously, dietary EWP reduces body fat mass in rats through an increase of body protein mass and the acceleration of β-oxidation in the liver.
We fabricated a novel open-air channel with high efficient capillary-driven system inspired by a coastal animal “wharf roach”. The animal has open-air channels on its legs to transport water spontaneously using by capillary force. We abstracted principles controlling this phenomenon and applied it to artificial open-air channels, aiming at manipulating liquids without external energies. After surface modification for high surface free energy, the inspired open-air channels were able to transport water against gravity as well as the open-air channels of wharf roach by capillary effect of surface microstructures and chemistries. Topographical variation in micrometer-scaled patterns induced transport velocities improvement due to the enhancement of spreading intervals between the microstructure and wettability. Considering topography of micropatterned surfaces, the open-air channels with controllable transport velocity are applicable to capillary-driven microfluidics and lab-on-a-chips.
To determine risk factors for the development of surgical site infections (SSIs) in neurosurgery patients undergoing spinal fusion.
Retrospective case-control study.
Large, academic, quaternary care center.
The study population included all neurosurgery patients who underwent spinal fusion between August 1, 2009, and August 31, 2013. Cases were defined as patients in the study cohort who developed an SSI. Controls were patients in the study cohort who did not develop an SSI.
To achieve 80% power with an ability to detect an odds ratio (OR) of 2, we performed an unmatched case-control study with equal numbers of cases and controls.
During the study period, 5,473 spinal fusion procedures were performed by neurosurgeons in our hospital. With 161 SSIs recorded during the study period, the incidence of SSIs associated with these procedures was 2.94%. While anterior surgical approach was found to be a protective factor (OR, 0.20; 95% confidence interval [CI], 0.08–0.52), duration of procedure (OR, 1.58; 95% CI, 1.29–1.93), American Society of Anesthesiologists score of 3 or 4 (OR, 1.79; 95% CI, 1.00–3.18), and hospitalization within the prior 30 days (OR, 5.8; 95% CI, 1.37–24.57) were found in multivariate analysis to be independent predictors of SSI following spinal fusion. Prior methicillin-resistant Staphylococcus aureus (MRSA) nares colonization was highly associated with odds 20 times higher of SSI following spinal fusion (OR, 20.30; 95% CI, 4.64–8.78).
In additional to nonmodifiable risk factors, prior colonization with MRSA is a modifiable risk factor very strongly associated with development of SSI following spinal fusion.
Dimensional measurements from secondary electron (SE) images were compared with those from backscattered electron (BSE) and low-loss electron (LLE) images. With the commonly used 50% threshold criterion, the lines consistently appeared larger in the SE images. As the images were acquired simultaneously by an instrument with the capability to operate detectors for both signals at the same time, the differences cannot be explained by the assumption that contamination or drift between images affected the SE, BSE, or LLE images differently. Simulations with JMONSEL, an electron microscope simulator, indicate that the nanometer-scale differences observed on this sample can be explained by the different convolution effects of a beam with finite size on signals with different symmetry (the SE signal’s characteristic peak versus the BSE or LLE signal’s characteristic step). This effect is too small to explain the >100 nm discrepancies that were observed in earlier work on different samples. Additional modeling indicates that those discrepancies can be explained by the much larger sidewall angles of the earlier samples, coupled with the different response of SE versus BSE/LLE profiles to such wall angles.