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To describe an outbreak of bacteremia caused by vancomycin-sensitive Enterococcus faecalis (VSEfe).
An investigation by retrospective case control and molecular typing by whole-genome sequencing (WGS).
A tertiary-care neonatal unit in Melbourne, Australia.
Risk factors for 30 consecutive neonates with VSEfe bacteremia from June 2011 to December 2014 were analyzed using a case control study. Controls were neonates matched for gestational age, birth weight, and year of birth. Isolates were typed using WGS, and multilocus sequence typing (MLST) was determined.
Bacteremia for case patients occurred at a median time after delivery of 23.5 days (interquartile range, 14.9–35.8). Previous described risk factors for nosocomial bacteremia did not contribute to excess risk for VSEfe. WGS typing results designated 43% ST179 as well as 14 other sequence types, indicating a polyclonal outbreak. A multimodal intervention that included education, insertion checklists, guidelines on maintenance and access of central lines, adjustments to the late onset sepsis antibiotic treatment, and the introduction of diaper bags for disposal of soiled diapers after being handled inside the bed, led to termination of the outbreak.
Typing using WGS identified this outbreak as predominately nonclonal and therefore not due to cross transmission. A multimodal approach was then sought to reduce the incidence of VSEfe bacteremia.
A viscous damping model is proposed based on a simplified equation of fluid motion in a moonpool or the narrow gap formed by two fixed boxes. The model takes into account the damping induced by both flow separation and wall friction through two damping coefficients, namely, the local and friction loss coefficients. The local loss coefficient is determined through specifically designed physical model tests in this work, and the friction loss coefficient is estimated through an empirical formula found in the literature. The viscous damping model is implemented in the dynamic free-surface boundary condition in the gap of a modified potential flow model. The modified potential flow model is then applied to simulate the wave-induced fluid responses in a narrow gap formed by two fixed boxes and in a moonpool for which experimental data are available. The modified potential flow model with the proposed viscous damping model works well in capturing both the resonant amplitude and frequency under a wide range of damping conditions.
We use ultrafast coherent two-dimensional electronic spectroscopy (2DES) to study the ultrafast spectral diffusion dynamics of colloidal CdSe quantum dots (QDs) and CdSe nanoplatelets (NPLs). The Center Line Slope (CLS) and Nodal Line Slope (NLS) techniques were employed to analyse the 2DES spectra. We show that no spectral diffusion dynamics occurs for the CdSe QDs. On the other hand, spectral diffusion was observed in the CdSe 5 mono-layers NPLs heavy-hole transition. The normalized Frequency Fluctuation Correlation Function (FFCF) of the CdSe NPLs heavy-hole transition was measured to have a major fast decay component at 140 fs.
The evolution of carbides and the coarsening behavior of L12 ordered γ′ phase in Ni–25Cr–20Co alloys aged for varying time from 1000 to 5000 h at 700 and 750 °C were discussed in this paper. The mechanical properties of the alloys after aging were also discussed. Due to the changing of predominated resistance factor, a few of the γ′ precipitates’ shape changed from spherical to cuboidal after aging at 750 °C for 3000 h. The sizes and volume fraction of the γ′ precipitates were measured after aging at both temperatures. The experimentally determined temporal exponent of the γ′ coarsening indicated that the coarsening kinetics is in accordance with both models: the classical matrix diffusion LSW model and the trans-interface diffusion-controlled model. Additionally, the coarsening rate of the γ′ precipitates is dominated by the diffusion coefficients of Nb based on the classical LSW model. Furthermore, the yield strength curves of the alloys aged at 700 °C showed different trends at both test temperatures which is related to the influence of γ′ coarsening on the critical resolved shear stress.
Inappropriate use of antibiotics is contributing to a serious antimicrobial resistance problem in Asian hospitals. Despite resource constraints in the region, all Asian hospitals should implement antimicrobial stewardship (AMS) programs to optimize antibiotic treatment, improve patient outcomes, and minimize antimicrobial resistance. This document describes a consensus statement from a panel of regional experts to help multidisciplinary AMS teams design programs that suit the needs and resources of their hospitals. In general, AMS teams must decide on appropriate interventions (eg, prospective audit and/or formulary restriction) for their hospital, focusing on the most misused antibiotics and problematic multidrug-resistant organisms. This focus is likely to include carbapenem use with the goal to reduce carbapenem-resistant gram-negative bacteria. Rather than initially trying to introduce a comprehensive, hospital-wide AMS program, it would be practical to begin by pilot testing a simple program based on 1 achievable core intervention for the hospital. AMS team members must work together to determine the most suitable AMS interventions to implement in their hospitals and how best to put them into practice. Continuous monitoring and feedback of outcomes to the AMS teams, hospital administration, and prescribers will enhance sustainability of the AMS programs.
The room-temperature switching effect is of great interest for many applications, such as smart buildings, sensors, thermal energy storage and automatic temperature control. In this paper, we report a room-temperature switchable carbon nanotube (CNT)/hexadecane composites. Electrical conductivity, thermal conductivity and permittivity of the CNT/hexadecane composites can be regulated around 18°C and the maximal switching ratio reaches 5 orders of magnitude, 3 times and 106.4, respectively. The switching behavior of composites is caused by rearrangement of the carbon nanotube fillers in hexadecane matrix during liquid-solid phase transition. It is found that surface modification is necessary to improve dispersion stability. Effects of filler properties on switching behaviour are also discussed.
China's model of development, often referred to as the ‘Beijing Consensus,’ involves a high degree of control for the state. Such control goes beyond economic planning and includes state-owned enterprises (SOEs) that are active participants in many sectors of the economy from manufacturing to services. The Beijing Consensus is often contrasted with the Washington Consensus which involved a set of ten policies that the US government and Washington-based international financial institutions – the World Bank and International Monetary Fund (IMF) – believed were necessary elements that developing countries should adopt to increase economic growth. The Washington Consensus, at its essence, placed emphasis on the importance of macroeconomic stability and the liberalization of the economy including reducing the role of the state. As the originator of the term, John Williamson, put it, the policies “may be summarized as prudent macroeconomic policies, outward orientation, and free-market capitalism.” It reflected a “neoliberal” set of economic reform policies as the term “neoliberalism” – which is used in a number of ways – is most commonly understood today. Scholars using the term in this manner typically characterize three sets of polices as being neoliberal: those that liberalize the economy by eliminating price controls, deregulating capital markets, and lowering trade barriers; those that reduce the role of the state in the economy, most notably via privatization of SOEs; and those that contribute to fiscal austerity and macroeconomic stabilization, including tight control of money supply, elimination of budget deficits, and curtailment of government subsidies.
However, even before the Beijing Consensus was coined as a term, the universality of the Washington Consensus, which was largely formulated in the context of economic problems in Latin America, was doubted. Part of the reason for this was that the recipe it prescribed led to economic chaos in some ex-Communist countries such as Russia. Another major reason was that it did not fit the development experience of some East Asian economies including Singapore. Although Singapore is not a communist or socialist country, at an early stage of her postindependence history Singapore embraced state capitalism and actively promoted the incorporation of companies – often referred to as government-linked companies or “GLCs” – to engage in various sectors of the economy. This was part of a two-pronged approach to achieve industrialization and GLCs continue to play an important role in Singapore's economy.
The Straits Settlements comprised a group of British territories located in the Malay Peninsula in Southeast Asia. It initially comprised Penang, Singapore, and Malacca, and was formed in 1826. Unlike Malacca which was a thriving city with a substantial Chinese community, Penang and Singapore were relatively uninhabited when the British arrived, but Chinese immigration to both territories swiftly took place and on a large scale. For much of the nineteenth century, British policy towards the Chinese community in the Straits was one of minimal governance. They were largely left to order their affairs privately and this suited the Chinese, who tended to be aloof from the machinery of government and were also unfamiliar with English law. While there were many positive aspects of such private ordering, some negative features included the manner in which secret societies evolved and the treatment of coolies. It was only when the colonial government introduced strong measures that these negative aspects were ameliorated.
The high order inverse Lax-Wendroff (ILW) procedure is extended to boundary treatment involving complex geometries on a Cartesian mesh. Our method ensures that the numerical resolution at the vicinity of the boundary and the inner domain keeps the fifth order accuracy for the system of the reactive Euler equations with the two-step reaction model. Shock wave propagation in a tube with an array of rectangular grooves is first numerically simulated by combining a fifth order weighted essentially non-oscillatory (WENO) scheme and the ILW boundary treatment. Compared with the experimental results, the ILW treatment accurately captures the evolution of shock wave during the interactions of the shock waves with the complex obstacles. Excellent agreement between our numerical results and the experimental ones further demonstrates the reliability and accuracy of the ILW treatment. Compared with the immersed boundary method (IBM), it is clear that the influence on pressure peaks in the reflected zone is obviously bigger than that in the diffracted zone. Furthermore, we also simulate the propagation process of detonation wave in a tube with three different widths of wall-mounted rectangular obstacles located on the lower wall. It is shown that the shock pressure along a horizontal line near the rectangular obstacles gradually decreases, and the detonation cellular size become large and irregular with the decrease of the obstacle width.
As electronic devices are indispensable in many aspects of our lives today, their integration with unconventional surfaces is increasingly essential. Electronic devices which maintain their electrical properties upon stretching are desirable for various wearable applications. Stretchable devices demonstrated are conventionally fabricated using semiconductor processing techniques. In this study, we demonstrate stretchable electrodes, which are basic components of electrical circuits, using screen printing, a large area printing method. It provides a low cost and scalable method to fabricate large area stretchable devices. Despite the larger width and thickness of the electrodes which increases the stiffness of the material, stretchability beyond 40% is demonstrated, which is suitable for certain wearable applications. The stretchable electrodes are integrated with light emitting diodes (LEDs) to demonstrate a stretchable LED matrix. The large area LED matrices exhibit variable stretchability, depending on the LED areal coverage. This technique is expected to be applicable in the fabrication of other stretchable, large area, and more complex electronic systems.
Introduction: The mortality of Parkinson’s disease (PD) and its associated risk factors among clinically definite PD patients in China has been rarely investigated. Our study aimed to identify the mortality rates and predictors of death in PD patients in China. Methods: 157 consecutive, clinically definite PD patients from the urban area of Shanghai were recruited from a central hospital based movement disorder clinic in 2006. All patients were regularly followed up at the clinic until December 31, 2011, or death. Mortality and associations with baseline demographics, health and medical factors were then determined within the cohort. Results: After 5 years, 11(7%) patients had died. The standardised mortality ratio was 0.62 (95% CI 0.32 to 1.07, P=0.104). The main causes of death were pneumonia (54.5%, 6/11) and digestive disorders (18.2%, 2/11), respectively. Age at onset, independent living, the mini mental state examination score, the Parkinson’s disease sleep scale score and the Epworth sleepiness scale score at baseline were statistically significantly different between the survival group and the deceased group (P<0.05). Across all participants, risk factors for death included low mini mental state examination score, and high Epworth sleepiness scale score according to a binary variable logistic regression analysis. Conclusions: This study confirms the similar survival of patients with PD to the control population up to a follow-up of 5 years. Interventions tailored to potential risk factors associated with death may offer further benefits.
This article starts off by providing an overview of the historical and structural aspects of legal education in selected representative jurisdictions in Asia. It then proceeds to tackle what the authors feel to be the most serious challenges faced by Asian law schools today - the need to balance legal education and inter-disciplinary perspectives, to provide sufficient comparative material, to reform teaching and assessment methodology, and to juggle competing needs with very limited resources.
We analyzed variations in the Sr/Ca, Ba/Ca, REE/Ca (REE: rare earth element), Zn/Ca, and Pb/Ca ratios preserved in an annually layered stalagmite, XL21, from central China. The stalagmite record spans the 95 year period AD 1914–2008. The Sr/Ca and Ba/Ca ratios have a significant positive correlation with the stalagmite's growth rate, suggesting that they were primarily controlled by growth-rate variations. Variations in REE/Ca ratios are consistent with local temperature changes, suggesting temperature influenced REE concentrations in the stalagmite over decadal to annual timescales. Higher temperature in this humid area can increase vegetation cover, microbial activity, and organic decomposition in the soil, resulting in enhanced pCO2, organic matter concentration and reduced pH, and consequently increased REE mobilization from the overlying soil layer and host rock. Higher temperatures may also increase the natural Zn mobilization from the overlying soil mediated by organic matter and consequently may have led to increased Zn retention in XL21. An increasing trend is seen in the Pb/Ca ratios from XL21 since 1985, which is consistent with increased lead production in this area, and indicates an increase in mine-derived lead pollution in the local environment over the past 30 years.
Commonly used techniques for cleaning copper substrates before graphene growth via chemical vapor deposition (CVD), such as rinsing with acetone, nitric, and acetic acid, and high temperature hydrogen annealing still leave residual adventitious carbon on the copper surface. This residual carbon promotes graphene nucleation and leads to higher nucleation density. We find that copper with an oxidized surface can act as a self-cleaning substrate for graphene growth by CVD. Under vacuum conditions, copper oxide thermally decomposes, releasing oxygen from the substrate surface. The released oxygen reacts with the carbon residues on the copper surface and forms volatile carbon monoxide and carbon dioxide, leaving a clean copper surface free of carbon for large-area graphene growth. Using oxidized electropolished copper foil leads to a reduction in graphene nucleation density by over a factor of 1000 when compared to using chemically cleaned oxygen free copper foil.
Review of “Interregional Recognition and Enforcement of Civil and Commercial Judgments” by Professor Jie Huang (Oxford and Portland, Oregon: Hart Publishing, 2014) which analyses the status quo of judgment recognition and enforcement in the Mainland China, Macao and Hong Kong under the ‘One Country, Two Systems’ regime. The book also presents a comparative study of the interregional recognition and enforcement of judgments in the US and EU.
A limited but growing body of evidence supports a significant role of antioxidant and anti-inflammatory micronutrients in pulmonary health. We investigated the associations of dietary and supplemental intakes of vitamins A, C, E and D, Se and n-3 PUFA with pulmonary function in a population-based study.
Population-based, cross-sectional study and data analysis of fruits and vegetables, dairy products and fish, vitamins A, C, E and D, Se and n-3 PUFA supplemental intakes, pulmonary risk factors and spirometry.
Chinese older adults (n 2478) aged 55 years and above in the Singapore Longitudinal Ageing Studies.
In multiple regression models that controlled simultaneously for gender, age, height, smoking, occupational exposure and history of asthma/chronic obstructive pulmonary disease, BMI, physical activity, and in the presence of other nutrient variables, daily supplementary vitamins A/C/E (b = 0·044, se = 0·022, P = 0·04), dietary fish intake at least thrice weekly (b = 0·058, se = 0·016, P < 0·0001) and daily supplementary n-3 PUFA (b = 0·068, se = 0·032, P = 0·034) were individually associated with forced expiratory volume in the first second. Supplemental n-3 PUFA was also positively associated with forced vital capacity (b = 0·091, se = 0·045, P = 0·045). No significant association with daily dairy product intake, vitamin D or Se supplements was observed.
The findings support the roles of antioxidant vitamins and n-3 PUFA in the pulmonary health of older persons.
We propose a nonscanning three-dimensional (3D) optical microscope based on reflectivity-height transformation in applications of biological and transparent plate measurements. The reflectivity of a prism can be transformed to the surface height of the specimen based on geometrical optics and the principle of internal reflection. Thus, the pattern of reflectivity is representative of the surface profile. Using charge-coupled device cameras to obtain the two-dimensional image patterns and combining with its reflectivity pattern, the 3D profile can be generated. The lateral resolution is determined by the diffraction limit, and the vertical resolution is better than several nanometers according to the incident angle and polarization used.
Roysten Abel's The Manganiyar Seduction is perhaps the most popular performance of Indian folk music on the global festival market today. This performance of Rajasthani folk music is an apt exemplification of an auto-exoticism framed as cultural commodity. Its mise en scène of musicians framed, literally, by illuminated red square boxes ‘theatricalizes’ Rajasthan's folk culture of orality and gives the performance a quality of strangeness that borders on theatre and music, contemporary and traditional. The ‘dazzling’ union of the Manganiyars' music and the scenography of Amsterdam's red-light district engendered an exotic seduction that garnered rave reviews on its global tour. This paper examines the production's performative interstices: the in-betweenness of sound and sight where aural tradition is ‘spectacularized’. It will also analyse the shifting convergences of tradition and cultural consumption and further interrogates the role of reception in the construction of such ‘exotic’ spectacles.