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We investigated the clinical predictors of methicillin-resistance and their impact on mortality in 371 patients with Staphylococcus aureus bacteraemia identified from two prospective multi-centre studies. Methicillin resistant S. aureus (MRSA) accounted for 42.2% of community-onset and 74.5% of hospital-onset cases. No significant clinical difference was found between patients infected with MRSA vs. methicillin-sensitive S. aureus (MSSA), except that the former were more likely to have had hospital-onset bacteraemia and received antibiotics in the preceding 90 days. After stratifying according to the acquisition site, prior antibiotic use was the only independent predictor of having MRSA in both community-onset and hospital-onset cases. The frequency of inappropriate empirical antibiotic therapy was higher in patients with MRSA than in those with MSSA bacteraemia. However, methicillin resistance was not a predictor of mortality in patients and the clinical characteristics and outcomes of both MRSA and MSSA bacteraemia were similar. This study indicates that there are no definitive clinical or epidemiological risk factors which could distinguish MRSA from MSSA cases with the exception of the previous use of antibiotics for having MRSA bacteraemia, which emphasises the prudent use of glycopeptide treatment of patients at risk for invasive MRSA infections.
We sought to evaluate the role healthcare providers play in carbapenem-resistant Enterobacteriaceae (CRE) acquisition among hospitalized patients.
A 1:4 case-control study with incidence density sampling.
Academic healthcare center with regular CRE perirectal screening in high-risk units.
We included case patients with ≥1 negative CRE test followed by positive culture with a length of stay (LOS) >9 days. For controls, we included patients with ≥2 negative CRE tests and assignment to the same unit set as case patients with a LOS >9 days.
Controls were time-matched to each case patient. Case exposure was evaluated between days 2 and 9 before positive culture and control evaluation was based on maximizing overlap with the case window. Exposure sources were all CRE-colonized or -infected patients. Nonphysician providers were compared between study patients and sources during their evaluation windows. Dichotomous and continuous exposures were developed from the number of source-shared providers and were used in univariate and multivariate regression.
In total, 121 cases and 484 controls were included. Multivariate analysis showed odds of dichotomous exposure (≥1 source-shared provider) of 2.27 (95% confidence interval [CI], 1.25–4.15; P=.006) for case patients compared to controls. Multivariate continuous exposure showed odds of 1.02 (95% CI, 1.01–1.03; P=.009) for case patients compared to controls.
Patients who acquire CRE during hospitalization are more likely to receive care from a provider caring for a patient with CRE than those patients who do not acquire CRE. These data support the importance of hand hygiene and cohorting measures for CRE patients to reduce transmission risk.
An updated compilation of published and new data of major-ion (Ca, Cl, K, Mg, Na, NO3, SO4) and methylsulfonate (MS) concentrations in snow from 520 Antarctic sites is provided by the national ITASE (International Trans-Antarctic Scientific Expedition) programmes of Australia, Brazil, China, Germany, Italy, Japan, Korea, New Zealand, Norway, the United Kingdom, the United States and the national Antarctic programme of Finland. The comparison shows that snow chemistry concentrations vary by up to four orders of magnitude across Antarctica and exhibit distinct geographical patterns. The Antarctic-wide comparison of glaciochemical records provides a unique opportunity to improve our understanding of the fundamental factors that ultimately control the chemistry of snow or ice samples. This paper aims to initiate data compilation and administration in order to provide a framework for facilitation of Antarctic-wide snow chemistry discussions across all ITASE nations and other contributing groups. The data are made available through the ITASE web page (http://www2.umaine.edu/itase/content/syngroups/snowchem.html) and will be updated with new data as they are provided. In addition, recommendations for future research efforts are summarized.
Extended-spectrum β-lactamase (ESBL) production has been very rare in serotype K1 Klebsiella pneumoniae ST23 strains, which are well-known invasive community strains. Among 92 ESBL-producing strains identified in 218 isolates from nine Asian countries, serotype K1 K. pneumoniae strains were screened. Two ESBL-producing K. pneumoniae isolates from Singapore and Indonesia were determined to be serotype K1 and ST23. Their plasmids, which contain CTX-M-15 genes, are transferable rendering the effective transfer of ESBL resistance plasmids to other organisms.
We conducted a cross-sectional seroepidemiological study in 2012–2013 to determine the seroprevalence of varicella-zoster virus (VZV) in adolescents and adults living in Korea, where varicella vaccination has been recommended universally at age 12–15 months since 2005. Residual serum samples were collected from 1196 healthy adults and adolescents aged ⩾10 years between November 2012 and March 2013. The fluorescent antibody to membrane antigen (FAMA) test and enzyme-linked immunosorbent assay (ELISA) were performed to determine the seroprevalence of VZV. The seroprevalences of VZV were compared between six age groups: 10–19, 20–29, 30–39, 40–49, 50–59, and ⩾60 years. The seroprevalence of VZV in the entire study cohort was 99·1% according to the FAMA test and 93·1% as determined by ELISA. The seroprevalences of the six age groups were as follows: 96·0%, 99·5%, 99·5%, 99·5%, 100%, and 100%, respectively, by the FAMA test, and 83·3%, 93·0%, 93·0%, 97·5%, 94·5%, and 97·5%, respectively, by ELISA. Seroprevalence increased significantly with age (P < 0·001); moreover, the seroprevalence in subjects aged 10–19 years was significantly lower than in other age groups (P < 0·001), as measured by both the FAMA test and ELISA. Thus, strategies to increase protective immunity against VZV in teenagers are necessary.
After an outbreak of pandemic influenza A/H1N1 (pH1N1) virus, we had previously reported the emergence of a recombinant canine influenza virus (CIV) between the pH1N1 virus and the classic H3N2 CIV. Our ongoing routine surveillance isolated another reassortant H3N2 CIV carrying the matrix gene of the pH1N1 virus from 2012. The infection dynamics of this H3N2 CIV variant (CIV/H3N2mv) were investigated in dogs and ferrets via experimental infection and transmission. The CIV/H3N2mv-infected dogs and ferrets produced typical symptoms of respiratory disease, virus shedding, seroconversion, and direct-contact transmissions. Although indirect exposure was not presented for ferrets, CIV/H3N2mv presented higher viral replication in MDCK cells and more efficient transmission was observed in ferrets compared to classic CIV H3N2. This study demonstrates the effect of reassortment of the M gene of pH1N1 in CIV H3N2.
Equine influenza virus (EIV) causes a highly contagious respiratory disease in equids, with confirmed outbreaks in Europe, America, North Africa, and Asia. Although China, Mongolia, and Japan have reported equine influenza outbreaks, Korea has not. Since 2011, we have conducted a routine surveillance programme to detect EIV at domestic stud farms, and isolated H3N8 EIV from horses showing respiratory disease symptoms. Here, we characterized the genetic and biological properties of this novel Korean H3N8 EIV isolate. This H3N8 EIV isolate belongs to the Florida sublineage clade 1 of the American H3N8 EIV lineage, and surprisingly, possessed a non-structural protein (NS) gene segment, where 23 bases of the NS1-encoding region were naturally truncated. Our preliminary biological data indicated that this truncation did not affect virus replication; its effect on biological and immunological properties of the virus will require further study.
A survey of the Milky Way disk and the Magellanic System at the wavelengths of the 21-cm atomic hydrogen (H i) line and three 18-cm lines of the OH molecule will be carried out with the Australian Square Kilometre Array Pathfinder telescope. The survey will study the distribution of H i emission and absorption with unprecedented angular and velocity resolution, as well as molecular line thermal emission, absorption, and maser lines. The area to be covered includes the Galactic plane (|b| < 10°) at all declinations south of δ = +40°, spanning longitudes 167° through 360°to 79° at b = 0°, plus the entire area of the Magellanic Stream and Clouds, a total of 13 020 deg2. The brightness temperature sensitivity will be very good, typically σT≃ 1 K at resolution 30 arcsec and 1 km s−1. The survey has a wide spectrum of scientific goals, from studies of galaxy evolution to star formation, with particular contributions to understanding stellar wind kinematics, the thermal phases of the interstellar medium, the interaction between gas in the disk and halo, and the dynamical and thermal states of gas at various positions along the Magellanic Stream.
The relationship between recurrent major depression (MD) in women and suicidality is complex. We investigated the extent to which patients who suffered with various forms of suicidal symptomatology can be distinguished from those subjects without such symptoms.
We examined the clinical features of the worst episode in 1970 Han Chinese women with recurrent DSM-IV MD between the ages of 30 and 60 years from across China. Student's t tests, and logistic and multiple logistic regression models were used to determine the association between suicidality and other clinical features of MD.
Suicidal symptomatology is significantly associated with a more severe form of MD, as indexed by both the number of episodes and number of MD symptoms. Patients reporting suicidal thoughts, plans or attempts experienced a significantly greater number of stressful life events. The depressive symptom most strongly associated with lifetime suicide attempt was feelings of worthlessness (odds ratio 4.25, 95% confidence interval 2.9–6.3). Excessive guilt, diminished concentration and impaired decision-making were also significantly associated with a suicide attempt.
This study contributes to the existing literature on risk factors for suicidal symptomatology in depressed women. Identifying specific depressive symptoms and co-morbid psychiatric disorders may help improve the clinical assessment of suicide risk in depressed patients. These findings could be helpful in identifying those who need more intense treatment strategies in order to prevent suicide.
Shockley-Queisser detailed balance theory predicts that under one sun a semiconductor with its bandgap in the range of 1.0 – 1.6 eV can potentially achieve an energy conversion efficiency > 30%. Therefore, the conversional wisdom would suggest looking for a semiconductor with a bandgap in this range for a single junction solar cell. Here we explore an alternative way of selecting the absorber material for PV, which allows using semiconductors with much larger bandgaps, in conjunction with new device architecture. Specifically, our device is based on an array of core-shell semiconductor nanowires, such as ZnO-ZnSe, where the two components exhibit type II band alignment. Our approach relies on the most basic property of a type II heterojunction, i.e., the staggered band alignment, that provides the function of charge separation, as in the case of dye-sensitized solar cell or (organic) bulk heterojunction solar cell. However, they differ in two important aspects: (1) the current structure is all inorganic, thus, expected to offer better chemical and photo- stability; and (2) In this approach, the interfacial transition provides an effective absorption or photo-response threshold that can be much lower than that of either component. In this work, using a ZnO-ZnSe core-shell nanowire array, we report the observation of the key signatures associated with the type II optical transition, and the demonstration of a solar cell based on the core-shell nanowire array.
The effects of source field plates on AlGaN/GaN High Electron Mobility Transistor reliability under off-state stress conditions were investigated using step-stress cycling. The source field plate enhanced the drain breakdown voltage from 55V to 155V and the critical voltage for off-state gate stress from 40V to 65V, relative to devices without the field plate. Transmission electron microscopy was used to examine the degradation of the gate contacts. The presence of cracking that appeared on both source and drain side of the gate edges was attributed to the inverse piezoelectric effect. In addition, a thin oxide layer was observed between the Ni gate contact and the AlGaN layer, and both Ni and oxygen had diffused into the AlGaN layer. The critical degradation voltage of AlGaN/GaN High Electron Mobility Transistors during off-state electrical stress was determined as a function of Ni/Au gate dimensions (0.1-0.17μm). Devices with different gate length and gate-drain distances were found to exhibit the onset of degradation at different source-drain biases but similar electric field strengths, showing that the degradation mechanism is primarily field-driven. The temperature dependence of sub-threshold drain current versus gate voltage at a constant drain bias voltage were used to determine the trap densities in AlGaN/GaN high electron mobility transistors (HEMTs) before and after the off-state stress. Two different trap densities were obtained for the measurements conducted at 300-493K and 493-573K, respectively.
We investigated the electrical characteristics of the MOSCAP structures with W/WNx/poly Si1−xGex gates stack using C-V and I-V. The low frequency C-V measurements demonstrated that the flat band voltage of the W/WNx /poly Si0.4Ge0.6 stack was lower than that of W/ WNx /poly Si0.2Ge0.8 stack by 0.3V, and showed less gate-poly-depletion-effect than that of W/ WNx /poly- Si0.2Ge0.8 gates due to the increase of dopant activation rate with the increase of Ge content in the poly Si1−xGex films. As Ge content in poly Si1−xGex increased, the leakage current level increased a little due to the increase of direct tunneling and QBD became higher due to the lower boron penetration.
A low-cost, non-vacuum reel-to reel dip-coating system has been used to continuously fabricate epitaxial Gd2O3 buffer layers on mechanically strengthened, biaxially textured Ni- (3at.%W-1.7at%Fe), defined as Ni-alloy, metal tapes. X-ray diffraction analysis of the seed Gd2O3 layers indicated that well textured films can be obtained at processing temperatures (Tp) between 1100 and 1175°C. Processing speed did not significantly affect the crystalline quality of the Gd2O3. Scanning electron microscopy revealed a continuous, dense and crack-free surface morphology for these dip-coated buffers. The Gd2O3 layer thickness led to remarkable differences in the growth characteristics of the subsequent YSZ and CeO2 layers deposited by rfmagnetron sputtering. Epitaxial YBCO films grown by pulsed laser deposition on the short prototype CeO2/YSZ/Gd2O3/Ni-(3at%W-1.7at%Fe) conductors yielded self-field critical current densities (Jc) as high as 1.2×106 A/cm2 at 77 K. Pure Ni tapes were used to asses the viability of dip-coated buffers for long length coated conductor fabrication. The YBCO films, grown on 80 cm long and 1 cm wide CeO2/YSZ/Gd2O3 buffered Ni tapes by the industrially scalable ex-situ BaF2 precursor process, exhibited end-to-end self-field Jc of 6.25×105 A/cm2 at 77 K.
Sol-gel processing of La2Zr2O7 (LZO) buffer layers on biaxially textured Ni-3 at.% W alloy substrates using a continuous reel-to-reel dip-coating unit has been studied. The epitaxial LZO films obtained have a strong cube texture and uniform microstructure. The effect of increasing the annealing speed on the texture, microstructure and the carbon content retained in the film were studied. On top of the LZO films, epitaxial layers of Yttria Stabilized Zirconia (YSZ) and Ceria (CeO2) were deposited using rf sputtering, and YBa2Cu3Ox (YBCO) films were then deposited using Pulsed Laser Deposition (PLD). A critical current density (Jc) of 1.9 MA/cm2 at 77K and self-field and 0.34 MA/cm2 at 77K and 0.5T have been obtained on these films. These values are comparable to those obtained on YBCO films deposited on all-vacuum deposited buffer layers, and are the highest ever obtained using solution seed layers. The use of all-solution buffers for coated conductor processing has also been explored. A critical current density of 1.1 MA/cm2 at 77 K and self-field was obtained on YBCO films grown be PLD on LZO buffered nickel substrates.
We report combined scanning near-field optical microscopy (SNOM) and near-field photocurrent (NPC) imaging of a binary conjugated polymer blend. We find phase separation on a scale of about 5 μm, with a good correspondence between topographic, fluorescence, and photocurrent images. We excited at 488 nm, a wavelength at which only one of the two polymers absorbs light. Under this illumination regions that are high in the topography image show high luminescence and photocurrent.
The photoluminescence (PL) efficiencies in the different regions of the sample were determined by calculating the absorbed energy using the Bethe-Bouwkamp model, and knowledge about the chemical composition of the different phases of the polymer blend. The calculation also allowed us to conclude that the photocurrent generation efficiency (current/absorbed photons) of the different polymer phases is comparable within the limit of confidence of this experiment (±10 %).
Ag nanoparticles have been prepared by thermal decomposition of Ag-oleate complex using electric furnace at 300 °C for about 4 hrs. TEM images of the particles showed 2-dimensional assembly of particles with diameter of 8.0 ± 1.3 nm, demonstrating the uniformity of these nanoparticles. Ag-TiO2 nanoparticles were synthesized by sol-gel process and they had core-shell structure. Results showed the formation of the silver core and titanium oxide shell. In this study, we investigated the structure of Ag nanoparticle and Ag-TiO2 nanoparticle and Ag-TiO2-chitosan complex and their functions of antibiosis and deodorization.