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Here we present the synthesis of porous platinum–palladium macrobeams templated from high aspect ratio Magnus’ salt needle derivatives. The combination of [PtCl4]2− and/or [PdCl4]2− with [Pt(NH3)4]2+ ions results in salt needles ranging from 15 to 300 µm in length. Electrochemical reduction of the salt templates results in porous macrobeams with a square cross-section. Porous side wall texture and elemental composition was controlled with initial platinum to palladium salt ratio. Macrobeam free-standing films exhibited a specific capacitance up to 11.73 F/g and a solvent accessible surface area of 26.6 m2/g. These salt-templated porous platinum–palladium macrobeams offer a promising material for fuel cell catalysis.
We reviewed all patients who were supported with extracorporeal membrane oxygenation and/or ventricular assist device at our institution in order to describe diagnostic characteristics and assess mortality.
A retrospective cohort study was performed including all patients supported with extracorporeal membrane oxygenation and/or ventricular assist device from our first case (8 October, 1998) through 25 July, 2016. The primary outcome of interest was mortality, which was modelled by the Kaplan–Meier method.
A total of 223 patients underwent 241 extracorporeal membrane oxygenation runs. Median support time was 4.0 days, ranging from 0.04 to 55.8 days, with a mean of 6.4±7.0 days. Mean (±SD) age at initiation was 727.4 days (±146.9 days). Indications for extracorporeal membrane oxygenation were stratified by primary indication: cardiac extracorporeal membrane oxygenation (n=175; 72.6%) or respiratory extracorporeal membrane oxygenation (n=66; 27.4%). The most frequent diagnosis for cardiac extracorporeal membrane oxygenation patients was hypoplastic left heart syndrome or hypoplastic left heart syndrome-related malformation (n=55 patients with HLHS who underwent 64 extracorporeal membrane oxygenation runs). For respiratory extracorporeal membrane oxygenation, the most frequent diagnosis was congenital diaphragmatic hernia (n=22). A total of 24 patients underwent 26 ventricular assist device runs. Median support time was 7 days, ranging from 0 to 75 days, with a mean of 15.3±18.8 days. Mean age at initiation of ventricular assist device was 2530.8±660.2 days (6.93±1.81 years). Cardiomyopathy/myocarditis was the most frequent indication for ventricular assist device placement (n=14; 53.8%). Survival to discharge was 42.2% for extracorporeal membrane oxygenation patients and 54.2% for ventricular assist device patients. Kaplan–Meier 1-year survival was as follows: all patients, 41.0%; extracorporeal membrane oxygenation patients, 41.0%; and ventricular assist device patients, 43.2%. Kaplan–Meier 5-year survival was as follows: all patients, 39.7%; extracorporeal membrane oxygenation patients, 39.7%; and ventricular assist device patients, 43.2%.
This single-institutional 18-year review documents the differential probability of survival for various sub-groups of patients who require support with extracorporeal membrane oxygenation or ventricular assist device. The indication for mechanical circulatory support, underlying diagnosis, age, and setting in which cannulation occurs may affect survival after extracorporeal membrane oxygenation and ventricular assist device. The Kaplan–Meier analyses in this study demonstrate that patients who survive to hospital discharge have an excellent chance of longer-term survival.
OBJECTIVES/SPECIFIC AIMS: Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea and an increasingly common infection in children in both hospital and community settings. Between 20% and 30% of pediatric patients will have a recurrence of symptoms in the days to weeks following an initial infection. Multiple recurrences have been successfully treated with fecal microbiota transplantation (FMT), though the body of evidence in pediatric patients is limited primarily to case reports and case series. The goal of our study was to better understand practices, success, and safety of FMT in children as well as identify risk factors associated with a failed FMT in our pediatric patients. METHODS/STUDY POPULATION: This multicenter retrospective analysis included 373 patients who underwent FMT for CDI between January 1, 2006 and January 1, 2017 from 18 pediatric centers. Demographics, baseline characteristics, FMT practices, C. difficile outcomes, and post-FMT complications were collected through chart abstraction. Successful FMT was defined as no recurrence of CDI within 60 days after FMT. Of the 373 patients in the cohort, 342 had known outcome data at two months post-FMT and were included in the primary analysis evaluating risk factors for recurrence post-FMT. An additional six patients who underwent FMT for refractory CDI were excluded from the primary analysis. Unadjusted analysis was performed using Wilcoxon rank-sum test, Pearson χ2 test, or Fisher exact test where appropriate. Stepwise logistic regression was utilized to determine independent predictors of success. RESULTS/ANTICIPATED RESULTS: The median age of included patients was 10 years (IQR; 3.0, 15.0) and 50% of patients were female. The majority of the cohort was White (89.0%). Comorbidities included 120 patients with inflammatory bowel disease (IBD) and 14 patients who had undergone a solid organ or stem cell transplantation. Of the 336 patients with known outcomes at two months, 272 (81%) had a successful outcome. In the 64 (19%) patients that did have a recurrence, 35 underwent repeat FMT which was successful in 20 of the 35 (57%). The overall success rate of FMT in preventing further episodes of CDI in the cohort with known outcome data was 87%. Unadjusted predictors of a primary FMT response are summarized. Based on stepwise logistic regression modeling, the use of fresh stool, FMT delivery via colonoscopy, the lack of a feeding tube, and a lower number of CDI episodes before undergoing FMT were independently associated with a successful outcome. There were 20 adverse events in the cohort assessed to be related to FMT, 6 of which were felt to be severe. There were no deaths assessed to be related to FMT in the cohort. DISCUSSION/SIGNIFICANCE OF IMPACT: The overall success of FMT in pediatric patients with recurrent or severe CDI is 81% after a single FMT. Children without a feeding tube, who receive an early FMT, FMT with fresh stool, or FMT via colonoscopy are less likely to have a recurrence of CDI in the 2 months following FMT. This is the first large study of FMT for CDI in a pediatric cohort. These findings, if confirmed by additional prospective studies, will support alterations in the practice of FMT in children.
The mental health outcomes of military personnel deployed on peacekeeping
missions have been relatively neglected in the military mental health
To assess the mental health impacts of peacekeeping deployments.
In total, 1025 Australian peacekeepers were assessed for current and
lifetime psychiatric diagnoses, service history and exposure to
potentially traumatic events (PTEs). A matched Australian community
sample was used as a comparator. Univariate and regression analyses were
conducted to explore predictors of psychiatric diagnosis.
Peacekeepers had significantly higher 12-month prevalence of
post-traumatic stress disorder (16.8%), major depressive episode (7%),
generalised anxiety disorder (4.7%), alcohol misuse (12%), alcohol
dependence (11.3%) and suicidal ideation (10.7%) when compared with the
civilian comparator. The presence of these psychiatric disorders was most
strongly and consistently associated with exposure to PTEs.
Veteran peacekeepers had significant levels of psychiatric morbidity.
Their needs, alongside those of combat veterans, should be recognised
within military mental health initiatives.
To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics.
A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators.
In-home survey interviews in south-western Uganda.
All adult residents across eight rural villages; 96 % response rate (n 1669).
Severe food insecurity was associated with greater depression symptom severity (b=0·4, 95 % CI 0·3, 0·5, P<0·001 for women; b=0·3, 95 % CI 0·2, 0·4, P<0·001 for men). There was no evidence of effect modification by social network factors for women. However, for men who are highly embedded within in their village social network, and (separately) for men who have few poor contacts in their personal network, the relationship between severe food insecurity and depression symptoms was stronger than for men on the periphery of their village social network, and for men with many poor personal network contacts, respectively.
In this population-based study from rural Uganda, food insecurity was associated with mental health for both men and women. Future research is needed on networks and food insecurity-related shame in relation to depression symptoms among food-insecure men.
The integration of dissimilar materials is highly desirable for many different types of device applications but often challenging to achieve in practice. The unrivalled imaging capabilities of the aberration-corrected electron microscope enable enhanced insights to be gained into the atomic arrangements across heterostructured interfaces. This paper provides an overview of our recent observations of oxide-semiconductor heterostructures using aberration-corrected high-angle annular-dark-field and large-angle bright-field imaging modes. The perovskite oxides studied include strontium titanate, barium titanate, and strontium hafnate, which were grown on Si(001) and/or Ge(001) substrates using the techniques of molecular-beam epitaxy or atomic-layer deposition. The oxide layers displayed excellent crystallinity and sharp, abrupt interfaces were observed with no sign of any amorphous interfacial layers. The Ge(001) substrate surfaces invariably showed both 1× and 2× periodicity consistent with preservation of the 2 × 1 surface reconstruction following oxide growth. Overall, the results augur well for the future development of functional oxide-based devices integrated on semiconductor substrates.
Brown dwarf atmospheres form molecules, then high temperature condensates (corundum, titanates, silicates, and iron compounds), and then low temperature condensates (ices) as they cool down over time. These produce large opacities which govern entirely their spectral energy distribution. Just as it is important to know molecular opacities (TiO, H2O, CH4, etc.) with accuracy, it is imperative to understand the interplay of processes (e.g. condensation, sedimentation, coagulation, convection) that determines the radial and size distribution of grains. Limiting case models have shown that young, hot brown (L) dwarfs form dust mostly in equilibrium, while at much cooler stages (late T dwarfs) all high temperature condensates have sedimented out of their photospheres. But this process is gradual and all intermediate classes of brown dwarfs can partly be understood in terms of partial sedimentation of dust. With new models accounting for these processes, we describe the effects they may have upon brown dwarf spectral properties.
We have completed a grid of spherically symmetric AGB star atmospheres using the state of the art spectral synthesis code PHOENIX. Models are constructed for stars with masses of 1 M⊙ and 1.5 M⊙, spanning the range 10 to 3300 L⊙ in luminosity and 2500 to 5200 K in effective temperature. We find that grains of Al2O3 and CaTiO3 among other species form in atmospheres cooler than Teff = 3000 K. In the coolest models the grains cause a weakening of the TiO absorption features in the red and near infrared of up to 30% through both a depression of the continuum and a depletion of the TiO number abundance. We use spectrophotometric observations from a number of catalogs to determine effective temperature – spectral class and effective temperature – color relationships. We also compare synthetic colors calculated from our models with observations of M giants on Wing's 8-color narrow-band system of classification photometry.
The atmospheres of M stars are dominated by a small number of very strong molecular compounds (H2O, TiO, H2, CO, VO). Most of the hydrogen is locked in molecular H2, most of the carbon in CO; and H2O, TiO and VO opacities define a pseudo-continuum covering the entire flux distribution of these stars. The optical “continuum” is due to TiO vibrational bands which are often used as temperature indicators for these stars. These may be the depth of the bands relative to the troughs in between them; or the depth of the VO bands; or of the atomic lines relative to the local “continuum”; or even the strength of the infrared water bands; all of these depend on the strength of the TiO bands and the amount of flux-redistribution to longer wavelengths exerted by them. Departures from LTE of the Ti I atom, and thus the concentration of the important TiO molecule, could, therefore, have severe and measurable consequences on the atmospheric structure and spectra of these stars.
Our survey of antimicrobial stewardship practices among Rhode Island long-term care facilities demonstrated opportunities to develop formal programs. Results suggest infection preventionists are largely responsible for ensuring appropriate antibiotic use in long-term care facilities and there is a need for increased interdisciplinary access to individuals with antimicrobial stewardship expertise.
Atoms and ions dominate the opacity of most astrophysical plasmas at temperatures above about 5000 K. In the range between 5000 K and about 1500 K, molecular processes are important contributors to the opacity. Depending upon the composition and pressure, grains may begin to condense at temperatures below about 1500 K. For the conditions of interest here, the grains which form are generally small (radius < 0.25 µm) compared to the wavelength of light near the peak of the Planck curve. Because their absorption and scattering cross section is so large compared to atoms or molecules, grains dominate the mean opacity whenever they are present and must, therefore, be taken into account whenever such temperatures are encountered. Our calculations indicate that failure to do so can lead to errors as large as five orders of magnitude in the mean opacity.
Among dialysis facilities participating in a bloodstream infection (BSI) prevention collaborative, access-related BSI incidence rate improvements observed immediately following implementation of a bundle of BSI prevention interventions were sustained for up to 4 years. Overall, BSI incidence remained unchanged from baseline in the current analysis.