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Hand hygiene compliance rates were estimated using direct observations. An AHHMS, installed on 4 nursing units in a sequential manner, determined hand hygiene performance rates, expressed as the number of hand hygiene events performed upon entering and exiting patient rooms divided by the number of room entries and exits. Additional strategies implemented to improve hand hygiene included goal setting, hospital leadership support, feeding AHHMS data back to healthcare personnel, and use of Toyota Kata performance improvement methods. HAIs were defined using National Healthcare Safety Network criteria.
Hand hygiene compliance rates generated by direct observation were substantially higher than performance rates generated by the AHHMS. Installation of the AHHMS without supplementary activities did not yield sustained improvement in hand hygiene performance rates. Implementing several supplementary strategies resulted in a statistically significant 85% increase in hand hygiene performance rates (P < .0001). The incidence density of non–Clostridioies difficile HAIs decreased by 56% (P = .0841), while C. difficile infections increased by 60% (P = .0533) driven by 2 of the 4 study units.
Implementation of an AHHMS, when combined with several supplementary strategies as part of a multimodal program, resulted in significantly improved hand hygiene performance rates. Reductions in non–C. difficile HAIs occurred but were not statistically significant.
is the prime power decomposition of an integer v, and we define the arithmetic function n(v) by
then it is known, MacNeish (10) and Mann (11), that there exists a set of at least n(v) mutually orthogonal Latin squares (m.o.l.s.) of order v. We shall denote by N(v) the maximum possible number of mutually orthogonal Latin squares of order v. Then the Mann-MacNeish theorem can be stated as
MacNeish conjectured that the actual value of N(v) is n(v).
The triazines are one of the most widely used herbicide classes ever developed and are critical for managing weed populations that have developed herbicide resistance. These herbicides are traditionally valued for their residual weed control in more than 50 crops. Scientific literature suggests that atrazine, and perhaps other s-triazines, may no longer remain persistent in soils due to enhanced microbial degradation. Experiments examined the rate of degradation of atrazine and two other triazine herbicides, simazine and metribuzin, in both atrazine-adapted and non-history Corn Belt soils, with similar soils being used from each state as a comparison of potential triazine degradation. In three soils with no history of atrazine use, the t1/2 of atrazine was at least four times greater than in three soils with a history of atrazine use. Simazine degradation in the same three sets of soils was 2.4 to 15 times more rapid in history soils than non-history soils. Metribuzin in history soils degraded at 0.6, 0.9, and 1.9 times the rate seen in the same three non-history soils. These results indicate enhanced degradation of the symmetrical triazine simazine, but not of the asymmetrical triazine metribuzin.
A scaling theory of long-wavelength electrostatic turbulence in a magnetised, weakly collisional plasma (e.g. drift-wave turbulence driven by ion temperature gradients) is proposed, with account taken both of the nonlinear advection of the perturbed particle distribution by fluctuating
flows and of its phase mixing, which is caused by the streaming of the particles along the mean magnetic field and, in a linear problem, would lead to Landau damping. It is found that it is possible to construct a consistent theory in which very little free energy leaks into high velocity moments of the distribution function, rendering the turbulent cascade in the energetically relevant part of the wavenumber space essentially fluid-like. The velocity-space spectra of free energy expressed in terms of Hermite-moment orders are steep power laws and so the free-energy content of the phase space does not diverge at infinitesimal collisionality (while it does for a linear problem); collisional heating due to long-wavelength perturbations vanishes in this limit (also in contrast with the linear problem, in which it occurs at the finite rate equal to the Landau damping rate). The ability of the free energy to stay in the low velocity moments of the distribution function is facilitated by the ‘anti-phase-mixing’ effect, whose presence in the nonlinear system is due to the stochastic version of the plasma echo (the advecting velocity couples the phase-mixing and anti-phase-mixing perturbations). The partitioning of the wavenumber space between the (energetically dominant) region where this is the case and the region where linear phase mixing wins its competition with nonlinear advection is governed by the ‘critical balance’ between linear and nonlinear time scales (which for high Hermite moments splits into two thresholds, one demarcating the wavenumber region where phase mixing predominates, the other where plasma echo does).
This paper considers science aspects of a 1980 spacecraft reconnaissance of Comet Encke. The mission discussed is a ballistic flyby (more exactly, a fly-through) of P/Encke, using either a spin-stabilized spacecraft, without despin of instruments, or a 3-axis-stabilized spacecraft. Celestial mechanics and imaging aspects of such a mission have been considered in more detail by Bender (1) and by Jaffe et al (2), respectively. Engineering designs (3, 4) and more detailed accounts of science aspects are given in other documents. A different approach to an Encke ballistic flyby has been suggested by Farquahar et al (5). Yeomans (6) has considered ephemeris uncertainties associated with such missions.
The present observational problem of understanding the nature and origin of comets is analogous to that we would face in attempting to understand a planet and its atmosphere if we possessed only data on its ionosphere and exosphere. Virtually everything we can observe remotely is a part of the rapidly escaping gas and dust atmosphere of the comet.
Non-alcoholic fatty liver disease (NAFLD) is an independent predictor of CVD in otherwise healthy individuals. Low n-3 PUFA intake has been associated with the presence of NAFLD; however, the relationship between a biomarker of n-3 status – the Omega-3 Index – and liver fat is yet to be elucidated. A total of eighty overweight adults (fifty-six men) completed the anthropometric and biochemical measurements, including the Omega-3 Index, and underwent proton magnetic resonance spectroscopy assessment of liver fat. Bivariate correlations and multiple regression analyses were performed with reference to prediction of liver fat percentage. The mean Omega-3 Index was high in both NAFLD (intrahepatic lipid concentration≥5·5 %) and non-NAFLD groups. The Omega-3 Index, BMI, waist circumference, glucose, insulin, TAG, high-sensitive C-reactive protein (hsCRP) and alanine aminotransferase (ALT) were positively correlated, and HDL and erythrocyte n-6:n-3 ratio negatively correlated with liver fat concentration. Regression analysis found that simple anthropometric and demographic variables (waist, age) accounted for 31 % of the variance in liver fat and the addition of traditional cardiometabolic blood markers (TAG, HDL, hsCRP and ALT) increased the predictive power to 43 %. The addition of the novel erythrocyte fatty acid variable (Omega-3 Index) to the model only accounted for a further 3 % of the variance (P=0·049). In conclusion, the Omega-3 Index was associated with liver fat concentration but did not improve the overall capacity of demographic, anthropometric and blood markers to predict NAFLD.
This research implements a recently proposed framework for meander migration, in order to explore the coevolution of planform and channel width in a freely meandering river. In the model described here, width evolution is coupled to channel migration through two submodels, one describing bank erosion and the other describing bank deposition. Bank erosion is modelled as erosion of purely non-cohesive bank material damped by natural armouring due to basal slump blocks, and bank deposition is modelled in terms of a flow-dependent rate of vegetal encroachment. While these two submodels are specified independently, the two banks interact through the medium of the intervening channel; the morphodynamics of which is described by a fully nonlinear depth-averaged morphodynamics model. Since both banks are allowed to migrate independently, channel width is free to vary locally as a result of differential bank migration. Through a series of numerical runs, we demonstrate coevolution of local curvature, width and streamwise slope as the channel migrates over time. The correlation between the local curvature, width and bed elevation is characterized, and the nature of this relationship is explored by varying the governing parameters. The results show that, by varying a parameter representing the ratio between a reference bank erosion rate and a reference bank deposition rate, the model is able to reproduce the broad range of river width–curvature correlations observed in nature. This research represents a step towards providing general metrics for predicting width variation patterns in river systems.
We surveyed 399 US acute care hospitals regarding availability of on-site Legionella testing; 300 (75.2%) did not offer Legionella testing on site. Availability varied according to hospital size and geographic location. On-site access to testing may improve detection of Legionnaires disease and inform patient management and prevention efforts.
We are presently using the Chandra X-ray Observatory to conduct the first systematic X-ray survey of planetary nebulae (PNe) in the solar neighborhood. The Chandra Planetary Nebula Survey (ChanPlaNS) is a 570 ks Chandra Cycle 12 Large Program targeting 21 high-excitation PNe within ~1.5 kpc of Earth. When complete, this survey will provide a suite of new X-ray diagnostics that will inform the study of late stellar evolution, binary star astrophysics, and wind interactions. Among the early results of ChanPlaNS (when combined with archival Chandra data) is a surprisingly high detection rate of relatively hard X-ray emission from CSPNe. Specifically, X-ray point sources are clearly detected in roughly half of the ~30 high-excitation PNe observed thus far by Chandra, and all but one of these X-ray-emitting CSPNe display evidence for a hard (few MK) component in their Chandra spectra. Only the central star of the Dumbbell appears to display “pure” hot blackbody emission from a ~200 kK hot white dwarf photosphere in the X-ray band. Potential explanations for the“excess” hard X-ray emission detected from the other CSPNe include late-type companions (heretofore undetected, in most cases) whose coronae have been rejuvenated by recent interactions with the mass-losing WD progenitor, non-LTE effects in hot white dwarf photospheres, self-shocking variable winds from the central star, and slow (re-)accretion of previously ejected red giant envelope mass.
SAXS and EXAFS were applied to study genesis of polynuclear zirconium hydroxyspecies in pillaring solutions as dependent upon the zirconium concentration, addition of alkaline-earth chlorides and aging. After the montmorillonite clay pillaring, the structure of zirconium nanopillars was characterized by applying X-ray structural analysis, UV-Vis, FTIRS of adsorbed CO and nitrogen adsorption isotherms. Main pillaring species appear to be nanorods comprised of several Zr4 tetramers. Basic structural features of the tetramers are preserved in zirconia nanoparticles fixed between alumosilicate layers in pillared clays. In calcined samples, those nanoparticles contain only bridging hydroxyls and/or oxygen anions responsible for bonding within pillars and between pillars and clay sheets.
(Ni75Fe25)v/(SiO2)1-v nanocomposites with v =0.5, 0.7, and 1.0, where 75 denotes the atomic percent of Ni in the Ni-Fe alloy phase and v denotes the volume fraction of the magnetic constituent in the composite, were synthesized using a wet chemical approach. The x-ray diffraction and TEM experiments show that the synthetic NiFe/SiO2 is a two-phase composite system in that an amorphous insulating SiO2 layer coats each Ni-Fe particle. The Ni-Fe particle is in a fcc Ni-Fe alloy state. Its size can be controlled over a rather large range between 5 nm to 70 nm by adjusting the reaction parameters. Particular attention was paid to reduce the chemical reaction temperature so as to insure the smallness of the particle size. Meanwhile, measurements of the saturation magnetization indicated that the higher the heat treatment temperature, the more complete the chemical reaction to form the Ni-Fe alloys from precursor materials.
Hydroxyapetite (HA) coating on medical implant has been used in commercial application for several decades. The coating, commercially made by thermal spray method, functions as a intermediate layer between human tissues and the metal implant. The coating can speed up early stage healing after operation but the life span is much limited by low interfacial bond strength, which comes from the dissolution of amorphous HA in human body fluid during its service. This amorphous phase is formed in coating process under high temperature. To overcome these problems, we have developed a novel room temperature electrophoretic deposition process to fabricate nanostructured HA coating. This nanostructured HA coating significantly improved coating's bond strength up to 50-60 MPa, 2-3 times better than the thermal sprayed HA coating. The nanostructured HA coating also has corrosion resistance 50-100 times higher than the conventional HA coating. X-ray diffraction shows that all the HA coating is fully crystalline phase. It is expected that the implants with the nanostructured HA coating will have much longer service life. Other benefits derived from this process include room temperature deposition, the ability to control the coating microstructure and phases, and low cost for production.
In an effort to explore new highly resistive soft magnetic materials, Fe/SiO2 nanocomposite materials have been synthesized using a wet chemical reaction approach in which the precursor complex was annealed at various temperatures. The crystallographic structure, nanostructure, morphology, and magnetic properties of the synthetic Fe/SiO2 particles were studied by x-ray diffraction, transmission electron microscopy, and magnetic measurements. The experimental results show that for this approach, the [.alpha]-Fe particles are coated with amorphous silica. The progress of the reaction, the purity of Fe/SiO2 in the synthetic powder, and the Fe particle size are highly dependent on the annealing temperature. By adjusting the annealing temperature, the particle size can be controlled from approximately 20 nm to 70 nm. For the synthetic nanopowder obtained by H2 reduction at 400 °C, there exists a superparamagnetic behavior below room temperature; while for the nanopowders obtained by reduction at higher temperatures, the ferromagnetic behavior is dominant. Based on these studies, optimum synthesis conditions for Fe/SiO2 nanocomposites is determined.
Highly reflective surface-metallized flexible polyimide films have been prepared by the incorporation of the soluble silver ion complex (1,1,1-trifluoroacetylacetonato)silver(I) into dimethylacetamide solutions of the poly(amic acid) prepared from 2,2-bis(3,4-dicarboxyphenyl)-hexafluoropropane dianhydride (6FDA) and 2,2-bis[4-(4-aminophenoxy)phenyl]hexafluoro-propane (4-BDAF). Thermal curing of solution cast silver(I)-poly(amic acid) films leads to cycloimidization of the amic acid with concommitant silver(I) reduction and formation of a reflective surface-silvered film at 8 and 13 weight percent silver. The metallized films are thermally stable and flexible with mechanical properties similar to those of the parent polyimide. TEM reveals that the bulk (interior) of the polyimide composite films have 5-20 nanometer-sized silver particles with a surface layer of silver metal ca. 80 nm thick. Neither the bulk nor the surface of the films is electrically conductive. Adhesion of the surface metal to polyimide is excellent.
NiFe2O4 is an important high frequency soft magnetic material due to its ultra high resistivity; however, its initial permeability is rather low. Conventional magnetic ferrites are manufactured through ceramic processing. In an effort to explore innovative approaches for fabricating ferrite materials with improved performance, a study of fabricating nanostructured NiFe2O4 using wet chemical approaches has been carried out. The synthetic NiFe2O4 precursor was synthesized by a citrate reaction method followed by calcinating at various temperatures. Systematic studies concerning the crystallographic structure, the nanostructure and morphology of the particle, the phase homogeneity, the conditions for chemical reaction completion, and the magnetic properties have been carried out using x-ray diffraction, transmission electron microscopy, and magnetic measurements. The results show that by using a citrate reaction approach, pure phase and stoichiometric NiFe2O4 can be fabricated easily, and the particle size can be controlled on a nanometer scale, even at high calcination temperatures. In addition, a comparative study of the NiFe2O4 fabricated by conventional ceramic processing and this new citrate processing will be presented.
Magnetic properties of sputtered Ni/Al multilayers have been investigated by vibrating sample magnetometry and ferromagnetic resonance. In these compositionally modulated films (CMFs) the Al ‘spacer’ layer thickness was fixed at 3.5 nm while the total Ni content of each film was held constant at 308 nm. The thickness of the individual Ni layers was varied from 4.8 to 154 nm. The CMFs showed a variety of magnetic characteristics which were dependent on the thickness of the Ni layers. CMFs with Ni layer thickness 30 nm and above showed clear evidence of perpendicular anisotropy. This anisotropy is characterized by low-remanence perpendicular hysteresis loops of the type commonly found in CoCr alloy films. As the Ni layer thickness diminishes the perpendicular anisotropy decreases and is eventually lost. Simultaneously, the CMFs show increasing in-plane remanence, rising to a peak squareness of greater than 0.5 at a Ni layer thickness of 11 nm. As the Ni thickness continues to decrease, the remanence again declines. At Ni thicknesses of a few nm the CMFs become quasi-superparamagnetic. These CMFs do not show a monotonic reduction in saturation magnetization, Ms, with decreasing Ni layer thickness. Instead, both Ms and the coercivity, Hc, pass through a maximum in the region of 40–80 nm Ni layer thickness. FMR measurements were also made on these films. A plot of the effective anisotropy field produces data of a similar form to the Ms versus Ni layer thickness plot, again with a clear maximum. The FMR data also reveals interesting resonances in the films exhibiting perpendicular anisotropy. The presence of satellite resonances adjacent to the principal resonance peaks seems to suggest, in structural terms, a two-phase system as the basis of the observed anisotropy.
The chemical functionality of binders, dispersants, and solvents will influence competitive adsorption/desorption behavior on alumina powder, and hence will affect both slurry and ultimate green tape properties. Given that multiple competitive interactions are common to most dispersions, it is usually difficult to ascertain mechanisms from simple settling density experiments. However, this problem can be partially overcome with the choice of model systems that minimize the number of competitive processes. This criterion is met to a first approximation with a model system of toluene solvent, polystyrene binder, and a C8 aliphatic dispersant with an anchor group of variable functionality. Plateau adsorption concentrations from settling experiments in toluene show that surface coverage for efficient dispersants is typically achieved at about 6μmoles/m2. Less efficient dispersants adsorb at higher plateau concentrations, and are eventually displaced after repeated washing steps in toluene. The settling densities of dispersions prepared with C8 dispersants are consistently higher than densities achieved in toluene alone, and as seen in a case study with n-octylsilane, the settling densities are independent of the presence of polystyrene. Green bodies cast from a polystyrene/Al2O3 slurry also show increased densities in the presence of n-octylsilane dispersant. However, despite the apparent low levels of interaction between polystyrene and n-octylsilane in the dispersion state, solid state NMR and dynamic mechanical results show that the solid state molecular motional behavior of polystyrene is strongly affected by the presence of n-octylsilane dispersant.