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Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.
Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.
We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).
PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.
This article updates Karen May’s earlier 2012 hypothesis (Could Captain Scott have been saved? Revisiting Scott’s last expedition). In this revised hypothesis, Cecil Meares, not Surgeon E. L. Atkinson, originated the unsubstantiated statement that “Strict injunctions had been given by Scott that the dogs should not be risked in any way.” This hypothesis incorporates new information uncovered since 2012, specifically Meares’ misrepresentations during the Terra Nova expedition; Atkinson’s 1911 journal entries; Atkinson’s 1919 allegation that Meares had “disobeyed orders”; and Tryggve Gran’s “The Race for the South Pole between Scott and Amundsen”, a 1945/post-1945 document that appears to have been Roland Huntford’s source for anecdotes in Huntford’s 1979 Scott–Amundsen biography. The article gives a proposed chronology for how Meares’ early misrepresentations and Gran’s later misunderstandings influenced the decisions, and later presentations, of the Terra Nova expedition.
In this contribution, a design methodology for octave-bandwidth power amplifiers (PA) for 5G communication systems using surface mount dual-flat-no-lead packaged gallium-nitride high-electron-mobility transistor devices is presented. Systematic source- and load-pull simulations have been used to find the optimum impedances across 75% fractional bandwidth for S- (1.9–4.2 GHz) and C-band (3.8–8.4 GHz) PAs. The harmonic impact is considered to improve the output power and efficiency of the PAs. Utilizing the characteristic behavior of the transistors leads to modified optimum fundamental load impedances for the low-frequency range, which have higher gain compared with high-frequency range, and minimize the influence of the higher harmonics. Continuous wave large-signal measurements of the realized S-Band PA show a power added efficiency (PAE) of more than 40% from 1.9–4.2 GHz and a flat power gain of 11 dB while achieving a saturated output power of 10 W. The measured performance of the C-Band PA demonstrates a delivered power between 3.5 and 5 W across the frequency range of 3.8–8.4 GHz. A flat power gain of around 9 ± 0.5 dB with 26–40% PAE is achieved.
This study discusses the investigation of a series of pit-kilns in and around the prehispanic site of Kiuic in the Puuc region of the northern Maya lowlands and presents the multiple lines of evidence that identify these structures as lime production features. The study reports the results of systematic excavations, archaeometric analyses, archaeological experiments, ethnographic inquiries, and spatial analyses. Burnt lime has been used for architectural, dietary, hygienic, and other purposes by the Maya for at least three millennia and yet its importance in prehispanic Maya society is belied by the lack of lime production features identified in the archaeological record. The identification of these structures as lime production features has implications for understanding subregional differences in socioeconomic organization and resource management practices among the prehispanic Maya. This report provides a model for using multiple methods and analyses to investigate and identify lime production kilns that can be applied to societies and landscapes throughout the Maya area and the broader premodern world.
To investigate the magnitude and country-specific differences in underestimation of children’s weight status by children and their parents in Europe and to further explore its associations with family characteristics and sociodemographic factors.
Children’s weight and height were objectively measured. Parental anthropometric and sociodemographic data were self-reported. Children and their parents were asked to comment on children’s weight status based on five-point Likert-type scales, ranging from ‘I am much too thin’ to ‘I am much too fat’ (children) and ‘My child’s weight is way too little’ to ‘My child’s weight is way too much’ (parents). These data were combined with children’s actual weight status, in order to assess underestimation of children’s weight status by children themselves and by their parents, respectively. Chi-square tests and multilevel logistic regression analyses were conducted to examine the aims of the current study.
Eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.
A school-based survey among 6113 children aged 10–12 years and their parents.
In the total sample, 42·9 % of overweight/obese children and 27·6 % of parents of overweight/obese children underestimated their and their children’s weight status, respectively. A higher likelihood for this underestimation of weight status by children and their parents was observed in Eastern and Southern compared with Central/Northern countries. Overweight or obese parents (OR=1·81; 95 % CI 1·39, 2·35 and OR=1·78, 95 % CI 1·22, 2·60), parents of boys (OR=1·32; 95 % CI 1·05, 1·67) and children from overweight/obese (OR=1·60; 95 % CI 1·29, 1·98 and OR=1·76; 95 % CI 1·29, 2·41) or unemployed parents (OR=1·53; 95 % CI 1·22, 1·92) were more likely to underestimate children’s weight status.
Children of overweight or obese parents, those from Eastern and Southern Europe, boys, younger children and children with unemployed parents were more likely to underestimate their actual weight status. Overweight or obese parents and parents of boys were more likely to underestimate the actual weight status of their children. In obesity prevention such underestimation may be a barrier for behavioural change.
Captain Robert Falcon Scott has been attacked in recent decades because his Terra Nova expedition (1910–1913) had to rely on substandard Siberian ponies. Certain commentators have argued that this was Scott's fault, but the available evidence indicates that blame should rest with the buyer Cecil Meares. Additionally, archive evidence indicates that Scott specifically requested Captain Lawrence Oates to travel to Siberia to assist Meares in 1910, and that Oates refused Scott's request.
An opinion piece by Ben Macintyre entitled ‘Sorry, Scott fans: noble death is so last century’ appeared in The Times (London) on 20 September 2013. In this, Macintyre argued not only that Ernest Shackleton should be explicitly contrasted against his contemporary and rival Robert Falcon Scott, but that Shackleton should be found superior to Scott in virtually every way. It was a dispiriting piece, strongly suggesting that that the media's understanding of Scott has not greatly advanced since the savage, cod-psychological and often unsubstantiated attacks upon Scott's character and reputation in the 1970s–1990s. Sadly, all too often polar history is reduced to a zero-sum game where praise for Shackleton is directly proportional to insults directed at Scott.
The purpose of the present study was to investigate the associations of family sociodemographic characteristics with children’s weight status and whether these potential associations are mediated by children’s breakfast habits.
A school-based survey among 10–12-year-old children was conducted in eight European countries. Children’s weight and height were measured and breakfast habits and family sociodemographic characteristics were self-reported by 5444 children and their parents. International Obesity Task Force cut-off points were used to categorize children as overweight/obese or normal weight. Mediation analyses were used to test the potential mediating effect of children’s breakfast consumption on the associations between family sociodemographic characteristics and children’s overweight/obesity.
Schools in eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.
Children aged 10–12 years and their parents (n 5444).
Children’s reported daily breakfast consumption varied from 56 % in Slovenia to 92 % in Spain on weekdays and from 79 % in Greece to 93 % in Norway on weekends. Children of native parents, with both parents employed and with at least one parent having more than 14 years of education were more likely to consume breakfast daily and less likely to be overweight/obese. Finally, mediation analyses revealed that the association of parental nationality and parental educational status with children’s overweight/obesity was partially mediated by children’s daily breakfast consumption.
The study shows that the lower likelihood of being overweight/obese among 10–12-year-old children of native background and higher parental educational status was partially mediated by children’s daily breakfast consumption.
In his book Scott and Amundsen (1979) Roland Huntford described Captain Robert Falcon Scott R.N. as ‘not well thought of in the Service’ and ‘an obscure, rather dull torpedo lieutenant with mediocre prospects’. A myth has subsequently arisen that Scott was forced into Antarctic exploration as his only route to naval promotion. In reality, Scott was an extremely able officer held in high regard by his naval contemporaries; he was on course for promotion to flag rank (rear-admiral and above) had he not taken up polar exploration; and his primary motivation for polar work was financial support for his family. In addition to a chronological account of Scott's career, this article will present his Admirals’ reports in full.
On 18 June 1928, Roald Amundsen and a team of five men (René Guilbaud, Leif Dietrichson, Albert Cavelier de Cuverville, Gilbert Brazy and Emile Valette) flew in a French Latham 47 prototype aeroplane from Tromsø, Norway, to aid in the rescue of survivors of the crashed airship Italia. The party disappeared nearly without trace into the Barents Sea. We shall examine Amundsen's last years, the decision to employ for an Arctic relief mission a prototype aeroplane which had not completed its flight tests, and the evidence that, in deciding to disregard warnings and fly this aeroplane unaccompanied over the Barents Sea, Amundsen took a significant risk that led to his death and those of his crew.
In writing and interviews Roland Huntford has stated that at the end of his life Captain Robert Falcon Scott ‘probably’ had no reason to wish to survive, and that he ‘persuaded’ Dr Edward A. Wilson and Lieutenant Henry Bowers to remain in the tent with him when they could have gone forward. This commentary demonstrates that Huntford's interpretation of events shows a serious misunderstanding of the primary sources and historical context; that Wilson and Bowers could not have survived had they gone forward, a fact which Huntford himself understands; and that Scott had extremely strong motivation to wish to return home.