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Early replacement of a new central venous catheter (CVC) may pose a risk of persistent or recurrent infection in patients with a catheter-related bloodstream infection (CRBSI). We evaluated the clinical impact of early CVC reinsertion after catheter removal in patients with CRBSIs.
We conducted a retrospective chart review of adult patients with confirmed CRBSIs in 2 tertiary-care hospitals over a 7-year period.
To treat their infections, 316 patients with CRBSIs underwent CVC removal. Among them, 130 (41.1%) underwent early CVC reinsertion (≤3 days after CVC removal), 39 (12.4%) underwent delayed reinsertion (>3 days), and 147 (46.5%) did not undergo CVC reinsertion. There were no differences in baseline characteristics among the 3 groups, except for nontunneled CVC, presence of septic shock, and reason for CVC reinsertion. The rate of persistent CRBSI in the early CVC reinsertion group (22.3%) was higher than that in the no CVC reinsertion group (7.5%; P = .002) but was similar to that in the delayed CVC reinsertion group (17.9%; P > .99). The other clinical outcomes did not differ among the 3 groups, including rates of 30-day mortality, complicated infection, and recurrence. After controlling for several confounding factors, early CVC reinsertion was not significantly associated with persistent CRBSI (OR, 1.59; P = .35) or 30-day mortality compared with delayed CVC reinsertion (OR, 0.81; P = .68).
Early CVC reinsertion in the setting of CRBSI may be safe. Replacement of a new CVC should not be delayed in patients who still require a CVC for ongoing management.
Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders.
We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling.
We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic/irritable mania; elation showed positive correlations with cyclicity and psychotic/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders.
We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.
Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).
We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).
As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.
Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.
A systematic study on the effect of sputtering deposition parameters on material properties of Al doped ZnO (ZnO:Al) films prepared by an in-line rf magnetron sputtering and on surface morphology of the films after wet etching process was carried out. For application to silicon thin film solar cells as a front electrode, the as-deposited films were surface-textured by a dilute HCl solution to improve the light scattering properties such as haze and angle resolved distribution of scattered light on the film surfaces. The microstructure of as-deposited films is affected significantly by the working pressure and film compactness decreases with increasing working pressure from 1.5 mTorr to 10 mTorr. High quality ZnO:Al films with electrical resistivity of 4.25 × 10-4 Ω cm and optical transmittance of 80% in a visible range are obtained at low working pressure of 1.5 mTorr and substrate temperature of 100℃. Crater-like surface morphologies are observed on the textured ZnO:Al films after wet etching. The size and shape of craters are closely dependent on the microstructure and film compactness of as-deposited films. Haze values of the textured ZnO:Al films are improved in a whole wavelength of 300 – 1100 nm compared to commercial SnO2:F films (Asahi U type) and incident light on the textured films is scattered effectively with 30° angle.
Semi-insulating undoped GaN films were grown based on controlling the size of the nucleation sites through a special two-step growth method: First, 16 nm LT-GaN was annealed at 950 ° with a ramping time of 4 min, then the GaN was grown at this temperature for 1 min. Second, the growth temperature was increased to 1020° with a ramping time of 2 min and the GaN layer finally grown at 1020 ° for 40 min. The film grown by this sequence exhibited sheet resistance of up to 109 Ω/sq with mirror-like surface morphology. By slow ramping to 950° in the initial phase of growth, smaller grain sizes and higher nuclei densities were formed and the columnar growth mode along the c direction was dominant. The observation of higher resistance in two-step growth is believed due to the increased misorientation of nuclei when the growth proceeds during temperature ramping to 1020°. The fabricated saw filter on semi-insulating GaN exhibited a high velocity of 5342 m/s at center frequencies of 133.57 MHz and an electromechanical coupling coefficient(k2) of about 0.763 %, which was enhanced due to the improvement of surface morphology with high sheet resistance by the two- step ramping technique.
Si delta-doping in the GaN layer has been successfully demonstrated by low-pressure metalorganic chemical vapor deposition at a growth temperature of 1040 . Si delta-doping concentration increases and then decreases with an increase in delta-doping time. This indicates that delta-doping concentration is limited by the desorption process owing to much higher thermal decomposition efficiency of silane at high growth temperatures of GaN. In addition, it was observed that the use of a post-purge step in the ammonia ambient reduces Si delta-doping concentration. From capacitance-voltage measurement, a sharp carrier concentration profile with a full-width at half maximum of 4.1 nm has been achieved with a high peak concentration of 9.8 1018 cm−3.
Si delta-doping in the GaN layer has been successfully demonstrated by low-pressure metalorganic chemical vapor deposition at a growth temperature of 1040°C. Si delta-doping concentration increases and then decreases with an increase in delta-doping time. This indicates that delta-doping concentration is limited by the desorption process owing to much higher thermal decomposition efficiency of silane at high growth temperatures of GaN. In addition, it was observed that the use of a post-purge step in the ammonia ambient reduces Si delta-doping concentration. From capacitance-voltage measurement, a sharp carrier concentration profile with a full-width at half maximum of 4.1 nm has been achieved with a high peak concentration of 9.8 x 1018 cm-3
The structural and optoelectronic properties of polycrystalline CdS films, fabricated by three different methods, are compared to one another for the purpose of preparing CdTe/CdS solar cells. The three methods were: alternated spraying of cation and anion solution at room temperature, spray pyrolysis, and chemical bath deposition. We studied the surface morphology and crystal quality and texture by scanning electron and optical microscopy and x-ray diffraction. All films had a well-developed wurtzite structure. Films grown by the alternated-spray method and the chemical bath method consist of randomly-oriented crystallites with dimensions <0.5 microns. Annealing at 400°C increases the crystallite size slightly. Films which were grown by pyrolysis at substrate temperatures from 400°C to 500°C were oriented in the <002> direction. For growth by pyrolysis at 500°C, the surface is rough on a lateral scale of 0.1 to 0.3 microns.
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