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Different manufacturers recommend different levels of disinfection for oxygen nipple and nut adaptors, also known as Christmas-tree adaptors (CTAs). We aimed to determine the bacterial contamination rates of CTAs before and after clinical use and whether disinfection wipes effectively eliminate bacteria from CTAs.
CTAs were swabbed for bacteria directly from the shipment box or after use in a medical intensive care unit to determine levels of contamination. CTAs were also inoculated in the laboratory with a variety of bacteria and disinfected with either 0.5% hydrogen peroxide (Oxivir 1) or 0.25% tetra-ammonium chloride with 44.50% isopropyl alcohol (Super Sani-Cloth), and the effectiveness of each wipe was determined by comparing the bacterial recovery before and after disinfection.
CTAs exhibit low levels of bacterial burden before and after clinical use. Both disinfecting wipes were effective at removing bacteria from the CTAs.
Low-level disinfection of CTAs is appropriate prior to redeployment in the clinical setting.
Objectives: Prior studies have found associations between visual acuity (VA) and cognitive function. However, these studies used a limited range of cognitive measures and did not control for cardiovascular disease risk factors (CVD-RFs) and baseline function. The primary objective of this study was to analyze the associations of VA and cognitive performance using a thorough neuropsychological test battery. Methods: This study used community-dwelling sample data across the sixth (2001–2006) and seventh (2006–2010) waves of the Maine-Syracuse Longitudinal Study (n=655). Wave 6 VA as measured by the Snellen Eye Test was the primary predictor of wave 6 and wave 7 Global cognitive performance, Visual-Spatial Organization and Memory, Verbal Episodic Memory, Working Memory, Scanning and Tracking, and Executive Function. Additionally, VA was used to predict longitudinal changes in wave 7 cognitive performance (wave 6 performance adjusted). We analyzed these relationships with multiple linear and logistic regression models adjusted for age, sex, education, ethnicity, depressive symptoms, physical function deficits in addition to CVD-RFs, chronic kidney disease, homocysteine, continuous systolic blood pressure, and hypertension status. Results: Adjusted for demographic covariates and CVD-RFs, poorer VA was associated with concurrent and approximate 5-year declines in Global cognitive function, Visual-Spatial Organization and Memory, and Verbal Episodic Memory. Discussion: VA may be used in combination with other screening measures to determine risk for cognitive decline. (JINS, 2018, 24, 1–9)
Liquid crystal polymers (LCP’s) comprise a class of materials that derive desirable, but anisotropic, engineering properties from long-range molecular ordering. The ability to model the polymer texture is essential to the design of manufacturing processes for isotropic material production. Previous efforts to model LCP directionality have been primarily restricted to structured grids and simple geometries that demonstrate the underlying theory, but fall short of simulating realistic manufacturing geometries. In this investigation, a practical methodology is proposed to simulate the director field in full-scale melt-processing domains and wide-angle x-ray scattering (WAXS) is used to experimentally validate modeling results. It is shown that the model generates good agreement with experimental measurements of both the orientation state and degree of order.
A randomised controlled trial (RCT) of high-dose v. low-dose fish oil in recent-onset rheumatoid arthritis (RA) demonstrated that the group allocated to high-dose fish oil had increased remission and decreased failure of disease-modifying anti-rheumatic drug (DMARD) therapy. This study examines the relationships between plasma phospholipid levels of the n-3 fatty acids in fish oil, EPA and DHA, and remission and DMARD use in recent-onset RA. EPA and DHA were measured in blood samples from both groups of the RCT. The data were analysed as a single cohort, and Cox proportional hazards models were used to examine relationships between plasma phospholipid (PL) EPA and DHA and various outcome measures. When analysed as a single cohort, plasma PL EPA was related to time to remission, with a one unit increase in EPA (1 % total fatty acids) associated with a 12 % increase in the probability of remission at any time during the study period (hazard ratio (HR)=1·12; 95 % CI 1·02, 1·23; P=0·02). Adjustment for smoking, anti-cyclic citrullinated peptide antibodies and ‘shared epitope’ HLA-DR allele status did not change the HR. Plasma PL EPA, adjusted for the same variables, was negatively related to time to DMARD failure (HR=0·85; 95 % CI 0·72, 0·99; P=0·047). The HR for DHA and time to remission or DMARD failure were similar in magnitude to those for EPA, but not statistically significant. Biomarkers of n-3 status, such as plasma PL EPA, have the potential to predict clinical outcomes relevant to standard drug treatment of RA patients.
We have demonstrated the synthesis of highly reactive boron nanomaterials by alkali metal reduction of BCl3 under sonication, followed by annealing. Unlike ordinary boron powders, these materials combust completely and release close to their theoretical energy content (based on elemental analysis) in polymer protected bomb calorimetry experiments. We have scaled up the synthesis using a commercial (Columbia International CIT-UHiPR-U1000V600) ultrasonic hi-pressure reactor. The synthesis reactions exhibit a scale problem, where they yield diminishes considerably on scale up, probably a result of alkali metals becoming trapped inside a mass of salts and rendered unable to react. We measured the combustion properties of the materials by bomb calorimetry, and thermogravimetric analysis/differential scanning calorimetry (TGA/DSC), and report elemental analyses on selected samples.
Nano-sized metallic powders have advantages as fuels including faster, more complete combustion than micron-sized metal powder particles; however, the unpassivated nanoparticles of some metals of interest, such as Al, are pyrophoric and highly reactive, making them difficult to handle. Additionally, metal-hydrides are of great potential interest for a significant gravimetric energy increase without a penalty in the volumetric energy content, as the inclusion of hydrogen in the metallic matrix does not significantly decrease overall density of the material. Reactive metal amorphous powders produced by the sonochemical decomposition and dehydrogenation of an in situ-produced mixed borohydride-tetrahydroaluminate of titanium and containing hydrogen are examined in the current work and show exceptional air-stability and higher energy content than nano-Al. An aerosolized powder burner is used to investigate the combustion behavior of these powders mixed with gaseous fuels to quantify the energy density and reaction rate as compared to commercial aluminum powders in an effort to benchmark the performance of the sonochemically generated amorphous Ti-Al-B powder fuels.
Few studies have examined associations between different subcategories of cholesterol and cognitive function. We examined relationships between total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglyceride levels and cognitive performance in the Maine-Syracuse Longitudinal Study, a community-based study of cardiovascular risk factors. Cross-sectional analyses were undertaken on data from 540 participants, aged 60 to 98 years, free of dementia and stroke. TC, HDL, LDL, and triglyceride levels were obtained. Cognitive function was assessed using a thorough neuropsychological test battery, including domains of cognitive function indexed by multiple cognitive tests. The cognitive outcomes studied were as follows: Visual-Spatial Memory and Organization, Verbal and Working Memory, Scanning and Tracking, Abstract Reasoning, a Global Composite score, and the Mini-Mental State Examination (MMSE). Significant positive associations were observed between HDL-cholesterol and the Global Composite score, Working Memory, and the MMSE after adjustment for demographic and cardiovascular risk factors. Participants with desirable levels of HDL (≥60 mg/dL) had the highest scores on all cognitive outcomes. There were no significant associations observed between TC, LDL, or triglyceride concentrations and cognition. In older individuals, HDL-cholesterol was related to a composite of Working Memory tests and for general measures of cognitive ability when adjusted for cardiovascular variables. We speculate that persons over 60 are survivors and thus less likely to show cognitive deficit in relation to TC, LDL-cholesterol, and triglycerides. Longitudinal studies are needed to examine relations between specific cognitive abilities and the different subcategories of cholesterol. (JINS, 2014, 20, 1–10)
This paper contends that Horace's comparison of his completed poetic monument to pyramids at the end of Odes 1–3 is both figurative and literal insofar as we possess ample art historical, literary and papyrological evidence from antiquity for the stacking of an appropriate number of book (sc)rolls in ‘pyramidal’ form. Most notable in this regard is the dedication to Delian Apollo of a triangular casket containing the ten books of Aristarchus' edition of Alcaeus, whose resonances with the Pythagorean τετρακτύς, and implications for Horace's own oeuvre, are duly explored.
Randomised controlled trials (RCT) examining the effects of fish oil supplementation on cardiac outcomes have yielded varying results over time. Although RCT are placed at the top of the evidence hierarchy, this methodology arose in the framework of pharmaceutical development. RCT with pharmaceuticals differ in important ways from RCT involving fish oil interventions. In particular, in pharmaceutical RCT, the test agent is present only in the intervention group and not in the control group, whereas in fish oil RCT, n-3 fats are present in the diet and in the tissues of both groups. Also, early phase studies with pharmaceuticals determine pharmacokinetics and pharmacodynamics to design the dose of the RCT intervention so that it is in a predicted linear dose–response range. None of this happens in fish oil RCT, and there is evidence that both baseline n-3 intake and tissue levels may be sufficiently high in the dose–response range that it is not possible to demonstrate a clinical effect with a RCT. When these issues are considered, it is possible that the changing pattern of fish consumption and fish oil use over time, especially in cardiac patients, can explain the disparity where benefit was observed in the early fish oil trials but not in the more recent trials.
A method for determining the sex of live adult Laricobius nigrinus Fender (Coleoptera: Derodontidae) is described. Beetles were briefly chilled and positioned ventral-side-up under a dissecting microscope. Two forceps with blunted ends were used to gently brace the beetle and press on the centre of the abdomen to extrude its terminal segments. Male beetles were distinguished by a sclerotised, reticulate ninth abdominal sternite. In females, the distinct ovipositor (tergite, valvifers (ninth sternite), and laterotergites of the ninth abdominal segment) was visible. The procedure was rapid and harmed only a small number of individuals (fewer than 5%).
Dielectric materials with GDR (e.g. CaCu3Ti4O12 – CCTO and isostructural systems, co-doped NiO etc) attract major research interest due to their bright prospective in energy storage and memory devices. However, after years of intensive experimental and theoretical studies of GDR materials, physical nature of their extremely high complex dielectric permittivity (specifically, real part ∼ 104 - 106) is still not established convincingly. Another serious problem is excessively high imaginary part of the permittivity (which usually exceeds real one). Better understanding on physical mechanisms and limitations of GDR behavior in aforementioned dielectrics could be achieved based on polaronic phase transition criteria, proposed S. Fratini and P. Quémerais [Eur. Phys. Journ. B14, 99 (2000)]. In particular, ‘melting’ of Polaronic Wigner Crystal (PWC) either to ‘polaronic liquid’ or ‘electron liquid’ manifests two different scenarios of PWC phase transition at increment of concentrations of appropriate dopants. The former scenario is certainly preferable for ionic dielectrics with GDR behavior, while the latter one would yield in metal-like dielectric response with very high real permittivity, but unacceptable loss. Described approach provides physically transparent guidelines for selection of prospective host dielectrics with GDR behavior and quantitative estimations on critical dopant/polaron concentrations, corresponding to both aforementioned types of the phase transitions as well as temperature ranges suitable for GDR.
Objectives: In recent years, there has been growth in the use of health technology assessment (HTA) for making decisions about the reimbursement, coverage, or guidance on the use of health technologies. Given this greater emphasis on the use of HTA, it is important to develop standards of good practice and to benchmark the various HTA organizations against these standards.
Methods: This study discusses the conceptual and methodological challenges associated with benchmarking HTA organizations and proposes a series of audit questions based on a previously published set of principles of good practice.
Results and Conclusions: It is concluded that a benchmarking exercise would be feasible and useful, although the question of who should do the benchmarking requires further discussion. Key issues for further research are the alternative methods for weighting the various principles and for generating an overall score, or summary statement of adherence to the principles. Any weighting system, if developed, would need to be explored in different jurisdictions to assess the extent to which the relative importance of the principles is perceived to vary. Finally, the development and precise wording of the audit questions requires further study, with a view to making the questions as unambiguous as possible, and the reproducibility of the assessments as high as possible.
Introduction: HTA agencies, especially in developing countries, are under resourced and unable to conduct the desired amount of assessments. Adapting HTA reports (HTAs) from other jurisdictions is an alternative for saving resources.
Objectives: To explore HTA transferability experiences in Latin-America and Caribbean (LAC): are decision makers (DMs) using HTAs from other jurisdictions? Are researchers adapting HTAs when developing local reports? How useful is the information found in HTAs from other jurisdictions?
Methods: Web-based survey sent to 13031 HTA researchers and DMs.
Results: We received 671 responses from 19 countries. DMs reported using HTAs from other jurisdictions to guide decisions in the majority of the situations: 52.6 percent HTAs from outside LAC (e.g., Europe), 23.1 percent from other LAC countries, and only 24.3 percent HTAs from their own countries. 63 percent of researchers reported using HTAs from other jurisdictions. Usefulness scored significantly higher for HTAs from other jurisdictions as compared to local HTAs (7.1 versus 6.0 in a 1–10 scale; p < .01). Both DMs and researchers considered the information regarding safety and effectiveness more applicable than the information on social aspects, or economic evaluation. Barriers that limit transferability had significantly different scores for HTAs from other LAC countries as compared to those from regions outside LAC (i.e., poor methodological quality 6.7 versus 5.3, different epidemiological context 6.0 versus 7.4; all p < .01).
Conclusions: HTAs from outside the region are commonly used. However, DMs and researchers agreed that HTAs from LAC had the greatest potential for transferability, provided that barriers such as poor methodological quality could be overcome.