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The majority of paediatric Clostridioides difficile infections (CDI) are community-associated (CA), but few data exist regarding associated risk factors. We conducted a case–control study to evaluate CA-CDI risk factors in young children. Participants were enrolled from eight US sites during October 2014–February 2016. Case-patients were defined as children aged 1–5 years with a positive C. difficile specimen collected as an outpatient or ⩽3 days of hospital admission, who had no healthcare facility admission in the prior 12 weeks and no history of CDI. Each case-patient was matched to one control. Caregivers were interviewed regarding relevant exposures. Multivariable conditional logistic regression was performed. Of 68 pairs, 44.1% were female. More case-patients than controls had a comorbidity (33.3% vs. 12.1%; P = 0.01); recent higher-risk outpatient exposures (34.9% vs. 17.7%; P = 0.03); recent antibiotic use (54.4% vs. 19.4%; P < 0.0001); or recent exposure to a household member with diarrhoea (41.3% vs. 21.5%; P = 0.04). In multivariable analysis, antibiotic exposure in the preceding 12 weeks was significantly associated with CA-CDI (adjusted matched odds ratio, 6.25; 95% CI 2.18–17.96). Improved antibiotic prescribing might reduce CA-CDI in this population. Further evaluation of the potential role of outpatient healthcare and household exposures in C. difficile transmission is needed.
The use of monthly intranasal mupirocin was associated with a significant reduction in the rate of methicillin-resistant Staphylococcus aureus transmission and Staphylococcus aureus invasive infection in a large neonatal intensive care unit. Resistance to mupirocin emerged over time, but it was rare and was not associated with adverse clinical outcomes.
In this work we have conducted a study on the radiative and spectroscopic properties of the radiative precursor and the post-shock region from experiments with radiative shocks in xenon performed at the Orion laser facility. The study is based on post-processing of radiation-hydrodynamics simulations of the experiment. In particular, we have analyzed the thermodynamic regime of the plasma, the charge state distributions, the monochromatic opacities and emissivities, and the specific intensities for plasma conditions of both regions. The study of the intensities is a useful tool to estimate ranges of electron temperatures present in the xenon plasma in these experiments and the analysis performed of the microscopic properties commented above helps to better understand the intensity spectra. Finally, a theoretical analysis of the possibility of the onset of isobaric thermal instabilities in the post-shock has been made, concluding that the instabilities obtained in the radiative-hydrodynamic simulations could be thermal ones due to strong radiative cooling.
Various medical and psychiatric conditions can determine the occurrence of disruptive behavior and aggression. Mechanical restraint is part of the strategies for managing these risks. Its use implies a multidisciplinary, phased and individualized for each case strategy, with attention to the ethical and legal issues surrounding this coercive intervention.
The objective of this work is the analysis of the profile of patients who required mechanical restraint during hospitalization in a psychiatric inpatient unit.
Retrospective descriptive analysis by collecting data of patients, who required mechanical restraint during admission, between 2007 and 2014. The data sources were medical clinical history and nursing records. Variables analyzed were sex, age, clinical diagnosis at discharge and clinical state during the episode of mechanical restraint.
Of the total sample of patients requiring restraint (n = 266), 66.92% were men. The mean age of patients was 38.01 years. Distribution of clinical diagnoses based on ICD-10 coding: 30.23% F60 personality disorder (n = 289), 19.56% diagnosed with F31 bipolar disorder (n = 187) and 14.02% F20 schizophrenia. Regarding the clinical characteristics of the episode, 49.47% of patients had an agitation/violent state and in 23.11% risk of impulsive self-injury was evident, 13.47% had confusional syndrome.
Data analyzed shows differences in frequency distribution because of patient profile and clinical diagnosis. Otherwise, organizational factors and appropriate amendments to this level appear to play a key role in minimizing the use of such coercive measures.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Deformed quartzitic rocks from the Carboneras and Palomares fault areas (SE Spain) are enriched in phyllosilicates compared to their respective protoliths. Deformation is mainly localized in highly foliated chlorite-rich bands. Quartz-rich bands show brittle deformation developing dolomite-rich cross-cutting veins re-cementing microcataclasite areas. Undamaged lenses within the cataclastic rocks contain patches of phyllosilicates with randomly oriented chlorite and mica. Mg, Fe, water, As and Zn enrichment of the damaged rocks suggests a process of hydrothermal chloritization associated with the Cabo de Gata volcanism. Petrographic characteristics indicate that hydrothermal alteration that produced chlorite and mica-enrichment occurred before faulting. Phyllosilicates provided lubricating properties to the quartzitic rocks, favouring the predominance of creep over seismic stick-slip and reducing the possibility of large seismogenic events. Dolomite cementation as a consequence of fluid–rock interaction processes would have a limited effect, due to the presence of weak phyllosilicate surfaces.
A gas-filled cylindrical liner z-pinch configuration has been used to drive convergent radiative shock waves into different gases at velocities of 20–50 km s−1. On application of the 1.4 MA, 240 ns rise-time current pulse produced by the Magpie generator at Imperial College London, a series of cylindrically convergent shock waves are sequentially launched into the gas-fill from the inner wall of the liner. This occurs without any bulk motion of the liner wall itself. The timing and trajectories of the shocks are used as a diagnostic tool for understanding the response of the liner z-pinch wall to a large pulsed current. This analysis provides useful data on the liner resistivity, and a means to test equation of state (EOS) and material strength models within MHD simulation codes. In addition to providing information on liner response, the convergent shocks are interesting to study in their own right. The shocks are strong enough for radiation transport to influence the shock wave structure. In particular, we see evidence for both radiative preheating of material ahead of the shockwaves and radiative cooling instabilities in the shocked gas. Some preliminary results from initial gas-filled liner experiments with an applied axial magnetic field are also discussed.
Nanogenerators (NGs) have great potential to solve the problems of energy depletion and environmental pollution. Here, two types of flexible nanogenerators (FNGs) based on graphene oxide (GO) and multiwall carbon nanotubes (MW-CNTs) are presented. The peak output voltage and current of GO based FNG reached up to 2 V and 30 nA, respectively, under 15 N force at 1 Hz. Moreover, the output voltage could be improved to 34.4 V when the frequency was increased to 10 Hz. It was also found the output voltage increased from 0.1 V to 2.0 V using a released GO structure. The other FNG was made by MW-CNTs mixed with ZnO nanoparticles (NPs). Its output voltage and power reached up to 7.5 V and 18.75 mW, respectively, which is much larger than that of bare ZnO based FNG. Furthermore, a peak voltage of 30 V could be gained by stamping one’s foot on the FNG. Finally, a modified NG was fabricated using four springs and two flexible layers. As a result, the voltage and power reached up to 9 V and 27mW, respectively. These works may bring out broad applications in energy harvesting.
This work presents an adsorption model based on the Sips isotherm for sensing different concentrations of DNA with open gate AlGaN/GaN high electron mobility field effect transistors (HEMTs). Probe-DNA was immobilized on the transistor gate before the application of target-DNA. Concentrations of 10-15 to 10-6 mol/L were tested. The sensor has a detection limit of 10-12 mol/L and saturates after the addition of 10-8 mol/L target-DNA.
In addition to the piezoelectric nanogenerators and triboelectric nanogenerators, recently, the graphene-based nanogenerator has been widely concerned because of its simple assembly, flexibility and high structural stability. There are many interesting effects in graphene applied for nanogenenrators including anion adsorption in electrolyte solution, ion channels in graphene sheets network and the strain (band engineering) effect, etc. In this paper, we focus explicitly on the experimental results, mechanisms and applications of the graphene-based nanogenerator, and introduce our recent research on the graphene-based nanogenerator based on "modulation of the graphene strain-energy band effect". This nanogenerator is expected to have potential applications in active sensors and sustainable power source.
The reaction mechanism of BaCO3+CaCO3+TiO2 by solid state methods has been studied in this work using thermal analysis (DSC-TG) from 500 to 1500 °C and in situ X-ray diffraction (XRD) from room temperature to 800 °C. In the mixed powders, the CaO is firstly formed followed by presence of an intermediate Ba2TiO4 phase and finally the formation of CaTiO3, BaTiO3 and/or (Ba,Ca)TiO3, where the presence of CaO or CaTiO3 (CT) has slowed down the formation of BaTiO3 (BT). Raman microscopy of a BT-CT diffusion couple has shown that Ca2+ firstly diffuses into the BT grain boundaries and then into the BT core.
This paper presents a method for noise-free recording of the keyboard-based musical instruments. By integrating an r-shaped triboelectric generator (TEG) into the keyboard of a piano, it can produce electric signal while playing music due to the combination of contact electrification and electric induction. We investigated the electric signal and developed a graphical user interface to convert the electric signal back to music. Using the piano and the graphical user interface, active noise-free recording can be realized. Namely, only the sound produced by the piano can be converted and recorded, while other noise in the environment can be filtered automatically.
Shape memory alloys (SMAs) exist in different phases depending on temperature and stress level. Experimental evidence shows that SMAs oscillate between two shapes during thermal cycling. This phenomenon, known as two-way shape-memory effect, occurs due to a transformation between the austenitic phase and the martensitic phase. The two-way shape-memory behavior is studied here by molecular dynamics simulations in NiTi nanowires of different diameter to understand the effect of loading on the size-dependent behavior. Thermal cycling is performed while holding the system at zero stress and at a fixed compressive stress. At zero stress, the martensite structure formed on cooling depends on the wire diameter. However, when cooling is performed at a sufficiently large constant compressive stress, the formation of a single martensitic variant is observed for all diameters.
The study of corrosion behavior of polyurethane/nanohydroxyapatite hybrid coating in aerated Hank solution at 25 °C by Potentiodinamic and Electrochemical Impedance techniques was realized. The nanohydroxyapatite (nHA) powders were synthesized by ultrasonic assisted co-precipitation wet chemical method and then mixed with pure polyurethane (PU) during the polymerization. Results were supported by SEM morphologic characterization. Results showed that good corrosion resistance of hybrid coating, showing small corrosion product layer formation. Corrosion mechanisms are affected by an increasing of polarization resistance, promoting decreasing in the corrosion rates. Diffusion of ionic species was the governing mechanism in the corrosion behavior of polyurethane/nanohydroxyapatite hybrid coating.
MEMS vibration energy harvesting has been investigated to provide energy to low-power micro-electronic systems and potentially to enable batteryless autonomous systems. While enjoying the small footprint hence the ability to be embedded in other systems, MEMS vibration energy harvesters are working at much higher frequencies and input vibration amplitudes. The mechanical resonator based energy harvesters seem inherently have such high frequency due to the scaling of the device dimension. Lower the working frequency range and input vibration amplitude are possible by optimizing the dimensions of the device. However, we are viewing the problem from a different perspective and proposing a solution based on employing the common material property of the micro-fabricated thin film – residual stress. We found that by taking advantage of the compressive residual stress, a bi-stable mechanical resonator could be built and a new spectrum of dynamics can be brought into energy harvesting, which could lower the working frequency range and input g value. The concepts have been analytically simulated and experimentally verified by a meso-scale model.