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Improvement of environmental cleaning in hospitals has been shown to decrease in-hospital cross transmission of pathogens. Several objective methods, including aerobic colony counts (ACCs), the adenosine triphosphate (ATP) bioluminescence assay, and the fluorescent marker method have been developed to assess cleanliness. However, the standard interpretation of cleanliness using the fluorescent marker method remains uncertain.
To assess the fluorescent marker method as a tool for determining the effectiveness of hospital cleaning.
A prospective survey study.
An academic medical center.
The same 10 high-touch surfaces were tested after each terminal cleaning using (1) the fluorescent marker method, (2) the ATP assay, and (3) the ACC method. Using the fluorescent marker method under study, surfaces were classified as totally clean, partially clean, or not clean. The ACC method was used as the standard for comparison.
According to the fluorescent marker method, of the 830 high-touch surfaces, 321 surfaces (38.7%) were totally clean (TC group), 84 surfaces (10.1%) were partially clean (PC group), and 425 surfaces (51.2%) were not clean (NC group). The TC group had significantly lower ATP and ACC values (mean ± SD, 428.7 ± 1,180.0 relative light units [RLU] and 15.6 ± 77.3 colony forming units [CFU]/100 cm2) than the PC group (1,386.8 ± 2,434.0 RLU and 34.9 ± 87.2 CFU/100 cm2) and the NC group (1,132.9 ± 2,976.1 RLU and 46.8 ± 119.2 CFU/100 cm2).
The fluorescent marker method provided a simple, reliable, and real-time assessment of environmental cleaning in hospitals. Our results indicate that only a surface determined to be totally clean using the fluorescent marker method could be considered clean.
Propofol is a intravenous anaesthetic most commonly used in ultrasound oocyte retrieval. We studied if the use of propofol had an effect on mouse oocyte maturation, pregnancy, childbirth and progeny and investigated the correlation between propofol side effects and reproductive performance in mice. There was no statistical difference in mating, pregnancy, childbirth, litter size, the number of stillbirths and survival between each group (P>0.05). Propofol also had no effect on polar body extrusion in oocyte maturation as well as on pronucleus formation and, subsequently, early embryo development (P>0.05). An increased concentration of propofol had no effect on this result, although propofol at more than 0.01 mg/ml reduced polar body extrusion. Different concentrations of propofol had no effect on oocyte culture in vitro, pronucleus formation and early embryo development.
This study examined the mediating effects of future social expectations and interpersonal distrust on the relationship between individual relative deprivation and intention to rebel. Data were gathered from 807 people from multiple occupational backgrounds in a municipality in southwest China. Structural equation modelling showed that individual relative deprivation predicted intention to rebel directly and also that it predicted intention to rebel indirectly via negative future social expectations, interpersonal distrust, and a chain mediating effect of negative future social expectations and interpersonal distrust. These results highlight the importance of the associations between future social expectations and interpersonal distrust with intention to rebel in people who report relative deprivation. The findings also indicate that prevention and intervention programs related to relative deprivation and intention to rebel in China are worthy of further research.
Apathy is a condition characterized by a lack of motivation that manifests in emotional, behavioral, and cognitive domains. Although previous studies have indicated that apathy is associated with frontal lesions, few studies have focused on the different subdomains of apathy, and no in vivo human biochemical data have been obtained to examine the neurochemical changes related to apathy in patients with Alzheimer's disease (AD). Thus, we investigated the frontal neurochemical alterations related to apathy among patients with AD using proton magnetic resonance spectroscopy (1H MRS).
Apathy was assessed through the Apathy Evaluation Scale (AES). 1H MRS was performed to measure neurochemical metabolite levels in the anterior cingulate region and right orbitofrontal region. Associations between neurochemical metabolites and the total score and subscores of each domain of the AES were analyzed.
Altogether, 36 patients completed the study. Patients with lower N-acetylaspartate/creatine ratios (NAA/Cr) in the anterior cingulate region demonstrated higher total apathy scores (β = −0.56, p = 0.003) with adjustments for age, gender, educational level, dementia severity, and depression severity. In a further analysis, a lower NAA/Cr in the anterior cingulate region was associated with all subdomains of apathy, including cognition (β = −0.43, p = 0.028), behavior (β = −0.55, p = 0.002), and emotion (β = −0.50, p = 0.005). No statistically significant associations were discovered in the right orbitofrontal region.
Our results suggest that apathy, in each of its cognitive, behavioral, or emotional subdomains is associated with brain neurochemical alterations in the anterior cingulate region. Abnormal neuronal integrity over the anterior cingulate cortex may exhibit a central role in causing all aspects of apathy in patients with AD.
Recent advances in synchrotron based x-ray spectroscopy enable materials scientists to emanate fingerprints on important materials properties, e.g., electronic, optical, structural, and magnetic properties, in real-time and under nearly real-world conditions. This characterization in combination with optimized materials synthesis routes and tailored morphological properties could contribute greatly to the advances in solid-state electronics and renewable energy technologies. In connection to this, such perspective reflects the current materials research in the space of emerging energy technologies, namely photocatalysis, with a focus on transition metal oxides, mainly on the Fe2O3- and TiO2-based materials.
The radiative transfer equation (RTE) arises in many different areas of science and engineering. In this paper, we propose and investigate a discrete-ordinate discontinuous-streamline diffusion (DODSD) method for solving the RTE, which is a combination of the discrete-ordinate technique and the discontinuous-streamline diffusion method. Different from the discrete-ordinate discontinuous Galerkin (DODG) method for the RTE, an artificial diffusion parameter is added to the test functions in the spatial discretization. Stability and error estimates in certain norms are proved. Numerical results show that the proposed method can lead to a more accurate approximation in comparison with the DODG method.
Beginning in 2007, all newly diagnosed cancer patients at the Koo Foundation Sun Yat-Sen Cancer Center (KF–SYSCC) were screened for psychosocial distress. Our social workers, as part of the psychosocial care team (PCT), have engaged in proactive outreach with patients identified as distressed. The goal of the present study was to assess the prevalence of psychosocial distress and the extent of contact between the PCT and distressed patients.
Newly diagnosed patients who were treated at KF–SYSCC between 2007 and 2010 for cancer were eligible if there were at least 100 patients with the same type of cancer. Before treatment began, they were screened with the Pain Scale and the Distress Thermometer (DT) and had the option to specify a desire for help. The rates of distress were analyzed by cancer type and by probable related factors. Information regarding contact with the PCT was retrieved from computerized databases.
Overall, some 5,335 cancer patients representing 12 major cancer types were included in our study. Of these, 1,771 (33.20%) were significantly distressed. By multivariate logistic regression, younger age, female gender, higher pain score, and disease stage, but not cancer type, were found to be associated with higher rates of distress. Among these distressed patients, 628 (36%) had some contact with the PCT.
Significance of results:
This Taiwanese study with a large sample size revealed a prevalence rate of psychosocial distress similar to rates found in Western countries. Contact with the PCT was established in only 36% of significantly distressed patients, despite a proactive outreach program. It is very important to have screening results made available in a timely fashion to the psycho-oncology team so that appropriate care can be offered promptly.
Bulk nanocrystalline (NC) silvers were fabricated by spark plasma sintering process. The effects of sintering temperature on physical and mechanical properties of the NC silvers were investigated. The results indicate that no impurities were introduced into the bulk compacts during the preparation procedure. Both the density and the electrical conductivity of the NC Ag increase with an increase in sintering temperature. However, the micro-hardness and ultimate tensile strength (UTS) of the bulk compacts increase initially and then decrease with increasing sintering temperature. The NC Ag sintered at 500 °C exhibits the highest micro-hardness of 85.3 HV along with the best compression yield strength of 379 MPa and the highest UTS of 534 MPa. The deterioration of the mechanical properties of the NC Ag sintered at 550 °C should be attributed to the rapid grain growth.
Hypoxia is the primary stimulus for the production of erythropoietin (EPO) in both fetal and adult life. Here, we investigated fetal plasma EPO concentrations in monochorionic (MC) twin pregnancies with selective intrauterine growth restriction (sIUGR) and abnormal umbilical artery (UA) Doppler. We diagnosed sIUGR in presence of (1) birth-weight discordance >20% and (2) either twin with a birth weight <10th percentile. An abnormal UA Doppler was defined as a persistent absent-reverse end diastolic flow (AREDF). The intertwin EPO ratio was calculated as the plasma EPO level of the smaller (or small-for-gestational-age) twin divided by the EPO concentration of the larger (or appropriate-for-gestational-age (AGA)) twin. Thirty-two MC twin pairs were included. Of these, 17 pairs were normal twins (Group 1), seven pairs were twins with sIUGR without UA Doppler abnormalities (Group 2), and eight pairs were twins with sIUGR and UA Doppler abnormalities (Group 3). The highest EPO ratio was identified in Group 3 (p < .001) but no significant differences were observed between Groups 1 and 2. Fetal hemoglobin levels did not differ significantly in the three groups, and fetal EPO concentration did not correlate with gestational age at birth. We conclude that fetal plasma EPO concentrations are selectively increased in MC twin pregnancies with sIUGR and abnormal UA Doppler, possibly as a result of uncompensated hypoxia.
Introduction: The mortality of Parkinson’s disease (PD) and its associated risk factors among clinically definite PD patients in China has been rarely investigated. Our study aimed to identify the mortality rates and predictors of death in PD patients in China. Methods: 157 consecutive, clinically definite PD patients from the urban area of Shanghai were recruited from a central hospital based movement disorder clinic in 2006. All patients were regularly followed up at the clinic until December 31, 2011, or death. Mortality and associations with baseline demographics, health and medical factors were then determined within the cohort. Results: After 5 years, 11(7%) patients had died. The standardised mortality ratio was 0.62 (95% CI 0.32 to 1.07, P=0.104). The main causes of death were pneumonia (54.5%, 6/11) and digestive disorders (18.2%, 2/11), respectively. Age at onset, independent living, the mini mental state examination score, the Parkinson’s disease sleep scale score and the Epworth sleepiness scale score at baseline were statistically significantly different between the survival group and the deceased group (P<0.05). Across all participants, risk factors for death included low mini mental state examination score, and high Epworth sleepiness scale score according to a binary variable logistic regression analysis. Conclusions: This study confirms the similar survival of patients with PD to the control population up to a follow-up of 5 years. Interventions tailored to potential risk factors associated with death may offer further benefits.
The basic error in Hu Shi's “An Exposition on Confucians” lay in discussing the basic nature of the Confucian school on the basis of the “tragic fate and miserable status of the survivors of the Shang”; for half a century this mistaken premise has been accepted by most historians as proven. On the basis of an analysis of pre-Qin literary sources, this paper first proves that there was no “tragedy of the defeated state”; on the contrary, the Yin survivors continued to possess considerable political power and quite high social status. Second, on the basis of newly un earthed Shang and Zhou inscriptions, the fate and status of the Shang survivors is set forth from three sides: (1) The history of the Wei Shi clan and Lu Sheng clan of the Guanzhong region, for which genealogies of seven-eight or six-seven generations exist, is reconstructed on the basis of, for the former, the Ding bronze horde newly unearthed from Fufeng Zhuangbai, and, for the latter, the inscriptions on already known as well as recently unearthed bronze vessels from the same area. Both clans were survivors from the Shang and close relatives of the Shang king; they possessed cities, subjects, and official positions, as well as holding offices in charge of troops. (2) The same conclusion may be reached in individual cases in various other kingdoms, such as for Mo Situ Sung of the state of Wei , and Dong Hefu of the state of Yan . As for the Ling Shi , Chen Chen and Deng of Cheng Zhou , Cheng Zhou is the ancient home of the Shang survivors, yet they seem not to have been the object of any special restriction or suppression. This section is based solely on inscriptions; the conclusions reached, however, are completely in agreement with those derived from literary evidence in the previous section. Finally an attempt is made to explain why the survivors of the Shang had land, subjects, offices, and power. We believe that it was due to a political and social structure with the clan as the primary unit. A complete explication of this question awaits a detailed study of oracle-bone and archaeological source material.
In this study we report changes in Indian summer monsoon (ISM) intensity during the past ~ 3500 yr inferred from proxy indices at Lake Erhai, southwestern China. Both the pollen concentrations and other proxy indices, including sediment grain size, total organic carbon contents (TOC), and elemental contents (e.g., Fe, Al), clearly indicate a long term decreasing trend in ISM intensity over the late Holocene. During the period from approximately AD 750 to AD 1200, pollen concentrations of conifer and broadleaf trees, and herbs reached the lowest levels over the past ~ 3500 yr; while the pollen percentages of both herbs and broadleaf trees increased, suggesting a significant medieval drought. The grain size, TOC, and elemental contents also support an arid climate during the medieval period. The Little Ice Age (LIA) at Lake Erhai was characterized as cold and wet. The medieval and LIA climatic patterns at Lake Erhai were similar to those over most of the ISM areas, but anti-phase with those over East Asian summer monsoon (EASM) areas. We suspect that sea surface temperature variations in the Indo-Pacific oceans and the related land-sea thermal contrasts may be responsible for such hydroclimatic differences between EASM and ISM areas.
Fe-Co-B was identified as a potential candidate for the development of high-frequency sensors and high-frequency actuators. To fabricate high-frequency magnetostrictive resonators, Fe-Co-B magetostrictive thin films were prepared by combining electrochemical deposition and microfabrication processes. It is crucial to obtain thin films with proper microstructure and composition. Results showed that Fe-rich Fe-Co-B thin films exhibited better resonance behavior than those with Co-rich and equiatomic Fe and Co compositions. It is also found that the deposition condition plays an important role on the performance of the films. Fe55Co28B17 thin films were fabricated under the same current density for different times. The films exhibited nanocrystalline structure, circular nodules as surface morphology and good resonance behavior. Fe/Co ratio on surface and cross section slightly decreased with increasing the deposition time. The resonance frequency slightly increased and the Q value was found to decrease with increasing deposition time.
The present study investigates the relationship between BMI and all-cause mortality among middle-aged and older adults with or without pre-existing diseases.
A population-based cohort study.
The Taiwan Longitudinal Study on Aging is a nationwide prospective cohort study comprising a representative random sample of middle-aged and older adults. The study period was 1996–2007.
We followed 4145 middle-aged and older adults, totalling 42 353 person-years.
Overweight and mildly obese participants showed a 16 % and 30 % decrease in the risk of death, respectively, compared with those of normal weight after adjusting for potential covariates (e.g. demographic characteristics, health behaviour, co-morbidities and physical function). Underweight adults showed a 1·36-fold increased adjusted hazard ratio of death compared with normal-weight adults. Adults with a BMI of 27·0–28·0 kg/m2 showed a significantly lower adjusted hazard ratio of all-cause mortality rate compared with adults who had normal BMI values when they had coexisting hypertension or diabetes (adjusted hazard ratio=0·50; 95 % CI 0·30, 0·81 for hypertension and adjusted hazard ratio=0·41; 95 % CI 0·18, 0·89 for diabetes).
The study demonstrates that underweight people have a higher risk of death, and overweight and mildly obese people have a lower risk of death, compared with people of normal weight among middle-aged and older adults. An optimal BMI may be based on the individual, who exhibits pre-existing diseases or not.
Recent research activities relevant to high energy density physics (HEDP) driven by the heavy ion beam at the Institute of Modern Physics, Chinese Academy of Sciences are presented. Radiography of static objects with the fast extracted high energy carbon ion beam from the Cooling Storage Ring is discussed. Investigation of the low energy heavy ion beam and plasma interaction is reported. With HEDP research as one of the main goals, the project HIAF (High Intensity heavy-ion Accelerator Facility), proposed by the Institute of Modern Physics as the 12th five-year-plan of China, is introduced.