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To determine the factors related to multiple ventilation tube insertions in children with otitis media with effusion.
A retrospective review was performed of 126 ears of 81 children aged less than 12 years who had undergone insertion of a Paparella type 1 ventilation tube for the first time between August 2012 and March 2018.
Mean age at the first operation was 4.0 ± 2.2 years, and the mean duration of otitis media with effusion before the first ventilation tube insertion was 5.4 ± 4.5 months. Among 126 ears, 80 (63.5 per cent) had a single ventilation tube insertion and 46 (36.5 per cent) had multiple insertions. On multivariate logistic regression, tympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion were independent predictive factors of multiple ventilation tube insertions.
Tympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion after the first tube extrusion are associated with multiple ventilation tube insertions.
A new approach is proposed to analyze Bremsstrahlung X-rays that are emitted from laser-produced plasmas (LPP) and are measured by a stack type spectrometer. This new method is based on a spectral tomographic reconstruction concept with the variational principle for optimization, without referring to the electron energy distribution of a plasma. This approach is applied to the analysis of some experimental data obtained at a few major laser facilities to demonstrate the applicability of the method. Slope temperatures of X-rays from LPP are determined with a two-temperature model, showing different spectral characteristics of X-rays depending on laser properties used in the experiments.
Δ14C values of leaves of deciduous trees provide a means to map the regional-scale fossil fuel ratio in the atmosphere. We collected a batch of ginkgo (Ginkgo biloba Linnaeus, a deciduous tree) leaf samples from across Korea in the month of July in both 2010 and 2011 to obtain the regional distribution of Δ14C. The Δ14C values of the samples were measured using accelerator mass spectrometry (AMS) at the Korea Institute of Geoscience and Mineral Resources (KIGAM). The average of the Δ14C values from clean air sites in Korea in 2011 measured slightly lower than the average of Δ14C values in 2010. Distribution maps of Δ14C of 2011 and 2010 in Korea were made based on a series of Δ14C values of ginkgo leaf samples from Korea using the Geostatistical and Spatial analyst tools in ESRI's ArcMap software. The distribution maps of Δ14C showed that Δ14C values in the western part of Korea are lower than those in the eastern part of Korea. This is because the western part of Korea is densely populated and contains many industrial complexes, and also because westerly winds from China, containing CO2 from fossil fuel use, blow into Korea. We compared the distribution maps of 2010 and 2011 and tried to find traces of the Fukushima power plant accident in Japan.
Antibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.
To evaluate risk factors for treatment of ASB.
Retrospective observational study.
A tertiary academic hospital, county hospital, and community hospital.
Hospitalized adults with bacteriuria.
Patients without documented symptoms of urinary tract infection per Infectious Diseases Society of America (IDSA) criteria were classified as ASB. We examined ASB treatment risk factors as well as broad-spectrum antibiotic usage and quantified diagnostic concordance between IDSA and National Healthcare Safety Network criteria.
Among 300 patients with bacteriuria, ASB was present in 71% by IDSA criteria. By National Healthcare Safety Network criteria, 71% of patients had ASB; within-patient diagnostic concordance with IDSA was moderate (kappa, 0.52). After excluding those given antibiotics for nonurinary indications, antibiotics were given to 38% (62/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, P<.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14–0.80], P =.01), presence of leukocyte esterase (5.48 [2.35–12.79], P<.01), presence of nitrites (2.45 [1.11–5.41], P=.03), and Escherichia coli on culture (2.4 [1.2–4.7], P=.01). Of patients treated for ASB, broad-spectrum antibiotics were used in 84%.
ASB treatment was prevalent across settings and contributed to broad-spectrum antibiotic use. Associating abnormal urinalysis results with the need for antibiotic treatment regardless of symptoms may drive unnecessary antibiotic use.
Infect. Control Hosp. Epidemiol. 2016;37(3):319–326
The incidence and severity of Clostridium difficile infections (CDI) have increased in Western countries. However, there are limited data regarding the epidemiology of CDI in Eastern countries. This nationwide study was conducted in 17 hospitals to determine temporal trends in CDI incidence (from 2004 to 2008) in South Korea. The total incidence of CDI in Korea was 1·7 cases/1000 adult admissions in 2004, and 2·7/1000 cases in 2008 (P = 0·028). When analysing the clinical features of 1367 CDI patients diagnosed in 2008, oral metronidazole was effective as a first-line treatment for CDI (61·9%). Relapse rate was 8·9% and complicated CDI was only observed in 3·6%. The incidence of CDI increased significantly in Korea from 2004 to 2008. Although the clinical features were milder than in Western countries, the increasing burden of CDI needs ongoing surveillance systems.
The whole body concentration ratio (CR) of 137Cs, 85Sr and 65Zn for Chinese minnow (P. oxycephalus) and earthworm (E. andrei) were experimentally measured in a laboratory. The mean CR (Bq/kg fresh per Bq/l) of Chinese minnow was 3.5 for 137Cs, 11.0 for 85Sr, and 9.8 for 65Zn, respectively. The mean CR (Bq/kg fresh per Bq/kg) of earthworm was 4.4 × 10−4 for 137Cs, 1.7 × 10−3 for 85Sr, and 1.4 × 10−3 for 65Zn, respectively.
A facile anodic electrophoretic deposition (EPD) process has been developed to prepare thin uniform films consisting of titanate nanotubes (TNTs) that were synthesized by a hydrothermal approach. Such an EPD process offers easy control in the film thickness and the adhesion to the substrate was found to be strong. The chemical composition and structure of the products have been characterized by HRTEM, FESEM, XRD and TG/DTA. It was found that the functionalization of TNTs plays a key role on the electrolyte stability and the successful formation of a uniform TNT film with good adhesion. The as-prepared TNT films show exceptional superhydrophilic behavior with ultra-fast spreading, while it converts to superhydrophobicity yet with high adhesion after 1H,1H,2H,2H-perfluorooctyl-triethoxysilane modification. This study provides an interesting method to prepare films with extremely high wettability contrast that are useful for producing different kinds of functional materials.
Recent PIC simulations of relativistic electron-positron (electron-ion) jets injected into a stationary medium show that particle acceleration occurs in the shocked regions. Simulations show that the Weibel instability is responsible for generating and amplifying highly nonuniform, small-scale magnetic fields and for particle acceleration. These magnetic fields contribute to the electron's transverse deflection behind the shock. The “jitter” radiation from deflected electrons in turbulent magnetic fields has properties different from synchrotron radiation calculated in a uniform magnetic field. This jitter radiation may be important for understanding the complex time evolution and/or spectral structure of gamma-ray bursts, relativistic jets in general, and supernova remnants. In order to calculate radiation from first principles and go beyond the standard synchrotron model, we have used PIC simulations. We present synthetic spectra to compare with the spectra obtained from Fermi observations.
In this work, the one dimensional (1D) titanate nanotubes (TNT)/nanowires (TNW), bulk titanate micro-particles (TMP), and three dimensional (3D) titanate microsphere particles (TMS) with high specific surface area were synthesized via different approaches. The chemical composition and structure of these products have been characterized by field emission scanning electron microscopy (FESEM), transmission electron microscope (TEM) study and Raman scattering spectroscopy. The as-prepared TMS shows excellent adsorption performance compared with TMP, TNW and TNT when methylene blue (MB) and PbII ions are used as representative organic and inorganic pollutants.
Thin film electrodes of the perovskite oxide (Ba,Sr)RuO3 (BSR) were deposited on 4 inch ptype Si wafers by metal organic chemical vapor deposition (MOCVD) for the practical (Ba,Sr)TiO3 (BST) capacitor application using a new single cocktail source. The source materials used for the MOCVD BSR process were Ba(METHD)2, Sr(METHD)2 and Ru(METHD)3 and these were dissolved in n-butyl acetate. The source-feeding rate was precisely controlled by liquid mass flow controllers (LMFC). As-deposited BSR films possessed a (110)-oriented structure, with good uniformity and adherence on bare Si wafer. The phase formation was strongly affected by the oxygen flow rate and the input source rate. As the oxygen flow rate increased, the Ru/(Ba+Sr) composition ratio in the film decreased, while the Ba/(Ba+Sr) ratio was almost independent of the oxygen flow rate. The dielectric constants of BST capacitors fabricated using these electrodes was greater than 500.
The feasibility of using LaVO3 as a semiconducting layer in all-oxide semiconductor/ferroelectric/conductor heterostructures was explored by growing epitaxial LaVO3/(Ba,Sr)TiO3/(Pb,La)(Zr,Ti)O3/(La,Sr)CoO3 heterostructures on (001) LaAlO3 single crystal substrates by pulsed laser deposition. A high degree of c-axis orientation and strong in-plane texture revealed by x-ray diffraction indicated the epitaxial crystallographic relationships between the layers. With a 30 nm layer of (Ba,Sr)TiO3, the heterostructure showed optimal ferroelectric hysteresis with remanent polarizations over 30 C/cm2. The capacitance measurement as a function of voltage might reveal the modulation of the depletion layer in the semiconducting LaVO3.
Double-shelled nanotubes composed of inner shell Pb(Zr0.52Ti0.48)O3 (PZT) and outer shell TiO2 are successfully fabricated by a spin coating of each sol-gel solution on porous anodic alumina template. Field emission transmission electron microscopy images show that they have a ~ 10 nm wall thickness. The selected area electron diffraction patterns show that they have two mixed crystalline phases of tetragonal PZT and anatase TiO2. The analyses of scanning transmission electron microscopy equipped with energy dispersive X-ray spectroscopy confirm their uniform distribution of each element.
A new structure of triode type field emission displays based on single-walled carbon nanotube emitters is demonstrated. In this structure, gate electrodes are situated under cathode electrodes with an in-between insulating layer, so called under-gate type triode. Electron emission from the carbon nanotube emitters is modulated by changing gate voltages. A threshold voltage is approximately 70 V at the anode bias of 275 V.
We develop a novel patterning technique to create 3D patterns of micro, nanoparticle assembly via evaporative self-assembly based on confinement/release of micro/nano particles assembly based on the coffee-ring effect of evaporating suspension. Based on the presented technique, we demonstrate that the patterns of 3D assembly of various sizes of microparticles (Silica), metal oxide nanoparticles (TiO2, ZnO) and metallic nanoparticles (Ag) can be successfully generated by low-concentrated particle suspension (1.25 wt % ~ 5 wt %) without additional sintering steps and we also show the geometries of the patterns can be finely controlled by adjusting the parameters of the process.
The ionized cluster beam deposition (ICBD) technique has been employed to fabricate high-purity polyimide (PI) films. The pyromellitic dianhydride (PMDA) and oxydianiline (ODA) were deposited using dual ionized cluster beam (ICB) sources. Fourier transform infrared spectroscopy (FT-IR) and X-ray photoemission spectroscopy (XPS) studies show that the bulk and surface chemical properties are very sensitive to the ICBD conditions such as cluster ion acceleration voltage and ionization voltage. At optimum ICBD conditions, the PI films have a maximum imidization and negligible impurities(∼;1% isoimide) probably due to the high surface migration energy and surface cleaning effect.
Electrical and structural investigation of AlAs/GaAs/AlAs resonant tunneling structures with pseudomorphic strained Ga1−xInxAs (x=0, 0.05, 0.1, 0.15, and 0.2) emitter spacer layer are presented. As indium composition increased, the peak current density, peak voltage, and peak to valley ratio increased. For a theoretical understanding of these increases, a self-consistent simulation was employed. In the simulation, we treated the 2-dimensional electrons confined in the low energy bandgap GalnAs emitter spacer well as pseudo-3-dimensional electrons, distributed continuously down to the emitter launching energy. In the simulation, we used the bottom energy of the pseudo-3-dimensional electrons to be ⅔δEc below the emitter conduction band edge. Using the above values, an excellent agreement of peak current density and peak voltage between the experiment and the simulation was achieved. Also, for structural identification, standard double crystal x-ray rocking curve technique has been used. From the interference analysis of the x-ray results, we could obtain the indium composition times thickness product.
Piezoelectric bimorphs and piezoelectric strain sensors based on sputtered ZnO films were fabricated on Si3N4 cantilever beams to form tactile sensors. The sensors were used to determine object positions. Deflections of the bimorphs showed a quadratic dependence on the applied voltages. Deflection as large as 1166 μm were registered for a bimorph of 2980 μm long. The apparent d33 of ZnO under a bias of -4 volts was - 103 × 1O-12 m/V, which was approximately 20 times larger than the previously reported values of -5.12 × 10-12m/V. The large deflections of the bimorphs were due to the quadratic effect under strong electric field.