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To compare the characteristics and risk factors for surgical site infections (SSIs) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in a nationwide survey, using shared case detection and recording systems.
Retrospective cohort study.
Twenty-six hospitals participating in the Korean Nosocomial Infections Surveillance System (KONIS).
From 2006 to 2009, all patients undergoing THA and TKA in KONIS were enrolled.
SSI occurred in 161 (2.35%) of 6,848 cases (3,422 THAs and 3,426 TKAs). Pooled mean SSI rates were 1.69% and 2.82% for THA and TKA, respectively. Of the cases we examined, 42 (26%) were superficial-incisional SSIs and 119 (74%) were “severe” SSIs; of the latter, 24 (15%) were deep-incisional SSIs and 95 (59%) were organ/space SSIs. In multivariate analysis, a duration of preoperative hospital stay of greater than 3 days was a risk factor for total SSI after both THA and TKA. Diabetes mellitus, revision surgery, prolonged duration of surgery (above the 75th percentile), and the need for surgery due to trauma were independent risk factors for total and severe SSI after THA, while male sex and an operating room without artificial ventilation were independent risk factors for total and severe SSI after TKA. A large volume of surgeries (more than 10 procedures per month) protected against total and severe SSI, but only in patients who underwent TKA.
Risk factors for SSI after arthroplasty differ according to the site of the arthroplasty. Therefore, clinicians should take into account the site of arthroplasty in the analysis of SSI and the development of strategies for reducing SSI.
To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.
A nationwide prospective multicenter study.
Twenty university-affiliated hospitals in Korea.
The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.
Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 (±12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09–2.58]), increased operation time (1.20 [1.07–1.34] per 1-hour increase), reoperation (7.27 [3.68–14.38]), combined multiple procedures (1.79 [1.13–2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09–8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26–5.64]) were independently associated with increased risk of SSI.
Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.
Web servers have to be protected against overload since overload can lead to a server breakdown, which in turn causes high response times and low throughput. In this paper, a stochastic model for breakdowns of server systems due to overload is proposed and an admission control policy which protects Web servers by controlling the amount and rate of work entering the system is studied. Requests from the clients arrive at the server following a nonhomogeneous Poisson process and each requested job takes a random time to be completed. It is assumed that the breakdown rate of the server depends on the number of jobs which are currently being performed by the server. Based on the proposed model, the reliability function and the breakdown rate function of the server system are derived. Furthermore, the long-run expected number of jobs completed per unit time is derived as the efficiency measure, and the optimal admission control policy which maximizes the efficiency will be discussed.
Epitaxial ZnGa2O4 and Sr2CeO4 thin-film phosphors were successfully grown on (100) MgO, YSZ, and SrTiO3 single crystal substrates using pulsed laser ablation. Cathodoluminescence efficiency was remarkably enhanced by adding lithium in the ZnGa2O4 and ZnGa2O4:Mn for both blue and green light emitting thin-film phosphors. The highest efficiencies, in this experiment, were 0.35 and 0.29 lm/W at 1kV for as-deposited blue and green zinc gallate phosphor films, respectively. In case of Sr2CeO4 films, the highest luminescence was 0.14 lm/W at 1kV and 0.26 A/m2 for films annealed at 1000°C in air.
In this study, we have investigated microencapsulation of magenta, yellow, and cyan color polymer balls with white pigment for multi-color electrophoretic display implementation. The charged color pigments have been prepared by physical coating of magenta, yellow, and cyan with functionalized polymers, then surface charging with charge control agent. These color balls with white pigment were microencapsulated in suspending fluid through in-situ polymerization.
We have investigated the growth mechanism and thin film morphology of pentacene thin films by the process of low-pressure gas assisted organic vapor deposition (LP-GAOVD). As the source temperature, flow rate of the carrier gas, substrate temperature and chamber pressure were varied, the growth rate, morphology and grain size of the films were differently obtained. The electrical properties of pentacene thin films for applications in organic thin film transistor and electrophoretic displays were discussed
The growth and properties of undoped and Mn-doped ZnGa2O4 thin-film phosphors on (100) MgO and glass substrates using pulsed laser ablation were investigated. Blue-white and green emission were observed for as-deposited undoped and Mn-doped films, respectively. Luminescent properties as well as crystallinity were considerably affected by processing conditions and film stoichiometry. Films with enhanced luminescent characteristics were obtained on single crystal substrates without post-annealing.
Pt thin films were deposited by a DC magnetron sputtering with Ar/O2 gas mixtures. Due to the oxygen incorporation into the Pt films, deposition rate and resistivity of as-deposited Pt thin films increased with oxygen fraction in the sputtering gas. No peaks from crystalline Pt oxides were observed by x-ray diffraction (XRD) and excessive oxygen incorporation into Pt lead to an amorphous Pt oxide formation. More oxygen could be incorporated in the Pt thin films deposited at lower temperatures and at higher total pressures. Incorporated oxygen was completely removed after an annealing at 800 °C for an hour in air ambient, as the resistivity of the Pt thin films recovered their bulk resistivity values. Tensile stress of the Pt films decreased with oxygen incorporation, and approached a saturation level at high resistivity of the films, presumably due to the formation of amorphous Pt oxides.
NiCr films were thermally evaporated on the Mn-Ni-Co-O thick-film substrates. The NiCr/Mn-Ni-Co-O bi-layer systems were tested in a thermal shock chamber with three temperature differences of 150, 175 and 200°C. The systems were considered to have failed when the sheet resistance of NiCr films changed by 30% relative to an initial value. As the cyclic repetition of thermal shock increased, the sheet resistance of NiCr coatings increased. The Coffin-Manson equation was applied to the failure mechanism of cracking of NiCr coatings and the SEM observation of cracks and delamination in NiCr coatings due to thermal cycling agreed well with the failure mechanism.
We consider a finite dam under the policy, where the input of water is formed by a Wiener process subject to random jumps arriving according to a Poisson process. The long-run average cost per unit time is obtained after assigning costs to the changes of release rate, a reward to each unit of output, and a penalty that is a function of the level of water in the reservoir.
We consider the policy in a finite dam in which the input of water is formed by a compound Poisson process and the rate of water release is changed instantaneously from a to M and from M to a (M > a) at the moments when the level of water exceeds λ and downcrosses τ (λ > τ) respectively. After assigning costs to the changes of release rate, a reward to each unit of output, and a cost related to the level of water in the reservoir, we determine the long-run average cost per unit time.
An infinite dam with input formed by a compound Poisson process is considered. As an output policy, we adopt the PλM-policy. The stationary distribution and expectation of the level of water in the reservoir are obtained.
The microstructural evolution, including preferred orientation and surface morphology, of ZnO films deposited by rf magnetron sputtering was investigated with increasing film thickness. Preferred orientation of the ZnO films changed from (0002) → (1011) → (1120) and fine and dense columnar grains also changed to large elongated grains with increasing thickness. Such selective texture growth was explained with an effect of highly energetic species bombardment on the growing film surface. The relationship between preferred orientation change and microstructural evolution was also discussed.
A Markovian stochastic model for a system subject to random shocks is introduced. It is assumed that the shock arriving according to a Poisson process decreases the state of the system by a random amount. It is further assumed that the system is repaired by a repairman arriving according to another Poisson process if the state when he arrives is below a threshold α. Explicit expressions are deduced for the characteristic function of the distribution function of X(t), the state of the system at time t, and for the distribution function of X(t), if . The stationary case is also discussed.
The state of a system is modelled by Brownian motion with negative drift and an absorbing barrier at the origin. A repairman arrives according to a Poisson process of rate λ. If the state of the system at arrival of the repairman does not exceed a certain threshold, he/she increases it by a random amount, otherwise no action is taken. Costs are assigned to each visit of the repairman, to each repair, and to the system being in state 0. It is shown that there exists a unique arrival rate λ which minimizes the average cost per unit time over an infinite horizon.
A model for a system whose state changes continuously with time is introduced. It is assumed that the system is modeled by Brownian motion with negative drift and an absorbing barrier at the origin. A repairman arrives according to a Poisson process and increases the state of the system by a random amount if the state is below a threshold α. Explicit expressions are deduced for the distribution function of X(t), the state of the system at time 1, if X(t) ≤ α and for the Laplace transform of the density of X( t). The stationary case is examined in detail.
An inventory whose stock decreases linearly with time is considered. The inventory may be replenished at the instants at which a deliveryman arrives provided that the level of the inventory does not exceed a certain threshold; deliveries are made according to a Poisson process. A partial differential equation for the distribution function of the level of the inventory is solved to yield a formula for the corresponding Laplace–Stieltjes transform. The evaluation of the transform is discussed and explicit results are obtained for the stationary case.
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