To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To evaluate the impact of outpatient parenteral antimicrobial therapy (OPAT) on a public hospital in a middle-income country.
A retrospective, observational study analyzing the economic data retrieved on the dehospitalization of patients on antibiotic therapy.
Public university trauma hospital.
Data were collected from June 2017 to May 2020. Antibiotic cost, hospital length of stay, and risk of multidrug-resistant (MDR) infection or colonization were reviewed, along with the break-even point at which a balance occurs between OPAT antimicrobial costs and all in-hospital costs. A cumulative risk curve was constructed showing the incidence of MDR during the review period.
In total, 225 patients were studied. The implementation of OPAT resulted in a reduction of $156,681 (49.6%), which is equivalent to an average of $696 per patient, as well as a shortened length of stay, from 33.5 to 15.7 days. OPAT reduces the risk of acquiring infection by MDR bacteria by having the final treatments administered outside of the hospital environment. The breakeven curves, comparing the duration of the OPAT to daily medication costs, allowed for the prediction of the time and dollar costs of antibiotic therapy.
OPAT presented a significant cost savings, shortened length of stay, and reduced risk of contamination of patients by MDR.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
Given the difficulty in obtaining robust chronologies from tree rings in tropical regions, the search for appropriate species is very important. Both dendrochronology and radiocarbon (14C) measurements are required to validate the use of any specific tree. Some species have proved to be reliable for representing atmospheric 14C concentration over time, such as Cedrela fissilis and Araucaria angustifolia. However, not only the species have to be validated, but also different climatic conditions may result in different growth patterns for the same species. In this work, we study the annual growth rings of Cedrela fissilis from a dry tropical forest patch typical of a highly seasonal climate in central Brazil. 14C accelerator mass spectrometry (AMS) was used to compare the isotopic ratios of tree rings with the 14C concentrations in the atmosphere during the nuclear tests based on curve Bomb13SH 1-2. Results are similar to the bomb peak curve within the period from 1958 to 1980 AD and serve as a crucial test for the cross-dating analyses using the skeleton plot technique.
Obtention of titanium (Ti)- and titanium dioxide (TiO2)–based nanocomposites is of great interest for biological nanomaterial applications, including for dental implants. Their mechanical properties can be improved by use of hydroxyapatite (HA) and chitosan through their biological anchorage with osseointegration and antibacterial activity. Electrochemical methods were chosen to obtain these composites in a quick and controllable way. In this work, electrochemical synthesis in one (alternated potential) or two steps (alternated or constant potential) was successfully applied. The single step (SS) obtained TiO2 + HA sample had different optical properties, as shown using ultraviolet–visible spectrometry, and the HA phase formation was proved using Raman spectroscopy. Thereby, SS_TiO2 + HA increased the corrosion resistance of titanium in artificial saliva medium, as shown by linear polarization and electrochemical impedance spectroscopy results. When using chitosan, the samples showed two corrosion interfaces, indicating its dissolution in human medium. These results indicate that the samples are excellent materials for dental implants.
Nanoparticles of titanium dioxide (TiO2), synthesized by the sonochemical technique, were mixed with different amounts of graphene oxide (GO), obtained by the improved method of Hummer, in order to modify their bandwidth. The TiO2/OG compounds were characterized using different techniques: X-ray Diffraction (XRD), transmission electron microscopy (TEM), Raman and UV-Vis-NIR spectroscopy. TiO2 bandgap decreased, with GO incorporation, from 3.2 to 2.72 eV when GO was present at 20 weigh percentage (TiO2/GO-20%). Photodegradation experiments of methylene blue (MB) were performed with the materials to verify their photocatalytic activity. At 40 minutes, the pure TiO2 degraded 48% of MB, whereas the compound TiO2/GO-20% degraded 88%, showing a good incorporation of both compounds and the improvement of TiO2 photocatalitic properties.
This paper evaluates the complexities of radiocarbon (14C) dates from soil organic matter (SOM) in archaeological scenarios. The aqueous NaOH-insoluble residual SOM from Neolithic to medieval sites in NW Spain produced consistently older calibrated 14C ages than NaOH-extractable SOM. Using pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) and thermally assisted hydrolysis and methylation (THM-GC-MS), we analyzed the molecular composition of these SOM fractions, aiming to understand the differences in 14C ages and to gain insight on SOM dynamics in relation to age fractionation. The molecular composition of the NaOH-extractable SOM, which accounts for roughly two-thirds of total SOM, has a larger proportion of microbial detritus than the NaOH-insoluble SOM. This might suggest that the discrepancies between the two fractions is due to microbial rejuvenation in the extractable fraction, leading to 14C results that are younger than the activity that is to be dated. However, archaeological evidence presented here unambiguously shows that the 14C age of the extractable SOM provides the more accurate age for the targeted activity, and that the insoluble fraction contains inherited old carbon. After statistical data evaluation using Partial Least Squares-Regression (PLS-R), it is concluded that this inherited SOM is a mixture of Black Carbon from wild and/or domestic fires and recalcitrant aliphatic SOM.
The adaptive changes of the foetal heart in intrauterine growth restriction can persist postnatally. Data regarding its consequences for early circulatory adaptation to extrauterine life are scarce. The aim of this study was to assess cardiac morphometry and function in newborns with late-onset intrauterine growth restriction to test the hypothesis that intrauterine growth restriction causes cardiac shape and functional changes at birth.
A comprehensive echocardiographic study was performed in 25 neonates with intrauterine growth restriction and 25 adequate-for-gestational-age neonates.
Compared with controls, neonates with intrauterine growth restriction had more globular ventricles, lower longitudinal tricuspid annular motion, and higher left stroke volume without differences in the heart rate. Neonates with intrauterine growth restriction also showed subclinical signs of diastolic dysfunction in the tissue Doppler imaging with lower values of early (e′) diastolic annular peak velocities in the septal annulus. Finally, the Tei index in the tricuspid annulus was higher in the intrauterine growth restriction group.
Neonates with history of intrauterine growth restriction showed cardiac remodelling and signs of systolic and diastolic dysfunction. Overall, there was a significant tendency to worse cardiac function results in the right heart. The adaptation to extrauterine life occurred with more globular hearts, higher stroke volumes but a similar heart rate compared to adequate-for-gestational-age neonates.
The objective of this study is to design and implement an intervention program centered on preventing functional dependence.
A pre/post quasi-experimental (typical case) design study with a control group was conducted on a group of 75–90-year-old individuals with functional dependence (n = 59) at three nursing homes in Madrid (Spain). The intervention program consists of two types of activities developed simultaneously. Some focused on emotional well-being (nine 90-minute sessions, once per week), whereas others focused on improving participants’ physical condition (two 30-minute sessions, twice per week). The simple randomized participants included 59 elderly individuals (Intervention Group = 30, Control Group = 29) (mean age 86.80) [SD, 5. 19].
Fifty-nine participants were analyzed. The results indicate that the program is effective in improving mood, lowering anxiety levels (d = 0.81), and increasing both self-esteem (d = 0.65) and the perception of self-efficacy (d = 1.04). There are improvements in systolic pressure and functional dependence levels are maintained. Linear simple regression (independent variable pre-Barthel) shows that the pre-intervention dependence level can predict self-esteem after the intervention.
We have demonstrated that the program is innovative with regard to bio-psychosocial care in elderly individuals, is based on actual practice, and is effective in increasing both self-esteem and self-efficacy. These variables positively affect functional capabilities and delay functional dependence.
The earliest functional living system on Earth should have been able to reproduce an ordered configuration and a self-organization dynamics. It was capable of resisting a random variability in time and space to keep the functionality. Amino acids (AAs) and nucleobases generated from abiotic reactions as seen in laboratory-based experiments have demonstrated that molecular elements for life can be obtained by predictable physicochemical processes. However, a functional, self-organized living system needs complex molecular interactions to endure. In this paper, we address the transference of spatial information on highly enantiopure polymers as a critical condition to support the dynamics in a self-organized biogenic system. Previous scenarios have considered almost exclusively the information encoded in sequences as the suitable source of prebiotic information. But the spatial information transference has been poorly understood thus far. We provide the supporting statements which predict that the ordered configuration in a biogenic system should be significantly influenced by spatial information, instead of being exclusively generated by sequences of polymers. This theoretical approach takes into consideration that the properties of mutation and inheritance did not develop before definition of the structures that allow the management of information. Rather, we postulate that the molecular structures to store and transfer information must exist at first, in order to retain particular functional ‘meaning’, and subsequently, such information can be ‘inherited’ and eventually modified. Thus, the present contribution follows the theory that life was originated from an unstable prebiotic environment that involves the early spatial information transference based on large chiral asymmetry.
In this work, the effect of three principal and independent parameters of Atmospheric Plasma Spray on the properties of coatings deposited using mixtures of commercial powders of titanium dioxide (TiO2) and chromium oxide (Cr2O3) was studied. The results of this work are used for special applications on turbomachinery components such as wear protection in sliding seals and in steam valves for turbines, chemical protection for centrifugal compressor members, and special seal applications.
The design of experiments (DoE) technique has proved to be very useful to study the influence factors and optimization. Pierlot et al.  demonstrated that the application of the Hadamard and two factorial design techniques are useful for the optimization of thermal spray processes. An example of the application of the DoE is the one mentioned by Murugan et al. . In their work, a factorial design was used to study the interactions between gas flow, oxygen flow, powder rate and spray distance on the percentage of porosity and hardness of TiO2 - Cr2O3 composite coatings generated by High Velocity Oxy-Fuel.
The ½ fractional two-level factorial DoE technique was used to analyze and optimize the Atmospheric Plasma Spray process parameters. In the current research, experiments were conducted varying the deposition velocity, gas flow and stand-off distance. The effect of these process variables were evaluated by thickness, hardness and microstructure analysis. In this study, an empirical relationship between process variables and response parameters was developed. The entire relationship was made using the results of the DoE.
Porous silicon (PSi) combines the potential of miniaturization with a very large surface area. The PSi surface can be chemically modified resulting in a high sensitivity (low detection threshold) device for chemical and biomolecular sensing. In previous work, we have shown that redox proteins and fluorescent ligands can be infiltrated into PSi (PSiMc) structures. The hybrid devices have shown interesting new properties produced by the coupling of the individual properties of PSi nanostructures and the modifiers. In this work, we have obtained a PSiMc/redox protein bioelectrode, which presents a quasi-reversible electrochemical response. This effect was attributed to the semiconducting nature of the PSi substrate and to the functional groups of the crosslinking molecules (MPTS), which together produce a capacitive effect on the device. On the other hand, the chemical modification of PSiMc with fluorescent ligands allowed us to fabricate fluorescent PSi hybrid nanostructures, which were tested for the detection of environmental pollutants such as heavy metals (specifically Hg2+). We found that the selectivity of this optical device depends on the selected recognizing molecule. The captured metal induces the formation of a metallic complex that shows higher fluorescence compared with the sensor device. These results demonstrate the viability of using porous silicon as optical sensors and electrochemical biosensors. The infiltration of fluorescent recognizing molecules and proteins into the PSi matrix were evaluated by specular reflectance, FTIR spectroscopy, fluorescence spectroscopy and cyclic voltammetry.
In this work, the correlation between the number of nonbridging oxygen (NBO) atoms and the thermal and optical properties of TeO2–Li2O–MoO3 glasses was studied. Samples containing (100 − x)TeO2–x(Li2O–MoO3) with x = 10, 15, 20, and 25 mol% were investigated by Raman and Fourier transform infrared (FTIR) spectroscopies. From the optical absorption measurements, the band gap energies were determined. The Raman and FTIR results showed that with increasing x, the TeO4 units transform into TeO3+1 units and then into TeO3 units, while the Mo coordination changes from 4 → 6. This transformation corresponds to a decrease in the total number of NBO with increasing x in this glass matrix. The decrease in the NBO is also confirmed by the increase in band gap energies and the decrease in the optical basicity, indicating a more polymerized network with increasing x.
Recently, the research team synthesized some scandium- and titanium-based oxide compounds, in order to analyze their thermoluminescent (TL) response [1-2]. The oxides mixture Sc2TiO5:Eu2Ti2O7:Sc2O3 was synthesized in equilibrium phase by solid state reaction at 1100 °C / 48 h. The structural characterization was performed by XRD and SEM. The TL properties of this oxide mixture were examined after exposing it to gamma radiation from a 60Co source. The glow curve showed two main glow peaks at 151 °C and 260 °C, yet the curve shape looks quite complex, revealing that it is composed by overlapped individual TL peaks, which was confirmed with the Tstop preheat method performed . The linear dose-response between 150 to 600 Gy was obtained, followed by a slow saturation stage. The intensity of the glow curves increases as the radiation dose increases, and their maxima remain at the same temperature values, which indicates that the TL phenomenon follows first-order kinetics . After ten irradiation-TL readout cycles at 500 Gy, good stability (SD 2.02 %) between TL integrated response and the exposure dose was found. It is concluded that Sc2TiO5:Eu2Ti2O7:Sc2O3 is a promising material to use as high-dose dosimeter.
Currently, the research team is systematically studying the oxide compounds present in the ternary system In2O3-TiO2-MgO in order to analyze its thermoluminescent (TL) response. The oxide Mg1.5InTi0.5O4 present in this system was synthesized by a solid state reaction at 1350 °C in air. The X-ray powder diffraction pattern showed a spinel-type structure for this compound. In this work, this spinel, as well as its TL properties when exposed to beta particles, are being reported for the first time. The glow curve is simple and wide with a TL maximum located at 203 °C at 21.33 Gy. The peak shows a shift to lower temperatures and it increases its intensity, as the irradiation dose increases. The lineal behavior was observed between 10.66 to 341 Gy, and no saturation signs were observed. The relative sensitivity variation was 2.7% and standard deviation after ten consecutive irradiation - TL readout cycles was 1 %. The minimum detectable dose was 5.65 Gy for this spinel-type oxide . These results suggest the possible application of Mg1.5InTi0.5O4 in dosimetry.
Field, greenhouse, and laboratory experiments were conducted to investigate resistance to glyphosate in tropical sprangletop biotypes (Lv8 and Lv9) collected in Persian lime from Veracruz, Mexico. Assays to determine the dose required to reduce seedling fresh weight by 50% indicated a resistance factor (RF) of 4.9 and 3.2 for biotypes Lv8 and Lv9, respectively; whereas the LD50 showed a RF of 4.4 and 3.3 for biotypes Lv8 and Lv9, respectively. On the other hand, the RFs using whole plant dose–response assays were lower (RF of 3 for Lv8 and 2.3 for Lv9). The susceptible biotype (LvS) accumulated 5.5 and 11.8 times more shikimate than biotypes Lv8 and Lv9, respectively, at 96 h after treatment (HAT). In field experiments, alternatives to glyphosate-resistant tropical sprangletop management were identified. Indaziflam + glufosinate and paraquat + diuron provided over 80% control of in-field populations of tropical sprangletop at 60 d after treatment (DAT). These results confirmed the first reported case of glyphosate-resistant tropical sprangletop.
The Cuban Twin Registry is a nation-wide, prospective, population-based twin registry comprising all zygosity types and ages. It was initiated in 2004 to study genetic and environmental contributions to complex diseases with high morbidity and mortality in the Cuban population. The database contains extensive information from 55,400 twin pairs enrolled in the period 2004–2006. Additionally, 2,600 new multiple births have been included from 2007 to date. In the past 4 years, more than 130 studies have been carried out using the registry with a classical genetic epidemiological approach in which concordance rates for monozygotic and dizygotic twins and heritability of various disease traits were estimated. This article summarizes the history, registry's methodology, recent research findings, and future directions of work.
High Risk Children (HRC) are those with an increased risk of abnormal development due to any factor affecting neurological growth. Those factors have been the focus of most studies in this area. However, little is known about their long-term consequences over the course of child development. Objectives: the goal was to study the cognitive, emotional and academic outcomes of 7-year-old children diagnosed as HRC at birth. Method: We compared 14 HRC and 20 healthy children using the WISC-IV, BASC and Brunet-Lezine tests. Results: HRC showed cognitive, emotional and academic deficits compared with healthy children. However, Brunet-Lezine scores obtained over the course of development (6, 12, 18 and 24 months) were not predictive of the children's' current psychological status. Conclusions: long-term follow-up with HRC should be maintained until 7 years of age, at which point an appropriate treatment should be implemented.
Ageing is an important determinant of atherosclerosis development rate, mainly by the creation of a chronic low-grade inflammation. Diet, and particularly its fat content, modulates the inflammatory response in the fasting and postprandial states. Our aim was to study the effects of dietary fat on the expression of genes related to inflammation (NF-κB, monocyte chemoattractant protein 1 (MCP-1), TNF-α and IL-6) and plaque stability (matrix metalloproteinase 9, MMP-9) during the postprandial state of twenty healthy, elderly people who followed three diets for 3 weeks each: (1) Mediterranean diet (Med Diet) enriched in MUFA with virgin olive oil; (2) SFA-rich diet; and (3) low-fat, high-carbohydrate diet enriched in n-3 PUFA (CHO-PUFA diet) by a randomised crossover design. At the end of each period, after a 12-h fast, the subjects received a breakfast with a composition similar to the one when the dietary period ended. In the fasting state, the Med Diet consumption induced a lower gene expression of the p65 subunit of NF-κB compared with the SFA-rich diet (P = 0·019). The ingestion of the Med Diet induced a lower gene postprandial expression of p65 (P = 0·033), MCP-1 (P = 0·0229) and MMP-9 (P = 0·041) compared with the SFA-rich diet, and a lower gene postprandial expression of p65 (P = 0·027) and TNF-α (P = 0·047) compared with the CHO-PUFA diet. Direct plasma quantification mostly reproduced the findings. Our data suggest that consumption of a Med Diet reduces the postprandial inflammatory response in mononuclear cells compared with the SFA-rich and CHO-PUFA diets in elderly people. These findings may be partly responsible for the lower CVD risk found in populations with a high adherence to the Med Diet.