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In preparation for a multisite antibiotic stewardship intervention, we assessed knowledge and attitudes toward management of asymptomatic bacteriuria (ASB) plus teamwork and safety climate among providers, nurses, and clinical nurse assistants (CNAs).
Prospective surveys during January–June 2018.
All acute and long-term care units of 4 Veterans’ Affairs facilities.
The survey instrument included 2 previously tested subcomponents: the Kicking CAUTI survey (ASB knowledge and attitudes) and the Safety Attitudes Questionnaire (SAQ).
A total of 534 surveys were completed, with an overall response rate of 65%. Cognitive biases impacting management of ASB were identified. For example, providers presented with a case scenario of an asymptomatic patient with a positive urine culture were more likely to give antibiotics if the organism was resistant to antibiotics. Additionally, more than 80% of both nurses and CNAs indicated that foul smell is an appropriate indication for a urine culture. We found significant interprofessional differences in teamwork and safety climate (defined as attitudes about issues relevant to patient safety), with CNAs having highest scores and resident physicians having the lowest scores on self-reported perceptions of teamwork and safety climates (P < .001). Among providers, higher safety-climate scores were significantly associated with appropriate risk perceptions related to ASB, whereas social norms concerning ASB management were correlated with higher teamwork climate ratings.
Our survey revealed substantial misunderstanding regarding management of ASB among providers, nurses, and CNAs. Educating and empowering these professionals to discourage unnecessary urine culturing and inappropriate antibiotic use will be key components of antibiotic stewardship efforts.
Influenza A(H1N1) viruses of the 2009 pandemic (A(H1N1)pdm09) continue to cause outbreaks in the post-pandemic period. During January to May 2015, an upsurge of influenza was recorded that resulted in high fatality in central India. Genetic lineage, mutations in the hemagglutinin (HA) gene and infection by quasi-species are reported to affect disease severity. The objective of this study is to present the molecular and epidemiological trends during the 2015 influenza outbreak in central India. All the referred samples were subjected to qRT–PCR for diagnosis. HA gene sequencing (23 survivors and 24 non-survivors) and cloning were performed and analyzed using Molecular Evolutionary Genomic Analyzer (MEGA 5·05). Of the 3625 tested samples, 1607 (44·3%) were positive for influenza A(H1N1)pdm09, of which 228 (14·2%) individuals succumbed to death. A significant trend was observed in positivity (P = 0·003) and mortality (P < 0·0001) with increasing age. The circulating A(H1N1)pdm09 virus was characterized as belonging to clade-6B. Clinically significant mutations were detected. Patients infected with the quasi-species of the virus had a greater risk of death (P = 0·009). This study proposes a robust molecular and clinical surveillance program for the detection and characterization of the virus, along with prompt treatment protocols to prevent outbreaks.
Various promising applications such as acoustic cloaking, sub-wavelength imaging, acoustic wave manipulation, transmission or reflection control etc. are feasible because of the ability of manipulating sounds and vibrations using artificially engineered “Acoustics meta-materials”. Recent works on space-coiling acoustic metamaterials show their extreme constitutive parameters like large refractive index, double negativity and zero mass density. Three dimensional structures have a wide application in sub-wavelength broadband acoustic wave suppression due to huge attenuation. Here we report the study of propagated and transmitted wave through 3D acoustic metamaterials structure using finite element method. Our simulations on 3D structure show a huge absorption/damping over few hundreds kilohertz frequency range.
We have developed a new method for controlling the size, crystallinity, and polydispersity of 100–2000 nm tetrafluoride phosphor particles. Five polyol-based deep eutectic solvents (DESs) were downselected out of a set of more than 130 candidates. We analyzed their benefits in synthesizing phosphor matrix particles of β-NaYF4, β-NaYbF4, and β-NaGdF4. We produced green (λmax = 540 nm) and blue/UV (λmax = 450 nm) upconverting phosphors in DES using Yb,Er and Yb,Tm codopants, respectively. The blue/UV phosphor reaction was scaled the up to 25 L, yielding nearly 400 g of high-quality, bright photoluminescent, β-phase product under mild conditions. We conclude that polyol-based DES systems offer a uniquely specialized and useful toolkit for phosphor synthesis.
X-ray and extreme ultraviolet emission from galaxy clusters can be interpreted as thermal emission from a hot plasma gravitationally bound to the cluster and constituting a significant amount of the mass of the cluster. The origin of this plasma and its thermal energy content can be linked to the formation process through the theory of self-organization of these structures.
This paper focuses on the progress in understanding the shielding around a test charge in the presence of ion-acoustic waves in multispecies plasmas, whose constituents are positive ions, two negative ions, and Boltzmann distributed electrons. By solving the linearized Vlasov equation with Poisson equation, the Debye–Hückel screening potential and wakefield (oscillatory) potential distribution around a test charge particle are derived. It is analytically found that both the Debye–Hückel potential and the wakefield potential are significantly modified due to the presence of two negative ions. The present results might be helpful to understand and to form new materials from plasmas containing two negative ions such as Xe+ − F− − SF−6 and Ar+ − F− − SF−6 plasmas, as well as to tackle extension of the test charge problem in multinegative ions' coagulation/agglomeration.
Nonlinear wave-driven processes in plasmas are normally described by either a monochromatic pump wave that couples to other monochromatic waves, or as a random phase wave coupling to other random phase waves. An alternative approach involves a random or broadband pump coupling to monochromatic and/or coherent structures in the plasma. This approach can be implemented through the wave-kinetic model. In this model, the incoming pump wave is described by either a bunch (for coherent waves) or a sea (for random phase waves) of quasi-particles. This approach has been applied to both photon acceleration in laser wakefields and drift wave turbulence in magnetized plasma edge configurations. Numerical simulations have been compared to experiments, varying from photon acceleration to drift mode-zonal flow turbulence, and good qualitative correspondences have been found in all cases.
We consider the nonlinear instability of modified Langmuir and ion–sound waves caused by partially coherent photons in dense quantum plasmas. In our model, the dynamics of the photons is governed by a wave kinetic equation. The evolution equations for the Langmuir and ion–sound waves are deduced from the quantum hydrodynamic equations accounting for the incoherent photon pressure, the quantum statistical electron pressure, and the quantum Bohm force acting on the degenerate electrons. The governing equations are Fourier analyzed to obtain nonlinear dispersion relations. The latter are analyzed to predict instability of the modified Langmuir and ion–sound waves in the presence of partially coherent photons. Possible applications of our investigation to the next generation of intense laser–solid dense plasma experiments and compact dense astrophysical bodies are mentioned.
We theoretically investigate conditions for the refraction of long-wavelength dust acoustic waves by arrays of periodic cylinders in a dusty plasma. This is based on a recent analysis of the refraction of shallow water waves by periodic cylinder arrays (Hu and Chan, Phys. Rev. Lett.95 (2005), 154501). In the dusty plasma case, however, the boundary conditions involve the formation of voids around the cylinders. Possible experimental conditions are discussed.
We present an investigation of the amplitude modulation of an external magnetic field-aligned right-hand circularly polarized electromagnetic electron-cyclotron (EMEC) wave in a strongly magnetized electron-positron plasma. It is shown that the dynamics of the modulated EMEC wave packet is governed by a cubic nonlinear Schrödinger equation. The latter reveals that a modulated wave packet can propagate in the form of either a dark or a grey envelope soliton. This result could have relevance to the transport of electromagnetic wave energy over long distances via envelope solitons in the magnetospheres of pulsars and magnetars.
The solar coronal plasma is maintained at temperatures of millions of degrees, much hotter than the photosphere, which is at a temperature of just 6000 K. In this paper, the plasma particle heating based on the kinetic theory of wave–particle interactions involving kinetic Alfvén waves and lower-hybrid drift modes is presented. The solar coronal plasma is collisionless and therefore the heating must rely on turbulent wave heating models, such as lower-hybrid drift models at reconnection sites or the kinetic Alfvén waves. These turbulent wave modes are created by a variety of instabilities driven from below. The transition region at altitudes of about 2000 km is an important boundary chromosphere, since it separates the collision-dominated photosphere/chromosphere and the collisionless corona. The collisionless plasma of the corona is ideal for supporting kinetic wave–plasma interactions. Wave–particle interactions lead to anisotropic non-Maxwellian plasma distribution functions, which may be investigated by using spectral analysis procedures being developed at the present time.
It is shown that double vortices are a special class of stationary solutions of the set of nonlinear equations that governs the dynamics of modified convective cells and shear Alfvén waves in a cold rotating magnetized plasma. Criteria for the existence of dipole vortices as well as several analytical expressions for the vortex profiles are presented. It is suggested that modified convective cell and Alfvén dipole vortices may cause anomalous cross-field particle transport in a low-β plasma, such as the ionosphere.
It is found that the inclusion of the electron inertia effect (parallel to an external magnetic field) can provide a linear coupling between the electrostatic drift and the convective modes in a non-uniform plasma. This coupling leads to new branches of rapidly growing modes, which are calculated in the kinetic as well as in the hydrodynamic regimes. To study the saturation of the linear unstable modes, we account for the mode coupling and derive a set of model nonlinear fluid equations. A perturbation technique is employed to obtain a nonlinear evolution equation. In the steady state, the latter yields the saturated electric potential. It is argued that the enhanced low-frequency fluctuations can cause anomalous particle transport in a magnetoplasma.
Accounting for an external electron current gradient, a set of nonlinear fluid equations governing the dynamics of kink instability in an inhomogeneous magnetized plasma has been derived. In the linear regime, the dispersion relation is analysed and the variation of the growth rate is graphically shown. In the nonlinear regime, it is shown that a quasi-stationary solution of the mode coupling equations can be represented as a dipolar vortex. Conditions under which the latter arises are given.
The nonlinear interaction of two three-wave systems, including the possibility of negative energy waves in the presence of linear damping or growth and frequency mismatch, is investigated in a plasma, where one system of two transverse and one longitudinal wave interacts with a system of three longitudinal waves, and one of the longitudinal waves introduces coupling between the two subsystems. The solutions are analysed under various initial conditions and it is shown that, if one triplet be explosively unstable by itself, the presence of the second triplet can stabilize the solutions, depending on the relative strength of the coupling factor.
Instabilities of the flute-like magnetic fluctuations in the presence of radiation cooling in a non-uniform magnetoplasma are investigated. It is shown that magnetic turbulence can cause anomalous cross-field electron energy transport. The relevance of the investigation to magnetic and inertial fusion as well as to astrophysical plasmas is pointed out.
A comparative study of the electromagnetic instabilities in anisotropic unmagnetized plasmas is undertaken. The instabilities considered are the filamentation and Weibel instability, and their cumulative effect. Dispersion relations are derived and the growth rates are plotted systematically for the representative cases of non-relativistic counterstreaming plasmas with isotropic or anisotropic velocity distributions functions of Maxwellian type. The pure filamentation mode is attenuated by including an isotropic Maxwellian distribution function. Moreover, it is observed that counterstreaming plasmas can be fully stabilized by including bi-Maxellian distributions with a negative thermal anisotropy. This effect is relevant for fusion plasma experiments. Otherwise, for plasma streams with a positive anisotropy the filamentation and Weibel instabilities cumulate leading to a growth rate by orders of magnitude larger than that of a simple filamentation mode. This is noticeable for the quasistatic magnetic field generated in astrophysical sources, and which is expected to saturate at higher values and explain the non-thermal emission observed.
Search for novel multi-functional materials, especially multiferroics, which are ferromagnetic above room temperature and at the same time exhibit a ferroelectric behavior much above room temperature, is an active topic of extensive studies today. Ability to address an entity with an external field, laser beam, and also electric potential is a welcome challenge to develop multifunctional devices enabled by nanoscience. While most of the studies to date have been on various forms of Bi- and Ba based Ferrites, rare earth chromites are a new class of materials which appear to show some promise. However in the powder and bulk form these materials are at best canted antiferromagnetics with the magnetic transition temperatures much below room temperature. In this presentation we show that thin films of YbCrO3 deposited by Pulsed Laser Deposition exhibit robust ferromagnetic properties above room temperature. It is indeed a welcome surprise and a challenge to understand the evolution of above room temperature ferromagnetism in such a thin film. The thin films are amorphous in contrast to the powder and bulk forms which are crystalline. The magnetic properties are those of a soft magnet with low coercivity. We present extensive investigations of the magnetic and ferroelectric properties, and spectroscopic studies using XAS techniques to understand the electronic states of the constituent atoms in this novel Chromite. While the amorphous films are ferromagnetic much above room temperature, we show that any observation of ferroelectric property in these films is an artifact of a leaky highly resistive material.
The present work reports the temperature and frequency dependence
of a.c. conductivity in glassy Se70Te30−xZnx (x = 0, 2, 4 and 6) alloys in the temperature range 300–500 K and frequency range 1 kHz.
An agreement between experimental and theoretical results suggests that the
a.c. conductivity behaviour of the present samples can be successfully
explained by correlated barrier hopping (CBH) model. The density of defect
states has been determined using this model for all the glassy alloys.
The results show that bipolaron hopping dominates over single-polaron
hopping in this glassy system. This is explained in terms of lower values of
the maximum barrier height for single-polaron hopping.