6 results
Impact of measurement and feedback on chlorhexidine gluconate bathing among intensive care unit patients: A multicenter study
- Yoona Rhee, Mary K. Hayden, Michael Schoeny, Arthur W. Baker, Meghan A. Baker, Shruti Gohil, Chanu Rhee, Naasha J. Talati, David K. Warren, Sharon Welbel, Karen Lolans, Bardia Bahadori, Pamela B. Bell, Heilen Bravo, Thelma Dangana, Christine Fukuda, Tracey Habrock Bach, Alicia Nelson, Andrew T. Simms, Pam Tolomeo, Robert Wolf, Rachel Yelin, Michael Y. Lin, for the CDC Prevention Epicenters Program
-
- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 9 / September 2023
- Published online by Cambridge University Press:
- 13 September 2023, pp. 1375-1380
- Print publication:
- September 2023
-
- Article
- Export citation
-
Objective:
To assess whether measurement and feedback of chlorhexidine gluconate (CHG) skin concentrations can improve CHG bathing practice across multiple intensive care units (ICUs).
Design:A before-and-after quality improvement study measuring patient CHG skin concentrations during 6 point-prevalence surveys (3 surveys each during baseline and intervention periods).
Setting:The study was conducted across 7 geographically diverse ICUs with routine CHG bathing.
Participants:Adult patients in the medical ICU.
Methods:CHG skin concentrations were measured at the neck, axilla, and inguinal region using a semiquantitative colorimetric assay. Aggregate unit-level CHG skin concentration measurements from the baseline period and each intervention period survey were reported back to ICU leadership, which then used routine education and quality improvement activities to improve CHG bathing practice. We used multilevel linear models to assess the impact of intervention on CHG skin concentrations.
Results:We enrolled 681 (93%) of 736 eligible patients; 92% received a CHG bath prior to survey. At baseline, CHG skin concentrations were lowest on the neck, compared to axillary or inguinal regions (P < .001). CHG was not detected on 33% of necks, 19% of axillae, and 18% of inguinal regions (P < .001 for differences in body sites). During the intervention period, ICUs that used CHG-impregnated cloths had a 3-fold increase in patient CHG skin concentrations as compared to baseline (P < .001).
Conclusions:Routine CHG bathing performance in the ICU varied across multiple hospitals. Measurement and feedback of CHG skin concentrations can be an important tool to improve CHG bathing practice.
Isotope dependence of energy, momentum and particle confinement in tokamaks
- Part of
- H. Weisen, C. F. Maggi, M. Oberparleiter, F. J. Casson, Y. Camenen, S. Menmuir, L. Horvath, F. Auriemma, T. W. Bache, N. Bonanomi, A. Chankin, E. Delabie, L. Frassinetti, J. Garcia, C. Giroud, D. King, R. Lorenzini, M. Marin, P. A. Schneider, P. Siren, J. Varje, E. Viezzer, JET contributors
-
- Journal:
- Journal of Plasma Physics / Volume 86 / Issue 5 / October 2020
- Published online by Cambridge University Press:
- 04 September 2020, 905860501
-
- Article
-
- You have access Access
- HTML
- Export citation
-
The isotope dependence of plasma transport will have a significant impact on the performance of future D-T experiments in JET and ITER and eventually on the fusion gain and economics of future reactors. In preparation for future D-T operation on JET, dedicated experiments and comprehensive transport analyses were performed in H, D and H-D mixed plasmas. The analysis of the data has demonstrated an unexpectedly strong and favourable dependence of the global confinement of energy, momentum and particles in ELMy H-mode plasmas on the atomic mass of the main ion species, the energy confinement time scaling as ${\tau _E}\sim {A^{0.5}}$ (Maggi et al., Plasma Phys. Control. Fusion, vol. 60, 2018, 014045; JET Team, Nucl. Fusion, vol. 39, 1999, pp. 1227–1244), i.e. opposite to the expectations based only on local gyro-Bohm (GB) scaling, ${\tau _E}\sim {A^{ - 0.5}}$, and stronger than in the commonly used H-mode scaling for the energy confinement (Saibene et al., Nucl. Fusion, vol. 39, 1999, 1133; ITER Physics Basis, Nucl. Fusion, vol. 39, 1999, 2175). The scaling of momentum transport and particle confinement with isotope mass is very similar to that of energy transport. Nonlinear local GENE gyrokinetic analysis shows that the observed anti-GB heat flux is accounted for if collisions, E × B shear and plasma dilution with low-Z impurities (9Be) are included in the analysis (E and B are, respectively the electric and magnetic fields). For L-mode plasmas a weaker positive isotope scaling ${\tau _E}\sim {A^{0.14}}$ has been found in JET (Maggi et al., Plasma Phys. Control. Fusion, vol. 60, 2018, 014045), similar to ITER97-L scaling (Kaye et al., Nucl. Fusion, vol. 37, 1997, 1303). Flux-driven quasi-linear gyrofluid calculations using JETTO-TGLF in L-mode show that local GB scaling is not followed when stiff transport (as is generally the case for ion temperature gradient modes) is combined with an imposed boundary condition taken from the experiment, in this case predicting no isotope dependence. A dimensionless identity plasma pair in hydrogen and deuterium L-mode plasmas has demonstrated scale invariance, confirming that core transport physics is governed, as expected, by the 4 dimensionless parameters ρ*, ν*, β, q (normalised ion Larmor radius, collisionality, plasma pressure and safety factor) consistently with global quasi-linear gyrokinetic TGLF calculations (Maggi et al., Nucl. Fusion, vol. 59, 2019, 076028). We compare findings in JET with those in different devices and discuss the possible reasons for the different isotope scalings reported from different devices. The diversity of observations suggests that the differences may result not only from differences affecting the core, e.g. heating schemes, but are to a large part due to differences in device-specific edge and wall conditions, pointing to the importance of better understanding and controlling pedestal and edge processes.
Contributors
-
- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
-
- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
-
- Chapter
- Export citation
Contributors
-
- By Michael H. Allen, Leora Amira, Victoria Arango, David W. Ayer, Helene Bach, Christopher R. Bailey, Ross J. Baldessarini, Kelsey Ball, Alan L. Berman, Marian E. Betz, Emily A. Biggs, R. Warwick Blood, Kathleen T. Brady, David A. Brent, Jeffrey A. Bridge, Gregory K. Brown, Anat Brunstein Klomek, A. Jacqueline Buchanan, Michelle J. Chandley, Tim Coffey, Jessica Coker, Yeates Conwell, Scott J. Crow, Collin L. Davidson, Yogesh Dwivedi, Stacey Espaillat, Jan Fawcett, Steven J. Garlow, Robert D. Gibbons, Catherine R. Glenn, Deborah Goebert, Erica Goldstein, Tina R. Goldstein, Madelyn S. Gould, Kelly L. Green, Alison M. Greene, Philip D. Harvey, Robert M. A. Hirschfeld, Donna Holland Barnes, Andres M. Kanner, Gary J. Kennedy, Stephen H. Koslow, Benoit Labonté, Alison M. Lake, William B. Lawson, Steve Leifman, Adam Lesser, Timothy W. Lineberry, Amanda L. McMillan, Herbert Y. Meltzer, Michael Craig Miller, Michael J. Miller, James A. Naifeh, Katharine J. Nelson, Charles B. Nemeroff, Alexander Neumeister, Matthew K. Nock, Jennifer H. Olson-Madden, Gregory A. Ordway, Michael W. Otto, Ghanshyam N. Pandey, Giampaolo Perna, Jane Pirkis, Kelly Posner, Anne Rohs, Pedro Ruiz, Molly Ryan, Alan F. Schatzberg, S. Charles Schulz, M. Katherine Shear, Morton M. Silverman, April R. Smith, Marcus Sokolowski, Barbara Stanley, Zachary N. Stowe, Sarah A. Struthers, Leonardo Tondo, Gustavo Turecki, Robert J. Ursano, Kimberly Van Orden, Anne C. Ward, Danuta Wasserman, Jerzy Wasserman, Melinda K. Westlund, Tracy K. Witte, Kseniya Yershova, Alexandra Zagoloff, Sidney Zisook
- Edited by Stephen H. Koslow, University of Miami, Pedro Ruiz, University of Miami, Charles B. Nemeroff, University of Miami
-
- Book:
- A Concise Guide to Understanding Suicide
- Published online:
- 05 October 2014
- Print publication:
- 18 September 2014, pp vii-x
-
- Chapter
- Export citation
Wear Characterization of Forging Dies Using a Large-Chamber Scanning Electron Microscope
- T Heidenblut, K Mohwald, TA Dei?er Dei?er, M Bistron, B-A Behrens, F-W Bach
-
- Journal:
- Microscopy and Microanalysis / Volume 13 / Issue S02 / August 2007
- Published online by Cambridge University Press:
- 05 August 2007, pp. 104-105
- Print publication:
- August 2007
-
- Article
- Export citation
-
Extended abstract of a paper presented at Microscopy and Microanalysis 2007 in Ft. Lauderdale, Florida, USA, August 5 – August 9, 2007
Intestinal metabolism of rye lignans in pigs
- L. V. Glitsø, W. M. Mazur, H. Adlercreutz, K. Wähälä, T. Mäkelä, B. Sandström, K. E. Bach Knudsen
-
- Journal:
- British Journal of Nutrition / Volume 84 / Issue 4 / October 2000
- Published online by Cambridge University Press:
- 09 March 2007, pp. 429-437
- Print publication:
- October 2000
-
- Article
-
- You have access Access
- Export citation
-
To study the intestinal metabolism of lignans, the concentrations of plant and mammalian lignans in intestinal digesta sampled along the intestinal tract of pigs were determined by isotope dilution GC–MS. The pigs were fed rye-bread diets made from either whole rye-grains or rye-grain milling fractions enriched in pericarp–testa, aleurone or endosperm cells. The content and characteristics of dietary fibre varied between diets and had been shown to induce different colon fermentation patterns. As the metabolism of lignans depends on the action of the intestinal flora, we tested whether the rye-bread diets influence the metabolism of lignans. In the ileum, the lignans were mainly present as conjugated plant lignans, which were determined only when the analytical procedure included a hydrolysis step. High recovery of dietary lignans in the ileum may indicate that the lignans enter the enterohepatic circulation. In addition, two to three times the intake of lignans were recovered in the faeces when the diets had a high content of dietary fibre suggesting underestimation of plant lignans in the diet. Most of the plant lignans disappeared from the intestinal tract between the terminal ileum and the caecum. The intestinal concentrations and the disappearance of lignans correlated with the content of lignans in the diet, being highest on the pericarp–testa diet and lowest on the endosperm diet. No effect of fermentation pattern on the intestinal metabolism of lignans was observed. The lignans were liberated from the pericarp–testa diet although the plant cell walls remained largely undegraded.