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To describe variation in blood culture practices in the neonatal intensive care unit (NICU).
Design:
Survey of neonatal practitioners involved with blood culturing and NICU-level policy development.
Participants:
We included 28 NICUs in a large antimicrobial stewardship quality improvement program through the California Perinatal Quality Care Collaborative.
Methods:
Web-based survey of bedside blood culture practices and NICU- and laboratory-level practices. We evaluated adherence to recommended practices.
Results:
Most NICUs did not have a procedural competency (54%), did not document the sample volume (75%), did not receive a culture contamination report (57%), and/or did not require reporting to the provider if <1 mL blood was obtained (64%). The skin asepsis procedure varied across NICUs. Only 71% had a written procedure, but ≥86% changed the needle and disinfected the bottle top prior to inoculation. More than one-fifth of NICUs draw a culture from an intravascular device only (if present). Of 13 modifiable practices related to culture and contamination, NICUs with nurse practitioners more frequently adopted >50% of practices, compared to units without (92% vs 50% of units; P < .02).
Conclusions:
In the NICU setting, recommended practices for blood culturing were not routinely performed.
We describe an adolescent with Streptococcus pneumoniae meningitis and symptomatic high-grade, second-degree atrioventricular block requiring permanent pacemaker placement. It is difficult to ascertain if these two diagnoses were independent or had a causal relationship though ongoing symptoms were not present prior to the infection. Because of this uncertainty, awareness that rhythm disturbances can be cardiac in origin but also secondary to other aetiologies, such as infection, is warranted.
Traumatic events are associated with increased risk of psychotic experiences, but it is unclear whether this association is explained by mental disorders prior to psychotic experience onset.
Aims
To investigate the associations between traumatic events and subsequent psychotic experience onset after adjusting for post-traumatic stress disorder and other mental disorders.
Method
We assessed 29 traumatic event types and psychotic experiences from the World Mental Health surveys and examined the associations of traumatic events with subsequent psychotic experience onset with and without adjustments for mental disorders.
Results
Respondents with any traumatic events had three times the odds of other respondents of subsequently developing psychotic experiences (OR=3.1, 95% CI 2.7–3.7), with variability in strength of association across traumatic event types. These associations persisted after adjustment for mental disorders.
Conclusions
Exposure to traumatic events predicts subsequent onset of psychotic experiences even after adjusting for comorbid mental disorders.
The Twin Study of Negative Valence Emotional Constructs is a multi-site study designed to examine the relationship between a broad selection of potential measures designed to assess putative endophenotypes for negative valence systems (NVS) and early symptoms of internalizing disorders (IDs). In this article, we describe the sample characteristics, data collection protocols, and measures used. Pre-adolescent Caucasian twin pairs were recruited through the Mid-Atlantic Twin Registry; data collection began in February of 2013. Enrolled twins completed various dimensional self-report measures along with cognitive, emotional, and psychophysiological tasks designed to assess NVS function. Parents also completed surveys about their twins and themselves. In addition, a subset of the twins also participated in a neuroimaging protocols. Data collection is in the final stages, and preliminary analyses are underway. The findings will potentially expand our understanding of the mechanisms by which genetic and environmental factors contribute to individual differences in NVS phenotypes and provide new insights into underlying risk factors for IDs.
Metamorphic epitaxy offers the possibility of growing devices on wafers composed of different materials that might be larger than the native bulk substrates for a potential cost-reduction of III–V components; this is especially important when native substrates with desired lattice constants are not available. This article reviews the concepts of metamorphic epitaxy of III–V compound semiconductor materials and examines how they have been applied to the development of advanced transistor devices. These metamorphic devices are expected to be a key enabler of future heterogeneous integrated circuits in which Si and III–V devices are monolithically integrated on a wafer scale using complementary metal oxide semiconductor-like process flows.
Thermoelectric phenomena strongly influence the behavior of chalcogenide materials in nanoelectronic devices including phase-change memory cells. This paper presents the annealing temperature and phase dependent thermoelectric properties of Ge2Sb2Te5 films including the thermoelectric power factor and the figure of merit. The Ge2Sb2Te5 films annealed at different temperatures contain varying fractions of the amorphous and crystalline phases which strongly influence the thermoelectric properties. The thermoelectric power factor increases fom 3.2 μW/mK2 to 65 μW/mK2as the crystal phase changes from face-centered cubic to hexagonal close-packed. The data are consistent with modeling based on effective medium theory and suggest that careful consideration of phase purity is needed to improve the figures of merit for phase change memories and potentially for thermoelectric energy conversion applications.
A new series of anionic photoacid generators (PAGs), and corresponding polymers were prepared. The thermostability of PAG bound polymers was superior to PAG blend polymers. PAG incorporated into the polymer main chain may improve acid diffusion compared with the PAG blend polymers, which was demonstrated by Extreme Ultraviolet lithography (EUVL) results: the fluorine PAG bound polymer resist gave 45 nm (1:1), 35 nm (1:2), 30 nm (1:3) and 20 nm (1:4) Line/Space as well as 50 nm (1:1) elbow patterned, showed better resolution than the blend sample.
Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene–nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient–genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries.
The thermal conductivity of interlevel dielectrics (ILD) in interconnect structures is an important parameter in determining the temperature rise in the interconnects during use. Numerous researchers have previously shown that the thermal conductivity of thin film dielectrics can be significantly lower than that of bulk materials. As new materials, such as low-dielectric constant materials, are considered for use as ILD's, methods are needed for measuring the thermal conductivity of the these materials to determine whether they can adequately conduct heat away from interconnect lines. Many methods reported in the literature use patterned metal lines atop the dielectric on a Si substrate as combination Joule heaters and temperature sensors, and extract the thermal conductivity from a model of heat conduction through the dielectric to the substrate. One drawback of these methods is the lack of agreement of the conductivity determined from the different techniques. For example, a thermal conductivity ranging from 0.6 to 1.4 W/m-K was calculated for a 1.25 μm thick PTEOS oxide using five different methods on the same test structure. In this paper we present a unique combination of test structures, experimental methods, and heat conduction models that highlight the limitations of some of the models and methods. We also show good agreement in the thermal conductivity determined from both an experimental method and a finite element model, and suggest that these two techniques yield an accurate measure of the thermal conductivity of thin film dielectrics.
The novel antimony source compound di-isopropylantimony hydride, (i-Pr)2 was synthesized and evaluated for use as a volatile Sb-source compound for low temperature growth of Sb-containing semiconductor materials. (i-Pr)2SbH was pyrolyzed in a horizontal atmospheric pressure organometallic vapor phase epitaxy (OMVPE) reactor using Arand H2 as carrier gases. The gaseous exhaust products were analyzed by a residual gas analyzer. Complete pyrolysis of (i-Pr)2SbH in our OMVPE reactor occursaround 300°C and 350°C in Ar and H2, respectively. A comparison between the pyrolysis temperatures and pyrolysis byproducts with respect to a proposed decomposition mechanism of (i-Pr)2SbH is presented. Sb films were grown on Si(100) andSi(111) as low as 200° C. The Sb films were analyzed by Auger and X-ray diffraction. These polycrystalline Sb films were free of detectable carbon by AES. X-ray diffraction data indicated that these Sb films were highly oriented in the [000L] direction.