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This study focused on exploring the relationship between antimicrobial use indicators, including the modified antibiotic heterogeneity index (mAHI), and the carbapenem susceptibility in Pseudomonas aeruginosa.
Design:
Survey-based observational study conducted across multiple facilities.
Setting:
Public community hospital institutions.
Methods:
This survey was conducted in 15 community hospitals in Japan. Indicators, such as the defined daily doses (DDDs), days of therapy (DOTs), antibiotic heterogeneity index (AHI), and mAHI, were analyzed for P. aeruginosa carbapenem susceptibility using Spearman’s rank correlation. The predictive accuracies of the AHI and mAHI for carbapenem susceptibility were compared using DeLong’s test for the 2 correlated receiver operating characteristic curves.
Results:
No significant correlations were observed between DDDs or DOTs and carbapenem susceptibility. However, a significant correlation was observed between carbapenem susceptibility and the mAHI (r = 0.261, P = .02), which also demonstrated a higher predictive accuracy for high susceptibility rates than that of the AHI (area under the curve: 0.75 vs 0.58, p < .01). The optimal mAHI cutoff value for predicting 90% susceptibility was 0.765, with a sensitivity of 67.7% and specificity of 76.5%.
Conclusions:
The mAHI may be a better predictor of carbapenem susceptibility than other commonly used indicators. This study underscores the utility of the mAHI as an effective indicator of antimicrobial usage patterns for managing carbapenem susceptibility in P. aeruginosa. Incorporating the mAHI into antimicrobial stewardship programs could enhance the effectiveness of antimicrobial interventions across diverse healthcare settings.
In Japan, evacuation at home is expected to increase in the future as a post-disaster evacuation type due to the pandemic, aging, and diverse disabilities of the population. However, more disaster-related indirect deaths occurred in homes than in evacuation centers after the 2011 Great East Japan Earthquake (GEJE). The health risks faced by evacuees at home have not been adequately discussed.
Study Objective:
This study aimed to clarify the gap in disaster health management for evacuees at home compared to the evacuees at the evacuation centers in Minamisanriku Town, which lost all health care facilities after the 2011 GEJE.
Methods:
This was a retrospective cross-sectional and quasi-experimental study based on the anonymized disaster medical records (DMRs) of patients from March 11 through April 10, 2011, that compared the evacuation-at-home and evacuation-center groups focusing on the day of the first medical intervention after the onset. Multivariable Cox regression analysis and propensity score (PS)-matching analysis were performed to identify the risk factors and causal relationship between the evacuation type and the delay of medical intervention.
Results:
Of the 2,838 eligible patients, 460 and 2,378 were in the evacuation-at-home and evacuation-center groups, respectively. In the month after the onset, the evacuation-at-home group had significantly lower rates of respiratory and mental health diseases than the evacuation-center group. However, the mean time to the first medical intervention was significantly delayed in the evacuation-at-home group (19.3 [SD = 6.1] days) compared to that in the evacuation-center group (14.1 [SD = 6.3] days); P <.001). In the multivariable Cox regression analysis, the hazard ratio (HR) of delayed medical intervention for evacuation-at-home was 2.31 with a 95% confident interval of 2.07–2.59. The PS-matching analysis of the adjusted 459 patients in each group confirmed that evacuation at home was significantly associated with delays in the first medical intervention (P <.001).
Conclusion:
This study suggested, for the first time, the causal relationship between evacuation at home and delay in the first medical intervention by PS-matching analysis. Although evacuation at home had several advantages in reducing the frequencies of some diseases, the delay in medical intervention could exacerbate the symptoms and be a cause of indirect death. As more evacuees are likely to remain in their homes in the future, this study recommends earlier surveillance and health care provision to the home evacuees.
The ammonia removal ability of heterotrophic bacteria Alcaligenes faecalis strain No.4 isolated from sewage sludge was examined in a batch operation to mitigate ammonia from piggery wastewater, consequently preventing pollution by the inflow of wastewater from piggeries adjacent to rivers. If this process works functionally, it can be effective in controlling nitrous oxide (N2O) and nitrate (NO3−) emissions derived from animal agriculture, the heterotrophic nitrifying and the aerobic denitrifying effect of A. faecalis strain No.4 on high-strength ammonium (NH4+-N) were evaluated in wastewater collected from a piggery. The removal rate by A. faecalis strain No.4 on high-strength ammonium (NH4+-N) was 0.97 kg N/m3/day which was more than 100 fold greater than that achieved using conventional aerobic nitrification and anaerobic denitrification processes. An aerobic one-step denitrification system using A. faecalis strain No.4 can be proposed to remove ammonia and phytopathogens from piggery wastewater with high efficiency and prevent water pollution in adjacent rivers.
Temperature is one of the most influential factors for the sexual maturation of fishes, but understanding of the extent to which temperature affects the maturational schedules is limited in multiple-spawning fishes over a protracted season. This study examined the effect of temperature on sexual maturation of Japanese anchovy Engraulis japonicus siblings under high and low temperature regimes on different birthdates. The maturation probability differed between the two temperature regimes. Specimens in high temperature regimes matured at much smaller size and younger age than their counterparts. Also, a significant difference in the maturation probability between sexes was found at low temperatures, but not at high temperatures. Our findings show that temperature affects the maturational schedules of siblings of Japanese anchovy, suggesting that the size and age at sexual maturation could differ among cohorts, even in a given sampling location and/or year.
This paper reports a NEMS (Nano Electro Mechanical Syetems) tunable color filter based on subwavelength grating with high color uniformity and low drive voltage. We newly proposed a GVG (Ground-Voltage-Ground) type tunable color filter deployed with a parallel-plate actuator with three pairs of electrode to decrease a crosstalk of an electrostatic attraction force between each actuator. The proposed structure was fabricated using an SOI wafer. The color tuning using was demonstrated by applying the drive voltage of 6.7 V. The reflected light intensity was decreased by 34 % at 680 nm wavelength. The color uniformity was also obtained in the filter area by reducing the variation of the displacement on one-dimensional arrayed actuators.
We developed a variable-temperature scanning microwave microscope (VT-SμM) that can perform high-throughput materials characterization in the temperature range between 4K and room temperature. As a sensor probe we used a high-Q coaxial cavity resonator, which was mounted on the low-temperature stage to allow variable-temperature measurements. We carried out systematic studies on the thermal degradation of the conducting polymers using the combinatorial libraries of polyaniline and polythiophene thin films, which showed rapid decrease of conductivity above 300C and 250C, respectively. The low-temperature performance of the VT-SμM was demonstrated by the measurement of composition-spread Nd1-xSrxMnO3 thin film, for which we succeeded in detecting the clear metal-insulator transition at 100K. We also propose a simple and easy method for the quantitative analysis of conductive thin films, by using the standard composition-spread thin films of Ti1-xNbxO2.
Hafnium oxide films were deposited on silicon substrates at deposition temperatures ranging from 190 to 500 °C by metalorganic chemical vapor deposition using an amide precursor, Hf[N(C2H5)2]4, and O2 as source materials. The effect of deposition temperature on the deposition characteristics and electrical properties of the resultant films were investigated. Reaction-limited deposition of hafnium oxide films occurred at deposition temperatures under 380 °C. Concentration of residues, such as carbon, nitrogen, and hydrogen, monotonously decreased with increasing deposition temperature, with nitrogen being the most thermally susceptible. However, surface roughness reached a minimum value at 400 °C. Amorphous films were obtained for deposition temperatures up to 450 °C, but obviously became crystallized at 500 °C. Accumulation capacitance increased with increasing deposition temperature but saturated above 400 °C. Moreover, postdeposition annealing at 800 °C caused no obvious degradation in the electrical properties of the film deposited at 400 °C.
Nitrogen delta-doped silicon carbide (SiC) layers were grown by a new pulse doping method in a chemical vapor deposition. Doping distribution with high peak concentration (1.×1018 cm−3) and narrow distribution width (12 nm) was fabricated in the nitrogen delta-doped structure of SiC. Mobility enhancement due to spatial separation of electrons and their ionized parent donors was observed for the delta-doped structure. Metal-semiconductor field-effect transistors with a nitrogen delta-doped channel and a recess gate structure were fabricated. The devices had large source-drain breakdown voltages, high drain current capability and easy control of the threshold voltage with a good pinch-off characteristics.
The Raman scattering from LO phonon–plasmon coupled (LOPC) mode in heavily carbon doped p–type InxGa1–xAs grown by metalorganic molecular beam epitaxy (MOMBE) was studied experimentally. Only one LOPC mode appears between the GaAs–like and InAs–like LO modes was observed. The peak position of the LOPC mode is near the GaAs–like TO mode frequency, and is not sensitive to the hole concentration. The intensity of the mode increases with increasing the carrier concentration while the two LO modes decrease and become unvisible under the higher doping level. The hole concentration dependence of the linewidth and intensity of the LOPC mode is very similar to that in p–type GaAs. It was shown that the plasmon damping effect plays a dominant role in the p–type doping case.
Metastasis of melanoma in the head and neck region is often reported but the report of amelanotic melanoma metastatic to the epiglottis is an extremely rare entity.
This paper describes a patients previously treated for cutaneous amelanotic melanoma who developed metastatic tumour involving his epiglottis. This legion was successfully excised by a intra-oral approach combined with KTP/532 laser surgery. The paper also describes the diagnostic evaluation, management, operative technique and DNA analysis of this rare case.
Triisobutylaluminum (TIBA) was used as an aluminum source for metalorganic molecular beam epitaxy (MOMBE). The optical absorption coefficient for TIBA was found to be larger than both tri ethyl aluminum and triethylgallium. TIBA was introduced into a laser-induced MOMBE system and selective deposition of Al and AlAs was carried out. Al metal was deposited on the area where the ArF excimer laser was irradiated and no deposition was observed without the excimer laser irradiation at a substrate temperature of 350 C. Furthermore, a laser large enhancement of the growth rate of AlAs was observed at 350 C.
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