Temporary Disruption
We have implemented additional assurance measures to protect our systems.
As a result, we have suspended some of our systems and services. We apologise for any temporary disruption some customers may experience.
Temporary Disruption
We have implemented additional assurance measures to protect our systems.
As a result, we have suspended some of our systems and services. We apologise for any temporary disruption some customers may experience.
To save 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 saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org 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 saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved 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.
Find out more about the Kindle Personal Document Service.
To determine patient-specific risk factors and clinical outcomes associated with contaminated blood cultures.
A single-center, retrospective case-control risk factor and clinical outcome analysis performed on inpatients with blood cultures collected in the emergency department, 2014–2018. Patients with contaminated blood cultures (cases) were compared to patients with negative blood cultures (controls).
A 509-bed tertiary-care university hospital.
Risk factors independently associated with blood-culture contamination were determined using multivariable logistic regression. The impacts of contamination on clinical outcomes were assessed using linear regression, logistic regression, and generalized linear model with γ log link.
Of 13,782 blood cultures, 1,504 (10.9%) true positives were excluded, leaving 1,012 (7.3%) cases and 11,266 (81.7%) controls. The following factors were independently associated with blood-culture contamination: increasing age (adjusted odds ratio [aOR], 1.01; 95% confidence interval [CI], 1.01–1.01), black race (aOR, 1.32; 95% CI, 1.15–1.51), increased body mass index (BMI; aOR, 1.01; 95% CI, 1.00–1.02), chronic obstructive pulmonary disease (aOR, 1.16; 95% CI, 1.02–1.33), paralysis (aOR 1.64; 95% CI, 1.26–2.14) and sepsis plus shock (aOR, 1.26; 95% CI, 1.07–1.49). After controlling for age, race, BMI, and sepsis, blood-culture contamination increased length of stay (LOS; β = 1.24 ± 0.24; P < .0001), length of antibiotic treatment (LOT; β = 1.01 ± 0.20; P < .001), hospital charges (β = 0.22 ± 0.03; P < .0001), acute kidney injury (AKI; aOR, 1.60; 95% CI, 1.40–1.83), echocardiogram orders (aOR, 1.51; 95% CI, 1.30–1.75) and in-hospital mortality (aOR, 1.69; 95% CI, 1.31–2.16).
These unique risk factors identify high-risk individuals for blood-culture contamination. After controlling for confounders, contamination significantly increased LOS, LOT, hospital charges, AKI, echocardiograms, and in-hospital mortality.
Objective: The human gut microbiota has been demonstrated to be associated with a number of host phenotypes, including obesity and a number of obesity-associated phenotypes. This study is aimed at further understanding and describing the relationship between the gut microbiota and obesity-associated measurements obtained from human participants. Subjects/Methods: Here, we utilize genetically informative study designs, including a four-corners design (extremes of genetic risk for BMI and of observed BMI; N = 50) and the BMI monozygotic (MZ) discordant twin pair design (N = 30), in order to help delineate the role of host genetics and the gut microbiota in the development of obesity. Results: Our results highlight a negative association between BMI and alpha diversity of the gut microbiota. The low genetic risk/high BMI group of individuals had a lower gut microbiota alpha diversity when compared to the other three groups. Although the difference in alpha diversity between the lean and heavy groups of the BMI-discordant MZ twin design did not achieve significance, this difference was observed to be in the expected direction, with the heavier participants having a lower average alpha diversity. We have also identified nine OTUs observed to be associated with either a leaner or heavier phenotype, with enrichment for OTUs classified to the Ruminococcaceae and Oxalobacteraceae taxonomic families. Conclusion: Our study presents evidence of a relationship between BMI and alpha diversity of the gut microbiota. In addition to these findings, a number of OTUs were found to be significantly associated with host BMI. These findings may highlight separate subtypes of obesity, one driven by genetic factors, the other more heavily influenced by environmental factors.
Metasedimentary rocks constitute an important but comparatively poorly understood part of the Antarctic Peninsula. Herein we report single-grain U-Pb detrital-zircon ages from samples of the Trinity Peninsula and Botany Bay Groups of north-western Graham Land. All studied samples are dominated by a large and narrowly defined population of late Palaeozoic zircons. Significant early–middle Palaeozoic and minor Neoproterozoic and Mesoproterozoic sub-populations constitute the majority of pre-Carboniferous grains. These detrital-zircon age populations are consistent with sediment derivation entirely from western Gondwana sources. Despite the clear Gondwana signatures, our data suggest that the Trinity Peninsula Group province was either a parautochthonous peri-Gondwanan terrane later accreted to the Antarctic Peninsula, or a significant topographic barrier precluded voluminous sediment contributions from the interior of Gondwana. Statistical comparisons with similar metasedimentary complexes of southern South America, the South Shetland Islands and eastern New Zealand indicate a diversity of sediment provenance not previously recognized, but may provide a means to better determine the pre-break-up configuration of western Gondwana. Although insufficient to definitively restore Antarctic Peninsula components adjacent to South American complexes, some Trinity Peninsula Group samples exhibit robust affinities to the Miers Bluff Formation in the South Shetland Islands and the Duque de York and Main Range Metamorphic Complexes of the Patagonian Andes.
We examine the interaction of a spherical foreign particle with a propagating solidification front in a binary alloy. Depending on the material properties and the speed of the front, the particle may be pushed ahead of the front, or engulfed and incorporated into the solid phase. We apply numerical boundary integral and continuation methods to determine the critical speed for particle capture, as a function of the system parameters. We reconcile the differing predictions of previous theoretical works, and show that many typical systems may obey a new scaling of the critical speed, as obtained here. We show that due to constitutional undercooling, the presence of solute decreases particle speeds by an order of magnitude below those for a single-component system. We briefly consider the case of spherical bubbles, where thermocapillary and solutocapillary effects play a large role.
Email your librarian or administrator to recommend adding this to your organisation's collection.