Real-time polymerase chain reaction (PCR) cycle threshold and Clostridioides difficile infection outcomes.

OBJECTIVE: Clostridioides difficile infection (CDI) causes significant morbidity and mortality; however, the diagnosis of CDI remains controversial. The primary aim of our study was to evaluate the association of polymerase chain reaction (PCR) cycle threshold (Ct) values with CDI disease severity, recurrence, and mortality among adult patients with CDI. DESIGN: Retrospective cohort study. SETTING: Single tertiary-care hospital. PATIENTS: Adult patients diagnosed with hospital-onset, healthcare facility-associated CDI from June 2014 to September 2015. METHODS: We performed a retrospective chart review of included patients. Univariate and multivariable logistic regression methods were used to evaluate the association between Ct values and CDI severity, 8-week recurrence, and 30-day mortality. RESULTS: Among 318 included patients, 51% were male and the mean age was 62 years; ~32% of the patients developed severe CDI and 11% developed severe-complicated CDI. The 30-day all-cause mortality rate was 11% and the 8-week recurrence rate was 9.5%. The overall mean Ct value was 32.9 (range, 23-40). Multivariable analyses showed that lower values of PCR Ct were associated with increased odds of 30-day morality (odds ratio [OR] 0.83; 95% confidence interval [CI], 0.72-0.96) but were not independently associated with CDI severity (OR, 0.99; 95% CI, 0.90-1.09) or recurrence (OR, 0.88; 95% CI, 0.77-1.00). CONCLUSIONS: Our findings suggest that PCR Ct values at the time of diagnosis may have a limited predictive value and utility in clinical decision making for inpatients with CDI. Larger, prospective studies across different patient populations are needed to confirm our findings.

Highly Conductive Fiber with Waterproof and Self-Cleaning Properties for Textile Electronics.

Major concerns in the development of wearable textile electronics are exposure to moisture and contamination. The exposure can cause electrical breakdown of the device and its interconnections, and thus continuous efforts have been made to fabricate textile electronics which are free from moisture and pollution. Herein, we developed a highly conductive and waterproof fiber with excellent electrical conductivity (0.11 Ω/cm) and mechanical stability for advanced interconnector components in wearable textile electronics. The fabrication process of the highly conductive fiber involves coating of a commercial Kevlar fiber with Ag nanoparticle-poly(styrene- block-butadiene- block-styrene) polymer composites. The fabricated fiber then gets treated with self-assembled monolayer (SAM)-forming reagents, which yields waterproof and self-cleaning properties. To find optimal SAM-forming reagents, four different kinds of reagents involving 1-decane thiol (DT), 1 H,1 H,2 H,2 H-perfluorohexanethiol, 1 H,1 H,2 H,2 H-perfluorodecyltrichlorosilane, 1 H,1 H,2 H,2 H-perfluodecanethiol (PFDT) were compared in terms of their thiol group and carbon chain lengths. Among the SAM-forming reagents, the PFDT-treated conductive fiber showed superior waterproof and self-cleaning property, as well as great sustainability in the water with varying pH because of nanoscale roughness and low surface energy. In addition, the functionality of the conductive fiber was tested under mechanical compression via repeated washing and folding processes. The developed conductive fiber with waterproof and self-cleaning property has promising applications in the interconnector operated under water and textile electronics.

Thermal Gradient During Vacuum-Deposition Dramatically Enhances Charge Transport in Organic Semiconductors: Toward High-Performance N-Type Organic Field-Effect Transistors.

A thermal gradient distribution was applied to a substrate during the growth of a vacuum-deposited n-type organic semiconductor (OSC) film prepared from N,N'-bis(2-ethylhexyl)-1,7-dicyanoperylene-3,4:9,10-bis(dicarboxyimide) (PDI-CN2), and the electrical performances of the films deployed in organic field-effect transistors (OFETs) were characterized. The temperature gradient at the surface was controlled by tilting the substrate, which varied the temperature one-dimensionally between the heated bottom substrate and the cooled upper substrate. The vacuum-deposited OSC molecules diffused and rearranged on the surface according to the substrate temperature gradient, producing directional crystalline and grain structures in the PDI-CN2 film. The morphological and crystalline structures of the PDI-CN2 thin films grown under a vertical temperature gradient were dramatically enhanced, comparing with the structures obtained from either uniformly heated films or films prepared under a horizontally applied temperature gradient. The field effect mobilities of the PDI-CN2-FETs prepared using the vertically applied temperature gradient were as high as 0.59 cm2 V-1 s-1, more than a factor of 2 higher than the mobility of 0.25 cm2 V-1 s-1 submitted to conventional thermal annealing and the mobility of 0.29 cm2 V-1 s-1 from the horizontally applied temperature gradient.

Diagnostic testing methods for Clostridium difficile infection: A statewide survey of Ohio acute care hospitals.

We surveyed Ohio acute care hospitals on laboratory testing used for diagnosis of Clostridium difficile infection (CDI). Of 146 hospitals surveyed, 109 (84%) used nucleic acid amplification tests (NAATs) as stand-alone diagnostic assays. Only 53 (42.4%) hospitals using NAATs had a mechanism in place to prevent repeat CDI testing.