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1.
Chem Commun (Camb) ; 60(29): 3970-3973, 2024 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-38501603

RESUMEN

SO2 emissions not only affect local air quality but can also contribute to other environmental issues. Developing low-cost and robust adsorbents with high uptake and selectivity is needed to reduce SO2 emissions. Here, we show the SO2 adsorption-desorption capacity of carbon microfibers (CMFs) at 298 K. CMFs showed a reversible SO2 uptake capacity (5 mmol g-1), cyclability over ten adsorption cycles with fast kinetics and good selectivity towards SO2/CO2 at low-pressure values. Additionally, CMFs' photoluminescence response to SO2 and CO2 was evaluated.

2.
J Synchrotron Radiat ; 30(Pt 6): 1168-1182, 2023 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-37860937

RESUMEN

The Femtosecond X-ray Experiments (FXE) instrument at the European X-ray Free-Electron Laser (EuXFEL) provides an optimized platform for investigations of ultrafast physical, chemical and biological processes. It operates in the energy range 4.7-20 keV accommodating flexible and versatile environments for a wide range of samples using diverse ultrafast X-ray spectroscopic, scattering and diffraction techniques. FXE is particularly suitable for experiments taking advantage of the sub-MHz repetition rates provided by the EuXFEL. In this paper a dedicated setup for studies on ultrafast biological and chemical dynamics in solution phase at sub-MHz rates at FXE is presented. Particular emphasis on the different liquid jet sample delivery options and their performance is given. Our portfolio of high-speed jets compatible with sub-MHz experiments includes cylindrical jets, gas dynamic virtual nozzles and flat jets. The capability to perform multi-color X-ray emission spectroscopy (XES) experiments is illustrated by a set of measurements using the dispersive X-ray spectrometer in von Hamos geometry. Static XES data collected using a multi-crystal scanning Johann-type spectrometer are also presented. A few examples of experimental results on ultrafast time-resolved X-ray emission spectroscopy and wide-angle X-ray scattering at sub-MHz pulse repetition rates are given.

3.
Porcine Health Manag ; 9(1): 25, 2023 May 26.
Artículo en Inglés | MEDLINE | ID: mdl-37237411

RESUMEN

This paper aimed to assess the success of cleaning and disinfection on microbiological contamination of anesthetic masks, which were used for automated isoflurane anesthesia for surgical castration of male piglets. Data collection took place on 11 farms in Southern Germany between September 2020 and June 2022. Each farm was visited three times (one farm having two different anesthesia devices was visited six times), and microbiological assessments took place at four sample points (SP): after unpacking the masks (SP0), after disinfection before anesthesia (SP1), after anesthesia of all piglets to be castrated in this run (SP2), and after disinfection after anesthesia (SP3). The microbiological assessment included the determination of total bacteria count, total count of hemolytic and non-hemolytic mesophilic aerotolerant bacteria and a qualitative detection of indicator bacteria Escherichia (E.) coli, extended-spectrum beta-lactamase-producing E. coli (ESBL) and methicillin-resistant Staphylococcus aureus (MRSA). For analysis, a generalized linear mixed model was applied using farms and farm visits as random effects and sampling points nested in farm visits as fixed effect. The fixed effect was highly significant for all three variables (total bacteria count, total count of hemolytic and non-hemolytic mesophilic aerotolerant bacteria) (p < 0.001). The bacterial counts at SP0 were about the same as at SP3. Concerning indicator bacteria, their presence was highest at SP2 and lowest at SP3. No indicator bacteria were present at SP1. It can be concluded that disinfection of anesthetic masks, especially before performing anesthesia, may effectively protect piglets of the following batch against unwanted transmission of pathogens. These findings will help farmers plan cleaning and disinfection activities.

4.
Neurosci Lett ; 802: 137134, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36801348

RESUMEN

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is standard care for severe motor symptoms of Parkinson's disease (PD). However, a challenge of DBS remains improving gait. Gait has been associated with the cholinergic system in the pedunculopontine nucleus (PPN). In this study, we investigated the effects of long-term intermittent bilateral STN-DBS on PPN cholinergic neurons in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) Parkinsonian mouse model. Motor behavior, previously assessed by the automated Catwalk gait analysis, demonstrated a parkinsonian-like motor phenotype with static and dynamic gait impairments, which were reversed by STN-DBS. In this study, a subset of brains was further immunohistochemically processed for choline acetyltransferase (ChAT) and the neuronal activation marker c-Fos. MPTP treatment resulted in a significant reduction of PPN ChAT expressing neurons compared to saline treatment. STN-DBS did not alter the number of ChAT expressing neurons, nor the number of double-labelled PPN neurons for ChAT and c-Fos. Although STN-DBS improved gait in our model this was not associated with an altered expression or activation of PPN acetylcholine neurons. Motor and gait effects of STN-DBS are therefore less likely to be mediated by the STN-PPN connection and PPN cholinergic system.


Asunto(s)
Estimulación Encefálica Profunda , Núcleo Tegmental Pedunculopontino , Núcleo Subtalámico , Ratones , Animales , Estimulación Encefálica Profunda/métodos , Núcleo Tegmental Pedunculopontino/metabolismo , Neuronas Colinérgicas , Marcha , Colinérgicos
5.
Orphanet J Rare Dis ; 18(1): 33, 2023 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-36814255

RESUMEN

BACKGROUND: Long-term sequelae are frequent and often disabling after epidermal necrolysis (Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)). However, consensus on the modalities of management of these sequelae is lacking. OBJECTIVES: We conducted an international multicentric DELPHI exercise to establish a multidisciplinary expert consensus to standardize recommendations regarding management of SJS/TEN sequelae. METHODS: Participants were sent a survey via the online tool "Survey Monkey" consisting of 54 statements organized into 8 topics: general recommendations, professionals involved, skin, oral mucosa and teeth, eyes, genital area, mental health, and allergy workup. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). Results were analyzed according to the RAND/UCLA Appropriateness Method. RESULTS: Fifty-two healthcare professionals participated. After the first round, a consensus was obtained for 100% of 54 initially proposed statements (disagreement index < 1). Among them, 50 statements were agreed upon as 'appropriate'; four statements were considered 'uncertain', and ultimately finally discarded. CONCLUSIONS: Our DELPHI-based expert consensus should help guide physicians in conducting a prolonged multidisciplinary follow-up of sequelae in SJS-TEN.


Asunto(s)
Síndrome de Stevens-Johnson , Humanos , Síndrome de Stevens-Johnson/complicaciones , Consenso , Piel , Progresión de la Enfermedad
7.
J Cardiovasc Transl Res ; 16(1): 77-85, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-35759180

RESUMEN

Myocardial fibrosis confers an almost threefold mortality risk in heart disease. There are no prognostic therapies and novel therapeutic targets are needed. Many thousands of unannotated small open reading frames (smORFs) have been identified across the genome with potential to produce micropeptides (< 100 amino acids). We sought to investigate the role of smORFs in myocardial fibroblast activation.Analysis of human cardiac atrial fibroblasts (HCFs) stimulated with profibrotic TGFß1 using RNA sequencing (RNA-Seq) and ribosome profiling (Ribo-Seq) identified long intergenic non-coding RNA LINC01013 as TGFß1 responsive and containing an actively translated smORF. Knockdown of LINC01013 using siRNA reduced expression of profibrotic markers at baseline and blunted their response to TGFß1. In contrast, overexpression of a codon-optimised smORF invoked a profibrotic response comparable to that seen with TGFß1 treatment, whilst FLAG-tagged peptide associated with the mitochondria.Together, these data support a novel LINC01013 smORF micropeptide-mediated mechanism of fibroblast activation. TGFß1 stimulation of atrial fibroblasts induces expression of LINC01013, whose knockdown reduces fibroblast activation. Overexpression of a smORF contained within LINC01013 localises to mitochondria and activates fibroblasts.


Asunto(s)
Fibrilación Atrial , ARN Largo no Codificante , Humanos , Proteómica , ARN Largo no Codificante/genética , Fibroblastos , Micropéptidos
8.
Ann Burns Fire Disasters ; 36(3): 243-250, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38680433

RESUMEN

Autografting with split-thickness skin grafts (STSG) remains an essential procedure in burn and reconstructive surgery. The process of harvesting STSG, however, leaves behind a donor site, an exposed area of partial-thickness dermis left to heal by secondary intention. There has yet to be a consensus amongst surgeons regarding optimal management of the donor site. The ideal donor site dressing is one that allows for expeditious healing while minimizing pain and infection. Despite numerous studies demonstrating the superiority of moist wound healing, many surgeons continue to treat STSG donor sites dry, with petroleum-based gauze. In this study, two burn centers performed a retrospective review of burn patients whose STSG donor sites were treated with either Xeroform® or Mepilex® Ag dressings. Infections were documented and in a subgroup analysis of patients, postoperative pain scores were noted and total opiate usage during hospitalization was calculated. Analysis revealed an overall infection rate of 1.2% in the Mepilex® Ag group and 11.4% in the Xeroform® group (p<0.0001). Patients with Xeroform® donor site dressings had increased odds of donor site infection (OR=10.8, p=0.002). In subgroup analysis, there were no significant differences in maximum pain scores between Mepilex® Ag and Xeroform® groups, nor were there differences in opiate usage. STSG donor sites dressed with silver foam dressings have a lower rate of donor site infection relative to those dressed with petroleum-based gauze. Moist donor site dressings such as foam dressings (including Mepilex® Ag) should be the standard of care in STSG donor site wound care.


La greffes de peau mince (GPM) demeure une procédure essentielle dans la chirurgie de brûlure et de reconstruction. La zone donneuse de greffe (ZDG) représente une perte de substance cutanée superficielle, cicatrisant spontanément. Il n'y a pas de consensus concernant la prise en charge optimale de la ZDG. Le pansement idéal de la ZDG doit promouvoir la cicatrisation et réduire la douleur ainsi que le risque infectieux. Malgré les nombreuses publications montrant l'intérêt d'un environnement humide pour la cicatrisation, de nombreux chirurgiens réalisent des pansements secs vaselinés. Cette étude rétrospective effectuée dans 2 CTB compare les pansements de ZDG réalisés au Xéroform® ou au Mepilex Ag®. Les infections ont été documentées et, dans un sous-groupe, les scores de douleur et la consommation d'opiacés au long de l'hospitalisation ont été notés. Les taux d'infection sont de 1,2% dans le groupe Mepilex Ag® et 11,4% avec Xéroform® (p<0,0001). Le risque d'infection de la ZDG est augmenté (OR 10,8 ; p = 0,002) en cas d'utilisation de Xéroform®. Il n'y avait pas de différence de douleur et de consommation d'opiacés entre les 2 groupes. Les ZDG recouvertes d'un pansement hydrocellulaire imprégné d'argent s'infectent moins que celles traitées avec une gaze imprégnée de vaseline. L'utilisation sur les ZDG d'un pansement humide comme une mousse hydrocellulaire (par exemple Mepilex Ag®) devrait devenir la norme.

9.
AJNR Am J Neuroradiol ; 43(9): 1299-1303, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35953279

RESUMEN

BACKGROUND AND PURPOSE: Because stroke therapy has changed with the introduction of endovascular stroke treatment as a standard approach, studies on intrahospital causes of death from stroke are no longer up-to-date. The purpose of this observational study was to present the causes of death during hospitalization of patients with ischemic stroke who received endovascular stroke treatment, with the focus on a differentiation of curative and secondary palliative treatment. MATERIALS AND METHODS: We studied a total cohort of 1342 patients who received endovascular stroke treatment in a tertiary stroke center (Aachen, Germany) between 2010 and 2020 and analyzed the causes of death in all 326 consecutive deceased patients. We distinguished between curative treatment and a secondary palliative approach and analyzed causes of death and treatment numbers across the years. RESULTS: In the entire cohort of 326 deceased patients, the most common cause of death was of a cerebrovascular nature (51.5%), followed by pneumonia and sepsis (25.8%) and cardiovascular causes (8.3%). Neurovascular causes constituted 75.8% of reasons for palliation. In the group with a secondary palliative approach, causes of death were neurovascular in 54.0% of patients and pneumonia and sepsis in 26.0% of patients. CONCLUSIONS: Cerebrovascular causes in patients with stroke play a major role in the intrahospital causes of death and reasons for palliation. Considering the large proportion of secondarily palliative-treated patients, reasons for palliation should be considered instead of causes of death to avoid concealment by, for example, life-terminating measures.


Asunto(s)
Procedimientos Endovasculares , Neumonía , Sepsis , Accidente Cerebrovascular , Humanos , Causas de Muerte , Accidente Cerebrovascular/terapia , Accidente Cerebrovascular/etiología , Causalidad , Neumonía/etiología , Sepsis/etiología , Resultado del Tratamiento , Procedimientos Endovasculares/efectos adversos
10.
Inn Med (Heidelb) ; 63(7): 791-797, 2022 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-35925266

RESUMEN

BACKGROUND: Patients with an unclear diagnosis and suspected rare disease pose special challenges to physicians, among others. AIM OF THE STUDY (RESEARCH QUESTION): The ZSE-DUO project aims to establish whether patient care under the joint supervision of a somatic expert and a mental health expert can improve diagnostic efficacy and precision, as well as shorten the time to diagnosis. MATERIAL AND METHODS: ZSE-DUO has successfully recruited more than 1000 patients at eleven national centres for rare diseases in a control and an intervention group. The findings are being analysed by three evaluating institutions. RESULTS AND DISCUSSION: The study is currently in its final phase. The results will be published in further papers.


Asunto(s)
Médicos , Enfermedades Raras , Humanos , Enfermedades Raras/diagnóstico
11.
Opt Express ; 30(6): 9869-9877, 2022 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-35299400

RESUMEN

We experimentally demonstrate that the next-nearest-neighbor-coupling (NNN-coupling) in an array of waveguides can naturally be negative. To do so, dielectric zig-zag shaped waveguide arrays are fabricated with direct laser writing (DLW). By changing the angle of the zig-zag shape it is possible to tune between positive and negative ratios of nearest and next-nearest-neighbor coupling, which also allows to reduce the impact of the NNN-coupling to zero at the correct respective angle. We confirm the existence of negative NNN-couplings experimentally and show the improved accuracy of a refined tight-binding model. Our results are also of importance for other discrete systems in which the tight-binding model is often used.

12.
Br J Dermatol ; 185(3): 616-626, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33657677

RESUMEN

BACKGROUND: Supportive care is the cornerstone of management of adult and paediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. OBJECTIVES: Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. METHODS: Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. RESULTS: Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. CONCLUSIONS: We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.


Asunto(s)
Síndrome de Stevens-Johnson , Adulto , Niño , Consenso , Humanos , Investigación , Estudios Retrospectivos , Síndrome de Stevens-Johnson/diagnóstico , Síndrome de Stevens-Johnson/terapia
13.
Can Prosthet Orthot J ; 4(2): 35208, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-37615005

RESUMEN

The prosthetic socket is commonly considered to be the most important part of the prosthesis and lack of fit can lead to skin breakdown, reduction in wear, reduction in activity, and consequential deleterious health effects. Furthermore, approximately 90% of amputations are due to a vascular etiology, which affect fluid retention regularity, and even small limb volume fluctuations can lead to lack of fit. Adjustability in the socket volume has been suggested as a potential solution to common fit issues but has lacked market penetration mostly due to lack of reimbursement. Despite this there are several adjustable-volume sockets emerging on the market today including prefabricated, modular, custom with adjustable-volume component, custom with adjustable-volume feature, and adjustable-hybrid sockets. Prefabricated sockets are mass produced in common sizes and fit directly to the patient by a prosthetist using pad kits, BOA dials, or straps. Modular sockets are assembled to a patient or model with panels or struts attached to an adjustable base. Custom sockets with adjustable-volume elements are traditionally-fabricated sockets made to a model of a patient's limb with a volume-adjustable component added or volume-adjustable feature built in. Custom-hybrid sockets are made custom to a model of the patient's limb and incorporate several aspects of the previous socket types and include some radically-unique design aspects which cannot be limited to one category. These adjustable-volume sockets offer several advantages to traditional rigid-volume sockets for the patient, prosthetist, and providing clinic. The micro-adjustability for the patient allows them to alter fit without removing the socket, maintaining a more intimate fit throughout the day than traditional sockets. The macro-adjustability for the prosthetist allows for increased options for fit customization including the ability to reverse or undo changes without necessarily re-making the socket. This allows for the most optimal fit for the patient. Adjustable volume also present efficiencies in the fitting process by simplifying or eliminating steps including residual limb shape capture, form modification, diagnostic fabrication, iterative alteration, and definitive fabrication with the different socket types affecting different steps. Due to these factors, adjustable-volume sockets have disrupted the market to the point where reimbursement reform is needed including additional L-codes in the United States and fee-for-service or fee-for-outcome associated with prosthetic follow-up care. Prosthetic care should also be separated from durable medical equipment to allow for alternative reimbursement models. As reimbursement adapts prosthetists must adapt correspondingly to differentiate their skillset from other allied health providers including incorporating more objective methods to show superior care outcomes. This adaptation should include a continued push for state and municipal licensure of prosthetists.

14.
Osteoarthritis Cartilage ; 29(2): 222-229, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33290812

RESUMEN

OBJECTIVE: Although mechanically-induced inflammation is an appealing explanation linking different etiologic factors in osteoarthritis (OA), clinical research investigating changes in both biomechanics and joint inflammation is limited. The purpose of this study was to evaluate the association between change in surrogate measures of knee load and knee effusion-synovitis in patients with medial compartment knee OA undergoing high tibial osteotomy (HTO). METHODS: Thirty-six patients with medial compartment knee OA and varus alignment underwent 3D gait analysis and 3T magnetic resonance imaging (MRI) preoperatively and 1 year after medial opening wedge HTO. Primary outcome measures were the change in the external knee adduction moment impulse during walking and change in knee suprapatellar effusion-synovitis volume manually segmented on MRI by one blinded assessor. RESULTS: Mean (SD) knee adduction moment impulse [24.0 (6.5) Nm•s] and knee effusion-synovitis volume [8976.7 (8016.9) mm3] suggested substantial preoperative medial knee load and inflammation. 1-year postoperative changes in knee adduction moment impulse [-10.1 Nm•s (95%CI: -12.7, -7.4)], and knee effusion-synovitis volume [-1856 mm3 (95%CI: -3830, 117)] were positively correlated [r = 0.60 (95% CI 0.34, 0.78)]. Simple linear regression suggested a 448 mm3 (95%CI: 241, 656) reduction in knee effusion-synovitis volume per 1 Nm•s reduction in knee adduction moment impulse. Change in knee adduction moment impulse explained 36% (R2 = 0.36) of the variance of change in knee effusion-synovitis volume. CONCLUSIONS: Reduction in medial knee load is positively associated with reduction in knee inflammation after HTO, suggesting the phenomenon of mechano-inflammation in patients with knee OA.


Asunto(s)
Desviación Ósea/cirugía , Genu Varum/cirugía , Inflamación/diagnóstico por imagen , Osteoartritis de la Rodilla/cirugía , Sinovitis/diagnóstico por imagen , Soporte de Peso , Fenómenos Biomecánicos , Desviación Ósea/diagnóstico por imagen , Desviación Ósea/fisiopatología , Femenino , Análisis de la Marcha , Genu Varum/diagnóstico por imagen , Genu Varum/fisiopatología , Humanos , Inflamación/fisiopatología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/fisiopatología , Osteotomía , Sinovitis/fisiopatología , Tibia/cirugía , Resultado del Tratamiento
15.
PLoS One ; 15(6): e0234044, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32544211

RESUMEN

Being a typical ground-breeding bird of the agricultural landscape in Germany, the pheasant has experienced a strong and persistent population decline with a hitherto unexplained cause. Contributing factors to the ongoing negative trend, such as the effects of pesticides, diseases, predation, increase in traffic and reduced fallow periods, are currently being controversially discussed. In the present study, 62 free-ranging pheasant chicks were caught within a two-year period in three federal states of Germany; Lower Saxony, North Rhine-Westphalia and Schleswig-Holstein. The pheasant chicks were divided into three age groups to detect differences in their development and physical constitution. In addition, pathomorphological, parasitological, virological, bacteriological and toxicological investigations were performed. The younger chicks were emaciated, while the older chicks were of moderate to good nutritional status. However, the latter age group was limited to a maximum of three chicks per hen, while the youngest age class comprised up to ten chicks. The majority of chicks suffered from dermatitis of the periocular and caudal region of the head (57-94%) of unknown origin. In addition, intestinal enteritis (100%), pneumonia (26%), hepatitis (24%), perineuritis (6%), tracheitis (24%), muscle degeneration (1%) and myositis (1%) were found. In 78% of the cases, various Mycoplasma spp. were isolated. Mycoplasma gallisepticum (MG) was not detected using an MG-specific PCR. Parasitic infections included Philopteridae (55%), Coccidia (48%), Heterakis/Ascaridia spp. (8%) and Syngamus trachea (13%). A total of 8% of the chicks were Avian metapneumovirus (AMPV) positive using RT-PCR, 16% positive for infectious bronchitis virus (IBV) using RT-PCR, and 2% positive for haemorrhagic enteritis virus (HEV) using PCR. All samples tested for avian encephalomyelitis virus (AEV), infectious bursal disease virus (IBDV) or infectious laryngotracheitis virus (ILTV) were negative. The pool samples of the ten chicks were negative for all acid, alkaline-free and derivative substances, while two out of three samples tested were positive for the herbicide glyphosate. Pheasant chick deaths may often have been triggered by poor nutritional status, probably in association with inflammatory changes in various tissues and organs as well as bacterial and parasitic pathogens. Theses impacts may have played a major role in the decline in pheasant populations.


Asunto(s)
Galliformes , Estado de Salud , Animales , Femenino , Alemania , Masculino , Estado Nutricional
16.
Public Health Action ; 9(Suppl 1): S43-S49, 2019 Sep 21.
Artículo en Inglés | MEDLINE | ID: mdl-31579649

RESUMEN

SETTING: The tuberculosis (TB) programmes at the Nonga General Hospital, Rabaul Urban Clinic and Kerevat District Hospital in East New Britain Province, Papua New Guinea. BACKGROUND: In East New Britain, TB care was mainly offered by the General Hospital, resulting in limited community-based care and poor treatment outcomes. In 2016, TB services were decentralised from the provincial to the district level by 1) training health workers, 2) increasing community awareness of TB, and 3) providing a weekly Clinical Outreach (TACO) service. OBJECTIVE: To describe the effect of TACO on the use of TB diagnostic and treatment services from 1 January 2014 to 31 December 2017. DESIGN: This was a retrospective study comparing 2014-2015 (pre-TACO) and 2016-2017 (TACO) cohorts. RESULTS: There was an increase in pre-TACO to TACO cohorts in screened cases (1581 to 2195), total registered TB cases (678 to 824) and registered cases at decentralised sites (209 to 615). Unfavourable treatment outcomes were common (pre-TACO, 46.0% vs. TACO, 40.1%). In multivariable analysis, treatment at a decentralised Basic Management Unit (aOR 0.55, 95%CI 0.42-0.74) was significantly associated with fewer unfavourable outcomes, but treatment outcomes between the pre-TACO and the TACO group were not significantly different. CONCLUSION: Strengthening decentralisation of TB services at the district level increased TB screening and case registration, with similar treatment outcomes.

17.
Phys Rev Lett ; 123(8): 080602, 2019 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-31491211

RESUMEN

We realize a heat engine using a single-electron spin as a working medium. The spin pertains to the valence electron of a trapped ^{40}Ca^{+} ion, and heat reservoirs are emulated by controlling the spin polarization via optical pumping. The engine is coupled to the ion's harmonic-oscillator degree of freedom via spin-dependent optical forces. The oscillator stores the work produced by the heat engine and, therefore, acts as a flywheel. We characterize the state of the flywheel by reconstructing the Husimi Q function of the oscillator after different engine run times. This allows us to infer both the deposited energy and the corresponding fluctuations throughout the onset of operation, starting in the oscillator ground state. In order to understand the energetics of the flywheel, we determine its ergotropy, i.e., the maximum amount of work which can be further extracted from it. Our results demonstrate how the intrinsic fluctuations of a microscopic heat engine fundamentally limit performance.

18.
J Child Orthop ; 13(3): 334-339, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31312275

RESUMEN

PURPOSE: Displaced supracondylar humerus fractures are treated with open or closed reduction and percutaneous pinning. In 2012, our management of patients with a displaced fracture changed from closed reduction in the emergency department (ED) to in situ splinting prior to closed reduction and pinning in the operating room (OR). The purpose of this study was to investigate if outcomes or complications differ between these two management methods. METHODS: Patients less than ten years old with a Gartland type II or III supracondylar humerus fracture between 2008 and 2016 were included. Cases of polytrauma were excluded. Radiographic outcomes were assessed at follow-up. The Fisher's exact test was used for categorical variables and the Wilcoxon rank sums tests for continuous variables. RESULTS: In all, 157 patients were included, 89 with reduction in the ED and 68 without. There was no significant difference between the groups related to demographic factors or fracture characteristics. Patients managed without reduction in the ED had a lower average delay from ED to OR compared with those treated with reduction (16 hours versus 22 hours, p < 0.005) and a shorter hospital length of stay (34 hours versus 40 hours, p < 0.005). CONCLUSION: No difference in complications or outcomes was found between patients with Type II or III supracondylar fractures treated initially with or without closed reduction in the ED. Patients treated without ED reduction were taken to the OR sooner and remained in the hospital for a shorter period of time. Splinting in situ reduces anaesthesia exposure without increasing postoperative complications or suboptimal outcomes. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

19.
J Synchrotron Radiat ; 26(Pt 2): 339-345, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30855241

RESUMEN

The SPB/SFX instrument of the European XFEL provides unique possibilities for high-throughput serial femtosecond crystallography. This publication presents the liquid-jet sample delivery setup of this instrument. The setup is compatible with state-of-the-art gas dynamic virtual nozzle systems as well as high-viscosity extruders and provides space and flexibility for other liquid injection devices and future upgrades. The liquid jets are confined in a differentially pumped catcher assembly and can be replaced within a couple of minutes through a load-lock. A two-microscope imaging system allows visual control of the jets from two perspectives.

20.
Vet Anim Sci ; 8: 100065, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32734083

RESUMEN

This study investigates air hygienic characteristics of housing systems without fixation for lactating sows, with a focus on microbiological air quality. For animal welfare considerations, free-farrowing systems have been developed to replace those with farrowing crates (FC) and are currently available on the market. A group housing system (GH) for six lactating sows, a single loose-housing system (LH), and a conventional system with FC were tested. By maintaining similar management conditions, microbiological air quality was examined in eight batches with 148 farrowings in total with samplings at the beginning, in the middle, and at the end of the occupancy period of 33 days. No significant differences between the systems were observed in the concentration of total airborne bacteria (TAB), haemolytic streptococci (HS), molds, or yeasts. However, the concentrations of TAB and HS increased significantly over time. Additionally, significant correlations were detected for LH and FC between TAB and HS, and between TAB and carbon dioxide; significant correlations between TAB and inside temperature and total animal weight were revealed only in GH. Significant correlations between TAB and both the dust and inside humidity parameters were found only in FC. Given these results, it was shown that the free-farrowing systems used here do not necessarily lead to poorer microbiological air quality.

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