transfer of accountability

OBJECTIVE: Audit and feedback is an antimicrobial stewardship (AMS) strategy, with the potential to also optimize antimicrobial use in non-audited patients. This study aimed to determine whether audit and feedback reduce antimicrobial use in both audited and non-audited patients. DESIGN: Before-after trial with a 1-year intervention period and 2.5-year historical cohort. SETTING: 750-bed community hospital in the Netherlands. PATIENTS: All patients admitted to the urology wards during the 3...

This paper presents a study investigating the performance of functionally graded material (FGM) annular fins in heat transfer applications. An annular fin is a circular or annular structure used to improve heat transfer in various systems such as heat exchangers, electronic cooling systems, and power generation equipment. The main objective of this study is to analyze the efficiency of the ring fin in terms of heat transfer and temperature distribution. The fin surfaces are exposed to convection and radiation to dissipate heat...

Representative single anisotropic matrix block 2D Green's function models for depletion through fully-penetrating, vertical fractures through different numbers of fracture faces are constructed that analytically capture both fracture and block depletion with fracture-matrix mass transfer. The 1D Green's function for a fracture system is likewise solved in terms of the time evolution of average fracture pressure. While transient average pressure values are not inherently measurable, they are transformed into cumulative production or instantaneous flowrate values, thus producing new rate decline model functional forms...

Congruency effects in conflict tasks are typically larger after congruent compared to incongruent trials. This congruency sequence effect (CSE) indicates that top-down adjustments of cognitive control transfer between processing episodes, at least when controlling for bottom-up memory processes by alternating between stimulus-response (S-R) sets in confound-minimised designs. According to the control-retrieval account, cognitive control is bound to task-irrelevant context features (e.g., stimulus position or modality) and retrieved upon subsequent context feature repetitions...

Meniscal injury represents a common type of knee injury, accounting for over 50% of all knee injuries. The clinical diagnosis and treatment of meniscal injury heavily rely on magnetic resonance imaging (MRI). However, accurately diagnosing the meniscus from a comprehensive knee MRI is challenging due to its limited and weak signal, significantly impeding the precise grading of meniscal injuries. In this study, a visual interpretable fine grading (VIFG) diagnosis model has been developed to facilitate intelligent and quantified grading of meniscal injuries...

ConspectusDue to its importance for electrolyzers or metal-air batteries for energy conversion or storage, there is huge interest in the development of high-performance materials for the oxygen evolution reaction (OER). Theoretical investigations have aided the search for active material motifs through the construction of volcano plots for the kinetically sluggish OER, which involves the transfer of four proton-electron pairs to form a single oxygen molecule. The theory-driven volcano approach has gained unprecedented popularity in the catalysis and energy communities, largely due to its simplicity, as adsorption free energies can be used to approximate the electrocatalytic activity by heuristic descriptors...

Radical-trapping antioxidants (RTAs) are an indispensable class of additive used to preserve hydrocarbon materials from oxidative degradation. Materials that are regularly subjected to elevated temperatures where autoxidation is self-initiated (i.e., >120 °C) require high concentrations of RTA for protection. Not only is this costly, but it can negatively impact material performance. Herein we show that inhibition of the autoxidation of a model hydrocarbon ( n -hexadecane) by phenothiazine (PTZ) at ≥160 °C can be greatly enhanced by the incorporation of either 1° or 2° alkyl substituents in the 3- and/or 7-positions of the scaffold...

The bee gut microbiota plays an important role in the services the bees pay to the environment, humans and animals. Alongside, gut-associated microorganisms are vehiculated between apparently remote habitats, promoting microbial heterogeneity of the visited microcosms and the transfer of the microbial genetic elements. To date, no metaproteomics studies dealing with the functional bee microbiota are available. Here, we employ a metaproteomics approach to explore a fraction of the bacterial, fungal, and unicellular parasites inhabiting the bee gut...

Expanded polystyrene will account for 5.3% of total global plastic production in 2021 and is widely used for food packaging due to its excellent moisture resistance and thermal insulation. However, some of these packages are often used only once before being discarded, generating large amounts of environmentally harmful plastic waste. A very attractive alternative to the conventional methods used for polymer processing is the use of supercritical carbon dioxide (scCO2 ) since it has mass-transfer properties adapted to the foam morphology, generating different path lengths for the diffusion of active compounds within its structure and can dissolve a wide range of organic molecules under supercritical conditions...

Secondary reactions in radical polymerization pose a challenge when creating kinetic models for predicting polymer structures. Despite the high impact of these reactions in the polymer structure, their effects are difficult to isolate and measure to produce kinetic data. To this end, we used solvation-corrected M06-2X/6-311+G(d,p) ab initio calculations to predict a complete and consistent data set of intrinsic rate coefficients of the secondary reactions in acrylate radical polymerization, including backbiting, β-scission, radical migration, macromonomer propagation, mid-chain radical propagation, chain transfer to monomer and chain transfer to polymer...

Posterior glenoid bone loss (pGBL) is frequently associated with posterior shoulder instability. Posterior glenohumeral instability accounts for a small percentage of shoulder pathologies, and critical bone loss in posterior instability has not been well defined in the literature. Younger patient populations who participate in activities that repetitively stress the posterior stabilizing structures of the shoulder are more prone to developing posterior shoulder instability. A variety of surgical options have been described, ranging from isolated capsulolabral repair to glenoid osteotomy...

The elevator door system plays a crucial role in ensuring elevator safety. Fault prediction is an invaluable tool for accident prevention. By analyzing the sound signals generated during operation, such as component wear and tear, the fault of the system can be accurately determined. This study proposes a GNN-LSTM-BDANN deep learning model to account for variations in elevator operating environments and sound signal acquisition methods. The proposed model utilizes the historical sound data from other elevators to predict the remaining useful life (RUL) of the target elevator door system...

ConspectusEvolution of implantable neural interfaces is critical in addressing the challenges in understanding the fundamental working principles and therapeutic applications for central and peripheral nervous systems. Traditional approaches utilizing hermetically sealed, rigid electronics and detached electrodes face challenges in power supply, encapsulation, channel count, dispersed application location, and modality. Employing thin-film, wirelessly powered devices is promising to expand capabilities. Devices that forego bulky power supplies, favoring a configuration where electronics are integrated directly onto thin films, reduce displacement volumes for seamless, fully implantable interfaces with high energy availability and soft mechanics to conform to the neuronal target...

The escalating prevalence of colistin-resistant Escherichia coli in poultry has emerged as a significant concern. This study aimed to assess the occurrence of the mcr-1 gene in colistin-resistant E. coli isolates from poultry samples. A cross-sectional study was conducted at National Avian Disease Investigation Laboratory, Nepal, on 210 chicken meat samples, including liver, heart, and spleen. E. coli was isolated and identified by conventional cultural methods. Antibiotic resistance pattern was assessed by the Kirby-Bauer disc diffusion method...

BACKGROUND: Extremely premature infants (EPIs) are those less than 32 weeks of gestational age. Preterm birth is the leading cause of neonatal death and poor prognosis, accounting for 25% of neonatal deaths, with extremely premature births accounting for 50% of all premature deaths. Continuous quality improvement (CQI) improves patient outcomes by changing and optimizing clinical practice including increasing participation of neonatologists in prenatal consultation, maintenance of normal body temperature in preterm infants, early use of pulmonary surfactant, reduction of mechanical ventilation time and intensive breastfeeding to reduce clinically avoidable adverse events...

ConspectusEnzymes are desired catalysts for chemical synthesis, because they can be engineered to provide unparalleled levels of efficiency and selectivity. Yet, despite the astonishing array of reactions catalyzed by natural enzymes, many reactivity patterns found in small molecule catalysts have no counterpart in the living world. With a detailed understanding of the mechanisms utilized by small molecule catalysts, we can identify existing enzymes with the potential to catalyze reactions that are currently unknown in nature...

OBJECTIVE: This study focuses on adults affected by the February 2023 Turkey earthquakes, aiming to uncover demographic and clinical traits. METHODS: A retrospective analysis of data from adult patients who sought emergency care between February 6 and February 21, 2023, following the earthquakes, was conducted. RESULTS: Among 3072 patients, 1544 (50.3%) of whom were women, trauma (31.1%) was the most prevalent cause of emergency department presentations...

STUDY QUESTION: Are blood pressure (BP) and lipid profiles different between children conceived after ART with frozen embryo transfer (FET), fresh embryo transfer (fresh-ET), and natural conception (NC)? SUMMARY ANSWER: Girls conceived after FET had significantly higher systolic BP and heart rate compared with girls born after fresh-ET; boys conceived after FET had a slightly more favourable lipid profile compared with boys born after fresh-ET and NC. WHAT IS KNOWN ALREADY: Children conceived after ART with FET are more often born large for gestational age (LGA)...

The contamination of wetlands by heavy metals, exacerbated by agricultural activities, presents a threat to both organisms and humans. Heavy metals may undergo trophic transfer through the food web. However, the methods for quantifying the bioaccumulation and trophic transfer processes of heavy metals based on the food web remains unclear. In this study, we employed stable isotope technology to construct a quantitative oriental white stork's typical food web model under a more accurate scaled Δ15 N framework...

Aeromonas hydrophila has ability to spread tetracycline resistance (tetR) under stresses of oxytetracycline (OTC), one of the most important antibiotics in aquaculture industry. Even though environmental reservoir of Aeromonas allows it to be at interfaces across One Health components, a robust modelling framework for rigorously assessing health risks is currently lacking. We proposed a One Health-based approach and leveraged recent advances in quantitative microbial risk assessment appraised by available dataset to interpret interactions at the human-animal-environment interfaces in various exposure scenarios...