Meningitis registry of hospitalized cases in children: epidemiological patterns of acute bacterial meningitis throughout a 32-year period

<p>Abstract</p> <p>Background</p> <p>Bacterial meningitis remains a source of substantial morbidity and mortality in childhood. During the last decades gradual changes have been observed in the epidemiology of bacterial meningitis, related to the introduction of new polysaccharide and conjugate vaccines. The study presents an overview of the epidemiological patterns of acute bacterial meningitis in a tertiary children 's hospital during a 32-year period, using information from a disease registry. Moreover, it discusses the contribution of communicable disease registries in the study of acute infectious diseases.</p> <p>Methods</p> <p>In the early 1970s a Meningitis Registry (MR) was created for patients admitted with meningitis in Aghia Sofia Children's Hospital in Athens. The MR includes demographic, clinical and laboratory data as well as treatment, complications and outcome of the patients. In 2000 a database was created and the collected data were entered, analyzed and presented in three chronological periods: A (1974–1984), B (1985–1994) and C (1995–2005).</p> <p>Results</p> <p>Of the 2,477 cases of bacterial meningitis registered in total, 1,146 cases (46.3%) were classified as "probable" and 1,331 (53.7%) as "confirmed" bacterial meningitis. The estimated mean annual Incidence Rate (IR) was 16.9/100,000 for bacterial meningitis, 8.9/100,000 for <it>Neisseria meningitidis</it>, 1.3/100,000 for <it>Streptococcus pneumoniae</it>, 2.5/100,000 for <it>Haemophilus influenzae </it>type b (Hib) before vaccination and 0.4/100,000 for Hib after vaccination. <it>Neisseria meningitis </it>constituted the leading cause of childhood bacterial meningitis for all periods and in all age groups. Hib was the second most common cause of bacterial meningitis before the introduction of Hib conjugate vaccine, in periods A and B. The incidence of bacterial meningitis due to <it>Streptococcus pneumoniae </it>was stable. The long-term epidemiological pattern of <it>Neisseria meningitidis </it>appears in cycles of approximately 10 years, confirmed by a significant rise of IR in period C. The Case Fatality Rate (CFR) from all causes was 3.8%, while higher CFR were estimated for <it>Streptococcus pneumoniae </it>(7.5%, RR=2.1, 95% CI 1.2–3.7) and <it>Neisseria meningitidis </it>(4.8%, RR=1.7, 95% CI 1.1–2.5) compared to other pathogens. Moreover, overall CFR varied significantly among the three time periods (p = 0.0015), and was estimated to be higher in period C.</p> <p>Conclusion</p> <p>By using the MR we were able to delineate long-term changes in the epidemiology of bacterial meningitis. Thus the MR proved to be a useful tool in the study and the prevention of communicable diseases in correlation with prevention strategies, such as vaccinations.</p

Preparation of hydrogen, fluorine and chlorine doped and co-doped titanium dioxide photocatalysts: a theoretical and experimental approach

Titanium dioxide (TiO2) has a strong photocatalytic activity in the ultra-violet part of the spectrum combined with excellent chemical stability and abundance. However, its photocatalytic efficiency is prohibited by limited absorption within the visible range derived from its wide band gap value and the presence of charge trapping states located at the band edges, which act as electron-hole recombination centers. Herein, we modify the band gap and improve the optical properties of TiO2via co-doping with hydrogen and halogen. The present density functional theory (DFT) calculations indicate that hydrogen is incorporated in interstitial sites while fluorine and chlorine can be inserted both as interstitial and oxygen substitutional defects. To investigate the synergy of dopants in TiO2 experimental characterization techniques such as Fourier transform infrared (FTIR), X-ray diffraction (XRD), X-ray and ultra-violet photoelectron spectroscopy (XPS/UPS), UV-Vis absorption and scanning electron microscopy (SEM) measurements, have been conducted. The observations suggest that the oxide’s band gap is reduced upon halogen doping, particularly for chlorine, making this material promising for energy harvesting devices. The studies on hydrogen production ability of these materials support the enhanced hydrogen production rates for chlorine doped (Cl:TiO2) and hydrogenated (H:TiO2) oxides compared to the pristine TiO2 reference

Fiber-shaped electronic devices

Textile electronics embedded in clothing represent an exciting new frontier for modern healthcare and communication systems. Fundamental to the development of these textile electronics is the development of the fibers forming the cloths into electronic devices. An electronic fiber must undergo diverse scrutiny for its selection for a multifunctional textile, viz., from the material selection to the device architecture, from the wearability to mechanical stresses, and from the environmental compatibility to the end-use management. Herein, the performance requirements of fiber-shaped electronics are reviewed considering the characteristics of single electronic fibers and their assemblies in smart clothing. Broadly, this article includes i) processing strategies of electronic fibers with required properties from precursor to material, ii) the state-of-art of current fiber-shaped electronics emphasizing light-emitting devices, solar cells, sensors, nanogenerators, supercapacitors storage, and chromatic devices, iii) mechanisms involved in the operation of the above devices, iv) limitations of the current materials and device manufacturing techniques to achieve the target performance, and v) the knowledge gap that must be minimized prior to their deployment. Lessons learned from this review with regard to the challenges and prospects for developing fiber-shaped electronic components are presented as directions for future research on wearable electronics

A Silanol-Functionalized Polyoxometalate with Excellent Electron Transfer Mediating Behavior to ZnO and TiO 2 Cathode Interlayers for Highly Efficient and Extremely Stable Polymer Solar Cells

Combining high efficiency and long lifetime under ambient conditions still poses a major challenge towards commercialization of polymer solar cells. Here we report a facile strategy that can simultaneously enhance the efficiency and temporal stability of inverted photovoltaic architectures. Inclusion of a silanol-functionalized organic–inorganic hybrid polyoxometalate derived from a PW9O34 lacunary phosphotungstate anion, namely (nBu4N)3[PW9O34(tBuSiOH)3], significantly increases the effectiveness of the electron collecting interface, which consists of a metal oxide such as titanium dioxide or zinc oxide, and leads to a high efficiency of 6.51% for single-junction structures based on poly(3-hexylthiophene):indene-C60 bisadduct (P3HT:IC60BA) blends. The above favourable outcome stems from a large decrease in the work function, an effective surface passivation and a decrease in the surface energy of metal oxides which synergistically result in the outstanding electron transfer mediating capability of the functionalized polyoxometalate. In addition, the insertion of a silanol-functionalized polyoxometalate layer significantly enhances the ambient stability of unencapsulated devices which retain nearly 90% of their original efficiencies (T90) after 1000 hours

Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members

Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods: A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results: A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (&gt; 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5&nbsp;years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p &lt; 0.01). With regard to hospital size (≤ 500 versus &gt; 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p &lt; 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children &lt; 12&nbsp;years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p &lt; 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively). Conclusions: Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management

An Enjoyable Workplace Combined Exercise Program for Health Promotion in Trained Employees: Yoga, Pilates, and Circuit Strength Training

Corporate wellness has become an important public health priority through the designing and implementation of different workplace exercise interventions. The objectives of this study were to investigate: (a) the effectiveness of a 4-month workplace combined yoga, Pilates, and circuit strength training program (outside work shift) on health indices, functional capacity, and physical fitness in office employees; and (b) the employees’ enjoyment following the program. Fifty physically active office employees (26–55 years old) were equally divided into training (TG) and control groups (CG). The TG followed a 4-month (3 times/week, 50–60 min/training) combined yoga, Pilates, and circuit strength training program. Health indices (body composition, body mass, circumferences, musculoskeletal pains), functional capacity (flexibility, balance), and physical fitness (strength, aerobic capacity) were measured before and after the 4-month time period. After the completion of the program, the TG participants’ enjoyment was assessed. The TG significantly improved (p p > 0.05). Furthermore, a great percentage of employees (84%) reported high levels of enjoyment. This program could be effectively and safely used in workplace settings as an enjoyable intervention to improve specific health, functional capacity, and physical fitness indices in office employees