Acinetobacterlwoffii Induced Cellulitis with Allergy-like Symptoms

Few reports document the misdiagnosis of Acinetobacterlwoffii skin infections for allergic reactions. In addition, A. lwoffii is frequently misidentified when applying conventional diagnostic methods. The bacterium has been reported to cause a multitude of diseases including skin and wound infections. The application of the newly established method “The Universal Method” allowed definite identification of the bacterium isolated from a leg and foot cellulitis case (Isolate QUBC mk1) that was misdiagnosed as an allergic reaction and was treated with intramuscular injections of diclofeneac sodium, anonsteroidal antiinflammatory drug.The isolate was identified as A. lwoffii, it failed to grow on MacConkey agar, and it was sensitive to ciprofloxacin but resistant to cefazolin. The 51-year old male patient was successfully treated with intravenous administration of ciprofloxacin, doxacillin, and cefazolin. He was released in good health after ten days.This work emphasizes the importance of distinguishing between skin infections and allergies. It also stresses the importance of prompt and accurate identification of A. Lwoffii and its possible relationship to allergic reactions. Misdiagnosis isdiscussed in the context of “The Hygiene Hypothesis”

Strategi Peningkatan Kinerja dengan Metode Balanced Scorecard di Rumah Sakit Umum Daerah Kabupaten Ogan Ilir

Pengukuran kinerja adalah penentuan secara periodik efektifitas operasional suatu organisasi, bagan organisasi, dan karyawannya berdasarkan sasaran standar dan kriteria yang telah ditetapkan sebelumnya. Salah satu metode pengukuran kinerja yang mengaitkan strategi didalam penerapannya adalah metode Balanced Scorecard. Penelitian ini bertujuan untuk mengetahui kinerja RSUD Kabupaten Ogan Ilir ditinjau berdasarkan empat perspektif dalam metode Balanced Scorecard yaitu perspektif keuangan, pelanggan, proses bisnis internal, serta pembelajaran dan pertumbuhan, serta mengaplikasikan metode Balanced Scorecard pada penyusunan strategi peningkatan kinerja di RSUD Kabupaten Ogan Ilir. Jenis penelitian ini berupa penelitian deskriptif dengan pengkombinasian dua metode (kualitatif dan kuantitatif) dalam satu penelitian. Jumlah sampel sebanyak 46 orang pegawai dan 110 orang pasien sebagai responden penyebaran kuesioner. Hasil penelitian didapatkan kinerja perspektif pelanggan dengan nilai 41,6% termasuk dalam kondisi kurang baik, perspektif keuangan dengan nilai 50% kondisi kurang baik, perspektif proses internal dengan nilai 32,3% kondisi kurang baik, dan perspektif pembelajaran & pertumbuhan dengan nilai 41,6% kondisi kurang baik. Kinerja RSUD Kabupaten Ogan Ilir dengan nilai Total Skor 41,44% termasuk dalam kondisi kurang baik. RSUD Ogan Ilir perlu meningkatkan kinerja dengan sasaran strategis perspektif pelanggan yaitu meningkatkan kepuasan pasien, loyalitas pasien, dan meningkatkan kunjungan pasien. Sasaran strategis perspektif proses bisnis internal; inovasi layanan, meningkatkan mutu proses layanan, meningkatkan kinerja operasional. Sasaran strategis pespektif keuangan; pertumbuhan pendapatan, dan minimalisir biaya. Sasaran strategis perspektif pembelajaran dan pertumbuhan; meningkatkan kepuasan karyawan, komitmen, motivasi dan kapabilitas karyawan

Solving thermal issues in tensile-strained Ge microdisks

International audienceWe propose to use a Ge-dielectric-metal stacking to allow one to address both thermal management with the metal as an efficient heat sink and tensile strain engineering with the buried dielectric as a stressor layer. This scheme is particularly useful for the development of Ge-based optical sources. We demonstrate experimentally the relevance of this approach by comparing the optical response of tensile-strained Ge microdisks with an Al heat sink or an oxide pedestal. Photoluminescence indicates a much reduced temperature rise in the microdisk (16 K with Al pedestal against 200 K with SiO 2 pedestal under a 9 mW continuous wave optical pumping). An excellent agreement is found with finite element modeling of the temperature rise. This original stacking combining metal and dielectrics is promising for integrated photonics where thermal management is an issue

Optimization of ruthenium as a buffer layer for non-collinear antiferromagnetic Mn<inf>3</inf>X films

Two thin film deposition routes were studied for the growth of high quality single crystalline Ru (0001) epitaxial films on c-Al2O3 substrates using RF-magnetron sputtering. Such films are very important as buffer layers for the deposition of epitaxial non-collinear antiferromagnetic Mn3X films. The first route involved depositing Ru at 700 °C, leading to a smooth 30 nm thick film. Although, high resolution X-ray diffraction (HRXRD) revealed twinned Ru film orientations, the in-situ post-annealing eliminated one orientation, leaving the film orientation aligned with the substrate, with no in-plane lattice rotation and a large lattice mismatch (13.6%). The second route involved deposition of Ru at room temperature followed by in-situ post-annealing at 700 °C. Transmission electron microscopy confirmed a very high quality of these films, free of crystal twinning, and a 30° in-plane lattice rotation relative to the substrate, resulting in a small in-plane lattice mismatch of –1.6%. X-ray reflectivity demonstrated smooth surfaces for films down to 7 nm thickness. 30 nm thick high quality single-crystalline Mn3Ga and Mn3Sn films were grown on top of the Ru buffer deposited using the second route as a first step to realize Mn3X films for antiferromagnetic spintronics applications.H2020-MSCA-ITN-2014 SELECTA (grant agreement no. 642642 of the European Commission)

Observation and control of hybrid spin-wave-Meissner-current transport modes

Superconductors are materials with zero electrical resistivity and the ability to expel magnetic fields known as the Meissner effect. Their dissipationless diamagnetic response is central to magnetic levitation and circuits such as quantum interference devices. Here, we use superconducting diamagnetism to shape the magnetic environment governing the transport of spin waves - collective spin excitations in magnets that are promising on-chip signal carriers - in a thin-film magnet. Using diamond-based magnetic imaging, we observe hybridized spin-wave-Meissner-current transport modes with strongly altered, temperature-tunable wavelengths. We extract the temperature-dependent London penetration depth from the wavelength shifts and realize local control of spin-wave refraction using a focused laser. Our results demonstrate the versatility of superconductor-manipulated spin-wave transport and have potential applications in spin-wave gratings, filters, crystals and cavities.Comment: main: 8 pages, 5 figures, supp: 15 pages, 6 figure

National assessment of prescribing practice of antibiotic prophylaxis among obstetrics and gynaecological surgeries in Kuwait

Antimicrobial resistance has become a significant global health concern, primarily resulting from excessive and inappropriate use of antimicrobials. A significant portion of antibiotics prescribed within hospitals is for surgical patients as prophylaxis (AP) to prevent surgical site infections. Thus, AP must be used judiciously to reduce antibiotic resistance. Proper infection control and judicious use of antibiotics are crucial. This research aims to explore and assess the appropriateness of AP prescribing practice for all obstetrics and gynaecological surgeries in Kuwait. Methods: A national multicentre point prevalence survey (PPS) based on the Global PPS and WHO PPS methodology. The PPS was conducted in all Kuwait governmental and some private hospitals. The PPS was conducted once in every OBS/GYN ward after the day of the most surgical interventions. All patient files were reviewed for AP usage from the past 24 hours to assess the appropriateness of AP against local and international AP guidelines. Results: preliminary results included 208 patients. Antibiotic usage among them was 98%. Only 53% of the patients received antibiotics before surgery, and only 11% were fully appropriate in terms of timing and selection. 85% of the patient received antibiotics for more than 24 hours. This research is still ongoing and requires further analysis. Conclusion: This study is a benchmark for AP utilisation in Kuwait, which helps in the establishment of antibiotic surveillance for surgical prevention as well as the development of ASP and recommendations for national guidelines tailored for the Kuwaiti healthcare system

Nanomechanical probing and strain tuning of the Curie temperature in suspended Cr2Ge2Te6-based heterostructures

Two-dimensional magnetic materials with strong magnetostriction are attractive systems for realizing strain-tuning of the magnetization in spintronic and nanomagnetic devices. This requires an understanding of the magneto-mechanical coupling in these materials. In this work, we suspend thin Cr2Ge2Te6 layers and their heterostructures, creating ferromagnetic nanomechanical membrane resonators. We probe their mechanical and magnetic properties as a function of temperature and strain by observing magneto-elastic signatures in the temperature-dependent resonance frequency near the Curie temperature, TC. We compensate for the negative thermal expansion coefficient of Cr2Ge2Te6 by fabricating heterostructures with thin layers of WSe2 and antiferromagnetic FePS3, which have positive thermal expansion coefficients. Thus we demonstrate the possibility of probing multiple magnetic phase transitions in a single heterostructure. Finally, we demonstrate a strain-induced enhancement of TC in a suspended Cr2Ge2Te6-based heterostructure by 2.5 ± 0.6 K by applying a strain of 0.026% via electrostatic force

Simulation of Mach-Zehnder interferometer plastic optical fibre for temperature and refractive index measurement

This work presents simulation of light propagation inside tapered structure-plastic optical fibre (POF) subjected to various surrounding temperatures and refractive index (RI). The tapered structure served as Mach-Zehnder interferometer (MZI) which split light into core modes and clad modes that recombined at the end of the taper. Simulation was done by using Beam Propagation Method (BPM) solved using Finite Difference Method (FDM). The light launched in to the MZI was varied from 611nm to 655nm. In order to give temperature effect, the temperature was varied from 30°C to 80°C with increment of 10°C. The results showed that the free spectral range (FSR) of the MZI are shifted as temperature increased. The sensitivity for the peak and dip of the FSR are -0.0158 nm/°C and -0.0153 nm/°C, respectively. For RI sensitivity investigation, the surrounding RI was varied from 1.333 to 1.349. The sensitivity of peak FSR and dip FSR to RI change are -98.638 nm/RIU and 105.4 nm/RIU. Therefore, the MZI can be used to measure RI and temperature simultaneously

Ultra-Low Threshold cw Lasing in Tensile Strained GeSn Microdisk Cavities

GeSn is proven as a good candidate to achieve CMOS-compatible laser sources on silicon. Lasing demonstrations in this alloy were based on directness of the band structure, this directness being increased with increasing the Sn content above 8 at.%. These past few years the research were consequently focused on incorporating the highest Sn content as possible to achieve high directness and high temperature laser operation. This unfortunately results is increased threshold. In this contribution we discuss the advantages in combining tensile strain engineering with lower Sn content alloys. This approach is motivated by the higher material quality in lower Sn content. The case with Sn content as small as 5.4 at.% Sn will be discussed. The alloy is initially compressively strained, and exhibits an indirect band gap that is turned to direct by applying tensile strain. A specific technology based on transfer On Insulator stressor layer on metal was developed to address strain engineering, thermal cooling and defective interface with the Ge-VS. This led to lasing in Ge0.95Sn0.05 microdisk cavities with dramatically reduced thresholds, by two order of magnitude, as compared to the case with high Sn alloys and as consequence enables cw operation

Development and validation of a tool to improve community pharmacists' surveillance role in the safe dispensing of herbal supplements

Background: There has been an appreciable increase in the use of herbal supplements, including immune boosters, during the current COVID-19 pandemic. However, there are concerns with falsified herbal supplements Objectives Developed a new questionnaire that can potentially help community pharmacists with identifying the extent of falsified herbal supplements. Methods: A cross sectional study conducted over nine months among 500 community pharmacies in the UAE. Face-to-face interviews were undertaken using a structured questionnaire, which was subjected to face and content validity, with the content validity index (CVI) computed. Construct validity was tested using an exploratory factor analysis (EFA) via principally component analysis (PCA). The model was then confirmed through Partial confirmatory factor analysis (PCFA). Reliability was assessed via test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs). Results: An instrument compromised of five domains with a 24-item scale was developed with CVI of 0.843. The KMO measure of sampling adequacy was 0.891, and Bartlett’s test of sphericity indicated significance (p-value < 0.001). Confirmation of the subsequent 5-domains was achieved through PCFA using MLA with oblimin rotation. The PCFA obtained values of 0.962 for NFI, 0.977 for CFI, and 0.987 for TLI; all values were greater than 0.95, and the RMSEA value was 0.03 (i.e., less than 0.06). Consequently, the model had a good fit. All domains demonstrated Cronbach’s alpha coefficients above 0.70, with 0.940 for the full instrument. Meanwhile, all items met the IIC correlation standard of ≥ 0.40. The instrument presented good ICC statistics of 0.940 (0.928 – 0.950) as well as statistical significance (p < 0.001). Those participants who had more than 10 experience years more likely to identify falsified herbal supplements compared to those who have 1 to 10 experience years (p < 0.001). Conclusions: This study developed and validated a new instrument to identify safe herbal supplements products, which will help enhance the role of the community pharmacists in safe and effective treatment of suitable patients with herbal supplements