Band bending at In-rich InGaN surfaces

The band bending and carrier concentration profiles as a function of depth below the surface for oxidized InxGa1−xN alloys with a composition range of 0.39 ≤ x ≤ 1.00 are investigated using x-ray photoelectron, infrared reflection, and optical absorption spectroscopies, and solutions of Poisson’s equation within a modified Thomas–Fermi approximation. All of these InGaN samples exhibit downward band bending ranging from 0.19 to 0.66 eV and a high surface sheet charge density ranging from 5.0×1012 to 1.5×1013 cm−2. The downward band bending is more pronounced in the most In-rich InGaN samples, resulting in larger near-surface electron concentrations

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prognostic assessment of valvular surgery in active infective endocarditis: multicentric nationwide validation of a new score developed from a meta-analysis

OBJECTIVES Several risk prediction models have been developed to estimate the risk of mortality after valve surgery for active infective endocarditis (IE), but few external validations have been conducted to assess their accuracy. We previously developed a systematic review and meta-analysis of the impact of IE-specific factors for the in-hospital mortality rate after IE valve surgery, whose obtained pooled estimations were the basis for the development of a new score (APORTEI). The aim of the present study was to assess its prognostic accuracy in a nationwide cohort. METHODS We analysed the prognostic utility of the APORTEI score using patient-level data from a multicentric national cohort. Patients who underwent surgery for active IE between 2008 and 2018 were included. Discrimination was evaluated using the area under the receiver operating characteristic curve, and the calibration was assessed using the calibration slope and the Hosmer-Lemeshow test. Agreement between the APORTEI and the EuroSCORE I was also analysed by Lin's concordance correlation coefficient (CCC), the Bland-Altman agreement analysis and a scatterplot graph. RESULTS The 11 variables that comprised the APORTEI score were analysed in the sample. The APORTEI score was calculated in 1338 patients. The overall observed surgical mortality rate was 25.56%. The score demonstrated adequate discrimination (area under the receiver operating characteristic curve = 0.75; 95% confidence interval 0.72-0.77) and calibration (calibration slope = 1.03; Hosmer-Lemeshow test P = 0.389). We found a lack of agreement between the APORTEI and EuroSCORE I (concordance correlation coefficient = 0.55). CONCLUSIONS The APORTEI score, developed from a systematic review and meta-analysis, showed an adequate estimation of the risk of mortality after IE valve surgery in a nationwide cohort

Multivalvular Endocarditis: A Rare Condition with Poor Prognosis

Background. Infective endocarditis (IE) is a severe condition. Our aim was to describe the profile and prognosis of patients with multivalvular infective endocarditis (MIE) and compare them to single-valve IE (SIE). Methods. We used a retrospective analysis of the Spanish IE Registry (2008-2020). Results. From 4064 definite cases of valvular IE, 577 (14.2%) had MIE. In patients with MIE, the most common locations were mitral (552, 95.7%) and aortic (550, 95.3%), with mitral-aortic involvement present in 507 patients (87.9%). The most common etiologies were S. viridans (192, 33.3%) and S. aureus (113, 19.6%). MIE involved only native valves in 450 patients (78.0%). Compared with patients with SIE, patients with MIE had a similar age (69 vs. 67 years, respectively, p = 0.27) and similar baseline characteristics, but were more frequently men (67.1% vs. 72.9%, p = 0.005) and had a higher incidence of intracardiac complications (36.2% vs. 50.4%, p < 0.001), heart failure (42.7% vs. 52.9%, p < 0.001), surgical indication (67.7 vs. 85.1%, p < 0.001), surgery (46.3% vs. 56.3%), and in-hospital mortality (26.9% vs. 34.3%, p < 0.001). MIE was an independent predictor of in-hospital mortality (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1-1.7, p = 0.004) but did not have an independent association with 1-year mortality (OR 1.1, 95% CI 0.9-1.4, p = 0.43). Conclusions. About one-seventh of the valvular IE patients had MIE, mainly due to mitral-aortic involvement. MIE is associated with a poor in-hospital prognosis. An early diagnosis and treatment of IE might avoid its spread to a second valve.Funding: This research received no external funding. Acknowledgments: The authors of this manuscript are grateful for the collaboration of the researchers in GAMES.Infective endocarditisMortalityMultivalvular endocarditisPrognosi

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Infective Endocarditis in Patients on Chronic Hemodialysis

International audienceInfective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD)

Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve Replacement

Abstract Background Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR versus TAVR. Methods Data were collected from the “Infectious Endocarditis after TAVR International” (enrollment from 2005 to 2020) and the “International Collaboration on Endocarditis” (enrollment from 2000 to 2012) registries. Only patients with an IE affecting the aortic valve prosthesis were included. A 1:1 paired matching approach was used to compare patients with TAVR and SAVR. Results A total of 1688 patients were included. Of them, 602 (35.7%) had a surgical bioprosthesis (SB), 666 (39.5%) a mechanical prosthesis, 70 (4.2%) a homograft, and 350 (20.7%) a transcatheter heart valve. In the SAVR versus TAVR matched population, the rate of new moderate or severe aortic regurgitation was higher in the SB group (43.4% vs 13.5%; P &lt; .001), and fewer vegetations were diagnosed in the SB group (62.5% vs 82%; P &lt; .001). Patients with an SB had a higher rate of perivalvular extension (47.9% vs 27%; P &lt; .001) and Staphylococcus aureus was less common in this group (13.4% vs 22%; P = .033). Despite a higher rate of surgery in patients with SB (44.4% vs 27.3%; P &lt; .001), 1-year mortality was similar (SB: 46.5%; TAVR: 44.8%; log-rank P = .697). Conclusions Clinical presentation, type of causative microorganism, and treatment differed between patients with an IE located on SB compared with TAVR. Despite these differences, both groups exhibited high and similar mortality at 1-year follow-up

Amplitude analysis of the radiative decay Bs0→K+K−γB^0_s\to K^+K^-\gamma

A search for radiative decay of $B^0_s$ mesons to orbitally excited $K^+K^-$ states is performed using proton proton collisions recorded by the \mbox{LHCb}\xspace experiment, corresponding to an integrated luminosity of 9 fb$^{-1}$. The dikaon spectrum in the mass range $m_{KK}<2400\ \text{MeV/}c^2$ is dominated by the $\phi(1020)$ resonance that accounts for almost 70$\%$ of the decay rate. Considering the possible contributions of $f_2{(1270)}$, $f'_2{(1525)}$ and $f_2{(2010)}$ meson states, the overall tensor contribution to the amplitude is measured to be \begin{equation} {\cal F}_{\{f_2\}}=16.8\pm0.5\mathrm{~(stat.)}\pm0.7\mathrm{~(syst.)}\%,\nonumber \end{equation} mostly dominated by the $f'_2(1525)$ state. Several statistically equivalent solutions are obtained for the detailed resonant structure depending on whether the smaller amplitudes interfere destructively or constructively with the dominant amplitude. The preferred solution that corresponds to the lowest values of the fit fractions along with constructive interference leads to the relative branching ratio measurement \begin{equation} \frac{{\cal B}(B^0_s\to f'_2\gamma)}{{\cal B}(B^0_s\to\phi\gamma)}= 19.4^{+0.9}_{-0.8}\mathrm{~(stat.)}{}^{+1.4}_{-0.5}\mathrm{~(syst.)}\pm0.5\mathrm{~(\cal{B})}\%\nonumber, \end{equation} where the last uncertainty is due to the ratio of measured branching fractions to the $K^+K^-$ final state. This result represents the first observation of the radiative $B^0_s\to f'_2(1525)\gamma$ decay, which is the second radiative transition observed in the $B^0_s$ sector.A search for radiative decay of $B^0_s$ mesons to orbitally excited $K^+K^-$ states is performed using proton proton collisions recorded by the \mbox{LHCb}\xspace experiment, corresponding to an integrated luminosity of 9~fb$^{-1}$. The dikaon spectrum in the mass range $m_{KK}<2400$~{\ensuremath{\,\text{Me\kern -0.1em V\!/}c^2}\xspace} is dominated by the $\phi(1020)$ resonance that accounts for almost 70$\%$ of the decay rate. Considering the possible contributions of $f_2{(1270)}$, $f'_2{(1525)}$ and $f_2{(2010)}$ meson states, the overall tensor contribution to the amplitude is measured to be \begin{equation} {\cal F}_{\{f_2\}}=16.8\pm 0.5\mathrm{~(stat.)}\pm0.7\mathrm{~(syst.)}\%,\nonumber \end{equation} mostly dominated by the $f'_2(1525)$ state. Several statistically equivalent solutions are obtained for the detailed resonant structure depending on whether the smaller amplitudes interfere destructively or constructively with the dominant amplitude. The preferred solution that corresponds to the lowest values of the fit fractions along with constructive interference leads to the relative branching ratio measurement \begin{equation} \frac{{\cal B}(B^0_s\to f'_2\gamma)}{{\cal B}(B^0_s\to\phi\gamma)}= 19.4^{+0.9}_{-0.8}\mathrm{~(stat.)}{}^{+1.4}_{-0.5}\mathrm{~(syst.)}\pm0.5\mathrm{~(\cal{B})}\%\nonumber, \end{equation} where the last uncertainty is due to the ratio of measured branching fractions to the $K^+K^-$ final state. This result represents the first observation of the radiative $B^0_s\to f'_2(1525)\gamma$ decay, which is the second radiative transition observed in the $B^0_s$ sector