Correlation between case mix index and antibiotic use in hospitals

Background To compare the quantitative antibiotic use between hospitals or hospital units and to explore differences, adjustment for severity of illness of hospitalized patients is essential. The case mix index (CMI) is an economic surrogate marker (i.e. the total cost weights of all inpatients per a defined time period divided by the number of admissions) to describe the average patients' morbidity of individual hospitals. We aimed to investigate the correlation between CMI and hospital antibiotic use. Methods We used weighted linear regression analysis to evaluate the correlation between in-hospital antibiotic use in 2006 and CMI of 18 departments of the tertiary care University Hospital Zurich and of 10 primary and 2 secondary acute care hospitals in the Canton of Zurich in Switzerland. Results Antibiotic use varied substantially between different departments of the university hospital [defined daily doses (DDD)/100 bed-days, 68.04; range, 20.97-323.37] and between primary and secondary care hospitals (range of DDD/100 bed-days, 15.45-57.05). Antibiotic use of university hospital departments and the different hospitals, respectively, correlated with CMI when calculated in DDD/100 bed-days [coefficient of determination (R2), 0.57 (P = 0.0002) and 0.46 (P = 0.0065)], as well as when calculated in DDD/100 admissions [R2, 0.48 (P = 0.0008) and 0.85 (P < 0.0001), respectively]. Conclusions Antibiotic use correlated with CMI across various specialties of a university hospital and across different acute care hospitals. For benchmarking antibiotic use within and across hospitals, adjustment for CMI may be a useful tool in order to take into account the differences in hospital category and patients' morbiditie

Cationic vacancy induced room-temperature ferromagnetism in transparent conducting anatase Ti_{1-x}Ta_xO_2 (x~0.05) thin films

We report room-temperature ferromagnetism in highly conducting transparent anatase Ti1-xTaxO2 (x~0.05) thin films grown by pulsed laser deposition on LaAlO3 substrates. Rutherford backscattering spectrometry (RBS), x-ray diffraction (XRD), proton induced x-ray emission (PIXE), x-ray absorption spectroscopy (XAS) and time-of-flight secondary ion mass spectrometry (TOF-SIMS) indicated negligible magnetic contaminants in the films. The presence of ferromagnetism with concomitant large carrier densities was determined by a combination of superconducting quantum interference device (SQUID) magnetometry, electrical transport measurements, soft x-ray magnetic circular dichroism (SXMCD), XAS, and optical magnetic circular dichroism (OMCD) and was supported by first-principle calculations. SXMCD and XAS measurements revealed a 90% contribution to ferromagnetism from the Ti ions and a 10% contribution from the O ions. RBS/channelling measurements show complete Ta substitution in the Ti sites though carrier activation was only 50% at 5% Ta concentration implying compensation by cationic defects. The role of Ti vacancy and Ti3+ was studied via XAS and x-ray photoemission spectroscopy (XPS) respectively. It was found that in films with strong ferromagnetism, the Ti vacancy signal was strong while Ti3+ signal was absent. We propose (in the absence of any obvious exchange mechanisms) that the localised magnetic moments, Ti vacancy sites, are ferromagnetically ordered by itinerant carriers. Cationic-defect-induced magnetism is an alternative route to ferromagnetism in wide-band-gap semiconducting oxides without any magnetic elements.Comment: 21 pages, 10 figures, to appear in Philosophical Transaction - Royal Soc.

Microbubble-Based Model Analysis of Liquid Breakdown Initiation by a Submicrosecond Pulse

An electrical breakdown model for liquids in response to a submicrosecond(∼100ns) voltage pulse is presented, and quantitative evaluations carried out. It is proposed that breakdown is initiated by field emission at the interface of pre-existing microbubbles. Impact ionization within the microbubble gas then contributes to plasma development, with cathode injection having a delayed and secondary role. Continuous field emission at the streamer tip contributes to filament growth and propagation. This model can adequately explain almost all of the experimentally observed features, including dendritic structures and fluctuations in the prebreakdown current. Two-dimensional, time-dependent simulations have been carried out based on a continuum model for water, though the results are quite general. Monte Carlo simulations provide the relevant transport parameters for our model. Our quantitative predictions match the available data quite well, including the breakdown delay times and observed optical emission

Hodgkin's lymphoma presenting with markedly elevated IgE: a case report

<p>Abstract</p> <p>Background</p> <p>Markedly elevated IgE as a manifestation of a lymphoproliferative disorder has been only rarely reported.</p> <p>Case Presentation</p> <p>We present the case of a 22 year old female referred to the adult Allergy & Clinical Immunology clinic for an extremely elevated IgE level, eventually diagnosed with Hodgkin's lymphoma. She had no history of atopy, recurrent infections, eczema or periodontal disease; stool was negative for ova & parasites. Chest X-ray revealed large bilateral anterior mediastinal masses that demonstrated prominent uptake on gallium scan. Mediastinal lymph node biopsy was consistent with Hodgkin's lymphoma, nodular sclerosing subtype, grade I/II.</p> <p>Conclusion</p> <p>Although uncommon, markedly elevated IgE may be a manifestation of a malignant process, most notably both Hodgkin's and Non-Hodgkin's lymphomas. This diagnosis should be considered in evaluating an otherwise unexplained elevation of IgE.</p

Néel-type skyrmion lattice with confined orientation in the polar magnetic semiconductor GaV4S8

Following the early prediction of the skyrmion lattice (SkL)—a periodic array of spin vortices—it has been observed recently in various magnetic crystals mostly with chiral structure. Although non-chiral but polar crystals with Cnv symmetry were identified as ideal SkL hosts in pioneering theoretical studies, this archetype of SkL has remained experimentally unexplored. Here, we report the discovery of a SkL in the polar magnetic semiconductor GaV4S8 with rhombohedral (C3v) symmetry and easy axis anisotropy. The SkL exists over an unusually broad temperature range compared with other bulk crystals and the orientation of the vortices is not controlled by the external magnetic field, but instead confined to the magnetic easy axis. Supporting theory attributes these unique features to a new Néel-type of SkL describable as a superposition of spin cycloids in contrast to the Bloch-type SkL in chiral magnets described in terms of spin helices

Hybrid stars with the color dielectric and the MIT bag models

We study the hadron-quark phase transition in the interior of neutron stars (NS). For the hadronic sector, we use a microscopic equation of state (EOS) involving nucleons and hyperons derived within the Brueckner-Bethe-Goldstone many-body theory, with realistic two-body and three-body forces. For the description of quark matter, we employ both the MIT bag model with a density dependent bag constant, and the color dielectric model. We calculate the structure of NS interiors with the EOS comprising both phases, and we find that the NS maximum masses are never larger than 1.7 solar masses, no matter the model chosen for describing the pure quark phase.Comment: 11 pages, 5 figures, submitted to Phys. Rev.