1,643 research outputs found
Structured antibiotic 'time-out' audits as recommended by the CDC reduce antibiotic use and costs
Synthesis, Characterization and Determination of Weight Poly Molecule (Lactic acid)
Experiments have been successfully carried out to react with lactic acid and 1,4-butanediol, tin (II) chloride dihydrate (SnCl2.2H2O), chloroform, methanol, liquid nitrogen, nitrogen gas, and silicone oil at various concentrations. The objective exists to synthesize polylactic acid by forming polylactic acid diol (PLA-OH) via a direct polycondensation reaction of lactic acid and 1,4-butanediol in a glass reactor following a specific reaction scheme. Synthesis was carried out using different amounts of reagents according to the predetermined mole ratio of lactic acid (AL) and 1,4-butanediol (BD). The FTIR, 1H NMR, and GPC analyses that characterized the PLA-OH revealed its physicochemical characteristics. The FTIR and 1H NMR characterization results show new absorption peaks and a shift in PLA-OH absorption peaks. It indicates that a bond has been formed from the reaction between lactic acid molecules and 1,4-butanediol to produce PLA-OH. From the spectrum analysis, it can be concluded that the structure of the synthesized PLA-OH has four different proton environments (there are four different peaks in the spectrum). The peaks originate from the protons in methylene (-OCH2CH2CH2CH2O), internal methine (-O-CH-), and methine at the end of the PLA-OH chain, as well as proton peaks in methyl (H3C-). The characterization results with GPC showed that the tendency to increase Mn PLA was directly proportional to the increasing amount of lactic acid in the PLA chain
 
A simple model of ocean temperature re-emergence and variability
A simple stochastic one-dimensional model of interannual mid-latitude sea surface temperature (SST) variability that can be solved analytically is developed. A novel two-season approach is adopted, with the annual cycle divided into two seasons denoted summer and winter. Within each season the mixed layer depth is constant, and the transition of the mixed layer from summer to winter and vice versa is discontinuous. SST anomalies are forced by random atmospheric heat fluxes, assumed to be constant within each season for simplicity, with linear damping to represent atmospheric feedback. At the start of summer the initial SST anomaly is set equal to that at the end of the previous winter, and at the start of winter the initial temperature anomaly is found by instantaneously mixing the summer mixed layer with the heat stored below in the deeper winter mixed layer, thereby explicitly taking into account the ‘re-emergence mechanism’. Two simple auto-regressive equations for the summer and winter SST anomalies are obtained that can be easily solved. Model parameters include seasonal damping coefficients, mixed layer depths and standard deviations of the atmospheric forcing. Analytic expressions for season-to-season correlation and variability and power spectra are used to explore and illustrate the effects of the parameters quantitatively. Among the results it is found that, with regard to winter-to-winter temperature correlation, the re-emergence pathway is more influential than persistence via the summer mixed layer when the winter layer is more than twice the depth of the summer layer. With regard to winter temperature variability, the effect of a deeper winter mixed layer is to decrease the sensitivity to surface forcing and thus decrease variability, but also to increase persistence via re-emergence and thus increase variance at multidecadal scales
Optimal management of urinary tract infections in older people
Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms. Urinalysis is commonly used to diagnose infection in this population, however, the evidence for its use is limited. There is overwhelming evidence that asymptomatic bacteriuria should not be treated. Catheter associated urinary tract infection accounts for a significant amount of hospital-associated infection. Indwelling urinary catheters should be avoided where possible and alternatives sought. The use of narrow spectrum antimicrobial agents for urinary tract infection is advocated. Local guidelines are now widely used to reflect local resistance patterns and available agents. Guidelines need to be updated to reflect changes in antimicrobial prescribing and a move from broad to narrow spectrum antimicrobials
Culture, Reform Politics, and Future Directions: A Review of China’s Animal Protection Challenge
Incidents of animal abuse in China attract worldwide media attention. Is China culturally inclined to animal cruelty, or is the country’s development strategy a better explanation? This article addresses the subject of animal protection in China, a topic that has been ignored for too long by Western China specialists. A review of ancient Chinese thought asks whether China lacks a legacy of compassion for animals. The article then considers how China’s reform politics underlie the animal welfare crisis. Through its discussion of the welfare crisis impacting nonhuman animals in China, this paper sheds light on the enormity of the country’s animal protection challenge. It concludes with an optimistic prediction for the future, despite the obstacles that remain in the way of animal protection policy change
All patients with diabetes should have annual UACR tests. Why is that so hard?
The urine albumin creatinine ratio (UACR) detects abnormal levels of protein in the urine and should be performed annually to detect kidney disease in patients with diabetes mellitus. UK national audits show that 25% of patients do not have annual tests and our data suggested that some patients had more than one test per year. Data from 20 patients showed that 55% had more than one UACR test per year, with a total of 19 unnecessary tests at an estimated cost of £20,000 per year. However 20% had not had a UACR in the previous year, so unreliable testing was potentially causing harm as well as waste. Process mapping showed that having a UACR test depended on whether the patient brought a urine sample to the clinic. Most (72%) patients were unaware that the urine sample was used to detect kidney damage. We encountered barriers when finding a process to automate measures of reliability of UACR testing using computer protocol, and therefore created a patient information leaflet. The first version of the leaflet was too technical and several changes were suggested by patients. After reading the revised leaflet 99% of patients understood the reason for UACR testing and 64% felt more motivated to bring in urine samples. The phlebotomist disseminated the patient information leaflet with a median of 90% reliability for six consecutive clinics. The patient information leaflet has the potential to improve patient involvement in their care and to increase the number of patients who bring urine samples to the clinic. However, this could increase the number of unnecessary tests unless the process of test ordering is changed to ensure that UACR is only measured annually
The Contribution of Natural Resources on Economic Welfare in Indonesia
The objective of this research is to examine the relationship between natural resource abundance and economic welfare at the national level of Indonesia. Four variables of institutional quality, investment level, education level, and industry value added are considered in the study as the moderating variables between economic welfare and natural resource rents. This study found that the results are not robust to conclude that the rent generated from natural resources is contributing to the economic welfare in Indonesia. Nevertheless, this study found there are three moderating variables that can become a support to strengthen the relationship between natural resources and economic welfare, these are institutional quality through improvement in the political stability, strengthening the accountability, stringent the regulations, and enforcing the rule of law; primary completion level; and industry value added
Modelling environmental factors correlated with podoconiosis: a geospatial study of non-filarial elephantiasis
Introduction
The precise trigger of podoconiosis — endemic non-filarial elephantiasis of the lower legs — is unknown. Epidemiological and ecological studies have linked the disease with barefoot exposure to red clay soils of volcanic origin. Histopathology investigations have demonstrated that silicon, aluminium, magnesium and iron are present in the lower limb lymph node macrophages of both patients and non-patients living barefoot on these clays. We studied the spatial variation (variations across an area) in podoconiosis prevalence and the associated environmental factors with a goal to better understanding the pathogenesis of podoconiosis.
Methods
Fieldwork was conducted from June 2011 to February 2013 in 12 kebeles (administrative units) in northern Ethiopia. Geo-located prevalence data and soil samples were collected and analysed along with secondary geological, topographic, meteorological and elevation data. Soil data were analysed for chemical composition, mineralogy and particle size, and were interpolated to provide spatially continuous information. Exploratory, spatial, univariate and multivariate regression analyses of podoconiosis prevalence were conducted in relation to primary (soil) and secondary (elevation, precipitation, and geology) covariates.
Results
Podoconiosis distribution showed spatial correlation with variation in elevation and precipitation. Exploratory analysis identified that phyllosilicate minerals, particularly clay (smectite and kaolinite) and mica groups, quartz (crystalline silica), iron oxide, and zirconium were associated with podoconiosis prevalence. The final multivariate model showed that the quantities of smectite (RR = 2.76, 95% CI: 1.35, 5.73; p = 0.007), quartz (RR = 1.16, 95% CI: 1.06, 1.26; p = 0.001) and mica (RR = 1.09, 95% CI: 1.05, 1.13; p < 0.001) in the soil had positive associations with podoconiosis prevalence.
Conclusions
More quantities of smectite, mica and quartz within the soil were associated with podoconiosis prevalence. Together with previous work indicating that these minerals may influence water absorption, potentiate infection and be toxic to human cells, the present findings suggest that these particles may play a role in the pathogenesis of podoconiosis and acute adenolymphangitis, a common cause of morbidity in podoconiosis patients
- …