Zn doped nanocrystalline CuCl thin films for optoelctronic applications

We report on the use of Zn as an n-type dopant in CuCl thin films for optoelectronic applications, wherein maximum n-type doping of the order of 1018 cm -3 has been achieved. Zn doped nanocrystalline CuCl thin films are successfully deposited on glass and Si substrates by pulsed dc magnetron sputtering. Structural and morphological properties are investigated using X-ray diffraction (XRD) studies and Scanning Electron Microscopy (SEM), respectively. The conductivity of the CuCl:Zn films is examined using the four point probe technique. An order of magnitude increase in the conductivity of CuCl, by the doping with Zn is reported herein. The doped CuCl films display strong room temperature cathodoluminescence (CL) at ~ 385nm, which is similar to that of the undoped films. Hall Effect measurements show an n-type conductivity of the doped films

Low temperature growth technique for nanocrystalline cuprous oxide thin films using microwave plasma oxidation of copper

We report on the direct formation of phase pure nanocrystalline cuprous oxide (Cu2O) film with band gap ~ 2 eV by microwave plasma oxidation of pulsed dc magnetron sputtered Cu films and the highly controlled oxidation of Cu in to Cu2O and CuO phases by controlling the plasma exposure time. The structural, morphological and optoelectronic properties of the films were investigated. p-type Cu2O film with a grain size ~20-30 nm, resistivity of ~66 Ω cm and a hole concentration of ~2×1017 cm-3 is obtained for a plasma exposure time of 10 min without using any foreign dopants. The optical absorption coefficient (~105 cm-1) of the Cu2O film is also reported

Factors in perioperative care that determine blood loss in liver surgery

AbstractObjectivesExcessive blood loss during liver surgery contributes to postoperative morbidity and mortality and the minimizing of blood loss improves outcomes. This study examines pre- and intraoperative factors contributing to blood loss and identifies areas for improvement.MethodsAll patients who underwent elective hepatic resection between June 2007 and June 2009 were identified. Detailed information on the pre- and perioperative clinical course was analysed. Univariate and multivariate analyses were used to identify factors associated with intraoperative blood loss.ResultsA total of 175 patients were studied, of whom 95 (54%) underwent resection of three or more segments. Median blood loss was 782ml. Greater blood loss occurred during major resections and prolonged surgery and was associated with an increase in postoperative complications (P= 0.026). Peak central venous pressure (CVP) of >10cm H2O was associated with increased blood loss (P= 0.01). Although no differences in case mix were identified, blood loss varied significantly among anaesthetists, as did intraoperative volumes of i.v. fluids and transfusion practices.ConclusionsThis study confirms a relationship between CVP and blood loss in hepatic resection. Intraoperative CVP values were higher than those described in other studies. There was variation in the intraoperative management of patients. Collaboration between surgical and anaesthesia teams is required to minimize blood loss and the standardization of intraoperative anaesthesia practice may improve outcomes following liver surgery

Identifying factors associated with intravenous fluid administration in patients with sepsis presenting to the emergency department : a retrospective cohort study

Background: Appropriate and timely administration of intravenous fluids to patients with sepsis-induced hypotension is one of the mainstays of sepsis management in the emergency department (ED), however, fluid resuscitation remains an ongoing challenge in ED. Our study has been undertaken with two specific aims: firstly, for patients with sepsis, to identify factors associated with receiving intravenous fluids while in the ED; and, secondly to identify determinants associated with the actual time to fluid administration. Methods: We conducted a retrospective multicentre cohort study of adult ED presentations between October 2018 and May 2019 in four metropolitan hospitals in Western Sydney, Australia. Patients meeting pre-specified criteria for sepsis and septic shock and treated with antibiotics within the first 24 h of presentation were included. Multivariable models were used to identify factors associated with fluid administration in sepsis. Results: Four thousand one hundred forty-six patients met the inclusion criteria, among these 2,300 (55.5%) patients with sepsis received intravenous fluids in ED. The median time to fluid administration from the time of diagnosis of sepsis was 1.6 h (Interquartile Range (IQR) 0.5 to 3.8), and the median volume of fluids administered was 1,100 mL (IQR 750 to 2058). Factors associated with patients receiving fluids were younger age (Odds Ratio (OR) 1.05, 95% Confidence Interval (CI (1.03 to 1.07), p < 0.001); lower systolic blood pressure (OR 1.11, 95% CI (1.08 to 1.13), p < 0.001); presenting to smaller hospital (OR 1.48, 95% CI (1.25 to 1.75, p < 0.001) and a Clinical Rapid Response alert activated (OR 1.64, 95% CI (1.28 to 2.11), p < 0.001). Patients with Triage Category 1 received fluids 101.22 min earlier (95% CI (59.3 to131.2), p < 0.001) and those with Category 2 received fluids 43.58 min earlier (95% CI (9.6 to 63.1), p < 0.001) compared to patients with Triage Category 3-5. Other factors associated with receiving fluids earlier included septic shock (-49.37 min (95% CI (-86.4 to -12.4), p < 0.001)); each mmol/L increase in serum lactate levels (-9.0 min, 95% CI (-15.7 to -2.3), p < 0.001) and presenting to smaller hospitals (-74.61 min, 95% CI (-94.0 to -55.3), p < 0.001). Conclusions: Younger age, greater severity of sepsis, and presenting to a smaller hospital increased the probability of receiving fluids and receiving it earlier. Recognition of these factors may assist in effective implementation of sepsis management guidelines which should translate into better patient outcomes. Future studies are needed to identify other associated factors that we have not explored

Ethofumesate-resistant annual bluegrass (Poa annua) in grass seed production systems

The prolific seed production and polyploidy of annual bluegrass allow for the rapid development of herbicide resistance. Ethofumesate-resistant annual bluegrass plants were identified in the 1990s in grass seed production in Oregon, but their prevalence and distribution are not well documented. Therefore a dose–response experiment was initiated to determine the potential level of ethofumesate resistance in seed production systems. Seeds from 55 annual bluegrass populations were obtained from three sources: seed production fields (31 populations), the seed cleaning process (6 populations), and seed testing lots prior to retail distribution (18 populations). Additionally, two populations, one with known ethofumesate resistance and one with known susceptibility, were identified in preliminary testing and used as controls in this experiment. Seed from each collected population was increased. Individual seedlings were then transplanted into separate cone-tainers, grown to a size of 2 to 3 tillers in the greenhouse, and then sprayed using a compressed air track spray chamber with 10 doses of ethofumesate at 0, 0.56, 1.1, 2.8, 5.6, 8.4, 11.2, 16.8, 22.4, and 44.8 kg ai ha−1, with 0.84 to 2.2 kg ha−1 as the label application rate for perennial ryegrass. The resistant to susceptible ratio of populations across all sources ranged from 0.5 to 5.5. The most resistant populations found in production fields, seed cleaning, and seed testing lots had the effective dose necessary to kill 50% of the population (ED50) of 12.1, 9.4, and 13.1 kg ha−1, respectively. Furthermore, 68% of the populations found in production fields had ED50 higher than 6 kg ha−1, indicating common annual bluegrass resistance in grass seed production. As such, growers should implement integrated weed management strategies, as herbicides alone will likely be ineffective at controlling annual bluegrass

Pulsed plasma physical vapour deposition approach towards the facile synthesis of multilayer and monolayer graphene for anticoagulation applications

We demonstrate the growth of multilayer and single layer graphene on copper foil using bipolar pulsed direct current (DC) magnetron sputtering of a graphite target in pure Ar atmosphere. Single layer and few layer graphene films (SG and FLG) are deposited at temperatures ranging from 700-920 °C in less than 30 minutes. We find that the deposition and post-deposition annealing temperatures influence the layer thickness and quality of the graphene films formed. The films were characterized using atomic force microscopy (AFM), scanning electron microscopy (SEM), High resolution transmission electron microscopy (HRTEM), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS) and optical transmission spectroscopy techniques. Based on the above studies, a diffusion controlled mechanism was proposed for the graphene growth. A single step whole blood assay was used to investigate the anticoagulant activity of graphene surfaces. Platelet adhesion, activation and morphological changes on the graphene/glass surfaces compared to bare glass were analysed using fluorescence microscopy and SEM techniques. We have found significant suppression of the platelet adhesion, activation and aggregation on the graphene covered surfaces compared to the bare glass, indicating the anticoagulant activity of the deposited graphene films. Our production technique represents an industrially relevant method for the growth of single and few layer graphene for various applications including the biomedical field

Effectiveness of epidural analgesia following open liver resection

AbstractObjectivesEpidural analgesia is often considered the reference standard for pain relief following major abdominal surgery; however, the provision of analgesia in the context of liver surgery raises unique challenges. This study investigated the effectiveness of analgesia and the postoperative course of patients who did or did not receive epidural analgesia following liver resection.MethodsData were collected retrospectively on 177 patients who underwent open liver resection between June 2007 and June 2009. Patients were divided into two groups consisting, respectively, of those who received epidural analgesia (Epidural group, n= 148) and those who did not (No-Epidural group, n= 29).ResultsIn the Epidural group, 27 patients (18%) required i.v. opiate analgesia on the day of surgery (DoS) or the first postoperative day (POD1). The Epidural group received significantly more i.v. colloid solution on the DoS (median: 1500ml vs. 750ml, range: 0–12000ml vs. 0–3500ml; P= 0.004) and POD1 (median: 0ml vs. 0ml, range: 0–5000ml vs. 0–1000ml; P= 0.018), and total fluid on the DoS and POD1 combined (median: 6522ml vs. 5453ml, range: 2150–21300ml vs. 2875–15886ml; P= 0.032).ConclusionsEpidural analgesia provided inadequate postoperative pain relief in approximately 20% of liver resection patients and was associated with the administration of significantly greater volumes of i.v. colloid solution

Managing chronic hepatitis B: A qualitative study exploring the perspectives of people living with chronic hepatitis B in Australia

<p>Abstract</p> <p>Background</p> <p>The implementation of a comprehensive public health response to hepatitis B in Australia is urgently required to reduce the increasing burden of hepatitis B infection on the health system and the community. A significant gap in the public health response to hepatitis B is an understanding of how people with chronic hepatitis B (CHB) respond to CHB.</p> <p>Findings</p> <p>A qualitative study involving semi-structured interviews and focus group discussions was conducted. Interviews were held with 20 people with CHB from three states of Australia. In addition, four focus group discussions were held with a total of 40 community and health workers from culturally and linguistically diverse communities in four Australian states.</p> <p>People with CHB reported no formal or informal pre or post test discussion with little information about hepatitis B provided at the point of diagnosis. Knowledge deficits about hepatitis B were found among most participants. Few resources are available for people with CHB or their families to assist them in understanding the infection and promoting their health and well-being. A lack of confidence in the professional knowledge of service providers was noted throughout interviews.</p> <p>Conclusions</p> <p>People with CHB need culturally and linguistically appropriate education and information, particularly at the point of diagnosis. Primary health care professionals need the knowledge, skills and motivation to provide appropriate information to people with CHB, to ensure they have the capacity to better manage their infection.</p

Emergence and dissemination of antimicrobial resistance in Escherichia coli causing bloodstream infections in Norway in 2002-17: a nationwide, longitudinal, microbial population genomic study.

BACKGROUND: The clonal diversity underpinning trends in multidrug resistant Escherichia coli causing bloodstream infections remains uncertain. We aimed to determine the contribution of individual clones to resistance over time, using large-scale genomics-based molecular epidemiology. METHODS: This was a longitudinal, E coli population, genomic, cohort study that sampled isolates from 22 512 E coli bloodstream infections included in the Norwegian surveillance programme on resistant microbes (NORM) from 2002 to 2017. 15 of 22 laboratories were able to share their isolates, and the first 22·5% of isolates from each year were requested. We used whole genome sequencing to infer the population structure (PopPUNK), and we investigated the clade composition of the dominant multidrug resistant clonal complex (CC)131 using genetic markers previously reported for sequence type (ST)131, effective population size (BEAST), and presence of determinants of antimicrobial resistance (ARIBA, PointFinder, and ResFinder databases) over time. We compared these features between the 2002-10 and 2011-17 time periods. We also compared our results with those of a longitudinal study from the UK done between 2001 and 2011. FINDINGS: Of the 3500 isolates requested from the participating laboratories, 3397 (97·1%) were received, of which 3254 (95·8%) were successfully sequenced and included in the analysis. A significant increase in the number of multidrug resistant CC131 isolates from 71 (5·6%) of 1277 in 2002-10 to 207 (10·5%) of 1977 in 2011-17 (p<0·0001), was the largest clonal expansion. CC131 was the most common clone in extended-spectrum β-lactamase (ESBL)-positive isolates (75 [58·6%] of 128) and fluoroquinolone non-susceptible isolates (148 [39·2%] of 378). Within CC131, clade A increased in prevalence from 2002, whereas the global multidrug resistant clade C2 was not observed until 2007. Multiple de-novo acquisitions of both blaCTX-M ESBL-encoding genes in clades A and C1 and gain of phenotypic fluoroquinolone non-susceptibility across the clade A phylogeny were observed. We estimated that exponential increases in the effective population sizes of clades A, C1, and C2 occurred in the mid-2000s, and in clade B a decade earlier. The rate of increase in the estimated effective population size of clade A (Ne=3147) was nearly ten-times that of C2 (Ne=345), with clade A over-represented in Norwegian CC131 isolates (75 [27·0%] of 278) compared with the UK study (8 [5·4%] of 147 isolates). INTERPRETATION: The early and sustained establishment of predominantly antimicrobial susceptible CC131 clade A isolates, relative to multidrug resistant clade C2 isolates, suggests that resistance is not necessary for clonal success. However, even in the low antibiotic use setting of Norway, resistance to important antimicrobial classes has rapidly been selected for in CC131 clade A isolates. This study shows the importance of genomic surveillance in uncovering the complex ecology underlying multidrug resistance dissemination and competition, which have implications for the design of strategies and interventions to control the spread of high-risk multidrug resistant clones. FUNDING: Trond Mohn Foundation, European Research Council, Marie Skłodowska-Curie Actions, and the Wellcome Trust