Tuning the Electrical and Thermal Conductivities of Thermoelectric Oxides through Impurity Doping

Waste heat and thermal gradients available at power plants can be harvested to power wireless networks and sensors by using thermoelectric (TE) generators that directly transform temperature differentials into electrical power. Oxide materials are promising for TE applications in harsh industrial environments for waste heat recovery at high temperatures in air, because they are lightweight, cheaply produced, highly efficient, and stable at high temperatures in air. Ca3Co4O9(CCO) with layered structure is a promising p-type thermoelectric oxide with extrapolated ZT value of 0.87 in single crystal form [1]. However the ZT values for the polycrystalline ceramics remain low of ∼0.1-0.3. In this research, nanostructure engineering approaches including doping and addition of nanoinclusions were applied to the polycrystalline CCO ceramic to improve the energy conversion efficiency.;Polycrystalline CCO samples with various Bi doping levels were prepared through the sol-gel chemical route synthesis of powders, pressing and sintering of the pellets. Microstructure features of Bi doped ceramic bulk samples such as porosity, development of crystal texture, grain boundary dislocations and segregation of Bi dopants at various grain boundaries are investigated from microns to atomic scale. The results of the present study show that the Bi-doping is affecting both the electrical conductivity and thermal conductivity simultaneously, and the optimum Bi doping level is strongly correlated with the microstructure and the processing conditions of the ceramic samples. At the optimum doping level and processing conditions of the ceramic samples, the Bi substitution of Ca results in the increase of the electrical conductivity, decrease of the thermal conductivity, and improvement of the crystal texture. The atomic resolution Scanning Transmission Electron Microscopy (STEM) Z-contrast imaging and the chemistry analysis also reveal the Bi-segregation at grain boundaries of CCO polycrystalline samples. In order to further decrease the thermal conductivity and increase the overall energy conversion efficiency of ceramic samples. The highest ZT value obtained is 0.32 at 973K for Ca and Co site Bi doping. The effect of the nanoinclusions on the performance and the microstructure of CCO were investigated as well

On the Unusual Amber Coloration of Nanoporous Sol-gel Processed Al-doped Silica Glass: An Experimental Study

Silica is the most abundant component on the earth’s surface. It plays an important role in many natural processes. Silica is also a critical material for a wide range of technical applications such as in optics and electronics. In this work, we discuss our recent experimental observation of the unusual amber coloration of aluminum doped sol-gel glass that has not been reported in the past. We characterized Al-doped sol-gel glasses, prepared at different sintering temperature, using a plethora of techniques to investigate the origin of this unusual coloration and to understand their structural and chemical properties. We used these experimental results to test a number of possible coloring mechanisms. The results suggested this coloring is likely caused by temperature-dependent aluminum-associated defect centers associated with different amorphous-to-crystalline ratios of the annealed sol-gel silica glass structures

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Mitigación con Sistemas Silvopastoriles en Latinoamérica: Aportes para la incorporación en los sistemas de Medición Reporte y Verificación bajo la CMNUCC

En Latinoamérica el 46% de las emisiones de GEI proviene del cambio de usos de la tierra y el 20% de la agricultura, en donde el 58% y el 70% de las emisiones son debidas a la ganadería. El continuo crecimiento de este sector (+32% previsto al 2050) ha impulsado la expansión de la frontera agropecuaria en los bosques, generando múltiples impactos ambientales entre los cuales se encuentra la emisión de Gases Efecto Invernadero (GEI). Sin embargo, el sector tiene un alto potencial de mitigación reconocido por políticas, estrategias y programas de mitigación nacionales como las Contribuciones Nacionalmente Determinadas (NDC) y de desarrollo sectorial como las Acciones de Mitigación nacionalmente Apropiadas (NAMA). Entre estas acciones se incluye la implementación de sistemas silvopastoriles, cuya medición monitoreo y reporte a escala nacional presenta un estado de avance muy limitado, dejando su aporte a la mitigación invisible. A través de un Grupo Técnico de Trabajo ad hoc se han analizado el avance de los países de la región en la incorporación de los sistemas silvopastoriles en los sistemas nacionales de Medición/Monitoreo, Reporte y Verificación (MRV) de los Inventarios Nacionales de Gases Efecto Invernadero, y los requerimientos a cumplir para esto, generando una hoja de ruta a corto-medio plazo así como unas orientaciones técnicas para reducir la brecha existente

Mitigación con Sistemas Silvopastoriles en Latinoamérica: Aportes para la incorporación en los sistemas de Medición Reporte y Verificación bajo la CMNUCC

En Latinoamérica el 46% de las emisiones de GEI proviene del cambio de usos de la tierra y el 20% de la agricultura, en donde el 58% y el 70% de las emisiones son debidas a la ganadería. El continuo crecimiento de este sector (+32% previsto al 2050) ha impulsado la expansión de la frontera agropecuaria en los bosques, generando múltiples impactos ambientales entre los cuales se encuentra la emisión de Gases Efecto Invernadero (GEI). Sin embargo, el sector tiene un alto potencial de mitigación reconocido por políticas, estrategias y programas de mitigación nacionales como las Contribuciones Nacionalmente Determinadas (NDC) y de desarrollo sectorial como las Acciones de Mitigación nacionalmente Apropiadas (NAMA). Entre estas acciones se incluye la implementación de sistemas silvopastoriles, cuya medición monitoreo y reporte a escala nacional presenta un estado de avance muy limitado, dejando su aporte a la mitigación invisible. A través de un Grupo Técnico de Trabajo ad hoc se han analizado el avance de los países de la región en la incorporación de los sistemas silvopastoriles en los sistemas nacionales de Medición/Monitoreo, Reporte y Verificación (MRV) de los Inventarios Nacionales de Gases Efecto Invernadero, y los requerimientos a cumplir para esto, generando una hoja de ruta a corto-medio plazo así como unas orientaciones técnicas para reducir la brecha existente

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Environmentally Friendly Engineering and Three-Dimensional Printing of TiO₂ Hierarchical Mesoporous Cellular Architectures

Three-dimensional (3D) printing of hierarchically ordered cellular materials with tunable microstructures is a major challenge from both synthesis and scalable manufacturing perspectives. A simple, environmentally friendly, and scalable concept to realize morphologically and microstructurally engineered cellular ceramics is herein demonstrated by combining direct foam writing with colloidal processing. These cellular structures are widely applicable across multiple technological fields including energy harvesting, waste management/water purification, and biomedicine. Our concept marries sacrificial templating with direct foaming to synthesize multiscale porous TiO₂ foams that can be 3D printed into planar, free-standing, and spanning hierarchical structures. The latter being reported for the first time. We show how by varying the foam-inks’ composition and frothing conditions, the rheological properties and foam configurations (i.e., open- or closed-cell) are tuned. Furthermore, our printing studies indicate a synergy between intermediate extrusion pressures and low speeds for realizing spanning features. Additionally, the dimensional changes associated with the postprocessing of the different foam configurations are discussed. We investigate the effects of the foams’ composition on their microstructure and surface area properties. Additionally, the foams’ photocatalytic performance is correlated with their microstructure, improving for open-cell architectures. The proposed synthesis and scalable manufacturing method can be extended to fabricate similar structures from alternative ceramic foam systems, where control of the porosity and surface properties is crucial, demonstrating the great potential of our synthesis approach