44 research outputs found
Compatibility of MAX phase-based ceramics with oxygen-poor, static liquid lead-bismuth eutectic
This work investigates the compatibility of MAX phase-based
ceramics with liquid LBE, and proposes a mechanism to explain the observed
local /LBE interaction. The ceramics were exposed to oxygen-poor
( mass%), static liquid LBE at 500{\deg}C for 1000
h. A new MAX phase solid solution formed in-situ in the
LBE-affected grains. Out-of-plane ordering was favorable in the new
solid solution, whereby -layers with high and low-Bi/Pb contents
alternated in the crystal structure, in agreement with first-principles
calculations. Bulk was synthesized by reactive hot pressing
to study the crystal structure of the solid solution by neutron diffraction
Incidence and outcome of inappropriate in-hospital empiric antibiotics for severe infection : a systematic review and meta-analysis
INTRODUCTION: The aims of this study were to explore the incidence of in-hospital inappropriate empiric antibiotic use in patients with severe infection and to identify its relationship with patient outcomes. METHODS: Medline (from 2004 to 2014) was systematically searched by using predefined inclusion criteria. Reference lists of retrieved articles were screened for additional relevant studies. The systematic review included original articles reporting a quantitative measure of the association between the use of (in)appropriate empiric antibiotics in patients with severe in-hospital infections and their outcomes. A meta-analysis, using a random-effects model, was conducted to quantify the effect on mortality by using risk ratios. RESULTS: In total, 27 individual articles fulfilled the inclusion criteria. The percentage of inappropriate empiric antibiotic use ranged from 14.1% to 78.9% (Q1-Q3: 28.1% to 57.8%); 13 of 27 studies (48.1%) described an incidence of 50% or more. A meta-analysis for 30-day mortality and in-hospital mortality showed risk ratios of 0.71 (95% confidence interval 0.62 to 0.82) and 0.67 (95% confidence interval 0.56 to 0.80), respectively. Studies with outcome parameter 28-day and 60-day mortality reported significantly (P ≤0.02) higher mortality rates in patients receiving inappropriate antibiotics. Two studies assessed the total costs, which were significantly higher in both studies (P ≤0.01). CONCLUSIONS: This systematic review with meta-analysis provides evidence that inappropriate use of empiric antibiotics increases 30-day and in-hospital mortality in patients with a severe infection. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-015-0795-y) contains supplementary material, which is available to authorized users