144 research outputs found
Thermal stability of nanoporous raney gold catalyst
© 2015 by the authors; licensee MDPI, Basel, Switzerland. Nanoporous “Raney gold” sponge was prepared by de-alloying an Au-Al precursor alloy. Catalytic tests using a micro-reactor confirmed that Raney gold can serve as an active heterogeneous catalyst for CO oxidation, reduction of NO to N2, and oxidation of NO to NO2. In general, the specific surface area of a heterogeneous catalyst has an influence on its catalytic efficacy. Unfortunately, gold sponges coarsen readily, leading to sintering of their structure and reduction in surface area. This potentially places constraints on their upper operating temperature in catalytic reactors. Here we analyzed the behavior of Raney gold when the temperature was raised. We examined the kinetics and mechanism of coarsening of the sponge using a combination of in situoptical measurements and Metropolis Monte Carlo modeling with a Lennard-Jones interatomic potential. Modeling showed that the sponges started with an isotropic “foamy” morphology with negative average “mean curvature” but that subsequent thermally activated coarsening will drive the morphology through a bi-continuous fibrous state and on, eventually, to a sponge consisting of sintered blobs of predominantly positive “mean curvature”
Feasibility and reliability of PRISMA-Medical for specialty-based incident analysis
Aims and objectives: In this study, the feasibility and reliability of the Prevention Recovery Information System for Monitoring and Analysis (PRISMA)-Medical method for systematic, specialty-based analysis and classification of incidents in the neonatal intensive care unit (NICU) were determined.
Methods: After the introduction of a Neonatology System for Analysis and Feedback on Medical Events (NEOSAFE) in eight tertiary care NICUs and one paediatric surgical ICU, PRISMA-Medical was started to be used to identify root causes of voluntary reported incidents by multidisciplinary unit patient safety committees. Committee members were PRISMA-trained and familiar with the department and its processes. In this study, the results of PRISMA-analysis of incidents reported during the first year are described. At t¿=¿3 months and t¿=¿12 months after introduction, test cases were performed to measure agreement at three levels of root cause classification using PRISMA-Medical. Inter-rater reliability was determined by calculating generalised ¿ values for each level of classification.
Results: During the study period, 981 out of 1786 eligible incidents (55%) were analysed for underlying root causes. In total, 2313 root causes were identified and classified, giving an average of 2.4 root causes for every incident. Although substantial agreement (¿ 0.70–0.81) was reached at the main level of root cause classification of the test cases (discrimination between technical, organisational and human failure) and agreement among the committees at the second level (discrimination between skill-based, rule-based and knowledge-based errors) was acceptable (¿ 0.53–0.59), discrimination between rule-based errors (the third level of classification) was more difficult to assess (¿ 0.40–0.47).
Conclusion: With some restraints, PRISMA-Medical proves to be both feasible and acceptably reliable to identify and classify multiple causes of medical events in the NICU
Disease activity in inflammatory bowel disease patients is associated with increased liver fat content and liver fibrosis during follow-up
Purpose Liver steatosis is a frequently reported condition in patients with inflammatory bowel disease (IBD). Different factors, both metabolic and IBD-associated, are believed to contribute to the pathogenesis. The aim of our study was to calculate the prevalence of liver steatosis and fibrosis in IBD patients and to evaluate which factors influence changes in steatosis and fibrosis during follow-up. Methods From June 2017 to February 2018, demographic and biochemical data was collected at baseline and after 6-12 months. Measured by transient elastography (FibroScan), liver steatosis was defined as Controlled Attenuation Parameter (CAP) >= 248 and fibrosis as liver stiffness value (Emed) >= 7.3 kPa. IBD disease activity was defined as C-reactive protein (CRP) >= 10 mg/l and/or fecal calprotectin (FCP) >= 150 mu g/g. Univariate and multivariate regression analysis was performed; a p-value of <= 0.05 was considered significant. Results Eighty-two out of 112 patients were seen for follow-up; 56% were male. The mean age was 43 +/- 16.0 years, and mean BMI was 25.1 +/- 4.7 kg/m(2). The prevalence of liver steatosis was 40% and of fibrosis was 20%. At baseline, 26 patients (32%) had an active episode of IBD. Using a multivariate analysis, disease activity at baseline was associated with an increase in liver steatosis (B = 37, 95% CI 4.31-69.35, p = 0.027) and liver fibrosis (B = 1.2, 95% CI 0.27-2.14, p = 0.016) during follow-up. Conclusions This study confirms the relatively high prevalence of liver steatosis and fibrosis in IBD patients. We demonstrate that active IBD at baseline is associated with both an increase in liver steatosis and fibrosis during follow-up.Cellular mechanisms in basic and clinical gastroenterology and hepatolog
Diet and feeding intensity of sardine Sardina pilchardus: correlation with satellite-derived chlorophyll data
Spatio-temporal variability of the diet of sardine Sardina pilchardus off Portugal was examined through analysis of the stomach contents of fish collected every 14 d from the west and south of Portugal during 2003/2004. Dietary composition of the modal sardine length class was assessed by determining the frequency of occurrence and carbon content of identified prey, and these 2 parameters were combined to estimate a modified index of relative importance of prey (mIRI). The most important prey for sardines were zooplankton, comprising crustacean eggs, copepods, decapods, cirripedes and fish eggs, dinoflagellates and diatoms (particularly the toxin-producer\ud
genus Pseudo-nitzschia), which together accounted for >90% of the estimated dietary carbon. Dietary seasonality was similar for both areas, except that the contribution of phytoplankton was higher for fish from the west Portuguese coast, where upwelling events are stronger and recurrent during spring and summer months. The predominance of prey <750 μm in sardine diet suggests that filter feeding is the dominant feeding mode used in the wild. Feeding intensity was similar for both sexes and for fish of different length classes and was higher on the west coast than in the south, which is probably related to the higher productivity of the west coast. Although there was high inter-annual variability in feeding intensity, this parameter was highest for both areas during spring and winter months. Temporal variability in satellite-derived chlorophyll a matched the temporal variability in the dietary contribution by phytoplankton and of sardine feeding intensity, suggesting further investigation of the potential use of satellite-derived chlorophyll a data as a proxy for sardine feeding intensity
Specialty-based, voluntary incident reporting in neonatal intensive care: description of 4846 incident reports
OBJECTIVES: To examine the characteristics of incidents reported after introduction of a voluntary, non-punitive incident reporting system for neonatal intensive care units (NICUs) in the Netherlands; and to investigate which types of reported incident pose the highest risk to patients in the NICU. DESIGN: Prospective multicentre survey. METHODS: Voluntary, non-punitive incident reporting was introduced in eight level III NICUs and one paediatric surgical ICU. An incident was defined as any unintended event which (could have) reduced the safety margin for the patient. Multidisciplinary, unit-based patient safety committees systematically collected and analysed incident reports, and assigned risk scores to each reported incident. Data were centrally collected for specialty-based analysis. This paper describes the characteristics of incidents reported during the first year. Bivariate logistic regression analysis was conducted to identify high-risk incident categories. RESULTS: There were 5225 incident reports on 3859 admissions, of which 4846 were eligible for analysis. Incidents with medication were most frequently reported (27%), followed by laboratory (10%) and enteral nutrition (8%). Severe harm was described in seven incident reports, and moderate harm in 63 incident reports. Incidents involving mechanical ventilation and blood products were most likely to be assigned high-risk scores, followed by those involving parenteral nutrition, intravascular lines and medication dosing errors. CONCLUSIONS: Incidents occur much more frequently in Dutch NICUs than has been previously observed, and their impact on patient morbidity is considerable. Reported incidents concerning mechanical ventilation, blood products, intravascular lines, parenteral nutrition and medication dosing errors pose the highest risk to patients in the NIC
Jellyfication of marine ecosystems as a likely consequence of overfishing small pelagic fishes: Lessons from the Benguela
Changes in two contrasting ecosystems of the Benguela upwelling region,
one dominated at mid-trophic level by jellyfishes (Namibia, northern Benguela
ecosystem, where small pelagic fish abundance has been severely depleted) and
one still dominated by small pelagic fishes (South Africa, southern Benguela)
were compared in an effort to determine ecosystem trajectories under different
exploitation regimes. The role of small pelagic fishes (clupeoids) was highlighted in
the context of their importance in maintaining interactions in marine ecosystems.
In particular, we examined trophic cascades and possible irreversible changes
that promote the proliferation of jellyfishes in marine systems. We found that
the presence of large populations of small pelagic fishes has a fundamental role
in preserving beneficial trophic interactions in these marine ecosystems. The
implications of trophic cascades, such as those observed in the northern Benguela,
for ecosystem-based management were apparent. In addition, this comparison
provides contrasting case studies to inform the development of management
scenarios that avoid ecosystem shifts that affect predators and reduce the value of
fisheries production.Web of Scienc
NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): evaluation of a national guideline on management of neonatal catheter-related thrombosis
Developmen
NEOnatal Central-venous Line Observational study on Thrombosis (NEOCLOT): Evaluation of a national guideline on management of neonatal catheter-related thrombosis
Background: In critically ill (preterm) neonates, central venous catheters (CVCs) are increasingly used for administration of medication or parenteral nutrition. A serious complication, however, is the development of catheter-related thrombosis (CVC-thrombosis), which may resolve by itself or cause severe complications. Due to lack of evidence, management of neonatal CVC-thrombosis varies among neonatal intensive care units (NICUs). In the Netherlands an expert-based national management guideline has been developed which is implemented in all 10 NICUs in 2014. Methods: The NEOCLOT study is a multicentre prospective observational cohort study, including 150 preterm and term infants (0-6 months) admitted to one of the 10 NICUs, developing CVC-thrombosis. Patient characteristics, thrombosis characteristics, risk factors, treatment strategies and outcome measures will be collected in a web-based database. Management of CVC-thrombosis will be performed as recommended in the protocol. Violations of the protocol will be noted. Primary outcome measures are a composite efficacy outcome consisting of death due to CVC-thrombosis and recurrent thrombosis, and a safety outcome consisting of the incidence of major bleedings during therapy. Secondary outcomes include individual components of primary efficacy outcome, clinically relevant non-major and minor bleedings and the frequency of risk factors, protocol variations, residual thrombosis and post thrombotic syndrome. Discussion: The NEOCLOT study will evaluate the efficacy and safety of the new, national, neonatal CVC-thrombosis guideline. Furthermore, risk factors as well as long-term consequences of CVC-thrombosis will be analysed
Accommodating Dynamic Oceanographic Processes and Pelagic Biodiversity in Marine Conservation Planning
Pelagic ecosystems support a significant and vital component of the ocean's productivity and biodiversity. They are also heavily exploited and, as a result, are the focus of numerous spatial planning initiatives. Over the past decade, there has been increasing enthusiasm for protected areas as a tool for pelagic conservation, however, few have been implemented. Here we demonstrate an approach to plan protected areas that address the physical and biological dynamics typical of the pelagic realm. Specifically, we provide an example of an approach to planning protected areas that integrates pelagic and benthic conservation in the southern Benguela and Agulhas Bank ecosystems off South Africa. Our aim was to represent species of importance to fisheries and species of conservation concern within protected areas. In addition to representation, we ensured that protected areas were designed to consider pelagic dynamics, characterized from time-series data on key oceanographic processes, together with data on the abundance of small pelagic fishes. We found that, to have the highest likelihood of reaching conservation targets, protected area selection should be based on time-specific data rather than data averaged across time. More generally, we argue that innovative methods are needed to conserve ephemeral and dynamic pelagic biodiversity
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