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Central Line Associated Bloodstream Infection in Adult Intensive Care Unit Population—Changes in Epidemiology, Diagnosis, Prevention, and Addition of New Technologies

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Advances in Infectious Diseases 2022年第2期12卷 252-280页

作者： Theresia edgar Lutufyo Weidong Qin Xiaomei Chen Department of Critical Care Medicine Qilu Hospital of Shandong University Jinan China Shandong University Cheelo College of Medicine Jinan China

Background: Intensive care units (ICUs) have an increased risk of Central line associated bloodstream infection (CLABSI) due to the prevalence of invasive procedures, devices, immunosuppression, comorbidity, frailty, and elderly patients. We have seen a successful reduction in Central line associated bloodstream infection related the past decade. In spite of this, Intensive care unit-Catheter related bloodstream infections remain high. The emergence of new pathogens further complicates treatment and threatens patient outcomes in this context. In addition, the SARS-CoV-2 (COVID-19) pandemic served as a reminder that an emerging pathogen poses a challenge for adjusting prevention measures regarding both the risk of exposure to caregivers and maintaining a high level of care. ICU nurses play an important role in the prevention and management of CLABSI as they are involved in basic hygienic care, quality improvement initiatives, microbiological sampling, and aspects of antimicrobial stewardship. Microbiological techniques that are more sensitive and our increased knowledge of the interactions between critically ill patients and their microbiota are forcing us to rethink how we define CLABSIs and how we can diagnose, treat, and prevent them in the ICU. The objective of this multidisciplinary expert review, focused on the ICU setting, is to summarize the recently observed occurrence of CLABSI in ICU, to consider the role of modern microbiological techniques in their diagnosis, to examine clinical and epidemiological definitions, and to redefine several controversial preventive measures including antimicrobial-impregnated catheters, chlorhexidine-gluconate impregnated sponge, and catheter dressings.

关键词： Central Venous Catheter SARS-COV-2 ICU Bloodstream Infection Catheter Colonization Catheter Insertion

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A review of resting-state fMRI and its use to examine psychiatric disorders

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Psychoradiology 2021年第1期1卷 42-53页

作者： edgar Canario Donna Chen Bharat Biswal Department of Biomedical Engineering New Jersey Institute of Technology619 Fenster HallNewarkNJ07102US

Resting-state fMRI(rs-fMRI)has emerged as an alternative method to study brain function in human and animal models.In humans,it has been widely used to study psychiatric disorders including schizophrenia,bipolar disorder,autism spectrum disorders,and attention deficit hyperactivity disorders.In this review,rs-fMRI and its advantages over task based fMRI,its currently used analysis methods,and its application in psychiatric disorders using different analysis methods are discussed.Finally,several limitations and challenges of rs-fMRI applications are also discussed.

关键词： fMRI resting state connectivity

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Photo-Induced Water Oxidation Based on a Mononuclear Cobalt(II)Complex

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Chinese Journal of Chemistry 2014年第6期32卷 467-473页

作者： Hongyan Wang Yongbin Lu edgar Mijangos Anders Thapper Key Laboratory for Mechanical and Environmental Behavior of Tubular Goods Tubular Goods Research Institute of CNPCXi'anShaannxi 710065China Department of Chemistry-Ångström Laboratory Uppsala UniversityUppsala 75120Sweden Research Institute of Yanchang Petroleum(Group)CO.LTD Xi'anShaanxi 710075China

Photo-induced water oxidation based on first row transition metal complexes has drawn much attention recently as a part of the efforts to design systems for solar fuel production.Here,the classic tetradentate ligand TPA(tris(2-pyridylmethyl)amine)is used together with cobalt(II)in CH_(3)CN to form a mononuclear cobalt complex[Co(TPA)Cl]Cl.Single crystal X-ray diffraction shows that[Co(TPA)Cl]Cl is composed of discrete cationic units with a penta-coordinate cobalt center,along with chloride counter ions.In borate buffer,the Co complex acts as a water oxidation catalyst,as shown by the presence of a catalytic wave in electrochemistry.Under visible light irra-diation,in the presence of photosensitizer and electron acceptor,the Co complex catalyzes O2 evolution with a turnover frequency(TOF)of 1.0 mol(O_(2))·mol(Co)^(-1)·s^(-1)and a turnover number(TON)of 55 mol(O_(2))·mol(Co)^(-1)in pH 8 borate buffer.

关键词： water splitting photosynthesis cobalt ligand design electron transfer

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ICU中心静脉相关血流感染五年的流行病学、危险因素和病原学演变

ICU中心静脉相关血流感染五年的流行病学、危险因素和病原学演变

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作者： Theresia edgar Lutufyo 山东大学

学位级别：硕士

研究目的:中心静脉导管(CVCs)作为治疗危重症患者的工具,在重症监护病房(ICU)中广泛应用。然而,CVC的应用与血流感染呈正相关。研究发现,近年来CVC相关血流感染(CLABSI)的发生率逐年增加,是ICU患者血流感染的主要原因之一。因此,我们强... 详细信息

研究目的:中心静脉导管(CVCs)作为治疗危重症患者的工具,在重症监护病房(ICU)中广泛应用。然而,CVC的应用与血流感染呈正相关。研究发现,近年来CVC相关血流感染(CLABSI)的发生率逐年增加,是ICU患者血流感染的主要原因之一。因此,我们强调研究CLABSI在ICU患者流行病学和危险因素中的重要性并且分析了 CLABSI在ICU人群中五年的发生率,致病病原体和危险因素。研究方法:对2016年1月至2020年12月期间在山东大学齐鲁医院ICU治疗的患者进行回顾性研究。纳入标准为患者年龄≥18岁,具有一根以上CVC,收集其外周血和中心静脉导管尖端的培养结果。排除在院外放置CVC的患者,以及无外周血或中心静脉导管尖端培养结果的患者,或主要终点数据缺失的患者。收集序贯器官衰竭评估(SOFA)评分、急性生理和慢性健康评估Ⅱ(APACHEII)评分、Charlson共病指数(CCI)评分、CVC置入时间和拔除时间等数据,使用Logistic回归等方法以分析CLABSI的病原学结果。结果:我们共收集了 1920例CVC,其中507例符合纳入标准。本研究中患者的平均年龄为60.31±16.64岁,其中355名(70%)男性。CVC置入部位中,颈内静脉CVC为101根,锁骨下静脉CVC为113根,股静脉部位CVC为293根。CVC放置的原因包括输注液体和血液制品201(39.6%)根、连续肾脏替代治疗(CRRT)216(42.6%)根、血流动力学监测53(10.5%)根、体外膜氧合治疗(ECM0)26(5.1%)根、肠外营养1(0.2%)、双分子血浆吸附系统(DPMAS)1(0.2%)根和血浆置换8(1.6%)根。在507根CVC中,发生CLABSI有52根,判定定植有70根。CLABSI病例在感染发生前CVC放置的平均持续时间为1.60±5.72天,定植CVC平均持续时间为1.88±6.04天。52例CLABSI由52种微生物引起。革兰阴性杆菌分别为多重耐多药肺炎克雷伯菌8(1.6%),鲍曼不动杆菌8(1.6%),耐碳青霉烯类耐药肠杆菌科2(0.4%),洋葱伯克霍尔德菌1(0.2%)。在革兰阳性菌中,分别为耐甲氧西林金黄色葡萄球菌11(2.2%),甲氧西林敏感金黄色葡萄球菌1(0.2%),条纹棒状杆菌1(0.2%),粪肠球菌4(0.8%)。在真菌中,仅发现白色念珠菌16(3.2%)。455份(89.7%)样本中未发现微生物生长。通过进行多因素Logistic回归分析,我们发现年龄(P值=0.004)、Charlson合并症指数(P值<0.001)和CVC放置持续时间(P值=0.001)与CLABSI风险升高有关。结论:我们的研究揭示了 5年期间ICU患者CLABSI的发生率平均为2.2‰,危险因素是高龄、基础病和留置时间大于8天,主要致病微生物主要为G-和白色念珠菌。

关键词：重症监护中心静脉导管血流感染流行病学危险因素病原体

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Visual grading criteria for Japanese larch ( Larix kaempferi ) structural timber from Spain

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Journal of Forestry Research 2020年第6期31卷 2605-2614页

作者： Mari-Jose Barriola José-Ramón Aira edgar Lafuente Tknika LHri Aplikatutako Ikerketa eta Berrikuntzako EAEko zentroaZamalbide Auzoa z/g20100 ErrenteriaGipuzkoaSpain Escuela de Ingeniería de la Industria Forestal Agronómica y de la BioenergíaUniversidad de ValladolidUVa-Campus Duques de Sorias/n42005 SoriaSpain Cesefor Centro de Servicios y Promoción Forestal y de su Industria de Castilla y LeónCalle C42005 SoriaSpain

Larch wood is structurally classifi ed in many countries as one of conifers with the highest load-bearing capacity(strength class of C30).The Spanish visual classifi cation regulation only assigns a strength class to 4 pine woods:Laricio pine(Pinus nigra Arn.var.Salzmannii),Silvestre pine(Pinus sylvestris L.),Radiata pine(Pinus radiata D.Don),and Pinaster pine(Pinus pinaster Ait.).This work adds to the number of structurally characterised species by creating a visual classifi cation table for Japanese larch wood(Larix kaempferi(Lamb.)Carr.)which diff erentiates between 2 visual classes,MEG-1 and MEG-2.Characteristic strength values were calculated for each class(fk,MEG-1=31.80 MPa,f k,MEG-2=24.55 MPa),mean module of elasticity(E 0,mean,MEG-1=13,082 MPA,E 0,mean,MEG-2=12,320 MPA)and density(ρk,MEG-1=456.6 kg m−3,ρk,MEG-2=469.1 kg m−3),before fi nally assigning a strength class of C30 to visual class MEG-1,and a strength class of C24 to visual class MEG-2.

关键词： Japanese larch wood Visual grading Strength class Mechanical properties Density

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High resolution, binder-free investigation of the intrinsic activity of immobilized NiFe LDH nanoparticles on etched carbon nanoelectrodes

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Nano Research 2018年第11期11卷 6034-6044页

作者： Patrick Wilde Stefan Barwe Corina Andronescu Wolfgang Schuhmann edgar Ventosa Analytical Chemistry - Center for Electroche.mical Sciences (CES) Ruhr-Universitat Bochum Universitasstr. 150 D-44780 Bochum Germany IMDEA Energy Avda. Ramo de la Sagra 3 28935 Motoles Spain

The determination of the intrinsic properties of nanomaterials is essential for their optimization as electrocatalysts, however it poses great challenges from the standpoint of analytical tools and methods. Herein, we report a novel methodology that allows for a binder-free investigation of electrocatalyst nanoparticles. The potential-assisted immobilization of a non-noble metal catalyst, i.e., nickel-iron layered double hydroxide (NiFe LDH) nanoparticles, was employed to directly attach small nanoparticle ensembles from a suspension to the surface of etched carbon nanoelectrodes. The dimensions of this type of electrodes allowed for the immobilization of the catalyst material below the picogram scale and resulted in a high resolution towards the faradaic current response. In addition the effect of the electrochemical aging on the intrinsic activity of the catalyst was investigated in alkaline media by means of continuous cyclic voltammetry. A change in the material properties could be observed, which was accompanied by a substantial decrease in its intrinsic activity.

关键词： oxygen evolution reaction nickel-iron layered double hydroxide (NiFe LDH) immobilization nanoelectrocatalysis nanoelectrodes nanoimpacts

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Diffusion tensor imaging-derived measures of fractional anisotropy across the pyramidal tract are influenced by the cerebral hemisphere but not by gender in young healthy volunteers： a split-plot factorial analysis of variance

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Chinese Medical Journal 2012年第12期125卷 2180-2187页

作者： Ernesto Roldan-Valadez edgar Rios-Piedra Rafael Favila Sarael Alcauter Camilo Rios Magnetic Resonance Unit Medica Sur Clinical FoundationMexico CityMexico Tecnologico de Monterrey Health Sciences DivisionMexico City CampusMexico GE Healthcare Mexico CityMexico Imagenes Cerebrales Instituto Nacional de Psiquiatria Ramon dela Fuente Ciudad de MexicoMexico Department of Neurochemistry National Institute of Neurologyand NeurosurgeryMexico CityMexico

Background Diffusion tensor imaging （DTI） permits quantitative examination within the pyramidal tract （PT） by measuring fractional anisotropy （FA）. To the best of our knowledge, the inter-variability measures of FA along the PT remain unexplained. A clear understanding of these reference values would help radiologists and neuroscientists to understand normality as well as to detect early pathophysiologic changes of brain diseases. The aim of our study was to calculate the variability of the FA at eleven anatomical landmarks along the PT and the influences of gender and cerebral hemisphere in these measurements in a sample of young, healthy volunteers. Methods A retrospective, cross-sectional study was performed in twenty-three right-handed healthy volunteers who underwent magnetic resonance evaluation of the brain. Mean FA values from eleven anatomical landmarks across the PT （at centrum semiovale, corona radiata, posterior limb of internal capsule （PLIC）, mesencephalon, pons, and medulla oblongata） were evaluated using split-plot factorial analysis of variance （ANOVA）. Results We found a significant interaction effect between anatomical landmark and cerebral hemisphere （F （10, 32）=4.516, P=0.001; Wilks＇ Lambda 0.415, with a large effect size （partial η2=0.585））. The influence of gender and age was non-significant. On average, the midbrain and PLIC FA values were higher than pons and medulla oblongata values; centrum semiovale measurements were higher than those of the corona radiata but lower than PLIC. Conclusions There is a normal variability of FA measurements along PT in healthy individuals, which is influenced by regions of interest location （anatomical landmarks） and cerebral hemisphere. FA measurements should be reported for comparing same-side and same-landmark PT to help avoid comparisons with the contralateral PT; ideally, normative values should exist for a clinically significant age group. A standardized package of selected DTI processing tools would allow DTI processing to be routinely performed in

关键词： anisotropy diffusion tensor imaging magnetic resonance imaging multivariate analysis analysis of variance

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Growth and form of Quercus robur and Fraxinus excelsior respond distinctly different to initial growing space: results from 24-year-old Nelder experiments

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Journal of Forestry Research 2013年第1期24卷 1-14页

作者： Christian Kuehne Patrick Pyttel edgar Kublin Jürgen Bauhus Institute of Silviculture University of FreiburgD-79085 Freiburg i.Br.Germany. Faculty of Forests and Forestry University of Applied Sciences Wei- henstephan-TriesdorfHans-Carl-von-Carlowitz-Platz 3D-85354 FreisingGermany Department of Biometry and Informatics Forest Research Station Baden-WürttembergPostfach 708D-79007 FreiburgGermany

Initial growing space is of critical importance to growth and quality development of individual trees. We investigated how mortality, growth （diameter at breast height, total height）, natural pruning （height to first dead and first live branch and branchiness） and stem and crown form of 24-year-old pedunculate oak （Quercus robur [L.]） and European ash （Fraxinus excelsior [L.]） were affected by initial spacing. Data were recorded from two replicate single-species Nelder wheels located in southern Germany with eight initial stocking regimes varying from 1,020 to 30,780 seedlings·ha？1. Mortality substantially decreased with increasing initial growing space but significantly differed among the two species, averaging 59% and 15% for oak and ash plots, respectively. In contrast to oak, the low self-thinning rate found in the ash plots over the investigated study period resulted in a high number of smaller intermediate or suppressed trees, eventually retarding individual tree as well as overall stand development. As a result, oak gained greater stem dimensions throughout all initial spacing regimes and the average height of ash significantly increased with initial growing space. The survival of lower crown class ashes also appeared to accelerate self-pruning dynamics. In comparison to oak, we observed less dead and live primary branches as well as a smaller number of epicormic shoots along the first 6 m of the lower stem of dominant and co-dominant ashes in all spacing regimes. Whereas stem form of both species was hardly affected by initial growing space, the percentage of brushy crowns significantly increased with initial spacing in oak and ash. Our findings suggest that initial stockings of ca. 12,000 seedlings per hectare in oak and 2,500 seedlings per hectare in ash will guarantee a sufficient number of at least 300 potential crop trees per hectare in pure oak and ash plantations at the end of the self-thinning phase, respectively. If the problem of epicormic shoots and inadequate self-pruning can be controlled wit

关键词： spacing trial stocking self-thinning intraspecific competition qualification spatially explicit modelling generalized additive model

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Multi-Channel Monolithic Integrated Optic Fiber Bragg Grating Sensor Interrogator

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Photonic Sensors 2011年第3期1卷 281-288页

作者： edgar A. MENDOZA Yan ESTERKIN Cornelia KEMPEN Zongjian SUN Redondo Optics Inc. 811 North Catalina Avenue Suite 1100 Redondo Beach CA 90277 USA

纤维布拉格栅栏(FBG ) 是为紧张，颤动，声学，加速，压力，温度，潮湿，和腐蚀的测量的一种成熟察觉到技术。它获得了快速的接受在民用，太空，化学、石油化学，药，航空和汽车的工业。FBG 的最突出的优点是：小尺寸和轻重量，单个纤... 详细信息

纤维布拉格栅栏(FBG ) 是为紧张，颤动，声学，加速，压力，温度，潮湿，和腐蚀的测量的一种成熟察觉到技术。它获得了快速的接受在民用，太空，化学、石油化学，药，航空和汽车的工业。FBG 的最突出的优点是：小尺寸和轻重量，单个纤维上的 FBG 变换器的分布式的数组，和到收音机频率干扰的免疫。然而， FBG 技术的主要劣势是常规最先进的 FBG 讯问系统典型地笨重、重、昂贵典型地从与信号电子学综合的眼、光的部件上进一台仪器的现成的纤维被装配的凳子顶仪器安慰。基于对一个紧缩的 FBG 讯问系统的工业需要，这份报纸向缩小的纤维布拉格的发展描述最近的进步栅栏传感器讯问者(FBG 收发器) 系统基于多信道的整体的综合眼的传感器微芯片技术。综合眼的微芯片技术启用所有功能的整体的集成，被动、活跃常规凳子顶 FBG 传感器讯问者系统，在使小型化的、低力量操作包装了， 2 厘米慨瑬湩吗？

关键词：光学传感器设计结构自动化技术传感器

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B cell development is critically dependent on NFATc1 activity

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Cellular & Molecular Immunology 2019年第5期16卷 508-520页

作者： Sabrina Giampaolo Gabriela Wojcik Stefan Klein-Hessling edgar Serfling Amiya K.Patra Department of Molecular Pathology Institute of PathologyUniversity of WürzburgJosef Schneider-Str.297080 WürzburgGermany Institute of Translational and Stratified Medicine Faculty of Medicine and DentistryUniversity of PlymouthPlymouth PL68BUUK Comprehensive Cancer Center Mainfranken University of WürzburgJosef Schneider-Str.697080 WürzburgGermany

B cell development in bone marrow is a precisely regulated complex process.Through successive stages of differentiation,which are regulated by a multitude of signaling pathways and an array of lineage-specific transcription factors,the common lymphoid progenitors ultimately give rise to mature B cells.Similar to early thymocyte development in the thymus,early B cell development in bone marrow is critically dependent on IL-7 signaling.During this IL-7-dependent stage of differentiation,several transcription factors,such as E2A,EBF1,and Pax5,among others,play indispensable roles in B lineage specification and maintenance.Although recent studies have implicated several other transcription factors in B cell development,the role of NFATc1 in early B cell developmental stages is not known.Here,using multiple gene-manipulated mouse models and applying various experimental methods,we show that NFATc1 activity is vital for early B cell differentiation.Lack of NFATc1 activity in pro-B cells suppresses EBF1 expression,impairs immunoglobulin gene rearrangement,and thereby preBCR formation,resulting in defective B cell development.Overall,deficiency in NFATc1 activity arrested the pro-B cell transition to the pre-B cell stage,leading to severe B cell lymphopenia.Our findings suggest that,along with other transcription factors,NFATc1 is a critical component of the signaling mechanism that facilitates early B cell differentiation.

关键词： Differentiation EBF1 NFATc1 Pro-B Pre-B

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