Staphylococcus capitis
is an opportunistic pathogen often implicated in bloodstream infections in the neonatal intensive care unit (NICU). This is assisted by its ability to form biofilms on ...indwelling central venous catheters (CVC), which are highly resistant to antibiotics and the immune system. We sought to understand the fundamentals of biofilm formation by
S. capitis
in the NICU, using seventeen clinical isolates including the endemic NRCS-A clone and assessing nine commercial and two modified polystyrene surfaces.
S. capitis
clinical isolates from the NICU initiated biofilm formation only in response to hyperosmotic conditions, followed by a developmental progression driven by
icaADBC
expression to establish mature biofilms, with polysaccharide being their major extracellular polymer substance (EPS) matrix component. Physicochemical features of the biomaterial surface, and in particular the level of the element oxygen present on the surface, significantly influenced biofilm development of
S. capitis
. A lack of highly oxidized carbon species on the surface prevented the immobilization of
S. capitis
EPS and the formation of mature biofilms. This information provides guidance in regard to the preparation of hyperosmolar total parenteral nutrition and the engineering of CVC surfaces that can minimize the risk of catheter-related bloodstream infections caused by
S. capitis
in the NICU.
Supported NiCu bimetallic catalysts have been produced in-situ on commercial Al2O3 by using layered double hydroxides as precursors. The resulting catalysts show a uniform Ni and Cu distribution, ...thus providing good activity and selectivity in the reforming reaction of n-heptane. The catalytic performance has been found to depend on the Cu/Ni ratio, revealing the synergic catalysis between homogeneously dispersed Ni and Cu sites. The good catalysis of NiCu bimetallic catalysts makes it possible to partly or even completely replace Pt with NiCu bimetallic catalysts.
NiCu bimetallic catalyst with uniform NiCu dispersion has been demonstrated to provide higher activity than Pt catalyst while with similar selectivity in the reforming reaction of n-heptane. The synergies between homogeneously dispersed Ni and Cu sites account for the enhancement of activity and selectivity.
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An electrochemical sensor for paracetamol is executed by using conductive MOF (NiCu-CAT), which is synthesized by 2, 3, 6, 7, 10, 11-hexahydroxytriphenylene (HHTP) ligand. The utility of this 2D ...NiCu-CAT is measured by the detection of paracetamol, p-stacking within the MOF layers is essential to achieve high electrical conductivity, redox activity, and catalytic activity. In particular, NiCu-CAT demonstrated detection Limit of determination near 5μM for paracetamol through a wide concentration range (5-190 μM). The NiCu-CAT/GCE exhibits excellent reproducibility, stability, and interference for paracetamol.
There is evidence that music therapy combined with physical contact to parents stabilizes the vital signs of hospitalized preterm infants. Yet, there is no evidence for the difference between simple ...contact by touching the infant in the incubator or cod, or close physical contact during music therapy sessions (MT). Behavioral effects of the various forms of attention toward the infant during therapy need to be elucidated. Our study aimed to quantify the effects of hand touch contact (HTC) and close physical contact (CPC) during live performed MT in preterm infants regardless of gestational age on behavioral state (assessed via COMFORTneo scale) and vital signs. A maximum of ten live music therapy sessions were delivered three to four times a week until hospital discharge to 50 stable infants. Pre-, during- and post-therapy heart rates, respiratory rates, oxygen saturations and COMFORTneo scores were recorded for each session. A total of 486 sessions was performed with 243 sessions using HTC and CPC each. The mean gestational age was 33 + 3 weeks, with 27 (54%) infants being male. We observed lower COMFORTneo scores, heart and respiratory rates and higher oxygen saturation during and after live performed music therapy independent of the kind of physical contact than before therapy. While pre-therapy values were better in the CPC group for all four variables, a higher mean response on COMFORTneo scale and vital signs was observed for HTC (COMFORTneo score -5.5, heart rate -12.4 beats per min., respiratory rate -8.9 breaths per min, oxygen saturation + 1.5%) compared to CPC (COMFORTneo score -4.6, heart rate -9.6 beats per min., respiratory rate -7.0 breaths per min, oxygen saturation + 1.1%). Nonetheless, post-therapy values were better for all four measures in the CPC group. Regression modeling with correction for individual responses within each patient also yielded attenuated effects of MT in the CPC group compared to HTC, likely caused by the improved pre-therapy values. Live performed music therapy benefits preterm infants' vital signs and behavioral state. During CPC with a parent, the absolute therapeutic effect is attenuated but resulting post-therapy values are nonetheless better for both the COMFORTneo scale and vital signs.
The implementation of a Hazard Analysis and Critical Control Point (HACCP) system in infant milk preparation can prevent and reduce the risk of bacterial contamination in infant feedings. Therefore, ...it is very important to determine the sensitive raw materials (SRM) in a milk room of a neonatal intensive care unit (NICU) to prevent contamination that can affect the safety of milk feeding. This study was conducted to identify the SRM at the milk preparation room of a NICU in the Canselor Tuanku Muhriz Hospital, Cheras, Kuala Lumpur, Malaysia. SRM were identified via HACCP system decision tree by the Malaysian Standard (MS1480:2007).. The results showed that donor expressed breast milk (DEBM), expressed breast milk at home (EBMH), freshly expressed breast milk (FEBM) and powdered infant formula (PIF) were identified as SRM. Expressed breast milk (DEBM, EBMH, FEBM) were known as non-sterile milk which were able to transmit pathogenic microorganisms such as Klebsiella pneumoniae and Pseudomonas aeruginosa derived from the mother or donor. PIF is also not sterile that are associated with Cronobacter sakazakii and Salmonella infections causing serious illnesses among premature and infants. Ready to feed milk (RTF) is classified as non-sensitive material as it is sterile, free from bacterial contamination and safe for high-risk infant’s feeding compare to PIF. Preventive measures were applied to control the significant hazards in all identified SRM to ensure the final product (milk) is safe for consumption.
This work demonstrates the use of a NiCu electrocatalyst prepared by hydrothermal method with different Ni/Cu mass ratios (70:30, 50:50 and 30:70) supported on carbon nanotubes (CNTs), which was ...studied with regards to its electrochemical behavior in the ammonia oxidation reaction and direct ammonia microfluidic fuel cell (DAMFC) performance. XRD and SEM‐EDX showed the formation of NiCu alloy while TEM showed the particles size to be 15–20 nm. Cyclic voltammetry and chronoamperometry showed that NiCu had higher catalytic activity than pure Ni and pure Cu, and that the active species was a NiCu oxyhydroxide. In DAMFC tests, 50 wt % Ni50Cu50/CNTs was found to be the most suitable one since it showed a 43 % higher peak power density and 65 % higher maximum current density than Ni electrode. The improved performance was attributed to the NiCu oxyhydroxides formation, which improved the anodic catalytic activity by increasing amounts of active sites and the combined electronic effect of the Ni‐Cu bimetallic catalysts.
The full picture: NiCu nanoparticles supported on carbon nanotubes were found to have high catalytic activity for the ammonia oxidation reaction. This material was used as the anode electrocatalyst in a direct ammonia–air microfluidic fuel cell, which showed good performance for power generation.
Implicit bias permeates beliefs and actions both personally and professionally and results in negative health outcomes for people of color-even in the neonatal intensive care unit (NICU). NICU ...clinicians may naïvely and incorrectly assume that NICU families receive unbiased care. Existing evidence establishing associations between sex, race, and neonatal outcomes may perpetuate the tendency to deny racial bias in NICU practice.
Using the socioecological model as a framework, this article outlines evidence for racial health disparities in the NICU on multiple levels-societal, community, institutional, interpersonal, and individual. Using current evidence and recommendations from the National Association of Neonatal Nurses Position Statement on "Racial Bias in the NICU," appropriate interventions and equitable responses of the NICU clinician are explored.
Based on current evidence, clinicians should reject the notion that the social construct of race is the root cause for certain neonatal morbidities. Instead, clinicians should focus on the confluence of medical and social factors contributing to each individual infant's progress. This critical distinction is not only important for clinicians employing life-saving interventions, but also for those who provide routine care, developmental care, and family education-as these biases can and do shape clinical interactions.
Healthcare practitioners have an ethical and moral responsibility to maintain up-to-date knowledge of new evidence that impacts our clinical practice. The evidence demonstrates the importance of recognizing the enduring role of racism in the health and well-being of people of color and the need to adjust care accordingly.
The simultaneous production of H2 and carbon nanomaterials (CNMs) over NiCu/SBA15 catalysts with different Ni–Cu contents (10, 20, 30, 40 and 50 wt%) was investigated using the pyrolysis-catalysis ...process of paraffin wax. The fresh and spent catalysts were characterized by various techniques including H2-TPR, XRD, TEM, Raman spectroscopy and BET surface area. TEM observations showed that broad particle size distributions were formed in fresh 40NiCu/SBA15 and 50NiCu/SBA15 catalysts, while catalysts with smaller Ni–Cu contents displayed better metals dispersion. We found that the catalyst activity is related to the type of carbon nanomaterials, catalyst particle size, and catalyst loading with Ni–Cu. Also, the largest yield of H2 and CNMs was achieved using the 30NiCu/SBA15 catalyst. NiCu/SBA15 catalysts with Ni-Cu contents of 30–50 wt% exhibited good catalytic stability and similar activity in terms of H2 yield, especially at reaction time above 225 min. Small diameters carbon nanofibers (CNFs) were produced over the 10NiCu/SBA15 catalyst, while a mixture of CNFs and carbon nano-onions (CNOs) was produced using catalysts with Ni-Cu loadings of 20–50 wt%. The generation of octopus-like CNFs over large catalyst particles was associated with the observed catalytic stability of H2 production. Raman spectroscopy and XRD analyses demonstrated the formation of the best quality CNMs using the 20NiCu/SBA15 catalyst.
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•The activity of xNiCu/SBA15 was studied to produce H2 and CNMs from a wax source.•Ni–Cu content affects the particle size distribution and reducibility of catalysts.•The highest yield of H2 and CNMs was achieved using the 30NiCu/SBA15 catalyst.•The best quality of CNMs have been produced over the 20NiCu/SBA15 catalyst.•Catalyst activity and stability were linked to Ni–Cu contents and the type of CNMs.
This paper reviews recent advances in non-invasive blood pressure monitoring and highlights the added value of a novel algorithm-based blood pressure sensor which uses machine-learning techniques to ...extract blood pressure values from the shape of the pulse waveform. We report results from preliminary studies on a range of patient populations and discuss the accuracy and limitations of this capacitive-based technology and its potential application in hospitals and communities.
Healthcare-associated infections in neonatal and paediatric populations are associated with poorer outcomes and healthcare costs, and surveillance is a necessary component of prevention programmes.
...To evaluate burden of illness, aetiology, and time-trends for central and peripheral line-associated bloodstream infection (CLABSI and PLABSI) in Australian neonatal and paediatric intensive care units (ICUs) between July 1st, 2008 and December 31st, 2016.
Using National Healthcare Safety Network methods, surveillance in neonatal and paediatric units was performed by hospitals participating in the Victorian Healthcare Associated Infection Surveillance System. Mixed effects Poisson regression was used to model infections over time.
Overall, 82 paediatric CLABSI events were reported during 37,125 CVC-days (2.21 per 1000 CVC-days), 203 neonatal CLABSI events were reported during 92,169 CVC-days (2.20 per 1000 CVC-days), and 95 neonatal PLABSI events were reported during 142,240 peripheral line-days (0.67 per 1000 peripheral line-days). Over time, a significant decrease in quarterly risk for neonatal CLABSI events was observed (risk ratio (RR): 0.98; 95% confidence interval: 0.97–0.99; P = 0.023) and this reduction was significant for the 751–1000 g birth weight cohort (RR: 0.97; P = 0.015). Most frequently, coagulase-negative Staphylococcus spp. (24.2%) and Staphylococcus aureus (16.1%) were responsible for CLABSI events. A significant reduction in Gram-negative neonatal infections was observed (annual RR: 0.85; P < 0.001).
CLABSI rates in neonatal and paediatric ICUs in our region are low, and neonatal infections have significantly diminished over time. Evaluation of infection prevention programmes is required to determine whether specific strategies can be implemented to further reduce infection risk.
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