Preterm infants are at increased risk for invasive neonatal bacterial infections.
, a ubiquitous skin commensal, is a major cause of late-onset neonatal sepsis, particularly in high-resource ...settings. The vulnerability of preterm infants to serious bacterial infections is commonly attributed to their distinct and developing immune system. While developmentally immature immune defences play a large role in facilitating bacterial invasion, this fails to explain why only a subset of infants develop infections with low-virulence organisms when exposed to similar risk factors in the neonatal ICU. Experimental research has explored potential virulence mechanisms contributing to the pathogenic shift of commensal
strains. Furthermore, comparative genomics studies have yielded insights into the emergence and spread of nosocomial
strains, and their genetic and functional characteristics implicated in invasive disease in neonates. These studies have highlighted the multifactorial nature of
traits relating to pathogenicity and commensalism. In this review, we discuss the known host and pathogen drivers of
virulence in neonatal sepsis and provide future perspectives to close the gap in our understanding of
as a cause of neonatal morbidity and mortality.
•Multi scale topography measurements are performed on as-built SLM surfaces.•Different building inclinations are observed.•Different surface generation phenomena are emphasized at different ...scales.•Some parameters are found to be good indicators of typical signatures of AM surfaces.•Correlations between the building inclination and the topography skewness or Rsm are found.
Topographies are one of the challenges for the development of the metal additive manufacturing promising technique. The article investigates multi scale topographies (from form to roughness) of as built surfaces generated by selective laser melting (SLM). Different building inclinations of samples were observed both for upskin and downskin surfaces with a wide range of measuring techniques. The two main aims are: (i) to make a critical review of measuring techniques at different scales, (ii) to enlighten the different surface generation phenomena (and the corresponding scale) occurring during additive manufacturing. The effect of heat treatment on each scale of the topography is also discussed. It is found that the focus variation technique is well suited for AM surfaces. Concerning the observation of the inclined surfaces, some parameters are emphasized as good indicators of typical signatures of AM surfaces: isotropy for the weld track component, the skewness and Rsm for the staircase effect, fractal dimension for the presence of partly melted particles. The different parameters studied helps to model and understand the different surface generation phenomena aforementioned.
Summary
Background
Whether diffusion‐weighted imaging (DWI)‐MRI is of value in detecting and assessing inflammation of ileal Crohn's disease (CD) remains poorly investigated.
Aim
To compare DWI‐MR ...enterography (MRE) with conventional MRE in estimating inflammation in small bowel CD, to determine an apparent diffusion coefficient (ADC) threshold to differentiate active from non‐active lesions and to assess inter‐observer agreement.
Methods
Thirty‐one CD patients from the Clermont‐Ferrand IBD unit with ileal involvement were consecutively and prospectively included between April and June 2011. All patients underwent DWI‐MRI to detect the digestive segment with the most severe lesions, which was then used to calculate the ADC. Qualitative and quantitative results were compared with conventional MRE including MaRIA (Magnetic Resonance Index of Activity) score calculation and independent activity predictors (wall thickening, oedema, ulcers). Each examination was interpreted independently by two radiologists blinded for clinical assessment.
Results
Seventeen patients (54.8%) had active CD as defined by the MaRIA score ≥7. DWI hyperintensity was highly correlated with disease activity evaluated using conventional MRE (P = 0.001). Qualitative analysis of DW sequences determined sensitivity, specificity, positive predictive value and negative predictive value as 100%, 92.9%, 94.4% and 100% respectively. Quantitative analysis using a cut‐off of 1.6 × 10−3 mm²/s for ADC yielded sensitivity and specificity values of, respectively, 82.4% and 100%. Inter‐observer agreement was high with regard to DWI hyperintensity (κ = 0.69, accuracy rate = 85.7%) and ADC (correlation = 0.74, P < 0.001, and concordance = 0.71, P < 0.001).
Conclusion
DWI‐MR enterography is a well‐tolerated, non‐time‐consuming and accurate tool for detecting and assessing inflammation in small bowel Crohn's disease.
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•Damping optimization of viscoelastic structures under free vibration.•Coupled shape and sizing optimization of polymer plates.•Impact of the material properties on the optimal ...design.
The goal of this work is to significantly enhance the damping of linear viscoelastic structures under free vibration by relying on optimal design. Homogeneous cantilever slender beams and plates satisfying, respectively, the Euler-Bernoulli and Kirchhoff-Love assumptions are considered. A sizing optimization of the beam or plate thickness is proposed, as well as a coupled optimization of the thickness and geometry of the plate applying Hadamard’s boundary variation method. The isotropic linear viscoelastic material is modeled by a classical generalized Maxwell model, well suited for polymers. Gradients of the objective functions are computed by an adjoint approach. Optimization is performed by a projected gradient algorithm and the mechanical models are evaluated by the finite element method. Numerical tests indicate that the optimal designs, as well as their damping properties, strongly depend on the material parameters.
Most of South Africa's energy is derived from the combustion of coal in pulverized coal-fired power plants (CFPP). However, when compared with the rest of the world, limited information regarding the ...main radioactive elements (U and Th) and specific radionuclides of interest (K40, Ra226 and Th232) from South African CFPP is available in the public domain. This paper aims to quantify the U, Th and specific radionuclides found in the coal used in selected South African CFPP in comparison to world averages found in literature. The U and Th concentrations were obtained by ICP-MS. The main radionuclides, K40, Ra226 and Th238, were quantified using gamma spectrometry. The U concentration and Th concentrations for the coal used in all the power plants was above the world average of 1.9 mg/kg and 3.2 mg/kg respectively. The coals with the highest Th content originated from the Mpumalanga power plant, while the U content in the Freestate power plant samples was the highest of the three. The concentrations of the K40 were between 88.43±10.75-110.76±8.92 Bq/kg, which are in-line with world averages of 4-785 Bq/kg. Similarly, the Ra226 and Th232 values were between 21.69±2.83-52.63±4.04 Bq/kg and 19.91±1.24-22.97±1.75 Bq/kg respectively, which are also in line with the world averages of 1-206 Bq/kg and 1-170 Bq/kg respectively. Radiological hazard indices such as radium equivalent (Raeq); external hazard index (Hex) and internal hazard index (Hin), that were estimated from these average radionuclide concentrations were less than the prescribed values found in literature. This indicated that no significant health risk was posed by the coal being used from these coal fields.
The role of fluids in trauma resuscitation is controversial. We compared resuscitation with 0.9% saline vs hydroxyethyl starch, HES 130/0.4, in severe trauma with respect to resuscitation, fluid ...volume, gastrointestinal recovery, renal function, and blood product requirements.
Randomized, controlled, double-blind study of severely injured patients requiring>3 litres of fluid resuscitation. Blunt and penetrating trauma were randomized separately. Patients were followed up for 30 days.
A total of 115 patients were randomized; of which, 109 were studied. For patients with penetrating trauma (n=67), the mean (sd) fluid requirements were 5.1 (2.7) litres in the HES group and 7.4 (4.3) litres in the saline group (P<0.001). In blunt trauma (n=42), there was no difference in study fluid requirements, but the HES group required significantly more blood products packed red blood cell volumes 2943 (1628) vs 1473 (1071) ml, P=0.005 and was more severely injured than the saline group (median injury severity score 29.5 vs 18; P=0.01). Haemodynamic data were similar, but, in the penetrating group, plasma lactate concentrations were lower over the first 4 h (P=0.029) and on day 1 with HES than with saline 2.1 (1.4) vs 3.2 (2.2) mmol litre−1; P=0.017. There was no difference between any groups in time to recovery of bowel function or mortality. In penetrating trauma, renal injury occurred more frequently in the saline group than the HES group (16% vs 0%; P=0.018). In penetrating trauma, maximum sequential organ function scores were lower with HES than with saline (median 2.4 vs 4.5, P=0.012). No differences were seen in safety measures in the blunt trauma patients.
In penetrating trauma, HES provided significantly better lactate clearance and less renal injury than saline. No firm conclusions could be drawn for blunt trauma.
Study registration: ISRCTN 42061860.
Purpose
To evaluate internet‐delivered cognitive behavioural therapy (iCBT) on clinical depression and/or anxiety, distress, fear of cancer recurrence, and quality of life in cancer survivors.
...Methods
Random assignation of 114 participants to iCBT or treatment‐as‐usual (TAU). The clinician‐supervised iCBT program (iCanADAPT Early) consisted of eight lessons over 16 weeks. Self‐report questionnaires occurred at baseline, midpoint, and posttreatment for both groups with 3‐month follow‐up for iCBT participants. A mixed modelling approach to compare groups occurred.
Results
iCBT was superior to TAU on all outcome measures at posttreatment. Compared with TAU, the iCBT group showed a significant decrease over time in anxiety and depression symptoms (primary outcome, Hospital Anxiety and Depression Scale, Hedges g = 1.51). Additionally the iCBT group had significantly lower general distress (Kessler‐10, g = 1.56), fear of cancer recurrence (Fear of Cancer Recurrence Inventory, g = 0.39), and significantly higher quality of life (Functional Assessment of Cancer Therapy—General, g = 0.74) at posttreatment compared with the TAU group. High adherence and satisfaction were found for iCBT with low clinician time.
Conclusion
Clinician‐supervised iCBT has significant benefits for cancer survivors with clinical depression and anxiety disorders.
Freshwater recreational angling is growing in popularity internationally. Due to the potential negative environmental impacts, various regulatory systems exist. In South Africa, freshwater ...recreational angling is regulated through a complex legal framework, consisting of national and provincial legislation dating back to the 1960s. The legislation also relates to historical and current provincial boundaries, adding to the regulatory complexity. Due to this complexity, the question arises whether freshwater recreational bank anglers in South Africa are aware of the regulatory requirements applicable to them. Low levels of awareness could lead to non-compliance, which would suggest an ineffective regulatory system. The aim of this research was thus to determine the environmental regulatory awareness of freshwater recreational bank anglers in South Africa. This was achieved through a literature review of national and provincial legislation, as well as the rules applicable to organised freshwater recreational bank angling. An online survey was completed by 100 members of the South African Freshwater Bank Angling Federation (SAFBAF). The results of the survey indicate that the regulatory awareness of the sample of SAFBAF freshwater recreational anglers is low in certain key areas, such as bag and size limits for specific fish species, catch and release requirements, as well as legal definitions for alien and invasive and TOPS species listings. However, the low level of awareness can be ascribed to the complex regulatory system and not unwillingness of anglers to comply per se. It is recommended that (i) a single consolidated and simplified regulatory system for freshwater recreational bank angling be developed, and (ii) that angling organisational and competition rules be aligned with relevant regulatory requirements, to improve overall awareness and promote higher levels of regulatory compliance.
Orientation Stress in the workplace is a common phenomenon that is classified in different ways and which also impacts academics. Previous research highlighted that job stressors in the workplace ...have been considered an important contributor towards low levels of job satisfaction (JS) for academics. This perspective aids the study of the influence of job stress on JS.Research purpose The aim of this research was to establish the influence of role conflict (RC), role ambiguity (RA), role overload (RO) and time pressure (TP) on work tension (WT) and the influence of WT on JS among academics at a university of technology.Motivation for the study The impact of the coronavirus disease 2019 (COVID-19) pandemic and the reduction of government and associated agency funding changed the scenario of academic life from being considered idyllic, autonomous and well protected. Congruent to these constraints, changes in the diversity of students and advances in technology, blended learning and the introduction of learning platforms created further challenges in the way students learn and how modules were offered.Research approach/design and method The researchers used a postpositivist quantitative paradigm with a convenience sample (n = 250) of academics in a university of technology in Gauteng. A structured questionnaire encompassing the study constructs was used.Main findings Results showed positive associations between RC, RA, RO and TP on WT. Further, WT and JS showed negative yet significant predictive relationships with JS.Practical/managerial implication It is pivotal for universities to understand the effects of job stressors on job satisfaction to improve the working conditions for academics.Contribution/value-add This research provides findings to the present body of knowledge among academics on the influence of job stressors on WT and WT on JS at HEIs. Research on job stress and JS has been of interest in many HEIs. The research makes a valuable contribution to the university management, especially the human resource division, on the effect of levels of job stressors (RC, RA, RO and TP) on WT among academics.
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