19684 research outputs found
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Baseline predictors of antibiotics de-escalation from empirical therapies in an intensive care unit:a five-year retrospective study
No full textBackground: The alarming rate of bacterial resistance has urged for vigorous antibiotic de-escalation cultures worldwide. However, the art of de-escalation remains challenging as most clinicians have the fear or stigma that antibiotic de-escalation is strongly associated with higher mortality. This study aimed to determine the factors strongly correlated with higher mortality rates after antibiotic de-escalation and possibly serve as a benchmark study for developing a validated antibiotic de-escalation tool in the near future. Method: This retrospective study was conducted on patients hospitalized in a medical intensive care unit of a referral tertiary care center and subjected to antibiotics de-escalation over five years. Independent factors associated with mortality post antibiotics de-escalation were assessed. Various data were collected, including patient demographics, admission and discharge dates, a primary source of infection and free of infection status, choices of antibiotic used and de-escalation history, vital signs, data on X-ray changes, relevant laboratory investigations, microbiological culture history, mortality status, history of COVID-19 infection, presence of central line, number of vasopressors used, ventilator settings and respective SOFA scores. Results: Prevalence of mortality among patients continued on broad-spectrum antibiotics empirically is remarkable. Through this study, it was found that the significant factors associated with mortality post antibiotic de-escalation were hospital-acquired infection (HAI) (Adjusted OR: 12.56; 95% CI: 2.88,54.98; p < 0.001), systolic blood pressure in mmHg (Adjusted OR: 0.08; 95% CI: 0.02,0.33; p < 0.001), heart rate in bpm (Adjusted OR: 0.12; 95% CI: 0.03,0.45; p:0.002), SOFA scores (Adjusted OR: 21.44; 95% CI: 3.55,129.52; p:0.001) and number of vasopressors (Adjusted OR: 38.46; 95% CI: 1.54,959.30; p:0.026). Conclusion: De-escalation of antibiotics is considerable as the identified significant factors serve as baseline predictors which would certainly be helpful especially during the decision-making process of antibiotic de-escalation among the clinicians. Therefore, antibiotics de-escalation is highly encouraged to reduce the mortality risks.</p
E-scooter dynamics in a tourism-driven city:Exploring spatiotemporal patterns and nonlinear effects of the built environment in Antalya, Türkiye
No full textExploring the travel behavior of e-scooter users and the relationship between the built environment and e-scooter usage helps urban planners and policymakers to allocate urban resources efficiently and meet demand. To the best of our knowledge, this study presents one of the first empirical evidence focusing on e-scooter usage in a tourism-driven city. It explores the nonlinear and threshold effects of the built environment on e-scooter usage using a machine learning technique, i.e., Gradient Boosted Regression Trees (GBRT). To this end, it examines extensive 8-month trajectory records of 16,480 e-scooter trips in Antalya, Türkiye. Trips were recorded mainly in the southwest part of Antalya, specifically along the coastline. In summer, e-scooter is primarily used for tourism in coastal and residential areas, while in winter for educational and residential purposes. Besides, e-scooter usage was impacted negatively by temperature and rain. People tend to ride e-scooters mainly in the evening during the summer and at midday during the winter season. The results indicate that the most influential factors on e-scooter usage were recorded as educational and touristic/offshore land use variables, residential area land use, intersection count, and bus accessibility, with respective 42%, 24%, 8.08%, 5%, and 4% contributions. The results of this research can be useful for transportation policies over dockless e-scooter usage in port and touristic cities such as Antalya
A typology of visual forms of nostalgia (imagery, colour, pattern) from the 1970s in contemporary printed ladies’ fashion textile design
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International Nurse Migration Experience of the First Two Years:A Mixed Methods Study
No full textAim: The aim of this study was to explore experiences of internationally educated nurses' first 2 years working and living in England in an age of contemporary migration. Design: Exploratory mixed method design. Methods: An online survey collected responses from August 2022 to October 2022. A mixed-methods approach was applied to gain a breadth of understanding through quantitative outcomes integrated with depth of qualitative analysis. Results: Data findings from 773 international nurses identified the recognition of prior professional skills and experiences, induction processes, career development systems and the role of line managers are integral to professional integration and could be improved. Communication barriers were frequently transient and time limited, and participants often had incomplete insight of human resource policies. Personal factors affecting life outside of work revealed compromise and sacrifice with accommodation choices, and participants were often not satisfied with their economic status, housing, cost of living in England, and social support. Mental well-being scores varied by country of origin and participants happier with decision to migrate to England had significantly higher mental well-being scores. Conclusion: International nurses have divergent professional and personal motivations for migration unique to individual circumstances. Recognition for transferable skills and experience, receipt of a comprehensive and warm welcome from organisations, safe and well-maintained suitable accommodation and living conveniently located to shops, work and transportation, improve experience. International nurses must have sufficient financial gains from salaries and opportunity to unite with children and families.Implications for the Profession and/or Patient Care: Progressing migration experience of international nurses can improve retention and augment improving patient care and outcomes. Patient or Public Contribution: No patient or members of public contributed to this research.</p
Patriarchy
No full textThis entry outlines definitions of and debates on patriarchy, ranging from the ‘rule of the fathers' to a diverse range of broader feminist theorizations in terms of, for example, the domestic mode of production, economic systems, reproduction, sexuality, and violence. This is followed by noting some critiques of the concept of patriarchy as, for example, too monolithic, ahistorical, or insufficiently intersectional, as well as how patriarchy has become important as a critical frame in some theorizations of masculinities. These discussions feed into the consideration of several ways in which patriarchy, as both concept and social formation, are relevant for analyses of management. These include: patriarchy as a context of management; the management of patriarchal arenas, such as the state and capitalist organizations; and management as a manifestation of patriarchy. More specifically, attention is drawn to the practices of patriarchal managements, patriarchal managing, and patriarchal masculinities; and the increasing recognition of plural, intersectional, and transnational patriarchal managements.</p
The interaction of phosphate species with cerium oxide:The known, the ambiguous and the unexplained
No full textCerium oxide based nanozymes are intensively studied due to their catalytic activity and structural flexibility. Such nanozymes have a great future potential in human therapeutics and antimicrobial activity. The structural complexity of their surfaces enables a great variety of enzyme mimetic activities. However, selection of a specific activity remains challenging, as such activities are sensitive to morphological and compositional changes as well as the physicochemical and biological environments. When delivered into biological systems, many processes occur at the surface, redefining the biological identity and activity of the nanozyme. Inorganic phosphates and phosphate-bearing molecules are some critical examples of items that can interact with cerium oxide nanozymes. Inorganic phosphates can interact directly with cerium oxide and even have a scavenging activity converting the material into cerium phosphate. Phosphate-bearing molecules can absorb on the surface of the nanozyme where phosphatase activity may occur. Given the abundance of phosphates in biological environments, cerium oxide nanozymes are strongly affected by their local concentration. Here, we discuss the interaction of cerium oxide with phosphates and phosphate-bearing molecules, providing a focussed review of the computational and experimental literature, with a focus on the surface morphology and chemistry of the nanozyme and their impact on the phosphate adsorption and phosphatase activity
Partition and the South Asian Diaspora:Exploring (inherited) Memories and Creative Practices of Remembering
No full textConceived at the unique, intersecting moment of commemoration of 1947 Partition of British India, 1971 Bangladesh independence, and 1972 exodus from Uganda, this book focuses on the entangled memories of Partition and its associated events in the diaspora. The chapters in this book explore the cultural and social significance of diasporic memorialisation done in reference to Partition, as it overlaps with the commemoration of key historical moments of change for the South Asian diaspora.Bringing together scholars based in Bangladesh, India, and the UK and working within memory studies, history, ethnomusicology, sound studies, literature, film studies, postcolonial studies and media and communication, this edited volume reflects the transnational and interdisciplinary nature of the study of Partition memory in the diaspora and the multiple ways diasporic Partition memory is inherited and creatively remembered. It examines how Partition memory is actively constructed and communicated in media and cultural forms and delves into the particularity and potential in diasporic remembering of Partition memory, the role of arts and culture in remembering contested pasts and shared cultural heritage, and the impact these commemorations have on diasporic identities in the present.This book is essential reading for students, scholars, and researchers of South Asian diaspora studies, memory studies, postcolonial studies, and those interested in the intersections of history, culture, and identity in the diaspora.The chapters in this book were originally published as a special issue of South Asian Diaspora
A Review of Measurement and Characterization of Film Layers of Perovskite Solar Cells by Spectroscopic Ellipsometry
No full textThis article aims to complete a review of current literature describing the measurement and characterization of photoelectric and geometric properties of perovskite solar cell (PSC) film layer materials using the spectroscopic ellipsometry (SE) measurement technique. Firstly, the influence of film quality on the performance of PSCs is combed and analyzed. Secondly, SE measurement technology is systematically introduced, including the measurement principle and data analysis. Thirdly, a detailed summary is provided regarding the characterization of the geometric and optoelectronic properties of the substrate, electron transport layer (ETL), perovskite layer, hole transport layer (HTL), and metal electrode layer using SE. The oscillator models commonly used in fitting film layer materials in PSCs are comprehensively summarized. Fourthly, the application of SE combined with various measurement techniques to assess the properties of film layer materials in PSCs is presented. Finally, the noteworthy direction of SE measurement technology in the development of PSCs is discussed. The review serves as a valuable reference for further enhancing the application of SE in PSCs, ultimately contributing to the commercialization of PSCs
Size-dependent finite element buckling analysis of porous cylindrical micro-shells reinforced by graphene platelets
No full textThis study introduces a spatial shear deformable rectangular element formulation to investigate the size-dependent buckling behavior of porous graphene platelets (GPL) reinforced micro-shells within the framework of the modified couple stress theory (MCST) for the first time in the worldwide term. The rectangular element, characterized by 4 nodes with 19 degrees of freedom each and possessing weak continuity of order (Formula presented.) incorporates a length scale parameter enabling size-dependent analyses of shells. The research considers three distinct functions for the distribution of porosity combined with three different patterns of the GPL distribution (called by patterns A to C) along the micro-shell thickness. The elastic modulus of the nanocomposite in the absence of porosity is obtained using the Halpin-Tsai micromechanics model. Subsequently, the study meticulously validates the modeling accuracy and then investigates variations in the critical buckling load with respect to porosity distribution functions, distribution patterns of GPL, porosity coefficient, weight percentage of GPL, geometric parameters of the cylinder, and the length-scale parameter. The results reveal that the combination of the GPL pattern A with the first symmetric type porosity distribution yields the highest critical buckling loads. On the contrary, if the pattern B is combined with the second symmetric type of porosity distribution, the lowest critical buckling load will be observed. Given the accuracy of the results obtained and the versatility of the finite element method (FEM) in handling complex geometries together with diverse boundary conditions, the developed element holds promise for analyzing shells of various shapes under different boundary conditions.</p
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