Search Results (10)

Following a surge in the prevalence of chloramphenicol-resistant methicillin-resistant Staphylococcus aureus (MRSA) in Kuwait hospitals, this study investigated the genotypes and antibiotic resistance of the chloramphenicol-resistant isolates to ascertain whether they represented new or a resurgence of sporadic endemic clones. Fifty-four chloramphenicol-resistant MRSA isolates obtained in 2014–2015 were investigated. Antibiotic resistance was tested by disk diffusion and MIC determination. Molecular typing was performed using spa typing, multilocus sequence typing, and DNA microarray. Curing and transfer experiments were used to determine the genetic location of resistance determinants. All 54 isolates were resistant to chloramphenicol (MIC: 32–56 mg/L) but susceptible to florfenicol. Two chloramphenicol-resistance determinants, florfenicol exporter (fexA) and chloramphenicol acetyl transferase (cat), were detected. The fexA-positive isolates belonged to CC5-ST627-VI-t688/t450/t954 (n = 45), CC5-ST5-V-t688 (n = 6), whereas the cat-positives isolates were CC8-ST239-III-t037/t860 (n = 3). While cat was carried on 3.5–4.4 kb plasmids, the location of fexA could not be established. DNA sequencing of fexA revealed 100% sequence similarity to a previously reported fexA variant that confers chloramphenicol but not florfenicol resistance. The resurgence of chloramphenicol resistance was due to the introduction and spread of closely related fexA-positive CC5-ST5-V and CC5-ST627-VI clones. Full article

The 7th edition of the Textbook of Neonatal Resuscitation recommends administration of epinephrine via an umbilical venous catheter (UVC) inserted 2–4 cm below the skin, followed by a 0.5-mL to 1-mL flush for severe bradycardia despite effective ventilation and chest compressions (CC). This volume of flush may not be adequate to push epinephrine to the right atrium in the absence of intrinsic cardiac activity during CC. The objective of our study was to evaluate the effect of 1-mL and 2.5-mL flush volumes after UVC epinephrine administration on the incidence and time to achieve return of spontaneous circulation (ROSC) in a near-term ovine model of perinatal asphyxia induced cardiac arrest. After 5 min of asystole, lambs were resuscitated per Neonatal Resuscitation Program (NRP) guidelines. During resuscitation, lambs received epinephrine through a UVC followed by 1-mL or 2.5-mL normal saline flush. Hemodynamics and plasma epinephrine concentrations were monitored. Three out of seven (43%) and 12/15 (80%) lambs achieved ROSC after the first dose of epinephrine with 1-mL and 2.5-mL flush respectively (p = 0.08). Median time to ROSC and cumulative epinephrine dose required were not different. Plasma epinephrine concentrations at 1 min after epinephrine administration were not different. From our pilot study, higher flush volume after first dose of epinephrine may be of benefit during neonatal resuscitation. More translational and clinical trials are needed. Full article

Resuscitation with 21% O₂ may not achieve target oxygenation in preterm infants and in neonates with persistent pulmonary hypertension of the newborn (PPHN). Inhaled nitric oxide (iNO) at birth can reduce pulmonary vascular resistance (PVR) and improve PaO₂. We studied the effect of iNO on oxygenation and changes in PVR in preterm lambs with and without PPHN during resuscitation and stabilization at birth. Preterm lambs with and without PPHN (induced by antenatal ductal ligation) were delivered at 134 d gestation (term is 147–150 d). Lambs without PPHN were ventilated with 21% O₂, titrated O₂ to maintain target oxygenation or 21% O₂ + iNO (20 ppm) at birth for 30 min. Preterm lambs with PPHN were ventilated with 50% O₂, titrated O₂ or 50% O₂ + iNO. Resuscitation with 21% O₂ in preterm lambs and 50%O₂ in PPHN lambs did not achieve target oxygenation. Inhaled NO significantly decreased PVR in all lambs and increased PaO₂ in preterm lambs ventilated with 21% O₂ similar to that achieved by titrated O₂ (41 ± 9% at 30 min). Inhaled NO increased PaO₂ to 45 ± 13, 45 ± 20 and 76 ± 11 mmHg with 50% O₂, titrated O₂ up to 100% and 50% O₂ + iNO, respectively, in PPHN lambs. We concluded that iNO at birth reduces PVR and FiO₂ required to achieve target PaO₂. Full article

This article details the mathematical model of a microfluidic device aimed at separating any binary heterogeneous sample of microparticles into two homogeneous samples based on size with sub-micron resolution. The device consists of two sections, where the upstream section is dedicated to focusing of microparticles, while the downstream section is dedicated to separation of the focused stream of microparticles into two samples based on size. Each section has multiple planar electrodes of finite size protruding into the microchannel from the top and bottom of each sidewall; each top electrode aligns with a bottom electrode and they form a pair leading to multiple pairs of electrodes on each side. The focusing section subjects all microparticles to repulsive dielectrophoretic force, from each set of the electrodes, to focus them next to one of the sidewalls. This separation section pushes the big microparticles toward the interior, away from the wall, of the microchannel using repulsive dielectrophoretic force, while the small microparticles move unaffected to achieve the desired degree of separation. The operating frequency of the set of electrodes in the separation section is maintained equal to the cross-over frequency of the small microparticles. The working of the device is demonstrated by separating a heterogeneous mixture consisting of polystyrene microparticles of different size (radii of 2 and 2.25 μm) into two homogeneous samples. The mathematical model is used for parametric study, and the performance is quantified in terms of separation efficiency and separation purity; the parameters considered include applied electric voltages, electrode dimensions, outlet widths, number of electrodes, and volumetric flowrate. The separation efficiencies and separation purities for both microparticles are 100% for low volumetric flow rates, a large number of electrode pairs, large electrode dimensions, and high differences between voltages in both sections. Full article

This article conceptualizes and mathematically models a dielectrophoretic microfluidic device with two sets of interdigitated transducer vertical electrodes for separation of a binary heterogeneous mixture of particles based on size; each set of electrodes is located on the sidewalls and independently controllable. To achieve separation in the proposed microfluidic device, the small microparticles are subjected to positive dielectrophoresis and the big microparticles do not experience dielectrophoresis. The mathematical model consists of equations describing the motion of each microparticle, fluid flow profile, and electric voltage and field profiles, and they are solved numerically. The equations of motion take into account the influence of phenomena, such as inertia, drag, dielectrophoresis, gravity, and buoyancy. The model is used for a parametric study to understand the influence of parameters on the performance of the microfluidic device. The parameters studied include applied electric voltages, electrode dimensions, volumetric flow rate, and number of electrodes. The separation efficiency of the big and small microparticles is found to be independent of and dependent on all parameters, respectively. On the other hand, the separation purity of the big and small microparticles is found to be dependent on and independent of all parameters, respectively. The mathematical model is useful in designing the proposed microfluidic device with the desired level of separation efficiency and separation purity. Full article

An experimentally validated mathematical model of a microfluidic device with nozzle-shaped electrode configuration for realizing dielectrophoresis based 3D-focusing is presented in the article. Two right-triangle shaped electrodes on the top and bottom surfaces make up the nozzle-shaped electrode configuration. The mathematical model consists of equations describing the motion of microparticles as well as profiles of electric potential, electric field, and fluid flow inside the microchannel. The influence of forces associated with inertia, gravity, drag, virtual mass, dielectrophoresis, and buoyancy are taken into account in the model. The performance of the microfluidic device is quantified in terms of horizontal and vertical focusing parameters. The influence of operating parameters, such as applied electric potential and volumetric flow rate, as well as geometric parameters, such as electrode dimensions and microchannel dimensions, are analyzed using the model. The performance of the microfluidic device enhances with an increase in applied electric potential and reduction in volumetric flow rate. Additionally, the performance of the microfluidic device improves with reduction in microchannel height and increase in microparticle radius while degrading with increase in reduction in electrode length and width. The model is of great benefit as it allows for generating working designs of the proposed microfluidic device with the desired performance metrics. Full article

This paper presents focusing of microparticles in multiple paths within the direction of the flow using dielectrophoresis. The focusing of microparticles is realized through partially perforated electrodes within the microchannel. A continuous electrode on the top surface of the microchannel is considered, while the bottom side is made of a circular meshed perforated electrode. For the mathematical model of this microfluidic channel, inertia, buoyancy, drag and dielectrophoretic forces are brought up in the motion equation of the microparticles. The dielectrophoretic force is accounted for through a finite element discretization taking into account the perforated 3D geometry within the microchannel. An ordinary differential equation is solved to track the trajectories of the microparticles. For the case of continuous electrodes using the same mathematical model, the numerical simulation shows a very good agreement with the experiments, and this confirms the validation of focusing of microparticles within the proposed perforated electrode microchannel. Microparticles of silicon dioxide and polystyrene are used for this analysis. Their initial positions and radius, the Reynolds number, and the radius of the pore in perforated electrodes mainly conduct microparticles trajectories. Moreover, the radius of the pore of perforated electrode is the dominant factor in the steady state levitation height. Full article

The current guidelines recommend the use of 100% O₂ during resuscitation of a neonate requiring chest compressions (CC). Studies comparing 21% and 100% O₂ during CC were conducted in postnatal models and have not shown a difference in incidence or timing of return of spontaneous circulation (ROSC). The objective of this study is to evaluate systemic oxygenation and oxygen delivery to the brain during CC in an ovine model of perinatal asphyxial arrest induced by umbilical cord occlusion. Pulseless cardiac arrest was induced by umbilical cord occlusion in 22 lambs. After 5 min of asystole, lambs were resuscitated with 21% O₂ as per Neonatal Resuscitation Program (NRP) guidelines. At the onset of CC, inspired O₂ was either increased to 100% O₂ (n = 25) or continued at 21% (n = 9). Lambs were ventilated for 30 min post ROSC and FiO₂ was gradually titrated to achieve preductal SpO₂ of 85–95%. All lambs achieved ROSC. During CC, PaO₂ was 21.6 ± 1.6 mm Hg with 21% and 23.9 ± 6.8 mm Hg with 100% O₂ (p = 0.16). Carotid flow was significantly lower during CC (1.2 ± 1.6 mL/kg/min in 21% and 3.2 ± 3.4 mL/kg/min in 100% oxygen) compared to baseline fetal levels (27 ± 9 mL/kg/min). Oxygen delivery to the brain was 0.05 ± 0.06 mL/kg/min in the 21% group and 0.11 ± 0.09 mL/kg/min in the 100% group and was significantly lower than fetal levels (2.1 ± 0.3 mL/kg/min). Immediately after ROSC, lambs ventilated with 100% O₂ had higher PaO₂ and pulmonary flow. It was concluded that carotid blood flow, systemic PaO₂, and oxygen delivery to the brain are very low during chest compressions for cardiac arrest irrespective of 21% or 100% inspired oxygen use during resuscitation. Full article

In this article, thermal performance of different waste materials and by-products of industrial processes is investigated experimentally. A geopolymer concrete block with 7.5 cm thickness and cross-sectional area of 5 × 5 cm was considered as a reference model to measure heat transmission across the two opposite surfaces while all four remnant surfaces were perfectly insulated. For all other samples, a sandwich concrete block was developed by taking two pieces of the geopolymer concrete with 2.5 cm thickness each on either side and insulation material of 2.5 cm thickness in between. The sandwich materials investigated were air cavity, expanded polystyrene foam, polyurethane foam, rubber tire, date palm, PCM-30, and PCM-42. Experimental investigations revealed that the investigated green materials and industrial by-products have comparable insulation performance with respect to the traditional insulations such as expanded polystyrene foam. It is found that polyurethane foam and date palm can reduce indoor cooling demand by 46.6% each in hot conditions while rubber tire can reduce indoor heating demand by 59.2% in cold climatic conditions at the maximum. The research results confirm and encourage the effective utilization of waste materials in building walls for reducing indoor air-conditioning demand in the extreme climatic conditions. Full article

Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of failed circulatory adaptation at birth due to delay or impairment in the normal fall in pulmonary vascular resistance (PVR) that occurs following birth. The fetus is in a state of physiological pulmonary hypertension. In utero, the fetus receives oxygenated blood from the placenta through the umbilical vein. At birth, following initiation of respiration, there is a sudden precipitous fall in the PVR and an increase of systemic vascular resistance (SVR) due to the removal of the placenta from circulation. There is dramatic increase in pulmonary blood flow with a decrease in, and later reversal of shunts at the foramen ovale and ductus arteriosus. The failure of this normal physiological pulmonary transition leads to the syndrome of PPHN. PPHN presents with varying degrees of hypoxemic respiratory failure. Survival of infants with PPHN has significantly improved with the use of gentle ventilation, surfactant and inhaled nitric oxide (iNO). PPHN is associated with significant mortality and morbidity among survivors. Newer agents that target different enzymatic pathways in the vascular smooth muscle are in different stages of development and testing. Further research using these agents is likely to further reduce morbidity and mortality associated with PPHN. Full article