Search Results (4)

Aim: Antibiotic de-escalation (ADE) is essential, but appears to be underperformed although being possible, which we refer to as a ‘missed opportunity’. We aimed to analyze the ADE missed opportunities in Gram-negative bloodstream infections (BSIs) in a setting with a high antimicrobial resistance profile. Methods: A retrospective, two-centered cohort study was performed from 1 January 2018 to 30 June 2019, including adults with mono- or polymicrobial Gram-negative BSIs. All ADE episodes and 30-day mortality were noted. Results/Discussion: Out of 273 BSIs (43 ADE vs. 230 no-ADE episodes), 101 were considered a ‘missed’ opportunity of ADE (36.9%, 101/273). In multivariate analysis, ADE opportunities were missed 4.4 times more (OR = 4.4; 95% CI 1.24–15.9) in the presence of hematological malignancy and 6.2 times more (OR = 6.2; 95% CI 1.76–22.2) in ESBL. Contrary to this, ADE opportunities were missed 0.24 times less (OR = 0.24; 95% CI 0.09–0.61) among patients with E. coli BSIs, and 0.17 less (OR = 0.17; 95% CI 0.05–0.67) if ertapenem was used as an empirical agent. The ADE missed opportunity group had a higher mortality rate, which is statistically significant in univariate analysis, but not in multivariate analysis. Conclusion: The presence of ESBL and hematological malignancy were the significant barriers to appropriate ADE practice in our study. A good stewardship program must address physician hesitation in ADE practice. Full article

One of the most promising solutions to slow down CO₂ emissions is the use of photocatalysis to produce hydrogen as a clean fuel. However, the efficiency of the photocatalysts is not at the desired level, and they usually need precious metal co-catalysts for reactions. In this study, to achieve efficient photocatalytic hydrogen production, a high-entropy oxide was synthesized by a mechano-thermal method. The synthesized high-entropy oxide had a bandgap of 2.45 eV, which coincided with both UV and visible light regions. The material could successfully produce hydrogen from water under light, but the main difference to conventional photocatalysts was that the photocatalysis proceeded without a co-catalyst addition. Hydrogen production increased with increasing time, and at the end of the 3 h period, 134.76 µmol/m² h of hydrogen was produced. These findings not only introduce a new method for producing high-entropy photocatalysts but also confirm the high potential of high-entropy photocatalysts for hydrogen production without the need for precious metal co-catalysts. Full article

Nowadays, zenith telescope-based digital zenith cameras (DZC), such as the COmpact DIgital Astrometric Camera (CODIAC) and VErtical by STArs (VESTA), are used to determine highly precise astrogeodetic deflections of the vertical (DoVs). The CODIAC and VESTA were developed by Eidgenossische Technische Hochschule (ETH) Zurich and University of Latvia, respectively, and only two CODIACs and four VESTAs were produced. The CODIAC has an established accuracy higher than 0.05″, while the accuracy of VESTA is ~0.1″. These two DZCs, which are the most used DZCs of the last decade, were used effectively over many survey campaigns. In this study, we used both the CODIAC and VESTA to conduct simultaneous observations at the School of Management and Engineering Vaud (HEIG-VD) in Yverdon-les-Bains, Switzerland, over five nights in August 2021. Our DZC measurements with CODIAC and VESTA mark the second time that simultaneous parallel observations were made with two different DZCs. Additionally, the VESTA was never tested against another DZC through comparative simultaneous measurements. These comparative measurements between the VESTA and CODIAC allowed for VESTA precision validation and checking the agreement between the two DZCs. The results of repeated, comparative DoV observations over five nights at HEIG-VD revealed a DoV measurement precision of VESTA around 0.13–0.16″ for 15 min long observation session and 0.10–0.13″ for 50 min long observation session. Mean DoV differences between CODIAC and VESTA at HEIG-VD were 0.08″ and −0.06″ for the North–South and East–West components, respectively. Full article

Background and Objective. It is unclear how immune tolerance develops to a semiallograft fetus in pregnancy. Human leukocyte antigen G (HLA-G) expressed by extravascular trophoblasts plays an important role in the recognition of the gestational tissues as self and the development of immune tolerance against the gestational tissues by the maternal immune system. The soluble form of the HLA-G (sHLA-G) molecule in the maternal serum is also reported to contribute to the prevention of rejection during pregnancy. The aim of the study was to compare the maternal serum sHLA-G levels of the women with missed abortions and control subjects with uncomplicated pregnancies.
Material and Methods. The prospective cross-sectional study involving 40 with missed abortions and 40 control women, matched by age, gestational age, and body mass index, was carried out. The study group consisted of the women with singleton pregnancies, who were diagnosed with a missed abortion. Only the patients who were confirmed to have an uncomplicated term delivery during follow-up were included in the control group. The serum sHLA-G level was compared between the groups.
Results. There was no significant difference in the mean serum sHLA-G levels in terms of gravidity (P=0.761) and a history of abortion (P=0.379) in the control group. The median serum sHLA-G level in the missed abortion group was significantly lower compared with the control group (16.8 [8.5–35.8] vs. 26 [11–135] U/mL, P<0.001). All the women in the control group had uncomplicated term deliveries.
Conclusion. Our results showed that the women with missed abortions had significantly lower serum sHLA-G levels compared with the healthy pregnant controls, which may have potentially played a role in the impairment of physiological immunological tolerance during pregnancy. However, the determination of the exact role and the potential clinical utility of maternal serum sHLA-G for the detection/prediction of a missed abortion risk requires further detailed studies. Full article