Lack of evidence for the efficacy of enhanced surveillance compared to other specific interventions to control neonatal healthcare-associated infection outbreaks.

BACKGROUND: Despite current prevention efforts, outbreaks of healthcare-associated infections in neonatal units remain high globally, with a considerable burden of mortality and morbidity. METHODS: We searched Medline, Cochrane Library and Outbreak database to identify studies of neonatal healthcare-associated outbreaks between 2005 and 2015 that described interventions to control outbreaks. All studies were evaluated using the ORION guidance. RESULTS: Thirty studies were identified including 17 102 infants of whom 664 (3.9%) became infected. No single intervention was identified that reduced duration or mortality. Studies that introduced multiple interventions had significantly reduced case fatality ratio and outbreak duration compared to those that used basic surveillance only. Low and low-middle income countries reported the fewest interventions to control outbreaks and these studies were also associated with higher mortality than that found in middle and high income countries. CONCLUSIONS: Systematic reporting and formal evaluation of interventions used to reduce healthcare-associated neonatal infection outbreaks is key to identifying containment strategies worldwide

Doctor of Philosophy

dissertationThis dissertation offers a study of the configurations of the idealized, new female gender identity in the public discourse within the late 19 th- and early 20th- century Ottoman Muslim urban context and investigates Ottoman Muslim women of letters' involvement in this discourse targeting their own images and presences. The new woman was configured as both the guardian of native values and a potent agent of social development. This study contends that women's increasing participation in public writing and their diversified literary input on issues related to female modesty and feminine/domestic identity created a collective agency in this venue, complicating and unsettling the constructions of the new woman's identity. Women with varying alliances to Islam, nationalism and modernity had changing interpretations of progress and cultural integrity. It brought about contestations, more often than not, over a range of conditions and practices, including Muslim women's attire, their appearance in public places, at gatherings, at work and school, with regard to its propriety for the idealized Ottoman Muslim womanhood. The discussion in this work also speaks accordingly to the general issue of subjectivity, in the face of dominant ideas, identities and projects that attempt to shape and represent individuals. A more inclusive picture of women's intellectual existence in history, in terms of ideological attitudes, and of social status and prominence, is offered based on (re)examination of primary sources, to counter the different ways of silencing and the avoiding of acknowledgment in the historiographies of the period

Investigation of a Pt containing washcoat on SiC foam for hydrogen combustion applications

A commercial Pt based washcoat, used for catalytic methane combustion, was studied supported on a commercial SiC foam as catalytic material (Pt/SiC) for catalytic hydrogen combustion (CHC). Structural and chemical characterization was performed using Electron Microscopy, X-Ray Diffraction (XRD) and X-Ray Photoelectron Spectroscopy (XPS). The reaction was monitored following water concentration by Fourier Transform Infrared spectra (FTIR). The FTIR method was compared with H2 detection by Gas Cromatography (GC) and has shown to be adequate to study the kinetics of the CHC reaction in steady state under our experimental conditions (very lean 1% (v/v) H2/air mixtures). The catalyst is composed of 5–20 nm disperse Pt nanoparticles decorating a mixture of high surface area Al2O3 and small amounts of ceria supported on the SiC foam which also contains alumina as binder. The Pt/SiC catalytic material has demonstrated to be active enough to start up the reaction in a few seconds at room temperature. The material has been able to convert at least 18.5 Lhydrogen min−1 gPt−1 at room temperature in conditions of excess of catalyst. The Pt/SiC material was studied after use using XPS and no significant changes on Pt oxidation states were found. The material was characterized from a kinetic point of view. From the conversion-temperature plot a T50 (temperature for 50% conversion) of 34 °C was obtained. Activation energy measured in our conditions was 35 ± 1 kJ mol−1.Peer reviewe

Aroma characterization of heterotrophic microalgae Crypthecodinium cohnii using solid -phase microextraction and gas chromatography ?mass spectrometry/olfactometry during different growth phases

[Anstract Not Available]Scientific Research Council of Canakkale Onsekiz Mart University [FBA-2016-748]This research was supported by Scientific Research Council of Canakkale Onsekiz Mart University with project number FBA-2016-748

Fermented Spirulina products with Saccharomyces and non- Saccharomyces yeasts: Special reference to their microbial, physico-chemical and sensory characterizations

Innovative products produced from various sources through fermentation processes have been a resurgence of interest. This study was designed to determine the performance of fermented Spirulina (FS) products by three different yeast species including Debaryomyces hansenii, Kluyveromyces marxianus and Saccharomyces cerevisiae and investigate the microbial, physicochemical and sensory characteristics of products. The results showed that the increase in yeast cell number was around 3 log after 48 h fermentation in Spirulina medium without additional carbon source. Protein bands with a molecular weight of-51 kDa seemed less visible and bands 14-22 kDa disappeared after 48 h fermentation by K. marxianus showed strong hydrolysis of proteins during fermentation. The amino acid compositions of the three kinds of FS were different also compared to unfermented Spirulina (unFS). Glutamic acid, methionine, lysine, isoleucine and valine became more dominant in FS samples. According to GC-MS analysis, there was a decrease in the concentration of pyrazine, ketone and aldehyde compounds of FS compared to unFS. The flavor notes of seaweed, cardboard, earthy/muddy and cereal/ straw were found to be the highest in unFS than in FS detected by panelists during sensory evaluations. FS by K. marxianus is highly characterized as having the lowest seaweed and umami flavor attributes and higher fermented and rose attributes. Finally, the current study revealed that the potential of Spirulina biomass to be a suitable substrate for yeasts and fermentation of Spirulina with different yeast species led to different kinds of products.Scientific and Technological Research Council of Turkey (TUBITAK) [218M389]; Gebze Technical University, Gebze Enzyme Recognition Center (Kocaeli, Turkiye)This research was supported by The Scientific and Technological Research Council of Turkey (TUBITAK) with project number 218M389. The authors want to thank TUBITAK for their financial support. The authors also thank the Gebze Technical University, Gebze Enzyme Recognition Center (Kocaeli, Turkiye) for their laboratory infrastructure and supports

Diagnosis of enteric fever in the emergency department: a retrospective study from Pakistan

Background:Enteric fever is one of the top differential diagnoses of fever in many parts of the world. Generally, the diagnosis is suspected and treatment is initiated based on clinical and basic laboratory parameters.Aims: The present study identifies the clinical and laboratory parameters predicting enteric fever in Patients visiting the emergency department of a tertiary care hospital in Pakistan.Methods:This is a retrospective chart review of all adult Patients with clinically suspected enteric fever admitted to the hospital through the emergency department during a 5-year period (2000-2005).Results:A total of 421 emergency department Patients were admitted to the hospital with suspected enteric fever. There were 53 cases of blood culture-positive enteric fever and 296 disease-negative cases on culture. The mean age in the blood culture-positive group was 27 years (SD: 10) and in the group with negative blood culture for enteric fever, 35 years (SD: 15) with a male to female ratio of 1:0.6 in both groups. Less than half (48%) of all Patients admitted with suspected enteric fever had the discharge diagnosis of enteric fever, of which only 13% of the Patients had blood culture/serologically confirmed enteric fever. None of the common clinical and laboratory parameters differed between enteric fever-positive Patients and those without it.Conclusion:Commonly cited clinical and laboratory parameters were not able to predict enteric fever

Characteristics and risk factors for typhoid fever after the tsunami, earthquake and under normal conditions in Indonesia

<p>Abstract</p> <p>Background</p> <p>Although typhoid transmitted by food and water is a common problem in daily life, its characteristics and risk factors may differ in disaster-affected areas, which reinforces the need for rapid public health intervention. Surveys were carried out post-tsunami in Banda Aceh, post-earthquake in Yogyakarta, and under normal conditions in Bandung, Indonesia. Logistic regression analysis was used to assess the risk factors with the dependent variable of typhoid fever, with or without complications.</p> <p>Findings</p> <p>Characteristic typhoid fever with complications was found in 5 patients (11.9%) affected by the tsunami in Aceh, 8 (20.5%) after the earthquake in Yogyakarta, and 13 (18.6%) in Bandung. After the tsunami in Aceh, clean water (OR = 0.05; 95%CI: 0.01-0.47) and drug availability (OR = 0.23; 95%CI: 0.02-2.43) are significant independent risk factors, while for the earthquake in Yogyakarta, contact with other typhoid patients (OR = 20.30; 95%CI: 1.93-213.02) and education (OR = 0.08; 95%CI: 0.01-0.98) were significant risk factors. Under normal conditions in Bandung, hand washing (OR = 0.07; 95%CI: 0.01-0.50) and education (OR = 0.08; 95%CI: 0.01-0.64) emerged as significant risk factors.</p> <p>Conclusion</p> <p>The change in risk factors for typhoid complication after the tsunami in Aceh and the earthquake in Yogyakarta emphasizes the need for rapid public health intervention in natural disasters in Indonesia.</p

Impact of antimicrobial drug restrictions on doctors' behaviors

Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics.Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician.Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had 5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05).Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did