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Objectives: To determine the diagnostic accuracy of a rapid host-protein test for differentiating bacterial from viral infections in patients who presented to the emergency department (ED) or urgent care center (UCC)., Methods: This was a prospective multicenter, blinded study. MeMed BV (MMBV), a test based on tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-inducible protein-10 (IP-10), and C-reactive protein (CRP), was measured using a rapid measurement platform. Patients were enrolled from 9 EDs and 3 UCCs in the United States and Israel. Patients >3 months of age presenting with fever and clinical suspicion of acute infection were considered eligible. MMBV results were not provided to the treating clinician. MMBV results (bacterial/viral/equivocal) were compared against a reference standard method for classification of infection etiology determined by expert panel adjudication. Experts were blinded to MMBV results. They were provided with comprehensive patient data, including laboratory, microbiological, radiological and follow-up., Results: Of 563 adults and children enrolled, 476 comprised the study population (314 adults, 162 children). The predominant clinical syndrome was respiratory tract infection (60.5% upper, 11.3% lower). MMBV demonstrated sensitivity of 90.0% (95% confidence interval [CI]: 80.3-99.7), specificity of 92.8% (90.0%-95.5%), and negative predictive value of 98.8% (96.8%-99.6%) for bacterial infections. Only 7.2% of cases yielded equivocal MMBV scores. Area under the curve for MMBV was 0.95 (0.90-0.99)., Conclusions: MMBV had a high sensitivity and specificity relative to reference standard for differentiating bacterial from viral infections. Future implementation of MMBV for patients with suspected acute infections could potentially aid with appropriate antibiotic decision-making., Competing Interests: Cesar A. Arias, Natasha Ballard, Karen C. Carroll, Andrea T. Cruz, Richard Gordon, Salim Halabi, Jeffrey D. Harris, Kristina G. Hulten, Theresa Jacob, Mark D. Kellogg, Adi Klein, Pninit Shaked Mishan, Sergey M. Motov, Octavia M. Peck‐Palmer, Leticia M. Ryan, Ma'anit Shapira, George S. Suits, Henry E. Wang, Alexandra Weissman, and Richard E. Rothman have no relevant conflict of interests to declare. Richard G. Bachur and Sheldon L. Kaplan participated in a scientific advisory board on health economic modeling for MeMed and were compensated for their time. Richard E. Rothman participated in a scientific board on health care economic modeling (without compensation). Richard G. Bachur, Sheldon L. Kaplan, and Richard E. Rothman participated in discussions with the U.S. Food and Drug Administration clearance and were involved in study design, patient recruitment, data collection and analysis, and drafting and revising the manuscript., (© 2024 The Authors. Journal of the American College of Emergency Physicians Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)

The ecosystem and economy's reliance on clean water is influenced by various factors such as geology, topography, soil types, activities, and the presence of plants and animals. The Ghana Water Company is encountering difficulties in delivering water to consumers in the Ashanti Region due to the shortage of surface water resources, leading to water rationing in the area. Furthermore, poor waste disposal practices, illegal mining, use of fertilizers, and industrial activities have resulted in surface and groundwater source damage. Therefore, there is a need to implement a reliable, simple, and timely method to assess groundwater quality. This study aims to employ GIS and RS techniques to evaluate groundwater quality and potential in the Ashanti Region, Ghana. The Water Quality Index (WQI) was estimated using pH, Total Dissolve Solid (TDS), Chloride, Total Hardness (TH), Nitrate, Temperature, Turbidity, Iron, and Electrical Conductivity (EC). The study then used the WQI distribution to conduct a groundwater potential analysis to identify suitable areas for borehole placement. Digital thematic layers and maps were developed to expose the spatial distribution of water quality parameters, enabling the identification of groundwater pollution control and remedial measures. The study estimated the region's groundwater potential using an integrated GIS and Analytical Hierarchical Process (AHP) technique, grouping under excellent, good, fair, and poor potential. The WQI in the Ashanti Region ranged from 5.208 to 134.232, with 32.252% of the study area having an excellent WQI and 60.168% of the study area having a good WQI. Poor water quality covered 7.550% of the study area. The results showed that the GIS-based AHP approach accurately mapped the spatial distribution of WQI and Groundwater Potential Zones (GWPZ). This information is helpful to planners in water resource management in groundwater exploration and future planning. Policymakers and stakeholders must ensure that groundwater sources are protected from pollution., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Objectives: Nursing specialty certification validates nurses' mastery of specialty knowledge in disease management, education, or leadership above entry-level education and licensing. Research suggests direct relationships between nursing certifications and patient care quality. However, nurses' specialty certification rates are still low. This study aims to better understand nurses' perceptions of the facilitators and barriers in promoting nurses' desires and ability to obtain specialty certifications, which exclude advanced nursing practice roles, such as nurse practitioner or nurse midwife., Methods: This qualitative descriptive study took place virtually across the United States from May 2022 to September 2022. The study sample was a nested sample of a large national survey study. Among the nurses agreeing to be interviewed, a purposive sampling method was used to achieve maximum variation in diversity, such as years as a nurse, race, ethnicity, and certification status. Information saturation was used to gauge the sample size. Data were collected via in-depth virtual face-to-face interviews. The coding process was based on Colaizzi's method of data analysis., Results: Twenty nurses participated in the study. Five major themes emerged related to organizational culture and strategies to foster nurse specialty certifications. The five organizational strategies included 1) sharing resources, 2) a culture of ownership and a sense of belonging, 3) mentorship and role modeling, 4) recognizing nurses' efforts and accomplishments, and 5) cultivating a sense of meaning, purpose, and support., Conclusions: The findings indicate that organizational culture and leadership significantly promote continuing learning environments. Organizations need to develop an organizational culture that promotes nurses' specialty certifications. This study identified significant areas that are important to support nurses seeking certifications. Additional research is needed to evaluate which interventions significantly impact initial and continued certification levels, especially in the post-COVID-19 era., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

The occurrence of intramolecular transfer to polymer in the radical polymerization of acrylic monomers has been extensively documented in the literature. Whilst it has been largely assumed that intramolecular transfer to polymer leads to short chain branches, there has been some speculation over whether the mid-chain radical can migrate. Herein, by the matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry (MS) of poly( n -butyl acrylate) synthesized by solution polymerization under a range of conditions, it is shown that this mid-chain radical migration does occur in the radical polymerization of acrylates conducted at high temperatures, as is evident from the shape of the molecular weight distribution. Using a mathematical model, an initial approximation of the rate at which migration occurs is made and the distribution of branching lengths formed in this scenario is explored. It is shown that the polymerizations carried out under a low monomer concentration and at high temperatures are particularly prone to radical migration reactions, which may affect the rheological properties of the polymer.

Hypothesis: It has been reported that surfactants generated in-situ are more efficient than their preformed analogues in preparation of miniemulsions for application in miniemulsion polymerization but conflicting experimental evidence exists over their use. Herein, the potential of preparing miniemulsions using in-situ generated surfactants is evaluated using KOH/oleic acid as a model system., Experiments: The kinetics of miniemulsification using either preformed or in-situ generated potassium oleate were evaluated by monitoring the evolution of droplet size, pH and conductivity during miniemulsification using sonication. Subsequently, the kinetics of surfactant adsorption to the monomer/water interface were studied using dynamic interfacial tension measurements. Finally, the ability of in-situ generated potassium oleate to produce miniemulsions under low shear was evaluated under a range of conditions., Findings: No difference in the evolution of droplet size, pH or conductivity was observed between the two surfactant systems when sonication was applied. Dynamic interfacial tension measurements showed that using in-situ generated potassium oleate, interfacial tension is significantly lower initially, but at long times the two surfactant systems reach similar values. Low shear emulsification by in-situ generated potassium oleate resulted in a bimodal droplet distribution. Only at very low oil contents with high surfactant concentration is the number of nanometer sized droplets large enough to account for a miniemulsion polymerization mechanism., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The effective stabilization of emulsions by solid particles, a phenomenon known as Pickering stabilization, is well known to be highly dependent on the wettability and the adhesion energy of the stabilizer employed at the liquid-liquid interface. We present a user-friendly computational model that can be used to determine equilibrium orientations and the adhesion energy of colloidal particles at interfaces. The model determines the free energy profile of particle adsorption at liquid-liquid interfaces using a triangular tessellation scheme. We demonstrate the use of the model, using a variety of anisotropic particles and demonstrate its ability to predict and explain experimental observations of particle behaviour at interfaces. In particular, we show that the concept of hydrophilic lipophilic balance commonly applied to molecular surfactants is insufficient to explain the complexity of the activity of colloidal particles at interfaces. In addition, we show the importance of the knowledge of the free energy adsorption profile of single particles at interfaces and the impact on overall free energy of emulsification of packed ensembles of particles. The delicate balance between optimization of adhesion energy, adsorption dynamics and particle packing is shown to be of great importance in the formation of thermodynamically stable emulsions. In order to use the model, the code is implemented by freely available software that can be readily deployed on personal computers., (Copyright © 2015 Elsevier Inc. All rights reserved.)

A 1 cm long, low-finesse fiber-optic cavity was used as a transducer for the vibrations of the soundboard of an acoustic guitar and of a violin. The reflected light is detected and then amplified and recorded using conventional audio instrumentation. The fiber-optic pickup is found to have a high response range in both amplitude (up to 100 microm displacement) and audio frequency (DC to 20 kHz) and good linearity up to a displacement of 225 microm. The audio noise is found to arise from the fiber-optic cables and, to a lesser extent, from the laser and laser driver.

An overview on high-resolution and fast interrogation of optical-fiber sensors relying on laser reflection spectroscopy is given. Fiber Bragg-gratings (FBGs) and FBG resonators built in fibers of different types are used for strain, temperature and acceleration measurements using heterodyne-detection and optical frequency-locking techniques. Silica fiber-ring cavities are used for chemical sensing based on evanescent-wave spectroscopy. Various arrangements for signal recovery and noise reduction, as an extension of most typical spectroscopic techniques, are illustrated and results on detection performances are presented.

Objective: Our goal was to determine the utility of clinical clues, white blood cell (WBC) and differential counts, and a rapid antigen test for differentiating influenza from coexistent infectious diseases during influenza epidemics., Study Design: Data were collected during 3 consecutive influenza outbreaks over a 2-year period. The information collected included date of onset, symptoms, vaccine status, WBC and differential counts, ZstatFlu test (ZymeTx, Oklahoma City, Ok), and influenza culture. Using culture positivity as the criterion for influenza diagnosis, we compared cases with noncases on each variable independently and by logistic regression. Receiver operating characteristic curves were plotted for WBC count, ZstatFlu, and their combination in an effort to determine the most useful diagnostic strategy., Population: We included consecutive patients presenting to a family practice office with fever, cough, sore throat, myalgia, and/or headache during flu season., Outcomes Measured: The outcomes were sensitivity, specificity, and other measures of test accuracy., Results: Culture-positive cases could not be reliably distinguished from those that were culture negative using symptoms or vaccination status. Both WBC count and ZstatFlu results discriminated fairly well, and their combination did somewhat better. Differential counts were not helpful. WBC counts above 8000 were associated with a low probability of influenza. The sensitivity and specificity of the ZstatFlu were 65% and 83%, respectively., Conclusions: Our data suggest that symptoms and vaccine status do not reliably identify patients with influenza. Use of WBC counts and the ZstatFlu test can be helpful. The sequence, combination, and criteria for use of these tests depend on tradeoffs between undertreatment of influenza cases and the overtreatment of noninfluenza cases, and the cost and benefit projections for individual patients.