The Antibiotic Resistance and Prescribing in European Children Project: A Neonatal and Pediatric Antimicrobial Web-based Point Prevalence Survey in 73 Hospitals Worldwide

BACKGROUND: The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use.

METHODS: A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project.

RESULTS: There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%).

CONCLUSIONS: An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

Effect of web holes on web crippling strength of cold-formed steel channel sections under end-one-flange loading condition – Part I: Tests and finite element analysis

Web openings could be used in cold-formed steel beam members, such as wall studs or floor joints, to facilitate ease of services in buildings. In this paper, a combination of tests and non-linear finite element analyses is used to investigate the effect of such holes on web crippling under end-one-flange (EOF) loading condition; the cases of both flanges fastened and unfastened to the bearing plates are considered. The results of 74 web crippling tests are presented, with 22 tests conducted on channel sections without web openings and 52 tests conducted on channel sections with web openings. In the case of the tests with web openings, the hole was either located centred above the bearing plates or having a horizontal clear distance to the near edge of the bearing plates. A good agreement between the tests and finite element analyses was obtained in term of both strength and failure modes.

Effect of web holes on web crippling strength of cold-formed steel channel sections under end-one-flange loading condition - Part II: Parametric study and proposed design equations

A parametric study of cold-formed steel sections with web openings subjected to web crippling under end-one-flange (EOF) loading condition is undertaken, using finite element analysis, to investigate the effects of web holes and cross-section sizes. The holes are located either centred above the bearing plates or with a horizontal clear distance to the near edge of the bearing plates. It was demonstrated that the main factors influencing the web crippling strength are the ratio of the hole depth to the depth of the web, the ratio of the length of bearing plates to the flat depth of the web and the location of the holes as defined by the distance of the hole from the edge of the bearing plate divided by the flat depth of web. In this study, design recommendations in the form of web crippling strength reduction factor equations are proposed, which are conservative when compared with the experimental and finite element results.

Direct spun aligned carbon nanotube web-reinforced proton exchange membranes for fuel cells

A new method combining electrospinning of SPEEK and direct spinning of CNT forests has been used to prepare sulfonated poly(ether ether ketone) (SPEEK)/directly spinnable carbon nanotube (dsCNT) composite proton exchange membranes. The SPEEK/dsCNT membrane is more robust than SPEEK alone, and in a fuel cell significantly outperforms both SPEEK and the commercial Nafion 212 membranes.

Eating from the same plate? Revisiting the role of labile carbon inputs in the soil food web

An increasing number of empirical studies are challenging the central fundamentals on which the classical soil food web model is built. This model assumes that bacteria consume labile substrates twice as fast as fungi, and that mycorrhizal fungi do not decompose organic matter. Here, we build on emerging evidence that points to significant consumption of labile C by fungi, and to the ability of ectomycorrhizal fungi to decompose organic matter, to show that labile C constitutes a major and presently underrated source of C for the soil food web. We use a simple model describing the dynamics of a recalcitrant and a labile C pool and their consumption by fungi and bacteria to show that fungal and bacterial populations can coexist in a stable state with large inputs into the labile C pool and a high fungal use of labile C. We propose a new conceptual model for the bottom trophic level of the soil food web, with organic C consisting of a continuous pool rather than two or three distinct pools, and saprotrophic fungi using substantial amounts of labile C. Incorporation of these concepts will increase our understanding of soil food web dynamics and functioning under changing conditions.