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This is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death. "In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, Ph.D., principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future. "Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and health care costs," he said. "Hospitals and other health care providers must act now to protect patients from this growing menace." Laxminarayan and his colleagues analyzed 69 million discharge records from hospitals in 40 states and identified two conditions caused by health care-associated infections: sepsis, a potentially lethal systemic response to infection and pneumonia, an infection of the lungs and respiratory tract. The researchers looked at infections that developed after hospitalization. They zeroed in on infections that are often preventable, like a serious bloodstream infection that occurs because of a lapse in sterile technique during surgery, and discovered that the cost of such infections can be quite high: For example, people who developed sepsis after surgery stayed in the hospital 11 days longer and the infections cost an extra $33,000 to treat per person. Even worse, the team found that nearly 20 percent of people who developed sepsis after surgery died as a result of the infection. "That's the tragedy of such cases," said Anup Malani, a study co-author, investigator at Extending the Cure, and professor at the University of Chicago. "In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control—and they can die." The team also looked at pneumonia, an infection that can set in if a disease-causing microbe gets into the lungs—in some cases when a dirty ventilator tube is used. They found that people who developed pneumonia after surgery, which is also thought to be preventable, stayed in the hospital an extra 14 days. Such cases cost an extra $46,000 per person to treat. In 11 percent of the cases, the patient died as a result of the pneumonia infection.

Scanning electron micrograph of the nanofossil Chiasmolithus from about 60 million years ago. This genus arose after the Cretacious Paleogene boundary mass extinction. The size about 8 microns.

The darkness caused by the collision would impair photosynthesis and reduce nannoplankton reproduction. While full darkness did not occur, the effects in the north would have lasted for up to six months. However, with ample sunlight and large amounts of nutrients in the oceans, the populations should have bounced back, even in the North, but they did not. The researchers suggest that toxic metals that where part of the asteroid, heavily contaminated the Northern oceans and were the major factor inhibiting recovery. "Metal loading is a great potential mechanism to delay recovery," said Bralower. "Toxic levels in the parts per billions of copper, nickel, cadmium and iron could have inhibited recovery." On the one hand, the researchers considered an impact scenario causing perpetual winter and ocean acidification to explain the slow recovery, but neither explains the lag between Southern and Northern Hemispheres. Trace metal poisoning, on the other hand, would have been severe near the impact in the Northern Hemisphere. When the high temperature debris from the impact hit the water, copper, chromium, aluminum, mercury and lead would have dissolved into the seawater at likely lethal levels for plankton. Iron, zinc and manganese -- normally micronutrients -- would reach harmful levels shortly after the impact. Other metal sources might be acid-rain leached soils or the effects of wildfires. Metals like these can inhibit reproduction or shell formation. The toxic metals probably exceeded the ability of organic compounds to bind them and remove them from the system. Because nannoplankton are the base of the food chain, larger organisms concentrate any metals found in nannoplankton making the metal poisoning more effective. With the toxic metals remaining in the oceans and the lack of sunlight, the length of time for recovery might increase.

The researchers, led by professor of applied and engineering physics Harold Craighead, made a device just 200 nanometers thick and a few microns long with an oscillating cantilever hanging off one end. (A nanometer is one-billionth of a meter; a micron is one-millionth of a meter.) They identified exactly how to tune its sensitivity -- a breakthrough that could lead to advanced sensing technologies. The experiments detailed online Feb. 8 in Journal of Applied Physics show how these oscillators, which are nanoelectromechanical systems (NEMS), could one day be made into everyday devices by lining up millions of them and treating each cantilever with a certain molecule. "The big purpose is to be able to drive arrays of these things all in direct synchrony," said first author Rob Ilic, a research associate at the Cornell NanoScale Science and Technology Facility. "They can be functionalized with different chemistries and biomolecules to detect various pathogens -- not just one thing."