Approximately Research Articles

Clinical and economical improvements after introducing rapid identification of bacteria and early antibiotic susceptibility testing in sepsis and bloodstream infections. Results of the PHENOMENON study.

Background: Sepsis and bloodstream infections pose severe challenges in intensive care. Early reliable diagnosis is the key to successful therapy. The objective of the study presented here was to investigate the clinical and economical effects of the new PhenoTM BC test, which allows bacteria identification (ID) and antimicrobial susceptibility testing (AST) in approximately 7 hours after a blood culture becomes positive (BC+).Methods: Historically controlled interventional study. Population: patients with BC+ and ICU admission. Inadequate initial antimicrobial therapy (IAT) is need of therapy change based on result. Prospectively the new test was used in addition. Primary endpoint: time-to-result in hours. Contribution margin (CM) i.e. revenue – costs was computed. All patients formed the intention-to-treat population (ITT). Patients with complete cost data formed the modified ITT group (mITT). CM results were calculated for mITT and PP. Further analyses: length-of-stay (LOS) and mortality.Results: 223 historical and 200 prospective patients were included. Time to result (ITT) was shortened by 51.1 hours (83 vs. 31.9; p<0.001). Overall savings (mITT) were 257,100 € (–301,264 € vs. –44,164 €). 143 of 181 (79%) patients had a test performed, 126 of 143 (88%) having a clinically useable result. 40 (32%) had IAT vs. 65 (29%) in the historic cohort. Median time to AST in PP was shortened by 61.7 hours (89.5 vs. 27.8; p<0.001). LOS was shortened 7 days (28 vs. 19; p=0.226) and mortality was 8% (40.5% vs. 32.5%; p=0.440) lower. Median CM +3,074.80 € per case (–2,350.50 € vs. +724.70 €; p=0.040). Conclusion: The new PhenoTM ID+AST test leads to faster and clinically meaningful results and saves money by shortening LOS on the ICU.

Reducing Rebleeding After Endoscopic Therapy of Dieulafoy Lesions

Although Dieulafoy lesions (DLs) are an unusual cause of upper gastrointestinal bleeding (UGIB), they are responsible for approximately 10% of severe

Variational approximate for high order bending analysis of laminated composite plates

This study presents a 4 node, 11 DOF/node plate element based on higher order shear deformation theory for lamina composite plates. The theory accounts for parabolic distribution of the transverse shear strain through the thickness of the plate. Differential field equations of composite plates are obtained from energy methods using virtual work principle. Differential field equations of composite plates are obtained from energy methods using virtual work principle. These equations were transformed into the operator form and then transformed into functions with geometric and dynamic boundary conditions with the help of the Gâteaux differential method, after determining that they provide the potential condition. Boundary conditions were determined by performing variational operations. By using the mixed finite element method, plate element named HOPLT44 was developed. After coding in FORTRAN computer program, finite element matrices were transformed into system matrices and various analyzes were performed. The current results are verified with those results obtained in the previous work and the new results are presented in tables and graphs.

Minimizing Cost of Transportation By Vogel’s Approximation Method: A Case Study of Maisango Cement Nigeria Plc

This piece of research was conducted to optimize the procedures of transporting and distributing of Cement products from MAISANGO Cement Plc to the require destinations which resultant to the reduction of operating cost of transportation problems that usually occurs due to the nature of bad roads to some selected locations in Lagos state- Nigeria. To minimize the cost, a mathematical optimization model (Vogel Approximation method) has been utilized to ease the processes of transporting the product to the various locations.

Futbol Müsabakaları ile İlgili Tweetlerin Anlık Duygu Analizi

Sosyal medya, insanlarin kendilerini ifade edebildikleri ortamlar olarak cok kullanilmaktadir. Bu sebeple Facebook, Instagram ve Twitter gibi sosyal medya ortamlarinin kullanici sayilari giderek artmaktadir. Sosyal medya kullanicilarinin paylasimlari analiz edilerek ilgili konu hakkindaki duygulari ortaya cikarilabilmektedir. Sosyal medya platformu olan Twitter da politikacilar, spor kulupleri, sirketler, aktivistler kisaca neredeyse tum bireyler ve kurumlar icin kendilerini ifade etme ortami haline gelmistir. Hemen hemen tum futbol takimlarinin taraftarlari icin haberlerini paylastiklari Twitter hesaplari vardir. Kullanicilar Twitter’da futbol musabakasi esnasinda ve sonrasinda da mesaj paylasabilmektedir. Bu calismanin konusu, Twitter ortaminda futbol takimlari ve futbol musabakalari hakkinda Twitter kullanicilarinin paylasimlarinin duygu analizi ile ilgilidir. Bu calismada Twitter’da futbol musabakalari hakkinda paylasilan 30.000 Turkce tweet ile anlik duygu analizi yapilmistir. Egitim setlerindeki siniflandirma hatalarini en aza indirmek icin toplanmis olan tweetler el ile etiketlendikten sonra yine ayni kisi tarafindan farkli zamanlarda beser defa kontrol edilmistir. Bu etiketlemede olumlu, olumsuz, tarafsiz ve alakasiz olarak 4 duygu sinifi kullanilmistir. Bu etiketlenmis tweetlerden farkli ozniteliklere sahip 12 farkli egitim seti olusturulmustur. Olusturulan bu egitim setleri kullanilarak farkli siniflama algoritmalari ile modeller cikarilmis ve bu modellerin capraz dogrulama ile siniflama basarimlari bulunmustur. Farkli ozniteliklere sahip olarak olusturdugumuz egitim setleri, belirlenen siniflandirma algoritmalari ile test edilmis ve algoritmalarinin siniflandirma dogruluklari; Naive Bayes algoritmasi icin %84.30, K-En Yakin Komsu (KNN- K-Nearest Neighborhood) algoritmasi icin %87.73, C4.5 algoritmasi icin %89.60, Destek Vektor Makinesi (SVM- Support Vector Machine) algoritmasi icin %92.30 olarak bulunmustur. Calismada zemberek kutuphanesi kullanilarak Turkce tweetlerde yaklasik 48.000 kelimenin duzeltmesi, siniflandirma basarimina olumlu katki saglamistir. Ayrica futbol musabakalari hakkinda paylasilan tweetleri anlik olarak toplayip, olusturulan modeller ile bu tweetlerin sinifini tespit ederek siniflara ait sonuclari gercek zamanli gorsellestiren bir uygulama gelistirilmistir.

Intervenções fisioterapêuticas em pacientes com DPOC descompensado

Introdução: a DPOC é definida como uma doença prevenível e tratável, caracterizada por limitação progressiva do fluxo aéreo. Calcula-se que no Brasil seja a doença respiratória que causa maior morbimortalidade em adultos. Pacientes que realizam reabilitação pulmonar necessitam de menos visitas ao médico ocasionadas por exacerbações e, quando ficam internados, permanecem por menos tempo. Há, consequentemente, aumento da qualidade de vida e melhora na capacidade de realizar exercícios físicos. Objetivos: descrever as intervenções fisioterapêuticas e seus desfechos em pacientes com DPOC. Métodos: trata-se de um estudo observacional retrospectivo, por meio da análise de prontuários com dados de janeiro a dezembro de 2019 em um hospital terciário do DF. Resultados: o resultado demonstrou maioria de indivíduos do sexo masculino (63%) com idade média de 72,4 anos. Além disso, a média do tempo de internação foi de 5,56 dias e 44,4% dos indivíduos apresentavam outras comorbidades associadas à DPOC. A maioria dos pacientes utilizaram VMNI (18,5%) e 14,8% utilizaram VM. Cerca de 11% dos pacientes admitidos no Pronto Socorro evoluíram a óbito. A VMNI foi utilizada como principal recurso fisioterapêutico juntamente mobilização precoce. Conclusão: A VMNI foi utilizada como principal recurso fisioterapêutico aliada à mobilização precoce, e a maior ocorrência de insucesso pode ser justificada pelo fato de os pacientes serem mais graves, com comorbidades associadas e idade mais avançada.

Modeling and optimization of energy consumption and performance characteristics of a solar assisted fluidized bed dryer

The major problem regarding conventional rice mills is the use of fixed-bed drying systems, which is accompanied by high energy consumption. In this study, a novel solar-assisted fluidized-bed system for drying paddy grains was used. The system included a solar water heater, an infrared lamp powered by photovoltaic panels, along with a gas water heater, which were used together to provide the required thermal energy. The working factors were drying air temperature (35, 45, and 55 °C), drying air velocity (7, 8, and 9 m/s), and the angle of the desiccant wheel regeneration gate (0, 45, and 90 degrees). The performance characteristics of the drying system were measured in terms of drying rate, total energy consumption, solar fraction and energy efficiency. Several mathematical models were also applied to fit the moisture ratio curves. In order to analyze the results and obtain the optimized working conditions of the drying system, Response Surface Methodology (RSM) based on the Box–Behnken technique was used. In all of the evaluated conditions, the model entitled “Approximation of diffusion” had the best results for fitting the moisture ratio curves with a correlation coefficient value of at least 0.9729. The selected optimum point included drying air velocity of 7 m/s, drying air temperature of 52.77 oC and regeneration gate angle of 0. Under the mentioned working conditions, the drying time of 75.99 min, the total energy consumption of 0.297 kWh, solar energy fraction of 0.540 and energy efficiency of 47.67% could be obtained with a desirability value of 0.970.

Considerations of Low Health Literacy during the COVID-19Pandemic

The Coronavirus (COVID–19) pandemic has had devastating effects throughout the United States and the world. Recent numbers indicate that approximately 250,000 people in the United States have died from COVID-19, while over 150,000 new cases are announced each day. The numbers of people affected, and the latest Covid research findings have been reported several times a day. Despite the reports, directions, mandates, and recommendations of public health officials, the number of people with COVID-19 continues to climb. Medical information has been reported by the media, medical officials, press briefings, social media, and through social interactions, but that information has often been confusing, conflicting, misleading, and fear inducing for many. Individuals with low health literacy may be impacted by COVID–19 more heavily and more frequently than individuals with proficient health literacy levels due to their inability to understand and carry out health safety recommendations.

Error estimation for 2-D crack analysis by utilizing an enriched natural element method

This paper presents an error estimation technique for 2-D crack analysis by an enriched natural element (more exactly, enriched Petrov-Galerkin NEM). A bare solution was approximated by PG-NEM using Laplace interpolation functions. Meanwhile, an accurate quasi-exact solution was obtained by a combined use of enriched PG-NEM and the global patch recovery. The Laplace interpolation functions are enriched with the near-tip singular fields, and the approximate solution obtained by enriched PG-NEM was enhanced by the global patch recovery. The quantitative error amount is measured in terms of the energy norm, and the accuracy (i.e., the effective index) of the proposed method was evaluated using the errors which obtained by FEM using a very fine mesh. The error distribution was investigated by calculating the local element-wise errors, from which it has been found that the relative high errors occurs in the vicinity of crack tip. The differences between the enriched and non-enriched PG-NEMs have been investigated from the effective index, the error distribution, and the convergence rate. From the comparison, it has been justified that the enriched PG-NEM provides much more accurate error information than the non-enriched PG-NEM.

Isogeometric Collocation Method to solve the strong form equation of UI-RM Plate Theory

This work presents the formulation of the isogeometric collocation method to solve the strong form equation of a unified and integrated approach of Reissner Mindlin plate theory (UI-RM). In this plate theory model, the total displacement is expressed in terms of bending and shear displacements. Rotations, curvatures, and shear strains are represented as the first, the second, and the third derivatives of the bending displacement, respectively. The proposed formulation is free from shear locking in the Kirchhoff limit and is equally applicable to thin and thick plates. The displacement field is approximated using the B-splines functions, and the strong form equation of the fourth-order is solved using the collocation approach. The convergence properties and accuracy are demonstrated with square plate problems of thin and thick plates with different boundary conditions. Two approaches are used for convergence tests, e.g., increasing the polynomial degree (NELT = 1✕1 with p = 4, 5, 6, 7) and increasing the number of element (NELT = 1✕1, 2✕2, 3✕3, 4✕4 with p = 4) with the number of control variable (NCV) is used as a comparable equivalent variable. Compared with DKMQ element of a 64✕64 mesh as the reference for all L/h, the problem analysis with isogeometric collocation on UI-RM plate theory exhibits satisfying results.

Rasgos definitorios del consumo experiencial del turista: Definiciones y caracterizadores

El presente estudio busca aportar una revisión teórica del consumo experiencial en el ámbito del turismo, con el objetivo de aportar un mejor entendimiento del comportamiento del consumidor turístico. La experiencia turística es un proceso complejo, cambiante en tiempos y espacios y que implica más elementos que los propios turistas; así, el enfoque del consumo experiencial se postula como ideal para una comprensión completa del comportamiento del consumidor en el contexto turístico. Bajo este enfoque, este trabajo plantea una revisión de las definiciones de la noción de “experiencia” propias del ámbito de estudio del comportamiento del consumidor general y turístico, con el objeto de identificar las características definitorias del consumo experiencial del turista, y así ofrecer una aproximación al concepto “experiencia” y a su aplicabilidad al consumo turístico. Hemos podido identificar cuatro caracterizadores predominantes (i.e. cognitivo; emocional; interactivo; sensorial), que podrán ser utilizados como definitorios y descriptivos para futuras investigaciones empíricas, y que nos brindan a formular implicaciones gerenciales que podrían ser llevadas a cabo de la mano de las nuevas tecnologías.

Chlamydial infections in women

Chlamydia trachomatis (Ct) is a Gram-negative bacterium with an obligatory intracellular life cycle. Tropism manifests through columnar epithelia in the uterine cervix, rectum, lungs, and eyes. The literature review of the Medline database identified 3,458 papers. The WHO estimates that over 100 million new cases of infection by Ct occur worldwide annually, with an increase of 4.1% since the last global evaluation conducted in 2006. Chlamydia trachomatis is the most frequent sexually transmissible bacterium in the United States with a yearly incidence of more than one million reported cases. Approximately 50 to 75% of infected women show no symptoms of the infection or appear to be mucopurulent cervicitis. Pain caused by cervical motion or evaluation of the accessories in response to a bimanual exam suggests the infection has moved on to the upper genital tract leading to endometritis, salpingitis and peritonitis and its consequences: pelvic pain, infertility, ectopic pregnancy. Chlamydia trachomatis may also be the etiologic agent of bacterial urethritis, in which case, despite the patient’s report of dysuria, the urine culture is negative for the usual urinary pathogens. Since bacteria favor columnar epithelia, the Skene and the Bartholin vestibular glands may also be a site of infection and attendant symptoms. The nucleic acid amplification test is the most recommended for its higher sensitivity and specificity and is currently the gold standard for diagnosis. The antibiotics for the treatment should be chosen for their intracellular penetration ability and should have a half-life of 36 to 48 hours to cover the bacterium’s life cycle. Azithromycin is excellent at intracellular penetration, has a half-life of 5 to 7 days, and can be administered in a single dose; it may also be given to pregnant women. A recent meta-analysis showed a small increase (3%) of better outcome in the use of doxycycline against azithromycin in the treatment of urogenital infection.

SEVEN-POINT FINITE ELEMENT OF INTEGRAL TYPE APPLIED TO CONFORMING - NONCONFORMING METHOD

The paper deals with integral variants of a seven-point triangular finiteelement. This is an enriched quadratic element constructed by adding a non-negativebasis bulb-function which vanishes on the element boundary. The polynomial spacewhich seven-point element uses is P 2 + span{x 2 y + xy 2 }. The main goal here is to determine two-sided bounds of eigenvalues for a second-order elliptic operator. The method consists of finite element solving of the problemby means of seven-point conforming element and then constructing an nonconforminginterpolant of the approximate conforming eigendunctions. Thus, solving only oncethe eigenvalue problem, we get upper and lower bounds for the exact eigenvalues.Furthermore, the fact that the nonconforming interpolants uses the nodal values of theconforming approximate eigenfunctions gives an obvious computational advantage.Finally, numerical experiments confirming the efficiency of the proposed algorithmare also provided.

Epidemiología de la fractura de cadera en la Argentina

La Asociación Argentina de Ortopedia y Traumatología a través del Comité de Morbi-Mortalidad confeccionó una encuesta sobre fracturas de cadera, con el fin de caracterizar este cuadro en nuestro país. Al completarse las primeras 1000 encuestas se elaboró este informe descriptivo. Se estima que, en la Argentina, la prevalencia de fracturas de cadera es de aproximadamente 264/100.000 habitantes. Estas lesiones resultaron más frecuentes en mujeres que en hombres (relación 2,7:1). El 80% de los pacientes tenía &gt;70 años y múltiples comorbilidades (hipertensión arterial, diabetes, anemia y osteoporosis, entre las más frecuentes). El 60% deambulaba solo dentro del domicilio. La incidencia de fracturas intertrocantéricas y mediales fue similar: 53% y 47%, respectivamente. La tasa de complicaciones posoperatorias fue de aproximadamente el 13%, y la infección fue la complicación más frecuente. La tasa de mortalidad en los primeros meses posteriores a la cirugía osciló entre el 3,8% y el 4,85%.&#x0D; Palabras clave: Fractura de cadera; morbilidad; mortalidad; prevalencia; epidemiología.Nivel de Evidencia: IV&#x0D; &#x0D; &#x0D; &#x0D;

Lopinavir Aids Azoles in Treating Drug-Resistant

Candida auris has caused several outbreaks of invasive infections around the world since it emerged in 2009, with mortality rates of approximately 50%

El dibujo de aproximación en Oporto: construyendo la imagen de la ciudad

&lt;p&gt;Oporto es una ciudad ubicada en un enclave privilegiado y que exhibe al observador, de una manera sencilla, su construcción, tanto a nivel espacial como temporal. Recogiendo los conceptos enunciados por varios autores en cuanto a la experiencia sensorial que ofrecen las ciudades para su reconocimiento y su legibilidad, se avanza hacia una reflexión en cuanto a la creación de la imagen de la ciudad. Finalmente, y ya en un plano práctico más aplicado al caso concreto de la ciudad de Oporto, se concluirá con un análisis pormenorizado, a través del dibujo de aproximación, y siguiendo el relato de K. Lynch, de los elementos fundamentales en el reconocimiento e identificación de la imagen urbana: bordes, barrios, sendas, nodos, hitos, y el propio relieve primigenio.&lt;/p&gt;

Color enhancement algorithm based on Daltonization and image fusion for improving the color visibility to color vision deficiencies and normal trichromats

In recent years, helping individuals with color vision deficiency to distinguish confusing colors in digital images, which is called Daltonization, is a hot topic. However, a number of Daltonization methods have a color reduction problem that causes unnatural image colors for normal color vision observers and those with anomalous trichromatic color vision deficiencies. A color-enhancing algorithm is proposed to make up for the shortage in color naturalness. Based on the conclusion in previous studies that colors confused in the same type of color blindness are approximately straight lines (called confusion lines) on the u ′ v ′ chromaticity plane and all of the confusion lines intersect at the same point (called the confusion point), we propose a polar coordinate transformation based on intersection points of confusion lines, which can transform chromaticity information into perceptually sensitive and perceptually insensitive color blindness information. From the two color-blind sensitive information of the Daltonized image and the one color-blind insensitive information of the original image, the three-dimensional information can be combined to obtain an enhanced image. The enhanced image has a similar color appearance of the Daltonized image under the perspective of dichromats and has a more natural and colorful color appearance under the perspective of anomalous and normal trichromats. In addition, we propose a lightness modification to reduce lightness errors between the enhanced images and the Daltonized images. The quantitative evaluation shows that the method proposed is effective but sacrificing a small amount of color contrast of the Daltonized images.

The Perceived Neighborhood Crime and Hazardous Alcohol Use Among Youth in University of the Northeastern Thailand Context.

Background: The residents’ perceptions of the crime and lack of safety with their neighborhood environment, associated with stress that confers risk for drinking. While many studies have focused on adult drinking, less is known about how subjective neighborhood crime influences drinking during adolescent. We aimed to determine the association of perceived neighborhood crime and youth alcohol use. Study design: A cross-sectional study. Methods: This study was conducted on 1087 university youths from 30 neighborhood clusters in Northeastern Thailand from May 2019 to Mar 2020. The data were collected by self-administered questionnaire. A multilevel logistic regression model was applied to examine the effect of perceived neighborhood crime on hazardous alcohol use. Results: Most of youths were female, approximately 60.7% reported hazardous alcohol use, and the average perceived neighborhood crime score was 65.1 (standard deviation, 2.1). The perceived neighborhood crime was associated with hazardous alcohol use; a 1-unit increase in the scores for perceived neighborhood crime corresponded to a 20% increase in hazardous alcohol use. The role of perceived neighborhood crime on alcohol use varied among males, but not females. Conclusion: The perceived neighborhood crime plays a role in the increase likelihood of hazardous alcohol use. The consideration of neighborhood crime context is important to design the alcohol preventive and intervention strategies.

O ambiente virtual no processo de ensino e esclarecimento de tutores de cães e gatos em tempos de pandemia

Os animais, atualmente, são considerados membros integrantes das famílias. Assim, a conscientização da comunidade sobre a posse responsável associada a políticas públicas é ponto fundamental para a promoção do bem-estar animal e, consequentemente, das famílias. Com isso, o projeto de ensino, pesquisa e extensão em clínica médica de pequenos animais da Universidade Federal de Pelotas (ClinPet –UFPel) realizou atividades extensionistas, com a finalidade de orientar e esclarecer a população sobre temas relacionados a saúde de cães e gatos, buscou também compreender o entendimento de guarda responsável e bem-estar animal por parte dos tutores, assim como suas necessidades e interesse. Logo, foram realizadas divulgações de conteúdos, palestras, Quiz pelas redes sociais, também foi realizado uma pesquisa de campo por meio da aplicação de um questionário online. O Instagram aumentou em quase 500% o número de seguidores, contando atualmente com aproximadamente 3700 seguidores. Através do questionário foi possível compreender que estes usuários são um público preocupado e interessado com o bem-estar de seus pets. No Quiz foi registrado um total de 15.123 visualizações, gerando um alto índice de interação. No mesmo âmbito, as palestras promoveram atualização dos participantes e proporcionou a troca de experiências entre os palestrantes e espectadores. Conclui-se, que as ações extensionistas realiza­das para tutores de cães e gatos são de grande importância e as redes sociais foram essenciais na formação continuada não só dos alunos que criam o conteúdo, mas também naqueles que estão interagindo.

Deep gold mineralization features of Jiaojia metallogenic belt, Jiaodong gold Province: Based on the breakthrough of 3000 m exploration drilling

ABSTRACT Recently, continuous breakthroughs have been made about deep gold prospecting in the Jiaodong gold province area of China. Approximately 5000 t of cumulative gold resources have been explored in Jiaodong, which has thus become an internationally noteworthy gold ore cluster. The gold exploration depth has been increased to about 2000 m from the previous