Search

Introduction: Timely recognition and treatment of sepsis improves survival. The objective is to examine the association between recognition of sepsis and timeliness of treatments. Methods: We identified a retrospective cohort of emergency department (ED) patients with positive blood cultures from May 2007 to January 2009, and reviewed vital signs, imaging, laboratory data, and physician/nursing charts. Patients who met systemic inflammatory response syndrome (SIRS) criteria and had evidence of infection available to the treating clinician at the time of the encounter were classified as having sepsis. Patients were dichotomized as RECOGNIZED if sepsis was explicitly articulated in the patient record or if a sepsis order set was launched, or as UNRECOGNIZED if neither of these two criteria were met. We used median regression to compare time to antibiotic administration and total volume of fluid resuscitation between groups, controlling for age, sex, and sepsis severity. Results: SIRS criteria were present in 228/315 (72.4%) cases. Our record review identified sepsis syndromes in 214 (67.9%) cases of which 118 (55.1%) had sepsis, 64 (29.9%) had severe sepsis, and 32 (15.0%) had septic shock. The treating team contemplated sepsis (RECOGNIZED) in 123 (57.6%) patients. Compared to the UNRECOGNIZED group, the RECOGNIZED group had a higher use of antibiotics in the ED (91.9 vs.75.8%, p=0.002), more patients aged 60 years or older (56.9 vs. 33.0%, p=0.001), and more severe cases (septic shock: 18.7 vs. 9.9%, severe sepsis: 39.0 vs.17.6%, sepsis: 42.3 vs.72.5%; p

The research analyses the historical evolution of the water supply systems of the city of Benevento (southern Italy) during centuries. We focused on three main historical periods, namely the Roman, Lombard and Papal times, and the recent-present times. During this long historical time, the water supply amount and quality have changed many times, and this has probably affected the well-being and growth of the city. The best water quality characterized the Roman times, when large karst springs were tapped, feeding the town for centuries. In this period, the town experienced the largest population expansion. On the other hand, the most depressed period was the Papal times, coinciding with the isolation of the city, as it was an enclave of the Pontifical State. During this period, the water supply from external sources was not guaranteed and therefore it primarily derived from the local, low-quality water resources. Only after the unification of Italy, and also after the Second World War, the water supply systems have been improved, and new aqueducts have brought again high-quality waters to Benevento coming from karst aquifers. Nowadays, the drinking water management of Benevento is still a matter of debate. In the near future, the water from a dam-reservoir (Campolattaro dam, Tammaro River) will be exploited to guarantee the water needs of the city, and water-supply systems will undergo further changes . The knowledge about the historical evolution of the water supply of Benevento represents an essential requirement for consciously analyzing the future planning and management of water resources.

Clinical metrics of baseline health in sentinel seabird species can offer insight into marine ecosystem dynamics, individual and population health, and assist in wildlife rehabilitation and conservation efforts. Protein electrophoresis is useful for detecting changes in acute phase proteins and immunoglobulin levels that may indicate subtle inflammatory responses and/or infectious disease. Serum biochemistry can highlight nutritional status, metabolic derangements, and organ injury and function. However, baseline values for such health parameters are largely unknown for many seabird species. Therefore, the objective of this study is to establish baseline clinical health reference intervals for serum protein electrophoresis, acute phase proteins including serum amyloid A and haptoglobin, and biochemistry parameters in the rhinoceros auklet (Cerorhinca monocerata), a key sentinel species in the North Pacific. From 2013 to 2019, 178 wild, apparently healthy breeding adult rhinoceros auklets were captured across four breeding colonies in British Columbia, Canada (Lucy Island, Pine Island, Triangle Islands, and SGang Gwaay) and from one colony in Washington, United States (Protection Island). Reference intervals were calculated for protein electrophoresis fractions and acute phase proteins (n = 163), and serum biochemistry (n = 35) following established guidelines by the American Society of Veterinary Clinical Pathology. Animals were also assessed for the presence of antibodies to the influenza A virus. Approximately 48% (70/147) of sampled birds were seropositive for influenza A virus, with a prevalence of 50% (6/12) in 2013, 75% (47/63) in 2014, and 24% (17/72) in 2019. This work provides clinical baseline health metrics of a key North Pacific sentinel species to help inform marine ecosystem monitoring, recovery, and rehabilitation efforts in the Pacific Northwest.

In a software-defined radar (SDR) system, most of the signal processing usually implemented in hardware is implemented by software, thus allowing for higher flexibility and modularity compared to conventional radar systems. However, the majority of SDR demonstrators and proofs of concept reported in the open literature so far have been based on simple antenna systems. As a result, the full potentialities of an SDR approach have not been completely exploited yet. In this work, we propose a flexible antenna module to be integrated into an active electronically scanning array (AESA) with controlled sidelobe level over a wide angular range, exhibiting polarization reconfigurability with a low cross-polarization level and high isolation. For this purpose, analytical and numerically efficient techniques for the synthesis of the aperture distribution and the correct evaluation of the radiating features (e.g., beamwidth, pointing angle, sidelobe levels, etc.) are presented in order to grant real-time control of the digital beamforming network. A sub-array module demonstrator is fabricated and measured to corroborate the concept.

This dataset contains the full results of a survey on mobility patterns after the Covid-19 pandemic. The survey was conducted in the second trimester of 2021 and collected information from 10000 respondents across 20 urban areas. The questions covered demographic and socio-economic characteristics, employment and job related situation, the use of technological alternatives in daily activities, mobility patterns (trip frequency, purpose, destination, mode, level of comfort), and perceptions as regards the usability of each transport option. Particular emphasis was given to the comparison of current activity to that before the pandemic. The survey combined an online (Computer-Assisted Web Interviews, CAWI) approach with telephone (Computer-Assisted Telephone Interviews, CATI) interviews. The sample in each city was representative of the local demographic and socio-economic profile according to age, sex, employment situation, education and urbanization.

T behavior refers to individual differences in thrill-seeking (T) and risk-taking behavior. This study was designed to explore and expand the understanding of self-reported T behavior in relation to flourishing, mindset, psychological entitlement, creativity, and stress. This on-line study used both college student (n = 248) and non-college adult (n = 224) samples, prompted by the need to examine psychological phenomena beyond the usual college undergraduate sample. Results showed complex relationships of T behavior to the other indices, with several differences attributable to gender, age, and student/non-student status. It was found that the college sample had a higher level of T behavior, higher level of psychological entitlement, a more malleable mindset, and was more stressed. Flourishing was found to highly predict T behavior in the non-college males. The results have expanded our understanding of T behavior, enriching its description and discerning provocative new relationships among some of the studied non-T variables themselves. Findings are further discussed in the article., Author(s): Mona Sarshar [sup.1] [sup.2], Frank Farley [sup.1], Catherine A. Fiorello [sup.1], Joseph DuCette [sup.1] Author Affiliations: (1) grid.264727.2, 0000 0001 2248 3398, Psychological Studies in Education, Temple University, , [...]

We report molecular detection of Rickettsia africae in Amblyomma ovale ticks from Nicaragua and a novel rickettsial strain in an A. triste tick. Of 146 ticks from dogs, 16.4% were Rickettsia PCR positive. The presence of Rickettsia spp. in human-biting ticks in Nicaragua may pose a public health concern.

Scientism and the Growing Divide Between the Humanities and the Sciences

The retinal macula is at the center of our visual field, and thus pathological damage in the macula significantly impacts an individual's quality of life. The parafoveal vessels form the inner retina provide oxygen perfusion, and the measurement of parafoveal oxygen saturation (sO2) can evaluate macular metabolism and provide pathophysiological insight. In this paper, for the first time, we present a baseline study of microvascular oxygen saturation (sO2) in perifoveal macular region using visible light optical coherence tomography (VIS-OCT) on normal eyes. The arterial and venous sO2 from all eyes was 92.1 ± 7.1 (vol %) and 48.4 ± 5.0 (vol %) (mean ± SD), respectively. Arteriovenous sO2 difference was 43.8 ± 9.5 (vol %). Marginal correlation was found between venous sO2 and intraocular pressure (IOP) among eyes. No significant correlation was found between sO2 and vessel topological features, including length, diameter, and distance to fovea. This baseline study could serve as a benchmark for the future sO2 investigation of retinal macular pathologies.

In a software-defined radar (SDR) system, most of the signal processing usually implemented in hardware is implemented by software, thus allowing for higher flexibility and modularity compared to conventional radar systems. However, the majority of SDR demonstrators and proofs of concept reported in the open literature so far have been based on simple antenna systems. As a result, the full potentialities of an SDR approach have not been completely exploited yet. In this work, we propose a flexible antenna module to be integrated into an active electronically scanning array (AESA) with controlled sidelobe level over a wide angular range, exhibiting polarization reconfigurability with a low cross-polarization level and high isolation. For this purpose, analytical and numerically efficient techniques for the synthesis of the aperture distribution and the correct evaluation of the radiating features (e.g., beamwidth, pointing angle, sidelobe levels, etc.) are presented in order to grant real-time control of the digital beamforming network. A sub-array module demonstrator is fabricated and measured to corroborate the concept. [ABSTRACT FROM AUTHOR]

Clinical metrics of baseline health in sentinel seabird species can offer insight into marine ecosystem dynamics, individual and population health, and assist in wildlife rehabilitation and conservation efforts. Protein electrophoresis is useful for detecting changes in acute phase proteins and immunoglobulin levels that may indicate subtle inflammatory responses and/or infectious disease. Serum biochemistry can highlight nutritional status, metabolic derangements, and organ injury and function. However, baseline values for such health parameters are largely unknown for many seabird species. Therefore, the objective of this study is to establish baseline clinical health reference intervals for serum protein electrophoresis, acute phase proteins including serum amyloid A and haptoglobin, and biochemistry parameters in the rhinoceros auklet (Cerorhinca monocerata), a key sentinel species in the North Pacific. From 2013 to 2019, 178 wild, apparently healthy breeding adult rhinoceros auklets were captured across four breeding colonies in British Columbia, Canada (Lucy Island, Pine Island, Triangle Islands, and SGang Gwaay) and from one colony in Washington, United States (Protection Island). Reference intervals were calculated for protein electrophoresis fractions and acute phase proteins (n = 163), and serum biochemistry (n = 35) following established guidelines by the American Society of Veterinary Clinical Pathology. Animals were also assessed for the presence of antibodies to the influenza A virus. Approximately 48% (70/147) of sampled birds were seropositive for influenza A virus, with a prevalence of 50% (6/12) in 2013, 75% (47/63) in 2014, and 24% (17/72) in 2019. This work provides clinical baseline health metrics of a key North Pacific sentinel species to help inform marine ecosystem monitoring, recovery, and rehabilitation efforts in the Pacific Northwest. [ABSTRACT FROM AUTHOR]

Objectives: To describe our technique to perform tubeless percutaneous nephrolithotomy (tPCNL) using hemostatic matrix (i.e. Floseal®) for the closure of the percutaneous tract, developed through the experience gained in our endourology specialized center. To evaluate the procedure efficacy and safety. Methods: tPCNL performed in our center with Floseal® application from February 2017 to December 2019 were retrospectively reviewed. Clinical and surgical data were collected in order to evaluate the success of the procedure and possible complications. Camposampiero technique is reported in detail. Results: Sixty-nine patients (45 males, mean age 58 years old) were included. In all patients the procedure was completed successfully and in 88% of subjects no further treatments were necessary; a low complication rate (6.9%) was reported. Conclusion: In our experience, tPCNL with Floseal application is feasible, safe, and effective. [ABSTRACT FROM AUTHOR]