(1) Background: The inflammation or cytokine storm that accompanies COVID-19 marks the prognosis. This study aimed to identify three risk categories based on inflammatory parameters on admission. (2) ...Methods: Retrospective cohort study of patients diagnosed with COVID-19, collected and followed-up from 1 March to 31 July 2020, from the nationwide Spanish SEMI-COVID-19 Registry. The three categories of low, intermediate, and high risk were determined by taking into consideration the terciles of the total lymphocyte count and the values of C-reactive protein, lactate dehydrogenase, ferritin, and D-dimer taken at the time of admission. (3) Results: A total of 17,122 patients were included in the study. The high-risk group was older (57.9 vs. 64.2 vs. 70.4 years; p < 0.001) and predominantly male (37.5% vs. 46.9% vs. 60.1%; p < 0.001). They had a higher degree of dependence in daily tasks prior to admission (moderate-severe dependency in 10.8% vs. 14.1% vs. 17%; p < 0.001), arterial hypertension (36.9% vs. 45.2% vs. 52.8%; p < 0.001), dyslipidemia (28.4% vs. 37% vs. 40.6%; p < 0.001), diabetes mellitus (11.9% vs. 17.1% vs. 20.5%; p < 0.001), ischemic heart disease (3.7% vs. 6.5% vs. 8.4%; p < 0.001), heart failure (3.4% vs. 5.2% vs. 7.6%; p < 0.001), liver disease (1.1% vs. 3% vs. 3.9%; p = 0.002), chronic renal failure (2.3% vs. 3.6% vs. 6.7%; p < 0.001), cancer (6.5% vs. 7.2% vs. 11.1%; p < 0.001), and chronic obstructive pulmonary disease (5.7% vs. 5.4% vs. 7.1%; p < 0.001). They presented more frequently with fever, dyspnea, and vomiting. These patients more frequently required high flow nasal cannula (3.1% vs. 4.4% vs. 9.7%; p < 0.001), non-invasive mechanical ventilation (0.9% vs. 3% vs. 6.3%; p < 0.001), invasive mechanical ventilation (0.6% vs. 2.7% vs. 8.7%; p < 0.001), and ICU admission (0.9% vs. 3.6% vs. 10.6%; p < 0.001), and had a higher percentage of in-hospital mortality (2.3% vs. 6.2% vs. 23.9%; p < 0.001). The three risk categories proved to be an independent risk factor in multivariate analyses. (4) Conclusion: The present study identifies three risk categories for the requirement of high flow nasal cannula, mechanical ventilation, ICU admission, and in-hospital mortality based on lymphopenia and inflammatory parameters.
We aimed to develop and validate a prediction model, based on clinical history and examination findings on initial diagnosis of coronavirus disease 2019 (COVID-19), to identify patients at risk of ...critical outcomes.
We used data from the SEMI-COVID-19 Registry, a cohort of consecutive patients hospitalized for COVID-19 from 132 centres in Spain (23rd March to 21st May 2020). For the development cohort, tertiary referral hospitals were selected, while the validation cohort included smaller hospitals. The primary outcome was a composite of in-hospital death, mechanical ventilation, or admission to intensive care unit. Clinical signs and symptoms, demographics, and medical history ascertained at presentation were screened using least absolute shrinkage and selection operator, and logistic regression was used to construct the predictive model.
There were 10 433 patients, 7850 in the development cohort (primary outcome 25.1%, 1967/7850) and 2583 in the validation cohort (outcome 27.0%, 698/2583). The PRIORITY model included: age, dependency, cardiovascular disease, chronic kidney disease, dyspnoea, tachypnoea, confusion, systolic blood pressure, and SpO2 ≤93% or oxygen requirement. The model showed high discrimination for critical illness in both the development (C-statistic 0.823; 95% confidence interval (CI) 0.813, 0.834) and validation (C-statistic 0.794; 95%CI 0.775, 0.813) cohorts. A freely available web-based calculator was developed based on this model (https://www.evidencio.com/models/show/2344).
The PRIORITY model, based on easily obtained clinical information, had good discrimination and generalizability for identifying COVID-19 patients at risk of critical outcomes.
Fracking is a technology used for the extraction of shale gas contained in rocks on the Earth’s surface. The main characteristic of this method is that it consists of injecting pressurized water into ...the ground, thus creating a series of fractures through which the gas comes out to be collected later. Fracking has a number of both socio-economic and environmental implications that can be both beneficial (including increased energy security, economic growth, or reduced emissions of pollutants and climate change) and harmful (induced seismicity, increased global temperature, and potential greenhouse emissions if not properly implemented). The realization of a systematic review of the literature classifying the articles found according to the type of evidence they present; that it gathers all the impacts has allowed to group them and to give a general vision about the topic; that no articles have been found that have this same objective in the existing literature, thus contributing to the increase of the existing knowledge in this field. It is concluded that environmental risks, including those that could affect human health, should be integrated into the cost structure of fracking, as a risk premium or provision of funds to remedy possible negative effects.
•Manuka honey protects against oxidative stress, improving mitochondrial functionality.•Manuka honey activates AMPK/Nrf2/ARE pathway, enhancing antioxidant defence.•Manuka honey promotes the healing ...of wounds.
Excessive amounts of free radicals are deleterious for cells, resulting in cell damage, affecting the wound healing process and causing premature ageing or even neoplastic transformation. Here the capacity of Manuka honey (MH) to protect against oxidative damage and improve the process of skin wound healing was investigated. Up to 16 compounds were identified in MH, with leptosin derivatives and methyl syringate as the major ones. MH protected against apoptosis, intracellular ROS production, and lipid and protein oxidative damage. MH also protected mitochondrial functionality, promoted cell proliferation and activated the AMPK/Nrf2/ARE signalling pathway, as well as the expression of the antioxidant enzymes such as SOD and CAT. Here we describe for the first time that one of the possible mechanisms by which MH exhibits its ability to promote wound healing could be due to its capacity to improve the antioxidant response by activating AMPK phosphorylation and the ARE response.
It is well known that working photovoltaic (PV) plants show several maintenance needs due to wiring and module degradation, mismatches, dust, and PV cell defects and faults. There are a wide range of ...theoretical studies as well as some laboratory tests that show how these circumstances may affect the PV production. Thus, it is mandatory to evaluate the whole PV plant performance and, then, its payback time, profitability, and environmental impact or carbon footprint. However, very few studies include a systematic procedure to quantify and supervise the real degradation effects and fault impacts on the field. In this paper, the authors first conducted a brief review of the most frequent PV faults and the degradation that can be found under real conditions of operation of PV plants. Then, they proposed and developed an innovative Geographic Information System (GIS) application to locate and supervise them. The designed tool was applied to both a large PV plant of 108 kWp and a small PV plant of 9 kWp installed on a home rooftop. For the large PV plant, 24 strings of PV modules were modelized and introduced into the GIS application and every module in the power plant was studied including voltage, current, power, series and parallel resistances, fill factor, normalized PV curve to standard test conditions (STC), thermography and visual analysis. For the small PV installation three strings of PV panels were studied identically. It must be noted that PV modules in this case included power optimizers. The precision of the study enabled the researchers to locate and supervise up to a third part of every PV cell in the system, which can be adequately georeferenced. The developed tool allows both the researchers and the investors to increase control of the PV plant performance, to lead to better planning of maintenance actuations, and to evaluate several PV module replacement strategies in a preventive maintenance program. The PV faults found include hot spots, snail tracks, ethylene vinyl acetate (EVA) discoloration, PV cell fractures, busbar discoloration, bubbles and Si discoloration.
An integrated service recovery system (ISRS) Leticia Santos‐Vijande, María; María Díaz‐Martín, Ana; Suárez‐Álvarez, Leticia ...
European journal of marketing,
01/2013, Letnik:
47, Številka:
5/6
Journal Article
Recenzirano
Purpose
Appropriate management of service failures involves a complex organizational response that allows an effective internal and external recovery, learn from mistakes and introduce future service ...innovations. Empirical evidence on the organizational recovery practices more suitable to achieve these objectives, leading to superior performance, is limited. The present work seeks to extend the existing literature by identifying the potential dimensions that constitute an integrated service recovery system (ISRS), introducing a strategic, proactive and relational approach to service failure and recovery management, and by proposing a causal model linking the ISRS with performance.
Design/methodology/approach
The ISRS dimensions and their attributes are derived from an extensive literature review and suggestions from academics and business experts. Structural equations modeling is used to test a model linking the ISRS (conceptualized as a second order construct), with client, employee and business performance indicators, using data from a Spanish sample of 151 Knowledge‐Intensive Business Services (KIBS).
Findings
Results confirm that the firms' ability to approach service recovery from a strategic, proactive and relational perspective allows improving performance among clients and employees, that is, the external and internal recovery to occur, which leads to a superior competitive performance.
Practical implications
The ISRS scale can provide managers with a diagnostic tool to analyze their recovery practices and to further improve their competitiveness in the long term.
Originality/value
The need to assess the integrative nature of effective service recovery systems has been claimed theoretically. An empirical study showing the link between comprehensive service recovery practices and performance was lacking.
The promotion of the development of co-digestion power plants will be intensified in many European Union member states as the main target of the Union concerning energy generation is complete ...decarbonisation by 2050. This potential expansion prompts the need for optimal resources allocation according to several techno-economical parameters, highlighting energy costs, power infrastructures access, and social and environmental aspects and restrictions. In Spain, agricultural and livestock biogas production trough co-digestion power plants is still poorly deployed, although the EU Directive 2009/28/EU stipulates that energy from bio-fuels and bio-liquids should contribute to a reduction of at least 35% of greenhouse gas emissions in order to be taken into account, and many authors agree that biogas produced from energy crops and livestock waste fulfils this criterion. Moreover, biogas can be used to upgrade gas pipelines and may have other efficient thermal uses. In this paper, through a Geographical Information System approach, eight different co-digestion mixtures have been evaluated and the most profitable ones have been optimized for the Spanish Iberian Peninsula according to the geographical distribution of the resources. Furthermore, the best locations for co-digestion power plants siting have been calculated, minimizing transport costs and considering technical, environmental and social restrictions. In contrast with other studies, this proposed approach is focused on a holistic optimization. Results show that in Spain the most feasible co-digestion mixtures are based on slurry, glycerine and animal meals, and four areas arise with an outstanding energetic potential up to 208 MW exploitable in large electrical power plants, while 347 MW can be reserved for distributed generation based on this technology.
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