To study the agreement between the level of satisfaction of patients and their families referred to the care and attention received during admission to the ICU.
A prospective, 5-month observational ...and descriptive study was carried out.
ICU of Marqués de Valdecilla University Hospital, Santander (Spain).
Adult patients with an ICU stay longer than 24h, who were discharged to the ward during the period of the study, and their relatives.
Instrument: FS-ICU 34 for assessing family satisfaction, and an adaptation of the FS-ICU 34 for patients. The Cohen kappa index was calculated to assess agreement between answers.
An analysis was made of the questionnaires from one same family unit, obtaining 148 pairs of surveys (296 questionnaires). The kappa index ranged between 0.278-0.558, which is indicative of mild to moderate agreement.
The families of patients admitted to the ICU cannot be regarded as good proxies, at least for competent patients. In such cases, we must refer to these patients in order to obtain first hand information on their feelings, perceptions and experiences during admission to the ICU. Only when patients are unable to actively participate in the care process should their relatives be consulted.
Helminth zoonoses are parasitic infections shared by humans and animals, being the soil-transmitted helminths (STHs) mainly caused by roundworms (ascarids) and hookworms. This study was aimed to ...assess the individual and/or mixed production of two helminth-antagonistic fungi, one ovicide (Mucor circinelloides) and other predator (Duddingtonia flagrans). Fungi were grown both in Petri plates and in a submerged culture (composed by water, NaCl, Na2HPO4 · 12 H2O, and wheat (Triticum aestivum)). A Fasciola hepatica recombinant protein (FhrAPS) was incorporated to the cultures to improve fungal production. All the cultured plates showed fungal growth, without difference in the development of the fungi when grown alone or mixed. High counts of Mucor spores were produced in liquid media cultures, and no significant differences were achieved regarding single or mixed cultures, or the incorporation of the FhrAPS. A significantly higher production of Duddingtonia spores after the incorporation of the FhrAPS was observed. When analyzing the parasiticide efficacy of the fungal mixture, viability of T. canis eggs reduced to 51%, and the numbers of third stage cyathostomin larvae reduced to 4%. It is concluded, the capability of a fungal mixture containing an ovicide (Mucor) and a predator species (Duddingtonia) for growing together in a submerged medium containing the FhrAPS offers a very interesting tool for preventing STHs.
A preliminary study to evaluate the possibilities of biological control procedures against parasites affecting livestock reared in a care farm has been conducted. Adults with mental disabilities were ...involved in spreading the spores of the filamentous fungus Mucor circinelloides directly onto the faeces, or as a food additive. In the first assay, the spores were sprayed directly onto the faeces of piglets and calves parasitised by roundworms (Ascaris suum) and liver flukes (Fasciola hepatica), respectively. In the second assay, the spores were mixed with on-farm mash feed. Participation of the adults in the experiments was fully satisfactory. In the manure sprayed Mucor spores, the viability of eggs of roundworms and flukes reduced by 53% and 74%, respectively. Significant reductions of viability of eggs of Ascaris (60%) and Fasciola (67%) in the faeces of piglets and calves given mash feed-added Mucor spores were achieved, which demonstrates their ability to survive in the digestive tract of the animals. It is concluded that biological control of parasites could be helpful to decrease the risk of infection in animals reared by intellectually disabled adults in a care farm, and it could motivate them to accomplish new tasks.
DIRAC: a community grid solution Tsaregorodtsev, A; Bargiotti, M; Brook, N ...
Journal of physics. Conference series,
07/2008, Letnik:
119, Številka:
6
Journal Article
Recenzirano
Odprti dostop
The DIRAC system was developed in order to provide a complete solution for using the distributed computing resources of the LHCb experiment at CERN for data production and analysis. It allows a ...concurrent use of over 10K CPUs and 10M file replicas distributed over many tens of sites. The sites can be part of a Computing Grid such as WLCG or standalone computing clusters all integrated in a single management structure. DIRAC is a generic system with the LHCb specific functionality incorporated through a number of plug-in modules. It can be easily adapted to the needs of other communities. Special attention is paid to the resilience of the DIRAC components to allow an efficient use of non-reliable resources. The DIRAC production management components provide a framework for building highly automated data production systems including data distribution and data driven workload scheduling. In this paper we give an overview of the DIRAC system architecture and design choices. We show how different components are put together to compose an integrated data processing system including all the aspects of the LHCb experiment - from the MC production and raw data reconstruction to the final user analysis.
To determine the level of satisfaction of family members with the care and decision making process, and to know the level of satisfaction of patients discharged from ICU.
A prospective, observational ...and descriptive study with a duration of 5 months was carried out.
The ICU of Marqués de Valdecilla University Hospital, Santander (Spain).
Family members of adult patients admitted to the ICU and patients discharged to the ward.
Family Satisfaction Intensive Care Survey (FS-ICU 34) of family members of patients discharged to the ward. We adapted the FS-ICU 34 in relation to care for application to the patients.
A total of 385 questionnaires were obtained: 192 from families of survivors and 162 from patients, and 31 from relatives of non-survivors. The majority of relatives were satisfied with overall care and overall decision making (survivors: 83.46 ± 11.83 and 79.42 ± 13.58, respectively; non-survivors: 80.41 ± 17.27 and 79.61 ± 16.93, respectively). Patients were very satisfied with the care received (84.71 ± 12.85).
The level of satisfaction of the relatives of patients admitted to the ICU is high, in the same way as the degree of patient satisfaction. Still, there are several points that should be improved, such as the waiting room environment and the atmosphere of the ICU in terms of noise, privacy and lighting. In relation to the decision making process, there are also some aspects that may be improved, such as the provision of hope regarding recovery of the critically ill relative.
Summary Background In a phase 3, randomised, non-inferiority trial, accelerated partial breast irradiation (APBI) for patients with stage 0, I, and IIA breast cancer who underwent breast-conserving ...treatment was compared with whole-breast irradiation. Here, we present 5-year follow-up results. Methods We did a phase 3, randomised, non-inferiority trial at 16 hospitals and medical centres in seven European countries. 1184 patients with low-risk invasive and ductal carcinoma in situ treated with breast-conserving surgery were centrally randomised to either whole-breast irradiation or APBI using multicatheter brachytherapy. The primary endpoint was local recurrence. Analysis was done according to treatment received. This trial is registered with ClinicalTrials.gov , number NCT00402519. Findings Between April 20, 2004, and July 30, 2009, 551 patients had whole-breast irradiation with tumour-bed boost and 633 patients received APBI using interstitial multicatheter brachytherapy. At 5-year follow-up, nine patients treated with APBI and five patients receiving whole-breast irradiation had a local recurrence; the cumulative incidence of local recurrence was 1·44% (95% CI 0·51–2·38) with APBI and 0·92% (0·12–1·73) with whole-breast irradiation (difference 0·52%, 95% CI −0·72 to 1·75; p=0·42). No grade 4 late side-effects were reported. The 5-year risk of grade 2–3 late side-effects to the skin was 3·2% with APBI versus 5·7% with whole-breast irradiation (p=0·08), and 5-year risk of grade 2–3 subcutaneous tissue late side-effects was 7·6% versus 6·3% (p=0·53). The risk of severe (grade 3) fibrosis at 5 years was 0·2% with whole-breast irradiation and 0% with APBI (p=0·46). Interpretation The difference between treatments was below the relevance margin of 3 percentage points. Therefore, adjuvant APBI using multicatheter brachytherapy after breast-conserving surgery in patients with early breast cancer is not inferior to adjuvant whole-breast irradiation with respect to 5-year local control, disease-free survival, and overall survival. Funding German Cancer Aid.
Polyphenolic compounds are plant nutraceuticals showing a huge structural diversity, including chlorogenic acids, hydrolyzable tannins, and flavonoids (flavonols, flavanones, flavan-3-ols, ...anthocyanidins, isoflavones, and flavones). Most of them occur as glycosylated derivatives in plants and foods. In order to become bioactive at human body, these polyphenols must undergo diverse intestinal transformations, due to the action of digestive enzymes, but also by the action of microbiota metabolism. After elimination of sugar tailoring (generating the corresponding aglycons) and diverse hydroxyl moieties, as well as further backbone reorganizations, the final absorbed compounds enter the portal vein circulation towards liver (where other enzymatic transformations take place) and from there to other organs, including behind the digestive tract or via blood towards urine excretion. During this transit along diverse tissues and organs, they are able to carry out strong antiviral, antibacterial, and antiparasitic activities. This paper revises and discusses these antimicrobial activities of dietary polyphenols and their relevance for human health, shedding light on the importance of polyphenols structure recognition by specific enzymes produced by intestinal microbial taxa.
This paper focuses on the influence of the step drill bit geometry on the damage induced during drilling Carbon Fiber Reinforced Polymer materials (CFRPs). Step geometry designed with the aim of ...avoiding composite damage in CFRPs drilling, is compared to conventional twist configuration. Despite the reduction of thrust force and torque observed when using the step drill, the delamination was only reduced at low feed rates. A numerical model developed for the step geometry was validated with experimental data demonstrating its ability to predict thrust force and delamination for different values of feed rate and cutting speed. Numerical model allowed the development of a parametrical study. Finally, using a response surface methodology a mechanistic model and surface diagrams have been presented in order to help in the selection of optimum variables minimizing drilling induced damage.
This paper focuses on the analysis of tool wear mechanisms in finishing turning of Inconel 718, one of the most used Ni alloys, both in wet and dry cutting. Cemented carbides, ceramics and CBN tools ...are suitable for machining Ni alloys; coated carbide tools are competitive for machining operations of Ni alloys and widely used in industry. Commercial coated carbide tools (multilayer coating TiAl/TiAlN recommended for machining Ni alloys) were studied in this work. The feasibility of two inserts tested for dry cutting of Inconel 718 has been shown in the work. Experimental test were performed in order to analyze wear patterns evolution. It was found great influence of side cutting edge angle in tool wear mode.
► Tool wear patterns in dry and wet turning of Inconel 718 were analyzed. ► The feasibility of dry turning with two types of inserts was proved. ► Different wear patterns were observed: notching, chipping, BUE and flank wear. ► Notch wear was especially significant due to high work hardening of the Ni alloy.
CFRPs drilling is a common process in the aerospace industry carried out prior to components assembly. Machining induced damage leads to significant percentage of component rejection. Damage ...extension strongly depends on drilling geometry and cutting parameters. Fresh drill geometry changes with cutting time due to the wear progression and the risk for hole quality is enhanced as cutting progresses. The influence of wear on hole quality has been analyzed in the literature using mainly an experimental approach.
Simulation of drilling process is an effective method that can be used to optimize drill geometry and process parameters in order to control hole quality and analyze the drill wear evolution. In this paper a finite element model for drilling woven CFRPs, reproducing both fresh and worn tools, is presented. Two different point angles considering fresh and honned edge were modeled. A progressive intra-laminar failure model based on the Chang and Chang model is considered. Cohesive elements allowed the analysis of inter-laminar damage (delamination). The model demonstrated its ability to predict thrust force and delamination for different values of feed rate and cutting speed. Model predictions show the influence of tool geometry (including variations induced due to wear) on delamination.
PDF
