Between 25%-50% of patients hospitalized with (COVID-19) suffer cardiovascular events. Limited information is available to identify those greatest risk for cardiac complications. The objective of ...this study is to analyze risk factors associated with cardiovascular events in COVID-19 patients.
This retrospective cohort study of 700 inpatients was conducted at nine hospitals within a large urban midwestern city. Data was collected from March 9, 2020, to June 20, 2020. Inclusion criteria included all COVID-19 inpatients and excluded non-inpatients. Predictor variables included demographics, comorbidities, and current clinical data. The outcomes were CE and mortality. Cardiovascular events included heart failure, deep-vein thrombosis, myocardial infarction, pulmonary edema, stroke, cardiomyopathy, myocarditis, reduced ejection fraction, cardiac arrhythmias, cardiogenic shock, and cardiac arrest. Mann-Whitney U, Chi-square, or Fisher's exact tests were used to examine differences in groups with and without CE. Multiple logistics regression analyses were used to determine predictors of CE and Kaplan-Meier was conducted for survival comparisons between groups. A p-value of ≤0.05 was considered statistically significant.
Inpatients with COVID-19 had greater odds of having a CE (n=126) if they were older, male, black, and had pulmonary and cardiovascular comorbidities (p < 0.001). Inpatients who had higher levels of potassium, glucose, blood urea nitrogen, creatinine, activated partial prothrombin time, domain-dimer, interleukin-6, white blood cell count, and oxygen requirements had an increased odds of having a CE (p < 0.05). Cardiovascular events were associated with higher mortality (45.24%). Blacks had greater odds of CEs in the presence of diabetes and cardiovascular comorbidities (p=0.008, p=0.014, respectively), however, blacks had better survival, despite having greater risk.
Multiple risk factors for cardiovascular events and death were identified in this sample of hospitalized patients with COVID-19, and mortality was increased significantly in those inpatients who had CEs.
Candida auris (C. auris) is a fungal pathogen that recently emerged and rapidly spread around the globe. It is now in California with 74 clinical cases according to the Centers for Disease Control ...and Prevention (August 31, 2020). C. auris can cause invasive disease with high mortality rates, is frequently resistant to one or more classes of antifungals, and can be difficult to identify. C. auris can also involve prolonged colonization of patients’ skin and contamination of surrounding environments, resulting in hospital outbreaks. The first known clinical case of C. auris in San Diego County was identified in an individual with recent hospitalization outside of the United States. The identification of this clinical case coincided with the first influx of COVID-19 patients.
The facility's carbapenemase-producing organism (CRO) screening program identified an individual who had recent hospitalization abroad. The patient was placed in a single room in pre-emptive Contact precautions. The patient tested positive for CRO colonization. The public health (PH) authorities asked that the patient be tested for C. auris colonization. While awaiting screening results, the hospital's microbiology laboratory identified C. auris in the patient's wound isolate. The C. auris case prompted the implementation of a robust infection prevention plan in collaboration with PH that included isolation precautions, environmental cleaning and disinfection and education.
The patient required forty-seven days of hospitalization during the early days of the COVID-19 pandemic. The PH department recommended C. auris colonization screening for selected patients to check for transmission. Neither C. auris colonization nor clinical isolates were identified in the subsequent six months.
A strong infection prevention response to the C. auris case prevented a potential outbreak. It is critical that acute-care hospitals are optimized to prevent the spread of C. auris during the COVID-19 pandemic.
•The flower-shaped pulsating heat pipe design can handle higher heat fluxes compared to the state-of-the-art design•The thermal resistance decreases due to continuous phase change processes in the ...evaporation chamber•The fluid oscillation is driven by the phase change in the evaporation chamber•Convective heat transfer is negligible in horizontal position
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Pulsating heat pipes (PHPs) are increasingly used for the thermal management of hot spots. A major goal in the design process of PHPs is the handling of high heat fluxes and, thus, improved thermal resistance. The thermal resistance can be reduced by increasing the latent or convective heat transfer. Two design approaches with that goal are presented in this study: a flower-shaped PHP design to increase the latent heat transfer and a star-shaped PHP design to increase the convective heat transfer. We compare the proposed designs to a state-of-the-art, meander-shaped PHP design. Thereby, we quantify the thermal performance and the flow pattern of the different PHP designs. The copper PHPs were filled with acetone and tested horizontally and vertically. The filling ratios varied from 0 % to 90 % and the heat inputs increased from 50 W to 200 W. Our results illustrate that the flower-shaped PHP design reduces the thermal resistance by 7 % in horizontal and 12 % in vertical position. We found a strong interrelation between flow pattern and heat transfer in PHPs. Our study shows that phase change plays a key role for the thermal resistance. Based on that, we provide design criteria to optimize the thermal capabilities of PHPs with a special focus on hot spots.
: The term pseudohypoparathyroidism (PHP) refers to the different disorders that are caused by mutations within GNAS or upstream of this complex genetic locus. GNAS gives rise to several different ...transcripts, including Gsα (α‐subunit of heterotrimeric stimulatory G protein), XLαs (extra‐large variant of Gsα), and several additional sense and antisense transcripts. The complexity of the GNAS locus is furthermore reflected by a parent‐specific methylation pattern of most of its different promotors. PHP can be divided into two major groups, PHP type Ia (PHP‐Ia) and PHP type Ib (PHP‐Ib). PHP‐Ia is caused by heterozygous mutations affecting one of the 13 GNAS exons encoding Gsα or by large intragenic deletions. In contrast, PHP‐Ib is caused by heterozygous deletions within STX16, the gene‐encoding syntaxin 16, which is located more than 220 kb upstream of GNAS, or by deletions within GNAS involving exon NESP55 and two of the antisense exons. In either form of PHP, hormonal resistance develops only after maternal inheritance of the mutation, while paternal inheritance of the same molecular defect is not associated with endocrine abnormalities. In most familial cases of PHP‐Ib, there is a loss of exon A/B methylation combined with active A/B transcription from both parental alleles, which leads to suppression of Gsα transcription in the proximal renal tubules and, therefore, PTH resistance.
BM Elektronik yang menjual berbagai macam alat elektronik. Namun dalam prosesnya, BM Elektronik mengalami beberapa masalah seperti kesalahan dalam mengolah data barang maupun transaksi, sering ...kehilangan bukti transaksi, tidak dapat menghitung jumlah persediaan di toko, hingga kurang luasnya jangkauan pasar ke pelanggan. Untuk mengatasi permasalahan tersebut, perancangan sistem informasi penjualan berbasis e-commerce dapat membantu proses pencatatan data barang maupun transaksi dan membantu pelanggan dalam mencari informasi produk yang ada di toko. Sistem Informasi Penjualan Berbasis E-commerce dengan menggunakan metode persediaan barang First In First Out (FIFO) dan dibangun menggunakan bahasa pemrograman Hypertex Processor (PHP) dan basis data MySQL. Hasil uji coba fungsionalitas menggunakan metode User Acceptance Testing (UAT) yang terdiri dari 42 butir uji dan telah disetujui oleh client. Uji coba terhadap sistem menggunakan metode Usability Testing dengan menyebarkan kuisioner kepada pelanggan toko, dengan hasil persentase 83,75%.
Saat ini perkembangan teknologi sangat pesat seiring dengan kemajuan ilmu pengetahuan di bidang teknologi dan komunikasi. Salah satunya dalam pemasaran dan mempromosikan produk berbasis online. Pada ...kelompok wanita tani Subur Lestari cara penjualannya masih dengan bertatap muka langsung atau datang langsung ke tempat pembuatan produk, dengan cara seperti ini masih kurang efektif dan juga belum banyak yang mengetahui tentang produk ini. Berdasarkan kondisi tersebut, dibutuhkan sebuah sistem informasi yang dapat membantu dalam penjualan secara online agar pelanggan dapat mengetahui informasi mengenai produk yang ditawarkan. Sistem ini dibuat dengan menggunakan metode waterfall, bahasa pemrograman PHP dan MySQL sebagai database servernya. Sistem ini dapat membantu untuk mengelola data sehingga memudahkan untuk mengetahui dan mengevaluasi usaha yang sedang dijalankan.
•Start-up, thermal performance, and vapour-liquid behavior were investigated.•Check valve layout made a clear difference in the start-up characteristics.•Start-up was improved when all check valves ...located near the condenser section.•Start-up was improved when check valves were in an alternate arrangement.•Check valve layout made no significant difference in thermal performance.
An Oscillating Heat Pipe with Check Valves (CVOHP) is one of the desired thermal control devices for future spacecraft with considerable heat dissipation. On-orbit CVOHP operation was conducted during an on-orbit experiment by the Japan Aerospace Exploration Agency (JAXA). However, some start-up difficulty was observed. For practical use, the start-up characteristics must be improved. In this study, the effects of check valve layout on the start-up and heat transfer characteristics were experimentally investigated to improve the start-up characteristics while maintaining high steady-state thermal performance. Both start-up and steady-state thermal performance were evaluated using a CVOHP, which can visualize internal flow for three different check valve layouts: all check valves located near the evaporator, all check valves located near the condenser, and check valves in an alternate arrangement. The results showed that locating all the check valves near the condenser or locating check valves in an alternate arrangement could improve the start-up characteristics. There was no significant difference (less than 10%) in steady-state thermal performance depending on the check valve layout. Those results suggest that the optimal check valve layout could help the CVOHP achieve both high start-up reliability and high steady-state thermal performance.
Human mitochondrial heteroplasmy is an extensively investigated phenomenon in the context of medical diagnostics, forensic identification and molecular evolution. However, technical limitations of ...high-throughput sequencing hinder reliable determination of point heteroplasmies (PHPs) with minor allele frequencies (MAFs) within the noise threshold.
To investigate the PHP landscape at an MAF threshold down to 0.1%, we sequenced whole mitochondrial genomes at approximately 7.700x coverage, in multiple technical and biological replicates of longitudinal blood and buccal swab samples from 11 human donors (159 libraries in total). The results obtained by two independent sequencing platforms and bioinformatics pipelines indicate distinctive PHP patterns below and above the 1% MAF cut-off. We found a high inter-individual prevalence of low-level PHPs (MAF < 1%) at polymorphic positions of the mitochondrial DNA control region (CR), their tissue preference, and a tissue-specific minor allele linkage. We also established the position-dependent potential of minor allele expansion in PHPs, and short-term PHP instability in a mitotically active tissue. We demonstrate that the increase in sensitivity of PHP detection to minor allele frequencies below 1% within a robust experimental and analytical pipeline, provides new information with potential applicative value.
Our findings reliably show different mutational loads between tissues at sub-1% allele frequencies, which may serve as an informative medical biomarker of time-dependent, tissue-specific mutational burden, or help discriminate forensically relevant tissues in a single person, close maternal relatives or unrelated individuals of similar phylogenetic background.
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