64 research outputs found

    Comparison of colistin-carbapenem, colistin-sulbactam, and colistin plus other antibacterial agents for the treatment of extremely drug-resistant Acinetobacter baumannii bloodstream infections

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    23rd European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) -- 41394 -- Berlin, GERMANYbalkan, ilker inanc/0000-0002-8977-5931; altay, fatma aybala/0000-0002-7149-2968; Durdu, Bulent/0000-0002-0244-4006; Karabay, Oguz/0000-0003-0502-432XWOS: 000338723600006PubMed: 24532009The purpose of this investigation was to compare the efficacy of colistin-based therapies in extremely drug-resistant Acinetobacter spp. bloodstream infections (XDR-ABSI). A retrospective study was conducted in 27 tertiary-care centers from January 2009 to August 2012. The primary end-point was 14-day survival, and the secondary end-points were clinical and microbiological outcomes. Thirty-six and 214 patients [102 (47.7 %): colistin-carbapenem (CC), 69 (32.2 %): colistin-sulbactam (CS), and 43 (20.1 %: tigecycline): colistin with other agent (CO)] received colistin monotherapy and colistin-based combinations, respectively. Rates of complete response/cure and 14-day survival were relatively higher, and microbiological eradication was significantly higher in the combination group. Also, the in-hospital mortality rate was significantly lower in the combination group. No significant difference was found in the clinical (p = 0.97) and microbiological (p = 0.92) outcomes and 14-day survival rates (p = 0.79) between the three combination groups. Neither the timing of initial effective treatment nor the presence of any concomitant infection was significant between the three groups (p > 0.05) and also for 14-day survival (p > 0.05). Higher Pitt bacteremia score (PBS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Charlson comorbidity index (CCI), and prolonged hospital and intensive care unit (ICU) stay before XDR-ABSI were significant risk factors for 14-day mortality (p = 0.02, p = 0.0001, p = 0.0001, p = 0.02, and p = 0.01, respectively). In the multivariable analysis, PBS, age, and duration of ICU stay were independent risk factors for 14-day mortality (p < 0.0001, p < 0.0001, and p = 0.001, respectively). Colistin-based combination therapy resulted in significantly higher microbiological eradication rates, relatively higher cure and 14-day survival rates, and lower in-hospital mortality compared to colistin monotherapy. CC, CS, and CO combinations for XDR-ABSI did not reveal significant differences with respect to 14-day survival and clinical or microbiological outcome before and after propensity score matching (PSM). PBS, age, and length of ICU stay were independent risk factors for 14-day mortality

    Buckling and fracture analysis of thick and long composite cylinders with cutouts under axial Compression: an experimental and numerical campaign

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    This article reports on the manufacturing, experimental testing, and finite element analysis of very thick and long carbon-fiber-reinforced polymers (CFRP) tubes under uniaxial compression (radius-to-thickness ratio ∼ 10 and length-to-radius ratio ∼ 21). Herein, long and hollow axisymmetric composite cylinders were produced through bladder molding. The CFRP tubes have two oppositely located cutouts in the middle of the structures. Three test specimens with different cutout diameters (5, 10, and 15 mm) were experimentally tested until failure. The experimental testing campaign was supported by digital image correlation, acoustic emission, and infrared thermographic measurements to investigate the damage propagation and failure analysis. The CFRP tubes failed at the cutout location due to fiber fracture. Linear static and geometrically non-linear analyses were performed using ABAQUS to analyze the CFPR tubes under axial compression. In general, numerical and experimental results are in good agreement if the maximum stress or Hashin criteria are applied

    Circulating testosterone regulates the local GnRH-II expression in peripheral lymphocytes: An in vivo interaction in patients with idiopathic hypogonadotrophic hypogonadism (IHH).

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    Sensor networks are often deployed with the purpose of providing data to large-scale information management and GIS systems, or to collect measurements for specific scientific experiments. The benefits of such use are clear and widely accepted. The reuse of observations in low-cost, lightweight, web applications and mashups is a further compelling use case for sensor networks, but requires provision of data through simple mechanisms, readily accessible, that are quick to develop with. To enable the latter while maintaining support for larger applications and, to increase information utility, links to and from other datasets, we propose a domain-driven approach that embodies REST and Linked Data principles using a common semantic framework that underpins a separation of concerns between domain models, sensor observation infrastructure, and Application Programming Interfaces (APIs) while maintaining information consistency. We describe a reusable, reconfigurable, web service that realises this design and can be deployed to provide access to multiple sources of sensor information, including databases and streaming data, with flexible semantic configuration of the API and domain mapping
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