324 research outputs found
Predicting candidemia in internal medicine departments: are we chasing the Holy Grail?
Candidemia is a challenging clinical condition with high rates of morbidity and mortality.1 Key requirements for its prompt management include early identification and timely initiation of appropriate systemic antifungal therapy, consistently reported as a major determinant of survival. However, the diagnosis of candidemia can be challenging and is often delayed as there are no specific clinical signs, blood cultures have low sensitivity, and detection of fungal blood cultures takes a long time. In addition, there is evidence that a significant percentage of such infections occurs in patients admitted to internal medicine departments. This is not particularly surprising given the advanced age of many inpatients at internal medicine departments and multiple complex comorbidities. Moreover, related therapies and healthcare system contacts often involve the use of central venous catheters and other indwelling devices, potentially entailing high risk of candidemia.2 Therefore, optimization of the diagnostic and therapeutic approach is an important and still unfulfilled need for the management of candidemia in internal medicine department
Hybrid membrane distillation reverse electrodialysis configuration for water and energy recovery from human urine: an opportunity for off-grid decentralised sanitation
The integration of membrane distillation with reverse electrodialysis has been investigated as a sustainable sanitation solution to provide clean water and electrical power from urine and waste heat. Reverse electrodialysis was integrated to provide the partial remixing of the concentrate (urine) and diluate (permeate) produced from the membrane distillation of urine. Broadly comparable power densities to those of a model salt solution (sodium chloride) were determined during evaluation of the individual and combined contribution of the various monovalent and multivalent inorganic and organic salt constituents in urine. Power densities were improved through raising feed-side temperature and increasing concentration in the concentrate, without observation of limiting behaviour imposed by non-ideal salt and water transport. A further unique contribution of this application is the limited volume of salt concentrate available, which demanded brine recycling to maximise energy recovery analogous to a battery, operating in a ‘state of charge’. During recycle, around 47% of the Gibbs free energy was recoverable with up to 80% of the energy extractable before the concentration difference between the two solutions was halfway towards equilibrium which implies that energy recovery can be optimised with limited effect on permeate quality. This study has provided the first successful demonstration of an integrated MD-RED system for energy recovery from a limited resource, and evidences that the recovered power is sufficient to operate a range of low current fluid pumping technologies that could help deliver off-grid sanitation and clean water recovery at single household scale
Symphytum Species: A Comprehensive Review on Chemical Composition, Food Applications and Phytopharmacology
Symphytum species belongs to the Boraginaceae family and have been used for centuries for
bone breakages, sprains and rheumatism, liver problems, gastritis, ulcers, skin problems, joint pain
and contusions, wounds, gout, hematomas and thrombophlebitis. Considering the innumerable
potentialities of the Symphytum species and their widespread use in the world, it is extremely
important to provide data compiling the available literature to identify the areas of intense research
and the main gaps in order to design future studies. The present review aims at summarizing the
main data on the therapeutic indications of the Symphytum species based on the current evidence,
also emphasizing data on both the e cacy and adverse e ects. The present review was carried
out by consulting PubMed (Medline), Web of Science, Embase, Scopus, Cochrane Database, Science
Direct and Google Scholar (as a search engine) databases to retrieve the most updated articles on this
topic. All articles were carefully analyzed by the authors to assess their strengths and weaknesses,
and to select the most useful ones for the purpose of review, prioritizing articles published from 1956
to 2018. The pharmacological e ects of the Symphytum species are attributed to several chemical
compounds, among them allantoin, phenolic compounds, glycopeptides, polysaccharides and some
toxic pyrrolizidine alkaloids. Not less important to highlight are the risks associated with its use.
In fact, there is increasing consumption of over-the-counter drugs, which when associated with
conventional drugs can cause serious and even fatal adverse events. Although clinical trials sustain
the folk topical application of Symphytum species in musculoskeletal and blunt injuries, with minor
adverse e ects, its antimicrobial potency was still poorly investigated. Further studies are needed to
assess the antimicrobial spectrum of Symphytum species and to characterize the active molecules both
in vitro and in vivo
Comparison of the Electronic Structures and Energetics of Ferroelectric LiNbO3 and LiTaO3
This paper explains the origin of the ferroelectric instability in LiNbO3 and
LiTaO3 and compares the electronic structures and energetics of the two
materials.Comment: 31 pages, 11 Postscript figure
On-chip quantum interference between silicon photon-pair sources
Large-scale integrated quantum photonic technologies will require the on-chip
integration of identical photon sources with reconfigurable waveguide circuits.
Relatively complex quantum circuits have already been demonstrated, but few
studies acknowledge the pressing need to integrate photon sources and waveguide
circuits together on-chip. A key step towards such large-scale quantum
technologies is the integration of just two individual photon sources within a
waveguide circuit, and the demonstration of high-visibility quantum
interference between them. Here, we report a silicon-on-insulator device
combining two four-wave mixing sources, in an interferometer with a
reconfigurable phase shifter. We configure the device to create and manipulate
two-colour (non-degenerate) or same-colour (degenerate), path-entangled or
path-unentangled photon pairs. We observe up to 100.0+/-0.4% visibility quantum
interference on-chip, and up to 95+/-4% off-chip. Our device removes the need
for external photon sources, provides a path to increasing the complexity of
quantum photonic circuits, and is a first step towards fully-integrated quantum
technologies
Risk Factors for Intra-Abdominal Candidiasis in Intensive Care Units: Results from EUCANDICU Study
Introduction: Intra-abdominal infections represent the second most frequently acquired infection in the intensive care unit (ICU), with mortality rates ranging from 20% to 50%. Candida spp. may be responsible for up to 10–30% of cases. This study assesses risk factors for development of intra-abdominal candidiasis (IAC) among patients admitted to ICU. Methods: We performed a case–control study in 26 European ICUs during the period January 2015–December 2016. Patients at least 18 years old who developed an episode of microbiologically documented IAC during their stay in the ICU (at least 48 h after admission) served as the case cohort. The control group consisted of adult patients who did not develop episodes of IAC during ICU admission. Matching was performed at a ratio of 1:1 according to time at risk (i.e. controls had to have at least the same length of ICU stay as their matched cases prior to IAC onset), ICU ward and period of study. Results: During the study period, 101 case patients with a diagnosis of IAC were included in the study. On univariate analysis, severe hepatic failure, prior receipt of antibiotics, prior receipt of parenteral nutrition, abdominal drain, prior bacterial infection, anastomotic leakage, recurrent gastrointestinal perforation, prior receipt of antifungal drugs and higher median number of abdominal surgical interventions were associated with IAC development. On multivariate analysis, recurrent gastrointestinal perforation (OR 13.90; 95% CI 2.65–72.82, p = 0.002), anastomotic leakage (OR 6.61; 95% CI 1.98–21.99, p = 0.002), abdominal drain (OR 6.58; 95% CI 1.73–25.06, p = 0.006), prior receipt of antifungal drugs (OR 4.26; 95% CI 1.04–17.46, p = 0.04) or antibiotics (OR 3.78; 95% CI 1.32–10.52, p = 0.01) were independently associated with IAC. Conclusions: Gastrointestinal perforation, anastomotic leakage, abdominal drain and prior receipt of antifungals or antibiotics may help to identify critically ill patients with higher probability of developing IAC. Prospective studies are needed to identify which patients will benefit from early antifungal treatment
Continuous and transparent multimodal authentication: reviewing the state of the art
Individuals, businesses and governments undertake an ever-growing range of activities online and via various Internet-enabled digital devices. Unfortunately, these activities, services, information and devices are the targets of cybercrimes. Verifying the user legitimacy to use/access a digital device or service has become of the utmost importance. Authentication is the frontline countermeasure of ensuring only the authorized user is granted access; however, it has historically suffered from a range of issues related to the security and usability of the approaches. They are also still mostly functioning at the point of entry and those performing sort of re-authentication executing it in an intrusive manner. Thus, it is apparent that a more innovative, convenient and secure user authentication solution is vital. This paper reviews the authentication methods along with the current use of authentication technologies, aiming at developing a current state-of-the-art and identifying the open problems to be tackled and available solutions to be adopted. It also investigates whether these authentication technologies have the capability to fill the gap between high security and user satisfaction. This is followed by a literature review of the existing research on continuous and transparent multimodal authentication. It concludes that providing users with adequate protection and convenience requires innovative robust authentication mechanisms to be utilized in a universal level. Ultimately, a potential federated biometric authentication solution is presented; however it needs to be developed and extensively evaluated, thus operating in a transparent, continuous and user-friendly manner
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