Prevalence of systemic inflammatory response syndrome (SIRS) in hospitalized children: a point prevalence study

<p>Abstract</p> <p>Background</p> <p>In accordance with the 1st International pediatric sepsis consensus conference, where sepsis was defined as SIRS associated with suspected or proven infection, we have identified the need to assess the prevalence of SIRS and sepsis in children with abnormal temperatures hospitalized in The Children's Clinical University Hospital in Latvia.</p> <p>Methods</p> <p>A descriptive prospective point prevalence study (using two time periods, each 24 h, randomly chosen) was conducted on all children (n = 943) treated in the hospital. All children with abnormal temperatures – fever or hypothermia (n = 92) – were included in the study. Questionnaires evaluating age-specific SIRS criteria were completed. The prevalence of SIRS was detected with 95% CI.</p> <p>Results</p> <p>Out of a total of 943 patients treated in the hospital, 10% (n = 92) had abnormal temperatures. In all these cases the abnormal temperature was a fever; hypothermia was not established in any patient. Of the children with fever, 72% (n = 66) had SIRS. Of the SIRS patients, 8% (n = 5) developed sepsis, 5% (n = 3) severe sepsis and 2% (n = 1) septic shock. Seventy-six percent (n = 50) of the SIRS patients had fever in combination with respiratory rate >2 SD above normal for age; 50% (n = 33) had fever with abnormal leukocyte count; 15% (n = 10) had fever with tachycardia >2 SD above normal for age. Most of the SIRS patients (39%, n = 25) were aged 2–5 years. Twenty-one percent (n = 14) of the children with SIRS and 50% (n = 2) of those with severe sepsis and septic shock had an underlying disease. In no case was SIRS and sepsis recognized by doctors and the diagnoses were not recorded on the patients' cards.</p> <p>Conclusion</p> <p>Our results would indicate a high risk for sepsis development in children with SIRS. Early SIRS diagnosis and awareness of risk of developing sepsis could change the medical approach to the patient in everyday clinical practice, eventually leading to early, goal-directed therapy for sepsis.</p

Search for Ultra-high-energy Photons from Gravitational Wave Sources with the Pierre Auger Observatory

A search for time-directional coincidences of ultra-high-energy (UHE) photons above 10 EeV with gravitational wave (GW) events from the LIGO/Virgo runs O1 to O3 is conducted with the Pierre Auger Observatory. Due to the distinctive properties of photon interactions and to the background expected from hadronic showers, a subset of the most interesting GW events is selected based on their localization quality and distance. Time periods of 1000 s around and 1 day after the GW events are analyzed. No coincidences are observed. Upper limits on the UHE photon fluence from a GW event are derived that are typically at &amp; SIM;7 MeV cm(-2) (time period 1000 s) and &amp; SIM;35 MeV cm(-2) (time period 1 day). Due to the proximity of the binary neutron star merger GW170817, the energy of the source transferred into UHE photons above 40 EeV is constrained to be less than 20% of its total GW energy. These are the first limits on UHE photons from GW sources

Arrival Directions of Cosmic Rays above 32 EeV from Phase One of the Pierre Auger Observatory

A promising energy range to look for angular correlations between cosmic rays of extragalactic origin and their sources is at the highest energies, above a few tens of EeV (1 EeV equivalent to 10^(18) eV). Despite the flux of these particles being extremely low, the area of similar to 3000 km^(2) covered at the Pierre Auger Observatory, and the 17 yr data-taking period of the Phase 1 of its operations, have enabled us to measure the arrival directions of more than 2600 ultra-high-energy cosmic rays above 32 EeV. We publish this data set, the largest available at such energies from an integrated exposure of 122,000 km^(2) sr yr, and search it for anisotropies over the 3.4 pi steradians covered with the Observatory. Evidence for a deviation in excess of isotropy at intermediate angular scales, with similar to 15 degrees Gaussian spread or similar to 25 degrees top-hat radius, is obtained at the 4 sigma significance level for cosmic-ray energies above similar to 40 EeV

Searches for Ultra-High-Energy Photons at the Pierre Auger Observatory

The Pierre Auger Observatory, which is the largest air-shower experiment in the world, offers unprecedented exposure to neutral particles at the highest energies. Since the start of data collection more than 18 years ago, various searches for ultra-high-energy (UHE, E greater than or similar to 10^(17) eV) photons have been performed, either for a diffuse flux of UHE photons, for point sources of UHE photons or for UHE photons associated with transient events such as gravitational wave events. In the present paper, we summarize these searches and review the current results obtained using the wealth of data collected by the Pierre Auger Observatory

Moderately hypofractionated post-operative radiation therapy for breast cancer: Preferences amongst radiation oncologists from countries in Latin America and the Caribbean

Background: The safety and effectiveness of moderately hypofractionated post-operative radiation therapy for breast cancer were demonstrated by several trials. This study aimed to evaluate the current patterns of practice and prescription preference about moderately hypofractionated post-operative radiation therapy to assess possible aspects that affect the decision-making process regarding the use of fractionation in breast cancer patients in Latin America and the Caribbean (LAC). We also aimed to identify factors that can restrain the utilization of moderately hypofractionated post-operative radiation therapy for breast cancer. Materials an methods: Radiation oncologists from LAC were invited to contribute to this study. A 38-question survey was used to evaluate their opinions. Results: A total of 173 radiation oncologists from 13 countries answered the questionnaire. The majority of respondents (84.9%) preferred moderately hypofractionated post-operative radiation therapy as their first choice in cases of whole breast irradiation. Whole breast plus regional nodal irradiation, post-mastectomy (chest wall and regional nodal irradiation) without reconstruction, and post-mastectomy (chest wall and regional node irradiation) with reconstruction hypofractionated post-operative radiation therapy was preferred by 72.2% 71.1%, and 53.7% of respondents, respectively. Breast cancer stage, and flap-based breast reconstruction were the factors associated with absolute contraindications for the use of hypofractionated schedules. Conclusion: Even though moderately hypofractionated post-operative radiation therapy for breast cancer is considered a new standard to the vast majority of the patients, its unrestricted application in clinical practice across LAC still faces reluctance

Itaipu Technology Park: An Eco-Innovative Niche for Renewable Energies

Technology parks are considered innovative environments for the development of new technologies, in a dynamic that can be explained by the micro level of multilevel analysis of the theory of sociotechnical transition, by contributing to explain the actors responsible for the process of development and dissemination of technology. The cases analyzed were composed of companies and eco-innovative projects in the renewable energy area of the Itaipu Technological Park. The methodology was based on a study of multiple cases of qualitative nature, supported by content analysis and triangulation of information. The main results showed that the ITP, with the support of its maintainer Itaipu Binacional, created an environment conducive to the development of eco-innovative companies in renewable energies, stimulating the exchange of knowledge between companies and favoring partnerships with national and international companies for technological development

Assinatura geol?gica e influ?ncia do uso e da ocupa??o do solo na geoqu?mica de ?guas e sedimentos da bacia do ribeir?o Cara?a, Catas Altas, MG.

O presente trabalho foi realizado na bacia hidrogr?fica do ribeir?o Cara?a, no munic?pio de Catas Altas, Minas Gerais. O objetivo principal foi obter par?metros qu?micos e f?sico?qu?micos para caracterizar a geoqu?mica das ?guas e sedimentos desta bacia e determinar a real influ?ncia das atividades antropog?nicas presentes na ?rea. As nascentes do ribeir?o Cara?a se encontram em uma ?rea de preserva??o ambiental (Parque Natural do Cara?a), isenta de contamina??o antr?pica; por?m, ao longo da bacia, existem diversos problemas de ordem ambiental, que podem ter origem na presen?a de ?reas urbanas, atividades de minera??o e agr?colas. Para este trabalho, foi realizado um estudo do uso e da ocupa??o do solo e monitorados 24 pontos, onde foram realizadas an?lises sazonais de ?gua (pH, Eh, condutividade el?trica e oxig?nio dissolvido) e medidos os teores de SO42 -, Cl- e HCO3 - (alcalinidade), al?m de metais (Al, Fe, Mn, Mg, Ca, K, Ti, P, As, Ba, Co, Cr, Cu, Ni, Sr, V, Zn e Zr, Na, K, Ca e Mg). Esses mesmos elementos foram determinados nas amostras de sedimentos. Os resultados permitiram dividir a bacia em tr?s ?reas distintas, com diferente ocupa??o e geoqu?mica. Apesar das atividades antropog?nicas mostrarem grande influ?ncia sobre a geoqu?mica das ?guas, a composi??o dos sedimentos ? influenciada fundamentalmente pela geologia local.The present study was carried out in the Cara?a stream basin, located at Catas Altas, Minas Gerais. The main goal was to obtain chemical and physical-chemical parameters in order to characterize the water and sediment geochemistry and ultimately to assess the real influence of the anthropogenic activities in the area. The springs are located in an environmental protection area (Parque Natural do Cara?a), which is free from anthropogenic influence. However, in the basin area there are several environmental problems which may be caused by urban areas, mining activities and farms. For this study, a land use and occupation assesment was carried out and 24 sampling stations were monitored, where seasonal water analyzes were carried out for pH, Eh, electrical conductivity and dissolved oxygen, concentrations of SO42 -, Cl- and HCO3 -(alkalinity) in addition to metals (Al, Fe, Mn, Mg, Ca, K, Ti, P, As, Ba, Co, Cr, Cu, Ni, Sr, V, Zn e Zr, Na, K, Ca and Mg). These same elements were also determined in sediment samples together with Si. The results allowed the division of the basin in three distinct areas according to occupation and geochemistry. The results show that the activities present in the basin have influence in that water quality, but the sediment composition is the reflex of only the local geology