The contribution of geophysical and spectral imaging techniques in the archaeological investigations of Minoan Koumasa

A manifold geophysical strategy has been carried out for mapping the Minoan cemetery and settlement of Koumasa, S. Crete. Multispectral imaging was used as a complementary method to investigate associations with the geophysical results. The GNVI proved the most effective in this task. Archaeological excavations have verified a number of features suggested by the remote sensing methods

Effect of Clarithromycin in Patients with Sepsis and Ventilator-Associated Pneumonia

Background. Because clarithromycin provided beneficiary nonantibiotic effects in experimental studies, its efficacy was tested in patients with sepsis and ventilator-associated pneumonia (VAP). Methods. Two hundred patients with sepsis and VAP were enrolled in a double-blind, randomized, multicenter trial from June 2004 until November 2005. Clarithromycin (1 g) was administered intravenously once daily for 3 consecutive days in 100 patients; another 100 patients were treated with placebo. Main outcomes were resolution of VAP, duration of mechanical ventilation, and sepsis-related mortality within 28 days. Results. The groups were well matched with regard to demographic characteristics, disease severity, pathogens, and adequacy of the administered antimicrobials. Analysis comprising 141 patients who survived revealed that the median time for resolution of VAP was 15.5 days and 10.0 days among placebo- and clarithromycin-treated patients, respectively (P=.011); median times for weaning from mechanical ventilation were 22.5 days and 16.0 days, respectively (P=.049). Analysis comprising all enrolled patients showed a more rapid decrease of the clinical pulmonary infection score and a delay for advent of multiple organ dysfunction in clarithromycin-treated patients, compared with those of placebo-treated patients (P=.047). Among the 45 patients who died of sepsis, time to death was significantly prolonged in clarithromycin-treated compared with placebo-treated patients (P=.004). Serious adverse events were observed in 0% and 3% of placebo- and clarithromycin-treated patients, respectively (P=.25). Conclusions. Clarithromycin accelerated the resolution of VAP and weaning from mechanical ventilation in surviving patients and delayed death in those who died of sepsis. The mortality rate at day 28 was not altered. Results are encouraging and render new perspectives on the management of sepsis and VA

Early apoptosis of blood monocytes in the septic host: is it a mechanism of protection in the event of septic shock?

INTRODUCTION: Based on the central role of the triggering of monocytes for the initiation of the septic cascade, it was investigated whether apoptosis of blood monocytes in septic patients is connected to their final outcome. METHODS: Blood monocytes were isolated from 90 patients with septic syndrome due to ventilator-associated pneumonia on days 1, 3, 5 and 7 from the initiation of symptoms. Apoptosis was defined after incubation with annexin-V-fluorescein isothiocyanate and propidium iodine and reading by a flow cytometer. The function of first-day monocytes was evaluated from the concentrations of tumour necrosis factor alpha (TNFα) and IL-6 in supernatants of cell cultures after triggering with endotoxins. TNFα, IL-6 and IL-8 were estimated in serum by an enzyme immunoassay. RESULTS: Mortality rates of patients with apoptosis ≤50% compared with patients with apoptosis >50% were 49.12% and 15.15%, respectively (P < 0.0001). Kaplan-Meier analysis showed a 28-day survival benefit in patients with septic shock and monocyte apoptosis >50% compared with those patients with apoptosis ≤50% (P = 0.0032). Production of IL-6 by monocytes on the first day by patients with apoptosis ≤50% was similar compared with monocytes isolated from healthy controls. Serum concentrations of TNFα were higher in patients with monocyte apoptosis ≤50% and septic shock compared with patients with apoptosis >50% on day 7; similar findings occurred for serum IL-6 on days 1 and 7 and for serum IL-8 on days 1 and 5. CONCLUSION: Early apoptosis of monocytes upon presentation of clinical signs of sepsis is connected to a favourable outcome. These findings are of particular importance for the patient with septic shock, where they might constitute a mechanism of pathogenesis

Diagnostic and prognostic value of procalcitonin among febrile critically ill patients with prolonged ICU stay

<p>Abstract</p> <p>Background</p> <p>Procalcitonin (PCT) has been proposed as a diagnostic and prognostic sepsis marker, but has never been validated in febrile patients with prolonged ICU stay.</p> <p>Methods</p> <p>Patients were included in the study provided they were hospitalised in the ICU for > 10 days, were free of infection and presented a new episode of SIRS, with fever >38°C being obligatory. Fifty patients fulfilled the above criteria. PCT was measured daily during the ICU stay. The primary outcome was proven infection.</p> <p>Results</p> <p>Twenty-seven out of 50 patients were diagnosed with infection. Median PCT on the day of fever was 1.18 and 0.17 ng/ml for patients with and without proven infections (p < 0.001). The area under the curve for PCT was 0.85 (95% CI; 0.71-0.93), for CRP 0.65 (0.46-0.78) and for WBC 0.68 (0.49-0.81). A PCT level of 1 ng/mL yielded a negative predictive value of 72% for the presence of infection, while a PCT of 1.16 had a specificity of 100%. A two-fold increase of PCT between fever onset and the previous day was associated with proven infection (p 0.001) (OR = 8.55; 2.4-31.1), whereas a four-fold increase of PCT of any of the 6 preceding days was associated with a positive predictive value exceeding 69.65%. A PCT value less than 0.5 ng/ml on the third day after the advent of fever was associated with favorable survival (p 0.01).</p> <p>Conclusion</p> <p>The reported data support that serial serum PCT may be a valuable diagnostic and prognostic marker in febrile chronic critically ill patients.</p

Developing a Harmony-based Optimization Toolbox: Application on renewable energy production.

The present study aims to develop a problem-independent, generic optimization toolkit applicable to engineering optimization problems. The authors designed a program in MATLAB environment, using a Harmony Search Algorithm (HSA) in its core. A Java-based Optimization Toolkit has also been developed, taking advantage of the inherent features of object-oriented Java. Both programs allow for optimization using the HSA, which is a recent development among metaheuristics, inspired from the music creation process. Since its presentation in 2001, HSA has attracted the interest of those involved in the optimization field and thus has been successfully applied in different implementations. HSA was initially designed to optimize urban water distribution networks. Since then its application has expanded to a remarkably wide range of scientific disciplines. Although the authors’ intention is to address water engineering, hydroelectric energy production and renewable energy related problems, the created tool is generic and can be applied to any scientific field. In section 2 the authors present the up-to-date related work i.e. recent approaches in developing tools to facilitate optimization processes. The architecture of both Toolkits is presented in detail along with the main characteristics of the programs in Section 3. In Section 4 a renewable energy production problem is optimized using HSA Toolkit. This problem deals with maximizing the benefits derived from electricity production of a mini-scale hydroelectric station in a rural area. The successful convergence to best management practices proves that in addition to being user-friendly, the created tool is also very effective.JRC.F.7-Renewables and Energy Efficienc

Residual Forest Biomass in Pinus Stands: Accumulation and Biogas Production Potential

Lignocellulosic biomass is an abundant resource that can be valorized for the production of bioenergy. However, studies aiming to quantify the amount of biogas production potential per km forest road are scarce in the literature. In this study, fresh pine needles, pine needle litter, pine branches, and pine bark were digested in batch reactors under mesophilic conditions after a grinding/milling pre-treatment. All samples were collected from a low-altitude Mediterranean Pinus forest (North Greece) adjacent to a category G forest road with a gentle slope. The methane yield of fresh pine needles was between 115 and 164 NmL g−1 volatile solids (VS), depending on the Pinus tree size. Pine needle litter produced a significantly lower methane yield (between 58 and 77 NmL g−1 VS), followed by pine bark (85 NmL g−1 VS) and pine branches (138 NmL g−1 VS). Considering the quantity of pine needle litter accumulated on adjacent forest roads (600 ± 200 g m−2), it was possible to calculate the biomethane production potential per km of forest road (up to 500 Nm3 km−1) if the biomass collected was disposed of at an anaerobic digestion facility. The results of the study demonstrate that residual forest biomass represents an additional resource for bioenergy production. Moreover, harvesting residual forest biomass can decrease the incidence of devastating summer forest fires and their disastrous consequences for the environment, the economy, and the local populations

Antimicrobial activity of copper surfaces against carbapenemase-producing contemporary Gram-negative clinical isolates

Objectives: The antimicrobial activity of copper surfaces against a variety of contemporary carbapenemase-producing Gram-negative bacteria representative of the most problematic nosocomial pathogens worldwide was evaluated. Methods: Twenty-four clinical isolates, comprising four of Escherichia coli, two of Enterobacter spp., eight of Klebsiella pneumoniae and five each of Pseudomonas aeruginosa and Acinetobacter baumannii producing either VIM-1 and/or KPC-2 or VIM-2 or OXA-type carbapenemases, were studied. The antimicrobial activity of 99% copper (Cu99%) and a 63% alloy (Cu63%) was evaluated in comparison with that of stainless steel (SS) and polyvinylchloride (PVC) by incubating similar to 10(6) cfu/cm(2) of the tested strains on each surface at room temperature. Results: Copper demonstrated antimicrobial activity against all studied isolates. This effect was observed earlier and was more pronounced for Cu99% than for Cu63%. Cu99% showed a bactericidal effect after &lt;2 h for A. baumannii, 3 h for Enterobacter spp., 5 h for K. pneumoniae and 6 h for P. aeruginosa and E. coli. No viable colonies were recovered from five (20.8%) isolates after 3 h and from nine (37.5%) isolates after 5 h of incubation on Cu99%. Conclusions: Copper has significant antimicrobial activity against multidrug-resistant nosocomial Gram-negative pathogens. This supports the hypothesis that replacement of high-contact materials with copper could reduce the high burden of environmental contamination around high-risk patients. However, this strategy should be seen as an adjunctive measure to established cleaning protocols and to good hygiene practices for prevention of hospital-acquired infections

Ulcerative Colitis in Hematological Malignancies: Paraneoplastic Manifestation or Coincidental Bystander?

Evidence of coexistence of diverse hematological malignancies—lymphoma, leukemia, multiple myeloma, and myelodysplastic syndromes—and either ulcerative colitis or Crohn’s disease can be found in the literature. However, a more “systemic” effort to reach further and examine the potential of either one as paraneoplastic manifestation has not been performed. Based on these, three cases of ulcerative colitis manifesting before, simultaneously, and after the onset of different hematological malignancies are presented and critically evaluated