204 research outputs found

    Distribution of Spoligotyping Defined Genotypic Lineages among Drug-Resistant Mycobacterium tuberculosis Complex Clinical Isolates in Ankara, Turkey

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    Background: Investigation of genetic heterogeneity and spoligotype-defined lineages of drug-resistant Mycobacterium tuberculosis clinical isolates collected during a three-year period in two university hospitals and National Tuberculosis Reference and Research Laboratory in Ankara, Turkey. Methods and Findings: A total of 95 drug-resistant M. tuberculosis isolates collected from three different centers were included in this study. Susceptibility testing of the isolates to four major antituberculous drugs was performed using proportion method on Löwenstein–Jensen medium and BACTEC 460-TB system. All clinical isolates were typed by using spoligotyping and IS6110-restriction fragment length polymorphism (RFLP) methods. Seventy-three of the 95 (76.8%) drug resistant M. tuberculosis isolates were isoniazid-resistant, 45 (47.4%) were rifampicin-resistant, 32 (33.7%) were streptomycinresistant and 31 (32.6%) were ethambutol-resistant. The proportion of multidrug-resistant isolates (MDR) was 42.1%. By using spoligotyping, 35 distinct patterns were observed; 75 clinical isolates were grouped in 15 clusters (clustering rate of 79%) and 20 isolates displayed unique patterns. Five of these 20 unique patterns corresponded to orphan patterns in th

    Estimation and analysis of multi-GNSS differential code biases using a hardware signal simulator

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    In ionospheric modeling, the differential code biases (DCBs) are a non-negligible error source, which are routinely estimated by the different analysis centers of the International GNSS Service (IGS) as a by-product of their global ionospheric analysis. These are, however, estimated only for the IGS station receivers and for all the satellites of the different GNSS constellations. A technique is proposed for estimating the receiver and satellites DCBs in a global or regional network by first estimating the DCB of one receiver set as reference. This receiver DCB is then used as a ‘known’ parameter to constrain the global ionospheric solution, where the receiver and satellite DCBs are estimated for the entire network. This is in contrast to the constraint used by the IGS, which assumes that the involved satellites DCBs have a zero mean. The ‘known’ receiver DCB is obtained by simulating signals that are free of the ionospheric, tropospheric and other group delays using a hardware signal simulator. When applying the proposed technique for Global Positioning System legacy signals, mean offsets in the order of 3 ns for satellites and receivers were found to exist between the estimated DCBs and the IGS published DCBs. It was shown that these estimated DCBs are fairly stable in time, especially for the legacy signals. When the proposed technique is applied for the DCBs estimation using the newer Galileo signals, an agreement at the level of 1–2 ns was found between the estimated DCBs and the manufacturer’s measured DCBs, as published by the European Space Agency, for the three still operational Galileo in-orbit validation satellites

    Improving a branch-and-bound approach for the degree-constrained minimum spanning tree problem with LKH

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    The degree-constrained minimum spanning tree problem, which involves finding a minimum spanning tree of a given graph with upper bounds on the vertex degrees, has found multiple applications in several domains. In this paper, we propose a novel CP approach to tackle this problem where we extend a recent branch-and-bound approach with an adaptation of the LKH local search heuristic to deal with trees instead of tours. Every time a solution is found, it is locally optimised by our new heuristic, thus yielding a tightened cut. Our experimental evaluation shows that this significantly speeds up the branch-and-bound search and hence closes the performance gap to the state-of-the-art bottom-up CP approach

    Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

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    Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk
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