Biochemical analyze as indirect marker of sepsis

Introduction: Sepsis is a complex pathophysiological disorder arising from systemic inflammatory response to infection. The inflammatory cascade has two limbs: one- inflammatory and one- pro-coagulant. Endothelium plays an important role in activation of clotting system and, simultaneous, in suppression of fibrinolitic system, that appears to be an essential component in the development of multi-organ failure (MOF). The objective of this study is analysing and describing clinical signs and biochemical values in adults with sepsis syndrome, which could allow the screening of indirect features of sepsis followed by early treatment as soon as possible. Methods: Thirty patients meeting the inclusion criteria who got admitted to the ICU at Municipal Clinical Hospital N3, Chisinau, between 2008-2010 were studied. Detailed history was taken and physical examination performed. Patients were investigated according to the clinical situation as defined by criteria set by the ACCP/SCCM Consensus Committee. Biochemical values were done on admission to detect metabolic derangements and organ dysfunction. The tests were repeated during 7 days depending on the severity of the derangement. Results: Tie patients were divided into two groups: the first group-20 patients with septic complications and the second group- 10 non-septic patients. The comparative analyze of biochemical profiles was performed between the groups. Ihus, in the first group, on admission, the average level of fibrinogen is 5,102 g/1 and the average level of indirect bilirubin is 20,14 mcmol/1. The correlation coefficient between prothrombin and ASAT is - 0,89434. In the second group, on admission, the average level of fibrinogen is 5,14 g/1 and the average level of indirect bilirubin is 29,16 mcmol/1. The correlation coefficient between prothrombin and ASAT is 0,091. Conclusions: Biochemical profile analyze of patients from both groups reveals a multiple organ dysfunction (MOD) in first hours of septic process. Thus, the indirect relation between hepotocyte injury markers iALAT/ASAT and prothrombin reveals hepatic failure, triggered in first hours of sepsis. Fibrinogen elevated levels in first 24-72 h reveals the suppression of fibrinolysis and the activation of clotting system with the spread of nncrothrombi in the microcirculatory bed and perfusion disorders. Hyperbilirubinemia due to indirect bilirubin confirms hepatocyte affection with the involvement of microsomal enzyme systems, which are exhausted in hypercatabolism conditions and ATP deficiency.The study confirms the alteration of clotting system, even in the first hours of septic process installation and the necessity of early supervised thrombolytic therapy. In the absence of specific markers in sepsis diagnosis, we could sense the evolution of septic complications through indirect analyze of patient s biochemical profile with the early begining of resuscitation therapy

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

Tool machinery vibrations frames comparison concerning welded or moulded manufacturing structures

Precision of manufactured object is the main goal for all engineers in modern times. The times of massive structures with low dis-placement have passed. We are looking forward now to develop new type of structures with controlled deformations easy to predict and therefore to correct in order to obtain the „ideal” product. The paper is analysing tool machinery frames vibrations in welded and moulded manufacturing structures, the vibrations being studied in both horizontal and vertical planes and the loads are simulated as manufacturing loading pulses generated by special excitation electromagnetic devices, in order to determine advantages and disadvantages of using them for frames in projecting, producing and exploitation of tool machinery

Study of Forces Influencing the Shaking Parameters in Mechanized / Robot-assisted Harvesting of Olives

In this paper, we carried out a study of the parameters influencing the separation of olives from tree branches when harvesting is executed by means of shaking the trunk. It showed there are two important parameters, namely the shaking force and the amplitude of the shaking [1, 2, 3]. In order to determine these two parameters, we used a mathematic model which was used in developing a software that can determine their value depending on the diameter of the trunk in the contact area [4]

Online learning environment tools in higher education : contributions to their integration in engineering courses

In order to understand the potential of Online Learning Environment tools and resources in Engineering Education, a project on the use of dedicated educational strategies has been carried-out in various European Schools of Engineering to improve students’ engagement on different forms of participation and to enhance their learning outcomes. This study focuses on the use of Web 2.0 tools while teaching Manufacturing Processes to Industrial Engineering students of a Higher Education Portuguese Polytechnic Institute during a full semester. Cumulatively to students’ perceptions, data was collected and assessed to infer about two main research questions: “Are engineering students able to use efficiently online learning tools to enhance their autonomous learning process?” and “Can engineering students work collaboratively using online tools towards achieving common learning goals?”. Preliminary findings showed that students managed to efficiently use the proposed online collaborative learning tools during the course. However, students preferred the individual learning tools and processes to working and learning collaboratively from and with each other.info:eu-repo/semantics/publishedVersio

Collaborative tools in higher education: the use of Wikis by industrial and mechanical engineering students

Continuous technological advances keep challenging current and future engineers to anticipate and adapt to the new trends and paradigms that are expected to take place in a near future. One of such paradigms is the Industry 4.0 that encompasses the promise of a new industrial revolution based on the interconnectivity of people and systems to communicate, analyse and use information related to industrial processes. New challenges, as well as new opportunities, will rise in this digital landscape, demanding from future engineers the ability to adapt and grow in such ground-breaking environments. With such dynamic changes taking place in the current and future industries, engineering education has to adapt and prepare future graduates to work and function in these demanding environments. The set of skills envisaged to be held by future engineers is the ability to work and collaborate using digital means of participation as well as the ability to effectively use intercultural communicative skills. To this end, an exploratory study was conducted among different European Higher Education Engineering Schools to integrate a project with common aims and goals, resulting in various collaborative engineering activities that were designed to be carried out by undergraduate industrial and mechanical engineering students to further improve their learning outcomes and to acquire, or improve on, dedicated intercultural, communicative and colaborative skills. Following both quantitative and qualitative approaches, this study combined different types of data and methods of analysis in order to provide an exploratory account of the envisaged findings.info:eu-repo/semantics/publishedVersio

Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019

BACKGROUND: Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. METHODS: We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. FINDINGS: We estimated that the number of people with dementia would increase from 57\ub74 (95% uncertainty interval 50\ub74-65\ub71) million cases globally in 2019 to 152\ub78 (130\ub78-175\ub79) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0\ub71% [-7\ub75 to 10\ub78]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1\ub769 [1\ub764-1\ub773]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1\ub767 [1\ub752-1\ub785]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. INTERPRETATION: Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. FUNDING: Bill &amp; Melinda Gates Foundation and Gates Ventures

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

10.1016/S2352-3018(21)00152-1LANCET HIV810E633-E65