Streptococcus anginosus bacteremia: a septic IVC thrombus and a large empyema requiring decortication

A previously healthy 39 year old male presented with complaints of cough, fever, abdominal pain and chills. The patient was found to be in active sepsis with hypotension on presentation so was resuscitated while a full septic work-up was ordered. Initial chest X-ray showed only increased broncho-alveolar markings and no consolidations, but blood cultures eventually revealed Streptococcus anginosus bacteremia. Intravenous antibiotics were started and infective endocarditis was ruled out. Computerized tomography scan of the abdomen with contrast revealed findings suggestive of a septic hepatic inferior vena cava thrombus and right lower lung findings suggestive of septic embolization and an empyema. Later on during admission, CT scan of the chest with contrast revealed a moderate-sized empyema of the right lung which eventually required decortication. Discovering such findings concurrently in a single patient is extremely rare, particularly an embolizing septic IVC thrombus with confirmed bacteremia. For this reason it is described in the following case presentatio

Implementation of a LoRaWAN Based Smart Agriculture Decision Support System for Optimum Crop Yield

A majority of the population of developing countries is associated with agriculture directly or indirectly. The liaison of engineering technology and Sustainable Development Goals (SDGs) can build a bridge for farmers to enhance their skills regarding advancements through future generation agriculture trends. The next-generation trends include better soil preparation, intelligent irrigation systems, advanced methods of crop nutrient inspection, smart fertilizers applications, and multi-cropping practices. This work proposes a smart Decision Support System (DSS) that acquires the input parameters based on real-time monitoring to optimize the yield that realizes sustainability by improving per hectare production and lessening water seepage wastage in agribusiness. The proposed model comprises three basic units including an intelligent sensor module, smart irrigation system and controlled fertilizer module. The system has integrated sensors, cloud employing decision support layers, and networking based DSS to recommend cautions for optimum sustainable yield. The intelligent sensors module contains a temperature and humidity sensor, NPK sensor, soil moisture sensor, soil conductivity sensor, and pH sensor to transmit the statistics to the cloud over the internet via Long Range (LoRa) using Serial Peripheral Interface (SPI) communication protocol. Moreover, an android application has been developed for real-time data monitoring according to GPS location and node information (accessed remotely). Furthermore, the DSS contemplates the accessible information from sensors, past patterns, monitoring climate trends and creating cautions required for sustainable fertilizer consumption. The presented results and comparison validate the novelty of the design as it embraces smart irrigation with smart control and smart decision-making based on accurate real-time field data. It is better than existing systems as it transmits the data over the LoRa that is an open-source communication with long-range transmission ability up to several kilometres. The sensor nodes helped in advancing the yield of crops, which resulted in achieving inclusive and sustainable economic goals

Implementation of a LoRaWAN Based Smart Agriculture Decision Support System for Optimum Crop Yield

A majority of the population of developing countries is associated with agriculture directly or indirectly. The liaison of engineering technology and Sustainable Development Goals (SDGs) can build a bridge for farmers to enhance their skills regarding advancements through future generation agriculture trends. The next-generation trends include better soil preparation, intelligent irrigation systems, advanced methods of crop nutrient inspection, smart fertilizers applications, and multi-cropping practices. This work proposes a smart Decision Support System (DSS) that acquires the input parameters based on real-time monitoring to optimize the yield that realizes sustainability by improving per hectare production and lessening water seepage wastage in agribusiness. The proposed model comprises three basic units including an intelligent sensor module, smart irrigation system and controlled fertilizer module. The system has integrated sensors, cloud employing decision support layers, and networking based DSS to recommend cautions for optimum sustainable yield. The intelligent sensors module contains a temperature and humidity sensor, NPK sensor, soil moisture sensor, soil conductivity sensor, and pH sensor to transmit the statistics to the cloud over the internet via Long Range (LoRa) using Serial Peripheral Interface (SPI) communication protocol. Moreover, an android application has been developed for real-time data monitoring according to GPS location and node information (accessed remotely). Furthermore, the DSS contemplates the accessible information from sensors, past patterns, monitoring climate trends and creating cautions required for sustainable fertilizer consumption. The presented results and comparison validate the novelty of the design as it embraces smart irrigation with smart control and smart decision-making based on accurate real-time field data. It is better than existing systems as it transmits the data over the LoRa that is an open-source communication with long-range transmission ability up to several kilometres. The sensor nodes helped in advancing the yield of crops, which resulted in achieving inclusive and sustainable economic goals

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN