2,503 research outputs found
Análisis de eventos compuestos en la costa de Catalunya
La rellevància dels esdeveniments composts radica en el fet que poden augmentar significativament la intensitat i/o l'extensió espacial i temporal de l'impacte (i dels danys) a causa de l'acció sinèrgica i/o acumulativa de diferents amenaces que poden resultar intensificades en un futur degut a l'escalfament global. Aquest efecte acumulatiu pot desbordar la capacitat de resposta dels serveis a les emergències, ja que aquests han de fer front a una situació "inusual" de gran mal, respondre a un gran nombre de situacions d'emergència en tota la regió al mateix temps i/o han de mantenir el nivell de resposta durant un període relativament llarg. Per això, des de la perspectiva de la gestió de riscos, és important caracteritzar aquests esdeveniments. En aquest treball s'analitza la variació de la probabilitat d'ocurrència d'esdeveniments composts de tempestes de pluja i onatge al llarg de la costa catalana (nord-oest del Mediterrani), s'avaluen els principals focus d'ocurrència d'esdeveniments composts i la seva possible magnitud, i s'estudia la dependència entre les amenaces que ho componenLa relevancia de los eventos compuestos radica en que pueden aumentar significativamente la intensidad y/o la extensión espacial y temporal del impacto (y de los daños) debido a la acción sinérgica y/o acumulativa de diferentes amenazas que pueden resultar intensificadas en un futuro debido al calentamiento global. Este efecto acumulativo puede desbordar la capacidad de respuesta de los servicios a las emergencias, ya que éstos tienen que hacer frente a una situación "inusual" de gran daño, responder a un gran número de situaciones de emergencia en toda la región al mismo tiempo y/o tienen que mantener el nivel de respuesta durante un período relativamente largo. Por ello, desde la perspectiva de la gestión de riesgos, es importante caracterizar estos eventos. En este trabajo se analiza la variación de la probabilidad de ocurrencia de eventos compuestos de tormentas de lluvia y oleaje a lo largo de la costa catalana (noroeste del Mediterráneo), se evalúan los principales focos de ocurrencia de eventos compuestos y su posible magnitud, y se estudia la dependencia entre las amenazas que lo componenThe relevance of compound events is that they can significantly increase the intensity and/or the spatial and temporal extent of the impact (and damage) due to the synergistic and/or cumulative action of different hazards that may be intensified in the future due to global warming. This cumulative effect may overwhelm the emergency response capacity of services as they have to cope with an "unusual" high damage situation, respond to a large number of emergency situations across the region at the same time and/or have to maintain the level of response over a relatively long period of time. From the risk management perspective, it is therefore important to characterise these events. This paper analyses the variation in the probability of occurrence of composite rainstorm-wave events along the Catalan coast (northwest Mediterranean), assesses the main focus of occurrence of composite events and their possible magnitude, and studies the dependency between the component hazards
Sjögren’s syndrome and acquired splenic atrophy with septic shock: a case report
INTRODUCTION: The most frequent causes of adult-onset recurrent infections are human immunodeficiency virus infection, malignancy, and autoimmune diseases, while acquired non-surgical hyposplenism is rare. Although acquired asplenia/hyposplenism have been described in association with celiac disease and, less frequently, with autoimmune diseases such as Sjögren’s syndrome, the manifestations in this context are usually only detectable in the laboratory setting, with Howell-Jolly bodies or thrombocytosis. To the best of our knowledge, no previous case of pneumococcal septic shock in a patient with acquired hyposplenism and co-morbid Sjögren’s syndrome has been reported. CASE PRESENTATION: We report a case of a 45-year-old Caucasian woman who developed pneumococcal pneumonia at age 42 years, pneumococcal meningitis at age 44 years and septic shock with Streptococcus agalactiae bacteremia at age 45 years and was subsequently diagnosed with radiological splenic atrophy and functional asplenia, as well as primary Sjögren’s syndrome. After appropriate immunizations, the patient has been free from clinically important infections. CONCLUSION: Hyposplenism should be suspected in patients with adult-onset infections caused by encapsulated bacteria, especially if autoantibodies are present. Early diagnosis can help prevent potentially life-threatening infections. Possible associations between splenic atrophy and Sjögren’s syndrome are discussed
Screening for tuberculosis and prediction of disease in Portuguese healthcare workers
<p>Abstract</p> <p>Introduction</p> <p>Results of systematic screening of healthcare workers (HCWs) for tuberculosis (TB) with the tuberculin skin test (TST) and interferon-γ release assays (IGRA) in a Portuguese hospital from 2007 to 2010 are reported.</p> <p>Methods</p> <p>All HCWs are offered screening for TB. Screening is repeated depending on risk assessment. TST and QuantiFERON Gold In-Tube (QFT) are used simultaneously. X-ray is performed when TST is > 10 mm, IGRA is positive or typical symptoms exist.</p> <p>Results</p> <p>The cohort comprises 2,889 HCWs. TST and IGRA were positive in 29.5%, TST-positive but IGRA-negative results were apparent in 43.4%. Active TB was diagnosed in twelve HCWs - eight cases were detected during screening and four cases were predicted by IGRA as well as by TST. However, the progression rate in IGRA-positive was higher than in TST-positive HCWs (0.4% vs. 0.2%, p-value 0.06).</p> <p>Conclusions</p> <p>The TB burden in this cohort was high (129.8 per 100,000 HCWs). However, the progression to active TB after a positive TST or positive IGRA was considerably lower than that reported in literature for close contacts in low-incidence countries. This may indicate that old LTBI prevails in these HCWs.</p
Standardized assessment of psychosocial factors and their influence on medically confirmed health outcomes in workers: a systematic review
Findings on health-related work outcomes [28–37]. (DOCX 27.8 kb
Results of a feasibility randomised controlled trial of osteopathy on neck-shoulder pain in computer users
Computer use is a well-known source of chronic pain, leading to absenteeism and reduced productivity and well-being. This study evaluated the feasibility of conducting a full-scale randomised controlled trial. Several methodological variables defined trial feasibility. Of 77 participants interested, 30 were included and randomised into three groups of ten. All participants concluded the study, and all the data was analysed. The feasibility outcomes were deemed appropriate. No adverse events or severe side effects were reported or identified. Studying the efficacy of osteopathic consultation on computer users by conducting an RCT is feasible and safe. With adjustments, a full-scale study can be designed.info:eu-repo/semantics/publishedVersio
Screening for tuberculosis and the use of a borderline zone for the interpretation of the interferon-γ release assay (IGRA) in Portuguese healthcare workers
A new data-driven framework to select the optimal replenishment strategy in complex supply chains
- Part of special issue: 10th IFAC Conference on Manufacturing Modelling, Management and Control MIM 2022: Nantes, France, 22-24 June 2022.
Edited by Alain Bernard, Alexandre Dolgui, Hichem Haddou Benderbal, Dmitry Ivanov, David Lemoine, Fabio Sgarbossa
- Copyright © 2022 The Authors. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/)Motivated by the high variability of markets occurred in the last years, which in turns determined significant uncertainty in lead times and supply chain dynamics, this paper introduces a data-driven framework based on machine learning and metaheuristic optimization to dynamically select the most suitable replenishment strategy for a complex two-echelon (supplier-inventory-factory) supply chain (SC) problem with perishable product and stochastic lead times. Since the supplier dispatches the product (i.e., the raw material) with a fixed expiration date, the product shelf-life strictly depends on the related delivery lead time, which is subject to uncertainty. In addition, a minimum order quantity has to be fulfilled and the time between two consecutive orders cannot be less than one month. The aim of the work is to select the most suitable replenishment strategy able to minimize the average stock level, which is a surrogate cost metric, while respecting a target fill rate. Considering a smoothing order-up-to policy, the data-driven prediction-optimization framework makes use of Artificial Neural Network (ANN) and Particle Swarm Optimization (PSO) to select the best replenishment parameters (i.e., forecasting factor, proportional controller and safety stock factor) able to dynamically enhance the SC economic performance under the fill rate constraint. The ability of the framework under the predictive and the optimization perspective is assessed and a sensitivity analysis on the influence of replenishment parameters is presented as well
Nanostructured porous silicon photonic crystal for applications in the infrared
In the last decades great interest has been devoted to photonic crystals aiming at the creation of novel devices which can control light propagation. In the present work, two-dimensional (2D) and three-dimensional (3D) devices based on nanostructured porous silicon have been fabricated. 2D devices consist of a square mesh of 2 μm wide porous silicon veins, leaving 5x5 μm square air holes. 3D structures share the same design although multilayer porous silicon veins are used instead, providing an additional degree of modulation. These devices are fabricated from porous silicon single layers (for 2D structures) or multilayers (for 3D structures), opening air holes in them by means of 1KeV argon ion bombardment through the appropriate copper grids. For 2D structures, a complete photonic band gap for TE polarization is found in the thermal infrared range. For 3D structures, there are no complete band gaps, although several new partial gaps do exist in different high-symmetry directions. The simulation results suggest that these structures are very promising candidates for the development of low-cost photonic devices for their use in the thermal infrared rangeThe authors also gratefully acknowledge funding from Comunidad de Madrid (Spain) under project “Microseres” and Ministerio de Economía y Competitividad (Spain) under Research Project MAT2011-28345-C02-0
Results of five-year systematic screening for latent tuberculosis infection in healthcare workers in Portugal
<p>Abstract</p> <p>Introduction</p> <p>The risk of tuberculosis (TB) in healthcare workers (HCWs) is related to its incidence in the general population, and increased by the specific risk as a professional group. The prevalence of latent tuberculosis infection (LTBI) in HCWs in Portugal using the tuberculin skin test (TST) and the interferon-γ release assays (IGRA) was analyzed over a five-year period.</p> <p>Methods</p> <p>A screening programme for LTBI in HCWs was conducted, with clinical evaluations, TST, IGRA, and chest radiography. Putative risk factors for LTBI were assessed by a standardised questionnaire.</p> <p>Results</p> <p>Between September 2005 and June 2009, 5,414 HCWs were screened. The prevalence of LTBI was 55.2% and 25.9% using a TST ≥ 10 mm or an IGRA test result (QuantiFERON-TB Gold In-Tube) INF-γ ≥0.35 IU/mL as a criterion for LTBI, respectively. In 53 HCWs active TB was diagnosed. The number of HCWs with newly detected active TB decreased from 19 in the first year to 6 in 2008. Risk assessment was poorly related to TST diameter. However, physicians (1.7%) and nurses (1.0%) had the highest rates of active TB.</p> <p>Conclusions</p> <p>LTBI and TB burden among HCWs in Portugal is high. The screening of these professionals to identify HCWs with LTBI is essential in order to offer preventive chemotherapy to those with a high risk of future progression to disease. Systematic screening had a positive impact on the rate of active TB in HCWs either by early case detection or by increasing the awareness of HCWs and therefore the precautions taken by them.</p
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