WASPSS: A Clinical Decision Support System for Antimicrobial Stewardship

The increase of infections caused by resistant bacteria has become one of the major health-care problems worldwide. The creation of multidisciplinary teams dedicated to the implementation of antimicrobial stewardship programmes (ASPs) is encouraged by all clinical institutions to cope with this problem. In this chapter, we describe the Wise Antimicrobial Stewardship Program Support System (WASPSS), a CDSS focused on providing support for ASP teams. WASPSS gathers the required information from other hospital systems in order to provide decision support in antimicrobial stewardship from both patient-centered and global perspectives. To achieve this, it combines business intelligence techniques with a rule-based inference engine to integrate the data and knowledge required in this scenario. The system provides functions such as alerts, recommendations, antimicrobial prescription support and global surveillance. Furthermore, it includes experimental modules for improving the adoption of clinical guidelines and applying prediction models related with antimicrobial resistance. All these functionalities are provided through a multi-user web interface, personalized for each role of the ASP team

LoRa Enabled Smart Inverters for Microgrid Scenarios with Widespread Elements

The introduction of low-power wide-area networks (LPWANs) has changed the image of smart systems, due to their wide coverage and low-power characteristics. This category of communication technologies is the perfect candidate to be integrated into smart inverter control architectures for remote microgrid (MG) applications. LoRaWAN is one of the leading LPWAN technologies, with some appealing features such as ease of implementation and the possibility of creating private networks. This study is devoted to analyze and evaluate the aforementioned integration. Initially, the characteristics of different LPWAN technologies are introduced, followed by an in-depth analysis of LoRa and LoRaWAN. Next, the role of communication in MGs with widespread elements is explained. A point-by-point LoRa architecture is proposed to be implemented in the grid-feeding control structure of smart inverters. This architecture is experimentally evaluated in terms of latency analysis and externally generated power setpoint, following smart inverters in different LoRa settings. The results demonstrate the effectiveness of the proposed LoRa architecture, while the settings are optimally configured. Finally, a hybrid communication system is proposed that can be effectively implemented for remote residential MG management

Primary pleural myxoid liposarcoma: case report and literature review

Myxoid liposarcoma is a histological subtype of malignant tumors within the group of sarcomas. It is more common in men between the ages of 40 and 50 years. Diagnosis is difficult because they are usually asymptomatic lesions, computed tomography (CT) scan and magnetic resonance are the studies of choice. The gold of treatment is surgical resection with free margins. Chemotherapy and radiotherapy have shown a good response. A 46-year-old male was detected incidental mediastinal lesion by radiography, CT scan showed a hypodense lesion in the right hemithorax that extended to the left hemithorax, infiltrating the diaphragm and large vessels. The patient underwent an exploratory thoracotomy, finding a multilobulated tumor and mucous content approximately 600 ml, adjacent structures were infiltrated, so complete resection was not possible. Subsequently, adjuvant chemotherapy given. The histopathological diagnosis was myxoid liposarcoma. Myxoid liposarcoma is a malignant lesion. The primary pleural origin is rare. Surgical resection with free margins has a good prognosis. Due to advanced disease, a complete resection in this case was not possible, that compromised the patient prognosis

Héðinsdalsjökull, northern Iceland: geomorphology recording the recent complex evolution of a glacier

The objective of this work is to conduct a detailed mapping of the Héðinsdalsjökull foreland, northern Iceland (65°39′N, 18°55′W). This cirque currently shows a variety of glacial and periglacial landforms derived from a complex deglaciation. Mapping was performed combining traditional hand-drawn and digital mapping. A hand-drawn sketch was georeferenced in ArcMap 10.7.1, supported on an aerial photograph (year 2000). Its vectorization, symbolization and final design were done in the computer-aided design (CAD) software MicroStation Connect. Complementary high-resolution Digital Surface Models were obtained from historical aerial photographs and ground-view field photographs through the application of Structure from Motion (SfM) photogrammetry. To improve the topographic expression of the geomorphological map, a photorealistic 3D view has been generated. The final map highlights the complexity of the foreland and the coexistence existence of a range of different units and landforms. The map will ease future studies on the transformation of receding glaciers.info:eu-repo/semantics/publishedVersio

The reaction mechanism of metallo-beta-lactamases is tuned by the conformation of an active site mobile loop

Carbapenems are "last resort" β-lactam antibiotics used to treat serious and life-threatening health care-associated infections caused by multidrug-resistant Gram-negative bacteria. Unfortunately, the worldwide spread of genes coding for carbapenemases among these bacteria is threatening these life-saving drugs. Metallo-β-lactamases (MβLs) are the largest family of carbapenemases. These are Zn(II)-dependent hydrolases that are active against almost all β-lactam antibiotics. Their catalytic mechanism and the features driving substrate specificity have been matter of intense debate. The active sites of MβLs are flanked by two loops, one of which, loop L3, was shown to adopt different conformations upon substrate or inhibitor binding, and thus are expected to play a role in substrate recognition. However, the sequence heterogeneity observed in this loop in different MβLs has limited the generalizations about its role. Here, we report the engineering of different loops within the scaffold of the clinically relevant carbapenemase NDM-1. We found that the loop sequence dictates its conformation in the unbound form of the enzyme, eliciting different degrees of active-site exposure. However, these structural changes have a minor impact on the substrate profile. Instead, we report that the loop conformation determines the protonation rate of key reaction intermediates accumulated during the hydrolysis of different β-lactams in all MβLs. This study demonstrates the existence of a direct link between the conformation of this loop and the mechanistic features of the enzyme, bringing to light an unexplored function of active-site loops on MβLs.Fil: Palacios, Antonela Rocio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Mojica, María F.. Case Western Reserve University; Estados UnidosFil: Giannini, Estefanía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Taracila, Magdalena A.. Case Western Reserve University; Estados Unidos. Louis Stokes Veterans Affairs Medical Center; Estados UnidosFil: Bethel, Christopher R.. Louis Stokes Veterans Affairs Medical Center; Estados UnidosFil: Alzari, Pedro M.. Institut Pasteur de Paris; FranciaFil: Otero, Lisandro Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Klinke, Sebastian. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Llarrull, Leticia Irene. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Bonomo, Robert A.. Case Western Reserve University; Estados UnidosFil: Vila, Alejandro Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; Argentin

Ice Particle Impacts on a Moving Wedge

This work presents the results of an experimental study of ice particle impacts on a moving wedge. The experiment was conducted in the Adverse Environment Rotor Test Stand (AERTS) facility located at Penn State University. The wedge was placed at the tip of a rotating blade. Ice particles shot from a pressure gun intercepted the moving wedge and impacted it at a location along its circular path. The upward velocity of the ice particles varied from 7 to 12 meters per second. Wedge velocities were varied from 0 to 120 meters per second. Wedge angles tested were 0 deg, 30 deg, 45 deg, and 60 deg. High speed imaging combined with backlighting captured the impact allowing observation of the effect of velocity and wedge angle on the impact and the post-impact fragment behavior. It was found that the pressure gun and the rotating wedge could be synchronized to consistently obtain ice particle impacts on the target wedge. It was observed that the number of fragments increase with the normal component of the impact velocity. Particle fragments ejected immediately after impact showed velocities higher than the impact velocity. The results followed the major qualitative features observed by other researchers for hailstone impacts, even though the reduced scale size of the particles used in the present experiment as compared to hailstones was 4:1