513 research outputs found

    The value of combined hemodynamic, respiratory and intra-abdominal pressure monitoring in predicting acute kidney injury after major intraabdominal surgeries

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    Background: The incidence of postoperative acute kidney injury (AKI) is predominantly determined by renal hemodynamics. Beside arterial blood pressure, the role of factors causing a deterioration of venous congestion (intraabdominal pressure, central venous pressure, mechanical ventilation) has emerged. The value of combined hemodynamic, respiratory and intra-abdominal pressure (IAP) monitoring in predicting postoperative acute kidney injury has received only limited exploration to date. Methods: Data were collected for adult patients admitted after major abdominal surgery at nine Hungarian ICUs. Hemodynamic parameters were compared in AKI vs. no-AKI patients at the time of admission and 48 h thereafter. Regarding ventilatory support, we tested mean airway pressures (Pmean). Effective renal perfusion pressure (RPP) was calculated as MAP−(IAP + CVP + Pmean). The Mann–Whitney U and the chi-square tests were carried out for statistical analysis with forward stepwise logistic regression for AKI as a dependent outcome. Results: A total of 84 patients (34 ventilated) were enrolled in our multicenter observational study. The median values of MAP were above 70 mmHg, IAP not higher than 12 mmHg and CVP not higher than 8 mmHg at all time-points. When we combined those parameters, even those belonging to the ‘normal’ range with Pmean, we found significant differences between no-AKI and AKI groups only at 12 h after ICU admission (median and IQR: 57 (42–64) vs. 40 (36–52); p < .05). Below it’s median (40.7 mmHg) on admission, AKI developed in all patients. If above 40.7 mmHg on admission, they were protected against AKI, but only if it did not decrease within the first 12 h. Conclusions: Calculated effective RPP with the novel formula MAP−(IAP + CVP + Pmean) may predict the onset of AKI in the surgical ICU with a great sensitivity and specificity. Maintaining effective RPP appears important not only at ICU admission but during the next 12 h, as well. Additional, larger studies are needed to explore therapeutic interventions targeting this parameter

    Utility of Parental Mediation Model on Youth’s Problematic Online Gaming

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    The Parental Mediation Model PMM) was initially designed to regulate children’s attitudes towards the traditional media. In the present era, because of prevalent online media there is a need for similar regulative measures. Spending long hours on social media and playing online games increase the risks of exposure to the negative outcomes of online gaming. This paper initially applied the PMM developed by European Kids Online to (i) test the reliability and validity of this model and (ii) identify the effectiveness of this model in controlling problematic online gaming (POG). The data were collected from 592 participants comprising 296 parents and 296 students of four foreign universities, aged 16 to 22 years in Kuala Lumpur (Malaysia). The study found that the modified model of the five-factor PMM (Technical mediation, Monitoring mediation, Restrictive mediation, Active Mediation of Internet Safety, and Active mediation of Internet Use) functions as a predictor for mitigating POG. The findings suggest the existence of a positive relation between ‘monitoring’ and ‘restrictive’ mediation strategies and exposure to POG while Active Mediation of Internet Safety and Active mediation of Internet use were insignificant predictors. Results showed a higher utility of ‘technical’ strategies by the parents led to less POG. The findings of this study do not support the literature suggesting active mediation is more effective for reducing youth’s risky behaviour. Instead, parents need to apply more technical mediations with their children and adolescents’ Internet use to minimize the negative effects of online gaming

    Incorporating risk in field services operational planning process

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    © Springer Nature Switzerland AG 2018. This paper presents a model for the risk minimisation objective in the Stochastic Vehicle Routing Problem (SVRP). In the studied variant of SVRP, service times and travel times are subject to stochastic events, and a time window is constraining the start time for service task. Required skill levels and task priorities increase the complexity of this problem. Most previous research uses a chance-constrained approach to the problem and their objectives are related to traditional routing costs whilst a different approach was taken in this paper. The risk of missing a task is defined as the probability that the technician assigned to the task arrives at the customer site later than the time window. The problem studied in this paper is to generate a schedule that minimises the maximum of risks and sum of risks over all the tasks considering the effect of skill levels and task priorities. The stochastic duration of each task is supposed to follow a known normal distribution. However, the distribution of the start time of the service at a customer site will not be normally distributed due to time window constraints. A method is proposed and tested to approximate the start time distribution as normal. Moreover, a linear model can be obtained assuming identical variance of task durations. Additionally Simulated Annealing method was applied to solve the problem. Results of this work have been applied to an industrial case of SVRP where field engineering individuals drive to customer sites to provide time-constrained services. This original approach gives a robust schedule and allows organisations to pay more attention to increasing customer satisfaction and become more competitive in the market

    Nanostructured 3D Constructs Based on Chitosan and Chondroitin Sulphate Multilayers for Cartilage Tissue Engineering

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    Nanostructured three-dimensional constructs combining layer-by-layer technology (LbL) and template leaching were processed and evaluated as possible support structures for cartilage tissue engineering. Multilayered constructs were formed by depositing the polyelectrolytes chitosan (CHT) and chondroitin sulphate (CS) on either bidimensional glass surfaces or 3D packet of paraffin spheres. 2D CHT/CS multi-layered constructs proved to support the attachment and proliferation of bovine chondrocytes (BCH). The technology was transposed to 3D level and CHT/CS multi-layered hierarchical scaffolds were retrieved after paraffin leaching. The obtained nanostructured 3D constructs had a high porosity and water uptake capacity of about 300%. Dynamical mechanical analysis (DMA) showed the viscoelastic nature of the scaffolds. Cellular tests were performed with the culture of BCH and multipotent bone marrow derived stromal cells (hMSCs) up to 21 days in chondrogenic differentiation media. Together with scanning electronic microscopy analysis, viability tests and DNA quantification, our results clearly showed that cells attached, proliferated and were metabolically active over the entire scaffold. Cartilaginous extracellular matrix (ECM) formation was further assessed and results showed that GAG secretion occurred indicating the maintenance of the chondrogenic phenotype and the chondrogenic differentiation of hMSCs

    Dystocia in Friesian cows and its effects on postpartum reproductive performance and milk production

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    A total of 1,243 records for 585 dairy Friesian cows from 1997–2004 were used to study the factors affecting dystocia and its effects on reproductive performance and milk production. The overall incidence of dystocia was 6.9%. The percentage of dystocia decreased with increasing live body weight, age, and parity of cows (P < 0.05); however, it increased with increasing birth weight of calves (P < 0.05). The highest percentage of dystocia was detected in winter season, but the least percentage was in summer season (P < 0.05). The percentage of incidence of dystocia was significantly (P < 0.05) higher with winter feeding compared to summer ration (8.2% vs. 5.1%). The percentage of incidence of dystocia was significantly (P < 0.05) higher with twinning than single calving (15.5% vs. 6.5%), while not significantly affected by the sex of born calves. Incidence of dystocia had adverse effects on reproductive performance and milk yield. The service interval, service period, days open, and calving interval were significantly (P < 0.05) longer in cows afflicted with dystocia compared to normal cows. The conception rate was lower (P < 0.05), but the number of service per conception was higher (P < 0.05) in cows afflicted with dystocia compared to normal cows (60.5% vs. 73.0% and 3.4 vs. 2.7, respectively). Average daily milk yield was lower (P < 0.05) by 1 kg for cows with incidence of dystocia compared to normal cows

    Selling lottery products to minors: factors affecting retailer compliance

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    Illegal gambling by adolescent minors has become a major issue in many societies and lottery gambling is often considered a "gateway" to gambling more generally among this age group. The purpose of this study was to identify the influencing factors that affect retailer compliance concerning the selling of lottery products to minors. The research team received the original data (i) directly from the sales agents of the Austrian Lotteries after their responsible gambling training of the retailer in 2014/2015 (Round 1: n = 5032), (ii) directly from a third-party agency carrying out test purchases (i.e., "mystery shopping") in 2014 (Round 2: n = 1421), and (iii) retailers’ responses to their attitudes to youth protection issues (through direct interface with the research team) in 2015 (Round 3: n = 4516). The data from a total of 1036 participants who had taken part in all three rounds was analyzed in the present study. Results showed that in 13.1% of mystery shopping checks (n = 1421), lottery products were sold to a test purchaser under the age of 16 years. The analysis also showed that the older the test purchaser, the greater the likelihood that a lottery product was sold. Under-age lottery sales to girls were over three times more prevalent than sales to boys. Finally, the analysis showed that the higher the number of responsible gambling training sessions completed in the past and the more positive the attitude towards mystery shopping, the higher the compliance rate not to sell a lottery product to young mystery shoppers. Recommendations to increase compliance and raise the awareness among retailers are presented

    Evolution of Female Preference for Younger Males

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    Previous theoretical work has suggested that females should prefer to mate with older males, as older males should have higher fitness than the average fitness of the cohort into which they were born. However, studies in humans and model organisms have shown that as males age, they accumulate deleterious mutations in their germ-line at an ever-increasing rate, thereby reducing the quality of genes passed on to the next generation. Thus, older males may produce relatively poor-quality offspring. To better understand how male age influences female mate preference and offspring quality, we used a genetic algorithm model to study the effect of age-related increases in male genetic load on female mate preference. When we incorporate age-related increases in mutation load in males into our model, we find that females evolve a preference for younger males. Females in this model could determine a male's age, but not his inherited genotype nor his mutation load. Nevertheless, females evolved age-preferences that led them to mate with males that had low mutation loads, but showed no preference for males with respect to their somatic quality. These results suggest that germ-line quality, rather than somatic quality, should be the focus of female preference in good genes models

    How Immunocontraception Can Contribute to Elephant Management in Small, Enclosed Reserves: Munyawana Population as a Case Study

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    Immunocontraception has been widely used as a management tool to reduce population growth in captive as well as wild populations of various fauna. We model the use of an individual-based rotational immunocontraception plan on a wild elephant, Loxodonta africana, population and quantify the social and reproductive advantages of this method of implementation using adaptive management. The use of immunocontraception on an individual, rotational basis stretches the inter-calving interval for each individual female elephant to a management-determined interval, preventing exposing females to unlimited long-term immunocontraception use (which may have as yet undocumented negative effects). Such rotational immunocontraception can effectively lower population growth rates, age the population, and alter the age structure. Furthermore, such structured intervention can simulate natural process such as predation or episodic catastrophic events (e.g., drought), which regulates calf recruitment within an abnormally structured population. A rotational immunocontraception plan is a feasible and useful elephant population management tool, especially in a small, enclosed conservation area. Such approaches should be considered for other long-lived, social species in enclosed areas where the long-term consequences of consistent contraception may be unknown

    Crossing Paths with Hans Bodlaender:A Personal View on Cross-Composition for Sparsification Lower Bounds

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    On the occasion of Hans Bodlaender’s 60th birthday, I give a personal account of our history and work together on the technique of cross-composition for kernelization lower bounds. I present several simple new proofs for polynomial kernelization lower bounds using cross-composition, interlaced with personal anecdotes about my time as Hans’ PhD student at Utrecht University. Concretely, I will prove that Vertex Cover, Feedback Vertex Set, and the H-Factor problem for every graph H that has a connected component of at least three vertices, do not admit kernels of (formula presented) bits when parameterized by the number of vertices n for any (formula presented), unless (formula presented). These lower bounds are obtained by elementary gadget constructions, in particular avoiding the use of the Packing Lemma by Dell and van Melkebeek.</p
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