Exponentially-fitted Gauss-Laguerre quadrature rule for integrals over an unbounded interval

New quadrature formulae are introduced for the computation of integrals over the whole positive semiaxis when the integrand has an oscillatory behavior with decaying envelope. The new formulae are derived by exponential fitting, and they represent a generalization of the usual Gauss-Laguerre formulae. Their weights and nodes depend on the frequency of oscillation in the integrand, and thus the accuracy is massively increased. Rules with one up to six nodes are treated with details. Numerical illustrations are also presented

Interruptions to intensive care nurses and clinical errors and procedural failures: A controlled study of causal connection

Objectives. Interruptions occur frequently in the Intensive Care Unit (ICU) and are associated with errors. To date, no causal connection has been established between interruptions and errors in healthcare. It is important to know if interruptions directly cause errors before implementing interventions designed to reduce interruptions in ICUs. Our objective was to investigate whether ICU nurses who receive a higher number of workplace interruptions commit more clinical errors and procedural failures than those who receive a lower number of interruptions. Methods. We conducted a prospective controlled trial in a high -fidelity ICU simulator. A volunteer sample of ICU nurses from a single unit prepare d and administered intravenous medications for a patient manikin. Nurses received either 3 (n=35) or 12 (n=35) scenario - relevant interruptions and were allocated to either condition in an alternating fashion. Primary outcomes were the number of clinica l errors and procedural failures committed by each nurse. Results . The rate ratio of clinical errors committed by nurses who received 12 interruptions compared to nurses who received 3 interruptions was 2.0 (95% CI [1.41, 2.83]), p < .001. The rate ratio of procedural failures committed by nurses who received 12 interruptions compared to nurses who were interrupted 3 times was 1.2 (95% CI [1.05, 1.37]), p = .006. Conclusions. More workplace interruptions during medication preparation and administration le ad to more clinical errors and procedural failures. Reducing the frequency of interruptions may reduce the number of errors committed; however, this should be balanced against important information that interruptions communicat

AUTHENTICATION OF WILD AND REARED SEA BASS BY INFRARED SPECTROSCOPY NIRs (NEAR INFRARED REFLECTANCE SPECTROSCOPY)

The aim of this study was to evaluate NIRs (Near Infrared Reflectance Spectroscopy) performances in the prediction of Farmed vs.Wild production method in European sea bass. Samples collected (n=39) were submitted to analysis in order to assess chemical composition and fatty acids profile of fillets. Aliquots of wet and ground freeze-dried minced samples were scanned in duplicates (1100 to 2498 nm; 2 nm intervals) in reflectance mode using a monochromator NIRsystem 5000. NIRs technique showed a satisfactory accurateness in predicting Protein, Lipids and Fatty acids profile in raw samples. Sample lyophilisation increased some predicting values (r2: coefficient of determination on cross-validation range from 0,671 to 0,992; SECV: standard error of cross-validation range from 0,864 to 2,981). Results showed that NIRs technique was able to discriminate between Wild (94,7% samples recognized) and Farmed (100% samples recognized) using wet muscles, and 100% for both classes on ground freeze-dried fillet

Interruptions to intensive care nurses lead to clinical errors

Introduction: Interruptions occur frequently in the Intensive Care Unit (ICU), and are associated with clinical errors. However, a potential causal connection between workplace interruptions and medical errors has not been investigated. It is important to know if a causal link exists before designing and implementing interventions to reduce interruption rates. Objectives: The purpose of this study was to test whether nurses who receive a high number of interruptions commit more clinical errors than nurses who receive a low number of interruptions. Methods: We carried out a controlled trial in a high-fidelity ICU simulator at a tertiary Queensland hospital. ICU nurses (N = 70) prepared and administered intravenous medications for a simulated patient manikin. Participants received 3 or 12 interruptions and were allocated to either condition in an alternating fashion. Interruptions were relevant to the scenario and delivered via either a confederate playing an Access Nurse or from patient, bedside phone, and equipment alarms. Video recordings were analysed for clinical errors, which were deviations from the medication order or procedure that resulted in the patient directly receiving a medication inconsistent with what was prescribed. Results: A Poisson regression revealed that nurses who received 12 interruptions (M = 2.74, 95% CIs [2.19, 3.29]) committed clinical errors 2.00 times (95% CIs [1.41, 2.83]) more frequently than nurses who received 3 interruptions (M = 1.37, 95% CIs [0.99, 1.75]), p < 0.001. Conclusions: This study was the first to directly test the causal connection between interruptions and errors in the ICU. Nurses who received a high number of interruptions committed twice the number of clinical errors as nurses who received a low number of interruptions. Interventions designed to reduce the frequency of interruptions may be effective at reducing clinical errors, but further research should investigate potential unintended consequences of eliminating interruptions in the ICU

Role of semiautomatic defibrillators in a general hospital: "Naples Heart Project".

In Italian hospitals, 85% of patients hospitalized in general medical wards who experience cardiac arrest die, while the incidence is much lower in patients in intensive care units. Defibrillation, in Italian hospitals, often occurs very late, either due to a lack of defibrillators, or due to architectural and structural barriers. The object of an in-hospital emergency service is to prevent and treat cardiac arrest without subsequent complications, such as brain damage, renal failure etc. The Naples Heart Project was based on a feasibility study of the in-hospital emergency service to evaluate and analyze problems associated with type of structure, departmental and institutional dislocation, internal practicability (architectural features and preferential ways), staff numbers and distribution, the calling system for emergency, and the equipment available. The Naples Heart Project began in July 2001, since then it has already created 835 BLSD first responders among the hospital staff; 440 were physicians and physicians still in training, 310 were nurses and 85 were administrative staf

Fast microwave-assisted acidolysis, a new biorefinery approach for a zero-waste utilisation of lignocellulosic biomass to produce high quality lignin and fermentable saccharides

Generally biorefineries convert lignocellulosic biomass into a range of biofuels and further value added chemicals. However, conventional biorefinery processes focus mainly on the cellulose and hemicellulose fractions and therefore produce only low quality lignin, which is commonly burnt to provide process heat. To make full use of the biomass, more attention needs to be focussed on novel separation techniques, where the lignin can be isolated in a high quality suitable for further valorisation into aromatic chemicals and fuel components. In this paper, three types of lignocellulosic biomass (softwood, hardwood and herbaceous biomass) were processed by microwave-assisted acidolysis, to produce high quality lignin. The lignin from the softwood was isolated largely intact in the solid residue after acidolysis. For example, a 10 min treatment, microwave-assisted acidolysis produced a lignin with a purity of 93% and yield of 82%, superior to other conventional separation methods reported. Furthermore, the py-GC/MS analysis proved that the isolated lignin retained the original structure as native lignin in the feedstock without severe chemical modification. This is a large advantage, and the purified lignin is suitable for further chemical processing. To assess the suitability of this methodology as part of a biorefinery system, the aqueous phase, produced after acidolysis of the softwood, was characterised and assessed for its suitability for fermentation. The broth contained some mono- and disaccharides but mainly organic acids, oligosaccharides and furans. While this is unsuitable for S. cerevisiae and other common ethanol producing yeasts, two oleaginous yeasts with known inhibitor tolerances were selected; Cryptococcus curvatus and Metschnikowia pulcherrima. Both yeasts could grow on the broth, demonstrating suitable catabolism of the oligosaccharides and inhibitors over 7 days. In addition, both yeasts were shown to be able to produce an oil with a similar composition to palm oil. This preliminary work demonstrates new protocols of microwave-assisted acidolysis and therefore offers an effective approach to produce high purity lignin and fermentable chemicals, a key step towards a zero-waste lignocellulosic biorefinery

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation