1,952 research outputs found
Capacity Leasing in Cloud Systems using the OpenNebula Engine
Depto. de Arquitectura de Computadores y AutomáticaFac. de InformáticaTRUEUnión Europea. FP7Ministerio de Educación y Ciencia (MEC)Comunidad de Madridsubmitte
Diagnosing early-onset neonatal sepsis in low-resource settings: development of a multivariable prediction model
OBJECTIVE: To develop a clinical prediction model to diagnose neonatal sepsis in low-resource settings. DESIGN: Secondary analysis of data collected by the Neotree digital health system from 1 February 2019 to 31 March 2020. We used multivariable logistic regression with candidate predictors identified from expert opinion and literature review. Missing data were imputed using multivariate imputation and model performance was evaluated in the derivation cohort. SETTING: A tertiary neonatal unit at Sally Mugabe Central Hospital, Zimbabwe. PATIENTS: We included 2628 neonates aged <72 hours, gestation ≥32+0 weeks and birth weight ≥1500 g. INTERVENTIONS: Participants received standard care as no specific interventions were dictated by the study protocol. MAIN OUTCOME MEASURES: Clinical early-onset neonatal sepsis (within the first 72 hours of life), defined by the treating consultant neonatologist. RESULTS: Clinical early-onset sepsis was diagnosed in 297 neonates (11%). The optimal model included eight predictors: maternal fever, offensive liquor, prolonged rupture of membranes, neonatal temperature, respiratory rate, activity, chest retractions and grunting. Receiver operating characteristic analysis gave an area under the curve of 0.74 (95% CI 0.70-0.77). For a sensitivity of 95% (92%-97%), corresponding specificity was 11% (10%-13%), positive predictive value 12% (11%-13%), negative predictive value 95% (92%-97%), positive likelihood ratio 1.1 (95% CI 1.0-1.1) and negative likelihood ratio 0.4 (95% CI 0.3-0.6). CONCLUSIONS: Our clinical prediction model achieved high sensitivity with low specificity, suggesting it may be suited to excluding early-onset sepsis. Future work will validate and update this model before considering implementation within the Neotree
The metformin in tuberous sclerosis (MiTS) study: A randomised double-blind placebo-controlled trial
Background: Tuberous Sclerosis Complex (TSC) is a genetic disorder characterised by the development of benign tumours secondary to loss of inhibitory regulation of the mTOR (mechanistic Target of Rapamycin) intracellular growth pathway. Metformin inhibits the mTOR pathway. We investigated whether metformin would reduce growth of hamartomas associated with tuberous sclerosis complex. /
Methods: In this multicentre randomized, double-blind, placebo-controlled trial, patients with a clinical diagnosis of tuberous sclerosis, aged over 10 years and with at least one renal angiomyolipoma of greater than 1 cm in diameter were enrolled. Participants were randomly allocated (1:1) by a secure website to receive metformin or placebo for 12 months. The primary outcome was percentage volume change of renal angiomyolipomas (AML) at 12 months compared to baseline. Secondary outcomes were percentage change at 12 months from baseline in volume of cerebral Subependymal Giant Cell Astrocytomas (SEGA); appearance of facial and ungual hamartomas; frequency of epileptic seizures; and adaptive behaviour. The trial is registered with The International Standard Randomised Controlled Trial Number (ISRCTN), number 92545532, and the European Union Drug Regulating Authorities Clinical Trials (EUDRACT), number 2011-001319-30. /
Findings: Between 1 November 2012 and 30 September 2015 72 patients were screened and 55 were randomly assigned to metformin (28) or placebo (27). Four participants withdrew between randomisation and starting treatment. All 51 patients who started therapy completed the trial and were assessed for outcome at 12 months. The median percentage change in angiomyolipoma (AML) volume was +7.6% (IQR -1.8% to +42.6%) for the placebo group and +8.9% (IQR 1.3% to 19.5%) for the metformin group (p = 0.28). Twenty-seven patients had SEGAs: 13 received placebo and 14 metformin. The median percentage change in SEGA volume was +3.0% (IQR -22.8% to +27.7%) for the placebo group and – 20.8% (IQR – 47.1% to - 5.0%) for the metformin group (p = 0.03). Twenty-one patients were assessed for seizure frequency: 9 received placebo and 12 received metformin. In the metformin group, a mean reduction of 43.7% from baseline in seizures was observed and in the placebo group a 3.1% mean reduction was observed, with a difference in response of 40.6% (95% CI -3.1% to +84.2%, p = 0.03). There were no significant differences between metformin and placebo groups for the other secondary outcomes. There were no deaths. Three serious adverse events (SAEs) occurred during the trial (all patients on metformin). /
Interpretation: Metformin did not reduce AML volume. Metformin did reduce SEGA volume and seizure frequency compared with placebo. There may be a role for metformin in slowing or reversing growth of some life-threatening hamartomas in TSC and for reducing seizure frequency. Further study is justified. /
Funding: This study was funded by the National Institute for Health and Research (NIHR) through the The Research for Patient Benefit Programme (RfPB)
Dynamics for a 2-vertex Quantum Gravity Model
We use the recently introduced U(N) framework for loop quantum gravity to
study the dynamics of spin network states on the simplest class of graphs: two
vertices linked with an arbitrary number N of edges. Such graphs represent two
regions, in and out, separated by a boundary surface. We study the algebraic
structure of the Hilbert space of spin networks from the U(N) perspective. In
particular, we describe the algebra of operators acting on that space and
discuss their relation to the standard holonomy operator of loop quantum
gravity. Furthermore, we show that it is possible to make the restriction to
the isotropic/homogeneous sector of the model by imposing the invariance under
a global U(N) symmetry. We then propose a U(N) invariant Hamiltonian operator
and study the induced dynamics. Finally, we explore the analogies between this
model and loop quantum cosmology and sketch some possible generalizations of
it.Comment: 28 pages, v2: typos correcte
Collective psychological ownership and reconciliation in territorial conflicts
Collective psychological ownership refers to people’s perception that an object, place, or idea belongs to their own group. We considered this concept in the context of territorial conflicts and proposed that (1) collective psychological ownership is distinct from place attachment, (2) higher ingroup identifiers are more likely to claim collective ownership and feel attached to the territory, yet (3) only ownership claims are related to lower support for reconciliation. These hypotheses were tested in two studies using structural equation modelling. Study 1 addressed the Kosovo conflict, based on Serbian participants living in Serbia (N = 264). We found that collective psychological ownership and place attachment were distinct. Moreover, higher Serbian identifiers had a stronger sense of collective ownership of Kosovo and were more attached to it. Those with stronger feelings of collective ownership supported reconciliation with Albanians less, while place attachment did not hinder reconciliation. Study 2 replicated these findings among a new sample of Serbs in Serbia (N = 173), among Serbs in Kosovo (N = 129), and in two other conflict settings: among Greek Cypriots in Cyprus (N = 135) and Jews in Israel (N = 109). Altogether, we provide evidence that collective psychological ownership can represent an obstacle to reconciliation in conflict regions
Effect of the Influent COD Concentration on the Anaerobic Digestion of Winery Wastewaters from Grape-Red and Tropical Fruit (Guava) Wine Production in Fluidized Bed Reactors with Chilean Natural Zeolite for Biomass Immobilization
The effect of the influent COD concentration on the performance of anaerobic fluidized bed reactors treating winery wastewaters from grape-red wine (GRWW) and guava wine production (GWW) was studied at laboratory scale. Two reactors were used: one treating GRWW (AFB1) and the other processing GWW (AFB2). The behaviour of these reactors packed with Chilean zeolite as biomass immobilization support was compared at mesophilic temperature (35 °C). Influent COD varied from γ = 1–24 g L–1 and the HRT was maintained constant at 1 day throughout the experiment. During the experiment, influent and effluent pH, TVFA, COD and methane gas production were determined. COD removal efficiency increased with the influent COD up to a maximum of around γ = 19 g L–1 for GRWW and up to around 22 g L–1 for GWW due to the increase
of the concentration of phenols. Process performance was slightly better with guava winery wastewater than with grape-red winery wastewater due its lower phenolic content. During the period of non-inhibition the methane yield was virtually constant
Mosca-dos-chifres: aspectos bio-ecológicos, importância econômica, interações parasito-hospedeiro e controle.
Esta publicação teve por objetivo apresentar aspectos relativos à biologia e às interações existentes entre a presença da mosca-dos-chifres sobre seu hospedeiro preferencial, os bovinos, bem como os métodos de avaliação do grau de parasitismo e controle da mosca-dos-chifres.bitstream/item/24807/1/Cot302-mosca-dos-chifres.pd
Direct and Simultaneous Observation of Ultrafast Electron and Hole Dynamics in Germanium
Understanding excited carrier dynamics in semiconductors is crucial for the
development of photovoltaics and efficient photonic devices. However,
overlapping spectral features in optical/NIR pump-probe spectroscopy often
render assignments of separate electron and hole carrier dynamics ambiguous.
Here, ultrafast electron and hole dynamics in germanium nanocrystalline thin
films are directly and simultaneously observed by attosecond transient
absorption spectroscopy (ATAS) in the extreme ultraviolet at the germanium
M_{4,5}-edge (~30 eV). We decompose the ATAS spectra into contributions of
electronic state blocking and photo-induced band shifts at a carrier density of
8*10^{20}cm^{-3}. Separate electron and hole relaxation times are observed as a
function of hot carrier energies. A first order electron and hole decay of ~1
ps suggests a Shockley-Read-Hall recombination mechanism. The simultaneous
observation of electrons and holes with ATAS paves the way for investigating
few to sub-femtosecond dynamics of both holes and electrons in complex
semiconductor materials and across junctions.Comment: Includes Supplementary Informatio
Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period
Neonatal encephalopathy (NE) accounts for ~23% of the 2.4 million annual global neonatal deaths. Approximately 99% of global neonatal deaths occur in low-resource settings, however, accurate data from these low-resource settings are scarce. We reviewed risk factors of neonatal mortality in neonates admitted with neonatal encephalopathy from a tertiary neonatal unit in Zimbabwe. A retrospective review of risk factors of short-term neonatal encephalopathy mortality was conducted at Sally Mugabe Central Hospital (SMCH) (November 2018 -October 2019). Data were gathered using a tablet-based data capture and quality improvement newborn care application (Neotree). Analyses were performed on data from all admitted neonates with a diagnosis of neonatal encephalopathy, incorporating maternal, intrapartum, and neonatal risk predictors of the primary outcome: mortality. 494/2894 neonates had neonatal encephalopathy on admission and were included. Of these, 94 died giving a neonatal encephalopathy-case fatality rate (CFR) of 190 per 1000 admitted neonates. Caesarean section (odds ratio (OR) 2.95(95% confidence interval (CI) 1.39-6.25), convulsions (OR 7.13 (1.41-36.1)), lethargy (OR 3.13 (1.24-7.91)), Thompson score "11-14" (OR 2.98 (1.08-8.22)) or "15-22" (OR 17.61 (1.74-178.0)) were significantly associated with neonatal death. No maternal risk factors were associated with mortality. Nearly 1 in 5 neonates diagnosed with neonatal encephalopathy died before discharge, similar to other low-resource settings but more than in typical high-resource centres. The Thompson score, a validated, sensitive and specific tool for diagnosing neonates with neonatal encephalopathy was an appropriate predictive clinical scoring system to identify at risk neonates in this setting. On univariable analysis time-period, specifically a period of staff shortages due to industrial action, had a significant impact on neonatal encephalopathy mortality. Emergency caesarean section was associated with increased mortality, suggesting perinatal care is likely to be a key moment for future interventions
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