29 research outputs found

    El terremoto del último 7 de septiembre : tiembla, todo tiembla

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    Fil: Folguera, Andrés. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Laboratorio de Tectónica Andina; Argentina.Fil: Triep, Enrique. Instituto de Sismología Volponi; Argentina.Fil: González Díaz, Emilio M. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina.Fil: Ramos, Víctor A. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Laboratorio de Tectónica Andina; Argentina.Los terremotos no son un fenómeno del pasado y las placas que conforman los niveles móviles más\nsuperficiales de la Tierra están aún en pleno movimiento. Con respecto a la intensidad de los mismos y\nsus desplazamientos asociados, la actividad actual, en especial la deformación permanente asociada\na estos terremotos, se ha mantenido en el mismo orden de magnitud que en los últimos 10 millones de\naños. La frecuencia con la que ocurren estos movimientos está también dentro del mismo orden,\nsiendo quizás la diferencia más significativa el avance de la tecnología y las comunicaciones de este\nmundo global que nos permiten conocer al instante este tipo de eventos en cualquier parte del planeta,\npareciendo de esta forma un fenómeno más periódico en la actualidad

    Sensitivity of ICD coding for sepsis in children-a population-based study.

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    BACKGROUND International Classification of Diseases 10th edition (ICD-10) is widely used to describe the burden of disease. AIM To describe how well ICD-10 coding captures sepsis in children admitted to the hospital with blood culture-proven bacterial or fungal infection and systemic inflammatory response syndrome. METHODS Secondary analysis of a population-based, multicenter, prospective cohort study on children with blood culture-proven sepsis of nine tertiary pediatric hospitals in Switzerland. We compared the agreement of validated study data on sepsis criteria with ICD-10 coding abstraction obtained at the participating hospitals. RESULTS We analyzed 998 hospital admissions of children with blood culture-proven sepsis. The sensitivity of ICD-10 coding abstraction was 60% (95%-CI 57-63) for sepsis; 35% (95%-CI 31-39) for sepsis with organ dysfunction, using an explicit abstraction strategy; and 65% (95%-CI 61-69) using an implicit abstraction strategy. For septic shock, the sensitivity of ICD-10 coding abstraction was 43% (95%-CI 37-50). Agreement of ICD-10 coding abstraction with validated study data varied by the underlying infection type and disease severity (p < 0.05). The estimated national incidence of sepsis, inferred from ICD-10 coding abstraction, was 12.5 per 100,000 children (95%-CI 11.7-13.5) and 21.0 per 100,000 children (95%-CI 19.8-22.2) using validated study data. CONCLUSIONS In this population-based study, we found a poor representation of sepsis and sepsis with organ dysfunction by ICD-10 coding abstraction in children with blood culture-proven sepsis when compared against a prospective validated research dataset. Sepsis estimates in children based on ICD-10 coding may thus severely underestimate the true prevalence of the disease. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s44253-023-00006-1

    Sensitivity of ICD coding for sepsis in children-a population-based study

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    BACKGROUND International Classification of Diseases 10th edition (ICD-10) is widely used to describe the burden of disease. AIM To describe how well ICD-10 coding captures sepsis in children admitted to the hospital with blood culture-proven bacterial or fungal infection and systemic inflammatory response syndrome. METHODS Secondary analysis of a population-based, multicenter, prospective cohort study on children with blood culture-proven sepsis of nine tertiary pediatric hospitals in Switzerland. We compared the agreement of validated study data on sepsis criteria with ICD-10 coding abstraction obtained at the participating hospitals. RESULTS We analyzed 998 hospital admissions of children with blood culture-proven sepsis. The sensitivity of ICD-10 coding abstraction was 60% (95%-CI 57-63) for sepsis; 35% (95%-CI 31-39) for sepsis with organ dysfunction, using an explicit abstraction strategy; and 65% (95%-CI 61-69) using an implicit abstraction strategy. For septic shock, the sensitivity of ICD-10 coding abstraction was 43% (95%-CI 37-50). Agreement of ICD-10 coding abstraction with validated study data varied by the underlying infection type and disease severity (p < 0.05). The estimated national incidence of sepsis, inferred from ICD-10 coding abstraction, was 12.5 per 100,000 children (95%-CI 11.7-13.5) and 21.0 per 100,000 children (95%-CI 19.8-22.2) using validated study data. CONCLUSIONS In this population-based study, we found a poor representation of sepsis and sepsis with organ dysfunction by ICD-10 coding abstraction in children with blood culture-proven sepsis when compared against a prospective validated research dataset. Sepsis estimates in children based on ICD-10 coding may thus severely underestimate the true prevalence of the disease. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s44253-023-00006-1

    Feather Vibration as a Stimulus for Sensing Incipient Separation in Falcon Diving Flight

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    Abstract Based on our preceding studies on the aerodynamics of a falcoperegrinus in diving flight along a vertical dam it is known that even when the body shape of the bird is rather streamlined in V-shape some feathers tips may elevate in certain regions of the body. These regions were identified in wind tunnel tests for typical diving flight conditions as regions of locally separated flow. A life-size model in V-shape of a falcoperegrinus with artificial feathers fixed along the body was studied in a wind tunnel to focus on the fluid-structure interaction of feathers located in this sector. The distal ends of the feathers show flow-induced vibrations at typical flight conditions which grow linear in amplitude with increasing angle of incidence until incipient separation. In light of the proven existence of vibration-sensitive mechanoreceptors in the follicles of secondary feathers in birds it is hypothesized that this linear amplitude response offers the bird to sense the angle of incidence during the diving flight using the vibration magnitude as sensory stimulus. Thus the bird in streamlined shape has still a good measure to control its attitude to be in the narrow window of safe angle of incidence. This might have implications also for other birds or technical applications of airfoil sensors regarding incipient separation detection

    Changepoint analysis of gestational age and birth weight: proposing a refinement of Diagnosis Related Groups

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    Background: Although the complexity and length of treatment is connected to the newborn’s maturity and birth weight, most case-mix grouping schemes classify newborns by birth weight alone. The objective of this study was to determine whether the definition of thresholds based on a changepoint analysis of variability of birth weight and gestational age contributes to a more homogenous classification. Methods: This retrospective observational study was conducted at a Tertiary Care Center with Level III Neonatal Intensive Care and included neonate cases from 2016 through 2018. The institutional database of routinely collected health data was used. The design of this cohort study was explorative. The cases were categorized according to WHO gestational age classes and SwissDRG birth weight classes. A changepoint analysis was conducted. Cut-off values were determined. Results: When grouping the cases according to the calculated changepoints, the variability within the groups with regard to case related costs could be reduced. A refined grouping was achieved especially with cases of >2500 g birth weight. An adjusted Grouping Grid for practical purposes was developed. Conclusions: A novel method of classification of newborn cases by changepoint analysis was developed, providing the possibility to assign costs or outcome indicators to grouping mechanisms by gestational age and birth weight combined. © 2019, International Pediatric Research Foundation, Inc
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