Limited effect of patient and disease characteristics on compliance with hospital antimicrobial guidelines

Objective: Physicians frequently deviate from guidelines that promote prudent use of antimicrobials. We explored to what extent patient and disease characteristics were associated with compliance with guideline recommendations for three common infections. Methods: In a 1-year prospective observational study, 1,125 antimicrobial prescriptions were analysed for compliance with university hospital guidelines. Results: Compliance varied significantly between and within the groups of infections studied. Compliance was much higher for lower respiratory tract infections (LRTIs; 79%) than for sepsis (53%) and urinary tract infections (UTIs; 40%). Only predisposing illnesses and active malignancies were associated with more compliant prescribing, whereas alcohol/ intravenous drug abuse and serum creatinine levels > 130 mu mol/l were associated with less compliant prescribing. Availability of culture results had no impact on compliance with guidelines for sepsis but was associated with more compliance in UTIs and less in LRTIs. Narrowing initial broad-spectrum antimicrobial therapy to cultured pathogens was seldom practised. Most noncompliant prescribing concerned a too broad spectrum of activity when compared with guideline-recommended therapy. Conclusion: Patient characteristics had only a limited impact on compliant prescribing for a variety of reasons. Physicians seemed to practise defensive prescribing behaviour, favouring treatment success in current patients over loss of effectiveness due to resistance in future patients

Infrarenal Aortic Coarctation as a Cause for Hypertension

In the Russian Arctic, nature protection is important to preserve valuable ecosystems and indigenous lifestyles against the rapidly expanding oil and gas activities. In this regard, zoning legitimately balances influential stakeholders versus weak ones, and can leverage stakeholders to exercise their rights. This study explores how various stakeholders employ zoning in the Numto Nature Park in the oil-rich Russian Khanty-Mansi Autonomous Okrug–Yugra to advance their interests and how they use scientific information to achieve this. Through stakeholder interviews, analysis of electronic media and literature review, we conclude that a participatory and science-based zoning exercise stimulates the necessary deliberation. However, legal ambiguity, deficient law implementation and informal practices limit the zoning's potential to balance stakeholders’ interests. All the stakeholders calculatingly used scientific information to legitimize their own ambitions, activities and claims. Hence, zoning and the underlying information claims should be interpreted as both a resource and a battleground in nature-use conflicts

Reference installation for the German grid initiative D-Grid

The D-Grid reference installation is a test platform for the German grid initiative. The main task is to create the grid prototype for software and hardware components needed in the D-Grid community. For each grid-related task field different alternative middleware is included. With respect to changing demands from the community, new versions of the reference installation are released every six months

Aspects of Cooling at the TRIμ\muP Facility

The Tri$\mu$P facility at KVI is dedicated to provide short lived radioactive isotopes at low kinetic energies to users. It comprised different cooling schemes for a variety of energy ranges, from GeV down to the neV scale. The isotopes are produced using beam of the AGOR cyclotron at KVI. They are separated from the primary beam by a magnetic separator. A crucial part of such a facility is the ability to stop and extract isotopes into a low energy beamline which guides them to the experiment. In particular we are investigating stopping in matter and buffer gases. After the extraction the isotopes can be stored in neutral atoms or ion traps for experiments. Our research includes precision studies of nuclear $\beta$-decay through $\beta$-$\nu$ momentum correlations as well as searches for permanent electric dipole moments in heavy atomic systems like radium. Such experiments offer a large potential for discovering new physics.Comment: COOL05 Workshop, Galena, Il, USA, 18-23. Sept. 2005, 5 pages, 3 figure

Several types of types in programming languages

Types are an important part of any modern programming language, but we often forget that the concept of type we understand nowadays is not the same it was perceived in the sixties. Moreover, we conflate the concept of "type" in programming languages with the concept of the same name in mathematical logic, an identification that is only the result of the convergence of two different paths, which started apart with different aims. The paper will present several remarks (some historical, some of more conceptual character) on the subject, as a basis for a further investigation. The thesis we will argue is that there are three different characters at play in programming languages, all of them now called types: the technical concept used in language design to guide implementation; the general abstraction mechanism used as a modelling tool; the classifying tool inherited from mathematical logic. We will suggest three possible dates ad quem for their presence in the programming language literature, suggesting that the emergence of the concept of type in computer science is relatively independent from the logical tradition, until the Curry-Howard isomorphism will make an explicit bridge between them.Comment: History and Philosophy of Computing, HAPOC 2015. To appear in LNC

Measurement of the half-life of the T=12\frac{1}{2} mirror decay of 19^{19}Ne and its implication on physics beyond the standard model

The $\frac{1}{2}^+ \rightarrow \frac{1}{2}^+$ superallowed mixed mirror decay of $^{19}$Ne to $^{19}$F is excellently suited for high precision studies of the weak interaction. However, there is some disagreement on the value of the half-life. In a new measurement we have determined this quantity to be $T_{1/2}$ = $17.2832 \pm 0.0051_{(stat)}$ $\pm 0.0066_{(sys)}$ s, which differs from the previous world average by 3 standard deviations. The impact of this measurement on limits for physics beyond the standard model such as the presence of tensor currents is discussed.Comment: 5 pages, 3 figures, 1 tabl

An evolutionary stage model of outsourcing and competence destruction : a Triad comparison of the consumer electronics industry

Outsourcing has gained much prominence in managerial practice and academic discussions in the last two decades or so. Yet, we still do not understand the full implications of outsourcing strategy for corporate performance. Traditionally outsourcing across borders is explained as a cost-cutting exercise, but more recently the core competency argument states that outsourcing also leads to an increased focus, thereby improving effectiveness. However, no general explanation has so far been provided for how outsourcing could lead to deterioration in a firm‟s competence base. We longitudinally analyze three cases of major consumer electronics manufacturers, Emerson Radio from the U.S., Japan‟s Sony and Philips from the Netherlands to understand the dynamic process related to their sourcing strategies. We develop an evolutionary stage model that relates outsourcing to competence development inside the firm and shows that a vicious cycle may emerge. Thus it is appropriate to look not only at how outsourcing is influenced by an organization‟s current set of competences, but also how it alters that set over time. The four stages of the model are offshore sourcing, phasing out, increasing dependence on foreign suppliers, and finally industry exit or outsourcing reduction. The evolutionary stage model helps managers understand for which activities and under which conditions outsourcing across borders is not a viable option. Results suggest that each of these firms had faced a loss of manufacturing competitiveness in its home country, to which it responded by offshoring and then outsourcing production. When a loss of competences occurred, some outsourcing decisions were reversed

Qualitative aspects and validation of a screening method for pesticides in vegetables and fruits based on liquid chromatography coupled to full scan high resolution (Orbitrap) mass spectrometry

The analytical capabilities of liquid chromatography with single-stage high-resolution mass spectrometry have been investigated with emphasis on qualitative aspects related to selective detection during screening and to identification. The study involved 21 different vegetable and fruit commodities, a screening database of 556 pesticides for evaluation of false positives, and a test set of 130 pesticides spiked to the commodities at 0.01, 0.05, and 0.20 mg/kg for evaluation of false negatives. The final method involved a QuEChERS-based sample preparation (without dSPE clean up) and full scan acquisition using alternating scan events without/with fragmentation, at a resolving power of 50,000. Analyte detection was based on extraction of the exact mass (±5 ppm) of the major adduct ion at the database retention time ±30 s and the presence of a second diagnostic ion. Various options for the additional ion were investigated and compared (other adduct ions, M + 1 or M + 2 isotopes, fragments). The two-ion approach for selective detection of the pesticides in the full scan data was compared with two alternative approaches based on response thresholds. Using the two-ion approach, the number of false positives out of 11,676 pesticide/commodity combinations targeted was 36 (0.3 %). The percentage of false negatives, assessed for 2,730 pesticide/commodity combinations, was 13 %, 3 %, and 1 % at the 0.01-, 0.05-, and 0.20-mg/kg level, respectively (slightly higher with fully automated detection). Following the SANCO/12495/2011 protocol for validation of screening methods, the screening detection limit was determined for 130 pesticides and found to be 0.01, 0.05, and ≥0.20 mg/kg for 86, 30, and 14 pesticides, respectively. For the detected pesticides in the spiked samples, the ability for unambiguous identification according to EU criteria was evaluated. A proposal for adaption of the criteria was made

Chapter 4 DATAFLOW ANALYSIS FOR REAL-TIME EMBEDDED MULTIPROCESSOR SYSTEM DESIGN

Keywords: Dataflow analysis techniques are key to reduce the number of design iterations and shorten the design time of real-time embedded network based multiprocessor systems that process data streams. With these analysis techniques the worstcase end-to-end temporal behavior of hard real-time applications can be derived from a dataflow model in which computation, communication and arbitration is modeled. For soft real-time applications these static dataflow analysis techniques are combined with simulation of the dataflow model to test statistical assertions about their temporal behavior. The simulation results in combination with properties of the dataflow model are used to derive the sensitivity of design parameters and to estimate parameters like the capacity of data buffers. real-time, dataflow analysis, multiprocessor system, predictable design, systemon-chip 1