Excess length of hospital stay due to healthcare acquired infections. Methodologies evaluation

BACKGROUND: Healthcare acquired infections (HAI) cause an increase of burden and in particular excess length of hospital stay (LOS) accounts for approximately up to 90% of total costs. Therefore accurate estimation of extra hospital stay due to healthcare acquired infections is very important. METHODS: The authors carried out a review comparing the principal methods internationally used for estimating the excess LOS attributable to healthcare acquired infections. RESULTS: The methods described and analysed are: 1) Implicit physician assessment; 2) appropriateness evaluation protocol; 3) unmatched case-control; 4) matched case-control; 5) regression analysis; 6) multistate model. The various methodologies are described underlining advantages and limits which researchers need to know before starting any economic analysis. CONCLUSIONS: Overall, studies taking into account the time-dependent nature of HAI show to give more precise and reliable results

Improving Visual Field Examination of the Macula Using Structural Information

Purpose: To investigate a novel approach for structure-function modeling in glaucoma to improve visual field testing in the macula. Methods: We acquired data from the macular region in 20 healthy eyes and 31 with central glaucomatous damage. Optical coherence tomography (OCT) scans were used to estimate the local macular ganglion cell density. Perimetry was performed with a fundus-tracking device using a 10-2 grid. OCT scans were matched to the retinal image from the fundus perimeter to accurately map the tested locations onto the structural damage. Binary responses from the subjects to all presented stimuli were used to calculate the structure-function model used to generate prior distributions for a ZEST (Zippy Estimation by Sequential Testing) Bayesian strategy. We used simulations based on structural and functional data acquired from an independent dataset of 20 glaucoma patients to compare the performance of this new strategy, structural macular ZEST (MacS-ZEST), with a standard ZEST. Results: Compared to the standard ZEST, MacS-ZEST reduced the number of presentations by 13% in reliable simulated subjects and 14% with higher rates (≥20%) of false positive or false negative errors. Reduction in mean absolute error was not present for reliable subjects but was gradually more important with unreliable responses (≥10% at 30% error rate). Conclusions: Binary responses can be modeled to incorporate detailed structural information from macular OCT into visual field testing, improving overall speed and accuracy in poor responders. Translational Relevance: Structural information can improve speed and reliability for macular testing in glaucoma practice

Cataract and optic disk drusen in a patient with glycogenosis and di George syndrome: clinical and molecular report

Background We report the ophthalmic findings of a patient with type Ia glycogen storage disease (GSD Ia), DiGeorge syndrome (DGS), cataract and optic nerve head drusen (ONHD). Case presentation A 26-year-old white woman, born at term by natural delivery presented with a post-natal diagnosis of GSD Ia. Genetic testing by array-comparative genomic hybridization (CGH) for DGS was required because of her low levels of serum calcium. The patient has been followed from birth, attending the day-hospital every six months at the San Paolo Hospital, Milan, outpatient clinic for metabolic diseases and previously at another eye center. During the last day-hospital visit, a complete eye examination showed ONHD and cataract in both eyes. Next Generation Sequencing (NGS) was subsequently done to check for any association between the eye problems and metabolic aspects. Conclusions This is the first description of ocular changes in a patient with GSD Ia and DGS. Mutations explaining GSD Ia and DGS were found but no specific causative mutation for cataract and ONHD. The metabolic etiology of her lens changes is known, whereas the pathogenesis of ONHD is not clear. Although the presence of cataract and ONHD could be a coincidence; the case reported could suggest that hypocalcemia due to DGS could be the common biochemical pathway

Innovar la enseñanza CTS y la evaluación de la mejora en el aula por una secuencia de enseñanza

Esta comunicación afronta el compromiso de la didáctica de las ciencias con la sociedad del conocimiento para promover la comprensión de la naturaleza de la ciencia y tecnología (NdCyT/CTS), es decir, el funcionamiento de CyTen la sociedad (CTS), mediante la enseñanza de una breve y específica secuencia de enseñanza aprendizaje (SEA) y la evaluación de la mejora lograda. Ambos aspectos, enseñanza y evaluación,forman el núcleo de esta investigación innovadora, cuyo objetivo central es investigar empíricamente la eficacia de la SEA sobre el tema de las implicaciones sociales de las explotaciones mineras. Losaspectos más innovadores de esta nueva metodología se centran en el diseño de la SEA, la estandarizaciónde la evaluación del a mejora del aprendizajede los estudiantes y la implementación en un contexto de estudiantes hispanos que no son profesores en formación (poco habitual en la investigación previa )

Stam: a framework for spatio-temporal affordance maps

A�ordances have been introduced in literature as action op- portunities that objects o�er, and used in robotics to semantically rep- resent their interconnection. However, when considering an environment instead of an object, the problem becomes more complex due to the dynamism of its state. To tackle this issue, we introduce the concept of Spatio-Temporal A�ordances (STA) and Spatio-Temporal A�ordance Map (STAM). Using this formalism, we encode action semantics re- lated to the environment to improve task execution capabilities of an autonomous robot. We experimentally validate our approach to support the execution of robot tasks by showing that a�ordances encode accurate semantics of the environment

Healthcare Associated Infections. educational intervention by "Adult Learning" in an Italian teaching hospital

An educational intervention for HAI prevention based on a combination of training, motivation and subsequent application in the current clinical practice in an Italian teaching hospital