755 research outputs found

    Characteristics of Long-Stay Patients in a PICU and Healthcare Resource Utilization after Discharge

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    OBJECTIVES: To examine the characteristics of long-stay patients (LSPs) admitted to a PICU and to investigate discharge characteristics of medical complexity among discharged LSP. DESIGN: We performed a retrospective cohort study where clinical data were collected on all children admitted to our PICU between July 1, 2017, and January 1, 2020. SETTING: A single-center study based at Erasmus MC Sophia Children's Hospital, a level III interdisciplinary PICU in The Netherlands, providing all pediatric and surgical subspecialties. PATIENTS:LSP was defined as those admitted for at least 28 consecutive days. INTERVENTIONS: None. MEASUREMENTS: Length of PICU stay, diagnosis at admission, length of mechanical ventilation, need for extracorporeal membrane oxygenation, mortality, discharge location after PICU and hospital admission, medical technical support, medication use, and involvement of allied healthcare professionals after hospital discharge. MAIN RESULTS: LSP represented a small proportion of total PICU patients (108 patients; 3.2%) but consumed 33% of the total admission days, 47% of all days on extracorporeal membrane oxygenation, and 38% of all days on mechanical ventilation. After discharge, most LSP could be classified as children with medical complexity (CMC) (76%); all patients received discharge medications (median 5.5; range 2-19), most patients suffered from a chronic disease (89%), leaving the hospital with one or more technological devices (82%) and required allied healthcare professional involvement after discharge (93%). CONCLUSIONS: LSP consumes a considerable amount of resources in the PICU and its impact extends beyond the point of PICU discharge since the majority are CMC. This indicates complex care needs at home, high family needs, and a high burden on the healthcare system across hospital borders.</p

    Derivative spectroscopy and the continuous relaxation spectrum

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    Derivative spectroscopy is conventionally understood to be a collection of techniques for extracting fine structure from spectroscopic data by means of numerical differentiation. In this paper we extend the conventional interpretation of derivative spectroscopy with a view to recovering the continuous relaxation spectrum of a viscoelastic material from oscillatory shear data. To achieve this, the term “spectroscopic data” is allowed to include spectral data which have been severely broadened by the action of a strong low-pass filter. Consequently, a higher order of differentiation than is usually encountered in conventional derivative spectroscopy is required. However, by establishing a link between derivative spectroscopy and wavelet decomposition, high-order differentiation of oscillatory shear data can be achieved using specially constructed wavelet smoothing. This method of recovery is justified when the reciprocal of the Fourier transform of the filter function (convolution kernel) is an entire function, and is particularly powerful when the associated Maclaurin series converges rapidly. All derivatives are expressed algebraically in terms of scaling functions and wavelets of different scales, and the recovered relaxation spectrum is expressible in analytic form. An important feature of the method is that it facilitates local recovery of the spectrum, and is therefore appropriate for real scenarios where the oscillatory shear data is only available for a finite range of frequencies. We validate the method using synthetic data, but also demonstrate its use on real experimental data

    Verbetering trosvorming bij trosrozen door teelthandelingen

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    Het jaarrond telen van trosrozen met voldoende bloemen op het bloemgestel is voor veel telers een probleem. In dit onderzoek is onderzocht of door gewasopbouw (snoeimethode) en de keuze van cultivar en onderstam een verbetering kan worden bereikt van het percentage trossen bij trosrozen. In totaal zijn in dit onderzoek drie knipmethoden en twee cultivars vergeleken. Bij één cultivar zijn twee onderstammen, in combinatie met eigen wortel, met elkaar vergeleken. Met behulp van de gewasopbouw het percentage trossen beïnvloeden is mogelijk gebleken. Een opbouw waarbij de basis van de plant dichter bij de grond blijft en waarbij er minder ogen zijn waar de plant mee uit kan lopen beïnvloedt het percentage trossen en het takgewicht positief. Het aantal geoogste takken wordt echter negatief beïnvloed, zodat per saldo er geen verschil in het totaal geoogste aantal kilogrammen per snoeimethode is. Bij de snoeimethode 'knotroos', waarbij contant nieuwe grondscheuten gevormd worden, is de groeiduur van knippen tot de volgende oogst langer dan bij de andere methoden

    Модификация поверхности имплантов органическими функциональными группами

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    Работа направлена на разработку модификации поверхности аддитивно полученных скэффолдов на основе титанового сплава Ti6Al4V с аренедиазониевыми тозилатами и металл-органическими каркасами для улучшения биосовместимости и процесса остеоинтеграции. Целью исследования является разработка методов ковалентной модификации поверхностей скэффолдов с использованием арендиазоний тозилатов и металлоорганических каркасов для повышения выживаемости имплантатов в организме человека.The work is aimed at developing a surface modification of additively obtained scaffolds based on a Ti6Al4V titanium alloy with arenediazonium tosylates and metal-organic frameworks to improve biocompatibility and osseointegration. Aim of research to develop methods for covalent modification of scaffold surfaces using arenediazonium tosylates and metal-organic frameworks for better implant survival in the human body

    Transport of argon ions in an inductively coupled high-density plasma reactor

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    The first direct observation of the velocity distribution of the metastable Ar1*~2G9/2! ions in the presheath of an inductively coupled plasma has been achieved by using the Doppler shifted laser induced fluorescence technique. Drift of the ions along the electric field in the presheath is observed and distribution functions of the velocity in both parallel and perpendicular directions, relative to the E field, are deduced at 5 and 40 mTorr. Present results show that in high density plasmas the velocity distribution of the metastable ions is directly related to that of the ground state argon ions. Neutral gas temperature of around 600 K is also measured from the absorption profile of a diode laser beam, set on one of the 772.4 nm argon lines

    Redefinition of Aureobasidium pullulans and its varieties

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    Using media with low water activity, a large numbers of aureobasidium-like black yeasts were isolated from glacial and subglacial ice of three polythermal glaciers from the coastal Arctic environment of Kongsfjorden (Svalbard, Spitsbergen), as well as from adjacent sea water, sea ice and glacial meltwaters. To characterise the genetic variability of Aureobasidium pullulans strains originating from the Arctic and strains originating pan-globally, a multilocus molecular analysis was performed, through rDNA (internal transcribed spacers, partial 28 S rDNA), and partial introns and exons of genes encoding β-tubulin (TUB), translation elongation factor (EF1α) and elongase (ELO). Two globally ubiquitous varieties were distinguished: var. pullulans, occurring particularly in slightly osmotic substrates and in the phyllosphere; and var. melanogenum, mainly isolated from watery habitats. Both varieties were commonly isolated from the sampled Arctic habitats. However, some aureobasidium-like strains from subglacial ice from three different glaciers in Kongsfjorden (Svalbard, Spitsbergen), appeared to represent a new variety of A. pullulans. A strain from dolomitic marble in Namibia was found to belong to yet another variety. No molecular support has as yet been found for the previously described var. aubasidani. A partial elongase-encoding gene was successfully used as a phylogenetic marker at the (infra-)specific level

    Phylogeny and ecology of the ubiquitous saprobe Cladosporium sphaerospermum, with descriptions of seven new species from hypersaline environments

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    Saprobic Cladosporium isolates morphologically similar to C. sphaerospermum are phylogenetically analysed on the basis of DNA sequences of the ribosomal RNA gene cluster, including the internal transcribed spacer regions ITS1 and ITS2, the 5.8S rDNA (ITS) and the small subunit (SSU) rDNA as well as β-tubulin and actin gene introns and exons. Most of the C. sphaerospermum-like species show halotolerance as a recurrent feature. Cladosporium sphaerospermum, which is characterised by almost globose conidia, is redefined on the basis of its ex-neotype culture. Cladosporium dominicanum, C. psychrotolerans, C. velox, C. spinulosum and C. halotolerans, all with globoid conidia, are newly described on the basis of phylogenetic analyses and cryptic morphological and physiological characters. Cladosporium halotolerans was isolated from hypersaline water and bathrooms and detected once on dolphin skin. Cladosporium dominicanum and C. velox were isolated from plant material and hypersaline water. Cladosporium psychrotolerans, which grows well at 4 °C but not at 30 °C, and C. spinulosum, having conspicuously ornamented conidia with long digitate projections, are currently only known from hypersaline water. We also newly describe C. salinae from hypersaline water and C. fusiforme from hypersaline water and animal feed. Both species have ovoid to ellipsoid conidia and are therefore reminiscent of C. herbarum. Cladosporium langeronii (= Hormodendrum langeronii) previously described as a pathogen on human skin, is halotolerant but has not yet been recorded from hypersaline environments
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