Intensive Care Management of The Critically Ill Elderly Population: The Case of ‘Sotiria’ Regional Chest Diseases Hospital of Athens, Greece

The aim of this study was to assess the characteristics and short-term outcome of elderly patients admitted to the ICU of ‘Sotiria’ Regional Chest Diseases Hospital of Athens. We examined retrospectively the records of 344 patients aged ≥70 years old admitted to the ICU of a tertiary hospital during a five-year period, from 2009-2013. We reported demographic and clinical data, length of ICU stay, need for mechanical ventilation and ICU mortality. Among 1730 admitted to the ICU during this period, the elderly comprised 344 (19.8%). The main causes of ICU admission were Chronic Obstructive Pulmonary Disease (COPD) exacerbation (n=169), postoperative respiratory failure (n=78), acute respiratory failure of various etiologies (n=76) and cardiogenic pulmonary edema (n=25). Overall mortality rate of elderly patients was 41.5%. According to age groups, 200 patients were 70-74 years old with a mortality rate of 47%, 42 patients were 80-84 years old presenting a mortality rate of 28.5%, while 14 patients aged over 85 years old, presented a mortality of 42.8%. The mean length of ICU stay (LOS) for the elderly patients was 11.2 days, while the corresponding LOS value for younger patients was 8.1 days. Elderly patients present highest mortality than younger population. However, mortality does not correlate exclusively with advancing age over 70 years, but mostly with the underlying disease. Therefore, age should not be the sole determinant of ICU admission

Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients

INTRODUCTION: The increasing prevalence of multiresistant Gram-negative strains in intensive care units (ICUs) has recently rekindled interest in colistin, a bactericidal antibiotic that was used in the 1960s for treatment of infections caused by Gram-negative bacilli. We conducted the present observational study to evaluate the efficacy of intravenous colistin in the treatment of critically ill patients with sepsis caused by Gram-negative bacilli resistant to all other antibiotics. PATIENTS AND METHOD: Critically ill patients with sepsis caused by Gram-negative bacilli resistant to all antibiotics with the exception of colistin were treated in the six-bed ICU of a trauma hospital. Diagnosis of infection was based on clinical data and isolation of bacteria, and the bacteria were tested with respect to their susceptibility to colistin. Clinical response to colistin was evaluated. RESULTS: Twenty-four patients (mean age 44.3 years, mean Acute Physiology and Chronic Health Evaluation II score 20.6) received 26 courses of colistin. Clinical response was observed for 73% of the treatments. Survival at 30 days was 57.7%. Deterioration in renal function was observed in 14.3% of 21 patients who were not already receiving renal replacement therapy, but in only one case did this deterioration have serious clinical consequences. CONCLUSION: The lack of a control group in the present study does not allow any definite conclusions to be drawn regarding the clinical effectiveness of colistin. On the other hand, this drug has an acceptable safety profile and its use should be considered in severe infections with multiresistant Gram-negative bacilli

Removal of phosphate from aqueous solutions by adsorption onto Ca(OH)2 treated natural clinoptilolite

Phosphorus (P) recovery from wastewater is of great interest especially when the loaded adsorbent can be used in the agriculture as slow-release fertilizer. The application depends on environmental concerns related to the chemical modification of the adsorbent and the release of toxic compounds from the loaded material to the soil or the water during adsorption. The present work focused on the phosphate (PO4-P) removal from aqueous solutions under low P concentrations (0.5–10mg/L) by using Ca(OH)2-pretreated natural zeolite (CaT-Z). As activation agent, Ca(OH)2 presents benefits in terms of pretreatment costs and environmental impact of the applied adsorbent. The pretreatment of natural zeolite (clinoptilolite) with 0.25mol/L Ca(OH)2 led to an increase of P removal from 1.7 to 97.6% at initial P concentration of 10mg/L, pH 7 and 298K. Low residual concentrations of 81–238μg P/L were achieved at 298K rendering CaT-Z a promising sorbent for tertiary wastewater treatment. At 200mg P/L, the adsorption capacity was 7.57mg P/g CaT-Z. The P removal efficiency was pH-independent suggesting a beneficial use of CaT-Z under acidic and alkaline conditions. Adsorption was found to be an endothermic and slow process reaching equilibrium after 120h, whereas the half of the PO4-P was adsorbed in the first 8h. The applied kinetic models showed that both film and intraparticle diffusion contributed to phosphate removal. Phosphate sorption decreased in the presence of the anionic surfactant SDS, Fe2+, HCO3−, acetate and citrate anion. The predominant mechanisms of ligand exchange and Ca-P surface precipitation were confirmed by the IR-ATR and SEM-EDS analyses, respectively

A general framework of high-performance machine learning algorithms : application in structural mechanics

Data-driven models utilizing powerful artificial intelligence (AI) algorithms have been implemented over the past two decades in different fields of simulation-based engineering science. Most numerical procedures involve processing data sets developed from physical or numerical experiments to create closed-form formulae to predict the corresponding systems’ mechanical response. Efficient AI methodologies that will allow the development and use of accurate predictive models for solving computational intensive engineering problems remain an open issue. In this research work, high-performance machine learning (ML) algorithms are proposed for modeling structural mechanics-related problems, which are implemented in parallel and distributed computing environments to address extremely computationally demanding problems. Four machine learning algorithms are proposed in this work and their performance is investigated in three different structural engineering problems. According to the parametric investigation of the prediction accuracy, the extreme gradient boosting with extended hyper-parameter optimization (XGBoost-HYT-CV) was found to be more efficient regarding the generalization errors deriving a 4.54% residual error for all test cases considered. Furthermore, a comprehensive statistical analysis of the residual errors and a sensitivity analysis of the predictors concerning the target variable are reported. Overall, the proposed models were found to outperform the existing ML methods, where in one case the residual error was decreased by 3-fold. Furthermore, the proposed algorithms demonstrated the generic characteristic of the proposed ML framework for structural mechanics problems.The EuroCC Project (GA 951732) and EuroCC 2 Project (101101903) of the European Commission. Open access funding provided by University of Pretoria.https://link.springer.com/journal/466hj2024Civil EngineeringSDG-09: Industry, innovation and infrastructur

Hydrotherapy (Project Hydriades)

Natural resources are being used for the maintenance of health. According to the Law 3498/2006 of the Greek Parliament the natural health spas must be validated for their therapeutic properties. The Association of Municipalities and Communities of Health Springs of Greece signed a contract with the Research Committee of the Aristotle University of Thessaloniki, Greece, in order to conduct the research programme: ‘Study for the documentation of the therapeutic properties of the thermomineral waters’. The main aim of the project is: (1) the study of biological and therapeutic parameters of the natural health sources, (2) the identification of the indications and contraindications of hydrotherapy. Aims parallel to the main ones have been also set

Energy Resolution Performance of the CMS Electromagnetic Calorimeter

The energy resolution performance of the CMS lead tungstate crystal electromagnetic calorimeter is presented. Measurements were made with an electron beam using a fully equipped supermodule of the calorimeter barrel. Results are given both for electrons incident on the centre of crystals and for electrons distributed uniformly over the calorimeter surface. The electron energy is reconstructed in matrices of 3 times 3 or 5 times 5 crystals centred on the crystal containing the maximum energy. Corrections for variations in the shower containment are applied in the case of uniform incidence. The resolution measured is consistent with the design goals

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good