Comparison between two treatment protocols with recombinant Human Erythropoietin (rHuEpo) in the treatment of late anemia in neonates with Rh-Isoimmunization

Objectve. The Rh-hemolytic disease can lead to a late anemia by hemolytic and hyporigenerative mechanism. We compared the effectiveness of rHuEPO in two care protocols that differ for doses of rHuEPO administrated and for timing of administration. Methods. A cohort of 14 neonates was investigated. The neonates were treated with two different protocols. Protocol A: a dose of 200 U/kg/day of rHuEpo administered subcutaneously starting from the end of the second week of life; Protocol B: a dose of 400 U/kg/day of rHuEpo administered subcutaneously starting from the end of the first week of life. Results. The hematocrit values in the protocol A group decreased during treatment (32,5% vs 25,2%), whereas the hematocrit value in protocol B group remained almost stable (38,7% vs 42,8%). The mean numbers of platelets remained stable in both groups while neutrophils increased in protocol A group and decreased in protocol B (p<0,05). Reticulocyte count increased during treatment in both groups, although only in protocol B group it was statistically significative (p<0,05). Conclusions. Our results suggest a similar efficacy between the two treatment protocols. Increasing doses of rHuEPO do not seem enhancing their effectiveness and the incidence of side effects

Using a task-based approach in evaluating the usability of BoBIs in an e-book environment

This paper reports on a usability evaluation of BoBIs (Back-of-the-book Indexes) as searching and browsing tools in an e-book environment. This study employed a task-based approach and within-subject design. The retrieval performance of a BoBI was compared with a ToC and Full-Text Search tool in terms of their respective effectiveness and efficiency for finding information in e-books. The results demonstrated that a BoBI was significantly more efficient (faster) and useful compared to a ToC or Full-Text Search tool for finding information in an e-book environment

Divergence of thermal physiological traits in terrestrial breeding frogs along a tropical elevational gradient

Critical thermal limits are thought to be correlated with the elevational distribution of species living in tropical montane regions, but with upper limits being relatively invariant compared to lower limits. To test this hypothesis, we examined the variation of thermal physiological traits in a group of terrestrial breeding frogs (Craugastoridae) distributed along a tropical elevational gradient. We measured the critical thermal maximum (CTmax; n = 22 species) and critical thermal minimum (CTmin; n = 14 species) of frogs captured between the Amazon floodplain (250 m asl) and the high Andes (3,800 m asl). After inferring a multilocus species tree, we conducted a phylogenetically informed test of whether body size, body mass, and elevation contributed to the observed variation in CTmax and CTmin along the gradient. We also tested whether CTmax and CTmin exhibit different rates of change given that critical thermal limits (and their plasticity) may have evolved differently in response to different temperature constraints along the gradient. Variation of critical thermal traits was significantly correlated with speciesâ elevational midpoint, their maximum and minimum elevations, as well as the maximum air temperature and the maximum operative temperature as measured across this gradient. Both thermal limits showed substantial variation, but CTmin exhibited relatively faster rates of change than CTmax, as observed in other taxa. Nonetheless, our findings call for caution in assuming inflexibility of upper thermal limits and underscore the value of collecting additional empirical data on speciesâ thermal physiology across elevational gradients.A widely held assumption is that climatic niches have not changed along the history of species, both within and among closely related species. Using a phylogenetic framework, this study documents high variability in both elevational distribution and tolerance to heat among closely related species. Our findings suggest that thermal traits in ectotherms can adjust rapidly and so cannot be simply extrapolated from relatives.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136724/1/ece32929_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136724/2/ece32929.pd

Trends in methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections: effect of the MRSA "search and isolate" strategy in a hospital in Italy with hyperendemic MRSA

Abstract OBJECTIVE: To evaluate the secular trends in MRSA BSIs after the introduction of a nosocomial MRSA control intervention. DESIGN: Before-after study. SETTING: An 850-bed community hospital with an ICU and vascular surgery, neurosurgery, bone marrow transplantation, and AIDS units. MRSA is endemic at this hospital; the prevalence of methicillin resistance among patients with S. aureus infection is greater than 50%. PATIENTS: Among all inpatients, MRSA BSI was identified, its origin defined, and incidence rates calculated by ward and origin. INTERVENTION: A MRSA control program was implemented based on active surveillance cultures to identify MRSA-colonized patients, followed by isolation using contact precautions. Incidence rates of MRSA BSI during the intervention (i.e., July 1, 1997, to December 31, 2001) and preintervention (i.e., January 1, 1996, to June 30, 1997) periods were compared. RESULTS: Sixty-nine MRSA BSIs were identified. When compared with the preintervention period, the incidence rate of MRSA BSI was reduced from 0.64 to 0.30 per 1000 admissions (RR, 0.46; CI95, 0.25-0.87; P = .02) during the intervention period. The impact was greater in the ICU, with an 89% reduction (RR, 0.11; CI95, 0.01-0.98; P = .03), and for CVC-associated MRSA BSIs, with an 82% decrease (RR, 0.17; CI95, 0.05-0.55; P = .002). Methicillin resistance among S. aureus blood isolates decreased from 46% to 17% (RR, 0.36; CI95, 0.22-0.62; P = .0002). CONCLUSION: A reduction in MRSA bacteremia is achievable through use of the MRSA "search and isolate" intervention even in a hospital with high rates of endemic MRSA

Challenges and Lessons Learned in Applying Sensitivity Analysis to Building Stock Energy Models

Uncertainty Analysis (UA) and Sensitivity Analysis (SA) offer essential tools to determine the limits of inference of a model and explore the factors which have the most effect on the model outputs. However, despite a wellestablished body of work applying UA and SA to models of individual buildings, a review of the literature relating to energy models for larger groups of buildings undertaken by Fennell et al. (2019) highlighted very limited application at larger scales. This contribution describes the efforts undertaken by a group of research teams in the context of IEA-EBC Annex 70 working with a diverse set of Building Stock Models (BSMs) to apply global sensitivity analysis methods and compare their results. Since BSMs are a class of model defined by their output and coverage rather than their structure and inputs, they represent a diverse set of modelling approaches. Key challenges for the application of SA are identified and explored, including the influence of model form, input data types and model outputs. This study combines results from 7 different modelling teams, each using different models across a range of urban areas to explore these challenges and begin the process of developing standardised workflows for SA of BSMs

Challenges and Lessons Learned in Applying Sensitivity Analysis to Building Stock Energy Models

Uncertainty Analysis (UA) and Sensitivity Analysis (SA) offer essential tools to determine the limits of inference of a model and explore the factors which have the most effect on the model outputs. However, despite a well-established body of work applying UA and SA to models of individual buildings, a review of the literature relating to energy models for larger groups of buildings undertaken by Fennell et al. (2019) highlighted very limited application at larger scales. This contribution describes the efforts undertaken by a group of research teams in the context of IEA-EBC Annex 70 working with a diverse set of Building Stock Models (BSMs) to apply global sensitivity analysis methods and compare their results. Since BSMs are a class of model defined by their output and coverage rather than their structure and inputs, they represent a diverse set of modelling approaches. Key challenges for the application of SA are identified and explored, including the influence of model form, input data types and model outputs. This study combines results from 7 different modelling teams, each using different models across a range of urban areas to explore these challenges and begin the process of developing standardised workflows for SA of BSMs

Comparison between two treatment protocols with recombinant Human Erythropoietin (rHuEpo) in the treatment of late anemia in neonates with Rh-Isoimmunization

Objectve. The Rh-hemolytic disease can lead to a late anemia by hemolytic and hyporigenerative mechanism. We compared the effectiveness of rHuEPO in two care protocols that differ for doses of rHuEPO administrated and for timing of administration. Methods. A cohort of 14 neonates was investigated. The neonates were treated with two different protocols. Protocol A: a dose of 200 U/kg/day of rHuEpo administered subcutaneously starting from the end of the second week of life; Protocol B: a dose of 400 U/kg/day of rHuEpo administered subcutaneously starting from the end of the first week of life. Results. The hematocrit values in the protocol A group decreased during treatment (32,5% vs 25,2%), whereas the hematocrit value in protocol B group remained almost stable (38,7% vs 42,8%). The mean numbers of platelets remained stable in both groups while neutrophils increased in protocol A group and decreased in protocol B (p<0,05). Reticulocyte count increased during treatment in both groups, although only in protocol B group it was statistically significative (p<0,05). Conclusions. Our results suggest a similar efficacy between the two treatment protocols. Increasing doses of rHuEPO do not seem enhancing their effectiveness and the incidence of side effects