Μελέτη μεταλλικού βιομηχανικού κτιρίου με εσωτερικό ημιώροφο γραφείων

123 σ.Ανάλυση και διαστασιολόγηση μεταλλικού φέροντα οργανισμού και σύμμικτου ημιώροφου.Steel frame design.Ανδρέας Γ. Περατικό

Design of steel structure with with columns of variable cross section and truss roof

135 σ.Ανάλυση και διαστασιολόγηση ενός φέροντα οργανισμού από χάλυβα, με τη χρήση του εμπορικού προγράμματος Etabs. Πρόκειται για μια μεταλλική κατασκευή, με υποστυλώματα μεταβλητής διατομής και δικτυωτά ζυγώματα, η οποία θα χρησιμεύει ως αποθηκευτικός χώρος. Εφαρμόστηκαν οι Ευρωκώδικες 0,1,3 και 8.Analysis and dimensioning of a support structure, using the commercial program Etabs. It is about a steel structure with columns of variable cross section and truss roof, which will be used as a storage space. Eurocodes 0,1,3, and 8 were applied.Ευθύμιος Γ. Περατικό

<i>Listeria monocytogenes</i> from Marine Fish and the Seafood Market Environment in Northern Greece: Prevalence, Molecular Characterization, and Antibiotic Resistance

The occurrence of Listeria monocytogenes in marine fish and fish market areas was investigated. Two hundred and eighty-eight samples (123 environmental samples—siphons, knives, cutting boards, floor, sinks, water, and ice—and 165 marine fish samples) were examined. Twenty-four isolates were characterized as Listeria monocytogenes (five from environmental samples (4.0%) and 19 from fish samples (11.5%)). The strains were further characterized according to their antibiotic resistance, pathogenicity, and biofilm formation ability. They were molecularly serotyped as IIc (n = 22) and IVb (n = 2) and possessed all the virulence genes tested (inlA, inlB, inlC, inlJ, actA, hlyA, iap, plcA, and prfA), except for two strains lacking the hlyA and iap genes, respectively. All strains showed strong (41.7%) or moderate biofilm-producing ability (58.3%) and almost all showed resistance to at least one antibiotic, with the highest rates being observed against clindamycin and vancomycin. The proteomic analysis by MALDI-TOF revealed two distinct clusters that involved strains from fish only and those from both fish and the environment. The presence of Listeria monocytogenes in the fish-market environment and marine fish, along with the pathogenicity and persistence characteristics of the seafood-related strains, emphasize the need for vigilance concerning the spread of this notorious foodborne pathogen

Is substance use associated with HIV cascade outcomes in Latin America?

<div><p>Background</p><p>The HIV care cascade has improved in Latin America over the last decade. However, the influence of alcohol and noninjected drug use (NIDU) on cascade outcomes is mostly unknown. This study estimated the association of alcohol and NIDU with retention in care, loss to follow up (LTFU), and virologic failure (VF).</p><p>Methods</p><p>Individuals ≥18 years attending routine HIV clinic visits and completing the Rapid Screening Tool (RST; evaluating NIDU and ART adherence in 7-day recall period) during 2012–13 were followed up to 2015 in the Caribbean, Central and South America network for HIV epidemiology. Adjusted odds ratios (aOR) were calculated for the association of alcohol consumption and NIDU with retention in care by logistic regression; adjusted hazard ratios (aHR) were estimated for the associations with LTFU and VF by Cox regression.</p><p>Results</p><p>Among 3604 individuals, the proportions retained in care for one year were 84%, 79%, 72%, and 69% for patients reporting non-use, alcohol use, NIDU, and both alcohol and NIDU, respectively. For the same patient groups, the proportions LTFU over 18 months were 6%, 8%, 12%, and 13%, respectively. There were 1901 patients (53%) with HIV RNA results; VF proportions were similar between users and nonusers (ranging from 14–16%). After controlling for age, sex, study site, HIV transmission mode, time on ART, AIDS status, and CD4 count, neither alcohol use (aOR = 1.1, CI = 0.9–1.4; aHR = 1.0, CI = 0.8–1.3) nor NIDU (aOR = 1.3, CI = 0.9–1.8; aHR = 1.4, CI = 0.9–2.1) were significantly associated with retention or VF, respectively. However, both alcohol use (aHR = 1.2, CI = 1.02–1.4) and NIDU (aHR = 1.3, CI = 1.00–1.8) were associated with increased LTFU.</p><p>Conclusion</p><p>Alcohol use and NIDU in a 7-day recall period increased the risk of being LTFU during the next 18 months, highlighting the need for routine screening and targeted interventions to keep these individuals in care and on ART.</p></div

Pre-operative opioid use negatively impacts the outcomes of hip and knee arthroplasty: A systematic review

Introduction There is increasing evidence that pre-operative administration of opioid analgesia in the management of hip and knee osteoarthritis pain negatively impacts post-operative outcomes. This article provides a literature review of the effects of pre-operative use of opioid analgesia on outcomes following hip and knee arthroplasty including patient reported outcome measures (PROMs), rate of infection, rate of revision surgery, length of hospital stay and readmission. Methods A systematic literature review of Medline, Embase and Cochrane CENTRAL was performed up until September 2020 according to PRISMA guidelines. Studies reporting post-operative outcomes in opioid using patients compared to non-opioid using patients undergoing total hip or knee arthroplasty were included. Results 21 studies of the 703 studies identified from the initial search were included. The evidence suggests that pre-operative use of opioid analgesia confers worse post-operative outcomes including inferior PROMs, increased rates of revision, infection and readmission, and prolonged hospital stay. Conclusion Whilst more large-scale data is required to ascertain the full effect of pre-operative opioid use and to determine effective strategies of cessation, pre-operative opioid use should be considered an independently modifiable risk factor for worse post-operative outcomes, and efforts should be made to either taper or cease usage prior to major joint arthroplasty

Tuberculosis treatment outcomes among HIV/TB-coinfected children in the International Epidemiology Databases to Evaluate AIDS (IeDEA) network

Management of tuberculosis (TB) is challenging in HIV/TB-coinfected children. The World Health Organization recommends nucleic acid amplification tests for TB diagnosis, a 4-drug regimen including ethambutol during intensive phase (IP) of treatment, and initiation of antiretroviral therapy (ART) within 8 weeks of TB diagnosis. We investigated TB treatment outcomes by diagnostic modality, IP regimen, and ART status.; We conducted a retrospective cohort study among HIV/TB-coinfected children enrolled at the International Epidemiology Databases to Evaluate AIDS treatment sites from 2012 to 2014. We modeled TB outcome using multivariable logistic regression including diagnostic modality, IP regimen, and ART status.; Among the 386 HIV-infected children diagnosed with TB, 20% had microbiologic confirmation of TB, and 20% had unfavorable TB outcomes. During IP, 78% were treated with a 4-drug regimen. Thirty-one percent were receiving ART at the time of TB diagnosis, and 32% were started on ART within 8 weeks of TB diagnosis. Incidence of ART initiation within 8 weeks of TB diagnosis was higher for those with favorable TB outcomes (64%) compared with those with unfavorable outcomes (40%) (P = 0.04). Neither diagnostic modality (odds ratio 1.77; 95% confidence interval: 0.86 to 3.65) nor IP regimen (odds ratio 0.88; 95% confidence interval: 0.43 to 1.80) was associated with TB outcome.; In this multinational study of HIV/TB-coinfected children, many were not managed as per World Health Organization guidelines. Children with favorable TB outcomes initiated ART sooner than children with unfavorable outcomes. These findings highlight the importance of early ART for children with HIV/TB coinfection, and reinforce the need for implementation research to improve pediatric TB management

J Int AIDS Soc

INTRODUCTION: Identification of persons living with human immunodeficiency virus (HIV)-associated tuberculosis (TB) at increased risk for unfavourable TB outcomes would inform efforts to improve such outcomes. We sought to identify factors associated with a decreased risk of unfavourable TB treatment outcomes among people living with HIV-infection (PLHIV) in low- and middle-income countries (LMIC), with a specific focus on directly observed therapy (DOT) compared with self-administered therapy (SAT) during the continuation phase of anti-TB therapy. METHODS: We conducted a retrospective cohort study among adults diagnosed with HIV-associated TB in Africa, Asia and the Americas from 2012 to 2013; data were collected from 2012 to 2016. Unfavourable TB treatment outcomes (death during TB treatment, and TB treatment failure or recurrence) were defined according to World Health Organization criteria. Receipt of DOT was obtained at the site level and defined as >/=5 days of DOT per week. The person administering DOT and treatment location varied by site. Lack of receipt of DOT was defined as SAT. Multivariable logistic regression estimated the adjusted odds of unfavourable TB treatment outcomes. RESULTS: Among 1862 adults with HIV-associated TB included, 252 (13.5%) had unfavourable TB outcomes (226 deaths, 26 recurrences/failures). Overall, 1825 (98%) received DOT in the intensive phase and 1617 (87%) received DOT in the continuation phase. DOT in the continuation phase was not significantly associated with unfavourable TB outcomes (aOR 1.43, 95% CI 0.86 to 2.38) compared to SAT. Body mass index (BMI) change during anti-TB treatment (per 2 units increase, aOR 0.74, 95% CI 0.68 to 0.82) and CD4(+) count at TB diagnosis (200 vs. 50 cells/microL, aOR 0.54, 95% CI 0.39 to 0.73) were both independently associated with decreased odds of unfavourable TB treatment outcomes. CONCLUSIONS: In this large, international cohort of people living with HIV-associated TB in LMIC who received intensive phase DOT, DOT during the continuation phase of anti-TB therapy was not associated with a decreased odds of unfavourable TB treatment outcomes compared to SAT. Randomized trials evaluating the effect of continuation-phase DOT on TB outcomes among PLHIV are needed

Cox regression models to estimate factors associated with loss to follow up after RST administration, not controlling and controlling for adherence at CCASAnet sites, 2012–2015 (n = 3604) ^a^,^b^,^c.

<p>Cox regression models to estimate factors associated with loss to follow up after RST administration, not controlling and controlling for adherence at CCASAnet sites, 2012–2015 (n = 3604) <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0194228#t003fn001" target="_blank">^a</a>^,<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0194228#t003fn002" target="_blank">^b</a>^,<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0194228#t003fn003" target="_blank">^c</a>.</p