Prognostic impact of hyperglycemia at onset of methicillin-sensitive Staphylococcus aureus bacteraemia

Previous reports have associated hyperglycemia to poor outcome among aged and comorbid Staphylococcus aureus bacteraemia (SAB) patients. However, the prognostic impact of hyperglycemia in SAB irrespective of age and underlying conditions including a diagnosis of diabetes has received little attention. The objective here was to evaluate the prognostic relevance of hyperglycemia at onset of methicillin-sensitive SAB (MS-SAB). It was a retrospective study of MS-SAB patients. Blood glucose was measured within 24 h of positive blood cultures. The patient cohort was analyzed en bloc and by categorization according to age, underlying conditions and a diagnosis of diabetes. Altogether 161 patients were identified. High initial blood glucose levels were observed among diabetics (p <0.001), patients with deep infections (p <0.05) and poor outcome at 28- or 90-days (p <0.05). Receiver operating characteristics presented the glucose cut-off level of 7.2 mmol/L as a significant predictor of mortality with an area under the curve of 0.63 (95% CI 0.52-0.75, p <0.05). Blood glucose ae7.2 mmol/L connected to higher 28- (9 vs. 20%, p <0.05) and 90-day (14 vs. 29%, p <0.01) mortality. In Cox proportional hazard regression the blood glucose cut-off value of 7.2 mmol/L significantly predicted 90-day mortality (HR, 2.12; 95% CI, 1.01-4.46; p <0.05). Among young and healthy non-diabetics the negative prognostic impact of high glucose was further accentuated (HR 7.46, p <0.05). High glucose levels had no prognostic impact among diabetics. Hyperglycemia at SAB onset may associate to poor outcome. The negative prognostic impact is accentuated among young and healthy non-diabetics.Peer reviewe

Sulfaattisellun valmistuksen sivuvirtojen hyödyntäminen

Tiivistelmä. Tässä kandidaatintyössä käsitellään sulfaattimenetelmällä valmistetun sellun sivuvirtojen hyödyntämistä kiertotalouden ja jätehierarkian näkökulmasta. Työssä käydään ensimmäisenä läpi kiertotalouden talousmallin perusperiaatteet, jätehierarkian tasot sekä sellun valmistus sulfaattimenetelmällä. Työssä esitellään sulfaattisellun valmistuksessa syntyvät sivuvirrat, sekä nykyisiä ja mahdollisia sivuvirtojen hyödyntämisen ja arvottamisen tapoja. Työssä keskitytään etenkin uusiin sekä kehitteillä oleviin sivuvirtojen hyödyntämistapoihin, mutta esitellään myös perinteisiä sivuvirtojen käyttökohteita. Työssä pohditaan myös, mille jätehierarkian tasolle sivuvirtojen hyödyntämiskeinot sijoittuvat, sekä esitetään taulukkomuotoinen yhteenveto, josta tasot käyvät ilmi. Työssä arvioitiin, että sulfaattisellun valmistuksen sivuvirroilla on suuri hyödyntämispotentiaali, ja suurta osaa sivuvirroista osataan jo hyödyntää. Uusia kehitteillä olevia sovellutuksia on syytä ottaa tulevaisuudessa huomioon, sekä jatkaa kehitys- ja tutkimustyötä, jotta selluteollisuus jatkaisi kehitystään kohti vihreämpää ja hiilineutraalimpaa suuntaa

Visualizing multi-dimensional pareto-optimal fronts with a 3D virtual reality system

In multiobjective optimization, there are several targets that are in conflict, and thus they all cannot reach their optimum simultaneously. Hence, the solutions of the problem form a set of compromised trade-off solutions (a Pareto-optimal front or Pareto-optimal solutions) from which the best solution for the particular problem can be chosen. However, finding that best compromise solution is not an easy task for the human mind. Pareto-optimal fronts are often visualized for this purpose because in this way a comparison between solutions according to their location on the Pareto-optimal front becomes somewhat easier. Visualizing a Pareto-optimal front is straightforward when there are only two targets (or objective functions), but visualizing a front for more than two objective functions becomes a difficult task. In this paper, we introduce a new and innovative method of using three-dimensional virtual reality (VR) facilities to present multi-dimensional Pareto-optimal fronts. Rotation, zooming and other navigation possibilities of VR facilities make easy to compare different trade-off solutions, and fewer solutions need to be explored in order to understand the interrelationships among conflicting objective functions. In addition, it can be used to highlight and characterize interesting features of specific Pareto-optimal solutions, such as whether a particular solution is close to a constraint boundary or whether a solution lies on a relatively steep trade-off region. Based on these additional visual aids for analyzing trade-off solutions, a preferred compromise solution may be easier to choose than by other means

Carnation wilt diseases caused by fungi in Finland

From 81 carnation samples collected in 1967—68 from nurseries in different parts of the country were identified 17 species of fungus, from a total of 177 fungus isolates. Among these, Fusarium oxysporum was most widespread, 31.1 %. F. arthrosporioides, F. avenaceum, F. culmorum, Alternaria tenuis and Cladosporium sp. occurred in considerable quantities. The percentage of Phialophora cinerescens was 1.1 %. In the inoculation trials F. oxysporum behaved as a strongly pathogenic, infecting plants via the air through cut surfaces and via the soil by root-penetration. A. tenuis, F. avenaceum and F. culmorum infected carnations only from the air through cut surfaces. In the fungicide trials against F. oxysporum, spraying the plants infected via the soil proved ineffective. The trials were made with the systemic Benlate (1-(butylcarbamoyl)-2-benzimidazole carbamic acid, methyl ester 50 %), Plantvax (2,3-Dihydro-5-carboxanilido- 6-methyl-1,4-oxathiin-4,4-dioxide), Vitavax (2,3-Dihydro-5-caboxanilido-6-methyl-1,4-oxathiin), and with the non-systemic Dithane M-45 (mancozeb 80 %), Orthocide 50 (captan 50 %) and Pomarsol Forte (thiram 80 %). The dipping of rooted cuttings into Benlate and Dithane M-45 compounds to a certain extent delayed the process of wilting

AX-PET: A novel PET concept with G-APD readout

Abstract The AX-PET collaboration has developed a novel concept for high resolution PET imaging to overcome some of the performance limitations of classical PET cameras, in particular the compromise between spatial resolution and sensitivity introduced by the parallax error. The detector consists of an arrangement of long LYSO scintillating crystals axially oriented around the field of view together with arrays of wave length shifter strips orthogonal to the crystals. This matrix allows a precise 3D measurement of the photon interaction point. This is valid both for photoelectric absorption at 511 keV and for Compton scattering down to deposited energies of about 100 keV. Crystals and WLS strips are individually read out using Geiger-mode Avalanche Photo Diodes (G-APDs). The sensitivity of such a detector can be adjusted by changing the number of layers and the resolution is defined by the crystal and strip dimensions. Two AX-PET modules were built and fully characterized in dedicated test set-ups at CERN, with point-like 22 Na sources. Their performance in terms of energy ( R energy ≈ 11.8 % (FWMH) at 511 keV) and spatial resolution was assessed ( σ axial ≈ 0.65 mm ), both individually and for the two modules in coincidence. Test campaigns at ETH Zurich and at the company AAA allowed the tomographic reconstructions of more complex phantoms validating the 3D reconstruction algorithms. The concept of the AX-PET modules will be presented together with some characterization results. We describe a count rate model which allows to optimize the planing of the tomographic scans

Predictive Value of C-Reactive Protein (CRP) in Identifying Fatal Outcome and Deep Infections in Staphylococcus aureus Bacteremia

IntroductionClear cut-off levels could aid clinicians in identifying patients with a risk of fatal outcomes or complications such as deep infection foci in Staphylococcus aureus bacteremia (SAB). Cutoff levels for widely used clinical follow-up parameters including serum C-reactive protein (CRP) levels and white blood cell counts (WBC) have not been previously studied.Methods430 adult SAB patients in Finland took part in prospective multicentre study in which their CRP levels and WBC counts were measured on the day of the positive blood culture, every other day during the first week, twice a week during hospitalization and at 30 days. Receiver operating characteristic (ROC) analysis was used to evaluate the prognostic value of CRP and WBC on the day of the positive blood culture and at days 4, 7, and 14 in predicting mortality and the presence of deep infections at 30 days. Adjusted hazard ratios (HR) for CRP level and WBC count cut-off values for mortality were calculated by the Cox regression analysis and adjusted odds ratios (OR) for cut-off values to predict the presence of deep infection by the binary logistic regression analysis.ResultsThe succumbing patients could be distinguished from the survivors, starting on day 4 after the positive blood culture, by higher CRP levels. Cut-off values of CRP for day 30 mortality in adjusted analysis, that significantly predicted fatal outcome were at day 4 CRP > 103 mg/L with sensitivity of 77%, specificity of 55%, and HR of 3.5 (95% CI, 1.2-10.3; p = 0.024), at day 14 CRP > 61 mg/L with a sensitivity of 82%, specificity of 80% and HR of 3.6 (95% CI, 1.1-10.3; p 8.6 x 10(9)/L was prognostic with sensitivity of 77%, specificity of 78% and HR of 8.2 (95% CI, 2.9-23.1; p 108 mg/L with sensitivity of 77%, specificity of 60%, and HR of 2.6 (95% CI, 1.3-4.9; p = 0.005) and at day 14 CRP > 22 mg/L with sensitivity of 59%, specificity of 68%, and HR of 3.9 (95% CI, 1.6-9.5; p = 0.003). The lack of decline of CRP in 14 days or during the second week were neither prognostic nor markers of deep infection focus.ConclusionsCRP levels have potential for the early identification of SAB patients with a greater risk for death and deep infections

Männyn sydänpuun stilbeenipitoisuuden optinen mittaus

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Optical measurement of Scots pine heartwood stilbene content

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