Bacterial Infections Change Natural History of Cirrhosis Irrespective of Liver Disease Severity

OBJECTIVES: We assessed the prognostic significance of infections in relation to current prognostic scores and explored if infection could be considered per se a distinct clinical stage in the natural history of cirrhosis. METHODS: We included consecutive patients with cirrhosis admitted to a tertiary referral liver unit for at least 48 h over a 2-year period. Diagnosis of infection was based on positive cultures or strict established criteria. We used competing risk analysis and propensity score matching for data analysis. RESULTS: 501 patients (63% male, 48% alcoholic liver disease, median Model of End-stage Liver Disease (MELD)=17) underwent 781 admissions over the study period. Portal hypertensive bleeding and complicated ascites were the commonest reasons of admission. The incidence of proven bacterial infection was 25.6% (60% community acquired and 40% nosocomial). Survival rates at 3, 6, 12, and 30 months were 83%, 77%, 71%, and 62% in patients without diagnosis of infection, vs. 50%, 46%, 41%, and 34% in patients with diagnosis of infection. Overall survival was independently associated with MELD score (hazards ratio (HR) 1.099), intensive care (ITU) stay (HR 1.967) and bacterial infection (HR 2.226). Bacterial infection was an independent predictor of survival even when patients who died within the first 30 days were excluded from the analysis in Cox regression (HR 2.013) and competing risk Cox models in all patients (HR 1.46) and propensity risk score-matched infected and non-infected patients (HR 1.67). CONCLUSIONS: Infection most likely represents a distinct prognostic stage of cirrhosis, which affects survival irrespective of disease severity, even after recovery from the infective episode

Exploring specific features of Transport Interchange Hubs (TIH) design, taking into account the climatic conditions of the Russian Arctic

This paper provides a more detailed analysis of the context of designing Transport Interchange Hubs (TIHs) in the Arctic Zone of the Russian Federation (AZRF). It uses a design framework proposed by another paper also presented in this conference by the same authors [1] to discuss how green spaces can be inte-grated to TIHs in extreme climates to enhance the qualities of different types of spaces inside terminals considering implications of these in the overall assess-ment of building performance. It also discusses, the way pedestrian flow and movement is modelled and simulated in Russia in relation to the different simula-tion techniques used in other countries (mainly the West) and what are the ad-vantages these different models offer in the assessment of design decisions for TIHs in the AZRF considering how these could potentially be integrated with parametric design tools, finishing by highlighting complexities involved in de-signing compact buildings, a necessary requirement to reduce heat losses and the impact of building footprint on the permafrost. As the AZRF is now experiencing unprecedented economic development and completely lacks transport integrated facilities (TIHs) this paper attempts to review and discuss specific features of these buildings so new developments currently planned for the Russian Arctic can be better designed and assessed mainly in relation to pedestrian flow and their integration with opportunity spaces to improve the quality of passengers’ waiting time

A user-centred approach to design Transport Interchange Hubs (TIH): A discussion illustrated by a case study in the Russian Arctic

This paper proposes a user-centred approach to design Transport In-terchange Hubs (TIH). It is based on a literature review of existing information related to TIHs outside the domain of transport engineering, so the focus is on the building and the usage of it by its main customers: the travellers. A literature review is used to extract high level information on travellers’ needs, technical and functional requirements of TIHs, constraints and design parameters. A prod-uct development approach is used to classify and combine this data so a proper set of design specifications to better address users’ needs is proposed. The method is illustrated through an example in the Russian Arctic, an area with un-der-developed transport facilities for travellers which would benefit from high-level design specifications to address complex needs, requirements and parame-ters involved in designing for extreme climate conditions. A proof of concept, using Axiomatic Design, to develop design specifications and manage constraints is applied and discussed considering major needs involved in building in the Rus-sian Arctic including how different types of simulation tools, essential to assess performance of complex buildings, can be integrated in the early stages of the design workflow. Robust specifications, despite being part of parametric design methods, are underexplored in the architecture design domain, meaning this work can contribute to further research in how to define common design targets and objectives for different stakeholders as well as to manage the collaborative work of consultants involved in designing complex buildings

Teaching ICT in Greek Secondary Schools

This study is an attempt to describe the teaching of Information Technologies (IT) in Greek secondary education. We analyzed the detailed training programs for gymnasium and lyceum as they have been designed by the Ministry of Education of Greece. Presents the objectives, axes content, analysis axes and interdisciplinary approaches to the high school and the knowledge content axes and general objectives (knowledge, skills, attitudes and values) per class. Finally assesses the current situation and propose improvements for better operation. The most important suggestion is:nbsp ldquoPreparation programs for teachers - students should be integrated into a comprehensive framework that is defined by technological and pedagogical dimension of Information and Communication Technologies ICTrdquo.nbs

Alternating quinoxaline/oligothiophene copolymers - Synthesis and unexpected absorption properties

The optical and electronic properties of novel, alternating quinoxaline/oligothiophene donor-acceptor copolymers show an unexpected independence of absorption and photoluminescence, as well as of the HOMO/LUMO energy levels, on the length of the oligothiophene segments in the copolymer main chai

Oral hygiene and gingival health in Greek airforce cadet candidates

A broad epidemiologic investigation on oral hygiene and gingival health in Greece has been undertaken since 1978. Part of our findings are presented in this study. 1291 male airforce cadet candidates aged 17-22 years were interviewed first concerning brushing habits and gingival bleeding and subsequently using the Russel Index. The mean P.I. score of the group was 0.71, ranging from 0 to 2.13. The highest P.I was found in the molars (0.82) followed by the anterior teeth and the premolars (0.75 and 0.63, respectively). Statistically significant correlation was found between P.I. and frequency of brushing (p.I. = 0.92 in never brushing, P.I. = 0.69 in twice or more daily brushing). The effect of brushing techniques and bristle stiffness on the P.I. was statistically not significant. As expected the presence of calculus decreased as the frequency of brushing increased. Finally a strong correlation existed between the P.I. and gingival bleeding

Model NSR catalysts:Fabrication and reactivity of barium oxide layers on Cu(1 1 1)

The growth of barium oxide on a Cu(1 1 1) substrate, formed by the deposition of barium and its subsequent oxidation, yields stable BaO films which expose predominantly the BaO(1 0 0) surface. The interaction of the oxide films with common components of motor-vehicle exhaust gases (CO2, H2O, NOx) has been studied using surface analytical techniques, including X-ray photoelectron spectroscopy (XPS), temperature programmed desorption (TPD) and reflection IR spectroscopy (RAIRS). The spectroscopic identification of Ba(OH)2, BaCO3 and Ba(NO2)2 phases is discussed, and the relative stabilities and decomposition mechanisms of these materials when supported on Cu(1 1 1) is revealed by a combination of TPD and XPS. BaO is shown to be resistant to reaction with pure NO and NO/O2 mixtures, but exposure to NO2 leads to the rapid formation of barium nitrite. The formation of the nitrite is proposed to be the first-step in the production of barium nitrate, which has previously been shown to be the main phase involved in NOx storage and reduction (NSR) catalysis.</p