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

Comportamento das isotermas de adsorção do pó da polpa de manga liofilizada

A qualidade e a vida útil dos pós de frutas dependem de seus teores de água e da maneira como esta se encontra ligada ao alimento. O comportamento higroscópico de alimentos em pó pode ser avaliado através de suas isotermas de sorção. O objetivo deste trabalho foi avaliar modelos matemáticos para representação da isoterma de sorção do pó de manga liofilizada e avaliar as características físico-químicas da polpa de manga in natura e seu pó liofilizado. Foram feitas as análises de umidade, pH, sólidos solúveis, acidez total titulável, ácido ascórbico e cor. Os modelos matemáticos ajustados aos dados experimentais foram BET, GAB, Henderson e Oswin nas temperaturas de 25, 30 e 35 °C. O melhor ajuste aos dados experimentais foi obtido pelo modelo de GAB. O modelo de GAB apresentou erros médios de 4,092 a 5,175% e valores de R entre 0,9986 a 0,9993 para as temperaturas estudadas. As isotermas do pó da polpa de manga liofilizada apresentaram formato característico do tipo III

Gender Impact on Transit Quality of Service Importance and Performance Assessment

This paper examines the impact of gender on transit travelers’ quality assessment considering 26 indicators’ importance and performance ratings. Through an online survey and using a 5 point Likert scale, transit travelers were asked to rate both the importance and the performance they recognize for the examined quality indicators. The online survey was distributed to a list of contacts, organizations, businesses, universities and operations’ websites in three Greek cities (Athens, Thessaloniki and Volos), aiming to cover all modes and quality conditions someone may face in Greek transit operations. In total, 211 PT users (96 male and 116 female transit travelers) provided their feedback that was further analyzed, aiming to underline the impact of their gender on transit quality importance and performance assessments. Research results, showed that women attribute a higher importance than men on route and service related characteristics, cleanliness and safety and security related indicators, along with the availability of shelter and benches at stops, the ease of purchasing ticket and the use of ecological vehicles. Similarly, women recognize a higher performance for the ease of purchasing ticket. Research results explicitly analyze the gender impact on transit quality assessment, providing useful knowledge and insights for decision makers planning and operations. © 2021, The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG

Guidance Provision for Increasing Quality of Service of Public Transport

Travellers formulate their optimal strategyto follow for their trip, every time they may shift to another mode. Trip generalized cost is perceived based on quality of service aspects and type of traveller. One of the most known models to assess service quality is the GAP model, proposed by Parasuramanet al. (1985), which considersboth consumer and provider beliefs, expectations, perceptions and standards. The present paper deals with the fifth GAP of the model, known as the quality GAP, thus expected versus perceived quality of service, for the assessment of the transit service quality. This GAP has been estimated for the case of the transit system in Greece. An internet based questionnaire was used to collect user expectations and perceptions of 26 selected transit quality indicators, based on a 5 point likert scale. Then, a decision tree was developed, using the J48 algorithm, which linked user perceptions and expectations with the overall service quality assessment. The decision tree analysis depicts the importance of various quality components in the generalized cost estimation. Findings showed that the performance indicator "Availability of information by phone, mail", was the most crucial parameter for the overall assessment of the service, while both performance and importance variables participated in the tree formulation. Tree paths provide guidance for transit operators and/or decision makers for increasing the quality of their services and at the same time enhance performance efficiency and operation profitability. © 2017 The Authors

Examining travelers "optimal strategies" in transit trip choices, applying a classification tree approach on transit quality of service indicators

According to Spiess and Florian (1989) [1], at each transfer point passengers may shape the "optimal" for them strategy taking into account minimum generalized travel cost. The generalized cost of trip choices is formulated based on objective and subjective criteria of travelers that reflect their perception of the generalized cost of their trip. Quality of Service (QS) parameters affect users?perceptions and may influence the formulation of the perceived cost and furthermore may influence travel choices. This paper examines the transit QS formulation by analyzing 26 quality indicators which have been assessed by transit users through a Customer Satisfaction Survey (CSS). The survey took place in the city of Thessaloniki, Greece in the summer of 2012. This paper examines travelers optimal strategies based on transit QS by applying two classification trees on transit quality of service indicators. A Classification and Regression tree has been used to classify the important quality indicators among male and female travelers and a J48 classification algorithm has been applied to classify all quality attributes based on their importance in the general assessment formulation of transit QS. Research pointed out that stop location is the most important attribute to a gender classification of transit QS attributes, followed by the indicator of information by phone, internet. For the general assessment of the transit QS as perceived by transit users, the root node of the classification tree is the security against crimes on bus, which denotes the most important predictor in such an analysis

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