Clinical Spectrum of Recurrent Urinary Tract Infections: A Single-Center Study

A retrospective observational study was undertaken to evaluate the clinical profile of recurrent urinary tract infections (UTIs) in a tertiary care hospital. Patients <18 years, kidney-transplant recipients, those on immunosuppressive agents and pregnant patients were excluded. Patients with ≥2 episodes of culture positive UTIs were included. Demographic details, investigations and treatment were recorded. Out of total 48 patients, 18 were female and 30 male. The common manifestations were acute pyelonephritis (52%), emphysematous pyelonephritis (20%) and cystitis (25%). Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (48%) was the most frequent organism isolated followed by Klebsiella spp. (29%) and Pseudomonas spp. (23%). Recurrent episodes of UTI with same organisms were noted in 62% patients. Death occurred in 12.5% patients due to septic shock. Renal calculi (24%) and double J (DJ) stent placement (30%) were associated with recurrent UTIs, though this was not statistically significant. Resistance to higher antibiotics (colistin, carbapenems, piperacillin-tazobactam, cefoperazone-sulbactam, third-generation cephalosporins) (65.4%, r = 0.81), diabetes (62.5%, r = 0.79), urological procedure (39.5%, r = 0.68), prior hospitalization (75%, r = 0.84), history of UTI prior to the study period (44%, r = 0.72) and need for per urethral catheter (PUC) beyond 7 days (35%, r = 0.74) had significant correlation with recurrent UTIs

Selenium in wastewater: fast analysis method development and advanced oxidation treatment applications.

Abstract Selenium, a ubiquitous non-metal in nature, is potentially toxic to natural ecosystems due to its bioaccumulation potential. Due to increased monitoring and enforcement of selenium regulations, the need to be able to measure and treat selenium efficiently has taken on an increased importance. The principal aqueous forms of inorganic selenium are selenite (Se(IV)) and selenate (Se(VI)). Selenate, due to its high mobility and lack of affinity to conventional adsorbents, is typically much more difficult to treat and remove. To address both measurement and removal, an analytical method is reported for quantification of selenium in wastewater (WW) using UV-Vis spectrophotometer followed by removal studies using advanced oxidation processes (AOPs). Malachite green and azure blue were selected for colorimetric analysis using UV-Vis. Malachite green indicator showed the best results for analysis. The reported UV-Vis method was applied to establish the effect of AOPs on selenium removal. It was noted that all of the AOP treated samples showed removal of selenium and it was established that the UV-Vis method has a lower limit of detection at 2 mg/L. Further, through this study, it was found that the chemical cavitation yield and selenium removal efficiency peaked at low frequency ultrasound of 40 kHz

Résultats de l’apprentissage par investigation dans les formation des professions de la santé : une étude de la portée

Background: Open inquiry-based learning (IBL) that aims to foster higher-level thinking, is defined by students formulating their own questions and learning through exploration. The present study aimed to summarize the breadth of metrics used to evaluate health professions trainees in open IBL curricula. Methods: We conducted a scoping review to identify publications detailing trainee outcomes in open IBL initiatives in health professions education. We queried five databases and included studies which described interventions with five phases of IBL (orientation, conceptualization, investigation, conclusion, and discussion). We completed abstract and full text reviews in duplicate. Data were collated and summarized. Results: From 3030 record, 21 studies were included in the final extraction (k = 0.94), with nine involving physician trainees and twelve involving nursing trainees. Three studies used validated data collection tools to measure student inquiry behavior, and a single study used a validated data collection tool to measure critical thinking abilities. Most studies (n = 11) reported trainee self-reported satisfaction or perceived gain of skills as the primary outcome. All four studies using validated tools reported high scores in inquiry behaviors at the end of the curriculum and results on critical thinking skills were mixed. One study collected serial data, while remaining studies collected pre-post or post-only data. Conclusion: IBL has the potential to cultivate a climate of curiosity among health professions learners. However, studies have relied heavily on subjective outcomes. Limited studies reported standardized measures of inquiry behaviors suggest favorable results. Curriculum innovations using IBL could make use of existing tools to better understand their impact on students’ inquiry-oriented skills.Contexte : L’apprentissage libre par investigation, qui vise à favoriser une réflexion de haut niveau, se définit par le fait que les étudiants formulent leurs propres questions et apprennent par l’exploration. La présente étude visait à résumer l’étendue des mesures utilisées pour évaluer les étudiants des professions de la santé dans les programmes qui appliquent la méthode d’apprentissage libre par investigation. Méthodes : Nous avons effectué une étude de la portée pour recenser les publications traitant des résultats des étudiants inscrits dans des programmes de formation en professions de la santé qui appliquent la méthode de l’apprentissage libre par investigation. Nous avons interrogé cinq bases de données et inclus les études qui décrivaient des interventions portant sur cinq phases de l’apprentissage par investigation (orientation, conceptualisation, investigation, conclusion et discussion). Nous avons procédé à l’examen des résumés et du texte intégral en double. Les données ont été groupées et résumées. Résultats : Sur 3030 documents, 21 études ont été incluses dans l’extraction finale (k=0,94), dont neuf concernaient des étudiants en médecine et douze des étudiants en sciences infirmières. Les auteurs de trois études ont utilisé des outils de collecte de données validés pour mesurer le comportement de recherche des étudiants, et ceux d’une seule étude ont employé un outil de collecte de données validé pour mesurer les capacités de réflexion critique. La plupart des études (n = 11) ont avancé comme résultat principal la satisfaction des étudiants ou l’amélioration perçue de leurs compétences. Les quatre études réalisées à l’aide d’outils validés ont fait état de scores élevés en matière de comportements de recherche à la fin du programme, tandis que les résultats concernant les capacités de réflexion critique étaient mitigés. Dans l’une des études, les données avaient été recueillies en série chronologique et dans les autres, avant et après ou seulement après. Conclusion : L’apprentissage par investigation a le potentiel de cultiver la curiosité chez les apprenants des professions de santé. Cependant, les travaux recensés se sont largement appuyés sur des résultats subjectifs. Des études limitées présentaient des mesures standardisées de la démarche de recherche des étudiants et suggéraient des résultats favorables. Pour leurs initiatives liées à l’apprentissage par investigation, les programmes peuvent recourir aux outils de mesure existants pour mieux comprendre l’impact de cette méthode sur les compétences des étudiants en matière de recherche

Factors influencing decision making in neonatology: inhaled nitric oxide in preterm infants.

ObjectiveWe studied decision making regarding inhaled nitric oxide (iNO) in preterm infants with Pulmonary Hypertension (PH).Study designWe asked members of the AAP-Society of Neonatal-Perinatal Medicine and Division-Chiefs to select from three management options- initiate iNO, engage parents in shared decision making or not consider iNO in an extremely preterm with PH followed by rating of factors influencing their decision.ResultsThree hundred and four respondents (9%) completed the survey; 36.5% chose to initiate iNO, 42% to engage parents, and 21.5% did not consider iNO. Provider's prior experience, safety, and patient-centered care were rated higher by those who initiated or offered iNO; lack of effectiveness and cost considerations by participants who did not chose iNO.ConclusionsMost neonatologists offer or initiate iNO therapy based on their individual experience. The minority who chose not to consider iNO placed higher value on lack of effectiveness and cost. These results demonstrate a tension between evidence and pathophysiology-based-therapy/personal experience

The relationship between R&D and patents : an econometric and event-time analysis

This research paper will attempt to describe and explain the relationship between corporate R&D investments and the output of this investment i.e. patents. The first section of the thesis describes the empirical relationship between R&D and patents using standard econometric techniques, and then compares these results with results from a nonparametric technique called locally weighted regression that makes only general assumptions regarding the shape of the regression function. Throughout the analysis, careful attention is payed to the specification of lag structure. In terms of in-sample goodnesss-of-fit and out-of-sample forecasting performance, several parametric models perform well and all models are dominated by the nonparametric procedure with suitably chosen smoothing parameters. The second section of the thesis employs standard event study techniques to investigate whether capital markets favourably perceive these innovative activities. Using a wide variety of R&D and new product announcements from the 1980's, it is found that markets do not respond to announcements of R&D investment changes, although they do reward announcements of new products, which can be viewed as the output of successful R&

The effect of aggregate on the strength of concrete

Call number: LD2668 .R4 1964 K5

Factors Affecting Body Mass Index Levels in African American Women Living in North Carolina

The prevalence of obesity has doubled over the past 25 years in the United States, particularly in North Carolina. Obesity is influenced by biological, social, and environmental factors; its prevalence has been found to be higher among African American women and other racial ethnic minorities. Guided by the social ecological model, the purpose of this cross sectional study was to examine the relationship of the psycho-social, psycho-behavioral factors, and body mass index levels (BMI) in African American women living in North Carolina versus their Hispanic American and European American counterparts. A logistic regression model using secondary data from the Behavioral Risk Factor Surveillance System revealed a significant association in income levels, house hold size, dietary intake, physical activity, and increased BMI levels in African American women. African American women were significantly more likely to be obese (r = 0.93 p \u3e 0.05) compared to European American and Hispanic American women. The association of each variable to BMI assessed for African American women was as follows: income (r = 0.46, p = 0.001), dietary intake (r = 0.-17, p = 0.04), household size (r = 0.57, p = 0.001), physical activity (r = -0.16, p = 0.05), depression (r = 0.37, p = 0.001), and alcohol consumption (r = 0.39, p = 0.001). A culturally sensitive weight loss model addressing the psycho-behavioral and psychosocial risk factors that negatively influence BMI and subsequently obesity is warranted for African American women living in North Carolina to promote social change and decrease the incidence of obesity in this ethnic group

Revealing the physicochemical mechanism for ultrasonic separation of alcohol-water mixtures

Peer reviewed: YesNRC publication: Ye