Quantifying Visible Image Quality A Bayesian View

Methicillin-resistant Staphylococcus aureus (MRSA) detection in cystic fibrosis (CF) is challenging. We compared different phenotypic methods among 157 S. aureus from 136 CF-patients cefoxitin (FOX) and oxacillin (OXA) broth-microdilution; MicroScan-WalkAway®; FOX and OXA disk-diffusion (DD), and PBP2a-latex agglutination. PCR detection of mecA/mecC was the gold standard. Growth on ChromIDTM-MRSA agar was evaluated and compared with that of 157 blood culture (BC) isolates. ChromIDTM-MRSA was also tested on sputa from 111 CF-patients. 32 isolates (20%) were mecA-positive. Both FOX DD and MicroScan-WalkAway® (FOX/OXA) showed the highest sensitivity and specificity (100% and 100%, 96.9% and 99.2%, 96.9% and 100%). ChromIDTM-MRSA showed an excellent sensitivity for BC and CF-isolates (100% and 96.9%) but a poorer specificity for CF ones (95.5% vs. 73.7%), which was also observed when samples were seeded on this medium. FOX DD and MicroScan-WalkAway® are suitable for MRSA detection among CF-isolates and should be used to confirm ChromIDTM-MRSA positive CF-cultures.It is unadvisable to discuss the antibiotic resistance genes (ARGs) reduction in anaerobic digestion (AD) system neglecting its main purpose-methane production. The methane production improvement coupling with antibiotic resistance genes (ARGs) reduction in anaerobic digestion (AD) by zero valent iron (ZVI) were simultaneously investigated. Whether the role of ZVI on the ARGs fate was random or specific was clarified through the high-throughput qPCR (HT-qPCR). Results indicated that ZVI improved methane production and ARGs reduction by 23.9% and 25.0%, respectively. The improved methane production was associated with chemical reaction and variances of microbial community caused by ZVI, where DIET between Petrimonas, Clostridium and Syntrophomonas, Methanosarcina was established along with ACAS being enriched. ZVI specifically, not randomly, facilitated the reduction of aminoglycoside resistance genes of antibiotic inactivation and tetracycline resistance genes of ribosomal protection proteins. The specifical reduction could be attributed to enzyme activity inhibition and intracellular ionic disturbance caused by higher amounts of ZVI, although most of ARGs fate could be well explained by microbial community which contributed the most to ARGs dynamics as a whole. ZVI-based AD was a promising way for the improvement of methane production coupling ARGs reduction.Broiler litter is generated in large quantities as a waste by-product of chicken meat production. N may be lost from the litter and emitted from bird housing as gaseous NH3, which can be damaging to the environment and limit the recycling of a valuable nutrient. This study investigated the effect of lignite application rate (0, 5, 10, 15, 20%) on N loss from broiler litter in a static chamber laboratory incubation. Lignite was subsequently dewatered and subbituminous coal modified by aerobic thermal oxidation and their ammoniacal N adsorption potentials were characterised. In a second static chamber incubation, the capacity of these materials (applied at 20%) to reduce N loss from litter was investigated. Finally, their potential to directly reduce NH3 emissions was examined using a chamber acid trap system. This study showed that lignite reduced N loss when applied to litter at a rate ≥ 5%, with the amount of N retained increasing with increasing lignite application rate. Litter treated with 20% lignite retained 24% more N than untreated litter. Following aerobic thermal treatment, maximum ammoniacal N adsorption capacities of the materials were as follows lignite > dewatered lignite > modified subbituminous coal > subbituminous coal. Despite inequalities in adsorption capacity, lignite, dewatered lignite and modified subbituminous coal reduced total N loss by 17.3, 18.2 and 18.4% and NH3 emissions by 41.6, 49.1 and 29.8%, respectively. This study demonstrates the potential of coal-based materials to reduce NH3 emissions from broiler litter and increase the nutrient value of waste by reducing N loss.In emergency medical services (EMS), response time is a key factor that shows the performance of the system. This factor is composed of two parts including activation time and travel time. The activation time of an emergency call is the time a call center spends on taking an incoming call for EMS and decides whether an ambulance should be dispatched or the emergency can be resolved by giving some medical advices. Having a good number of call center operators including call takers and dispatchers can help to reduce this time and thus the response time. However, this alone may not be enough to have a reasonable cycle time. In fact, having idle ambulances located in right places when emergency calls occur is an influential factor to reduce the travel time and thus have an optimal response time and save people's lives. Although many researchers have studied improving either the activation time or the travel time, to the best of our knowledge, there exists no study focusing on both. Motivated by this gap, in this h evaluating the performance of their systems and determining the optimal number of operators and locatations of ambulances in a way that enhances the quality of emergency services.
Chest pain is one of the most common reasons for contacting the emergency medical services (EMS). About 15% of these chest pain patients have a high-risk condition, while many of them have a low-risk condition with no need for acute hospital care. It is challenging to at an early stage distinguish whether patients have a low- or high-risk condition. The objective of this study has been to develop prediction models for optimising the identification of patients with low- respectively high-risk conditions in acute chest pain early in the EMS work flow.
This prospective observational cohort study included 2578 EMS missions concerning patients who contacted the EMS in a Swedish region due to chest pain in 2018. All the patients were assessed as having a low-, intermediate- or high-risk condition, i.e. read more occurrence of a time-sensitive diagnosis at discharge from hospital. Multivariate regression analyses using data on symptoms and symptom onset, clinical findings including ECG, previous medical history and Troponource-intensive venues.
Models based on readily available information in the EMS setting can identify high- and low-risk conditions with acceptable accuracy. A clinical decision support tool based on developed models may provide valuable clinical guidance and facilitate referral to less resource-intensive venues.In 1845, Friedrich Engels identified how the living and working conditions experienced by English workers sent them prematurely to the grave, arguing that those responsible for these conditions -- ruling authorities and the bourgeoisie -- were committing social murder. The concept remained, for the most part, dormant in academic journals through the 1900s. Since 2000, there has been a revival of the social murder concept with its growth especially evident in the UK over the last decade as a result of the Grenfell Tower Fire and the effects of austerity imposed by successive Conservative governments. The purpose of this paper is to document the reemergence of the concept of social murder in academic journal articles. To do so we conducted a scoping review of content applying the social murder concept since 1900 in relation to health and well-being. We identified two primary concepts of social murder social murder as resulting from capitalist exploitation and social murder as resulting from bad public policy across the domains of working conditions, living conditions, poverty, housing, race, health inequalities, crime and violence, neoliberalism, gender, food, social assistance, deregulation and austerity. We consider reasons for the reemergence of Engels' social murder concept and the role it can play in resisting the forces responsible for the living and working conditions that kill.This study analyzes how U.S. healthcare organizations implemented legal requirements to treat patients in a manner consistent with their gender identity under Section 1557 of the Affordable Care Act. The ways that healthcare organizations determine gender and track complaints constitute socio-technical systems for compliance, and they shape what discrimination protections look like on the ground. We interviewed grievance handlers about how they use information technologies to process possible civil rights claims from patients and argue that their work demobilizes and erases civil rights, especially claims such as transgender harassment. Mobilized physician-led implementation groups, by contrast, enacted a version of gender identity recognition by tracking identities and bodies in electronic medical records and material objects such as specimen labels. Default structures-the dropdown menus of healthcare software-both shape and are shaped by professional norms, financial incentives, and conceptions of justice and deservingness. These socio-technical structures allow conflicting stories of transgender rights to continue on in different parts of the healthcare organization, making it difficult for law to transform healthcare delivery.
No large-scale, prospective, randomized study has evaluated the effect of thoracic surgery on patients with unresectable stage IIIB-IV epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma who received and responded to EGFR tyrosine kinase inhibitor (TKI) treatment. Therefore, we designed a propensity-score-matched, nationwide, population-based, cohort study to investigate the effects of thoracic surgery on patients with EGFR-mutant lung adenocarcinoma.
We included patients with unresectable stage IIIB-IV EGFR-mutant lung adenocarcinoma and categorized them into two groups according to their treatment modalities and compared their outcomes the case group consisted of patients who underwent thoracic surgery for lung tumors after receiving and responding to EGFR-TKI treatment and the comparison group consisted of patients who received EGFR-TKI treatment alone until tumor progression. Patients in both groups were matched at a ratio of 14.
The matching process yielded a final cohort of 1395 patients (279 and 1,116 in the case and comparison groups, respectively) who were eligible for further analysis. According to multivariable Cox regression analyses, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) for thoracic surgery for lung tumors after EGFR-TKI use and tumor response (group 2) compared with EGFR-TKI treatment alone (group 1) was 0.445 (0.351-0.564).
Thoracic surgery prolonged overall survival in patients with unresectable stage IIIB-IV EGFR-mutant lung adenocarcinoma who received and responded to EGFR-TKI treatment.
Thoracic surgery prolonged overall survival in patients with unresectable stage IIIB-IV EGFR-mutant lung adenocarcinoma who received and responded to EGFR-TKI treatment.Retention behavior of two structural isomeric pentacyclic triterpenic acids, maslinic acid and corosolic acid, was investigated by reverse phase high performance liquid chromatography (HPLC) with hydroxypropyl-β-cyclodextrin (HP-β-CD) as mobile phase additive. Inclusion complexation of maslinic acid, corosolic acid with hydroxypropyl-β-cyclodextrin was evaluated under different concentration of hydroxypropyl-β-cyclodextrin. Apparent formation constant (Km) between methanol and hydroxypropyl-β-cyclodextrin was determined to be 13.82 L mol-1 under 25 °C using UV-spectrophotometry. Two retention models were employed individually for evaluation of inclusion complexation between the two pentacyclic triterpenic acids and hydroxypropyl-β-cyclodextrin. It was found that a higher apparent formation constant (Kf) for corosolic acid and hydroxypropyl-β-cyclodextrin was obtained, 19115 L mol-1, indicating that a greater affinity of hydroxypropyl-β-cyclodextrin with corosolic acid was produced compared with that of maslinic acid, 11775 L mol-1, in the selected mobile phase, and stoichiometric ratio for both of inclusion complex was found to be 11.