Search Results (12)

Background: Community-acquired pneumonia (CAP) is the leading cause of death in infants aged 1–59 months. Concurrent with this, there is a need to prescribe antibiotics wisely in Vietnam due to concerns with rising antimicrobial resistance (AMR). Consequently, an urgent need has arisen to treat patients according to agreed guidelines. The aim of this study was to investigate the current management of infants under five years old with CAP in Vietnam as well as identify possible obstacles to adhering to national guidelines. Methods: A mixed-method approach was used incorporating both quantitative and qualitative data analysis in a leading hospital in Vietnam, which influences others. Data from 108 pediatric patient records were collected and analyzed. Subsequently, in-depth interviews were conducted with pediatric doctors treating these patients to ascertain possible reasons for non-adherence to guidelines. Results: The mean age of children diagnosed with CAP was 27.94 ± 12.99 months, with 82.4% having non-severe CAP, and 41.7% of children had previously used antibiotics before hospitalization. The median length of hospital stay was 7 days. All children were prescribed antibiotics, 91.4% of children received these initially intravenously, with third-generation cephalosporins being the most (91.7%) commonly prescribed. Cefoperazone/sulbactam was the most frequently prescribed (48.2%) antibiotic. However, on 96.1% of occasions cefoperazone/sulbactam was given at higher doses than the label instructions. Overall, 73.3% of antibiotics prescribed were “Watch” antibiotics. In addition, the proportion of initial antibiotic regimens that were consistent with current national guidelines was only 4.63%. Conclusions: There were considerable concerns with low adherence rates to current guidelines alongside high rates of prescribing of injectable third-generation cephalosporins due to various internal and external barriers. Antimicrobial stewardship programs with updated national guidelines are urgently needed in Vietnamese hospitals to treat CAP in children as part of ongoing measures to reduce increasing AMR rates. Such activities should also help improve antibiotic use in the community following improved education of trainee ambulatory care physicians regarding appropriate management of children with CAP. Full article

The conscious and efficient reuse of historic buildings has turned out to be a fundamental point of European programs for the management and conservation of the Architectural Heritage. In this context, the Industrial Heritage shows architectural and spatial peculiarities that facilitate its change of use and performance updating. In fact, the large internal spaces limit the issue of material compatibility to retrofit interventions on the casing. Often the interventions of reuse of the industrial heritage are solved with new architectures designed to be completely inserted inside the original envelope, remaining independent from it. This work presents the reuse project of an industrial building in the city of Sagunto, Spain, where the logic of the “box within the box” is re-proposed with the aim of spatial and constructive flexibility. The research shows a design methodology that allows the new functional modules inside the old building to be designed according to flexibility requirements and how flexibility design is a means for environmental sustainability in the occasion of disused industrial heritage reuse. Full article

Hepatocellular carcinoma (HCC) is the most frequent liver cancer with high lethality and low five-year survival rates leading to a substantial worldwide burden for healthcare systems. HCC initiation and progression are favored by different etiological risk factors including hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, non-/and alcoholic fatty liver disease (N/AFLD), and tobacco smoking. In molecular pathogenesis, endogenous alteration in genetics (TP53, TERT, CTNNB1, etc.), epigenetics (DNA-methylation, miRNA, lncRNA, etc.), and dysregulation of key signaling pathways (Wnt/β-catenin, JAK/STAT, etc.) strongly contribute to the development of HCC. The multitude and complexity of different pathomechanisms also reflect the difficulties in tailored medical therapy of HCC. Treatment options for HCC are strictly dependent on tumor staging and liver function, which are structured by the updated Barcelona Clinic Liver Cancer classification system. Surgical resection, local ablative techniques, and liver transplantation are valid and curative therapeutic options for early tumor stages. For multifocal and metastatic diseases, systemic therapy is recommended. While Sorafenib had been the standalone HCC first-line therapy for decades, recent developments had led to the approval of new treatment options as first-line as well as second-line treatment. Anti-PD-L1 directed combination therapies either with anti-VEGF directed agents or with anti-CTLA-4 active substances have been implemented as the new treatment standard in the first-line setting. However, data from clinical trials indicate different responses on specific therapeutic regimens depending on the underlying pathogenesis of hepatocellular cancer. Therefore, histopathological examinations have been re-emphasized by current international clinical guidelines in addition to the standardized radiological diagnosis using contrast-enhanced cross-sectional imaging. In this review, we emphasize the current knowledge on molecular pathogenesis of hepatocellular carcinoma. On this occasion, the treatment sequences for early and advanced tumor stages according to the recently updated Barcelona Clinic Liver Cancer classification system and the current algorithm of systemic therapy (first-, second-, and third-line treatment) are summarized. Furthermore, we discuss novel precautional and pre-therapeutic approaches including therapeutic vaccination, adoptive cell transfer, locoregional therapy enhancement, and non-coding RNA-based therapy as promising treatment options. These novel treatments may prolong overall survival rates in regard with quality of life and liver function as mainstay of HCC therapy. Full article

Since the publication of the first edition of the WHO (World Health Organization) Laboratory Manual for the examination of Human Semen in 1980, the reference values of sperm parameters have been updated on four occasions. Currently and globally, most of the laboratories analyzing semen samples use the latest, 5th edition of the manual that recommends ejaculatory abstinence from two to seven days before producing the sample for examination. While this standardized interval of time facilitates the interpretation of the results and research, no solid evidence exists to support the WHO-recommended abstinence time for a semen analysis in order to optimize clinical outcomes after assisted reproduction. Most of the studies refer to different clinical outcomes, different groups of patients and different editions of the WHO Laboratory Manual, including heterogeneous intervals of abstinence or sperm parameters. The aim of the current systematic review was to evaluate available evidence correlating ejaculatory abstinence time with clinical outcomes and sperm parameters analyzed according to the last edition of the World Health Organization Laboratory Manual reference values in different male populations. The results from the included studies indicate that WHO abstinence recommendations may need revision, given that a shorter ejaculatory abstinence interval appears to be associated with improved sperm parameters, such as sperm DNA fragmentation, progressive motility or morphology, while evidence suggests a potential increase in embryo euploidy rates and pregnancy outcomes. Full article

Investigation of bryozoan faunas collected in two submarine caves in Lesvos Island, Aegean Sea revealed a great number of colonies of three species currently assigned to the cheilostome family Onychocellidae: Onychocella marioni Jullien, 1882, O. vibraculifera Neviani, 1895, and Smittipora disjuncta Canu & Bassler, 1930. All species were first described and subsequently recorded on several occasions, from the Mediterranean Sea, particularly from the Aegean Sea. The availability of this material provided the basis for more detailed observations and first scanning electron microscopy (SEM) study of some diagnostic characters, including ovicells and ancestrulae, for the well-known species, as well as a few colonies of a species left in open nomenclature (i.e., Onychocellidae sp. 1) in previous works. In this paper we (i) update the descriptions of these four species; (ii) resurrect the species Floridinella arculifera Canu & Bassler, 1927, which was previously synonymised with Caleschara minuta (Maplestone, 1909), suggesting for it the new combination Tretosina arculifera; (iii) and introduce the new genus Bryobifallax for S. disjuncta. Full article

In 2016, the Alcohol Hangover Research Group defined the alcohol hangover as “the combination of mental and physical symptoms experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration (BAC) approaches zero”. In the light of new findings and evidence, we carefully reviewed the different components of that definition. Several studies demonstrated that alcohol hangovers are not limited to heavy drinking occasions. Instead, data from both student and non-student samples revealed that at a group level, alcohol hangover may occur at much lower BAC levels than previously thought. Regression analysis further revealed that for individual drinkers, the occurrence of hangovers is more likely when subjects consume more alcohol than they usually do. However, hangovers may also occur at a drinker’s usual BAC, and in some cases even at lower BAC (e.g. in case of illness). We also carefully reviewed and modified other parts of the definition. Finally, hangovers are not necessarily limited to the ‘next day’. They can start at any time of day or night, whenever BAC approaches zero after a single dinking occasion. This may also be on the same day as the drinking occasion (e.g. when drinking in, or until the morning and subsequently having a hangover in the afternoon or evening). To better reflect the new insights and sharpen the description of the concept, we hereby propose to update the definition of the alcohol hangover as follows: “The alcohol hangover refers to the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero”, and recommend to use this new definition in future hangover research. Full article

Object tracking has always been an interesting and essential research topic in the domain of computer vision, of which the model update mechanism is an essential work, therefore the robustness of it has become a crucial factor influencing the quality of tracking of a sequence. This review analyses on recent tracking model update strategies, where target model update occasion is first discussed, then we give a detailed discussion on update strategies of the target model based on the mainstream tracking frameworks, and the background update frameworks are discussed afterwards. The experimental performances of the trackers in recent researches acting on specific sequences are listed in this review, where the superiority and some failure cases on each of them are discussed, and conclusions based on those performances are then drawn. It is a crucial point that design of a proper background model as well as its update strategy ought to be put into consideration. A cascade update of the template corresponding to each deep network layer based on the contributions of them to the target recognition can also help with more accurate target location, where target saliency information can be utilized as a tool for state estimation. Full article

The Pharmacy Education in Europe (PHARMINE) project studied pharmacy practice and education in the European Union (EU) member states. The work was carried out using an electronic survey forwarded to selected pharmacy representatives at community and hospital pharmacies, in the pharmacy industry and at drug authorities. The surveys of the individual member states are now being published as reference documents for students and staff interested in research on pharmacy education in the EU, and in mobility. This paper presents the results of the PHARMINE project on pharmacy practice and education in Estonia. In this paper, we examine the harmonisation of practice and education in Estonia with EU norms. Community pharmacies in Estonia provide traditional and extended services, of which influenza vaccination, the evaluation of the risk of diabetes, and medication use review have been introduced recently. Pharmacists (in Estonian proviisor) study at the University of Tartu for five years and graduate with a Master of Pharmacy (MSc Pharm) degree. A pharmacist can be the owner of a pharmacy, or work as a pharmacy manager or chief pharmacist in either a community or a hospital pharmacy. Assistant pharmacists (in Estonian farmatseut) study at the Tallinn Health Care College for 3 years; after graduation, they are mainly employed in community pharmacies. The University of Tartu is the only university in Estonia providing higher education in pharmacy at university level. The pharmacy curriculum is an integrated (bachelor followed by master), pharmaceutical product-oriented study programme. It was last updated in 2019. On that occasion, several changes were made such as the introduction of competency-based modules; novel methods in education and training based on the constructive alignment and the restructuring of the six-month traineeship. Several new courses focus on the concepts of clinical pharmacy and on patient-centred communication. In the current pharmacy curriculum, there is a balance between chemical and medical subjects. The traineeship is provided for six months at a community and/or hospital pharmacy in the 5th year. Currently, the pharmacy curriculum at the University of Tartu does not offer specialization in subjects such as hospital or industrial pharmacy. Full article

Many traffic occasions such as tunnels, subway stations and underground parking require accurate and continuous positioning. Navigation and timing services offered by the Global Navigation Satellite System (GNSS) is the most popular outdoor positioning method, but its signals are vulnerable to interference, leading to a degraded performance or even unavailability. The combination of magnetometer and Inertial Measurement Unit (IMU) is one of the commonly used indoor positioning methods. Within the proposed mobile platform for positioning in seamless indoor and outdoor scenes, the data of magnetometer and IMU are used to update the positioning when the GNSS signals are weak. Because the magnetometer is susceptible to environmental interference, an intelligent method for calculating heading angle by magnetometer is proposed, which can dynamically calculate and correct the heading angle of the mobile platform in a working environment. The results show that the proposed method of calculating heading angle by magnetometer achieved better performance with interference existence. Compared with the uncorrected heading angle, the corrected accuracy results could be improved by 60%, and the effect was more obvious when the interference was stronger. The error of overall positioning trajectory and true trajectory was within 2 m. Full article

Cognitive modeling studies in adults have established that visual working memory (WM) capacity depends on the representational precision, as well as its variability from moment to moment. By contrast, visuospatial WM performance in children has been typically indexed by response accuracy—a binary measure that provides less information about precision with which items are stored. Here, we aimed at identifying whether and how children’s WM performance depends on the spatial precision and its variability over time in real-world contexts. Using smartphones, 110 Grade 3 and Grade 4 students performed a spatial WM updating task three times a day in school and at home for four weeks. Measures of spatial precision (i.e., Euclidean distance between presented and reported location) were used for hierarchical modeling to estimate variability of spatial precision across different time scales. Results demonstrated considerable within-person variability in spatial precision across items within trials, from trial to trial and from occasion to occasion within days and from day to day. In particular, item-to-item variability was systematically increased with memory load and lowered with higher grade. Further, children with higher precision variability across items scored lower in measures of fluid intelligence. These findings emphasize the important role of transient changes in spatial precision for the development of WM. Full article

An electronic nose (E-nose) is an intelligent system that we will use in this paper to distinguish three indoor pollutant gases (benzene (C₆H₆), toluene (C₇H₈), formaldehyde (CH₂O)) and carbon monoxide (CO). The algorithm is a key part of an E-nose system mainly composed of data processing and pattern recognition. In this paper, we employ support vector machine (SVM) to distinguish indoor pollutant gases and two of its parameters need to be optimized, so in order to improve the performance of SVM, in other words, to get a higher gas recognition rate, an effective enhanced krill herd algorithm (EKH) based on a novel decision weighting factor computing method is proposed to optimize the two SVM parameters. Krill herd (KH) is an effective method in practice, however, on occasion, it cannot avoid the influence of some local best solutions so it cannot always find the global optimization value. In addition its search ability relies fully on randomness, so it cannot always converge rapidly. To address these issues we propose an enhanced KH (EKH) to improve the global searching and convergence speed performance of KH. To obtain a more accurate model of the krill behavior, an updated crossover operator is added to the approach. We can guarantee the krill group are diversiform at the early stage of iterations, and have a good performance in local searching ability at the later stage of iterations. The recognition results of EKH are compared with those of other optimization algorithms (including KH, chaotic KH (CKH), quantum-behaved particle swarm optimization (QPSO), particle swarm optimization (PSO) and genetic algorithm (GA)), and we can find that EKH is better than the other considered methods. The research results verify that EKH not only significantly improves the performance of our E-nose system, but also provides a good beginning and theoretical basis for further study about other improved krill algorithms’ applications in all E-nose application areas. Full article