1,721,155 research outputs found
Bloodstream infections : implementation and development of novel diagnostic tools
No full textLes bactériémies constituent une cause majeure de mortalité dans le monde, y compris dans le contexte des pays à haut niveau de développement sanitaire. Le prélèvement d'hémocultures est l'examen de référence pour leur diagnostic mais reste un outil imparfait et relativement coûteux. Cette thèse rapporte les travaux que nous avons menés dans le cadre d'une démarche globale d'optimisation des performances du prélèvement d'hémocultures. Notre premier objectif a été de développer un score de prédiction de bactériémie pour identifier les patients à très faible risque (Pehlivan et al. Emerg Med J. 2023), ouvrant la voie à une prescription plus pertinente des hémocultures. Parallèlement, alors que les déterminants d'un prélèvement optimisé d'hémocultures sont connus, leur application dans les soins courants reste limitée. A l'aide des outils proposés par les sciences de l'implémentation, nous avons intégré ces éléments autour d'une procédure d'hémoculture unique en réanimation. Nous avons pu montrer qu'une réduction majeure du nombre de flacons prélevés était possible tout en améliorant les performances diagnostiques des hémocultures (maintien de l'identification des bactériémies, diminution des contaminants). Enfin, nous avons étudié les effets de l'implémentation en vie réelle d'un outil innovant de PCR multiplex réalisé sur flacon d'hémoculture positif. Dans une organisation locale déjà efficiente, cet outil a permis d'optimiser les délais d'initiation d'une antibiothérapie adaptée.Bloodstream infections (BSI) a major cause of death worldwide, including in the context of countries with a high level of health development. . Blood culture is the gold standard for diagnosis but remains an imperfect and relatively expensive tool. This thesis reports the work we have carried out as part of a comprehensive approach to optimizing the performance of blood culture sampling. Our first aim of this thesis was to develop an easy-to-use predictive tool to rule out BSI without blood cultures (Pehlivan et al. Emerg Med J 2023). While the parameters associated with optimized blood culture testing are well known, most of them are not used in clinical practice. Through implementation science tools, we have developed a unique blood culture-based strategy to improve the diagnosis of BSI in intensive care unit. We were able to show that a major reduction in the number of vials collected was possible while improving the diagnostic performance of blood cultures (maintaining bacteremia identification, reducing contaminants). Finally, we studied the effects of the real-life implementation of an innovative multiplex PCR tool on a positive blood culture bottle. In an already efficient local organization, this tool has made it possible to optimize the time taken to initiate appropriate antibiotic therapy
Community and non-human reservoirs of Acinetobacter baumannii in La Reunion Island
No full textAcinetobacter baumannii est une bactérie responsable d’infections communautaires, en particulier dans les régions tropicales et chez des blessés lors de conflits armés. Or, les réservoirs extra-hospitaliers de la bactérie sont peu connus. L’objectif de ce travail était d’étudier ces réservoirs dans une zone tropicale, l’île de la Réunion, en étudiant à la fois le réservoir animal (dépistage), environnemental et humain. En parallèle, des études ont été conduites en zone tempérée (France métropolitaine), avec le dépistage des animaux domestiques. Dans un premier temps, l’identification des espèces du complexe Acinetobacter calcoaceticus-Acinetobacter baumannii par spectrométrie de masse a été perfectionnée sur l’automate VitekÒ MS. La deuxième partie du travail a permis de mettre en évidence une prévalence élevée de portage de la bactérie chez les animaux domestiques réunionnais (6,5 et 8,5%). Une prévalence inférieure a été décelée chez les animaux domestiques de métropole (2,7%). Dans tous les réservoirs étudiés, une grande diversité des souches a été retrouvée lors de l’analyse par Multi-Locus Sequence Typing, avec la mise en évidence de nouveauxSequence Types. Enfin, 2 souches productrices d’OXA-23 et OXA-24 ont pu être isolées respectivement en portage chez un patient et un animal d’élevage de l’île de la Réunion, et 2 souches productrices d’OXA-23 ont été isolées chez des animaux de compagnie de métropole. Ce travail a permis des observations intéressantes sur l’épidémiologie communautaire d’ A. baumannii. D’autres travaux restent à prévoir pour mieux comprendre les relations entre les réservoirs extra-hospitaliers, mais aussi avec le réservoir hospitalier.Acinetobacter baumannii is a bacterium responsible for community-acquired infections, especially in tropical areas and among soldiers during warfare. However, community reservoirs of this bacterium are not very well known. The aim of this work was to study these reservoirs in a topical area, Reunion Island, by analyzing at the same time the animal (carriage), the environmental, and the human reservoirs. Studies were also performed in a temperate zone (metropolitan France), by analyzing carriage of companion animals. First, identification of species belonging to the Acinetobacter calcoaceticus - Acinetobacter baumannii complex by mass spectrometry has been improved on the VitekÒ MS automated system. In asecond part of the study, a high prevalence of A. baumannii carriage has been observed in domesticated animals of La Reunion Island (6,5 and 8,5%). A lower prevalence has been detected in metropolitan companion animals (2,7%). Within allthe reservoirs studied, a great diversity of strains isolated has been shown by Multi-Locus Sequence Typing analysis, with the dicovery of new Sequence Types. At last, 2 strains producing OXA-23 and OXA-24 have been isolated respectively in carriage in a patient and in a livestock animal of La Reunion Island, and 2 strains producing OXA-23 have been isolated in metropolitan companion animals. This work has permitted to do some interesting observations on the community epidemiology of A. baumannii. Other studies are needed to better understandrelationships between the different community reservoirs, and also with the hospital reservoir
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
- …
