18 research outputs found
Using Machine Learning to Predict Antimicrobial Resistance―A Literature Review
No full textMachine learning (ML) algorithms are increasingly applied in medical research and in healthcare, gradually improving clinical practice. Among various applications of these novel methods, their usage in the combat against antimicrobial resistance (AMR) is one of the most crucial areas of interest, as increasing resistance to antibiotics and management of difficult-to-treat multidrug-resistant infections are significant challenges for most countries worldwide, with life-threatening consequences. As antibiotic efficacy and treatment options decrease, the need for implementation of multimodal antibiotic stewardship programs is of utmost importance in order to restrict antibiotic misuse and prevent further aggravation of the AMR problem. Both supervised and unsupervised machine learning tools have been successfully used to predict early antibiotic resistance, and thus support clinicians in selecting appropriate therapy. In this paper, we reviewed the existing literature on machine learning and artificial intelligence (AI) in general in conjunction with antimicrobial resistance prediction. This is a narrative review, where we discuss the applications of ML methods in the field of AMR and their value as a complementary tool in the antibiotic stewardship practice, mainly from the clinician’s point of view
Applying the Kirkpatrick-Model on evaluating an educational intervention about transfusion medicine among nurses. Preliminary results
No full textBackground: Implementation of systematic and sustainable training in theoretical and practical aspects of transfusion, maximizes transfusion-safety and improves quality of nursing services. Kirkpatrick-Model can be used effectively for evaluating such educational programs.
Method and Materials: According to Kirkpatrick-Model, evaluation of educational programs is determined by four levels: 1st-Reaction, 2nd-Learning, 3rd-Behavior, 4th-Results. During years 2018-2019, an educational program about transfusion-medicine (presentations-lectures, brochures distribution, individual training) was implemented among nurses working mainly in an Oncology Hospital of the Hellenic National Health System. Demographics, educational/professional experience, knowledge-level on transfusion-medicine as well as suggestions for improving it, were checked with pre-and post-training questionnaires. Statistical analysis was made using SAS9.4-software for Windows/Excel 2007 (Kruskal-Wallis method for numeric parameters, x2-test for categorical). The significance level was set to P<0.05.
Results: Regarding trainees’ reaction (level 1), 38.59% considered the educational program “satisfactory” (before training, 13.67% answered that they needed no training, after training 52.26%, P<0.05).
Regarding learning (level 2), there was improvement in knowledge (14.2±3 correct answers/respondent before training, 21.1±1.8 correct answers/respondent post-training, 48.6% increase in correct answers/respondent, P<0.000001).
The evaluation of the trainees' change of work-behavior due to training (level 3) will be performed through an extended observation-period by auditors using an extensive evidence-based observatory checklist. The overall outcome of training (level 4) will be assessed after completing the above-mentioned audits.
Conclusions: According to Kirkpatrick-Model, the applied educational program is evaluated positively in terms of levels 1-2, as it was considered sufficient by trainees and improved their theoretical knowledge. Further evaluation in terms of levels 3-4 is an ongoing procedure
Cosmic Radiation Intensity Measurements Using TL Dosimeters at Various Mountain Altitudes
No full textA Comparative Study of Three Spatial Interpolation Methodologies for the Analysis of Air Pollution Concentrations in Athens, Greece
No full textΕκτίμηση της ποιότητας ζωής ασθενών με άσηπτη νέκρωση κεφαλής μηριαίου μετά από υπερβαρική οξυγονοθεραπεία
No full textΕισαγωγή: Η Άσηπτη Νέκρωση Κεφαλής Μηριαίου (ΑΝΚΜ), είναι μια παθολογική κατάσταση όπου η παροχή αίματος προς τη μηριαία κεφαλή ανεπαρκεί χωρίς όμως να έχει προηγηθεί τραυματισμός. Η θεραπεία της ΑΝΚΜ έγκειται σε επεμβατικές (αποσυμπίεση του πυρήνα, μόσχευμα οστού και οστεοτομία) και μη επεμβατικές μεθόδους (ηλεκτρική διέγερση, μαγνητικά πεδία, φαρμακευτική αγωγή και θεραπεία με Υπερβαρικό Οξυγόνο - ΥΒΟ). Σκοπός: Η αξιολόγηση της επίδρασης της θεραπείας με ΥΒΟ στην Ποιότητα Ζωής των ασθενών που πάσχουν από ΑΝΚΜ, όταν αυτή χρησιμοποιείται σε συνδυασμό με τη διεθνώς αποδεκτή μη χειρουργική θεραπεία. Υλικό και Μέθοδος: Πραγματοποιήθηκε προοπτική μελέτη παρατήρησης με μία ομάδα παρέμβασης, που διήρκησε 3,5 έτη. Διενεργήθηκε σε 73 ασθενείς που παραπέμφθηκαν από ειδικό ορθοπαιδικό για ΥΒΟ, με ΑΝΚΜ σταδίου Ι ή ΙΙ σύμφωνα με την κλίμακα Steinberg. Οι ασθενείς αξιολόγησαν την Ποιότητα Ζωής σχετιζόμενη με την Υγεία τους (HR-QoL) συμπληρώνοντας το Ερωτηματολόγιο για την Υγεία EuroQol-5D-5L (EQ) και την οπτική αναλογική κλίμακα πόνου (VAS) πριν την έναρξη ΘΥΒΟ, μετά την Α’ φάση (20 ΥΒΟ) και μετά τη Β’ φάση (επιπλέον 20 ΥΒΟ). Αποτελέσματα: Κατά την ένταξη, την Α’ φάση και τη Β’ φάση, η μέση τιμή στο ερωτηματολόγιο για την Υγεία (EQ) ήταν 58,01, 65,07 και 77,36 αντίστοιχα ενώ η αξιολόγηση του πόνου (VAS) ήταν 5,4 (+/-ΤΑ:1,9), 4,8 (+/-ΤΑ:1,8) και 2,7 (+/-ΤΑ:2,02), γεγονός που δηλώνει τη βελτίωση της ποιότητας ζωής των ασθενών. Συμπεράσματα: Η ΥΒΟ επηρεάζει σημαντικά την ποιότητα ζωής των ασθενών με ΑΝΚΜ. Ο πόνος και η ποιότητα των συνήθων δραστηριοτήτων του ασθενούς σχετίζονται με τη χρήση ΥΒΟ. Μεγαλύτερες μελέτες απαιτούνται για πιο ενδελεχή αξιολόγηση
Mitochondrial Homeostasis and Cellular Senescence
No full textCellular senescence refers to a stress response aiming to preserve cellular and, therefore, organismal homeostasis. Importantly, deregulation of mitochondrial homeostatic mechanisms, manifested as impaired mitochondrial biogenesis, metabolism and dynamics, has emerged as a hallmark of cellular senescence. On the other hand, impaired mitostasis has been suggested to induce cellular senescence. This review aims to provide an overview of homeostatic mechanisms operating within mitochondria and a comprehensive insight into the interplay between cellular senescence and mitochondrial dysfunction
Mitochondrial Homeostasis and Cellular Senescence
No full textCellular senescence refers to a stress response aiming to preserve cellular and, therefore, organismal homeostasis. Importantly, deregulation of mitochondrial homeostatic mechanisms, manifested as impaired mitochondrial biogenesis, metabolism and dynamics, has emerged as a hallmark of cellular senescence. On the other hand, impaired mitostasis has been suggested to induce cellular senescence. This review aims to provide an overview of homeostatic mechanisms operating within mitochondria and a comprehensive insight into the interplay between cellular senescence and mitochondrial dysfunction
Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort
No full textObjectives: We utilized the database of the Defining Antibiotic Levels in Intensive care unit patients (DALI) study to statistically compare the pharmacokinetic/pharmacodynamic and clinical outcomes between prolonged- infusion and intermittent-bolus dosing of piperacillin/tazobactam and meropenem in critically ill patients using inclusion criteria similar to those used in previous prospective studies. Methods: This was a post hoc analysis of a prospective, multicentre pharmacokinetic point-prevalence study (DALI), which recruited a large cohort of critically ill patients from 68 ICUs across 10 countries. Results: Of the 211 patients receiving piperacillin/tazobactam and meropenem in the DALI study, 182 met inclusion criteria. Overall, 89.0% (162/182) of patients achieved the most conservative target of 50% fT≥MIC (time over which unbound or free drug concentration remains above the MIC). Decreasing creatinine clearance and the use of prolonged infusion significantly increased the PTA for most pharmacokinetic/pharmacodynamic targets. In the subgroup of patients who had respiratory infection, patients receiving β-lactams via prolonged infusion demonstrated significantly better 30 day survival when compared with intermittent-bolus patients [86.2% (25/29) versus 56.7% (17/30); P=0.012]. Additionally, in patients with a SOFA score of ≥ 9, administration by prolonged infusion compared with intermittent-bolus dosing demonstrated significantly better clinical cure [73.3% (11/15) versus 35.0% (7/20); P=0.035] and survival rates [73.3% (11/15) versus 25.0% (5/20); P=0.025]. Conclusions: Analysis of this large dataset has provided additional data on the niche benefits of administration of piperacillin/tazobactam and meropenem by prolonged infusion in critically ill patients, particularly for patients with respiratory infections. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved
