20 research outputs found
Doença Pulmonar Obstrutiva Crônica e Transtornos de Deglutição: revisão de literatura
No full textTCC(graduação) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Fonoaudiologia.Introdução: Pelas projeções dos órgãos de saúde e sociedades científicas da área, nas próximas décadas a DPOC será uma das cinco primeiras causas de morte em todo o mundo sendo que no Brasil já é uma das doenças mais incapacitantes e com elevados índices de mortalidade. A DPOC corresponde a presença de obstrução ou limitação crônica do fluxo aéreo, apresentando progressão lenta e irreversível. A respiração é a parte intrínseca e vital no processo de deglutição, porém, é a função mais afetada na DPOC. Objetivo:Realizar uma revisão de literatura visando encontrar artigos que busquem a relação da Doença Pulmonar Obstrutiva Crônica com transtornos de deglutição.Metodologia:Foi conduzida uma busca em artigos nos idiomas PORTUGUES, INGLES e ESPANHOL sobre a relação da Doença Pulmonar Obstrutiva Crônica com transtornos de deglutição, sem limite de tempo, texto na íntegra, tipo de estudo (sem delimitação), população-alvo (adultos) nas bases de dados MEDLINE-PUBMED, LILACS, SCIELO e SCOPUS. As palavras-chave usadas isoladas e em cruzamentos foram: em português: DPOC; transtornos de deglutição, deglutição, disfagia e disfagia orofaríngea; em inglês: COPD, deglutition disorders, swallowing disorders, dysphagia e em espanhol: EPOC e transtornos de Deglución. Resultados: A pesquisa resultou em 224 artigos, destes apenas 18 preencheram os critérios de inclusão, sendo 12 artigos encontrados na base de dados PUBMED, 3 artigos encontrados na base de dados LILACS e 3 na base SCIELO. Conclusão: Há escassez de trabalhos sobre a correlação entre disfagia no paciente com DPOC, porém, em 15 (quinze) dos 18 (dezoito) artigos estudados, o que corresponde a 79% do total, houve esta relação. Sugerem-se novos estudos, estruturados metodologicamente, abordando este mesmo tema, para a disseminação do conhecimento a cerca dos fatores que podem influenciar a estabilidade do paciente acometido por estas comorbidades.Introduction: According to projections of health agencies and scientific societies of the area in the coming decades COPD is one of the five leading causes of death worldwide and in Brazil is already one of the most disabling diseases and high mortality. COPD accounts for obstruction or chronic airflow limitation, with slow progression and irreversible. Breathing is a vital and intrinsic part of the swallowing process, however, is the most affected function in COPD. Objective:To review the literature in order to find articles that seek the relationship of Chronic Obstructive Pulmonary Disease with swallowing disorders. Methods: We conducted a search for articles in languages PORTUGUESE, ENGLISH and SPANISH on the relationship of Chronic Obstructive Pulmonary Disease with swallowing disorders, no time limit, full text, type of study (without boundary), the target population (adults ) in MEDLINE, PUBMED, LILACS, SCIELO and SCOPUS. The keywords used were isolated and crossings: in Portuguese: COPD; swallowing disorders, swallowing, dysphagia and oropharyngeal dysphagia, in English: COPD, deglutition disorders, swallowing disorders, dysphagia and Spanish: EPOC and disorders Deglución. Results:The search resulted in 224 articles, of which only 18 met the inclusion criteria, 12articles found in PUBMED database, 3 articles found in the database LILACS and SCIELO third base. In SCOPUS database items found were discarded due to the exclusion criteria. Conclusion:There are few studies on the correlation between dysphagia in patients with COPD, however, within fifteen (15) of the eighteen (18) items studied, which corresponds to 79% of the total, there was this relationship. Suggest new studies, methodologically structured, addressing the same subject, for the dissemination of knowledge about the factors that may influence the stability of patients affected by these comorbidities
Immunity from arrest? - An analysis of obligations for State Parties to the Rome Statute to arrest and surrender a Head of State of a state not party to the Statute in a situation referred to the ICC pursuant to a UN Security Council resolution
No full textThe International Criminal Court (ICC) was created as a compliment to domestic courts in the global fight against impunity. However, customary international law has afforded Heads of State with immunity from prosecution, even for serious international crimes. Some key challenges of international criminal law are to reconcile the competing objectives of maintaining stable international relations, and protecting the sovereignty of States, through immunity rules and ensuring that perpetrators of international crimes are held accountable. These challenges are currently under intense scrutiny. Some State Parties to the Rome Statute of the International Criminal Court (Rome Statute) are refusing to comply with the ICC’s request to arrest Omar Hassan Al Bashir, the incumbent President of Sudan. Bashir is facing charges before the ICC due to a referral by the United Nation Security Council (UNSC) to the ICC of the situation in Darfur, Sudan. Sudan is not a party to the Statute. Therefore, State Parties argues customary international law governs the relationship between them and Sudan. According to the states, this entails that Bashir is entitled to immunity from being arrested, even when the arrest is sought by ICC. The purpose of this thesis was to discuss and analyse the concept of Head of State immunity and the obligation states have to respect such immunity. Immunity rules under customary international law has been analysed in relation to State Party obligations pursuant to the Rome Statute to disregard such immunity when the Court seeks to arrest an incumbent Head of State. The purpose included clarifying which legal regime applies with regards to the allegedly conflicting obligations for State Parties when a situation is before the ICC pursuant to a referral of a situation by the UNSC. As there is no genuine solution of norm conflict in international law, the author has opted for a legal dogmatic method combined with international legal doctrine. As such, interpretation of the relevant sources of law according to established principles has been of focus. In order to provide the most appropriate interpretation of the relevant legal regimes, the thesis includes a historical and political perspective. There is also sufficient evidence African states are not willing to cooperate with the ICC because of political concerns. The development of customary international law governing Head of State immunity entails that personal immunity before domestic courts is absolute. However, the International Court of Justice (ICJ) opened up for an exception which removes personal Head of State immunity before international courts. Incumbent Heads of State has since then been arrested and prosecuted before e.g. the International Criminal Tribunal for Former Yugoslavia, International Criminal Tribunal for Rwanda and the Special Court of Sierra Leone. Scholars have argued that the ICJ suggested there is a new rule under customary international law which removes Head of State immunity before international jurisdiction. The author of this thesis argues that state practice has not yet constituted such exception. Instead, the author argues international courts have applied different legal regimes enabling them to prosecute and arrest incumbent Heads of States. These regimes provide for provisions which make that legal regime prevailing over customary international law. In efforts to solve the issues of non-cooperation in the Bashir case, the ICC’s three-panel Pre-trial Chamber (PTC) has issued decisions against several State Parties. In line with these decisions, the author argues that the legal effect of a UNSC resolution referring a situation to the ICC is that the Rome Statute in its entirety is applicable to that situation. By applying a teleological interpretation of the referral mechanism and Resolution 1593, Sudan should be treated analogously to a State Party under the Rome Statute. Under the Rome Statute, State Parties cannot impose personal immunity as a bar for prosecution. As such, the Rome Statute prevails over customary international law on immunities. It has been argued that removal of immunity before the ICC only applies to its jurisdiction. The author argues it applies also at the national level, when national authorities act in support of the ICC. However, the PTC has been inconsistent in its decisions, applying different legal rationales. Therefore, the legal rationale, to some extent, lacks credibility. This fact opens up for critique and leaves the legal rationale ineffective. The author of this thesis argues against this critique. However, higher authority must address these matters to provide acceptance to the legal rationale in the international community. The ICC’s Appeals Chamber has this opportunity since Jordan appealed the decision on non-cooperation against it. The credibility of the legal rationale is to some extent also dependent on political actions. The Assembly of State Parties to the ICC has called upon State Parties to comply with ICC’s arrest warrant. UNSC is the sole actor involved, which has not taken any measures to either endorse or decline the legal rationale issued by the PTC. Leaving the legal issues to the politically oriented UNSC is neither desirable nor compatible with respect for the rule of law. Therefore, Jordan’s appeal and the future judgment by the Appeals Chamber are crucial for the future practice by the ICC. Specifically, with regards to personal Head of State immunity in situations referred by the UNSC
Ethnomedicinal Uses of Animals in Vicinity of Ayubia National Park, Khyber Pakhtunkhwa-Pakistan
No full textO Desvio pela Animação
No full textO objetivo deste trabalho é a pesquisa por onde o desvio pela animação em filmes
documentários sobre guerras e conflitos violentos, dialoga com o espectador, para isso,
analisamos o encontro ao longo da história de documentários que utilizam a animação,
em suas múltiplas perspectivas, para representar conflitos reais. Mais do que trabalhar
questões da faculdade da credibilidade documental da animação, interessa as
possibilidades narrativas decorrentes deste encontro, onde a animação é amplamente
associada à temas infantis e ficcionais, e a imagem-câmera, que é usualmente utilizada
para apresentação de fatos históricos. Almejamos compreender os seguimentos desta
ruptura documental tradicional com a efabulação pela animação no decorrer da
história, a reestruturação no diálogo entre autor e receptor, no decurso da evidenciação
do realizador no objeto fílmico. Para concluir, faremos um estudo de caso de seis
documentários sobre guerras, assim, permitir aprofundar o conhecimento sobre o
documentário animado, onde as perguntas de partida serão, como e por que da
utilização da animação. No intuito de compreender o objeto estudado e o seu caráter
único, identificamos as principais técnicas implementadas, a proposta comunicacional,
a metaforização, ou seja, a narrativa como um todo. Onde o hibridismo de formatos
também é pertinente em obras que se utilizam concomitantemente de múltiplas
técnicas e fontes, como imagens e áudios de arquivo, encenações, animação e
imagens-câmera. O escopo dos filmes para este estudo orientou-se em virtude do tema,
documentários que se utilizem de animação, integralmente ou parcialmente, para
representar algum momento de guerra ao longo da história, considerando indispensável
trabalhar com obras com histórico de participação em reconhecidos festivais de
documentários ou que sejam objetos de análise de pesquisadores renomados no campo
de filmes documentais ou animação. Os filme selecionados são; O Naufrágio de
Lusitania (The Sinking of Lusitania, 1918); A Vitória pela Força Aérea (Victory
through air power, 1943); Waltz; with Bashir (2008); As 18 Fugitivas (The wanted
18, 2014); Torre (Tower, 2016); Mais uma Dia de Vida (Another Day of Life, 2017).The purpose of this work is the research on the diversion by animation in documentary
films, on wars and violent conflicts, and how they dialogue with the viewer. We will
analyze the meeting throughout the history of the documentary that uses animation, in
its multiple perspectives, to represent real conflicts. More than working on the issues of
documentary credibility in animation, the narrative possibilities resulted from this
encounter are interesting, where animation is largely associated with children's and
fictional themes, and the image of the camera, usually used to present historical facts.
We aim to understand the rupture of the traditional documentary with the use of
effabulation and the restructuring in the dialogue between author and viewer during
the revelation of the director's presence in the cinematographic object. Finally, we will
make a study of six documentaries about wars, allowing us to deepen the knowledge
about the animated documentary. The main question is how and why to use animation.
To understand the studied object and its unique character, we will try to identify the
main techniques used, the communicational proposal, the metaphorization, the
narrative as a whole. Where format hybridism is also relevant, in works that use
multiple techniques and sources simultaneously, such as images and audio files,
staging, animation and camera images.
The scope of the films for this study was based on the theme, documentaries that use
animation, in whole or in part, to represent some moment of war throughout history.
considering it essential to work with films with a history of participation in renowned
documentary festivals or that are the object of analysis by renowned researchers in the
field of documentary or animation. The selected films are The Sinking of Lusitania,
(1914); Victory through air power, (1943); Waltz with Bashir (2008); The wanted 18,
(2014); Tower (2016), Another Day of Life (2017)
Statistical analysis plan for the multicenter, open, randomized controlled clinical trial to assess the efficacy and safety of intravenous tirofiban vs aspirin in acute ischemic stroke due to tandem lesion, undergoing recanalization therapy by endovascular treatment (ATILA trial)
No full text© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.[Rationale] In-stent reocclusion after endovascular therapy has a negative impact on outcomes in acute ischemic stroke (AIS) due to tandem lesions (TL). Optimal antiplatelet therapy approach in these patients to avoid in-stent reocclusion is yet to be elucidated.[Aims] To assess efficacy and safety of intravenous tirofiban versus intravenous aspirin in patients undergoing MT plus carotid stenting in the setting of AIS due to TL.[Sample size estimates] Two hundred forty patients will be enrolled, 120 in every treatment arm.[Methods and design] A multicenter, prospective, randomized, controlled (aspirin group), assessor-blinded clinical trial will be conducted. Patients fulfilling the inclusion criteria will be randomized at MT onset to the experimental or control group (1:1). Intravenous aspirin will be administered at a 500-mg single dose and tirofiban at a 500-mcg bolus followed by a 200-mcg/h infusion during the first 24 h. All patients will be followed for up to 3 months.[Study outcomes] Primary efficacy outcome will be the proportion of patients with carotid in-stent thrombosis within the first 24 h after MT. Primary safety outcome will be the rate of symptomatic intracranial hemorrhage.[Discussion] This will be the first clinical trial to assess the best antiplatelet therapy to avoid in-stent thrombosis after MT in patients with TL.[Trial registration] The trial is registered as NCT05225961. February, 7th, 2022.This project was funded by the Instituto de Salud Carlos III (ISCIII) through the project PI21/01322 and co-funded by the European Union. The Spanish Clinical Research Network (SCReNCode: 21.033) also contributed to the study. The ITRIBiS project (Improving Translational Research Potential at the Institute of Biomedicine of Seville) has the registration number REGPOT-2013-1. M. Medina-Rodríguez was granted a Rio Hortega contract (CM21/00096). The project was included in the Cooperative Cerebrovascular Disease Research Network (INVICTUS) (RD16/0019/0015).Peer reviewe
a descriptive analysis of the Eurobact II study
No full textFunding Information: The Eurobact 2 study group, National coordinators, scientific committee and participating intensive care units: East Asia and Pacific: Australia —National Coordinator: A/Prof. Alexis Tabah; Scientific Committee: Prof. Jeffrey Lipman; Participating ICUs: The Prince Charles Hospital, Adult Intensive Care Services: Dr. Mahesh Ramanan. Fiona Stanley Hospital, Intensive Care Unit: Dr. Edward Litton, Ms Anna Maria Palermo, Mr Timothy Yap, Mr Ege Eroglu. Japan —National Coordinator: Dr. Yoshiro Hayashi; Participating ICUs: Hiroshima University Hospital, ICU: Dr. Koji Hosokawa. St. Marianna University School of Medicine Hospital, Mixed ICU: Dr. Hideki Yoshida, Prof. Shigeki Fujitani. Middle East and North Africa: Iran —National Coordinator: Prof. Farid Zand; Participating ICUs: Imam-Reza, General Icu: Prof Ata Mahmoodpoor. Zahedan University of Medical Sciences, Clinical Immunology Research Center: Dr. Seyed Mohammad Nasirodin (S.M.N.) Tabatabaei. Saudi Arabia —Participating ICUs: Prince Sultan Medical Military Center, Intensive Care Unit: Dr. Omar Elrabi, Dr. Ghaleb A Almekhlafi. Latin America and The Caribbean: Argentina —National Coordinator: Dr. Gabriela Vidal; Participating ICUs: Hospital Zatti, Ucia: Dra Marta Aparicio, Microbiologa Irene Alonzo. Mexico —National Coordinator: Dr. Silvio A. Namendys-Silva; Participating ICUs: Centenario Hospital Miguel Hidalgo: Dr. Mariana Hermosillo, Dr. Roberto Alejandro Castillo. Europe And Central Asia: Belgium —National Coordinator: Dr. Liesbet De Bus; Scientific Committee: Jan De Waele; Participating ICUs: A.S.Z., Iz: Dr. Isabelle Hollevoet. Clinique Saint-Pierre, Intensive Care Unit: Dr. Nicolas De Schryver, Dr. Nicolas Serck. Bosnia And Herzegovina —National Coordinator: Dr. Pedja Kovacevic; Participating ICUs: University Clinical Centre of The Republic Of Srpska, Medical Intensive Care Unit: Dr. Pedja Kovacevic, Dr. Biljana Zlojutro. France —National Coordinator: Prof. Marc Leone; Scientific Committee: Prof. Jean-François Timsit, Prof. Etienne Ruppe, Mr. Stephane Ruckly, Prof. Philippe Montravers; Participating ICUs: Centre Hospitalier De Bigorre, Service De Réanimation Polyvalente: Dr. Thierry Dulac, Dr. Jérémy Castanera. Centre Hospitalier De Pau, Réanimation Polyvalente: Dr. Alexandre Massri, Dr. Charlotte Guesdon. Ghef Site De Marne-La-Vallée, Réanimation Polyvalente: Dr. Pierre Garcon, Dr. Matthieu Duprey. Groupe Hospitalier Paris Saint Joseph, Médecine Intensive et Réanimation: Dr. François Philippart, Dr. Marc Tran, Dr. Cédric Bruel. Hôpital De La Source, Centre Hospitalier Régional D'orléans, Médecine Intensive & Réanimation (Medical Icu): Dr. François Barbier. Hôpital Louis Pasteur, Réanimation: Dr. Pierre Kalfon, Mr Gaëtan Badre. Sorbonne Universite Pitie Salpetriere, Médecine Intensive Et Réanimation Neurologique: Dr. Sophie Demeret, Dr. Loïc Le Guennec. Italy —National Coordinator: Prof. Matteo Bassetti and Dr. Daniele Giacobbe; Participating ICUs: Città Della Salute E Della Scienza - Molinette, Anestesia E Rianimazione Universitaria: Dr. Giorgia Montrucchio, Dr. Gabriele Sales. Irccs Sacro Cuore Don Calabria, Terapia Intensiva: Dr. Ivan Daroui, Dr. Giovanni Lodi. Policlino Paolo Giaccone, Università Degli Studi Di Palermo, Terapia Intensiva Polivalente: Dr. Andrea Cortegiani, Dr. Mariachiara Ippolito, Dr. Davide Bellina, Dr. Andrea Di Guardo. Sant'andrea Hospital Sapienza University of Rome, Department of Medical And Surgical Science And Translational Medicine Intensive Care Unit: Dr. Monica Rocco, Dr. Silvia Fiorelli. Poland —National Coordinator: Dr. Adam Mikstacki; Participating ICUs: Wss Im. Wl. Bieganskiego, Oddzial Anestezjologii I Intensywnej Terapii - Osrodek Pozaustrojowych Technik Wspomagania Czynnosci Nerek I Wątroby: Prof Assoc Mariusz Peichota, Dr. Iwona Pietraszek-Grzywaczewska. Portugal —National Coordinator: Prof. José-Artur Paiva; Scientific Committee: Prof. Pedro Póvoa; Participating ICUs: CHUA Faro, Smi-1: Dr. Andriy Krystopchuk, Dr. Ana Teresa. Hospital De Cascais Dr Jose De Almeida, Unidade de Cuidados Intensivos: Dr. António Manuel Pereira de Figueiredo, Dr. Isabel Botelho. Hospital Sao Francisco Xavier, CHLO, Unidade De Cuidados Intensivos Polivalente: Dr. Vasco Costa, Dr. Rui Pedro Cunha. Russian Federation —National Coordinator: Prof Alexey Gritsan; Participating ICUs: Privolzhskiy District Medical Center, Department Anesthesiology and Intensive Care: Dr. Vladislav Belskiy, Dr. Mikhail Furman. Spain —National Coordinator: Dr. Ricard Ferrer; Participating ICUs: Vall D'herbon, Intensive Care Medicine: Dr. Ricard Ferrer, Dr. Maria Martinez, Dr. Vanessa Casares. Hospital Del Mar, Critical Care Unit: Dr. Maria Pilar Gracia Arnillas, Dr. Rosana Munoz Bermudez. Hospital Punta De Europa, Intensive Care Unit: Dr. Alejandro Ubeda, Dra Maria Salgado. Hospital Universitario La Paz, Surgical Critical Care Unit: Dr. Emilio Maseda, Dr. Alejandro Suarez De La Rica. University Hospital Severo Ochoa, Intensive Care Unit: Dr. Miguel Angel Blasco-Navalpotro, Dr. Alberto Orejas Gallego. Switzerland —National Coordinator: Dr. Josef Prazak; Scientific Committee: Dr. Niccolò Buetti; Participating ICUs: Chuv, Service De Médecine Intensive Adulte: Dr. Jl Pagani, Mrs S Abed-Maillard. Turkey —National Coordinator: Prof. Akova Murat, Dr. Abdullah Tarık Aslan; Participating ICUs: Hacettepe University of Faculty of Medicine, Intensive Care Unit(ICU): Dr. Akova Murat, Dr. Abdullah Tarik Aslan, Dr. Arzu Topeli Iskit. Acibadem Kadikoy Hospital, ICU: Dr. Selcuk Mehtap, Dr. Solakoğlu Ceyhun. Ankara Yildirim Beyazit University, Ankara City Hospital, Infectious Diseases and Clinical Microbiology: Dr. Bircan Kayaaslan, Dr. Ayşe Kaya Kalem. Aydin Adnan Menderes University Research Hospital, Anesthesia and Reanimation ICU: Prof. Dr. Ibrahim Kurt, Dr. (Professor) Murat Telli, Dr. (Associate Professor) Barcin Ozturk. Hitit University Erol Olcok Education and Research Hospital, Infectious Diseases and Clinical Microbiology: Prof. Dr. Nurcan (N) Baykam, Assistant Prof. Dr. Özlem (O) Akdoğan. Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Sadi Sun ICU: Prof.Dr. Nese Saltoglu, Ass Prof.Dr. Ridvan Karaali. Karadeniz Technical University Faculty of Medicine, Infectious Disease and Clinical Microbiology: Prof Dr. Iftihar Koksal, Assist. Prof. Firdevs Aksoy. Kartal Dr. Lutfi Kirdar Training and Research Hospital, ICU: Dr. Kemal Tolga Saracoglu, Dr. Yeliz Bilir. Kayseri City Hospital, ICU: Dr. Seda Guzeldag. Mersin University Hospital, Department of Infectious Diseases and Clinical Microbiology: Dr. Gulden Ersoz, Dr. Guliz Evik. School Of Medicine, Medipol Mega University Hospitals Complex, Department of Anesthesiology and Reanimation: Dr. Cem Erdogan. Turgut Ozal Medical Center, Department of Infectious Diseases and Clinical Microbiology: Dr. Yasar Bayindir, Dr. Yasemin Ersoy. The United Kingdom —National Coordinator: Dr. Andrew Conway Morris; Participating ICUs: Addenbrookes Hospital, John V Farman Intensive Care Unit: Dr. Andrew Conway Morris, Dr. Matthew Routledge. Addenbrookes Hospital, Neurocritical Care Unit (NCCU): Dr. Andrew Conway Morris, Dr. Ari Ercole. Croydon University Hospital, Critical Care Unit: Dr. Ashok Raj, Dr. Artemis Zormpa, Dr. George Tinaslanidis, Mrs Reena Khade. Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, Critical Care Unit: Dr. Ashraf Roshdy Sandwell And West Birmingham Hospitals NHS Trust, Intensive Care Unit: Dr. Santhana Kannan, Dr. Supriya Antrolikar, Dr. Nicholas Marsden. Warwick Hospital, Intensive Care Unit: Dr. Ben Attwood, Dr. Jamie Patel. South Asia: India —National Coordinator: Prof. Mohan Gurjar; Participating ICUs: St Johns Medical College Hospital, Department of Critical Care Medicine, Micu: Dr. Carol Dsilva, Dr. Jagadish Chandran. Sub-Saharan Africa: Sudan —National Coordinator: Dr. Bashir El Sanousi; Participating ICUs: East Nile Hospital, Intensive Care Unit: Dr. Elfayadh Saidahmed, Dr. Hytham K.S. Hamid. Funding Information: The authors have disclosed that they do not have conflict of interest. Dr. Buetti received a grant from the Swiss National Science Foundation (Grant Number: P4P4PM_194449). Prof. Timsit received fees for lectures to 3M, MSD, Pfizer, and BioMérieux; he received research grants from Astellas, 3M, MSD, and Pfizer; and he participated to advisory boards of 3M, MSD, Bayer Pharma, Nabriva, and Pfizer. Dr. Barbier received consulting and lecture fees from MSD and BioMérieux. Prof. Cortegiani received fees for lectures from Gilead, MSD, Pfizer; and he participated to advisory boards of MSD, Gilead, Pfizer. Dr. Montrucchio received fees for lectures from Gilead, Pfizer, Thermofisher; and she participated to advisory boards of Gilead. Dr. Conway Morris sits on the scientific advisory board of Cambridge Infection Diagnostics. Prof. Akova received grants from Pfizer and Gilead, had lecture fees paid to the institution by Pfizer and Sanofi. Dr. Ramanan acknowledges support from the Metro North Hospital and Health Services Clinician-Researcher Fellowship. Dr. Conway Morris sits on the scientific advisory board of Cambridge Infection Diagnostics. Dr. Conway Morris is supported by a Clinician Scientist Fellowship from the Medical Research Council (MR/V006118/1). Prof. José-Artur Paiva received fees for consulting, advisory boards or lectures from MSD, Pfizer, Astra-Zeneca, Gilead, Jansen, Cepheid, AOP Orphan Pharmaceuticals. Funding Information: Research grants were obtained from the European society of Intensive Care Medicine (ESICM) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study Group for Infections in Critically Ill Patients (ESGCIP), the Norva Dahlia foundation and the Redcliffe Hospital Private Practice Trust Fund. Dr. Buetti received a grant from the Swiss National Science Foundation (Grant Number: P4P4PM_194449). The study was endorsed by the critically ill group of the ESCMID (ESGCIP) and by the infection group of the ESICM with scientific input of the OUTCOMEREA network. Publisher Copyright: © 2022, The Author(s).Background: The study aimed to describe the epidemiology and outcomes of hospital-acquired bloodstream infections (HABSIs) between COVID-19 and non-COVID-19 critically ill patients. Methods: We used data from the Eurobact II study, a prospective observational multicontinental cohort study on HABSI treated in ICU. For the current analysis, we selected centers that included both COVID-19 and non-COVID-19 critically ill patients. We performed descriptive statistics between COVID-19 and non-COVID-19 in terms of patients’ characteristics, source of infection and microorganism distribution. We studied the association between COVID-19 status and mortality using multivariable fragility Cox models. Results: A total of 53 centers from 19 countries over the 5 continents were eligible. Overall, 829 patients (median age 65 years [IQR 55; 74]; male, n = 538 [64.9%]) were treated for a HABSI. Included patients comprised 252 (30.4%) COVID-19 and 577 (69.6%) non-COVID-19 patients. The time interval between hospital admission and HABSI was similar between both groups. Respiratory sources (40.1 vs. 26.0%, p < 0.0001) and primary HABSI (25.4% vs. 17.2%, p = 0.006) were more frequent in COVID-19 patients. COVID-19 patients had more often enterococcal (20.5% vs. 9%) and Acinetobacter spp. (18.8% vs. 13.6%) HABSIs. Bacteremic COVID-19 patients had an increased mortality hazard ratio (HR) versus non-COVID-19 patients (HR 1.91, 95% CI 1.49–2.45). Conclusions: We showed that the epidemiology of HABSI differed between COVID-19 and non-COVID-19 patients. Enterococcal HABSI predominated in COVID-19 patients. COVID-19 patients with HABSI had elevated risk of mortality. Trial registration ClinicalTrials.org number NCT03937245. Registered 3 May 2019.publishersversionpublishe
Metodología para el análisis del comportamiento y el desempeño de los estudiantes en un curso en línea
No full textAlthough many researchers have studied student performance prediction in online courses, they have primarily focused on courses with a linear structure, where students complete lessons and assessments sequentially. However, non-linear courses allow students to take lessons and assessments in any order, making performance prediction more challenging due to varying cumulative assessment percentages among students at any given time. This master's thesis aims to develop a data-driven method for early student performance prediction in non-linear courses.
We created a feature extractor and evaluated three types of features: engagement, behavior, and performance. The data comes from Moodle courses designed to prepare high school students for a public university entrance exam. Our method achieved early predictions at 20% of cumulative weight assessment with an F1-score of 0.73 for binary classification and an R² of 0.40 for regression. We also conducted a feature importance analysis, showing that performance and behavior features are the most significant predictors, with engagement features, such as time spent on educational resources, also contributing significantly.
In addition to predicting student performance, we performed a clustering analysis and identified four patterns that consistently appear across various cumulative weight assessments. These patterns significantly impact performance and can help educators provide better feedback and more personalized attention to students' needs.Aunque muchos investigadores han estudiado la predicción del rendimiento de los estudiantes en cursos en línea, se han centrado principalmente en cursos con una estructura lineal, en los que los estudiantes completan las lecciones y las evaluaciones de forma secuencial. Sin embargo, los cursos no lineales permiten a los estudiantes realizar las lecciones y evaluaciones en cualquier orden, lo que hace que la predicción del rendimiento sea más difícil debido a la variación de los porcentajes de evaluación acumulada entre los estudiantes en un momento dado. Esta tesis de máster tiene como objetivo desarrollar un método basado en datos para la predicción temprana del rendimiento de los estudiantes en cursos no lineales.
Creamos un extractor de características y evaluamos tres tipos de características: compromiso, comportamiento y rendimiento. Los datos proceden de cursos de Moodle diseñados para preparar a estudiantes de secundaria para un examen de acceso a una universidad pública. Nuestro método logró predicciones tempranas al 20% de la evaluación del peso acumulado con una puntuación F1 de 0.73 para la clasificación binaria y un R² de 0.40 para la regresión. También llevamos a cabo un análisis de la importancia de las características, mostrando que las características de rendimiento y comportamiento son los predictores más significativos, con características de compromiso, como el tiempo dedicado a los recursos educativos, que también contribuyen significativamente.
Además de predecir el rendimiento de los alumnos, realizamos un análisis de agrupación e identificamos cuatro patrones que aparecen de forma consistente en varias evaluaciones de peso acumulativo. Estos patrones influyen significativamente en el rendimiento y pueden ayudar a los educadores a proporcionar mejores comentarios y una atención más personalizada a los estudiantes.ModelamientoCOL0044448MaestríaMagíster en Ingeniería de Telecomunicacione
Strategy for the Management of Uncomplicated Retinal Detachments
No full textObjective: To study success and failure in the treatment of uncomplicated rhegmatogenous retinal detachments (RRDs). Design: Nonrandomized, multicenter retrospective study. Participants: One hundred seventy-six surgeons from 48 countries spanning 5 continents provided information on the primary procedures for 7678 cases of RRDs including 4179 patients with uncomplicated RRDs. Methods: Reported data included specific clinical findings, the method of repair, and the outcome after intervention. Main Outcome Measures: Final failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachment (level 3 failure rate). Results: Four thousand one hundred seventy-nine uncomplicated cases of RRD were included. Combining phakic, pseudophakic, and aphakic groups, those treated with scleral buckle alone (n = 1341) had a significantly lower final failure rate than those treated with vitrectomy, with or without a supplemental buckle (n = 2723; P = 0.04). In phakic patients, final failure rate was lower in the scleral buckle group compared with those who had vitrectomy, with or without a supplemental buckle (P = 0.028). In pseudophakic patients, the failure rate of the initial procedure was lower in the vitrectomy group compared with the scleral buckle group (P = 3×10-8). There was no statistically significant difference in failure rate between segmental (n = 721) and encircling (n = 351) buckles (P = 0.5). Those who underwent vitrectomy with a supplemental scleral buckle (n = 488) had an increased failure rate compared with those who underwent vitrectomy alone (n = 2235; P = 0.048). Pneumatic retinopexy was found to be comparable with scleral buckle when a retinal hole was present (P = 0.65), but not in cases with a flap tear (P = 0.034). Conclusions: In the treatment of uncomplicated phakic retinal detachments, repair using scleral buckle may be a good option. There was no significant difference between segmental versus 360-degree buckle. For pseudophakic uncomplicated retinal detachments, the surgeon should balance the risks and benefits of vitrectomy versus scleral buckle and keep in mind that the single-surgery reattachment rate may be higher with vitrectomy. However, if a vitrectomy is to be performed, these data suggest that a supplemental buckle is not helpful. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2013 American Academy of Ophthalmology
Strategy for the Management of Complex Retinal Detachments
No full textObjective: To study the outcome of the treatment of complex rhegmatogenous retinal detachments (RRDs). Design: Nonrandomized, multicenter, retrospective study. Participants: One hundred seventy-six surgeons from 48 countries spanning 5 continents reported primary procedures for 7678 RRDs. Methods: Reported data included clinical manifestations, the method of repair, and the outcome. Main Outcome Measures: Failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachments (level 3 failure rate). Results: The main categories of complex retinal detachments evaluated in this investigation were: (1) grade B proliferative vitreoretinopathy (PVR; n = 917), (2) grade C-1 PVR (n = 637), (3) choroidal detachment or significant hypotony (n = 578), (4) large or giant retinal tears (n = 1167), and (5) macular holes (n = 153). In grade B PVR, the level 1 failure rate was higher when treated with a scleral buckle alone versus vitrectomy (P = 0.0017). In grade C-1 PVR, there was no statistically significant difference in the level 1 failure rate between those treated with vitrectomy, with or without scleral buckle, and those treated with scleral buckle alone (P = 0.7). Vitrectomy with a supplemental buckle had an increased failure rate compared with those who did not receive a buckle (P = 0.007). There was no statistically significant difference in level 1 failure rate between tamponade with gas versus silicone oil in patients with grade B or C-1 PVR. Cases with choroidal detachment or hypotony treated with vitrectomy had a significantly lower failure rate versus treatment with scleral buckle alone (P = 0.0015). Large or giant retinal tears treated with vitrectomy also had a significantly lower failure rate versus treatment with scleral buckle (P = 7×10-8). Conclusions: In patients with retinal detachment, when choroidal detachment, hypotony, a large tear, or a giant tear is present, vitrectomy is the procedure of choice. In retinal detachments with PVR, tamponade with either gas or silicone oil can be considered. If a vitrectomy is to be performed, these data suggest that a supplemental buckle may not be helpful. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2013 American Academy of Ophthalmology
Clinical and epidemiological issues and applications of mammographic density
No full textThe copyright of this thesis rests with the author and no quotation from it or information derived from it may be published without the prior written consent of the authorMammographic density, the amount of radiodense tissue on a mammogram, is a strong risk factor for breast cancer, with properties that could be an asset in screening and prevention
programmes. Its use in risk prediction contexts is currently limited, however,
mainly due to di culties in measuring and interpreting density.
This research investigates rstly, the properties of density as an independent marker of
breast cancer risk and secondly, how density should be measured.
The rst question was addressed by analysing data from a chemoprevention trial, a trial
of hormonal treatment, and a cohort study of women with a family history of breast
cancer . Tamoxifen-induced density reduction was observed to be a good predictor of
breast cancer risk reduction in high-risk una ected subjects. Density and its changes
did not predict risk or treatment outcome in subjects with a primary invasive breast
tumour. Finally absolute density predicted risk better than percent density and showed
a potential to improve existing risk-prediction models, even in a population at enhanced
familial risk of breast cancer.
The second part of thesis focuses on density measurement and in particular evaluates
two fully-automated volumetric methods, Quantra and Volpara. These two methods
are highly correlated and in both cases absolute density (cm3) discriminated cases from
controls better than percent density. Finally, we evaluated and compared di erent measurement
methods. Our ndings suggested good reliability of the Cumulus and visual
assessments. Quantra volumetric estimates appeared negligibly a ected by measurement
error, but were less variable than visual bi-dimensional ones, a ecting their ability
to discriminate cases from controls. Overall, visual assessments showed the strongest
association with breast cancer risk in comparison to computerised methods.
Our research supports the hypothesis that density should have a role in personalising
screening programs and risk management. Volumetric density measuring methods,
though promising, could be improved.Cancer Research U
