Characteristics and management of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in a tertiary hospital.

Background: The emergence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases is rare. We report an occurrence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases in a Chinese tertiary care hospital from November 2010 to December 2012. Methods: The clinical characteristics of 30 patients were described. The genetic relationship of isolates was determined by pulsed-field gel electrophoresis (PFGE). Carbapenemases were detected by modified Hodge test (MHT) and polymerase chain reactions (PCRs). Amplicons were sequenced and blasted to determine the genotype. Results: Most infected patients were from intensive care unit and had complex and serious underlying illnesses requiring mechanical ventilation. PFGE revealed that Klebsiella pneumoniae showed two major PFGE types. Two Klebsiella oxytoca had an indistinguishable PFGE pattern, while four Enterobacter cloacae were different strains. The sequencing studies showed Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in the 23 infected patients. The majority of patients had infections with the carbapenemase-producing Enterobacteriaceae (CPE) strain, most were successfully treated with a range of antibiotics and discharged. Conclusion: It is important to maintain a high index of suspicion to screen for carbapenemase-producing Enterobacteriaceae strains. Rapid identification of these strains and implementation of stringent procedures are the key to prevent major outbreaks in a hospital setting. Keywords:

Knowledge and use of asthma control measurement tools in the management of asthma: a survey of doctors working in family and internal medicine practice in Nigeria.

Objective: To investigate the knowledge and use of asthma control measurement (ACM) tools in the management of asthma among doctors working in family and internal medicine practice in Nigeria. Method: A questionnaire based on the global initiative on asthma (GINA) guideline was self-administered by 194 doctors. It contains 12 test items on knowledge of ACM tools and its application. The knowledge score was obtained by adding the correct answers and classified as good if the score ≥ 9, satisfactory if score was 6-8 and poor if < 6. Results: The overall doctors knowledge score of ACM tools was 4.49±2.14 (maximum of 12). Pulmonologists recorded the highest knowledge score of 10.75±1.85. The majority (69.6%) had poor knowledge score of ACM tools. Fifty (25.8%) assessed their patients’ level of asthma control and 34(17.5%) at every visit. Thirty-nine (20.1%) used ACM tools in their consultation, 29 (15.0%) of them used GINA defined control while 10 (5.2 %) used asthma control test (ACT). The use of the tools was associated with pulmonologists, having attended CME within six months and graduated within five years prior to the survey. Conclusion: The results highlight the poor knowledge and use of ACM tools and the need to address the knowledge gap.

Addressing wildfire risk in forest management with a wildfire resistance indicator

Mestrado Mediterranean Forestry and Natural Resources Management - Instituto Superior de Agronomia - UL

Experience of a Single Center in NTBC Use in Management of Hereditary Tyrosinemia Type I in Libya

Background: Hereditary Tyrosinemia type I (HTI) is a metabolic disease caused by deficiency of fumarylacetoacetate hydrolase enzyme. Objectives: This study reports beside its clinical and biochemical presentation, the outcome of NTBC [2- (2-nitro-4-trifloro-methylbenzoyl)-1, 3-cyclohexanedion] treatment of the disease and evaluates its biochemical markers in 16 pediatric Libyan patients. Patients and Methods: The diagnosis was based on presence of high tyrosine levels in blood and succinylacetone in urine. Results: The consanguinity rate was 81.2%, the median age at onset, at diagnosis and at starting treatment were 4.5, 8, and 9.5 months respectively. At presentation hepatomegaly, jaundice, rickets and high gamma glutamyl transferase (GGT) were observed in 87.5% of patients. All patients had extremely high alpha fetoprotein (AFP) and high alkaline phosphatase (ALP) levels. Fifteen patients were treated with NTBC, normalization of PT (Prothrombine time) was achieved in average in 14 days. The other biochemical parameters of liver function (transaminases, GGT, ALP, bilirubin and albumin) took longer to improve and several months to be normalized. Survival rate with NTBC was 86.6%. Patients who started treatment in a median of 3 months post onset observed a fast drop of AFP in 90.6% of patients (P = 0.003). Abnormal liver function and rickets were the common presentations, GGT was an early cholestatic sensitive test. ALP was constantly high even in asymptomatic patients. Conclusions: In HT1 a faster dropping of AFP is a marker of good prognosis.

In situ epicatechin-loaded hydrogel implants for local drug delivery to spinal column for effective management of post-traumatic spinal injuries

Purpose: To prepare hydrogels loaded with epicatechin, a strong antioxidant, anti-inflammatory, and neuroprotective tea flavonoid, and characterise them in situ as a vehicle for prolonged and safer drug delivery in patients with post-traumatic spinal cord injury. Methods: Five in situ gel formulations were prepared using chitosan and evaluated in terms of their visual appearance, clarity, pH, viscosity, and in vitro drug release. In vivo anti-inflammatory activity was determined and compared with 2 % piroxicam gel as standard. Motor function activity in a rat model of spinal injury was examined comparatively with i.v. methylprednisolone as standard. Results: The N-methyl pyrrolidone solution (containing 1 % w/w epicatechin with 2 to 10 % w/w chitosan) of the in situ gel formulation had a uniform pH in the range of 4.01 ± 0.12 to 4.27 ± 0.02. High and uniform drug loading, ranging from 94.48 ± 1.28 to 98.08 ± 1.24 %, and good in vitro drug release (79.48 ± 2.84 to 96.48 ± 1.02 % after 7 days) were achieved. The in situ gel prepared from 1 % epicatechin and 2 % chitosan (E5) showed the greatest in vivo anti-inflammatory activity (60.58 % inhibition of paw oedema in standard carrageenan-induced hind rat paw oedema model, compared with 48.08 % for the standard). The gels showed significant therapeutic effectiveness against post-traumainduced spinal injury in rats. E5 elicited maximum motor activity (horizontal bar test) in the spinal injury rat model; the rats that received E5 treatment produced an activity score of 3.62 ± 0.02 at the end of 7 days, compared with 5.0 ± 0.20 following treatment with the standard. Conclusion: In situ epicatechin-loaded gel exhibits significant neuroprotective and anti-inflammatory effects, and therefore can potentially be used for prolonged and safe drug delivery in patients with traumatic spinal cord injury.

Gender and size diversity in top management team: evidence from Portugal

In recent years the Top Management Team (TMT) in the companies has been extensively studied and discussed by many researchers (Campbell & Mínguez-Vera, 2008; Erhardt et al, 2003; Haleblian & Finkelstein, 1993; Amason & Spienza, 1997). Thus, this theme has undergone a major evolution as well as it has been diversified progressively. Combined with the Upper Echelons Theory, it was established a new dimension of diversity of the Top Management Team that addresses, for example, the diversity of gender and the size of the team. There are several countries that have established laws and regulatory requirements in order to increase the presence of women in the business environment such as Norway, Spain, France, Holland and Italy. However, the female gender is far from equal in terms of representativeness (Torchia et al., 2011), but there are noteworthy developments yearly. It is also noticeable that the size of Top Management Teams has also increased, which can provide advantages for the company (Heleblian & Finkelstein, 1993). In the course of this dissertation it was studied the female gender ratio and the size of the Top Management Team with the profitability (ROA – Return On Assets) of 41 Portuguese companies listed on the Euronext Lisbon between 2011 - 2015. Initially, the Spearman test was applied in order to verify the correlations between the variables in study. It was created a linear regression that relates the number of women (independent variable) and ROA (dependent variable). The Mann-Whitney test was used to verify the ROA behaviour between companies with no women in TMT and companies with women in TMT. After analysis, the results demonstrated that there was a positive relationship between the number of women with ROA. Also companies that have women in TMT have better performance compared to companies with no women in the Top Management Team. As far as the size of the team is concerned, it positively influences the economic profitability, in a meaningful way.

Assessment of the spatial variability in Tall wheatgrass forage using LANDSAT 8 satellite imagery to delineate potential management zones

Little information is available on the degree of within-field variability of potential production of Tall wheatgrass (Thinopyrum ponticum) forage under unirrigated conditions. The aim of this study was to characterize the spatial variability of the accumulated biomass (AB) without nutritional limitations through vegetation indexes, and then use this information to determine potential management zones. A 27-×-27-m grid cell size was chosen and 84 biomass sampling areas (BSA), each 2 m(2) in size, were georeferenced. Nitrogen and phosphorus fertilizers were applied after an initial cut at 3 cm height. At 500 °C day, the AB from each sampling area, was collected and evaluated. The spatial variability of AB was estimated more accurately using the Normalized Difference Vegetation Index (NDVI), calculated from LANDSAT 8 images obtained on 24 November 2014 (NDVInov) and 10 December 2014 (NDVIdec) because the potential AB was highly associated with NDVInov and NDVIdec (r (2) = 0.85 and 0.83, respectively). These models between the potential AB data and NDVI were evaluated by root mean squared error (RMSE) and relative root mean squared error (RRMSE). This last coefficient was 12 and 15 % for NDVInov and NDVIdec, respectively. Potential AB and NDVI spatial correlation were quantified with semivariograms. The spatial dependence of AB was low. Six classes of NDVI were analyzed for comparison, and two management zones (MZ) were established with them. In order to evaluate if the NDVI method allows us to delimit MZ with different attainable yields, the AB estimated for these MZ were compared through an ANOVA test. The potential AB had significant differences among MZ. Based on these findings, it can be concluded that NDVI obtained from LANDSAT 8 images can be reliably used for creating MZ in soils under permanent pastures dominated by Tall wheatgrass.

Impacts of crop level, soil and irrigation management in grape berries of cv ‘Trincadeira’ (Vitis vinifera L.)

Berry size and crop yield are widely recognized as important factors that contribute to wine quality. The final berry size indirectly affects the phenolic concentration of the wine due to skin surface-to-berry volume ratio. The effects of different irrigation levels, soil management and plant crop level on growth of ‘Trincadeira’ berries were studied. In order to test the influence of different irrigation levels (rainfed, pre-veraison and post-veraison), different soil management (tillage and natural cover crops) and different plant crop levels (8 and 16 clusters per vine), leaf water potential, skin anthocyanin, polyphenols, berry skin and seed fresh weight were measured in fruits. The segregation of berries into three different berry classes: small, medium and large, allowed to identify different levels of contribution of soil management and irrigation level into berry, skin and seeds ratios. As expected, higher water availability due to irrigation and soil tillage management during berry development induced an increase in berry flesh weight and this was more evident in larger berries; however, berry skin and seed fresh weight remained unchanged. Also, anthocyanins did not show significant differences.

Soil management systems for sustainable melon cropping in the Submedian of the São Francisco Valley.

Changes in soils management systems, including the application of green manure, are able to increase crop productivity. The aim of this study was to propose a soil management system with the use of green manure to improve the nutritional status and melon productivity in the submedian of the São Francisco Valley. The experiment was installed in Typic Plinthustalf and conducted in split plot. There were two soil tillage systems, tillage (T) and no tillage (NT), and three types of green manure (two vegetal cocktails: VC1- 75% legumes (L) + 25% non-legumes (NL); VC2- 25% L+ 75% NL and spontaneous vegetation (SV)). The experimental design was a randomised block with four replications. Fourteen species of legumes, grasses and oilseeds were used for the composition of the plant cocktails. We evaluated production of the dry shoot and root biomass and carbon and nutrient accumulation by green manures and melon plant. Data were subjected to analysis of variance and the treatment means were compared by Tukey´s test (P<0.05). Shoot biomass production and carbon and nutrient accumulation were higher in plant mixtures compared to spontaneous vegetation. The root system of the plant cocktails added larger quantities of biomass and nutrients to the soil to a depth of 0.60 m when compared to the spontaneous vegetation. The cultivation of plant cocktails with soil tillage, regardless of their composition, is a viable alternative for adding biomass and nutrients to the soil in melon crops in semi-arid conditions, providing productivity increases.

Practical Management of the Endangered African Wild Dog (Lycaon Pictus): Implementation of Research Methodologies, Management Tools and Validation of Non-Invasive Endocrinology Applications

The porpoise of this study was to implement research methodologies and assess the effectiveness and impact of management tools to promote best practices for the long term conservation of the endangered African wild dog (Lycaon pictus). Different methods were included in the project framework to investigate and expand the applicability of these methodologies to free-ranging African wild dogs in the southern African region: ethology, behavioural endocrinology and ecology field methodologies were tested and implemented. Additionally, research was performed to test the effectiveness and implication of a contraceptive implant (Suprenolin) as a management tool for the species of a subpopulation hosted in fenced areas. Attention was especially given to social structure and survival of treated packs. This research provides useful tools and advances the applicability of these methods for field studies, standardizing and improving research instruments in the field of conservation biology and behavioural endocrinology. Results reported here provide effective methodologies to expand the applicability of non-invasive endocrine assessment to previously prohibited fields, and validation of sampling methods for faecal hormone analysis. The final aim was to fill a knowledge gap on behaviours of the species and provide a common ground for future researchers to apply non-invasive methods to this species research and to test the effectiveness of the contraception on a managed metapopulation.

Agroecological management of insect pests on sugarbeets and lettuce cultivated in organic farming

Two-year field trials were conducted in northern Italy with the aim of developing a trapcrop-based agroecological approach for the control of flea beetles (Chaetocnema tibialis (Illiger), Phyllotreta spp. (Chevrolat) (Coleoptera: Chrysomelidae)) and Lygus rugulipennis Poppius (Hemiptera: Miridae), key pests of sugar beet and lettuce, respectively. Flea beetle damage trials compared a trap cropping treatment, i.e., a sugar beet plot with a border of Sinapis alba (L.) and Brassica juncea (L.) with a control treatment, i.e., a sugar beet plot with bare soil as field border. Sugar beets grown near trap crops showed a significant decrease (≈40%) in flea beetle damage compared to control. Moreover, flea beetle damage varied with distance from the edge of the trap plants, being highest at 2 m from the edge, then decreasing at higher distances. Regarding L. rugulipennis on lettuce two experiments were conducted. A semiochemical-assisted trap cropping trial was supported by another test evaluating the efficacy of pheromones and trap placement. In this trial, it was found that pheromone baited traps caught significantly more specimens of L. rugulipennis than unbaited traps. It was also found that traps placed at ground level produced larger catches than traps placed at the height of 70 cm. In the semiochemical-assisted trap cropping experiment, a treatment where lettuce was grown next to two Alfa-Alfa borders containing pheromone baited traps was compared with a control treatment, where lettuce was grown near bare soil. This experiment showed that the above-mentioned strategy managed to reduce L. rugulipennis damage to lettuce by ≈30%. From these studies, it appears that trap crop-based strategy, alone or with baited traps, made it possible to reduce crop damage to economically acceptable levels and to minimize the need for insecticide treatments, showing that those strategy could be implemented in organic farming as a means of controlling insect pests.

Intelligenza artificiale e test di Turing

Obiettivo di questo lavoro di tesi consiste nell’analizzare la domanda che il matematico e logico inglese Alan Turing propose di considerare: “Can machines think?”. Il quesito, esaminato attraverso la formulazione del gioco dell’imitazione e ormai ricordato come Test di Turing, è talmente interessante da essere divenuto uno degli argomenti più discussi nell’ambito delle scienze cognitive, della filosofia della mente e dell’informatica. In particolare è stata fondata una disciplina, chiamata intelligenza artificiale o IA, che intende studiare e comprendere se e come un sistema informatico possa essere capace di simulare una mente umana e un suo tipico comportamento. Questa tesi presenta una disamina sull’intelligenza artificiale e sul Test di Turing. Dell’IA si prenderanno in esame alcune definizioni formali della disciplina, le teorie di intelligenza artificiale debole e forte, e in particolare l’esperimento mentale della Stanza Cinese, il machine learning, il deep learning e le reti neurali, alcuni loro esempi di implementazione in diversi ambiti e infine alcune questioni etiche relative all’IA. Successivamente verranno esaminati la descrizione del gioco dell’imitazione, le più importanti critiche ed obiezioni al test di Turing, una variante del test, chiamata Test di Turing Totale, il premio Loebner, le previsioni fatte dal matematico e alcuni tentativi di superamento del test, tra cui l’implementazione dei chatterbot ELIZA, ALICE ed Eugene Goostman. Saranno infine proposte delle conclusioni in merito al lavoro svolto.

Semplificare i test per la misurazione dell’usabilità dei siti web: test “light” e questionari brevi

Oggi tutti sappiamo cosa sia un sito web e, senza nemmeno accorgercene, navighiamo su decine di pagine online quotidianamente. Per farsi conoscere come brand, avere un sito web al giorno d'oggi è di fondamentale importanza. Ormai, però, non è più sufficiente solo essere presenti su Internet, ma è necessario che si approfondiscano certi aspetti che riguardano l'usabilità del sito, come il rapido apprendimento di esso, il raggiungimento di un obiettivo senza sforzi eccessivi e tutto ciò che riguarda la sua facilità di utilizzo. Per fare ciò, è necessario avvalersi di uno strumento che è molto efficace e che permette di concretizzare queste peculiarità: i test di usabilità. Il presente elaborato, infatti, ha lo scopo di analizzare la definizione di usabilità, comprendere i test di usabilità, concentrarsi maggiormente sui test “light” analizzati e esaminare diverse tipologie di test allestiti sotto forma di questionari. In particolare, verranno esaminati il SUS, l'UMUX, l'UMUX-Lite e diversi tipi di questionari con pochissime domande. Lungo il corso di questa tesi, quindi, verrà affrontata l’evoluzione dei test di usabilità: si partirà da quello generale avente dimensioni maggiori e si progredirà sempre più verso la riduzione del volume del test, arrivando fino ai questionari composti da poche e brevi domande o, addirittura, composti da un unico e semplice quesito.

Adapting The Sniffin' Sticks Olfactory Test To Diagnose Parkinson's Disease In Estonia.

The aim of the study was to develop a culturally adapted translation of the 12-item smell identification test from Sniffin' Sticks (SS-12) for the Estonian population in order to help diagnose Parkinson's disease (PD). A standard translation of the SS-12 was created and 150 healthy Estonians were questioned about the smells used as response options in the test. Unfamiliar smells were replaced by culturally familiar options. The adapted SS-12 was applied to 70 controls in all age groups, and thereafter to 50 PD patients and 50 age- and sex-matched controls. 14 response options from 48 used in the SS-12 were replaced with familiar smells in an adapted version, in which the mean rate of correct response was 87% (range 73-99) compared to 83% with the literal translation (range 50-98). In PD patients, the average adapted SS-12 score (5.4/12) was significantly lower than in controls (average score 8.9/12), p < 0.0001. A multiple linear regression using the score in the SS-12 as the outcome measure showed that diagnosis and age independently influenced the result of the SS-12. A logistic regression using the SS-12 and age as covariates showed that the SS-12 (but not age) correctly classified 79.0% of subjects into the PD and control category, using a cut-off of <7 gave a sensitivity of 76% and specificity of 86% for the diagnosis of PD. The developed SS-12 cultural adaption is appropriate for testing olfaction in Estonia for the purpose of PD diagnosis.

Effects Of Therapeutic Approach On The Neonatal Evolution Of Very Low Birth Weight Infants With Patent Ductus Arteriosus.

To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD. This was a multicentric, cohort study, retrospective data collection, including newborns (BW < 1000 g) with gestational age (GA) < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 - conservative approach (without treatment), G2 - pharmacologic (indomethacin or ibuprofen), G3 - surgical ligation (independent of previous treatment). Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II), respiratory distress syndrome (RDS), late sepsis (LS), mechanical ventilation (MV), surfactant (< 2 h of life), and time of MV. death, O2 dependence at 36 weeks (BPD36wks), IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Student's t-test, chi-squared test, or Fisher's exact test; Odds ratio (95% CI); logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator) software, version 12.1.4.0. p-values < 0.05 were considered statistically significant. 1,097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%), G2 - 205 (41.5%), and G3 - 102 (20.6%). The highest mortality was observed in G1 (51.3%) and the lowest in G3 (14.7%). The highest frequencies of BPD36wks (70.6%) and ROPsur were observed in G3 (23.5%). The lowest occurrence of death/BPD36wks occurred in G2 (58.0%). Pharmacological (OR 0.29; 95% CI: 0.14-0.62) and conservative (OR 0.34; 95% CI: 0.14-0.79) treatments were protective for the outcome death/BPD36wks. The conservative approach of PDA was associated to high mortality, the surgical approach to the occurrence of BPD36wks and ROPsur, and the pharmacological treatment was protective for the outcome death/BPD36wks.