The Role of Biomarkers for Starting Antifungals in the Intensive Care Unit

Invasive candidiasis is associated with high mortality rates (35% to 60%), similar to the range reported for septic shock. The most common types include candidemia, frequently observed in immunocompromised patients, and noncandidemic systemic candidiasis, which constitutes the majority of cases in critically ill patients. However, they are difficult to prove and a definite diagnosis usually occurs late in the course of the disease, thus contributing to their bad prognosis. Early empirical treatment improves the prognosis and currently relies on the positive predictive value (PPV) of risk-assessment strategies (colonization index, Candida score, predictive rules) based on combinations of risk factors, but it may have also largely contributed to the overuse of antifungal agents in critically ill patients. In this context, non- culture-based diagnostic methods, including specific and nonspecific biomarkers, may significantly improve the diagnosis of invasive candidiasis. Candida DNA and mannan antigen/antimannan antibodies are of limited interest for the diagnosis of invasive candidiasis as they fail to identify noncandidemic systemic candidiasis, despite early positivity in candidemic patients. The utility of 1,3-beta-D-glucan (b-D-glucan), a panfungal cell wall antigen, has been demonstrated for the diagnosis of fungal infections in immunocompromised patients. Preliminary data suggest that it is also detectable early in critically ill patients developing noncandidemic systemic candidiasis. To take advantage of the high negative predictive value of risk-assessment strategies and the early increase in specific fungal biomarkers in high-risk patients, we propose a practical 2-step approach to improve the selection of patients susceptible to benefit from empirical antifungal treatment.

Aerosol therapy in intensive and intermediate care units: prospective observation of 2808 critically ill patients.

PURPOSE: Unlike in the outpatient setting, delivery of aerosols to critically ill patients may be considered complex, particularly in ventilated patients, and benefits remain to be proven. Many factors influence aerosol delivery and recommendations exist, but little is known about knowledge translation into clinical practice. METHODS: Two-week cross-sectional study to assess the prevalence of aerosol therapy in 81 intensive and intermediate care units in 22 countries. All aerosols delivered to patients breathing spontaneously, ventilated invasively or noninvasively (NIV) were recorded, and drugs, devices, ventilator settings, circuit set-up, humidification and side effects were noted. RESULTS: A total of 9714 aerosols were administered to 678 of the 2808 admitted patients (24 %, CI95 22-26 %), whereas only 271 patients (10 %) were taking inhaled medication before admission. There were large variations among centers, from 0 to 57 %. Among intubated patients 22 % (n = 262) received aerosols, and 50 % (n = 149) of patients undergoing NIV, predominantly (75 %) inbetween NIV sessions. Bronchodilators (n = 7960) and corticosteroids (n = 1233) were the most frequently delivered drugs (88 % overall), predominantly but not exclusively (49 %) administered to patients with chronic airway disease. An anti-infectious drug was aerosolized 509 times (5 % of all aerosols) for nosocomial infections. Jet-nebulizers were the most frequently used device (56 %), followed by metered dose inhalers (23 %). Only 106 (<1 %) mild side effects were observed, despite frequent suboptimal set-ups such as an external gas supply of jet nebulizers for intubated patients. CONCLUSIONS: Aerosol therapy concerns every fourth critically ill patient and one-fifth of ventilated patients.

CO2 utilization in the perspective of industrial ecology, an overview

Carbon dioxide emissions from anthropic activities have accumulated in the atmosphere in excess of 800 Gigatons since preindustrial times, and are continuously increasing. Among other strategies, CO2 capture and storage is one option to mitigate the emissions from large point sources. In addition, carbon dioxide extraction from ambient air is assessed to reduce the atmospheric concentration of CO2. Both direct and indirect (through photosynthesis) pathways are possible. Geological sequestration has significant disadvantages (high cost, low public acceptance, long term uncertainty) whereas carbon dioxide recycling (or utilization) is more consistent with the basic principle of industrial ecology, almost closing material cycles. In this article, a series of technologies for CO2 capture and valorization is described as integrated and optimized pathways. This integration increases the environmental and economic benefits of each technology. Depending on the source of carbon dioxide, appropriate capture and valorization processes are evaluated based on material and energy constraints.

Health care utilization among immigrants and native-born populations in 11 European countries. Results from the Survey of Health, Ageing and Retirement in Europe

This study examines health care utilization of immigrants relative to the native-born populations aged 50 years and older in eleven European countries. Methods. We analyzed data from the Survey of Health Aging and Retirement in Europe (SHARE) from 2004 for a sample of 27,444 individuals in 11 European countries. Negative Binomial regression was conducted to examine the difference in number of doctor visits, visits to General Practitioners (GPs), and hospital stays between immigrants and the native-born individuals. Results: We find evidence those immigrants above age 50 use health services on average more than the native-born populations with the same characteristics. Our models show immigrants have between 6% and 27% more expected visits to the doctor, GP or hospital stays when compared to native-born populations in a number of European countries. Discussion: Elderly immigrant populations might be using health services more intensively due to cultural reasons.

Optimised Utilization of Bioenergy in Poland

The aim of the study was to ford out the availability of biomasses, which are available for energy production, in Poland. Biomasses which were examined were forest residues and surplus straw. Availability was examined by 16 Polish voivodeships, which are provinces in Poland. After fording out the amounts of biomasses for energy production was examined the need of biomass in the biggest CHP plants in Poland. It was expected that all the plants uses 15 % of biomass as the fuel. In the first parts of the report are explained the legislation which effects to biomass use in energy production in EU level and in Polish level. Also the combustion methods best for biomasses are explained by examples. After this, is studied the general situation of renewable energy use in Poland and the facts about the country. In the last parts it's explained the calculations and is shown the example cases. When it was found out the needs and supply of biomass it was examined by examples how it could be transported to the plants from the producers. Also was examined costs effected, if there were logistical terminals between the producer and the end user. The estimation was done by setting prices for the biomass, and fording out average costs for producing and transporting biomass. There are a lot of surplus biomasses in Poland which could be used for energy production, and this is a one way to reach the goals that EU has set of renewable energies. But because biomasses doesn't have such a good calorific value, it isn't worth able to transport it very long distances. In the research was set the prices for producer 9€/MWh and for end user 15€/MWh, the maximum transportation distance for forest residues was 52 km and for straw 56 km. These are example estimations and it has to be remembered that there are a lot of factors that makes inaccurate. The model is really sensitive and by changing one parameter the results change a lot.

The influence of substratum type and nutrient supply on biofilm organic matter utilization in streams

We investigated the effect of benthic substratum type (sand and rocks) and nutrient supply (N and P) on biofilm structure and heterotrophic metabolism in a field experiment in a forested Mediterranean stream (Fuirosos). Rock and sand colonization and biofilm formation was intensively studied for 44 d at two stream reaches: control and experimental (continuous addition of phosphate, ammonia, and nitrate). Structural (C, N, and polysaccharide content and bacterial and chlorophyll density) and metabolic biofilm parameters (b-glucosidase, peptidase, and phosphatase enzyme activities) were analyzed throughout the colonization process. The epilithic biofilm (grown on rocks) had a higher peptidase activity at the impacted reach, together with a higher algal and bacterial biomass. The positive relationship between the peptidase activity per cell and the N content of the epilithic biofilm suggested that heterotrophic utilization of proteinaceous compounds from within the biofilm was occurring. In contrast, nutrient addition caused the epipsammic biofilm (grown on sand) to exhibit lower b-glucosidase and phosphatase activities, without a significant increase in bacterial and algal biomass. The differential response to nutrient addition was related to different structural characteristics within each biofilm. The epipsammic biofilm had a constant and high C:N ratio (22.7) throughout the colonization. The epilithic biofilm had a higher C:N ratio at the beginning of the colonization (43.2) and evolved toward a more complex structure (high polysaccharide content and low C:N ratio) during later stages. The epipsammic biofilm was a site for the accumulation and degradation of organic matter: polysaccharides and organic phosphorus compounds had higher degradation activities

Fate of peat utilization

Peat is an organic substance with the maintenance of a mineral part, what shows it as interesting object for studying. Both organic and mineral parts of peat find application in various fields of activity of the people. Antibacterial properties of peat are known since an antiquity. Today people have expanded a spectrum of application of peat to use of by-products of its processing for reception of rather ecologically harmless fuel. The master theses are focused on peat, as on ambiguous raw materials for processing and fuel manufacture. The purpose of theses to show how much widely applied peat, technologies on its processing and its influence on environment at all stages of its working out.

Engendering Group Support Based Foresight for Capital Intensive Manufacturing Industries - Case Paper and Steel Industry Scenarios by 2018

In recent times of global turmoil, the need for uncertainty management has become ever momentous. The need for enhanced foresight especially concerns capital-intensive industries, which need to commit their resources and assets with long-term planning horizons. Scenario planning has been acknowledged to have many virtues - and limitations - concerning the mapping of the future and illustrating the alternative development paths. The present study has been initiated to address both the need of improved foresight in two capital-intensive industries, i.e. the paper and steel industries and the imperfections in the current scenario practice. The research problem has been approached by engendering a problem-solving vehicle, which combines, e.g. elements of generic scenario process, face-to-face group support methods, deductive scenario reasoning and causal mapping into a fully integrated scenario process. The process, called the SAGES scenario framework, has been empirically tested by creating alternative futures for two capital-intensive industries, i.e. the paper and steel industries. Three scenarios for each industry have been engendered together with the identification of the key megatrends, the most important foreign investment determinants, key future drivers and leading indicators for the materialisation of the scenarios. The empirical results revealed a two-fold outlook for the paper industry, while the steel industry future was seen as much more positive. The research found support for utilising group support systems in scenario and strategic planning context with some limitations. Key perceived benefits include high time-efficiency, productivity and lower resource-intensiveness. Group support also seems to enhance participant satisfaction, encourage innovative thinking and provide the users with personalised qualitative scenarios.

Utilization of Sn/Nb2O5 composite for the removal of methylene blue

In this work, the oxidation of methylene blue textile dye in the presence of hydrogen peroxide, using niobium oxide impregnated with different proportions of tin (1, 5 and 10% in mass) as catalyst was studied. The materials were characterized by TPR, XPS, XRD and FTIR. The oxidation tests monitored by ESI-MS showed that the composite containing the higher amount of tin was the most efficient in the removal of the dye. The XRD, XPS, and TPR data presented evidence of the formation of the tin-niobium oxide composite containing Sn0 and supported SnO2.

Properties of silica from rice husk and rice husk ash and their utilization for zeolite y synthesis

This study compared properties of silica (SiO2) from rice husk (RH) and rice husk ash (RHA) extracted by acid- and heat-treatment. The SiO2 from RH was in amorphous phase with nearly 100% purity while that from RHA was in crystalline phase with 97.56% purity. Both extracted SiO2 were used in the synthesis of zeolite NaY but that from RH was better due to the efficiency in product recovery and simplicity of extraction. After the NaY was exchanged to NH4Y and calcined to convert to HY, the product did not carry over the textural properties of the parent NaY and NH4Y.

Determining the location for a mobile device by utilization of local resources of the environment

The subject being analyzed of this Master’s Thesis is a development of a service that is used to define a current location of a mobile device. The service utilized data that is obtained from own GPS receiver in some possible cases and as well data from mobile devices which can be afforded for the current environment for acquisition of more precise position of the device. The computation environment is based on context of a mobile device. The service is implemented as an application for communicator series Nokia N8XX. The Master’s Thesis presents theoretical concept of the method and its practical implementation, architecture of the application, requirements and describes a process of its functionality. Also users’ work with application is presented and recommendations for possible future improvements are made.

Utilization of retention chemicals in non-wood containing furnishes

The usage of the non-wood pulps in furnishes for various paper grades is the real alternative for substitution of wood fibres in the papermaking. This is especially important now, when the prices for wood are increasing and forest resources are depleting in many regions of our planet. However, there are several problems associated with utilization of such pulps. In terms of the papermaking process one of the main problems is the poor dewatering of the non-wood pulps. This problem can be partially solved by means of retention aids. In the literature part were described technological features of the non-wood pulps as the raw materials for paper production. Moreover, overviews of the retention chemicals and methods for retention measurement were done; special attention was paid to the mechanisms of retention and drainage. Finally, factors affecting on the drainage and retention of non-wood pulps were considered holistically. Particular emphasis was put on the possibility of enzyme treatment for drainage improvement. It was stated that retention aids can significantly improve dewatering of non-wood pulps. In the experimental part the goal was to investigate influence of various microparticle retention aids on the drainage, retention and formation of furnish containing wheat straw pulp, obtained by novel pulping process (Formico™Fib). The parallel test were performed with reference furnish containing only wood pulps. It was found that Bentonite-CPAM retention aid can significantly improve drainage and retention; however formation seems be suffer from such additives. It was stated that performance of the Silica-Starch retention aid significantly depends on the starch dosing sequence and wet-end conditions; this system have shown better formation than other tested retention aids. Silica-CPAM retention aid have provided comparable results in retention and drainage with Bentonite-CPAM, while Silica-starch did not improve dewatering and yielded in lowest filler retention among other aids. Ultimately, optimal dosages for the tested retention chemicals have been suggested.

Utilization of non-wood pulp in different fibers products

The correct utilization of non-wood raw material allows reducing tree cutting and reduces emissions of carbon dioxide from burning of non-wood plants on farmers fields. Also it allows increasing economical situation in regions that non-wood plants are grown and where they are converted into pulp and paper. Also it gives positive effect on population pressure of work by addition of working place. In the literature survey included an overview of the historical meaning of non-wood pulp on developing paper production and structure of non-wood pulps. Moreover, anatomical and chemical composition of straw, reed and bamboo were studied more detailed. Also, an overview of the utilization of non-wood pulp in papermaking was made. Especially tissue, tree-free and release papers were reviewed. In the experimental part the goal was to investigate suitability of non-wood pulp like wheat straw pulp and bamboo pulp for different fiber products. Finally release and tree-free paper products were selected for experimental studies. It was discovered that wheat straw, especially screened wheat straw, showed good results for release paper. Also utilization of wheat straw and bamboo pulp in tree-free paper showed good results and suitability of these non-wood pulps for tree-free paper production. Also it was noticed that addition of wheat straw pulp gave positive effect on initial wet strength for release and tree-free paper.