No Specific Time Window Distinguishes between Community-, Healthcare-, and Hospital-Acquired Bacteremia, but They Are Prognostically Robust

2014 ◽  
Vol 35 (12) ◽  
pp. 1474-1482 ◽  
Author(s):  
Kim Oren Gradel ◽  
Stig Lønberg Nielsen ◽  
Court Pedersen ◽  
Jenny Dahl Knudsen ◽  
Christian Østergaard ◽  
...  
Keyword(s):  
Roc Curve ◽  
Operating Characteristic ◽  
Time Window ◽  
Time Windows ◽  
Population Based ◽  
Prognostic Models ◽  
Specific Time ◽  
Sharp Transition ◽  
Community Healthcare ◽  
Hospital Acquired

Objective.We examined whether specific time windows after hospital admission reflected a sharp transition between community and hospital acquisition of bacteremia. We further examined whether different time windows to distinguish between community acquisition, healthcare association (HCA), and hospital acquisition influenced the results of prognostic models.Design.Population-based cohort study.Setting.Hospitals in 3 areas of Denmark (2.3 million inhabitants) during 2000–2011.Methods.We computed graphs depicting proportions of males, absence of comorbidity, microorganisms, and 30-day mortality pertaining to bacteremia 0, 1, 2, …, 30, and 31 days and later after admission. Next, we assessed whether different admission (0–1, 0–2, 0–3, 0–7 days) and HCA (30, 90 days) time windows were associated with changes in odds ratio (OR) and area under the receiver operating characteristic (ROC) curve for 30-day mortality, adjusting for sex, age, comorbidity, and microorganisms.Results.For 56,606 bacteremic episodes, no sharp transitions were detected on a specific day after admission. Among the 8 combined time windows, ORs for 30-day mortality varied from 1.30 (95% confidence interval [CI], 1.23–1.37) to 1.99 (95% CI, 1.48–2.67) for HCA and from 1.36 (95% CI, 1.24–1.50) to 2.53 (95% CI, 2.01–3.20) for hospital acquisition compared with community acquisition. Area under the ROC curve changed marginally from 0.684 (95% CI, 0.679–0.689) to 0.700 (95% CI, 0.695–0.705).Conclusions.No time transitions unanimously distinguished between community and hospital acquisition with regard to sex, comorbidity, or microorganisms, and no difference in 30-day mortality was seen for HCA patients in relation to a 30- or 90-day time window. ORs decreased consistently in the order of hospital acquisition, HCA, and community acquisition, regardless of time window combination, and differences in area under the ROC curve were immaterial.

scholarly journals Lipid accumulation product is a reliable indicator for identifying metabolic syndrome: the China Multi-Ethnic Cohort (CMEC) Study

QJM ◽  
2020 ◽  
Author(s):  
X Zhang ◽  
F Hong ◽  
L Liu ◽  
F Nie ◽  
L Du ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Roc Curve ◽  
Lipid Accumulation ◽  
Operating Characteristic ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sensitivity Analyses ◽  
Lipid Accumulation Product ◽  
Cross Sectional ◽  
Obesity Indices

Abstract Background Previous studies have shown that lipid accumulation product (LAP) was associated with the risk of cardiometabolic disease. It is not clear whether LAP could be used as a marker to identify metabolic syndrome (MetS) among Chinese ethnic groups. Aim: To assess the reliability of LAP as a maker to identify MetS among Dong adults. Design: Population-based cross-sectional study. Method We included 6494 Dong individuals (1403 patients) aged 30–79 years from southwest China. MetS was established by Chinese Diabetes Society. Logistic regression model was utilized to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic (ROC) curve was utilized to calculate area under the ROC curve (AUC) and 95% CIs to obtain the identification ability for MetS. Results The risk of MetS was increased with per 5 units increase of LAP (OR 1.37 [95% CI, 1.34–1.39]). Similar results were found in subgroup analyses and sensitivity analyses. Clustered metabolic risk associated with per 5 units increase of LAP was observed for people with 1 (OR 1.59 [95% CI, 1.53–1.65]), 2 (2.15 [2.06–2.24]), 3 (2.59 [2.48–2.71]), 4 (2.81 [2.69–2.95]) and 5 (3.03 [2.87–3.21]) MetS components. LAP presented higher AUC (0.915 [95% CI, 0.907–0.923]) than other included obesity indices (P < 0.05). Conclusion These data support evidence that LAP was related to the risk of MetS, had a high AUC and could be a reliable index for identifying MetS patients among Dong adults in Chinese.

scholarly journals Serotonin Signals Modulate Mushroom Body Output Neurons for Sustaining Water-Reward Long-Term Memory in Drosophila

2021 ◽  
Vol 9 ◽  
Author(s):  
Wang-Pao Lee ◽  
Meng-Hsuan Chiang ◽  
Li-Yun Chang ◽  
Wei-Huan Shyu ◽  
Tai-Hsiang Chiu ◽  
...  
Keyword(s):  
Mushroom Body ◽  
Molecular Mechanisms ◽  
Time Window ◽  
Time Windows ◽  
Long Term Memory ◽  
Specific Time ◽  
Water Reward ◽  
Term Memory ◽  
Output Neurons

Memory consolidation is a time-dependent process through which an unstable learned experience is transformed into a stable long-term memory; however, the circuit and molecular mechanisms underlying this process are poorly understood. The Drosophila mushroom body (MB) is a huge brain neuropil that plays a crucial role in olfactory memory. The MB neurons can be generally classified into three subsets: γ, αβ, and α′β′. Here, we report that water-reward long-term memory (wLTM) consolidation requires activity from α′β′-related mushroom body output neurons (MBONs) in a specific time window. wLTM consolidation requires neurotransmission in MBON-γ3β′1 during the 0–2 h period after training, and neurotransmission in MBON-α′2 is required during the 2–4 h period after training. Moreover, neurotransmission in MBON-α′1α′3 is required during the 0–4 h period after training. Intriguingly, blocking neurotransmission during consolidation or inhibiting serotonin biosynthesis in serotoninergic dorsal paired medial (DPM) neurons also disrupted the wLTM, suggesting that wLTM consolidation requires serotonin signals from DPM neurons. The GFP Reconstitution Across Synaptic Partners (GRASP) data showed the connectivity between DPM neurons and MBON-γ3β′1, MBON-α′2, and MBON-α′1α′3, and RNAi-mediated silencing of serotonin receptors in MBON-γ3β′1, MBON-α′2, or MBON-α′1α′3 disrupted wLTM. Taken together, our results suggest that serotonin released from DPM neurons modulates neuronal activity in MBON-γ3β′1, MBON-α′2, and MBON-α′1α′3 at specific time windows, which is critical for the consolidation of wLTM in Drosophila.

The effect of the crust on the estimation of mantle Q from spectral ratios of multiple ScS phases

1997 ◽  
Vol 87 (3) ◽  
pp. 778-781
Author(s):  
Takehi Isse ◽  
Ichiro Nakanishi
Keyword(s):  
Background Noise ◽  
Numerical Experiments ◽  
Time Window ◽  
Time Windows ◽  
Specific Time ◽  
Spectral Ratios ◽  
Arrival Times ◽  
Numerical Tests ◽  
Error Bars ◽  
The Difference

Abstract To estimate Qscs, previous studies used the spectral ratios of multiple ScS phases calculated for specific time windows. They assumed that the spectral ratios had linear relation with frequency. However, the spectral ratios very often did not seem to be linear, and the error bars were very large for frequencies higher than about 0.05 Hz. We have performed numerical experiments to search for the cause of these anomalies and found that they are caused by the multiple reflection in the crust under the surface bounce point of ScS2. A method of suppressing the anomalies is to start the time of the time window at 40 sec prior to the theoretical arrival times of the multiple ScS phases. In numerical tests, the difference between the correct and estimated values of Qscs is only 0 to 5% using this method, but it is 10 to 50% in the conventional method. We find that the crustal effect is more important in the estimation of Qscs than background noise, which has been readily handled in previous studies using standard stacking techniques.

scholarly journals A hybrid ant colony algorithm based on multiple strategies for the vehicle routing problem with time windows

2021 ◽  
Author(s):  
Hongguang Wu ◽  
Yuelin Gao ◽  
Wanting Wang ◽  
Ziyu Zhang
Keyword(s):  
Vehicle Routing ◽  
Vehicle Routing Problem ◽  
Ant Colony Algorithm ◽  
Time Window ◽  
Time Windows ◽  
Ant Colony ◽  
Routing Problem ◽  
Multiple Strategies ◽  
Hard Time ◽  
Mutation Operation

AbstractIn this paper, we propose a vehicle routing problem with time windows (TWVRP). In this problem, we consider a hard time constraint that the fleet can only serve customers within a specific time window. To solve this problem, a hybrid ant colony (HACO) algorithm is proposed based on ant colony algorithm and mutation operation. The HACO algorithm proposed has three innovations: the first is to update pheromones with a new method; the second is the introduction of adaptive parameters; and the third is to add the mutation operation. A famous Solomon instance is used to evaluate the performance of the proposed algorithm. Experimental results show that HACO algorithm is effective against solving the problem of vehicle routing with time windows. Besides, the proposed algorithm also has practical implications for vehicle routing problem and the results show that it is applicable and effective in practical problems.

scholarly journals The last-mile vehicle routing problem with delivery options

OR Spectrum ◽  
2021 ◽  
Author(s):  
Christian Tilk ◽  
Katharina Olkis ◽  
Stefan Irnich
Keyword(s):  
Vehicle Routing ◽  
Vehicle Routing Problem ◽  
Resource Constraints ◽  
Time Window ◽  
Time Windows ◽  
Service Level ◽  
Optimal Solutions ◽  
Routing Problem ◽  
Common Location ◽  
Delivery Options

AbstractThe ongoing rise in e-commerce comes along with an increasing number of first-time delivery failures due to the absence of the customer at the delivery location. Failed deliveries result in rework which in turn has a large impact on the carriers’ delivery cost. In the classical vehicle routing problem (VRP) with time windows, each customer request has only one location and one time window describing where and when shipments need to be delivered. In contrast, we introduce and analyze the vehicle routing problem with delivery options (VRPDO), in which some requests can be shipped to alternative locations with possibly different time windows. Furthermore, customers may prefer some delivery options. The carrier must then select, for each request, one delivery option such that the carriers’ overall cost is minimized and a given service level regarding customer preferences is achieved. Moreover, when delivery options share a common location, e.g., a locker, capacities must be respected when assigning shipments. To solve the VRPDO exactly, we present a new branch-price-and-cut algorithm. The associated pricing subproblem is a shortest-path problem with resource constraints that we solve with a bidirectional labeling algorithm on an auxiliary network. We focus on the comparison of two alternative modeling approaches for the auxiliary network and present optimal solutions for instances with up to 100 delivery options. Moreover, we provide 17 new optimal solutions for the benchmark set for the VRP with roaming delivery locations.

scholarly journals Statistical Assessment of Discrimination Capabilities of a Fractional Calculus Based Image Watermarking System for Gaussian Watermarks

Entropy ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 255
Author(s):  
Mario Gonzalez-Lee ◽  
Hector Vazquez-Leal ◽  
Luis J. Morales-Mendoza ◽  
Mariko Nakano-Miyatake ◽  
Hector Perez-Meana ◽  
...  
Keyword(s):  
Fractional Calculus ◽  
Roc Curve ◽  
Gaussian Noise ◽  
False Positive ◽  
Operating Characteristic ◽  
Image Watermarking ◽  
Area Under The Curve ◽  
Statistical Assessment ◽  
Watermarking Scheme ◽  
Fractional Equation

In this paper, we explore the advantages of a fractional calculus based watermarking system for detecting Gaussian watermarks. To reach this goal, we selected a typical watermarking scheme and replaced the detection equation set by another set of equations derived from fractional calculus principles; then, we carried out a statistical assessment of the performance of both schemes by analyzing the Receiver Operating Characteristic (ROC) curve and the False Positive Percentage (FPP) when they are used to detect Gaussian watermarks. The results show that the ROC of a fractional equation based scheme has 48.3% more Area Under the Curve (AUC) and a False Positives Percentage median of 0.2% whilst the selected typical watermarking scheme has 3%. In addition, the experimental results suggest that the target applications of fractional schemes for detecting Gaussian watermarks are as a semi-fragile image watermarking systems robust to Gaussian noise.

scholarly journals Presepsin values and prognostic nutritional index predict mortality in intensive care unit patients with sepsis: a pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami
Keyword(s):  
Multivariate Analysis ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Prognostic Nutritional Index ◽  
Early Mortality ◽  
Curve Analysis ◽  
Rank Test ◽  
Roc Curve Analysis ◽  
Log Rank Test ◽  
Nutritional Index

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).

scholarly journals Impact of COVID-19 pandemic on HIV viremia: a single-center cohort study in northern Italy

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ilaria Izzo ◽  
Canio Carriero ◽  
Giulia Gardini ◽  
Benedetta Fumarola ◽  
Erika Chiari ◽  
...  
Keyword(s):  
Time Window ◽  
Time Windows ◽  
Continuum Of Care ◽  
Northern Italy ◽  
Hiv Diagnosis ◽  
Hiv Patients ◽  
Before And After ◽  
Missed Visits ◽  
Hiv Continuum Of Care ◽  
The Impact

Abstract Background Brescia Province, northern Italy, was one of the worst epicenters of the COVID-19 pandemic. The division of infectious diseases of ASST (Azienda Socio Sanitaria Territoriale) Spedali Civili Hospital of Brescia had to face a great number of inpatients with severe COVID-19 infection and to ensure the continuum of care for almost 4000 outpatients with HIV infection actively followed by us. In a recent manuscript we described the impact of the pandemic on continuum of care in our HIV cohort expressed as number of missed visits, number of new HIV diagnosis, drop in ART (antiretroviral therapy) dispensation and number of hospitalized HIV patients due to SARS-CoV-2 infection. In this short communication, we completed the previous article with data of HIV plasmatic viremia of the same cohort before and during pandemic. Methods We considered all HIV-patients in stable ART for at least 6 months and with at least 1 available HIV viremia in the time window March 01–November 30, 2019, and another group of HIV patients with the same two requisites but in different time windows of the COVID-19 period (March 01–May 31, 2020, and June 01–November 30, 2020). For patients with positive viremia (PV) during COVID-19 period, we reported also the values of viral load (VL) just before and after PV. Results: the percentage of patients with PV during COVID-19 period was lower than the previous year (2.8% vs 7%). Only 1% of our outpatients surely suffered from pandemic in term of loss of previous viral suppression. Conclusions Our efforts to limit the impact of pandemic on our HIV outpatients were effective to ensure HIV continuum of care.

Wideband Absorbance in Ears with Retraction Pockets and Cholesteatomas: A Preliminary Study

2021 ◽  
Author(s):  
Sreedevi Aithal ◽  
Venkatesh Aithal ◽  
Joseph Kei ◽  
Shane Anderson
Keyword(s):  
Prospective Study ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Peak Pressure ◽  
Clinical Sample ◽  
Ambient Pressure ◽  
Control Group ◽  
Retraction Pockets ◽  
Preliminary Study ◽  
The Difference

Abstract Objectives The objective of this study was to describe wideband absorbance (WBA) findings in patients with cholesteatomas and retraction pockets (RPs). Design In this prospective study, tympanometry, audiometry, and wideband tympanometry (WBT) were performed on 27 ears with an RP (eight with epitympanic RP and 19 ears with mesotympanic RP), 39 ears with a cholesteatoma (23 ears with epitympanic and 16 ears with mesotympanic cholesteatomas [MCs]), and 49 healthy ears serving as controls. Results Mean WBA at ambient pressure (WBAamb) of both experimental groups was reduced significantly between 0.8 and 5 kHz relative to the control group. The difference between mean WBAamb and mean WBA at tympanometric peak pressure (WBATPP) was greater for the RP (0.12–0.16 between 0.5 and 1.5 kHz) than for the cholesteatoma group (0.03–0.11 between 0.6 and 3 kHz). Mean WBAamb of both epitympanic RP (ERP) and epitympanic cholesteatoma (EC) subgroups was significantly lower than that of the control group. Mean WBATPP of the ERP subgroup attained normal levels as per the control group, while mean WBATPP of EC subgroup was significantly lower than that of the control group at 0.8 to 1.5 kHz and 4 to 5 kHz. In contrast, both mesotympanic RP and MC subgroups demonstrated similar mean WBAamb and WBATPP values. No significant differences in WBAamb and WBATPP results between the RP and cholesteatomas groups were observed. Receiver operating characteristic (ROC) analyses indicated that the area under the ROC curve for distinguishing between the RP and cholesteatomas groups ranged from 0.44 to 0.60, indicating low accuracy in separating the two groups. Conclusion While it is not possible to distinguish between the RP and cholesteatomas groups based on the WBAamb and WBATPP results, it is potentially feasible to differentiate between the EC and ERP conditions. Further study using a large clinical sample is recommended to determine the sensitivity and specificity of the WBA test to identify the EC and ERP conditions.

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