scholarly journals The relationship between maximal expiratory pressure values and critical outcomes in mechanically ventilated patients: a post hoc analysis of an observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yann Combret ◽  
Guillaume Prieur ◽  
Roger Hilfiker ◽  
Francis-Edouard Gravier ◽  
Pauline Smondack ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Univariate Analysis ◽  
Premature Death ◽  
Extubation Failure ◽  
Short Term ◽  
Expiratory Muscle ◽  
Maximal Expiratory Pressure ◽  
The Impact ◽  
The Relationship

Abstract Background Little interest has been paid to expiratory muscle strength, and the impact of expiratory muscle weakness on critical outcomes is not known. Very few studies assessed the relationship between maximal expiratory pressure (MEP) and critical outcomes. The aim of this study was to investigate the relationship between MEP and critical outcomes. Methods This work was a secondary analysis of a prospective, observational study of adult patients who required mechanical ventilation for ≥ 24 h in an 18-bed ICU. MEP was assessed before extubation after a successful, spontaneous breathing trial. The relationships between MEP and extubation failure, and short-term (30 days) mortality, were investigated. Univariate logistic regressions were computed to investigate the relationship between MEP values and critical outcomes. Two multivariate analyses, with and without maximal inspiratory pressure (MIP), both adjusted using principal component analysis, were undertaken. Unadjusted and adjusted ROC curves were computed to compare the respective ability of MEP, MIP and the combination of both measures to discriminate patients with and without extubation failure or premature death. Results One hundred and twenty-four patients were included. Median age was 66 years (IQR 18) and median mechanical ventilation duration was 7 days (IQR 6). Extubation failure rate was 15% (18/124 patients) and the rate for 30-day mortality was 11% (14/124 patient). Higher MEP values were significantly associated with a lower risk of extubation failure in the univariate analysis [OR 0.96 95% CI (0.93–0.98)], but not with short-term mortality. MEP was independently linked with extubation failure when MIP was not included in the multivariate model, but not when it was included, despite limited collinearity between these variables. This study was not able to differentiate the respective abilities of MEP, MIP, and their combination to discriminate patients with extubation failure or premature death (adjusted AUC for the combination of MEP and MIP: 0.825 and 0.650 for extubation failure and premature death, respectively). Conclusions MEP is related to extubation failure. But, the results did not support its use as a substitute for MIP, since the relationship between MEP and critical outcomes was no longer significant when MIP was included. The use of MIP and MEP measurements combined did not reach higher discriminative capacities for critical outcomes that MEP or MIP alone. Trial Registration This study was retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT02363231?cond=NCT02363231&draw=2&rank=1 (NCT02363231) in 13 February 2015

scholarly journals Relationship between daily suicide counts and temperature in England and Wales

2007 ◽  
Vol 191 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Lisa A. Page ◽  
Shakoor Hajat ◽  
R. Sari Kovats
Keyword(s):  
Time Series ◽  
Seasonal Fluctuation ◽  
Daily Temperature ◽  
Short Term ◽  
Time Series Regression ◽  
England And Wales ◽  
Increased Risk ◽  
Hot Weather ◽  
The Impact ◽  
The Relationship

BackgroundSeasonal fluctuation in suicide has been observed in many populations. High temperature may contribute to this, but the effect of short-term fluctuations in temperature on suicide rates has not been studied.AimsTo assess the relationship between daily temperature and daily suicide counts in England and Wales between 1 January 1993 and 31 December 2003 and to establish whether heatwaves are associated with increased mortality from suicide.MethodTime-series regression analysis was used to explore and quantify the relationship between daily suicide counts and daily temperature. The impact of two heatwaves on suicide was estimated.ResultsNo spring or summer peak in suicide was found. Above 18 °, each 1 ° increase in mean temperature was associated with a 3.8 and 5.0% rise in suicide and violent suicide respectively. Suicide increased by 46.9% during the 1995 heatwave, whereas no change was seen during the 2003 heat wave.ConclusionsThere is increased risk of suicide during hot weather.

scholarly journals THE INNOVATIVE POTENTIAL OF HUMAN RESOURCES AS A FACTOR IN THE DEVELOPMENT OF THE INNOVATIVE TECHNOLOGIES MARKET IN UKRAINE

2021 ◽  
Vol 23 (1(78)) ◽  
pp. 58-74
Author(s):  
I.V. GRYSHCHENKO ◽  
V.F. GRYSHCHENKO
Keyword(s):  
Mathematical Model ◽  
Human Resources ◽  
Market Development ◽  
Short Term ◽  
Model Calculations ◽  
Innovative Technologies ◽  
Innovation Capacity ◽  
Innovative Potential ◽  
The Impact ◽  
The Relationship

Topicality. The successful operation of an economic entity, in the development of the innovative technologies market, is largely determined by the innovative potential of its human resources - by the people who work for it - their knowledge, talents, and skills. The wrong combination of these elements, lack of employees who have the necessary qualifications, lack of harmony in the relationship between employers and employees can inevitably lead to serious financial and economic problems. Improving the efficiency of the use of the innovative potential of human resources in the development of the innovative technologies market is one of the most urgent tasks for any business entity. The competitive advantages of business entities, financial and economic indicators of their activity, ensuring sustainable development of entrepreneurship in general, are depending on the degree and balance of its use. Aim and tasks. The purpose of the work is to analyze and develop on its basis recommendations for increasing the level of the innovative potential of human resources in the context of the development of the innovative technologies market in Ukraine. Research results. The article analyzes the main structural elements of the innovative potential of human resources and identifies the factors influencing its level in Ukraine. The results of the analysis allowed us to build an economic and mathematical model of the relationship between innovation capacity, as an indicator of the development of the innovative technologies market and components of the innovative potential of human resources in Ukraine. This made it possible to predict the level of innovation capacity as an indicator of the innovative technologies market development in Ukraine in the short term. The obtained results allowed us to identify problems and develop recommendations for increasing the level of the innovative potential of human resources in the context of the innovative technologies market development in Ukraine. Conclusion. Based on the developed economic and mathematical model, calculations were made that characterize the relationship between innovation capacity as an indicator of the innovative technologies market development and components of the innovative potential of human resources in Ukraine. As shown in the calculations, the proposed economic and mathematical model with high accuracy allows to assess the impact of components of the innovative potential of human resources on innovation capacity and identify major obstacles for its development, which made it possible to predict trends in innovation capacity as an indicator of the innovative technologies market development in Ukraine in the short term.

scholarly journals Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aiko Tanaka ◽  
Akinori Uchiyama ◽  
Yu Horiguchi ◽  
Ryota Higeno ◽  
Ryota Sakaguchi ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Spontaneous Breathing Trial ◽  
Leak Test ◽  
Endotracheal Suctioning ◽  
Cuff Leak ◽  
The Impact

AbstractThe cuff leak test (CLT) has been widely accepted as a simple and noninvasive method for predicting post-extubation stridor (PES). However, its accuracy and clinical impact remain uncertain. We aimed to evaluate the reliability of CLT and to assess the impact of pre-extubation variables on the incidence of PES. A prospective observational study was performed on adult critically ill patients who required mechanical ventilation for more than 24 h. Patients were extubated after the successful spontaneous breathing trial, and CLT was conducted before extubation. Of the 191 patients studied, 26 (13.6%) were deemed positive through CLT. PES developed in 19 patients (9.9%) and resulted in a higher reintubation rate (8.1% vs. 52.6%, p < 0.001) and longer intensive care unit stay (8 [4.5–14] vs. 12 [8–30.5] days, p = 0.01) than patients without PES. The incidence of PES and post-extubation outcomes were similar in patients with both positive and negative CLT results. Compared with patients without PES, patients with PES had longer durations of endotracheal intubation and required endotracheal suctioning more frequently during the 24-h period prior to extubation. After adjusting for confounding factors, frequent endotracheal suctioning more than 15 times per day was associated with an adjusted odds ratio of 2.97 (95% confidence interval, 1.01–8.77) for PES. In conclusion, frequent endotracheal suctioning before extubation was a significant PES predictor in critically ill patients. Further investigations of its impact on the incidence of PES and patient outcomes are warranted.

scholarly journals Key Factors for Activated Carbon Adsorption of Pharmaceutical Compounds from Wastewaters: A Multivariate Modelling Approach

Water ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 166
Author(s):  
Rui M. C. Viegas ◽  
Ana S. Mestre ◽  
Elsa Mesquita ◽  
Miguel Machuqueiro ◽  
Marta A. Andrade ◽  
...  
Keyword(s):  
Adsorption Capacity ◽  
Activated Carbons ◽  
Univariate Analysis ◽  
Pharmaceutical Compounds ◽  
Pls Regression ◽  
Short Term ◽  
Latent Structures ◽  
The Impact ◽  
Inorganic Matrix ◽  
Modelling Approach

Projection to Latent Structures (PLS) regression, a generalization of multiple linear regression, is used to model two datasets (40 observed data points each) of adsorption removal of three pharmaceutical compounds (PhCs), of different therapeutic classes and physical–chemical properties (carbamazepine, diclofenac, and sulfamethoxazole), from six real secondary effluents collected from wastewater treatment plants onto different powdered activated carbons (PACs). For the PLS regression, 25 descriptors were considered: 7 descriptors related to the PhCs properties, 10 descriptors related to the wastewaters properties (8 related to the organic matrix and 2 to the inorganic matrix), and 8 descriptors related to the PACs properties. This modelling approach showed good descriptive capability, showing that hydrophobic PhC-PAC interactions play the major role in the adsorption process, with the solvation energy and log Kow being the most suitable descriptors. The results also stress the importance of the competition effects of water dissolved organic matter (DOM), namely of its slightly hydrophobic compounds impacting the adsorption capacity or its charged hydrophilic compounds impacting the short-term adsorption, while the water inorganic matrix only appears to impact PAC adsorption capacity and not the short-term adsorption. For the pool of PACs tested, the results point to the BET area as a good descriptor of the PAC capacity, while the short-term adsorption kinetics appears to be better related to its supermicropore volume and density. The improvement in these PAC properties should be regarded as a way of refining their performance. The correlations obtained, involving the impact of water, PhC and PAC-related descriptors, show the existence of complex interactions that a univariate analysis is not sufficient to describe.

scholarly journals The Relationship of Waste Management With The Incidence Of Diarrhea In Argasunya Village Cirebon City

2018 ◽  
Vol 5 (1) ◽  
pp. 16-22
Author(s):  
Jaenudin ◽  
Sandi Aprianto ◽  
Citra Setyo Dwi Andini
Keyword(s):  
Waste Management ◽  
Univariate Analysis ◽  
P Value ◽  
Chi Square ◽  
The Status ◽  
Diarrhea Incidence ◽  
Chi Square Test ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

Background: Garbage is something material or solid objects that is no used by humans. The impact or risk of improper handling of garbage can cause to environmental damages that can cause health problems and disesase, one of them is diarrhea disease. According to the health profile of West Java Province (2012) showed that the 1.906.886 diarrhea incidence. Cirebon City is ranked ninth with 88,702 diarrhea incidence. Purpose: The purpose of this research is to know the relationship of waste management with the incidence of diarrhea In Argasunya Village Cirebon City. Method: This research used descriptive correlation with kohort retrospekif approach. The population in this study that is all the people who suffer from diarrhea in the Argasunya Village with 72 respondents. The sample in this study using total sampling with 72 respondents who suffer from diarrhea. The research instrument used the observation sheet of waste management and the result of the status of the patient according the medical record data in Sitopeng Public Health Center. The analysis used univariate and bivariate used Chi Square test. Result: The result of univariate analysis showed that most of the waste management did not fulfill the requirement of 59 respondents (81,9%) and most of the acute diarrhea was 62 respondents (86,1%). There was no significant relationship of waste management with the incidence of diarrhea In Argasunya Village Cirebon City, p-value = 0,677.

scholarly journals Pattern of antidepressant use and duration of depression-related absence from work

10.1192/03-91 ◽  
2003 ◽  
Vol 183 (6) ◽  
pp. 507-513 ◽  
Author(s):  
Carolyn S. Dewa ◽  
Jeffrey S. Hoch ◽  
Elizabeth Lin ◽  
Michael Paterson ◽  
Paula Goering
Keyword(s):  
Observational Study ◽  
Return To Work ◽  
Disability Benefits ◽  
First Line ◽  
Short Term ◽  
Insurance Sector ◽  
Antidepressant Prescription ◽  
Antidepressant Use ◽  
Absence From Work ◽  
The Relationship

BackgroundFew studies have examined the relationship between antidepressant prescription and receipt of depression-related disability benefits.AimsTo address two questions: first, is prescription of antidepressants in accordance with published clinical guides associated with better disability outcomes, and second, what is the relationship between guideline-concordant antidepressant prescription and length of disability?MethodAn observational study was conducted using administrative data from three major Canadian financial and insurance sector companies. Short-term disability and prescription drug claims records for 1996–1998 were linked for workers receiving depression-related short-term disability benefits during that time.ResultsRecommended first-line agents and recommended doses were significantly associated with return to work (χ2=6.64, P < 0.036). In addition, among those who returned to work, early intervention was significantly associated with a shortened disability episode (β=-24.1; 95% CI-34.4 to −13.8).ConclusionsDepression-related workplace disability is a problem for which there is no simple solution. These results provide an additional piece to the puzzle of helping workers disabled by depression to return to work.

Terrorism and tourism in Israel

2016 ◽  
Vol 23 (6) ◽  
pp. 1343-1352 ◽  
Author(s):  
Marion Karl ◽  
Gordon Winder ◽  
Alexander Bauer
Keyword(s):  
Time Lag ◽  
Research Model ◽  
Long Term Effects ◽  
Short Term ◽  
Event Tourism ◽  
Using Data ◽  
Terrorist Event ◽  
The Impact ◽  
The Relationship

While the relation between terrorism and tourism has been an important topic for tourism research, the questions whether terrorism affects tourism immediately and how long after a terrorism event tourism recovers are, as yet, not clearly answered. The aim of this article is to better understand the magnitude and temporal scale of the impact of terrorism on tourism. To this end, a research model differentiating between short-term and long-term effects of terrorism on tourism is developed and analyzed for the destination Israel using data on tourists from Germany. The results show both short-term and long-term impacts with a time lag between the terrorist event and the beginning of tourism decline of 1 or up to 6 months. An economic influence on the development of tourist arrivals was not detected, but seasonality plays an important role in the relationship between terrorism and tourism.

scholarly journals The Impact of Oil Prices on the Economy of Vietnam

2015 ◽  
Vol 22 (04) ◽  
pp. 142-159
Author(s):  
Hoa Nguyen Thi Lien ◽  
Trang Tran Thu ◽  
Giang Nguyen Le Ngan
Keyword(s):  
Industrial Production ◽  
Oil Prices ◽  
Test Results ◽  
Macroeconomic Performance ◽  
Price Shocks ◽  
Short Term ◽  
Correction Model ◽  
The Impact ◽  
The Relationship

In this paper we study the relationship between oil prices and macroeconomic performance by investigating the impact of oil price shocks on key macroeconomic variables of Vietnam over the 2001–2012 period. In order to test the relationship between oil prices and the value of industrial production, we use cointegration method to consider the long-term relationship and Error Correction Model (ECM) to ponder the short-term one. The test results show that the price of oil and the value of industrial production in Vietnam are positively correlated in the long term, whereas in the short term the volatility of oil prices in the last two months will negatively affect the fluctuation in the value of the current industrial production.

scholarly journals Impact of Capital Structure on Profitability:An empirical analysis of listed firms in India

2018 ◽  
Vol 7 (2) ◽  
pp. 1-6
Author(s):  
Atif Ghayas ◽  
Javaid Akhter
Keyword(s):  
Capital Structure ◽  
Stock Exchange ◽  
Short Term ◽  
Return On Equity ◽  
Listed Firms ◽  
Relationship Capital ◽  
The Impact ◽  
The Relationship ◽  
Positive Effect

This study aims to empirically examine and analyze the impact of capital structure decision on the firm’s profitability by using a sample of 35 Indian pharmaceutical companies listed on Bombay Stock Exchange (BSE) during the period of 5 years from 2012 to 2016. Regression Analysis is used to measure the extent and nature of the relationship. Capital structure variables used in the study are ratio of long-term debt to total assets (LDA), ratio of short-term debt to total assets (SDA) and ratio of Total debt to total assets (DA) while profitability has been measure by Return on Equity (ROE). Firms Size (SIZE)and Salesgrowth(GROW) are also used as control variables. Results reveal a positive effect of SDA and DA on ROE, while a weak-to-no effect was found of LDA on ROE.

scholarly journals Therapeutic Interventions are Important Risk Factors for Delirium in the ICU Setting ： A Multicenter Observational Study

2021 ◽  
Author(s):  
Ying Liu ◽  
Zhiyong Yuan ◽  
Shixia Cai ◽  
Xiaoning Han ◽  
Kai Song ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Enteral Nutrition ◽  
Observational Study ◽  
Univariate Analysis ◽  
Therapeutic Interventions ◽  
Physical Restraints ◽  
Icu Patients ◽  
Icu Stay ◽  
Increased Risk

Abstract Background Delirium is an important independent predictor of negative clinical outcomes in intensive care unit (ICU) patients. The purpose of this study was to investigate the territorial incidence of ICU delirium, its related risk factors, and short-term outcomes in Shandong Province, China, to provide precise information for territorial patient management. Methods A multicenter prospective observational study was conducted. Patients with delirium were defined as any patient with at least one positive CAM-ICU or ICDSC assessment. Demographics, admission clinical data, daily interventions provided to patients and environmental factors were collected. Results From May 1, 2018 to Jan 31, 2020, 536 noncomatose patients were ultimately eligible for the study. One hundred eighteen patients (22%) experienced delirium at least once. In the univariate analysis, age (p = 0.009), SOFA score (p = 0.006), a history of cerebrovascular disease (p = 0.044) and impaired renal function (p = 0.003) were risk factors for delirium. Most therapeutic interventions were linked to delirium in the univariate analysis, including enteral nutrition (p = 0.000), artificial airway (p = 0.021), nasogastric tube (p = 0.001), use of restraint straps (p = 0.000), and use of sedative medications, including midazolam (p = 0.003), propofol (p = 0.032) and butorphanol (p = 0.028). Among the patient’s vital signs and laboratory examinations performed on the day of assessment, body temperature, BUN levels and CRP levels were risk factors for delirium. Midazolam use, chronic renal insufficiency, physical restraints, nosogastric tube, enteral nutrition, and CRP and BUN levels were factors associated with an increased risk of delirium in the multivariate analysis. The durations of mechanical ventilation and ICU stay in patients with delirium was significantly higher than those in patients without delirium [8 (IQR: 4–14) vs 5 (IQR: 3–10) and 9 (IQR: 4–17) vs 6 (IQR: 4–12), p < 0.05]. Conclusions Delirium was associated with prolonged mechanical ventilation and a prolonged ICU stay. Based on the findings from this study, we should not only reduce the use of sedatives and analgesics but also minimize invasive operations, including the placement of nasogastric tubes, to recover eternal nutrition for ICU patients and avoid physical restraints as much as possible to prevent delirium. Trial registration: This study was registered in the Chinese Clinical Trial Registry (ChiCTR1900021360).

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