Predictors of Non-invasive Ventilation Response Do Not Indicate Response to High Flow Nasal Oxygen: A Bicentric Observational Study.

BackgroundIn patients receiving high flow nasal oxygen (HFNO), predicting chance of response is crucial in order to avoid unnecessary delay of intubation. Whether commonly used predictors of non-invasive ventilation (NIV) response may be as applicable for HFNO, is unclear.MethodsWe conducted a retrospective bi-centric analysis of adults treated with HFNO in two Austrian medical intensive care units from 01/2014 until 09/2017. Predictive value of respiratory rate, PaO2, PaCO2, SpO2, ROX index, pH, heart rate, base excess, SOFA-Score and SAPS III was analysed by means of logistic regression with HFNO responding as dependent variable. Calculations were also done separately in patients receiving HFNO as post-extubation support (Group A) and all other indications (Group B). ResultsWe registered 127 patients (m:f = 70:57, median age: 67 [IQR 53-77] years). Forty-eight patients (37.8%) received HFNO as post-extubation support and were assigned to group A. Seventy-nine patients (62.2%) received HFNO due to any other indication and were assigned to group B. Criteria of HFNO response were fulfilled by 42 patients (87.5%) of group A and 53 (67.1%) of group B patients.Whereas respiratory rate, PaO2, PaCO2, SpO2, pH, heart rate, base excess, SOFA-Score and SAPS III did not differ between responders and non-responders, ROX index showed significant association with HFNO success in all patients. With increasing ROX index, the odds for response increased (OR [95% CI]: baseline: 1.21 [1.05, 1.38], p = 0.0069, after 2 hours: 1.19 [1.05; 1.34], p = 0.0061, after 6 hours: 1.23 [1.06; 1.42], p = 0.0049). Subgroup analyses revealed similar odds ratios for ROX index (baseline: group A: 1.17 [0.90; 1.52], p = 0.24; group B: 1.22 [1.04; 1.43], p = 0.015; after 2 hours: 1.30 [0.94; 1.82], p = 0.12, group B: 1.18 [1.03; 1.34], p = 0.014; after 6 hours: 1.76 [1.01; 3.06], p = 0.047, group B: 1.19 [1.03; 1.37], p = 0.022). ConclusionsCriteria of HFNO success deviate from criteria for response to NIV. ROX index indicated HFNO response in a wide range of indications.

Parametric Sensitivity of CSTBRs for Lactobacillus casei: Normalized Sensitivity Analysis

In this paper, a sensitivity analysis of a continuous stirred tank bioreactor (CSTBR) was conducted to determine a parametrically sensitive regime. The growth of a lactic acid bacterium, namely, Lactobacillus casei, in a pH-controlled CSTBR was considered as a process model. Normalized objective sensitivities of the minimum pH were determined with respect to input parameters. A generalized criterion for sensitivity was defined for determining the parametric range of three input variables, i.e., dilution rate base stream (θ), base concentration (R), and initial pH (pH0) for maintaining optimal pH range in the reactor. The system exhibits sensitive behavior for θ, R, and pH0, from 0.095 to 0.295, 0 to 0.865, and 4.42 to 4.77, respectively. The critical values of θ, R, and pH0 are 0.0195, 0.48, and 4.6, respectively. The mathematical model can also be used to determine a parametrically sensitive regime for other important parameters, namely, temperature, the concentration of metabolites, and other byproducts. The mathematical tool can also be used in bioreactor design and the improvement of control strategies.

Evaluation of Biochar and Compost Mixes as Substitutes to a Commercial Propagation Mix

The effects of biochar (BC) on seed propagation depend on the type of BC, BC incorporation rate, base substrate, and plant seed species. Limited research tested BC-compost mixes for seed propagation. High percentages (70% or 80%, by volume) of BC with vermicompost (VC) or chicken manure compost (CM) were evaluated to substitute a commercial propagation mix (control) in three experiments. Seeds, including basil, coleus, edamame, marigold, okra, petunia, radish, salvia, tomato, vinca, and zinnia in Experiments 1 and 2 had similar or higher emergence percentages (EPs) and emergence indexes (EIs) in both BC:VC mixes, while celosia, cowpea, corn, and pumpkin had lower EPs or EIs in either 8BC:2VC or 7BC:3VC mixes compared to the control. Seedling fresh weights in both BC:VC mixes were similar to the control except for vinca, pumpkin, marigold, and salvia. The BC:VC mixes had no negative effects on plant dry weights at 7 weeks after transplanting. In Experiment 3, BC:CM mixes suppressed the seed germination or seedling growth of coleus, corn, cowpea, marigold, petunia, pumpkin, radish, salvia, vinca, watermelon, and zinnia due to high pH and CM’s high electrical conductivity. Therefore, 7BC:3VC and 8BC:2VC can be used as seed propagation mix, while 7BC:3CM and 8BC:2CM are not recommended.

Gambaran Rasa Percaya Diri Warga Belajar pada Program Pendidikan Keaksaraan Fungsional di PKBM Diknaker

The research was distributed by the phenomenon of functional literacy program success rate base on the South coast of Diknaker PKBM. This is evidenced by the high learning outcomes acquired citizens learn. Researchers suspect that the cause of the success of these KF due to high confidence that is owned by the citizens of learning. Type of this research is quantitative descriptive research. Withdrawal technique used is the sample census, all of the population sample was made as many as 20 people, which is called the respondent. Using data collection techniques interviews that is in the form of structured interviews. While the data analysis techniques using the formula percentages. From the results of the study found that the confidence of citizens learning related to believe in its own ability, courageous decisions, courageous and suggested categorized either. Keywords: Self-Confidence, Learning Outcomes