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Tolerability regarding MenACWY-TT vaccination inside teens from the Netherlands; the cross-sectional review.
The present findings will have implications in the design of 2D membranes to retain a high water filtration rate.The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. Bacterial co-infections are associated with unfavourable outcomes in respiratory viral infections; however, microbiological and antibiotic data related to COVID-19 are sparse. Adequate use of antibiotics in line with antibiotic stewardship (ABS) principles is warranted during the pandemic. We performed a retrospective study of clinical and microbiological characteristics of 140 COVID-19 patients admitted between February and April 2020 to a German University hospital, with a focus on bacterial co-infections and antimicrobial therapy. The final date of follow-up was 6 May 2020. Clinical data of 140 COVID-19 patients were recorded The median age was 63.5 (range 17-99) years; 64% were males. According to the implemented local ABS guidelines, the most commonly used antibiotic regimen was ampicillin/sulbactam (41.5%) with a median duration of 6 (range 1-13) days. Decitabine Urinary antigen tests for Legionella pneumophila and Streptococcus peumoniae were negative in all cases. In critically ill patients admitted to intensive care units (n = 50), co-infections with Enterobacterales (34.0%) and Aspergillus fumigatus (18.0%) were detected. Blood cultures collected at admission showed a diagnostic yield of 4.2%. Bacterial and fungal co-infections are rare in COVID-19 patients and are mainly prevalent in critically ill patients. Further studies are needed to assess the impact of antimicrobial therapy on therapeutic outcome in COVID-19 patients to prevent antimicrobial overuse. ABS guidelines could help in optimising the management of COVID-19. Investigation of microbial patterns of infectious complications in critically ill COVID-19 patients is also required.Porous scaffolds of poly(lactide-co-glycolide) (PLGA; 8515) and nano-hydroxyapatite (nHAP) were prepared by an emulsion-precipitation procedure from uniform PLGA-nHAP spheres (150-250 µm diameter). These spheres were then thermally sintered at 83 °C to porous scaffolds that can serve for bone tissue engineering or for bone substitution. The base materials PLGA and nHAP and the PLGA-nHAP scaffolds were extensively characterized by X-ray powder diffraction, infrared spectroscopy, thermogravimetry, differential scanning calorimetry, and scanning electron microscopy. The scaffold porosity was about 50 vol% as determined by relating mass and volume of the scaffolds, together with the computed density of the solid phase (PLGA-nHAP). The cultivation of HeLa cells demonstrated their high cytocompatibility. In combination with DNA-loaded calcium phosphate nanoparticles, they showed a good activity of gene transfection with enhanced green fluorescent protein (EGFP) as model protein. This is expected enhance bone growth around an implanted scaffold or inside a scaffold for tissue engineering.
Preservation and improvement of heart and vessel health is the primary motivation behind cardiovascular disease (CVD) research. Development of advanced imaging techniques can improve our understanding of disease physiology and serve as a monitor for disease progression. Various image processing approaches have been proposed to extract parameters of cardiac shape and function from different cardiac imaging modalities with an overall intention of providing full cardiac analysis. Due to differences in image modalities, the selection of an appropriate segmentation algorithm may be a challenging task.

This paper presents a comprehensive and critical overview of research on the whole heart, bi-ventricles and left atrium segmentation methods from computed tomography (CT), magnetic resonance (MRI) and echocardiography (echo) imaging. The paper aims to (1) summarize the considerable challenges of cardiac image segmentation, (2) provide the comparison of the segmentation methods, (3) classify significant contributie methods described are classified based on the used segmentation approach into (1) edge-based segmentation methods, (2) model-fitting segmentation methods and (3) machine and deep learning segmentation methods and are further split based on the targeted cardiac structure. Edge-based methods are mostly developed as semi-automatic and allow end-user interaction, which provides physicians with extra control over the final segmentation. Model-fitting methods are very robust and resistant to the high variability in image contrast and overall image quality. Nevertheless, they are often time-consuming and require appropriate models with prior knowledge. While the emerging deep learning segmentation approaches provide unprecedented performance in some specific scenarios and under the appropriate training, their performance highly depends on the data quality and the amount and the accuracy of provided annotations.
Persistent hyperlactatemia has been considered as a signal of tissue hypoperfusion in septic shock patients, but multiple non-hypoperfusion-related pathogenic mechanisms could be involved. Therefore, pursuing lactate normalization may lead to the risk of fluid overload. Peripheral perfusion, assessed by the capillary refill time (CRT), could be an effective alternative resuscitation target as recently demonstrated by the ANDROMEDA-SHOCK trial. We designed the present randomized controlled trial to address the impact of a CRT-targeted (CRT-T) vs. a lactate-targeted (LAC-T) fluid resuscitation strategy on fluid balances within 24h of septic shock diagnosis. In addition, we compared the effects of both strategies on organ dysfunction, regional and microcirculatory flow, and tissue hypoxia surrogates.

Forty-two fluid-responsive septic shock patients were randomized into CRT-T or LAC-T groups. Fluids were administered until target achievement during the 6h intervention period, or until safety criteria were metnd a faster achievement of the predefined resuscitation target. Our data suggest that stopping fluids in patients with CRT ≤ 3s appears as safe in terms of tissue perfusion. Clinical Trials ClinicalTrials.gov Identifier NCT03762005 (Retrospectively registered on December 3rd 2018).
CRT-targeted fluid resuscitation was not superior to a lactate-targeted one on fluid administration or balances. However, it was associated with comparable effects on regional and microcirculatory flow parameters and hypoxia surrogates, and a faster achievement of the predefined resuscitation target. Our data suggest that stopping fluids in patients with CRT ≤ 3 s appears as safe in terms of tissue perfusion. Clinical Trials ClinicalTrials.gov Identifier NCT03762005 (Retrospectively registered on December 3rd 2018).
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