Rapid bacterial identification and antimicrobial susceptibility testing assay in positive blood cultures / 预防医学

Objective@#To establish a rapid bacterial identification and antimicrobial susceptibility testing assay in positive blood cultures, so as to provide insights into timely diagnosis and treatment of bloodstream infections.@*Methods@#A total of 1 154 blood culture samples were collected from inpatients in Zhejiang Hospital from February to May, 2022. The bacterial isolates were enriched and purified using improved separation gel method, and bacterial identification and antimicrobial susceptibility tests were performed using VITEK2 mass spectrometry system and VITEK2 Compact automated microbiology system. The accuracy of the new assay for bacterial identification and antimicrobial susceptibility tests was evaluated with the conventional VITEK 2 compact system as the standard. @*Results@#Of 1 154 blood culture specimens, the conventional VITEK 2 compact system detected 174 positives and 980 negatives. The new assay and the conventional VITEK 2 compact system identified consistent bacterial isolates in 165 out of 174 positive blood culture samples, and the accuracy of bacterial identification was 94.83% for the new assay, with a 99.21% accuracy for identifying Gram-negative bacteria and 82.22% for Gram-positive bacteria. Antimicrobial susceptibility tests were performed in 158 bacterial isolates, and the new assay presented a 90.17% accuracy, with a 90.27% accuracy for Gram-negative bacteria and 89.74% for Gram-positive bacteria. The conventional VITEK 2 compact system required 30 hours and longer to complete bacterial identification and antimicrobial susceptibility tests, and the new assay required 9 to 18 hours.@*Conclusions@#The new rapid bacterial identification and antimicrobial susceptibility testing assay shortens the time of bacterial culture, achieves rapid bacterial identification and antimicrobial susceptibility testing in blood culture specimens and has a high accuracy that meets clinical needs, which facilitates rapid diagnosis and treatment of bloodstream infections.

STUDIES ON THE PROPOGATION OF ELASTIC WAVES IN BOVINE COMPACT BONES AS A FUNCTION OF TEMPERATURE

To study the physical properties of biomaterials like bony hard tissues through the propagation of elastic waves is one of the most successful method.With the help of internal friction measurement, we can study the processes such as recrystallization, annealing, quenching and tempering, plastic deformation and strain ageing. In the present investigation we calculate and -1 reported the internal friction loss (Q ) for all the six types of bovine compact bones for the first time in a single experiment by using the ultrasonic piezoelectric composite oscillator technique with the help of X-cut crystal in different physiological conditions. Significant variation is observed from bone to bone. This may be attributed to composition and mineral content of the bones. Peak temperature data also is also determined. Temperature variation of logarithmic decrement in X-cut quartz transducer is also verified with mounting of bovine compact bar shaped bone -1 samples. Change of internal friction (Q ) with temperature is also calculated to predict the mechanism of acoustic losses and phase transitions in these bony hard tissues. Internal friction measurements are also useful to obtain the information about imperfections in bony hard tissues. The present investigation constitutes a step towards the application of natural bovine bone ceramic materials for the transducer applications

Discussion on the current situation and prospect of compact county medical community in China based on typical cases / 中华医院管理杂志

In order to further promote hierarchical medical system and enhance the capacity of primary healthcare services, China began to build compact county medical community. At present, the development of China′s compact county community still exists such problems as the construction of service system, the basic institutional mechanism, the quality of supply capacity and the core guarantee mechanism. In order to solve the existing problems, the authors took Shaxian District of Sanming City, Fujian Province, Dancheng County of Zhoukou City, Henan Province, and Yangqu County, Taiyuan City, Shanxi Province as examples to summarize the experience of the advanced pilot areas of the policy. In the future, the construction of compact county community in China should be based on the construction of " single-core multi-layer" system, starting from the five levels of collaborative management, practical operation, system construction, basic guarantee and multi-party supervision, to comprehensively enhance the healthcare services, and finally achieve the goal of the strategy of hierarchical medical and Healthy China.

Practice and exploration of compact county medical consortium based on medical group / 中华医院管理杂志

The construction of compact county medical consortium is an effective way to integrate county medical resources, improve county diagnosis and treatment capabilities, and establish and improve the hierarchical diagnosis and treatment system. It is the guidance of national policy and the demand of social practice. Based on the reality of Jiangyin′s developed local economy, sufficient overall high-quality medical resources and high health demand of residents, Jiangyin People′s Hospital Medical Group explored the construction practice of compact county medical consortium according to local conditions. The group focused on implementing the functional positioning of medical institutions, improving the primary service ability, and straightening out the two-way referral process. Through the four major measures of establishing mechanism, strengthening the primary level, optimizing the process, and focusing on convergence, the group improved the organization structure and operation mechanism, continuously improved the management level and service connotation of the medical consortium. The goal of establishing an overall management mode, improving primary service capabilities, and forming an up-down cooperation mechanism had been initially realized.

Comparación de dos métodos comerciales para la determinación de la concentración mínima inhibitoria de meropenem en Klebsiella pneumoniae productora de carbapenemasa tipo KPC / Comparison of two commercial methods for determination of the minimum inhibitory meropenem concentration in KPC carbapenemase-producing Klebsiella pneumoniae

Introducción: El tratamiento de las infecciones por Klebsiella pneumoniae productora de carbapenemasa tipo KPC es complicado debido a las escasas opciones terapéuticas existentes, lo cual obliga a optimizar los esquemas terapéuticos disponibles. Objetivo: Determinar la concordancia de la tarjeta AST-N272 del Sistema Vitek 2 Compact y las tiras M.I.C.ETM Evaluator con la dilución en agar para la determinación de la concentración mínima inhibitoria del meropenem en Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Métodos: Se estudiaron 53 aislados de K. pneumoniae bla KPC positivas no clonales, provenientes de hisopados rectales recolectados en diferentes unidades hospitalarias de Guayaquil, Ecuador, entre enero a junio de 2016. Se determinó la concentración mínima inhibitoria de meropenem por dilución en agar (método de referencia), así como por el sistema Vitek 2 Compact (AST-N272) y las tiras M.I.C.ETM. Se determinó la CMI 50, CMI 90 y la concordancia esencial. Resultados: El rango de la CMI de meropenem de los aislados estudiados fue de 1 a ≥ 32 µg/mL, con una CMI50= 4 µg/mL y una CMI90= ≥ 32 µg/mL. El 86,79 por ciento (n= 46) de los aislados tuvo una CMI≤ 8 µg/mL. Se observó un 94,33 por ciento de concordancia esencial con las tiras M.I.C.ETM, mientras que la tarjeta AST-N272 mostró una concordancia esencial inferior al 50 por ciento. Conclusiones: Los resultados sugieren posibles implicaciones en el tratataminto del paciente, pues reduce opciones terapéuticas en contextos de difícil manejo. Además, resaltan la necesidad de la confirmación de la resistencia a carbapenémicos mediante el método de Kirby Bawer en aquellos laboratorios que tienen métodos automatizados para estudios de susceptibilidad(AU)

Introduction: The treatment for KPC carbapenemase-producing Klebsiella pneumoniae infections is complicated, due to the scant therapeutic options available, which forces us to optimize the therapies at hand. Objective: Determine the agreement between the AST-N272 card of the Vitek 2 Compact system and the M.I.C.E.TM Evaluator strips, and the agar dilution method for determination of the minimum inhibitory meropenem concentration in KPC carbapenemase-producing Klebsiella pneumoniae. Methods: A study was conducted of 53 positive non-clonal K. pneumoniae bla KPC isolates from rectal swabs collected at several hospitals in Guayaquil, Ecuador, from January to June 2016. Minimum inhibitory meropenem concentration was determined by agar dilution (reference method), the Vitek 2 Compact system (AST-N272) and M.I.C.E.TM strips. Determination was made of MIC 50, MIC 90 and essential agreement. Results: The meropenem MIC range for the isolates studied was 1 to ≥ 32 µg/ml, with MIC50= 4 µg/ml and MIC90= ≥ 32 µg/ml. In 86.79 percent (n= 46) of the isolates MIC was ≤ 8 µg/ml. Essential agreement was 94.33 percent with the M.I.C.E.TM strips and under 50 percent with the AST-N272 card. Conclusions: The results obtained suggest potential implications for the treatment of patients, since therapeutic options are reduced in difficult management contexts. They also highlight the need for confirmation of carbapenem resistance by the Kirby-Bauer procedure in laboratories equipped with automated methods for susceptibility studies(AU)

Artifical Intelligence In Pharma Manufacturing: A Review

In the world of pharmaceuticals, there is a vital role for robotics to play in thecomplicated processes of research and development, production, and packaging. Justificationfor robots ranges from improved worker safety to improved quality. A number of robotmanufacturers have products specifically designed for this industry. Industrial robotics forpharmaceutical applications has a bright future. With a rapidly aging population that urgentlyrequires sophisticated medical devices and newer drugs, robotics systems are increasinglyadopted for improved productivity and efficiency to meet this growing demand. Robots inlaboratory, life science and pharmaceutical applications perform tasks at rates beyond humancapability. These robots function in potentially hazardous settings in proximity to biologicaldangers, the threat of radioactive contamination and toxic chemotherapy compounds.Robotics is called upon to assemble and package a variety of medical devices and implants aswell as preparing prescriptions for mail-order pharmacies or hospitals. The Laboratory RoboticsInterest Group (LRIG) is an international non-profit organization dedicated to the study anddiscussion of laboratory automation. LRIG activates the uses of laboratory automation in highthroughput screening, drug discovery, combinatorial chemistry, chemical synthesis, compoundpurification, compound distribution, data management, pharmaceutical dosage form samplepreparation, dissolution testing, bio analytical technology, chemical analysis, solid phaseextraction, validation and product formulation.

Estrutura urbana e mobilidade populacional: implicações para o distanciamento social e disseminação da Covid-19 / Urban structure and population mobility: implications for social distance and dissemination of COVID-19 / Estructura urbana y movilidad poblacional: implicancias para el distanciamiento social y la diseminación de covid-19

O mundo vem testemunhando a rápida disseminação dos casos confirmados da síndrome respiratória aguda por meio do coronavírus (Sars-CoV-2 Covid-19). Nos primeiros meses de pandemia, as estatísticas indicam que as grandes cidades tornaram-se palcos destacados de contágio e disseminação da Covid-19. Diante desse cenário, o presente estudo oferece argumentos que auxiliam na construção e aferição preliminar de três hipóteses: a estrutura urbana e a organização das cidades interferem na taxa de distanciamento social e, portanto, no ritmo de contágio da doença; na cidade, a forma com que o sistema de transporte de pessoas está estruturado desempenha papel relevante no ritmo de disseminação da Covid-19; e a pandemia e as práticas de distanciamento físico e social alteram os padrões de mobilidade intraurbana. Analisam-se dados nacionais e regionais disponíveis em órgãos oficiais e outros trabalhos empíricos sobre a Covid-19 à luz de estudos teóricos sobre mobilidade urbana. Em seguida, por método indutivo, é feita uma associação destes dados aos diferentes modelos de cidades (compacta x espraiada), considerando, em especial, aspectos de mobilidade urbana. Os argumentos desenvolvidos nesse estudo parecem corroborar o teor central das hipóteses apresentadas. É preciso desenvolver modelos que incorporem estes elementos para avançarmos na compreensão da pandemia e, também, de elementos que auxiliem na construção de cidades mais resilientes a fenômenos como a Covid-19.

The world has witnessed the rapid spread of confirmed cases of acute respiratory syndrome through coronavirus (SARS-CoV-2 COVID-19). In the first months of the pandemic, statistics indicate that large cities have become prominent places of contagion and dissemination of COVID-19. In view of this, the present study offers arguments that assist in the construction and preliminary assessment of three hypotheses: 1) the urban structure and the organization of cities interfere in social distancing rates and, therefore, in the rate of contagion of the disease; 2) in cities, the way in which transport system is structured plays an important role in the pace of dissemination of COVID-19; 3) the pandemic and practices of physical and social distancing alter patterns of intra-urban mobility. National and regional data available from official agencies and other empirical studies on COVID-19 are analyzed in the light of theoretical studies on urban mobility. Then, using the inductive method, an association of these data is made with the different city models (compact vs. sprawled), considering, in particular, aspects of urban mobility. The arguments developed in this study seem to corroborate the central issues of the hypotheses presented in this work. It is necessary to develop models that incorporate these elements to advance in understanding the pandemic and elements that help in the construction of cities more resilient to phenomena such as COVID-19.

El mundo ha sido testigo de la rápida propagación de casos confirmados de síndrome respiratorio agudo a través del coronavirus (SARS-CoV-2, covid-19). En los primeros meses de la pandemia, las estadísticas indican que las grandes ciudades se han convertido en espacios prominentes de contagio y difusión de covid-19. En vista de esto, el presente estudio ofrece argumentos que ayudan en la construcción y evaluación preliminar de tres hipótesis: 1) la estructura urbana y la organización de las ciudades interfieren en la tasa de distancia social y, por lo tanto, en la tasa de contagio de la enfermedad; 2) en las ciudades, la forma en que se estructura el sistema de transporte colectivo de personas juega un papel importante en el ritmo de difusión de la covid-19; 3) la pandemia y las prácticas de distancia física y social alteran los patrones de movilidad intraurbana. Los datos nacionales y regionales disponibles de organismos oficiales y otros estudios empíricos sobre covid-19 se analizan a la luz de los estudios teóricos sobre movilidad urbana. Luego, utilizando el método inductivo, se hace una asociación de estos datos con los diferentes modelos de ciudad (compacto contra extendido), considerando, en particular, aspectos de la movilidad urbana. Los argumentos desarrollados en este estudio parecen corroborar el tenor central de las hipótesis. Es necesario desarrollar modelos que incorporen otros elementos para avanzar a la recopilación de datos de la pandemia y de otros elementos que permitan la construcción de ciudades más resistentes a los fenómenos como la covid-19.

Presence of mycotic microorganisms in raw milk from cooling tanks in the Boyacense highlands (Colombia) / Presencia de microorganismos micóticos en leche cruda de tanques de enfriamiento en el Altiplano Boyacense (Colombia) / Presença de microrganismos micóticos no leite cru de tanques de resfriamento no Altiplano Boyacense (Colômbia)

Abstract Yeasts and molds are germs that should not be found in milk samples because they are potentially pathogenic for both animals and humans. Due to its high handling during collection, storage, and transport, milk is susceptible to contamination with these microorganisms, so its detection in this food in these phases is relevant in order to prevent possible situations that compromise public health. The objective of the present work was to determine the presence of molds and yeasts in samples of milk cooling tanks in the Boyacense highlands. Samples were taken from 20 raw milk cooling tanks located in 20 different dairy municipalities of the department of Boyacá in order to determine the presence of molds and yeasts through Compact Dry YM®. 35% of the samples of milk did not present growth of molds or yeasts, meanwhile, in 25% yellow colony growth and its tonalities were found, which would correspond with mold colonies, in 5% determined the growth only of blue colonies, corresponding to yeast growth. In the remaining 35% growth of blue and yellow colonies was detailed. This shows that there is a high percentage of molds and yeasts in samples of refrigerated raw milk, a situation that could trigger a public health problem.

Resumen Las levaduras y los mohos son gérmenes que no se deben encontrar en muestras de leche porque son potencialmente patógenos tanto para los animales como para el ser humano. Debido a su alta manipulación durante la recolección, almacenamiento y transporte, la leche es susceptible de contaminación con estos microorganismos, por lo cual su detección en este alimento en estas fases, es relevante con el fin de prevenir posibles situaciones que comprometan la salud pública. El objetivo del presente trabajo fue determinar la presencia de mohos y levaduras en muestras de tanques de enfriamiento de leche en el Altiplano Boyacense. Se tomaron muestras de 20 tanques de enfriamiento de leche cruda ubicados en 20 diferentes municipios lecheros del departamento de Boyacá con el fin de determinar la presencia de mohos y levaduras a través de Compact Dry YM®. El 35% de las muestras de leche no presentó crecimiento de mohos ni de levaduras, por su parte, en el 25% se encontró crecimiento de colonias de color amarillo y sus tonalidades, lo que correspondería con colonias de mohos, en el 5% se determinó el crecimiento únicamente de colonias azules, correspondiente a crecimiento de levaduras. En el 35% restante se detalló un crecimiento de colonias azules y amarillas. Esto demuestra que existe un alto porcentaje mohos y levaduras en muestras de leche cruda refrigerada, situación que podría desencadenar un problema de salud pública.

Resumo Leveduras e fungos são germes que não devem ser encontrados em amostras de leite, pois são potencialmente patogênicos tanto para animais como para humanos. Devido ao seu alto manuseio durante a coleta, armazenamento e transporte, o leite é suscetível à contaminação com esses microrganismos, por isso sua detecção neste alimento nestas fases, é relevante para prevenir possíveis situações que comprometam a saúde pública. O objetivo do presente trabalho foi determinar a presença de bolores e leveduras em amostras de tanques de resfriamento de leite no Altiplano de Boyacense. Foram coletadas amostras de 20 tanques de resfriamento de leite cru, localizados em 20 diferentes municípios leiteiros do departamento de Boyacá, a fim de determinar a presença de bolores e leveduras através do Compact Dry YM®. 35% das amostras de leite não apresentaram crescimento de bolores ou leveduras, entretanto, em 25% de crescimento de colônia amarela e suas tonalidades foram encontradas, o que corresponderia às colônias de bolores, em 5% determinou o crescimento apenas das colônias azuis, correspondendo ao crescimento das leveduras. Isso mostra que há uma alta porcentagem de bolores e leveduras em amostras de leite cru refrigerado, situação que pode desencadear um problema de saúde pública.

Double surface light emitting diode phototherapy versus double surface compact florescent light phototherapy in neonatal non-haemolytic hyperbilirubinemia: a randomized controlled trial

Background: The aim of the study was to evaluate whether light-emitting diode (LED) phototherapy is as efficacious as compact fluorescent tube (CFT) phototherapy for the treatment of non-hemolytic jaundice in healthy term and late preterm neonates.Methods: Study design was open label randomized controlled trial conducted at tertiary care NICU. Healthy term and late preterm neonates with non-haemolytic jaundice included in the present study. Intervention was double-surface LED or CFT phototherapy. Primary outcome variable was duration of phototherapy.Results: A total of 60 neonates were randomized to receive LED (n=30) or CFT (n=30) phototherapy. The baseline demographic and biochemical variables were similar in the two groups. The median duration of phototherapy (Mean'SD) in the two groups was comparable (26.7'7.0) h vs (24.8'6.05) h, P=0.0.241). The rate of fall of serum total bilirubin (STB) during phototherapy in initial 6 hours was significantly more LED group (n=30), 3.43'0.65 versus (n=30) 2.22'0.55 with P-value of <0.001.Conclusions: LED and CFT phototherapy units were equally efficacious in the management of non-haemolytic hyperbilirubinemia in healthy term and late-preterm neonates.' Side effects were rare, comparable in the two groups and included only rash.

Formulation And Evaluation Of Liquisolid Compacts Of Lornoxicam

Objective: Objective of the present investigation was to enhance the solubility and dissolution rate of poorly water-soluble drug lornoxicam using liquisolid technique with comparative determination of in vitro release profile of liquisolid compacts and conventional formulation of lornoxicam. Methods: Formulation was prepared by a liquisolid technique using different drug concentration in a liquid vehicle and different carrier/coating ratio. Prepared liquisolid compact was evaluated for Fourier transform infrared (FTIR) spectra analysis, differential scanning calorimetry (DSC), X-ray diffraction (P-XRD), scanning electron microscopy (SEM) and in vitro dissolution study. Results: The result showed that liquisolid compacts of lornoxicam displayed significantly higher drug release rate as compared to pure drug and conventional tablet prepared. The results of both DSC and X-ray crystallography indicated loss of crystallinity of the drug upon formulated into the liquisolid compact. Conclusion: Dissolution rate of the drug from liquisolid compacts was affected by changing the drug concentration and excipient ratio. The liquisolid technique appeared to be a promising approach for improving the dissolution of poorly soluble drug lornoxicam.

Antifungal susceptibility profile of diferent yeasts isolates from wild animals, cow's milk with subclinical mastitis and hospital environment / Perfil de suscetibilidade antifúngica de diferentes leveduras isoladas da microbiota de animais silvestres, leite com mastite subclínica e ambiente hospitalar

Abstract Yeast infections have acquired great importance due to increasing frequency in immunocompromised patients or patients undergoing invasive diagnostic and therapeutic techniques, and also because of its high morbidity and mortality. At the same time, it has been seen an increase in the emergence of new pathogenic species difficult to diagnose and treat. The aim of this study was to determine the in vitro susceptibility of 89 yeasts from different sources against the antifungals amphotericin B, voriconazole, fluconazole and flucytosine, using the VITEK® 2 Compact system. The antifungal susceptibility was performed automatically by the Vitek® 2 Compact system. The origin of the yeasts was: Group 1 - microbiota of wild animals (W) (26/89), 2 - cow's milk with subclinical mastitis (M) (27/89) and 3 - hospital enviorment (H) (36/89). Of the 89 yeasts submitted to the Vitek® 2 test, 25 (20.9%) were resistant to fluconazole, 11 (12.36%) to amphotericin B, 3 (3.37%) to voriconazole, and no sample was resistant to flucytosine. Regarding the minimum inhibitory concentration (MIC), fluconazole showed an MIC between 1 and 64 mg/mL for the three groups, voriconazole had an MIC between 0.12 and 8 mg/mL, amphotericin B had an MIC between 0.25 and 4 mg/mL for group H and group W respectively, between 0.25 and 16 mg/mL for group M and flucytosine had an MIC equal to 1μg/mL for all groups. The yeasts isolated from the H group showed the highest resistance to fluconazole 12/89 (13.49%), followed by group W (7.87%) and group M (5.62%). The more resistant group to voriconazole was followed by the M and H groups, the W group showed no resistance to this antifungal. Group H was the least resistant (2.25%) to amphotericin.

Resumo As infecções por leveduras têm adquirido grande importância, devido ao aumento da sua frequência em pacientes imunocomprometidos ou pacientes submetidos a técnicas diagnosticas e terapêuticas agressivas, e devido sua alta morbidade e mortalidade. Paralelamente tem-se observado um incremento na aparição de novas espécies patógenas difíceis de diagnosticar e tratar. O objetivo desse estudo foi avaliar a suscetibilidade in vitro de 89 leveduras de diferentes origens frente aos antifúngicos Anfotericina B, Voriconazol, Fluconazol e Fluocitocina pelo Sistema Vitek® 2. O antifungigrama foi realizado automaticamente pelo Vitek® 2 Compact. A origem das leveduras foi: Grupo 1- Microbiota de Animais Silvestres (S) (26/89), 2- Leite com mastite bovina subclínica (L) (27/89) e 3- Ambiente Hospitalar (H) (36/89). Das 89 leveduras submetidas à carta Vitek®, 25 (20.09%) foram resistentes ao fluconazol, oito (8.99%) à anfotericina B, três (3.37%) ao voriconazol, e nenhuma amostra mostrou-se resistente a fluocitosina. O grupo três (H) foi mais resistente ao fluconazol que os demais, já o dois (L) foi mais resistente ao voriconazol e a anfotericina B que os outros dois. O fluconazol pode ter apresentado maior número de resistências devido ser um fármaco comumente usado principalmente em humanos. As leveduras isoladas de humanos apresentaram maior número de resistências aos fármacos testados do que as leveduras isoladas de animais silvestres. O que pode ocorrer devido a uma maior exposição dos humanos aos fármacos em relação aos animais que vivem isolados em ambientes selvagens e na maioria dos casos nunca teve contato com fármacos de qualquer origem.

Acompanhamento operacional e avaliação de uma estação compacta de tratamento de esgoto sanitário: reator UASB seguido de filtro aerado submerso / Operational monitoring and evaluation of a compact sanitary wastewater treatment plant: UASB reactor followed by submerged aerated filter

RESUMO Estações Compactas de Tratamento de Efluentes (ECTEs) são uma ótima alternativa para a implantação de sistemas descentralizados de esgoto doméstico que possam atender pequenas comunidades. No entanto, tais sistemas ainda são pouco utilizados e há pouca experiência em relação à sua operação. Diante de tal demanda, esta pesquisa visou avaliar a eficiência e realizar o acompanhamento operacional de uma ECTE composta por reator Upflow Anaerobic Sludge Blanket (UASB), seguido de filtro aerado submerso (FAS), que está localizada no município de Uru, em São Paulo, Brasil. Durante a pesquisa, o sistema mostrou-se uma alternativa viável de tratamento para pequenas comunidades, pois apresentou boa eficiência, com valores médios de remoção de demanda bioquímica de oxigênio (DBO5) e demanda química de oxigênio (DQO) de 91 e 85%, respectivamente. O monitoramento realizado durante a pesquisa também contribuiu para melhorias gerais no sistema.

ABSTRACT Compact Wastewater Treatment Plants (CWTPs) are a great alternative to implementing decentralized sewage systems that can serve small communities. However, such systems are still poorly used and there is little experience regarding their operation. Based on such demand, this research aimed to evaluate the efficiency and to conduct an operational monitoring of a CWTP composed by an Upflow Anaerobic Sludge Blanket (UASB) reactor, followed by Submerged Aerated Filter (SAF), in the city of Uru, São Paulo, Brazil. During the research, the system proved to be a viable alternative for small communities, because it showed good efficiency, with average removal values of biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) of 91 and 85%, respectively. The monitoring carried out during the research also contributed to general improvements in the system.

Internal Architecture Of Human Tali

Introduction: The talus is one of the seven tarsal bones. It is responsible for receiving the body weight andtransmitting it to the plantar arch below. The architecture of cancellous bone is based on its mechanical demands.The trabecular patterns of a bone are formed by the stress trajectories that are placed on that bone. The preferreddirectional orientation of the trabeculae thus provides a history of the stresses to which the bone has beensubjected.Aim: To study the internal architecture and pressure lines of human tali.Materials and Methods: 30 tali were dissected out from the formalin fixed lower limbs available at the Departmentof Anatomy of KVG Medical College, Sullia and they were dried and serial longitudinal (parasagittal), transverse(coronal) and horizontal sections of the bone were made in 10 each. The coronal sections were made at 3 levelsi.e at the body, neck and head. A good quality digital photograph of the cut surfaces were taken using a digitalcamera for analysis of the trabeculae of cancellous bone. Radiographs of the slices were also taken to study thepressure and the tension lines.Results: The sections showed an outer thin layer of compact bone, but it was much thicker at the neck of the talus.In the head, the cancellous bone was made of thick, parallel running semi-arched plates which consisted of twolimbs i.e vertical and horizontal which were continuous with each otherConclusion: It can be concluded that the part of compressive force, acting vertically downward on the body of thetalus during standing, was converted to tensile force in the neck, and its direction was made perpendicular, toenable this force to go toward the head of the talus. These findings may help in better understanding of fracturelines in the talus, which could improve internal fixation techniques, and help in designing of talar prosthesis.

Measuring Pressure Interface Of Local Car Seats Under Static And Dynamic Circumstances: A Comparative Study

@# Measuring discomfort towardthe car seat is important as the act of driving requires a driver to remain at the car seat while controlling the car. The seat condition, including sitting position as well as the driver’s posture can lead to discomfort and fatigue. The objective of this study is to investigate a driver’s pressure distribution in static and dynamic circumstances for two types of cars; the sedan and compact car. This study involved both subjective and objective evaluations of 12 respondents. For the subjective evaluation, the Visual Analog Scales (VAS) were used to obtain respondents' perception of discomfort. For the objective evaluation, pressure distribution readings of the seat interface were obtained using piezo capacitive sensors. The findings showed that the highest pressure was recorded for the compact car. Furthermore, the static circumstance showed greater pressure compared to the dynamic state. Subjective evaluation indicated that the right buttocks and the lower back (lumbar)experience the highest discomfort for both types of seats.The type of seat found to contribute to the value of different pressure. Thus, it can be concluded that appropriate seat selection can reduce pressure as well as discomfort.

Practice and reflections of medical alliance development in Wuxi / 中华医院管理杂志

The paper covered attempts of Wuxi city in construction of medical alliances and continuous perfection of primary medical systems within the region.It is pointed out that medical alliances should center on patients'medical needs to build a vertical medical model; build an effective constraint framework and incentive mechanism without involving into unnecessary conflicts of core interests of stakeholders;and leverage highly informationized networks to achieve seamless interconnection of the entire medical process with the IT process.

The reliability and validity of comprehensive assessment of ACT process(CompACT)in financial staffs / 中华行为医学与脑科学杂志

Objective To measure the reliability and validity of the Chinese version of the compre-hensive assessment of ACT processes(CompACT)in financial staffs. Methods A total of 3 735 valid ques-tionnaires were obtained from financial staffs.The valid questionnaires were randomly allocated into two groups,of which one subset(n=1 873)was used for exploratory factor analysis(EPA),and the other(n=1 845)for confirmatory factor analysis(CFA).Criterion and convergent validity were tested by Pearson corre-lation respectively.Incremental validity was tested by hierarchical regression analysis. Results The EFA suggested theoretically-coherent three-factor structure for a 15-itemed version of the CompACT.The three fac-tors named as acceptance and cognitive defusion,mindfulness and self as context,value and committed ac-tion,and explained 73.75% of the total variance and factor loadings ranged from 0.67 to 0.90.The CFA con-firmed the hypothesized three-factor mode(χ2/df=5.91,CFI=0.98,TLI=0.98,RMSEA=0.05). Conclu-sion The research suggests that the Chinese version of the CompACT has acceptable psychometric in prop-erties,so it can be applied in the assessment of the psychological flexibility and mental health in China.

Evaluation on the Accuracy of VITEK 2 Compact for the Susceptibility of Carbapenem-Resistant Klebsiella Peumoniae to Amikacin / 现代检验医学杂志

Objective To evaluate the accuracy of VITEK 2 Compact in the detection of the drug susceptibility of carbapenemresistant Klebsiella pneumoniae (CRKP) to Amikacin.Methods The susceptibility for 147 isolates of SRKP to Amikacin were detected by VITEK 2 Compact,disk diffusion method (K-B method) and E-test method,respectively.Results Among the 147 strains of Klebsiella pneumoniae,the drug susceptibility results were consistent between K B and E-test method.Among the 5 strains,the results were totally consistent by VITEK 2 Compact,K-B method and E test method,of which 4 strains were sensitive,1 strains were resistant.There were 142 strains being not consistent between VITEK 2 Compact and E-test method.The results of VITEK 2 Compact were sensitive or intermediate,while E test were drug resistance.Conclusion VITEK 2 Compact is not reliable for the detection of CRKP to Amikacin,which requires that K B method or other methods should be used for the susceptibility of CRKP to Amikacin.

Antifungal susceptibility profile of diferent yeasts isolates from wild animals, cows milk with subclinical mastitis and hospital environment

Abstract Yeast infections have acquired great importance due to increasing frequency in immunocompromised patients or patients undergoing invasive diagnostic and therapeutic techniques, and also because of its high morbidity and mortality. At the same time, it has been seen an increase in the emergence of new pathogenic species difficult to diagnose and treat. The aim of this study was to determine the in vitro susceptibility of 89 yeasts from different sources against the antifungals amphotericin B, voriconazole, fluconazole and flucytosine, using the VITEK® 2 Compact system. The antifungal susceptibility was performed automatically by the Vitek® 2 Compact system. The origin of the yeasts was: Group 1 - microbiota of wild animals (W) (26/89), 2 - cows milk with subclinical mastitis (M) (27/89) and 3 - hospital enviorment (H) (36/89). Of the 89 yeasts submitted to the Vitek® 2 test, 25 (20.9%) were resistant to fluconazole, 11 (12.36%) to amphotericin B, 3 (3.37%) to voriconazole, and no sample was resistant to flucytosine. Regarding the minimum inhibitory concentration (MIC), fluconazole showed an MIC between 1 and 64 mg/mL for the three groups, voriconazole had an MIC between 0.12 and 8 mg/mL, amphotericin B had an MIC between 0.25 and 4 mg/mL for group H and group W respectively, between 0.25 and 16 mg/mL for group M and flucytosine had an MIC equal to 1g/mL for all groups. The yeasts isolated from the H group showed the highest resistance to fluconazole 12/89 (13.49%), followed by group W (7.87%) and group M (5.62%). The more resistant group to voriconazole was followed by the M and H groups, the W group showed no resistance to this antifungal. Group H was the least resistant (2.25%) to amphotericin.

Resumo As infecções por leveduras têm adquirido grande importância, devido ao aumento da sua frequência em pacientes imunocomprometidos ou pacientes submetidos a técnicas diagnosticas e terapêuticas agressivas, e devido sua alta morbidade e mortalidade. Paralelamente tem-se observado um incremento na aparição de novas espécies patógenas difíceis de diagnosticar e tratar. O objetivo desse estudo foi avaliar a suscetibilidade in vitro de 89 leveduras de diferentes origens frente aos antifúngicos Anfotericina B, Voriconazol, Fluconazol e Fluocitocina pelo Sistema Vitek® 2. O antifungigrama foi realizado automaticamente pelo Vitek® 2 Compact. A origem das leveduras foi: Grupo 1- Microbiota de Animais Silvestres (S) (26/89), 2- Leite com mastite bovina subclínica (L) (27/89) e 3- Ambiente Hospitalar (H) (36/89). Das 89 leveduras submetidas à carta Vitek®, 25 (20.09%) foram resistentes ao fluconazol, oito (8.99%) à anfotericina B, três (3.37%) ao voriconazol, e nenhuma amostra mostrou-se resistente a fluocitosina. O grupo três (H) foi mais resistente ao fluconazol que os demais, já o dois (L) foi mais resistente ao voriconazol e a anfotericina B que os outros dois. O fluconazol pode ter apresentado maior número de resistências devido ser um fármaco comumente usado principalmente em humanos. As leveduras isoladas de humanos apresentaram maior número de resistências aos fármacos testados do que as leveduras isoladas de animais silvestres. O que pode ocorrer devido a uma maior exposição dos humanos aos fármacos em relação aos animais que vivem isolados em ambientes selvagens e na maioria dos casos nunca teve contato com fármacos de qualquer origem.

Performance evaluation of the GP68 Antibiotic Susceptibility Testing card in testing the susceptibility of Streptococcuspneumoniae on VITEK 2-Compact system / 中国感染与化疗杂志

Objective To evaluate the performance of GP68 Antibiotic Susceptibility Testing card in testing the susceptibility of Streptococcus pneumoniae on VITEK 2-Compact system,taking E-test as reference.Methods A total of 98 strains of S.pneumoniae were collected and subjected to susceptibility testing using E-test and VITEK 2-Compact (AST-GP68) in Luzhou People's Hospital form January 1 to December 31,2015.Results According to the breakpoints of Clinical and Laboratory Standards Institute (CLSI),category agreement (CA) of penicillin was 80.6％.Very major error (VME) was 0.Major error (ME) was 12.2％,minor error (mE) was 7.1％.CA of ceffriaxone was 90.8％,VME 0,ME 4.1％,mE 5.1％.CA of cefotaxime was 91.8％,VME 0,mE 5.1％,mE 3.1％.CA of meropenem was 85.7％,VME 0,ME 2.0％,mE 12.2％.CA of other antibiotics (amoxicillin,ertapenem,erythromycin,tetracycline,chloramphenicol,telithromycin,linezolid,vancomycin,moxifloxacin,ofloxacin,levofloxacin) was 100％.Conclusions AST-GP68 on VITEK 2-Compact system may have false results of antimicrobial resistance to some antibiotics such as penicillin,ceftriaxone,cefepime,meropenem due to the defects of the underlying principle.Such false results should be verified by other methods in clinical practice.

Haversian system of compact bone and comparison between endosteal and periosteal sides using three-dimensional reconstruction in rat / 대한해부학회지

The current model of compact bone is that of a system of Haversian (longitudinal) canals connected by Volkmann's (transverse) canals. Models based on either histology or microcomputed tomography do not accurately represent the morphologic detail and microstructure of this system, especially that of the canal networks and their spatial relationships. The aim of the present study was to demonstrate the morphologic pattern and network of the Haversian system and to compare endosteal and periosteal sides in rats using three-dimensional (3D) reconstruction. Ten Sprague-Dawley rats aged 8-10 weeks were used. The femurs were harvested from each rat and fixed, decalcified with 10% EDTA-2Na, serially sectioned at a thickness of 5 microm, and then stained with hematoxylin and eosin. The serial sections were reconstructed three-dimensionally using Reconstruct software. The Haversian canals in the endosteal region were found to be large, highly interconnected, irregular, and close to neighboring canals. In contrast, the canals in the periosteal region were straight and small. This combined application of 3D reconstruction and histology examinations to the Haversian system has confirmed its microstructure, showing a branched network pattern on the endosteal side but not on the periosteal side.