Clostridioides difficile Infection in Hospitalized Patients-A Retrospective Epidemiological Study.

Clostridioides difficile infection (CDI) is the main source of healthcare and antibiotic-associated diarrhea in hospital context and long-term care units, showing significant morbidity and mortality. This study aimed to analyze the epidemiological context, describing the severity and outcomes of this event in patients admitted to our hospital, thus confirming the changing global epidemiological trends in comparison with other cohorts. We conducted a single-center, observational, and retrospective study at the Hospital do Espírito Santo (HESE), Évora, in Portugal, analyzing the incidence of CDI in patients meeting eligibility criteria from January to December 2018. During this period, an annual incidence rate of 20.7 cases per 10,000 patients was documented. The studied population average age was 76.4 ± 12.9 years, 83.3% over 65. Most episodes were healthcare-acquired, all occurring in patients presenting multiple risk factors, with recent antibiotic consumption being the most common. Regarding severity, 23.3% of cases were classified as severe episodes. Recurrences affected 16.7% of participants, predominantly female patients over 80 years old, all of whom were healthcare-acquired. Mortality rate was disproportionately high among the older population. Our investigation documented an overall incidence rate of over 10.4-fold the number of cases identified in the year 2000 at the same hospital, more recently and drastically, in community-associated episodes.

Spectroscopic Methods for Quantifying Gabapentin: Framing the Methods without Derivatization and Application to Different Pharmaceutical Formulations.

This work aimed at analyzing the performance of direct spectroscopic methods for the quantification of gabapentin (GABAp), given the lack of previous studies, in comparison with the more reviewed and complex derivatization techniques, discussing their susceptibility to the pharmaceutical formulations. All of the methods analyzed showed high selectivity for this pharmaceutical analyte, with recoveries close to 100%. Absorption spectroscopy without derivatization yielded better sensitivity and lower limits of detection and quantification of gabapentin in aqueous solution (AqSol method) when compared with other solvents, such as acidic solution or ethanol/water mixture. Derivatization with sodium hypochlorite presented the highest precision, whereas derivatization with vanillin exhibited the highest accuracy. The best method for GABAp quantification in terms of highest sensitivity, lowest limits of detection, and quantification, and also with good precision and accuracy, proved to be fluorescence with derivatization by 4-chloro-7-nitrobenzofurazan. The effect of the pharmaceutical formulation (nature of excipients) was tested for the most robust and sensitive methods, with and without derivatization, on capsules of five commercial brands. Recoveries in the range of 97.9-101.5% proved that there are no matrix interfering effects. Although not presenting the best performance in all the parameters evaluated, the AqSol method, due to its simplicity, proved to be suitable for the quantification of GABAp in capsules and tables containing the molecule as the active ingredient.

Carbon stock loss from deforestation through 2013 in Brazilian Amazonia.

The largest carbon stock in tropical vegetation is in Brazilian Amazonia. In this ~5 million km(2) area, over 750,000 km(2) of forest and ~240,000 km(2) of nonforest vegetation types had been cleared through 2013. We estimate current carbon stocks and cumulative gross carbon loss from clearing of premodern vegetation in Brazil's 'Legal Amazonia' and 'Amazonia biome' regions. Biomass of 'premodern' vegetation (prior to major increases in disturbance beginning in the 1970s) was estimated by matching vegetation classes mapped at a scale of 1 : 250,000 and 29 biomass means from 41 published studies for vegetation types classified as forest (2317 1-ha plots) and as either nonforest or contact zones (1830 plots and subplots of varied size). Total biomass (above and below-ground, dry weight) underwent a gross reduction of 18.3% in Legal Amazonia (13.1 Pg C) and 16.7% in the Amazonia biome (11.2 Pg C) through 2013, excluding carbon loss from the effects of fragmentation, selective logging, fires, mortality induced by recent droughts and clearing of forest regrowth. In spite of the loss of carbon from clearing, large amounts of carbon were stored in stands of remaining vegetation in 2013, equivalent to 149 Mg C ha(-1) when weighted by the total area covered by each vegetation type in Legal Amazonia. Native vegetation in Legal Amazonia in 2013 originally contained 58.6 Pg C, while that in the Amazonia biome contained 56 Pg C. Emissions per unit area from clearing could potentially be larger in the future because previously cleared areas were mainly covered by vegetation with lower mean biomass than the remaining vegetation. Estimates of original biomass are essential for estimating losses to forest degradation. This study offers estimates of cumulative biomass loss, as well as estimates of premodern carbon stocks that have not been represented in recent estimates of deforestation impacts.

Assessing the Certainty of Locations Produced by an Address Geocoding System.

Addresses are the most common georeferencing resource people use to communicate to others a location within a city. Urban GIS applications that receive data directly from citizens, or from legacy information systems, need to be able to quickly and efficiently obtain a spatial location from addresses. In this paper we understand addresses in a broader perspective, in which not only the conventional elements of postal addresses are considered, but other kinds of direct or indirect references to places, such as building names, postal codes, or telephone area codes, which are also valuable as locators to urban places. This broader view on addresses allows us to work with two perspectives. First, in the ontological definition, modeling, and implementation of an addressing database that is flexible enough to accommodate the variety of concepts and address formats used worldwide, along with direct and indirect references to places. Second, in the definition of an indicator that is able to quantify the degree of certainty that could be reached when a user-given, semi-structured address is geocoded into a spatial position, as a function of the type and completeness of the available addressing data and of the geocoding method that has been employed. This indicator, which we call Geocoding Certainty Indicator (GCI), can be used as a threshold, beyond which the geocoded event should be left out of any statistical analysis, or as a weight that allows spatial analysis methods to reduce the influence of events that have been less reliably located. In order to support geocoding activities and the determination of the GCI, we propose a conceptual schema for addressing databases. The schema is flexible enough to accommodate a variety of addressing systems, at various levels of detail, and in different countries. Our intention is to depart from the usual geocoding strategy employed in commercial GIS products, which is usually limited to the average American or British address format. The schema also extends the notion of postal address to something broader, including popular names for places, building names, reference places, and other concepts. This approach extends Simpson's and Yu's Comput. Environ. Urban Syst., 27: 283-307, 2003 work on postal codes to records of any kind, including place names and loosely formatted addresses.