Objective: Traumatic brain injury (TBI) is an independent risk factor for venous thromboembolism (VTE). This study aimed to determine the optimal timing for initiating pharmacological thromboprophylaxis for VTE in patients with isolated severe TBI using rotational thromboelastometry (ROTEM). Methods: This single-center observational study enrolled 115 patients aged 18-59 years with isolated severe TBI within the first 48 hours after injury. Results: Using ROTEM data, we identified hypercoagulation due to an increase in clot density (MCF EXTEM >72), which was attributed to fibrinogen (MCF FIBTEM >25). From day 4, hypercoagulation occurred in 14.8% of the patients. By day 7, these changes were observed in 85.2% of patients. According to brain computed tomography findings, patients who received early VTE chemoprophylaxis on days 3-4 after severe TBI did not experience progression of hemorrhagic foci. Conclusion: Our results emphasize the clinical significance of thromboelastometry in patients with isolated severe traumatic TBI. Anticoagulant prophylaxis started on 3-4 days after severe TBI was relatively safe, and most patients did not experience hemorrhagic foci progression. The data acquired in this study may enable the optimization of VTE chemoprophylactic approaches, thereby reducing the associated risks to patients.
Acinetobacter baumannii is one of the significant healthcare-associated meningitis agents characterized by multidrug resistance and a high mortality risk. Thirty-seven A. baumannii strains were isolated from thirty-seven patients of Moscow neuro-ICU with meningitis in 2013-2020. The death rate was 37.8%. Strain susceptibility to antimicrobials was determined on the Vitek-2 instrument. Whole-genome sequencing was conducted using Illumina technology; the sequence types (ST), capsular types (KL), lipooligosaccharide outer core locus (OCL), antimicrobial resistance genes, and virulence genes were identified. The prevalent ST was ST2, belonging to the international clone IC2, and rarer, ST1, ST19, ST45, ST78, ST106, and ST400, with prevalence of KL9 and OCL1. Twenty-nine strains belonged to multidrug-resistant (MDR) and eight extensively drug-resistant (XDR) categories. Genes conferring resistance to beta-lactams (blaPER, blaGES, blaADC, blaCARB, blaCTX-M, blaTEM, and blaOXA-types), aminoglycosides (aac, aad, ant, aph, and arm), tetracyclines (tet), macrolides (msr and mph), phenicols (cml, cat, and flo), sulfonamides (dfr and sul), rifampin (arr), and antiseptics (qac) were identified. Virulence genes of nine groups (Adherence, Biofilm formation, Enzymes, Immune evasion, Iron uptake, Regulation, Serum resistance, Stress adaptation, and Antiphagocytosis) were detected. The study highlights the heterogeneity in genetic clones, antimicrobial resistance, and virulence genes variability among the agents of A. baumannii meningitis, with the prevalence of the dominant international clone IC2.
INTRODUCTION: Cerebral autoregulation is an essential mechanism for maintaining cerebral blood flow stability. The phenomenon of transtentorial intracranial pressure (ICP) gradient after neurosurgical operations, complicated by edema and intracranial hypertension in the posterior fossa, has been described in clinical practice but is still underinvestigated. The aim of the study was to compare autoregulation coefficients (i.e., pressure reactivity index [PRx]) in two compartments (infratentorial and supratentorial) during the ICP gradient phenomenon. METHODS: Three male patients, aged 24 years, 32 years, and 59 years, respectively, were involved in the study after posterior fossa surgery. Arterial blood pressure and ICP were invasively monitored. Infratentorial ICP was measured in the cerebellar parenchyma. Supratentorial ICP was measured either in the parenchyma of the cerebral hemispheres or through the external ventricular drainage. Cerebral autoregulation was evaluated by the PRx coefficient (ICM + , Cambridge, UK). RESULTS: In all patients, ICP was higher in the posterior fossa, and the transtentorial ICP gradient in each patient was 5 ± 1.6 mm Hg, 8.5 ± 4.4 mm Hg, and 7.7 ± 2.2 mm Hg, respectively. ICP in the infratentorial space was 17 ± 4 mm Hg, 18 ± 4.4 mm Hg, and 20 ± 4 mm Hg, respectively. PRx values in the supratentorial and infratentorial spaces had the smallest difference (- 0.01, 0.02, and 0.01, respectively), and the limits of precision were 0.1, 0.2, and 0.1 in the first, second, and third patients, respectively. The correlation coefficient between the PRx values in the supratentorial and infratentorial spaces for each patient was 0.98, 0.95, and 0.97, respectively. CONCLUSIONS: A high degree of correlation was established between the autoregulation coefficient PRx in two compartments in the presence of transtentorial ICP gradient and persistent intracranial hypertension in the posterior fossa. Cerebral autoregulation, according to the PRx coefficient in both spaces, was similar.
Intracranial Hypertension , Intracranial Pressure , Humans , Male , Intracranial Pressure/physiology , Arterial Pressure/physiology , Homeostasis/physiology , Cerebrovascular Circulation/physiology , Cerebellum/surgery , Intracranial Hypertension/etiology , Intracranial Hypertension/surgery
BACKGROUND: Klebsiella pneumoniae, a member of the ESKAPE group of bacterial pathogens, has developed multi-antimicrobial resistance (AMR), including resistance to carbapenems, which has increased alarmingly due to the acquisition of carbapenemase genes located on specific plasmids. METHODS: Four clinical K. pneumoniae isolates were collected from four patients of a neuro-intensive care unit in Moscow, Russia, during the point prevalence survey. The AMR phenotype was estimated using the Vitec-2 instrument, and whole genome sequencing (WGS) was done using Illumina and Nanopore technologies. RESULTS: All strains were resistant to beta-lactams, nitrofurans, fluoroquinolones, sulfonamides, aminoglycosides, and tetracyclines. WGS analysis revealed that all strains were closely related to K. pneumoniae ST39, capsular type K-23, with 99.99% chromosome identity. The novelty of the study is the description of the strains carrying simultaneously three large plasmids of the IncHI1B, IncC, and IncFIB groups carrying the carbapenemase genes of three types, blaOXA-48, blaNDM-1, and blaKPC-2, respectively. The first of them, highly identical in all strains, was a hybrid plasmid that combined two regions of the resistance genes (blaOXA-48 and blaTEM-1 + blaCTX-M-15 + blaOXA-1 + catB + qnrS1 + int1) and a region of the virulence genes (iucABCD, iutA, terC, and rmpA2::IS110). CONCLUSION: The spread of K. pneumoniae strains carrying multiple plasmids conferring resistance even to last-resort antibiotics is of great clinical concern.
To foresee global economic trends, one needs to understand the present startup companies that soon may become new market leaders. In this paper, we explore textual descriptions of more than 250 thousand startups in the Crunchbase database. We analyze the 2009-2019 period by using topic modeling. We propose a novel classification of startup companies free from expert bias that contains 38 topics and quantifies the weight of each of these topics for all the startups. Taking the year of establishment and geographical location of the startups into account, we measure which topics were increasing or decreasing their share over time, and which of them were predominantly present in Europe, North America, or other regions. We find that the share of startups focused on data analytics, social platforms, and financial transfers, and time management has risen, while an opposite trend is observed for mobile gaming, online news, and online social networks as well as legal and professional services. We also identify strong regional differences in topic distribution, suggesting certain concentration of the startups. For example, sustainable agriculture is presented stronger in South America and Africa, while pharmaceutics, in North America and Europe. Furthermore, we explore which pairs of topics tend to co-occur more often together, quantify how multisectoral the startups are, and which startup classes attract more investments. Finally, we compare our classification to the one existing in the Crunchbase database, demonstrating how we improve it.
Climate change has revived the debate on growth-versus-environment. In line with this, recently it has been proposed to shift the target focus of IPCC scenarios from emissions to post-growth. We argue here that this confounds ends and means, since while reduction of growth may be an outcome of good climate policies, it should not be a goal in itself. In fact, a post- or degrowth goal would mean an ineffective and costly way to reduce emissions. Instead, we suggest that the debate about pursuing economic growth versus achieving climate goals will become more transparent and policy-relevant through refocusing scenarios from targets to policy.
Climate Change , Policy , Humans
The spread of multidrug-resistant Gram-negative bacteria, which is associated with the distribution of beta-lactamase genes and class 1 and 2 integrons, is a global problem. In this study, in the Moscow neurosurgery intensive care unit (neuro-ICU), the high prevalence of the above-stated genes was found to be associated with intestinal and tracheal carriage. Seven-point prevalence surveys, which included 60 patients in the neuro-ICU, were conducted weekly in the period from Oct. to Nov. 2019. A total of 293 clinical samples were analyzed, including 146 rectal and 147 tracheal swabs; 344 Gram-negative bacteria isolates were collected. Beta-lactamase genes (n = 837) were detected in the isolates, including beta-lactamase blaTEM (n = 162), blaSHV (n = 145), cephalosporinase blaCTX-M (n = 228), carbapenemase blaNDM (n = 44), blaKPC (n = 25), blaOXA-48 (n = 126), blaOXA-51-like (n = 54), blaOXA-40-like (n = 43), blaOXA-23-like (n = 8), and blaVIM (n = 2), as well as class 1 (n = 189) and class 2 (n = 12) integrons. One extensively drug-resistant Klebsiella pneumoniae strain (sequence type ST39 and capsular type K23), simultaneously carried beta-lactamase genes, blaSHV-40 and blaTEM-1B, three carbapenemase genes, blaNDM, blaKPC, and blaOXA-48, the cephalosporinase gene blaCTX-M, and two class 1 integrons. Before this study, such heavily armed strains have not been reported, suggesting the ongoing evolution of antibiotic resistance.
Since the onset of the COVID-19 crisis many have opinionated on how it may affect society's response to climate change. Two key questions here are how COVID-19 is expected to influence climate action by citizens and by the government. We answer these by applying topic modelling to textual responses from a survey of Spanish citizens. The identified topics tend to be more negative than positive, and more optimistic concerning future climate action by citizens. Positive views involve increasing pro-environmental behavior and are more common among younger, higher educated and male respondents as well as among those who perceive climate change as a serious threat or positively assessed COVID-19 confinement. Negative topics express concern that financial resources for climate action will be limited due to a focus on healthcare and economic recovery. In addition, they mention government mismanagement and waste due to use of protective measures like masks and gloves as impediments to effective climate action.
COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Climate Change , Government , Humans , Male , Masks , Motivation
It remains unclear how COVID-19 has affected public engagement with the climate crisis. According to the finite-pool-of-worry hypothesis, concern about climate change should have decreased after the pandemic, in turn reducing climate-policy acceptance. Here we test these and several other conjectures by using survey data from 1172 Spanish participants who responded before and after the first wave of COVID-19, allowing for both aggregate and within-person analyses. We find that on average climate concern has decreased, while acceptance of most climate policies has increased. At the individual-level, adverse health experiences are unrelated to these changes. The same holds for negative economic experiences, with the exception that unemployment is associated with reduced acceptance of some policies. Complementary to the finite-pool-of-worry test, we examine three additional pandemic-related issues. As we find, (1) higher climate concern and policy acceptance are associated with a belief that climate change contributed to the COVID-19 outbreak; (2) higher policy acceptance is associated with a positive opinion about how the government addressed the COVID-19 crisis; (3) citizens show favorable attitudes to a carbon tax with revenues used to compensate COVID-19-related expenditures. Overall, we conclude there is support for addressing the global climate crisis even during a global health crisis.
The incidence of healthcare-associated respiratory tract infections in non-ventilated patients (NVA-HARTI) in neurosurgical intensive care units (ICUs) is unknown. The impact of NVA-HARTI on patient outcomes and differences between NVA-HARTI and ventilator-associated healthcare-associated respiratory tract infections (VA-HARTI) are poorly understood. Our objectives were to report the incidence, hospital length of stay (LOS), ICU LOS, and mortality in NVA-HARTI patients and compare these characteristics to VA-HARTI in neurocritical care patients. This cohort study was conducted in a neurosurgical ICU in Moscow. From 2011 to 2020, all patients with an ICU LOS > 48 h were included. A competing risk model was used for survival and risk analysis. A total of 3,937 ICU admissions were analyzed. NVA-HARTI vs VA-HARTI results were as follows: cumulative incidence 7.2 (95%CI: 6.4-8.0) vs 15.4 (95%CI: 14.2-16.5) per 100 ICU admissions; incidence rate 4.2 ± 2.0 vs 9.5 ± 3.0 per 1000 patient-days in the ICU; median LOS 32 [Q1Q3: 21, 48.5] vs 46 [Q1Q3: 28, 76.5] days; median ICU LOS 15 [Q1Q3: 10, 28.75] vs 26 [Q1Q3: 17, 43] days; mortality 12.3% (95%CI: 7.9-16.8) vs 16.7% (95%CI: 13.6-19.7). The incidence of VA-HARTI decreased over ten years while NVA-HARTI incidence did not change. VA-HARTI was an independent risk factor of death, OR 1.54 (1.11-2.14), while NVA-HARTI was not. Our findings suggest that NVA-HARTI in neurocritical care patients represents a significant healthcare burden with relatively high incidence and associated poor outcomes. Unlike VA-HARTI, the incidence of NVA-HARTI remained constant despite preventive measures. This suggests that extrapolating VA-HARTI research findings to NVA-HARTI should be avoided.
Cross Infection , Respiratory Tract Infections , Cohort Studies , Cross Infection/epidemiology , Cross Infection/therapy , Delivery of Health Care , Hospital Mortality , Humans , Incidence , Intensive Care Units , Length of Stay , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/therapy
Public acceptability of carbon taxation depends on its revenue use. Which single or mixed revenue use is most appropriate, and which perceptions of policy effectiveness and fairness explain this, remains unclear. It is, moreover, uncertain how people's prior knowledge about carbon taxation affects policy acceptability. Here we conduct a survey experiment to test how distinct revenue uses, prior knowledge, and information provision about the functioning of carbon taxation affect policy perceptions and acceptability. We show that spending revenues on climate projects maximises acceptability as well as perceived fairness and effectiveness. A mix of different revenue uses is also popular, notably compensating low-income households and funding climate projects. In addition, we find that providing information about carbon taxation increases acceptability for unspecified revenue use and for people with more prior tax knowledge. Furthermore, policy acceptability is more strongly related to perceived fairness than to perceived effectiveness.
The purpose of this study was the identification of genetic lineages and antimicrobial resistance (AMR) and virulence genes in Klebsiella pneumoniae isolates associated with severe infections in the neuro-ICU. Susceptibility to antimicrobials was determined using the Vitek-2 instrument. AMR and virulence genes, sequence types (STs), and capsular types were identified by PCR. Whole-genome sequencing was conducted on the Illumina MiSeq platform. It was shown that K. pneumoniae isolates of ST14K2, ST23K57, ST39K23, ST76K23, ST86K2, ST218K57, ST219KL125/114, ST268K20, and ST2674K47 caused severe systemic infections, including ST14K2, ST39K23, and ST268K20 that were associated with fatal incomes. Moreover, eight isolates of ST395K2 and ST307KL102/149/155 were associated with manifestations of vasculitis and microcirculation disorders. Another 12 K. pneumoniae isolates of ST395K2,KL39, ST307KL102/149/155, and ST147K14/64 were collected from patients without severe systemic infections. Major isolates (n = 38) were XDR and MDR. Beta-lactamase genes were identified: blaSHV (n = 41), blaCTX-M (n = 28), blaTEM (n = 21), blaOXA-48 (n = 21), blaNDM (n = 1), and blaKPC (n = 1). The prevalent virulence genes were wabG (n = 41), fimH (n = 41), allS (n = 41), and uge (n = 34), and rarer, detected only in the genomes of the isolates causing severe systemic infections-rmpA (n = 8), kfu (n = 6), iroN (n = 5), and iroD (n = 5) indicating high potential of the isolates for hypervirulence.
Hyperthermia is a common detrimental condition in patients with an acute brain injury (ABI), which can worsen their prognosis and outcome. The aim of this study was to evaluate the effects of hyperthermia on intracranial pressure (ICP) and cerebral autoregulation (CA).Eight patients with ABI were studied. CA was assessed on the basis of the pressure reactivity index (PRx) coefficient. The ICP, cerebral perfusion pressure (CPP), and PRx were compared before and during development of hyperthermia. Hyperthermia was defined as an increase in cerebral temperature above 38.3 °C.Thirty-three episodes of hyperthermia were analyzed: 25 of these occurred on a background of initially normal ICP whereas 8 occurred on a background of initially elevated ICP, and 17 of the 33 episodes occurred on a background of initially intact autoregulation whereas 16 occurred on a background of initially impaired autoregulation.During hyperthermia, elevated ICP was found in 52% of instances where it was initially normal, and further progression of intracranial hypertension occurred in 100% of instances where ICP was initially elevated. The median ICP during hyperthermia was 24 [range quartiles 22-28] mmHg in instances where it was initially normal and 31 [quartiles 27-32] mmHg in instances where it was initially elevated (p < 0.01). The correlation coefficient between the brain temperature and ICP was 0.11 (p < 0.01). During hyperthermia, the number of episodes of ICP >20 mmHg increased by 41% in instances with intact autoregulation but ICP was above 20 mmHg and by 38% (p > 0.05) in instances with impaired autoregulation and ICP was 20 mmHg. The cerebral hyperthermia-associated increase in ICP was not associated with impaired autoregulation.
Brain Injuries , Intracranial Hypertension , Brain Injuries/complications , Brain Injuries/therapy , Cerebrovascular Circulation , Homeostasis , Humans , Hyperthermia , Intracranial Hypertension/etiology , Intracranial Hypertension/therapy , Intracranial Pressure
The invasive wasp-mimicking Tiger Longicorn Beetle, Xylotrechus chinensis, a potentially lethal pest of mulberry trees (Moraceae: Morus sp.), was first reported in Europe in 2018, although its colonization and establishment were estimated to have occurred during the year 2012 or earlier. In Catalonia the infestation spread from four towns and 44.1 km2 in 2018 to 12 towns and 378.1 km2 in 2020; in the studied town of Barberà del Vallès, infested trees rose from 16.21% in February 2016 to 59.29% in December 2018. Human safety in public parks and avenues is a concern, as beetle infestation increases the risk of falling branches. The main objective of this study was to evaluate how the infestation progresses over time, with and without abamectin treatment, and provide insights into female egg-laying preferences. Such knowledge helps contribute to management efforts to reduce expansion of the range of beetle infestation. Our statistical analysis shows that females prefer laying eggs on larger trees, on the highest part of trunks and on the crown base (this being more preferred than the trunk), and they do so on warmer, SW orientations rather than those facing N, NW and E. Emergence holes and gallery slits predict the spreading of infestations to new trees. An abamectin treatment (trunk injection) carried out at the end of April significantly reduced the number of new infestation. However, for maximum insecticide efficiency, the best time for treating with abamectin would be from mid-July to mid-August, when newly hatched larvae begin feeding on the phloem.
Coleoptera , Insect Control/statistics & numerical data , Insecticides , Introduced Species , Ivermectin/analogs & derivatives , Morus , Animals , Europe , Morus/anatomy & histology , Morus/growth & development , Outcome Assessment, Health Care
Subarachnoid hemorrhage after cerebral aneurysm rupture (aSAH) leads to delayed cerebral ischemia (DCI) in 25-35% of surviving patients. It is believed that DCI has a multifactorial etiology, including vasospasm. Furthermore, aSAH is associated with the development of hypercoagulation and microthrombosis; thus, its pharmacological correction may help to prevent DCI. We encountered a case where hypercoagulation was detected using rotational thromboelastometry (ROTEM), although the standard coagulation test results were within the normal ranges. Based on reviews of viscoelastic tests in cases of aSAH, ROTEM could be more sensitive to hypercoagulation after aSAH, compared to standard coagulation testing.
Brain Ischemia , Cerebral Infarction , Intracranial Aneurysm , Subarachnoid Hemorrhage , Thrombophilia , Brain Ischemia/etiology , Cerebral Infarction/complications , Humans , Intracranial Aneurysm/complications , Subarachnoid Hemorrhage/diagnosis , Subarachnoid Hemorrhage/etiology , Thrombelastography , Thrombophilia/complications
The speed and extent of diffusion of behaviors in social networks depends on network structure and individual preferences. The contribution of the present study is twofold. First, we introduce weighted interactions between potential adopters that depend on the similarity in their preferences and moderate the strength of social reinforcement. The reason for the extension is the existence of a confirmation bias in the way agents treat information by prioritizing evidence conforming to their opinion. As a result, individuals become less likely to be influenced by peers with relatively different preferences, reducing the overall diffusion rate under clustered networks. Second, we enrich our analysis by also considering a scale free network topology with a high degree asymmetry, motivated by its pervasiveness in online social networks. This network performs consistently well in terms of diffusion for different parameter combinations and clearly outperforms clustered networks under weighted interactions. Our results show that more realistic assumptions regarding agents' interactions shift the focus from clustering to degree distribution in the study of network structures allowing for fast and widespread behavior adoption.
Interpersonal Relations , Models, Theoretical , Social Networking
Background: The impact of infection prevention and control (IPC) programs in limited resource countries such as Russia are largely unknown due to a lack of reliable data. The aim of this study is to evaluate the effect of an IPC program with respect to healthcare associated infection (HAI) prevention and to define the incidence of HAIs in a Russian ICU. Methods: A pioneering IPC program was implemented in a neuro-ICU at Burdenko Neurosurgery Institute in 2010 and included hand hygiene, surveillance, contact precautions, patient isolation, and environmental cleaning measures. This prospective observational cohort study lasted from 2011 to 2016, included high-risk ICU patients, and evaluated the dynamics of incidence, etiological spectrum, and resistance profile of four types of HAIs, including subgroup analysis of device-associated infections. Survival analysis compared patients with and without HAIs. Results: We included 2038 high-risk patients. By 2016, HAI cumulative incidence decreased significantly for respiratory HAIs (36.1% vs. 24.5%, p-value = 0.0003), urinary-tract HAIs (29.1% vs. 21.3%, p-value = 0.0006), and healthcare-associated ventriculitis and meningitis (HAVM) (16% vs. 7.8%, p-value = 0.004). The incidence rate of EVD-related HAVM dropped from 22.2 to 13.5 cases per 1000 EVD-days. The proportion of invasive isolates of Klebsiella pneumoniae and Acinetobacter baumannii resistant to carbapenems decreased 1.7 and 2 fold, respectively. HAVM significantly impaired survival and independently increasing the probability of death by 1.43. Conclusions: The implementation of an evidence-based IPC program in a middle-income country (Russia) was highly effective in HAI prevention with meaningful reductions in antibiotic resistance.
Acinetobacter Infections/prevention & control , Cross Infection/prevention & control , Drug Resistance, Bacterial , Klebsiella Infections/prevention & control , Acinetobacter Infections/epidemiology , Acinetobacter Infections/microbiology , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/genetics , Acinetobacter baumannii/isolation & purification , Acinetobacter baumannii/physiology , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Carbapenems/therapeutic use , Child , Cross Infection/epidemiology , Cross Infection/microbiology , Female , Humans , Incidence , Infection Control/methods , Intensive Care Units/statistics & numerical data , Klebsiella Infections/epidemiology , Klebsiella Infections/microbiology , Klebsiella pneumoniae/classification , Klebsiella pneumoniae/genetics , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/physiology , Male , Middle Aged , Prospective Studies , Russia/epidemiology , Young Adult
PURPOSE: To define the incidence of healthcare-associated ventriculitis and meningitis (HAVM) in the neuro-ICU and to identify HAVM risk factors using tree-based machine learning (ML) algorithms. METHODS: An observational cohort study was conducted in Russia from 2010 to 2017, and included high-risk neuro-ICU patients. We utilized relative risk analysis, regressions, and ML to identify factors associated with HAVM development. RESULTS: 2286 patients of all ages were included, 216 of them had HAVM. The cumulative incidence of HAVM was 9.45% [95% CI 8.25-10.65]. The incidence of EVD-associated HAVM was 17.2 per 1000 EVD-days or 4.3% [95% CI 3.47-5.13] per 100 patients. Combining all three methods, we selected four important factors contributing to HAVM development: EVD, craniotomy, superficial surgical site infections after neurosurgery, and CSF leakage. The ML models performed better than regressions. CONCLUSION: We first reported HAVM incidence in a neuro-ICU in Russia. We showed that tree-based ML is an effective approach to study risk factors because it enables the identification of nonlinear interaction across factors. We suggest that the number of found risk factors and the duration of their presence in patients should be reduced to prevent HAVM.
Cerebral Ventriculitis/epidemiology , Cross Infection/epidemiology , Intensive Care Units , Machine Learning , Meningitis, Bacterial/epidemiology , Postoperative Complications/epidemiology , Adolescent , Adult , Cerebral Ventriculitis/etiology , Child , Child, Preschool , Craniotomy/adverse effects , Cross Infection/microbiology , Female , Humans , Incidence , Male , Meningitis, Bacterial/etiology , Middle Aged , Postoperative Complications/microbiology , Prospective Studies , Risk Factors , Russia/epidemiology , Surgical Wound Infection/epidemiology , Young Adult
Data collected in electronic patient records (EPR) databases may be used for different goals besides their direct purpose - information support for medical staff in their everyday activities. One of the most promising spheres is a monitoring of various processes induced in medical facility. In our studies EPR serves as a basis for healthcare associated infections (HAI) surveillance system at neurosurgical intensive care unit. The results of HAI prospective surveillance using EPR are presented and discussed.
Cross Infection/diagnosis , Decision Support Systems, Clinical/organization & administration , Electronic Health Records/organization & administration , Population Surveillance/methods , Surgical Wound Infection/diagnosis , Surgical Wound Infection/prevention & control , Cross Infection/prevention & control , Diagnosis, Computer-Assisted/methods , Humans , Reproducibility of Results , Russia , Sensitivity and Specificity
