ABSTRACT
Lower respiratory tract infections (LRTI) are still burdened by considerable morbidity and mortality. Rapid and appropriate treatment imply knowledge of the underlying causative pathogen; while it is tempting to offer broad spectrum antibiotics, Antimicrobial Stewardship Practices invite a judicious use of the latter, especially when bacteria are not the cause. However, the epidemiology shifts to multidrug resistant (MDR) pathogens that require optimization of molecules in order to provide optimal treatment. Novel methods requiring direct sample result testing such as the Biofire Pneumonia (PN) panel have recently been made available on the market. Syndromic testing may hence provide support in the diagnosis of LRTI. There is paucity of data concerning experiences in high MDR settings, and even less concerning the performance of these panels in pediatric settings with moderate MDR prevalence. Our study highlights the optimal sensitivity and importance of support from such methods in settings burdened by MDR presence and where fast and appropriate therapy is mandatory.
Subject(s)
Anti-Bacterial Agents , Humans , Italy/epidemiology , Child , Child, Preschool , Infant , Male , Female , Anti-Bacterial Agents/therapeutic use , Drug Resistance, Multiple, Bacterial , Pneumonia/microbiology , Pneumonia/drug therapy , Bacteria/isolation & purification , Bacteria/drug effects , Adolescent , Pneumonia, Bacterial/drug therapy , Pneumonia, Bacterial/microbiology , Pneumonia, Bacterial/epidemiology , Pneumonia, Bacterial/diagnosisABSTRACT
The purpose of this study is to evaluate whether additive manufactory technology through the use of 3D mandible and skull cast models can provide additional support to the virtual surgical planning for patients affected by unilateral condylar hyperplasia (UCH). This study describes 2 patients affected by active UCH. Cone beam computed tomography (CBCT) scans were converted in STL files and then sent to a 3D printer that provided 3D cast models of patient's mandible and skull. Surgical planning was conducted performing linear measurement both on 3D virtual images and on 3D cast models. Proportional condylectomy was then simulated with the virtual software and on the 3D cast models as well. After 18 months, new CBCT scans of the patients were acquired and new 3D cast models were printed. Measurements performed on the 3D cast models were close and reliable if compared to measurements obtained on 3D virtual images. None of the patients underwent further surgeries obtaining stable results in terms of symmetry. 3D printing technologies have a relevant support for a more accurate planning and surgical treatment in UCH.
Subject(s)
Printing, Three-Dimensional , Skull/diagnostic imaging , Adolescent , Child , Cone-Beam Computed Tomography/methods , Female , Humans , Hyperplasia , Imaging, Three-Dimensional/methods , Male , Osteotomy/methods , Skull/pathology , SoftwareABSTRACT
Hypersonic air-breathing engines rely on scramjet combustion processes, which involve high-speed, compressible, and highly turbulent reacting flows. The combustion environment and the turbulent flames at the heart of these engines are difficult to simulate and study in the laboratory under well controlled conditions. Typically, wind-tunnel testing is performed that more closely approximates engine development rather than a careful investigation of the underlying physics that drives the combustion process. The experiments described in this paper, along with companion data sets, aim to isolate the chemical kinetic effects and turbulence-chemistry interaction from the fuel-air mixing process in a dual-mode scramjet combustion environment. A unique fuel injection approach is adopted that produces a uniform fuel-air mixture at the entrance to the combustor and results in premixed combustion. This approach relies on the mixing enhancement of a precombustion shock train upstream of the dual-mode scramjet's combustor. For the first time a stable flame, anchored on a cavity flameholder, is reported for a scramjet combustor operating in premixed fuel-air mode. The new experimental capability has enabled numerous companion studies involving advanced diagnostics such as coherent anti-Stokes Raman scattering (CARS), particle image velocimetry (PIV), and planar laser induced fluorescence (PLIF).
ABSTRACT
Width-increased dual-pump enhanced coherent anti-Stokes Raman spectroscopy (WIDECARS) has been developed for spatially and temporally resolved simultaneous measurement of temperature and mole fraction of most major species in ethylene-air flames. This paper describes a method to infer coherent anti-Stokes Raman spectroscopy complex susceptibility distributions of the ν3 band of ethylene from WIDECARS spectra measured in heated mixtures of ethylene and air, and to use such distributions to fit experimental WIDECARS spectra in an ethylene-air flame. The method is used to measure mole fraction ethylene in a dual-mode supersonic combustor burning premixed ethylene and air with single-laser-shot precision (one standard deviation) of ±0.0025 (absolute).
ABSTRACT
A inclusão de pessoas com deficiências no ambiente escolar tem sido tema de discussões e estudos, principalmente no que diz respeito à acessibilidade. Com isso, este estudo teve como objetivo analisar a acessibilidade das pessoas com deficiência física nas escolas de Chapecó-SC. Foram visitadas 27 escolas do município de Chapecó durante os meses de maio e junho de 2010. Para a realização dapesquisa, utilizou-se um protocolo de pesquisa contendo questões norteadoras sobre acessibilidade, espaço físico, mobiliário e edificaçõesencontradas. A análise dos dados mostra 18 alunos com deficiência inseridos nas escolas do município, sendo que a maioria dessasescolas apresenta-se acessível em relação à circulação interna, no entanto apenas dez delas possuem rampa de acesso. Treze escolaspossuem banheiros adaptados, onze possuem bebedouros adaptados e nenhuma apresenta existência de sinalização para deficientesfísicos. Com isso, observa-se que nenhuma das escolas está adaptada em todos os itens avaliados, no entanto a maioria possui um ou mais itens adaptados aos deficientes físicos. Diante disso, o profissional fisioterapeuta pode intervir com o objetivo de minimizar as barreiras arquitetônicas, proporcionando o acesso sem barreiras aos deficientes no ambiente escolar.
The inclusion of people with deficiencies is the school setting is subject to discussions and studies, mainly concerning accessibility. This study aimed to analyze accessibility of people with physical deficiencies in the schools of Chapecó-SC. In May andJune, 2010 we visited 27 schools of the municipality of Chapecó. For the accomplishment of the investigation, it has been used an adapted protocol with guiding questions on accessibility, physical moving space and real facilities. The analysis of the data shows 18 students with deficiencies inserted in the schools of the municipality; most schools are accessible in relation to the internal circulation, although only ten have access ramp. Thirteen schools have adapted lavatories, eleven adapted potable water equipment and none isadapted in all the evaluated items; nevertheless, the majority have one or more items adapted to the physical needs. Thus, professionalphysiotherapist can take part with the aim of diminishing the architectonic barriers, allow for access without barriers to people with deficiencies in the school setting.
La inclusión de personas con discapacidad en el ambiente escolar viene siendo tema de discusiones y estudios, principalmente en lo que se refiere a la accesibilidad. Con eso, este estudio tuvo como objetivo analizar la accesibilidad de las personas con deficiencia física en las escuelas de Chapecó-SC. Han sido visitadas 27 escuelas del municipio de Chapecó durante los meses de mayo y junio de2010. Para la realización de la investigación, ha sido utilizado un protocolo de investigación con cuestiones norteadoras sobre accesibilidad, espacio físico, mobiliario y edificaciones encontradas. El análisis de los datos muestra 18 alumnos con deficiencia insertados en las escuelas del municipio; la mayoría de esas escuelas se revela accesible con relación a la circulación interna, aunque apenas diez tengan rampa de acceso. Trece escuelas poseen lavatorios adaptados, once poseen bebederos adaptados y ninguna de las escuelas sehalla adaptada en todos los ítems evaluados; sin embargo, la mayoría posee uno o más ítems adaptados a los impedidos físicos. Delante de eso, el profesional fisioterapeuta puede intervenir con el objetivo de minimizar las barreras arquitectónicas, proporcionado el accesosin barreras a los impedidos en el ambiente escolar.