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- Prusakov, Pavel, et al.
(författare)
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A global point prevalence survey of antimicrobial use in neonatal intensive care units : The no-more-antibiotics and resistance (NO-MAS-R) study
- 2021
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Ingår i: eClinicalMedicine. - : Elsevier. - 2589-5370. ; 32
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Tidskriftsartikel (refereegranskat)abstract
- Background: Global assessment of antimicrobial agents prescribed to infants in the neonatal intensive care unit (NICU) may inform antimicrobial stewardship efforts.Methods: We conducted a one-day global point prevalence study of all antimicrobials provided to NICU infants. Demographic, clinical, and microbiologic data were obtained including NICU level, census, birth weight, gestational/chronologic age, diagnoses, antimicrobial therapy (reason for use; length of therapy), antimicrobial stewardship program (ASP), and 30-day in-hospital mortality.Findings: On July 1, 2019, 26% of infants (580/2,265; range, 0-100%; median gestational age, 33 weeks; median birth weight, 1800 g) in 84 NICUs (51, high-income; 33, low-to-middle income) from 29 countries (14, high-income; 15, low-to-middle income) in five continents received >= 1 antimicrobial agent (92%, antibacterial; 19%, antifungal; 4%, antiviral). The most common reasons for antibiotic therapy were "rule-out" sepsis (32%) and "culture-negative" sepsis (16%) with ampicillin (40%), gentamicin (35%), amikacin (19%), vancomycin (15%), and meropenem (9%) used most frequently. For definitive treatment of presumed/confirmed infection, vancomycin (26%), amikacin (20%), and meropenem (16%) were the most prescribed agents. Length of therapy for culture-positive and "culture-negative" infections was 12 days (median; IQR, 8-14) and 7 days (median; IQR, 5-10), respectively. Mortality was 6% (42%, infection-related). An NICU ASP was associated with lower rate of antibiotic utilization (p = 0.02).Interpretation: Global NICU antibiotic use was frequent and prolonged regardless of culture results. NICU-specific ASPs were associated with lower antibiotic utilization rates, suggesting the need for their implementation worldwide.
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- Elkadeem, M. R., et al.
(författare)
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Geospatial-assisted multi-criterion analysis of solar and wind power geographical-technical-economic potential assessment
- 2022
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Ingår i: Applied Energy. - : Elsevier Ltd. - 0306-2619 .- 1872-9118. ; 322
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Tidskriftsartikel (refereegranskat)abstract
- Amid the increasing electricity demand, energy crisis and pollution, the transition to renewable energy (RE) is becoming a preoccupation and major global challenge due to the multidimensional and intricate problem of RE planning. In Egypt, about 90% of gross power generation comes from carbon-intensive power plants (natural gas and coal). Here, we propose a novel geospatial-decision-making model aimed at geographical-technical–economic potential mapping and assessment of solar photovoltaic (PV) and onshore wind turbine (WT) power plants at a high level of resolution (1 km2) in Egypt. We identify the locations suitable for PV and WT development considering sixteen restrictive and contradictory evaluation criteria. These locations have been further analyzed to estimate how much energy generation is available and at what energy cost. The analysis identifies Middle-Upper Egypt and Suez Canal as hosting the majority of highly suitable locations for PV and WT power plants, respectively. Our finding reveals that the proper planning on RE projects at the proposed optimum locations could support the country's energy mix with a sizable 32% share of the projected country's electricity consumption from PV and 50% share from WT, by 2030. Furthermore, we show that the investment opportunities of PV and WT generation are potentially attractive with affordable competitive prices estimated at 57.84 $/MWh and 32.36 $/MWh, respectively, against conventional generation for today and the future. We anticipate that our results will provide valuable support in realizing Egypt's vision for sustainable electricity generation and in keeping abreast of the global transformation in power systems being witnessed. Ultimately, the method's relevance extends beyond the geographical boundaries of the present territory; it features a strategic, clear and reproducible approach that may be applied to a larger area or continent, provided the necessary input data and criteria are introduced.
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- Garcia-Alonso, L, et al.
(författare)
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Single-cell roadmap of human gonadal development
- 2022
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 607:7919, s. 540-
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Tidskriftsartikel (refereegranskat)abstract
- Gonadal development is a complex process that involves sex determination followed by divergent maturation into either testes or ovaries1. Historically, limited tissue accessibility, a lack of reliable in vitro models and critical differences between humans and mice have hampered our knowledge of human gonadogenesis, despite its importance in gonadal conditions and infertility. Here, we generated a comprehensive map of first- and second-trimester human gonads using a combination of single-cell and spatial transcriptomics, chromatin accessibility assays and fluorescent microscopy. We extracted human-specific regulatory programmes that control the development of germline and somatic cell lineages by profiling equivalent developmental stages in mice. In both species, we define the somatic cell states present at the time of sex specification, including the bipotent early supporting population that, in males, upregulates the testis-determining factor SRY and sPAX8s, a gonadal lineage located at the gonadal–mesonephric interface. In females, we resolve the cellular and molecular events that give rise to the first and second waves of granulosa cells that compartmentalize the developing ovary to modulate germ cell differentiation. In males, we identify human SIGLEC15+ and TREM2+ fetal testicular macrophages, which signal to somatic cells outside and inside the developing testis cords, respectively. This study provides a comprehensive spatiotemporal map of human and mouse gonadal differentiation, which can guide in vitro gonadogenesis.
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- Gentile, Luca, et al.
(författare)
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A 15-year consolidated overview of data in over 6000 patients from the Transthyretin Amyloidosis Outcomes Survey (THAOS)
- 2023
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Ingår i: Orphanet Journal of Rare Diseases. - : BioMed Central (BMC). - 1750-1172. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, multisystemic, life-threatening disease resulting from the deposition of variant or wild-type (ATTRwt amyloidosis) transthyretin amyloid fibrils in various tissues and organs.Methods: Established in 2007, the Transthyretin Amyloidosis Outcomes Survey (THAOS) is the largest ongoing, global, longitudinal, observational study of patients with ATTR amyloidosis, including both hereditary and wild-type disease, and asymptomatic carriers of pathogenic TTR mutations. This analysis describes the baseline characteristics of symptomatic patients and asymptomatic gene carriers enrolled in THAOS since its inception in 2007 (data cutoff: August 1, 2022), providing a consolidated overview of 15-year data from the THAOS registry.Results: This analysis included 4428 symptomatic patients and 1707 asymptomatic gene carriers. The majority of symptomatic patients were male (70.8%) with a mean (standard deviation [SD]) age at symptom onset of 56.6 (17.9) years. Compared with the 14-year analysis, V30M remained the most prevalent genotype in Europe (62.2%), South America (78.6%), and Japan (74.2%) and ATTRwt remained most common in North America (56.2%). Relative to the 14-year analysis, there was an increase of mixed phenotype (from 16.6 to 24.5%) and a reduction of predominantly cardiac phenotype (from 40.7 to 31.9%). The proportion of patients with predominantly neurologic phenotype remained stable (from 40.1 to 38.7%). Asymptomatic gene carriers were 58.5% female with a mean age at enrollment of 41.9 years (SD 15.5).Conclusions: This overview of > 6000 patients enrolled over 15 years in THAOS represents the largest registry analysis of ATTR amyloidosis to date and continues to emphasize the genotypic and phenotypic heterogeneity of the disease. Nearly a quarter of the symptomatic population within THAOS was mixed phenotype, underscoring the need for multidisciplinary management of ATTR amyloidosis.
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- Giuffrida, G, et al.
(författare)
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Big data and network analysis : A promising integration for decision-making
- 2017
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Ingår i: Studies in Classification, Data Analysis, and Knowledge Organization. - Cham : Springer Berlin Heidelberg. - 9783319554761 ; , s. 165-174
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Konferensbidrag (refereegranskat)abstract
- In recent years, we have witnessed an extraordinary growth in globally generated data. The automatic extraction of such extraordinary amount of data, together with innovative data mining and predictive analytics techniques, represents an innovative opportunity in supporting decision-making. Thus, the main aim of this paper is to explore the opportunity of integrating Big Data techniques with Network Analysis methods. In particular, our study employs descriptive measurements and clustering methods of Network Analysis in order to define relational structures within a Big Data set. We discuss a Big Data tool that collects and analyses information from user interactions with published news and comments about a case study related to a recent Italian constitutional review bill with important political implications.
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