| 1. |
- van Houten, C. B., et al.
(författare)
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Antibiotic misuse in respiratory tract infections in children and adultsa prospective, multicentre study (TAILORED Treatment)
- 2019
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Ingår i: European Journal of Clinical Microbiology & Infectious Diseases. - : Springer Science and Business Media LLC. - 0934-9723 .- 1435-4373. ; 38:3, s. 505-514
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Tidskriftsartikel (refereegranskat)abstract
- Respiratory tract infections (RTI) are more commonly caused by viral pathogens in children than in adults. Surprisingly, little is known about antibiotic use in children as compared to adults with RTI. This prospective study aimed to determine antibiotic misuse in children and adults with RTI, using an expert panel reference standard, in order to prioritise the target age population for antibiotic stewardship interventions. We recruited children and adults who presented at the emergency department or were hospitalised with clinical presentation of RTI in The Netherlands and Israel. A panel of three experienced physicians adjudicated a reference standard diagnosis (i.e. bacterial or viral infection) for all the patients using all available clinical and laboratory information, including a 28-day follow-up assessment. The cohort included 284 children and 232 adults with RTI (median age, 1.3years and 64.5years, respectively). The proportion of viral infections was larger in children than in adults (209(74%) versus 89(38%), p<0.001). In case of viral RTI, antibiotics were prescribed (i.e. overuse) less frequently in children than in adults (77/209 (37%) versus 74/89 (83%), p<0.001). One (1%) child and three (2%) adults with bacterial infection were not treated with antibiotics (i.e. underuse); all were mild cases. This international, prospective study confirms major antibiotic overuse in patients with RTI. Viral infection is more common in children, but antibiotic overuse is more frequent in adults with viral RTI. Together, these findings support the need for effective interventions to decrease antibiotic overuse in RTI patients of all ages.
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| 2. |
- Zupanski, M., et al.
(författare)
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Initiation of ensemble data assimilation
- 2006
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Ingår i: Tellus. Series A, Dynamic meteorology and oceanography. - 0280-6495 .- 1600-0870. ; 58:2
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Tidskriftsartikel (refereegranskat)abstract
- The specification of the initial ensemble for ensemble data assimilation is addressed. The presented work examines the impact of ensemble initiation in the Maximum Likelihood Ensemble Filter (MLEF) framework, but is also applicable to other ensemble data assimilation algorithms. Two methods are considered: the first is based on the use of the Kardar- Parisi-Zhang (KPZ) equation to form sparse random perturbations, followed by spatial smoothing to enforce desired correlation structure, while the second is based on the spatial smoothing of initially uncorrelated random perturbations. Data assimilation experiments are conducted using a global shallow-water model and simulated observations. The two proposed methods are compared to the commonly used method of uncorrelated random perturbations. The results indicate that the impact of the initial correlations in ensemble data assimilation is beneficial. The root-mean-square error rate of convergence of the data assimilation is improved, and the positive impact of initial correlations is notable throughout the data assimilation cycles. The sensitivity to the choice of the correlation length scale exists, although it is not very high. The implied computational savings and improvement of the results may be important in future realistic applications of ensemble data assimilation.
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