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A semi-automated surveillance system for surgical site infections (SSIs), SPICMI (Surveillance and Prevention Program for Infectious Risk in Surgery and Interventional Medicine), has been implemented in French hospitals, leveraging data from electronic health records (EHRs).
Objective:
To evaluate the performance of the SPICMI algorithm in detecting SSIs in orthopedic and digestive surgery.
Setting:
Surveillance data were collected annually from the EHRs. The algorithm identified suspected SSIs based on two criteria: (1) surgical revision during the index stay or readmission, (2) positive microbiological samples from the wound. Suspected SSIs identified were subsequently validated by surgeons.
Methods:
A stochastic modeling approach was used to estimate probability intervals for performance indicators. Various detection scenarios were constructed based on SPICMI criteria. Logistic regression analysis was performed using surveillance data. Data unavailable in the database were estimated through a literature review and expert opinions.
Results:
The probability of surgical revision following an SSI varied significantly between surgical specialties, ranging from 92% in orthopedic surgery to 45.2% in gynecology. In orthopedic and digestive surgery, the SPICMI algorithm demonstrated good reliability for detecting SSIs in minimizing false-negative and false-positive cases (Youden index: 0.96 and 0.79, respectively). Sensitivity (Se) was lower in digestive surgery (0.7–0.9) compared to orthopedic surgery (0.9–1), while specificity (Sp) remained high (0.9–1) in both specialties.
Conclusion:
The SPICMI algorithm shows potential to support efficient use of time and resources in SSIs surveillance management. Further evaluation is needed with a broader panel of surgery procedures.
Smooth surface features were recently found to stabilise stationary cross-flow instability (CFI) of swept-wing boundary layers, thus holding potential for passive laminar flow control. Notably, the effect of surface features on the transition location exhibited a significant dependence on the CFI amplitude. In this work, numerical solutions of the harmonic Navier–Stokes (HNS) equations are used to explore the impact of a smooth surface hump on the linear and nonlinear development of stationary CFI under various perturbation amplitudes. Linear simulations identify regions of successive inhibited and enhanced perturbation growth. Despite the recovery of the base flow and perturbation kinetic energy to the reference (i.e. no-hump) state, significantly reduced perturbation growth is observed. The distorted perturbation profile due to the interaction with the hump is postulated to be responsible for this. Increasing the perturbation amplitude results in a response of the flow that is qualitatively similar to the linear case, albeit with increasing local destabilisation of new fundamental (i.e. primary wavelength) structures and higher-order harmonics near the wall. An energy budget analysis reveals that the growth of the fundamental incoming CFI is inhibited through the reduced effectiveness of the lift-up mechanism downstream of the hump. This is preceded by a spatial perturbation shape deformation, governed by (spanwise) transport terms. The results suggest that stabilisation of incoming stationary CFI via smooth surface humps is most effective at low incoming perturbation amplitudes. At higher perturbation amplitudes, newly formed near-wall structures, pre-conditioned by the incoming CFI, overtake the incoming CFI and could anticipate the transition process.
The measurement of sodium excretion in 24-h urine samples is the recommended method to assess dietary salt intake to monitor salt-related public health policies. Ensuring complete collection of 24-h urine samples is important for the accurate assessment of salt intake. We compare the use of the objective biomarker, recovery of para-aminobenzoic acid (PABA), to self-reported 24-h urine completeness. Data collected from 868 men and women aged 19–64 years from the England Sodium Survey 2018/2019 (part of the UK National Diet and Nutrition Survey (NDNS)) were used to compare self-reported 24-h urine completeness based on a collection duration of 23–25 h, no missed urine collections/voids and a minimum urine volume of > 0·4 L against completeness based on the urinary recovery of oral doses of PABA. Two-thirds (69 %; 561/812) of participants who adhered to the PABA protocol provided a complete 24-h urine collection. Assessed by self-report, 71 % (619/868) of participants provided a complete 24-h urine collection. Sodium excretion was (geometric mean (interquartile range)) 127 (97–170) mmol/24 h with PABA and 126 (97–169) mmol/24 h by self-report; salt intake was 7·40 (5·65–9·94) g/d and 7·38 (4·53–8·83) g/d, respectively. The proportion of participants above the UK-recommended salt intake of 6 g/d was 70 % by both PABA and self-report. This study shows that the use of self-report of 24-h urine collection completeness provides an assessment of sodium excretion and dietary salt intake with the same accuracy as when PABA recovery is used to assess completeness.
Partition regularity over algebraic structures is a topic in Ramsey theory that has been extensively researched by combinatorialists [2, 3, 5, 15]. Motivated by recent work in this area, we investigate the computability-theoretic and reverse-mathematical aspects of partition regularity over algebraic structures—an area that, to the best of our knowledge, has not been explored before. This article focuses on a 1975 theorem by Straus [25], which has played a significant role in many of the results in this field.
In this article, we prove that the set of well-approximable points $W_\varphi (z) = \{x \in X : d (f^n x, z ) < \varphi (n) \mathrm {\ for\ infinite\ } n \in \mathbb {N}^+\}$ in the shrinking targets problems is distributional chaotic of type 1 for systems with a weak form of the exponential specification property. We apply it to transitive Anosov systems, $\beta $-shifts, etc.
This study tested the effects of soil amendment with orange peel powder (Citrus sinensis L.) on Brassica rapa growth, the performance of the aphid Myzus persicae Sulzer, and the foraging behaviour of its parasitoid Aphidius gifuensis Ashmead. Three peel: soil ratios (1:10, 1:15, 1:20 w/w) were compared with an unamended control. The 1:10 amendment significantly reduced seed germination, plant height, leaf size, and fresh weight, while the 1:20 amendment also decreased fresh weight. Aphid nymphal development was significantly delayed in the 1:10 and 1:15 treatments, and adult weight gain was reduced in the 1:15 treatment. Aphid population growth and parasitoid foraging time were unaffected across treatments. The results indicate that orange peel amendments can delay aphid development but also suppress plant growth at higher concentrations, highlighting the need for optimized application rates. This study supports further exploration of orange peel as a sustainable soil amendment in integrated pest management.
Fluids at supercritical pressure (SCP) exhibit significant real-fluid effects across the pseudo-critical point, which challenges the validity of the existing wall-scaling laws developed under atmospheric pressure condition. This study revisits prior efforts on the temperature-based transformation for the collapse of mean scalar profiles, emphasising the difficulties in accurately describing universal characteristics of thermal boundary layers at SCP. To address this, a novel thermal scaling law using enthalpy transformation is proposed by incorporating the chain rule and heat flux balance. This transformation effectively accounts for variations in the near-wall thermophysical properties associated with the scalar profile while excluding the gradient of isobaric specific heat capacity-related terms. The proposed scaling law demonstrates substantially improved alignment of transformed mean scalar profiles in SCP channel flows at different wall-temperature differences and Reynolds numbers. Additionally, the enthalpy transformation shows superior performance compared with the existing enthalpy–velocity relations, particularly near the heated-wall region where the fluid thermodynamic states undergo the pseudo-boiling process. The present work could facilitate the development of universal wall model in supercritical flows, enabling rapid and reliable heat transfer predictions in practical applications.
The purpose of this work is to develop a version of Forman’s discrete Morse theory for simplicial complexes, based on internal strong collapses. Classical discrete Morse theory can be viewed as a generalization of Whitehead’s collapses, where each Morse function on a simplicial complex $K$ defines a sequence of elementary internal collapses. This reduction guarantees the existence of a CW-complex that is homotopy equivalent to $K$, with cells corresponding to the critical simplices of the Morse function. However, this approach lacks an explicit combinatorial description of the attaching maps, which limits the reconstruction of the homotopy type of $K$. By restricting discrete Morse functions to those induced by total orders on the vertices, we develop a strong discrete Morse theory, generalizing the strong collapses introduced by Barmak and Minian. We show that, in this setting, the resulting reduced CW-complex is regular, enabling us to recover its homotopy type combinatorially. We also provide an algorithm to compute this reduction and apply it to obtain efficient structures for complexes in the library of triangulations by Benedetti and Lutz.
Research into the Developmental Origins of Health and Disease (DOHaD) has established links between environmental exposures in early life and later-life health outcomes. Emerging interventions typically focus on improving maternal nutrition and neonatal healthcare practices yet often neglect to assess or enhance subject understanding of potential long-term impacts or to communicate the benefits of maximising parental health prior to conception. This study critically evaluates a survey tool developed to measure knowledge of non-communicable diseases (NCDs) and early-life contributors to lifelong health. The rationale behind the wording and format of the questions is examined alongside options for coding and statistical interpretation of the data. Considerations for implementation are discussed, illustrated by key findings arising from tracking of the tool’s application in Aotearoa New Zealand over ten years. We demonstrate that the survey tool can be adapted for use in a variety of contexts, producing both quantitative and qualitative baseline data suitable for informing health promotion interventions and monitoring changes in population knowledge. This research also highlights a key difference between awareness of and understanding of scientific concepts and the importance of distinguishing between these when considering public engagement with science.
El surgimiento de la banca en Hispanoamérica durante la década de 1820 tuvo implicaciones en la estabilidad financiera de los nuevos estados independientes y en los modos con los que los actores económicos locales desarrollaban sus negocios. La aparición de novedosos instrumentos de pago, como billetes y cheques bancarios, habilitó transacciones con base en una infraestructura hasta entonces desconocida localmente. Los cheques permitieron el empleo de depósitos y sobregiros como medios para la concreción de pagos, expresando la emergencia del dinero bancario propiamente dicho. Aplicando el Análisis de Redes Sociales sobre la información del archivo bancario, el presente artículo propone explicar los mecanismos que permitieron la difusión de aquel instrumento, propiciando su admisibilidad en la economía de un Estado naciente.
Individuals with mild cognitive impairment (MCI) and dementia often engage in self-regulatory driving behaviours, but less is known about individuals with subjective cognitive impairment (SCI), who perceive cognitive decline without objective evidence of it.
Objective and Methods
This study describes the driving status and habits of older Canadians in the COMPASS-ND data set (n = 955) across cognitive groups: cognitively unimpaired (CU), SCI, MCI, and dementia.
Findings
Most participants reported having a driver’s license without restrictions, including over half of the Dementia group, who differed from the other groups by driving less often, shorter distances, and with greater restrictions. Interestingly, on driving frequency and restriction measures, the SCI group showed greater similarity to the MCI than the CU group. Females reported driving less frequently, shorter distances, and with more restrictions than males across cognitive groups.
Discussion
Results suggest that cognitive status and sex influence the driving habits of older adults, with potential implications for autonomy and independent mobility.