In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergen...In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergence of NSD random variables.We establish and improve a general result on the complete f-moment convergence for Sung’s type randomly weighted sums of NSD random variables under some general assumptions.As an application,we show the complete consistency for the randomly weighted estimator in a nonparametric regression model based on NSD errors.展开更多
Assume that{a_(i),−∞<i<∞}is an absolutely summable sequence of real numbers.We establish the complete q-order moment convergence for the partial sums of moving average processes{X_(n)=Σ_(i=−∞)^(∞)a_(i)Y_(i+...Assume that{a_(i),−∞<i<∞}is an absolutely summable sequence of real numbers.We establish the complete q-order moment convergence for the partial sums of moving average processes{X_(n)=Σ_(i=−∞)^(∞)a_(i)Y_(i+n),n≥1}under some proper conditions,where{Yi,-∞<i<∞}is a doubly infinite sequence of negatively dependent random variables under sub-linear expectations.These results extend and complement the relevant results in probability space.展开更多
With a three-dimensional semiclassical ensemble method, we theoretically investigated the nonsequential double ionization of Ar driven by the spatially inhomogeneous few-cycle negatively chirped laser pulses. Our resu...With a three-dimensional semiclassical ensemble method, we theoretically investigated the nonsequential double ionization of Ar driven by the spatially inhomogeneous few-cycle negatively chirped laser pulses. Our results show that the recollision time window can be precisely controlled within an isolated time interval of several hundred attoseconds, which is useful for understanding the subcycle correlated electron dynamics. More interestingly, the correlated electron momentum distribution (CEMD) exhibits a strong dependence on laser intensity. That is, at lower laser intensity, CEMD is located in the first quadrant. As the laser intensity increases,CEMD shifts almost completely to the second and fourth quadrants, and then gradually to the third quadrant.The underlying physics governing the CEMD's dependence on laser intensity is explained.展开更多
Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperativ...Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.展开更多
In the second paper on the inverse relativity model, we explained in the first paper [1] that analyzing the four-dimensional displacement vector on space-time according to a certain approach leads to the splitting of ...In the second paper on the inverse relativity model, we explained in the first paper [1] that analyzing the four-dimensional displacement vector on space-time according to a certain approach leads to the splitting of space-time into positive and negative subspace-time. Here, in the second paper, we continue to analyze each of the four-dimensional vectors of velocity, acceleration, momentum, and forces on the total space-time fabric. According to the approach followed in the first paper. As a result, in the special case, we obtain new transformations for each of the velocity, acceleration, momentum, energy, and forces specific to each subspace-time, which are subject to the positive and negative modified Lorentz transformations described in the first paper. According to these transformations, momentum remains a conserved quantity in the positive subspace and increases in the negative subspace, while the relativistic total energy decreases in the positive subspace and increases in the negative subspace. In the general case, we also have new types of energy-momentum tensor, one for positive subspace-time and the other for negative subspace-time, where the energy density decreases in positive subspace-time and increases in negative subspace-time, and we also obtain new gravitational field equations for each subspace-time.展开更多
Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countri...Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countries like Botswana where ±84% of PLHIV is on ART, the paucity of data comparing overweight/obesity between HIV-positive on ART and HIV-negative patients may impede clinical and policy decision-making. This study sought to estimate and compare: i) the prevalence of overweight/obesity between HIV-positive on ART and HIV-negative patients;ii) the prevalence of hypertension (HTN), diabetes mellitus (DM)/coronary heart disease (CHD) between HIV-positive patients on ART and HIV-negative patients attending same outpatient departments of general clinics in Gaborone, Botswana. Patients and Methods: Five hundred eighty-one (581) outpatients were recruited in four major clinics of Gaborone, Botswana, between June and July 2019;294 or 51% of them were HIV-negative and 287 or 49% were HIV-positive on ART. The prevalence of overweight/obesity and of HTN and DM/CHD were calculated and examined using stratified analysis. Subgroups were compared using Chi-square analysis with Yates correction or Fisher exact test and t-student test for continuous data. Results: Major findings after stratification of the study population by HIV status were: i) the prevalence of all categories of (BMI), including overweight/obesity, were comparable between HIV-negative-patients and HIV-positive. In fact, there were 24 (8.0%) cases of underweight among HIV-negative-Patients and 15(5%) cases among HIV-positive patients, p = 0.2;145 (49%) HIV-negative-patients and 128 (45%) HIV-positive, p = 0.07 cases of normal weight;72 (25%) HIV-negative-patients and 87 (30%) HIV-positive, p = 0.08, were overweight;53 (18%) HIV-negative-patients and 57 (20%) HIV-positive, p = 0.12, were obese;125 (43%) HIV-negative patients and 144 (50%) HIV-positive, p=0.06 were overweight/obese;ii) the prevalence of HTN and DM/CHD among HIV-positive-patients were significantly lower (p < 0.05) compared to HIV-negative patients: There were 32 (10.9%) cases of HTN among HIV-negative patients compared to 18 (6.3%) cases of HTN among HIV-positive patients, p = 0.001;32 (11%) cases of DM/CHD HIV-negative patients compared to 4 (1.4%) cases of DM/CHD among HIV-positive patients, p = 0.001. Conclusion: the prevalence of overweight/obesity observed between HIV-negative and HIV-positive patients may suggest that the two groups shared the same exposure factors. That HTN and DM/CHD prevalence was lower among HIV-positive compared to HIV-negative patients, is possibly due to interplay factors of ART, HIV or the host population. Further studies are, however, recommended for clarifications.展开更多
Introduction: Coagulase-negative staphylococci (CoNS) are currently recognized as genuine pathogens. However, little is known about the resistance and virulence genes that explain their pathogenicity in hospitals in C...Introduction: Coagulase-negative staphylococci (CoNS) are currently recognized as genuine pathogens. However, little is known about the resistance and virulence genes that explain their pathogenicity in hospitals in Cte d'Ivoire. The aim of this study was to contribute to the genotypic identification of resistance and virulence genes in CoNS isolated from blood cultures at the University Teaching Hospital (CHU) of Bouak, in order to improve patient management. Material and Methods: This was a descriptive study conducted from September to December 2023. The CoNS isolates studied came from the collection of strains isolated from blood cultures of febrile patients hospitalized or attending consultations at the CHU of Bouak. The strains were analyzed using conventional simplex PCR. Results: Of the 45 isolates analyzed, 46.7% carried both the aacA-aphD and tetK genes and 40% carried the mecA gene. With regard to virulence genes, only the LukS-PV gene was observed in S. epidermidis and S. haemolyticus isolates. Conclusion: The high prevalence of CoNS isolates carrying the mecA gene and the presence of virulence genes observed in this study give cause for concern in hospitals. It is important to develop comprehensive surveillance strategies against nosocomial and multi-resistant infections at the CHU of Bouak.展开更多
Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insig...Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.展开更多
Objective: This study aims to compare the effects of different drainage tube diameters (22F vs. 26F) combined with negative pressure suction on patients after valve replacement surgery, including postoperative indicat...Objective: This study aims to compare the effects of different drainage tube diameters (22F vs. 26F) combined with negative pressure suction on patients after valve replacement surgery, including postoperative indicators and complications. Methods: A total of 104 patients undergoing valve replacement surgery were included and divided into a 22F group (45 patients) and a 26F group (59 patients). The basic characteristics, postoperative ICU stay duration, drainage duration, postoperative complications, and pain scores were compared between the two groups. All data were analyzed using SPSS statistical software, with p Results: There were no significant differences between the two groups in terms of age, sex, and underlying diseases. The ICU stay duration and drainage duration showed no significant differences (p > 0.05). The total drainage volume in the 22F group was significantly lower than that in the 26F group (225 vs. 380 ml, p = 0.035), and the pain scores on the third postoperative day were also significantly lower in the 22F group (p Conclusion: Compared to the 26F group, patients in the 22F group exhibited less postoperative drainage volume and lower pain scores, suggesting that the 22F drainage tube may have better clinical outcomes after valve replacement surgery.展开更多
Pneumcystis jirovecii is a pathogen that causes Pneumocystis pneumonia (PCP), an infection in (HIV/ADS) and other immunocompromised patients. The rare reports of P. jirovecii pneumonia in sub-Saharan Africa are contro...Pneumcystis jirovecii is a pathogen that causes Pneumocystis pneumonia (PCP), an infection in (HIV/ADS) and other immunocompromised patients. The rare reports of P. jirovecii pneumonia in sub-Saharan Africa are controversial due to the high HIV/AIDS seropositivity. The study determined the significance of P. jirovecii in TB smear negative retreatment patients at the Coast General Teaching Referral Hospital-Mombasa. Sputum samples were subjected to toluidine blue O(TBO) stain for microscopy and polymerase chain reaction (PCR). A total of 100 TB smear negative participants were enrolled in the study and expectorated sputum was collected. Out of the 100 patients, 63 men and 37 women. Patients aged 31 to 53 made up 62% of the patients. The patients aged 31 to 53 made up 75% of the patients (Min = 11y, Max = 85y). The median age of the patients was 42 years. Nested PCR has a prevalence of 41% (41 instances). TBO staining has a prevalence of 29% (29 instances). Detecting an additional 13 more patients than toluidine O staining technique. The sensitivity of toluidine blue O staining was 33.82%, which indicates that it correctly identified 33.82% of true positive cases compared to PCR. The specificity of toluidine blue O staining was 97.82%, indicating that it had a high ability to correctly identify true negative cases compared to PCR, suggesting that it was good at ruling out non-P. jirovecii cases. The study confirms that P. jirovecii is as a significant cause of persistent symptoms in TB patients that could be responsible for persistent symptoms despite TB treatment. We recommend fungal diagnostics in such patients before retreatment.展开更多
Background: Coagulase negative Staphylococci (CoNS) positive blood cultures represent a complex and common challenge in clinical medicine. CoNS are common in skin flora and are often mistaken as contamination. Convers...Background: Coagulase negative Staphylococci (CoNS) positive blood cultures represent a complex and common challenge in clinical medicine. CoNS are common in skin flora and are often mistaken as contamination. Conversely, CoNS can also be implicated in severe and life-threatening bacteremia requiring prompt treatment. A gray area in terms of treatment approach exists for health care providers. The primary aim of this study was to examine predictive factors in patients who have positive CoNS blood cultures that met the CDC case definition of a laboratory confirmed bloodstream infection (LCBI-II) that were subsequently found to have clinically significant true bacteremia. Methods: A retrospective cohort of 288 patients that had at least two separate blood cultures positive for a coagulase negative Staphylococci between November 1st, 2017, and November 1st, 2018, were examined to determine if there were any patient specific factors that would indicate a true bacteremia with CoNS. Results: Retrospective regression analysis demonstrated that those subjected to antibiotics for two days or more (OR = 3.01), those subjected to antibiotics for seven days or more (OR = 2.86), and patients with central access (OR = 4.06) were more likely to have a true infection. Although not statistically significant, an association was also found in immunosuppressed patients (OR = 1.65), and in patients with implanted hardware (OR = 1.16). Conclusion: Patients receiving antibiotics for greater than two days and patients with a central line were more likely to have a true bloodstream infection with coagulase negative Staphylococci.展开更多
The Negative Binomial Multiple Change Point Algorithm is a hybrid change detection and estimation approach that works well for overdispersed and equidispersed count data. This simulation study assesses the performance...The Negative Binomial Multiple Change Point Algorithm is a hybrid change detection and estimation approach that works well for overdispersed and equidispersed count data. This simulation study assesses the performance of the NBMCPA under varying sample sizes and locations of true change points. Various performance metrics are calculated based on the change point estimates and used to assess how well the model correctly identifies change points. Errors in estimation of change points are obtained as absolute deviations of known change points from the change points estimated under the algorithm. Algorithm robustness is evaluated through error analysis and visualization techniques including kernel density estimation and computation of metrics such as change point location accuracy, precision, sensitivity and false positive rate. The results show that the model consistently detects change points that are present and does not erroneously detect changes where there are none. Change point location accuracy and precision of the NBMCPA increases with sample size, with best results for medium and large samples. Further model accuracy and precision are highest for changes located in the middle of the dataset compared to changes located in the periphery.展开更多
Under the background that urban development has been renovated constantly, the paper has analyzed cultural circulation system and recycling effect in urban renovation, and emphasized that traditional culture should be...Under the background that urban development has been renovated constantly, the paper has analyzed cultural circulation system and recycling effect in urban renovation, and emphasized that traditional culture should be extended with industrial heritage as the carrier, so as to transform post- industrial negative heritage into modern civilization adapting to modern life. By taking Beijing "789" for example, its development process and situation have been introduced. Based on the spirit of place, the practical significance of cultural creative park and reuse of industrial heritage have been illustrated. It considers that cultural creation can not only extend cultural context, but also help to find new inspiration in industrial heritage, transforming the function of negative landscape in urban renovation in the form of "catalysis", improving its economic value, social cultural value and cultural effective circulation value.展开更多
基金supported by the National Social Science Fundation(Grant No.21BTJ040)the Project of Outstanding Young People in University of Anhui Province(Grant Nos.2023AH020037,SLXY2024A001).
文摘In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergence of NSD random variables.We establish and improve a general result on the complete f-moment convergence for Sung’s type randomly weighted sums of NSD random variables under some general assumptions.As an application,we show the complete consistency for the randomly weighted estimator in a nonparametric regression model based on NSD errors.
基金Supported by the Academic Achievement Re-cultivation Projects of Jingdezhen Ceramic University(Grant Nos.215/20506341215/20506277)the Doctoral Scientific Research Starting Foundation of Jingdezhen Ceramic University(Grant No.102/01003002031)。
文摘Assume that{a_(i),−∞<i<∞}is an absolutely summable sequence of real numbers.We establish the complete q-order moment convergence for the partial sums of moving average processes{X_(n)=Σ_(i=−∞)^(∞)a_(i)Y_(i+n),n≥1}under some proper conditions,where{Yi,-∞<i<∞}is a doubly infinite sequence of negatively dependent random variables under sub-linear expectations.These results extend and complement the relevant results in probability space.
基金supported by the National Natural Science Foundation of China (Grant No. 12074329)Nanhu Scholars Program for Young Scholars of Xinyang Normal University。
文摘With a three-dimensional semiclassical ensemble method, we theoretically investigated the nonsequential double ionization of Ar driven by the spatially inhomogeneous few-cycle negatively chirped laser pulses. Our results show that the recollision time window can be precisely controlled within an isolated time interval of several hundred attoseconds, which is useful for understanding the subcycle correlated electron dynamics. More interestingly, the correlated electron momentum distribution (CEMD) exhibits a strong dependence on laser intensity. That is, at lower laser intensity, CEMD is located in the first quadrant. As the laser intensity increases,CEMD shifts almost completely to the second and fourth quadrants, and then gradually to the third quadrant.The underlying physics governing the CEMD's dependence on laser intensity is explained.
文摘Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.
文摘In the second paper on the inverse relativity model, we explained in the first paper [1] that analyzing the four-dimensional displacement vector on space-time according to a certain approach leads to the splitting of space-time into positive and negative subspace-time. Here, in the second paper, we continue to analyze each of the four-dimensional vectors of velocity, acceleration, momentum, and forces on the total space-time fabric. According to the approach followed in the first paper. As a result, in the special case, we obtain new transformations for each of the velocity, acceleration, momentum, energy, and forces specific to each subspace-time, which are subject to the positive and negative modified Lorentz transformations described in the first paper. According to these transformations, momentum remains a conserved quantity in the positive subspace and increases in the negative subspace, while the relativistic total energy decreases in the positive subspace and increases in the negative subspace. In the general case, we also have new types of energy-momentum tensor, one for positive subspace-time and the other for negative subspace-time, where the energy density decreases in positive subspace-time and increases in negative subspace-time, and we also obtain new gravitational field equations for each subspace-time.
文摘Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countries like Botswana where ±84% of PLHIV is on ART, the paucity of data comparing overweight/obesity between HIV-positive on ART and HIV-negative patients may impede clinical and policy decision-making. This study sought to estimate and compare: i) the prevalence of overweight/obesity between HIV-positive on ART and HIV-negative patients;ii) the prevalence of hypertension (HTN), diabetes mellitus (DM)/coronary heart disease (CHD) between HIV-positive patients on ART and HIV-negative patients attending same outpatient departments of general clinics in Gaborone, Botswana. Patients and Methods: Five hundred eighty-one (581) outpatients were recruited in four major clinics of Gaborone, Botswana, between June and July 2019;294 or 51% of them were HIV-negative and 287 or 49% were HIV-positive on ART. The prevalence of overweight/obesity and of HTN and DM/CHD were calculated and examined using stratified analysis. Subgroups were compared using Chi-square analysis with Yates correction or Fisher exact test and t-student test for continuous data. Results: Major findings after stratification of the study population by HIV status were: i) the prevalence of all categories of (BMI), including overweight/obesity, were comparable between HIV-negative-patients and HIV-positive. In fact, there were 24 (8.0%) cases of underweight among HIV-negative-Patients and 15(5%) cases among HIV-positive patients, p = 0.2;145 (49%) HIV-negative-patients and 128 (45%) HIV-positive, p = 0.07 cases of normal weight;72 (25%) HIV-negative-patients and 87 (30%) HIV-positive, p = 0.08, were overweight;53 (18%) HIV-negative-patients and 57 (20%) HIV-positive, p = 0.12, were obese;125 (43%) HIV-negative patients and 144 (50%) HIV-positive, p=0.06 were overweight/obese;ii) the prevalence of HTN and DM/CHD among HIV-positive-patients were significantly lower (p < 0.05) compared to HIV-negative patients: There were 32 (10.9%) cases of HTN among HIV-negative patients compared to 18 (6.3%) cases of HTN among HIV-positive patients, p = 0.001;32 (11%) cases of DM/CHD HIV-negative patients compared to 4 (1.4%) cases of DM/CHD among HIV-positive patients, p = 0.001. Conclusion: the prevalence of overweight/obesity observed between HIV-negative and HIV-positive patients may suggest that the two groups shared the same exposure factors. That HTN and DM/CHD prevalence was lower among HIV-positive compared to HIV-negative patients, is possibly due to interplay factors of ART, HIV or the host population. Further studies are, however, recommended for clarifications.
文摘Introduction: Coagulase-negative staphylococci (CoNS) are currently recognized as genuine pathogens. However, little is known about the resistance and virulence genes that explain their pathogenicity in hospitals in Cte d'Ivoire. The aim of this study was to contribute to the genotypic identification of resistance and virulence genes in CoNS isolated from blood cultures at the University Teaching Hospital (CHU) of Bouak, in order to improve patient management. Material and Methods: This was a descriptive study conducted from September to December 2023. The CoNS isolates studied came from the collection of strains isolated from blood cultures of febrile patients hospitalized or attending consultations at the CHU of Bouak. The strains were analyzed using conventional simplex PCR. Results: Of the 45 isolates analyzed, 46.7% carried both the aacA-aphD and tetK genes and 40% carried the mecA gene. With regard to virulence genes, only the LukS-PV gene was observed in S. epidermidis and S. haemolyticus isolates. Conclusion: The high prevalence of CoNS isolates carrying the mecA gene and the presence of virulence genes observed in this study give cause for concern in hospitals. It is important to develop comprehensive surveillance strategies against nosocomial and multi-resistant infections at the CHU of Bouak.
文摘Introduction: Bacterial skin and soft tissue infections (SSTIs) are a cause of frequent inpatient and outpatient care visits whose causative agents are associated with a high antimicrobial resistance burden. For insights on antimicrobial susceptibilities in a rural setting, we examined specimens from suspected SSTIs from two public health facilities in Kenya. We additionally assessed antibiotic use, appropriateness of empiric therapy and risk factors for SSTI. Methodology: Between 2021 and 2023, 265 patients at Kisii and Nyamira County Referral hospitals were enrolled. Wound swabs/aspirates were collected and processed following standard microbiological procedures. Identification and antimicrobial susceptibility were performed using the VITEK 2 Compact platform. Demographic, clinical, and microbiological data were analyzed with R Statistical software. Results: S. aureus was isolated in 16.2% (43/265) of patients with a methicillin resistance (MRSA) proportion of 14% (6/43). While 13/15 drugs elicited susceptibilities ranging from 84% - 100%, penicillin (16%) and trimethoprim-sulfamethoxazole [TMP-SXT] (23%) yielded the lowest susceptibilities. Escherichia coli (n = 33), Klebsiella pneumoniae (n = 8), Pseudomonas aeruginosa (n = 8), and Citrobacter species (n = 4) were the most commonly isolated gram-negative species. Gram-negative strains showed high susceptibilities to most of the tested drugs (71% - 100%) with the exception of ampicillin (18%), TMP-SXT (33%), and first and second generation cephalosporins. Conclusions: The low MRSA prevalence and generally high antibiotic susceptibilities for S. aureus and gram-negative bacteria present opportunities for antibiotic stewardship in the study setting. Diminished susceptibilities against penicillin/ampicillin and TMP-SXT accord with prevailing local data and add a layer of evidence for their cautious empiric use.
文摘Objective: This study aims to compare the effects of different drainage tube diameters (22F vs. 26F) combined with negative pressure suction on patients after valve replacement surgery, including postoperative indicators and complications. Methods: A total of 104 patients undergoing valve replacement surgery were included and divided into a 22F group (45 patients) and a 26F group (59 patients). The basic characteristics, postoperative ICU stay duration, drainage duration, postoperative complications, and pain scores were compared between the two groups. All data were analyzed using SPSS statistical software, with p Results: There were no significant differences between the two groups in terms of age, sex, and underlying diseases. The ICU stay duration and drainage duration showed no significant differences (p > 0.05). The total drainage volume in the 22F group was significantly lower than that in the 26F group (225 vs. 380 ml, p = 0.035), and the pain scores on the third postoperative day were also significantly lower in the 22F group (p Conclusion: Compared to the 26F group, patients in the 22F group exhibited less postoperative drainage volume and lower pain scores, suggesting that the 22F drainage tube may have better clinical outcomes after valve replacement surgery.
文摘Pneumcystis jirovecii is a pathogen that causes Pneumocystis pneumonia (PCP), an infection in (HIV/ADS) and other immunocompromised patients. The rare reports of P. jirovecii pneumonia in sub-Saharan Africa are controversial due to the high HIV/AIDS seropositivity. The study determined the significance of P. jirovecii in TB smear negative retreatment patients at the Coast General Teaching Referral Hospital-Mombasa. Sputum samples were subjected to toluidine blue O(TBO) stain for microscopy and polymerase chain reaction (PCR). A total of 100 TB smear negative participants were enrolled in the study and expectorated sputum was collected. Out of the 100 patients, 63 men and 37 women. Patients aged 31 to 53 made up 62% of the patients. The patients aged 31 to 53 made up 75% of the patients (Min = 11y, Max = 85y). The median age of the patients was 42 years. Nested PCR has a prevalence of 41% (41 instances). TBO staining has a prevalence of 29% (29 instances). Detecting an additional 13 more patients than toluidine O staining technique. The sensitivity of toluidine blue O staining was 33.82%, which indicates that it correctly identified 33.82% of true positive cases compared to PCR. The specificity of toluidine blue O staining was 97.82%, indicating that it had a high ability to correctly identify true negative cases compared to PCR, suggesting that it was good at ruling out non-P. jirovecii cases. The study confirms that P. jirovecii is as a significant cause of persistent symptoms in TB patients that could be responsible for persistent symptoms despite TB treatment. We recommend fungal diagnostics in such patients before retreatment.
文摘Background: Coagulase negative Staphylococci (CoNS) positive blood cultures represent a complex and common challenge in clinical medicine. CoNS are common in skin flora and are often mistaken as contamination. Conversely, CoNS can also be implicated in severe and life-threatening bacteremia requiring prompt treatment. A gray area in terms of treatment approach exists for health care providers. The primary aim of this study was to examine predictive factors in patients who have positive CoNS blood cultures that met the CDC case definition of a laboratory confirmed bloodstream infection (LCBI-II) that were subsequently found to have clinically significant true bacteremia. Methods: A retrospective cohort of 288 patients that had at least two separate blood cultures positive for a coagulase negative Staphylococci between November 1st, 2017, and November 1st, 2018, were examined to determine if there were any patient specific factors that would indicate a true bacteremia with CoNS. Results: Retrospective regression analysis demonstrated that those subjected to antibiotics for two days or more (OR = 3.01), those subjected to antibiotics for seven days or more (OR = 2.86), and patients with central access (OR = 4.06) were more likely to have a true infection. Although not statistically significant, an association was also found in immunosuppressed patients (OR = 1.65), and in patients with implanted hardware (OR = 1.16). Conclusion: Patients receiving antibiotics for greater than two days and patients with a central line were more likely to have a true bloodstream infection with coagulase negative Staphylococci.
文摘The Negative Binomial Multiple Change Point Algorithm is a hybrid change detection and estimation approach that works well for overdispersed and equidispersed count data. This simulation study assesses the performance of the NBMCPA under varying sample sizes and locations of true change points. Various performance metrics are calculated based on the change point estimates and used to assess how well the model correctly identifies change points. Errors in estimation of change points are obtained as absolute deviations of known change points from the change points estimated under the algorithm. Algorithm robustness is evaluated through error analysis and visualization techniques including kernel density estimation and computation of metrics such as change point location accuracy, precision, sensitivity and false positive rate. The results show that the model consistently detects change points that are present and does not erroneously detect changes where there are none. Change point location accuracy and precision of the NBMCPA increases with sample size, with best results for medium and large samples. Further model accuracy and precision are highest for changes located in the middle of the dataset compared to changes located in the periphery.
文摘Under the background that urban development has been renovated constantly, the paper has analyzed cultural circulation system and recycling effect in urban renovation, and emphasized that traditional culture should be extended with industrial heritage as the carrier, so as to transform post- industrial negative heritage into modern civilization adapting to modern life. By taking Beijing "789" for example, its development process and situation have been introduced. Based on the spirit of place, the practical significance of cultural creative park and reuse of industrial heritage have been illustrated. It considers that cultural creation can not only extend cultural context, but also help to find new inspiration in industrial heritage, transforming the function of negative landscape in urban renovation in the form of "catalysis", improving its economic value, social cultural value and cultural effective circulation value.
