Search

Background: Although preventive strategies have been proposed against catheter-associated urinary tract infections (CAUTIs) in intensive care units (ICUs), more efforts are needed to control the incidence rate. Aim: To distinguish patients according to their characteristics at ICU admission, and to identify clusters of patients at higher risk for CAUTIs. Methods: A two-step cluster analysis was conducted on 9656 patients from the Italian Nosocomial Infections Surveillance in Intensive Care Units project. Findings: Three clusters of patients were identified. Type of admission, patient origin and administration of antibiotics had the greatest weight on the clustering model. Cluster 1 comprised more patients with a medical type of ICU admission who came from the community. Cluster 2 comprised patients who were more likely to come from other wards/hospitals, and to report administration of antibiotics 48 h before or after ICU admission. Cluster 3 was similar to Cluster 2 but was characterized by a lower percentage of patients with administration of antibiotics 48 h before or after ICU admission. Patients in Clusters 1 and 2 had a longer duration of urinary catheterization [median 7 days, interquartile range (IQR) 12 days for Cluster 1; median 7 days, IQR 11 days for Cluster 2] than patients in Cluster 3 (median 6 days, IQR 8 days; P

Identifying patients at higher risk of healthcare-associated infections (HAIs) in intensive care units (ICUs) represents a major challenge for public health. Machine learning could improve patient risk stratification and lead to targeted infection prevention and control interventions.To evaluate the performance of the Simplified Acute Physiology Score (SAPS) II for HAI risk prediction in ICUs, using both traditional statistical and machine learning approaches.Data for 7827 patients from the 'Italian Nosocomial Infections Surveillance in Intensive Care Units' project were used in this study. The Support Vector Machines (SVM) algorithm was applied to classify patients according to sex, patient origin, non-surgical treatment for acute coronary disease, surgical intervention, SAPS II at admission, presence of invasive devices, trauma, impaired immunity, and antibiotic therapy in 48 h preceding ICU admission.The performance of SAPS II for predicting HAI risk provides a receiver operating characteristic curve with an area under the curve of 0.612 (P0.001) and accuracy of 56%. Considering SAPS II along with other characteristics at ICU admission, the SVM classifier was found to have accuracy of 88% and an AUC of 0.90 (P0.001) for the test set. The predictive ability was lower when considering the same SVM model but with the SAPS II variable removed (accuracy 78%, AUC 0.66).This study suggested that the SVM model is a useful tool for early prediction of patients at higher risk of HAIs at ICU admission.

Dans le Second Alcibiade, Socrate propose une prière simple pour les « bonnes choses » comme exemple de la manière adéquate de s’adresser aux dieux et il l’attribue au « poète ». Jusqu’à présent, une telle prière a été étudiée comme exemple de prière philoso­phique, c’est-à-dire en tant que discours sur la prière plutôt que comme prière en tant que telle. Même si elle fait partie intégrante de l’enseignement proposé par Socrate dans ce dialogue, sa signification véritablement liturgique ne peut être minimisée. En regard des autres prières platoniciennes, la prière du poète se présente comme une réponse concrète, propédeutique, répondant à une nécessité pratique. Il s’agit de chercher la manière la plus générale possible d’éviter les conséquences néfastes d’une prière irréfléchie et peu respectueuse à l’égard des dieux. In Alcibiades II Socrates provides a prayer simply for “good things” as an instance of the proper way to address the gods and ascribes it to the “poet”. This prayer has been studied up to now as a philosophical prayer, an instruction on prayer much more than a prayer in its own right. Even if it is understood as a part of the philosophical teaching proposed by Socrates in the dialogue, its actual and authentic liturgical meaning cannot be overlooked. Compared to the other platonic prayers, the poet’s prayer seems to be a real and propaedeutic answer to practical necessity in order to find the most general way of avoiding the aftermath of an apathetic, disrespectful prayer to the gods.