Miracle-dz/UniFAR-FTUs huggingface dataset:
S57 Sonographic septations in pleural infection – what do they actually mean?

Introduction It is well established that when associated with infection, pleural effusions carry a significant morbidity and mortality. Sonographic septations are assumed to be associated with poor fluid drainage and some clinicians use this radiological parameter as an indication to proceed directly to surgical drainage, but the evidence for this was unclear. We therefore undertook a literature review to assess the relationship between septations and pleural infection outcome. Methods A systematic literature search was conducted using Medline (1946 to present), Embase (1974 to present), Cochrane database of systematic reviews, Cochrane Central Register of Controlled Trials, Scopus and Web of Science Core Collection. The search did not restrict on language and included all age groups. Septated effusions were captured using the following MeSH terms; [septations, septae, locules, loculations, septated pleural effusions, pleural infection, empyema and parapneumonic effusion]. The outcomes assessed included length of hospital stay, mortality, sepsis, surgery, VATS, decortication, intensive care, death and a number of patient centred outcomes. Results The search resulted in a total of 267 publications. After de-duplication, two researchers independently reviewed the remaining 136 papers for inclusion criteria. Only 6 papers examined baseline sonographic appearances and related these to outcomes, and these were further evaluated. Apart from one, these were all retrospective studies (see table 1). Only 2 similar papers from the same group (Chen et al) addressed our question directly and concluded that patients with a complex septated sonographic pattern have a poorer prognosis. Lai et al specifically addressed septations as a predictor of residual pleural thickening in tuberculous pleurisy. Whilst some papers suggested that the presence of loculations carries a prognostic value and possibly indicate need for early surgery (Cheng et al, Bongiolatti et al), others (Kearney et al) concluded that no sonographic findings reliably influence outcomes. Conclusion This systematic review demonstrates that there is a paucity of evidence linking septations and outcome in pleural infection. Previous large pleural infection trials (MIST1 and MIST2) were conducted prior to the era of common ultrasound. The oft-held belief that a septated effusion requires upfront surgical treatment is not currently evidence based and necessitates urgent further prospective studies.Abstract S57 Table 1
An “Exercise Vital Sign” Is a Valid Proxy Measure of Physical Activity in COPD in Routine Clinical Care

ABSTRACT Measurement of physical activity (PA) during routine care is currently not performed in most health systems. An “exercise vital sign” (EVS) is routinely assessed and entered into the electronic medical records at Kaiser Permanente. The purpose of this article is to examine the construct validity of the EVS for measuring PA in patients with chronic obstructive pulmonary disease (COPD). Patients with COPD who had a history of a COPD exacerbation requiring an admission, observational stay, or emergency department visit in the previous 12 months were included in the study. Baseline data of patients with COPD who were included in a pragmatic trial of a PA coaching intervention were used. Patients were classified as being inactive (0 min · wk−1 of moderate to vigorous PA), insufficiently active (1–149 min · wk−1), and active (150+ min · wk−1) using all available EVS data in the 12 months before identification for the study. The relationship between the EVS and standardized measures of COPD disease severity, functional performance, quality of life and symptoms were examined to establish construct validity. Because of the variable data collection scheme, data were available for 172 to 1834 patients. Patients with higher levels of PA, as categorized by the EVS, tended to have fewer comorbidities and less airway obstruction, used less supplemental oxygen, had higher 6-min walk test distance, and had more objectively measured PA, higher quality of life, and lower depressive symptoms compared with inactive and insufficiently active patients. In conclusion, the EVS provides a valid proxy measure of PA in patients with COPD and may be an efficient measure to assess PA during routine care compared with lengthy questionnaires or objectively measured PA.
Relationship between Outdoor and TV Viewing Time with Children's Movement in Early Care Settings

ABSTRACT Childhood obesity may be prevented by decreasing sedentary behavior (SB) and increasing moderate-to-vigorous physical activity (MVPA) in young children. Outdoor time and TV viewing time may contribute to SB and MVPA. Early childcare and education (ECE) settings are important environments for SB and MVPA. The purpose of this study is to determine the relationship between outdoor and TV viewing time with body mass index (BMI) percentile and movement in children attending ECE. An observational study at ECE centers and classrooms within those centers was conducted. Outdoor and TV viewing times were collected for 2 d using trained research assistants. Height and weight of children were objectively measured. Movement was measured for the entire school day using accelerometry. Dependent variables included BMI percentile, minutes of SB, light physical activity (LPA), MVPA, and steps. Hierarchical models adjusted for confounders and clustering of children in classrooms. In 34 classrooms (202 children), outdoor time was associated with BMI percentile (P < 0.03), SB (P < 0.01), LPA (P < 0.01), MVPA (P < 0.01), and steps (P < 0.01). On the classroom level, more outdoor time was associated with lower BMI percentile and higher MVPA, but outdoor time had different directions of association for SB and LPA on the classroom level. TV viewing time was associated with MVPA (P < 0.01). In TV viewing time, there were differing directions of association at the classroom level. Differing directions indicate that there was no consistent direction of association between classrooms. In conclusion, individual classrooms within centers had different relationships to outdoor time and TV viewing time to movement. Investigating the differences between classrooms may improve movement.
Frequency and variability in errors in the use of english prepositions

The purpose of this study is: a) to determine the frequency of preposition errors in a descriptive composition written by Spanish secondary students; b) to prove the systematicity of these errors in students from different state secondary schools; c) to carry out a tentative qualitative analysis of the variability of prepositional errors in terms of their formal classification, and in terms of the linguistic contexts in which they occur. Although percentages differ from one school to another, the results show that preposition errors are the most common of all errors. Results also show considerable difference in the frequency of error types: substitution errors are far more common than omission or addition errors. We have also obtained evidence that preposition errors seldom appear in linguistic contexts such as preceding non-finite -ing clauses and stranded-preposition constructions including wh-questions and zero-relative clauses.
A Worst-Case Bound Analysis for Nonignorable Missing Data

In order to make statistical inference with missing data, we usually need to make some assumption on the missing-data mechanism. If the data can be assumed to be missing completely at random (MCAR), then we can estimate a parameter of interest in a statistical model specified for a targeted population by ignoring missing data. If not, however, the parameter of interest cannot be identified unless some other assumption is made on the missing-data mechanism. A crucial difficulty in this problem is that such an assumption is untestable from observed data and often strong for the parameter to be identifiable. We may have a misleading result unless the assumption is strongly supported from background information other than data. In most applications, however, such information (if exists) is not necessarily sufficient to make the parameter of interest identifiable. The purpose of this research is to propose a method of calculating the bounds for statistical quantities such as bias of estimates, confidence intervals and P-values under some (weak) assumption on the missing-data mechanism for statistical inference with missing data. Our starting point is our recent paper [1] on publication bias in meta-analysis. Meta-analysis is a statistical analysis to strengthen some statistical evidence by combining results from several studies. However, study selection in meta-analysis is often not random and biased. This is called the problem of publication bias and can be thought of as a missingdata problem in the sense that some studies are missing (unpublished). In [1], we first considered a class of all possible selection functions (conditional selection probabilities given the data) satisfying the assumption that smaller studies are more likely to be missing than larger studies, which is often the case in meta-analysis and is much weaker than usual assumptions. Then we derived the bounds for confidence intervals and P-values within the above class of selection functions, and proposed the use of these bounds for a sensitivity analysis. (Note that once a selection function is given, the parameter of interest is identified and these statistical quantities can be calculated.) We aim to develop our method by extending this work to more general missing-data problems. Manski and his colleagues, in a series of their papers ([2] and its references for example), developed a method of calculating the bound for a (nonidentifiable) parameter of interest itself under no or few assumptions on the missing-data mechanism. Although the target for which the bound is calculated is different from ours, it seems that their work is closely related to our work. Another difference is that their approach is considered in a nonparametric setting, whereas we mainly consider parametric or semiparametric models for complete data. In the poster presentation, we first introduce our previous work [1] on publication bias, and then propose some (tentative) ideas for more general missing-data problems. As well as Manskis’ bound, we would like to discuss possible relationships with some other concepts of imprecise probability.
A Multicenter Trial of Vena Cava Filters in Severely Injured Patients.

BACKGROUND Whether early placement of an inferior vena cava filter reduces the risk of pulmonary embolism or death in severely injured patients who have a contraindication to prophylactic anticoagulation is not known. METHODS In this multicenter, randomized, controlled trial, we assigned 240 severely injured patients (Injury Severity Score >15 [scores range from 0 to 75, with higher scores indicating more severe injury]) who had a contraindication to anticoagulant agents to have a vena cava filter placed within the first 72 hours after admission for the injury or to have no filter placed. The primary end point was a composite of symptomatic pulmonary embolism or death from any cause at 90 days after enrollment; a secondary end point was symptomatic pulmonary embolism between day 8 and day 90 in the subgroup of patients who survived at least 7 days and did not receive prophylactic anticoagulation within 7 days after injury. All patients underwent ultrasonography of the legs at 2 weeks; patients also underwent mandatory computed tomographic pulmonary angiography when prespecified criteria were met. RESULTS The median age of the patients was 39 years, and the median Injury Severity Score was 27. Early placement of a vena cava filter did not result in a significantly lower incidence of symptomatic pulmonary embolism or death than no placement of a filter (13.9% in the vena cava filter group and 14.4% in the control group; hazard ratio, 0.99; 95% confidence interval [CI], 0.51 to 1.94; P = 0.98). Among the 46 patients in the vena cava filter group and the 34 patients in the control group who did not receive prophylactic anticoagulation within 7 days after injury, pulmonary embolism developed in none of those in the vena cava filter group and in 5 (14.7%) in the control group, including 1 patient who died (relative risk of pulmonary embolism, 0; 95% CI, 0.00 to 0.55). An entrapped thrombus was found in the filter in 6 patients. CONCLUSIONS Early prophylactic placement of a vena cava filter after major trauma did not result in a lower incidence of symptomatic pulmonary embolism or death at 90 days than no placement of a filter. (Funded by the Medical Research Foundation of Royal Perth Hospital and others; Australian New Zealand Clinical Trials Registry number, ACTRN12614000963628.).
Effect of Egg Consumption on Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

BACKGROUND There is little evidence whether eggs affect inflammation. The aim of this meta-analysis was to explore the effects of egg consumption on inflammation. A systemic search of online databases (ISI, Scopus, Ovid, PubMed, Cochrane) was used to gather clinical trials that assessed the effect of egg consumption on circulating inflammatory biomarkers from inception up to April 2019. Using a random-effects model, pooled weighted mean differences (WMD) and corresponding standard deviations (SD) were calculated. Of the 21 total references found, 9 trials (8 trials assessed high sensitivity C-Reactive Protein (hs-CRP), 4 trials assessed Interleukin-6 (IL-6) and 5 trials assessed Tumor necrosis factor alpha (TNF-α)) were eligible for analysis. Egg consumption did not affect hs-CRP (WMD 0.24 mg/L; 95% CI: -0.43, 0.90; I2 = 53.8; P= 0.48), IL-6 (WMD 0.20 pg/mL; 95% CI: -0.71, 1.11; I2 = 69.3; P= 0.50), and TNF-α (WMD: -0.38 pg/mL; 95% CI: -0.87, 0.10; I2 = 0.00; P= 0.12) relative to controls. Overall, this meta-analysis revealed that egg consumption had no significant effect on serum biomarkers of inflammation in adults. This article is protected by copyright. All rights reserved.
A Practical Approach to Teach Web Programming Course

Web programming is an interesting and important course, which commands innovative methods to reach the students in large. This paper describes an approach to effective teaching of this course in our department. The traditional method of teaching this course includes the use of black board and power point presentations. But to enable students to apply the learned concepts in real time projects, the usage of different constructs was demonstrated live in the classrooms using a computer projector. The highlight of the course was to make students in batches of 2 or 3 to develop a simple web portal and host it on internet. The whole process enhanced student learning, their confidence to take up live projects and fostered communication skills and human relationship. This indirectly led to the development of better student community in the department, hence the institute.
Telemedicine and home care: controversies and opportunities

Key points The costs for care assistance in chronic disease patients are dramatically increasing. Telemedicine may be a very useful application of information and communication technologies in high-quality healthcare services. The efficacy of respiratory disease telemedicine projects is promising (i.e. to tailor therapeutic intervention; to avoid useless hospital and emergency department admissions, reduce GP visits and specialised visits; and to involve the patients and their families). The nurse practitioner is common to all the trials and appears to have a key role in the management of chronic disease. Different programmes based on specific and local situations, on specific diseases and levels of severity with a high level of flexibility should be utilised. Respiratory team members and the ERS need to identify the ideal candidates and the most appropriate systems to deliver telemedicine with an acceptable cost/efficacy and costs/benefits balance. Educational aims To motivate the interest of chest physicians in a new approach to delivering medical care. To define the different types of telemedicine: telecare and telesurveillance. To provide information on the main clinical results in this field and give examples of case studies. To provide details on the recommendations and limitations of telemedicine programmes. Summary This review focuses on the prospects, and possible drawbacks, of a new innovative instrument of care known as “home telehealth”, “telecare” or “telemedicine”. The main results from utilising telemedicine in respiratory diseases (asthma and chronic obstructive pulmonary disease (COPD) as the illustrative conditions) are presented. A principal goal of telemedicine is to improve access to healthcare services. During this process, savings in time and travel costs should be achieved, thereby rationalising access to medical care. The field of telemedicine is relatively new and expanding. In order to establish evidencebased guidelines for the design and implementation of disease management plans that employ telemedicine, further research is required. Telemedicine is not simply “technology” but an innovative medical approach (based more on a dedicated healthcare team than on high-tech instruments) that will help the medical team to care for patients and their families. In the future, it is hoped that telemedicine will form a valuable part of the disease management process, because, when used intelligently, home telehealth should supplement conventional delivery techniques and not replace them.
The Impact of CenteringPregnancy Group Prenatal Care on Birth Outcomes in Medicaid Eligible Women.

Background: CenteringPregnancy group prenatal care (GPNC) has been shown to reduce rates of preterm birth (PTB). We evaluated the impact of GPNC on spontaneous PTB (sPTB) as a first step in exploring the possible mechanism by which GPNC may decrease rates of PTB. We also evaluated whether attending more than five GPNC sessions affected PTB risk and examined all differences by race/ethnicity. Materials and Methods: We conducted a retrospective cohort study among women delivering at a single institution between April 2009 and March 2014. Birth outcome data from vital statistics records were appended to patient records, and detailed chart abstraction was used to determine spontaneous versus indicated PTB. The association between GPNC and attending more than five GPNC sessions and birth outcomes (i.e., PTB, sPTB, low birth weight [LBW], and neonatal intensive care unit [NICU] admissions) was analyzed using generalized estimating equation log binomial regression models. We examined effect modification of the associations by race/ethnicity. Results: The analysis included 1,292 women in GPNC and 8,703 in traditional individual prenatal care (IPNC). After controlling for potential confounders, the risk of PTB (risk ratio [RR] 0.38; 95% confidence interval [CI] 0.31-0.47), sPTB (RR 0.49; 95% CI 0.38-0.63), LBW (RR 0.46; 95% CI 0.37-0.56), and NICU admissions (RR 0.46; 95% CI 0.37-0.57) was lower in GPNC compared to IPNC women. Results differed by maternal race/ethnicity, with the strongest associations among non-Hispanic white mothers and the weakest associations among Hispanic mothers, especially for sPTB. Similarly, the risk of PTB, LBW, and NICU admissions was lower among GPNC women who attended more than five sessions. Conclusion: Participation in GPNC demonstrated a decreased risk for sPTB, as well as other adverse birth outcomes. In addition, participation in more than five GPNC sessions demonstrated a decreased risk for adverse birth outcomes. Prospective longitudinal studies are needed to further explore mechanisms associated with these findings.
Metabolic stability and its role in the discovery of new chemical entities

Abstract Determination of metabolic profiles of new chemical entities is a key step in the process of drug discovery, since it influences pharmacokinetic characteristics of therapeutic compounds. One of the main challenges of medicinal chemistry is not only to design compounds demonstrating beneficial activity, but also molecules exhibiting favourable pharmacokinetic parameters. Chemical compounds can be divided into those which are metabolized relatively fast and those which undergo slow biotransformation. Rapid biotransformation reduces exposure to the maternal compound and may lead to the generation of active, non-active or toxic metabolites. In contrast, high metabolic stability may promote interactions between drugs and lead to parent compound toxicity. In the present paper, issues of compound metabolic stability will be discussed, with special emphasis on its significance, in vitro metabolic stability testing, dilemmas regarding in vitro-in vivo extrapolation of the results and some aspects relating to different preclinical species used in in vitro metabolic stability assessment of compounds.
Evaluation of laccase production by Ganoderma lucidum in submerged and solid‐state fermentation using different inducers

Laccases are multicopper oxidases with high potential for industrial applications. Several basidiomycete fungi are natural producers of this enzyme; however, the optimization of production and selection of inducers for increased productivity coupled with low costs is necessary. Lignocellulosic residues are important lignin sources and potential inducers for laccase production. Pinus taeda, a dominant source of wood‐based products, has not been investigated for this purpose yet. The aim of this study was to evaluate the production of laccase by the basidiomycete fungus Ganoderma lucidum in the presence of different inducers in submerged and solid‐state fermentation. The results of submerged fermentation in presence of 5 μM CuSO 4, 2 mM ferulic acid, 0.1 g/L P. taeda sawdust, or 0.05 g/L Kraft lignin indicated that although all the tested inducers promoted increase in laccase activity in specific periods of time, the presence of 2 mM ferulic acid resulted in the highest value of laccase activity (49 U/L). Considering the submerged fermentation, experimental design following the Plackett–Burman method showed that the concentrations of ferulic acid and P. taeda sawdust had a significant influence on the laccase activity. The highest value of 785 U/L of laccase activity on submerged fermentation was obtained on the seventh day of cultivation. Finally, solid‐state fermentation cultures in P. taeda using ferulic acid or CuSO 4 as inducers resulted in enzymatic activities of 144.62 and 149.89 U/g, respectively, confirming the potential of this approach for laccase production by G. lucidum.
A microfluidic device for inferring metabolic landscapes in yeast monolayer colonies

Microbial colonies are fascinating structures in which growth and internal organization reflect the morphogenesis of complex spatiotemporal processes. However, there is no global understanding of how metabolic interactions between cells affect the internal structure of microbial colonies. Here, we generated long arrays of monolayer yeast colonies within a multi-layered microfluidic device perfused from only one side to study gradient formation and microbial colony dynamics within defined boundary conditions. We observed the emergence of stable glucose gradients using fluorescently labelled hexose transporters and quantified the spatial correlations with intra-colony growth rates and expression of other genes regulated by glucose availability. These landscapes depended on the external glucose concentration as well as secondary gradients, e.g., amino acid availability. This work demonstrates the regulatory genetic networks governing cellular physiological adaptation are the key to internal structuration of cellular assemblies. This approach could be used in the future to decipher the interplay between long-range metabolic interactions, cellular development and morphogenesis in more complex systems.