A randomized trial of nebulized 3% hypertonic saline with salbutamol in the treatment of acute bronchiolitis in hospitalized infants

OBJECTIVE: Acute bronchiolitis is a common disorder of infants that often results in hospitalization. Apart from supportive care, no therapy has been shown to influence the course of the disease, except for a possible effect of nebulized hypertonic saline (HS). To determine whether this does have beneficial effects on length of stay in hospital or on severity scores, we undertook a double-blind, randomized, controlled trial in a pediatric department of a Portuguese hospital. METHODS: Previously healthy infants, younger than 12 months, hospitalized with mild-to-moderate acute viral bronchiolitis were randomized to receive either nebulized 3% (hypertonic, HS) or 0.9% (normal, NS) saline during their entire hospital stay. Primary endpoints were: length of hospital stay and severity scores on each day of hospitalization. Need for supplemental oxygen, further add-on medications and adverse effects were also analyzed. RESULTS: Sixty-eight patients completed the study (HS: 33; NS: 35). The median length of hospital stay did not differ between groups: HS: 5.6 ± 2.3 days; NS: 5.4 ± 2.1 days (P = 0.747). We found no difference between groups in severity scores from day 1 to day 4. There were no differences in need for supplemental oxygen or add-on medications. Patients in HS group had significantly more cough (46% vs. 20%, P = 0.025) and rhinorrhoe (58% vs. 31%, P = 0.30). CONCLUSION: This study does not support the use of nebulized HS over NS in therapy of hospitalized children with mild-to-moderate acute viral bronchioliti

Neck and supraclavicular lymphadenopathy secondary to 9-valent human papillomavirus vaccination

We present two clinical cases of lymphadenopathy after vaccination with the human papillomavirus (HPV) 9-valent vaccine: an asymptomatic 11-year-old boy with inferior cervical and supraclavicular lymphadenopathy, and a 13-year-old girl who presented with lymphadenopathy. In both cases, medical history was unremarkable and there was no recent infection, or other clinical findings. Both adolescents had received the HPV 9-valent vaccine in the previous week. In the first case, blood tests, ultrasonography and biopsy were performed, while in the second, a watchful waiting strategy was adopted. In both cases, the lymphadenopathy resolved spontaneously. The boy received the second dose of the vaccine 6 months later and lymphadenopathy reappeared. The Naranjo scale was applied, classifying the events as definite (in the case of the boy) and probable (girl) adverse drug reactions. The vaccine is safe, but recognising this minor adverse event is important to prevent unnecessary investigation and reduce patient and parental anxiety.info:eu-repo/semantics/publishedVersio

Impact of Ground Truth Annotation Quality on Performance of Semantic Image Segmentation of Traffic Conditions

Preparation of high-quality datasets for the urban scene understanding is a labor-intensive task, especially, for datasets designed for the autonomous driving applications. The application of the coarse ground truth (GT) annotations of these datasets without detriment to the accuracy of semantic image segmentation (by the mean intersection over union - mIoU) could simplify and speedup the dataset preparation and model fine tuning before its practical application. Here the results of the comparative analysis for semantic segmentation accuracy obtained by PSPNet deep learning architecture are presented for fine and coarse annotated images from Cityscapes dataset. Two scenarios were investigated: scenario 1 - the fine GT images for training and prediction, and scenario 2 - the fine GT images for training and the coarse GT images for prediction. The obtained results demonstrated that for the most important classes the mean accuracy values of semantic image segmentation for coarse GT annotations are higher than for the fine GT ones, and the standard deviation values are vice versa. It means that for some applications some unimportant classes can be excluded and the model can be tuned further for some classes and specific regions on the coarse GT dataset without loss of the accuracy even. Moreover, this opens the perspectives to use deep neural networks for the preparation of such coarse GT datasets.Comment: 10 pages, 6 figures, 2 tables, The Second International Conference on Computer Science, Engineering and Education Applications (ICCSEEA2019) 26-27 January 2019, Kiev, Ukrain

The Radiative Corrections to the Mass of the Kink Using an Alternative Renormalization Program

In this paper we compute the radiative correction to the mass of the kink in $\phi^4$ theory in 1+1 dimensions, using an alternative renormalization program. In this newly proposed renormalization program the breaking of the translational invariance and the topological nature of the problem, due to the presence of the kink, is automatically taken into account. This will naturally lead to uniquely defined position dependent counterterms. We use the mode number cutoff in conjunction with the above program to compute the mass of the kink up to and including the next to the leading order quantum correction. We discuss the differences between the results of this procedure and the previously reported ones.Comment: 8 pages, 2 figures. arXiv admin note: substantial text overlap with arXiv:0806.036

Globally enhanced calcification across the coccolithophore Gephyrocapsa complex during the mid-Brunhes interval

Evolutionary or adaptative changes in Noelaerhabdaceae coccolithophores occurred in parallel with major changes in carbonate export and burial during scenarios of low orbital eccentricity, with a ∼400 kyr recurrence, during the Pleistocene. Coeval with these conditions of enhanced proliferation, here we report that the calcification of specimens was enhanced at a global scale and across multiple species or morphotypes within the Gephyrocapsa complex during the Mid-Brunhes (MB) interval. This acme of increased production of organic and inorganic carbon by Gephyrocapsa, suggests that such global changes may originate from a common driver. Increased seawater alkalinity, with an appropriately long residence time, is proposed as environmental trigger on the selection of a wide variety of highly calcified and prolific Gephyrocapsa taxa. This new perspective highlights the role of orbital forcing in phytoplankton evolution or adaptation, via a global environmental driver in the form of seawater carbon chemistry. Our results fit with earlier proposals appealing for an intensified biological pump and respiration dissolution during this interval. We hypothesize that the Gephyrocapsa acme may play a double-edged role, by increasing shallow respiration dissolution rates, limiting the removal of alkalinity by burial, which may help to recycle alkalinity and maintain constant levels at the ∼400 kyr scale. This idea suggests the potential capacity of the Noelaerhabdaceae coccolithophore acmes to modify the typical behaviour of carbonate compensation in the ocean and that the changes in coccolithophore calcification may be indicative of changes in ocean carbonate chemistry and the operation of the global carbon cycle in the past

Overcoming language barriers with foreign-language speaking patients: a survey to investigate intra-hospital variation in attitudes and practices

Background Use of available interpreter services by hospital clincial staff is often suboptimal, despite evidence that trained interpreters contribute to quality of care and patient safety. Examination of intra-hospital variations in attitudes and practices regarding interpreter use can contribute to identifying factors that facilitate good practice. The purpose of this study was to describe attitudes, practices and preferences regarding communication with limited French proficiency (LFP) patients, examine how these vary across professions and departments within the hospital, and identify factors associated with good practices. Methods A self-administered questionnaire was mailed to random samples of 700 doctors, 700 nurses and 93 social workers at the Geneva University Hospitals, Switzerland. Results Seventy percent of respondents encounter LFP patients at least once a month, but this varied by department. 66% of respondents said they preferred working with ad hoc interpreters (patient's family and bilingual staff), mainly because these were easier to access. During the 6 months preceding the study, ad hoc interpreters were used at least once by 71% of respondents, and professional interpreters were used at least once by 51%. Overall, only nine percent of respondents had received any training in how and why to work with a trained interpreter. Only 23.2% of respondents said the clinical service in which they currently worked encouraged them to use professional interpreters. Respondents working in services where use of professional interpreters was encouraged were more likely to be of the opinion that the hospital should systematically provide a professional interpreter to LFP patients (40.3%) as compared with those working in a department that discouraged use of professional interpreters (15.5%) and they used professional interpreters more often during the previous 6 months. Conclusion Attitudes and practices regarding communication with LFP patients vary across professions and hospital departments. In order to foster an institution-wide culture conducive to ensuring adequate communication with LFP patients will require both the development of a hospital-wide policy and service-level activities aimed at reinforcing this policy and putting it into practice

Experiência de um serviço de pediatria no apoio pós-operatório a correção da escoliose

info:eu-repo/semantics/publishedVersio