Changes in physical activity during hospital admission for chronic respiratory disease: Inpatient step count does not recover

Background and objectiveEstablishing the amount of inpatient physical activity (PA) undertaken by individuals hospitalized for chronic respiratory disease is needed to inform interventions. This observational study investigated whether PA changes when a person is an inpatient, how long is required to obtain representative PA measures and whether PA varies within a day and between patients of differing lengths of stay.MethodsA total of 389 participants were recruited as early as possible into their hospitalization. Patients wore a PA monitor from recruitment until discharge. Step count was extracted for a range of wear time criteria. Single‐day intraclass correlation coefficients (ICC) were calculated, with an ICC ≥ 0.80 deemed acceptable.ResultsPA data were available for 259 participants. No changes in daily step count were observed during the inpatient stay (586 (95% CI: 427–744) vs 652 (95% CI: 493–812) steps/day for day 2 and 7, respectively). ICC across all wear time criteria were > 0.80. The most stringent wear time criterion, retaining 80% of the sample, was ≥11 h on ≥1 day. More steps were taken during the morning and afternoon than overnight and evening. After controlling for the Medical Research Council (MRC) grade or oxygen use, there was no difference in step count between patients admitted for 2–3 days (short stay) and those admitted for 7–14 days (long stay).ConclusionPatients move little during their hospitalization, and inpatient PA did not increase during their stay. A wear time criterion of 11 waking hours on any single day was representative of the entire admission whilst retaining an acceptable proportion of the initial sample size. Patients may need encouragement to move more during their hospital stay

Pitfalls in machine learning‐based assessment of tumor‐infiltrating lymphocytes in breast cancer: a report of the international immuno‐oncology biomarker working group

The clinical significance of the tumor-immune interaction in breast cancer (BC) has been well established, and tumor-infiltrating lymphocytes (TILs) have emerged as a predictive and prognostic biomarker for patients with triple-negative (estrogen receptor, progesterone receptor, and HER2 negative) breast cancer (TNBC) and HER2-positive breast cancer. How computational assessment of TILs can complement manual TIL-assessment in trial- and daily practices is currently debated and still unclear. Recent efforts to use machine learning (ML) for the automated evaluation of TILs show promising results. We review state-of-the-art approaches and identify pitfalls and challenges by studying the root cause of ML discordances in comparison to manual TILs quantification. We categorize our findings into four main topics; (i) technical slide issues, (ii) ML and image analysis aspects, (iii) data challenges, and (iv) validation issues. The main reason for discordant assessments is the inclusion of false-positive areas or cells identified by performance on certain tissue patterns, or design choices in the computational implementation. To aid the adoption of ML in TILs assessment, we provide an in-depth discussion of ML and image analysis including validation issues that need to be considered before reliable computational reporting of TILs can be incorporated into the trial- and routine clinical management of patients with TNBC

Anti-tuberculous drug prescribing: doctors\u27 compliance at a private teaching hospital in Pakistan

An adequate and appropriate anti-TB drug prescription is of crucial importance in order to cure a TB patient of his or her disease. This study looked at the prescribing habits of doctors working in a private teaching hospital of Pakistan. The results showed that the majority of doctors (79%) were choosing the correct four-drug regiment of RHZE in the intensive phase, as recommended in the National Guidelines. However, the dosage of some drugs were below the recommended ranges (43% of prescriptions for Pyraizinamide and 48% for Ethambutol). Regular audit of doctors\u27 prescriptions is necessary in order to ensure that the National TB Guidelines are fully implemented by physicians working in the private sector of Pakistan

Mechanical behavior of Cu-Zr bulk metallic glasses (BMGs): A molecular dynamics approach

10.1088/1674-1056/22/9/096101Chinese Physics B229