Improving adaptive bagging methods for evolving data streams

We propose two new improvements for bagging methods on evolving data streams. Recently, two new variants of Bagging were proposed: ADWIN Bagging and Adaptive-Size Hoeffding Tree (ASHT) Bagging. ASHT Bagging uses trees of different sizes, and ADWIN Bagging uses ADWIN as a change detector to decide when to discard underperforming ensemble members. We improve ADWIN Bagging using Hoeffding Adaptive Trees, trees that can adaptively learn from data streams that change over time. To speed up the time for adapting to change of Adaptive-Size Hoeffding Tree (ASHT) Bagging, we add an error change detector for each classifier. We test our improvements by performing an evaluation study on synthetic and real-world datasets comprising up to ten million examples

Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. Results: The median [p25–p75] time from discharge to follow-up was 3.57 [2.77–4.92] months. Median age was 60 [53–67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18–2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37–1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18–1.63)), urea (OR: 1.16 (0.97–1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73–1.06)). Bacterial pneumonia (1.62 (1.11–2.35)) and duration of ventilation (NIMV (1.23 (1.06–1.42), IMV (1.21 (1.01–1.45)) and prone positioning (1.17 (0.98–1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients’ baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Perspectives of the potential implications of wine polyphenols on human oral and gut microbiota

Food polyphenols are able to selectively modify the growth of susceptible micro-organisms. Wine is a good source of polyphenols and thus, the moderate consumption of this beverage can lead to the modulation of both oral and gut microbiota. This review aims to bring together the knowledge acquired concerning the potential effects of wine polyphenols on human microbiota, as well as taking into account the ability of bacteria to metabolize these compounds. Red wine phenolic composition, characterized by the occurrence of flavan-3-ols, flavonols, anthocyanins, hydroxybenzoic and hydroxycinnamic acids, stilbenes and phenolic alcohols as the main phenolic compounds, will determine the microbiota-modulating effects of wine consumption. Moreover, although the same bacterial genera can be found in oral and gut ecosystems, their relative amount is different, which can influence the metabolic transformations of wine polyphenols. Taking all this into account, the potential implications of these studies on human microbiota are finally discussed together with perspective and future research trends in this field. © 2010 Elsevier Ltd.Peer Reviewe

Bacterial wilt and canker of tomato: fundamentals of a complex biological system

"Tomato (Solanum lycopersicum) is well-known as a model for study of plant–pathogen interactions, since it is a crop of global relevance and susceptible to multiple bacterial, fungal, viral and nematode pathogens. Among bacterial phytopathogens, the actinomycete Clavibacter michiganensis subsp. michiganensis (Cmm) is the causal agent of bacterial wilt and canker of tomato, considered a quarantine disease at international level. The tomato–Cmm interaction has been studied to decipher the pathogenicity mechanisms in Cmm, susceptibility mechanisms in tomato, molecular basis of resistance to Cmm in wild species relative to domesticated tomato, and the level of genetic variability in Cmm. The objective of this review is to discuss recent advances in tomato–Cmm compatible interaction, which can be integrated for application in early diagnosis and biological control of bacterial wilt and canker of tomato. Further study of plant–microorganism interactions is a promising field for improvements in tomato pathogen resistance.