Disseminated BCG disease: A case report

AbstractDisseminated BCG disease is a rare life-threatening complication of BCG administration, characterised by miliary pulmonary nodules. Presentation can mimic tuberculosis, both in symptoms and on radiological imaging. Here we report a case of disseminated BCG disease following intravesical BCG treatment for superficial bladder cancer that responded to anti-tuberculous treatment and corticosteroids, and briefly review the literature on disseminated BCG disease

A Study Among General Dental Practitioners, Orthodontists and Forensic Odontologists Regarding Forensic Identification in Orthodontic Context

The process of dental identification involves comparing the dentition of the deceased with the latest dental records of presumed dead. It may become challenging to identify an individual whose orthodontic treatment records are untraceable for any reason. In such instances the dentition of the dead who underwent orthodontic treatment may need to be compared with the records before orthodontic treatment. The goal of this study was to determine the accuracy of matching pre and post-orthodontic treatment casts among general dental practitioners (GDPs), orthodontists, and forensic odontologists. Pre and post-orthodontic treatment dental casts from ten patients were used in this study. Pre-orthodontic maxillary and mandibular dental casts were separated from post-orthodontic maxillary and mandibular dental casts. A total of fifteen assessors comprising five orthodontists, five forensic odontologists and five GDPs compared and matched the pre and post-orthodontic dental cast pairs. Results revealed higher correct matches among forensic odontologists (94%) as compared to orthodontists (88%) followed by GDPs (80%). Among the parameters, ‘specific features in the dentition’ were most successful at correct identification. Orthodontic therapy causes morphometric changes in the dentition, which can make comparative identification difficult. Unique features in the dentition present before orthodontic treatment and persistent even after orthodontic treatment such as peculiar attrition facets, etc. can prove highly accurate in the identification

Transformation as Praxis: Responding to Climate Change Uncertainties in Marginal Environments in South Asia

This paper provides some of the conceptual and methodological underpinnings being developed in the ongoing TAPESTRY project which is part of the Transformations to Sustainability (T2S) Programme. We debate how the notion of transformation may be conceptualized from ‘below’ in marginal environments that are especially marked by high levels of climate-related uncertainties. We propose the notion of transformation as praxis — where the focus is on bottom-up change, identities, wellbeing and the recovery of agency by marginalized people and explore how ‘patches’ and the ‘marginal’ offer critical conceptual templates to examine whether and how systemic transformative changes are being assembled and effected on the ground by hybrid and transformative alliances. The article concludes by discussing potential challenges of such engagements, alongside pursuing a normative and political approach to T2S

Remote Data Acquisition and Visualization on an App

In order to allow power consumers to have a better understanding of their industrial electricity, it is necessary to provide them with real-time electricity information. Now a days we need to do meter reading, analysis manually. If any meter is goes down or fluctuating we need to do manual servicing and troubleshooting. It may cause meter loss, Time loss, and financial loss. The platform enables power consumers to have a better understanding of their own electricity consumption status and reasonable arrangements for use of electricity. Its deployment is very simple. For users, they do not need to change the household electricity structure. They can easily view the home electricity information and real-time monitor and control after installing power information visualization APP on their mobile phones or other mobile terminals. User interaction needs to collect power information of all equipment, and provide users with real-time electricity price and electricity information. The basic purpose of system is M-Measure, A-Analysis, R-Record, and CControl. No human intervention for data processing analysis. This is use for Power quality analysis, Identification and prevention of downtime of assets, Alarms and triggers are used for preventive control to avoid loss. Reduce the losses by monitoring and controlling the power quality. Accurate analytics depending on the load connected to the system. It supports most of all make sensors and hardware meters to work with the system. Periodical analysis of the organization for the complete energy health check-up

Identifying best approaches for engaging patients and family members in health informatics initiatives: a case study of the Group Priority Sort technique

Background Patient engagement strategies in health service delivery have become more common in recent years. However, many healthcare organizations are challenged in identifying the best methods to engage patients in health information technology (IT) initiatives. Engaging with important stakeholders to identify effective opportunities can inform the development of a resource that addresses this issue and supports organizations in their endeavors. The purpose of this paper is to share our experience and lessons learned from applying a novel consensus-building technique in order to identify key elements for effective patient engagement in health IT initiatives. This will be done through a case study approach. Methods Patients, family members of patients, health professionals, researchers, students, vendor representatives and individuals who work in health IT roles in health organizations were engaged through a one-day symposium in Toronto, Canada in September, 2018. During the symposium, the Group Priority Sort technique was used to obtain structured feedback from symposium attendees in the context of small group discussions. Descriptive statistics and a content analysis were undertaken to analyze the data collected through the Group Priority Sort as well as participant feedback following the symposium. Results A total of 37 participants attended the symposium from a variety of settings and organizations. Using the Group Priority Sort technique, 30 topics were classified by priority to be included in a future resource. Participant feedback pertaining to the symposium and research methods was largely positive. Several areas of improvement, such as clarity of items, were identified from this case study. Conclusions The Group Priority Sort technique was an efficient method for obtaining valuable suggestions from a diverse group of stakeholders, including patients and family members. The specific priorities and feedback obtained from the symposium will be incorporated into a resource for healthcare organizations to aid them in engaging patients in health IT initiatives. Additionally, five important considerations were identified when conducting future work with the Group Priority Sort technique and are outlined in this paper

Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke).

BACKGROUND: Endovascular treatment with mechanical thrombectomy (MT) is beneficial for patients with acute stroke suffering a large-vessel occlusion, although treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared with direct presentation. METHODS: STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter, observational, single-arm study of real-world MT for acute stroke because of anterior-circulation large-vessel occlusion performed at 55 sites over 2 years, including 1000 patients with severe stroke and treated within 8 hours. Patients underwent MT with or without intravenous tissue plasminogen activator and were admitted to endovascular-capable centers via either interhospital transfer or direct presentation. The primary clinical outcome was functional independence (modified Rankin Score 0-2) at 90 days. We assessed (1) real-world time metrics of stroke care delivery, (2) outcome differences between direct and transfer patients undergoing MT, and (3) the potential impact of local hospital bypass. RESULTS: A total of 984 patients were analyzed. Median onset-to-revascularization time was 202.0 minutes for direct versus 311.5 minutes for transfer patients ( CONCLUSIONS: In this large, real-world study, interhospital transfer was associated with significant treatment delays and lower chance of good outcome. Strategies to facilitate more rapid identification of large-vessel occlusion and direct routing to endovascular-capable centers for patients with severe stroke may improve outcomes. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02239640

Prevalence and architecture of de novo mutations in developmental disorders.

The genomes of individuals with severe, undiagnosed developmental disorders are enriched in damaging de novo mutations (DNMs) in developmentally important genes. Here we have sequenced the exomes of 4,293 families containing individuals with developmental disorders, and meta-analysed these data with data from another 3,287 individuals with similar disorders. We show that the most important factors influencing the diagnostic yield of DNMs are the sex of the affected individual, the relatedness of their parents, whether close relatives are affected and the parental ages. We identified 94 genes enriched in damaging DNMs, including 14 that previously lacked compelling evidence of involvement in developmental disorders. We have also characterized the phenotypic diversity among these disorders. We estimate that 42% of our cohort carry pathogenic DNMs in coding sequences; approximately half of these DNMs disrupt gene function and the remainder result in altered protein function. We estimate that developmental disorders caused by DNMs have an average prevalence of 1 in 213 to 1 in 448 births, depending on parental age. Given current global demographics, this equates to almost 400,000 children born per year

HIV prevention transformed : the new prevention research agenda.

We have entered a new era in HIV prevention whereby priorities have expanded from biomedical discovery to include implementation, effectiveness, and the effect of combination prevention at the population level. However, gaps in knowledge and implementation challenges remain. In this Review we analyse trends in the rapidly changing landscape of HIV prevention, and chart a new path for HIV prevention research that focuses on the implementation of effective and efficient combination prevention strategies to turn the tide on the HIV pandemic

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis