New International Guidelines and Consensus on the Use of Lung Ultrasound

Following the innovations and new discoveries of the last 10 years in the field of lung ultrasound (LUS), a multidisciplinary panel of international LUS experts from six countries and from different fields (clinical and technical) reviewed and updated the original international consensus for point-of-care LUS, dated 2012. As a result, a total of 20 statements have been produced. Each statement is complemented by guidelines and future developments proposals. The statements are furthermore classified based on their nature as technical (5), clinical (11), educational (3), and safety (1) statements

The blood vasculature instructs lymphatic patterning in a SOX7-dependent manner

Despite a growing catalog of secreted factors critical for lymphatic network assembly, little is known about the mechanisms that modulate the expression level of these molecular cues in blood vascular endothelial cells (BECs). Here, we show that a BEC-specific transcription factor, SOX7, plays a crucial role in a non-cell-autonomous manner by modulating the transcription of angiocrine signals to pattern lymphatic vessels. While SOX7 is not expressed in lymphatic endothelial cells (LECs), the conditional loss of SOX7 function in mouse embryos causes a dysmorphic dermal lymphatic phenotype. We identify novel distant regulatory regions in mice and humans that contribute to directly repressing the transcription of a major lymphangiogenic growth factor (Vegfc) in a SOX7-dependent manner. Further, we show that SOX7 directly binds HEY1, a canonical repressor of the Notch pathway, suggesting that transcriptional repression may also be modulated by the recruitment of this protein partner at Vegfc genomic regulatory regions. Our work unveils a role for SOX7 in modulating downstream signaling events crucial for lymphatic patterning, at least in part via the transcriptional repression of VEGFC levels in the blood vascular endothelium.Peer reviewe

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Ocena stanu zagrożenia wyrzutowego na podstawie wiedzy i doświadczenia ekspertów – system ekspercki na bazie logiki rozmytej

The Author endeavored to consult some of the Polish experts who deal with assessing and preventing outburst hazards as to their knowledge and experience. On the basis of this knowledge, an expert system, based on fuzzy logic, was created. The system allows automatic assessment of outburst hazard. The work was completed in two stages. The first stage involved researching relevant sources and rules concerning outburst hazard, and, subsequently, determining a number of parameters measured or observed in the mining industry that are potentially connected with the outburst phenomenon and can be useful when estimating outburst hazard. Then, the Author contacted selected experts who are actively involved in preventing outburst hazard, both in the industry and science field. The experts were anonymously surveyed, which made it possible to select the parameters which are the most essential in assessing outburst hazard. The second stage involved gaining knowledge from the experts by means of a questionnaire-interview. Subjective opinions on estimating outburst hazard on the basis of the parameters selected during the first stage were then systematized using the structures typical of the expert system based on fuzzy logic.Autor współpracował z polskimi ekspertami związanymi z badaniami i zwalczaniem zagrożenia wyrzutowego. W wyniku współpracy pozyskał ich wiedzę i doświadczenie, na bazie której stworzył system ekspercki, oparty na logice rozmytej. System umożliwia automatyczną ocenę zagrożenia wyrzutowego. Prace przebiegały w dwóch etapach. Pierwszy etap polegał na określeniu istotnych parametrów mierzonych, bądź obserwowanych w górnictwie, które mają silny związek ze stanem zagrożenia wyrzutowego. Następnie wybrana grupa ekspertów dokonała oceny stanu zagrożenia wyrzutowego, bazując na parametrach które w pierwszym etapie uznane zostały za najistotniejsze. Pozwoliło to zbudować system ekspercki na bazie logiki rozmytej, który określa stan zagrożenia wyrzutowego w zależności od bieżącej wartości analizowanych parametrów

Szybka ocena metanośności węgla jako element poprawy warunków eksploatacji

Methane, as a co-occurring compound, can be found in the majority of coal basins all over the world. The knowledge of methane content is a basic piece of information used in balancing and describing a given coal seam, in conducting safe exploitation – with methane hazards and methane and rock outburst hazards in mind – as well as in less common procedures, such as coal seam fracturing and methane extraction, or storing carbon dioxide in off-balance coal seams. The author of the present paper outlines a thoroughly modified desorbometric method used to analyze the coal-methane system. The research object, in underground conditions, is the full process of releasing methane from coal, which makes it possible to determine gas losses, the desorbable methane content, and the effective diffusion coefficient. This type of research can be conducted in less than 24 hours due to the reduction of the grain fraction of the analyzed bore dust. The thorough research in underground conditions was preceded by a model analysis of the simultaneous impact of the desorbable methane content in coal and the effective diffusion coefficient upon the value of the desorption indensity index. The influence of a grain fraction on the kinetics of methane release from coal was described, and the 0.20–0.25 [mm] grain fraction was selected. The choice of this particular fraction made it possible to register the full process of methane release from coal, in the assumed time. […]Metan jako kopalina towarzysząca występuje w większości zagłębi węglowych na świecie. Wiedza o zawartości metanu w węglu jest podstawową informacją wykorzystywaną do bilansowania i opisywania złoża, prowadzenia bezpiecznej eksploatacji węgla w obliczu zagrożeń metanowych oraz wyrzutami metanu i skał, czy też rzadszych działań, jak próby szczelinowania pokładu i pozyskiwania metanu, bądź składowania CO2 w pokładach pozabilansowych. Autor przedstawia głęboko zmodyfikowaną metodę desorbometryczną wykorzystaną do analizy układu węgiel–metan. Badaniu w warunkach kopalnianych podlega pełen proces uwalniania metanu z węgla, co pozwala na określenie strat gazu, desobowalnej zawartości metanu oraz efektywnego współczynnika dyfuzji. Możliwość przeprowadzenia tego typu badań w czasie poniżej 24 godzin daje obniżenie klasy ziarnowej analizowanych zwiercin. Obszerne badania kopalniane poprzedzone zostały analizą modelową dotyczącą jednoczesnego wpływu desorbowalnej zawartości metanu w węglu oraz efektywnego współczynnika dyfuzji na wartość wskaźnika intensywności desorpcji. Opisany został wpływ klasy ziarnowej na kinetykę emisji metanu z węgla oraz dokonany został wybór klasy ziarnowej 0,20–0,25 mm, której zastosowanie pozwoliło na rejestrację pełnej emisji metanu z węgla w zakładanym czasie. [...