Predictors of mortality in patients hospitalized for congestive heart failure with left ventricular ejection fraction ≥ 40%

Background: There are limited data regarding the predictors of mortality in patients with acute congestive heart failure (CHF) and left ventricular ejection fraction (LVEF) ≥ 40%. Methods: We evaluated clinical characteristics, mortality and prognostic factors in a sample of consecutive patients hospitalized for CHF with LVEF ≥ 40%. Multivariable Cox regression models were developed to predict mortality using baseline clinical characteristics and echocardiographic variables. Results: The study population consisted of 191 patients, mean age 70 ± 14.6 years (60% female) with average follow-up of 4.0 ± 2.8 years. Cumulative 5-year mortality was 58% in the entire population and it was 59% in men and 57% in women (p = 0.411). In multivariable analyses, predictors of mortality were the following: blood urea nitrogen (BUN) > 25 mg/dL (HR = 1.77; p = 0.002); absence of hypertension (HR = 1.58; p = 0.032), left ventricular end diastolic dimension (LVEDD) ≤ 4.1 cm (HR = 1.73; p = 0.011) and LVEF ≤ 45% (HR = 1.69; p = 0.027). Conclusions: Patients hospitalized for heart failure with LVEF ≥ 40% have very high mortality. Absence of hypertension, elevated BUN and lower LVEF ≤ 45% indicate increased risk of short- and long-term mortality. Lower LVEDD is an independent predictor of mortality in heart failure patients with LVEF ≥ 40%

A Domain-Agnostic Approach for Characterization of Lifelong Learning Systems

Despite the advancement of machine learning techniques in recent years, state-of-the-art systems lack robustness to "real world" events, where the input distributions and tasks encountered by the deployed systems will not be limited to the original training context, and systems will instead need to adapt to novel distributions and tasks while deployed. This critical gap may be addressed through the development of "Lifelong Learning" systems that are capable of 1) Continuous Learning, 2) Transfer and Adaptation, and 3) Scalability. Unfortunately, efforts to improve these capabilities are typically treated as distinct areas of research that are assessed independently, without regard to the impact of each separate capability on other aspects of the system. We instead propose a holistic approach, using a suite of metrics and an evaluation framework to assess Lifelong Learning in a principled way that is agnostic to specific domains or system techniques. Through five case studies, we show that this suite of metrics can inform the development of varied and complex Lifelong Learning systems. We highlight how the proposed suite of metrics quantifies performance trade-offs present during Lifelong Learning system development - both the widely discussed Stability-Plasticity dilemma and the newly proposed relationship between Sample Efficient and Robust Learning. Further, we make recommendations for the formulation and use of metrics to guide the continuing development of Lifelong Learning systems and assess their progress in the future.Comment: To appear in Neural Network

Democratic Leadership - A local story

Leadership is traditionally viewed as an individual property and researched from the perspective of behaviours, traits or characteristics that these individuals possess. Notions of democratic leadership can offer early childhood centres a more expansive conception of leadership to include children, teachers and families. This study explores the possibility of positioning all stakeholders in an early childhood centre as leaders by repositioning leadership as a jointly constructed, emergent process. Drawing on an existing feature of the kindergarten programme, that of regular excursions within the local community, connections are interwoven between children’s inquires, democratic principles and elements of place based education. Using narratives from five excursions in the local community the study experiments with Leadership-as-practice to analyse how these excursions fostered democratic and inclusive participation of children and adults. Inquiry as a form of participatory democracy is a key feature of decision-making and provides a common purpose for community excursions while encouraging leadership opportunities. The study reveals the potential of leadership-as-practice, underpinned by democratic values as an approach to leadership in early childhood organisations, enabling leader/follower roles to be blurred and learning to be co constructed during dialogue. The local community holds enormous capacity as a system to facilitate democratic leadership and promote place based learning and citizenship education. This study recognises that democratic leadership exists in tension with current neo liberal beliefs and therefore positions itself as a counter to the current market driven early childhood environment. The underlying belief of this study is that leadership can occur as a collaborative practice, emerging through day to day experiences and seeks to contribute to the slowly emerging body of research concerned with early childhood leadership.

Genome-wide meta-analysis identifies five new susceptibility loci for cutaneous malignant melanoma.

Thirteen common susceptibility loci have been reproducibly associated with cutaneous malignant melanoma (CMM). We report the results of an international 2-stage meta-analysis of CMM genome-wide association studies (GWAS). This meta-analysis combines 11 GWAS (5 previously unpublished) and a further three stage 2 data sets, totaling 15,990 CMM cases and 26,409 controls. Five loci not previously associated with CMM risk reached genome-wide significance (P < 5 × 10(-8)), as did 2 previously reported but unreplicated loci and all 13 established loci. Newly associated SNPs fall within putative melanocyte regulatory elements, and bioinformatic and expression quantitative trait locus (eQTL) data highlight candidate genes in the associated regions, including one involved in telomere biology.[Please see the Supplementary Note for acknowledgments.]This is the author accepted manuscript. The final version is available from NPG via http://dx.doi.org/10.1038/ng.337

Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. METHODS: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. FINDINGS: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week. INTERPRETATION: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. FUNDING: Bill & Melinda Gates Foundation

Solids velocity measurement using electric capacitance sensor assemblies

This paper covers the application of the cross-correlation method for measuring the velocity of solid particles. Capacitive electrodes are used as primary sensors to measure the time required by the solid particles to cover a known distance between the electrodes. The capacitive variations of both the electrode sensors are stored in computer synchronously for offline estimation of the velocity of the solid particles. Single glass marble is used as a solid particle to conduct the performance in the lab for its good signal to noise ratio (SNR) and vivid graphs. Matlab R2018a is used as a programming tool to perform the cross-correlation algorithm. The distance between the sensors is adjusted optimally. The results were realistic to ensure the correctness of the system. © 2020 Published under licence by IOP Publishing Ltd

Ventriculoperitoneal shunt blockage by hydatid cyst

Ventriculoperitoneal (VP) shunt is one of the commonest procedures done in neurosurgical practice throughout the world. One of the commonest problems after putting the VP shunt is the shunt obstruction, which can be due to varied causes. Shunt obstruction secondary to the parasitic infections is rarely seen. We are presenting a 15-year-old child, a case of operated cerebral hydatid cyst with hydrocephalus. She presented with shunt malfunction after 1 year of surgical excision of the hydatid cyst. Revision of the VP shunt was done and peroperatively, it was found that the shunt tubing was obstructed due to small hydatid cysts. This is the first reported case of VP shunt obstruction by hydatid cyst

Effect of Pregnant Mothers Infected with the Corona Virus 19 on Neonate Baby

Background: On March 7, 2020, the World Health Organization (WHO) declared the novel coronavirus illness (COVID-19) a Pandemic after the number of confirmed cases surpassed 100,000. COVID-19 has spread over the planet as of April 21, 2020, resulting in approximately 180,000 deaths out of a total of more than 2 million verified cases. &nbsp;Objective: to assess outcome of pregnant infected with COVID19 on newborn. Methodology: A descriptive cross sectional study was conducted on newborn of mother infected with COVID 19 during pregnancy at Bint Al-Huda teaching hospital in Nasiriyah. This study started from (3rd January 2022) to (4th April 2022). Method in data collection started from the (9th February 2022) to (23th February 2022). A nonprobability purposive sampling which consists of 20 newborn. The study instrument comprised of three parts: Demographic Data and Information consist of age, trimester, and chronic disease. Clinical feature domain and complication domain. The instrument presented to (5) experts in the different fields. Results: Our study shows that good evaluation at first and second trimester and poor evaluation at third trimester. High score of good evaluation at (18-22 y) of mothers age and poor evaluation at (33-38 y)

A genome-wide association study of cutaneous squamous cell carcinoma among european descendants

Background: NoGWASon the risk of cutaneous squamous cell carcinoma (SCC) has been published. We conducted a multistage genome-wide association study (GWAS) to identify novel genetic loci for SCC. Methods: The study included 745 SCC cases and 12,805 controls of European descent in the discovery stage and 531 SCC cases and 551 controls of European ancestry in the replication stage. We selected 64 independent loci that showed the most significant associations with SCC in the discovery stage (linkage disequilibrium r2 < 0.4) for replication. Results: Rs8063761 in the DEF8 gene on chromosome 16 showed the strongest association with SCC (P = 1.7 × 10-9 in the combined set; P = 1.0 × 10-6 in the discovery set and P = 4.1 × 10-4 in the replication set). The variant allele of rs8063761 (T allele) was associated with a decreased expression of DEF8 (P=1.2×10-6). Besides, we validated four other SNPs associated with SCC in the replication set, including rs9689649 in PARK2 gene (P = 2.7 × 10-6 in combined set; P = 3.2 × 10-5 in the discovery; and P = 0.02 in the replication), rs754626 in the SRC gene (P = 1.1 × 10-6 in combined set; P = 1.4 × 10-5 in the discovery and P=0.02 in the replication), rs9643297 in ST3GAL1 gene (P = 8.2 × 10-6 in combined set; P = 3.3 × 10-5 in the discovery; and P = 0.04 in the replication), and rs17247181 in ERBB2IP gene (P=4.2×10-6 in combined set; P= 3.1×10-5 in the discovery; and P = 0.048 in the replication). Conclusion: Several genetic variants were associated with risk of SCC in a multistage GWAS of subjects of European ancestry. Impact: Further studies are warranted to validate our finding and elucidate the genetic function of these variants