Searching the Sky with CONFIGR-STARS

SyNAPSE program of the Defense Advanced Projects Research Agency (HRL Laboratories LLC, subcontract #801881-BS under DARPA prime contract HR0011-09-C-0001); CELEST, a National Science Foundation Science of Learning Center (SBE-0354378)CONFIGR-STARS, a new methodology based on a model of the human visual system, is developed for registration of star images. The algorithm first applies CONFIGR, a neural model that connects sparse and noisy image components. CONFIGR produces a web of connections between stars in a reference starmap or in a test patch of unknown location. CONFIGR-STARS splits the resulting, typically highly connected, web into clusters, or "constellations." Cluster geometry is encoded as a signature vector that records edge lengths and angles relative to the cluster’s baseline edge. The location of a test patch cluster is identified by comparing its signature to signatures in the codebook of a reference starmap, where cluster locations are known. Simulations demonstrate robust performance in spite of image perturbations and omissions, and across starmaps from different sources and seasons. Further studies would test CONFIGR-STARS and algorithm variations applied to very large starmaps and to other technologies that may employ geometric signatures. Open-source code, data, and demos are available from http://techlab.bu.edu/STARS/

Development and implementation of guidelines for the management of depression: a systematic review

Objective: To evaluate the development and implementation of clinical practice guidelines for the management of depression globally. Methods: We conducted a systematic review of existing guidelines for the management of depression in adults with major depressive or bipolar disorder. For each identified guideline, we assessed compliance with measures of guideline development quality (such as transparency in guideline development processes and funding, multidisciplinary author group composition, systematic review of comparative efficacy research) and implementation (such as quality indicators). We compared guidelines from low- and middle-income countries with those from high-income countries. Findings: We identified 82 national and 13 international clinical practice guidelines from 83 countries in 27 languages. Guideline development processes and funding sources were explicitly specified in a smaller proportion of guidelines from low- and middle-income countries (8/29; 28%) relative to high-income countries (35/58; 60%). Fewer guidelines (2/29; 7%) from low- and middle-income countries, relative to high-income countries (22/58; 38%), were authored by a multidisciplinary development group. A systematic review of comparative effectiveness was conducted in 31% (9/29) of low- and middle-income country guidelines versus 71% (41/58) of high-income country guidelines. Only 10% (3/29) of low- and middle-income country and 19% (11/58) of high-income country guidelines described plans to assess quality indicators or recommendation adherence. Conclusion: Globally, guideline implementation is inadequately planned, reported and measured. Narrowing disparities in the development and implementation of guidelines in low- and middle-income countries is a priority. Future guidelines should present strategies to implement recommendations and measure feasibility, cost-effectiveness and impact on health outcomes

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

COST CONSEQUENCE ANALYSIS OF DIABETIC NEPHROPATHY MANAGEMENT IN A TERTIARY CARE HOSPITAL

ABSTRACT Objective:  To assess the overall costs incurred to patients with Diabetic Nephropathy (DN) and to disclose the elements that could affect them. Materials and Methods: Two year retrospective, observational study using hospital database of a tertiary care centre in Mangalore. Outcomes were assessed based on the survival of patients, length of hospital stay, coexistence of risk factors and co-morbidities. Severity was identified through staging of the disease; costs and clinical outcomes assessed via the Cost – Consequence Analysis. Results: Of the 156 patients who met the diagnostic criteria, it was noticed that demographic age factor for DN was declining and the minimum duration to develop DN was seen to be as less as 1-5 years. In spite of having ample evidence that Angiotensin Converting Enzyme inhibitors (ACEI’s) and Angiotensin Receptor Blockers (ARB’s) control the progression of disease, not many doctors were inclined to follow. Study showed that patients of DN with Chronic Kidney Disease (CKD) spent more and patients with CKD and End Stage Renal Disease (ESRD) spent double than those with CKD alone. Conclusion: Overall costs in treating 156 patients of DN, amounted to 10 lakh INR and the major determinant was the cost of investigations, unlike what was expected of the drug prices.   Key words: Type 2 DM, Diabetic Nephropathy, CKD, Pharmacoeconomics, Cost Consequence Analysis, Direct costs, Indirect medical costs, Indi

Comparing and Contrasting MERS, SARS-CoV, and SARS-CoV-2: Prevention, Transmission, Management, and Vaccine Development

The COVID-19 pandemic is responsible for an unprecedented disruption to the healthcare systems and economies of countries around the world. Developing novel therapeutics and a vaccine against SARS-CoV-2 requires an understanding of the similarities and differences between the various human coronaviruses with regards to their phylogenic relationships, transmission, and management. Phylogenetic analysis indicates that humans were first infected with SARS-CoV-2 in late 2019 and the virus rapidly spread from the outbreak epicenter in Wuhan, China to various parts of the world. Multiple variants of SARS-CoV-2 have now been identified in particular regions. It is apparent that MERS, SARS-CoV, and SARS-CoV-2 present with several common symptoms including fever, cough, and dyspnea in mild cases, but can also progress to pneumonia and acute respiratory distress syndrome. Understanding the molecular steps leading to SARS-CoV-2 entry into cells and the viral replication cycle can illuminate crucial targets for testing several potential therapeutics. Genomic and structural details of SARS-CoV-2 and previous attempts to generate vaccines against SARS-CoV and MERS have provided vaccine targets to manage future outbreaks more effectively. The coordinated global response against this emerging infectious disease is unique and has helped address the need for urgent therapeutics and vaccines in a remarkably short time

Biodiesel production from Ulva linza, Ulva tubulosa, Ulva fasciata, Ulva rigida, Ulva reticulate by using Mn2ZnO4 heterogenous nanocatalysts

10.1016/j.fuel.2019.115744Fuel255115744-11574