Streptococcus pneumoniae antimicrobial resistance decreased in the Helsinki Metropolitan Area after routine 10-valent pneumococcal conjugate vaccination of infants in Finland

Since the introduction of 10-valent pneumococcal conjugate vaccine (PCV10) into the Finnish national vaccination program in September 2010, the incidence of invasive pneumococcal disease in children has decreased steeply in Finland. We studied the antimicrobial susceptibility of invasive and non-invasive Streptococcus pneumoniae (pneumococcus) isolated in the Helsinki Metropolitan Area during 2009-2014. We divided the data into two age groups: isolates from patients <5 years old and ae5 years old. We also studied the serotype distribution of invasive isolates and of a subset of non-invasive multidrug-resistant isolates. The invasive isolate numbers recovered from patients aged <5 years old declined from 33/228 (15%) in 2009 to 8/208 (4%) in 2014 (p <0.001) and non-invasive isolate numbers declined during the same time period from 221/595 (37%) to 119/432 (28%) (p <0.001). At the same time, the proportion of penicillin non-susceptible non-invasive isolates in this age group decreased from 25% (56/220) to 13% (15/119) (p = 0.001) and multidrug-resistant isolates from 22% (49/220) to 6% (7/119) (p <0.001), respectively. The number of PCV10 serotype isolates also decreased among the serotyped multidrug-resistant non-invasive isolates. Among patients aged ae5 years old, the isolate numbers did not show a similar decreasing trend compared to the younger group and, further, the number of non-PCV10 serotype isolates increased in invasive cases. To conclude, the antimicrobial non-susceptibility of pneumococcus has decreased markedly, especially among young patients (<5 years old), following PCV10 implementation in Finland.Peer reviewe

Not a “Nonissue”: Perceptions and Realities of Campus Carry at The University of Texas at Austin

As a publicly funded institution,The University of Texas at Austin had to implement the state’s legislation to allow concealed handguns on campus. Yet its own Campus Carry policy has sought to erase the matter from everyday campus life. The administration deems it a “nonissue,” presuming that students have become accustomed to the idea, do not think about it actively, and have a low interest in acquiring a handgun license. This paper, based on a survey of the university’s undergraduates, questions these ideas. It shows that a majority of students think that the issue is important and examines in what sense the students are troubled by its effects. While opinions differ between supporters and opponents of Campus Carry, divergences also exist within their ranks, such as among supporters of the law regarding where guns should specifically be allowed at the university. On the basis of the survey, the essay also examines how many licensed carriers are actually on campus, compared to the university’s estimates.</p

Radiation-associated sarcoma after breast cancer in a nationwide population : Increasing risk of angiosarcoma

Radiation-associated sarcoma (RAS) is a rare complication of radiation therapy (RT) to breast cancer (BC). This study explored RAS after RT to BC in a nationwide population-based material. The Finnish Cancer Registry was queried for patients with BC treated during 1953-2014 who were later diagnosed with a secondary sarcoma in 1953-2014. Registry data, patient files, and sarcoma specimens were analyzed to confirm diagnosis and location of RAS at or close to the RT target volume. A total of 132 512 patients were diagnosed with invasive BC during the study period. A subsequent sarcoma was diagnosed in 355 patients. After exclusion, 96 RAS were identified. Angiosarcoma (AS) was the most prevalent histology in 50 (52%) of 96 patients. However, the first radiation-associated AS was diagnosed in a patient treated for BC with breast-conserving surgery in 1984, and thereafter, the proportion of AS continuously increased. The 5-year sarcoma-specific survival was 75.1% for RAS treated with a curative intent. The distribution of histologic subtypes of RAS has changed during the 60 years of this registry study. The first radiation-associated AS was diagnosed in 1989, and presently, AS is the most common histologic subtype of RAS. It is possible that changes in BC treatment strategies are influencing the characteristics of RAS.Peer reviewe

Kasvojentunnistussovelluksen haasteet lisätyn todellisuuden sulautetussa järjestelmässä

Tiivistelmä. Tutkimuksessa tarkastellaan reaaliaikaisen lisätyn todellisuuden kasvojentunnistussovelluksen haasteita sulautetuissa järjestelmissä. Merkittävimmät haasteet liittyvät reaaliaikaisuuden toteuttamiseen säilyttäen samalla hyvä kuvanlaatu ja sovelluksen tarkoituksenmukaisuus. Työtä varten kehitetty kasvojentunnistussovellus testattiin Raspberry Pi -tietokoneella. Tarkkailun kohteena olivat sovelluksen suorituskyky ja tunnistustarkkuus, sekä Raspberry Pi:n kaltaisen tietokoneen soveltuvuus sovelluksen alustana. Testit havainnollistavat sovelluksen toteutukseen vaikuttavien ratkaisujen merkitystä sovelluksen suorituskykyyn. Nämä vaatimukset täyttävä reaaliaikainen lisätyn todellisuuden sovellus tarvitsee tarkkaa kuvankäsittelyä, hyvää kuvanlaatua sekä mobiilisuutta. Sulautettu järjestelmä tarvitsee optimointia, reaktiivisuutta ja pientä kokoa. Kehitetty sovellus tunnistaa videokameran kuvasta ihmisen kasvot, piirtää kasvojen päälle grafiikkaa ja toistaa tehostetun kuvan reaaliaikaisesti käyttöliittymän kautta. Sovellus hyödyntää Raspberry Pi -kosketusnäyttöä ja Raspberry Pi -kameraa, sekä tietokonenäköä varten koottua kirjastoa OpenCV. Sovellus ja alusta yhdessä eivät täyttäneet kaikkia suorituskyvyn vaatimuksia. Metrin etäisyydellä sovellus kykeni 99,9 %:n tunnistustarkkuuteen alhaisellakin resoluutiolla, mutta etäisyyden kasvaessa tunnistustarkkuus pieneni lähes täysin lineaarisesti kolmeen metriin, jossa se ei enää kyennyt tunnistamaan yhtään kasvoa kuvamateriaalista. Parhaimmillakin olosuhteilla ruudunpäivitysnopeus valitettavasti ei riittänyt toistamaan kolmeakymmentä kuvaa sekunnissa. Pienimmällä 144p resoluutiolla se oli kaksikymmentä kuvaa sekunnissa ja suurimmalla 720p resoluutiolla se oli kolme kuvaa sekunnissa. Raspberry Pi ei testien perusteella sovi reaaliaikaisen lisätyn todellisuuden sovelluksen alustaksi.Face recognition application in augmented reality embedded system. Abstract. In this research, the challenges of real time augmented reality application are inspected, while software is developed for embedded systems. The most significant challenges consider simultaneous implementation of real time application, high image quality and purposefulness of the software. For the purpose experimentation in this research, a face recognition software was developed and tested with Raspberry Pi 2 single board computer. Under examination were performance and face recognition accuracy of the application. The experiments illustrate the effect on the performance of the software for the implementation choices’ of the software. A real time augmented reality software, which passes these criteria, requires accurate image processing, high image quality and mobility. Embedded systems, on the other hand, require optimization, reactivity and small size. The developed software recognizes faces from image produced by the Raspberry Pi’s video camera, draws graphic on the faces and plays the enhanced image in real time from the user interface. The software utilizes Raspberry Pi touchscreen and Raspberry Pi camera, as well as a computer vision library called OpenCV. In the research, the software does not pass an acceptable level of performance using Raspberry Pi 2 single board computer. In one meter’s distance, the software achieved face recognition accuracy of 99.9 %, yet, while increasing the distance, the face recognition accuracy diminished nearly in a linear fashion until three meters, in which the face recognition accuracy was zero. Additionally, while the image size grew larger, FPS was reduced exponentially. Even with the best conditions the FPS was low, for the smallest resolution, 144p, the FPS was 20 and for the largest, 720p, resolution the FPS was three

Low incidence of severe bacterial infections in hospitalised patients with COVID-19 : A population-based registry study

Background Bacterial infections complicating COVID-19 are rare but present a challenging clinical entity. The aim of this study was to evaluate the incidence, aetiology and outcome of severe laboratory-verified bacterial infections in hospitalised patients with COVID-19. Methods All laboratory-confirmed patients with COVID-19 admitted to specialised healthcare hospitals in the Capital Province of Finland during the first wave of COVID-19 between 27 February and 21 June 2020 were retrospectively studied. We gathered the blood and respiratory tract culture reports of these patients and analysed their association with 90-day case-fatality using multivariable regression analysis. Results A severe bacterial infection was diagnosed in 40/585 (6.8%) patients with COVID-19. The range of bacteria was diverse, and the most common bacterial findings in respiratory samples were gram-negative, and in blood cultures gram-positive bacteria. Patients with severe bacterial infection had longer hospital stay (mean 31; SD 20 days) compared to patients without (mean 9; SD 9 days; p < 0.001). Case-fatality was higher with bacterial infection (15% vs 11%), but the difference was not statistically significant (OR 1.38 CI95% 0.56-3.41). Conclusions Severe bacterial infection complicating COVID-19 was a rare occurrence in our cohort. Our results are in line with the current understanding that antibiotic treatment for hospitalised COVID-19 patients should only be reserved for situations where a bacterial infection is strongly suspected. The ever-evolving landscape of the pandemic and recent advances in immunomodulatory treatment of COVID-19 patients underline the need for continuous vigilance concerning the possibility and frequency of nosocomial bacterial infections.Peer reviewe

Scaling Data-Constrained Language Models

The current trend of scaling language models involves increasing both parameter count and training dataset size. Extrapolating this trend suggests that training dataset size may soon be limited by the amount of text data available on the internet. Motivated by this limit, we investigate scaling language models in data-constrained regimes. Specifically, we run a large set of experiments varying the extent of data repetition and compute budget, ranging up to 900 billion training tokens and 9 billion parameter models. We find that with constrained data for a fixed compute budget, training with up to 4 epochs of repeated data yields negligible changes to loss compared to having unique data. However, with more repetition, the value of adding compute eventually decays to zero. We propose and empirically validate a scaling law for compute optimality that accounts for the decreasing value of repeated tokens and excess parameters. Finally, we experiment with approaches mitigating data scarcity, including augmenting the training dataset with code data or removing commonly used filters. Models and datasets from our 400 training runs are freely available at https://github.com/huggingface/datablations.Comment: 47 pages (9 main), 37 figures, 13 table

Treatment and Prognosis of Radiation-Associated Breast Angiosarcoma in a Nationwide Population

Background Radiation-associated angiosarcoma of the breast (RAASB) is an aggressive malignancy that is increasing in incidence. Only a few previous population-based studies have reported the results of RAASB treatment. Methods A search for RAASB patients was carried out in the Finnish Cancer Registry, and treatment data were collected to identify prognostic factors for survival. Results Overall, 50 RAASB patients were identified. The median follow-up time was 5.4 years (range 0.4-15.6), and the 5-year overall survival rate was 69%. Forty-seven (94%) patients were operated on with curative intent. Among these patients, the 5-year local recurrence-free survival, distant recurrence-free survival, and overall survival rates were 62%, 75%, and 74%, respectively. A larger planned surgical margin was associated with improved survival. Conclusions We found that the majority of RAASB patients were eligible for radical surgical management in this population-based analysis. With radical surgery, the prognosis is relatively good.Peer reviewe

Modelling and analysing oriented fibrous structures

Volume: 490Peer reviewe

Improved prognosis in soft-tissue sarcoma of extremity and trunk wall : Comparison of patients diagnosed during 1998-2001 and 2005-2010 in Finland

Background and purpose - Soft-tissue sarcoma (STS) is rare, with challenging individualized treatment, so diagnostics and treatment should be centralized. Historical controls are sometimes used for investigation of whether new diagnostic or therapeutic tools affect patient outcome. However, as yet unknown factors may affect the outcome. We investigated prognostic factors and prognosis in 2 nationwide cohorts of patients diagnosed with a local STS during the periods 1998-2001 and 2005-2010, with special interest in finding factors lying behind possible improvement of prognosis. Patients and methods - 2 cohorts of patients with STS of the extremities or trunk diagnosed during the periods 1998-2001 and 2005-2010 were retrieved from the nationwide Finnish Cancer Registry. Detailed information was gathered from patient files. Results - Compared to first cohort, a larger proportion of patients with inadequate surgery in the second cohort received radiation therapy, and both the local control rate and the sarcoma-specific survival rate improved in the second cohort. For sarcoma-specific survival, cohort (HR =0.6, 95% CI: 0.5-0.9), age, depth, grade, and margin were significant factors in multivariate analysis. For local control, cohort (HR =0.6, 95% CI: 0.5-0.9), age, and margin were significant in multivariate analysis. Interpretation - Known prognostic factors including type of treatment did not entirely explain the secular trend of continuous improvement in prognosis in STS. This illustrates the danger of using historical controls for investigation of whether new diagnostic or therapeutic tools have an effect on patient outcome.Peer reviewe

Polymerase Chain Reaction (PCR) provides a superior tool for the diagnosis of Pneumococcal Infection in Burkina Faso

Purpose of study: The aim of this study was to determine the value of real-time Polymerase Chain Reaction (rt-PCR) in the routine surveillance of pneumococcal meningitis in Burkina Faso, compared to standard methods of culture, Gram stain and latex agglutination assay.Materiel and methods: A total of 385 specimens of cerebrospinal fluid were analyzed by the three standard bacteriological methods (Gram stain, latex agglutination assay, and culture) and real-time Polymerase Chain Reaction.Results: Of 385 specimens analyzed by these methods, 204 S. pneumoniae were detected by one or more  methods. Gram stain detected 36.4% (140/385) Gram positive encapsulated diplococci; 37.7% (145/385) and 20.8% (80/385) of the specimens were positive for pneumococci by latex agglutination assay and culture. These specimens were tested with rt-PCR, which confirmed 51.2% (197/385) S. pneumoniae positive. The sensitivity and specificity of culture were 54.4% and 31.5%, respectively, and the sensitivity and specificity of rt-PCR were 96.6% and 100%, respectively. These results showed that rt-PCR was more sensitive than Gram stain (p=0.0235), latex agglutination assay (p=0.0442)and culture (p=0.0006).The culture is the gold standard method; however, the result showed that rt-PCR had specificity and was as specific as Gram stain (p=0.3405) and latex agglutination assay (p=0.7745).Conclusion: rt-PCR was highly sensitive and specific. It could be used as a complementary diagnostic tool to  mprove case confirmation of bacterial meningitis. However,its high cost, the qualification of the technical staff and infrastructures required for its implementation, constitute obstacles to its widened use in countries with limited resources.Keywords: Streptococcus pneumoniae, meningitis, rt-PCR, standard bacteriological methods Objectif: Le but de cette étude était de déterminer la place de la rt-PCR dans la surveillance de routine deméningitespneumococciquesau Burkina Faso et la comparée avec les méthodes de la bactériologie classique: Culture, coloration de Gram et l’agglutination au latex.Matériel etméthodes: Au total, 385 échantillons deliquides céphalorachidiens (LCR)étaient analysés par les trois méthodes de la bactériologie classique (coloration de Gram, agglutination au latex, culture) et la PCR en temps réel.RESULTATS: Parmi 385 échantillons analysés, 204 cas de Streptococcuspneumoniae étaient détectés par une ou plusieurs méthodes. La coloration de Gram adétecté 36,4% (140/385) diplocoques encapsulés à Gram positif (DGP); 37,7% (145/385) et 20,8% (80/385) d’échantillons étaient positifs aux pneumocoques par l’agglutination au latex et la culture. Ces échantillons étaient aussi testés par rt-PCR qui a confirmé 51,2% (197/385) cas positifs de S. pneumoniae. La sensibilité et la spécificité de la culture étaient respectivement de 54,4% et 31,5%, et la sensibilité et la spécificité de rt-PCR étaient respectivement de 96,6% et 100%. Ces résultats ont montré que la rt-PCR était plus sensible que la coloration de Gram (p=0,0235), l’agglutination au latex (p=0,0442) et la  culture(p=0,0006).La culture est une méthode de référence; cependant, le résultat a montré que rt-PCR était plus sensibleet aussi spécifique que la coloration de Gram ((p=0,3405)et l’agglutination au latex (p=0,7745).Conclusion : :rt-PCR était plus sensible et plus spécifique. Elle pourrait être utilisée comme un outil de diagnosticcomplémentaire pour améliorer les cas de confirmation de méningites bactériennes. Cependant, ces coûts de réalisation, la qualification de techniciens et les matériels pour son application constituent des obstacles pour sa vulgarisation dans les pays à ressources limités.Keywords: Streptococcus pneumoniae, méningites, rt-PCR, méthodes de la bactériologie classique Article in English