Hospital volume and mortality after transjugular intrahepatic portosystemic shunt creation in the United States

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141487/1/hep29354-sup-0001-suppinfo1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141487/2/hep29354_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141487/3/hep29354.pd

Hydroxychloroquine for treatment of non-hospitalized adults with COVID-19: A meta-analysis of individual participant data of randomized trials

Hydroxychloroquine (HCQ) was initially promoted as an oral therapy for early treatment of coronavirus disease 2019 (COVID-19). Conventional meta-analyses cannot fully address the heterogeneity of different designs and outcomes of randomized controlled trials (RCTs) assessing the efficacy of HCQ in outpatients with mild COVID-19. We conducted a pooled analysis of individual participant data from RCTs that evaluated the effect of HCQ on hospitalization and viral load reduction in outpatients with confirmed COVID-19. We evaluated the overall treatment group effect by log-likelihood ratio test (−2LL) from a generalized linear mixed model to accommodate correlated longitudinal binary data. The analysis included data from 11 RCTs. The outcome of virological effect, assessed in 1560 participants (N = 795 HCQ, N = 765 control), did not differ significantly between the two treatment groups (−2LL = 7.66; p = 0.18) when adjusting for cohort, duration of symptoms, and comorbidities. The decline in polymerase chain reaction positive tests from day 1 to 7 was 42.0 and 41.6 percentage points in the HCQ and control groups, respectively. Among the 2037 participants evaluable for hospitalization (N = 1058 HCQ, N = 979 control), we found no significant differences in hospitalization rate between participants receiving HCQ and controls (odds ratio 0.995; 95% confidence interval 0.614–1.610; −2LL = 0.0; p = 0.98) when adjusting for cohort, duration of symptoms, and comorbidities. This individual participant data meta-analysis of 11 HCQ trials that evaluated severe acute respiratory syndrome-coronavirus 2 viral clearance and COVID-19 hospitalization did not show a clinical benefit of HCQ. Our meta-analysis provides evidence to support the interruption in the use of HCQ in mild COVID-19 outpatients to reduce progression to severe disease

Gestural Workspaces for Computer Interaction, Configuration and Performance

While the hardware challenges facing integration of hand-gestural controls into mainstream computer interfaces appear to be shrinking, design challenges related to the physical and mental burden required of gesture interfaces remain. This study aims to determine the effect of the gestural workspace configuration (vertical, horizontal, and jointspace) and affordance of arm support on speed, accuracy, and performance when performing pointing tasks on a computer. Seventeen participants played a computer card game (Solitaire) and then completed Fitts’ serial clicking tasks to evaluate performance in five gestural workspace configurations implemented using a Microsoft Kinect®. Gestural input configurations were also compared to a traditional mouse input. A traditional mouse performed better than gestural controls in all aspects of performance. Among gestural workspaces, the vertical configuration performed significantly better in throughput and accuracy outcomes. Limitations of the gestural tracking system and large variation in individual performance may hinder establishment of generalized design recommendations at this point; however, gestural workspace configurations with direct mapping to onscreen movements and the presence of supporting surfaces appear to increase user performance and reduce perceived difficulty

Simulation, synthesis and band-gap engineering of 2nd group doped ZnO nanostructures

Nano-materials are considered as a fundamental constituent in almost every field of medical science to engineering. However, the field of application of nano-material largely depends on its structural, chemical and optical properties of nano-material. Doping of nano-materials results in changes their particle size and band-gap which effects its applications. In this work, the effect of change in band-gap and particle size has been studied for 2nd group element doped ZnO (Zinc Oxide) nanostructures synthesized on AAO (Anode Aluminum Oxide) template having a pore size of 180.5 nm fabricated using chemical bath deposition and Anodization respectively. Fuzzy logic rule based system is used to study the effect of 2nd group element doping in ZnO nano-structure fabricated on AAO template with a fix pore size on the band-gap and output nanostructure. With addition of 2nd group element in ZnO nano-structure, a variation in rod length and band-gap has been observed. A decrease of rod length and an increase in band-gap have been observed by the addition of 2nd group including Be, Mg, Ca and Sr elements in ZnO nano-crystal. The fuzzy logic results are in accordance with the experimental system which shows the effectiveness of the simulations

Hydrological evaluation of 14 satellite-based, gauge-based and reanalysis precipitation products in a data-scarce mountainous catchment

Availability of high-quality data is a major problem for climate and hydrological studies, especially in basins with complex topography where gauge network is typically limited and unevenly distributed. This study investigates the performance of 14 precipitation products – seven satellite-based (SPPs), two gauge-based (GPPs) and five reanalysis products (RPPs) – against ground observations (1998–2007) in the transboundary Jhelum River basin (33 397 km2). Among the seven SPPs (bias corrected), five demonstrate a significantly high correlation coefficient (CC > 0.7) with observed rainfall. However, most of the products tend to underestimate the seasonal precipitation amount, particularly in winter and spring. Likewise, Asian Precipitation – Highly Resolved Observational Data Integration Towards Evaluation of water resources APHRODITE (GPPs) and Japanese 55-year Reanalysis JRA-55 (RPPs) are the best-performing products in daily streamflow predictions, with Nash-Sutcliffe efficiency values of 0.68 and 0.62, whilst MSWEP (Multi-Source Weighted-Ensemble Precipitation), AgMERRA (Climate Forcing Dataset for Agricultural Modeling) and CHIRPS (Climate Hazards Group InfraRed Precipitation with Station data) have also good potential in flow prediction. Generally, our results indicate that APHRODITE and JRA-55 could be used as alternative sources of precipitation data in the Himalayas region

Evaluation of therapeutic effectiveness of prescribed medications in patients with type 2 diabetes mellitus: findings from a tertiary care hospital, Lahore, Pakistan

Aim: The present study was aimed to highlight the current prescribing pattern of oral hypoglycemia in type 2 diabetes mellitus and to evaluate the therapeutic effectiveness of these therapeutic categories in achieving target glycemic control. Methods: This is a prospective, cross-sectional, observational study of 6 months' duration conducted in a tertiary care hospital of Lahore, Pakistan. Results: The current research recruited 145 patients presented in diabetes management center of a tertiary care hospital in Lahore, Pakistan. Mean age of the participants was 50.2 (± 8.5) years. Out of the 145 patients, 63% were females and 37% were males. Most patients were diagnosed to have diabetes within the past 5 years. Diabetes-induced neuropathy was the most common complication (71.7%) among the patients. A large proportion of these patients (70.3%) were also suffering from other comorbidities among which the most common one is hypertension. The average number of prescribed medications was 1.31. Metformin was prescribed to a majority of patients (64%) as monotherapy while 28.96% received combination therapy. Mean glycated hemoglobin (HBA1c) before and after 3 months of treatment was 8.5 (± 2.3) and 8.04 (± 2.1), respectively. Inferential statistics show a strong association between HBA1c and life style modifications and adherence to medication therapy (P = 0.05). However, the correlation between HBA1c and Morisky score and duration of disease was inverse and weak (P = 0.6, 0.4). The t-test values show a small difference between HBA1c values before and after 3 months (t = 0.440 and 0.466, respectively). Conclusion: Optimization of medication regimen and continuous patient education regarding life style modification and adherence to medication therapy are necessitated to bring HBA1c values near to targe