Inflammatory and blood gas markers of COVID-19 delirium compared to non-COVID-19 delirium: a cross-sectional study

OBJECTIVES: We aimed to find the association of inflammation and respiratory failure with delirium in COVID-19 patients. We compare the inflammatory and arterial blood gas markers between patients with COVID-19 delirium and delirium in other medical disorders. METHODS: This cross-sectional study used the CHART-DEL, a validated research tool, to screen patients for delirium retrospectively from clinical notes. Inflammatory markers C-reactive protein (CRP) and white cell count (WBC), and the partial pressures of oxygen (PO2) and carbon dioxide (PCO2) were compared between patients with COVID-19 delirium and delirium in other medical disorders. RESULTS: In bivariate analysis, CRP (mg/L) was significantly higher in the COVID-19 group, (81.7 ± 80.0 vs. 58.8 ± 87.7, p = 0.04), and WBC (109/L) was significantly lower (7.44 ± 3.42 vs. 9.71 ± 5.45, p = 0.04). The geometric mean of CRP in the COVID-19 group was 140% higher in multiple linear regression (95% CI = 7-439%, p = 0.03) with age and sex as covariates. There were no significant differences in pO2 or pCO2 across groups. CONCLUSION: The association between higher CRP and COVID-19 in patients with delirium may suggest an inflammatory basis for delirium in COVID-19. Our findings may assist clinicians in establishing whether delirium is due to COVID-19, which may improve management and outcomes of infected patients

The 2D Continuum Radiative Transfer Problem: Benchmark Results for Disk Configurations

We present benchmark problems and solutions for the continuum radiative transfer (RT) in a 2D disk configuration. The reliability of three Monte-Carlo and two grid-based codes is tested by comparing their results for a set of well-defined cases which differ for optical depth and viewing angle. For all the configurations, the overall shape of the resulting temperature and spectral energy distribution is well reproduced. The solutions we provide can be used for the verification of other RT codes.We also point out the advantages and disadvantages of the various numerical techniques applied to solve the RT problem.Comment: 13 pages, 10 figures, To appear in Astronomy and Astrophysic

Pulsational and evolutionary analysis of the double-mode RR Lyrae star BS Com

We derive the basic physical parameters of the field double-mode RR Lyrae star BS Com from its observed periods and the requirement of consistency between the pulsational and evolutionary constraints. By using the current solar-scaled horizontal branch evolutionary models of Pietrinferni et al. (2004) and our linear non-adiabatic purely radiative pulsational models, we get M/M(Sun) = 0.698 +/- 0.004, log(L/L(Sun)) = 1.712 +/- 0.005, T(eff) = 6840 +/- 14 K, [Fe/H] = -1.67 +/- 0.01, where the errors are standard deviations assuming uniform age distribution along the full range of uncertainty in age. The last two parameters are in a good agreement with the ones derived from the observed BVIc colours and the updated ATLAS9 stellar atmosphere models. We get T(eff) = 6842 +/- 10 K, [Fe/H] = -1.58 +/- 0.11, where the errors are purely statistical ones. It is remarkable that the derived parameters are nearly independent of stellar age at early evolutionary stages. Later stages, corresponding to the evolution toward the asymptotic giant branch are most probably excluded because the required high temperatures are less likely to satisfy the constraints posed by the colours. We also show that our conclusions are only weakly sensitive to nonlinear period shifts predicted by current hydrodynamical models.Comment: Accepted for publication by MNRAS on 2008 February 01. The paper contains 4 figures and 8 table

Crack-Like Processes Governing the Onset of Frictional Slip

We perform real-time measurements of the net contact area between two blocks of like material at the onset of frictional slip. We show that the process of interface detachment, which immediately precedes the inception of frictional sliding, is governed by three different types of detachment fronts. These crack-like detachment fronts differ by both their propagation velocities and by the amount of net contact surface reduction caused by their passage. The most rapid fronts propagate at intersonic velocities but generate a negligible reduction in contact area across the interface. Sub-Rayleigh fronts are crack-like modes which propagate at velocities up to the Rayleigh wave speed, VR, and give rise to an approximate 10% reduction in net contact area. The most efficient contact area reduction (~20%) is precipitated by the passage of slow detachment fronts. These fronts propagate at anomalously slow velocities, which are over an order of magnitude lower than VR yet orders of magnitude higher than other characteristic velocity scales such as either slip or loading velocities. Slow fronts are generated, in conjunction with intersonic fronts, by the sudden arrest of sub-Rayleigh fronts. No overall sliding of the interface occurs until either of the slower two fronts traverses the entire interface, and motion at the leading edge of the interface is initiated. Slip at the trailing edge of the interface accompanies the motion of both the slow and sub-Rayleigh fronts. We might expect these modes to be important in both fault nucleation and earthquake dynamics.Comment: 19 page, 5 figures, to appear in International Journal of Fractur

Clinical and economic comparison of an individualised immunoglobulin protocol vs. standard dosing for chronic inflammatory demyelinating polyneuropathy

Background The clinical and economic implications of an individualised intravenous immunoglobulin (IVIg) protocol for chronic inflammatory demyelinating polyneuropathy (CIDP) are unknown. Comparison with standard dosing regimens has not been performed. Methods We retrospectively studied 47 IVIg-treated subjects with CIDP over 4 years with an individualised, outcome-measured, dose-modifying protocol. We evaluated responder and remission rates, clinical improvement levels and dose requirements. We compared clinical benefits and costs with those reported with standard dosing at 1 g/kg every 3 weeks. Results The IVIg-responder rate was 83% and the 4-year remission rate was 25.6%. Mean IVIg dose requirements were 22.06 g/week (SD:15.29) in patients on ongoing therapy. Dose range was wide (5.83–80 g/week). Mean infusion frequency was every 4.34 weeks (SD:1.70) and infusion duration of 2.79 days (SD:1.15). Mean Overall Neuropathy Limitation Scale improvement was 2.54 (SD:1.89) and mean MRC sum score improvement of 12.23 (SD:7.17) in IVIg-responders. Mean modified-INCAT (Inflammatory Neuropathy Cause and Treatment) score improvement was similar (p = 0.47) and mean MRC sum score improvement greater (p < 0.001) in our cohort, compared to the IVIg-treated arm of the ICE Study. Mean drug costs were GBP 37,660/patient/year (€ 43,309) and mean infusion-related costs of GBP 17,115/patient/year (€ 19,682), totalling GBP 54,775/patient/year (€ 62,991). Compared to standard dosing using recorded weight, mean savings were of GBP 13,506/patient/year (€ 15,532). Compared to standard dosing using dosing weight, savings were of GBP 6,506/patient/year (€ 7,482). Conclusion Our results indicate that an individualised IVIg treatment protocol is clinically non-inferior and 10–25% more cost-effective than standard dosing regimens in CIDP

Understanding the adoption of business analytics and intelligence

Cruz-Jesus, F., Oliveira, T., & Naranjo, M. (2018). Understanding the adoption of business analytics and intelligence. In Á. Rocha, H. Adeli, L. P. Reis, & S. Costanzo (Eds.), Trends and Advances in Information Systems and Technologies, pp. 1094-1103. (Advances in Intelligent Systems and Computing; Vol. 745). Springer Verlag. DOI: 10.1007/978-3-319-77703-0_106Our work addresses the factors that influence the adoption of business analytics and intelligence (BAI) among firms. Grounded on some of the most prominent adoption models for technological innovations, we developed a conceptual model especially suited for BAI. Based on this we propose an instrument in which relevant hypotheses will be derived and tested by means of statistical analysis. We hope that the findings derived from our analysis may offer important insights for practitioners and researchers regarding the drivers that lead to BAI adoption in firms. Although other studies have already focused on the adoption of technological innovations by firms, research on BAI is scarce, hence the relevancy of our research.authorsversionpublishe

Translation of evidence-based Assistive Technologies into stroke rehabilitation: Users' perceptions of the barriers and opportunities

Background: Assistive Technologies (ATs), defined as "electrical or mechanical devices designed to help people recover movement", demonstrate clinical benefits in upper limb stroke rehabilitation; however translation into clinical practice is poor. Uptake is dependent on a complex relationship between all stakeholders. Our aim was to understand patients', carers' (P&Cs) and healthcare professionals' (HCPs) experience and views of upper limb rehabilitation and ATs, to identify barriers and opportunities critical to the effective translation of ATs into clinical practice. This work was conducted in the UK, which has a state funded healthcare system, but the findings have relevance to all healthcare systems. Methods. Two structurally comparable questionnaires, one for P&Cs and one for HCPs, were designed, piloted and completed anonymously. Wide distribution of the questionnaires provided data from HCPs with experience of stroke rehabilitation and P&Cs who had experience of stroke. Questionnaires were designed based on themes identified from four focus groups held with HCPs and P&Cs and piloted with a sample of HCPs (N = 24) and P&Cs (N = 8). Eight of whom (four HCPs and four P&Cs) had been involved in the development. Results: 292 HCPs and 123 P&Cs questionnaires were analysed. 120 (41%) of HCP and 79 (64%) of P&C respondents had never used ATs. Most views were common to both groups, citing lack of information and access to ATs as the main reasons for not using them. Both HCPs (N = 53 [34%]) and P&C (N = 21 [47%]) cited Functional Electrical Stimulation (FES) as the most frequently used AT. Research evidence was rated by HCPs as the most important factor in the design of an ideal technology, yet ATs they used or prescribed were not supported by research evidence. P&Cs rated ease of set-up and comfort more highly. Conclusion: Key barriers to translation of ATs into clinical practice are lack of knowledge, education, awareness and access. Perceptions about arm rehabilitation post-stroke are similar between HCPs and P&Cs. Based on our findings, improvements in AT design, pragmatic clinical evaluation, better knowledge and awareness and improvement in provision of services will contribute to better and cost-effective upper limb stroke rehabilitation. © 2014 Hughes et al.; licensee BioMed Central Ltd

Hybridization in parasites: consequences for adaptive evolution, pathogenesis and public health in a changing world

[No abstract available