Another option for patients with liver disease

Consider prescribing rifaximin for patients with hepatic encephalopathy, not only as a treatment for acute episodes but also to prevent a recurrence. Stength of recommendation: A: Based on a high-quality randomized controlled trial (RCT)

What is the recommended approach to asymptomatic patients who develop a reactive PPD?

Clinical evaluation and chest x-ray are recommended for asymptomatic patients with a positive purified protein derivative (PPD) test result, to exclude the slight possibility of active tuberculosis (TB). Patients with radiographic evidence of old (healed) TB infection should also undergo sputum testing (strength of recommendation [SOR]: C, expert opinion). Treatment with isoniazid (INH) monotherapy (300 mg/d) reduces progression of latent tuberculosis to active disease (SOR: A, large randomized controlled trials [RCT]), with 9 months as the optimal treatment length (SOR: B, derivation from RCTs). A 3-month course of combined rifampin (600 mg/d) and INH (300 mg/d) is equivalent in efficacy to INH monotherapy and is associated with similar rates of toxicity (SOR: A, meta-analysis of RCTs), but this regimen is not included in Centers for Disease Control and Prevention recommendations

Bisphosphonate therapy: When not to monitor BMD

After starting patients on bisphosphonates for osteoporosis, wait at least 3 years before ordering a repeat dual-energy x-ray absorptiometry (DXA) scan. Stength of recommendation: C: Based on a secondary analysis of a large randomized controlled trial

Pulsatile Drug Delivery System – A Novel Approach for Time and Spatial Controlled Drug Delivery

The area of pharmaceutical research is broadened with the invention of new pharmaceutical drug delivery system. The traditional drug deliveries systems have not the way to treat or cure special disease or as well as the common disease with less side effects and maximized efficacy. ODDS have various advantages and disadvantages but their disadvantages are overcome by the CDDS. CDDS although they overcome the disadvantages of ODDS but do not handle the special pharmacological disease requirements. To overcome this PDDS is established to overcome the disadvantages of CDDS. PDDS has gained importance in the drug delivery system because of improved patient compliance, therapeutic efficacy and having fewer side effects. PDDS uses lag time for delivery of drug in body. Various systems are there in PDDS to overcome the patient’s special chronopharmacological needs

Ovary-sparing hysterectomy: Is it right for your patient?

Advise patients undergoing hysterectomy for benign conditions that there are benefits to conserving their ovaries. The risk of coronary heart disease (CHD) and death is lower in women whose ovaries are conserved, compared with those who have had them removed. Stength of recommendation: B: A large, high-quality observational study

Currents and Radiation from the large DD Black Hole Membrane

It has recently been demonstrated that black hole dynamics in a large number of dimensions $D$ reduces to the dynamics of a codimension one membrane propagating in flat space. In this paper we define a stress tensor and charge current on this membrane and explicitly determine these currents at low orders in the expansion in $\frac{1}{D}$. We demonstrate that dynamical membrane equations of motion derived in earlier work are simply conservation equations for our stress tensor and charge current. Through the paper we focus on solutions of the membrane equations which vary on a time scale of order unity. Even though the charge current and stress tensor are not parametrically small in such solutions, we show that the radiation sourced by the corresponding membrane currents is generically of order $\frac{1}{D^D}$. In this regime it follows that the `near horizon' membrane degrees of freedom are decoupled from asymptotic flat space at every perturbative order in the $\frac{1}{D}$ expansion. We also define an entropy current on the membrane and use the Hawking area theorem to demonstrate that the divergence of the entropy current is point wise non negative. We view this result as a local form of the second law of thermodynamics for membrane motion.Comment: 104 pages plus 69 pages appendix, 1 figure, Minor correction

Author Correction: Federated learning enables big data for rare cancer boundary detection.

10.1038/s41467-023-36188-7NATURE COMMUNICATIONS14

Federated learning enables big data for rare cancer boundary detection.

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing