MRSA eradication of newly acquired lower respiratory tract infection in cystic fibrosis

UK cystic fibrosis (CF) guidelines recommend eradication of methicillin-resistant Staphylococcus aureus (MRSA) when cultured from respiratory samples. As there is no clear consensus as to which eradication regimen is most effective, we determined the efficacy of eradication regimens used in our CF centre and long-term clinical outcome. All new MRSA positive sputum cultures (n=37) that occurred between 2000 and 2014 were reviewed. Eradication regimen characteristics and clinical, microbiological and long-term outcome data were collected. Rifampicin plus fusidic acid was the most frequently used regimen (24 (65%) out of 37 patients), with an overall success rate of 79% (19 out of 24 patients). Eradication failure was more likely in patients with an additional MRSA-positive peripheral screening swab (p=0.03) and was associated with worse survival (p=0.04). Our results demonstrate the feasibility and clinical benefits of MRSA eradication. As peripheral colonisation was associated with lower eradication success, strategies combining systemic and topical treatments should be considered to optimise outcomes in CF patients

A quantitative test of Jones NTC beaming theory using CLUSTER constellation

Non-thermal continuum (NTC) radiation is, with auroral kilometric radiation (AKR), one of the two electromagnetic emissions generated within the Earth's magnetosphere and radiated into space. The location of the source of NTC has been sought for several decades, with only limited success. The constellation formed by the four CLUSTER spacecraft provides the possibility of triangulation in the vicinity of the source, thus allowing progress in source localisation, while simultaneously revealing the beaming properties of NTC radio sources. <br><br> We present a case event showing two beams localised on opposite sides of the magnetic equator. At any selected frequency, triangulation points to a single region source of small size. Its position is compatible with the range of possible loci of sources predicted by the radio window theory of Jones (1982) in a frame of constraints relaxed from the simple sketch proposed in early works. The analysis of similar observations from the Dynamics Explorer 1 by Jones et al. (1987) enabled the authors to claim validation of the radio window theory. CLUSTER observations, however, reveal a large beaming cone angle projected onto the ecliptic plane, a feature unobservable by Dynamics Explorer which had a different spin axis orientation. According to the radio window theory, such a large observed cone angle can only be formed by a series of point sources, each beaming in a narrow cone angle. This study demonstrates the difficulty of validating NTC linear generation mechanisms using global beaming properties alone

Tracking the Irish adult population during the first year of the COVID-19 pandemic : a methodological report of the COVID-19 psychological research consortium (C19PRC) study in Ireland

The COVID-19 Psychological Research Consortium (C19PRC) study was established to determine the impact of the COVID-19 pandemic on the population of multiple countries. Here, we provide a methodological overview, cohort profile, data access, and summary of key findings from the Republic of Ireland arm of the C19PRC study. A longitudinal internet panel survey was designed to collect data from a nationally representative sample of Irish adults (N = 1041) who were tracked from March/April 2020 to March/April 2021. Quota sampling methods were used to produce a sample that was representative of the population with respect to sex, age, and regional distribution. Data were collected in five waves, and new participants were recruited at follow-up waves to cover sample attrition and produce nationally representative samples at various points during the first year of the pandemic. A comprehensive battery of measures was used throughout the project to assess an array of sociodemographic, political, social, psychological, physical health, COVID-19, and mental health variables. Analyses were conducted to compare sample characteristic to known population parameters from available census data. These analyses showed that the sample was representative of the general adult population of Ireland on the three quota variables and was reasonable representative of the population across a diverse range of sociodemographic variables. These data representative the first and only nationally representative, longitudinal survey of the mental health of the Irish population. These data are made freely available to interested users (https://osf.io/2huzd/files/) and the findings of this study provide a methodological basis for the future use of these data

Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy.

Introduction. Octogenarians are at increased risk for complications after lung resection. With alternatives such as radiation, understanding the risks of surgery and associated survival are valuable. Data grading the severity of complications and long-term survival in this population is lacking. We reviewed our experience with lobectomy in octogenarians, grading complications using a validated thoracic morbidity and mortality schema. Methods. We retrospectively reviewed consecutive patients aged ≥80 undergoing lobectomy between 2004 and 2012. Demographics, clinical/pathologic stage, complications, recurrence, and mortality were collected. Complications were graded by the Seely thoracic morbidity and mortality model. Results. 45 patients (mean age 82.2 years) were analyzed. The majority of patients (28/45, 62%) were clinical stage IA/IB. 62% (28/45) of patients experienced a complication. Only 15.6% (7/45) were considered significantly morbid (≥ grade IIIB) per the Seely model. Perioperative mortality was 2% and half of patients were living at a follow-up of 53 months. Overall five-year survival was 52%. Conclusions. In carefully selected octogenarians, lobectomy carries a 15.6% rate of significantly morbid complications with encouraging overall survival. These data provide the basis for a more complete discussion with patients regarding lobectomy for lung cancer

Modulation of NTC frequencies by Pc5 ULF pulsations : experimental test of the generation mechanism and magnetoseismology of the emitting surface

Nonthermal continuum (NTC) radiation is believed to be emitted by the conversion of an electrostatic wave into an electromagnetic one, which takes place at the Earth's magnetic equator. It is generally accepted that the frequency of the electrostatic wave at the source meets a local characteristic frequency placed in between two multiples of the electron cyclotron frequency, fce, which results in emission of a narrow band frequency element. In an event on 14 August 2003, we compare oscillations of the central frequency of distinct NTC frequency elements observed from Cluster orbiting near perigee, with simultaneous Pc5 Ultra Low Frequency (ULF) pulsations in the magnetic field observed from the same platform. The latter magnetic perturbations are interpreted as magnetohydrodynamic poloidal waves, where fundamental and second harmonic modes coexist. The NTC oscillation and the fundamental wave have similar periods, but are phase shifted by a quarter of period. From the correlation between both signals, and the proximity of the NTC source (localized via triangulation) with Cluster, we infer that the poloidal perturbations are spatially uniform between the source and the satellites. From the phase shift between signals, we conclude that the electrostatic wave which converts into NTC is mainly governed by the plasma density, affected by movements of the magnetic field lines. Furthermore, we demonstrate that the observations can be used to perform a magnetoseismology of the emitting surface. The results show a steepening of the plasmapause density profile near the satellites, which can be responsible for the generation of NTC emission

Predicting Adverse Radiation Effects in Brain Tumors After Stereotactic Radiotherapy With Deep Learning and Handcrafted Radiomics

Introduction There is a cumulative risk of 20-40% of developing brain metastases (BM) in solid cancers. Stereotactic radiotherapy (SRT) enables the application of high focal doses of radiation to a volume and is often used for BM treatment. However, SRT can cause adverse radiation effects (ARE), such as radiation necrosis, which sometimes cause irreversible damage to the brain. It is therefore of clinical interest to identify patients at a high risk of developing ARE. We hypothesized that models trained with radiomics features, deep learning (DL) features, and patient characteristics or their combination can predict ARE risk in patients with BM before SRT. Methods Gadolinium-enhanced T1-weighted MRIs and characteristics from patients treated with SRT for BM were collected for a training and testing cohort (N = 1,404) and a validation cohort (N = 237) from a separate institute. From each lesion in the training set, radiomics features were extracted and used to train an extreme gradient boosting (XGBoost) model. A DL model was trained on the same cohort to make a separate prediction and to extract the last layer of features. Different models using XGBoost were built using only radiomics features, DL features, and patient characteristics or a combination of them. Evaluation was performed using the area under the curve (AUC) of the receiver operating characteristic curve on the external dataset. Predictions for individual lesions and per patient developing ARE were investigated. Results The best-performing XGBoost model on a lesion level was trained on a combination of radiomics features and DL features (AUC of 0.71 and recall of 0.80). On a patient level, a combination of radiomics features, DL features, and patient characteristics obtained the best performance (AUC of 0.72 and recall of 0.84). The DL model achieved an AUC of 0.64 and recall of 0.85 per lesion and an AUC of 0.70 and recall of 0.60 per patient. Conclusion Machine learning models built on radiomics features and DL features extracted from BM combined with patient characteristics show potential to predict ARE at the patient and lesion levels. These models could be used in clinical decision making, informing patients on their risk of ARE and allowing physicians to opt for different therapies

Beta decay and shape isomerism in 74Kr

We study the properties of $^{74}$Kr, and particularly the Gamow Teller strength distribution, using a deformed selfconsistent HF+RPA method with Skyrme type interactions. Results are presented for two density-dependent effective two-body interactions, including the dependence on deformation of the HF energy that exhibits two minima at close energies and distant deformations, one prolate and one oblate. We study the role of deformation, residual interaction, pairing and RPA correlations on the Gamow Teller strength distribution. Results on moments of inertia and gyromagnetic factors, as well as on $E0$ and $M1$ transitions are also presented.Comment: 20 pages, RevTeX. 12 PS figures. To appear in Nucl. Phys.

Electronic Medical Record Inaccuracies: Multicenter Analysis of Challenges with Modified Lung Cancer Screening Criteria.

The National Comprehensive Cancer Network expanded their lung cancer screening (LCS) criteria to comprise one additional clinical risk factor, including chronic obstructive pulmonary disease (COPD). The electronic medical record (EMR) is a source of clinical information that could identify high-risk populations for LCS, including a diagnosis of COPD; however, an unsubstantiated COPD diagnosis in the EMR may lead to inappropriate LCS referrals. We aimed to detect the prevalence of unsubstantiated COPD diagnosis in the EMR for LCS referrals, to determine the efficacy of utilizing the EMR as an accurate population-based eligibility screening trigger using modified clinical criteria. We performed a multicenter review of all individuals referred to three LCS programs from 2012 to 2015. Each individual\u27s EMR was searched for COPD diagnostic terms and the presence of a diagnostic pulmonary functionality test (PFT). An unsubstantiated COPD diagnosis was defined by an individual\u27s EMR containing a COPD term with no PFTs present, or the presence of PFTs without evidence of obstruction. A total of 2834 referred individuals were identified, of which 30% (840/2834) had a COPD term present in their EMR. Of these, 68% (571/840) were considered unsubstantiated diagnoses: 86% (489/571) due to absent PFTs and 14% (82/571) due to PFTs demonstrating no evidence of postbronchodilation obstruction. A large proportion of individuals referred for LCS may have an unsubstantiated COPD diagnosis within their EMR. Thus, utilizing the EMR as a population-based eligibility screening tool, employing expanded criteria, may lead to individuals being referred, potentially, inappropriately for LCS

Quadrupole Collective States in a Large Single-J Shell

We discuss the ability of the generator coordinate method (GCM) to select collective states in microscopic calculations. The model studied is a single-$j$ shell with hamiltonian containing the quadrupole-quadrupole interaction. Quadrupole collective excitations are constructed by means of the quadrupole single-particle operator. Lowest collective bands for $j$=31/2 and particle numbers $N$=4,6,8,10,12, and $14$ are found. For lower values of $j$, exact solutions are obtained and compared with the GCM results.Comment: submitted for publication in Phys. Rev. C, revtex, 28 pages, 15 PostScript figures available on request from [email protected], preprint No. IFT/17/9