Palliatiivisen hoidon opettajien osaamisen vahvistaminen

Tiivistelmä Sosiaali- ja terveysalan opettajilla tulee olla riittävä osaaminen palliatiivisesta hoidosta. Osaamisen päivittäminen opetussuunnitelma- ja kansainvälisten suositusten mukaiseksi on ajankohtaista. Näin taataan koulutuksessa oleville opiskelijoille riittävä osaaminen toimia palliatiivisen potilaan ja hänen läheisensä tukena sairauden eri vaiheissa. EduPal-hankkeessa palliatiivisen hoidon opettajille suunniteltiin viiden opintopisteen laajuinen verkkokurssi, jonka tavoitteena on vahvistaa opettajien osaamista palliatiivista hoidosta sekä pedagogista osaamista.Abstract Strenghtening competencies of palliative care teachers Teachers of future healthcare professionals should have adequate expertise in palliative care, and they should update their expertise in accordance with curriculum- and international recommendations. In this way, students in education are guaranteed sufficient skills to act as support for the palliative patient and their loved ones at different stages of the disease. A fivecredit online course for palliative care teachers was designed to strengthen the teachers’ competence in palliative care and pedagogical competence

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

High-frequency internal wave motions at the ANTARES site in the deep western mediterranean

[EN] High-frequency internal wave motions of periods down to 20 min have been observed in a yearlong record from the deep Western Mediterranean, mainly in vertical currents. The observations were made using the ANTARES neutrino telescope infrastructure. One line of the telescope is instrumented with environmental monitoring devices, and in particular with an Acoustic Doppler Current Profiler that was used to measure currents around 2,200 m. Such high-frequency internal waves are commonly observed much closer to the sea surface where the vertical density stratification is more stable than in the deep sea. In this paper, they are supported by the relatively large stratification following newly formed dense water. During the severe winters of 2005 and 2006, deep dense-water formation occurred in the Ligurian subbasin. Its collapse and spread over the sea floor across the basin remained detectable for at least 3 years as deduced from the present yearlong current record, which is from 2008. The observed high-frequency internal waves match the occasional density stratification observed in ¡«1-m-thin layers using previous shipborne conductivity¿C temperature¿C depth measurements. Such layers and waves are relatively unusual in the deep Mediterranean, where commonly several hundreds-ofmeters- thick near-homogeneous layers dominate. Such thick near-homogeneous layers provide about a half-decade narrow internal wave band around the inertial frequency (f). In contrast, the presently observed vertical currents occasionally show a ¡°small-scale¡± internal wave band that is on average 1.5 decades wide, associated with thin-layer stratification. In spite of its relatively largewidth, this band still shows variance peaking near f rather than near the large-scale buoyancy frequency N (= 2.3 4.5f) and this variance is found to increase with increasing N.The CTD observations were made in the framework of "Gyroscop" and "Gyroscop-2" for which we acknowledge Claude Millot and the Netherlands Organisation for the Advancement of Scientific Research, NWO, and Centre National de la Recherche Scientifique, CNRS, for support (French-Dutch collaboration). The authors acknowledge the financial support of the funding agencies: Centre National de la Recherche Scientifique (CNRS), Commissariat a l'energie atomique et aux energies alternatives (CEA), Commission Europeenne (FEDER fund and Marie Curie Program), Region Alsace (contrat CPER), Region Provence-Alpes-Cote d'Azur, Departement du Var and Ville de La Seyne-sur-Mer, France; Bundesministerium fur Bildung und Forschung (BMBF), Germany; Istituto Nazionale di Fisica Nucleare (INFN), Italy; Stichting voor Fundamenteel Onderzoek der Materie (FOM) and NWO, the Netherlands; Council of the President of the Russian Federation for young scientists and leading scientific schools supporting grants, Russia; National Authority for Scientific Research (ANCS - UEFISCDI), Romania; Ministerio de Ciencia e Innovacion (MICINN), Prometeo of Generalitat Valenciana and MultiDark, Spain; Agence de l'Oriental and CNRST, Morocco. We also acknowledge the technical support of Ifremer, AIM, and Foselev Marine for the sea operation and the CC-IN2P3 for the computing facilities.Van Haren, H.; Adrián Martínez, S.; Al Samarai, I.; Albert, A.; André, M.; Anghinolfi, M.; Anton, G.... (2014). High-frequency internal wave motions at the ANTARES site in the deep western mediterranean. Ocean Dynamics. 64(4):507-517. https://doi.org/10.1007/s10236-014-0702-0S507517644Ageron M, ANTARES collaboration et al (2011) ANTARES: the first neutrino telescope in the Mediterranean Sea. Nucl Inst Methods Phys Res A 656:11–38Aguilar JA, ANTARES collaboration et al (2007) The data acquisition for the ANTARES neutrino telescope. Nucl Inst Meth Phys Res A 570:107–116Albérola C, Millot C, Font J (1995) On the seasonal and mesoscale variabilities of the Northern Current during the PRIMO-0 experiment in the western Mediterranean Sea. Oceanol Acta 18:163–192Cairns JL, Williams GO (1976) Internal wave observations from a midwater float, 2. J Geophys Res 81:1943–1950Crépon M, Wald L, Monget JM (1982) Low-frequency waves in the Ligurian Sea during December 1977. J Geophys Res 87:595–600Crépon M, Boukhtir M, Barnier B, Aikman F III (1989) Horizontal ocean circulation forced by deep-water formation. Part I: an analytical study. J Phys Oceanogr 19:1781–1792Fofonoff NP (1969) Spectral characteristics of internal waves in the ocean. Deep-Sea Res 16:58–71Garrett CJR, Munk WH (1972) Space-time scales of internal waves. Geophys Fluid Dyn 3:225–264Gascard J-C (1973) Vertical motions in a region of deep water formation. Deep-Sea Res 20:1011–1027Gerkema T, Zimmerman JTF, Maas LRM, van Haren H (2008) Geophysical and astrophysical fluid dynamics beyond the traditional approximation. Rev Geophys 46:RG2004. doi: 10.1029/2006RG000220LeBlond PH, Mysak LA (1978) Waves in the ocean. Elsevier, AmsterdamMillot C (1999) Circulation in the Western Mediterranean Sea. J Mar Syst 20:423–442Munk WH (1980) Internal wave spectra at the buoyant and inertial frequencies. J Phys Oceanogr 10:1718–1728Pinkel R (1981) Observations of the near-surface internal wavefield. J Phys Oceanogr 11:1248–1257RDI (1992) A practical primer. RD-Instruments, San DiegoSchroeder K, Ribotti A, Borghini M, Sorgente R, Perilli A, Gasparini GP (2008) An extensive Western Mediterranean deep water renewal between 2004 and 2006. Geophys Res Lett 35:L18605. doi: 10.1029/2008GL035146Schroeder K, Gasparini GP, Borghini M, Ribotti A (2009) Experimental evidence of recent abrupt changes in the deep Western Mediterranean Sea. CIESM Workshop Monographs, n°38: Dynamics of Mediterranean deep waters, Malta, 27–30 May 2009:51–56Sheremet VA (2004) Laboratory experiments with tilted convective plumes on a centrifuge: a finite angle between the buoyancy and the axis of rotation. J Fluid Mech 506:217–244Straneo F, Kawase M, Riser SC (2002) Idealized models of slantwise convection in a baroclinic flow. J Phys Oceanogr 32:558–572Taupier-Letage I, Millot C (1986) General hydrodynamic features in the Ligurian Sea inferred from the DYOME experiment. Oceanol Acta 9:119–132Testor P, Gascard J-C (2006) Post-convection spreading phase in the Northwestern Mediterranean Sea. Deep-Sea Res I 53:869–893van Haren H (2008) A comparison between vertical motions measured by ADCP and inferred from temperature data. Ocean Sci 4:215–222van Haren H, Gostiaux L (2011) Large internal waves advection in very weakly stratified deep Mediterranean waters. Geophys Res Lett 38:L22603. doi: 10.1029/2011GL049707van Haren H, Millot C (2004) Rectilinear and circular inertial motions in the Western Mediterranean Sea. Deep-Sea Res I 51:1441–1455van Haren H, Millot C (2005) Gyroscopic waves in the Mediterranean Sea. Geophys Res Lett 32:L24614. doi: 10.1029/2005GL023915van Haren H, Millot C (2006) Determination of buoyancy frequency in weakly stable waters. J Geophys Res 111:C03014. doi: 10.1029/2005JC003065van Haren H, Millot C (2009) Slantwise convection: a candidate for homogenization of deep newly formed dense waters. Geophys Res Lett 36:L12604. doi: 10.1029/2009GL038736van Haren H, Millot C, Taupier-Letage I (2006) Fast deep sinking in Mediterranean eddies. Geophys Res Lett 33:L04606. doi: 10.1029/2005GL025367van Haren H, ANTARES-collaboration et al (2011) Acoustic and optical variations during rapid downward motion episodes in the deep north-western Mediterranean Sea. Deep-Sea Res I 58:875–88

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research

DUNE Offline Computing Conceptual Design Report

This document describes Offline Software and Computing for the Deep Underground Neutrino Experiment (DUNE) experiment, in particular, the conceptual design of the offline computing needed to accomplish its physics goals. Our emphasis in this document is the development of the computing infrastructure needed to acquire, catalog, reconstruct, simulate and analyze the data from the DUNE experiment and its prototypes. In this effort, we concentrate on developing the tools and systems thatfacilitate the development and deployment of advanced algorithms. Rather than prescribing particular algorithms, our goal is to provide resources that are flexible and accessible enough to support creative software solutions as HEP computing evolves and to provide computing that achieves the physics goals of the DUNE experiment

Reconstruction of interactions in the ProtoDUNE-SP detector with Pandora

International audienceThe Pandora Software Development Kit and algorithm libraries provide pattern-recognition logic essential to the reconstruction of particle interactions in liquid argon time projection chamber detectors. Pandora is the primary event reconstruction software used at ProtoDUNE-SP, a prototype for the Deep Underground Neutrino Experiment far detector. ProtoDUNE-SP, located at CERN, is exposed to a charged-particle test beam. This paper gives an overview of the Pandora reconstruction algorithms and how they have been tailored for use at ProtoDUNE-SP. In complex events with numerous cosmic-ray and beam background particles, the simulated reconstruction and identification efficiency for triggered test-beam particles is above 80% for the majority of particle type and beam momentum combinations. Specifically, simulated 1 GeV/$c$ charged pions and protons are correctly reconstructed and identified with efficiencies of 86.1$\pm0.6$% and 84.1$\pm0.6$%, respectively. The efficiencies measured for test-beam data are shown to be within 5% of those predicted by the simulation

Reconstruction of interactions in the ProtoDUNE-SP detector with Pandora

International audienceThe Pandora Software Development Kit and algorithm libraries provide pattern-recognition logic essential to the reconstruction of particle interactions in liquid argon time projection chamber detectors. Pandora is the primary event reconstruction software used at ProtoDUNE-SP, a prototype for the Deep Underground Neutrino Experiment far detector. ProtoDUNE-SP, located at CERN, is exposed to a charged-particle test beam. This paper gives an overview of the Pandora reconstruction algorithms and how they have been tailored for use at ProtoDUNE-SP. In complex events with numerous cosmic-ray and beam background particles, the simulated reconstruction and identification efficiency for triggered test-beam particles is above 80% for the majority of particle type and beam momentum combinations. Specifically, simulated 1 GeV/$c$ charged pions and protons are correctly reconstructed and identified with efficiencies of 86.1$\pm0.6$% and 84.1$\pm0.6$%, respectively. The efficiencies measured for test-beam data are shown to be within 5% of those predicted by the simulation

Reconstruction of interactions in the ProtoDUNE-SP detector with Pandora

International audienceThe Pandora Software Development Kit and algorithm libraries provide pattern-recognition logic essential to the reconstruction of particle interactions in liquid argon time projection chamber detectors. Pandora is the primary event reconstruction software used at ProtoDUNE-SP, a prototype for the Deep Underground Neutrino Experiment far detector. ProtoDUNE-SP, located at CERN, is exposed to a charged-particle test beam. This paper gives an overview of the Pandora reconstruction algorithms and how they have been tailored for use at ProtoDUNE-SP. In complex events with numerous cosmic-ray and beam background particles, the simulated reconstruction and identification efficiency for triggered test-beam particles is above 80% for the majority of particle type and beam momentum combinations. Specifically, simulated 1 GeV/$c$ charged pions and protons are correctly reconstructed and identified with efficiencies of 86.1$\pm0.6$% and 84.1$\pm0.6$%, respectively. The efficiencies measured for test-beam data are shown to be within 5% of those predicted by the simulation