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Over the last few years, the microfluidics phenomenon coupled with the Internet of Things (IoT) using innovative nano-functional materials has been recognized as a sustainable and economical tool for point-of-care testing (POCT) of various pathogens influencing human health. The sensors based on these phenomena aim to be designed for cost-effectiveness, make it handy, environment-friendly, and get an accurate, easy, and rapid response. Considering the burgeoning importance of analytical devices in the healthcare domain, this review paper is based on the gist of sensing aspects of the microfabricated paper-based analytical devices (μPADs). The article discusses the various used design methodologies and fabrication approaches and elucidates the recently reported surface modification strategies, detection mechanisms viz., colorimetric, electrochemical, fluorescence, electrochemiluminescence, etc. In a nutshell, this article summarizes the state-of-the-art research work carried out over the nano functionalized paper-based analytical devices and associated challenges/solutions in the point of care testing domain.

In recent years, the paper industry is developing strongly and plays an important role in the industry of our country. Most of the factories have their own wastewater treatment systems. In general, wastewater in paper mill is very difficult to treat and to handle, especially color (Pt–Co) index. In this research, activated carbon with a high surface area and high adsorption capacity was prepared from corn stalks, an agricultural by-products. The suitable conditions of pyrolysis were investigated to prepare activated bio-char from corn stalk. Then, as-obtained carbon material was applied for color treatment of effluent from paper mill. The activated carbon showed high efficiency and capability in color removal of waste water, with the color reduction of 77%.

Environmental pollution and the exploitation of fossil-based products are topical issues that should be a matter of concern to the global population. The production of bio-based substances from waste biomass is a way to reduce the consumption of fossil fuels and limit environmental pollution. Enzymatic catalysed saccharification of cellulose is an important step for the bio-conversion of biomass such as waste paper into glucose that could be utilized as a feedstock for the production of value added bioproducts and this process can also be considered as an alternative route of waste management. During this study, fresh cellulase enzyme from Trichoderma viride was incubated separately with seven different waste paper materials during twelve successive incubation periods of 2 h each. The amount of sugar released from each paper material during each incubation period was determined. The highest sugar concentration released from each paper materials was produced during the first incubation period except the filter paper for which the highest amount of sugar was produced during the 9th period of incubation. During these optimum sugar producing incubation periods the highest total sugar concentration was released from brown envelope paper (3.3 mg.mL-1 followed by foolscap paper (3.0 mg.mL-1) and office paper (2.8 mg.mL-1) while the lowest amount of sugar was released from Pick ’n Pay paper (0.6 mg.mL-1). The relative saccharification percentage was also calculated which showed that filter paper produced the highest amounts of sugar followed by newspaper, and foolscap paper with advertising paper from a retailer. Pick ’n Pay offered the highest resistance towards cellulase catalysed bio-conversion into sugar.

The built environment of an older person’s home can reduce or promote the possibility of a fall or other injury. A user-friendly tool can help the residents to evaluate their home environment withi...

In the US, 28 biosimilars have been approved, with 10 in the last two years. The US is keeping pace with the EU who pioneered biosimilars approvals a decade earlier. Herein, current FDA regulations and hurdles encountered for US biosimilar approval and uptake are discussed.

See related Editorial See cover image, Spirometry has been established as an essential test for diagnosing and monitoring respiratory disease, particularly asthma and COPD, as well as in occupational health surveillance. In Australia and New Zealand, there is currently no pathway for spirometry operators in community‐based healthcare settings to demonstrate spirometry competence. The Australia and New Zealand Society of Respiratory Science (ANZSRS) has identified a need for developing a pathway for operators working in community‐based practices in Australia and New Zealand to demonstrate spirometry competence and certification. Spirometry certification provides evidence to patients, clients, employers and organizations that an individual has participated in an assessment process that qualifies them to perform spirometry to current international spirometry standards set out by the American Thoracic Society and the European Respiratory Society (ATS/ERS). This document describes a competence assessment pathway that incorporates a portfolio and practical assessment. The completion of this pathway and the award of certification confer an individual is competent to perform spirometry for 3 years, after which re‐certification is required. The adoption of this competency assessment and certification process by specialist organizations, and the commitment of operators performing spirometry to undergo this process, will enhance spirometry quality and practice in community‐based healthcare settings.

Heart failure is a complex syndrome affecting several organs including kidney, lungs, liver, brain muscles and sympathetic system. Each of these organs might contribute to its severity and prognosis. The prognosis assessment is critical for a correct heart failure management. It has already been demonstrated that a single parameter is weaker for prognosis than different parameters combined. The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score has been built and validated for heart failure with reduced ejection fraction (HFrEF) patients by considering cardiopulmonary exercise test data combined with clinical, laboratory and echocardiographic measurements. The betablockers treatment is a milestone in the HFrEF management. In the MECKI score database, the association of betablockers treatment with outcome has been investigated in different settings.

Microfluidic paper-based analytical devices (µPADs) has been broadly used and gained many researchers attention for clinical medicine and health, food quality inspection and environmental analysis. Qualitative analysis on several related articles managed to review the development of µPADs and as a result the proposal on its fabrication techniques by using waste paper for the application in environmental analysis through colorimetric detection is determined. The deinking process of waste paper can be carried out by using enzymatic treatment while the fabrication of µPADs can be carried out by using wax printing technique. Therefore, the device is subjected to be tested with detection of metal ions from water sample through colorimetric detection

This collaborative statement from the Digital Health Committee of the Heart Rhythm Society provides everyday clinical scenarios in which wearables may be utilized by patients for cardiovascular health and arrhythmia management. We describe herein the spectrum of wearables that are commercially available for patients, and their benefits, shortcomings and areas for technological improvement. Although wearables for rhythm diagnosis and management have not been examined in large randomized clinical trials, undoubtedly the usage of wearables has quickly escalated in clinical practice. This document is the first of a planned series in which we will update information on wearables as they are revised and released to consumers.

With more than 23 million infections and more than 814,000 deaths worldwide, the coronavirus disease-2019 (COVID-19) pandemic is still far from over. Several classes of drugs including antivirals, antiretrovirals, anti-inflammatory, immunomodulatory, and antibiotics have been tried with varying levels of success. Still, there is lack of any specific therapy to deal with this infection. Although less than 30% of these patients require intensive care unit admission, morbidity and mortality in this subgroup of patients remain high. Hence, it becomes imperative to have general principles to guide intensivists managing these patients. However, as the literature emerges, these recommendations may change and hence, frequent updates may be required. How to cite this article: Juneja D, Savio RD, Srinivasan S, Pandit RA, Ramasubban S, Reddy PK, et al. Basic Critical Care for Management of COVID-19 Patients: Position Paper of Indian Society of Critical Care Medicine, Part-I. Indian J Crit Care Med 2020;24(Suppl 5):S244-S253.

This work describes the log-MAP (BCJR) algorithm implementation of a close to capacity dirty paper coding CODEC. The CODEC consists of eight deep pipeline processors. It decodes blocks of 975 bits in 26.9 ms using less than 9.7% of low-cost FPGA (and no DSP blocks). Two pipelines, for alpha and beta, calculate the values of gamma (of the BCJR) to reduce the storage requirements. The final log-likelihood ratio (LLR) is calculated together with alpha, reusing intermediate results. The number of bits used by the different signals of the processor is easily configurable. It was set to six bits to the channel measure signals and eight bits to log of probability signals like alpha, beta, and others. The CODEC clock was 100 MHz. The achieved bit rate is 36.2 Kbps per CODEC, but multiple CODECs can be fit into a single chip. The CODEC is 3.49 dB from the channel capacity.

The reported incidence of pediatric pancreatitis is increasing. Noninvasive imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), play important roles in the diagnosis, staging, follow-up, and management of pancreatitis in children. In this position paper, generated by members of the Pancreas Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the Abdominal Imaging Committee of The Society for Pediatric Radiology (SPR), we review the roles of noninvasive imaging in pediatric acute, acute recurrent, and chronic pancreatitis. We discuss available evidence related to noninvasive imaging, highlighting evidence specific to pediatric populations, and we make joint recommendations for use of noninvasive imaging. Further, we highlight the need for research to define the performance and role of noninvasive imaging in pediatric pancreatitis.

Cervical spine spondylosis is so prevalent in almost all because it is a degenerative disease. Cervical spine spondylosis is a condition caused by the narrowing of the space required for the spinal cord and the nerve roots that pass through the spine to the rest of the body. Suspected cases or warranted cases are advised to avoid trauma or stress to prevent a dreadful complication that is myelopathy. This research is to study and assess the Cervical Spine Canal Body Ratio in healthy individuals and also in patients with myelopathy. The cervical spinal canal and body with disc space ratio are measured using lateral view plain X-ray of the cervical spine, placed over a graph paper. This test was done both in healthy individuals from the age group of twenty-five to thirty-five of female and male. Out of these, twelve patients were with cervical myelopathy. Cervical Spinal canal stenosis may be either congenital or acquired. The content of the canal that is the Spinal cord is more likely to get compromised when the canal is shallow even a minimal trauma or degenerative arthrosis can precipitate myelopathy. In healthy individuals it is unit and when

يناقش البحث صيغا جديدة من الصيغ المعاصرة في التبادلات المالية (الأوراق المالية قصيرة الأجل). وبعد التعريف بها وبيان أصلها الشرعي، تناولت الدراسة البعد المقاصدي لهذه الأوراق المالية، وإذا كان قصد مشرعي القانون الخاص من هذه الأوراق السرعة، والائتمان، والتوثيق، فهذه المقاصد تتفق مع قصد الشارع من استيفاء الحقوق، وحفظ الأموال، ومبدأ التوثيق العام، كما تنطلق من روح الاقتصاد الإسلامي، من حرية السوق والتنافس، والتيسير في المعاملات التجارية، وكسر الحواجز بين الطبقات، وسرعة تبادل المال وتنقله، وتحريم الإكتناز، والوضوح والشفافية التي تعتبر معيار لصحة العقد وبركته، فالمعاملات المتكررة لها خصوصية في التشريع الفقهي الذي يتوافق مع متطلبات السوق، وحركته في العامة. وقد استخدم الباحث المنهج الوصفي التحليلي، بمناقشة المنتج المالي وبيان مفهومه، ثم جذره المقاصدي، وتحليل نصوص الشارع في ذلك، وبيان قصد الشارع من هذه الأوراق المالية. الكلمات المفتاحيّة: الأوراق التجارية (الكمبيالة، سندات لأمر، الشيك)، العرف التجاري، الائتمان، التوثيق، التبادل. Abstract The research discusses new forms of contemporary formulas in financial exchanges (short-term securities). After the definition and stating their legal origin, the study examined the intent dimensions of these securities. If the intention of the private law legislators of these securities is to quickness, credit, and documentation, thus, these purposes are in line with the legislator's intends to fulfill the rights, preserve the funds, and the principle of public documentation. It is also in line with the spirit of the Islamic economy, of market freedom, and competition, to facilitate trade transactions, to break down barriers between classes, the speed of exchange and transfer of money, the prohibition of hoarding, clarity, and transparency that are a criterion for the validity of the contract And his blessing. The repeated transactions have specificity in the jurisprudential legislation that corresponds to the requirements of the market, and its movement in public. The researcher used the descriptive-analysis method by discussing the financial product and explaining its concept. Its intent root, and analyzing the legislator texts in that, and explaining the intent of the law-giver from these securities. Keywords: Business papers, bills to order, check, trade usage, credit, documentation, exchange.

Advancements in technology have led to the use of smartphones as biosensor detectors. However, it is difficult to obtain stable color information of colorimetric sensors using multiple smartphones owing to different light conditions and image correction operations. In this study, we attempted color detection of the colorimetric paper chip using smartphone-embedded light-emitting diode (LED) and simple transformation calculation. This method enables the acquisition of stable color information using different smartphones by reducing the influence of external light sources. Moreover, we studied characteristics such as convergence and distinction of detection result details by the manufacturers and smartphones. These findings suggested the necessity of classification criteria for the use of smartphones to achieve optimal detection. In addition, white and black references were used to set the standard for color correction of various light sources. Based on our results, we conclude that this approach presents the possibility of smartphone-based colorimetric detection in practical applications.

Objectives To provide a multiorganizational statement to update recommendations for critical care pharmacy practice and make recommendations for future practice. A position paper outlining critical care pharmacist activities was last published in 2000. Since that time, significant changes in healthcare and critical care have occurred. Design The Society of Critical Care Medicine, American College of Clinical Pharmacy Critical Care Practice and Research Network, and the American Society of Health-Systems Pharmacists convened a joint task force of 15 pharmacists representing a broad cross-section of critical care pharmacy practice and pharmacy administration, inclusive of geography, critical care practice setting, and roles. The Task Force chairs reviewed and organized primary literature, outlined topic domains, and prepared the methodology for group review and consensus. A modified Delphi method was used until consensus (> 66% agreement) was reached for each practice recommendation. Previous position statement recommendations were reviewed and voted to either retain, revise, or retire. Recommendations were categorized by level of ICU service to be applicable by setting and grouped into five domains: patient care, quality improvement, research and scholarship, training and education, and professional development. Main results There are 82 recommendation statements: 44 original recommendations and 38 new recommendation statements. Thirty-four recommendations represent the domain of patient care, primarily relating to critical care pharmacist duties and pharmacy services. In the quality improvement domain, 21 recommendations address the role of the critical care pharmacist in patient and medication safety, clinical quality programs, and analytics. Nine recommendations were made in the domain of research and scholarship. Ten recommendations were made in the domain of training and education and eight recommendations regarding professional development. Conclusions Critical care pharmacists are essential members of the multiprofessional critical care team. The statements recommended by this taskforce delineate the activities of a critical care pharmacist and the scope of pharmacy services within the ICU. Effort should be made from all stakeholders to implement the recommendations provided, with continuous effort toward improving the delivery of care for critically ill patients.

International audience; Magnetic resonance imaging (MRI) has become the reference imaging for the management of a large number of diseases. The number of MR examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). A CEID was considered an absolute contraindication for MRI for years. The progressive replacement of conventional pacemakers and defibrillators by MR-conditional CEIDs and recent data on the safety of MRI in patients with "MR-nonconditional" CEIDs have progressively increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with "MR-conditional" devices because these devices are not "MR-safe". A specific programing of the device in "MR-mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) describes the effect and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional nonguaranteed" and MR-nonconditional devices.

Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of healthcare facilities with home and everyday life settings barely addressed.\ud \ud As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms.\ud \ud This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in healthcare settings requires a mirrored reduction in the community.\ud \ud The authors call upon national and international policy makers, health agencies and healthcare professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR.

We describe a paper-based microfluidic device for iron(III) assay in an applied instrumental analysis laboratory. Simple and convenient devices were fabricated by the students using patterning of f...

Direct oral anticoagulants (DOAC) are mostly prescribed to prevent cardioembolic stroke in patients with non-valvular atrial fibrillation (AF). An increasing number of guidelines recommend DOAC in AF patients with preserved renal function for the prevention of thromboembolism and an increased use of DOAC in daily practice is recorded also in elderly patients. Aging is associated with a reduction of glomerular filtration rate and impaired renal function, regardless of the cause, increases the risk of bleeding. Multiple medication use (polypharmacy) for treating superimposed co-morbidities is common in both elderly and chronic kidney disease (CKD) patients and drug-drug interaction may cause accumulation of DOAC, thereby increasing the risk of bleeding. There is uncertainty on the safety profile of DOAC in patients with CKD, particularly in those with severely impaired renal function or end stage renal disease, due to the heterogeneity of studies and the relative paucity of data. This document reports the position of three Italian scientific societies engaged in the management of patients with atrial fibrillation who are treated with DOAC and present with CKD.

The paper discusses current research efforts focusing on security and privacy for 5G cellular networks. It then outlines research directions.

Nonischemic-dilated cardiomyopathy (NIDCM) is an entity that gathers extremely heterogeneous diseases. This awareness, although leading to continuous improvement in survival, has increased the complexity of NIDCM patients' management. Even though the endorsed 'red-flags' approach helps clinicians in pursuing an accurate etiological definition in clinical practice, it is not clear when and how peripheral centers should interact with referral centers with specific expertise in challenging scenarios (e.g. postmyocarditis and genetically determined dilated cardiomyopathy) and with easier access to second-line diagnostic tools and therapies. This position paper will summarize each step in NIDCM management, highlighting the multiple interactions between peripheral and referral centers, from first-line diagnostic workup and therapy to advanced heart failure management and long-term follow-up.

Emergency Medical Services provider agencies and programs for systems of care for time-sensitive conditions in many communities and regions struggle with hospitals to obtain feedback data regarding patient outcomes and hospital processes relevant to EMS quality programs. EMS provider agencies also have issues in providing information to hospitals at the time of patient transfer to support continuity of care. The paper presents a position statement and supporting rationale from the National EMS Management Association on the bi-lateral exchange of data between EMS and hospitals. It examines the underlying issues and offers recommendations for how the various barriers to bi-lateral information exchange can be resolved.

A two-step process involving coagulation-flocculation followed by solar photocatalysis – based Advanced Oxidation Process (AOP) using TiO2-Reduced Graphene Oxide (TRGO) nanocomposite as catalyst ha...

As a global shift continues to occur in high burden diseases toward developing countries, the importance of medical diagnostics based on point-of-care testing (POCT) is rapidly increasing. However, most diagnostic tests that meet clinical standards rely on high-end analyzers in central hospitals. Here, we report the development of a simple, low-cost, mass-producible, highly sensitive/quantitative, automated, and robust paper/soluble polymer hybrid-based lateral flow biosensing platform, paired with a smartphone-based reader, for high-performance POCT. The testing architecture incorporates a polymeric barrier that programs/automates sequential reactions via a polymer dissolving mechanism. The smartphone-based reader with simple opto-mechanical parts offers a stable framework for accurate quantification. Analytical performance of this platform was evaluated by testing human cardiac troponin I (cTnI), a preferred biomarker for the diagnosis of myocardial infarction, in serum/plasma samples. Coupled with catalytic/colorimetric gold-ion amplification, this platform produced results within 20 min with a detection limit of 0.92 pg mL

Author(s): Anker, Stefan D; Butler, Javed; Khan, Muhammad Shahzeb; Abraham, William T; Bauersachs, Johann; Bocchi, Edimar; Bozkurt, Biykem; Braunwald, Eugene; Chopra, Vijay K; Cleland, John G; Ezekowitz, Justin; Filippatos, Gerasimos; Friede, Tim; Hernandez, Adrian F; Lam, Carolyn SP; Lindenfeld, JoAnn; McMurray, John JV; Mehra, Mandeep; Metra, Marco; Packer, Milton; Pieske, Burkert; Pocock, Stuart J; Ponikowski, Piotr; Rosano, Giuseppe MC; Teerlink, John R; Tsutsui, Hiroyuki; Van Veldhuisen, Dirk J; Verma, Subodh; Voors, Adriaan A; Wittes, Janet; Zannad, Faiez; Zhang, Jian; Seferovic, Petar; Coats, Andrew JS | Abstract: The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has important implications for the safety of participants in clinical trials and the research staff caring for them and, consequently, for the trials themselves. Patients with heart failure may be at greater risk of infection with COVID-19 and the consequences might also be more serious, but they are also at risk of adverse outcomes if their clinical care is compromised. As physicians and clinical trialists, it is our responsibility to ensure safe and effective care is delivered to trial participants without affecting the integrity of the trial. The social contract with our patients demands no less. Many regulatory authorities from different world regions have issued guidance statements regarding the conduct of clinical trials during this COVID-19 crisis. However, international trials may benefit from expert guidance from a global panel of experts to supplement local advice and regulations, thereby enhancing the safety of participants and the integrity of the trial. Accordingly, the Heart Failure Association of the European Society of Cardiology on 21 and 22 March 2020 conducted web-based meetings with expert clinical trialists in Europe, North America, South America, Australia, and Asia. The main objectives of this Expert Position Paper are to highlight the challenges that this pandemic poses for the conduct of clinical trials in heart failure and to offer advice on how they might be overcome, with some practical examples. While this panel of experts are focused on heart failure clinical trials, these discussions and recommendations may apply to clinical trials in other therapeutic areas.

The Centers for Medicare & Medicaid Services’ Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) measure has appropriately established sepsis as a national priority. However, the Infectious Diseases Society of America (IDSA and five additional endorsing societies) is concerned about SEP-1’s potential to drive antibiotic overuse because it does not account for the high rate of sepsis overdiagnosis and encourages aggressive antibiotics for all patients with possible sepsis, regardless of the certainty of diagnosis or severity of illness. IDSA is also concerned that SEP-1’s complex “time zero” definition is not evidence-based and is prone to inter-observer variation. In this position paper, IDSA outlines several recommendations aimed at reducing the risk of unintended consequences of SEP-1 while maintaining focus on its evidence-based elements. IDSA’s core recommendation is to limit SEP-1 to septic shock, for which the evidence supporting the benefit of immediate antibiotics is greatest. Prompt empiric antibiotics are often appropriate for suspected sepsis without shock, but IDSA believes there is too much heterogeneity and difficulty defining this population, uncertainty about the presence of infection, and insufficient data on the necessity of immediate antibiotics to support a mandatory treatment standard for all patients in this category. IDSA believes guidance on managing possible sepsis without shock is more appropriate for guidelines that can delineate the strengths and limitations of supporting evidence and allow clinicians discretion in applying specific recommendations to individual patients. Removing sepsis without shock from SEP-1 will mitigate the risk of unnecessary antibiotic prescribing for noninfectious syndromes, simplify data abstraction, increase measure reliability, and focus attention on the population most likely to benefit from immediate empiric broad-spectrum antibiotics.

Purpose To determine the measurement equivalence of computer touch screen assessment (CTSA) and paper based assessment (PBA) of the oral health impact profile (OHIP-14). Patients and Methods A randomized crossover trial was conducted. Sixty participants were randomized to either i) Arm A: completed CTSA then PBA of OHIP-14, or ii) Arm B: PBA and then CTSA of OHIP-14 within the same day. User preference and time taken to complete the assessments were recorded. Agreement between CTSA and PBA was determined using directional difference (DD), absolute difference (AD), and intraclass correlation coefficient (ICC). Results There was no significant difference in CTSA and PBA OHIP-14 scores (P>0.05). The magnitude of the DD in scores between assessment methods was small for overall scores and all domains (

Purpose Current trials on adjunctive treatment with antiseizure drugs often do not reveal results which are relevant for clinical practice. Method Therefore, an interdisciplinary group of German experts discussed a new framework for future antiseizure drug (ASD) trials in adults. This group included members of the executive board of the German Society of Epileptology, of the German institutes for health technology assessment (HTA), of patient organizations and of drug manufacturers. Agreement was reached by consensus decision making after intensive discussion of the findings of a narrative review of the current literature. Results The group jointly recommends that ASD trials in adults should be based on and include relevant patient groups, e.g. elderly patients and patients with relevant co-morbidities, should adopt a study duration of at least 12 months, should avoid placebo arms, should include active comparators of clinical relevance, may be designed as open label trials with blinded outcome measurements, should focus on patient relevant outcomes that reflect the impact of benefits and harms of treatments on daily living, such as seizure freedom and seizure severity as well as retention rate, functional outcomes and quality of life as compound measures, and should avoid arbitrary and non-sensitive primary endpoints such as dichotomized changes in seizure frequency. Conclusions This paper focused on improved head-to-head trials on adjunctive treatment with antiseizure drugs. The group welcomes any further work and discussion to enhance future studies which can be applied to the entire spectrum of potentially meaningful study populations and outcomes.

Effective integration of learning technology tools in classrooms is a key component of 21st century higher education classrooms. The goal of the position paper is to provide a discussion from the results of the research study and to uncover the faculty members’ views and perceptions about implementing learning technology tools. Insights from this study revealed that it is a teaching technique and style of the faculty members in the use of these learning technology tools that determined the nature of their perception of success rather than the learning tools themselves.

Through this paper an ARDUINO based automatic remote meter readinghas been presented. Monitoring and recording of the readingof energy meter is done using microcontroller. Application of this work has uses as follows.Nophysical visitsarerequired for data collection of energy consumedor distribution of bills.Utility connection can be disconnected or re-connected without any physical visit using in-built software. Allservice alerts can be forwarded to the customers and they can check the status of respective electricity load from anywhere through IOT software. The overall ciruit is also flexible and cost effective

COVID-19 pandemic raised the issue to guarantee the proper level of care to patients with acute cardiovascular diseases and concomitant suspected or confirmed COVID-19 and, in the meantime safety and protection of healthcare providers. The aim of this position paper is to provide standards to healthcare facilities and healthcare providers on infection prevention and control measures during the management of suspected and confirmed cases of 2019-nCoV infection accessing in cath-lab. The document represents the view of the Italian Society of Interventional Cardiology (GISE), and it is based on recommendations from the main World and European Health Organizations (WHO, and ECDC) as well as from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).

We developed a portable device for blood detection as well as blood typing assay, using a microfluidic paper-based analytical devices (µPADs) which proves to be sensitive, cost-effective, user-frie...

The ACR Incidental Findings Committee (IFC) presents recommendations for managing adnexal masses incidentally detected on CT and MRI. These recommendations represent an update of those provided in our previous JACR 2013 white paper. The Adnexal Subcommittee, which included six radiologists with subspecialty expertise in abdominal imaging or ultrasound and one gynecologist, developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by iterative consensus. Algorithm branches successively categorize adnexal masses based on patient characteristics (eg, pre- versus postmenopausal) and imaging features. They terminate with a management recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. Our goal is to improve quality of care by providing guidance on how to manage incidentally detected adnexal masses.

Coronavirus Disease-2019 (COVID-19) refers to a clinical disorder caused by a new coronavirus that emerged in late 2019. According to the European Centre for Disease Prevention and Control, as of June 23 2020, over 15 million confirmed cases of patients with COVID-19 have been reported globally, out of which over 600,000 deaths were recorded. The management of patients with COVID-19 is critical. This position paper was prepared through online search for the available guideline in the literature to serve as treatment guidelines for Nigerian physiotherapists and possibly physiotherapists in Sub-Saharan Africa region.

The wide spread of smartphones and QR codes for various end-user applications has had an impact beyond traditional fields of use, recently also reaching point-of-care testing (POCT). This work presents the integration of QR code recognition into paper-based analytical devices (PADs) with "distance-based" colorimetric signalling, resulting in semiquantitative readout fully relying on straightforward barcode reader solutions. PADs consist of an array of QR codes arranged in series inside a paperfluidic channel. A mask dye concept has been developed, which enables utilisation of colour changing indicators by initially hiding QR codes. The colour change of the indicator induced by the presence of an analyte of interest results in gradual unmasking of QR codes, which become recognisable by the smartphone barcode reader app. To reproducibly fabricate devices, all fabrication steps were performed by commercial desktop solid ink and inkjet printing. The QR code masking function was optimised by controlling the amount of printed mask dye through adjusting the opacity of printing patterns during the inkjet deposition process. For proof-of-concept, a model assay in the form of colorimetric copper ion (Cu2+) detection in the concentration range of 0.4 mM to 3.2 mM was evaluated. Consistent results independent of the smartphone model and environmental light condition were achieved with a free barcode reader app. To the best of our knowledge, this work is the first demonstration of a semiquantitative assay approach fully relying on QR code readout without digital colour analysis, customised app or hardware modification.

There is a great need to evaluate and/or test programming performance. For this purpose, two schemes have been used. Constructed response (CR) tests let the examinee write programs on a blank sheet (or with a computer keyboard). This scheme can evaluate the programming performance. However, it is difficult to apply in a large volume because skilled human graders are required (automatic evaluation is attempted but not widely used yet). Multiple choice (MC) tests let the examinee choose the correct answer from a list (often corresponding to the “hidden” portion of a complete program). This scheme can be used in a large volume with computer-based testing or mark-sense cards. However, many teachers and researchers are suspicious in that a good score does not necessarily mean the ability to write programs from scratch. We propose a third method, split-paper (SP) testing. Our scheme splits a correct program into each of its lines, shuffles the lines, adds “wrong answer” lines, and prepends them with choice symbols. The examinee answers by using a list of choice symbols corresponding to the correct program, which can be easily graded automatically by using computers. In particular, we propose the use of edit distance (Levenshtein distance) in the scoring scheme, which seems to have affinity with the SP scheme. The research question is whether SP tests scored by using an edit-distance-based scoring scheme measure programming performance as do CR tests. Therefore, we conducted an experiment by using college programming classes with 60 students to compare SP tests against CR tests. As a result, SP and CR test scores are correlated for multiple settings, and the results were statistically significant. Therefore, we might conclude that SP tests with automatic scoring using edit distance are useful tools for evaluating the programming performance.

Contains fulltext : 229587.pdf (Publisher’s version ) (Open Access) In Europe, lung cancer ranks third among the most common cancers, remaining the biggest killer. Since the publication of the first European Society of Radiology and European Respiratory Society joint white paper on lung cancer screening (LCS) in 2015, many new findings have been published and discussions have increased considerably. Thus, this updated expert opinion represents a narrative, non-systematic review of the evidence from LCS trials and description of the current practice of LCS as well as aspects that have not received adequate attention until now. Reaching out to the potential participants (persons at high risk), optimal communication and shared decision-making will be key starting points. Furthermore, standards for infrastructure, pathways and quality assurance are pivotal, including promoting tobacco cessation, benefits and harms, overdiagnosis, quality, minimum radiation exposure, definition of management of positive screen results and incidental findings linked to respective actions as well as cost-effectiveness. This requires a multidisciplinary team with experts from pulmonology and radiology as well as thoracic oncologists, thoracic surgeons, pathologists, family doctors, patient representatives and others. The ESR and ERS agree that Europe's health systems need to adapt to allow citizens to benefit from organised pathways, rather than unsupervised initiatives, to allow early diagnosis of lung cancer and reduce the mortality rate. Now is the time to set up and conduct demonstration programmes focusing, among other points, on methodology, standardisation, tobacco cessation, education on healthy lifestyle, cost-effectiveness and a central registry.Key Points* Pulmonologists and radiologists both have key roles in the set up of multidisciplinary LCS teams with experts from many other fields.* Pulmonologists identify people eligible for LCS, reach out to family doctors, share the decision-making process and promote tobacco cessation.* Radiologists ensure appropriate image quality, minimum dose and a standardised reading/reporting algorithm, together with a clear definition of a "positive screen".* Strict algorithms define the exact management of screen-detected nodules and incidental findings.* For LCS to be (cost-)effective, it has to target a population defined by risk prediction models.