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Background: A high incidence of air leak syndromes (ALSs) has been reported in critically ill coronavirus disease 2019 (COVID-19) patients, which affects disease outcome. Objective: To evaluate the incidence, outcome, and risk factors associated with ALSs in critically ill COVID-19 patients receiving invasive or non-invasive positive pressure ventilation. Result: Out of 79 patients, 16 (20.2%) patients had ALS. The mean age of the ALS group was 48.6 ± 13.1 years as compared to 52.8 ± 13.1 (p = 0.260) years in the non-ALS group. The study group had a lower median body mass index (25.9 kg/m2 vs 27.6 kg/m2, P = 0.096), a higher D-dimer value (1179.5 vs 762.0, P = 0.024), lower saturation (74% vs 88%, P = 0.006), and a lower PF ratio (134 vs 189, P = 0.028) at presentation as compared to the non-ALS group. Patients with ALS had received a higher median positive end-expiratory pressure (PEEP) (10 cm vs 8 cm of water, P = 0.005). The pressure support, highest driving pressure, and peak airway pressure were not significantly different in the two groups. The ALS group had a significantly longer duration of hospital stay (17.5 vs 9 days, P = 0.003). Multiple logistic regression analyses indicated that patients who received inj. dexamethasone were less likely to develop ALS (OR: 12.6 (95% CI 1.6-95.4), P = 0.015). Conclusion: A high incidence of ALS is present in critically ill COVID-19 patients. High inflammatory parameters, severe hypoxia at presentation, and use of high PEEP are significant risk factors associated with ALS. The risk of developing ALS was lower in patients who received inj. dexamethasone.

BackgroundAdvancing the use of genomic data with routinely collected health data holds great promise for health care and research. Increasing the use of these data is a high priority to understand and address the causes of disease. ObjectiveThis study aims to provide an outline of the use of genomic data alongside routinely collected data in health research to date. As this field prepares to move forward, it is important to take stock of the current state of play in order to highlight new avenues for development, identify challenges, and ensure that adequate data governance models are in place for safe and socially acceptable progress. MethodsWe conducted a literature review to draw information from past studies that have used genomic and routinely collected data and conducted interviews with individuals who use these data for health research. We collected data on the following: the rationale of using genomic data in conjunction with routinely collected data, types of genomic and routinely collected data used, data sources, project approvals, governance and access models, and challenges encountered. ResultsThe main purpose of using genomic and routinely collected data was to conduct genome-wide and phenome-wide association studies. Routine data sources included electronic health records, disease and death registries, health insurance systems, and deprivation indices. The types of genomic data included polygenic risk scores, single nucleotide polymorphisms, and measures of genetic activity, and biobanks generally provided these data. Although the literature search showed that biobanks released data to researchers, the case studies revealed a growing tendency for use within a data safe haven. Challenges of working with these data revolved around data collection, data storage, technical, and data privacy issues. ConclusionsUsing genomic and routinely collected data holds great promise for progressing health research. Several challenges are involved, particularly in terms of privacy. Overcoming these barriers will ensure that the use of these data to progress health research can be exploited to its full potential.

Connectivity between coral reefs is critical to ensure their resilience and persistence against disturbances. It is driven by ocean currents, which often have very complex patterns within reef systems. Only biophysical models that simulate both the fine-scale details of ocean currents and the life-history traits of larvae transported by these currents can help to estimate connectivity in large reef systems. Here we use the unstructured-mesh coastal ocean model SLIM that locally achieves a spatial resolution of ~100 m, 10 times finer than existing models, over the entire Florida Reef Tract (FRT). It allows us to simulate larval dispersal between the ~1,000 reefs composing the FRT. By using different connectivity measures and clustering methods, we have identified two major connectivity pathways, one originating on the westernmost end of the outer shelf and the other originating on the inner shelf, North of the Lower Keys. We introduce new connectivity indicators, based on the PageRank algorithm, to show that protection efforts should be focused on the most upstream reefs of each pathway, while reefs best suited for restoration are more evenly spread between the Lower and Upper Keys. We identify one particular reef, North of Vaca Key, that is a major stepping stone in the connectivity network. Our results are the first reef-scale connectivity estimates for the entire FRT. Such fine-scale information can provide knowledge-based decision support to allocate conservation and restoration resources optimally.

Background: Pediatric trauma is a significant cause of morbidity, and few studies on profile and outcome have been done in the emergency departments (EDs) of India. Methodology: This prospective observational study was conducted between October 2014 and December 2014 in the adult and pediatric ED's of Christian Medical College, Vellore. All patients younger than 18 years, who presented with unintentional injury, were enrolled in this study. Results: The adult and pediatric ED's attended to a combined 24,482 patients (16,169 adults and 8313 children and adolescents) during the 3-month study with 8.2% (2022/24,482) being trauma incidents. Pediatric and adolescent (18 years) trauma patients made up the remainder 80% (1624). Falls are the most common mechanism of injury among infants and toddlers with decreasing frequency with age. With increasing age, the place of injury changes from the surroundings of home to playgrounds, schools, and the roads. About 80% of injuries among infants occur at home while only 12% of adolescent injuries occur at home. Road traffic injuries account for 46% of injuries sustained by adolescents. Most of the children and adolescents (63%) were managed conservatively. Minor surgical intervention was required in 20% whereas 11% required major surgical intervention. Majority (77%) was discharged stable from the ED, and 21% were admitted. The in-hospital mortality of pediatric trauma was 1.2% (5/397). Conclusions: Pediatric and adolescent trauma is a significant cause of morbidity and mortality in India, accounting for almost one-fifth of injured patients. There exists a need for injury prevention programs focusing on peridomestic safety among children 12 years and adolescents.

This article explores how two influential 8th-century Indian philosophers, Śaṅkara and Kamalaśīla, treat the threefold scheme of learning, reasoning, and meditation in their spiritual path philosophies. They have differing institutional and ontological commitments: the former, who helped establish Advaita Vedānta as the religious philosophy of an elite Hindu monastic tradition, affirms an unchanging “self” (ātman) identical to the “world-essence” (brahman); the latter, who played a significant role in the development of Buddhist monasticism in Tibet, denies both self and essence. Yet, they share a concern with questions of truth and the means by which someone could gain access to it, such as what, if anything, meditation contributes to knowledge and its acquisition. By exploring their answers to this and related questions, including how discursive and conceptual practices like learning, reasoning, and meditation could generate nonconceptual knowledge or knowledge of the nonconceptual, this essay shows the difficulty of separating “philosophical” problems of truth from those related to self-transformation or “spirituality,” as Michel Foucault defines the terms. It also reassesses, as a framework for comparison, the well-known contrast between “gradual” and “sudden” approaches to the achievement of liberating knowledge and highlights them as tensions we still struggle to resolve today.

Background The Secure Anonymised Information Linkage (SAIL) Databank is a national data safe haven of de‑identified datasets principally about the population of Wales, made available in anonymised form to researchers across the world. It was established to enable the vast arrays of data collected about individuals in the course of health and other public service delivery to be made available to answer important questions that could not otherwise be addressed without prohibitive effort. The SAIL Databank is the bedrock of other funded centres relying on the data for research. Approach SAIL is a data repository surrounded by a suite of physical, technical and procedural control measures embodying a proportionate privacy-by-design governance model, informed by public engagement, to safeguard the data and facilitate data utility. SAIL operates on the UK Secure Research Platform (SeRP), which is a customisable technology and analysis platform. Researchers access anonymised data via this secure research environment, from which results can be released following scrutiny for disclosure risk. SAIL data are being used in multiple research areas to evaluate the impact of health and social exposures and policy interventions. Discussion Lessons learned and their applications include: managing evolving legislative and regulatory requirements; employing multiple, tiered security mechanisms; working hard to increase analytical capacity efficiency; and developing a multi-faceted programme of public engagement. Further work includes: incorporating new data types; enabling alternative means of data access; and developing further efficiencies across our operations. Conclusion SAIL represents an ongoing programme of work to develop and maintain an extensive, whole population data resource for research. Its privacy-by-design model and UK SeRP technology have received international acclaim, and we continually endeavour to demonstrate trustworthiness to support data provider assurance and public acceptability in data use. We strive for further improvement and continue a mutual learning process with our contemporaries in this rapidly developing field.

The value of using population data to answer important questions for individual and societal benefit has never been greater. Governments and research funders world-wide are recognizing this potential and making major investments in data-intensive initiatives. However, there are challenges to overcome so that safe, socially-acceptable data sharing can be achieved. This paper outlines the field of population data science, the International Population Data Linkage Network (IPDLN), and their roles in advancing data-intensive research. We provide an overview of core concepts and major challenges for data-intensive research, with a particular focus on ethical, legal, and societal implications (ELSI). Using international case studies, we show how challenges can be addressed and lessons learned in advancing the safe, socially-acceptable use of population data for public benefit. Based on the case studies, we discuss the common ELSI principles in operation, we illustrate examples of a data scrutiny panel and a consumer panel, and we propose a set of ELSI-based recommendations to inform new and developing data-intensive initiatives.We conclude that although there are many ELSI issues to be overcome, there has never been a better time or more potential to leverage the benefits of population data for public benefit. A variety of initiatives, with different operating models, have pioneered the way in addressing many challenges. However, the work is not static, as the ELSI environment is constantly evolving, thus requiring continual mutual learning and improvement via the IPDLN and beyond.

Este artículo analiza la dinámica de la reciente alfabetización en masa en Inglaterra en el contexto de prácticas en países modernos en desarrollo, incluido Brasil. Gran Bretaña empezó a invertir en educación a lo largo de las décadas de 1860 y 1870, aproximadamente, y desarrolló técnicas para medir los índices de alfabetización, que influenciaron profundamente las concepciones de lectura y escritura de hoy y del pasado. Se ignoraban redes de poder y acciones en favor de la realización individual. Los datos sugieren que Inglaterra tardó más tiempo que los países modernos para lograr sus metas, pero presentó desigualdades parecidas en lo que se refiere a edad, género y renta. El énfasis dado a la enseñanza subsidiada e inspeccionada sistemáticamente ignoró el papel de los métodos informales de instrucción. La antigua escolarización inglesa, igual que la del presente, eligió prácticamente un único método de alfabetizar. Comparada a sus contemporáneos, Inglaterra tuvo la ventaja de haber tenido un fuerte desarrollo económico y una larga historia de prácticas de alfabetización.

Tall fescue (Lolium arundinaceum) is a valuable and broadly adapted forage grass that occupies approximately 14 million hectares across the United States. A native to Europe, tall fescue was likely introduced into the U.S. around the late 1800’s. Much of the success of tall fescue can be attributed to Epichloë coenophiala (formerly Neotyphodium coenophialum) a seed borne symbiont that aids in host persistence. Epichloë species are capable of producing a range of alkaloids (ergot alkaloids, indole-diterpenes, lolines and peramine) that provide protection to the plant host from herbivory. Unfortunately, most tall fescue within the U.S., commonly referred to as KY31, harbors the endophyte E. coenophiala that causes toxicity to grazing livestock due to the production of ergot alkaloids. Molecular analyses of tall fescue endophytes have identified four independent associations, representing tall fescue with E. coenophiala, Epichloë sp. FaTG-2, Epichloë sp. FaTG-3 or Epichloë sp. FaTG-4. Each of these Epichloë species can be further distinguished based on genetic variation that equates to differences in the alkaloid gene loci. Tall fescue samples were evaluated using markers to SSR and alkaloid biosynthesis genes to determine endophyte strain variation present within continental U.S. Samples represented seed and tillers from the Suiter farm (Menifee County, KY), which is considered the originating site of KY31, as well as plant samples collected from 14 states, breeder’s seed and plant introduction lines (National Plant Germplasm System, NPGS). This study revealed two prominent E. coenophiala genotypes based on presence of alkaloid biosynthesis genes and SSR markers and provides insight into endophyte variation within continental U.S. across historical and current tall fescue samples.

By connecting the agricultural sector and other sectors of the economy general equilibrium model simulation calculation, results show that the protection policy in the agricultural sector is not only a burden on household spending, but also can reduce national income. If we lower the level of agricultural protection to the half of current level, the real income of Korea will increase 0.3 percentage points and South Korean household expenditures in the actual consumption will increase by 1 percentage point. Agricultural protection policy makes export-oriented manufacturing shrinking. If we ease or withdraw the policy of suppression farm income we can increase the export point to the type of international competitiveness of the manufacturing sector, thereby increasing the manufacturing sector, production, raise incomes and increase employment opportunities GATP model simulation results show that if Korea abandons agricultural protection, there will not be so much effect on its major trading partner-America and Australia. On the hand it will increase the national income and consumption, that will of course result in the expansion the Korean economy.

Simple Summary: There is a high demand for eggs in developing countries. Poultry feed is expensive; thus, farmers cannot afford to buy commercial feed. Therefore, it is important to explore the qualities of potential new feed materials for egg production. Desmodium tortuosum is a common weed in sub-Saharan Africa. These feed materials can be used for supplementing laying hen diets. Three hundred hens were used for 13 weeks. Two control groups received diet W, based on white corn, or diet Y containing yellow corn. The other groups received a diet based on white corn supplemented with Desmodium tortuosum leaf flour at 2.5%, 5%, 7.5%, or 10%. Diets supplemented with Desmodium improved laying performance and yolk color at a reduced feed cost per egg but had no effect on cholesterol content. The inclusion of Desmodium tortuosum leaf flour in a white corn-based diet for laying hens is effective in lowering feed cost, increasing egg production, and improving yolk color. The objective of this study was to investigate the effects on laying performance, egg quality traits, color, and composition of supplementing a white corn-based diet with Desmodium tortuosum leaf flour. Three hundred 32-week-old hens were distributed to 30 pens of 10 hens each and allocated to six dietary treatments (five replicates per treatment) for 13 weeks. Two control groups of 50 hens received one of either diet Y, based on yellow corn, or diet W, based on white corn. The other groups received a diet based on white corn supplemented with Desmodium tortuosum leaf flour at 2.5%, 5%, 7.5%, or 10% (diet D). Diet D improved laying performance and yolk color at a reduced feed cost per egg but had no effect on cholesterol content. In conclusion, the inclusion of Desmodium tortuosum leaf flour, in a white corn-based diet, is effective in lowering feed cost, increasing egg production, and improving yolk color. [ABSTRACT FROM AUTHOR]

Corchorus olitorius L, a traditional leafy vegetable of the Malvaceae family, is well appreciated in the central region of Côte d'Ivoire, where there are 5 cultivars whose phytochemical profile and antioxidant potential remain poorly understood. To better characterise them, phytochemical analysis and evaluation of antioxidant activity by DPPH and ABTS were carried out. The analyses revealed that the leaves of these cultivars are good sources of nutrients, with high levels of protein (19 - 25%), ash (8 - 12%), fibre (3 - 9%), total carbohydrates (40 - 48%), energy (252 - 288 Kcal/100g), iron (29 - 192 mg/100g), calcium (2167 - 2574 mg/100g) and potassium (6799 - 10692 mg/100g). The leaves are also rich in bioactive compounds such as polyphenols (11 - 81 mg GA eq/g extract), flavonoids (268 - 474 mg Q eq/g extract) and condensed tannins (8 - 75 mg TA eq/g extract). High antioxidant activity was observed (IC50 DPPH = 61 - 173 μg/mL and IC50 ABTS = 12 - 29 μg/mL). The best phytochemical profile and antioxidant potential were obtained in the CONB cultivar, which is also the most widely consumed by the population. [ABSTRACT FROM AUTHOR]