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Background Pain is one of the most common and most difficult symptoms to manage in adult burn patients in the Intensive Care Unit (ICU). Insufficient or unsuccessful pain management can negatively affect physiological, psychological and social health in burn patients, both during and after hospitalization. Music therapy and music medicine interventions have been shown to positively affect pain and mental health in this population. This systematic review and meta-analysis provide an update of Randomized Controlled Trials (RCTs) using music therapy or music medicine interventions in adult burn patients. Methods A variety of databases were searched from their beginning to June 2020, including PsycINFO and PsycArticles (via APAsycNET), PubMed and MEDLINE (via OvidSP), Scopus, Web of Science, and the Cochrane Library. Data of all articles meeting the inclusion criteria were extracted, organized and processed according to the PRISMA guidelines. Statistical analysis was performed using Q-test and I2 statistics. Results 10 RCTs with a total of 1,061 participants were included. The results of the meta-analysis showed a statistically significant reduction of pain (I2 = 96.03%, P Conclusions This review provides preliminary evidence for the effectiveness of music interventions for adult burn patients. However, more high-quality RCTs are needed to safely establish guidelines for music therapists and other health care professionals in using music for health purposes with this population.

Background During the first wave of the COVID-19 pandemic, shortages of ventilators and ICU beds overwhelmed health-care systems. Whether early tracheostomy reduces the duration of mechanical ventilation and ICU stay is controversial. Research Question Can failure-free day outcomes focused on ICU resources help to decide the optimal timing of tracheostomy in overburdened health-care systems during viral epidemics? Study Design and Methods This retrospective cohort study included consecutive patients with COVID-19 pneumonia who had undergone tracheostomy in 15 Spanish ICUs during the surge, when ICU occupancy modified clinician criteria to perform tracheostomy in Patients with COVID-19. We compared ventilator-free days at 28 and 60 days and ICU- and hospital bed-free days at 28 and 60 days in propensity score-matched cohorts who underwent tracheostomy at different timings (≤ 7 days, 8-10 days, and 11-14 days after intubation). Results Of 1,939 patients admitted with COVID-19 pneumonia, 682 (35.2%) underwent tracheostomy, 382 (56%) within 14 days. Earlier tracheostomy was associated with more ventilator-free days at 28 days (≤ 7 days vs > 7 days [116 patients included in the analysis]: median, 9 days [interquartile range (IQR), 0-15 days] vs 3 days [IQR, 0-7 days]; difference between groups, 4.5 days; 95% CI, 2.3-6.7 days; 8-10 days vs > 10 days [222 patients analyzed]: 6 days [IQR, 0-10 days] vs 0 days [IQR, 0-6 days]; difference, 3.1 days; 95% CI, 1.7-4.5 days; 11-14 days vs > 14 days [318 patients analyzed]: 4 days [IQR, 0-9 days] vs 0 days [IQR, 0-2 days]; difference, 3 days; 95% CI, 2.1-3.9 days). Except hospital bed-free days at 28 days, all other end points were better with early tracheostomy. Interpretation Optimal timing of tracheostomy may improve patient outcomes and may alleviate ICU capacity strain during the COVID-19 pandemic without increasing mortality. Tracheostomy within the first work on a ventilator in particular may improve ICU availability.

The incidence of human papillomavirus (HPV)-associated cancers, especially those from the head and neck region, has increased. The relatively early age of presentation of HPV-positive head and neck cancer (HNC) indicates that viral infection might be acquired early in life. Persistent HPV infection has been recognized as the main risk factor for cancer development, but most studies have focused on evaluating HPV persistence in the genital region. Thus, in this work, we aimed to evaluate the prevalence of HPV in oral cavity and oropharynx in a young population, as well as the possible persistence of the infection after 12 months. Our results indicate that almost half (46.8%) of the analyzed population harbors an HPV infection either in the oral cavity or in the oropharynx. Furthermore, after 1 year of initial identification, half of them eliminated the infection, and only one person (5.26%) exhibited persistence. Interestingly, 50% of the individuals who successfully eliminated the infection acquired a new viral type, indicating that even when the primary infection is effectively eliminated by the immune system, there is a dynamic circulation of HR-HPV types that produce reinfection. This dynamic HPV infection among young individuals could influence the future establishment of cancer in some proportion of the cases. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42770-021-00602-3.

Background The disease presentation of the severe acute respiratory syndrome coronavirus 2 infection (COVID-19) ranges from asymptomatic to fatal. COVID-19 patients with pre-existing coronary artery disease (CAD) risk factors or overt cardiovascular disease more often develop severe COVID-19, which are also related to thrombotic, inflammatory, and to viral infectivity response. We hypothesised that despite some genetic predisposition, especially in COVID-19 severity, the main determinants of fatal complications in COVID-19 patients are related to comorbidity. Purpose To determine the role of genetics and cardiovascular comorbidity in mortality from COVID-19. Methods We conducted a retrospective cohort study including 3,120 patients with positive COVID-19 test from several hospitals and primary care between February 2020 and June 2021. Among them 1,096 required hospitalization, and 121 died within 3 months after symptom onset. Standard parametric and non-parametric methods, as required, were used to compare patient characteristics by vital status. Individual genotypes for 32 CAD, 14 thrombosis, 19 inflammation, and 11 viral infectivity single nucleotide variants (SNV), as well as, 2 COVID-19 SNVs already published were tested for association with mortality with Cochran-Armitage statistics and p-values corrected for multiple comparisons. The mutually-adjusted odds ratio (OR) and 95% confidence interval (95% CI) of fatal COVID-19 was analysed for SNVs significantly associated to case-fatality, with their adverse alleles count (0, 1 or 2), and for comorbidity factors with logistic regression adjusted for age and sex. The discrimination of the models was also estimated by the area under the curve (AUC). Results Fatal and non-fatal cases' characteristics are compared in Table 1. Fatal cases had a more adverse cardiovascular and anthropometric risk profile. After correcting for multiple testing by Benjamini-Hochberg method, we observed the inflammation-related rs6993770 SNV to be significantly associated with COVID-19 fatality (p-value = 0.04). The CAD-related rs9982601 and rs2505083 SNVs, and the thrombosis-related rs7853989 SNV were moderately associated with COVID-19 fatality (p-value ≤0.1). On Figure 1 we show the adjusted OR for rs6993770 (OR: 1.02; 95% CI 1.01–1.03 per risk allele) and that for clinical factors related to COVID-19 case-fatality. The AUC of the model was 0.85 (95% CI 0.81–0.88), which not improved that of a model with clinical risk factors alone (AUC: 0.84; 95% CI 0.81–0.87). Conclusion The rs6993770 inflammation (interleukin measurement trait)-related SNV was independently associated to case fatality; however the outcome was mainly driven by age, male sex, diabetes, and glomerular filtration rate. Funding Acknowledgement Type of funding sources: Other. Main funding source(s): Carlos III Health Institute and the European Regional Development FundAgency for Management of University and Research GrantsCrue-CSIC-Santander FONDO SUPERA COVID-19

This is a randomized phase-2 trial aimed to compare consolidation vs. maintenance in untreated patients with follicular lymphoma (FL) responding to induction. 146 patients were enrolled from 25 Spanish institutions (ZAR2007; ClinicalTrials.gov #NCT00662948). Patients in PR or CR/CR[u] after R-CHOP were randomized 1:1 to 90Y-ibritumomab-tiuxetan 0.4 mCi/kg (arm A) vs. rituximab 375 mg/m2 every 8 weeks for 2 years (arm B). After a median follow-up of 10.55 years, 53 patients eventually progressed with a 10-year PFS of 50% vs. 56% for patients in arm A and B, respectively (HR = 1.42; p > 0.1). No significant differences were seen in OS (10-year OS 78% vs. 84.5%; HR = 1.39, p > .1). Patients receiving 90Y-ibritumomab-tiuxetan showed higher incidence of second neoplasms than those in arm B (10-year cumulative incidence 18.5 vs. 2%, respectively; p = .038). In conclusion, in FL patients responding to R-CHOP, no significant differences were found between consolidation and maintenance, although with higher late toxicity for consolidation.

Introduction: the “Assessment of Spondyloarthritis International Society Health Index” (ASASHI) questionnaire was developed to globally measure function and health status in patients with spondyloarthritis (SpA). Cut-off points have been proposed to determine different health states that were poorly evaluated in real-life patients. Objectives: to describe the health status measured by ASAS-HI in Argentine patients with axial SpA (AxSpA) and peripheral SpA (SpAp) in daily practice and to evaluate the factors associated with poor health. Materials and methods: cross-sectional, analytical and multicenter study. Patients with SpAax and SpAp were consecutively included according to ASAS criteria, from 15 Argentine centers. Statistical analysis: descriptive statistics, bivariate and multivariate analysis (multiple logistic regression) were performed to evaluate the factors associated with poor health status (ASAS-HI≥12). To analyze the construct validity of the tool, Spearman correlation was performed between the ASAS-HI and other disease evaluation parameters. Results: 274 patients with SpA were included, with a mean age of 49 (± 14) years and a median duration of the disease of 62 months (p25-75: 24-135), 155 (56.6%) were male, 129 patients (47%) with AxSpA and 145 (52.9%) SpAp. According to the ASAS-HI, 119 patients (43.4%) had good health, 117 (42.7%) had moderate health and 38 (13.9%) had poor health. In patients with SpAp, the mean ASAS-HI value was 7 (p25-75: 3-10). The ASAS-HI positively correlated with: DAS28: rho: 0.5 (p

espanolEl objetivo de esta investigacion consistio en identificar algunos de los procesos de escritura que miembros del Sistema Nacional de Investigadores (SNI) implementan cuando preparan articulos cientificos para su publicacion. Aplicamos un cuestionario validado mediante juicio de expertos a 12 participantes. Entre los resultados que podemos reportar encontramos, por ejemplo, que la metodologia tiene prioridad en el proceso de redaccion del articulo, y que aunque esta suele ser una labor individual, la revision del articulo es mas bien una tarea compartida. Finalmente, a partir de estos resultados ofrecemos estrategias de redaccion cientifica que podrian ser utiles a investigadores expertos o en formacion EnglishThe goal of this study was to identify some of the writing processes that the members of the National System of Researchers (SNI) implement while preparing scientific papers for their further publication. We applied a questionnaire, validated by an expert committee, to 12 subjects. Some of the results we can report, for example, include that the methodology section is the first to be written; and while writing down the paper is often an individual task, reviewing the paper, prior to journal submission, is a shared task. Finally, given these results, we offer some strategies for scientific writing that may be of interest for researchers both established and beginners

Some physically based landslide models analyse pore water pressure changes due to rainfall infiltration and its effects on slope stability. The physically-based model TRIGRS has been successfully used in rainfall-induced shallow landslide assessments in different studies around the world; nevertheless, evaluating its performance in tropical mountain terrains, such as the Colombian Andes, is necessary. In this study, the TRIGRS model was applied to the La Arenosa basin (San Carlos, Colombia) and ROC (receiver operating characteristic) analysis was used to assess its effectiveness (performance) at predicting areas susceptible to shallow landslides in this tropical mountainous area. The results were compared with those obtained using the SHIA_Landslide (Simulacion Hidrologica Abierta, or SHIA, in Spanish) and SHALSTAB models in the same case study. The three models performed well, especially TRIGRS and SHIA_Landslide. The predictive results using TRIGRS were thoroughly analysed, describing the effect of the slope angle and its relationship with the estimated soil depth on the variation of the pressure head and the factor of safety (FS) during the simulated rainfall event. The high dependence of FS on soil thickness demonstrated that defining this variable must be carefully accomplished. The results suggest that TRIGRS can be a valuable tool in tropical mountain terrains, such as the Colombian Andes basins, and it can be useful despite the lack of data and the high parameter uncertainty that is common in many study areas.

For landslide assessment in a specific small area of interest, regional thresholds may not be applicable and the application of empirical-statistical methodologies could be limited due to a lack of required databases (landslide inventories and triggering rainfall events). Rainfall thresholds for landslides have been recently derived from the implementation of physically based methodologies that usually provide a power-law equation for the study area (e.g. region or a specific basin). In this work, a new methodology for defining rainfall intensity and duration thresholds using a physically based model (TRIGRS) is presented and implemented in a tropical mountain basin of the Colombian Andes. Multiple calculations of the factor of safety for different (synthetic) rainfall events permitted the fitting of power-law equations to the sets of critical intensity and duration conditions, causing failure in each grid cell. Maps of the equation parameters (scale and shape) and the range of applicability (initial and final duration) of the grid cell thresholds were analysed. The results show that the hydraulic and mechanical properties of the soil affected the threshold curve characteristics, comparing sandy soil with silty loam; the higher strength characteristics of sandy soil meant that most extreme rainfall conditions are required to reach their thresholds. This methodology could improve landslide early warning systems in terms of analysing the specific (local) areas that are highly susceptible to landslide occurrence.

Laboratory tests are an integral part of the diagnosis and management of patients; however, these tests are far from perfect. Their imperfections can be due to patient health condition, specimen collection, and/or technological difficulty with performing the assay and/or interpretation. To be useful clinically, testing requires calculation of positive predictive values (PPVs) and negative predictive values (NPVs). During the current global pandemic of COVID-19 (coronavirus disease 2019), multiple assays with unknown clinical sensitivity and specificity have been rapidly developed to aid in the diagnosis of the disease. Due to a lack of surveillance testing, the prevalence of COVID-19 remains unknown. Hence, using this situation as an clinical example, the goal of this article is to clarify the key factors that influence the PPV and NPV yielded by diagnostic testing, By doing so, we hope to offer health-care providers information that will help them better understand the potential implications of utilizing these test results in clinical patient management.

El riesgo de deslizamientos superficiales expresa las pérdidas o daños causados por la ocurrencia de este fenómeno y depende de la magnitud, relacionada con su probabilidad de ocurrencia, y su efecto en los elementos expuestos, determinado por su grado de vulnerabilidad. En esta investigación se analizan y evalúan la amenaza, vulnerabilidad y riesgo de deslizamientos superficiales en un terreno montañoso tropical. Se utilizó el modelo físico SHALSTAB para el análisis de la amenaza y otros modelos de fácil implementación para calcular la vulnerabilidad física de ocho viviendas y de personas dentro de las mismas. Se calcula el riesgo de las estructuras, en términos económicos, y el riesgo de pérdidas de vidas humanas, para personas dentro de las viviendas, mediante un análisis de las consecuencias de estos elementos expuestos dada la ocurrencia de deslizamientos superficiales definidos en la evaluación de la amenaza. Esta metodología representa una herramienta que puede ser útil en planes de ordenamiento territorial y gestión del riesgo de movimientos en masa.

Physically-based models have been used to assess landslide susceptibility, hazard, and risk in many regions worldwide. They have also been regarded as valuable tools for landslide prediction and the development or improvement of landslide early warning systems. They are usually validated to demonstrate their predictive capacity, but they are not deeply studied regularly to understand the sensitivity of the input variables and the behavior of the models under many different rainfall scenarios. In this research paper, we studied two distributed physically-based models for shallow landslides: SLIP and Iverson. For this, the first-order second-moment (FOSM) method was used to calculate the contribution of random input variables (soil strength, unit weight, and permeability parameters) to the variance of the factor of safety. Different intensity and duration rainfall events were simulated to assess the response of the models to those rainfall conditions in terms of the factor of safety and failure probability. The results showed that the shear strength (cohesion and friction angle, in order of significance) parameters have the largest contribution to the variance in both models, but they vary depending on geological, geotechnical, and topographic conditions. The Iverson and SLIP models respond in different ways to the variation of rainfall conditions: for shorter durations (e.g. ≤ 8 h), increasing the intensity caused more unstable areas in the SLIP model, while for longer durations the unstable areas were considerably higher for the Iverson model. Understanding those behaviors can be useful for practical and appropriate implementation of the models in landslide assessment projects. Resumen Se han implementado modelos basados en la física para evaluar la susceptibilidad, la amenaza y el riesgo de movimientos en masa en muchas regiones del mundo. También se han considerado herramientas valiosas para la predicción de movimientos en masa y el desarrollo o mejora de sistemas de alerta temprana. Por lo general, se validan para demostrar su capacidad predictiva, pero pocas veces se estudian en profundidad para comprender la sensibilidad de las variables de entrada y el comportamiento de los modelos en diversos escenarios de lluvias. En este artículo de investigación se utilizaron dos modelos distribuidos de base física para deslizamientos superficiales: Iverson y SLIP. Para ello, se utiliza el método de first-order second moment (FOSM) para calcular la contribución de las variables de entrada aleatorias (resistencia del suelo, peso unitario y parámetros de permeabilidad) a la varianza del factor de seguridad. Se simularon eventos de lluvia de diferente intensidad y duración para evaluar la respuesta de los modelos a esas condiciones de lluvia en términos del factor de seguridad y probabilidad de falla. Los resultados mostraron que los parámetros de resistencia al corte (cohesión y ángulo de fricción, en orden de importancia) tienen la mayor contribución a la varianza en ambos modelos, pero varían según las condiciones geológicas, geotécnicas y topográficas. Los modelos Iverson y SLIP responden de diferentes maneras a la variación de las condiciones de lluvia: para duraciones más cortas (por ejemplo, ≤ 8 h), el aumento de la intensidad provocó más áreas inestables en el modelo SLIP; mientras que, para duraciones más largas, las áreas inestables fueron considerablemente mayores para el modelo de Iverson. Comprender esos comportamientos puede ser útil para una implementación práctica y adecuada de los modelos en proyectos de evaluación de deslizamientos de tierra.

Primary central nervous system lymphoma is a rare but aggressive brain malignancy. It is associated with poor prognosis even with the current standard of care. The aim of this study was to evaluate the effect and tolerability of blood–brain barrier disruption treatment combined with high-dose treatment with autologous stem cell transplantation as consolidation on primary central nervous system lymphoma patients. We performed a prospective phase II study for 25 patients with previously untreated primary central nervous system lymphoma. The blood–brain barrier disruption treatment was initiated 3–4 weeks after the MATRix regimen using the previously optimized therapy protocol. Briefly, each chemotherapy cycle included two subsequent intra-arterial blood–brain barrier disruption treatments on days 1 and 2 via either one of the internal carotid arteries or vertebral arteries. Patients received the therapy in 3-week intervals. The treatment was continued for two more courses after achieving a maximal radiological response to the maximum of six courses. The complete treatment response was observed in 88.0% of the patients. At the median follow-up time of 30 months, median progression-free and overall survivals were not reached. The 2-year overall and progression-free survival rates were 67.1% and 70.3%, respectively. Blood–brain barrier disruption treatment is a promising option for primary central nervous system lymphoma with an acceptable toxicity profile.

Environment landmarks are generally employed by visual SLAM (vSLAM) methods in the form of keypoints. However, these landmarks are unstable over time because they belong to areas that tend to change, e.g., shadows or moving objects. To solve this, some other authors have proposed the combination of keypoints and artificial markers distributed in the environment so as to facilitate the tracking process in the long run. Artificial markers are special elements (similar to beacons) that can be permanently placed in the environment to facilitate tracking. In any case, these systems keep a set of keypoints that is not likely to be reused, thus unnecessarily increasing the computing time required for tracking. This paper proposes a novel visual SLAM approach that efficiently combines keypoints and artificial markers, allowing for a substantial reduction in the computing time and memory required without noticeably degrading the tracking accuracy. In the first stage, our system creates a map of the environment using both keypoints and artificial markers, but once the map is created, the keypoints are removed and only the markers are kept. Thus, our map stores only long-lasting features of the environment (i.e., the markers). Then, for localization purposes, our algorithm uses the marker information along with temporary keypoints created just in the time of tracking, which are removed after a while. Since our algorithm keeps only a small subset of recent keypoints, it is faster than the state-of-the-art vSLAM approaches. The experimental results show that our proposed sSLAM compares favorably with ORB-SLAM2, ORB-SLAM3, OpenVSLAM and UcoSLAM in terms of speed, without statistically significant differences in accuracy. This research was funded by the project PID2019-103871GB-I00 of the Spanish Ministry of Economy, Industry and Competitiveness, FEDER, Project 1380047-F UCOFEDER-2021 of Andalusia and by the European Union–NextGeneration EU for requalification of Spanish University System 2021–2023.

Given that von Willebrand disease (VWD) is one of the most common bleeding disorders, the diagnosis or the exclusion is essential in the workup of individuals that have unexplained bleeding. For the clinical laboratory, the challenge is highlighted by the variable presentations of this disorder and the multiple assays that are available from different vendors. This review will give a brief overview of primary hemostasis with a detailed explanation of the biosynthesis, structure, and mechanics of von Willebrand factor (VWF). The final sections will focus on the distinguishing characteristics of the different types of VWD and the array of clinical laboratory tests currently available to assist in the diagnosis.

Physically-based distributed models are implemented for landslide susceptibility and hazard assessment around the world. Probabilistic methodologies are considered appropriate to study and quantify...

Pandan volcano is one of the dormant Quaternary volcanoes in East Java characterized by several volcanic centers which extend to the northern part. This study is aimed to identify the volcanic rocks and intrusions of Jari - Krondonan area, Bojonegoro as well as determine their petrology and mineralogical characteristics. Geological observation was conducted to obtain primary data and to collect samples. Thin section of samples was prepared to analyze the petrographic aspects. Field observation shows several volcanic hills at Mount Jati, Mount Puru, Mount Watu, and Mount Lawang sites. Based on field mapping, lithologies of the research area are andesitic lava and intrusion with columnar joint or sheeting joint structure, surrounded by andesitic breccia. Andesite characterized by porphyritic texture with visible phenocrysts and volcanic glass groundmass. Samples from Mount Lawang and Mount Watu are composed of plagioclase and hornblende as main minerals. Samples from Mount Jati and Mount Puru are composed of plagioclase and pyroxene. Quartz, sanidine, and olivine present as accessory minerals. Plagioclase and pyroxene occasionally formed glomerocryst and poikilitic texture, which play an important role in the fractionation and crystal settling processes. Sieve and regular zoning in plagioclase suggest magma mixing. Gabbro and metamorphic xenoliths found in Mount Lawang and Mount Watu indicates an interaction with country rock during magma rising.

A female patient aged 47 years presented with a hemoglobin A1c (HbA1c) level of 54.6%, as measured by ion-exchange high-performance liquid chromatography (HPLC), and a glucose level of 106 mg/dL. The HbA1c was re-evaluated using a turbidimetric inhibition immunoassay and found below the level of detection. Hemoglobinopathy testing led to the identification of a hemoglobin variant consistent with Hb Raleigh, in which a valine → alanine substitution on the beta chain effects a charge difference, resulting in coelution with HbA1c on HPLC and a spuriously high reading. Many Hb variants may interfere with HbA1c measurement and generate misleading results. The unique properties of Hb Raleigh may give rise to analytical errors when evaluating HbA1c using 2 different methods—molecular charge–based (eg, HPLC) and molecular structure–based (eg, immunoassay)—yielding diametrically opposed results. Consequently, recognition and diagnosis of this entity are essential in patients with Hb Raleigh, especially when monitoring long-term glucose control.

Introduction/Objective PathElective.com was founded as a means of combating stagnating resident and medical student education due to halting of in-person educational activities during the COVID-19 pandemic. The site has since grown to be included in medical student and resident training programs at numerous institutions across the world, serving as a unique means of delivering high-quality and trackable laboratory medicine education. Methods/Case Report The PathElective website was developed using Squarespace, video lectures were recorded by each professor or sourced from openly available web resources incorporating virtual slides, reading assignments, or relevant podcasts at the course director’s discretion. Monthly website traffic data were obtained through Squarespace analytics for the first 11 months of the website being available (May 1, 2020, to April 22, 2021). Geographic and source data were obtained through deidentified IP address analysis built-in to Squarespace analytics. Students who registered to take the online courses were assessed before and after interacting with the course materials using a dual form crossover quiz design to prevent memorization of questions and assess comprehension. Quiz data were all anonymous and improvement was determined using a paired t-test. Comparisons between courses were made via percentage improvements. Results (if a Case Study enter NA) Over the tracking period, PathElective.com received 352,012 page views, 73,550 visits, 33,225 unique visitors, and accrued 5,815 registered users. Most of the visitors (72.8%) arrived at the site via a direct URL input, 14.9% through a search engine, and 10.6% through social media. Most visitors were from the US (43.8%) or India (11.9%). With a total of 1598 test pairs being analyzed from all clinical pathology modules, the average increase in score was 14.4% (95%, CI=10.3-18.6, p=0.0052). All courses experienced a statistically significant increase in scores except for Clinical Chemistry lesson 3.2 (7%, -1.8-15.9% CI, p=0.12). Courses were well received with a median satisfaction score was very satisfied in all six assessment categories. Conclusion PathElective.com is a free and effective means of enhancing clinical pathology training in medical education. Students liked the online format, the quality of the lectures, and course faculty, and felt they could get help if needed. An area of improvement for this platform would be the interaction with students on social media.

Background COVID-19, the disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) can present with symptoms ranging from none to severe. Thrombotic events occur in a significant number of patients with COVID-19, especially in critically ill patients. This apparent novel form of coagulopathy is termed COVID-19-associated coagulopathy (CAC), and endothelial derived von Willebrand factor (vWF) may play an important role in its pathogenesis. Content vWF is a multimeric glycoprotein molecule that is involved in inflammation, primary and secondary hemostasis. Studies have shown that patients with COVID-19 have significantly elevated levels of vWF antigen and activity, likely contributing to an increased risk of thrombosis seen in CAC. The high levels of both vWF antigen and activity have been clinically correlated with worse outcomes. Furthermore, the severity of a COVID-19 infection appears to reduce molecules that regulate vWF level and activity such as ADAMTS-13 and high-density lipoproteins (HDL). Finally, studies have suggested that patients with group O blood (a blood group with lower baseline levels of vWF) have a lower risk of infection and disease severity compared to other ABO blood groups; however, more studies are needed to elucidate the role of vWF. Summary CAC is a significant contributor to morbidity and mortality. Endothelial dysfunction with the release of prothrombotic factors, such as vWF, needs further examination as a possible important component in the pathogenesis of CAC.

Supporting novice programming learners at scale has become a necessity. Such a support generally consists of delivering automated feedback on what and why learners did incorrectly. Existing approaches cast the problem as automatically repairing learners’ incorrect programs; specifically, data-driven approaches assume there exists a correct program provided by other learner that can be extrapolated to repair an incorrect program. Unfortunately, their repair potential, i.e., their capability of providing feedback, is hindered by how they compare programs. In this paper, we propose a flexible program alignment based on program dependence graphs, which we enrich with semantic information extracted from the programs, i.e., operations and calls. Having a correct and an incorrect graphs, we exploit approximate graph alignment to find correspondences at the statement level between them. Each correspondence has a similarity attached to it that reflects the matching affinity between two statements based on topology (control and data flow information) and semantics (operations and calls). Repair suggestions are discovered based on this similarity. We evaluate our flexible approach with respect to rigid schemes over correct and incorrect programs belonging to nine real-world introductory programming assignments. We show that our flexible program alignment is feasible in practice, achieves better performance than rigid program comparisons, and is more resilient when limiting the number of available correct programs.

The number of introductory programming learners is increasing worldwide. Delivering feedback to these learners is important to support their progress; however, traditional methods to deliver feedback do not scale to thousands of programs. We identify several opportunities to improve a recent data-driven technique to analyze individual program statements. These statements are grouped based on their semantic intent and usually differ on their actual implementation and syntax. The existing technique groups statements that are semantically close, and considers outliers those statements that reduce the cohesiveness of the clusters. Unfortunately, this approach leads to many statements to be considered outliers. We propose to reduce the number of outliers through a new clustering algorithm that processes vertices based on density. Our experiments over six real-world introductory programming assignments show that we are able to reduce the number of outliers and, therefore, increase the total coverage of the programs that are under evaluation.

Purpose To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). Materials and methods Inclusion criteria comprised patients with COVID-19-related moderate–severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value. Results Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X‑ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. Conclusions LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities.

BackgroundThe goal of targeted treatment in patients with Systemic Lupus Erythematosus (SLE) is to achieve clinical remission or low disease activity, with the best quality of life, low damage rates and better survival 1-4. RELESSAR is a multicenter, cross-sectional study registry of ≥18 years SLE (ACR 97) patients 5.ObjectivesTo describe demographic, clinical characteristics and treatments in SLE patients according to disease activity state. To evaluate the proportion of SLE and refractory SLE patients that are potentially candidates for Belimumab treatment (Active SLE despite standard treatment including increased acDNA autoantibodies and low complement).MethodsWe evaluated demographic and clinical data, treatments, score of damage (SLICC), activity (SLEDAI) and comorbidity (Charlson), hospital admissions and severe infections. The patients were compared according to disease activity: remission (SLEDAI = 0 and without corticosteroids), low disease activity (LDA, SLEDAI> 0 and ≤4 and without corticosteroids) and non-optimal control (SLEDAI> 4 and any dose of corticosteroids). Refractory SLE was defined according to Rituximab (RTX) use, non-response to cyclophosphamide or two or more immunosuppressant or splenectomized patients. Potential use of Belimumab according approved prescription in Argentina was analyzed.ResultsOverall, 1277 patients were analyzed: 299 (23.4%) were in remission, 162 (12.7%) in LDA and 816 (63.9%) with non-optimal control of the disease.Patients in non-optimal control group were younger, less frequently female and they showed less time of disease and lower socioeconomic status (p < 0.001). They were also more prevalent mestizos (p= 0.004), had higher SLEDAI and SLICC indexes (p Two hundred and one SLE patients fulfilled the use of Belimumab prescription criteria but only 45/201 patients (22,3%) received it in the last visit. Malar rash was the only clinical variable associated with the use of Belimumab (72.7% vs 29.8% p= 0.005).Seventy-six patients classified as refractory SLE (15.7%) and 56/76 (75.7%) never received Belimumab. Patients on Belimumab therapy were associated to treatment with lower doses of corticoids (p= 0.018) and lower rate of hospital admission caused by SLE flare (p= 0.027).ConclusionA high percentage of patients had uncontrolled disease upon entry into the registry and were potential candidates for treatment with Belimumab. The patients who received biologic treatment showed the benefit of requiring fewer doses of corticosteroids and having a lower rate of hospitalizations.References[1]Mok CC. Treat-to-target in systemic lupus erythematosus: Are we there yet? Expert Rev Clin Pharmacol. 2016;9(5).[2]Morand EF, Mosca M. Treat to target, remission and low disease activity in SLE. Vol. 31, Best Practice and Research: Clinical Rheumatology. 2017.[3]Golder V, Tsang-A-Sjoe MWP. Treatment targets in SLE: Remission and low disease activity state. Rheumatol (United Kingdom). 2020;59.[4]Ruiz-Irastorza G, Bertsias G. Treating systemic lupus erythematosus in the 21st century: new drugs and new perspectives on old drugs. Vol. 59, Rheumatology (United Kingdom). 2021.[5]Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum [Internet]. 1997;40(9):1725. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9324032Disclosure of InterestsRosana Quintana: None declared, Lucila Garcia: None declared, Paula Alba: None declared, Susana Roverano: None declared, Analia Alvarez: None declared, Cesar Graf: None declared, Cecilia Pisoni: None declared, Alberto Spindler: None declared, Catalina Gomez: None declared, Heber Matias Figueredo: None declared, Silvia Papasidero: None declared, Raul Horacio Paniego: None declared, Maria DeLaVega: None declared, Emma Estela Civit De Garignani: None declared, Luciana Gonzalez Lucero: None declared, Victoria Martire: None declared, Rodrigo Águila Maldonado: None declared, Sergio Gordon: None declared, Carla Gobbi: None declared, Romina Nieto: None declared, Gretel Rausch: None declared, Vanina Góngora: None declared, Maria Agustina D´Amico: None declared, Diana Dubinsky: None declared, Alberto Omar Orden: None declared, Johana Zacariaz: None declared, Julia Romero: None declared, Mariana Alejandra Pera: None declared, Oscar Rillo: None declared, Roberto Baez: None declared, Valeria Arturi: None declared, Andrea Gonzalez: None declared, Florencia Vivero: None declared, Marcela Schmid: None declared, Victor Caputo: None declared, Maria Silvia Larroude: None declared, Graciela Gomez: None declared, Graciela Rodriguez: None declared, Josefina Marin: None declared, Maria Victoria Collado: None declared, Marisa Jorfen: None declared, Zaida Bedran: None declared, Judith Sarano: None declared, David Zelaya: None declared, MONICA SACNUN: None declared, Pablo Finucci: None declared, Romina Rojas Tessel: None declared, Maria Emilia Sattler: None declared, MAXIMILIANO MACHADO ESCOBAR: None declared, Pablo Astesana: None declared, Ursula Vanesa Paris: None declared, Alberto Allievi: None declared, Juan Manuel Vandale: None declared, Bernardo Pons-Estel: None declared, Guillermo Pons-Estel: None declared, Mercedes García Grant/research support from: GSK grant

A common practice among programmers is to find pieces of source code using search engines. Programs retrieved by these engines are typically semantically but not necessarily syntactically similar. As a result, ranking methods are exploited to present relevant programs to users. However, due to implementation variability, users need to understand such programs. In this paper, we propose a method to group statements into clusters from a set of programs retrieved by a source code search engine. Each cluster comprises a number of program statements that have similar but not exact semantics and are pervasive. Our hypothesis is that such clusters help understand at a glance a set of semantically-related programs. We use approximate graph alignment to find correspondences among statements in two program dependence graphs that are similar with respect to their control and data flows, as well as operations they perform. We then build a graph with pairwise comparisons of program dependence graphs, and cast the problem of clustering statements as finding communities of statements that consistently align. Our evaluation using programs collected by BigCloneBench shows that clusters of statements discovered by our approach help discern implementation variations.

In the rehabilitation field, clinicians are continually struggling to assess improvements in patients following interventions. In this paper, we propose an approach to use gait analysis based on inertial motion capture (MoCap) to monitor individuals during rehabilitation. Gait is a cyclical movement that generates a sufficiently large data sample in each capture session to statistically compare two different sessions from a single patient. Using this crucial idea, 21 heterogeneous patients with hemiplegic spasticity were assessed using gait analysis before and after receiving treatment with botulinum toxin injections. Afterwards, the two sessions for each patient were compared using the magnitude-based decision statistical method. Due to the challenge of classifying changes in gait variables such as improvements or impairments, assessing each patient&rsquo, s progress required an interpretative process. After completing this process, we determined that 10 patients showed overall improvement, five patients showed overall impairment, and six patients did not show any overall change. Finally, the interpretation process was summarized by developing guidelines to aid in future assessments. In this manner, our approach provides graphical information about the patients&rsquo, progress to assess improvement following intervention and to support decision-making. This research contributes to integrating MoCap-based gait analysis into rehabilitation.

Gait analysis based on full-body motion capture technology (MoCap) can be used in rehabilitation to aid in decision making during treatments or therapies. In order to promote the use of MoCap gait analysis based on inertial measurement units (IMUs) or optical technology, it is necessary to overcome certain limitations, such as the need for magnetically controlled environments, which affect IMU systems, or the need for additional instrumentation to detect gait events, which affects IMUs and optical systems. We present a MoCap gait analysis system called Move Human Sensors (MH), which incorporates proposals to overcome both limitations and can be configured via magnetometer-free IMUs (MH-IMU) or clusters of optical markers (MH-OPT). Using a test&ndash, retest reliability experiment with thirty-three healthy subjects (20 men and 13 women, 21.7 &plusmn, 2.9 years), we determined the reproducibility of both configurations. The assessment confirmed that the proposals performed adequately and allowed us to establish usage considerations. This study aims to enhance gait analysis in daily clinical practice.

Brain-derived proteins are present in the peripheral blood circulation in exceptionally low concentrations. This is primarily due to the physical hindrance of the blood–brain barrier and the dilutional effect of the peripheral blood volume. Measuring these proteins in the blood as potential biomarkers of traumatic brain injury (TBI) requires ultrasensitive methods. This chapter discusses the measurement principles, performance, and applications in TBI biomarker research of two immunoassay platforms that have the highest sensitivity: digital enzyme-linked immunosorbent assay using single-molecule array (Simoa) technology developed by Quanterix and single-molecule counting developed by Singulex. Both technologies have already been integrated in fully automated analyzers destined to be part of the (specialized) clinical laboratory in the near future.

Background It has been documented that anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health care resources, and poor asthma control. Objective To examine the association of asthma diagnosis with symptoms of depression/anxiety and asthma control not only at baseline but also over a 6-month period of specialist supervision. Methods We enrolled 3182 patients with moderate to severe asthma. All were evaluated with spirometry, the Asthma Control Test, and the Hospital Anxiety and Depression Scale at baseline and at 6 months. Treatments were decided by specialists according to published guidelines. Results At baseline, 24.2% and 12% of the patients were diagnosed with anxiety and depression, respectively, according to the Hospital Anxiety and Depression Scale. After 6 months, anxiety and depression improved, affecting 15.3% and 8.1% of patients, respectively (P Conclusion Under standardized asthma care and after a specific visit with the specialist, patients present significant improvement in these psychological disorders and exhibit better asthma control and functional parameters.