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Background: Cancer patients who are exposed to sepsis and had previous chemotherapy may have increased severity. Among chemotherapeutic agents, anthracyclines have been associated with cardiac toxicity. Like other chemotherapeutic agents, they may cause endothelial toxicity. The aim of this study was to evaluate the effect of anthracycline treatment on the outcome of cancer patients with sepsis. Methods: Data from cancer patients admitted to intensive care units (ICUs) for sepsis or septic shock were extracted from the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique database (1994–2015). Comparison between patients who received anthracycline and those who did not was performed using a propensity score, including confounding variables (age and underlying diseases). A competing risk adjusted for severity of illness (Sequential Organ Failure Assessment [SOFA] score) was used to analyze the duration of vasopressor requirement. Results: Among 2046 patients, 1070 (52.3%) patients who received anthracycline were compared with 976 (47.7%) who did not. The underlying disease was mostly acute hematological malignancy (49.2%). Sepsis, mostly pneumonia (47.7%), had developed 2 days (interquartile range [IQR]:1–4 days) prior to ICU admission. Most patients (n=1156/1980,58.4%) required vasopressors for 3 days (IQR: 2–6 days). Factors associated with the need for vasopressors were aplasia (hazard ratio [HR]=1.72, 95% confidence interval [CI]: 1.21 to 2.47, P=0.002) and day 1 respiratory SOFA score (HR=7.07, 95% CI: 2.75 to 22.1, P

Riverine barriers are threatening freshwater fish migration, with major impacts on fish populations. Effective management requires understanding of fish movement and behaviour as they approach a barrier and fish pass, which can inform optimal mitigation options and barrier management. Here, the movements of upstream migrating barbel Barbus barbus and grayling Thymallus thymallus near a barrier were analysed and results used to develop predictive models. Fish were tracked via 2D acoustic telemetry. Hidden Markov models were used to distinguish behavioural states and step selection functions were applied to determine habitat selection by the fish in each state. Model results were explored to assess the benefits of including behavioural state and understand state-specific habitat preferences, then cross-validated and used to develop an individual based model to predict fish spatial usage. Little difference existed in habitat selection between states and individual variation was high, limiting general trends that could be described. Overall, barbel preferred deeper or faster water while for grayling, few trends could be described. Under the tested flow conditions, high spatial usage was predicted in the area directly downstream of the barrier. In addition, barbel usage was high in the area by and downstream of the fish pass entrance but not for grayling, which may indicate a need to improve pass attractiveness for grayling. The predictive model produced directed upstream movements of fish similar to those expected for upstream migrating freshwater fish, highlighting model potential for fish passage applications in future iterations. The high individual variability in fish behaviour drives the need for individual-based approaches for predicting fish movement.

Aquatic ecosystems are facing intensifying challenges, such as pollution, habitat destruction, and climate perturbations; hence, high-resolution, cost-effective monitoring tools are becoming increasingly important to provide timely and accurate data for effective conservation and management strategies. This review investigates the crucial role of unmanned vehicle systems (UVS) in conducting multi-spatial scale monitoring across different facets of aquatic ecosystems, including ecosystem habitat, algal bloom, vegetation conditions, and animal behaviors. Using a combination of bibliometric analysis and systematic review techniques, we assess UVS applications over the past decade (2013−2023), track research trends and evaluate the effectiveness, challenges, and prospects of UVS technologies. Our findings reveal a 12-fold increase in UVS applications in aquatic research during this period, with 60–70 % focusing on habitat monitoring and animal behavior research, and less than 10 % addressing algal blooms and eutrophication. Unmanned Aerial Vehicles (UAV), representing 70 % of the published applications, have been the primary research instrument, outpacing Unmanned Surface Vehicles (USV) and Autonomous Underwater Vehicles/Remotely Operated Vehicles (AUV/ROV). While enhancing monitoring at various scales with broad coverage, integrated applications between UAVs and USVs or AUVs/ROVs still need to solve crucial issues, such as weather impacts, communication complexities, and data processing needs. The systematic analysis highlights the gap in UVS applications for multi-spatial scale monitoring and reveals significant opportunities for integrating UVS with Artificial Intelligence (AI), machine learning, and Internet of Things (IoT) technologies, which are improving UVS integration, security, and efficiency, and enabling better resource management and navigation accuracy. Furthermore, object tracking, Digital Image Processing (DIP), Geographic Information System (GIS), and data management platforms enable efficient, multi-spatial scale monitoring and advanced research capabilities, offering the potential to enhance data collection and management of aquatic ecosystems.

Nocardia is a ubiquitous, filamentous, gram-positive bacillus present in soil and decaying plants (2), affecting immunocompromised patients by way of inhalation, with a risk of secondary dissemination. Invasive Nocardia infections [...]

Mentoring is a favoured practice in many fields, including teacher education. This article challenges the uncritical acceptance of the beneficial effects of mentoring, by developing a novel conceptual model which allows to theorise and study mentoring as a discursive practice, focusing on the relations between all actors involved (i.e. teacher educator, student teacher, mentor), located in broader socio-cultural contexts. The model integrates (elements of) positioning theory and frame analysis which together deliver the necessary conceptual tools to explain how mentoring triads exactly operate and why they operate as they do. The model is substantiated with empirical results from an exploratory single case-study of one mentoring triad from a teacher education provider in England. The article concludes with an agenda for future research, inviting the research community to engage with the proposed model to start building a broader evidence base in both the dynamics and outcomes (broadly defined) of mentoring.

Abstract Insight into the detection range of acoustic telemetry systems is crucial for both sampling design and data interpretation. The detection range is highly dependent on the environmental conditions and can consequently be substantially different among aquatic systems. Also within systems, temporal variability can be significant. The number of studies to assess the detection range in different systems has been growing, though there remains a knowledge gap in estuarine habitats. In this study, a 2-month experimental set-up was used to assess the detection range variability and affecting environmental factors of an estuary. Given the expected complex interplay of different factors and the difficulties it entails for interpretation, a structural equation modelling (pSEM) approach is proposed. The detection range of this estuarine study was relatively low and variable (average 50% detectability of 106 m and ranging between 72 and 229 m) compared to studies of riverine and marine systems. The structural equation models revealed a clear, yet complex, tidal pattern in detection range variability which was mainly affected by water speed (via ambient noise and tilt of the receivers), water depth and wind speed. The negative effect of ambient noise and positive effect of water depth became more pronounced at larger distances. Ambient noise was not only affected by water speed, but also by water depth, precipitation, tilt angle and wind speed. Although the tilt was affected by water speed, water depth and wind speed, most of the variability in tilt could be traced back to the receiver locations. Similarly, the receiver locations seemed to explain a considerable portion of the detection range variability. Retrospective power analyses indicated that for most factors only a minor gain in explanatory power was achieved after more than two days of data collecting. Redirecting some of the sampling effort towards more spatially extensive measurements seems to be a relevant manner to improve the insights in the performance of telemetry systems in estuarine environments. Since the low and variable detection range in estuaries can seriously hamper ecological inferences, range tests with sound sampling designs and appropriate modelling techniques are paramount.

Abstract Background Acute respiratory failure (ARF) is the leading cause of ICU admission. Viruses are increasingly recognized as a cause of pneumonia in immunocompromised patients, but epidemiologic data are scarce. We used the Groupe de Recherche en Réanimation Respiratoire en Onco-Hématologie’s database (2003–2017, 72 intensive care units) to describe the spectrum of critically ill immunocompromised patients with virus-detected ARF and to report their outcomes. Then, patients with virus-detected ARF were matched based on clinical characteristics and severity (1:3 ratio) with patients with ARF from other origins. Results Of the 4038 immunocompromised patients in the whole cohort, 370 (9.2%) had a diagnosis of virus-detected ARF and were included in the study. Influenza was the most common virus (59%), followed by respiratory syncytial virus (14%), with significant seasonal variation. An associated bacterial infection was identified in 79 patients (21%) and an invasive pulmonary aspergillosis in 23 patients (6%). The crude in-hospital mortality rate was 37.8%. Factors associated with mortality were: neutropenia (OR = 1.74, 95% confidence interval, CI [1.05–2.89]), poor performance status (OR = 1.84, CI [1.12–3.03]), and the need for invasive mechanical ventilation on the day of admission (OR = 1.97, CI [1.14–3.40]). The type of virus was not associated with mortality. After matching, patients with virus-detected ARF had lower mortality (OR = 0.77, CI [0.60–0.98]) than patients with ARF from other causes. This result was mostly driven by influenza-like viruses, namely, respiratory syncytial virus, parainfluenza virus, and human metapneumovirus (OR = 0.54, CI [0.33–0.88]). Conclusions In immunocompromised patients with virus-detected ARF, mortality is high, whatever the species, mainly influenced by clinical severity and poor general status. However, compared to non-viral ARF, in-hospital mortality was lower, especially for patients with detected viruses other than influenza.

We consider a system of two coupled parallel queues with infinite waiting rooms. The time setting is discrete. In either queue, the service of a customer requires exactly one discrete time slot. Arrivals of new customers occur independently from slot to slot, but the numbers of arrivals into both queues within a slot may be mutually dependent. Their joint probability generating function (pgf) is indicated as A(z1,z2) and characterizes the whole model. In general, determining the steady-state joint probability mass function (pmf) u(m,n),m,n≥0 or the corresponding joint pgf U(z1,z2) of the numbers of customers present in both queues is a formidable task. Only for very specific choices of the arrival pgf A(z1,z2) are explicit results known. In this paper, we identify a multi-parameter, generic class of arrival pgfs A(z1,z2), for which we can explicitly determine the system-content pgf U(z1,z2). We find that, for arrival pgfs of this class, U(z1,z2) has a denominator that is a product, say r1(z1)r2(z2), of two univariate functions. This property allows a straightforward inversion of U(z1,z2), resulting in a pmf u(m,n) which can be expressed as a finite linear combination of bivariate geometric terms. We observe that our generic model encompasses most of the previously known results as special cases.

Purpose: Speech-language pathologists usually apply a "one size fits all" approach to eliminate compensatory cleft speech characteristics (CSCs). It is necessary to investigate what intervention works best for a particular patient. This pilot study compared the effectiveness of two therapy approaches (a motorphonetic approach and a linguistic-phonological approach) on different subtypes of compensatory CSCs in Dutch-speaking children with a cleft (lip and) palate (CP ± L). Method: Fourteen children with a CP ± L (Mage = 7.71 years) were divided into two groups using block randomization stratified by age, gender, and type of compensatory CSC. Six children received intervention to eliminate anterior oral CSCs (n = 3 motor-phonetic intervention, n = 3 linguistic-phonological intervention). Eight children received intervention to eliminate non-oral CSCs (n = 4 motorphonetic intervention, n = 4 linguistic-phonological intervention). Each child received 10 hr of speech intervention divided over 2 weeks. Perceptual and psychosocial outcome measures were used to determine intervention effects. Results: Children who received linguistic-phonological intervention to eliminate anterior oral CSCs had significantly higher correctly produced consonant scores and health-related quality of life (HRQoL) scores compared to children who received motor-phonetic intervention to eliminate anterior oral CSCs. In the group of children who received intervention to eliminate non-oral CSCs, no significant differences were found in the correctly produced consonant scores nor in the HRQoL scores between the two intervention approaches. Conclusions: Linguistic-phonological intervention seems to be more appropriate to eliminate anterior oral CSCs. The beneficial effects of linguistic-phonological intervention were less pronounced in children with non-oral CSCs. Perhaps, children with non-oral CSCs benefit more from a hybrid phonetic-phonological approach. This study is a step forward in the provision of performance-specific intervention in children with a CP ± L. Replication in larger samples is needed and will aid to tailor treatment plans to the needs of our patients.