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Bálint Lajos - Daróczi Gergely (2012): A Pécsről történő elvándorlás térbeli-időbeli mintázatai.

Caro Editor, Esta carta visa complementar os dados publicados por Silva et al., ( ) apresentando os resultados das concentracoes plasmaticas de pacientes que utilizaram piperacilina (PIP) em dose empirica (DE) ou dose ajustada (DA) pelo software Optimum Dosing Strategies (ID-ODS), alem de expor alguns pontos limitadores observados pelos autores durante a utilizacao do software na realidade de um hospital brasileiro. […] Software para ajuste de doses de antimicrobianos. Implicacoes nas concentracoes plasmaticas e limitacoes praticas

The Rocker Project provides widely used Docker images for R across different application scenarios. This article surveys downstream projects that build upon the Rocker Project images and presents the current state of R packages for managing Docker images and controlling containers. These use cases cover diverse topics such as package development, reproducible research, collaborative work, cloud-based data processing, and production deployment of services. The variety of applications demonstrates the power of the Rocker Project specifically and containerisation in general. Across the diverse ways to use containers, we identified common themes: reproducible environments, scalability and efficiency, and portability across clouds. We conclude that the current growth and diversification of use cases is likely to continue its positive impact, but see the need for consolidating the Rockerverse ecosystem of packages, developing common practices for applications, and exploring alternative containerisation software., Source code for article available at https://github.com/nuest/rockerverse-paper/ Updated version includes some new paragraphs and corrections throughout the text; full diff available at https://github.com/nuest/rockerverse-paper/compare/preprint.v2...preprint.v3

Objective To adapt an antibiotic dose adjustment software initially developed in English, to Portuguese and to the Brazilian context. Methods This was an observational, descriptive study in which the Delphi method was used to establish consensus among specialists from different health areas, with questions addressing the visual and operational aspects of the software. In a second stage, a pilot experimental study was performed with the random comparison of patients for evaluation and adaptation of the software in the real environment of an intensive care unit, where it was compared between patients who used the standardized dose of piperacillin/tazobactam, and those who used an individualized dose adjusted through the software Individually Designed and Optimized Dosing Strategies. Results Twelve professionals participated in the first round, whose suggestions were forwarded to the software developer for adjustments, and subsequently submitted to the second round. Eight specialists participated in the second round. Indexes of 80% and 90% of concordance were obtained between the judges, characterizing uniformity in the suggestions. Thus, there was modification in the layout of the software for linguistic and cultural adequacy, minimizing errors of understanding and contradictions. In the second stage, 21 patients were included, and there were no differences between doses of piperacillin in the standard dose and adjusted dose Groups. Conclusion The adapted version of the software is safe and reliable for its use in Brazil.

Disszertaciomban a Magyarorszagon elő hajlektalanok ezredfordulo utani szamanak becslesere es egy alternativ hajlektalantipologia felvazolasara tettem kiserletet egy nagymintas, tobb mint 60 000 kerdőivet magaban foglalo adatfelvetel masodelemzese soran, amely kutatas ujdonsagat az alkalmazott statisztikai modszerek es a rendelkezesemre allo 13 evnyi, osszevont es egysegesitett adatsor keresztmetszeti es longitudinalis feldolgozasa adja. A kapcsolodo definicios kerdesek tisztazasa es korabbi kutatasi eredmenyek szintetizalasa erdekeben attekintettem a vonatkozo hazai, tovabba a modszertani szempontbol innovativ nemzetkozi szakirodalmat, amely alapjan a hajlektalanok szamat kapcsolatban capture-recapture mintavetelre alapozott log-linearis modellek segitsegevel becsultem, a tipologiat pedig Latent Class Analysis modszerrel keszitettem. Az F3 adatok anonim azonositoinak a kulonboző kutatasi hullamokban valo előfordulasi gyakorisagaira illesztett log-linearis modellek segitsegevel adott becsleseim a kapcsolodo kutatasokhoz hasonloan meglehetősen nagy szorast mutattak, igy pontos eredmenyek megallapitasara nem alkalmasak, de a kutatomunka nem volt haszontalan. Egyreszt a hazai hajlektalankutatasban korabban nem hasznalt "open population" modelleknek koszonhetően megismerhetőve valt a hajlektalansagbol kitorni nem tudo nepesseg aranya, tovabba a bekerulesi valoszinűseg es a hajlektalansagbol kilepők szama alapjan pontosabb kepet kaphattunk arrol, hogy mennyire atmeneti allapot hajlektalannak lenni ma Magyarorszagon. Sajnalatos, hogy a modellek tanusaga szerint magas es egyre nő azon hajlektalanok szama, akik tobb eve elnek kozteruleten vagy hajlektalanszallokon. A teljes adatsoron futtatott LCA modellek fontos előfeltetele volt a kapcsolodo homogenitasvizsgalatok elvegzese. Ennek fontos eredmenye, hogy az evenkenti adatfelvetelek megbizhatonak, egy mintabol valonak bizonyultak, igy nem volt akadalya az adatbazisok standardizalasanak, majd egyseges feldolgozasanak sem. A kapott modellek kizarolag empirikus adatokra epultek, igy a hagyomanyos prekoncepciokat, sőt egyes modellek eseteben meg a demografiai valtozokat is nelkulozik: a megkerdezettek kozott 5 csoport sikerult elkuloniteni, amelyek a fedel nelkulieket es a videki hajlektalanokat, a szallohasznalok ket csoportjat jovedelemforras szerint, a fővarosi fedel nelkulieket es ejjeli menedekhelyek lakoit, tovabba a TB ellatott, altalaban atmeneti szallos hajlektalanokat tartalmazza. A klaszterek eloszlasa a kulonboző időszakokban tobbnyire stabil, azonban az egyes tipusok tarsadalmi-demografiai profilja sokkal erdekesebb kepet mutat: bar a tipologia tobbnyire erzeketlenek a nemre, azonban az eletkor tekinteteben komoly eltereseket talalunk a klaszterbeli aranyokban.

Background Torsades de pointes is a life-threatening ventricular tachycardia associated with prolongation of the QT interval. Many diseases and medications have been implicated as potentially prolonging the QT interval, but little data exists regarding the means of quantifying this risk. The aim of this study was to describe the impact of commonly used antimicrobials on the QT interval in hospitalized patients. Methods Demographic, diseases, laboratory, medication administration history and ECG recording data were collected from the electronic records of adult patients admitted, from July 2018 to December 2018, to two urban hospitals. A model for the QT interval comprised of four sub-models: gender, heart rate, circadian rhythm, and the drug and disease effects. Fixed and random effects with between occasion variability were estimated for the parameters. A Bayesian approach using the NUTS in STAN was used via the brms package in the R® software. Results Data from 1,353 patients were used with baseline characteristics shown in Table 1. Observed vs. predicted plots based on the training (Figure 1A) and validation data set (Figure 1B) showed a great fit. The parameters for QTc0, α, gender, and circadian rhythm were accurately identified (Table 2). Similarly, the model correctly described the expected impact of acute or chronic diseases on the QT interval. Uncertainty interval estimates (Figure 2) show that patients treated with fluconazole and levofloxacin are likely to present with a QT interval [mean (95% CI) of 6.84 (0.22,21.45) and 5.05 (0.15, 16.70), respectively], that is > 5 ms longer vs. no treatment, the minimum cutoff that should evoke further risk assessment of QT interval prolongation. Conclusion The model developed correctly describes the impact baseline risk factors have on the QT interval. Point estimates of QT interval prolongation show that patients treated with fluconazole and levofloxacin may be at considerable risk; while those treated with azithromycin or ciprofloxacin are more likely to be at an insignificant risk for QT interval prolongation during hospital admission. Further workup to quantify the impact of concomitant treatment with these and other at-risk medications is underway. Disclosures All authors: No reported disclosures.

Population pharmacokinetic analyses can be applied to predict optimized dosages for individual patients. The aim of this study was to compare the prediction performance of the published population pharmacokinetic models for meropenem in critically ill patients. We coded the published population pharmacokinetic models with covariate relationships into dosing software to predict unbound meropenem concentrations measured in a separate cohort of critically ill patients. The agreements between the observed and predicted concentrations were evaluated with Bland-Altman plots. The absolute and relative bias and precision of the models were determined. The clinical implications of the results were evaluated according to whether dose adjustments were required from the predictions to achieve a meropenem concentration of >2 mg/liter throughout the dosing interval. A total of 157 free meropenem concentrations from 56 patients were analyzed. Eight published population pharmacokinetic models were compared. The models showed an absolute bias in predicting the unbound meropenem concentrations from a mean percent difference (95% confidence interval [CI]) of −108.5% (−119.9% to −97.3%) to 19.9% (7.3% to 32.7%), while absolute precision ranged from −249.1% (−263.4% to −234.8%) to 31.9% (17.6% to 46.2%) and −178.9% (−196.9% to −160.9%) to 175.0% (157.0% to 193.0%). A dose change was required in 44% to 64% of the concentration results. Seven of the eight equations evaluated underpredicted free meropenem concentrations. In conclusion, the overall accuracy of these models supports their inclusion in dosing software and application for individualizing meropenem doses in critically ill patients to increase the likelihood of achievement of optimal antibiotic exposures.

One condition of the stable and balanced functioning of democratic systems is the active participation of citizens. Considering the political subsystem, civilian activity is primarily, although not exclusively, manifested in participation at elections.The relationship between participation in the 2010 parliamentary election and the number of votes cast in favour of the winning party was in the focus of our investigations in this study. According to Klimek et al. (2012), who greatly inspired the current research, conclusions can be drawn about the fairness of the election based on the concentration of votes cast for the winning party. This is possible because salient differences observable in the joint distributions of concentration and participation may suggest problems concerning the fairness of the election. Since the chance of salient differences occurring is negligible, these might suggest manipulation. In our study, we argue that a method which ignores spatial effects may be inefficient in the case of auto-correlated error components because the independence assumption is not met, so this method may lead to biased estimations.In order to answer the research question, we relied on data derived from voting districts in Budapest which were used to create a geo-referenced spatial point database. Data were entered by voting district, then areal data was created with the help of Voronoi tesselation. In order to shed light on the relationship between participation and the votes cast for the winning party, we relied on spatial filtering as suggested by Getis and Ord, which enables the explicit expression of spatial effects.The non-parametric Getis spatial filtering has been investigated with the help of optimal distances and first-order topological neighbourhood as well, although the method is primarily based on determining distance-based auto-correlations. The approach which took topological relations into consideration did not result in significant differences in parameter estimates, although it had a somewhat better fit (higher R2 and lower AIC value). This calls attention to the problems of applying distance approaches in the case of very unevenly sized irregular configurations.By the decomposition of variables to spatial and non-spatial components and by the explicit expression of spatial effects, the independence assumption of error components can be fulfilled. As a consequence, it is possible to return to using the traditional Ordinary Least Squares (OLS) method.The most important finding of our research was that the relationship between voting turnout and votes cast for the winning party in Budapest in 2010 was unjustifiable. Relying on the OLS method and disregarding spatial effects led to serious consequences; it resulted in biased estimations. For this reason, we emphasize the importance of handling auto-correlations properly in the case of spatial data.

The high variability in the estimates of the number of homeless people living in Hungary suggested a review of recent methods and possible data sources. After verifying the models fitted by Dávid and Snijders (2002), those and various other models were applied to a wider range of data compiled between 1999 and 2011 in Hungary, thus estimating the number of homeless people over the last decade. The limitations of the models were obvious: more frequent and extended data collection would be favourable to produce reliable estimates, and a robust design (mixture of closed and open population model) could be used to fine-tune the results.

Background In the last century Hungary had astonishingly high suicide rates characterized by marked regional within-country inequalities, a spatial pattern which has been quite stable over time. Aims To explain the above phenomenon at the level of micro-regions ( n =175) in the period between 2005 and 2011. Methods Our dependent variable was the age and gender standardized mortality ratio (SMR) for suicide while explanatory variables were factors which are supposed to influence suicide risk, such as measures of religious and political integration, travel time accessibility of psychiatric services , alcohol consumption, unemployment and disability pensionery. When applying the ordinary least squared regression model, the residuals were found to be spatially autocorrelated, which indicates the violation of the assumption on the independence of error terms and – accordingly – the necessity of application of a spatial autoregressive (SAR) model to handle this problem. According to our calculations the SAR lag model was a better way (versus the SAR err model) of addressing the problem of spatial autocorrelation, furthermore its substantive meaning is more convenient. Results SMR was significantly associated with the “political integration” variable in a negative and with “lack of religious integration” and “disability pensionery” variables in a positive manner. Associations were not significant for the remaining explanatory variables. Limitations Several important psychiatric variables were not available at the level of micro-regions. We conducted our analysis on aggregate data. Conclusion Our results may draw attention to the relevance and abiding validity of the classic Durkheimian suicide risk factors – such as lack of social integration – apropos of the spatial pattern of Hungarian suicides.