摘要： We describe six teenagers presenting with fever and severe abdominal symptoms admitted with concerns for multisystem inflammatory syndrome in children (MIS-C). Laboratory evaluation revealed elevated markers of inflammation, lymphopenia, and increased D-dimers. Imaging studies revealed multifocal airspace disease and ground-glass opacities. SARS-CoV-2 polymerase chain reaction and serologies were negative. All patients reported a history of vaping, prompting E-cigarette, or vaping, product use-associated lung injury (EVALI) diagnosis. MIS-C has overlapping clinical and laboratory features highlighting the added challenge of diagnosing EVALI during the COVID-19 pandemic. Keywords COVID-19 pandemic, EVALI, MIS-C

关键词： Qubit   Logic gates   Computer architecture   Couplings   Computers   Coupling graph   IBM QX architecture   quantum architecture  

摘要： Noisy intermediate scale quantum (NISQ) computers are becoming a reality thanks to the recent advances made by researchers who physically build such systems. In order to execute corresponding quantum algorithms (usually provided in terms of quantum circuits), certain physical constraints in the architectures need to be satisfied. More precisely, physical constraints restrict the possible interactions between qubits which frequently result in cases where qubits which are supposed to interact in a quantum circuit are not allowed to interact on the physical device. Thus far, this is addressed by dedicated methods that map the logical quantum circuit to a physical realization and satisfy the constraints by inserting further operations. This leads to additional costs which harm the fidelity of the circuit and, hence, urgently need to be avoided. Unfortunately, current state-of-the-art approaches for this mapping process take the existing architectures as invariant and only try to reduce the number of additionally needed operations. In contrast, (slight) changes in the, respectively, given architectures (which still keep the underlying physical constraints satisfied) might be possible and may allow for even better (i.e., less costly) mappings. But this potential has not been investigated yet. In this work, we explore this potential. More precisely, we introduce several schemes for generating alternative coupling graphs (and, by this, quantum computing architectures) that still might be able to satisfy physical constraints but, at the same time, allow for a more efficient realization of the desired quantum functionality. Evaluations confirm the potential of those alternative coupling graphs and demonstrate that they can reduce the mapping overhead by up to 60% in the best case and up to almost 40% on average.

关键词： hospital quality   performance measurement   quality of care   quality performance  

摘要： Background: Hospital performance comparisons for transparency initiatives may be inadequate if peer comparison groups are poorly defined. Objective: The objective of this study was to evaluate a new approach identifying hospital peers for comparison. Design/Setting: We used Mahalanobis distance as a new method of developing peer-specific groupings for hospitals to incorporate both external and internal complexity. We compared the overlap in groups with an existing method used by the Veterans' Health Administration's Office for Productivity, Efficiency, and Staffing (OPES). Participants: One hundred twenty-two acute-care Veterans' Health Administration's Medical Facilities as defined in the OPES fiscal year 2014 report. Measures: Using 15 variables in 9 categories developed from expert input, including both hospital internal measures and community-based external measures, we used principal components analysis and calculated Mahalanobis distance between each hospital pair. This method accounts for correlation between variables and allows for variables having different variances. We identified the 50 closest hospitals, then eliminated any potential peer whose score on the first component was >1 SD from the reference hospital. We compared overlap with OPES measures. Results: Of 15 variables, 12 have SDs exceeding 25% of their means. The first 2 components of our analysis explain 24.8% and 18.5% of variation among hospitals. Eight of 9 variables scaling positively on the first component measure internal complexity, aligning with OPES groups. Four of 5 variables scaling positively on the second component but not the first are factors from the policy environment;this component reflects a dimension not considered in OPES groups. Conclusion: Individualized peers that incorporate external complexity generate more nuanced comparators to evaluate quality.

关键词： hydraulic conductivity function   unsaturated soil   volumetric water content  

摘要： The simplified evaporation method (SEM) is frequently used for the determination of the hydraulic conductivity function (HCF) of the unsaturated soil. Usually, the mass of soil samples during evaporation is often monitored to calculate the flux. However, the balance is sensitive to the external conditions, such as the tensiometers connected by the cables to transmit data, and the cable will have a disturbing effect on the balance. In this study, a series of laboratory tests were conducted to obtain the hydraulic conductivity function of six kinds of soils, which texture ranged from sand to silty clay by using the alternative simplified evaporation method (ASEM) that reduces the sensitivity of the external environment brought by the balance. The volumetric water content near the centre depth was monitored by the soil moisture sensor, and the change of flux during evaporation was calculated by the volumetric water content. At the same time, for comparison, the mass was monitored during the evaporation process, and the mass of evaporated water was used to calculate the flux (SEM). The HCF obtained by the ASEM was consistent with that obtained by the SEM.

关键词： Enchytraeid   Potworms   Counting juveniles   Time optimization   Soil toxicity  

摘要： Soil toxicity tests are commonly applied using Enchytraeus crypticus to analyze reproductive outputs. However, the traditional method for counting potworms takes a long time due to the significant number of offspring. This paper compares the conventional total counting of E. crypticus juveniles (M1) and an alternative methodology (M2). The proposed methodology (M2) uses a simple random counting method (1/4) for the partial counting of juveniles and total estimation. Chronic bioassays (21 days of exposure) were performed in tropical artificial soil (TAS) using sugarcane vinasse as a hazardous substance. Comparing the final density of juveniles recorded in M1 and M2, no statistical differences were pointed out in either one. Applying analyses based on effective concentration (EC10 and EC50), no statistical differences were identified there either. The t-test showed that there was no statistical difference between the counting methods (M1 and M2) in each treatment (control and dilutions). Moreover, we ran the Tukey test for M1 and M2 methods separately and observed that 100 % of the vinasse showed a statistical difference compared to the control treatment in both (p <= 0.05), affirming that independent of the counting method, the ecotoxicological outputs were similar. Therefore, the proposed alternative is a suitable method for bioassay using. E. crypticus in tropical artificial soil, decreasing to 1/4 the total time required for counting.

关键词： androgen antagonists   pharmacovigilance   prostatic neoplasms  

摘要： Purpose: The comparative cardiovascular risk profiles of available hormone therapies for the treatment of prostate cancer is not *** and Methods: We queried the U.S. Food and Drug Administration Adverse Event Reporting System, a retrospective, pharmacovigilance database, for cardiovascular adverse event reports in men with prostate cancer receiving gonadotropin releasing hormone (GnRH) agonists, GnRH antagonists, androgen receptor antagonists, and/or androgen synthesis inhibitors from January 2000 to April ***: Cardiovascular adverse events accounted for 6,231 reports (12.6%) on hormone monotherapy and 1,793 reports (26.1%) on combination therapy. Arterial vascular events were reported most commonly, followed by arrhythmias, heart failure, and venous thromboembolism. Compared to GnRH agonists, GnRH antagonists were associated with fewer cardiovascular adverse event reports as monotherapy (adjusted reporting odds ratio [ROR]=0.70 [95% CI 0.59-0.84], p <0.001) and as combination therapy (ROR=0.47 [0.34-0.67], p <0.0001), driven by reductions in arterial vascular events. Second generation androgen receptor antagonists and abiraterone were associated with more reports of hypertension requiring hospitalization (ROR=1.21 [1.03-1.41], p=0.02 and ROR=1.19 [1.01-1.40], p=0.03, respectively), and more heart failure events when used in combination with GnRH antagonists (ROR=2.79 [1.30-6.01], p=0.009 and ROR=2.57 [1.12-5.86], p=0.03).Conclusions: In this retrospective analysis of a pharmacovigilance database, arterial vascular events were the most commonly reported cardiovascular adverse events in men on hormone therapy for prostate cancer. GnRH antagonists were associated with fewer reports of overall cardiovascular events and arterial vascular events than GnRH agonists. Additional study is needed to identify optimal strategies to reduce cardiovascular morbidity among men with prostate cancer receiving hormone therapy.(C) 2021 by the American Urological As

关键词： Alternative livelihoods   Community based management   Ecosystem service valuation   J-curve   Marine protected areas   Meiofauna   Active acoustics  

摘要： Widespread overharvest has led to marine ecosystem degradation and declining fishery catches in many tropical communities. To allow stocks to recover and provide increased flows of food and income, reductions in fishing effort are necessary. The development of Alternative Income Generating Activities can help to reduce the economic reliance of coastal communities on fishing, potentially reducing pressure on fish stocks. Here we assess the local conditions which have enabled the creation of Alternative Income Generating Activities to fishing based on marine ecotourism in Moalboal, Philippines. Importantly, while marine ecotourism typically centers around charismatic megafauna, a combination of nearshore fringing reefs, the establishment of nearshore marine protected areas and the occurrence of a consistently large herring aggregation provide a large tourism draw to this community. Using a combination of regional and local economic statistics and stakeholder surveys, we implement an economic valuation of Moalboal marine ecotourism for 2018 and compare this valuation to an independent estimate of the extractive value of the herring aggregation. The Moalboal case indicates that a combination of strong community engagement in the governance of the ecotourism resource, a network of locally managed marine protected areas and the retention and distribution of economic benefits within the local community have led to a significant marine ecotourism sector. We contextualize these conditions into a set of potential enabling conditions for marine ecotourism as an Alternative Income Generating Activity to fishing to contribute insights to diversifying livelihood opportunities beyond extractive fishing for coastal communities in the tropics.

关键词： Hypericin-P123   Photodynamic therapy   Onychomycosis   Fusarium spp   Molecular phylogenetics  

摘要： Background Fusarium has been considered an opportunistic pathogen, causing several infections in humans, including onychomycosis. In addition, a high resistance to conventional antifungals has been linked to this genus. Photodynamic Therapy (PDT), known as a non-invasive therapy, can be an alternative treatment for fungal infections, based on the excitation of a photosensitizing compound (PS) by a specific length of light, causing damage to the target. The aim of this study was to evaluate the effects of a formulation of Hypericin (Hyp) encapsulated in PluronicTM (P123), via photodynamic therapy (PDT), on planktonic cells and biofilms in Fusarium spp. using in vitro and ex vivo assays. Materials & Methods epidemiology studies about Fusarium spp. in onychomycosis was perfomed, carried out molecular identification, compared the antifungal activity of the conventional antifungals with PDT with encapsulated Hypericin (Hyp-P123), carried out detection of reactive oxygen species, and measured the antibiofilm effect of the Hyp-P123-PDT in vitro and in an ex vivo model of onychomycosis. Results Hyp-P123-PDT exhibited a fungicidal effect in vitro with reductions >= 3 log10. ROS generation increased post-Hyp-P123-PDT in Fusarium spp. Hyp-P123-PDT showed a potent inhibitory effect on adhesion-phase and mature biofilms in vitro tests and an ex vivo model of onychomycosis (p<0.0001). Conclusion Hyp-P123-PDT had a potent effect against Fusarium spp., suggesting that photodynamic therapy with Hyp-P123 is a safe and promising treatment for onychomycosis in clinical practice.

关键词： COVID-19   Antigen rapid test   RT-PCR  

摘要： Introduction: In the current standard of care (SoC) RT-PCR method for COVID-19, the patient's swab was extracted in viral transport media (VTM). For the PanbioTM COVID-19 Ag Rapid Test, the patient swab is flushed out in extraction buffer, of which a small fraction is used for testing, leaving more than half the sample unused. This study was designed to show that RT-PCR results from the residual sample of the PanbioTM COVID-19 Ag Rapid Test (called Novel RT-PCR) are not worse than the SoC RT-PCR result. Methods: The study was performed using (1) dilution series of five patient samples, and (2) 413 patient samples comparing SOC versus Novel RT-PCR results. Results: For the dilution series samples, all tested positive by both methods. The bias between Ct values of Novel RT-PCR and SoC RT-PCR did not exceed 3.00 Ct using primers N1 and N2. A total of 413 COVID symptomatic patients seeking COVID testing were tested, of which 89 patients tested positive and 324 tested negative with SoC RT-PCR. In 324 patients who tested negative with SoC RT-PCR, 323 tested negative with Novel RT-PCR, and one (1) tested positive. Out of 89 who tested positive with SoC RT-PCR, 80 tested positive with the Novel RT-PCR, and nine patients showed a negative test result. The Overall Percent Agreement for the 413 valid patient sample pairs was 97.5 [95% CI 97 to 98]. Conclusion: The study demonstrated that the performance of the Novel RT-PCR method is acceptable compared to the SoC RT-PCR method and can be a useful tool to perform RTPCR without the need for new swab collections. (C) 2021 Sociedade Brasileira de Infectologia. Published by Elsevier Espana, S.L.U.