Project description:Informed by a series of systematic reviews, scoping reviews and evidence updates from the International Liaison Committee on Resuscitation, the 2021 European Resuscitation Council Guidelines present the most up to date evidence-based guidelines for the practice of resuscitation across Europe. The guidelines cover the epidemiology of cardiac arrest; the role that systems play in saving lives, adult basic life support, adult advanced life support, resuscitation in special circumstances, post resuscitation care, first aid, neonatal life support, paediatric life support, ethics and education.
Project description:Radiation therapy is an effective cancer treatment that is constantly being transformed by technological innovation. Dedicated devices for fraction-by-fraction imaging and guidance within the treatment room have enabled image guided radiation therapy (IGRT) allowing clinicians to pursue highly conformal dose distributions, higher dose prescriptions, and shorter fractionation schedules. Capitalizing on IGRT-enabled accuracy and precision requires a strong link between IGRT practices and planning target volume (PTV) design. This is clearly central to high quality, safe radiation therapy. Failure to properly apply IGRT methods or to coordinate their use with an appropriate PTV margin can result in a treatment that is 'precisely wrong'. The white paper summarized in this executive summary recommends foundational elements and specific activities to maximize the safety and effectiveness of IGRT.
Project description:MotivationPolygenic scores (PGS) aim to genetically predict complex traits at an individual level. PGS are typically trained on genome-wide association summary statistics and require an independent test dataset to tune parameters. More recent methods allow parameters to be tuned on the training data, removing the need for independent test data, but approaches are computationally intensive. Based on fine-mapping principles, we present RápidoPGS, a flexible and fast method to compute PGS requiring summary-level GWAS datasets only, with little computational requirements and no test data required for parameter tuning.ResultsWe show that RápidoPGS performs slightly less well than two out of three other widely-used PGS methods (LDpred2, PRScs, and SBayesR) for case-control datasets, with median r2 difference: -0.0092, -0.0042, and 0.0064, respectively, but up to 17,000-fold faster with reduced computational requirements. RápidoPGS is implemented in R and can work with user-supplied summary statistics or download them from the GWAS catalog.AvailabilityOur method is available with a GPL license as an R package from CRAN and GitHub.Supplementary informationSupplementary data are available at Bioinformatics online.
Project description:The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: 1) researchers; 2) research culture, environment, and infrastructure; 3) funding; 4) partnerships; and 5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report (see Additional File 1).
Project description:We developed an open-access, Excel-based model simulating currently recommended and alternative algorithms for adult HIV testing as a preliminary investigation of trade-offs between accuracy and costs. Despite higher costs, simpler HIV testing algorithms incorporating point of care nucleic acid testing may improve outcomes and thus merit additional research and field testing.
Project description:This report is part of a series of white papers commissioned for the American Society for Radiation Oncology (ASTRO) Board of Directors as part of ASTRO's Target Safely Campaign, focusing on the role of peer review as an important component of a broad safety/quality assurance (QA) program. Peer review is one of the most effective means for assuring the quality of qualitative, and potentially controversial, patient-specific decisions in radiation oncology. This report summarizes many of the areas throughout radiation therapy that may benefit from the application of peer review. Each radiation oncology facility should evaluate the issues raised and develop improved ways to apply the concept of peer review to its individual process and workflow. This might consist of a daily multidisciplinary (eg, physicians, dosimetrists, physicists, therapists) meeting to review patients being considered for, or undergoing planning for, radiation therapy (eg, intention to treat and target delineation), as well as meetings to review patients already under treatment (eg, adequacy of image guidance). This report is intended to clarify and broaden the understanding of radiation oncology professionals regarding the meaning, roles, benefits, and targets for peer review as a routine quality assurance tool. It is hoped that this work will be a catalyst for further investigation, development, and study of the efficacy of peer review techniques and how these efforts can help improve the safety and quality of our treatments.
Project description:BackgroundPeople experiencing homelessness who live in congregate shelters are at high risk of SARS-CoV2 transmission and severe COVID-19. Current screening and response protocols using rRT-PCR in homeless shelters are expensive, require specialized staff and have delays in returning results and implementing responses.MethodsWe piloted a program to offer frequent, rapid antigen-based tests (BinaxNOW) to residents and staff of congregate-living shelters in San Francisco, California, from January 15th to February 19th, 2021. We used the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework to evaluate the implementation.ResultsReach: We offered testing at ten of twelve eligible shelters. Shelter residents and staff had variable participation across shelters; approximately half of eligible individuals tested at least once; few tested consistently during the study. Effectiveness: 2.2% of participants tested positive. We identified three outbreaks, but none exceeded 5 cases. All BinaxNOW-positive participants were isolated or left the shelters. Adoption: We offered testing to all eligible participants within weeks of the project's initiation. Implementation: Adaptations made to increase reach and improve consistency were promptly implemented. Maintenance: San Francisco Department of Public Health expanded and maintained testing with minimal support after the end of the pilot.ConclusionRapid and frequent antigen testing for SARS-CoV2 in homeless shelters is a viable alternative to rRT-PCR testing that can lead to immediate isolation of infectious individuals. Using the RE-AIM framework, we evaluated and adapted interventions to enable the expansion and maintenance of protocols.
Project description:Software Test Case Prioritization (TCP) is an effective approach for regression testing to tackle time and budget constraints. The major benefit of TCP is to save time through the prioritization of important test cases first. Existing TCP techniques can be categorized as value-neutral and value-based approaches. In a value-based fashion, the cost of test cases and severity of faults are considered whereas, in a value-neutral fashion these are not considered. The value-neutral fashion is dominant over value-based fashion, and it assumes that all test cases have equal cost and all software faults have equal severity. But this assumption rarely holds in practice. Therefore, value-neutral TCP techniques are prone to produce unsatisfactory results. To overcome this research gap, a paradigm shift is required from value-neutral to value-based TCP techniques. Currently, very limited work is done in a value-based fashion and to the best of the authors' knowledge, no comprehensive review of value-based cost-cognizant TCP techniques is available in the literature. To address this problem, a systematic literature review (SLR) of value-based cost-cognizant TCP techniques is presented in this paper. The core objective of this study is to combine the overall knowledge related to value-based cost-cognizant TCP techniques and to highlight some open research problems of this domain. Initially, 165 papers were reviewed from the prominent research repositories. Among these 165 papers, 21 papers were selected by using defined inclusion/exclusion criteria and quality assessment procedures. The established questions are answered through a thorough analysis of the selected papers by comparing their research contributions in terms of the algorithm used, the performance evaluation metric, and the results validation method used. Total 12 papers used an algorithm for their technique but 9 papers didn't use any algorithm. Particle Swarm Optimization (PSO) Algorithm is dominantly used. For results validation, 4 methods are used including, Empirical study, Experiment, Case study, and Industrial case study. The experiment method is dominantly used. Total 6 performance evaluation metrics are used and the APFDc metric is dominantly used. This SLR yields that value-orientation and cost cognition are vital in the TCP process to achieve its intended goals and there is great research potential in this research domain.
Project description:ObjectiveTo develop formal consensus-based guidance for the management of myasthenia gravis (MG).MethodsIn October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness methodology was used to develop consensus guidance statements. Definitions were developed for goals of treatment, minimal manifestations, remission, ocular MG, impending crisis, crisis, and refractory MG. An in-person panel meeting then determined 7 treatment topics to be addressed. Initial guidance statements were developed from literature summaries. Three rounds of anonymous e-mail votes were used to attain consensus on guidance statements modified on the basis of panel input.ResultsGuidance statements were developed for symptomatic and immunosuppressive treatments, IV immunoglobulin and plasma exchange, management of impending and manifest myasthenic crisis, thymectomy, juvenile MG, MG associated with antibodies to muscle-specific tyrosine kinase, and MG in pregnancy.ConclusionThis is an international formal consensus of MG experts intended to be a guide for clinicians caring for patients with MG worldwide.