Application of ASTER Data for Differentiating Carbonate Minerals and Evaluating MgO Content of Magnesite in the Jiao-Liao-Ji Belt, North China Craton

Numerous reports have successfully detected or differentiated carbonate minerals such as calcite and dolomite by using the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER). However, there is a need to determine whether existing methods can differentiate magnesite from other carbonate minerals. This study proposes optimal band ratio combinations and new thresholds to distinguish magnesite, dolomite, and calcite using ASTER shortwave-infrared (SWIR) data. These were determined based on the spectral and chemical analysis of rock samples collected from Liaoning, China and Danchon, North Korea and the reflectance values from ASTER images. The results demonstrated that the simultaneous use of thresholds 2.13 and 2.015 for relative absorption band depths (RBDs) of (6 + 8)/7 and (7 + 9)/8, respectively, was the most effective for magnesite differentiation. The use of RBDs and band ratios to discriminate between dolomite and calcite was sufficiently effective. However, talc, tremolite, clay, and their mixtures with dolomite and calcite, which are commonly found in the study area, hampered the classification. The assessment of the ASTER band ratios for magnesite grade according to magnesium oxide content indicated that a band ratio of 5/6 was the most effective for this purpose. Therefore, this study proved that ASTER SWIR data can be effectively utilized for the identification and grade assessment of magnesite on a regional scale.

The effect of chemotherapy on the complication rates of implant and free flap breast reconstruction: A Systematic Review

Purpose This study investigated the impact of chemotherapy on complication rates of implant and free flap breast reconstruction. The effect of timing and dosage of chemotherapy in minimizing the breast reconstruction surgery (BRS) complications were also investigated. Methods PRISMA guidelines were used to search relevant studies published from January 2009 to September 2021. Quality of selected studies were assessed using GRADE assessment and risk of bias was performed using Cochrane Collaboration’s tool and ROBINS-I. Rates of major and minor complications of neoadjuvant systemic therapy (NST) and adjuvant systemic therapy (AST) were compared by t-test using GraphPad Prism v.9.3.0 and P value <0.05 was considered statistically significant. Results A total of 19 studies comprising 49,217 patients were included. The GRADE assessment showed low risk of bias and good quality across studies. Three-hundred and twenty patients had implant reconstruction, 3,172 had flap reconstruction and 46,062 had both flap and implant reconstruction surgery. There was no significant difference in complication rates of patients between flap reconstruction surgery and implants. (P=0.4) In all studies, total complication rates for post-chemotherapy BRS patients was 46.03% compared to 32.49% without chemotherapy (P=0.09). Overall major complications rate was 14.5% (P=0.61) with NST and 21.1% (P=0.69) with AST. Minor complications rate was 28.8% (P=0.97) with NST and 39.5% (P=0.59) with AST. Complication rate of NST was lower than AST, but not statistically significant (P=0.64). No significant correlation was found between timing/duration of chemotherapy and rates of BRS complications (P=0.76). Conclusion No significant difference in BRS complications with and without chemotherapy was established. Despite these results suggesting little difference between NST and AST or chemotherapy in BRS complications, prospective control studies are currently limited, and more are necessary to better inform surgeons and their patients.

Invisible ECG for High Throughput Screening in eSports

eSports is a rapidly growing industry with increasing investment and large-scale international tournaments offering significant prizes. This has led to an increased focus on individual and team performance with factors such as communication, concentration, and team intelligence identified as important to success. Over a similar period of time, personal physiological monitoring technologies have become commonplace with clinical grade assessment available across a range of parameters that have evidenced utility. The use of physiological data to assess concentration is an area of growing interest in eSports. However, body-worn devices, typically used for physiological data collection, may constitute a distraction and/or discomfort for the subjects. To this end, in this work we devise a novel “invisible” sensing approach, exploring new materials, and proposing a proof-of-concept data collection system in the form of a keyboard armrest and mouse. These enable measurements as an extension of the interaction with the computer. In order to evaluate the proposed approach, measurements were performed using our system and a gold standard device, involving 7 healthy subjects. A particularly advantageous characteristic of our setup is the use of conductive nappa leather, as it preserves the standard look and feel of the keyboard and mouse. According to the results obtained, this approach shows 3–15% signal loss, with a mean difference in heart rate between the reference and experimental device of −1.778 ± 4.654 beats per minute (BPM); in terms of ECG waveform morphology, the best cases show a Pearson correlation coefficient above 0.99.

Symptomatic fever management in children: A systematic review of national and international guidelines

Introduction Divergent attitudes towards fever have led to a high level of inconsistency in approaches to its management. In an attempt to overcome this, clinical practice guidelines (CPGs) for the symptomatic management of fever in children have been produced by several healthcare organizations. To date, a comprehensive assessment of the evidence level of the recommendations made in these CPGs has not been carried out. Methods Searches were conducted on Pubmed, google scholar, pediatric society websites and guideline databases to locate CPGs from each country (with date coverage from January 1995 to September 2020). Rather than assessing overall guideline quality, the level of evidence for each recommendation was evaluated according to criteria of the Oxford Centre for Evidence-Based Medicine (OCEBM). A GRADE assessment was undertaken to assess the body of evidence related to a single question: the threshold for initiating antipyresis. Methods and results are reported according to the PRISMA statement. Results 74 guidelines were retrieved. Recommendations for antipyretic threshold, type and dose; ambient temperature; dress/covering; activity; fluids; nutrition; proctoclysis; external applications; complementary/herbal recommendations; media; and age-related treatment differences all varied widely. OCEBM evidence levels for most recommendations were low (Level 3–4) or indeterminable. The GRADE assessment revealed a very low level of evidence for a threshold for antipyresis. Conclusion There is no recommendation on which all guidelines agree, and many are inconsistent with the evidence–this is true even for recent guidelines. The threshold question is of fundamental importance and has not yet been answered. Guidelines for the most frequent intervention (antipyresis) remain problematic.

The association between silica exposure, silicosis and tuberculosis: a systematic review and meta-analysis

Background While the association between occupational inhalation of silica dust and pulmonary tuberculosis has been known for over a century, there has never been a published systematic review, particularly of experience in the current era of less severe silicosis and treatable tuberculosis. We undertook a systematic review of the evidence for the association between (1) silicosis and pulmonary tuberculosis, and (2) silica exposure and pulmonary tuberculosis controlling for silicosis, and their respective exposure-response gradients. Methods We searched PUBMED and EMBASE, and selected studies according to a priori inclusion criteria. We extracted, summarised and pooled the results of published case-control and cohort studies of silica exposure and/or silicosis and incident active tuberculosis. Study quality was assessed on the Newcastle-Ottawa Scale. Where meta-analysis was possible, effect estimates were pooled using inverse-variance weighted random-effects models. Otherwise narrative and graphic synthesis was undertaken. Confidence regarding overall effect estimates was assessed using the GRADE schema. Results Nine studies met the inclusion criteria. Meta-analysis of eight studies of silicosis and tuberculosis yielded a pooled relative risk of 4.01 (95% confidence interval (CI) 2.88, 5.58). Exposure-response gradients were strong with a low silicosis severity threshold for increased risk. Our GRADE assessment was high confidence in a strong association. Meta-analysis of five studies of silica exposure controlling for or excluding silicosis yielded a pooled relative risk of 1.92 (95% CI 1.36, 2.73). Exposure-response gradients were observable in individual studies but not finely stratified enough to infer an exposure threshold. Our GRADE assessment was low confidence in the estimated effect owing to inconsistency and use of proxies for silica exposure. Conclusions The evidence is robust for a strongly elevated risk of tuberculosis with radiological silicosis, with a low disease severity threshold. The effect estimate is more uncertain for silica exposure without radiological silicosis. Research is needed, particularly cohort studies measuring silica exposure in different settings, to characterise the effect more accurately as well as the silica exposure threshold that could be used to prevent excess tuberculosis risk.

O1 Admission avoidance in tonsillitis and peritonsillar abscess: a prospective national audit during the initial peak of the COVID-19 pandemic

Introduction During the COVID-19 outbreak, the collaborative network for ENT trainees in the UK (INTEGRATE), conducted a multi-centre prospective audit on the management of Tonsillitis and Quinsy. This was in response to the implementation of new COVID-19 specific guidelines released by ENT UK and to explore factors relating to unscheduled re-presentations discharges direct from the Emergency Department (ED). Methods Consecutive patients with suspected tonsillitis or quinsy, aged 18 or over, and referred to ENT in secondary care were eligible for inclusion. Data was collected, using a standardised electronic case report form, relating to patient demographics, COVID-19 status, clinicians’ grade, assessment and interventions. Each case was followed-up for 10 days to assess predictors of unscheduled re-presentation after discharge direct from the ED. Results 83 centres submitted 765 tonsillitis and 416 quinsy cases. 54.4% of tonsillitis cases and 45.3% of quinsy were discharged directly from the ED. 9.6% of tonsillitis and 10.3% of quinsy discharges re-presented within 10 days, compared to 9.7% and 10.6% for those initially admitted. IV steroids were given to 67.0% of tonsillitis patients and 73.6% of quinsy. 77.2% of quinsy patients underwent drainage during their initial presentation, but there was no significant difference in re-presentation rate in those drained vs not-drained (p = 0.85). Univariable logistic regression showed no significant predictors of re-presentation within 10 days. Conclusion Management of tonsillitis and quinsy was affected during the initial peak of the pandemic, with a shift towards outpatient care. Some patients who may previously have been admitted to hospital may be safely discharged from the ED.