The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Brian Hurwitz - One of the best experts on this subject based on the ideXlab platform.
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topical antibiotics for acute bacterial conjunctivitis cochrane systematic review and meta analysis update
British Journal of General Practice, 2005Co-Authors: Aziz Sheikh, Brian HurwitzAbstract:Background Uncertainty remains about the extent to which findings from our previously published systematic review and meta-analysis of double-blind, randomised controlled trials of topical antibiotics compared with placebo in the management of patients with acute bacterial conjunctivitis treated in secondary care outpatient settings are generalisable to the management of the condition in primary care settings. We updated our review, undertaking searches, methodological assessment, data extraction and analysis according to a pre-Defined Protocol. In addition to the previous three included studies, we identified two additional double-blind primary care trials, one which compares fusidic acid gel with placebo gel and one which compares chloramphenicol eye drops with placebo eye drops in children. Meta-analyses of clinical and microbiological remission data reveal that topical antibiotics are of benefit in improving early (days 2–5) clinical (relative risk [RR] = 1.24, 95% confidence interval [CI] = 1.05 to 1.45) and microbiological (RR = 1.77, 95% CI = 1.23 to 2.54) remission rates; later (days 6–10) data reveal that these early advantages in clinical (RR = 1.11, 95% CI = 1.02 to 1.21) and microbiological cure rates are reduced (RR 1.56, 95% CI = 1.17 to 2.09), but persist. Most cases of acute bacterial conjunctivitis resolve spontaneously. While topical antibiotics are associated with significantly improved rates of early (days 2–5) clinical remission, this benefit is marginal for later remission (days 6–10).
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topical antibiotics for acute bacterial conjunctivitis a systematic review
British Journal of General Practice, 2001Co-Authors: Aziz Sheikh, Brian HurwitzAbstract:There has been uncertainty about whether antibiotic therapy confers significant benefit in the treatment of acute bacterial conjunctivitis. This study aimed to assess the efficacy of antibiotic therapy in the management of acute bacterial conjunctivitis. Using standard Cochrane search methods, we identified double-blind randomised controlled trials in which any form of antibiotic treatment (topical, systemic or combination) had been compared with placebo in the management of acute bacterial conjunctivitis. Data extraction and analysis followed a pre-Defined Protocol. Meta-analysis was performed to obtain summary measures of relative risk. Six published trials were identified, of which three fulfilled the eligibility criteria for inclusion in this review. The trials were heterogeneous in terms of their inclusion and exclusion criteria, the nature of the intervention, and the outcome measures assessed. Meta-analysis indicates that acute bacterial conjunctivitis is frequently a self-limiting condition, as clinical remission occurred by days 2 to 5 in 64% (95% confidence interval (CI) = 57-71) of those treated with placebo. Treatment with antibiotics was, however, associated with significantly better rates of clinical remission (days 2 to 5: relative risk (RR) = 1.31, 95% CI = 1.11-1.55), with a suggestion that this benefit was maintained for late clinical remission (days 6 to 10: RR = 1.27, 95% CI = 1.00-1.61). Acute bacterial conjunctivitis is frequently a self-limiting condition but the use of antibiotics is associated with significantly improved rates of early clinical remission, and early and late microbiological remission. Since trials to date have been conducted in selected specialist care patient populations, generalisation of these results to a primary care-based population should be undertaken with a degree of caution.
Aziz Sheikh - One of the best experts on this subject based on the ideXlab platform.
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topical antibiotics for acute bacterial conjunctivitis cochrane systematic review and meta analysis update
British Journal of General Practice, 2005Co-Authors: Aziz Sheikh, Brian HurwitzAbstract:Background Uncertainty remains about the extent to which findings from our previously published systematic review and meta-analysis of double-blind, randomised controlled trials of topical antibiotics compared with placebo in the management of patients with acute bacterial conjunctivitis treated in secondary care outpatient settings are generalisable to the management of the condition in primary care settings. We updated our review, undertaking searches, methodological assessment, data extraction and analysis according to a pre-Defined Protocol. In addition to the previous three included studies, we identified two additional double-blind primary care trials, one which compares fusidic acid gel with placebo gel and one which compares chloramphenicol eye drops with placebo eye drops in children. Meta-analyses of clinical and microbiological remission data reveal that topical antibiotics are of benefit in improving early (days 2–5) clinical (relative risk [RR] = 1.24, 95% confidence interval [CI] = 1.05 to 1.45) and microbiological (RR = 1.77, 95% CI = 1.23 to 2.54) remission rates; later (days 6–10) data reveal that these early advantages in clinical (RR = 1.11, 95% CI = 1.02 to 1.21) and microbiological cure rates are reduced (RR 1.56, 95% CI = 1.17 to 2.09), but persist. Most cases of acute bacterial conjunctivitis resolve spontaneously. While topical antibiotics are associated with significantly improved rates of early (days 2–5) clinical remission, this benefit is marginal for later remission (days 6–10).
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topical antibiotics for acute bacterial conjunctivitis a systematic review
British Journal of General Practice, 2001Co-Authors: Aziz Sheikh, Brian HurwitzAbstract:There has been uncertainty about whether antibiotic therapy confers significant benefit in the treatment of acute bacterial conjunctivitis. This study aimed to assess the efficacy of antibiotic therapy in the management of acute bacterial conjunctivitis. Using standard Cochrane search methods, we identified double-blind randomised controlled trials in which any form of antibiotic treatment (topical, systemic or combination) had been compared with placebo in the management of acute bacterial conjunctivitis. Data extraction and analysis followed a pre-Defined Protocol. Meta-analysis was performed to obtain summary measures of relative risk. Six published trials were identified, of which three fulfilled the eligibility criteria for inclusion in this review. The trials were heterogeneous in terms of their inclusion and exclusion criteria, the nature of the intervention, and the outcome measures assessed. Meta-analysis indicates that acute bacterial conjunctivitis is frequently a self-limiting condition, as clinical remission occurred by days 2 to 5 in 64% (95% confidence interval (CI) = 57-71) of those treated with placebo. Treatment with antibiotics was, however, associated with significantly better rates of clinical remission (days 2 to 5: relative risk (RR) = 1.31, 95% CI = 1.11-1.55), with a suggestion that this benefit was maintained for late clinical remission (days 6 to 10: RR = 1.27, 95% CI = 1.00-1.61). Acute bacterial conjunctivitis is frequently a self-limiting condition but the use of antibiotics is associated with significantly improved rates of early clinical remission, and early and late microbiological remission. Since trials to date have been conducted in selected specialist care patient populations, generalisation of these results to a primary care-based population should be undertaken with a degree of caution.
Steven M Green - One of the best experts on this subject based on the ideXlab platform.
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intravenous ketamine for pediatric sedation in the emergency department safety profile with 156 cases
Academic Emergency Medicine, 1998Co-Authors: Steven M Green, Steven G Rothrock, Troy Harris, Wayne Garrett, Gary Hopkins, Thomas SherwinAbstract:OBJECTIVES To determine the safety of i.v. ketamine when administered by emergency physicians (EPs) for pediatric procedures, and to contrast the sedation characteristics of the i.v. and i.m. routes. METHODS The study was a retrospective consecutive case series of children aged < or =15 years given i.v. ketamine in the EDs of a university medical center and an affiliated county hospital over a 9-year period. A Protocol for ketamine was used by treating physicians. Records were reviewed for adverse effects, indication, dosing, adjunctive drugs, inadequate sedation, and time to release. Results were contrasted with previously reported data for the i.m. route. RESULTS During the study period i.v. ketamine was administered 156 times, primarily for laceration repair and fracture reduction. Transient apnea and respiratory depression occurred in one patient each; both were quickly identified and were without sequelae. Laryngospasm or aspiration was not noted in any children. There were 6 children with emesis and 2 with mild agitation during recovery. The median time from initial dose to ED release was 103 minutes (25th to 75th percentiles 76 to 146 minutes). The i.v. and i.m. routes were comparable in terms of adverse effects, inadequate sedation, and time to release. CONCLUSION I.v. ketamine can be administered safely by EPs to facilitate pediatric procedures when used in a Defined Protocol. The sedation characteristics of the i.v. and i.m. routes appear comparable.
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intramuscular ketamine for pediatric sedation in the emergency department safety profile in 1 022 cases
Annals of Emergency Medicine, 1998Co-Authors: Steven M Green, Steven G Rothrock, Elizabeth L Lynch, Troy Harris, Rodney Hestdalen, Alan G Hopkins, Wayne Garrett, Kelli WestcottAbstract:Abstract Study objective: To determine the safety of intramuscular ketamine when administered by emergency physicians for pediatric procedures in accordance with a Defined Protocol. Methods: We assembled a consecutive case series of children aged 15 years or younger who were given ketamine in the emergency departments of a university medical center and an affiliated county hospital over a 9-year period. A Protocol for ketamine use (4 mg/kg, intramuscularly) was followed. Treating physicians were instructed to complete data forms recording complications and adequacy of sedation concurrent with patient care. Subsequent chart review was used to determine indications, adjunctive drugs, time to discharge, and adverse reactions for all patients. Results: Intramuscular ketamine was administered 1,022 times, mainly for laceration repair and fracture reduction. Physicians completed data forms for 431 of treated children (42%). Transient airway complications occurred in 1.4%: airway malalignment (n=7), laryngospasm (n=4), apnea (n=2), and respiratory depression (n=1). All were quickly identified and treated without intubation or sequelae. Emesis occurred in 6.7%, without evidence of aspiration. Mild recovery agitation occurred in 17.6%, moderate to severe agitation in 1.6%. No child required hospitalization for complications caused by ketamine. Ketamine produced acceptable sedation in 98% of patients. The median time from injection to emergency department discharge was 110 minutes for children given a single dose of ketamine. Conclusion: Intramuscular ketamine may be administered safely by emergency physicians to facilitate pediatric procedures in accordance with a Defined Protocol and with appropriate monitoring. Ketamine is highly effective, has a wide margin of safety, does not require intravenous access, and uniquely preserves protective airway reflexes. [Green SM, Rothrock SG, Lynch EL, Ho M, Harris T, Hestdalen R, Hopkins GA, Garrett W, Westcott K: Intramuscular ketamine for pediatric sedation in the emergency department: Safety profile in 1,022 cases. Ann Emerg Med June 1998;31:688-697.]
Gang Feng - One of the best experts on this subject based on the ideXlab platform.
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Protocol Function Block Mapping of Software Defined Protocol for 5G Mobile Networks
IEEE Transactions on Mobile Computing, 2018Co-Authors: Gang Feng, Rui Ni, Gang WangAbstract:In this paper, we propose software-Defined Protocol (SDP) technique to facilitate flexible service-oriented Protocol stack deployment for providing high-throughput, low-latency and elastic mobile services based on platform virtualization and functionality modularization. We first elaborate the principle of SDP and then address one of the most important issues in SDP, namely SDP request mapping (SDPM), where an SDP request is fulfilled by mapping a set of required SDP function blocks and virtual links onto underlying SDP servers. We formulate the SDPM problem as a mixed integer programming (MIP). To address the NP-hardness and scalability of SDPM problem, we propose a decomposition algorithm which breaks down the SDPM problem into inter-block link and block mapping problems to accomplish the upper bound (UB) and lower bound (LB) of the MIP solution, respectively. The optimality can be achieved when the UB and the LB converges by using iterations. We employ LTE Layer-2 data-plane processing as a benchmark for validating the effectiveness of the SDP technique and evaluate the performance of SDPM algorithm. Numerical results show that SDP is effective to provide elastic low-latency mobile services and the proposed SDPM algorithm significantly outperforms the benchmark in stack processing delay, mapping cost, and resource utilization.
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Protocol stack mapping of software Defined Protocol for next generation mobile networks
2016 IEEE International Conference on Communications (ICC), 2016Co-Authors: Gang Feng, Wei CaoAbstract:Virtualization of network functions and centralized management are anticipated to provide 5G mobile networks with flexibility, lower end-to-end latency and reduced cost. Based on the concept of emerging Software Defined Network (SDN) and Network Function Virtualization (NFV) techniques, we propose Software Defined Protocol (SDP) technique to facilitate a flexible service-oriented Protocol stack deployment under centralized network control. The design objective of SDP is to provide high-throughput, low-latency and elastic mobile services by making data-plane Protocol programmable. In this paper, we first elaborate the SDP mechanisms and then address one of the most important issues in SDP, namely Protocol stack mapping (PSM). We formulate the PSM problem as a 0-1 quadratic programming for selecting the optimal SDP servers to balance network load. We employ the legacy LTE data-plane processing as a benchmark for validating the effectiveness of the SDP and PSM algorithm. Numerical results show that SDP is effective to provide elastic low-latency mobile services and the proposed PSM algorithm significantly outperforms the benchmark in stack processing delay, mapping cost and resource utilization.
Todd M Valerius - One of the best experts on this subject based on the ideXlab platform.
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nephron organoids derived from human pluripotent stem cells model kidney development and injury
Nature Biotechnology, 2015Co-Authors: Ryuji Morizane, Albert Q Lam, Benjamin S Freedman, Seiji Kishi, Todd M ValeriusAbstract:Kidney cells and tissues derived from human pluripotent stem cells (hPSCs) may enable organ regeneration, disease modeling and drug screening. We report an efficient, chemically Defined Protocol for differentiating hPSCs into multipotent nephron progenitor cells (NPCs) that can form nephron-like structures. By recapitulating metanephric kidney development in vitro, we generate SIX2+ SALL1+ WT1+ PAX2+ NPCs with 90% efficiency within 9 days of differentiation. The NPCs possess the developmental potential of their in vivo counterparts and form PAX8+ LHX1+ renal vesicles that self-organize into nephron structures. In both two- and three-dimensional culture, NPCs form kidney organoids containing epithelial nephron-like structures expressing markers of podocytes, proximal tubules, loops of Henle and distal tubules in an organized, continuous arrangement that resembles the nephron in vivo. We also show that this organoid culture system can be used to study mechanisms of human kidney development and toxicity.
