Brown University

About: Brown University is a education organization based out in Providence, Rhode Island, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 35778 authors who have published 90896 publications receiving 4471489 citations. The organization is also known as: brown.edu & Brown.

The impact of diabetes on tuberculosis treatment outcomes: A systematic review

Abstract: Background: Multiple studies of tuberculosis treatment have indicated that patients with diabetes mellitus may experience poor outcomes. We performed a systematic review and meta-analysis to quantitatively summarize evidence for the impact of diabetes on tuberculosis outcomes. Methods: We searched PubMed, EMBASE and the World Health Organization Regional Indexes from 1 January 1980 to 31 December 2010 and references of relevant articles for reports of observational studies that included people with diabetes treated for tuberculosis. We reviewed the full text of 742 papers and included 33 studies of which 9 reported culture conversion at two to three months, 12 reported the combined outcome of failure and death, 23 reported death, 4 reported death adjusted for age and other potential confounding factors, 5 reported relapse, and 4 reported drug resistant recurrent tuberculosis. Results: Diabetes is associated with an increased risk of failure and death during tuberculosis treatment. Patients with diabetes have a risk ratio (RR) for the combined outcome of failure and death of 1.69 (95% CI, 1.36 to 2.12). The RR of death during tuberculosis treatment among the 23 unadjusted studies is 1.89 (95% CI, 1.52 to 2.36), and this increased to an effect estimate of 4.95 (95% CI, 2.69 to 9.10) among the 4 studies that adjusted for age and other potential confounding factors. Diabetes is also associated with an increased risk of relapse (RR, 3.89; 95% CI, 2.43 to 6.23). We did not find evidence for an increased risk of tuberculosis recurrence with drug resistant strains among people with diabetes. The studies assessing sputum culture conversion after two to three months of tuberculosis therapy were heterogeneous with relative risks that ranged from 0.79 to 3.25. Conclusions: Diabetes increases the risk of failure and death combined, death, and relapse among patients with tuberculosis. This study highlights a need for increased attention to treatment of tuberculosis in people with diabetes, which may include testing for suspected diabetes, improved glucose control, and increased clinical and therapeutic monitoring.

Robust Localization in Reverberant Rooms

Abstract: Talker localization with microphone arrays has received significant attention lately as a means for the automated tracking of individuals in an enclosure and as a necessary component of any general purpose speech capture system. Several algorithmic approaches are available for speech source localization with multi-channel data. This chapter summarizes the current field and comments on the general merits and shortcomings of each genre. A new localization method is then presented in detail. By utilizing key features of existing methods, this new algorithm is shown to be significantly more robust to acoustical conditions, particularly reverberation effects, than the traditional localization techniques in use today.

The 8 requirements of real-time stream processing

Abstract: Applications that require real-time processing of high-volume data steams are pushing the limits of traditional data processing infrastructures. These stream-based applications include market feed processing and electronic trading on Wall Street, network and infrastructure monitoring, fraud detection, and command and control in military environments. Furthermore, as the "sea change" caused by cheap micro-sensor technology takes hold, we expect to see everything of material significance on the planet get "sensor-tagged" and report its state or location in real time. This sensorization of the real world will lead to a "green field" of novel monitoring and control applications with high-volume and low-latency processing requirements.Recently, several technologies have emerged---including off-the-shelf stream processing engines---specifically to address the challenges of processing high-volume, real-time data without requiring the use of custom code. At the same time, some existing software technologies, such as main memory DBMSs and rule engines, are also being "repurposed" by marketing departments to address these applications.In this paper, we outline eight requirements that a system software should meet to excel at a variety of real-time stream processing applications. Our goal is to provide high-level guidance to information technologists so that they will know what to look for when evaluation alternative stream processing solutions. As such, this paper serves a purpose comparable to the requirements papers in relational DBMSs and on-line analytical processing. We also briefly review alternative system software technologies in the context of our requirements.The paper attempts to be vendor neutral, so no specific commercial products are mentioned.

Screening for obesity in children and adolescents us preventive services task force recommendation statement

Abstract: Importance Based on year 2000 Centers for Disease Control and Prevention growth charts, approximately 17% of children and adolescents aged 2 to 19 years in the United States have obesity, and almost 32% of children and adolescents are overweight or have obesity. Obesity in children and adolescents is associated with morbidity such as mental health and psychological issues, asthma, obstructive sleep apnea, orthopedic problems, and adverse cardiovascular and metabolic outcomes (eg, high blood pressure, abnormal lipid levels, and insulin resistance). Children and adolescents may also experience teasing and bullying behaviors based on their weight. Obesity in childhood and adolescence may continue into adulthood and lead to adverse cardiovascular outcomes or other obesity-related morbidity, such as type 2 diabetes. Subpopulation Considerations Although the overall rate of child and adolescent obesity has stabilized over the last decade after increasing steadily for 3 decades, obesity rates continue to increase in certain populations, such as African American girls and Hispanic boys. These racial/ethnic differences in obesity prevalence are likely a result of both genetic and nongenetic factors (eg, socioeconomic status, intake of sugar-sweetened beverages and fast food, and having a television in the bedroom). Objective To update the 2010 US Preventive Services Task Force (USPSTF) recommendation on screening for obesity in children 6 years and older. Evidence Review The USPSTF reviewed the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Findings Comprehensive, intensive behavioral interventions (≥26 contact hours) in children and adolescents 6 years and older who have obesity can result in improvements in weight status for up to 12 months; there is inadequate evidence regarding the effectiveness of less intensive interventions. The harms of behavioral interventions can be bounded as small to none, and the harms of screening are minimal. Therefore, the USPSTF concluded with moderate certainty that screening for obesity in children and adolescents 6 years and older is of moderate net benefit. Conclusions and Recommendation The USPSTF recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)