manage

Importing ODF to vManager does not update vplan

I exported vplan to .odf file in vManager and after editing it I imported it to vManager. The vplan was expected to be synchronized and updated. However, nothing has changed to it. Does anyone know why?




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Using Vmanager Pre-Script to launch a timed script

I would like to send an update about a vmanager regression status x days after the regression has been run. In the current environment, the vmanager regression is creating a new filepath for logs automatically based on regression name/date, so I can't use a cron job to gather logs, as the log location is not known. 


I tried to use the pre session script to launch a detached shell script that would run after a delay, but when the pre_script runs, it waits until everything is completed before finishing and moving on to starting the regression.

Here is the test pre_script I am using:

#!/bin/sh

echo "pre_script start"

delay_script "FIRST" 1
nohup delay_script "SECOND" 30 & disown
delay_script "THIRD" 1

echo "pre_script end"
exit 0

Here is the test delay_script I am using:

#!/bin/sh

echo "Starting $1"

sleep $2

echo "Ending $1"

Here is the script output when run from terminal. After the "pre_script end", I get control back.

Here is the script output when run from vmanager. There is no "nohup", and the pre_session phase doesn't complete until all the delay scripts complete.


My question is, is there a better way to achieve my goal here? (The goal being to run a script from the vmanager log directory automatically x days after the regression). I think I could use the pre_script to send directory information for an auxiliary cron job to pick up, but I would prefer to not have to have extra cronjobs needed for this.




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vManager crashes when analyzing multiple sessions simultaneously with a fatal error detected by the Java Runtime Environment

When analyzing multiple sessions simultaneously Verisium Manager crashed and reported below error messages:

# A fatal error has been detected by the Java Runtime Environment:
#
#  SIGSEGV (0xb) at pc=0x00007efc52861b74, pid=14182, tid=18380
#
# JRE version: OpenJDK Runtime Environment Temurin-17.0.3+7 (17.0.3+7) (build 17.0.3+7)
# Java VM: OpenJDK 64-Bit Server VM Temurin-17.0.3+7 (17.0.3+7, mixed mode, sharing, tiered, compressed oops, compressed class ptrs, g1 gc, linux-amd64)
# Problematic frame:
# C  [libucis.so+0x238b74]

......

For more details please refer to the attached log file "hs_err_pid21143.log".

Two approaches were tried to solve this problem but neither has worked.
Method.1:

Setting larger heap size of Java process by "-memlimit" options.For example "vmanager -memlimit 8G".

Method.2:

Enlarging stack memory size limit of the Coverage engine by setting "IMC_NATIVE_STACKSIZE" environment variable to a larger value. For example "setenv IMC_NATIVE_STACKSIZE 1024000"

According to "hs_err_pid*.log" it is almost certain that the memory overflow triggered Java's CrashOnOutOfMemoryError and caused Verisium Manager to crash. There are some arguments about memory management of Java like "Xms, Xmx, ThreadStackSize, Xss5048k etc" and maybe this problem can be fixed by setting these arguments during analysis. However, how exactly does Verisium Manager specify these arguments during analysis? I tried to set them by the form of setting environment variables before analysis but it didn't work in analysis and their values didn't change.

Is there something wrong with my operation or is there a better solution?

Thank you very much.




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Collecting Coverage using Vmanager

Hi, 

I am running a regression in order to collect the coverage. However I have an issue. I am setting a signal to 0 when reset is de-asserted  then this signal takes a fixed value when the reset is asserted. 

if(!rst_n) 
init_val= 'b0;

else 

init_val31'h34013FF7

the issue is that I got 0%  coverage for the init_value since we only have a rising edge and the signal is not toggling during the simulation. is there an option to collect coverage when there is a rising edge or a falling edge? 




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Using vManager to identify line coverage from a specific test

I have been using the rank feature to identify tests that are redundant in our environment, but then I realized I'd also like to be able to see exactly what coverage goes into increasing the delta_cov value for a given test. If I had a test in my rank report that contributed 0.5% of the delta_cov, how could I got about seeing exactly where that 0.5% was coming from? It seems like that might be part of the correlate function, but I couldn't mange to find a way to see what specific coverage was being contributed for a given test.




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AllegroX. ConstraintManager: how to define an exemption inside a SPACING RULE ?

Hi

I have fixed a SPACING RULE (SP1) for a CLASS_DIFF_PAIR whereas for via associated to the net (DP_VIA), the DISTANCE > 60mils respect to ANY other vias (PTH, BB, TEST vias)

Now my problem is that this rules should NOT be applied for GND VIAS (STICHING VIA) which must be placed at a distance < 40mils respect to DP_VIA

How to create an exemption to the SPACING RULE (SP1)?




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Unlocking the Concepts of IEEE 1801 Standard for Efficient Power Management

Power efficiency is a critical factor in the fast-evolving world of semiconductor design.

The IEEE 1801 standard, also known as UPF (Unified Power Format), was developed by the IEEE to address the intricate challenges associated with power management in contemporary semiconductor designs. This standard offers a uniform framework for defining power domains, power states, and power intent, ensuring consistency across diverse tools and phases of the design process. By utilizing UPF, you can precisely model and regulate power consumption, a critical aspect for battery-operated devices, high-performance computing, and energy-efficient designs.

The key concepts of IEEE 1801 are:

  1. Power domains
  2. Power states
  3. Power gating and isolation
  4. Power switches
  5. Level shifters, isolation, and retention cells
  6. Macro model

Based on these building blocks, you write the power intent of the design.

The power intent for the design includes identifying/implementing low-power strategies that provide a clear description of the power architecture of a design.

The power definitions can effectively manage power consumption and ensure the chip meets its power and performance requirements.

You can start by creating the Power Supply Network, which defines how power is supplied to the design's various power domains and logic cells.

What's the next step to build the file? How do you understand the various concepts related to IEEE 1801? How do you complete the rest of the power intent file?

Relax!

Gear up to attend the training class created just for you to dive deep into the entire format and explore this exciting power specification method/format with hands-on labs in one day!

Training

Fundamentals of IEEE 1801 Low-Power Specification Format Training

This course is a complete tutorial for understanding the fundamentals of IEEE 1801 low-power specification format concepts. You learn about IEEE 1801 power supply networks, ground ports and nets, creating and connecting supply ports/nets, power domain, power switch, power states, defining isolation and level shifter strategies, hierarchical IEEE 1801, and various versions of the IEEE 1801. You also explore how power intent information can be used for a design across various flow stages, such as functional verification, synthesis, logic equivalency checking, place-and-route, test, timing signoff, power integrity, and so forth, using Cadence® tools.

Labs

We ensure that your learning journey is smooth with hands-on labs covering various design scenarios.

Lab Videos

Now, the exciting part is that to help you further, we have created engaging videos of the training labs. You can refer to the lab module's instructions in demo format at https://support.cadence.com.

Lab DemoChecking Power Supply Network in IEEE 1801 format and Running IEEE 1801 Quality Checks using Conformal Low Power

Lab Demo: Checking Power Intent for The Macro Connections in IEEE 1801 Format And Running IEEE 1801 Quality Checks using Conformal Low Power 

Online Class

Here is the course link.

Get ready for the most thrilling experience with Accelerated Learning!

The more you know, the faster you go!

Grab the cycle  or hike it, based on your existing knowledge.

Take the quiz and increase your learning pace!!

What's Next?

Grab your Badge after finishing the training and flaunt the expertise you have built up. 😊

Ready to take a tour of this power specification world? Let's help you enroll in this course.

We organize this training for you as a "Blended" or "Live" training. Please reach out to Cadence Training for further information. If you want to ensure you are always the first to know about anything new in training, you can use the SUBSCRIBE button on the landing page to sign up for our regular training newsletters.

Related Short Training Bytes/Videos

Enhance the learning experience with short videos:

Genus Synthesis Solution: Video Library

 Joules RTL Power Solution: Video Library

Related Training

 Low-Power Synthesis Flow with Genus Synthesis Solution

Genus Low-Power Synthesis Flow with IEEE 1801

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Binge on Chip Design Concepts this Weekend! - Digital Design - Cadence Blogs - Cadence Community




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Samruk-Kazyna manager looks to diversify portfolio

Kazakhstan’s sovereign wealth fund, Samruk-Kazyna, will invest domestically and internationally to diversify its portfolio and increase its value, claims Lyazzat Borankulova, the fund’s managing director for strategic development. 




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The Warming Arctic Requires Precautionary Management

The Warming Arctic Requires Precautionary Management The Warming Arctic Requires Precautionary Management

stanfords

Web Article

Recent online articles and analysis that have been published on the East-West Center website.

Explore

Web Article

Recent online articles and analysis that have been published on the East-West Center website.

Explore




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Abiodun promises prudent resource management

Ogun State Governor, Dapo Abiodun, on Tuesday, said his administration is committed to pursuing fiscal responsibility, through public financial management reforms. This, he said, is to build strong institutions that will promote accountability and transparency. Abiodun made the commitment in Abeokuta during the Treasury Board Meeting on Year 2025-2027 Medium Term Expenditure Framework and the


Read More




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Pay back the money, court orders Nelson Mandela Bay ex-managers




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Letter: Holding ex-managers accountable for irregular spending




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FCMB attains ISO Certification for Quality Management

Leading financial services provider, First City Monument Bank (FCMB), has been awarded the prestigious International Organisation for Standardisation (ISO) 9001:2015 certificate for Quality Management System. The Bank was presented with the certificate by the Standards Organisation of Nigeria (SON), following a comprehensive audit and evaluation exercise conducted by the Organisation. The exercise covered departments and […]

FCMB attains ISO Certification for Quality Management




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Sedibeng mayor accuses municipal manager of smear campaign




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Financial mismanagement: Gauteng Health Department’s R743 million debt to suppliers




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Japan's 7-Eleven reportedly considering management buyout of up to $58B

TOKYO, Japan — Japan’s Seven & i Holdings 3382.T is considering launching a management buyout that would see the retailer go private in a deal that could be worth up to $58 billion, Bloomberg News reported on Wednesday. The Nikkei newspaper also reported that the owner of the 7-Eleven convenience store chain was looking at […]...

Keep on reading: Japan's 7-Eleven reportedly considering management buyout of up to $58B




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2024 Asian Regional Forum on Investment Management of Foreign Exchange Reserves - Roberta Casali

Opening remarks by Roberta Casali, ADB Vice-President for Finance and Risk Management, at the 2024 Asian Regional Forum on Investment Management of Foreign Exchange Reserves, 25 September 2024, Japan




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Asian Impact Webinar 80: Statistical Data and Metadata eXchange for Enhanced Data Management

Decision makers need to analyze, exchange, and disseminate statistical information effectively in today’s data-driven world. See how Statistical Data and Metadata eXchange (SDMX) standards are helping create robust data links across the globe.




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Associate IT Officer (Technology Operations Governance and Service Management)

ADB has a vacancy for the position of Associate IT Officer (Technology Operations Governance and Service Management) in the Information Technology Department . The deadline for submitting applications is on 19-NOV-2024.




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Asian Development Blog: Four Ways to Strengthen Public Financial Management Systems and Drive Reform

Public financial management systems in Asia and the Pacific face significant challenges, with many indicators falling short of international standards. Fixing these issues requires a strategic, transparent, and carefully timed approach to reform.




manage

Asian Development Blog: Five Ways to Strengthen Public Financial Management Systems and Drive Reform

Public financial management systems in Asia and the Pacific face significant challenges, with many indicators falling short of international standards. Fixing these issues requires a strategic, transparent, and carefully timed approach to reform.




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Development Asia: Designing a Comprehensive Public Financial Management Reform Plan for the Philippines




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to write a project management report

to write a project management report




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asset manager manuals

asset manager manuals




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Climate-Resilient Fiscal Management: Experience from Southeast Asia

This report considers how finance and planning ministries can respond strategically to climate risk, highlighting best practices from Southeast Asia and identifying crosscutting priorities.




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2940-PRC: Hubei Huangshi Urban Pollution Control and Environmental Management Project[LR-C01-1 Ci lake dredging part 1 Bid No.: 0703-1520CIC1J602]




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2970/L8262-CAM: GMS Flood and Drought Risk Management and Mitigation Project[CAM2-ICB-W02- Upgrading of Damnak Chheukrom Irrigation System Main Canal]




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Loan No. 2492/2493-UZB (SF): Water Resources Management Sector Project [WRMSP/ICB/03]




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Public Financial Management Project 3rd Additional Financing




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Capacity Development for Climate Mitigative Water Management Technology

The technical assistance (TA), which will be approved with the proposed Integrated Water Resources Management Project, will help the Ministry of Water Resources and Meteorology: (i) implement one of the activities of output 2 (para 6), (ii) inform rice farmers about and train them to implement innovative climate mitigative water management technology, and (iii) disseminate this innovative AWD technology to the entire country. The TA project's demonstration activities are expected to reduce emissions by 11,750 tons of carbon dioxide equivalent.




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Digital Agriculture Management for Improved Food Security Project




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Preparing the Babeldaob Island Urban Resilience Project (formerly Strengthening Urban Planning and Management)

For approval in 2023.




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Indigenous Australians have managed land with fire for 11,000 years

Lake sediments reveal the ancient history of Aboriginal people’s use of fire to manage the landscape, a tradition that has benefits for biodiversity




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Health Tip: Manage Stress to Keep Diabetes in Check

Title: Health Tip: Manage Stress to Keep Diabetes in Check
Category: Health News
Created: 8/25/2014 7:35:00 AM
Last Editorial Review: 8/25/2014 12:00:00 AM




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Pain Management

Title: Pain Management
Category: Diseases and Conditions
Created: 12/7/2006 12:00:00 AM
Last Editorial Review: 7/28/2022 12:00:00 AM




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Cholesterol Management

Title: Cholesterol Management
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 7/6/2022 12:00:00 AM




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How to Manage Menopause Symptoms After Breast Cancer

Title: How to Manage Menopause Symptoms After Breast Cancer
Category: Diseases and Conditions
Created: 7/7/2022 12:00:00 AM
Last Editorial Review: 7/7/2022 12:00:00 AM




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Evidence-based management of symptoms in serious respiratory illness: what is in our toolbox?

Extract

Living with a respiratory illness requires patients to manage a wide range of symptoms, many of which will worsen as a disease progresses. Breathlessness is a hallmark feature of respiratory conditions, occurring in almost all individuals with COPD and interstitial lung disease (ILD) [1, 2]. Cough is present in 78% of people with ILD and is frequently distressing, with physical, social and emotional impacts [1, 3].




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Patient-managed interventions for adults with bronchiectasis: evidence, challenges and prospects

Bronchiectasis is a chronic lung condition which is characterised by recurrent chest infections, chronic sputum production and cough, and limited exercise tolerance. While bronchiectasis may be caused by various aetiologies, these features are shared by most patients with bronchiectasis regardless of the cause. This review consolidates the existing evidence on patient-managed interventions for adults with bronchiectasis, while also outlining areas for future research. Airway clearance techniques and hyperosmolar agents are key components of the bronchiectasis management and consistently recommended for clinical implementation. Questions around their prescription, such as optimal sequence of delivery, are still to be answered. Pulmonary rehabilitation and exercise are also recommended for patients with bronchiectasis. Relatively strong evidence underpins this recommendation during a clinically stable stage of the disease, although the role of pulmonary rehabilitation following an exacerbation is still unclear. Additionally, self-management programmes feature prominently in bronchiectasis treatment, yet the lack of consensus regarding their definition and outcomes presents hurdles to establishing a cohesive evidence base. Moreover, cough, a cardinal symptom of bronchiectasis, warrants closer examination. Although managing cough in bronchiectasis may initially appear risky, further research is necessary to ascertain whether strategies employed in other respiratory conditions can be safely and effectively adapted to bronchiectasis, particularly through identifying patient responder populations and criteria where cough may not enhance airway clearance efficacy and its control is needed. Overall, there is a growing recognition of the importance of patient-managed interventions in the bronchiectasis management. Efforts to improve research methodologies and increase research funding are needed to further advance our understanding of these interventions, and their role in optimising patient care and outcomes.




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Cannabis and Pain Management

Family physicians are fielding questions about cannabis --particularly for the use of cannabis for treatment of pain. Like about every substance ingested to treat medical conditions, cannabis has risks and benefits. But regarding evidence-based practice and practice-based recommendations for patients about cannabis use, the cart is in front of the horse. Cannabis use is still illegal at a federal level and a Schedule 1 drug, but most states have challenged federal law by decriminalizing or legalizing cannabis for a variety of uses. Research is difficult due to this federal status as a Schedule 1 drug since federal funding is not readily available to support research. As a result, physicians have little to no guidance about the clinical usefulness of the product. This article explores what we know and what we are learning about cannabis, and the authors provide clinical guidance for patient care based on this evidence.




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Be SMART About Asthma Management: Single Maintenance and Reliever Therapy

Single maintenance and reliever therapy (SMART) is an asthma treatment approach that utilizes combined inhaled corticosteroids and long-acting β-agonists for maintenance and quick relief therapy. Despite the evidence for its benefits in asthma treatment and its adoption into American and international asthma guidelines and recommendations, SMART remains a practice of some debate. This article reviews the available evidence for SMART and offers guidance for its integration into comprehensive asthma management. Overall, short-acting β-agonist-only asthma therapy regimens should be avoided, regardless of condition severity (SOR A Recommendation). Family medicine clinicians should start SMART for patients requiring either GINA Step 3 or 4 therapy, especially if they have signs of poor adherence (SOR B Recommendation). Finally, use budesonide-formoterol over other inhaled corticosteroid/long-acting β-agonist combinations when implementing SMART (SOR B Recommendation).




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Assessing Patient Readiness for Hospital Discharge, Discharge Communication, and Transitional Care Management

Background:

Discharge communication between hospitalists and primary care clinicians is essential to improve care coordination, minimize adverse events, and decrease unplanned health services use. Health-related social needs are key drivers of health, and hospitalists and primary care clinicians value communicating social needs at discharge.

Objective:

To 1) characterize the current state of discharge communications between an academic medical center hospital and primary care clinicians at associated clinics; 2) seek feedback about the potential usefulness of discharge readiness information to primary care clinicians.

Design:

Exploratory, convergent mixed methods.

Participants:

Primary care clinicians from Family Medicine and General Internal Medicine of an academic medical center in the US Intermountain West.

Approach:

Literature-informed REDCap survey. Semistructured interview guide developed with key informants, grounded in current literature. Survey data were descriptively summarized; interview data were deductively and inductively coded, organized by topics.

Results:

Two key topics emerged: 1) discharge communication, with interrelated topics of transitional care management and follow-up appointment challenges, and recommendations for improving discharge communication; and 2) usefulness of the discharge readiness information, included interrelated topics related to lack of shared understanding about roles and responsibilities across settings and ethical concerns related to identifying problems that may not have solutions.

Conclusions:

While reiterating perennial discharge communication and transitional care management challenges, this study reveals new evidence about how these issues are interrelated with assessing and responding to patients’ lack of readiness for discharge and unmet social needs during care transitions. Primary care clinicians had mixed views on the usefulness of discharge readiness information. We offer recommendations for improving discharge communication and transitional care management (TCM) processes, which may be applicable in other care settings.




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A Review of Artificial Intelligence and Machine Learning in Product Life Cycle Management

The pursuit of harnessing data for knowledge creation has been an enduring quest, with the advent of machine learning (ML) and artificial intelligence (AI) marking significant milestones in this journey. ML, a subset of AI, emerged as the practice of employing mathematical models to enable computers to learn and improve autonomously based on their experiences. In the pharmaceutical and biopharmaceutical sectors, a significant portion of manufacturing data remains untapped or insufficient for practical use. Recognizing the potential advantages of leveraging the available data for process design and optimization, manufacturers face the daunting challenge of data utilization. Diverse proprietary data formats and parallel data generation systems compound the complexity. The transition to Pharma 4.0 necessitates a paradigm shift in data capture, storage, and accessibility for manufacturing and process operations. This paper highlights the pivotal role of AI in converting process data into actionable knowledge to support critical functions throughout the whole product life cycle. Furthermore, it underscores the importance of maintaining compliance with data integrity guidelines, as mandated by regulatory bodies globally. Embracing AI-driven transformations is a crucial step toward shaping the future of the pharmaceutical industry, ensuring its competitiveness and resilience in an evolving landscape.




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A worldwide perspective of long COVID management: how can we END-COVID?

Extract

As of 15 May 2024, >775 million confirmed cases of COVID-19 and >7 million deaths have been reported to the World Health Organization [1]. Although most patients with COVID-19 survive, survivors are at risk of long COVID, the sequelae of the viral infection affecting multiple organ systems [2]. Long COVID poses a substantial burden to individuals and society, even with a conservative estimate of 10% prevalence among COVID-19 survivors [3–5]. However, as the symptoms of long COVID vary substantially, ranging from respiratory symptoms, such as dyspnoea and cough, to fatigue and cognitive impairment [6], developing a standard set of investigations and management protocols for patients with long COVID is challenging.




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A worldwide look into long COVID-19 management: an END-COVID survey

Background

Long COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide.

Methods

A survey-based study investigating long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS) END-COVID clinical research collaboration with the support of other international societies (ALAT, APSR, CHEST, ESCMID and PATS). A global analysis of the results is provided here, alongside sub-population analysis based on continents, national income levels, type of involved healthcare professional and inclusion or exclusion of paediatric patients.

Findings

1015 healthcare professionals from 110 different countries worldwide participated in this study, the majority of them being respiratory physicians (60.6%). A dedicated long COVID programme was present in 55.4% of the investigated institutions, with hospital admission during the acute infection being the main inclusion criteria to access them. Consistent differences in long COVID-related procedures were identified among centres, mainly regarding the multidisciplinary approach, the availability of telemedicine and psychological support, the type of requested exams and the total amount of visits in the centre.

Interpretation

Long COVID management shows important differences related to geographical areas and national income levels. SOPs were significantly different when centres were managed by a pulmonologist or when paediatric patients were included.




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Multidisciplinary management of adult patients with chylothorax: a consensus statement

The management of chylothorax remains challenging given the limited evidence and significant heterogeneity in practice. In addition, there are no practical guidelines on the optimal approach to manage this complex condition. We convened an international group of 27 experts from 20 institutions across five countries and four specialties (pulmonary, interventional radiology, thoracic surgery and nutrition) with experience and expertise in managing adult patients with chylothorax. We performed a literature and internet search for reports addressing seven clinically relevant PICO (Patient, Intervention, Comparison and Outcome) questions pertaining to the management of adult patients with chylothorax. This consensus statement, consisting of best practice statements based on expert consensus addressing these seven PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with provider experience. Panel members participated in the development of the final best practice statements using the modified Delphi technique. Our consensus statement aims to offer guidance in clinical decision making when managing patients with chylothorax while also identifying gaps in knowledge and informing future research.




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Reassessing Halm's clinical stability criteria in community-acquired pneumonia management

Background

Halm's clinical stability criteria have long guided antibiotic treatment and hospital discharge decisions for patients hospitalised with community-acquired pneumonia (CAP). Originally introduced in 1998, these criteria were established based on a relatively small and select patient population. Consequently, our study aims to reassess their applicability in the management of CAP in a contemporary real-world setting.

Methods

This cohort study included 2918 immunocompetent patients hospitalised with CAP from three hospitals in Denmark between 2017 and 2020. The primary outcome was time to achieve clinical stability as defined by Halm's criteria. Additionally, we examined recurrence of clinical instability and severe complications. Cumulative incidence function or Kaplan–Meier survival curves were used to analyse these outcomes, considering competing risks.

Results

The study population primarily comprised elderly individuals (median age 75 years) with significant comorbidities. The median time to clinical stability according to Halm's criteria was 4 days, with one-fifth experiencing recurrence of instability after early clinical response (stability within 3 days). Severe complications within 30 days mainly comprised mortality, with rates of 5.1% (64/1257) overall in those with early clinical response, 1.7% (18/1045) in the subgroup without do-not-resuscitate orders and 17.3% (276/1595) among the rest.

Conclusion

Halm's clinical stability criteria effectively classify CAP patients with different disease courses, yet achieving stability required more time in this ageing population with substantial comorbidities and more severe disease. Early clinical response indicates reduced risk of complications, especially in those without do-not-resuscitate orders.




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Impact of 18F-FES PET/CT on Clinical Decisions in the Management of Recurrent or Metastatic Breast Cancer

The clinical impact of 16α-18F-fluoro-17β-estradiol (18F-FES) PET/CT on patient management has not been well investigated. The aim of this study was to assess the clinical impact of 18F-FES PET/CT on the management of patients with recurrent or metastatic breast cancer. Methods: Study subjects were identified retrospectively from a database of a prospective trial for postmarketing surveillance of 18F-FES between 2021 and 2023. Patients who were suspected or known to have recurrent or metastatic estrogen receptor–positive breast cancer based on a routine standard workup were included. Planned management before and actual management after 18F-FES PET/CT were assessed by 2 experienced medical oncologists via medical chart review. A 5-point questionnaire was provided to evaluate the value of 18F-FES PET/CT for management planning. The rate of intention-to-treat and interdisciplinary changes, and the impact of 18F-FES PET/CT according to PET/CT result or clinical indication, were examined. Results: Of the 344 included patients, 120 (35%) experienced a change in management after 18F-FES PET/CT. In 139 (40%) patients,18F-FES PET/CT supported the existing management decision without a change in management. Intention-to-treat and interdisciplinary changes accounted for 64% (77/120) and 68% (82/120) of all changes, respectively. A higher rate of change was observed when lesions were 18F-FES–negative (44% [36/81]) than 18F-FES–positive (30% [51/172]) or mixed 18F-FES–positive/negative (36% [33/91]). Regarding clinical indications, the highest rate of change was shown when evaluating the origins of metastasis of double primary cancers (64% [9/14]). Conclusion: 18F-FES PET/CT modified the management of recurrent or metastatic breast cancer, serving as an impactful imaging modality in clinical practice.




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Is the Clinical Application of CXCR4 Imaging in the Diagnosis and Management of Primary Aldosteronism Really Happening?




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Weight management with orlistat in type 2 diabetes: an electronic health records study

BackgroundOrlistat is recommended as an adjunct to diet and exercise for weight loss in the treatment of type 2 diabetes mellitus (T2DM).AimTo explore associations between patient characteristics and orlistat prescribing, and to determine associations of orlistat with weight loss in T2DM and prediabetes.Design and settingCohort study using anonymised health records from a UK database of general practice.MethodThe UK Clinical Practice Research Datalink (CPRD) Aurum database was searched to compile a cohort of patients aged ≥18 years, first diagnosed with T2DM or prediabetes in 2016 or 2017. Once the data had been collated, multivariable logistic regression models were used to determine associations with starting orlistat and stopping it early (<12 weeks of prescriptions) and orlistat’s associations with weight loss in those who had not been prescribed second-line antidiabetic medications.ResultsOut of 100 552 patients with incident T2DM or prediabetes, 655 (0.8%) patients with T2DM and 128 (0.7%) patients with prediabetes were prescribed orlistat. Younger people, females, those in areas of deprivation, current smokers, those coprescribed metformin, and those recorded as having hypertension were statistically significantly more likely to be prescribed orlistat; higher baseline glycated haemoglobin levels were associated with early stopping. In comparison with patients not on orlistat, those who continued using it for ≥12 weeks were more likely to lose ≥5% weight (adjusted odds ratio [AOR] 1.69, 95% confidence interval [CI] = 1.07 to 2.67) but those who stopped orlistat early were less likely to lose ≥5% weight (AOR 0.56, 95% CI = 0.29 to 1.09).ConclusionOrlistat was significantly associated with weight loss in patients with T2DM and prediabetes when taken for at least 12 weeks; however, it was infrequently prescribed and often taken for <12 weeks. Orlistat may be a useful adjunct to lifestyle modifications for patients with T2DM and prediabetes, but barriers to continued use means it may not be effective for everyone in managing weight loss.