IntroductionVitamin D deficiency is encountered frequently in critically ill patients and might be harmful. Current nutrition guidelines recommend very low vitamin D doses. The objective of this trial was to evaluate the safety and efficacy of a single oral high-dose vitamin D3 supplementation in an intensive care setting over a one-week observation period.MethodsThis was a randomized, double-blind, placebo-controlled pilot study in a medical ICU at a tertiary care university center in Graz, Austria. Twenty-five patients (mean age 62 ± 16yrs) with vitamin D deficiency [25-hydroxyvitamin D (25(OH)D) ≤20 ng/ml] and an expected stay in the ICU >48 hours were included and randomly received either 540,000 IU (corresponding to 13.5 mg) of cholecalciferol (VITD) dissolved in 45 ml herbal oil or matched placebo (PBO) orally or via feeding tube.ResultsThe mean serum 25(OH)D increase in the intervention group was 25 ng/ml (range 1-47 ng/ml). The highest 25(OH)D level reached was 64 ng/ml, while two patients showed a small (7 ng/ml) or no response (1 ng/ml). Hypercalcemia or hypercalciuria did not occur in any patient. From day 0 to day 7, total serum calcium levels increased by 0.10 (PBO) and 0.15 mmol/L (VITD; P < 0.05 for both), while ionized calcium levels increased by 0.11 (PBO) and 0.05 mmol/L (VITD; P < 0.05 for both). Parathyroid hormone levels decreased by 19 and 28 pg/ml (PBO and VITD, ns) over the seven days, while 1,25(OH)D showed a transient significant increase in the VITD group only.ConclusionsThis pilot study shows that a single oral ultra-high dose of cholecalciferol corrects vitamin D deficiency within 2 days in most patients without causing adverse effects like hypercalcemia or hypercalciuria. Further research is needed to confirm our results and establish whether vitamin D supplementation can affect the clinical outcome of vitamin D deficient critically ill patients.EudraCT Number2009-012080-34German Clinical Trials Register (DRKS)DRKS00000750

Background Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status. Objective The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes. Methods A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components. Results Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD −1.48, 95% CI −2.81 to −0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD −10.62, 95% CI −35.50 to 14.27; P=.40 and standardized MD −0.11, 95% CI −0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component. Conclusions The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450

Background and Purpose-Nontraumatic subarachnoid hemorrhage at the convexity of the brain (cSAH) is an incompletely characterized subtype of nonaneurysmal subarachnoid bleeding. This study sought to systematically describe the clinical presentation, etiology, and long-term outcome in patients with cSAH. Methods-For a 6-year period, we searched our radiological database for patients with nontraumatic nonaneurysmal subarachnoid hemorrhages (nϭ131) seen on CT or MRI. By subsequent image review, we identified 24 patients with cSAH defined by intrasulcal bleeding restricted to the hemispheric convexities. We reviewed their medical records, analyzed the neuroimaging studies, and followed up patients by telephone or a clinical visit. Results-The 24 patients with cSAH had a mean age of 70 years (range, 37-88 years), 20 (83%) were Ͼ60 years, and 13 (54%) were women. Patients often presented with transient sensory and/or motor symptoms (nϭ10 [42%]) and seizures (nϭ5 [21%]), whereas headaches typical of subarachnoid hemorrhage were rare (nϭ4 [17%]). MRI provided evidence for prior bleedings in 11 patients (microbleeds in 10 and parenchymal bleeds in 5) with a bleeding pattern suggestive of cerebral amyloid angiopathy in 5 subjects. At follow-up (after a mean of 33 months), 14 patients (64%) had an unfavorable outcome (modified Rankin scale score 3-6), including 5 deaths. We did not observe recurrent cSAH. Conclusions-Our data suggest that cSAH often presents with features not typical for subarachnoid bleeding. In the elderly, cSAH is frequently associated with bleeding-prone conditions such as cerebral amyloid angiopathy. Recurrence of cSAH is rare but the condition itself is a marker of poor prognosis. (Stroke. 2011;42:3055-3060.)

Organization have to deal with a plethora of IT security threats nowadays and to ensure smooth and uninterrupted business operations, firms are challenged to predict the volume of IT security vulnerabilities and to allocate resources for fixing them. This challenge requires decision makers to assess which system or software packages are prone to vulnerabilities, what impact exploits might have, and how many vulnerabilities can be expected to occur during a certain period of time. The academic literature has increasingly drawn attention to the need for predicting IT security vulnerabilities.However, only limited research has addressed the problem of forecasting IT security vulnerabilities based on time series that deal with the specific properties of IT security vulnerabilities, i.e., rareness of occurrence and high volatility. To address this shortcoming, we apply established methods which are capable of forecasting events characterized by rareness of occurrence and high volatility. Based on a dataset taken from the National Vulnerability Database (NVD), we use the Mean Absolute Error (MAE) and Root Mean Square Error (RMSE) to measure the forecasting accuracy of single, double and triple exponential smoothing methodologies, Croston's method, ARIMA, and a neural network-based approach. We analyze the impact of the applied forecasting methodology on the prediction accuracy with regard to its robustness along the dimensions of the examined system and software packages "operating systems", "browsers" and "office solutions" and the applied metrics.To the best of our knowledge, this study is the first that analyzes the effect of prediction techniques and applies forecasting metrics that are suitable in this context. Our results show that the optimal forecasting methodology depends on the software or system package as some methods perform poorly in the context of IT security vulnerabilities, that absolute metrics can cover the actual prediction error precisely and that the prediction accuracy is robust within the two applied forecasting-error metrics.

Artificial intelligence (AI) is beginning to transform traditional research practices in many areas. In this context, literature reviews stand out because they operate on large and rapidly growing volumes of documents, that is, partially structured (meta)data, and pervade almost every type of paper published in information systems research or related social science disciplines. To familiarize researchers with some of the recent trends in this area, we outline how AI can expedite individual steps of the literature review process. Considering that the use of AI in this context is in an early stage of development, we propose a comprehensive research agenda for AI-based literature reviews (AILRs) in our field. With this agenda, we would like to encourage design science research and a broader constructive discourse on shaping the future of AILRs in research.

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