Pervasive and intelligent decision support in Intensive Medicine – the complete picture

Series : Lecture notes in computer science (LNCS), vol. 8649In the Intensive Care Units (ICU) it is notorious the high number of data sources available. This situation brings more complexity to the way of how a professional makes a decision based on information provided by those data sources. Normally, the decisions are based on empirical knowledge and common sense. Often, they don’t make use of the information provided by the ICU data sources, due to the difficulty in understanding them. To overcome these constraints an integrated and pervasive system called INTCare has been deployed. This paper is focused in presenting the system architecture and the knowledge obtained by each one of the decision modules: Patient Vital Signs, Critical Events, ICU Medical Scores and Ensemble Data Mining. This system is able to make hourly predictions in terms of organ failure and outcome. High values of sensitivity where reached, e.g. 97.95% for the cardiovascular system, 99.77% for the outcome. In addition, the system is prepared for tracking patients’ critical events and for evaluating medical scores automatically and in real-time.(undefined

An associative memory of Hodgkin-Huxley neuron networks with Willshaw-type synaptic couplings

An associative memory has been discussed of neural networks consisting of spiking N (=100) Hodgkin-Huxley (HH) neurons with time-delayed couplings, which memorize P patterns in their synaptic weights. In addition to excitatory synapses whose strengths are modified after the Willshaw-type learning rule with the 0/1 code for quiescent/active states, the network includes uniform inhibitory synapses which are introduced to reduce cross-talk noises. Our simulations of the HH neuron network for the noise-free state have shown to yield a fairly good performance with the storage capacity of $\alpha_c = P_{\rm max}/N \sim 0.4 - 2.4$ for the low neuron activity of $f \sim 0.04-0.10$. This storage capacity of our temporal-code network is comparable to that of the rate-code model with the Willshaw-type synapses. Our HH neuron network is realized not to be vulnerable to the distribution of time delays in couplings. The variability of interspace interval (ISI) of output spike trains in the process of retrieving stored patterns is also discussed.Comment: 15 pages, 3 figures, changed Titl

Reduced functional measure of cardiovascular reserve predicts admission to critical care unit following kidney transplantation

Background: There is currently no effective preoperative assessment for patients undergoing kidney transplantation that is able to identify those at high perioperative risk requiring admission to critical care unit (CCU). We sought to determine if functional measures of cardiovascular reserve, in particular the anaerobic threshold (VO2AT) could identify these patients. Methods: Adult patients were assessed within 4 weeks prior to kidney transplantation in a University hospital with a 37-bed CCU, between April 2010 and June 2012. Cardiopulmonary exercise testing (CPET), echocardiography and arterial applanation tonometry were performed. Results: There were 70 participants (age 41.7614.5 years, 60% male, 91.4% living donor kidney recipients, 23.4% were desensitized). 14 patients (20%) required escalation of care from the ward to CCU following transplantation. Reduced anaerobic threshold (VO2AT) was the most significant predictor, independently (OR = 0.43; 95% CI 0.27–0.68; p,0.001) and in the multivariate logistic regression analysis (adjusted OR = 0.26; 95% CI 0.12–0.59; p = 0.001). The area under the receiveroperating- characteristic curve was 0.93, based on a risk prediction model that incorporated VO2AT, body mass index and desensitization status. Neither echocardiographic nor measures of aortic compliance were significantly associated with CCU admission. Conclusions: To our knowledge, this is the first prospective observational study to demonstrate the usefulness of CPET as a preoperative risk stratification tool for patients undergoing kidney transplantation. The study suggests that VO2AT has the potential to predict perioperative morbidity in kidney transplant recipients

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

US Cosmic Visions: New Ideas in Dark Matter 2017: Community Report

This white paper summarizes the workshop "U.S. Cosmic Visions: New Ideas in Dark Matter" held at University of Maryland on March 23-25, 2017.Comment: 102 pages + reference

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Physical mixing effects on iron biogeochemical cycling: FeCycle experiment

The effects of physical processes on the distribution, speciation, and sources/sinks for Fe in a high-nutrient low-chlorophyll (HNLC) region were assessed during FeCycle, a mesoscale SF6 tracer release during February 2003 (austral summer) to the SE of New Zealand. Physical mixing processes were prevalent during FeCycle with rapid patch growth (strain rate γ = 0.17–0.20 d−1) from a circular shape (50 km2) into a long filament of ∼400 km2 by day 10. Slippage between layers saw the patch-head overlying noninfused waters while the tail was capped by adjacent surface waters resulting in a SF6 maximum at depth. As the patch developed it entrained adjacent waters containing higher chlorophyll concentrations, but similar dissolved iron (DFe) levels, than the initial infused patch. DFe was low ∼60 pmol L−1 in surface waters during FeCycle and was dominated by organic complexation. Nighttime measurements of Fe(II) ∼20 pmol L−1 suggest the presence of Fe(II) organic complexes in the absence of an identifiable fast Fe(III) reduction process. Combining residence times and phytoplankton uptake fluxes for DFe it is cycled through the biota 140–280 times before leaving the winter mixed layer (WML). This strong Fe demand throughout the euphotic zone coupled with the low Fe:NO3 − (11.9 μmol:mol) below the ferricline suggests that vertical diffusion of Fe is insufficient to relieve chronic iron limitation, indicating the importance of atmospheric inputs of Fe to this region

Anthropogenic influence on sediment transport in the Whittard Canyon, NE Atlantic

Unusual peaks in turbidity were detected in two branches of the Whittard Canyon in June 2013. Enhanced nepheloid layers (ENLs) were defined as layers with concentrations of suspended particulate matter exceeding those of nepheloid layers typically observed in a given region. Here, ENLs had peaks in turbidity and elevated suspended particulate matter concentrations exceeding ~1 mg L−1 with the largest ENLs measuring between ~2–8mg L−1. The ENLs measured ~100–260m in vertical height and were detected inwater depths of between 640 and 2880 m. Vessel Monitoring System data showed that high spatial and temporal activity of potential bottom trawling vessels coincided with the occurrence of the ENLs. Molar C/N ratios of the suspended organic material from the ENLs showed a high degree of degradation. Regular occurrences of such events are likely to have implications for increased sediment fluxes, burial of organic carbon and alteration of benthic and canyon ecosystems

US Cosmic Visions: New Ideas in Dark Matter 2017: Community Report

This white paper summarizes the workshop "U.S. Cosmic Visions: New Ideas in Dark Matter" held at University of Maryland on March 23-25, 2017

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics