Wireless charging dock with low frequency speaker

High quality audio playback requires faithful reproduction of low, middle, and high frequency portions of audio. Low frequency sound playback on small devices such as mobile phones is difficult because of the relatively small size of the transducers used and other constraints. This disclosure describes a charging stand with a built-in speaker that receives and plays low frequency portion of audio from a phone coupled to the stand. The speakers in the phone are utilized for playback of other portions of the audio. Low frequency audio content is obtained using a low pass filter on the phone and is sent via a wireless link, such as Bluetooth or NFC. This provides is a less expensive mechanism for audio playback than speakers or stands that reproduce the entire frequency range of audio

High-flow nasal cannulae for respiratory support in adult intensive care patients

Background High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). Objectives We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of Science, proceedings from four conferences, and clinical trials registries; and we handsearched reference lists of relevant studies. We conducted searches from January 2000 to March 2016 and reran the searches in December 2016. We added four new studies of potential interest to a list of ‘Studies awaiting classification' and will incorporate them into formal review findings during the review update. Selection criteria We included randomized controlled studies with a parallel or cross-over design comparing HFNC use in adult ICU patients versus other forms of non-invasive respiratory support (low-flow oxygen via nasal cannulae or mask, continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP)). Data collection and analysis Two review authors independently assessed studies for inclusion, extracted data, and assessed risk of bias. Main results We included 11 studies with 1972 participants. Participants in six studies had respiratory failure, and in five studies required oxygen therapy after extubation. Ten studies compared HFNC versus low-flow oxygen devices; one of these also compared HFNC versus CPAP, and another compared HFNC versus BiPAP alone. Most studies reported randomization and allocation concealment inadequately and provided inconsistent details of outcome assessor blinding. We did not combine data for CPAP and BiPAP comparisons with data for low-flow oxygen devices; study data were insufficient for separate analysis of CPAP and BiPAP for most outcomes. For the primary outcomes of treatment failure (1066 participants; six studies) and mortality (755 participants; three studies), investigators found no differences between HFNC and low-flow oxygen therapies (risk ratio (RR), Mantel-Haenszel (MH), random-effects 0.79, 95% confidence interval (CI) 0.49 to 1.27; and RR, MH, random-effects 0.63, 95% CI 0.38 to 1.06, respectively). We used the GRADE approach to downgrade the certainty of this evidence to low because of study risks of bias and different participant indications. Reported adverse events included nosocomial pneumonia, oxygen desaturation, visits to general practitioner for respiratory complications, pneumothorax, acute pseudo-obstruction, cardiac dysrhythmia, septic shock, and cardiorespiratory arrest. However, single studies reported adverse events, and we could not combine these findings; one study reported fewer episodes of oxygen desaturation with HFNC but no differences in all other reported adverse events. We downgraded the certainty of evidence for adverse events to low because of limited data. Researchers noted no differences in ICU length of stay (mean difference (MD), inverse variance (IV), random-effects 0.15, 95% CI -0.03 to 0.34; four studies; 770 participants), and we downgraded quality to low because of study risks of bias and different participant indications. We found no differences in oxygenation variables: partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) (MD, IV, random-effects 7.31, 95% CI -23.69 to 41.31; four studies; 510 participants); PaO2 (MD, IV, random-effects 2.79, 95% CI -5.47 to 11.05; three studies; 355 participants); and oxygen saturation (SpO2) up to 24 hours (MD, IV, random-effects 0.72, 95% CI -0.73 to 2.17; four studies; 512 participants). Data from two studies showed that oxygen saturation measured after 24 hours was improved among those treated with HFNC (MD, IV, random-effects 1.28, 95% CI 0.02 to 2.55; 445 participants), but this difference was small and was not clinically significant. Along with concern about risks of bias and differences in participant indications, review authors noted a high level of unexplained statistical heterogeneity in oxygenation effect estimates, and we downgraded the quality of evidence to very low. Meta-analysis of three comparable studies showed no differences in carbon dioxide clearance among those treated with HFNC (MD, IV, random-effects -0.75, 95% CI -2.04 to 0.55; three studies; 590 participants). Two studies reported no differences in atelectasis; we did not combine these findings. Data from six studies (867 participants) comparing HFNC versus low-flow oxygen showed no differences in respiratory rates up to 24 hours according to type of oxygen delivery device (MD, IV, random-effects -1.51, 95% CI -3.36 to 0.35), and no difference after 24 hours (MD, IV, random-effects -2.71, 95% CI -7.12 to 1.70; two studies; 445 participants). Improvement in respiratory rates when HFNC was compared with CPAP or BiPAP was not clinically important (MD, IV, random-effects -0.89, 95% CI -1.74 to -0.05; two studies; 834 participants). Results showed no differences in patient-reported measures of comfort according to oxygen delivery devices in the short term (MD, IV, random-effects 0.14, 95% CI -0.65 to 0.93; three studies; 462 participants) and in the long term (MD, IV, random-effects -0.36, 95% CI -3.70 to 2.98; two studies; 445 participants); we downgraded the certainty of this evidence to low. Six studies measured dyspnoea on incomparable scales, yielding inconsistent study data. No study in this review provided data on positive end-expiratory pressure measured at the pharyngeal level, work of breathing, or cost comparisons of treatment. Authors' conclusions We were unable to demonstrate whether HFNC was a more effective or safe oxygen delivery device compared with other oxygenation devices in adult ICU patients. Meta-analysis could be performed for few studies for each outcome, and data for comparisons with CPAP or BiPAP were very limited. In addition, we identified some risks of bias among included studies, differences in patient groups, and high levels of statistical heterogeneity for some outcomes, leading to uncertainty regarding the results of our analysis. Consequently, evidence is insufficient to show whether HFNC provides safe and efficacious respiratory support for adult ICU patients

LA LINGUA DEL IESSE. OSSERVAZIONI LINGUISTICHE NELL’«ITALIA RANDAGIA» DI AMY BERNARDY

Nel 1913 Amy Bernardy (1880-1959), giornalista e storica fiorentina, scrive Italia randagia, resoconto dettagliato della situazione materiale e morale degli emigrati italiani negli Stati Uniti. Poco frequentata dall’ambiente accademico, che le dedica – soprattutto in anni recenti – studi di natura prevalentemente biografico-letteraria, la Bernardy è la prima giornalista ad offrire nei suoi scritti uno spaccato fedele della vita delle comunità italiane d’oltreoceano (cfr. Prezzolini 1960). Delle rare fonti oggi a disposizione, pochissime sembrano soffermarsi sull’attenzione riservata dalla Bernardy alla questione linguistica degli immigrati italiani in Nord America. Il contributo si propone dunque di fornire, in una prospettiva storico-linguistica, un close reading di quei capitoli che in Italia randagia esaminano i tratti di un inglese «rivestito di forme italiane» (Bernardy, 1913: 89), che, se nelle sue espressioni individuali perde gradualmente i caratteri identitari, nelle sue manifestazioni collettive resta invece saldamente ancorato alla propria italianità. I tentativi di adattamento al nuovo contesto sociale e culturale si declinano e si coniugano in una lingua dai tratti confusi, «italiana d’aspetto» e «inglese d’etimologia» (p. 91): è l’«italiano del sì» che progressivamente diventa «italiano del iesse» (p. 93).   The language of iesse. Linguistic observations in Amy Bernardy’s Italia randagia In 1913, Florentine journalist and historian Amy Bernardy (1880-1959) published Italia randagia, a detailed account of the material and moral conditions of Italian emigrants in the United States. Although largely overlooked by the academic community, which has only recently dedicated predominantly biographical-literary studies to her work, Bernardy was the first journalist to provide a faithful depiction of the lives of Italian communities overseas (see Prezzolini 1960). Of the rare available sources, very few focus on Bernardy’s attention to the linguistic issues faced by Italian immigrants in North America. This paper aims to offer a close reading, from a historical-linguistic perspective, of the chapters in Italia randagia that examine the characteristics of an English «rivestito di forme italiane» (Bernardy, 1913: 89), a language that, while gradually losing its identity on an individual level, remains collectively anchored to its Italian roots. The attempts to adapt to the new social and cultural context are reflected in a language with blurred features, «italiana d’aspetto» and «inglese d’etimologia» (p. 91). This linguistic shift marks the transition from the «italiano del sì» to the «italiano del iesse» (p. 93).

Network-augmented Evolvable Reconfigurable Architectures: a Novel Platform for Evolvable Hardware

The research presented in this thesis focuses on Evolvable Hardware, a circuit design technique that relies on biologically-inspired algorithms and reconfigurable hardware to realize innovative designs. Circuits evolved with these methodologies can adapt to highly dynamic environments and are able to reconfigure themselves around faults which would permanently disable canonically-designed hardware. Furthermore, the evolutionary algorithms employed often produce hardware which a conventional, human-driven, design flow would have excluded a priori. These unconventional circuits have, in some cases, resulted in lower power consumption and higher performance with respect to their conventional counterparts. Recently introduced platforms, directly coupling high-performance processing systems with reconfigurable logic, have considerably expanded the range of possibilities that can be attained by evolvable hardware. Exploiting one family of such platforms, a network-enabled evolvable hardware platform was developed. Creating such a system invariably requires the development of several interconnected components, starting from the low-level architecture up to the network interconnections. The result is a novel and intuitive network-enhanced evolvable reconfigurable architecture, developed on an open-source Linux-based operating system. Aside from the network-related improvements, the platform also offers a radically different perspective into evolvable hardware, which enables effortless integration of new features and considerably reduces the effort required to create new evolvable hardware designs. The evolutionary performance of the developed platform was evaluated on a widespread family of circuits, image filters. The development of this benchmark application enabled verification of the capabilities of the architecture as well as validation of the proposed network-based enhancements for evolvable hardware. In-depth testing, using a wide variety of different configurations, demonstrated the superior performance of the network-based evolvable hardware compared to that of conventional evolvable hardware architectures

Use of nasal cannula versus face mask after extubation in patients after cardiothoracic surgery

Continuous reevaluation of protocols for patients' care is necessary to maintain high quality and cost-effectiveness in today's healthcare environment. A study of patients who had cardiothoracic surgery proved that after early extubation, patients could safely be given oxygen via nasal cannula with maintenance of acceptable oxygen saturation. The positive outcomes of this study were shorter exposure to oxygen at higher concentrations, greater compliance by patients, greater comfort for patients, and cost savings for the institution. This project was the result of thoughtful consideration and a willingness to question a standard practice that had been in existence in this cardiothoracic program for 20 years. Both patients and the institution benefit when we question why we do things and thoroughly evaluate our daily practice. All practitioners should always look for ways to change and improve practice for the betterment of patients.</jats:p

Improving the care of cardiothoracic surgery patients through advanced nursing skills

All the nurses in the cardiothoracic ICU are now certified in these advanced skills. The skills are reviewed with current staff members on a yearly basis during the annual evaluation. During their orientation to the cardiothoracic ICU, new staff nurses are certified by using the original process of attending an in-service training program and demonstrating the skill 3 times. The quality management department reviews medical records daily to detect complications. In addition, we (DRZ and MB) conducted a quality assurance review in which we monitored 20 patients being extubated and having PA catheters removed by nurses. No complications were noted during either review. The institution has seen improvements in quality of care and earlier discharge from the hospital. With earlier removal of endotracheal tubes and PA catheters, patients are more comfortable and their rehabilitation can be advanced sooner. Comparison of the mean length of stay for patients undergoing coronary artery bypass graft in March 1995 with the mean length of stay for such patients in March 1998 showed a 50.6% decrease, from 14.94 days to 7.38 days. These advanced skills have provided an increased autonomy for the nurses and have benefited the patients undergoing cardiac surgery in our institution.</jats:p

Network-augmented Evolvable Reconfigurable Architectures: a Novel Platform for Evolvable Hardware

The research presented in this thesis focuses on Evolvable Hardware, a circuit design technique that relies on biologically-inspired algorithms and reconfigurable hardware to realize innovative designs. Circuits evolved with these methodologies can adapt to highly dynamic environments and are able to reconfigure themselves around faults which would permanently disable canonically-designed hardware. Furthermore, the evolutionary algorithms employed often produce hardware which a conventional, human-driven, design flow would have excluded a priori. These unconventional circuits have, in some cases, resulted in lower power consumption and higher performance with respect to their conventional counterparts. Recently introduced platforms, directly coupling high-performance processing systems with reconfigurable logic, have considerably expanded the range of possibilities that can be attained by evolvable hardware. Exploiting one family of such platforms, a network-enabled evolvable hardware platform was developed. Creating such a system invariably requires the development of several interconnected components, starting from the low-level architecture up to the network interconnections. The result is a novel and intuitive network-enhanced evolvable reconfigurable architecture, developed on an open-source Linux-based operating system. Aside from the network-related improvements, the platform also offers a radically different perspective into evolvable hardware, which enables effortless integration of new features and considerably reduces the effort required to create new evolvable hardware designs. The evolutionary performance of the developed platform was evaluated on a widespread family of circuits, image filters. The development of this benchmark application enabled verification of the capabilities of the architecture as well as validation of the proposed network-based enhancements for evolvable hardware. In-depth testing, using a wide variety of different configurations, demonstrated the superior performance of the network-based evolvable hardware compared to that of conventional evolvable hardware architectures

Comparison of heparinized and nonheparinized solutions for maintaining patency of arterial and pulmonary artery catheters

BACKGROUND: Arterial and pulmonary artery catheters are often used in the management of critically ill patients. If heparin were not necessary to maintain the patency of arterial and pulmonary artery catheters, these patients could avoid exposure to heparin. OBJECTIVES: The purpose of this study was to determine if the failure rate of arterial and pulmonary artery catheters differs depending on whether a nonheparinized or heparinized solution is used. The null hypothesis was that catheter failure rates would not differ. METHODS: The study was done at a large tertiary medical center in the northeastern United States, and all subjects who had pulmonary artery or arterial catheters inserted were included in the study. A solution of 1 U of heparin per 1 mL of normal saline was used to maintain the patency of the arterial catheter and the distal portion of the pulmonary artery catheter in one group; normal saline alone was used in the other group. Variables used to monitor catheter patency and the reasons for catheter removal were recorded. RESULTS: Failure rates of pulmonary artery catheters were not significantly different between the two groups. For arterial catheters, however, the failure rate was significantly different between the two groups, regardless of whether the subjects had received other anticoagulants. CONCLUSION: The failure rate of pulmonary artery catheters was not affected by the use of nonheparinized solutions. Arterial catheters failed less often when they were maintained with heparinized solutions. The authors recommend that all arterial catheters be maintained with heparinized solutions, unless use of heparin is contraindicated.</jats:p