Adaptation Algorithm and Theory Based on Generalized Discrepancy

We present a new algorithm for domain adaptation improving upon a discrepancy minimization algorithm previously shown to outperform a number of algorithms for this task. Unlike many previous algorithms for domain adaptation, our algorithm does not consist of a fixed reweighting of the losses over the training sample. We show that our algorithm benefits from a solid theoretical foundation and more favorable learning bounds than discrepancy minimization. We present a detailed description of our algorithm and give several efficient solutions for solving its optimization problem. We also report the results of several experiments showing that it outperforms discrepancy minimization

Echocardiographic Guidance During Neonatal and Pediatric Jugular Cannulation for ECMO

Background Internal jugular vein extracorporeal membrane oxygenation (ECMO) cannula position is traditionally confirmed via plain film. Misplaced cannulae can result in need for repositioning and increased morbidity. Echocardiography (ECHO) may be used during cannulation as a more accurate means of guiding cannula position. This study reviews the effect of a protocol encouraging the use of ECHO at cannulation. Methods and materials Single institution retrospective review of patients who received ECMO support using jugular venous cannulation. We compared those who underwent ECHO (ECHO+) at the time of cannulation with those who did not (ECHO−). Results Eighty-nine patients were included: 26 ECHO+, 63 ECHO−. Most ECHO+ patients underwent dual-lumen veno-venous (VV) cannulation (65%); 32% of ECHO− patients had VV support (P = 0.003). There was no difference in the rate of cannula repositioning between the two groups: 8% ECHO+ and 10% ECHO−, P = 0.78. In the VV ECMO subgroup, ECHO+ patients required no repositioning (0/17), while 20% (4/20) of ECHO− VV patients did (P = 0.10). After cannulation, there were 0.58 ECHO studies per patient to verify cannula position in the ECHO+ group compared with 0.22 in the ECHO− group (P = 0.02). Each group had a major mechanical complication: atrial perforation from a guidewire during cannulation in ECHO+ and late atrial perforation from a loose cannula in ECHO−, and there was no difference in minor complications. Conclusions ECHO guidance during neonatal and pediatric jugular cannulation for ECMO did not decrease morbidity or reduce the need for cannula repositioning. ECHO may still be a useful adjunct for precise placement of a dual-lumen VV cannula and during difficult cannulations

Repair of Thoracic and Thoracoabdominal Mycotic Aneurysms and Infected Aortic Grafts Using Allograft

Background Mycotic aneurysm of the thoracic or thoracoabdominal aorta and infection of thoracic or thoracoabdominal aortic grafts are challenging problems with high mortality. In-situ reconstruction with cryopreserved allograft(CPA) avoids placement of prosthetic material in an infected field and avoids suppressive antibiotics or autologous tissue coverage. Methods Fifty consecutive patients with infection of a thoracic or thoracoabdominal aortic graft or mycotic aneurysm underwent resection and replacement with CPA from 2006 to 2016. Intravenous antibiotics were continued postoperatively for 6 weeks. Long-term suppressive antibiotics were uncommonly used (8 patients). Follow up imaging occurred at 6, 18 and 42 months postoperatively. Initial follow up was 93% complete. Results Males comprised 64% of the cohort. The mean age was 63±14 years. The procedures performed included reoperations in 37, replacement of the aortic root, ascending aorta or transverse arch in 19, replacement of the descending or thoracoabdominal aorta in 27 and extensive replacement of the ascending, arch and descending or thoracoabdominal aorta in 4. Intraoperative cultures revealed most commonly staphylococcus 24%), enterococcus (12%), candida (6%) and gram negative rods (14%). Operative mortality was 8%, stroke 4%, paralysis 2%, hemodialysis 6%, and respiratory failure requiring tracheostomy 6%. Early reoperation for pseudoaneurysm of the CPA was necessary in 4 patients. One, two and five year survival was 84%, 76% and 64%, respectively. Conclusions Radical resection and in-situ reconstruction with CPA avoids placing prosthetic material in an infected field and provides good early and mid-term outcomes. However, early postoperative imaging is necessary given the risk of pseudoaneurysm formation

Orbital dynamics of "smart dust" devices with solar radiation pressure and drag

This paper investigates how perturbations due to asymmetric solar radiation pressure, in the presence of Earth shadow, and atmospheric drag can be balanced to obtain long-lived Earth centred orbits for swarms of micro-scale 'smart dust' devices, without the use of active control. The secular variation of Keplerian elements is expressed analytically through an averaging technique. Families of solutions are then identified where Sun-synchronous apse-line precession is achieved passively to maintain asymmetric solar radiation pressure. The long-term orbit evolution is characterized by librational motion, progressively decaying due to the non-conservative effect of atmospheric drag. Long-lived orbits can then be designed through the interaction of energy gain from asymmetric solar radiation pressure and energy dissipation due to drag. In this way, the usual short drag lifetime of such high area-to-mass spacecraft can be greatly extended (and indeed selected). In addition, the effect of atmospheric drag can be exploited to ensure the rapid end-of-life decay of such devices, thus preventing long-lived orbit debris

P02.35. Methodology in integrative medicine research: challenges and solutions from a randomized clinical control trial using adapted yoga

Purpose This randomized controlled clinical study evaluated the efficacy of adapted yoga (vs. usual care) to reduce psychosocial risks, which have been clinically shown to impact morbidity and mortality in implantable cardioverter defibrillator (ICD) recipients. The ICD collects and records real-time cardiac data, which were used in the study. Methods Forty-six patients participated from a hospital in Connecticut. All participants were administered validated measures on psychosocial risk factors at weeks one and eight of the eight-week intervention. Patients in the intervention group participated in a weekly adapted yoga class for eighty minutes for eight weeks with assigned home practices. Clinical measures, including patients’ current and past medical health status and device usage, were collected three months prior to the study, during the study, and at a six-month follow-up. Results Data revealed that the yoga group’s overall shock anxiety decreased while the control group’s increased, t(4.43, 36), p<0.0001 (total). The yoga group had less shock anxiety, t(2.86,36) p=0.007 (mean consequence), greater overall self-compassion, t(-2.84,37), p=0.007 (total), and greater mindfulness (equanimity) regarding emotions, t(-2.10,37) p=0.04 (mindfulness), than the control group. Exploratory analyses utilizing a linear model (R2=.98) of the observed anti-tachycardia pacing (ATP) events revealed that the expected number of ATP events in the intervention group was significantly lower than the control group. Additionally, the expected number of ATP events increased more rapidly as a function of the initial ATP events for the control group than for the intervention group. Conclusion Our study demonstrated psychological benefits from a program of adapted yoga compared to usual care for ICD recipients. Marked improvements were reported in total shock anxiety, self-compassion, sense of equanimity, and decreased likelihood of ATPs. The data supports the continuation of research in mind-body interventions to better understand the role of complementary medicine to address ICD-specific psychosocial stress and its potential contributory role in cardiac outcomes

Low-Rank Subspace Override for Unsupervised Domain Adaptation

Current supervised learning models cannot generalize well across domain boundaries, which is a known problem in many applications, such as robotics or visual classification. Domain adaptation methods are used to improve these generalization properties. However, these techniques suffer either from being restricted to a particular task, such as visual adaptation, require a lot of computational time and data, which is not always guaranteed, have complex parameterization, or expensive optimization procedures. In this work, we present an approach that requires only a well-chosen snapshot of data to find a single domain invariant subspace. The subspace is calculated in closed form and overrides domain structures, which makes it fast and stable in parameterization. By employing low-rank techniques, we emphasize on descriptive characteristics of data. The presented idea is evaluated on various domain adaptation tasks such as text and image classification against state of the art domain adaptation approaches and achieves remarkable performance across all tasks

Neural correlates of abnormal sensory discrimination in laryngeal dystonia

AbstractAberrant sensory processing plays a fundamental role in the pathophysiology of dystonia; however, its underpinning neural mechanisms in relation to dystonia phenotype and genotype remain unclear. We examined temporal and spatial discrimination thresholds in patients with isolated laryngeal form of dystonia (LD), who exhibited different clinical phenotypes (adductor vs. abductor forms) and potentially different genotypes (sporadic vs. familial forms). We correlated our behavioral findings with the brain gray matter volume and functional activity during resting and symptomatic speech production. We found that temporal but not spatial discrimination was significantly altered across all forms of LD, with higher frequency of abnormalities seen in familial than sporadic patients. Common neural correlates of abnormal temporal discrimination across all forms were found with structural and functional changes in the middle frontal and primary somatosensory cortices. In addition, patients with familial LD had greater cerebellar involvement in processing of altered temporal discrimination, whereas sporadic LD patients had greater recruitment of the putamen and sensorimotor cortex. Based on the clinical phenotype, adductor form-specific correlations between abnormal discrimination and brain changes were found in the frontal cortex, whereas abductor form-specific correlations were observed in the cerebellum and putamen. Our behavioral and neuroimaging findings outline the relationship of abnormal sensory discrimination with the phenotype and genotype of isolated LD, suggesting the presence of potentially divergent pathophysiological pathways underlying different manifestations of this disorder