Compact recurrent neural networks for acoustic event detection on low-energy low-complexity platforms

Outdoor acoustic events detection is an exciting research field but challenged by the need for complex algorithms and deep learning techniques, typically requiring many computational, memory, and energy resources. This challenge discourages IoT implementation, where an efficient use of resources is required. However, current embedded technologies and microcontrollers have increased their capabilities without penalizing energy efficiency. This paper addresses the application of sound event detection at the edge, by optimizing deep learning techniques on resource-constrained embedded platforms for the IoT. The contribution is two-fold: firstly, a two-stage student-teacher approach is presented to make state-of-the-art neural networks for sound event detection fit on current microcontrollers; secondly, we test our approach on an ARM Cortex M4, particularly focusing on issues related to 8-bits quantization. Our embedded implementation can achieve 68% accuracy in recognition on Urbansound8k, not far from state-of-the-art performance, with an inference time of 125 ms for each second of the audio stream, and power consumption of 5.5 mW in just 34.3 kB of RAM

The evolutionary conserved BER1 gene is involved in microtubule stability in yeast

In yeast, microtubules are dynamic filaments necessary for spindle and nucleus positioning, as well as for proper chromosome segregation. We identify a function for the yeast gene BER1 (Benomyl REsistant 1) in microtubule stability. BER1 belongs to an evolutionary conserved gene family whose founding member Sensitivity to Red light Reduced is involved in red-light perception and circadian rhythms in Arabidopsis. Here, we present data showing that the ber1Δ mutant is affected in microtubule stability, particularly in presence of microtubule-depolymerising drugs. The pattern of synthetic lethal interactions obtained with the ber1Δ mutant suggests that Ber1 may function in N-terminal protein acetylation. Our work thus suggests that microtubule stability might be regulated through this post-translational modification on yet-to-be determined protein

Continuous erector spinae plane block for pain management in laparoscopic liver resection: case report

Pain after liver resection can be difficult to manage. Epidural anesthesia (EA) isaneffective technique inpain control inthis surgery. However, postoperative coagulopathy and hypotension due to autonomic nervous system block in high-risk patients, may result that the EA is an inadequate analgesic technique in according to enhanced recovery after surgery (ERAS) recommendations for liver surgery. Regional block techniques have been recommended for liver surgery in ERAS guidelines. Erector spinae plane (ESP) block is a recent block described for thoracic and abdominal surgeries and provides both somatic and visceral analgesia. We describe a high-risk patient with cardiac dysfunction and Parkinson's disease who underwent laparoscopic right liver resection for hepatocellular carcinoma. Satisfactory intra and postoperative analgesia was achieved by a combined continuous ESP block, transversus abdominis plane (TAP), and oblique subcostal TAP blocks. Surgery and postoperative period was uneventful. No opioids were administered during hospitalization. A combined of thoracic and abdominal wall blocks can be an effective approach for intra and postoperative analgesia in highrisk patients undergoing laparoscopic liver resection. Further clinical research is recommended to establish the effectiveness of the ESP block as an analgesic technique in this surgery

Application of the general perceived self-efficacy scale in cardiovascular rehabilitation

Psychosocial support, education and self-management are important complements of rehabilitation programs. A central concept in self-management is self-efficacy, which refers to oneself confidence in reaching a desired goal. The General Perceived Self-Efficacy scale (GSE), developed to measure self-efficacy at the broadest level, could be useful in the rehabilitation setting, in order to assess patients’ selfmanagement difficulties as well as to design specific interventions for specific diseases. Aim of this work is to verify the GSE Italian version psychometric properties applied to the rehabilitation setting. Data were analyzed from 395 in-patients attending cardiac (83.8%) and neurological (16.2%) rehabilitation. Cardiac patients suffered from post-MI, CABG or heart-failure; all of the neurological patients suffered from amiotrophic lateral sclerosis (ALS). They were mostly males (84.5%), and the mean age was 55.7 years. Principal component factor analysis confirmed that GSE has a monofactorial structure with internal consistency of .85. As in previous studies, a gender difference emerged. There was no difference in cardiac patients, on the basis of their specific disease, but they showed higher self-efficacy perception compared to ALS patients. The findings confirm that GSE is a valid measure of self-efficacy in settings characterised by different levels of functional abilities, as in cardiac and neurological rehabilitation

Hypotension Prediction Index Software to Prevent Intraoperative Hypotension during Major Non-Cardiac Surgery: Protocol for a European Multicenter Prospective Observational Registry (EU-HYPROTECT)

Intraoperative hypotension is common in patients having non-cardiac surgery and associated with postoperative acute myocardial injury, acute kidney injury, and mortality. Avoiding intraoperative hypotension is a complex task for anesthesiologists. Using artificial intelligence to predict hypotension from clinical and hemodynamic data is an innovative and intriguing approach. The AcumenTM Hypotension Prediction Index (HPI) software (Edwards Lifesciences; Irvine, CA, USA) was developed using artificial intelligence-specifically machine learning-and predicts hypotension from blood pressure waveform features. We aimed to describe the incidence, duration, severity, and causes of intraoperative hypotension when using HPI monitoring in patients having elective major non-cardiac surgery

Hypotension prediction index software to prevent intraoperative hypotension during major non-cardiac surgery: protocol for a european multicenter prospective observational registry (EU-HYPROTECT)

Background: Intraoperative hypotension is common in patients having non-cardiac surgery and associated with postoperative acute myocardial injury, acute kidney injury, and mortality. Avoiding intraoperative hypotension is a complex task for anesthesiologists. Using artificial intelligence to predict hypotension from clinical and hemodynamic data is an innovative and intriguing approach. The AcumenTM Hypotension Prediction Index (HPI) software (Edwards Lifesciences; Irvine, CA, USA) was developed using artificial intelligence-specifically machine learning-and predicts hypotension from blood pressure waveform features. We aimed to describe the incidence, duration, severity, and causes of intraoperative hypotension when using HPI monitoring in patients having elective major non-cardiac surgery. Methods: We built up a European, multicenter, prospective, observational registry including at least 700 evaluable patients from five European countries. The registry includes consenting adults (?18 years) who were scheduled for elective major non-cardiac surgery under general anesthesia that was expected to last at least 120 min and in whom arterial catheter placement and HPI monitoring was planned. The major objectives are to quantify and characterize intraoperative hypotension (defined as a mean arterial pressure [MAP] < 65 mmHg) when using HPI monitoring. This includes the time-weighted average (TWA) MAP < 65 mmHg, area under a MAP of 65 mmHg, the number of episodes of a MAP < 65 mmHg, the proportion of patients with at least one episode (1 min or more) of a MAP < 65 mmHg, and the absolute maximum decrease below a MAP of 65 mmHg. In addition, we will assess causes of intraoperative hypotension and investigate associations between intraoperative hypotension and postoperative outcomes. Discussion: There are only sparse data on the effect of using HPI monitoring on intraoperative hypotension in patients having elective major non-cardiac surgery. Therefore, we built up a European, multicenter, prospective, observational registry to describe the incidence, duration, severity, and causes of intraoperative hypotension when using HPI monitoring in patients having elective major non-cardiac surgery.Funding: Edwards Lifesciences SA, Department of Critical Care, Route de l’Etraz 70, 1260 Nyon, Switzerland funded the study and acts as the legal sponsor. The sponsor/funder had an active role in the design of the study. The collection, analysis, and interpretation of the data will be a collaborative effort of all investigators, who will also write the manuscript. Acknowledgments: We acknowledge the support of all participating patients and their physicians. We also acknowledge the tremendous contribution of the staff at Edwards Lifesciences, especially Edward Hembrow, Tim van den Boom, Anne Halfmann, Pierre Sibileau, Barbara Plasschaert, Volker Haag, Giulia Torricella and Alessia Longo. We further appreciate the excellent project management secured by Daniel Greinert, Marie Zielinksi and Claudia Lüske at the Institute for Pharmacology and Preventive Medicine (Cloppenburg, Germany). Data are captured using the s4trials software provided by Software for Trials Europe GmbH (Berlin, Germany)

Cystatin C as a nmarker of renal function Immediately after liver transplantation

To verify whether cystatin C may be of some use as a renal function marker immediately after orthotopic liver transplantation (OLT), we compared serum cystatin C (S(Cyst)), serum creatinine (S(cr)), and creatinine clearance (C(cr)) levels with the glomerular filtration rate (GFR). On postoperative days 1, 3, 5, and 7, S(Cyst) and S(cr) was measured in simultaneously drawn blood samples, whereas C(cr) was calculated using a complete 24-hour urine collection. The GFR was determined on the same days by means of iohexol plasma clearance (I-GFR). The correlation between 1/S(Cyst) and I-GFR was stronger than that of 1/S(cr) or C(cr) (P< 0.01). In the case of moderate reductions in I-GFR (80-60 mL/minute/1.73 m), S(cr) remained within the normal range, whereas the increase in S(cyst) was beyond its upper limit; for I-GFR reductions to lower levels (59-40 mL/minute/1.73 m), S(cr) increased slightly, whereas S(cyst) was twice its upper normal limit. When we isolated all of the I-GFR values on days 3, 5, and 7 that were > or = 30% lower than that recorded on the first postoperative day, S(Cyst)(P< 0.0001) and S(cr) (P< 0.01) levels were increased, whereas C(cr) remained unchanged (P = 0.09). Receiver operating characteristic (ROC) area-under-the-curve analysis showed that the diagnostic accuracy of S(cyst) was better than that of S(cr) and C(cr). S(cyst) levels of 1.4, 1.7, and 2.2 mg/L respectively predicted I-GFR levels of 80, 60, and 40 mL/minute/1.73 m. In conclusion, cystatin C is a reliable marker of renal function during the immediate post-OLT period, especially when the goal is to identify moderate changes in GFR

Comparative Genomics Reveals Two Novel RNAi Factors in Trypanosoma brucei and Provides Insight into the Core Machinery

The introduction ten years ago of RNA interference (RNAi) as a tool for molecular exploration in Trypanosoma brucei has led to a surge in our understanding of the pathogenesis and biology of this human parasite. In particular, a genome-wide RNAi screen has recently been combined with next-generation Illumina sequencing to expose catalogues of genes associated with loss of fitness in distinct developmental stages. At present, this technology is restricted to RNAi-positive protozoan parasites, which excludes T. cruzi, Leishmania major, and Plasmodium falciparum. Therefore, elucidating the mechanism of RNAi and identifying the essential components of the pathway is fundamental for improving RNAi efficiency in T. brucei and for transferring the RNAi tool to RNAi-deficient pathogens. Here we used comparative genomics of RNAi-positive and -negative trypanosomatid protozoans to identify the repertoire of factors in T. brucei. In addition to the previously characterized Argonaute 1 (AGO1) protein and the cytoplasmic and nuclear Dicers, TbDCL1 and TbDCL2, respectively, we identified the RNA Interference Factors 4 and 5 (TbRIF4 and TbRIF5). TbRIF4 is a 3′-5′ exonuclease of the DnaQ superfamily and plays a critical role in the conversion of duplex siRNAs to the single-stranded form, thus generating a TbAGO1-siRNA complex required for target-specific cleavage. TbRIF5 is essential for cytoplasmic RNAi and appears to act as a TbDCL1 cofactor. The availability of the core RNAi machinery in T. brucei provides a platform to gain mechanistic insights in this ancient eukaryote and to identify the minimal set of components required to reconstitute RNAi in RNAi-deficient parasites

WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.Peer reviewe