Hypoxaemia on arrival in a multidisciplinary intensive care unit

Background. Transport of the critically ill patient poses the risk of numerous complications. Hypoxaemia is one such serious adverse event and is associated with potential morbidity and mortality. It is, however, potentially preventable.Objective. To determine the incidence of hypoxaemia on arrival in a tertiary multidisciplinary intensive care unit (ICU) and to identify risk factors for this complication.Method. A retrospective observational study was conducted at King Edward VIII Hospital, Durban, South Africa, from May 2013 to February 2014.Results. Hypoxaemia occurred in 15.5% of admissions sampled. Statistically significant risk factors for hypoxaemia on univariate analysis (p<0.05) included lack of peripheral capillary oxygen saturation (SpO2) monitoring, transfer by an intern as opposed to other medical/ paramedical staff, and transfer from internal medicine. Use of neuromuscular blockers and transfer from theatre were protective. Binary logistic regression analysis revealed lack of SpO2 monitoring to be the only significant independent predictor of hypoxaemia (odds ratio 6.1; 95% confidence interval 1.5 - 24.5; p=0.02).Conclusion. Hypoxaemia is common on admission to the ICU and may be prevented by simple interventions such as appropriate transport monitoring

Learning Visual Question Answering by Bootstrapping Hard Attention

Attention mechanisms in biological perception are thought to select subsets of perceptual information for more sophisticated processing which would be prohibitive to perform on all sensory inputs. In computer vision, however, there has been relatively little exploration of hard attention, where some information is selectively ignored, in spite of the success of soft attention, where information is re-weighted and aggregated, but never filtered out. Here, we introduce a new approach for hard attention and find it achieves very competitive performance on a recently-released visual question answering datasets, equalling and in some cases surpassing similar soft attention architectures while entirely ignoring some features. Even though the hard attention mechanism is thought to be non-differentiable, we found that the feature magnitudes correlate with semantic relevance, and provide a useful signal for our mechanism's attentional selection criterion. Because hard attention selects important features of the input information, it can also be more efficient than analogous soft attention mechanisms. This is especially important for recent approaches that use non-local pairwise operations, whereby computational and memory costs are quadratic in the size of the set of features.Comment: ECCV 201

Designing Mamdani-Type Fuzzy Reasoning for Visualizing Prediction Problems Based on Collaborative Fuzzy Clustering

In this paper a collaborative fuzzy c-means (CFCM) is used to generate fuzzy rules for fuzzy inference systems to evaluate the time series model. CFCM helps system to integrate two or more different datasets having similar features which are collected at the different environment with the different time period and it integrates these datasets together in order to visualize some common patterns among the datasets. In order to do any mode of integration between datasets, there is a necessity to define the common features between datasets by using some kind of collaborative process and also need to preserve the privacy and security at higher levels. This collaboration process gives a common structure between datasets which helps to define an appropriate number of rules for structural learning and also improve the accuracy of the system modeling

Responsiveness differences in outcome instruments after revision hip arthroplasty: What are the implications?

Responsiveness to change is an important psychometric property of an outcome instrument. Assessment of health-related quality of life (HRQoL) is critical to outcome assessment after total joint replacement, a surgery aimed at improving pain, function and HRQoL of the patients undergoing these procedures. In a recent study, Shi et al. examined the responsiveness to change of various subscales of two instruments, physician-administered Harris Hip Score and patient self-administered Short Form-36 (SF-36), 6 months after revision total hip arthroplasty. The responsiveness statistics for both scales were reasonable, higher for Harris Hip Score than SF-36. This is the first study to examine responsiveness of these instruments in revision THA patients in a systematic fashion

Plasma Perturbations and Cosmic Microwave Background Anisotropy in the Linearly Expanding Milne-like Universe

We expose the scenarios of primordial baryon-photon plasma evolution within the framework of the Milne-like universe models. Recently, such models find a second wind and promise an inflation-free solution of a lot of cosmological puzzles including the cosmological constant one. Metric tensor perturbations are considered using the five-vectors theory of gravity admitting the Friedmann equation satisfied up to some constant. The Cosmic Microwave Background (CMB) spectrum is calculated qualitatively.Comment: 20 page

The competent sentinel node: an association with an axillary presentation and an occult or a small primary invasive breast carcinoma

The concept of the sentinel node describes a primary or sentinel lymph node (SLN), which exists and through which tumour cells from a primary tumour in a particular location must first travel to spread to a particular regional lymph node group. In this series we present three patients presenting with a pathological axillary node associated with either an occult or very small primary breast cancer. In each case the primary tumour was found to have metastasised to the palpable node, however despite the significant enlargement of this node, no other axillary nodes were found to be affected on axillary node clearance. This has led us to postulate that the SLN in some cases contains unique characteristics that enable it to prevent further spread of the tumour up the lymphatic chain. Hence the term the competent sentinel node

Non-small cell lung cancer presenting with choroidal metastasis as first sign and showing good response to chemotherapy alone: a case report

<p>Abstract</p> <p>Introduction</p> <p>Metastatic tumors are the most common intra-ocular malignancies and choroid is by far the most common site for intra-ocular malignancies. Multiple foci are usually involved, and bilateral involvement is frequently seen. The primary sites for choroidal metastasis in decreasing order and by gender are: breast, lung, unknown primary, gastrointestinal and pancreas, skin melanoma and other rare sources in females, and lung, unknown primary, gastrointestinal and pancreas, prostate, kidney, skin melanoma and other rare sources in males. Available treatment options are external beam radiotherapy and plaque radiotherapy, while new methods like surgical resection, transpupillary thermotherapy and intravitreal chemotherapy offer promises for the future. The use of chemotherapy alone for choroidal metastases is not widely reported.</p> <p>Case presentation</p> <p>We report the case of a 50-year-old Indian man who had a unilateral solitary lesion in his right eye. He was found to have an adenocarcinoma of the lung with choroidal metastasis as the first presenting sign. There were no findings of metastasis involving his contralateral eye. He was administered chemotherapy based on gemcitabine and carboplatin. He had significant progressive subjective and objective improvement since his first chemotherapy. His current best corrected visual acuity is 20/60 after three cycles of chemotherapy.</p> <p>Conclusions</p> <p>Chemotherapy alone can be used as an effective mode of treatment in patients who have primary tumors that respond to chemotherapy.</p