A Reinforcement Learning Approach to Weaning of Mechanical Ventilation in Intensive Care Units

The management of invasive mechanical ventilation, and the regulation of sedation and analgesia during ventilation, constitutes a major part of the care of patients admitted to intensive care units. Both prolonged dependence on mechanical ventilation and premature extubation are associated with increased risk of complications and higher hospital costs, but clinical opinion on the best protocol for weaning patients off of a ventilator varies. This work aims to develop a decision support tool that uses available patient information to predict time-to-extubation readiness and to recommend a personalized regime of sedation dosage and ventilator support. To this end, we use off-policy reinforcement learning algorithms to determine the best action at a given patient state from sub-optimal historical ICU data. We compare treatment policies from fitted Q-iteration with extremely randomized trees and with feedforward neural networks, and demonstrate that the policies learnt show promise in recommending weaning protocols with improved outcomes, in terms of minimizing rates of reintubation and regulating physiological stability

Privacy Preserving Internet Browsers: Forensic Analysis of Browzar

With the advance of technology, Criminal Justice agencies are being confronted with an increased need to investigate crimes perpetuated partially or entirely over the Internet. These types of crime are known as cybercrimes. In order to conceal illegal online activity, criminals often use private browsing features or browsers designed to provide total browsing privacy. The use of private browsing is a common challenge faced in for example child exploitation investigations, which usually originate on the Internet. Although private browsing features are not designed specifically for criminal activity, they have become a valuable tool for criminals looking to conceal their online activity. As such, Technological Crime units often focus their forensic analysis on thoroughly examining the web history on a computer. Private browsing features and browsers often require a more in-depth, post mortem analysis. This often requires the use of multiple tools, as well as different forensic approaches to uncover incriminating evidence. This evidence may be required in a court of law, where analysts are often challenged both on their findings and on the tools and approaches used to recover evidence. However, there are very few research on evaluating of private browsing in terms of privacy preserving as well as forensic acquisition and analysis of privacy preserving internet browsers. Therefore in this chapter, we firstly review the private mode of popular internet browsers. Next, we describe the forensic acquisition and analysis of Browzar, a privacy preserving internet browser and compare it with other popular internet browser

Incidence and Mortality of Mucosal Disease in Iowa

Mucosal disease was first recognized in Iowa as an apparently new disease entity in cattle in January of 1951. The following inquiry is often made: Is the incidence of mucosal disease in cattle increasing in Iowa? It is difficult to determine accurately the incidence of any disease in farm animals

Early infant feeding and adiposity risk: from infancy to adulthood

Introduction: Systematic reviews suggest that a longer duration of breast-feeding is associated with a reduction in the risk of later overweight and obesity. Most studies examining breast-feeding in relation to adiposity have not used longitudinal analysis. In our study, we aimed to examine early infant feeding and adiposity risk in a longitudinal cohort from birth to young adulthood using new as well as published data. Methods: Data from the Western Australian Pregnancy Cohort (Raine) Study in Perth, W.A., Australia, were used to examine associations between breast-feeding and measures of adiposity at 1, 2, 3, 6, 8, 10, 14, 17, and 20 years. Results: Breast-feeding was measured in a number of ways. Longer breast-feeding (in months) was associated with reductions in weight z-scores between birth and 1 year (β = -0.027; p \u3c 0.001) in the adjusted analysis. At 3 years, breast-feeding for \u3c4 months increased the odds of infants experiencing early rapid growth (OR 2.05; 95% CI 1.43-2.94; p \u3c 0.001). From 1 to 8 years, children breast-fed for ≤4 months compared to ≥12 months had a significantly greater probability of exceeding the 95th percentile of weight. The age at which breast-feeding was stopped and a milk other than breast milk was introduced (introduction of formula milk) played a significant role in the trajectory of the BMI from birth to 14 years; the 4-month cutoff point was consistently associated with a higher BMI trajectory. Introduction of a milk other than breast milk before 6 months compared to at 6 months or later was a risk factor for being overweight or obese at 20 years of age (OR 1.47; 95% CI 1.12-1.93; p = 0.005). Discussion: Breast-feeding until 6 months of age and beyond should be encouraged and is recommended for protection against increased adiposity in childhood, adolescence, and young adulthood. Adverse long-term effects of early growth acceleration are fundamental in later overweight and obesity. Formula feeding stimulates a higher postnatal growth velocity, whereas breast-feeding promotes slower growth and a reduced likelihood of overweight and obesity. Biological mechanisms underlying the protective effect of breast-feeding against obesity are based on the unique composition and metabolic and physiological responses to human milk

Physical and energy demand of soccer: A brief review

Soccer is a complex and exhaustive team-sport requiring a high level of tactical, technical, and physical ability to succeed. During a competitive match, a random combination of explosive and powerful activities, together with technical and tactical gestures, is performed in an intermittent manner over a 90-minute game. This review presents a detailed analysis and up-to-date synthesis of the literature describing activities and energy system contribution during soccer to provide to strength and conditioning coaches a clear understanding of soccer players’ physical needs during competition

Modulators of change-of-direction economy after repeated sprints in elite soccer players

Purpose: To investigate the acute effect of repeated-sprint activity (RSA) on change-of-direction economy (assessed using shuttle running economy [SRE]) in soccer players and explore neuromuscular and cardiorespiratory characteristics that may modulate this effect. Methods: Eleven young elite male soccer players (18.5 [1.4] y old) were tested on 2 different days during a 2-week period in their preseason. On day 1, lower-body stiffness, power and force were assessed via countermovement jumps, followed by an incremental treadmill test to exhaustion to measure maximal aerobic capacity. On day 2, 2 SRE tests were performed before and after a repeated-sprint protocol with heart rate, minute ventilation, and blood lactate measured. Results: Pooled group analysis indicated no significant changes for SRE following RSA due to variability in individual responses, with a potentiation or impairment effect of up to 4.5% evident across soccer players. The SRE responses to RSA were significantly and largely correlated to players’ lower-body stiffness (r = .670; P = .024), and moderately (but not significantly) correlated to players’ force production (r = −.455; P = .237) and blood lactate after RSA (r = .327; P = .326). Conclusions: In summary, SRE response to RSA in elite male soccer players appears to be highly individual. Higher lower-body stiffness appears as a relevant physical contributor to preserve or improve SRE following RSA