Pervasive and intelligent decision support in Intensive Medicine – the complete picture

Series : Lecture notes in computer science (LNCS), vol. 8649In the Intensive Care Units (ICU) it is notorious the high number of data sources available. This situation brings more complexity to the way of how a professional makes a decision based on information provided by those data sources. Normally, the decisions are based on empirical knowledge and common sense. Often, they don’t make use of the information provided by the ICU data sources, due to the difficulty in understanding them. To overcome these constraints an integrated and pervasive system called INTCare has been deployed. This paper is focused in presenting the system architecture and the knowledge obtained by each one of the decision modules: Patient Vital Signs, Critical Events, ICU Medical Scores and Ensemble Data Mining. This system is able to make hourly predictions in terms of organ failure and outcome. High values of sensitivity where reached, e.g. 97.95% for the cardiovascular system, 99.77% for the outcome. In addition, the system is prepared for tracking patients’ critical events and for evaluating medical scores automatically and in real-time.(undefined

Interstellar Scintillation of the Polarized Flux Density in Quasar, PKS 0405-385

The remarkable rapid variations in radio flux density and polarization of the quasar PKS 0405-385 observed in 1996 are subject to a correlation analysis, from which characteristic time scales and amplitudes are derived. The variations are interpreted as interstellar scintillations. The cm wavelength observations are in the weak scintillation regime for which models for the various auto- and cross-correlations of the Stokes parameters are derived and fitted to the observations. These are well modelled by interstellar scintillation (ISS) of a 30 by 22 micro-as source, with about 180 degree rotation of the polarization angle along its long dimension. This success in explaining the remarkable intra-day variations (IDV)in polarization confirms that ISS gives rise to the IDV in this quasar. However, the fit requires the scintillations to be occurring much closer to the Earth than expected according to the standard model for the ionized interstellar medium (IISM). Scattering at distances in the range 3-30 parsec are required to explain the observations. The associated source model has a peak brightness temperature near 2.0 10^{13}K, which is about twenty-five times smaller than previously derived for this source. This reduces the implied Doppler factor in the relativistic jet, presumed responsible to 10-20, high but just compatible with cm wavelength VLBI estimates for the Doppler factors in Active Galactic Nuclei (AGNs).Comment: 43 pages 15 figures, accepted for ApJ Dec 200

An associative memory of Hodgkin-Huxley neuron networks with Willshaw-type synaptic couplings

An associative memory has been discussed of neural networks consisting of spiking N (=100) Hodgkin-Huxley (HH) neurons with time-delayed couplings, which memorize P patterns in their synaptic weights. In addition to excitatory synapses whose strengths are modified after the Willshaw-type learning rule with the 0/1 code for quiescent/active states, the network includes uniform inhibitory synapses which are introduced to reduce cross-talk noises. Our simulations of the HH neuron network for the noise-free state have shown to yield a fairly good performance with the storage capacity of $\alpha_c = P_{\rm max}/N \sim 0.4 - 2.4$ for the low neuron activity of $f \sim 0.04-0.10$. This storage capacity of our temporal-code network is comparable to that of the rate-code model with the Willshaw-type synapses. Our HH neuron network is realized not to be vulnerable to the distribution of time delays in couplings. The variability of interspace interval (ISI) of output spike trains in the process of retrieving stored patterns is also discussed.Comment: 15 pages, 3 figures, changed Titl

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

US Cosmic Visions: New Ideas in Dark Matter 2017: Community Report

This white paper summarizes the workshop "U.S. Cosmic Visions: New Ideas in Dark Matter" held at University of Maryland on March 23-25, 2017.Comment: 102 pages + reference

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Physical mixing effects on iron biogeochemical cycling: FeCycle experiment

The effects of physical processes on the distribution, speciation, and sources/sinks for Fe in a high-nutrient low-chlorophyll (HNLC) region were assessed during FeCycle, a mesoscale SF6 tracer release during February 2003 (austral summer) to the SE of New Zealand. Physical mixing processes were prevalent during FeCycle with rapid patch growth (strain rate γ = 0.17–0.20 d−1) from a circular shape (50 km2) into a long filament of ∼400 km2 by day 10. Slippage between layers saw the patch-head overlying noninfused waters while the tail was capped by adjacent surface waters resulting in a SF6 maximum at depth. As the patch developed it entrained adjacent waters containing higher chlorophyll concentrations, but similar dissolved iron (DFe) levels, than the initial infused patch. DFe was low ∼60 pmol L−1 in surface waters during FeCycle and was dominated by organic complexation. Nighttime measurements of Fe(II) ∼20 pmol L−1 suggest the presence of Fe(II) organic complexes in the absence of an identifiable fast Fe(III) reduction process. Combining residence times and phytoplankton uptake fluxes for DFe it is cycled through the biota 140–280 times before leaving the winter mixed layer (WML). This strong Fe demand throughout the euphotic zone coupled with the low Fe:NO3 − (11.9 μmol:mol) below the ferricline suggests that vertical diffusion of Fe is insufficient to relieve chronic iron limitation, indicating the importance of atmospheric inputs of Fe to this region