VOICE - a spectrogram computer display package

A real-time spetrogram instrument has been developed to provide an inexpensive and field-portable instrument for the analysis of animal sounds. The instrument integrates a computer graphics display package with a PC-AT computer equipped with an A/D board and a digital signal processing board. It provides a real-time spectrogram display of frequencies up to 50kHz in a variety of modes: a running display, a signal halted on screen, successive expanded views of the signal. The signal amplitude may also be displayed. Portions of the scrolled data may be saved to disk file for future viewing, or as part of a database collection. The screen display may be manipulated to adapt to special needs. Program source listings are included in the text.Funding was provided by the Office of Naval Research through Grant Nos. N00014-88-K-0273 and N00014-87-K-0236, the National Institutes of Health through Grant No.1 R29 NS25290, and the Andrew W. Mellon Foundation

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Clinical use of ivabradine in the acute coronary syndrome: A systematic review and narrative synthesis of current evidence

Heart rate (HR) lowering during acute coronary syndrome (ACS) is beneficial as it reduces myocardial oxygen consumption. However, the role of ivabradine as an HR-lowering agent in the setting of ACS is not clear. We aimed to systematically review and synthesize the current evidence on the role of ivabradine use in the ACS. A systematic review was conducted for eligible randomized clinical trials and quasi-experimental studies, between 2009 and 2020, that investigated the use of ivabradine in ACS. Various clinical endpoints were evaluated such as major adverse cardiovascular events, efficacy in HR control, impact on left ventricular (LV) dimensions and function, and overall safety. Eleven publications were included encompassing a total of 1833 patients. The mean age of the examined cohort was 57 +/- 11 years and 80 % were men. Seven studies were in the setting of STsegment elevation myocardial infarction (MI) while the remaining studies also included patients with unstable angina and non-ST-segment elevation MI. Ivabradine was administered as a peroral drug with dosing from 2.5 to 7.5 mg b.i.d. Overall, the addition of ivabradine was superior to the control arm concerning HR control with a good safety profile. Beneficial effects on LV function and potential impact on infarct size reduction were observed as well. The use of ivabradine appeared to not affect short-term mortality. In conclusion, the use of ivabradine for HR control is safe, feasible, and efficacious for HR control in the ACS. Further studies are required to elucidate other potentially beneficial effects of ivabradine

Interdisciplinary Research Center on Critical Systems Engineering for Socio-Technical Systems - Progress Report

Critical Systems, i.e., systems whose failure either endangers human life or causes drastic economic losses, form the technological backbone of today's society and are an integral part in such vastly diverse industrial sectors as automotive, aerospace, maritime, automation, energy, health care, banking, and others. The Interdisciplinary Research Center on Critical Systems Engineering for Socio-technical Systems addresses critical systems, which rely on synergistically blending human skills with IT-enabled capabilities of technical systems to jointly achieve the overarching societal and industrial objectives. We focus on instances of such socio-technical systems in the transportation domain, where the overarching objectives are to achieve safe and green mobility, through cooperative semi-autonomous guidance of vehicles with humans in the loop, such as in their roles as drivers, operators, navigation officers, flight controllers, etc., and consider two industrial sectors key in Lower Saxony, the automotive and maritime domains. Such systems are safety critical – human errors, technical failures and malicious manipulation of information can cause catastrophic events leading to loss of life. Creating sufficiently precise real-time mental or digital images of real-world situations, and assuring their coherence among all involved actors (both humans and technical systems) as a basis for coordinated action is a major challenge in socio-technical system design. This calls for constructive approaches involving intuitive and scalable patterns of cooperation, between humans and technical systems, seeking for a balanced sharing of tasks best matching both the abilities of humans and technical systems, or between technical systems. It calls for insights in understanding humans in their interaction with technical systems. It calls for layered approaches in aggregating information along both spatio-temporal and cognitive dimensions. It calls for robust and adaptable designs, seamlessly catering with adverse and changing environmental conditions. It calls for executable and composable models of socio-technical systems, both human and technical, allowing to adaptively, as it were, “zoom” into detailed levels, when reaching critical states to provide fine-grained views of the actual interactions, as well as the need to aggregate to coarse views in order to cope with the sheer complexity of such models

ARTigo – Social Image Tagging [Dataset and Images]

ARTigo is a platform that uses crowdsourcing to gather annotations (tags) on works of art (see http://www.artigo.org/). The dataset is compromised of 54.497 objects, which are associated with 18.492 artists (11.519 of which are either anonymous or unknown), 295.343 German-, French-, English-language tags, and 9.669.410 taggings. It is based on a cleansed database dump dated November 15, 2018. The cleansing concerned only the metadata of the objects; tags and taggings are provided „as is“. A current but uncleansed version of the data is available via a RESTful API at: http://www.artigo.org/api.html. The data is licensed under Creative Commons BY-NC-SA 4.0. If you are unsure whether your project is a commercial use, please contact us at: [email protected]

A multicentre, prospective, randomised controlled trial to assess the safety and effectiveness of cooling as an adjunctive therapy to percutaneous intervention in patients with acute myocardial infarction: the COOL AMI EU Pivotal Trial

Background: Despite primary PCI (PPCI), STEMI can still result in large infarct size (IS). New technology with rapid intravascular cooling showed positive signal for reduction in IS in anterior STEMI. Aims: We investigated the effectiveness and safety of rapid systemic intravascular hypothermia as an adjunct to primary PCI (PPCI) in conscious patients with anterior ST-elevation myocardial infarction (STEMI) without cardiac arrest. Methods: Hypothermia was induced using ZOLL® Proteus™ Intravascular Cooling System. After randomization of 111 patients, 58 to hypothermia and 53 to control groups, the study was prematurely discontinued by the sponsor due to inconsistent patient logistics between the groups resulting in significantly longer total ischemic delay in hypothermia group (232 vs 188 minutes; p <0.001). Results: There were no differences in angiographic features and PPCI result between the groups. Intravascular temperature at wire crossing was 33.3+0.9°C. Infarct size/left ventricular mass (IS/LV) by cardiac magnetic resonance (CMR) at day 4-6 was 21.3% in hypothermia group and 20.0% in control group (p=0.540). Major adverse cardiac events (MACE) at 30 days were non significantly increased in hypothermia group (8.6% vs 1.9%; p=0.117) while cardiogenic shock (10.3% vs 0%; p=0.028) and paroxysmal atrial fibrillation (43.1% vs 3.8%; p<0.001) were significantly more frequent in hypothermia group. Conclusion: Intravascular ZOLL TM Proteus Cooling System reduced temperature to 33.3oC before PPCI in patients with anterior STEMI. Due to inconsistent patient logistics between the groups, this hypothermia protocol resulted in longer ischemic delay, did not reduce IS/LV mass and was associated with increased adverse events