796 research outputs found
Effects of Age and Comorbidities on Intensive Care and 1-year Mortality after HeartMate 3 Implantation
Background: The use of left ventricular assist devices (LVAD) has been rapidly increasing in older people over the past two decades due to their availability as destination therapy. This study aimed to assess the effect of age and comorbidities on the intensive care unit (ICU) and 1-year mortality after HeartMate 3 LVAD implantation. Methods: From 2016 to 2023, all consecutive adult patients implanted with HeartMate 3 LVAD in our tertiary referral center were enrolled in the study. Patients were stratified according to their age at implantation into Group-1 (<45 years), Group-2 (46â64 years), and Group-3 (>65 years). The effect of age and comorbidities on ICU and 1-year mortality were assessed. Results: In total, 135 patients were included (mean age 54±13 years, 79% males). Baseline vital signs, comorbidities, and hemodynamic support were not different between age groups. The older population had significantly lower eGFR (p=0.025), ischemic cardiac diseases as the underlying heart problem (p<0.001), and LVAD as destination therapy (p<0.001). The mortality rate at the ICU and at one year were 90% and 83%, respectively. The median age of the patients who died in the ICU was significantly higher than 63 [56â65] years versus 57 years [49â62, p=0.034). However, age lost its significance with logistic regression analysis. Having a recent major myocardial infarct, high preoperative leukocyte count, and cardiopulmonary bypass time were independent risk factors for ICU mortality. On the other hand, age was an independent risk factor for one-year mortality. Conclusion: Older age predicts increased one-year but not ICU mortality after HeartMate 3 LVAD implantation, while recent major myocardial infarction, high preoperative leukocyte count, and longer cardiopulmonary bypass time were independent risk factors for ICU mortality. Careful patient selection is critical to optimize outcomes after HeartMate 3 LVAD implantation.</p
Mitigating Gender Bias in Machine Learning Data Sets
Artificial Intelligence has the capacity to amplify and perpetuate societal
biases and presents profound ethical implications for society. Gender bias has
been identified in the context of employment advertising and recruitment tools,
due to their reliance on underlying language processing and recommendation
algorithms. Attempts to address such issues have involved testing learned
associations, integrating concepts of fairness to machine learning and
performing more rigorous analysis of training data. Mitigating bias when
algorithms are trained on textual data is particularly challenging given the
complex way gender ideology is embedded in language. This paper proposes a
framework for the identification of gender bias in training data for machine
learning.The work draws upon gender theory and sociolinguistics to
systematically indicate levels of bias in textual training data and associated
neural word embedding models, thus highlighting pathways for both removing bias
from training data and critically assessing its impact.Comment: 10 pages, 5 figures, 5 Tables, Presented as Bias2020 workshop (as
part of the ECIR Conference) - http://bias.disim.univaq.i
Compact left-handed metamaterial based on double-layer planar metal strip arrays
The existence of a left-handed transmission peak of a metamaterial consisting of double-layer planar metal strip arrays at 15 GHz is demonstrated. This design is very suitable to submicron scales required at communication wavelengths. © 2006 Optical Society of America
Diabetic Foot Due to Anaphylactic Shock: A Case Report
Introduction: Diabetic foot is a clinical disorder, which is commonly seen in patients with diabetes mellitus. It is also the major cause of below knee amputation in the world. There are many underlying causes such as neuropathic, ischemic, and infectious causes for diabetic foot. Local or systemic complications may develop after snake bite.
Case Presentation: We reported a very rare case, involving a 78-year-old male admitted to the Emergency Department, who developed anaphylactic shock and diabetic foot after the snake bite.
Conclusions: Reviewing the literature, this is the second reported case of snake bite associated with diabetic foot
Dynamical transition, hydrophobic interface, and the temperature dependence of electrostatic fluctuations in proteins
Molecular dynamics simulations have revealed a dramatic increase, with
increasing temperature, of the amplitude of electrostatic fluctuations caused
by water at the active site of metalloprotein plastocyanin. The increased
breadth of electrostatic fluctuations, expressed in terms of the reorganization
energy of changing the redox state of the protein, is related to the formation
of the hydrophobic protein/water interface allowing large-amplitude collective
fluctuations of the water density in the protein's first solvation shell. On
the top of the monotonic increase of the reorganization energy with increasing
temperature, we have observed a spike at 220 K also accompanied by a
significant slowing of the exponential collective Stokes shift dynamics. In
contrast to the local density fluctuations of the hydration-shell waters, these
spikes might be related to the global property of the water solvent crossing
the Widom line.Comment: 9 pages, 8 figure
The role of long-term mechanical circulatory support in patients with advanced heart failure
In patients with end-stage heart failure, advanced therapies such as heart transplantation and long-term mechanical circulatory support (MCS) with a left ventricular assist device (LVAD) have to be considered. LVADs can be implanted as a bridge to transplantation or as an alternative to heart transplantation: destination therapy. In the Netherlands, long-term LVAD therapy is gaining importance as a result of increased prevalence of heart failure together with a low number of heart transplantations due to shortage of donor hearts. As a result, the difference between bridge to transplantation and destination therapy is becoming more artificial since, at present, most patients initially implanted as bridge to transplantation end up receiving extended LVAD therapy. Following LVAD implantation, survival after 1, 2 and 3 years is 83%, 76% and 70%, respectively. Quality of life improves substantially despite important adverse events such as device-related infection, stroke, major bleeding and right heart failure. Early referral of potential candidates for long-term MCS is of utmost importance and positively influences outcome. In this review, an overview of the indications, contraindications, patient selection, clinical outcome and optimal time of referral for long-term MCS is given
Like trainer, like bot? Inheritance of bias in algorithmic content moderation
The internet has become a central medium through which `networked publics'
express their opinions and engage in debate. Offensive comments and personal
attacks can inhibit participation in these spaces. Automated content moderation
aims to overcome this problem using machine learning classifiers trained on
large corpora of texts manually annotated for offence. While such systems could
help encourage more civil debate, they must navigate inherently normatively
contestable boundaries, and are subject to the idiosyncratic norms of the human
raters who provide the training data. An important objective for platforms
implementing such measures might be to ensure that they are not unduly biased
towards or against particular norms of offence. This paper provides some
exploratory methods by which the normative biases of algorithmic content
moderation systems can be measured, by way of a case study using an existing
dataset of comments labelled for offence. We train classifiers on comments
labelled by different demographic subsets (men and women) to understand how
differences in conceptions of offence between these groups might affect the
performance of the resulting models on various test sets. We conclude by
discussing some of the ethical choices facing the implementers of algorithmic
moderation systems, given various desired levels of diversity of viewpoints
amongst discussion participants.Comment: 12 pages, 3 figures, 9th International Conference on Social
Informatics (SocInfo 2017), Oxford, UK, 13--15 September 2017 (forthcoming in
Springer Lecture Notes in Computer Science
Temporal evolution of anxiety and depression in chronic heart failure and its association with clinical outcome
Background: Although anxiety and depression have been associated with adverse outcomes in chronic heart failure (HF), data on temporal evolution of these symptoms are scarce. We aimed to investigate the association between repeatedly measured depression and anxiety symptoms and clinical outcome in chronic HF patients. Methods: In this prospective observational study, outpatients with chronic HF were included and followed-up for a maximum of 2.5 years. The hospital anxiety and depression scale (HADS) questionnaire was conducted every six months. The primary endpoint was a composite of HF hospitalization, cardiovascular death, heart transplantation and left ventricular assist device (LVAD) implantation. Cox and joint models were used to investigate the association between the HADS score and the endpoint. Results: A total of 362 patients filled out a median (25thâ75th percentile) of 3 [2â4] questionnaires each. Mean ± SD age was 63 ± 13 years, 72% were men. Anxiety scores remained relatively stable leading up to the endpoint, while depression scores increased. Higher baseline depression scores were significantly associated with the endpoint (hazard ratio [HR] 1.68 and 95% confidence interval [CI] 1.19â2.36 per log(score+1), p = 0.003), while higher baseline anxiety scores did not reach statistical significance (HR [95% CI] 1.34 [0.99â1.83], p = 0.061). When repeatedly measured, both higher anxiety (HR [95% CI] 1.57[1.07â2.30], p = 0.022) and depression (HR [95% CI] 2.04 [1.39â3.06], p < 0.001) scores were significantly associated with the endpoint. Conclusion: Serial measurements of depression and anxiety symptoms identify chronic HF patients with increased risk of adverse clinical outcomes. Screening for both disorders should be considered in clinical practice.</p
Pricing Bodies: A Feminist New Materialist Approach to the Relations Between the Economic and Socio-Cultural
Arguments that the economic and socio-cultural should be understood as relational and intertwined, and that price involves a reciprocal relationship between the economic and socio-cultural, are increasingly prevalent in the social sciences. I develop these notions of relationality and reciprocation through a feminist new materialist perspective, which emphasises the entanglement of and intra-action between what might usually be seen as independent and autonomous entities. To do this, I focus on a range of recent body-image initiatives, led by government, corporate and non-profit organisations, which aim to improve girlsâ and young womenâs levels of confidence and self-esteem. I explore how feminist theory tends to see such initiatives in terms of the expansion of the economic sphere into the socio-cultural, which involves a tainting or contamination of embodiment and feeling. Rather than dispute these arguments, I take seriously theories and practices from cultural economy that see the economic and socio-cultural as co-constitutive. I augment these ideas with a feminist new materialist approach and argue that the economic and socio-cultural are in intra-active relations: they do not precede or exist apart from each other. In doing so, I consider how body-image initiatives can be understood as phenomena produced through these entangled intra-active relations, and offer an understanding of pricing as a simultaneously socio-cultural and economic process, where value and values become. I also raise questions regarding how, ethically and politically, boundary making and unmaking can be conceived, and how despite being in entangled relations, asymmetries between economic and socio-cultural relations may be approached
- âŠ