426 research outputs found

    Self-advising SVM for sleep apnea classification

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    In this paper Self-Advising SVM, a new proposed version of SVM, is investigated for sleep apnea classification. Self-Advising SVM tries to trans-fer more information from training phase to the test phase in compare to the traditional SVM. In this paper Sleep apnea events are classified to central, ob-structive or mixed, by using just three signals, airflow, abdominal and thoracic movement, as inputs. Statistical tests show that self-advising SVM performs better than traditional SVM in sleep apnea classification

    Sepsis during pregnancy: case report

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    BACKGROUND AND OBJECTIVES: Sepsis during pregnancy is a rare complication. This potentially fatal disease often occurs due to maternal infectious and can lead to fetal loss. Therefore, any attempted treatment must be aimed at the mother s well being. As a matter of fact, there are few recent medical publications about sepsis in pregnancy. In spite of this, the treatment based on Surviving Sepsis Campaign seems suitable and practical. The aim of this article is making a case report highlighting a very well succeeded treatment of a pregnant woman with urinary sepsis. CASE REPORT: A 22 year old in her 27th week of pregnancy is hospitalized with pyelonefhritis. One day later, she begins presenting signs of sepsis and unresponsive hypoxemia, resulting in intubation. Afterwards, she evolved with persistent low blood pressure that was unresponsive to volume expansion and had to be put on vasopressor medication. She received intensive care support based on Surviving Sepsis Campaign. The patient evolved with an important improvement of her ventilatory stats and was extubated. After completing antibiotic treatment, she was discharged and delivered a healthy baby after 42 weeks pregnancy. CONCLUSIONS: Sepsis in pregnancy is a rare and potentially fatal complication. The main treatment is based on Surviving Sepsis Campaign. The patient had an outstanding improvement and overcame her condition after intensive care support.JUSTIFICATIVA E OBJETIVOS: A sepse durante a gestação é uma complicação rara. O comprometimento fetal resulta principalmente da descompensação materna, por conseguinte, o tratamento deve ser direcionado ao bem-estar da mãe. Poucas evidências permitem extrapolar o tratamento de pacientes não gestantes para as gestantes, porém, o tratamento baseado no Surviving Sepsis Campaing parece adequado e prático. O objetivo deste estudo foi rever o tratamento da sepse na gestação e relatar um caso de gestante com sepse grave que evoluiu favoravelmente. RELATO DO CASO: Paciente com 22 anos, primigesta, na 27ª semana de gestação foi internada com diagnóstico de pielonefrite aguda. Um dia após a internação apresentou quadro de sepse, com hipoxemia refratária às medidas não-invasivas necessitando de intubação traqueal. Após a intubação evoluiu com hipotensão refratária à expansão volêmica necessitando de fármaco vasoativo. Foi interrompido o uso de noradrenalina no mesmo dia e prescrito cefepima. Evoluiu com importante melhora dos padrões ventilatórios, sendo extubada e recebeu alta hospitalar logo após completar o tratamento com antibiótico. Ao completar a 42ª semana de gestação foi internada para indução do trabalho de parto, sendo realizado parto vaginal, sem intercorrências. CONCLUSÕES: A sepse na gestação, mesmo sendo rara é potencialmente fatal. O tratamento foi baseado no Surviving Sepsis Campaign e a paciente apresentou melhora significativa dos parâmetros de perfusão nas primeiras horas com ótima evolução, apesar da gravidade da doença.UNIFESP Clínica Médica da EPMUNIFESP Pronto Socorro da EPM Unidade de Terapia IntensivaUNIFESP, Clínica Médica da EPMUNIFESP, Pronto Socorro da EPM Unidade de Terapia IntensivaSciEL

    Feasibility Studies on Disturbance Feedforward Techniques to Improve Wind Turbine Load Mitigation Performance: January 2009 -- January 2010

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    This study investigates disturbance feedforward and preview control to better understand the best possible improvement in load mitigation using advanced wind measurement techniques

    High-Dose Chemotherapy with Autologous Hematopoietic Stem-Cell Rescue for Pediatric Brain Tumor Patients: A Single Institution Experience from UCLA

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    Background. Dose-dependent response makes certain pediatric brain tumors appropriate targets for high-dose chemotherapy with autologous hematopoietic stem-cell rescue (HDCT-AHSCR). Methods. The clinical outcomes and toxicities were analyzed retrospectively for 18 consecutive patients ≤19 y/o treated with HDCT-AHSCR at UCLA (1999–2009). Results. Patients' median age was 2.3 years. Fourteen had primary and 4 recurrent tumors: 12 neural/embryonal (7 medulloblastomas, 4 primitive neuroectodermal tumors, and a pineoblastoma), 3 glial/mixed, and 3 germ cell tumors. Eight patients had initial gross-total and seven subtotal resections. HDCT mostly consisted of carboplatin and/or thiotepa ± etoposide (n = 16). Nine patients underwent a single AHSCR and nine ≥3 tandems. Three-year progression-free and overall survival probabilities were 60.5% ± 16 and 69.3% ± 11.5. Ten patients with pre-AHSCR complete remissions were alive/disease-free, whereas 5 of 8 with measurable disease were deceased (median followup: 2.3 yrs). Nine of 13 survivors avoided radiation. Single AHSCR regimens had greater toxicity than ≥3 AHSCR (P < .01). Conclusion. HDCT-AHSCR has a definitive, though limited role for selected pediatric brain tumors with poor prognosis and pretransplant complete/partial remissions

    Impact Ionization in ZnS

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    The impact ionization rate and its orientation dependence in k space is calculated for ZnS. The numerical results indicate a strong correlation to the band structure. The use of a q-dependent screening function for the Coulomb interaction between conduction and valence electrons is found to be essential. A simple fit formula is presented for easy calculation of the energy dependent transition rate.Comment: 9 pages LaTeX file, 3 EPS-figures (use psfig.sty), accepted for publication in PRB as brief Report (LaTeX source replaces raw-postscript file

    Non infective severe aortic paravalvular leakage 7 years after surgery: the role of suture technique

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    We report a case of redo aortic prosthesis replacement for a severe paravalvular leak (PVL) in a man operated with continuous suture technique 7 years earlier. The severe aortic regurgitation was due to the rupture of the suture. In spite of operations to replace malfunctioning heart valves are common procedures and performed all over the world from more than 50 years, there is still an open debate about the most suitable suture technique. In this case report, we'll discuss if the suture technique has a role in preventing or leading complications as severe PVL

    Psychophysiological Responses to Stress after Stress Management Training in Patients with Rheumatoid Arthritis

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    Contains fulltext : 97274.pdf (publisher's version ) (Open Access)BACKGROUND: Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA). METHODS: Seventy-four patients with RA, who were randomly assigned to either a control group or a group that received short-term stress management training, performed a standardized psychosocial stress task (Trier Social Stress Test; TSST) 1 week after the stress management training and at a 9-week follow-up. Psychological and physical functioning, and the acute psychophysiological response to the stress test were assessed. RESULTS: Patients in the intervention group showed significantly lower psychological distress levels of anxiety after the training than did the controls. While there were no between-group differences in stress-induced tension levels, and autonomic (alpha-amylase) or endocrine (cortisol) responses to the stress test 1 week after the intervention, levels of stress-induced tension and cortisol were significantly lower in the intervention group at the 9-week follow-up. Overall, the response to the intervention was particularly evident in a subgroup of patients with a psychological risk profile. CONCLUSION: A relatively short stress management intervention can improve psychological functioning and influences the psychophysiological response to stress in patients with RA, particularly those psychologically at risk. These findings might help understand how stress can affect health and the role of individual differences in stress responsiveness. TRIAL REGISTRATION: TrialRegister.nl NTR1193

    Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials

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    Objective Mindfulness-based interventions (MBIs) can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs) of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder. Method Post-intervention between-group Hedges g effect sizes were calculated using a random effects model. Moderator analyses of primary diagnosis, intervention type and control condition were conducted and publication bias was assessed. Results Twelve studies met inclusion criteria (n = 578). There were significant post-intervention between-group benefits of MBIs relative to control conditions on primary symptom severity (Hedges g = −0.59, 95% CI = −0.12 to −1.06). Effects were demonstrated for depressive symptom severity (Hedges g = −0.73, 95% CI = −0.09 to −1.36), but not for anxiety symptom severity (Hedges g = −0.55, 95% CI = 0.09 to −1.18), for RCTs with an inactive control (Hedges g = −1.03, 95% CI = −0.40 to −1.66), but not where there was an active control (Hedges g = 0.03, 95% CI = 0.54 to −0.48) and effects were found for MBCT (Hedges g = −0.39, 95% CI = −0.15 to −0.63) but not for MBSR (Hedges g = −0.75, 95% CI = 0.31 to −1.81). Conclusions This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population

    Effects of anharmonic strain on phase stability of epitaxial films and superlattices: applications to noble metals

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    Epitaxial strain energies of epitaxial films and bulk superlattices are studied via first-principles total energy calculations using the local-density approximation. Anharmonic effects due to large lattice mismatch, beyond the reach of the harmonic elasticity theory, are found to be very important in Cu/Au (lattice mismatch 12%), Cu/Ag (12%) and Ni/Au (15%). We find that is the elastically soft direction for biaxial expansion of Cu and Ni, but it is for large biaxial compression of Cu, Ag, and Au. The stability of superlattices is discussed in terms of the coherency strain and interfacial energies. We find that in phase-separating systems such as Cu-Ag the superlattice formation energies decrease with superlattice period, and the interfacial energy is positive. Superlattices are formed easiest on (001) and hardest on (111) substrates. For ordering systems, such as Cu-Au and Ag-Au, the formation energy of superlattices increases with period, and interfacial energies are negative. These superlattices are formed easiest on (001) or (110) and hardest on (111) substrates. For Ni-Au we find a hybrid behavior: superlattices along and like in phase-separating systems, while for they behave like in ordering systems. Finally, recent experimental results on epitaxial stabilization of disordered Ni-Au and Cu-Ag alloys, immiscible in the bulk form, are explained in terms of destabilization of the phase separated state due to lattice mismatch between the substrate and constituents.Comment: RevTeX galley format, 16 pages, includes 9 EPS figures, to appear in Physical Review

    Surface plasmon-related resonances on deep and asymmetric gold gratings

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    M. Kreiter, S. Mittler, W. Knoll, and J. Roy Sambles, Physical Review B, Vol. 65, article 125415 (2002). "Copyright © 2002 by the American Physical Society."Based on theoretical calculations, the surface plasmonlike resonances on deep and asymmetric gold gratings are reinvestigated and assigned to two classes possessing different characteristic symmetry properties. Reflectivity measurements on deep grating structures with varying depth and asymmetry allow for a detailed study of the influence of these parameters on the lowest-order resonances as well as the experimental observation of a higher-order resonance
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