Commencing rehabilitation in the ICU.

Rehabilitation is an integral part of the management of patients inIntensive Care Units (ICUs).The most important aim in this area isto enhance the patient's overall functional capacity and to restorehis/her respiratory and physical independence, thus decreasing the risks of bed-rest and associated complications.The evidence for applying a weaning protocol and physiotherapytechniques (postures, percussion/vibration, limb exercise, and active mobilization) in these patients has proved to be effective according to the application rationale of each process. However, todate, there are only strong recommendations concerning the evidence-based strategies to speed weaning from mechanical ventilation.Early physiotherapy may be effective in the ICU: nonetheless,most techniques need to be further studied in a wider population.In particular, evidence supporting physiotherapy interventionsis limited as there are no studies examining the specific effectsof interventions on long-term outcomes

Activity and analysis of costs in a dedicated weaning centre.

AIM: To analyse the diagnosis-related characteristics and the costs of treating patients with difficult/prolonged weaning from mechanical ventilation we have undertaken a retrospective observational study. METHODS: The study has considered all the patients admitted to our weaning unit of a regional Rehabilitation department during 3 consecutive periods since the opening date. Characteristics of the admitted patients and the DRG-related cares delivered have been recorded. A cost analysis has been obtained over time. RESULTS: The number of beds allocated to this unit (from 4 in the 1st period to 6 in the 2nd and 3rd periods) and the number of patients cared for (from 32 to 43 and to 65, respectively) increased over time. In particular, the COPD to non-COPD patient ratio (from 2.2 to 1.3 and to 1.0) and the DRG/patient weight (from 3.0 +/- 0.3 to 3.1 +/- 0.2 and to 3.3 +/- 0.2 point) changed significantly (p < 0.05). The daily reimbursement per patient from the public health care system only slightly increased, whereas the operating margin (reimbursement less costs) per patient significantly improved (from -304, to +17 and +55 Euro/pt/day, respectively, p < 0.05) due to a gradual restriction in the variable costs. Length of stay, mortality rate and weaning rate did not change over time. CONCLUSION: The weaning centre is a hospital area where economic burdens should be carefully evaluated. Given the actual reimbursement received on a national level for these patients, variable costs might be better spread, thus optimising the burdens without losing out on clinical outcomes

Activity and analysis of costs in a dedicated weaning centre

Aim. To analyse the diagnosis-related characteristics and the costs of treating patients with difficult/prolonged weaning from mechanical ventilation we have undertaken a retrospective observational study. Methods. The study has considered all the patients admitted to our weaning unit of a regional Rehabilitation department during 3 consecutive periods since the opening date. Characteristics of the admitted patients and the DRG-related cares delivered have been recorded. A cost analysis has been obtained over time. Results. The number of beds allocated to this unit (from 4 in the 1st period to 6 in the 2nd and 3rd periods) and the number of patients cared for (from 32 to 43 and to 65, respectively) increased over time. In particular, the COPD to non-COPD patient ratio (from 2.2 to 1.3 and to 1.0) and the DRG/patient weight (from 3.0±0.3 to 3.1±0.2 and to 3.3±0.2 point) changed significantly (p<0.05). The daily reimbursement per patient from the public health care system only slightly increased, whereas the operating margin (reimbursement less costs) per patient significantly improved (from -304, to +17 and +55 €/pt/day, respectively, p<0.05) due to a gradual restriction in the variable costs. Length of stay, mortality rate and weaning rate did not change over time. Conclusion. The weaning centre is a hospital area where economic burdens should be carefully evaluated. Given the actual reimbursement received on a national level for these patients, variable costs might be better spread, thus optimising the burdens without losing out on clinical outcomes

Some Experiments on the influence of Problem Hardness in Morphological Development based Learning of Neural Controllers

Natural beings undergo a morphological development process of their bodies while they are learning and adapting to the environments they face from infancy to adulthood. In fact, this is the period where the most important learning pro-cesses, those that will support learning as adults, will take place. However, in artificial systems, this interaction between morphological development and learning, and its possible advantages, have seldom been considered. In this line, this paper seeks to provide some insights into how morphological development can be harnessed in order to facilitate learning in em-bodied systems facing tasks or domains that are hard to learn. In particular, here we will concentrate on whether morphological development can really provide any advantage when learning complex tasks and whether its relevance towards learning in-creases as tasks become harder. To this end, we present the results of some initial experiments on the application of morpho-logical development to learning to walk in three cases, that of a quadruped, a hexapod and that of an octopod. These results seem to confirm that as task learning difficulty increases the application of morphological development to learning becomes more advantageous.Comment: 10 pages, 4 figure

SWARM-BOT: Pattern Formation in a Swarm of Self-Assembling Mobile Robots

In this paper we introduce a new robotic system, called swarm-bot. The system consists of a swarm of mobile robots with the ability to connect to/disconnect from each other to self-assemble into different kinds of structures. First, we describe our vision and the goals of the project. Then we present preliminary results on the formation of patterns obtained from a grid-world simulation of the system

Chemotaxis Based Virtual Fence for Swarm Robots in Unbounded Environments

This paper presents a novel swarm robotics application of chemotaxis behaviour observed in microorganisms. This approach was used to cause exploration robots to return to a work area around the swarm’s nest within a boundless environment. We investigate the performance of our algorithm through extensive simulation studies and hardware validation. Results show that the chemotaxis approach is effective for keeping the swarm close to both stationary and moving nests. Performance comparison of these results with the unrealistic case where a boundary wall was used to keep the swarm within a target search area showed that our chemotaxis approach produced competitive results

Cooperative object transport with a swarm of e-puck robots: robustness and scalability of evolved collective strategies

Cooperative object transport in distributed multi-robot systems requires the coordination and synchronisation of pushing/pulling forces by a group of autonomous robots in order to transport items that cannot be transported by a single agent. The results of this study show that fairly robust and scalable collective transport strategies can be generated by robots equipped with a relatively simple sensory apparatus (i.e. no force sensors and no devices for direct communication). In the experiments described in this paper, homogeneous groups of physical e-puck robots are required to coordinate and synchronise their actions in order to transport a heavy rectangular cuboid object as far as possible from its starting position to an arbitrary direction. The robots are controlled by dynamic neural networks synthesised using evolutionary computation techniques. The best evolved controller demonstrates an effective group transport strategy that is robust to variability in the physical characteristics of the object (i.e. object mass and size of the longest object’s side) and scalable to different group sizes. To run these experiments, we designed, built, and mounted on the robots a new sensor that returns the agents’ displacement on a 2D plane. The study shows that the feedback generated by the robots’ sensors relative to the object’s movement is sufficient to allow the robots to coordinate their efforts and to sustain the transports for an extended period of time. By extensively analysing successful behavioural strategies, we illustrate the nature of the operational mechanisms underpinning the coordination and synchronisation of actions during group transport

System for deployment of groups of unmanned micro aerial vehicles in GPS-denied environments using onboard visual relative localization

A complex system for control of swarms of micro aerial vehicles (MAV), in literature also called as unmanned aerial vehicles (UAV) or unmanned aerial systems (UAS), stabilized via an onboard visual relative localization is described in this paper. The main purpose of this work is to verify the possibility of self-stabilization of multi-MAV groups without an external global positioning system. This approach enables the deployment of MAV swarms outside laboratory conditions, and it may be considered an enabling technique for utilizing fleets of MAVs in real-world scenarios. The proposed visual-based stabilization approach has been designed for numerous different multi-UAV robotic applications (leader-follower UAV formation stabilization, UAV swarm stabilization and deployment in surveillance scenarios, cooperative UAV sensory measurement) in this paper. Deployment of the system in real-world scenarios truthfully verifies its operational constraints, given by limited onboard sensing suites and processing capabilities. The performance of the presented approach (MAV control, motion planning, MAV stabilization, and trajectory planning) in multi-MAV applications has been validated by experimental results in indoor as well as in challenging outdoor environments (e.g., in windy conditions and in a former pit mine)

The State of Coral Reef Ecosystems of the United States and Pacific Freely Associated States: 2002

Called for by the U.S. Coral Reef Task Force’s (USCRTF) National Action Plan to Conserve Coral Reefs, this is the first biennial report on the condition of coral reefs. It is the scientific baseline for subsequent reports on the health of U.S. coral reef ecosystems that are to be used by NOAA and others to evaluate the efficacy of coral reef conservation and management practices. The National Oceanic and Atmospheric Administration’s National Ocean Service led the development of this report. It was authored by 38 experts and supported by 79 contributors from government agencies and non-governmental organizations across the nation and internationally. Over 100 Task Force members and other notable scientists have reviewed this document