The Ariadne's Clew Algorithm

We present a new approach to path planning, called the "Ariadne's clew algorithm". It is designed to find paths in high-dimensional continuous spaces and applies to robots with many degrees of freedom in static, as well as dynamic environments - ones where obstacles may move. The Ariadne's clew algorithm comprises two sub-algorithms, called Search and Explore, applied in an interleaved manner. Explore builds a representation of the accessible space while Search looks for the target. Both are posed as optimization problems. We describe a real implementation of the algorithm to plan paths for a six degrees of freedom arm in a dynamic environment where another six degrees of freedom arm is used as a moving obstacle. Experimental results show that a path is found in about one second without any pre-processing

The Ariadne's Clew Algorithm

We present a new approach to path planning, called the ``Ariadne's clew algorithm''. It is designed to find paths in high-dimensional continuous spaces and applies to robots with many degrees of freedom in static, as well as dynamic environments --- ones where obstacles may move. The Ariadne's clew algorithm comprises two sub-algorithms, called SEARCH and EXPLORE, applied in an interleaved manner. EXPLORE builds a representation of the accessible space while SEARCH looks for the target. Both are posed as optimization problems. We describe a real implementation of the algorithm to plan paths for a six degrees of freedom arm in a dynamic environment where another six degrees of freedom arm is used as a moving obstacle. Experimental results show that a path is found in about one second without any pre-processing

Opioid Administration and Prescribing in Older Adults in U.S. Emergency Departments (2005-2015).

Introduction: We assess trends in opioid administration and prescribing from 2005-2015 in older adults in United States (U.S.) emergency departments (ED). Methods: We analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) survey from 2005 to 2015. ED visits for painful conditions were selected and stratified by age (18-64, 65-74, 75-84, ≥ 85 years). We analyzed trends in opioid administration in the ED and prescribing at discharge to encounters ≥ 65 and assessed predictors of use using survey-weighted chi-square tests and logistic regression. Trends in the use of five commonly prescribed opioids were also explored. Results: Opioid administration in the ED and prescribing at discharge for encounters with patients ≥ 65 years fell overall, but not significantly. By contrast, opioid administration in the ED and prescribing at discharge significantly declined for adult encounters 18-64 by 20% and 32%, respectively. A similar proportion of adult encounters ≥ 65 were administered opioids in the ED as 18-64, but adult encounters ≥ 85 had the lowest rates of administration. A smaller proportion of adult encounters ≥ 65 years with painful conditions were prescribed opioids at discharge compared to Conclusion: From 2005-15, 1 in 4 to 1 in 10 ED patients with painful conditions were administered or prescribed an opioid in U.S. EDs. Opioids prescribing increased from 2005-11 and then declined from 2012-15, more so among visits in the 18-64 age group compared to ≥ 65 years. Opioid administrating demonstrated a gradual rise and decline in all adult age groups. Age consistently appears to be an important consideration, where opioid prescribing declines with advancing age. Given the nationwide opioid crisis, ED providers should remain vigilant in limiting opioids, particularly in older adults who are at higher risk for adverse effects

Proportional fair buffer scheduling algorithm for 5G enhanced mobile broadband

The impending next generation of mobile communications denoted 5G intends to interconnect user equipment, things, vehicles, and cities. It will provide an order of magnitude improvement in performance and network efficiency, and different combinations of use cases enhanced mobile broadband (eMBB), ultra reliable low latency communications (URLLC), massive internet of things (mIoT) with new capabilities and diverse requirements. Adoption of advanced radio resource management procedures such as packet scheduling algorithms is necessary to distribute radio resources among different users efficiently. The proportional fair (PF) scheduling algorithm and its modified versions have proved to be the commonly used scheduling algorithms for their ability to provide a tradeoff between throughput and fairness. In this article, the buffer status is combined with the PF metric to suggest a new scheduling algorithm for efficient support for eMBB. The effectiveness of the proposed scheduling strategy is proved through à comprehensive experimental analysis based on the evaluation of different quality of service key performance indicators (QoS KPIs) such as throughput, fairness, and buffer status

Prescription Drug Shortages: Implications for Public Health and Potential Solutions

Prescription drug shortages have reached critical levels in the United States and represent a significant threat to healthcare quality and patient safety. The increase in drug shortages has been attributed to a variety of factors, although some underlying themes prevail, primarily quality problems at manufacturing facilities. Market factors also play a significant role. Sterile generic injectable medications have been disproportionately impacted by drug shortages. This thesis is intended to explore the impacts of drug shortages across a wide range of specialties, care settings, and populations. This work will describe trends in drug shortages over time and the potential implications for patient care and public health. It also addresses current and proposed initiatives to mitigate this public health threat

Google It

Violence prevention is of the utmost concern in some schools. For various reasons, rural schools face a number of challenges that may prevent them from implementing strong, evidence-based violence prevention initiatives. Given that the Internet houses a plethora of cost-free resources on threat assessment and violence prevention in schools, rural educators may consult the internet for information. However, because little is known about the composition and quality of such resources, it is important that they are properly evaluated. As such, the purpose of the present study was to compare existing, free, online school-based threat assessment resources to an evidence-based threat assessment framework to determine how well online resources communicate evidence-based principles. Using component analysis, a total of 11 online resources were evaluated. Overall, the findings from this investigation revealed that the evaluated online threat assessment resources were not as comprehensive as evidence-based guidelines. Keywords: online, prevention, schools, threat assessment, violenc

Vivienda unifamiliar, Chicago

Este edificio fue proyectado para un contratista de casas. Él lo quería funcional, adaptado a las costumbres de vivir de su familia y debía ser el prototipo de las casas que él quería construir en el futuro para su clientela. Su arquitecto propuso una casa con muchos conceptos modernos y progresivos que se adaptaría fácilmente en una ciudad, pero quedaría dentro de los medios económicos de una familia normal. El resultado fue que el arquitecto, junto con el contratista, construyeron muchas casas parecidas en Chicago y sus alrededores

Magnesium Depletion in Patients Treated with Therapeutic Hypothermia After Cardiac Arrest

Magnesium (Mg2+) depletion can have detrimental effects in postcardiac arrest patients through multiple potential mechanisms. Therapeutic hypothermia (TH) produces a Mg2+ diuresis, but the effects of postcardiac arrest TH on serum Mg2+ levels in patients with postcardiac arrest syndrome (PCAS) are yet to be systematically quantified. We conducted a retrospective chart review of 119 consecutive comatose PCAS patients treated with TH between 2005 and 2010 and compared them to 33 matched historic controls (HCs) seen at the same institution between 2002 and 2005 who were not treated with TH. We abstracted data from the first 96 hours postarrest, including date, time, and value of serum Mg2+ levels and date, time, and amount of Mg2+ repletion, along with outcomes at discharge. The median Mg2+ level of TH patients was 2.0?mg/dL [interquartile range (IQR), 1.9?2.2?mg/dL] (0.82 mmol/L [IQR, 0.78?0.90 mmol/L]) versus 2.2?mg/dL [IQR, 1.9?2.4?mg/dL] (0.90 mmol/L [IQR, 0.82?0.99 mmol/L]) (p=0.2) in HCs. In addition, 42.9% (520/1214) of Mg2+ levels in TH patients versus 31.9% (43/135) (p=0.014) in HC patients were below 2.0?mg/dL [0.82 mmol/L]. The average number of times the Mg2+ level was checked in TH patients was 10.2 (range 1?18) versus 4.1 (range 1?10) in HCs. The TH patients were more likely to receive supplemental Mg2+ than HCs (81.5% [97/119] vs. 27.3% [9/33] [p<0.01]). The mean supplemental Mg2+ dose was 1.9?g for TH patients versus 0.5?g for HC patients. Mortality in patients treated with TH was 53.1% (60/113) versus 78.6% (22/28) (p=0.014) in HCs. Low serum Mg2+ levels with subsequent Mg2+ supplementation were more common in comatose patients with PCAS treated with TH compared to normothermic HC patients. The effect of untreated hypomagnesemia on postcardiac arrest outcomes remains to be determined.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140255/1/ther.2014.0012.pd

Improving the Diagnosis of Acute Heart Failure Using a Validated Prediction Model

ObjectivesWe sought to derive and validate a prediction model by using N-terminal pro–B-type natriuretic peptide (NT-proBNP) and clinical variables to improve the diagnosis of acute heart failure (AHF).BackgroundThe optimal way of using natriuretic peptides to enhance the diagnosis of AHF remains uncertain.MethodsPhysician estimates of probability of AHF in 500 patients treated in the emergency department from the multicenter IMPROVE CHF (Improved Management of Patients With Congestive Heart Failure) trial recruited between December 2004 and December 2005 were classified into low (0% to 20%), intermediate (21% to 79%), or high (80% to 100%) probability for AHF and then compared with the blinded adjudicated AHF diagnosis. Likelihood ratios were calculated and multiple logistic regression incorporated covariates into an AHF prediction model that was validated internally by the use of bootstrapping and externally by applying the model to another 573 patients from the separate PRIDE (N-Terminal Pro-BNP Investigation of Dyspnea in the Emergency Department) study of the use of NT-proBNP in patients with dyspnea.ResultsLikelihood ratios for AHF with NT-proBNP were 0.11 (95% confidence interval [CI]: 0.06 to 0.19) for cut-point values <300 pg/ml; increasing to 3.43 (95% CI: 2.34 to 5.03) for values 2,700 to 8,099 pg/ml, and 12.80 (95% CI: 5.21 to 31.45) for values ≥8,100 pg/ml. Variables used to predict AHF were age, pre-test probability, and log NT-proBNP. When applied to the external data by use of its adjudicated final diagnosis as the gold standard, the model appropriately reclassified 44% of patients by intermediate clinical probability to either low or high probability of AHF with negligible (<2%) inappropriate redirection.ConclusionsA diagnostic prediction model for AHF that incorporates both clinical assessment and NT-proBNP has been derived and validated and has excellent diagnostic accuracy, especially in cases with indeterminate likelihood for AHF