Information fusion schemes for real time risk assessment in adaptive control systems

Intelligent Flight Control System (IFCS) deploys a neural network for in-flight aircraft failure accommodation. Verification and validation (V&V) of adaptive systems is a challenging research problem. Our approach to V&V relies on real-time monitoring of neural network learning. Monitors detect learning anomalies and react to different failure conditions. We investigated data fusion techniques suitable for the analysis of neural network monitors. Monitor outputs are fused into a measure of confidence, indicating the belief in the correctness of failure accommodation mechanism provided by the neural network. We investigated two data fusion techniques, one based on Dempster-Shafer theory and the other based on fuzzy logic. Our techniques were applied to nine flight simulation datasets including those with failures. The monitor fusion algorithms provide unique, meaningful and novel technique for V&V of adaptive flight control systems. Being theoretically sound, the algorithms can be applied to a broad range of other data fusion applications

Eliciting goal and value-based conversations among the chronic critical illness population in a long-term acute care hospital

In the United States, goal and value-based conversations between healthcare professionals and patients experiencing chronic critical illness (CCI) in a long-term acute care hospital (LTACH) do not occur routinely as part of the standard of care, leading to a poor quality of life and increased levels of stress, anxiety, and depression among this patient population (Kahn et al., 2015; Lamas et al., 2017a; Lamas et al., 2017b). Since the Theory of Planned Behavior is designed to both explain and predict behavior in specific contexts, such as healthcare professionals’ intentions and behavior to have goal and valued-based conversations with this patient population (Ajzen & Fishbein, 2005), and the literature supports the use of semi-structured interview tools to do so with this patient population (Chochinov et al., 2015; Johnston et al., 2015; Lamas et al., 2017a), this doctoral capstone aims to enhance patient-reported outcomes among this patient population by providing healthcare professionals, specifically occupational therapists, with the most useful semi-structured interview tool (i.e., the Canadian Occupational Performance Measure [COPM]) to facilitate goal and value-based conversations more routinely. The COPM is client-centered OT semi-structured interview tool designed to generally (1) elicit goal and value-based conversations; (2) guide collaborative goal-setting; and (3) measure patient-reported outcomes (Law et al., 2005). The results indicate both clinical and statistical significance over time across patients for the patient-reported outcomes, self-perceived performance and satisfaction, demonstrating support for the establishment of routine goal and value-based conversations as part of the standard of care between healthcare professionals and this patient population

CORTICAL BLINDNESS DUE TO BILATERAL STROKES – A CASE REPORT OF ANTON SYNDROME

Background: Blindness (anopia) is a functional loss of vision, which could be due either to ophthalmological or neurological conditions. Blindness may be congenital or acquired. The main causes of blindness in adults are cataracts, uncorrected ametropia (myopia, astigmatism), glaucoma, macular dystrophy, cortical ischemic strokes, etc. In less than 10% of the patients, the reason for cortical blindness is bilateral occipital strokes, one of them hemorrhagic. Case Description: In the current case report, we present a 75-year-old patient with complaints of headache and visual loss. The patient has a history of a left PCA (posterior cerebral artery) distal ischemic stroke. The CT scan reveals a hypodense cerebral lesion in the left medial occipital cortex and subcortex (lingual gyri and cuneus) and a hyperdense cerebral lesion in the right medial occipital cortex and subcortex (lingual gyri and cuneus). The neurological examination shows only bilateral visual loss without motor deficits. The patient has visual anosognosia and confabulation in the setting of obvious visual loss and cortical blindness(Anton-Babinski syndrome, also known as ABS or Anton syndrome). However, performing cerebellar tests (dysdiadochokinesis, finger-to-nose test, heel-to-shin test, cerebellar ataxia) was not done because of the visual loss. After being consulted by a neurologist and neurosurgeon with the preliminary diagnosis of brain hemorrhage, the patient was admitted to the Neurology Clinic of UMHAT D-r "Georgi Stranski", Pleven, Bulgaria. Conclusion: Occipital infarction must be considered in all cases with sudden onset of isolated visual loss. Early diagnosis and treatment of stroke reduce mortality and morbidity. The prognosis depends on the extension of the visual cortex damage

Surgical Outcomes After Fixation of Acromioclavicular Joint Dislocation with Hook Plate and Coracoacromial Ligament Transfer Technique

BACKGROUND: Treatment of acute and chronic acromioclavicular joint dislocations is still controversial. We aimed evaluation of surgical outcomes after using the combined technique with a hook plate and transposition of the coracoacromial ligament in the treatment of acromioclavicular dislocation. CASE PRESENTATION: During two years 4 patients (2 acute and 2 chronic cases) were operated with this technique. Three male and one female with an average 37 (26-43) years old were: three on the right and one of the left side. Rockwood classification was used. The evaluation was done according to Constant score - preoperatively, 3 months after the operation and 3 months after the titanium plate was removed. CONCLUSION: Evaluation of the effectiveness using this combined technique show excellent result in all four patients. No surgical site infection and the favourable cosmetic result were present

Локални антимикробни агенси во третманот на пародонталната болест

Употребата на локални антимикробни агенси во третманот на пародонталната болест се смета дека претставува значително дополнение на конвенционалните механички терапевтски модалитети. Главната цел на овој труд е приказ на значењето на локалните антимикробни агенси кои може да се користат при пародонталната терапија. Доминантно кај пациенти со напредната пародонтална болест, ваквите медикаменти со локално деjство се значајни во третманот на локализирани пародонтални дефекти поголеми од 5 mm, кај кои се јавува крвавење по сондирање и кога не реагираат на примарна терапија. Паралелната механичка обработка заедно со субгингивално аплицирани локални медикаменти може да доведе до успешен третман, особено кај пациенти што имаат локализирани регии на рекурентни пародонтални дефекти. Концентрираните количини на локални медикаменти, пак, лесно може да бидат доставени до одредено заболено место со минимален ризик за системско дејствување на лекот. Локалната апликација на медикаменти ја намалува вкупната доза која треба да ја прими пациентот за 400 пати, со што се намалуваат и потенцијалните несакани ефекти од употребата на системскиот антибиотик и создавањето на резистентни микроорганизми. Според методот на локалната дистрибуција во пародонталниот џеб овие медикаменти може да се класифицираат во две големи групи во зависност од разградливоста, и тоа на ресорптивни и нересорптивни. Како заклучок може да се истакне дека овие медикаменти аплицирани субгингивално претставуваат само дополнителен тераписки модалитет, при што примарна улога имаат оралната хигиена и обработката на пародонталниот џеб. Клучни зборови: локални антимикробни средства, локални антибиотици, пародонтална болест, пародонтална терапија