Survey of advances and challenges in intelligent autonomy for distributed cyber-physical systems

With the evolution of the Internet of things and smart cities, a new trend of the Internet of simulation has emerged to utilise the technologies of cloud, edge, fog computing, and high-performance computing for design and analysis of complex cyber-physical systems using simulation. These technologies although being applied to the domains of big data and deep learning are not adequate to cope with the scale and complexity of emerging connected, smart, and autonomous systems. This study explores the existing state-of-the-art in automating, augmenting, and integrating systems across the domains of smart cities, autonomous vehicles, energy efficiency, smart manufacturing in Industry 4.0, and healthcare. This is expanded to look at existing computational infrastructure and how it can be used to support these applications. A detailed review is presented of advances in approaches providing and supporting intelligence as a service. Finally, some of the remaining challenges due to the explosion of data streams; issues of safety and security; and others related to big data, a model of reality, augmentation of systems, and computation are examined

Number of addictive substances used related to increased risk of unnatural death: A combined medico-legal and case-record study

<p>Abstract</p> <p>Background</p> <p>Substance use disorders have repeatedly been found to lead to premature death, i.e. drug-related death by disease, fatal intoxications, or trauma (accidents, suicide, undetermined suicide, and homicide). The present study examined the relationship between multi-drug substance use and natural and unnatural death.</p> <p>Methods</p> <p>All consecutive, autopsied patients who had been in contact with the Addiction Centre in Malmö University Hospital from 1993 to 1997 inclusive were investigated. Drug abuse was investigated blindly in the case records and related to the cause of death in 387 subjects.</p> <p>Results</p> <p>Every substance apart from alcohol used previously in life added to the risk of unnatural death in a linear way. There were independent increased risks of fatal heroin overdoses or undetermined suicide. Death by suicide and violent death were unrelated to additional abuse.</p> <p>Conclusion</p> <p>The number of drugs used was related to an increased risk of unnatural death by undetermined suicide (mainly fatal intoxications) and heroin overdose.</p

Teambasert læring – en studentaktiviserende og lærerstyrt undervisningsform

Sammendrag Bakgrunn: Studentaktiviserende undervisning er viktig for å oppnå god læring. I teambasert læring (TBL) aktiviseres studentene individuelt, gruppevis og i plenum under ledelse av faglærer. TBL er i liten grad prøvd ut og evaluert i medisinsk utdanning i Norge. Vi ville derfor undersøke hvorvidt TBL kan være egnet som undervisningsform i grunnutdanningen av leger. Materiale og metode: Vi arrangerte TBL i generell patologi for andreårs medisinstudenter i 2013 og 2014. TBL-sesjonen varte i tre timer og inkluderte individuell og gruppevis oppvarmingstest, gruppearbeid, plenumsdiskusjon og oppsummering fra faglærer. Svarene på oppgavene ble samlet inn for å sammenlikne individuelle og gruppevise prestasjoner på testene. Studentene ble også bedt om å evaluere undervisningen. Resultater: Gruppenes prestasjoner var bedre enn eller like gode som 84 % (2013) og 72 % (2014) av de individuelle prestasjonene. TBL ble av studentene oppfattet som en engasjerende og lærerik undervisningsform som egner seg til oppsummering og som tilbakemelding på eget kunnskapsnivå. Til tross for at tidsbruken ble beskrevet som unødvendig lang, var studentene tydelige på at TBL burde integreres i medisinstudiet. Fortolkning: Vi anbefaler TBL som undervisningsform i grunnutdanningen i medisin

Gastric Carcinomas Localized to the Cardia

Objectives. Gastric adenocarcinomas localized to the cardia are increasing. Enterochromaffin-like (ECL) cells play a role in gastric carcinogenesis in hypergastrinemia, and the use of proton pump inhibitors (PPI) leading to hypergastrinemia has increased considerably during the last decades. We have examined cardia cancers for neuroendocrine and ECL cell differentiation. Methods. Thirty-two cardia cancers were examined by immunohistochemical labelling of chromogranin A (CgA), synaptophysin, serotonin, and histidine decarboxylase (HDC). Information about PPI use was collected from the patient records. Results. In 15 of 32 tumours, there were positive signs for one or several neuroendocrine markers. Five cases were CgA and serotonin positive; three of these carcinomas were also positive for HDC. Three patients were long-term users of PPI, and two of these were immunoreactive for neuroendocrine markers. Conclusions. A high proportion of cardia cancers expressed neuroendocrine markers, but only few patients with cardia cancers were using PPI

Alcohol and premature death in Estonian men: a study of forensic autopsies using novel biomarkers and proxy informants.

BACKGROUND: Alcohol makes an important contribution to premature mortality in many countries in Eastern Europe, including Estonia. However, the full extent of its impact, and the mechanisms underlying it, are challenging issues to research. We describe the design and initial findings of a study aimed at investigating the association of alcohol with mortality in a large series of forensic autopsies of working-age men in Estonia. METHODS: 1299 male deaths aged 25-54 years were subject to forensic autopsy in 2008-2009. The routine autopsy protocol was augmented by a more systematic inspection of organs, drug testing, assay of liver enzymes and novel biomarkers of alcohol consumption (EtG, EtS and PEth), together with proxy interviews with next of kin for deaths among men who lived in or close to a major town. RESULTS: 595 augmented autopsies were performed. Of these, 66% were from external causes (26% suicide, 25% poisoning). 17% were attributed to circulatory system diseases and 7% to alcoholic liver disease. Blood alcohol concentrations (BAC) of ≥ 0.2 mg/g were found for 55% of deaths. Interviews were conducted with proxy informants for 61% of the subjects who had resided in towns. Of these, 28% were reported in the previous year to have been daily or almost daily drinkers and 10% had drunk non-beverage alcohols. Blood ethanol and the liver enzyme GGT were only associated with daily drinking. However, the novel biomarkers showed a more graded response with recent consumption. In contrast, the liver enzymes AST and ALT were largely uninformative because of post-mortem changes. The presence of extremely high PEth concentrations in some samples also suggested post-mortem formation. CONCLUSION: We have shown the feasibility of deploying an extended research protocol within the setting of routine forensic autopsies that offer scope to deepen our understanding of the alcohol-related burden of premature mortality. The most unique feature of the study is the information on a wide range of informative alcohol biomarkers, several of which have not been used previously in this sort of post-mortem research study. We have demonstrated, for the first time, the epidemiological value and validity of these novel alcohol biomarkers in post-mortem samples

Validation of the Revised Physical Therapist Clinical Performance Instrument (PT CPI): Version 2006

Based on changes in core physical therapy documents and problems with the earlier version, the Physical Therapist Clinical Performance Instrument (PT CPI): Version 1997 was revised to create the PT CPI: Version 2006. The purpose of this study was to validate the PT CPI: Version 2006 for use with physical therapist students as a measure of clinical performance. This was a combined cross-sectional and prospective study. A convenience sample of physical therapist students from the United States and Canada participated in this study. The PT CPI: Version 2006 was used to collect CPI item-level data from the clinical instructor about student performance at midterm and final evaluation periods in the clinical internship. Midterm evaluation data were collected from 196 students, and final evaluation data were collected from 171 students. The students who participated in the study had a mean age of 24.8 years (SD=2.3, range=21-41). Sixty-seven percent of the participants were from programs in the United States, and 33% were from Canada. The PT CPI: Version 2006 demonstrated good internal consistency, and factor analysis with varimax rotation produced a 3-factor solution explaining 94% of the variance. Construct validity was supported by differences in CPI item scores between students on early compared with final clinical experiences. Validity also was supported by significant score changes from midterm to final evaluations for students on both early and final internships and by fair to moderate correlations between prior clinical experience and remaining course work. This study did not examine rater reliability. The results support the PT CPI: Version 2006 as a valid measure of physical therapist student clinical performance