Recurrent post‐partum seizures after epidural blood patch

There are many causes for headaches after childbirth. Even though postdural puncture headache (PDPH) has to be considered in a woman with a history of difficult epidural anaesthesia, pre‐eclampsia should always be excluded as an important differential diagnosis. We report a case with signs of late‐onset pre‐eclampsia where administration of an epidural blood patch (EBP) was associated with eclampsia. A hypothetical causal relationship between the EBP and seizures was discarded on the basis of evidence presented in this report. Br J Anaesth 2003; 90: 247-5

Multimodal system for recording individual-level behaviors in songbird groups

In longitudinal observations of animal groups, the goal is to identify individuals and to reliably detect their interactive behaviors including their vocalizations. However, to reliably extract individual vocalizations from their mixtures and other environmental sounds remains a serious challenge. Promising approaches are multi-modal systems that make use of animal-borne wireless sensors and that exploit the inherent signal redundancy. In this vein, we designed a modular recording system (BirdPark) that yields synchronized data streams and contains a custom software-defined radio receiver. We record pairs of songbirds with multiple cameras and microphones and record their body vibrations with custom low-power frequency-modulated (FM) radio transmitters. Our custom multi-antenna radio demodulation technique increases the signal-to-noise ratio of the received radio signals by 6 dB and reduces the signal loss rate by a factor of 87 to only 0.03% of the recording time compared to standard single-antenna demodulation techniques. Nevertheless, neither a single vibration channel nor a single sound channel is sufficient by itself to signal the complete vocal output of an individual, with each sensor modality missing on average about 3.7% of vocalizations. Our work emphasizes the need for high-quality recording systems and for multi-modal analysis of social behavior

A system for controlling vocal communication networks

Animal vocalizations serve a wide range of functions including territorial defense, courtship, social cohesion, begging, and vocal learning. Whereas many insights have been gained from observational studies and experiments using auditory stimulation, there is currently no technology available for the selective control of vocal communication in small animal groups. We developed a system for real-time control of vocal interactions among separately housed animals. The system is implemented on a field-programmable gate array (FPGA) and it allows imposing arbitrary communication networks among up to four animals. To minimize undesired transitive sound leakage, we adopted echo attenuation and sound squelching algorithms. In groups of three zebra finches, we restrict vocal communication in circular and in hierarchical networks and thereby mimic complex eavesdropping and middleman situations

TinyBird-ML: An ultra-low Power Smart Sensor Node for Bird Vocalization Analysis and Syllable Classification

Animal vocalisations serve a wide range of vital functions. Although it is possible to record animal vocalisations with external microphones, more insights are gained from miniature sensors mounted directly on animals' backs. We present TinyBird-ML; a wearable sensor node weighing only 1.4 g for acquiring, processing, and wirelessly transmitting acoustic signals to a host system using Bluetooth Low Energy. TinyBird-ML embeds low-latency tiny machine learning algorithms for song syllable classification. To optimize battery lifetime of TinyBird-ML during fault-tolerant continuous recordings, we present an efficient firmware and hardware design. We make use of standard lossy compression schemes to reduce the amount of data sent over the Bluetooth antenna, which increases battery lifetime by 70% without negative impact on offline sound analysis. Furthermore, by not transmitting signals during silent periods, we further increase battery lifetime. One advantage of our sensor is that it allows for closed-loop experiments in the microsecond range by processing sounds directly on the device instead of streaming them to a computer. We demonstrate this capability by detecting and classifying song syllables with minimal latency and a syllable error rate of 7%, using a light-weight neural network that runs directly on the sensor node itself. Thanks to our power-saving hardware and software design, during continuous operation at a sampling rate of 16 kHz, the sensor node achieves a lifetime of 25 hours on a single size 13 zinc-air battery

The Lattice and Simplex Structure of States on Pseudo Effect Algebras

We study states, measures, and signed measures on pseudo effect algebras with some kind of the Riesz Decomposition Property, (RDP). We show that the set of all Jordan signed measures is always an Abelian Dedekind complete $\ell$-group. Therefore, the state space of the pseudo effect algebra with (RDP) is either empty or a nonempty Choquet simplex or even a Bauer simplex. This will allow represent states on pseudo effect algebras by standard integrals

Value of hospital antimicrobial stewardship programs [ASPs]:a systematic review

Abstract Background Hospital antimicrobial stewardship programs (ASPs) aim to promote judicious use of antimicrobials to combat antimicrobial resistance. For ASPs to be developed, adopted, and implemented, an economic value assessment is essential. Few studies demonstrate the cost-effectiveness of ASPs. This systematic review aimed to evaluate the economic and clinical impact of ASPs. Methods An update to the Dik et al. systematic review (2000–2014) was conducted on EMBASE and Medline using PRISMA guidelines. The updated search was limited to primary research studies in English (30 September 2014–31 December 2017) that evaluated patient and/or economic outcomes after implementation of hospital ASPs including length of stay (LOS), antimicrobial use, and total (including operational and implementation) costs. Results One hundred forty-six studies meeting inclusion criteria were included. The majority of these studies were conducted within the last 5 years in North America (49%), Europe (25%), and Asia (14%), with few studies conducted in Africa (3%), South America (3%), and Australia (3%). Most studies were conducted in hospitals with 500–1000 beds and evaluated LOS and change in antibiotic expenditure, the majority of which showed a decrease in LOS (85%) and antibiotic expenditure (92%). The mean cost-savings varied by hospital size and region after implementation of ASPs. Average cost savings in US studies were $732 per patient (range:$2.50 to $2640), with similar trends exhibited in European studies. The key driver of cost savings was from reduction in LOS. Savings were higher among hospitals with comprehensive ASPs which included therapy review and antibiotic restrictions. Conclusions Our data indicates that hospital ASPs have significant value with beneficial clinical and economic impacts. More robust published data is required in terms of implementation, LOS, and overall costs so that decision-makers can make a stronger case for investing in ASPs, considering competing priorities. Such data on ASPs in lower- and middle-income countries is limited and requires urgent attention

Mortality and morbidity in the city of Bern, Switzerland, 1805-1815 with special emphasis on infant, child and maternal deaths

This article contributes to the research on demographics and public health of urban populations of preindustrial Europe. The key source is a burial register that contains information on the deceased, such as age and sex, residence and cause of death. This register is one of the earliest compilations of data sets of individuals with this high degree of completeness and consistency. Critical assessment of the register's origin, formation and upkeep promises high validity and reliability. Between 1805 and 1815, 4,390 deceased inhabitants were registered. Information concerning these individuals provides the basis for this study. Life tables of Bern's population were created using different models. The causes of death were classified and their frequency calculated. Furthermore, the susceptibility of age groups to certain causes of death was established. Special attention was given to causes of death and mortality of newborns, infants and birth-giving women. In comparison to other cities and regions in Central Europe, Bern's mortality structure shows low rates for infants (q0=0.144) and children (q1-4=0.068). This could have simply indicated better living conditions. Life expectancy at birth was 43 years. Mortality was high in winter and spring, and decreased in summer to a low level with a short rise in August. The study of the causes of death was inhibited by difficulties in translating early 19th century nomenclature into the modern medical system. Nonetheless, death from metabolic disorders, illnesses of the respiratory system, and debilitation were the most prominent causes in Bern. Apparently, the worst killer of infants up to 12 months was the "gichteren", an obsolete German term for lethal spasmodic convulsions. The exact modern identification of this disease remains unclear. Possibilities such as infant tetanus or infant epilepsy are discussed. The maternal death rate of 0.72% is comparable with values calculated from contemporaneous sources. Relevance of childbed fever in the early 1800s was low. Bern's data indicate that the extent of deaths related to childbirth in this period is overrated. This research has an explicit interdisciplinary value for various fields including both the humanities and natural sciences, since information reported here represents the complete age and sex structure of a deceased population. Physical anthropologists can use these data as a true reference group for their palaeodemographic studies of preindustrial Central Europe of the late 18th and early 19th century. It is a call to both historians and anthropologists to use our resources to a better effect through combination of methods and exchange of knowledge