Dimension Reduction for Polynomials over Gaussian Space and Applications

We introduce a new technique for reducing the dimension of the ambient space of low-degree polynomials in the Gaussian space while preserving their relative correlation structure. As an application, we obtain an explicit upper bound on the dimension of an epsilon-optimal noise-stable Gaussian partition. In fact, we address the more general problem of upper bounding the number of samples needed to epsilon-approximate any joint distribution that can be non-interactively simulated from a correlated Gaussian source. Our results significantly improve (from Ackermann-like to "merely" exponential) the upper bounds recently proved on the above problems by De, Mossel & Neeman [CCC 2017, SODA 2018 resp.] and imply decidability of the larger alphabet case of the gap non-interactive simulation problem posed by Ghazi, Kamath & Sudan [FOCS 2016]. Our technique of dimension reduction for low-degree polynomials is simple and can be seen as a generalization of the Johnson-Lindenstrauss lemma and could be of independent interest

Thesaurus - an ideal tool for vocabulary control in post-coordinate systems : INIS Thesaurus - a case study

The complex conceptual relationships contained in multi-dimensional documents present the problem of inconsistency in subject analysis and vocabulary control for efficient retrieval is stressed. The development of Thesaurus, an important contribution for effective vocabulary control in mechanised IR systems which is among the many developmental efforts in this direction, is highlighted. The development, structure and design of INIS Thesaurus is given in detail. Adaptability of the INIS thesaurus to a computer-based information handling system is examine

Descriptive analysis of sleep quality and its determinants among rural population of coastal Karnataka

Background: A good quality of sleep helps to maintain mood, memory and cognitive performance. Aim & Objective: To assess quality of sleep and its determinants among rural adults. Settings and Design: A community based cross sectional study was carried out in rural field practice area of a medical college Methods and Material: Pittsburg sleep quality index scale was used to assess quality of sleep. Semi-structured questionnaire was used to collect information from participants. Anthropometric and blood pressure measurements were taken. Statistical analysis used: Chi-square test was used to find out association between poor sleep and specific morbidities. Univariate and multivariate logistic regression was done to assess predictors of poor sleep. Results: Among the 614 study subjects, 60.3% had good sleep. Presence of morbidity was significantly associated with poor sleep [AOR=1.48; 95%CI=1.05-2.08]. Presence of a dark room, taking a bath or having milk before bed time were top reasons cited to be facilitating good sleep. Presence of mosquitoes, having young children or adolescent at home and vital events in last one year were reported to hinder good sleep. Conclusions: A sizeable proportion of rural adults have poor sleep. Presence of morbidity was a significant predictor of poor sleep

A comparative study of laser posterior cordotomy and vocal cord lateralization

AbstractIntroductionThe treatment of bilateral vocal cord paralysis continues to be a challenge to the otolaryngologist, head and neck surgeon even today. Numerous surgical procedures have been proposed to improve the patient’s airway insufficiency without leaving the patient with a breathy, weak voice or an incompetent larynx. In this study we compared the outcome of laser posterior cordotomy and vocal cord lateralization in a group of bilateral abductor palsy patients.MethodRetrospective as well as a prospective study of 25 patients was carried out. The total of 25 patients was divided into 2 groups, group 1 consisted of 15 patients who underwent vocal cord lateralization with SUTUPAK suture and group 2 consisted of 10 patients who underwent laser assisted posterior partial cordotomy.ResultsThyroidectomy was the commonest cause for bilateral vocal fold paralysis i.e. 80% (20) of cases. Patients who underwent laser posterior cordotomy had 100% successful decannulation rate as compared to 92.8% for vocal cord lateralization patients. Comparison between pre and post operative voice assessment data by WILCOXON SIGNED RANKS test revealed that excepting the parameter of fluctuations/s in F0, all other parameters were statistically not significant.ConclusionLaser cordotomy is a superior, reliable and viable alternative to the other lateralization procedures for bilateral vocal fold paralysis

Acute Philadelphia Chromosome Positive Biphenotypic Leukemia Presenting with Bilateral Orbital Chloroma: A Rare Case Report

Introduction: Chloromas are characteristically formed by the extramedullary soft tissue infiltration by the immature myeloid malignant cells. Such extramedullary masses are most commonly seen in acute myeloid leukemia usually in the M2, M4, M5 subtypes of the AML FAB classification. However, it has been reported to rarely present only in pediatric patients with acute lymphoblastic leukemia.Presentation of the case: We encountered an unusual case of a young male, who presented with proptosis of both eyes followed by fever and fatigue. On evaluation, he was diagnosed to have bilateral orbital chloroma which was due to infiltration by leukemic cells of acute leukemia. Flowcytometry revealed features confirming an acute biphenotypic leukemia. Subsequently, cytogenetic evaluation revealed the leukemic cells to be Philadelphia chromosome positive.Conclusion: To our knowledge, this is the first case of bilateral orbital choloroma due to Philadelphia positive biphenotypic acute lymphoblastic leukemia

The effectiveness of self-directed learning (SDL) for teaching physiology to first-year medical students

Background Self-directed learning (SDL) has become popular in medical curricula and has been advocated as an effective learning strategy for medical students to develop competence in knowledge acquisition. Aims The primary aim was to find out if there was any benefit of supplementing self-directed learning activity with a traditional lecture on two different topics in physiology for first-year medical students. Method Two batches of first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) (Batch A and Batch B) comprising 125 students each, received an SDL session on Morphological classification of anaemia. The students belonging to Batch A received a one-hour lecture on the same topic three days prior to the SDL session. The students were given 10 multiple choice questions (MCQ) test for a maximum of 10 marks immediately following the SDL session. The next topic, Conducting system of the heart, disorders and conduction blocks was taught to both batches in traditional lecture format. This was followed by an SDL session on the same topic for Batch A only. The students were evaluated with a MCQ test for a maximum of 10 marks. Results The mean test scores on the first topic were 4.38±2.06 (n=119) and 4.17±1.71 (n=118) for Batch A and Batch B, respectively. The mean test scores on the second topic were 5.4± 1.54 (n=112) and 5.15±1.37 (n=107) for Batch A and Batch B, respectively. There was no significant difference between the groups. Conclusion For first-year medical students, SDL is an effective teaching strategy for learning physiology. However, no additional benefit is gained by supplementing SDL with a lecture to facilitate learning physiology.

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Acid Resistance of Glass Fiber Composites with Different Layup Sequencing: Part I-Diffusion Studies

The effects of sulphuric acid,concentration nd the sequential layup of glass fiber reinforcement on the diffusion behavior of glass epoxy composite laminates were studied. In all, composites of six d t f f h n t resin systems viz., general purpose polyester, bis phenol-A polyester, vinyl ester, LY 556 epoxy, and MY 750 epoxy resins, reinforced with differen1 layup sequencing consisting of chopped strand mar (CSM) and woven roving mat (WR) were exposed to ,sulphuric acid environments of different concentrations. The results of the study indicated that isophrhalic polyester resin exhibited maximum resistance to sulphuric acid while general purpose polyester resin performed relatively inferior. The diffusion phenomenon became anamalous as the concentration of the sulphuric acid increased. Among the layup sequences considered, composite specimens with CSM as the skin layers exhibited higher weight gain than those with WR as the skin layer;