138 research outputs found

    Re-audit of Cystic Fibrosis inpatient blood glucose monitoring with the unit policy

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    Introducing non-linear analysis into sustained speech characterization to improve sleep apnea detection

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    The final publication is available at Springer via http://dx.doi.org/10.1007/978-3-642-25020-0_28Proceedings of 5th International Conference on Nonlinear Speech Processing, NOLISP 2011, Las Palmas de Gran Canaria (Spain)We present a novel approach for detecting severe obstructive sleep apnea (OSA) cases by introducing non-linear analysis into sustained speech characterization. The proposed scheme was designed for providing additional information into our baseline system, built on top of state-of-the-art cepstral domain modeling techniques, aiming to improve accuracy rates. This new information is lightly correlated with our previous MFCC modeling of sustained speech and uncorrelated with the information in our continuous speech modeling scheme. Tests have been performed to evaluate the improvement for our detection task, based on sustained speech as well as combined with a continuous speech classifier, resulting in a 10% relative reduction in classification for the first and a 33% relative reduction for the fused scheme. Results encourage us to consider the existence of non-linear effects on OSA patients’ voices, and to think about tools which could be used to improve short-time analysis.The activities described in this paper were funded by the Spanish Ministry of Science and Innovation as part of the TEC2009-14719-C02-02 (PriorSpeech) project

    Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)

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    BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems

    True substrates: The exceptional resolution and unexceptional preservation of deep time snapshots on bedding surfaces

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    Abstract: Rock outcrops of the sedimentary–stratigraphic record often reveal bedding planes that can be considered to be true substrates: preserved surfaces that demonstrably existed at the sediment–water or sediment–air interface at the time of deposition. These surfaces have high value as repositories of palaeoenvironmental information, revealing fossilized snapshots of microscale topography from deep time. Some true substrates are notable for their sedimentary, palaeontological and ichnological signatures that provide windows into key intervals of Earth history, but countless others occur routinely throughout the sedimentary–stratigraphic record. They frequently reveal patterns that are strikingly familiar from modern sedimentary environments, such as ripple marks, animal trackways, raindrop impressions or mudcracks: all phenomena that are apparently ephemeral in modern settings, and which form on recognizably human timescales. This paper sets out to explain why these short‐term, transient, small‐scale features are counter‐intuitively abundant within a 3.8 billion year‐long sedimentary–stratigraphic record that is known to be inherently time‐incomplete. True substrates are fundamentally related to a state of stasis in ancient sedimentation systems, and distinguishable from other types of bedding surfaces that formed from a dominance of states of deposition or erosion. Stasis is shown to play a key role in both their formation and preservation, rendering them faithful and valuable archives of palaeoenvironmental and temporal information. Further, the intersection between the time–length scale of their formative processes and outcrop expressions can be used to explain why they are so frequently encountered in outcrop investigations. Explaining true substrates as inevitable and unexceptional by‐products of the accrual of the sedimentary–stratigraphic record should shift perspectives on what can be understood about Earth history from field studies of the sedimentary–stratigraphic record. They should be recognized as providing high‐definition information about the mundane day to day operation of ancient environments, and critically assuage the argument that the incomplete sedimentary–stratigraphic record is unrepresentative of the geological past

    The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

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    Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy
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