Development and Use of a Tablet-Based Resuscitation Sheet for Improving Outcomes During Intensive Patient Care

Data documentation from resuscitation events in hospitals, termed code blue events, utilizes a paper form, which is institution-specific. Problems with data capture and transcription exists, due to the challenges of dynamic documentation of patient, event and outcome variables as the code blue event unfolds. We hypothesize that an electronic version of code blue real-time data capture would lead to improved resuscitation data transcription, and enable clinicians to address deficiencies in quality of care. To this effect, we present the design of a tablet-based application and its use by 20 nurses at the Mayo Clinic hospital. The results showed that the nurses preferred the tablet application over the paper based form. Furthermore, a qualitative survey showed the clinicians perceived the electronic version to be more accurate and efficient than paper-based documentation, both of which are essential for an emergency code blue resuscitation procedure

Analysis of fetal growth restriction in pregnancy in subjects attending in an obstetric clinic of a tertiary care teaching hospital

Background: Intrauterine growth restriction (IUGR) is defined as fetal growth less than the normal growth potential of a specific infant because of genetic or environmental factors. Fetal growth restriction or intrauterine growth restriction is one of the leading causes of perinatal mortality and morbidity in newborns. Fetal growth restriction is a complex multifactorial condition resulting from several fetal and maternal disorders. Objective of present study was to find out incidence of IUGR and assessment and evaluation of different important changes in IUGR.Methods: Women who attended the Obstetric OPD in their 1st trimester of pregnancy and those who were thought would be able to visit the antenatal clinic for their fortnightly check-up regularly were screened for intrauterine foetal growth retardation. Women with irregular and uncertain menstrual history and where the 1st trimester USG foetal crown rump length did not corroborate with the menstrual gestational age were excluded from this study.Results: Incidence of IUGR was 18.2% and 84% were found to be asymmetrical. IUGR was found to be double among primigravids and women above 30 years. It had been observed that IUGR was associated with certain conditions like short stature (52%), pregnancy induced hypertension (24%) and anaemia (12%).Conclusions: Thus, early USG screening along with robust screening for maternal BMI, nutritional status, and anaemia can assist the obstetric team in providing early diagnosis, prompt intervention, and better outcome in pregnancy with fetal growth restriction

Constructing "hair" for the three charge hole

It has been found that the states of the 2-charge extremal D1-D5 system are given by smooth geometries that have no singularity and no horizon individually, but a `horizon' does arise after `coarse-graining'. To see how this concept extends to the 3-charge extremal system, we construct a perturbation on the D1-D5 geometry that carries one unit of momentum charge $P$. The perturbation is found to be regular everywhere and normalizable, so we conclude that at least this state of the 3-charge system behaves like the 2-charge states. The solution is constructed by matching (to several orders) solutions in the inner and outer regions of the geometry. We conjecture the general form of `hair' expected for the 3-charge system, and the nature of the interior of black holes in general.Comment: 37 pages, 7 figures LaTex, Minor revision in the discussio

A Heart Disease Prediction Model using Decision Tree

Abstract-I

How the AIS can Improve its Contributions to the UN’s Sustainability Development Goals: Towards A Framework for Scaling Collaborations and Evaluating Impact

In June, 2019, the Association for Information Systems (AIS) adopted a new approach to addressing global sustainability issues by establishing the AIS Sustainability Task Force (AIS STF). This initiative focuses on building on the outcomes from the United Nations (UN) Millennium Development Goals (MDG, 2000-2015) and applying them to address the challenges associated with the UN Sustainable Development Goals (SDG, 2016-2030). In this paper, we review the challenges and outcomes from the UN sustainability programs with their potential relevance to IS in general and the AIS in particular to inform and assist increased efforts to achieve the global sustainability goals. The initial event, the AIS Sustainability Summit held at ICIS 2019, provided a forum for AIS groups and communities to share their current interests, plans, activities, and experiences relevant to the MDG and SDG. The event primarily focused on facilitating opportunities to scale the AIS’s sustainability activities through multi-disciplinary collaboration across the AIS and its communities. Members from four AIS special interest groups and the STF’s Education Workgroup presented exemplary projects at the summit that demonstrated how one can apply applied IS and research capabilities to address sustainability challenges. The sustainability summit’s also explored opportunities to achieve positive impact in addressing the SDG’s global challenges through applying AIS members’ knowledge, skills, and capabilities in relevant ways in collaboration with suitable organizations outside the AIS. Potential organizations include business, government, societal groups, and UN bodies. We presented and discussed the AIS STF’s aims, plans, outcomes, and impact. By analyzing details and options for cross-organizational collaboration, the representatives of organizations at the sustainability summit developed a proposed framework for scaling contributions and evaluating impact. Finally, they drew conclusions about the proposed activities, approaches, and framework for the AIS to improve the scope and scale of its contributions in addressing the SDG. Critically, the AIS needs to ensure that its proposed activities, contributions, and impact are examined by an internationally recognized independent process. We propose a model for the AIS to realize this requirement for evaluation in 2021

Tachyon condensation and `bounce' in the D1-D5 system

We construct supergravity solutions dual to microstates of the D1-D3-D5 system with nonzero B field moduli. Just like the D1-D5 solutions in hep-th/0109154 these solutions are generically nonsingular everywhere, with the `throat' closing smoothly near r=0. We write expressions relating the asymptotic supergravity fields to the integral brane charges. We study the infall of a D1 brane down the throat of the geometries. This test brane `bounces' off the smooth end for generic initial conditions. The details of the bounce depend on both the choice of D1-D3-D5 microstate and the direction of approach of the infalling D1 brane. In the dual field theory description we see that the tachyon mode starts to condense, but the tachyon bounces back up the potential hill without reaching the deepest point of the potential.Comment: 32 pages, references adde

RVD: A Handheld Device-Based Fundus Video Dataset for Retinal Vessel Segmentation

Retinal vessel segmentation is generally grounded in image-based datasets collected with bench-top devices. The static images naturally lose the dynamic characteristics of retina fluctuation, resulting in diminished dataset richness, and the usage of bench-top devices further restricts dataset scalability due to its limited accessibility. Considering these limitations, we introduce the first video-based retinal dataset by employing handheld devices for data acquisition. The dataset comprises 635 smartphone-based fundus videos collected from four different clinics, involving 415 patients from 50 to 75 years old. It delivers comprehensive and precise annotations of retinal structures in both spatial and temporal dimensions, aiming to advance the landscape of vasculature segmentation. Specifically, the dataset provides three levels of spatial annotations: binary vessel masks for overall retinal structure delineation, general vein-artery masks for distinguishing the vein and artery, and fine-grained vein-artery masks for further characterizing the granularities of each artery and vein. In addition, the dataset offers temporal annotations that capture the vessel pulsation characteristics, assisting in detecting ocular diseases that require fine-grained recognition of hemodynamic fluctuation. In application, our dataset exhibits a significant domain shift with respect to data captured by bench-top devices, thus posing great challenges to existing methods. In the experiments, we provide evaluation metrics and benchmark results on our dataset, reflecting both the potential and challenges it offers for vessel segmentation tasks. We hope this challenging dataset would significantly contribute to the development of eye disease diagnosis and early prevention

"The fruits of independence": Satyajit Ray, Indian nationhood and the spectre of empire

Challenging the longstanding consensus that Satyajit Ray's work is largely free of ideological concerns and notable only for its humanistic richness, this article shows with reference to representations of British colonialism and Indian nationhood that Ray's films and stories are marked deeply and consistently by a distinctively Bengali variety of liberalism. Drawn from an ongoing biographical project, it commences with an overview of the nationalist milieu in which Ray grew up and emphasizes the preoccupation with colonialism and nationalism that marked his earliest unfilmed scripts. It then shows with case studies of Kanchanjangha (1962), Charulata (1964), First Class Kamra (First-Class Compartment, 1981), Pratidwandi (The Adversary, 1970), Shatranj ke Khilari (The Chess Players, 1977), Agantuk (The Stranger, 1991) and Robertsoner Ruby (Robertson's Ruby, 1992) how Ray's mature work continued to combine a strongly anti-colonial viewpoint with a shifting perspective on Indian nationhood and an unequivocal commitment to cultural cosmopolitanism. Analysing how Ray articulated his ideological positions through the quintessentially liberal device of complexly staged debates that were apparently free, but in fact closed by the scenarist/director on ideologically specific notes, this article concludes that Ray's reputation as an all-forgiving, ‘everybody-has-his-reasons’ humanist is based on simplistic or even tendentious readings of his work

A class of BPS time-dependent 3-charge microstates from spectral flow

We construct an infinite family of asymptotically flat 3-charge solutions carrying D1, D5 and momentum charges. Generically the solutions also carry two angular momenta. The geometries describe the spectral flow of all the ground states of the D1-D5 CFT. The family is parametrized by four functions describing the embedding of a closed curve in R^4 and an integer n labelling the spectral flow on the left sector. After giving the general prescription for spectral flowing any of the ground states, we give an explicit example of the construction. We identify the asymptotic charges of the resulting solution and show the matching with the corresponding CFT result.Comment: 28 pages, LaTeX, references added and a minor typo fixe

Risk Factors for and Prediction of Post-Intubation Hypotension in Critically Ill Adults: A Multicenter Prospective Cohort Study

OBJECTIVE: Hypotension following endotracheal intubation in the ICU is associated with poor outcomes. There is no formal prediction tool to help estimate the onset of this hemodynamic compromise. Our objective was to derive and validate a prediction model for immediate hypotension following endotracheal intubation. METHODS: A multicenter, prospective, cohort study enrolling 934 adults who underwent endotracheal intubation across 16 medical/surgical ICUs in the United States from July 2015-January 2017 was conducted to derive and validate a prediction model for immediate hypotension following endotracheal intubation. We defined hypotension as: 1) mean arterial pressure \u3c 65 mmHg; 2) systolic blood pressure \u3c 80 mmHg and/or decrease in systolic blood pressure of 40% from baseline; 3) or the initiation or increase in any vasopressor in the 30 minutes following endotracheal intubation. RESULTS: Post-intubation hypotension developed in 344 (36.8%) patients. In the full cohort, 11 variables were independently associated with hypotension: increasing illness severity; increasing age; sepsis diagnosis; endotracheal intubation in the setting of cardiac arrest, mean arterial pressure \u3c 65 mmHg, and acute respiratory failure; diuretic use 24 hours preceding endotracheal intubation; decreasing systolic blood pressure from 130 mmHg; catecholamine and phenylephrine use immediately prior to endotracheal intubation; and use of etomidate during endotracheal intubation. A model excluding unstable patients’ pre-intubation (those receiving catecholamine vasopressors and/or who were intubated in the setting of cardiac arrest) was also developed and included the above variables with the exception of sepsis and etomidate. In the full cohort, the 11 variable model had a C-statistic of 0.75 (95% CI 0.72, 0.78). In the stable cohort, the 7 variable model C-statistic was 0.71 (95% CI 0.67, 0.75). In both cohorts, a clinical risk score was developed stratifying patients’ risk of hypotension. CONCLUSIONS: A novel multivariable risk score predicted post-intubation hypotension with accuracy in both unstable and stable critically ill patients. STUDY REGISTRATION: Clinicaltrials.gov identifier: NCT02508948 and Registered Report Identifier: RR2-10.2196/11101