A Posteriori Probabilistic Bounds of Convex Scenario Programs with Validation Tests

Scenario programs have established themselves as efficient tools towards decision-making under uncertainty. To assess the quality of scenario-based solutions a posteriori, validation tests based on Bernoulli trials have been widely adopted in practice. However, to reach a theoretically reliable judgement of risk, one typically needs to collect massive validation samples. In this work, we propose new a posteriori bounds for convex scenario programs with validation tests, which are dependent on both realizations of support constraints and performance on out-of-sample validation data. The proposed bounds enjoy wide generality in that many existing theoretical results can be incorporated as particular cases. To facilitate practical use, a systematic approach for parameterizing a posteriori probability bounds is also developed, which is shown to possess a variety of desirable properties allowing for easy implementations and clear interpretations. By synthesizing comprehensive information about support constraints and validation tests, improved risk evaluation can be achieved for randomized solutions in comparison with existing a posteriori bounds. Case studies on controller design of aircraft lateral motion are presented to validate the effectiveness of the proposed a posteriori bounds

Application of Thoracic Ultrasonography for Acute Cor Pulmonale in Acute Respiratory Distress Syndrome Patients

Beneficial therapeutic interventions for acute respiratory distress syndrome (ARDS) include lung protective ventilation; however, ventilator may cause or sometimes worsen acute cor pulmonale (ACP) induced by pulmonary gas exchange disorder and pulmonary vascular dysfunction due to ARDS. The incidence of ACP was 22–50% in mechanically ventilated patients. Currently, point-of-care ultrasound has been widely used in ARDS patients, which becomes much more important in the early detection and management of ARDS and its complications. Application of lung ultrasound combined with echocardiography could monitor respiratory status, hemodynamics, and cardiac function and optimize the ventilation setting in order to protect both lung and right ventricle. This chapter will discuss the pathophysiology of ACP associated with ARDS and the use of point-of-care ultrasound to make protective strategies for lung and right ventricle in detail

Urine Screening for Opiod and Illicit Drugs in the Total Joint Arthroplasty Population

Introduction. Recent studies have shown an increase in post-operative orthopaedic complications associated with pre-operative opioid use. It is, therefore, important to know if patients use opioids before scheduled surgery. The purpose of this study was to determine if urine drug screening (UDS) is an effective screening tool for detecting opioid and illicit drug use prior to joint arthroplasty (JA) procedures. Methods. This retrospective chart review was performed with IRB approval on 166 out of 172 consecutive patients in a community-based practice. All the patients had a pre-operative UDS prior to primary or revision JA by a fellowship trained orthopaedic surgeon between March 2016 and April 2017. Patient demographics documented opioid and illicit drug use, co-morbid diagnosis, and UDS results were collected from clinical charts. Statistical analysis was conducted using Pearson Chi-square, Fisher’s exact, McNemar test, and t-tests with IBM SPSS Statistics, ver. 23. Significant differences were p < 0.05. Results. Sixty-four of 166 patients (38.6%) tested positive for opioids. Among them, 55.0% (35/64) had no history of prescription opioid use. Significant differences were observed when comparing the test results of the UDS with the patient reported history of prescribed opioids (p = 0.001). Conclusion. With a significant number of patients testing positive for opioids without evidence of a previous prescription, UDS may be beneficial for initial risk assessment for patients undergoing JA procedures

Biocompatibility of Poly-ε-caprolactone-hydroxyapatite composite on mouse bone marrow-derived osteoblasts and endothelial cells

Open Access. Click on the DOI link to access this article at the publisher's website, or download /view it on SOAR.Background. Tissue-engineered bone may be developed by seeding the cells capable of both osteogenesis and vascularization on biocompatible composite scaffolds. The current study investigated the performance of mice bone marrow-derived osteogenic cells and endothelial cells as seeded on hydroxyapatite (HA) and poly-ε-caprolactone (PCL) composite scaffolds. Methods Mononuclear cells were induced to osteoblasts and endothelial cells respectively, which were defined by the expression of osteocalcin, alkaline phosphatase (ALP), and deposits of calcium-containing crystal for osteoblasts, or by the expression of vascular endothelial growth factor receptor-2 (VEGFR-2) and von Willebrand factor (vWF), and the formation of a capillary network in Matrigel™ for endothelial cells. Both types of cell were seeded respectively on PCL-HA scaffolds at HA to PCL weight ratio of 1:1, 1:4, or 0:1 and were evaluated using scanning electron microscopy, ALP activity (of osteoblasts) and nitric oxide production (of endothelial cells) plus the assessment of cell viability. Results The results indicated that HA led to a positive stimulation of osteoblasts viability and ALP activity, while HA showed less influence on endothelial cells viability. An elevated nitric oxide production of endothelial cells was observed in HA-containing group. Conclusion Supplement of HA into PCL improved biocompatible for bone marrow-derived osteoblasts and endothelial cells. The PCL-HA composite integrating with two types of cells may provide a useful system for tissue-engineered bone grafts with vascularization.Peer reviewe