Towards cluster based adaptive learning

Accepted manuscrip

Pain Management via Ultrasound-guided Nerve Block in Emergency Department; a Case Series Study

Introduction: Pain is the most common complaint of patients referring to emergency department (ED). Consideringthe importance of pain management in ED, this study aimed to investigate the efficacy and feasibility ofultrasound-guided nerve blocks in this setting. Methods: 46 patients who came to the ED with injured extremitieswere enrolled in the study and received either femoral, axillary or sciatic nerve block depending on theirsite of injury (1.5 mg Bupivacaine per kg of patient’s weight). Patients were asked about their level of pain beforeand after receiving the nerve block based on numerical rating scale. The difference between pre and post blockpain severity was measured. Both patients and physicians were asked about their satisfaction with the nerveblock in 5 tiered Likert scale. Results: 46 patients with the mean age of 37.5 § 12.5 years (8-82 years) receivedultrasound-guided nerve block (84.8% male). 6 Sciatic, 25 axillary, and 15 femoral nerve blocks were performed.Mean pain severity on NRS score at the time of admission was 8.1 § 1.4, which reduced to 2.04 § 2.06 after block.25 (54.3%) patients were highly satisfied (Likert scale 5), 15 (32.6%) were satisfied (Likert scale 4), 3 (6.5%) wereneutral and had no opinion (Likert scale 3), 1 (2.1%) was not satisfied (Likert scale 2), and 2 (4.3%) were highlyunsatisfied (Likert scale 1). There was no significant difference among the satisfaction scores within the threeblock locations (p = 0.8). There was no significant difference in physicians level of satisfaction between the threeblock locations either (p = 0.9). 1 (2.1%) case of agitation and tachycardia and 1 (2.1%) case of vomiting wereobserved after the procedure. Conclusion: Ultrasound-guided nerve block of extremities is a safe and effectivemethod that can be used for pain management in the ED. It results in high levels of satisfaction among bothpatients and physicians

Ergonomics Evaluation in Designed Maintainability: Case Study Using 3 DSSPP

Maintainability is one of the design parameters (reliability, availability, maintainability, and safety (RAMS)) and maintenance is needed to keep the respective design in sustainable use. At the same time, the human is involved in the form of interface and interaction in an engineered product/system designed. Ergonomics is a multi-discipli nary science that considers human capabilities and limitations in a broader sense. The objective of this paper is to integrate ergonomics into the maintainability design process in order to facilitate maintenance operation in lesser; time, cost, easier operation as well as the well-being of human who is involved. In other words, good er gonomics lead to good economics and in a broader sense, sustainability. This investigation shows that designing comfortable workplaces and lesser workload for maintenance operators will be beneficial for the maintainability design process and also improve the meantime to repair MTTR. In order to evaluate the effect of designed work place and workload on maintainers 3 D Static Strength Prediction Program (3D SSPP) that is commonly used as an ergonomics evaluation tool in scientific studies was applied

PlinyCompute: A Platform for High-Performance, Distributed, Data-Intensive Tool Development

This paper describes PlinyCompute, a system for development of high-performance, data-intensive, distributed computing tools and libraries. In the large, PlinyCompute presents the programmer with a very high-level, declarative interface, relying on automatic, relational-database style optimization to figure out how to stage distributed computations. However, in the small, PlinyCompute presents the capable systems programmer with a persistent object data model and API (the "PC object model") and associated memory management system that has been designed from the ground-up for high performance, distributed, data-intensive computing. This contrasts with most other Big Data systems, which are constructed on top of the Java Virtual Machine (JVM), and hence must at least partially cede performance-critical concerns such as memory management (including layout and de/allocation) and virtual method/function dispatch to the JVM. This hybrid approach---declarative in the large, trusting the programmer's ability to utilize PC object model efficiently in the small---results in a system that is ideal for the development of reusable, data-intensive tools and libraries. Through extensive benchmarking, we show that implementing complex objects manipulation and non-trivial, library-style computations on top of PlinyCompute can result in a speedup of 2x to more than 50x or more compared to equivalent implementations on Spark.Comment: 48 pages, including references and Appendi

Termination of pregnancy in a twin pregnant patient with COVID-19

In this article, we present a pregnant case suspected of COVID-19 with underlying symptoms of respiratory distress; which was referred to Shohada-e-Tajrish Hospital. Due to the progressive decrease of O2 saturation, the medical team decided to terminate the pregnancy to save the patient's life. Despite all these efforts including pharmaceutical agents, the patient passed away

Requirements and Use Cases ; Report I on the sub-project Smart Content Enrichment

In this technical report, we present the results of the first milestone phase of the Corporate Smart Content sub-project "Smart Content Enrichment". We present analyses of the state of the art in the fields concerning the three working packages defined in the sub-project, which are aspect-oriented ontology development, complex entity recognition, and semantic event pattern mining. We compare the research approaches related to our three research subjects and outline briefly our future work plan

Anesthetic Management “Arnold Chiari Malformation” in the well-known Case of Cystic Fibrosis

Cystic fibrosis (CF) is a genetic disease resulting from a chlorine channel defect with autosomal recessive show, a physical and functional disorder in the transport of chlorine (Cl) through the plasma membrane in epithelial cells in organs such as the lungs, pancreas, liver, intestines, sweat glands, and epididymis. These cases are important for their perioperative respiratory complications. We present an anesthesia method conducted on a 24-year-old men CF case receiving general anesthesia for Arnold Chiari malformation surgery

Characterization of the Hamamatsu R11410-10 3-Inch Photomultiplier Tube for Liquid Xenon Dark Matter Direct Detection Experiments

To satisfy the requirements of the next generation of dark matter detectors based on the dual phase TPC, Hamamatsu, in close collaboration with UCLA, has developed the R11410-10 photomultipler tube. In this work, we present the detailed tests performed on this device. High QE (>30%) accompanied by a low dark count rate (50 Hz at 0.3 PE) and high gain (10^7) with good single PE resolution have been observed. A comprehensive screening measurement campaign is ongoing while the manufacturer quotes a radioactivity of 20 mBq/PMT. These characteristics show the R11410-10 to be particularly suitable for the forthcoming zero background liquid xenon detectors.Comment: 19 pages, 18 figure

XAX: a multi-ton, multi-target detection system for dark matter, double beta decay and pp solar neutrinos

A multi-target detection system XAX, comprising concentric 10 ton targets of 136Xe and 129/131Xe, together with a geometrically similar or larger target of liquid Ar, is described. Each is configured as a two-phase scintillation/ionization TPC detector, enhanced by a full 4pi array of ultra-low radioactivity Quartz Photon Intensifying Detectors (QUPIDs) replacing the conventional photomultipliers for detection of scintillation light. It is shown that background levels in XAX can be reduced to the level required for dark matter particle (WIMP) mass measurement at a 10^-10 pb WIMP-nucleon cross section, with single-event sensitivity below 10^-11 pb. The use of multiple target elements allows for confirmation of the A^2 dependence of a coherent cross section, and the different Xe isotopes provide information on the spin-dependence of the dark matter interaction. The event rates observed by Xe and Ar would modulate annually with opposite phases from each other for WIMP mass >~100 GeV/c^2. The large target mass of 136Xe and high degree of background reduction allow neutrinoless double beta decay to be observed with lifetimes of 10^27-10^28 years, corresponding to the Majorana neutrino mass range 0.01-0.1 eV, the most likely range from observed neutrino mass differences. The use of a 136Xe-depleted 129/131Xe target will also allow measurement of the pp solar neutrino spectrum to a precision of 1-2%.Comment: 16 pages with 17 figure

Magnesium Gargle versus Ketamine Gargle in Postoperative Sore Throat Pain; A Randomized Placebo-Controlled Clinical Trial

Background: A wide range of approaches have been tested for the prevention and treatment of postoperative sore throat pain (POST pain). This study attempted to compare the effects of gargling with Ketamine or Magnesium Sulfate on POST pain.  Materials and Methods: In a randomized clinical trial, 60 patients scheduled for prone position laminectomy were randomly assigned into three groups: Ketamine (n=20), Magnesium (n=20), and Control (n=20). The Magnesium group received magnesium sulfate gargle (30 mg/kg in a total of 30 ml 5% Dextrose water), the Ketamine group received Ketamine gargle (0.5 mg/kg in a total of 30 ml 5% Dextrose water) and the control group received 30 ml 5% Dextrose water gargle; all these solutions were administered 10 min before anesthesia induction. Visual Analog Scale (VAS) for throat pain was recorded in the recovery room; immediately after arrival and then, at 2, 4, and 24 hours postoperatively in the ward. Would there be any VAS equal to or more than 3 of 10, rescue analgesics were administered immediately and their cumulative doses were recorded.  Results: The incidence of complaint-free patients in the Ketamine group was significantly higher than in the other two groups. The incidence of sore throat with VAS≥3, mandating rescue analgesia, was significantly lower than the other two groups. patient satisfaction after surgery was significantly higher in the Ketamine group.  Conclusion: Patients experiencing POST pain treated with “Ketamine gargle” had better results compared with “Magnesium Sulfate” or “Placebo” gargle.&nbsp