The role of trauma team activation by emergency physicians on outcomes in severe trauma patients

AbstractBackgroundIn our region, trauma team activation (TTA) is initiated by emergency physicians once an injured patient meets any of the criteria of TTA after the injured patient arrives at the emergency department (ED).PurposeTo evaluate the role of TTA on outcomes in patients with severe trauma.MethodsAll trauma patients who had injury severity score (ISS) >15 and were admitted from ED between January 2010 to December 2010 were included in the study. Mann–Whitney U test (non-normal distribution) or Student's t test (normal distribution) for continuous variables and Fisher exact test or Chi-square test for categorical variables were used to compare the statistically significant differences between TTA and non-TTA groups. Logistic regression was applied to determine any significant differences found in the statistical analysis for 30-day mortality.ResultsA total of 231 patients were signed up in the study. The TTA group had shorter time from ED to operation room (170 minutes vs. 534 minutes, p = 0.02) and tended to have more emergent operations (42.7% vs. 23.2%, p = 0.002). Emergent operation [odds ratio (OR), 0.34; 95% confidence interval (CI), 0.12–0.92, p = 0.035) was associated with lower mortality while ISS > 25 (OR, 7.48; 95% CI, 2.48–22.57, p < 0.0001), Glasgow coma scale score <13 (OR, 32.1; 95% CI, 4.30–94.6, p < 0.0001), hypotension (OR, 3.0; 95% CI, 1.1–7.9, p = 0.03), and coagulopathy (OR, 9.3; 95% CI, 1.2–71.4, p = 0.033) were associated with higher mortality.ConclusionThis study shows that TTA may shorten the time from ED to operation room in trauma patients with an ISS > 15

High Altitude Pulmonary Edema in a Patient with Previous Pneumonectomy

High altitude pulmonary edema (HAPE) is a life-threatening illness that can occur in individuals ascending to altitudes exceeding 2400 m. The risk factors are rapid ascent, physical exertion and a previous history of HAPE. This work presents a case study of a 74-year-old man who underwent left side pneumonectomy 40 years ago and subsequently experienced several instances of HAPE. The well-known risk factors for HAPE were excluded in this patient. We suspect that the post-pneumonectomy condition may be a risk factor for HAPE based on this case. [J Formos Med Assoc 2007;106(4):320-322

A Reinforcement Learning Badminton Environment for Simulating Player Tactics (Student Abstract)

Recent techniques for analyzing sports precisely has stimulated various approaches to improve player performance and fan engagement. However, existing approaches are only able to evaluate offline performance since testing in real-time matches requires exhaustive costs and cannot be replicated. To test in a safe and reproducible simulator, we focus on turn-based sports and introduce a badminton environment by simulating rallies with different angles of view and designing the states, actions, and training procedures. This benefits not only coaches and players by simulating past matches for tactic investigation, but also researchers from rapidly evaluating their novel algorithms.Comment: Accepted by AAAI 2023 Student Abstract, code is available at https://github.com/wywyWang/CoachAI-Projects/tree/main/Strategic%20Environmen

Transcriptome profiling of the fifth-stage larvae of Angiostrongylus cantonensis by next-generation sequencing

Angiostrongylus cantonensis is an important zoonotic nematode. It is the causative agent of eosinophilic meningitis and eosinophilic meningoencephalitis in humans. However, information of this parasite at the genomic level is very limited. In the present study, the transcriptomic profiles of the fifth-stage larvae (L5) of A. cantonensis were investigated by next-generation sequencing (NGS). In the NGS database established from the larvae isolated from the brain of Sprague–Dawley rats, 31,487 unique genes with a mean length of 617 nucleotides were assembled. These genes were found to have a 46.08 % significant similarity to Caenorhabditis elegans by BLASTx. They were then compared with the expressed sequence tags of 18 other nematodes, and significant matches of 36.09–59.12 % were found. Among these genes, 3,338 were found to participate in 124 Kyoto Encyclopedia of Genes and Genomes pathways. These pathways included 1,514 metabolisms, 846 genetic information processing, 358 environmental information processing, 264 cellular processes, and 91 organismal systems. Analysis of 30,816 sequences with the gene ontology database indicated that their annotations included 5,656 biological processes (3,364 cellular processes, 3,061 developmental processes, and 3,191 multicellular organismal processes), 7,218 molecular functions (4,597 binding and 3,084 catalytic activities), and 4,719 cellular components (4,459 cell parts and 4,466 cells). Moreover, stress-related genes (112 heat stress and 33 oxidation stress) and genes for proteases (159) were not uncommon. This study is the first NGS-based study to set up a transcriptomic database of A. cantonensis L5. The results provide new insights into the survival, development, and host–parasite interactions of this blood-feeding nematode. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00436-013-3495-z) contains supplementary material, which is available to authorized users

Probing onset of strong localization and electron-electron interactions with the presence of direct insulator-quantum Hall transition

We have performed low-temperature transport measurements on a disordered two-dimensional electron system (2DES). Features of the strong localization leading to the quantum Hall effect are observed after the 2DES undergoes a direct insulator-quantum Hall transition with increasing the perpendicular magnetic field. However, such a transition does not correspond to the onset of strong localization. The temperature dependences of the Hall resistivity and Hall conductivity reveal the importance of the electron-electron interaction effects to the observed transition in our study.Comment: 9 pages, 4 figure

Outcome of lung cancer patients with acute respiratory failure requiring mechanical ventilation

AbstractTo assess the weaning outcome of lung cancer patients with acute respiratory failure (ARF) requiring mechanical ventilation, we retrospectively analyzed the database of the respiratory intensive care unit at a university-affiliated tertiary care hospital.Charts were reviewed for cancer status, biochemistries before respiratory failure, causes of respiratory failure, acute physiology and chronic health evaluation (APACHE) III score, ventilatory settings, data recorded during spontaneous breathing, duration of ventilator days, and weaning outcome. Ninety-five consecutive respiratory failure events in 81 patients were recorded from January 1, 1995 through June 30, 1999.Twenty-six episodes ended with successful weaning (27.4%). Age, gender, and cancer status did not affect the weaning outcome. Serum albumin level, APACHE III score, highest fractional inspired O2 (FiO2) and highest positive end-expiratory pressure, organ failure, ability to shift to partial ventilatory support, and duration of mechanical ventilation could significantly influence the weaning outcome statistically. The overall hospital mortality rate was 85.2%.Our results suggested that lung cancer patients with ARF will have a better chance to wean if the initial APACHE III score was less than 70, use of FiO2 never exceeded 0.6, or less than 2 additional organ systems failed during the treatment course

Predicting Multi-Codebook Vector Quantization Indexes for Knowledge Distillation

Knowledge distillation(KD) is a common approach to improve model performance in automatic speech recognition (ASR), where a student model is trained to imitate the output behaviour of a teacher model. However, traditional KD methods suffer from teacher label storage issue, especially when the training corpora are large. Although on-the-fly teacher label generation tackles this issue, the training speed is significantly slower as the teacher model has to be evaluated every batch. In this paper, we reformulate the generation of teacher label as a codec problem. We propose a novel Multi-codebook Vector Quantization (MVQ) approach that compresses teacher embeddings to codebook indexes (CI). Based on this, a KD training framework (MVQ-KD) is proposed where a student model predicts the CI generated from the embeddings of a self-supervised pre-trained teacher model. Experiments on the LibriSpeech clean-100 hour show that MVQ-KD framework achieves comparable performance as traditional KD methods (l1, l2), while requiring 256 times less storage. When the full LibriSpeech dataset is used, MVQ-KD framework results in 13.8% and 8.2% relative word error rate reductions (WERRs) for non -streaming transducer on test-clean and test-other and 4.0% and 4.9% for streaming transducer. The implementation of this work is already released as a part of the open-source project icefall.Comment: Submitted to ICASSP 202

Tunable van Hove singularity without structural instability in Kagome metal CsTi3_3Bi5_5

In Kagome metal CsV$_3$Sb$_5$, multiple intertwined orders are accompanied by both electronic and structural instabilities. These exotic orders have attracted much recent attention, but their origins remain elusive. The newly discovered CsTi$_3$Bi$_5$ is a Ti-based Kagome metal to parallel CsV$_3$Sb$_5$. Here, we report angle-resolved photoemission experiments and first-principles calculations on pristine and Cs-doped CsTi$_3$Bi$_5$ samples. Our results reveal that the van Hove singularity (vHS) in CsTi$_3$Bi$_5$ can be tuned in a large energy range without structural instability, different from that in CsV$_3$Sb$_5$. As such, CsTi$_3$Bi$_5$ provides a complementary platform to disentangle and investigate the electronic instability with a tunable vHS in Kagome metals