The interpretation of brain natriuretic peptide in critical care patients; will it ever be useful?

The measurement of B-type natriuretic peptide (BNP) is recommended for the diagnosis of decompensated heart failure, the prognosis of chronic heart failure is worse if BNP is increased and studies suggest that BNP is useful to guide therapy. A study by Di Somma and colleagues adds to the body of evidence showing that patients with a marked decrease in BNP concentrations during their hospital admission are less likely to be readmitted with a further adverse cardiac event than patients in whom BNP fails to decrease. However, the wider interpretation of BNP concentrations in critically ill patients with other conditions remains uncertain

NASA TileWorld manual (system version 2.2)

The commands are documented of the NASA TileWorld simulator, as well as providing information about how to run it and extend it. The simulator, implemented in Common Lisp with Common Windows, encodes a particular range in a spectrum of domains, for controllable research experiments. TileWorld consists of a two dimensional grid of cells, a set of polygonal tiles, and a single agent which can grasp and move tiles. In addition to agent executable actions, there is an external event over which the agent has not control; this event correspond to a 'gust of wind'

An analysis of commitment strategies in planning: The details

We compare the utility of different commitment strategies in planning. Under a 'least commitment strategy', plans are represented as partial orders and operators are ordered only when interactions are detected. We investigate claims of the inherent advantages of planning with partial orders, as compared to planning with total orders. By focusing our analysis on the issue of operator ordering commitment, we are able to carry out a rigorous comparative analysis of two planners. We show that partial-order planning can be more efficient than total-order planning, but we also show that this is not necessarily so

"Fear of stigma is stronger than fear of death": a workplace initiative to reduce sickness and death due to HIV/AIDS among health staff in Malawi

Mexico AIDS Conference 200

The min-conflicts heuristic: Experimental and theoretical results

This paper describes a simple heuristic method for solving large-scale constraint satisfaction and scheduling problems. Given an initial assignment for the variables in a problem, the method operates by searching through the space of possible repairs. The search is guided by an ordering heuristic, the min-conflicts heuristic, that attempts to minimize the number of constraint violations after each step. We demonstrate empirically that the method performs orders of magnitude better than traditional backtracking techniques on certain standard problems. For example, the one million queens problem can be solved rapidly using our approach. We also describe practical scheduling applications where the method has been successfully applied. A theoretical analysis is presented to explain why the method works so well on certain types of problems and to predict when it is likely to be most effective

An extended abstract: A heuristic repair method for constraint-satisfaction and scheduling problems

The work described in this paper was inspired by a surprisingly effective neural network developed for scheduling astronomical observations on the Hubble Space Telescope. Our heuristic constraint satisfaction problem (CSP) method was distilled from an analysis of the network. In the process of carrying out the analysis, we discovered that the effectiveness of the network has little to do with its connectionist implementation. Furthermore, the ideas employed in the network can be implemented very efficiently within a symbolic CSP framework. The symbolic implementation is extremely simple. It also has the advantage that several different search strategies can be employed, although we have found that hill-climbing methods are particularly well-suited for the applications that we have investigated. We begin the paper with a brief review of the neural network. Following this, we describe our symbolic method for heuristic repair

How informed are bronchial asthma patients: a questionnaire based study in a tertiary care hospital

Background: Asthma has been considered as one of the most common chronic diseases worldwide. Asthma due to its effects on bronchial passage compromises the respiration and intern impairs the quality of life. Aim was to evaluate the knowledge of asthma among patients attending our tertiary care hospital.Methods: The patients were subjected to chest X-ray and spirometry followed by the knowledge on asthma questionnaire which consisted of 28 questions.Results: Out of 75 patients, aged between 18-80 years, majority were males. Out of 75 patients, 60 (80%) patients had obtained a total score below 10 out of the total of 28 score. The causative factors for asthma, 60 (80%) patients believed that asthma was due to allergy. Only 2-3 patients (3-4%) had knowledge of the underlying pathologic process during an asthma attack. Fifty nine (79%) patients were aware of the symptoms of asthma. However, only 10 (13%) patients knew about the early signs of worsening of asthma and only 14 (19%) patients could judge the severity of asthma. Only 5 (7%) patients knew which drug was for regular use and which was to be used if breathlessness occurred. Merely around 4-10 (5 to 13%) patients knew that asthma could be prevented by avoiding trigger factors and by taking medication regularly.Conclusions: A good level of knowledge about asthma and better practices are rigorously important to prevent asthma exacerbations. More comprehensive, regular and patient centred counselling programs will be beneficial in improving awareness of asthma

Detecting superior mutual fund managers: evidence from copycats

We examine the ex ante ability of investors to identify superior mutual fund managers among the investor set likely most able, and with the greatest incentive to do so, their rivals. Identifying actual copycat funds via comparisons of trading in consecutive periods, we find little evidence to suggest that managers are able to detect superior funds. Copycats select funds with high prior performance and investment inflows, and the performance of the target fund reverses following copying initiation. If superior managers exist, our results suggest that the source of skill lies in private information obtained by these managers. These results are consistent with information models indicating that private, but not public, information can be profitabl

A case study of an adverse drug reaction caused by long term use of proton pump inhibitors

Proton pump inhibitors (PPI) are the class of drugs used to treat a wide variety of disorders related to the stomach's acid production. Although it is considered safe for short term use, reports revealed that many serious life-threatening adverse reactions occurred from long term use. Here we report a case of hypomagnesemia and hypocalcemia induced by long-term use of PPIs in a patient with crest syndrome. From his past history, it was revealed that he was on pantoprazole 40 mg for more than 3 months. While he was admitted here for other complaints, we were able to discover that he had hypomagnesemia defined by low magnesium level of 1.3 mg/dL. As a consequence, he also showed signs of hypocalcemia with a low calcium level of 7 mg/dL. A peculiar complaint seen in this patient was three episodes of supraventricular tachycardia which is the most common cardiac manifestations of hypomagnesemia. As a conclusion, hypomagnesemia can sometimes be asymptomatic and cause unspecific and serious manifestations such as asthenia, paresthesia’s, seizures, arrhythmias, and cardiac arrest. Hence routine monitoring of serum magnesium and calcium levels should be made mandatory in practice for patients on long term use of PPI. Besides, it should be kept in mind that interchanging PPI class with histamine 2 receptor antagonist or fitful use of PPI may not cause hypomagnesemia