A Simulation of Oblivious Multi-Head One-Way Finite Automata by Real-Time Cellular Automata

In this paper, we present the simulation of a simple, yet significantly powerful, sequential model by cellular automata. The simulated model is called oblivious multi-head one-way finite automata and is characterized by having its heads moving only forward, on a trajectory that only depends on the length of the input. While the original finite automaton works in linear time, its corresponding cellular automaton performs the same task in real time, that is, exactly the length of the input. Although not truly a speed-up, the simulation may be interesting and reminds us of the open question about the equivalence of linear and real times on cellular automata.Comment: Journ\'ees Automates Cellulaires 2010, Turku : Finland (2010

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Reconnaissance de langages en temps réel par des automates cellulaires avec contraintes

Dans cette thèse, on s'intéresse aux automates cellulaires en tant que modèle de calcul permettant de reconnaître des langages. Dans un tel domaine, il est toujours difficile d'établir des résultats négatifs, typiquement de prouver qu'un langage donné n'est pas reconnu en une certaine fonction de temps par une certaine classe d'automates. On se focalisera en particulier sur les classes de faible complexité comme le temps réel, au sujet desquelles de nombreuses questions restent ouvertes.Dans une première partie, on propose plusieurs manières d'affaiblir encore les classes de langages étudiées, permettant ainsi d'obtenir des exemples de résultats négatifs. Dans une seconde partie, on montre un théorème d'accélération par automate cellulaire d'un modèle séquentiel, les automates finis oublieux. Ce modèle est une version a priori affaiblie, mais non triviale, des automates finis à plusieurs têtes de lecture.This document deals with cellular automata as a model of computation used to recognise languages. In such a domain, it is always difficult to provide negative results, that is, typically, to prove that a given language is not recognised in some function of time by some class of automata. The document focuses in particular on the low-complexity classes such as real time, about which a lot of questions remain open since several decades.In a first part, several techniques to weaken further still these classes of languages are investigated, thereby bringing examples of negative results. A second part is dedicated to the comparison of cellular automata with another model language recognition, namely multi-head finite automata. This leads to speed-up theorem when finite automata are oblivious, which makes them a priori weaker than in the general case but leaves them a nontrivial power

A speed-up of oblivious multi-head finite automata by cellular automata

International audienceIn this paper, we present a parallel speed-up of a simple, yet significantly powerful, sequential model by cellular automata. The simulated model is called oblivious multi-head finite automata and is characterized by the fact that the trajectory of the heads only depends on the length of the input word. While the original $k$-head finite automaton works in time O(\cramped{n^k}), its corresponding cellular automaton performs the same task in time O(\cramped{n^{k - 1}}\log(n)) and space O(\cramped{n^{k - 1}})

Reconnaissance de langages en temps réel par des automates cellulaires avec contraintes

Dans cette thèse, on s'intéresse aux automates cellulaires en tant que modèle de calcul permettant de reconnaître des langages. Dans un tel domaine, il est toujours difficile d'établir des résultats négatifs, typiquement de prouver qu'un langage donné n'est pas reconnu en une certaine fonction de temps par une certaine classe d'automates. On se focalisera en particulier sur les classes de faible complexité comme le temps réel, au sujet desquelles de nombreuses questions restent ouvertes.Dans une première partie, on propose plusieurs manières d'affaiblir encore les classes de langages étudiées, permettant ainsi d'obtenir des exemples de résultats négatifs. Dans une seconde partie, on montre un théorème d'accélération par automate cellulaire d'un modèle séquentiel, les automates finis oublieux. Ce modèle est une version a priori affaiblie, mais non triviale, des automates finis à plusieurs têtes de lecture.This document deals with cellular automata as a model of computation used to recognise languages. In such a domain, it is always difficult to provide negative results, that is, typically, to prove that a given language is not recognised in some function of time by some class of automata. The document focuses in particular on the low-complexity classes such as real time, about which a lot of questions remain open since several decades.In a first part, several techniques to weaken further still these classes of languages are investigated, thereby bringing examples of negative results. A second part is dedicated to the comparison of cellular automata with another model language recognition, namely multi-head finite automata. This leads to speed-up theorem when finite automata are oblivious, which makes them a priori weaker than in the general case but leaves them a nontrivial power.AIX-MARSEILLE1-Bib.electronique (130559902) / SudocSudocFranceF

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p &lt; 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p &lt; 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

International audienceBackground: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/ hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results: From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59-78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57-77] vs 74 [64-80] years, p < 0.001) and had lower driving (12 [8-16] vs 15 [11-17] cmH 2 O, p < 0.001), plateau (20 [15-23] vs 22 [19-26] cmH 2 O, p < 0.001) and peak (21 [17-27] vs 26 [20-32] cmH 2 O, p < 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60-1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16-2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06-1.18], p < 0.001) and tidal volume after day 7 (HR 0.69 [0.52-0.93], p = 0.015) were related to survival. Conclusions: Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury

Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study

Background: Current incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS). Methods: An international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-expiratory pressure of ≥5 cmH2O. ICU prevalence, causes of hypoxaemia, hospital survival and factors associated with hospital mortality were measured. Patients with unilateral versus bilateral opacities were compared. Findings: 12 906 critically ill patients received mechanical ventilation and 34.9% with hypoxaemia and new infiltrates were enrolled, separated into ARDS (69.0%), unilateral infiltrate (22.7%) and congestive heart failure (CHF; 8.2%). The global hospital mortality was 38.6%. CHF patients had a mortality comparable to ARDS (44.1% versus 40.4%). Patients with unilateral-infiltrate had lower unadjusted mortality, but similar adjusted mortality compared to those with ARDS. The number of quadrants on chest imaging was associated with an increased risk of death. There was no difference in mortality comparing patients with unilateral-infiltrate and ARDS with only two quadrants involved. Interpretation: More than one-third of patients receiving mechanical ventilation have hypoxaemia and new infiltrates with a hospital mortality of 38.6%. Survival is dependent on the degree of pulmonary involvement whether or not ARDS criteria are reached

Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study

Background: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results: From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59-78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57-77] vs 74 [64-80] years, p &lt; 0.001) and had lower driving (12 [8-16] vs 15 [11-17] cmH2O, p &lt; 0.001), plateau (20 [15-23] vs 22 [19-26] cmH2O, p &lt; 0.001) and peak (21 [17-27] vs 26 [20-32] cmH2O, p &lt; 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60-1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16-2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06-1.18], p &lt; 0.001) and tidal volume after day 7 (HR 0.69 [0.52-0.93], p = 0.015) were related to survival. Conclusions: Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073