Effective superior vena cava isolation using a novel C-shaped approach

IntroductionSuperior vena cava (SVC) isolation has been proposed as part of the ablation strategy for atrial fibrillation. However, circumferential isolation of the SVC can lead to late-onset complications, such as SVC stenosis.MethodsWe describe a detailed observation of the SVC conduction pattern and present a newly developed approach for SVC isolation that involves creating a C-shaped non-circumferential ablation line while sparing the lateral segment.ResultsTwelve consecutive patients were included in the study, all of whom achieved bidirectional block during the ablation procedure.DiscussionThis approach to SVC isolation is effective and has the potential to reduce ablation related complications; however, larger studies and long-term follow-up is warranted to confirm these findings

Reliability and Validity of the Taiwan Chinese Version of the EORTC QLQ-PR25 in Assessing Quality of Life of Prostate Cancer Patients

Background/PurposeThis study examined the psychometric properties and clinical validity of the EORTC QLQ-PR25, a questionnaire for assessing the quality of life of patients with prostate cancer.MethodsThe Taiwan Chinese version of the prostate cancer module (EORTC QLQ-PR25) and the core questionnaires (EORTC QLQ-C30) were administered to 81 patients with prostate cancer after they had been treated with surgery or hormone therapy or both. The QLQ-PR25 module assesses urinary symptoms, bowel symptoms, hormonal treatment-related symptoms, sexual activity and sexual functioning.ResultsThe questionnaires were well accepted by the patients and very few of the items had missing data. Only the urinary symptom scale showed satisfactory internal consistency. Scales were able to differentiate clinical groups of patients with corresponding symptoms, but the differences were smaller than that of major functioning scales in the core questionnaire.ConclusionThe Taiwan Chinese version of the EORTC QLQ-PR25 is acceptable in patients with prostate cancer in Taiwan, able to differentiate corresponding symptoms, but the scale structure needs further improvement

Learning Deep Latent Spaces for Multi-Label Classification

Multi-label classification is a practical yet challenging task in machine learning related fields, since it requires the prediction of more than one label category for each input instance. We propose a novel deep neural networks (DNN) based model, Canonical Correlated AutoEncoder (C2AE), for solving this task. Aiming at better relating feature and label domain data for improved classification, we uniquely perform joint feature and label embedding by deriving a deep latent space, followed by the introduction of label-correlation sensitive loss function for recovering the predicted label outputs. Our C2AE is achieved by integrating the DNN architectures of canonical correlation analysis and autoencoder, which allows end-to-end learning and prediction with the ability to exploit label dependency. Moreover, our C2AE can be easily extended to address the learning problem with missing labels. Our experiments on multiple datasets with different scales confirm the effectiveness and robustness of our proposed method, which is shown to perform favorably against state-of-the-art methods for multi-label classification.Comment: published in AAAI-201

Esophageal Food Impaction: A Homemade Suction Tube Attached to Esophagogastroduodenoscopy for Food Bolus Removal

The most common esophageal foreign body in adults is impacted food bolus. Polypectomy snares, Dormia baskets, retrieval nets, rat-tooth forceps, alligator forceps or polyp graspers are usually used to remove it. Here, we report the case of a 78-year-old woman whose esophagogastroduodenoscopy (EGD) showed a firm goose liver impacted tightly in the lower esophagus; all of the above-mentioned retrieval instruments could not remove it. We used a homemade device by attaching a modified nasogastric tube to an EGD and successfully removed the goose liver by suction under endoscopic visualization. The method is very effective to remove firm and tightly impacted materials in a narrow lumen. When the usual retrieval instruments fail, a homemade suction tube attached to an EGD is an alternative

The Behavior of Retaining Walls Under 1999 Chi-Chi Earthquake

This paper reports failure of retaining structures related to the 1999 Chi-Chi earthquake. On September 21 of 1999, an earthquake with a magnitude of 7.3 on the Richter scale struck Taiwan. At the site near Tou-Sheh, overturning failure was observed on a 2.5 m-high gravity wall located near the epicenter. At the site near the Temple of Ten-thousand Buddha, a masonry wall constructed with cobble was damaged. Upper part of wall shifted outward about 0.2 m with respect to its lower part. At the site of Cinema-Culture Town, a gravity wall built on top of the Che-Lung-Pu fault was severely damaged. The heel of the wall was uplifted by the fault rupture. At the parking lot of the Lalu Resort, the retaining wall constructed on a slope moved down the slope during the earthquake. A circular sliding surface can be observed in the collapsed backfill. At the entrance of National Chi-Nan University, a geogrid-reinforced wall was severely damaged during the earthquake. Reinforcing strips were pulled out under the seismic load and fill materials fell out

Seismic test and numerical verification of the scaled-down reinforced concrete containment vessel

According to the ASME-359 code, a scaled-down structure of Reinforced Concrete Containment Vessel (RCCV) of Advanced Boiling Water Reactor (ABWR) building is constructed for the seismic test on the shaking table. Several acceleration time history satisfing design response spectrum with different magnitudes are used in the test. Besides, the numerical finite element model of RCCV is built by SAP2000 for calculating the dynamic responses numerically

Obstacle-Resistant Deployment Algorithms for Wireless Sensor Networks

[[abstract]]Node deployment is an important issue in wireless sensor networks (WSNs). Sensor nodes should be efficiently deployed in a predetermined region in a low-cost and high-coverage-quality manner. Random deployment is the simplest way to deploy sensor nodes but may cause unbalanced deployment and, therefore, increase hardware costs and create coverage holes. This paper presents the efficient obstacle-resistant robot deployment (ORRD) algorithm, which involves the design of a node placement policy, a serpentine movement policy, obstacle-handling rules, and boundary rules. By applying the proposed ORRD, the robot rapidly deploys a near-minimal number of sensor nodes to achieve full sensing coverage, even though there exist unpredicted obstacles with regular or irregular shapes. Performance results reveal that ORRD outperforms the existing robot deployment mechanism in terms of power conservation and obstacle resistance and, therefore, achieves better deployment performance.[[incitationindex]]SC

An Obstacle-Free and Power Efficient Deployment Algorithm for Wireless Sensor Networks

[[abstract]]This paper proposes a robot-deployment algorithm that overcomes unpredicted obstacles and employs full-coverage deployment with a minimal number of sensor nodes. Without the location information, node placement and spiral movement policies are proposed for the robot to deploy sensors efficiently to achieve power conservation and full coverage, while an obstacle surrounding movement policy is proposed to reduce the impacts of an obstacle upon deployment. Simulation results reveal that the proposed robot-deployment algorithm outperforms most existing robot-deployment mechanisms in power conservation and obstacle resistance and therefore achieves a better deployment performance.[[notice]]補正完

Application and comparison of scoring indices to predict outcomes in patients with healthcare-associated pneumonia

Introduction: Healthcare-associated pneumonia HCAP is a relatively new category of pneumonia. It refers to infections that occur prior to hospital admission in patients with specific risk factors following contact or exposure to a healthcare environment. There is currently no scoring index to predict the outcomes of HCAP patients. We applied and compared different community acquired pneumonia CAP scoring indices to predict 30-day mortality and 3-day and 14-day intensive care unit ICU admission in patients with HCAP. Methods: We conducted a retrospective cohort study based on an inpatient database from six medical centers, recruiting a total of 444 patients with HCAP between 1 January 2007 and 31 December 2007. Pneumonia severity scoring indices including PSI pneumonia severity index, CURB 65 confusion, urea, respiratory rate, blood pressure , age 65, IDSA/ATS Infectious Diseases Society of America/American Thoracic Society, modified ATS rule, SCAP severe community acquired pneumonia, SMART-COP systolic blood pressure, multilobar involvement, albumin, respiratory rate, tachycardia, confusion, oxygenation, pH, SMRT- CO systolic blood pressure, multilobar involvement, respiratory rate, tachycardia, confusion, oxygenation, and SOAR systolic blood pressure, oxygenation, age, respiratory rate were calculated for each patient. Patient characteristics, co-morbidities, pneumonia pathogen culture results, length of hospital stay LOS, and length of ICU stay were also recorded. Results: PSI > 90 has the highest sensitivity in predicting mortality, followed by CURB-65 >= 2 and SCAP > 9 SCAP score area under the curve AUC: 0.71, PSI AUC: 0.70 and CURB-65 AUC: 0.66. Compared to PSI, modified ATS, IDSA/ATS, SCAP, and SMART-COP were easy to calculate. For predicting ICU admission Day 3 and Day 14, modified ATS AUC: 0.84, 0.82 , SMART-COP AUC: 0.84, 0.82, SCAP AUC: 0.82, 0.80 and IDSA/ ATS AUC: 0.80, 0 .79 performed better statistically significant difference than PSI, CURB- 65, SOAR and SMRT-CO. Conclusions: The utility of the scoring indices for risk assessment in patients with healthcare-associated pneumonia shows that the scoring indices originally designed for CAP can be applied to HCAP

CHANGE IN BLOOD GELSOLIN CONCENTRATION IN RESPONSE TO PHYSICAL EXERCISE

Plasma gelsolin (pGSN) produced by muscle is an abundant protein of extracellular fluids capable of severing actin filaments and eliminating actin from the circulation. Additionally, pGSN modulates the cellular effects of some bioactive lipids. In this study we test the hypothesis that hormonal and metabolic adaptations to exercise are associated with changes in gelsolin concentration in blood. Plasma samples were collected from twenty healthy males recruited from untrained (UT, n=10) and endurance trained (ET, n=10) groups that performed 30-60 minutes of exercise on a cycloergometer at a workload corresponding to 700of VO2max. Gelsolin concentration was determined by quantitative Western blot analysis with an anti-human gelsolin antibody. The gelsolin concentration in UT and ET subjects before starting exercise ranged from 104 to 330 and 163 to 337 µg•ml-1 respectively. After 30 minutes of exercise we observed a significant decrease of plasma gelsolin in the UT group (p<0.05) while the gelsolin concentration in the ET group rose on average from 244 to 271 µg•ml-1. However, this increase did not reach statistical significance. Endurance training might increase the ability of muscle tissue to express plasma gelsolin as part of an adaptive mechanism