Mathematical picture language program Jaffe, Arthur M.; Liu, Zhengwei
Proceedings of the National Academy of Sciences - PNAS,
01/2018, Letnik:
115, Številka:
1
Journal Article
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We give an overview of our philosophy of pictures in mathematics. We emphasize a bidirectional process between picture language and mathematical concepts: abstraction and simulation. This motivates a ...program to understand different subjects, using virtual and real mathematical concepts simulated by pictures.
In young febrile infants, serious bacterial infections (SBIs), including urinary tract infections, bacteremia, and meningitis, may lead to dangerous complications. However, lumbar punctures and ...hospitalizations involve risks and costs. Clinical prediction rules using biomarkers beyond the white blood cell count (WBC) may accurately identify febrile infants at low risk for SBIs.
To derive and validate a prediction rule to identify febrile infants 60 days and younger at low risk for SBIs.
Prospective, observational study between March 2011 and May 2013 at 26 emergency departments. Convenience sample of previously healthy febrile infants 60 days and younger who were evaluated for SBIs. Data were analyzed between April 2014 and April 2018.
Clinical and laboratory data (blood and urine) including patient demographics, fever height and duration, clinical appearance, WBC, absolute neutrophil count (ANC), serum procalcitonin, and urinalysis. We derived and validated a prediction rule based on these variables using binary recursive partitioning analysis.
Serious bacterial infection, defined as urinary tract infection, bacteremia, or bacterial meningitis.
We derived the prediction rule on a random sample of 908 infants and validated it on 913 infants (mean age was 36 days, 765 were girls 42%, 781 were white and non-Hispanic 43%, 366 were black 20%, and 535 were Hispanic 29%). Serious bacterial infections were present in 170 of 1821 infants (9.3%), including 26 (1.4%) with bacteremia, 151 (8.3%) with urinary tract infections, and 10 (0.5%) with bacterial meningitis; 16 (0.9%) had concurrent SBIs. The prediction rule identified infants at low risk of SBI using a negative urinalysis result, an ANC of 4090/µL or less (to convert to ×109 per liter, multiply by 0.001), and serum procalcitonin of 1.71 ng/mL or less. In the validation cohort, the rule sensitivity was 97.7% (95% CI, 91.3-99.6), specificity was 60.0% (95% CI, 56.6-63.3), negative predictive value was 99.6% (95% CI, 98.4-99.9), and negative likelihood ratio was 0.04 (95% CI, 0.01-0.15). One infant with bacteremia and 2 infants with urinary tract infections were misclassified. No patients with bacterial meningitis were missed by the rule. The rule performance was nearly identical when the outcome was restricted to bacteremia and/or bacterial meningitis, missing the same infant with bacteremia.
We derived and validated an accurate prediction rule to identify febrile infants 60 days and younger at low risk for SBIs using the urinalysis, ANC, and procalcitonin levels. Once further validated on an independent cohort, clinical application of the rule has the potential to decrease unnecessary lumbar punctures, antibiotic administration, and hospitalizations.
This paper reviews 28 papers or commentaries published in Journal of Clinical Monitoring and Computing in 2018 and 2019, within the field of respiration. Papers were published covering endotracheal ...tube cuff pressure monitoring, ventilation and respiratory rate monitoring, lung mechanics monitoring, gas exchange monitoring, CO
2
monitoring, lung imaging, and technologies and strategies for ventilation management.
Debra M. Jaffe
Hollywood, FL
Timothy M. McCulloch
Harborview Medical Center, Seattle, WA
Eileen M. Finnegan
University of Iowa, Iowa City, IA
Douglas J. Van Daele
University of Iowa Hospitals and ...Clinics
Erich S. Luschei
University of Iowa
Contact author: Phyllis M. Palmer, University of New Mexico, 1 University of New Mexico, MSC01 1195, Albuquerque, NM 87131. E-mail: ppalmer{at}unm.edu .
Purpose: The purpose of this investigation was to evaluate the relationship between tongue-to-palate pressure and the electromyography (EMG) measured from the mylohyoid, anterior belly of the digastric, geniohyoid, medial pterygoid, velum, genioglossus, and intrinsic tongue muscles.
Methods: Seven healthy adults performed tongue-to-palate pressure tasks at known percentages of their maximum pressure while intramuscular EMG was recorded from the muscles stated above. Multiple regression analysis was performed.
Results: Predictors of pressure included the posterior fibers of the genioglossus, mylohyoid, anterior belly of digastric, medial pterygoid, and intrinsic tongue.
Conclusions: Increasing tongue-to-palate pressure coincides with increased muscle activity. Activation of the floor-of-mouth, tongue, and jaw closing muscles increased tongue-to-palate pressure. These findings support the use of a tongue-press exercise to strengthen floor-of-mouth muscles, tongue, and jaw-closing muscles.
KEY WORDS: electromyography, pressure, mylohyoid, anterior belly digastric, geniohyoid, tongue, velum, medial pterygoid, genioglossus, Iowa Oral Performance Instrument (IOPI)
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Background Female recipients of male kidneys have an inferior graft survival, and patients receiving larger kidneys relative to their body size may have a graft survival advantage. Thus, graft ...survival may be affected by both gender and kidney size mismatches. The objective of this study was to analyze the possible confounding effect of body mass mismatch (body mass as proxy for kidney size) between female recipients of male donor kidneys. Study Design A total of 668 kidney transplantations between 1996 and 2005 at our center were studied retrospectively. Graft and patient survival were determined by Kaplan-Meier estimation. Multivariate Cox proportional analyses were performed to determine the hazards of graft loss. Results There were 146 female recipients of male kidneys. Compared with all other gender combinations, this group had the lowest unadjusted graft survival (86%, 79%, and 78% vs 92%, 88%, and 86% at 1, 2, and 3 years, respectively; log-rank p = 0.01). Donor body mass index (BMI) correlated with donor kidney size (p < 0.001). Male kidneys were a risk factor of graft loss for female recipients (hazard ratio HR 3.45, 95% CI 1.40 to 8.51, p = 0.01), but male donors with a larger BMI relative to female recipients' significantly reduced the risk (HR 0.19, 95% CI 0.05 to 0.67, p = 0.01). Conclusions The inferior graft survival for female recipients of male donor kidneys is mitigated by male donors with a larger BMI.
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