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Diseases play central roles in many areas of biomedical research and healthcare. Consequently, aggregating the disease knowledge and treatment research reports becomes an extremely critical issue, especially in rapid-growth knowledge bases (e.g. PubMed). We therefore developed a system, AuDis, for disease mention recognition and normalization in biomedical texts. Our system utilizes an order two conditional random fields model. To optimize the results, we customize several post-processing steps, including abbreviation resolution, consistency improvement and stopwords filtering. As the official evaluation on the CDR task in BioCreative V, AuDis obtained the best performance (86.46% of F-score) among 40 runs (16 unique teams) on disease normalization of the DNER sub task. These results suggest that AuDis is a high-performance recognition system for disease recognition and normalization from biomedical literature.Database URL: http://ikmlab.csie.ncku.edu.tw/CDR2015/AuDis.html.
A multitude of assistive devices is available for deaf people (i.e. deaf, deafened, and hard of hearing). Besides hearing and communication aids, devices to access environmental sounds are available commercially. But the devices have two major drawbacks: 1. they are targeted at indoor environments (e.g. home or work), and 2. only specific events are supported (e.g. the doorbell or telephone). Recent research shows that important sounds can occur in all contexts and that the interests in sounds are diverse. These drawbacks can be tackled by using modern information and communication technology that enables the development of new and improved assistive devices. The smartwatch, a new computing platform in the form of a wristwatch, offers new potential for assistive technology. Its design promises a perfect integration into various different social contexts and thus blends perfectly into the user's life. Based on a smartwatch and algorithms from pattern recognition, a prototype for awareness of environmental sounds is presented here. It observes the acoustic environment of the user and detects environmental sounds. A vibration is triggered when a sound is detected and the type of sound is shown on the display. The design of the prototype was discussed with deaf people in semi-structured interviews, leading to a set of implications for the design of such a device.
The "cocktail party problem" was studied using virtual stimuli whose spatial locations were generated using anechoic head-related impulse responses from the AUDIS database [Blauert et al., J. Acoust. Soc. Am. 103, 3082 (1998)]. Speech reception thresholds (SRTs) were measured for Harvard IEEE sentences presented from the front in the presence of one, two, or three interfering sources. Four types of interferer were used: (1) other sentences spoken by the same talker, (2) time-reversed sentences of the same talker, (3) speech-spectrum shaped noise, and (4) speech-spectrum shaped noise, modulated by the temporal envelope of the sentences. Each interferer was matched to the spectrum of the target talker. Interferers were placed in several spatial configurations, either coincident with or separated from the target. Binaural advantage was derived by subtracting SRTs from listening with the "better monaural ear" from those for binaural listening. For a single interferer, there was a binaural advantage of 2-4 dB for all interferer types. For two or three interferers, the advantage was 2-4 dB for noise and speech-modulated noise, and 6-7 dB for speech and time-reversed speech. These data suggest that the benefit of binaural hearing for speech intelligibility is especially pronounced when there are multiple voiced interferers at different locations from the target, regardless of spatial configuration; measurements with fewer or with other types of interferers can underestimate this benefit.
Pulmonary inflammation induced in the rabbit lung by the intravenous injection of complete Freund's adjuvant (CFA) increases the lung uptake of 14C-diazepam from the pulmonary circulation. The objective of this study was to determine the extent to which mitochondrial (or peripheral) benzodiazepine receptors (mBRs) may contribute to this increased uptake. To this end, we measured the pulmonary venous effluent concentration versus time for 14C-diazepam following its injection into the pulmonary artery of isolated perfused normal and CFA inflamed lungs with and without an inhibitor (PK11195) of diazepam binding to mBRs. The results demonstrate that this model of pulmonary inflammation is associated with an increase in lung tissue mBR. Lung tissue caspase-3 activity was also measured as one index of lung inflammation, and we found that in inflamed lungs, there was an inverse correlation between mBR density and lung tissue capase-3 activity. This is consistent with observations in other organs and a role for mBRs in apoptotic elimination of inflammatory cells in the resolution of this inflammatory response. The results suggest the potential utility of mBR ligands for noninvasive detection and/or characterization of pulmonary inflammation, e.g., via nuclear medicine methods.
NAD(P)H:quinone oxidoreductase 1 (NQO1) plays a dominant role in the reduction of the quinone compound 2,3,5,6-tetramethyl-1,4-benzoquinone (duroquinone, DQ) to durohydroquinone (DQH2) on passage through the rat lung. Exposure of adult rats to 85% O2 for > or =7 days stimulates adaptation to the otherwise lethal effects of >95% O2. The objective of this study was to examine whether exposure of adult rats to hyperoxia affected lung NQO1 activity as measured by the rate of DQ reduction on passage through the lung. We measured DQH2 appearance in the venous effluent during DQ infusion at different concentrations into the pulmonary artery of isolated perfused lungs from rats exposed to room air or to 85% O2. We also evaluated the effect of hyperoxia on vascular transit time distribution and measured NQO1 activity and protein in lung homogenate. The results demonstrate that exposure to 85% O2 for 21 days increases lung capacity to reduce DQ to DQH2 and that NQO1 is the dominant DQ reductase in normoxic and hyperoxic lungs. Kinetic analysis revealed that 21-day hyperoxia exposure increased the maximum rate of pulmonary DQ reduction, Vmax, and the apparent Michaelis-Menten constant for DQ reduction, Kma. The increase in Vmax suggests a hyperoxia-induced increase in NQO1 activity of lung cells accessible to DQ from the vascular region, consistent qualitatively but not quantitatively with an increase in lung homogenate NQO1 activity in 21-day hyperoxic lungs. The increase in Kma could be accounted for by approximately 40% increase in vascular transit time heterogeneity in 21-day hyperoxic lungs.
Hydrogen peroxide generated by monoamine oxidase (MAO)-mediated deamination of biogenic amines has been implicated in cell signaling and oxidative injury. Because the pulmonary endothelium is a site of metabolism of monoamines present in the venous return, this brings into question a role for MAO in hyperoxic lung injury. The objective of this study was to evaluate the O(2) dependency of the MAO reaction in the lung. To this end, we measured the pulmonary venous effluent concentrations of the MAO substrate [(14)C]phenylethylamine and its metabolite [(14)C]phenylacetic acid after the bolus injection of either phenylethylamine or phenylacetic acid into the pulmonary artery of perfused rabbit lungs over a range of PO(2) values from 16 to 518 Torr. The apparent Michaelis constant for O(2) was approximately 18 microM, which is more than an order of magnitude less that measured for purified MAO. The results suggest a minimal influence of high O(2) on MAO activity in the normal lung and demonstrate the importance of measuring reaction kinetics in the intact organ.
Burnout syndrome (BOS) affects up to 50% of healthcare practitioners. Limited data exist on BOS in paramedics/firstresponders, or others whose practice involves trauma. We sought to assess the impact of BOS in practitioners of rural healthcare systems involved in the provision of trauma care within West Virginia. A 3-part survey was distributed at two regional trauma conferences in 2018. The survey consisted of 1) Demographic/occupational items, 2) The Mini Z Burnout Survey, and 3) elements measuring the impact, and supportive infrastructure to prevent and/or manage BOS. Response rate was 74.7% (127/170 attendees). Respondents included emergency medical services (EMS) (44.9%), nurses (37.8%), and physicians (9.4%). Overall, 31% reported BOS - physicians (45.5%), EMS (35.1%), and nurses (25.0%). Most agreed that BOS impacts the health of medical professionals (99.2%) and presents a barrier to patient care (97.6%). Those with BOS reported higher stress (p < 0.001), chaos at work (p < 0.001), and excessive documentation time at home (p < 0.001). Fewer respondents with BOS reported job satisfaction (p < 0.001), control over workload (p = 0.001), sufficient time for documentation (p ≤0.001), value alignment with institutional leadership (p = 0.001), and team efficiency (p = 0.004). Unique factors for BOS in EMS included: lack of control over workload (p = 0.032), poor value alignment with employer (p = 0.002), lack of efficient teamwork (p = 0.006), and excessive time documenting at home (p = 0.003). Burnout syndrome impacts rural healthcare practitioners, regardless of discipline. These data highlight a need to address the entire team and implement occupation-specific approaches for prevention and treatment. Further prospective study of these findings is warranted.
To mathematically model multiple indicator dilution (MID) data for the purpose of estimating parameters descriptive of indicator-tissue interactions, it is necessary to account for the effects of the distribution of capillary transit times, h(c)(t). In this paper, we present an efficient approach for incorporating h(c)(t) in the mathematical modeling of MID data. In this method, the solution of the model partial differential equations obtained at different locations along the model capillary having the longest transit time provides the outflow concentrations for all capillaries. When weighted by h(c)(t), these capillary outflow concentrations provide the outflow concentration versus time curve for the capillary bed. The method is appropriate whether the available data on capillary dispersion are in terms of capillary transit time or relative flow distributions, and whether the dispersion results from convection time differences among heterogeneous parallel pathways or axial diffusion along individual pathways. Finally, we show that the knowledge of a relationship among the moments of h(c)(t), rather than h(c)(t) per se, is sufficient information to account for the effect of h(c)(t) in the mathematical modeling interpretation of MID data. This relationship can be determined by including a flow-limited indicator in the injected bolus, thus providing an efficient means for obtaining the experimental data sufficient to account for capillary flow and transit time heterogeneity in MID modeling.
The lungs can substantially influence the redox status of redox-active plasma constituents. Our objective was to examine aspects of the kinetics and mechanisms that determine pulmonary disposition of redox-active compounds during passage through the pulmonary circulation. Experiments were carried out on rat and mouse lungs with 2,3,5,6-tetramethyl-1,4-benzoquinone [duroquinone (DQ)] as a model amphipathic quinone reductase substrate. We measured DQ and durohydroquinone (DQH2) concentrations in the lung venous effluent after injecting, or while infusing, DQ or DQH2 into the pulmonary arterial inflow. The maximum net rates of DQ reduction to DQH2 in the rat and mouse lungs were approximately 4.9 and 2.5 micromol. min(-1).g dry lung wt(-1), respectively. The net rate was apparently the result of freely permeating access of DQ and DQH2 to tissue sites of redox reactions, dominated by dicumarol-sensitive DQ reduction to DQH2 and cyanide-sensitive DQH2 reoxidation back to DQ. The dicumarol sensitivity along with immunodetectable expression of NAD(P)H-quinone oxidoreductase 1 (NQO1) in the rat lung tissue suggest cytoplasmic NQO1 as the dominant site of DQ reduction. The effect of cyanide on DQH2 oxidation suggests that the dominant site of oxidation is complex III of the mitochondrial electron transport chain. If one envisions DQ as a model compound for examining the disposition of amphipathic NQO1 substrates in the lungs, the results are consistent with a role for lung NQO1 in determining the redox status of such compounds in the circulation. For DQ, the effect is conversion of a redox-cycling, oxygen-activating quinone into a stable hydroquinone.
The objective of this study was to assess the predictive value of lactate and base deficit in determining outcomes in trauma patients who are positive for ethanol. Retrospective cohort study of patients admitted to a level 1 trauma center between 2005 and 2014. Adult patients who had a serum ethanol, lactate, base deficit, and negative urine drug screen obtained upon presentation were included. Data for 2482 patients were analyzed with 1127 having an elevated lactate and 1092 an elevated base deficit. In these subgroups, patients with a positive serum ethanol had significantly lower 72-hour mortality, overall mortality, and hospital length of stay compared with the negative ethanol group. Abnormal lactate (odds ratio [OR], 2.607; 95% confidence interval [CI], 1.629-4.173; P = .000) and base deficit (OR, 1.917; 95% CI, 1.183-3.105; P = .008) were determined to be the strongest predictors of mortality in the ethanol-negative patients. Injury Severity Score was found to be the lone predictor of mortality in patients positive for ethanol (OR, 1.104; 95% CI, 1.070-1.138; P = .000). Area under the curve and Youden index analyses supported a relationship between abnormal lactate, base deficit, and mortality in ethanol-positive patients when the serum lactate was greater than 4.45 mmol/L and base deficit was greater than -6.95 mmol/L. Previously established relationships between elevated lactate, base deficit, and outcome do not remain consistent in patients presenting with positive serum ethanol concentrations. Ethanol skews the relationship between lactate, base deficit, and mortality thus resetting the threshold in which lactate and base deficit are associated with increased mortality.
The surging popularity of all-terrain vehicles (ATV) in the United States has caused an "epidemic of injuries and mortality." The U.S. Consumer Product Safety Commission reported 99,600 injuries and 426 fatalities from ATV accidents in 2013. The aim of this study was to examine the relationship between helmet use and positive toxicology screenings on outcomes in ATV accident victims. This is a retrospective study of patients admitted to a Level 1 Trauma Center in southwestern West Virginia following an ATV accident between 2005 and 2013. Data were obtained from the institution's Trauma Registry. A total of 1,857 patients were admitted during the study period with 39 (1.9%) reported deaths. Positive serum alcohol and/or urine drug screens were obtained in 66.4% of the patients tested (n=1,293). Those with positive screenings were 9.5% less likely to utilize a helmet (13.2% vs. 22.7%, p<0.001); and the lack of helmet use was associated with an increase in traumatic brain injury (57.1% vs. 41.7%, p<0.001). Positivity for substances or the lack of helmet use was significantly associated with higher morbidity. Lack of helmet use resulted in a 3.94-fold increase in the risk of discharge in a vegetative state or death. Drugs and alcohol use may predispose riders to be less likely to wear helmets and significantly increase the risk of a poor clinical outcome following an ATV accident. Rigorous efforts should be made to enhance safety measures through educational endeavors and amendment of current regulations to promote safe and responsible use of ATVs. Modification of regulatory requirements should be considered in order to mandate the wearing of helmets during ATV operation. In addition, expansion of safety programs should be considered in an effort to improve availability, affordability and awareness of safe ATV practices.
Many lipophilic amine compounds are rapidly extracted from the blood on passage through the pulmonary circulation. The extent of their extraction in normal lungs depends on their physical-chemical properties, which affect their degree of ionization, lipophilicity, and propensity for interacting with blood and tissue constituents. The hypothesis of the present study was that changes in the tissue composition that occur during pulmonary inflammation would have a differential effect on the pulmonary extraction of lipophilic amines having different properties. If so, measurement of the extraction patterns for a group of lipophilic amines, having different physical-chemical properties, might provide a means for detecting and identifying lung tissue abnormalities. To evaluate this hypothesis, we measured the pulmonary extraction patterns for four lipophilic amines, [(14)C]diazepam, [(3)H]alfentanil, [(14)C]lidocaine, and [(14)C]codeine, along with two hydrophilic compounds, (3)HOH and [(14)C]phenylethylamine, after the bolus injection of these indicators into the pulmonary artery of isolated lungs from normal rabbits and from rabbits with pulmonary inflammation induced by an intravenous injection of complete Freund's adjuvant. The pulmonary extraction patterns, parameterized using a previously developed mathematical model, were, in fact, differentially altered by the inflammatory response. For example, the tissue sequestration rate, k(seq) (ml/s), per unit (3)HOH accessible extravascular lung water volume significantly increased for diazepam and lidocaine, but not for codeine and alfentanil. The results are consistent with the above hypothesis and suggest the potential for using lipophilic amines as indicators for detection and quantification of changes in lung tissue composition associated with lung injury and disease.
Previous studies have evaluated dose-to-weight ratios to define best practices for obtaining therapeutic anti-Xa assays for enoxaparin venous thromboembolism (VTE) prophylaxis. These studies have not examined relationships among dosing, patient characteristics, and therapeutic assays. This study examines factors associated with therapeutic assays and enoxaparin prophylaxis. This is a retrospective review of patients admitted to a Level 1 trauma center between March 2016 and June 2018. Prophylaxis was managed according to the trauma service's enoxaparin VTE prophylaxis protocol, which targets anti-Xa concentrations of 0.2 to 0.5 IU/mL. Assays were divided into sub-therapeutic, therapeutic, and super-therapeutic groups to determine factors associated with therapeutic concentrations. Overall, 623 patients (634 total anti-Xa assays) were identified during the study period. Patients with sub-therapeutic (n = 35) and therapeutic (n = 536) assays did not differ. Significant differences were identified between patients with therapeutic and super-therapeutic assays (n = 63). Receiver operating characteristic curve analysis was used to determine that the optimal cutoff for the dose-to-weight ratio was 0.4 mg/kg/dose (area under the curve 0.78; 95% CI 0.73 to 0.84; p < 0.001) differentiating therapeutic and super-therapeutic assays. Logistic regression revealed male sex, doses of 0.31 to 0.4 mg/kg, and creatinine clearance > 90 mL/min were independently associated with therapeutic assays. The combined effect of these 3 variables showed that therapeutic assays were 13.76 times more likely to occur (OR 13.76; 95% CI 3.43 to 56.96; p < 0.001). These data demonstrate that a dose of 0.4 mg/kg predicts a therapeutic anti-Xa level. When regimens of 0.31 to 0.4 mg/kg/dose are administered in males with a creatinine clearance >90 mL/min therapeutic results are 13.76 times more likely, suggesting that monitoring with anti-Xa assays might be unnecessary in this subgroup. Additional prospective study of these findings is warranted.
The objective was to evaluate the pulmonary disposition of the ubiquinone homolog coenzyme Q(1) (CoQ(1)) on passage through lungs of normoxic (exposed to room air) and hyperoxic (exposed to 85% O(2) for 48 h) rats. CoQ(1) or its hydroquinone (CoQ(1)H(2)) was infused into the arterial inflow of isolated, perfused lungs, and the venous efflux rates of CoQ(1)H(2) and CoQ(1) were measured. CoQ(1)H(2) appeared in the venous effluent when CoQ(1) was infused, and CoQ(1) appeared when CoQ(1)H(2) was infused. In normoxic lungs, CoQ(1)H(2) efflux rates when CoQ(1) was infused decreased by 58 and 33% in the presence of rotenone (mitochondrial complex I inhibitor) and dicumarol [NAD(P)H-quinone oxidoreductase 1 (NQO1) inhibitor], respectively. Inhibitor studies also revealed that lung CoQ(1)H(2) oxidation was via mitochondrial complex III. In hyperoxic lungs, CoQ(1)H(2) efflux rates when CoQ(1) was infused decreased by 23% compared with normoxic lungs. Based on inhibitor effects and a kinetic model, the effect of hyperoxia could be attributed predominantly to 47% decrease in the capacity of complex I-mediated CoQ(1) reduction, with no change in the other redox processes. Complex I activity in lung homogenates was also lower for hyperoxic than for normoxic lungs. These studies reveal that lung complexes I and III and NQO1 play a dominant role in determining the vascular concentration and redox status of CoQ(1) during passage through the pulmonary circulation, and that exposure to hyperoxia decreases the overall capacity of the lung to reduce CoQ(1) to CoQ(1)H(2) due to a depression in complex I activity.
The department of trauma at a Level 1 trauma center sought to improve outcomes by enhancing the continuity of care for patients admitted to trauma services. Departmental leadership explored opportunities to improve this aspect of patient care through expansion of existing trauma nurse practitioner (NP) services. The restructured trauma NP service model was implemented in September 2013. A retrospective study was conducted with patients who presented at the trauma center between September 2012 and August 2015. Patients with at least a 24-hr hospital length of stay (LOS) were separated into 3 comparator groups by 12-month increments: 12 months pre-, 12 months during, and 12 months postimplementation. Data revealed improvement in hospital LOS, intensive care unit LOS, time to place rehabilitation consultation, and placement of discharge orders before noon. A significant decline in the rate of complications including pneumonia and deep vein thrombosis (DVT) was also noted. Accordingly, expansion of the trauma NP model resulted in significant improvements in patient and process of care outcomes. This model for NP services may prove to be beneficial for acute care settings at other hospitals with high volume trauma services.
While battery aging is commonly studied at the cell-level, evaluating aging and performance within battery modules remains a critical challenge. Testing cells within fully assembled modules requires hardware solutions to access cell-level information without compromising module integrity. In this paper, we design and develop a hardware testing platform to monitor and control the internal cells of battery modules contained in the Audi e-tron battery pack. The testing is performed across all 36 modules of the pack. The platform integrates voltage sensors, balancing circuitry, and a micro-controller to enable safe, simultaneous cell screening without disassembling the modules. Using the proposed testing platform, cell voltage imbalances within each module are constrained to a defined reference value, and cell signals can be safely accessed, enabling accurate and non-invasive cell-level state-of-health assessments. On a broader scale, our solution allows for the quantification of internal heterogeneity within modules, providing valuable insights for both first- and second-life applications and supporting efficient battery pack maintenance and repurposing.
Although semantic 3D city models are internationally available and becoming increasingly detailed, the incorporation of material information remains largely untapped. However, a structured representation of materials and their physical properties could substantially broaden the application spectrum and analytical capabilities for urban digital twins. At the same time, the growing number of repeated mobile laser scans of cities and their street spaces yields a wealth of observations influenced by the material characteristics of the corresponding surfaces. To leverage this information, we propose radiometric fingerprints of object surfaces by grouping LiDAR observations reflected from the same semantic object under varying distances, incident angles, environmental conditions, sensors, and scanning campaigns. Our study demonstrates how 312.4 million individual beams acquired across four campaigns using five LiDAR sensors on the Audi Autonomous Driving Dataset (A2D2) vehicle can be automatically associated with 6368 individual objects of the semantic 3D city model. The model comprises a comprehensive and semantic representation of four inner-city streets at Level of Detail (LOD) 3 with
Effective leveraging of real-world driving datasets is crucial for enhancing the training of autonomous driving systems. While Offline Reinforcement Learning enables training autonomous vehicles with such data, most available datasets lack meaningful reward labels. Reward labeling is essential as it provides feedback for the learning algorithm to distinguish between desirable and undesirable behaviors, thereby improving policy performance. This paper presents a novel approach for generating human-aligned reward labels. The proposed approach addresses the challenge of absent reward signals in the real-world datasets by generating labels that reflect human judgment and safety considerations. The reward function incorporates an adaptive safety component that is activated by analyzing semantic segmentation maps, enabling the autonomous vehicle to prioritize safety over efficiency in potential collision scenarios. The proposed method is applied to an occluded pedestrian crossing scenario with varying pedestrian traffic levels, using simulation data. When the generated rewards were used to train various Offline Reinforcement Learning algorithms, each model produced a meaningful policy, d
This study investigates the aerodynamic performance of an Audi A4 sedan using CFD analysis. A 3D model was developed in SolidWorks and validated against DrivAer Notchback wind-tunnel data, showing only a 3.25 percent deviation in drag coefficient (Cd). Ride height varied from 1.336 to 1.536 m and rake angle from 0 to 5 degrees, across four Reynolds numbers. Gradient Boosting emerged as the most accurate predictive model (R square = 0.97 for Cd and 0.96 for lift coefficient, Cl), outperforming Random Forest and LightGBM. Differential Evolution optimization was performed under balanced, drag-focused, and downforce-focused conditions. Reynolds number had minimal impact on optimum location; therefore, detailed results are reported for one Reynolds number, with other Re showing similar trends. The baseline geometry exhibited Cd = 0.313 and Cl = 0.0288. Balanced optimization achieved Cd = 0.287 and Cl = - 0.0826. Minimum drag condition reached Cd = 0.285 with slight positive lift (Cl = 0.0142), while maximum downforce optimization reached Cl = - 0.1084 with a 6.71 percent drag penalty (Cd = 0.334). Near-optimal solutions were found within ride heights of 1.341 to 1.365 m and rakes of 0.1
Autonomous driving (AD) relies heavily on high precision localization as a crucial part of all driving related software components. The precise positioning is necessary for the utilization of high-definition maps, prediction of other road participants and the controlling of the vehicle itself. Due to this reason, the localization is absolutely safety relevant. Typical errors of the localization systems, which are long term drifts, jumps and false localization, that must be detected to enhance safety. An online assessment and evaluation of the current localization performance is a challenging task, which is usually done by Kalman filtering for single localization systems. Current autonomous vehicles cope with these challenges by fusing multiple individual localization methods into an overall state estimation. Such approaches need expert knowledge for a competitive performance in challenging environments. This expert knowledge is based on the trust and the prioritization of distinct localization methods in respect to the current situation and environment. This work presents a novel online performance assessment technique of multiple localization systems by using subjective logic (SL)