Developing a machine-learning model for real-time prediction of successful extubation in mechanically ventilated patients using time-series ventilator-derived parameters.

Background: Successful weaning from mechanical ventilation is important for patients admitted to intensive care units. However, models for predicting real-time weaning outcomes remain inadequate. Therefore, this study aimed to develop a machine-learning model for predicting successful extubation only using time-series ventilator-derived parameters with good accuracy.

Validation of a Deep Learning-based Automatic Detection Algorithm for Measurement of Endotracheal Tube-to-Carina Distance on Chest Radiographs.

Background: Improper endotracheal tube (ETT) positioning is frequently observed and potentially hazardous in the intensive care unit. The authors developed a deep learning-based automatic detection algorithm detecting the ETT tip and carina on portable supine chest radiographs to measure the ETT-carina distance. This study investigated the hypothesis that the algorithm might be more accurate than frontline critical care clinicians in ETT tip detection, carina detection, and ETT-carina distance measurement.

Deep Learning Applied to Defect Detection in Powder Spreading Process of Magnetic Material Additive Manufacturing.

Due to its advantages of high customization and rapid production, metal laser melting manufacturing (MAM) has been widely applied in the medical industry, manufacturing, aerospace and boutique industries in recent years. However, defects during the selective laser melting (SLM) manufacturing process can result from thermal stress or hardware failure during the selective laser melting (SLM) manufacturing process. To improve the product's quality, the use of defect detection during manufacturing is necessary.

Impact of Pharmacists to Improve Patient Care in the Critically Ill: A Large Multicenter Analysis Using Meaningful Metrics With the Medication Regimen Complexity-ICU (MRC-ICU) Score.

Objectives: Despite the established role of the critical care pharmacist on the ICU multiprofessional team, critical care pharmacist workloads are likely not optimized in the ICU. Medication regimen complexity (as measured by the Medication Regimen Complexity-ICU [MRC-ICU] scoring tool) has been proposed as a potential metric to optimize critical care pharmacist workload but has lacked robust external validation. The purpose of this study was to test the hypothesis that MRC-ICU is related to both patient outcomes and pharmacist interventions in a diverse ICU population.

International Survey of Thrombolytic Use for Treatment of Cardiac Arrest Due to Massive Pulmonary Embolism.

Objectives: This survey sought to characterize the national prescribing patterns and barriers to the use of thrombolytic agents in the treatment of pulmonary embolism, with a specific focus on treatment during actual or imminent cardiac arrest.

Design: A 19-question international, cross-sectional survey on thrombolytic use in pulmonary embolism was developed, validated, and administered. A multivariable logistic regression was conducted to determine factors predictive of utilization of thrombolytics in the setting of cardiac arrest secondary to pulmonary embolism.

Medication-Induced Hyperlactatemia and Lactic Acidosis: A Systematic Review of the Literature.

Hyperlactatemia and lactic acidosis are two syndromes that are associated with morbidity and mortality. Medication-induced hyperlactatemia and lactic acidosis are diagnoses of exclusion and have the potential to be overlooked. The purposes of this systematic review are to identify published reports of medication-induced lactate level elevations to aid clinicians in diagnosing and comprehending the underlying mechanism of this rare adverse drug effect and to provide management strategies.

Cobb Angle Measurement of Spine from X-Ray Images Using Convolutional Neural Network.

Scoliosis is a common spinal condition where the spine curves to the side and thus deforms the spine. Curvature estimation provides a powerful index to evaluate the deformation severity of scoliosis. In current clinical diagnosis, the standard curvature estimation method for assessing the curvature quantitatively is done by measuring the Cobb angle, which is the angle between two lines, drawn perpendicular to the upper endplate of the uppermost vertebra involved and the lower endplate of the lowest vertebra involved.

An effective and accurate identification system of Mycobacterium tuberculosis using convolution neural networks.

Tuberculosis (TB) remains the leading cause of morbidity and mortality from infectious disease in developing countries. The sputum smear microscopy remains the primary diagnostic laboratory test. However, microscopic examination is always time-consuming and tedious.

Using lean methodology to optimize time to antibiotic administration in patients with sepsis.

Purpose: Results of a study to apply lean methodology to an inpatient pharmacy workflow to optimize timely administration of Centers for Medicare and Medicaid Services (CMS)-approved antibiotics for patients with severe sepsis or septic shock are presented.

Methods: This quasi-experimental study was conducted at an 802-bed institution using lean methodology to assess the inpatient pharmacy workflow for dispensing antibiotics to adult patients. The preintervention and postintervention phases occurred from February to September, 2015, and from October 2015 to May 2016, respectively.

Major publications in the critical care pharmacotherapy literature in 2015.

Purpose: Recently published practice guidelines and research reports on pharmacotherapy in critical care patient populations are summarized.

Summary: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group is composed of over 50 experienced critical care pharmacists who evaluate 31 peer-reviewed journals monthly to identify literature pertaining to pharmacotherapy in critical care populations. Articles are chosen for summarization in a monthly CCPLU Group publication on the basis of applicability and relevance to clinical practice and strength of study design.

Inhaled Iloprost for Chronic Thromboembolic Pulmonary Hypertension (CTEPH) During Pregnancy: A Case Report.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a subset of pulmonary hypertension caused by acute and recurrent pulmonary emboli. Pulmonary thromboendarterectomy is the treatment of choice, but 10-50% of patients are ineligible for this procedure. We describe the case of a 25-year-old, morbidly obese (228-kg, body mass index 83.

Glycemic Control with Thiazolidinedione Is Associated with Fracture of T2DM Patients.

Objective: Diabetes is a common diseases and a major problem worldwide. Diabetic osteopathy might be elevated in diabetic patients and is usually caused by bone fracture. Several diabetes medications, such as thiazolidinediones (TZDs), could lead to increased risks of fracture.

Motion estimation using the firefly algorithm in ultrasonic image sequence of soft tissue.

Ultrasonic image sequence of the soft tissue is widely used in disease diagnosis; however, the speckle noises usually influenced the image quality. These images usually have a low signal-to-noise ratio presentation. The phenomenon gives rise to traditional motion estimation algorithms that are not suitable to measure the motion vectors.

The construction of support vector machine classifier using the firefly algorithm.

The setting of parameters in the support vector machines (SVMs) is very important with regard to its accuracy and efficiency. In this paper, we employ the firefly algorithm to train all parameters of the SVM simultaneously, including the penalty parameter, smoothness parameter, and Lagrangian multiplier. The proposed method is called the firefly-based SVM (firefly-SVM).

Medical students' awareness and perception of national health examinations.

Key ingredients for upgrading health care include bolstering and appraising professional medical education. Health examination as a crucial element of health care that we must incorporate into medical education. This research evaluates medical students' awareness of national health examinations.

Using multivariate regression model with least absolute shrinkage and selection operator (LASSO) to predict the incidence of Xerostomia after intensity-modulated radiotherapy for head and neck cancer.

Purpose: The aim of this study was to develop a multivariate logistic regression model with least absolute shrinkage and selection operator (LASSO) to make valid predictions about the incidence of moderate-to-severe patient-rated xerostomia among head and neck cancer (HNC) patients treated with IMRT.

Methods And Materials: Quality of life questionnaire datasets from 206 patients with HNC were analyzed. The European Organization for Research and Treatment of Cancer QLQ-H&N35 and QLQ-C30 questionnaires were used as the endpoint evaluation.

A transmission power optimization with a minimum node degree for energy-efficient wireless sensor networks with full-reachability.

Transmission power optimization is the most significant factor in prolonging the lifetime and maintaining the connection quality of wireless sensor networks. Un-optimized transmission power of nodes either interferes with or fails to link neighboring nodes. The optimization of transmission power depends on the expected node degree and node distribution.

Spontaneous recovery of ventilator-associated pneumothorax.

Background: The usual management of ventilator-associated pneumothorax (VPX) is tube thoracostomy. However, this recommendation is based on tradition rather than on solid evidence. Although it has been applied successfully to other types of pneumothoraces, observation has not been used in the management of VPX.

Dosimetric advantages of generalised equivalent uniform dose-based optimisation on dose-volume objectives in intensity-modulated radiotherapy planning for bilateral breast cancer.

Objective: We compared and evaluated the differences between two models for treating bilateral breast cancer (BBC): (i) dose-volume-based intensity-modulated radiation treatment (DV plan), and (ii) dose-volume-based intensity-modulated radiotherapy with generalised equivalent uniform dose-based optimisation (DV-gEUD plan).

Methods: The quality and performance of the DV plan and DV-gEUD plan using the Pinnacle(3) system (Philips, Fitchburg, WI) were evaluated and compared in 10 patients with stage T2-T4 BBC. The plans were delivered on a Varian 21EX linear accelerator (Varian Medical Systems, Milpitas, CA) equipped with a Millennium 120 leaf multileaf collimator (Varian Medical Systems).

Application of a pull on a disk method to measure surface tension of liquids.

The intrinsic property of liquids is a vital indicator of formulation performance and stability. Therefore, investigation of the interfacial phenomenon of surface tension is a routine procedure in the development of products in a wide variety of areas including foods, pharmaceuticals, cosmetics, and painting technologies. We hypothesize that studies related to the maximum pull on a rod can be extrapolated to disk geometry and applied to measure surface tension using a texture analyzer.

Simultaneous use of traditional Chinese medicine (si-ni-tang) to treat septic shock patients: study protocol for a randomized controlled trial.

Background: Even though there are continually upgraded recommendations for managing sepsis, such as "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock", mortality is still high. Si-ni-tang, a remedy documented in Shanghan Lun, a medical collection from ancient China, is used for treating patients with sepsis and septic shock. Using a well-designed clinical trial, we are eager to survey the effectiveness of the concurrent use of this remedy in restoring these patients' hemodynamic status, or "Yang Qi".