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The measurement of quality indicators supports quality improvement initiatives. The German Interdisciplinary Society of Intensive Care Medicine (DIVI) has published quality indicators for intensive care medicine for the fourth time now. After a scheduled evaluation after three years, changes in several indicators were made. Other indicators were not changed or only minimally. The focus remained strongly on relevant treatment processes like management of analgesia and sedation, mechanical ventilation and weaning, and infections in the ICU. Another focus was communication inside the ICU. The number of 10 indicators remained the same. The development method was more structured and transparency was increased by adding new features like evidence levels or author contribution and potential conflicts of interest. These quality indicators should be used in the peer review in intensive care, a method endorsed by the DIVI. Other forms of measurement and evaluation are also reasonable, for example in quality management. This fourth edition of the quality indicators will be updated in the future to reflect the recently published recommendations on the structure of intensive care units by the DIVI., Die Messung relevanter Qualitätsindikatoren unterstützt Initiativen zur Qualitätsverbesserung. Die Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI) hat die intensivmedizinischen Qualitätsindikatoren nun zum vierten Mal publiziert. Sie wurden nach drei Jahren überarbeitet und einige Indikatoren wurden angepasst. Andere Indikatoren erfuhren keine oder nur minimale Änderungen. Der Fokus besteht weiter auf relevanten Behandlungsprozessen wie Management von Analgesie und Sedierung, Beatmung und Weaning sowie Infektionen auf der Intensivstation. Die Gesamtzahl von zehn Indikatoren blieb bestehen. Die Entwicklung der Indikatoren erfolgte in der neuen Version nach einem anderen Prozess. Die Transparenz wurde durch Erwähnung der Einzelbeiträge der Autoren sowie auch potenzieller Interessenkonflikte erhöht. Die Anwendung der Qualitätsindikatoren im Peer-Review-Prozess der DIVI ist weiter wesentlicher Schwerpunkt. Aber auch andere Anwendungen, z.B. im Qualitätsmanagement, sind sinnvoll. Diese vierte Auflage der Qualitätsindikatoren wird noch einmal aktualisiert, um die kürzlich veröffentlichten Empfehlungen der DIVI zur Struktur der Intensivstationen zu berücksichtigen.

The enormous traffic growth sets a stringent requirement to upgrade short-reach optical links to 1.6 TbE capacity in an economically viable way. The power consumption and latency in these links should be as low as possible, especially for high-speed computing. This is possible to achieve using high baudrate on-off keying links thanks to a better noise tolerance and a relaxed requirement on linearity for electronics and photonics. In this regard, we demonstrate a 200 Gbaud on-off keying link without any optical amplification using an externally modulated laser with 3.3 dBm of modulated output power operating at 1541.25 nm wavelength. We achieve transmission over 200 meters of single-mode fiber with performance below 6.25% overhead hard-decision forward error correction threshold for each baudrate and all selection of modulation formats. We also show 108 Gbaud on-off keying link with superior performance without decision feedback equalizer up to 400 meters of single-mode fiber. In addition, we benchmark the short-reach optical link with 112 Gbaud four-level pulse amplitude modulation and 100 Gbaud six-level pulse amplitude modulation. For 108 Gbaud on-off keying and 112 Gbaud four-level pulse amplitude modulation, we can achieve an even lower bit error rate., QC 20230613

Given a large unlabeled document collection, the aim of this paper is to develop an accurate and efficient algorithm for solving the clustering problem over this collection. Document collections typically contain tens or hundreds of thousands of documents, with thousands or tens of thousands of features (i.e., distinct words). Most existing clustering algorithms struggle to find accurate solutions on such large data sets. The proposed algorithm overcomes this difficulty by an incremental approach, incrementing the number of clusters progressively from an initial value of one to a set value. At each iteration, the new candidate cluster is initialized using a partitioning approach which is guaranteed to minimize the objective function. Experiments have been carried out over six, diverse datasets and with different evaluation criteria, showing that the proposed algorithm has outperformed comparable state-of-the-art clustering algorithms in all cases.

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© Springer Nature Singapore Pte Ltd. 2019. In document clustering, individual documents are typically represented by feature vectors based on term-frequency or bag-of-word models. However, such feature vectors intrinsically dismiss the order of the words in the document and suffer from very high dimensionality. For these reasons, in this paper we present novel taxonomy-augmented features that enjoy two promising characteristics: (1) they leverage semantic word embeddings to take the word order into account, and (2) they reduce the feature dimensionality to a very manageable size. Our feature extraction approach consists of three main steps: first, we apply a word embedding technique to represent the words in a word embedding space. Second, we partition the word vocabulary into a hierarchy of clusters by using k-means hierarchically. Lastly, the individual documents are projected to the hierarchy and a compact feature vector is extracted. We propose two methods for generating the features: the first uses all the clusters in the hierarchy and results in a feature vector whose dimensionality is equal to the number of the clusters. The second uses a small set of user-defined words and results in an even smaller feature vector whose dimensionality is equal to the size of the set. Numerical experiments on document clustering show that the proposed approach is capable of achieving comparable or even higher accuracy than conventional feature vectors with a much more compact representation.

© 2019 Esmaili et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. After publication of this article [1], concerns were raised that the references to the software packages used for this analysis had been omitted. The authors utilized Stata Statistical Software: Release 15. The reference is StataCorp. 2017. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC. The authors also utilized the seqHMM package package in R. The reference is: Helske S, Helske J. Mixture hidden markov models for sequence data: the seqhmm package in R. arXiv preprint arXiv:1704.00543. 2017 Apr 3.

© 2018 Esmaili et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Transport injuries commonly result in significant disease burden, leading to physical disability, mental health deterioration and reduced quality of life. Analyzing the patterns of healthcare service utilization after transport injuries can provide an insight into the health of the affected parties, allow improved health system resource planning, and provide a baseline against which any future system-level interventions can be evaluated. Therefore, this research aims to use time series of service utilization provided by a compensation agency to identify groups of claimants with similar utilization patterns, describe such patterns, and characterize the groups in terms of demographic, accident type and injury type. Methods To achieve this aim, we have proposed an analytical framework that utilizes latent variables to describe the utilization patterns over time and group the claimants into clusters based on their service utilization time series. To perform the clustering without dismissing the temporal dimension of the time series, we have used a well-established statistical approach known as the mixture of hidden Markov models (MHMM). Ensuing the clustering, we have applied multinomial logistic regression to provide a description of the clusters against demographic, injury and accident covariates. Results We have tested our model with data on psychology service utilization from one of the main compensation agencies for transport accidents in Australia, and found that three clear clusters of service utilization can be evinced from the data. These three clusters correspond to claimants who have tended to use the services 1) only briefly after the accident; 2) for an intermediate period of time and in moder

Item does not contain fulltext, BACKGROUND: In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial. METHODS: We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups. RESULTS: Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome. CONCLUSIONS: Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis.

Item does not contain fulltext, BACKGROUND: In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial. METHODS: We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups. RESULTS: Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome. CONCLUSIONS: Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis.

Item does not contain fulltext, BACKGROUND: In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial. METHODS: We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups. RESULTS: Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome. CONCLUSIONS: Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis.

Skyrmions are topologically protected winding vector fields characterized by a spherical topology. Magnetic skyrmions can arise as the result of the interplay of various interactions, including exchange, dipolar and anisotropy energy in the case of magnetic bubbles and an additional Dzyaloshinskii-Moriya interaction in the case of chiral skyrmions. Whereas the static and low-frequency dynamics of skyrmions are already well under control, their gigahertz dynamical behaviour has not been directly observed in real space. Here, we image the gigahertz gyrotropic eigenmode dynamics of a single magnetic bubble and use its trajectory to experimentally confirm its skyrmion topology. The particular trajectory points to the presence of strong inertia, with a mass much larger than predicted by existing theories. This mass is endowed by the topological confinement of the skyrmion and the energy associated with its size change. It is thereby expected to be found in all skyrmionic structures in magnetic systems and beyond. Our experiments demonstrate that the mass term plays a key role in describing skyrmion dynamics..

Skyrmions are topologically protected winding vector fields characterized by a spherical topology. Magnetic skyrmions can arise as the result of the interplay of various interactions, including exchange, dipolar and anisotropy energy in the case of magnetic bubbles and an additional Dzyaloshinskii-Moriya interaction in the case of chiral skyrmions. Whereas the static and low-frequency dynamics of skyrmions are already well under control, their gigahertz dynamical behaviour has not been directly observed in real space. Here, we image the gigahertz gyrotropic eigenmode dynamics of a single magnetic bubble and use its trajectory to experimentally confirm its skyrmion topology. The particular trajectory points to the presence of strong inertia, with a mass much larger than predicted by existing theories. This mass is endowed by the topological confinement of the skyrmion and the energy associated with its size change. It is thereby expected to be found in all skyrmionic structures in magnetic systems and beyond. Our experiments demonstrate that the mass term plays a key role in describing skyrmion dynamics..

Skyrmions are topologically protected winding vector fields characterized by a spherical topology. Magnetic skyrmions can arise as the result of the interplay of various interactions, including exchange, dipolar and anisotropy energy in the case of magnetic bubbles and an additional Dzyaloshinskii-Moriya interaction in the case of chiral skyrmions. Whereas the static and low-frequency dynamics of skyrmions are already well under control, their gigahertz dynamical behaviour has not been directly observed in real space. Here, we image the gigahertz gyrotropic eigenmode dynamics of a single magnetic bubble and use its trajectory to experimentally confirm its skyrmion topology. The particular trajectory points to the presence of strong inertia, with a mass much larger than predicted by existing theories. This mass is endowed by the topological confinement of the skyrmion and the energy associated with its size change. It is thereby expected to be found in all skyrmionic structures in magnetic systems and beyond. Our experiments demonstrate that the mass term plays a key role in describing skyrmion dynamics..

Measures for planning the remediation, reclamation and use of mined-out areas in the former East Germany include the compilation of so-called "utilisation concepts" to integrate and co-ordinate plans for the post-mining landscape. The utilisation concepts aim to reach a concensus between redevelopment plans under mining law and urban land-use plans under laws relating to construction and planning. Their main components are diverse digitally compiled thematic maps and explanatory reports identifying the features of each location and recording the various plans for its re-utilisation., Measures for planning the remediation, reclamation and use of mined-out areas in the former East Germany include the compilation of so-called "utilisation concepts" to integrate and co-ordinate plans for the post-mining landscape. The utilisation concepts aim to reach a concensus between redevelopment plans under mining law and urban land-use plans under laws relating to construction and planning. Their main components are diverse digitally compiled thematic maps and explanatory reports identifying the features of each location and recording the various plans for its re-utilisation.