Search

Second-generation FloTrac software has been shown to reliably measure cardiac output (CO) in cardiac surgical patients. However, concerns have been raised regarding its accuracy in vasoplegic states. The aim of the present multicenter study was to investigate the accuracy of the third-generation software in patients with sepsis, particularly when total systemic vascular resistance (TSVR) is low., Journal Article, Multicenter Study, Validation Studies, SCOPUS: ar.j, info:eu-repo/semantics/published

Top of pageAbstract Summary: This paper describes a study comparing the impedance cardiac output (ICO) with effective pulmonary capillary blood flow (Qpc eff), measured by rebreathing N2O, in a group of healthy babies during the neonatal period. The calculation of ICO requires a value for the electrical resistivity of blood, p. The resistivity of blood was measured on 40 samples of neonatal blood with hematocrit range of 18–70% and a new relationship was defined between haematocrit and resistivity, whereby p = 67.919 exp (0.02433 Het) (Fig. 2). A total of 109 simultaneous measurements of Qpc eff and ICO, made from 32 different babies studied upon 41 occasions, was considered for correlation purposes (Table 2). The different methods are plotted against each other in the graphs (Fig. 3). It is seen that using any one of the available data for human blood resistivity alone, a good correlation between ICO and Qpc eff is only achieved over a part of the haematocrit range. A hematocrit-related correction factor, S, has been derived to be applied to the stroke volume equation. The corrected ICO compared with Qpc eff results is shown in Figure 5 and the correlation coefficients and percentage differences between the two methods for the different hematocrit groups are shown in Table 2. The mean ICO is 205 ml kg1 min1 SEM 3.5 (range 124–289). Impedance cardiography is a safe and easy technique to apply to the newborn human infant but even if accurate values for resistivity are used, a further hematocrit-related factor should be applied for optimal results. Speculation: A technique having been established by which impedance cardiography can be used to make accurate measurements of cardiac output in the healthy newborn infant, it is now possible to use this method to provide noninvasive observations on the normal cardiovascular physiology of the newborn and to assess its potential for making clinically useful measurements on sick infants. Keywords: Effective pulmonary capillary blood flow; impedance cardiography; neonate; nitrous oxide

A group of 25 patients with patent extracranial-intracranial anastomoses were followed for 18 months in an effort to determine the long-term effects on regional cerebral blood flow (rCBF). The 133Xe inhalation method was used to measure rCBF. In patients whose preoperative mean rCBF (mCBF) on the affected side was low, i.e., less than 40 ml/100 gm/min, or who had internal carotid artery occlusion (ICO) or middle cerebral artery occlusion (MCO), mCBF on the affected side increased postoperatively. In patients with high preoperative mCBF rates on the affected side, i.e., 40 ml/100 gm/min or more, or internal carotid artery stenosis (ICS) or middle cerebral artery stenosis (MCS), mCBF on the affected side did not change after bypass. Postoperatively, the hemispheric difference in mCBF between the anastomosed and opposite sides was small in cases with ICO or MCO and negligible in patients with ICS or MCS, relative to the preoperative values. The rCBF significantly increased in the frontal, precentral, and superior temporal areas in patients with ICO, MCO, or low preoperative mCBF rates on the affected side.

In the normal chick, conspicuous visual stimuli induce targetting and pecking together, with vocalization. All three are abolished by lesions of the intercollicular area (ICo) or of connections passing through its medial margin. After such lesions, chicks also cease to treat significant visual stimuli as if they were startling and exciting, and may delay response as a result. However, they are still able to recognise, orient accurately to, and respond appropriately to, a variety of complex visual stimuli (e.g. food grains, copulation object). In addition, they are little affected by strange surroundings. Lesion evidence suggests the mammalian subcollicular area to have similar functions to the ICo and to be homologous with it.A route (present in birds), which is well-known in mammals for its association with threat, defence and escape evoked by strange and frightening objects (amygdala-diencephalic periventricular system-central mesencephalic grey, A-DPS-CMG) is probably important in regulating visual responsiveness to conspicuous and significant stimuli via the ICo (subcollicular area). Two different mechanisms may be involved caudal to the ICo. One consists of tectal afferents which might modulate the evocation of targetting, pecking and other responses via the tectum. The other is the pre-dorsal system of tectal efferents which may mediate such responses. Classical syndromes of tameness and unresponsiveness produced by various interruptions of the A-DPS-CMG route may depend on interruption of connections to these midbrain mechanisms.Attack is depressed by ICo lesions as one aspect of reduced responsiveness to conspicuous and startling visual stimuli. Avoidance, which is apparently mediated by a separate system, much as in Anura, is facilitated.

Bilateral lesions confined to the anterior intercollicular area (ICo) produce muting in domestic chicks. Calling is lost both in open field tests, and to novel stimuli which evoke pecking. Lesions of the medial edge of the ICo also mute, perhaps by cutting connections with the central mesencephalic grey. Partial destruction of the ICo allows full intensity calling but with greatly increased latency. If an area ventral to the ICo is also destroyed, one type of calling reappears: it is still not readily evoked by particular stimuli which are effective in normal chicks but it often occurs during locomotion. Crowing survives ICo lesions and presumably depends on a different route to lower centres. Totally deaf birds show quite normal calling, so that hearing deficits are probably not involved in the muting. Finally, mammalian homologues of the ICo and its connections are identified.

Many interesting applications emerged with the increasing popularity of deep learning. This project explored natural language processing and visualization techniques as well as two neural network architectures to classify ICOs. The first network focused on the ICOs white-paper with a bi-directional LSTM attention network. The second targeted the ICOs website structure with a Graph neural network as well as page topics with Latent Dirichlet Analysis.

This paper considers the implications for Supply Chain Management (SCM) from the development of the Internet of Things (IoT) or Internet Connected Objects (ICO). We focus on opportunities and challenges stemming from consumption data that comes from ICO, and on how this data can be mapped onto strategic choices of product variety. We develop a simple analytical framework that illustrates the underlying mechanisms of a product supplier/producer’s choice between (i) producing multiple product varieties as a way of meeting consumer demand (a “tailoring strategy”), and (ii) offering a flexible and standardised platform which enables consumers’ needs to be met by incorporating personal ICO data into various customisable applications (a “platform strategy”). Under a platform strategy, the ICO data is independently produced by other providers and can be called on in both use and context of use. We derive conditions under which each of the strategies may be profitable for the provider through maximising consumers’ value. Our findings are that the higher the demand for contextual variety, the more profitable the platform strategy becomes, relative to the tailoring strategy. Our study concludes by considering the implications for SCM research and practice with an extension to postponement taxonomies, including those where the customer, and not the supplier, is the completer of the product, and we show that this yields higher profits than the tailoring strategy.

Draft regulatory guidance suggests that if the processing of a child's personal data begins with the consent of a parent, then there is a need to find and defend an enduring consent through the child's growing capacity and on to their maturity. We consider the implications for health research of the UK Information Commissioner's Office's (ICO) suggestion that the relevant test for maturity is the Gillick test, originally developed in the context of medical treatment. Noting the significance of the welfare principle to this test, we examine the implications for the responsibilities of a parent to act as proxy for their child. We argue, contrary to draft ICO guidance, that a data controller might legitimately continue to rely upon parental consent as a legal basis for processing after a child is old enough to provide her own consent. Nevertheless, we conclude that data controllers should develop strategies to seek fresh consent from children as soon as practicable after the data controller has reason to believe they are mature enough to consent independently. Techniques for effective communication, recommended to address challenges associated with Big Data analytics, might have a role here in addressing the dynamic relationship between data subject and processing. Ultimately, we suggest that fair and lawful processing of a child's data will be dependent upon data controllers taking seriously the truism that consent is ongoing, rather than a one-time event: the core associated responsibility is to continue to communicate with a data subject regarding the processing of personal data.

Initial Coin Offerings have revolutionised the way that startups are funded. Furthermore, besides their use in an ICO, tokens unlock many possibilities within the context of the artificial economies that are being set up through blockchain: from incentivisation to automatic balancing of the economy. In spite of these developments, there is still no commonly accepted theoretical framework for analysing token economies and ICOs. This presents a unique challenge to the scientific community. A proper theory of token economies would allow us to understand which models work best and are sustainable. This would also help improve the credibility of ICOs as a method of raising money, calming criticism and concerns about speculative bubbles. The science of economics has given us powerful insights into how the laws of real world economies work. What we, as the scientific blockchain community, need to do, is spend more time and resources in understanding how to transfer learnings from traditional economics into token economies and how to create new economic models and theories that exploit the possibilities offered by the blockchain.

This study is the first to provide systematic evidence regarding investor behaviour in initial coin offerings (ICOs), their investment patterns and their role in the success of campaigns. Using hand-collected data on 472 public token sales over the period of 2013–2017, we advance the ICO literature by demonstrating that some contributors often invest in more than one campaign, and such serial investors contribute earlier. However, they are not more informed and fail to pick better-quality ICOs. Only large serial investors invest more in campaigns that raise more funds, attract more contributors, are more likely to reach their hard caps, and distribute tokens that are listed on crypto exchange. Our findings raise the question of whether regulatory or industry self-regulation agreements on information provision measures are needed to protect smaller retail ICO investors that exhibit naïve reinforcement learning behaviour.

Next-generation sequencing (NGS) has revolutionized genomic research and is set to have a major impact on genetic diagnostics thanks to the advent of benchtop sequencers and flexible kits for targeted libraries. Among the main hurdles in NGS are the difficulty of performing bioinformatic analysis of the huge volume of data generated and the high number of false positive calls that could be obtained, depending on the NGS technology and the analysis pipeline. Here, we present the development of a free and user-friendly Web data analysis tool that detects and filters sequence variants, provides coverage information, and allows the user to customize some basic parameters. The tool has been developed to provide accurate genetic analysis of targeted sequencing of common high-risk hereditary cancer genes using amplicon libraries run in a GS Junior System. The Web resource is linked to our own mutation database, to assist in the clinical classification of identified variants. We believe that this tool will greatly facilitate the use of the NGS approach in routine laboratories.

(1975). The IIEP-ICO Program of Curriculum Activities. Curriculum Theory Network: Vol. 5, No. 1, pp. 63-77.

• A retrospective review of the clinical course surrounding internal carotid artery occlusion (ICO) was undertaken in 97 patients with 106 instances of ICO. No neurologic symptoms could be attributed to more than half of the ICOs. Of the 52 symptomatic occlusions, 19 (37%) were associated with transient ischemic attacks and 33 (63%) with fixed strokes. Only 10% of all patients had permanent disabling neurologic sequelae. There was no correlation between development of neurologic symptoms and the side of the ICO, the presence or severity of contralateral carotid artery disease, or other risk factors. Women, however, were twice as likely as men to develop a fixed stroke with ICO. Seventy-six of these patients underwent reconstructive carotid surgery. Although there was a high rate of abnormal intraoperative findings with electroencephalographic monitoring (32 of 62 cases), with the use of intraoperative shunts there was no increase in the postoperative stroke complication rate (1.8%). These data suggest that the concern that ICO leads to serious fixed neurologic deficits may be overestimated, and that its presence does not adversely affect carefully performed contralateral carotid endarterectomy. ( Arch Surg 1987;122:432-435)

Introduction The present study compared measurements of cardiac output by an arterial pressure-based cardiac output (APCO) analysis method with measurement by intermittent thermodilution cardiac output (ICO) via pulmonary artery catheter in a clinical setting. Methods The multicenter, prospective clinical investigation enrolled patients with a clinical indication for cardiac output monitoring requiring pulmonary artery and radial artery catheters at two hospitals in the United States, one hospital in France, and one hospital in Belgium. In 84 patients (69 surgical patients), the cardiac output was measured by analysis of the arterial pulse using APCO and was measured via pulmonary artery catheter by ICO; to establish a reference comparison, the cardiac output was measured by continuous cardiac output (CCO). Data were collected continuously by the APCO and CCO technologies, and at least every 4 hours by ICO. No clinical interventions were made as part of the study. Results For APCO compared with ICO, the bias was 0.20 l/min, the precision was ± 1.28 l/min, and the limits of agreement were -2.36 l/m to 2.75 l/m. For CCO compared with ICO, the bias was 0.66 l/min, the precision was ± 1.05 l/min, and the limits of agreement were -1.43 l/m to 2.76 l/m. The ability of APCO and CCO to assess changes in cardiac output was compared with that of ICO. In 96% of comparisons, APCO tracked the change in cardiac output in the same direction as ICO. The magnitude of change was comparable 59% of the time. For CCO, 95% of comparisons were in the same direction, with 58% of those changes being of similar magnitude. Conclusion In critically ill patients in the intensive care unit, continuous measurement of cardiac output using either APCO or CCO is comparable with ICO. Further study in more homogeneous populations may refine specific situations where APCO reliability is strongest.