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Introduction: Use of mechanical ventilation during general anesthesia is a necessary practice in the anesthetization of small cetaceans as spontaneous ventilation fails to provide adequate gas exchange. Currently available methods of ventilation do not account for the intermittent breathing strategy of representative species within this infraorder of fully aquatic mammals and may have a significant effect on cardiac and respiratory physiology. Methods: To understand the impact of mechanical ventilation on cardiopulmonary function in one small species of cetacean, the bottlenose dolphin (Tursiops truncatus), we compared controlled mechanical ventilation (CMV) to a novel ventilation method known as apneustic anesthesia ventilation (AAV). AAV simulates the normal inspiratory breath-hold pattern of dolphins. Ten anesthetic procedures (dental procedure, n = 9; bronchoscopy, n = 2) were performed on nine dolphins (age range: 10-42 years; mean = 32 years; median = 37 years; female = 3, 40%; male = 6, 60%). In a cross-over study design, dolphins were instrumented and randomly assigned to AAV or CMV as the initial mode of ventilation, then switched to the alternate mode. Baseline cardiopulmonary data were collected and again after 30 min on each mode of ventilation. Cardiac index, stroke volume index, systemic vascular resistance, alveolar dead space, alveolar-arterial oxygen tension gradient, arterial oxygen content, oxygen delivery index, and dynamic respiratory system compliance index were calculated at each of the four time points. Results: During AAV, dolphins had higher arterial oxygen tension, higher mean airway pressure, reduced alveolar dead space ventilation and lower alveolararterial oxygen difference. Cardiovascular performance was not statistically different between the two modes. Discussion: Our study suggests AAV, which more closely resembles the conscious intermittent respiratory pattern phenotype of dolphins, improves ventilation and pulmonary function in the anesthetized dolphin. Future studies should evaluate the cardiopulmonary effects of neutral buoyancy and cardiopulmonary sparing drug protocols to reduce the need for hemodynamic support of current protocols. [ABSTRACT FROM AUTHOR]

A new decision tree method for application in data mining, machine learning, pattern recognition, and other areas is proposed in this paper. The new method incorporates a classical multivariate statistical method, linear discriminant function, into decision trees' recursive partitioning process. The proposed method considers not only the linear combination with all variables, but also combinations with fewer variables. It uses a tabu search technique to find appropriate variable combinations within a reasonable length of time. For problems with more than two classes, the tabu search technique is also used to group the data into two superclasses before each split. The results of our experimental study indicate that the proposed algorithm appears to outperform some of the major classification algorithms in terms of classification accuracy, the proposed algorithm generates decision trees with relatively small sizes, and the proposed algorithm runs faster than most multivariate decision trees and its computing time increases linearly with data size, indicating that the algorithm is scalable to large datasets. Index Terms--Classification, data mining, decision trees, linear discriminant, tabu search.

This paper concerns a decision-tree pruning method, a key issue in the development of decision trees. We propose a new method that applies the classical optimization technique, dynamic programming, to […]

Objective: Dysphagia is common following facial nerve injury; however, research is sparse regarding swallowing-related outcomes and targeted treatments. Previous animal studies have used eye blink and vibrissae movement as measures of facial nerve impairment and recovery. The purpose of this study was to create a mouse model of facial nerve injury that results in dysphagia to enhance translational research outcomes.Study Design: Prospective animal study.Methods: Twenty C57BL/6J mice underwent surgical transection of the main trunk (MT) (n = 10) or marginal mandibular branch (MMB) (n = 10) of the left facial nerve. Videofluoroscopic swallow study (VFSS) assays for drinking and eating were performed at baseline and 14 days postsurgery to quantify several deglutition-related outcome measures.Results: VFSS analysis revealed that MT transection resulted in significantly slower lick and swallow rates during drinking (P ≤ .05) and significantly slower swallow rates and longer inter-swallow intervals during eating (P ≤ .05), congruent with oral and pharyngeal dysphagia. After MMB transection, these same VFSS metrics were not statistically significant (P > .05).Conclusion: The main finding of this study was that transection of the facial nerve MT leads to oral and pharyngeal stage dysphagia in mice; MMB transection does not. These results from mice provide novel insight into specific VFSS metrics that may be used to characterize dysphagia in humans following facial nerve injury. We are currently using this surgical mouse model to explore promising treatment modalities such as electrical stimulation to hasten recovery and improve outcomes following various iatrogenic and idiopathic conditions affecting the facial nerve.Level Of Evidence: NA Laryngoscope, 131:17-24, 2021. [ABSTRACT FROM AUTHOR]

A new decision tree method for application in data mining, machine learning, pattern recognition, and other areas is proposed in this paper. The new method incorporates a classical multivariate statistical method, linear discriminant function, into decision trees' recursive partitioning process. The proposed method considers not only the linear combination with all variables, but also combinations with fewer variables. It uses a tabu search technique to find appropriate variable combinations within a reasonable length of time. For problems with more than two classes, the tabu search technique is also used to group the data into two superclasses before each split. The results of our experimental study indicate that the proposed algorithm appears to outperform some of the major classification algorithms in terms of classification accuracy, the proposed algorithm generates decision trees with relatively small sizes, and the proposed algorithm runs faster than most multivariate decision trees and its computing time increases linearly with data size, indicating that the algorithm is scalable to large datasets. [ABSTRACT FROM AUTHOR]

Presents a decision-tree method that applies the dynamic programming technique to the decision-tree pruning procedure. Sequence of optimal pruned trees with respect to tree size; Comparison between the dynamic programming based pruning algorithm and the cost complexity pruning.

Background: Health care-associated infections are serious complications impacting 2 million patients and accounting for approximately 100,000 deaths per year. In the present study, we evaluated the effectiveness of a new hand hygiene monitoring program (HHMP) and measured the sustainability of this effectiveness over a 1-year period., Methods: The HHMP consisted of 4 key components: extensive education, conspicuous and visible monitors, immediate feedback concerning compliance to health care workers, and real-time data dissemination to leadership. The HHMP was implemented in 2 hospital care units. Two different, but similar, departments served as controls, and hand hygiene compliance was monitored via the "secret shopper" technique. All 4 departments were followed for 12 months., Results: Both experimental departments showed statistically significant increases in hand hygiene compliance. Experimental department 1 increased compliance from 49% to an average of 90%, and experimental department 2 increased compliance from 60% to an average of 96%. Both experimental departments were able to sustain these results for at least 6 months. Compliance rates were significantly higher in the experimental departments compared with the control departments. No significant changes were seen in the control departments., Conclusions: These finding suggest that continuous monitoring by salient observers and immediate feedback are critical to the success of hand hygiene programs., (Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)