Predictive score for mortality in patients with COPD exacerbations attending hospital emergency departments

Background: Limited information is available about predictors of short-term outcomes in patients with exacerbation of chronic obstructive pulmonary disease (eCOPD) attending an emergency department (ED). Such information could help stratify these patients and guide medical decision-making. The aim of this study was to develop a clinical prediction rule for short-term mortality during hospital admission or within a week after the index ED visit. Methods: This was a prospective cohort study of patients with eCOPD attending the EDs of 16 participating hospitals. Recruitment started in June 2008 and ended in September 2010. Information on possible predictor variables was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up. Main short-term outcomes were death during hospital admission or within 1 week of discharge to home from the ED, as well as at death within 1 month of the index ED visit. Multivariate logistic regression models were developed in a derivation sample and validated in a validation sample. The score was compared with other published prediction rules for patients with stable COPD. Results: In total, 2,487 patients were included in the study. Predictors of death during hospital admission, or within 1 week of discharge to home from the ED were patient age, baseline dyspnea, previous need for long-term home oxygen therapy or non-invasive mechanical ventilation, altered mental status, and use of inspiratory accessory muscles or paradoxical breathing upon ED arrival (area under the curve (AUC) = 0.85). Addition of arterial blood gas parameters (oxygen and carbon dioxide partial pressures (PO2 and PCO2)) and pH) did not improve the model. The same variables were predictors of death at 1 month (AUC = 0.85). Compared with other commonly used tools for predicting the severity of COPD in stable patients, our rule was significantly better. Conclusions: Five clinical predictors easily available in the ED, and also in the primary care setting, can be used to create a simple and easily obtained score that allows clinicians to stratify patients with eCOPD upon ED arrival and guide the medical decision-making process.

A Novel Scheduling Index Rule Proposal for QoE Maximization in Wireless Networks

This paper deals with the resource allocation problem aimed at maximizing users' perception of quality in wireless channels with time-varying capacity. First of all, we model the subjective quality-aware scheduling problem in the framework of Markovian decision processes. Then, given that the obtaining of the optimal solution of this model is unachievable, we propose a simple scheduling index rule with closed-form expression by using a methodology based on Whittle approach. Finally, we analyze the performance of the achieved scheduling proposal in several relevant scenarios, concluding that it outperforms the most popular existing resource allocation strategies.

James's rule and causes and consequences of a latitudinal cline in the demography of John's Snapper (Lutjanus johnii) in coastal waters of Australia

Demographic parameters were derived from sectioned otoliths of John’s Snapper (Lutjanus johnii) from 4 regions across 9° of latitude and 23° of longitude in northern Australia. Latitudinal variation in size and growth rates of this species greatly exceeded longitudinal variation. Populations of John’s Snapper farthest from the equator had the largest body sizes, in line with James’s rule, and the fastest growth rates, contrary to the temperature-size rule for ectotherms. A maximum age of 28.6 years, nearly 3 times previous estimates, was recorded and the largest individual was 990 mm in fork length. Females grew to a larger mean asymptotic fork length (L∞) than did males, a finding consistent with functional gonochorism. Otolith weight at age and gonad weight at length followed the same latitudinal trends seen in length at age. Length at maturity was ~72–87% of L∞ and varied by ~23% across the full latitudinal gradient, but age at first maturity was consistently in the range of 6–10 years, indicating that basic growth trajectories were similar across vastly different environments. We discuss both the need for complementary reproductive data in age-based studies and the insights gained from experiments where the concept of oxygen- and capacity-limited thermal tolerance is applied to explain the mechanistic causes of James’s rule in tropical fish species.

Home range and seasonal movements of Black Sea Bass (Centropristis striata) during their inshore residency at a reef in the mid-Atlantic Bight

Black Sea Bass (Centropristis striata) in the mid-Atlantic Bight undertake seasonal cross-shelf movements to occupy inshore rocky reefs and hardbottom habitats between spring and fall. Shelf-wide migrations of this stock are well documented, but movements and home ranges of fish during their inshore residency period have not been described. We tagged 122 Black Sea Bass with acoustic transmitters at a mid-Atlantic reef to estimate home-range size and factors that influence movements (>400 m) at a 46.1-km2 study site between May and November 2003. Activity of Black Sea Bass was greatest and most consistent during summer but declined rapidly in September as water temperatures at the bottom of the seafloor increased on the inner shelf. Black Sea Bass maintained relatively large home ranges that were fish-size invariant but highly variable (13.7–736.4 ha), underscoring the importance of large sample sizes in examination of population-level characteristics of mobile species with complex social interactions. On the basis of observed variations in movement patterns and the size of home ranges, we postulate the existence of groups of conspecifics that exhibit similar space-use behaviors. The group of males released earlier in the tagging period used larger home ranges than the group of males released later in our study. In addition, mean activity levels and the probability of movement among acoustic stations varied among groups of fish in a complex manner that depended on sex. These differences in movement behaviors may increase the vulnerability of male fish to passive fishing gears, further exacerbating variation in exploitation rates for this species among reefs.

Toward a rule-based biome model

EXTRACT (SEE PDF FOR FULL ABSTRACT): Current projections of the response of the biosphere to global climatic change indicate as much as 50 to 90% spatial displacement of extratropical biomes. The mechanism of spatial shift could be dominated either by competitive displacement of northern biomes by southern biomes or by drought-induced dieback of areas susceptible to change. The current suite of global biosphere models cannot distinguish between these two processes, hence the need for a mechanistically based biome model. The first steps have been taken toward development of a rule-based, mechanistic model of regional biomes at a continental scale. ... The model is in an early stage of development and will require several enhancements, including: explicit simulation of potential evapotranspiration, extension to boreal and tropical biomes, a shift from steady-state to transient dynamics, and validation on other continents.

Rule-based grapheme-to-phoneme method for the Greek

This paper describes a trainable method for generating letter to sound rules for the Greek language, for producing the pronunciation of out-of-vocabulary words. Several approaches have been adopted over the years for grapheme-to-phoneme conversion, such as hand-seeded rules, finite state transducers, neural networks, HMMs etc, nevertheless it has been proved that the most reliable method is a rule-based one. Our approach is based on a semi-automatically pre-transcribed lexicon, from which we derived rules for automatic transcription. The efficiency and robustness of our method are proved by experiments on out-of-vocabulary words which resulted in over than 98% accuracy on a word-base criterion.