Presented in Xth European Symposium on Poultry Welfare
Date: 19 June 2017 - 22 June 2017
Venue: ISPAIA - ZOOPOLE développement City: Ploufragan, France
Sujan Perera's Dissertation Defense: Friday, August 12, 2016
Ph.D. Committee: Drs. Amit Sheth, Advisor; T.K. Prasad, Michael Raymer, and Pablo Mendes (IBM Research)
Video: https://youtu.be/pbjJ1zb8ayY
ABSTRACT:
Natural language is a powerful tool developed by humans over hundreds of thousands of years. The extensive usage, flexibility of the language, creativity of the human beings, and social, cultural, and economic changes that have taken place in daily life have added new constructs, styles, and features to the language. One such feature of the language is its ability to express ideas, opinions, and facts in an implicit manner. This is a feature that is used extensively in day to day communications in situations such as: 1) expressing sarcasm, 2) when trying to recall forgotten things, 3) when required to convey descriptive information, 4) when emphasizing the features of an entity, and 5) when communicating a common understanding.
Consider the tweet 'New Sandra Bullock astronaut lost in space movie looks absolutely terrifying' and the text snippet extracted from a clinical narrative 'He is suffering from nausea and severe headaches. Dolasteron was prescribed.' The tweet has an implicit mention of the entity Gravity and the clinical text snippet has implicit mention of the relationship between medication Dolasteron and clinical condition nausea. Such implicit references of the entities and the relationships are common occurrences in daily communication and they add unique value to conversations. However, extracting implicit constructs has not received enough attention. This dissertation focuses on extracting implicit entities and relationships from clinical narratives and extracting implicit entities from Tweets.
This dissertation demonstrates manifestations of implicit constructs in text, studies their characteristics, and develops a solution that is capable of extracting implicit factual information from text. The developed solution starts by acquiring relevant knowledge to solve the implicit information extraction problem. The relevant knowledge includes domain knowledge, contextual knowledge, and linguistic knowledge. The acquired knowledge can take different syntactic forms such as a text snippet, structured knowledge represented in standard knowledge representation languages like Resource Description Framework (RDF) or custom formats. Hence, the acquired knowledge is processed to create models that can be understood by machines. Such models provide the infrastructure to perform implicit information extraction of interest.
This dissertation focuses on three different use cases of implicit information and demonstrates the applicability of the developed solution in these use cases. They are:
- implicit entity linking in clinical narratives,
- implicit entity linking in Twitter,
- implicit relationship extraction from clinical narratives.
The document discusses concussion management in youth sports. It outlines that concussions are a serious public health issue, especially among children and adolescents involved in sports. Return to play protocols should be conservative for young athletes, involving complete resolution of symptoms and a gradual, stepwise return to full activities. Neurocognitive testing is important to compare injured athletes to their own baseline data to guide safe return to school and sports.
Efficacy of Koechner euthanizing device in comparison to manual cervical disl...RMAS Bandara
The study evaluated the efficacy of the Koechner euthanizing device (KED) compared to manual and assisted manual cervical dislocation in anesthetized layer chicks. Anesthetized chicks lost reflexes and died faster than conscious chicks. The KED resulted in a longer time to loss of reflexes and cessation of heartbeat compared to cervical dislocation, but caused less neck trauma. While no brain hemorrhages were found, the KED may cause a longer time to loss of sensibility and death in conscious chicks compared to other methods.
The document summarizes key aspects of death and brain death from a medicolegal perspective. It defines death and outlines the vital systems that cease to function at death. It discusses the presumption of death and survivorship under Indian law. The document then examines the historical definitions of death and milestones in determining brain death. It provides details on the anatomy of the normal brain and causes, mechanisms, and conditions distinct from brain death. The neurological examination for determining brain death and confirmatory testing are described. The key provisions of the Transplantation of Human Organs Act of 1994 and its amendment in 2009 are summarized.
This document provides a summary of several clinical decision rules and guidelines used in emergency medicine to determine the need for imaging or other diagnostic tests. It discusses rules for ankle/foot fractures, knee fractures, cervical spine injuries, minor head injuries, and subarachnoid hemorrhage. For each rule, it provides the essential criteria included in the rule as well as validation studies showing the sensitivity and specificity of the rules. The overall message is that these clinical decision rules can help standardize clinical decision making and reduce unnecessary testing, but clinicians must first thoroughly evaluate the patient's history and presentation before applying any rule.
This document discusses temporal bone trauma, including evaluation, management, common injuries, and treatment approaches. It covers topics such as CSF otorrhea, hearing loss, dizziness, facial nerve injuries, and surgical versus conservative treatment options. Imaging techniques like CT and MRI are important for diagnosis. Prognosis depends on factors like nerve excitability test results and whether paralysis is immediate or delayed.
This document provides an overview of spinal cord injury (SCI), including statistics, causes, classifications, complications, and systems affected. It discusses that there are approximately 12,000 new SCI cases per year in the US, with males more likely to sustain injury. SCI can be traumatic or non-traumatic, and is classified by level and completeness of injury. Common complications include respiratory issues, autonomic dysreflexia, skin breakdown, edema, DVT, and temperature regulation problems. Systems like bladder, bowel, sensation and motor function below the level of injury are impacted depending on the severity and level of the lesion.
Sujan Perera's Dissertation Defense: Friday, August 12, 2016
Ph.D. Committee: Drs. Amit Sheth, Advisor; T.K. Prasad, Michael Raymer, and Pablo Mendes (IBM Research)
Video: https://youtu.be/pbjJ1zb8ayY
ABSTRACT:
Natural language is a powerful tool developed by humans over hundreds of thousands of years. The extensive usage, flexibility of the language, creativity of the human beings, and social, cultural, and economic changes that have taken place in daily life have added new constructs, styles, and features to the language. One such feature of the language is its ability to express ideas, opinions, and facts in an implicit manner. This is a feature that is used extensively in day to day communications in situations such as: 1) expressing sarcasm, 2) when trying to recall forgotten things, 3) when required to convey descriptive information, 4) when emphasizing the features of an entity, and 5) when communicating a common understanding.
Consider the tweet 'New Sandra Bullock astronaut lost in space movie looks absolutely terrifying' and the text snippet extracted from a clinical narrative 'He is suffering from nausea and severe headaches. Dolasteron was prescribed.' The tweet has an implicit mention of the entity Gravity and the clinical text snippet has implicit mention of the relationship between medication Dolasteron and clinical condition nausea. Such implicit references of the entities and the relationships are common occurrences in daily communication and they add unique value to conversations. However, extracting implicit constructs has not received enough attention. This dissertation focuses on extracting implicit entities and relationships from clinical narratives and extracting implicit entities from Tweets.
This dissertation demonstrates manifestations of implicit constructs in text, studies their characteristics, and develops a solution that is capable of extracting implicit factual information from text. The developed solution starts by acquiring relevant knowledge to solve the implicit information extraction problem. The relevant knowledge includes domain knowledge, contextual knowledge, and linguistic knowledge. The acquired knowledge can take different syntactic forms such as a text snippet, structured knowledge represented in standard knowledge representation languages like Resource Description Framework (RDF) or custom formats. Hence, the acquired knowledge is processed to create models that can be understood by machines. Such models provide the infrastructure to perform implicit information extraction of interest.
This dissertation focuses on three different use cases of implicit information and demonstrates the applicability of the developed solution in these use cases. They are:
- implicit entity linking in clinical narratives,
- implicit entity linking in Twitter,
- implicit relationship extraction from clinical narratives.
The document discusses concussion management in youth sports. It outlines that concussions are a serious public health issue, especially among children and adolescents involved in sports. Return to play protocols should be conservative for young athletes, involving complete resolution of symptoms and a gradual, stepwise return to full activities. Neurocognitive testing is important to compare injured athletes to their own baseline data to guide safe return to school and sports.
Efficacy of Koechner euthanizing device in comparison to manual cervical disl...RMAS Bandara
The study evaluated the efficacy of the Koechner euthanizing device (KED) compared to manual and assisted manual cervical dislocation in anesthetized layer chicks. Anesthetized chicks lost reflexes and died faster than conscious chicks. The KED resulted in a longer time to loss of reflexes and cessation of heartbeat compared to cervical dislocation, but caused less neck trauma. While no brain hemorrhages were found, the KED may cause a longer time to loss of sensibility and death in conscious chicks compared to other methods.
The document summarizes key aspects of death and brain death from a medicolegal perspective. It defines death and outlines the vital systems that cease to function at death. It discusses the presumption of death and survivorship under Indian law. The document then examines the historical definitions of death and milestones in determining brain death. It provides details on the anatomy of the normal brain and causes, mechanisms, and conditions distinct from brain death. The neurological examination for determining brain death and confirmatory testing are described. The key provisions of the Transplantation of Human Organs Act of 1994 and its amendment in 2009 are summarized.
This document provides a summary of several clinical decision rules and guidelines used in emergency medicine to determine the need for imaging or other diagnostic tests. It discusses rules for ankle/foot fractures, knee fractures, cervical spine injuries, minor head injuries, and subarachnoid hemorrhage. For each rule, it provides the essential criteria included in the rule as well as validation studies showing the sensitivity and specificity of the rules. The overall message is that these clinical decision rules can help standardize clinical decision making and reduce unnecessary testing, but clinicians must first thoroughly evaluate the patient's history and presentation before applying any rule.
This document discusses temporal bone trauma, including evaluation, management, common injuries, and treatment approaches. It covers topics such as CSF otorrhea, hearing loss, dizziness, facial nerve injuries, and surgical versus conservative treatment options. Imaging techniques like CT and MRI are important for diagnosis. Prognosis depends on factors like nerve excitability test results and whether paralysis is immediate or delayed.
This document provides an overview of spinal cord injury (SCI), including statistics, causes, classifications, complications, and systems affected. It discusses that there are approximately 12,000 new SCI cases per year in the US, with males more likely to sustain injury. SCI can be traumatic or non-traumatic, and is classified by level and completeness of injury. Common complications include respiratory issues, autonomic dysreflexia, skin breakdown, edema, DVT, and temperature regulation problems. Systems like bladder, bowel, sensation and motor function below the level of injury are impacted depending on the severity and level of the lesion.
Nurses as the primary care providers would be the immediate health care professional to assess the patient's response and to determine whether he is improving or deteriorating. Signs of brain death can be identified and reported early by a nurse with adequate knowledge.
Temporal bone trauma can cause a wide range of clinical issues involving hearing loss, dizziness, CSF leaks, and facial nerve injuries. Knowledge of temporal bone anatomy is important for diagnosis and management. The most common causes are motor vehicle accidents and penetrating trauma. Evaluation involves a thorough head and neck exam and imaging like CT and MRI. Findings may include basilar skull fractures, mastoid ecchymosis, and hemotympanum. Treatment depends on the specific problems but may include observation, antibiotics, surgery to repair CSF leaks, and facial nerve decompression. Prognosis relates to the severity and location of injuries as well as how quickly they are identified and addressed.
This document provides information on performing a neurological examination. It discusses taking a patient history including personal details and history of present illness. It then describes performing a physical examination including vital signs and systematic examination of body systems. The neurological exam section details assessing higher mental functions, cranial nerves, motor function, coordination, reflexes, sensation and special tests. It also discusses tools used in the exam and evaluating conditions like head injuries.
The document discusses management of patients after cardiac arrest. It notes that cardiac arrest is a leading cause of death worldwide and survival rates are low. It describes the pathophysiology of post-cardiac arrest syndrome, including chemical and inflammatory responses that can cause organ dysfunction. Key aspects of management are discussed like therapeutic hypothermia, prognostication using tools like the PAR score, and maintaining circulation, breathing, and neurological function. Local data on outcomes for patients admitted to the ICU after cardiac arrest at one hospital are presented, finding a mortality rate of around 50%.
1. The document discusses the diagnosis and treatment of acute ischemic stroke. It outlines the time windows for treatment with intravenous thrombolysis, which is most effective within 4.5 hours of symptom onset.
2. Early diagnosis is critical in stroke care due to the concept of "time is brain". Delays in treatment can lead to further neuronal damage and worse outcomes. The goals are to perform a CT scan within 20 minutes of arrival and initiate thrombolysis within 60 minutes.
3. Post-thrombolytic management focuses on monitoring for hemorrhagic complications and providing supportive care to reduce disability from the stroke.
1) Brain death is defined as irreversible cessation of all functions of the entire brain, including the brainstem. Tests to determine brain death include examining brainstem reflexes and performing an apnea test.
2) Organ donation provides terminally ill patients a new lease on life but organ availability is low in India. Living donors can donate renewable tissues while deceased donors are a major source of organs.
3) For organ donation to occur, all reversible causes of coma must first be excluded through testing and the diagnosis of brain death must be certified by a board of medical experts according to the law.
Dr. Donald C. Lay Jr. - Pain: Abolishing a Necessary EvilJohn Blue
Pain: Abolishing a Necessary Evil - Donald C. Lay Jr., PhD, Research Leader, Livestock Behavior Research Unit, USDA, from the 2014 NIAA Annual Conference titled 'The Precautionary Principle: How Agriculture Will Thrive', March 31 - April 2, 2014, Omaha, NE, USA.
More presentations at http://www.trufflemedia.com/agmedia/conference/2014_niaa_how_animal_agriculture_will_thrive
This document provides information about brain death. It begins with definitions of death and introduces brain death as an irreversible form of unconsciousness characterized by loss of brain function while other organs may still be functioning. The document then discusses the history of how brain death was recognized and defined. It outlines the criteria for determining brain death, including assessing brain stem reflexes and performing an apnea test. The document notes that Indian law recognizes brain death and defines a deceased person. It emphasizes the importance of establishing the cause of brain dysfunction and ruling out potential confounders before determining brain death.
1) Status epilepticus refers to prolonged or continuous seizure activity lasting more than 5 minutes. It is a medical emergency that can cause neuronal damage the longer it persists.
2) Treatment involves controlling airway and vital signs, administering glucose and thiamine, performing diagnostic tests, and starting anticonvulsant drug therapy.
3) First line drug therapy includes lorazepam or diazepam followed by phenytoin or fosphenytoin. If seizures continue, additional doses of these drugs or alternative drugs like phenobarbital are given.
This document discusses status epilepticus (SE), including:
- Definitions and types of SE such as convulsive SE, nonconvulsive SE, and acute repetitive seizures.
- Characteristics of generalized convulsive SE.
- Incidence and mortality rates of SE which increase with age.
- Main causes of SE such as low antiepileptic drug levels, cerebrovascular accidents, anoxia/hypoxia, and metabolic disturbances.
- Guidelines for the management of SE including initiating treatment with benzodiazepines like lorazepam or diazepam, followed by antiepileptic drugs like fosphenytoin, phenytoin,
14.54 krajcer global experience with tri vascularSalutaria
This document discusses the global experience with the TriVascular Ovation Abdominal Stent Graft System based on data from clinical studies and registries. It notes that over 6,500 patients worldwide have been treated with the Ovation system, including patients in the Ovation Global Pivotal Trial, Continued Access Trial, US Post-Approval Study, and OVATION Post-Market Registry. The data demonstrate the safety and effectiveness of the Ovation system for treating abdominal aortic aneurysms, including in patients with hostile neck anatomy and narrow access vessels.
3 forette prevention of alzheimer ifa 2012] 2ifa2012
The document discusses potential approaches for preventing Alzheimer's disease and dementia. It notes that while some observational studies have found associations between certain factors and reduced dementia risk, large randomized controlled trials have not shown that anti-inflammatory agents, antioxidants, or estrogen therapy can prevent Alzheimer's disease. The document does provide evidence from randomized trials that treating hypertension through blood pressure lowering agents can reduce incidence of dementia. It summarizes trials showing reduced dementia risk when treating hypertension with calcium channel blockers, ACE inhibitors, and diuretics.
The document provides tips for using a PowerPoint presentation (ppt). It recommends that users can freely download, edit, and modify the ppt and add their name. It also notes that half the slides are blank except for the title. The document instructs the user to first show the blank slides and ask students what they know about the topic, then show the next slide with information. This process should be repeated three times for active learning. The ppt can also be used for self-study. A checklist is included and notes provide a bibliography.
Spinal Cord Injuries are uncommon, but they are a leading cause of high cost disability, and with ageing population, the incidence is expected to increase. This presentation looks at the many facets of spinal cord injuries.
This document discusses the impact of meningitis on the brain and an overview of neurorehabilitation for children with neurological sequelae from meningitis. It provides details on the pathophysiology of meningitis and how it can cause brain damage. The document also presents clinical evidence from cases of meningitis, including outcomes and the incidence of post-meningitic hydrocephalus requiring shunt surgery. It concludes with an overview of neurorehabilitation services and a proposed model for a regional pediatric neurorehabilitation network.
Anesthetic management of elderly patients requires special considerations. The elderly population is growing rapidly. Preoperative testing may not be needed for low or intermediate risk surgery if the patient is followed by their primary care physician and has no concerning findings on history and physical. Anesthetic drugs have longer durations of action in the elderly and some require lower doses for induction to avoid hypotension. Emergence from anesthesia takes longer in the elderly and regional anesthesia may be preferable to general anesthesia when possible. Careful titration of anesthetic drugs is important due to age-related changes in pharmacokinetics and pharmacodynamics.
Vertigo is a subtype of dizziness in which a patient inappropriately experiences the perception of motion (usually a spinning motion) due to dysfunction of the vestibular system.
Ultrasound assisted thrombolysis for vte turkish experienceuvcd
This document summarizes the key findings from several studies on using ultrasound-accelerated thrombolysis to treat pulmonary embolism and deep vein thrombosis. The ULTIMA trial found that low-dose catheter-directed ultrasound-accelerated thrombolysis was superior to anticoagulation alone in reversing right ventricular dysfunction in pulmonary embolism patients. The SEATTLE II study aimed to evaluate this technique for submassive and massive pulmonary embolism. A single-center retrospective review of 106 patients treated for chronic deep vein thrombosis found that over 90% reported significant symptom improvement and ultrasound follow-up showed high patency rates over time. The mechanism of action is that ultrasound energy exposes plasminogen receptor sites and increases
Death by Neurological Criteria and Organ Donation: Bill KnightSMACC Conference
Bill Knight explains the concept of death by neurological criteria and the complexities surrounding organ donation in such situations.
Bill discusses the process of dying, the definition of death, how to approach the neurologically dead patient and how to consider organ donation.
Death is a complex topic.
Due to advancements in medical technology and processes, the definition of death is a challenging one.
Bill talks at length about the definition of death by the neurological criteria. Dying is an active process, whereas death is an event.
The acceptance of death by the neurological criteria is often challenging as Bill will highlight. Bill talks about the care of the dying or dead patient.
There is a point at which care will transition from supporting the patient to supporting the organs. This is still good care.
There is an alignment of parallel intentions – first and foremost resuscitation of patients and then failing that, proceeding to considering and actioning organ donation. This is important due to the shortage of viable donor organ worldwide.
The donation process itself is complex. Bill provides his thoughts. He insists that an intensivist be involved as this has been shown to increase the number of viable and healthy organs made available.
The timing is also important. Available evidence does not support the need for immediate procurement after brain death. Taking time to optimise perfusion and allow recovery and cardiac function is appropriate and should be done.
Bill also discusses other treatment options at the time of death such as optimising endocrine function.
Finally, Bill will provide some practical considerations when communicating with the dead patient’s family. This involves being clear on your messaging. You are supporting organs, not life.
To reinforce this point, Bill suggests not examining or talking to the patient. He also recommends using all of the available hospital support services.
Similarly, it is best to not introduce the topic of organ donation to the family yourself as the treating clinician. Utilise the Organ Procurement Organisations (or similar services) and get them involved early to speak with the family.
Join Bill Knight in his talk on the North American perspective on Organ Donation, brain death and management of the brain dead donor prior to organ donation.
For more like this, head to our podcast page. #CodaPodcast
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Nurses as the primary care providers would be the immediate health care professional to assess the patient's response and to determine whether he is improving or deteriorating. Signs of brain death can be identified and reported early by a nurse with adequate knowledge.
Temporal bone trauma can cause a wide range of clinical issues involving hearing loss, dizziness, CSF leaks, and facial nerve injuries. Knowledge of temporal bone anatomy is important for diagnosis and management. The most common causes are motor vehicle accidents and penetrating trauma. Evaluation involves a thorough head and neck exam and imaging like CT and MRI. Findings may include basilar skull fractures, mastoid ecchymosis, and hemotympanum. Treatment depends on the specific problems but may include observation, antibiotics, surgery to repair CSF leaks, and facial nerve decompression. Prognosis relates to the severity and location of injuries as well as how quickly they are identified and addressed.
This document provides information on performing a neurological examination. It discusses taking a patient history including personal details and history of present illness. It then describes performing a physical examination including vital signs and systematic examination of body systems. The neurological exam section details assessing higher mental functions, cranial nerves, motor function, coordination, reflexes, sensation and special tests. It also discusses tools used in the exam and evaluating conditions like head injuries.
The document discusses management of patients after cardiac arrest. It notes that cardiac arrest is a leading cause of death worldwide and survival rates are low. It describes the pathophysiology of post-cardiac arrest syndrome, including chemical and inflammatory responses that can cause organ dysfunction. Key aspects of management are discussed like therapeutic hypothermia, prognostication using tools like the PAR score, and maintaining circulation, breathing, and neurological function. Local data on outcomes for patients admitted to the ICU after cardiac arrest at one hospital are presented, finding a mortality rate of around 50%.
1. The document discusses the diagnosis and treatment of acute ischemic stroke. It outlines the time windows for treatment with intravenous thrombolysis, which is most effective within 4.5 hours of symptom onset.
2. Early diagnosis is critical in stroke care due to the concept of "time is brain". Delays in treatment can lead to further neuronal damage and worse outcomes. The goals are to perform a CT scan within 20 minutes of arrival and initiate thrombolysis within 60 minutes.
3. Post-thrombolytic management focuses on monitoring for hemorrhagic complications and providing supportive care to reduce disability from the stroke.
1) Brain death is defined as irreversible cessation of all functions of the entire brain, including the brainstem. Tests to determine brain death include examining brainstem reflexes and performing an apnea test.
2) Organ donation provides terminally ill patients a new lease on life but organ availability is low in India. Living donors can donate renewable tissues while deceased donors are a major source of organs.
3) For organ donation to occur, all reversible causes of coma must first be excluded through testing and the diagnosis of brain death must be certified by a board of medical experts according to the law.
Dr. Donald C. Lay Jr. - Pain: Abolishing a Necessary EvilJohn Blue
Pain: Abolishing a Necessary Evil - Donald C. Lay Jr., PhD, Research Leader, Livestock Behavior Research Unit, USDA, from the 2014 NIAA Annual Conference titled 'The Precautionary Principle: How Agriculture Will Thrive', March 31 - April 2, 2014, Omaha, NE, USA.
More presentations at http://www.trufflemedia.com/agmedia/conference/2014_niaa_how_animal_agriculture_will_thrive
This document provides information about brain death. It begins with definitions of death and introduces brain death as an irreversible form of unconsciousness characterized by loss of brain function while other organs may still be functioning. The document then discusses the history of how brain death was recognized and defined. It outlines the criteria for determining brain death, including assessing brain stem reflexes and performing an apnea test. The document notes that Indian law recognizes brain death and defines a deceased person. It emphasizes the importance of establishing the cause of brain dysfunction and ruling out potential confounders before determining brain death.
1) Status epilepticus refers to prolonged or continuous seizure activity lasting more than 5 minutes. It is a medical emergency that can cause neuronal damage the longer it persists.
2) Treatment involves controlling airway and vital signs, administering glucose and thiamine, performing diagnostic tests, and starting anticonvulsant drug therapy.
3) First line drug therapy includes lorazepam or diazepam followed by phenytoin or fosphenytoin. If seizures continue, additional doses of these drugs or alternative drugs like phenobarbital are given.
This document discusses status epilepticus (SE), including:
- Definitions and types of SE such as convulsive SE, nonconvulsive SE, and acute repetitive seizures.
- Characteristics of generalized convulsive SE.
- Incidence and mortality rates of SE which increase with age.
- Main causes of SE such as low antiepileptic drug levels, cerebrovascular accidents, anoxia/hypoxia, and metabolic disturbances.
- Guidelines for the management of SE including initiating treatment with benzodiazepines like lorazepam or diazepam, followed by antiepileptic drugs like fosphenytoin, phenytoin,
14.54 krajcer global experience with tri vascularSalutaria
This document discusses the global experience with the TriVascular Ovation Abdominal Stent Graft System based on data from clinical studies and registries. It notes that over 6,500 patients worldwide have been treated with the Ovation system, including patients in the Ovation Global Pivotal Trial, Continued Access Trial, US Post-Approval Study, and OVATION Post-Market Registry. The data demonstrate the safety and effectiveness of the Ovation system for treating abdominal aortic aneurysms, including in patients with hostile neck anatomy and narrow access vessels.
3 forette prevention of alzheimer ifa 2012] 2ifa2012
The document discusses potential approaches for preventing Alzheimer's disease and dementia. It notes that while some observational studies have found associations between certain factors and reduced dementia risk, large randomized controlled trials have not shown that anti-inflammatory agents, antioxidants, or estrogen therapy can prevent Alzheimer's disease. The document does provide evidence from randomized trials that treating hypertension through blood pressure lowering agents can reduce incidence of dementia. It summarizes trials showing reduced dementia risk when treating hypertension with calcium channel blockers, ACE inhibitors, and diuretics.
The document provides tips for using a PowerPoint presentation (ppt). It recommends that users can freely download, edit, and modify the ppt and add their name. It also notes that half the slides are blank except for the title. The document instructs the user to first show the blank slides and ask students what they know about the topic, then show the next slide with information. This process should be repeated three times for active learning. The ppt can also be used for self-study. A checklist is included and notes provide a bibliography.
Spinal Cord Injuries are uncommon, but they are a leading cause of high cost disability, and with ageing population, the incidence is expected to increase. This presentation looks at the many facets of spinal cord injuries.
This document discusses the impact of meningitis on the brain and an overview of neurorehabilitation for children with neurological sequelae from meningitis. It provides details on the pathophysiology of meningitis and how it can cause brain damage. The document also presents clinical evidence from cases of meningitis, including outcomes and the incidence of post-meningitic hydrocephalus requiring shunt surgery. It concludes with an overview of neurorehabilitation services and a proposed model for a regional pediatric neurorehabilitation network.
Anesthetic management of elderly patients requires special considerations. The elderly population is growing rapidly. Preoperative testing may not be needed for low or intermediate risk surgery if the patient is followed by their primary care physician and has no concerning findings on history and physical. Anesthetic drugs have longer durations of action in the elderly and some require lower doses for induction to avoid hypotension. Emergence from anesthesia takes longer in the elderly and regional anesthesia may be preferable to general anesthesia when possible. Careful titration of anesthetic drugs is important due to age-related changes in pharmacokinetics and pharmacodynamics.
Vertigo is a subtype of dizziness in which a patient inappropriately experiences the perception of motion (usually a spinning motion) due to dysfunction of the vestibular system.
Ultrasound assisted thrombolysis for vte turkish experienceuvcd
This document summarizes the key findings from several studies on using ultrasound-accelerated thrombolysis to treat pulmonary embolism and deep vein thrombosis. The ULTIMA trial found that low-dose catheter-directed ultrasound-accelerated thrombolysis was superior to anticoagulation alone in reversing right ventricular dysfunction in pulmonary embolism patients. The SEATTLE II study aimed to evaluate this technique for submassive and massive pulmonary embolism. A single-center retrospective review of 106 patients treated for chronic deep vein thrombosis found that over 90% reported significant symptom improvement and ultrasound follow-up showed high patency rates over time. The mechanism of action is that ultrasound energy exposes plasminogen receptor sites and increases
Death by Neurological Criteria and Organ Donation: Bill KnightSMACC Conference
Bill Knight explains the concept of death by neurological criteria and the complexities surrounding organ donation in such situations.
Bill discusses the process of dying, the definition of death, how to approach the neurologically dead patient and how to consider organ donation.
Death is a complex topic.
Due to advancements in medical technology and processes, the definition of death is a challenging one.
Bill talks at length about the definition of death by the neurological criteria. Dying is an active process, whereas death is an event.
The acceptance of death by the neurological criteria is often challenging as Bill will highlight. Bill talks about the care of the dying or dead patient.
There is a point at which care will transition from supporting the patient to supporting the organs. This is still good care.
There is an alignment of parallel intentions – first and foremost resuscitation of patients and then failing that, proceeding to considering and actioning organ donation. This is important due to the shortage of viable donor organ worldwide.
The donation process itself is complex. Bill provides his thoughts. He insists that an intensivist be involved as this has been shown to increase the number of viable and healthy organs made available.
The timing is also important. Available evidence does not support the need for immediate procurement after brain death. Taking time to optimise perfusion and allow recovery and cardiac function is appropriate and should be done.
Bill also discusses other treatment options at the time of death such as optimising endocrine function.
Finally, Bill will provide some practical considerations when communicating with the dead patient’s family. This involves being clear on your messaging. You are supporting organs, not life.
To reinforce this point, Bill suggests not examining or talking to the patient. He also recommends using all of the available hospital support services.
Similarly, it is best to not introduce the topic of organ donation to the family yourself as the treating clinician. Utilise the Organ Procurement Organisations (or similar services) and get them involved early to speak with the family.
Join Bill Knight in his talk on the North American perspective on Organ Donation, brain death and management of the brain dead donor prior to organ donation.
For more like this, head to our podcast page. #CodaPodcast
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This presentation by OECD, OECD Secretariat, was made during the discussion “Competition and Regulation in Professions and Occupations” held at the 77th meeting of the OECD Working Party No. 2 on Competition and Regulation on 10 June 2024. More papers and presentations on the topic can be found at oe.cd/crps.
This presentation was uploaded with the author’s consent.
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Career goals serve as a roadmap for individuals, guiding them toward achieving long-term professional aspirations and personal fulfillment. Establishing clear career goals enables professionals to focus their efforts on developing specific skills, gaining relevant experience, and making strategic decisions that align with their desired career trajectory. By setting both short-term and long-term objectives, individuals can systematically track their progress, make necessary adjustments, and stay motivated. Short-term goals often include acquiring new qualifications, mastering particular competencies, or securing a specific role, while long-term goals might encompass reaching executive positions, becoming industry experts, or launching entrepreneurial ventures.
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Collapsing Narratives: Exploring Non-Linearity • a micro report by Rosie WellsRosie Wells
Insight: In a landscape where traditional narrative structures are giving way to fragmented and non-linear forms of storytelling, there lies immense potential for creativity and exploration.
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Rosie Wells is an Arts & Cultural Strategist uniquely positioned at the intersection of grassroots and mainstream storytelling.
Their work is focused on developing meaningful and lasting connections that can drive social change.
Please download this presentation to enjoy the hyperlinks!
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Suzanne Lagerweij - Influence Without Power - Why Empathy is Your Best Friend...Suzanne Lagerweij
This is a workshop about communication and collaboration. We will experience how we can analyze the reasons for resistance to change (exercise 1) and practice how to improve our conversation style and be more in control and effective in the way we communicate (exercise 2).
This session will use Dave Gray’s Empathy Mapping, Argyris’ Ladder of Inference and The Four Rs from Agile Conversations (Squirrel and Fredrick).
Abstract:
Let’s talk about powerful conversations! We all know how to lead a constructive conversation, right? Then why is it so difficult to have those conversations with people at work, especially those in powerful positions that show resistance to change?
Learning to control and direct conversations takes understanding and practice.
We can combine our innate empathy with our analytical skills to gain a deeper understanding of complex situations at work. Join this session to learn how to prepare for difficult conversations and how to improve our agile conversations in order to be more influential without power. We will use Dave Gray’s Empathy Mapping, Argyris’ Ladder of Inference and The Four Rs from Agile Conversations (Squirrel and Fredrick).
In the session you will experience how preparing and reflecting on your conversation can help you be more influential at work. You will learn how to communicate more effectively with the people needed to achieve positive change. You will leave with a self-revised version of a difficult conversation and a practical model to use when you get back to work.
Come learn more on how to become a real influencer!
Suzanne Lagerweij - Influence Without Power - Why Empathy is Your Best Friend...
Anatomical pathology and behavioural reflex responses induced by nonpenetrating captive bolt devices for on farm euthanasia of layer chickens
1. Anatomical pathology and behavioural
reflex responses induced by nonpenetrating
captive bolt devices for on farm euthanasia
of layer chickens
R.M.A.S. Bandara1, S. Torrey1, L. J. Caston1, K. Schwean-Lardner2 and
T. M. Widowski1
1Department of Animal Biosciences, University of Guelph
2 Department of Animal and Poultry Science, University of Saskatchewan,
2. Introduction
• Euthanasia – good death/humane killing
• Ending of a life of an individual to minimize or
eliminate pain and distress ( AVMA, 2013)
• Humaneness of methods based on how quickly
animal lose consciousness
(AVMA, 2013; Raj et al.,2006: Erasmus et al., 2010)
Brain death and
cardiac/
respiratory
arrest
Loss of
consciousness
Rapid loss of
consciousness
Reliable
and
irreversible
3. Pain and unconsciousness
• Pain: “an unpleasant sensory and emotional experience
associated with actual or potential tissue damage”
(IASP, 1979)
• Unconscious/insensible: “a state of unawareness in
which the individual is unable to respond to normal
stimuli, including pain” (EFSA, 2006)
• Insensibility results from lesions to the reticular formation and direct injury to the
cerebral cortex or brain stem
(Parvizi, J., and A. R. Damasio. 2003, Brierley et al., 1971. French, J. D., and H. W. Magoun. 1952)
Reticular formation
4. Cerebral concussion
• Mild traumatic brain injury
• Violent physical shaking of the brain that is responsible for the sudden temporary
loss of consciousness due to disturbances of neural functions usually without skull
fractures. (Plum and Posner, 1980; Bannister, 1992; Rosenthal, 1993; Label, 1997)
• Caused by blow to the head, acceleration forces and explosions
• Cerebral contusion/ hematoma: Severe traumatic brain injury
Bruising of the brain tissue through direct trauma to the head.
Always with loss of consciousness and internal bleeding
Disrupt the
neuronal activities
Cerebral blood flow
is impaired
5. Nonpenetrating captive bolts (NPCB)
• Designed with a blunt bolt that does not penetrate the brain
Kinetic energy = ½ MV2
M= mass of the bolt V= velocity (travel distance) of the bolt
Zephyr-E (120 psi) Zephyr-EXL (98-100 psi) TED
6. Facilitate placement of the tool
Velocity of the bolt is
proportional to the air
pressure
Stunning energy of NPCB
Compressed air
Compressed air
Gas canister
Kinetic energy = ½ MV2
M= mass V= velocity
120 psi
98-100 psi
For chicken
Velocity of the bolt is
changed by the subject
adapter
Z- E
Z- EXL
TED
Hen
Cock
7. Objectives
• To assess the effectiveness of Zephyr-E, Zephyr-EXL and TED for on-
farm euthanasia of different production stages (rearing, growing,
laying and end of production) of layer chickens based on time to
insensibility and death.
8. Methodology
End of
production
Laying
Growing
Rearing
• 25 birds were studied under each age
group for each device
• > 1 application was considered a failure
• Correct positioning of the device
10-11 wks
20-21 wks
30-35 wks
60-75 wks
9. Assessment of insensibility
• Brain stem reflexes
• Time at loss of pupillary reflex
• Time at loss of nictitating membrane reflex
• Time at loss of corneal reflex
• Spinal reflex
• Time at loss of pedal reflex
(pinching of toe) Nictitating
membrane
Dilated
pupil
Constricted
pupil
(Erasmus et al., 2010; Dawson et al., 2009; Raj et al.,1990)
10. Assessment of brain failure and death
• Time at onset of tonic convulsions
• Time at cessation of all convulsions
• Time at cloacal relaxation
• Time at cessation of heart beat
(Erasmus et al., 2010; Dawson et al., 2009; Raj et al.,1990; Blackmore and Delany. 1987)
Cloacal relaxation
Severe contraction of cloaca
Tonic convulsions
Stretching of leg and neck
Clonic convulsions
Severe wing flapping + Paddling Onset of tonic
11. Assessment of postmortem lesions
• Head injuries
• Skin laceration and external bleeding (Y/N)
• Subcutaneous hemorrhages on the head ( 0 - 4 scale system)
• Brain hemorrhages
Macroscopic – Gross subdural hemorrhages (0-4 scale system)
0 1 2 3 4
No
hemorrhage
< 25% 26-50 % 51-75 % > 75 %
12. Skull fractures
0 1 2 3
Intact skull
Depression
fracture
Penetrating
fracture/no
embedded
fragments
Pieces of skull
have broken off
and embedded
into the brain
13. Statistical analysis
• Proc GLM procedure in SAS (ver. 9.4 )
• Variables used to assess insensibility and brain death
• Residuals were normally distributed
• Proc Glimmix procedure in SAS (ver.9.4)
• Score data of postmortem lesions
• Mean separation – Tukey’s Test
14. Results: Time of insensibility
• All brain stem reflexes, pedal reflex and breathing disappeared within
5 seconds for all three NPCB devices
• Five failures were experienced for Zephyr-E — 70 wks old roosters
Pressure down of the air compressor
No adapter application
15. Results: Time of brain failure and death
Device effect
Z-E
(n=94)
Z-EXL
(n=92)
TED
(n= 93)
P
Onset of tonic
convulsions
111.1±4.9 126.1±5.0 121.8±5 0.0920
Cessation of
convulsions
152.4±5.7 b 166.4 ± 5.8 ab 173.6 ± 6 a 0.0315
Cloacal
relaxation
155.6±5.6 b 170.2±5.7ab 179.3 ± 5 a 0.0100
Cessation of
heart beat
176.2±5.8 b 192.6±5.9 ab 201.7 ± 6 a 0.0091
Time in seconds
16. Results: Time of brain failure and death
Age effect
10-11 wks 20-21 wks 30-35 wks 60-75 wks P
Onset of tonic
convulsions
153.8±5.5a 133.4±6.4a 91.6±5.5b 99.8±5.5b
< 0.0001
Cessation of
convulsions
207.2±6.3a 181.7±7.4b 125.1±6.4c 142.6±6.4c
< 0.0001
Cloacal
relaxation
179.3±5.5a 191.6±7.4a 131.9±6.1b 145.9±6.1b < 0.0001
Cessation of
heart beat
236.0±6.5 a 200.9±7.6 b 150.0±6.5 c 173.8±6.5c < 0.0001
Time in seconds
20. Results: Gross subdural hemorrhage of the brain
Device effect
• Dorsal side of the brain - Lowest score for Z-E ( P = 0.0001)
• Ventral side of the brain - Lowest score for Z-E ( P < 0.001)
Device < 25% > 50%
Z-E 16 % 40 %
Z-EXL 11 % 57 %
TED 8 % 65 %
Device < 25% > 50%
Z-E 53 % 15 %
Z-EXL 25 % 33 %
TED 34 % 39 %
50 % of hemorrhage
Intact brain
Cerebellum
Cerebrum
21. Results: Gross subdural hemorrhage of the brain
Age effect
Dorsal side of the brain
• 10-11 week old birds showed highest
score ( P < 0.0001)
Ventral side of the brain
• 10-11 week old birds showed highest
score ( P < 0.0001)
Age
(weeks)
< 25% > 50%
10-11 3 % 67 %
20-21 14 % 57 %
30-35 19 % 40 %
60-75 12 % 49 %
Age
(weeks)
< 25% > 50%
10-11 4 % 81 %
20-21 31 % 30 %
30-35 69 % 5 %
60-75 44 % 15 %
22. Conclusion
• All three devices induced immediate insensibility leading to death in
all age groups of layer chickens
• The Zephyr-E had more failures and lower anatomical pathology
scores
• Therefore, the TED and Zephyr-EXL (98-100 psi) appear to be more
efficient for all four production stages of rearing, growing, laying and
end of production for the on-farm euthanasia of layer chickens
23. Acknowledgements
Advisors
• Prof. Tina M. Widowski
• Dr. Stephanie Torrey
Advisory committee
• Prof. P. Turner
• Dr. Karen Schwean-Lardner
Students and volunteers
• Kahlee Latreille
• Linda J. Caston
• Animal behavior and welfare group
• Staff- Arkell Poultry Rsearch Station