Entry Matching Research Articles

Echocardiography Does not Reduce Mortality in Sepsis: A Re-Evaluation Using the Medical Information Mart for Intensive Care IV Dataset.

Echocardiography is commonly used for hemodynamic assessment in sepsis, but data regarding its association with outcome are conflicting. The aim of this study was to evaluate the association between echocardiography and outcomes in patients with septic shock using the Medical Information Mart for Intensive Care IV database. Retrospective cohort study comparing patients who did or did not undergo transthoracic echocardiography within the first 5 days of admission for the primary outcome of 28-day mortality. Admissions to the Beth Israel Deaconess Medical Center intensive care from 2008 to 2019. Adults 16 years old or older with septic shock requiring vasopressor support within 48 hours of admission. Readmissions and patients admitted to the coronary care unit or cardiovascular intensive care were excluded, as well as patients with ST-elevation myocardial infarction or cardiac arrest. None. Echocardiography was performed in 1,515 (27%) of 5,697 eligible admissions. The primary outcome was analyzed using a marginal structural model and rolling entry matching to adjust for baseline and time-varying confounders. Patients who underwent echocardiography showed no significant difference in 28-day mortality (adjusted hazard ratio 1.09; 95% CI, 0.95-1.25; p = 0.24). This was consistent across multiple sensitivity analyses. Secondary outcomes were changes in management instituted within 4 hours of imaging. Treatment changes occurred in 493 patients (33%) compared with 431 matched controls (29%), with the most common intervention being the administration of a fluid bolus. Echocardiography in sepsis was not associated with a reduction in 28-day mortality based on observational data. These findings do not negate the utility of echo in cases of diagnostic uncertainty or inadequate response to initial treatment.

Trends in Representation of Female Applicants and Matriculants in Canadian Residency Programs Across Specialties, 1995 to 2019

Disparities in representation between sexes have been shown at multiple career stages in medicine despite increasing representation in the overall physician workforce. To assess sex representation of applicants to the Canadian R-1 entry match for postgraduate training programs from 1995 to 2019, comparing distribution between different specialties as well as applied vs matched applicants. This cross-sectional analysis of aggregate data provided by the Canadian Resident Matching Service between 1995 and 2019 analyzed aggregate data for the Canadian R-1 residency match from 1995 through 2019. Applicant sex as reported in the Canadian Resident Matching Service database. The sex representation of applicants was compared and the longitudinal trends in sex representation were analyzed by specialty between 1995 and 2019. The sex representation of overall applicants to the Canadian R-1 entry match were compared with matched applicants, and both were stratified by specialty. A total of 48 424 applicants were identified (26 407 [54.5%] female applicants), of which 41 037 were matched applicants. Using specialty groupings, female applicants were most highly represented in obstetrics and gynecology (1776 of 2090 [85.0%]) and least represented in radiology (658 of 2055 [32.0%]). Within individual subspecialties, female applicants had the lowest representation in neurosurgery (90 of 394 [22.8%]). While female applicants represented an increasing proportion of the overall applicant population between 1995 and 2019 (z = 2.71; P = .007), significant increases were seen in some, but not all, individual specialties. Differences by sex were found among Canadian medical graduate match rates to their top-ranked specialty: female applicants had a lower likelihood of being rejected for family medicine (rejection of male applicants: OR, 0.46; 95% CI, 0.39-0.54; P < .001) and psychiatry (OR, 0.59; 95% CI, 0.46-0.76; P < .001) and were more likely to be rejected for all-encompassing surgery (acceptance of male applicants: OR, 1.19; 95% CI, 1.10-1.28; P < .001). Increasing representation of female residency applicants over time was seen in some, but not all, medical specialties in Canada, and sex-based differences in successful match rates were observed in some specialties. The reasons for these disparities require further investigation for corrective strategies to be identified.

Intelligent Routing Scheme for SDN Satellite Network Based on Neural Network

In view of the existing SDN-based satellite network system, the tri-state content-addressable memory (TCAM) space occupied by the flow table is increasing, and the search and matching of flow entries are complicated, resulting in reduced routing and forwarding efficiency, which cannot meet the needs of diverse application requirements. Therefore, an intelligent routing scheme of SDN satellite network based on neural network (IRSSN) is proposed. The controller acquires the transmission mode of the data stream by training the neural network (NN), and replaces the flow table with the trained NN. An intelligent routing mechanism based on the orthogonal polynomial (Chebyshev) neural network is proposed. The switch predicts its forwarding path according to the traffic type of the data stream to meet the QoS requirements of the satellite network application. The simulation results show that IRSSN significantly reduces the occupied TCAM space and improves routing efficiency.

Genomic-Scale Interaction Involving Complementary Sequences in the Hepatitis C Virus 5'UTR Domain IIa and the RNA-Dependent RNA Polymerase Coding Region Promotes Efficient Virus Replication.

The hepatitis C virus (HCV) genome contains structured elements thought to play important regulatory roles in viral RNA translation and replication processes. We used in vitro RNA binding assays to map interactions involving the HCV 5′UTR and distal sequences in NS5B to examine their impact on viral RNA replication. The data revealed that 5′UTR nucleotides (nt) 95–110 in the internal ribosome entry site (IRES) domain IIa and matching nt sequence 8528–8543 located in the RNA-dependent RNA polymerase coding region NS5B, form a high-affinity RNA-RNA complex in vitro. This duplex is composed of both wobble and Watson-Crick base-pairings, with the latter shown to be essential to the formation of the high-affinity duplex. HCV genomic RNA constructs containing mutations in domain IIa nt 95–110 or within the genomic RNA location comprising nt 8528–8543 displayed, on average, 5-fold less intracellular HCV RNA and 6-fold less infectious progeny virus. HCV genomic constructs containing complementary mutations for IRES domain IIa nt 95–110 and NS5B nt 8528–8543 restored intracellular HCV RNA and progeny virus titers to levels obtained for parental virus RNA. We conclude that this long-range duplex interaction between the IRES domain IIa and NS5B nt 8528–8543 is essential for optimal virus replication.

Comparison group selection in the presence of rolling entry for health services research: Rolling entry matching.

To demonstrate rolling entry matching (REM), a new statistical method, for comparison group selection in the context of staggered nonuniform participant entry in nonrandomized interventions. Four Health Care Innovation Award (HCIA) interventions between 2012 and 2016. Center for Medicare and Medicaid Innovation HCIA participants entering these interventions over time were matched with nonparticipants who exhibited a similar pattern of health care use and expenditures during each participant's baseline period. Medicare fee-for-service claims data were used to identify nonparticipating, fee-for-service beneficiaries as a potential comparison group and conduct REM. Rolling entry matching achieved conventionally-accepted levels of balance on observed characteristics between participants and nonparticipants. The method overcame difficulties associated with a small number of intervention entrants. In nonrandomized interventions, valid inference regarding intervention effects relies on the suitability of the comparison group to act as the counterfactual case for the intervention group. When participants enter over time, comparison group selection is complicated. Rolling entry matching is a possible solution for comparison group selection in rolling entry interventions that is particularly useful with small sample sizes and merits further investigation in a variety of contexts.

Flexibility vs. robustness in cell cycle regulation of timing of M-phase entry in Xenopus laevis embryo cell-free extract.

During the cell cycle, cyclin dependent kinase 1 (CDK1) and protein phosphatase 2A (PP2A) play major roles in the regulation of mitosis. CDK1 phosphorylates a series of substrates triggering M-phase entry. Most of these substrates are dephosphorylated by PP2A. To allow phosphorylation of CDK1 substrates, PP2A is progressively inactivated upon M-phase entry. We have shown previously that the interplay between these two activities determines the timing of M-phase entry. Slight diminution of CDK1 activity by the RO3306 inhibitor delays M-phase entry in a dose-dependent manner in Xenopus embryo cell-free extract, while reduction of PP2A activity by OA inhibitor accelerates this process also in a dose-dependent manner. However, when a mixture of RO3306 and OA is added to the extract, an intermediate timing of M-phase entry is observed. Here we use a mathematical model to describe and understand this interplay. Simulations showing acceleration and delay in M-phase entry match previously described experimental data. CDC25 phosphatase is a major activator of CDK1 and acts through CDK1 Tyr15 and Thr14 dephosphorylation. Addition of CDC25 activity to our mathematical model was also consistent with our experimental results. To verify whether our assumption that the dynamics of CDC25 activation used in this model are the same in all experimental variants, we analyzed the dynamics of CDC25 phosphorylation, which reflect its activation. We confirm that these dynamics are indeed very similar in control extracts and when RO3306 and OA are present separately. However, when RO3306 and OA are added simultaneously to the extract, activation of CDC25 is slightly delayed. Integration of this parameter allowed us to improve our model. Furthermore, the pattern of CDK1 dephosphorylation on Tyr15 showed that the real dynamics of CDK1 activation are very similar in all experimental variants. The model presented here accurately describes, in mathematical terms, how the interplay between CDK1, PP2A and CDC25 controls the flexible timing of M-phase entry.

K-Means Clustering Algorithm based on Entity Resolution

resolution is the problem of recognizing which entry in database refers to same cluster.in this we have to run the ER in order to reduce the running time and to obtain good results. This paper investigates how we can reduce the running of ER with minimum amount of work using k-means clustering algorithm. In this, clustering can be done according to the matching of entries. We introduce a concept of technique called as k-means clustering to maximize the matching of entries identified using a limited amount of work. We illustrate the potential gains of this entity resolution approach using k-means.

Modeling and improving locality for the sparse-matrix–vector product on cache memories

A model for representing and improving the locality exhibited by the execution of sparse irregular problems is developed in this work. We focus on the product of a sparse matrix by a dense vector ( SpM× V). We consider the cache memory as a representative level of the memory hierarchy. Locality is evaluated through four functions based on two parameters called entry matches and line matches. In order to increase the locality, two algorithms are applied: one based on the construction of minimum spanning trees and the other on the nearest-neighbor heuristic. These techniques were tested and compared with some standard ordering algorithms.

Modeling data locality for the sparse matrix–vector product using distance measures

In this work, we model the data locality in the execution of codes with irregular accesses. We focus on the product of a sparse matrix by a dense vector ( SpM× V). In the model, locality is established taking into account pairs of rows or columns of sparse matrices. In order to evaluate this locality three functions are introduced based on two parameters: number of entry matches and number of block matches. The model is generalized considering windows of locality (groups of consecutive rows/columns of the matrix). We show results for a broad set of matrices measuring the goodness of our predictions of locality.

Synthesis of MVL functions using input and output assignments

A number of decomposition based mapping techniques are proposed. In these techniques, the synthesis problem is formulated as a mapping from an input matrix to an output matrix. The minimisation is obtained by constructing a 'matching-count matrix'. The entries of the matching-count matrix MC ij represent the number of entry matches between the input variable number i in the input matrix (X) and the output function number j in the output matrix (Y). It then selects those input-output pairings that give the maximum matching count, thus maximising the number of switching operations which can be eliminated in the realisation of multiple-valued logic (MVL) functions. The proposed techniques are classified as: output-phase with complement, input-phase with and without complement. Numerical results are presented to show that the proposed techniques result in significant reduction in the number of switching operators required for the implementation of 5000 randomly generated r-valued functions (for r = 3, 4 and 5). It is also shown that the input-phase assignment techniques do not require any additional hardware circuitry at the output to restore the original function. This may give this technique an edge over other techniques.

Physiologic rate of carrier-mediated Ca2+ entry matches active extrusion in human erythrocytes.

The intracellular Ca2+ concentration of nearly all cells is kept at submicromolar levels. The magnitudes of transmembrane Ca2+ movement that maintain this steady state in the human red blood cell have long been debated. Although there is agreement that the physiologic extrusion of Ca2+ by the well-characterized Ca2+. ATPase amounts to 45 mumol/liter cells per h (1982. Nature (Lond.). 298:478-481), the reported passive entry rates in physiological saline (2-20 mumol/liter cells per h) are all substantially lower. This discrepancy could be due to incomplete inhibition of the pump in the previous measurements of Ca2+ entry. We therefore examined both rate and mechanism of entry after completely inactivating the pump. This required pretreatment with iodoacetamide (to lower the intracellular ATP concentration) and vanadate (to inhibit any residual Ca2+ pump activity). The rate of Ca2+ entry (53 mumol/liter cells per h) was now found to be comparable to the accepted extrusion rate. Entry closely obeyed Michaelis-Menten kinetics (Vmax = 321 +/- 17 nmol Ca/g dry wt per h, Km = 1.26 +/- 0.13 mM), was competitively inhibited by external Sr2+ (Ki = 10.8 +/- 1.2 mM), and was accelerated by intracellular Ca2+. 45Ca2+ efflux from these pump-inactivated cells was also accelerated by either external Ca2+ or Sr2+. These accelerating effects of divalent cations on the opposite (trans) face of the membrane rule out a simple channel. Substrate-gated channels are also ruled out: cells equilibrated with 45Ca2+ lost the isotope when unlabeled Ca2+ or Sr2+ was added externally. Thus, passive Ca2+ movements occur predominantly by a reversible carrier-mediated mechanism for which Sr2+ is an alternate substrate. The carrier's intrinsic affinity constants for Ca2+ and Sr2+, 1.46 and 0.37 mM-1, respectively, indicate that Ca2+ is the preferred substrate.

Automatic indexing of pathology data.

A procedure for automated indexing of pathology diagnostic reports at the National Institutes of Health is described. Diagnostic statements in medical English are encoded by computer into the Systematized Nomenclature of Pathology (SNOP). SNOP is a structured indexing language constructed by pathologists for manual indexing. It is of interest that effective automatic encoding can be based upon an existing vocabulary and code designed for manual methods. Morphosyntactic analysis, a simple syntax analysis, matching of dictionary entries consisting of several words, and synonym substitutions are techniques utilized.