Cervical vagal schwannoma, a rare differential of a neck swelling: A case report.

Cervical vagal schwannoma is a rare clinical entity that requires a different clinical approach than other neck swellings. Magnetic resonance imaging is the preferred initial diagnostic test. Complications may arise due to vagal stimulation in unsuspecting open biopsies. Surgical excision with perioperative vagal monitoring is recommended for the treatment of vagal schwannomas.

Healthcare Biclustering-Based Prediction on Gene Expression Dataset.

In this paper, we develop a healthcare biclustering model in the field of healthcare to reduce the inconveniences linked to the data clustering on gene expression. The present study uses two separate healthcare biclustering approaches to identify specific gene activity in certain environments and remove the duplication of broad gene information components. Moreover, because of its adequacy in the problem where populations of potential solutions allow exploration of a greater portion of the research area, machine learning or heuristic algorithm has become extensively used for healthcare biclustering in the field of healthcare. The study is evaluated in terms of average match score for nonoverlapping modules, overlapping modules through the influence of noise for constant bicluster and additive bicluster, and the run time. The results show that proposed FCM blustering method has higher average match score, and reduced run time proposed FCM than the existing PSO-SA and fuzzy logic healthcare biclustering methods.

AlN-SWCNT Metacomposites Having Tunable Negative Permittivity in Radio and Microwave Frequencies.

Discovery of plasmon resonance and negative permittivity in carbon allotropes at much lower frequencies than those of metals has evoked interest to develop random metacomposites by suitable means of addition of these dispersoids in an overall dielectric matrix. Random metacomposites have always the advantage for their easy preparation techniques over those of their regular arrayed artificial counterpart. However, thermal management during the heat generation by electromagnetic attenuation in metamaterials is not yet studied well. The present communication discusses the dielectric permittivities and loss parameters of aluminum nitride-single-wall carbon nanotube (AlN-SWCNT) composites considering high thermal conductivities of both materials. The composites are dense and have been prepared by a standard powder technological method using hot pressing at 1850 °C under a nitrogen atmosphere. Increase in the negative permittivity value with SWCNT concentration (1, 3, and 6 vol %) in the composites had been observed at low frequencies. Characterization of the materials with Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, and microstructure analysis by scanning and transmission electron microscopy (TEM) revealed the survivability of the SWCNTs and the nature of the matrix-filler interface. Plasmonic resonance following Drude's law could be observed at much lower plasma frequencies than that of pure SWCNT and for very little SWCNT addition. Exhibition of the negative permittivity has been explained with relation to the microstructure of the composites observed from field emission scanning electron micrographs (FESEM), TEM images, and the equivalent circuit model. High energy conversion efficiency is expected in these composites due to the possession of dual functionalities like high thermal conductivity as well as high negative permittivity, which should ensure the application of these materials in wave filter, cloaking device, supercapacitors, and wireless communication.

Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit.

INTRODUCTION: Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU. MATERIALS AND METHODS: A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU. RESULTS: A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68%) required mechanical ventilation, and 39 (55%) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7%) were admitted after cardiac arrest, and eight (57.1%) of them died in ICU. A total of 28 patients (39.4%) died in the hospital, and 18 (25.4%) died in ICU. CONCLUSION: Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses.

Factors influencing triage decisions in patients referred for ICU admission.

BACKGROUND: Few data is available on triage of critically ill patients. Because the demand for ICU beds often exceeds their availability, frequently intensivists need to triage these patients in order to equally and efficiently distribute the available resources based on the concept of potential benefit and reasonable chance of recovery. The objective of this study is to evaluate factors influencing triage decisions among patients referred for ICU admission and to assess its impact in outcome. METHODS: A single-center, prospective, observational study of 165 consecutive triage evaluations was conducted in patients referred for ICU admission that were either accepted, or refused and treated on the medical or surgical wards as well as the step-down and telemetry units. RESULTS: Seventy-one patients (43.0%) were accepted for ICU admission. Mean Acute Physiology and Chronic Health Evaluation (APACHE)-II score was 15.3 (0 - 36) and 13.9 (0 - 30) for accepted and refused patients, respectively. Three patients (4.2%) had active advance directives on admission to ICU. Age, gender, and number of ICU beds available at the time of evaluation were not associated with triage decisions. Thirteen patients (18.3%) died in ICU, while the in-hospital mortality for refused patients was 12.8%. CONCLUSION: Refusal of admission to ICU is common, although patients in which ICU admission is granted have higher mortality. Presence of active advance directives seems to play an important role in the triage decision process. Further efforts are needed to define which patients are most likely to benefit from ICU admission. Triage protocols or guidelines to promote efficient critical care beds use are warranted.