POPULARITY
Show Notes: https://thisdayinai.com/bookmarks/42-ep55SimTheory Claude Haiku Agent: https://simtheory.ai/agent/795-claude-haiku-chatbotSign up for daily AI news: https://thisdayinai.com====CHAPTERS00:00 - OpenAI CTO Mira Murati Sora Interview Train Wreck16:47 - EU Passes the AI Act 24:25 - 1 year since Greg Brockman Unveiled GPT-4 + Cognition's Devin52:34 - Anthropic Releases Claude 3: Haiku & It's REALLY GOOD!1:05:20 - DeepSeek-7B Real World Vision Language Understanding1:16:09 - It's all about the training data, why Tesla might win Robotics & Vision1:17:27 - Figure1 Robot with OpenAI for Vision and Language + Discussion on Robot Slavery====Please consider subscribing if you like the podcast! Thanks for listening.
Few patients. A scarcity of literature. Working in rare disease can feel like you're standing at the edge of an abyss with just a flashlight in your hand. And someone's life depends on you--Meet the doctors who spend their time searching for zebras, and find out what motivates them.Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.
When a baby girl is born with two broken femurs, doctors don't notice the bluish-grey discoloration of her sclera, her bowed and shortened legs, or her larger-than-normal head. And it will be months before they piece together the puzzleHead to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.
Host Matt Fisher's guest is Josh Wildstein, CEO of Figure1. Discussion topics include, using technology to build upon clinician engagement, the need to develop clear value proposition, enabling collaboration to solve problems or seek input, and incorporate collegiality to reflect in-person interactions; opportunity to promote health equity. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play HealthcareNOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
After a patient in his early 30s develops muscle weakness so severe he requires a wheelchair, he's diagnosed with multiple sclerosis, and starts treatment for the disease. But when a bone scan reveals multiple fractures, his physicians start to question their original diagnosis.Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.
Host Tom talks to Dr. Joshua Landy, CMO for Figure 1 and practicing critical care specialist. In 2012, Joshua was invited to become a visiting scholar at Stanford University, where he researched online and multimedia-oriented approaches to health education. Joshua serves as Figure 1's Chief Medical Officer and continues to practice medicine. Their discussion leads us to the value of Clinical Discussion Support (CDC) tools coupled with AI and how it can/will influence the delivery of care. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play HealthcareNOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen
A one-year old boy is brought to his doctor with a history of febrile seizures, odd movements, and developmental delay. His seizures continue, but the fevers stop. And doctors realize they're in a race against time.Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.
木原均先生と3倍体種無しスイカについて話しました。Show notes だらけとまみれの違い マルコ・ポーロ … 東方見聞録の人 マルコ・ポーロ … プールの鬼ごっこ 東方見聞録 ジパング 麺の起源 蕎麦粉のガレット ワクワク伝説 Trader Joe's NeuroRadio ピクルス味のポップコーン 種無しスイカがnon GMOなのか?という質問はお控えください。 サイケデリック・マッシュルームやその他のエンテジェニック植物の非犯罪化に向けての協議(サマービル市) … “サマービルは、マサチューセッツ州で初めて、サイケデリック・マッシュルームやその他のエンテジェニック植物の非犯罪化に向けて動き出しました。” しいな 西瓜 シークヮーサー … 小さい「ヮ」って存在するんですね。 スペースワールド H2 … あだち充先生の傑作漫画 木原均 木原均小伝 … 木原ゆり子さんによる回顧録 Kihara. Proc. Amer. Soc. Hort. Sci. (1951) … “Triploid Watermelons” 3倍体種無しスイカについて英語で発表した最初の論文 スイバ … XY染色体による性決定を行う。高等植物では珍しい。 48. XXXXXYYYYY … researchat.fm ep48ではスイバについても触れています。性と染色体について話しました。 ゲノム Hans Winkler … 1920年にゲノムを提唱 倍数性 多倍体 … 多倍体(polyploidy)というべきところを倍数体といってしまうの良くないですね… 木原均 メンデル コレンス、チェルマク、ド・フリース … 1900年にメンデルの法則を同時に再発見 ネーゲリ … 染色体を初期に発見した人。ネーゲリの細胞生物学への貢献はすさまじいのでまたいつかまとめたい。 フレミング … 染色体を初期に観察した人。クロマチンの名付け親。フレミングの法則のフレミングとは別人。 Sakamura. Shokubutsugaku zasshi (1918) … “Kurze Mitteilung über die Chromosomenzahlen und die Verwandt-schaftsverhältnisse der Triticum-Arten.” 坂村徹先生が小麦がn=7であることを発見した論文。 財団法人木原生物学研究所編 生研時報 … “西瓜に種子がなかったらとは従来多くの人たちの願望であった。ところが最近その希望にそう如く西瓜の種子を発達せしめず単位結果のみをせしむることに成功した。即ち種子をなくす二つの新技術を発見することができたのである。第一は植物ホルモン処理によって西瓜の単位結果を促す方法で(寺田・益田1938,1940,1941,1942)、第二は三倍体の不燃性を利用する方法である(寺田・益田1943)。” このことからも寺田・益田の研究が先んじていたことは明白であろう。ただ、木原ゆり子さんの手記には”しかし、前述の寺田、益田両氏、共同研究者の西山市三氏、近藤典生氏、阿久津昴氏など大勢の協力によって作出は成功した。”と書かれているので、お互い協力関係にあったことは想像できる。また、4倍体スイカの作成は「木原・山下 1939」と「寺田・益田1943」なので、木原・山下の方が先行しているようだ。詳しいことをご存知の方はご連絡ください。現状、弊チャンネルでは「木原均先生は世界で初めて種なしスイカの実用化に成功した」とします。 寺田甚七先生・益田健三先生 … この寺田先生と益田先生は寺田植物研究所で研究をしていたと、木原ゆり子さんの手記には書いてあった。お二人とも北大の出身のようです。 寺田・益田. 京都園芸 (1935) … 単為結実に依る無種子西瓜に就いて: 初めての種無しスイカに関する論文。 寺田・益田.京都園芸 (1938) ….単為結実に依る無核西瓜に就いて(続報):インドール酢酸を使用? 寺田・益田.農及園 (1943) ...三倍性による西瓜の単為結実に就いて:三倍体種無しスイカに関する初めての報告 Sugiyama et al., Hort. Res. (Japan) (2015) … 上記の寺田先生と益田先生の論文群に関しては、資料を読むことができなかったために、杉山先生の論文を参考にさせていただきました。 単位結果 子房 受粉 … 今回の話は「種子植物においては」と毎回注釈をつけるべきでした。 受精 ジベレリン ノウカノタネ ヒトの非科学を笑うな … ノウカノタネさんによるジベレリンの解説 胚珠 花粉と花粉粒 減数分裂 autosome … 常染色体のこと 自家不和合性 コルヒチン Bomblies et al., Chromosoma (2016) … “The challenge of evolving stable polyploidy: could an increase in “crossover interference distance” play a central role?”: 4倍体植物の減数分裂に関する解説。 南洋興発 国立遺伝学研究所 … 静岡県三島市にある遺伝学を中心とした研究所 遺伝研年報 … 1949年以降、毎年の年報が見られる。英語も毎年発行されている。 片山哲 ソメイヨシノ 遺伝研のさくら 大麻 29. Born to chat … researchat.fm ep29では通し矢について言及しています。 カラコルム Morishima et al., Heredity (2008) … “Meiotic hybridogenesis in triploid Misgurnus loach derived from a clonal lineage”: 三倍体ドジョウにおけるmeiotic hybridogenesisについて プロイディゲーム 染色体セットの数と組み合わせの変化は魚介類に何をもたらすか。… 上記のドジョウの減数分裂の研究も行われている北大荒井先生によるドジョウとギンブナの三倍体減数分裂の解説。まだまだ理解しきれていないので勉強させていただきます。Figure1にギンブナの三極紡錘体形成についての記述があります。めちゃくちゃワクワクしますね! ギンブナの減数分裂 … まいん先生の三倍体ギンブナクローンの解説 Stenberg and Saura. Cytogenetic and Genome Research (2013) … “Meiosis and its deviations in polyploid animals”: hybridogenesis, Kleptogenesis, Pre-equalizing hybrid meiosis, Meiotic hybridogenesisの解説。何が何だかわかりません。勉強します。 プラナリア Cebrià et al., Nature (2002) … “FGFR-related gene nou-darake restricts brain tissues to the head region of planarians” プラナリアのnoudarake(ndk)に関する論文 おもてうら さかさに見ても 変わらぬは 螺旋の巻きと 縄のよれ方 木原均 1974 “The History of the Earth is recorded in the Layers of its Crust; The History of all Organisms is inscribed in the Chromosomes.” Hitoshi Kihara (1946) … “地球の歴史は地層に、生物の歴史は染色体に刻まれている。” 木原均 (1946) Editorial notes 種無しスイカを食べるときには遺伝学に感謝しながらいただくことにします。種子は苦手ですが、フルーツは好きです、パイナップル以外は。(tadasu) 近場で種無しスイカが売ってないので、バナナを食べながら歴史に思いを馳せます。(coela)
“Code blue, unit 305. Code blue, unit 305.” After an 8-year-old boy with recurrent episodes of rhabdomyolysis is hospitalized for treatment of a rare inherited disease, his condition quickly deteriorates.Head to Figure1.com/ddx where you can find full show notes, photos, and speaker bios.
A 35-year-old man thought he had outgrown the rare disorder which he was diagnosed with as a child. But as his movement becomes increasingly limited, he realizes that he never escaped it, and now there's more than just his mobility at stake.Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
This week’s reading is Lenin’s Imperialism in the 21st Century, part 1.This is our first in a short run of selected chapters from this book.The full book is available online here:https://iboninternational.org/download/lenins-imperialism-in-the-21st-century/This week – Chapter 1The Second Century of Imperialism:Neoliberal “Globalization” and Permanent War Project of Monopoly Capitalby Antonio Tujan Jr.• Establishment of US Economic Hegemony after WWII until 1970s – 03:59• Crisis of Monopoly Capital and the Rise of Neoliberalism – 13:31• Production Globalization – 26:49• Crisis of Neoliberalization and the Downward Spiral of Depression and War – 35:06Acronyms (in alphabetical order)APEC: Asia-Pacific Economic CooperationASEAN: Association of Southeast Asian NationsEOI: Export-Oriented IndustrializationEPAs: Expanded Partnership AgreementsEU: European UnionFTA: Free Trade AgreementGATS: General Agreement on Trade in ServicesGATT: General Agreement on Tariffs and TradeGDP: Gross Domestic ProductIMF: International Monetary FundISI: Import-Substitution IndustrializationIBRD: International Bank for Reconstruction and Development, later became the World BankLIEO: Labor-Intensive Export OrientedMAI: Multilateral Agreement on InvestmentMIA: Multilateral Investment AgreementNAFTA: North American Free Trade AgreementNAMA: Non-Agricultural Market AccessNATO: North Atlantic Treaty OrganisationNIEs: Newly Industrializing EconomiesODA: Official Development AssistanceOECD: The Organisation for Economic Co-operation and DevelopmentQE: Quantitative EasingRCEP: Regional Comprehensive Economic PartnershipSADC: Southern African Development CommunitySAPs: Structural Adjustment ProgramsSEZs: Special Export ZonesTPPA: Transpacific Partnership AgreementTRIPS: Trade Related Aspects of Intellectual Property RightsTTIP: Transatlantic Trade and Investment PartnershipUK: United KingdomUN: United NationsUNCTAD: The United Nations Conference on Trade and DevelopmentUNDP: United Nations Development ProgramUNRRA: UN Relief and Rehabilitation AdministrationUS: United States (of America)USSR: Union of Soviet Socialist RepublicsWTO: World Trade OrganisationTables1 – 11:102 – 11:18Figures1 – 32:052 – 36:12Footnotes1. 04:06This section closely follows Harry Magdoff 1969.2. 06:42Magdoff 1969, 87.3. 07:48Nelson 1968, 11, quoted in Magdoff 1969.4. 08:15Eichengreen 2011.5. 12:51Ranis et al. 1974.6. 13:51Duménil and Levy 2004.7. 16:42Steger and Roy 2010.8. 17:13Lensink 1996.9. 21:53Williamson 1989.10. 24:20Humphreys 2001, 88‒101.11. 25:03Khor 1997.12. 27:02Credit for coining the term is often attributed to Theodore Levitt who used it in his article “Globalization of Markets,” in the May-June 1983 issue of the Harvard Business Review, though there are earlier uses.13. 28:20Tujan 1996, 10.14. 31:16Tujan 2010.15. 32:13Tujan and Verzola 2013.16. 32:52Tujan and Verzola 2013.17. 37:15Haldane 2015.18. 37:58Jubilee Debt Campaign 2017.
This week’s reading is Imperialism, the Highest Stage of Capitalism, part 8.by Vladimir Ilyich LeninThis is our final reading of the book, and next week we’ll start a short run of some modern readings on how Imperialism has developed to where we find ourselves today.Available online here: https://www.marxists.org/archive/lenin/works/1916/imp-hsc/imperialism.pdf[Part 1]I. Concentration of Production and Monopolies[Part 2]II. Banks and Their New Role[Part 3]III. Finance Capital and the Financial Oligarchy[Part 4]IV. Export of CapitalV. Division of the World Among Capitalist Associations[Part 5]VI. Division of the World Among the Great Powers[Part 6]VII. Imperialism as a Special Stage of Capitalism[Part 7]VIII. Parasitism and Decay of Capitalism[Part 8 – This Week]IX. Critique of Imperialism – 00:21X. The Place of Imperialism in History – 32:40Figures – Chapter 9 Critique of Imperialism:1 – 14:54“Export trade of Germany to countries financially dependent on and independent of it.”Footnotes – Chapter 9: Critique of Imperialism1. 04:03Weltwirtschaffliches Archiv, Bd. II, S. 193. —Lenin2. 06:18J. Patouillet, L’impérialisme américain, Dijon, 1904, p. 272. —Lenin3. 08:04Bulletin de l’Institut International deStatistique, T. XIX, Lvr. II, p. 225. —Lenin4. 09:33Kautsky, Nationalstaat, imperialistischer Staat und Staatenbund, Nürnberg, 1915, S. 72, 70. —Lenin5. 10:44Finance Capital, p. 567. —Lenin6. 17:38Die Bank, 1909, 2, S. 819 et seq. —Lenin7. 20:41Die Neue Zeit, April 30, 1915,S. 144. —Lenin8. 27:20David Jayne Hill, History of the Diplomacy in the International Development of Europe, Vol. I, p. X. —Lenin9. 28:04Schilder, op. cit., S. 178. —Lenin10. 30:45Finance Capital, p. 487. —LeninFootnotes – Chapter 10: The Place of Imperialism in History11. 45:54Grundriss der Sozialökonomik, S. 146. —Lenin
This week’s reading is Imperialism, the Highest Stage of Capitalism, part 7by Vladimir Ilyich LeninAvailable online here: https://www.marxists.org/archive/lenin/works/1916/imp-hsc/imperialism.pdf[Part 1]I. Concentration of Production and Monopolies[Part 2]II. Banks and Their New Role[Part 3]III. Finance Capital and the Financial Oligarchy[Part 4]IV. Export of CapitalV. Division of the World Among Capitalist Associations[Part 5]VI. Division of the World Among the Great Powers[Part 6]VII. Imperialism as a Special Stage of Capitalism[Part 7 – This Week]VIII. Parasitism and Decay of Capitalism[Part 8]IX. Critique of ImperialismX. The Place of Imperialism in HistoryFigures:1 – 15:22“Population in England and Wales, millions of workers in basic industries and percentage of the population that they make up.”Footnotes:1. 03:52Hobson, op. cit., pp. 59, 62. —Lenin2. 05:40Schulze-Gaevernitz, Britischer Imperialismus, S. 320 et seq. —Lenin3. 05:57Sartorius von Waltershausen, Das volkswirtschaftliche System, etc., Berlin, 1907, Buch IV. —Lenin4. 06:15Schilder, op. cit., S. 393. —Lenin5. 07:00Schulze-Gaevernitz, op. cit., S. 122. —Lenin6. 07:27Die Bank, 1911, 1, S. 10-11. —Lenin7. 12:14Hobson, op. cit., pp. 103, 205, 144, 335, 386. —Lenin8. 13:49Gerhard Hildebrand, Die Erschütterung der Industrieherrschaft und des Industriesozialismus, 1910, S. 229 et seq. —Lenin9. 16:40Schulze-Gaevernitz, Britischer Imperialismus S. 301. —Lenin10. 18:12Statistik des Deutschen Reichs, Bd. 211. —Lenin11. 18:28Henger, Die Kapitalsanlage der Franzosen, Stuttgart, 1913. —Lenin12. 18:42Hourwich, Immigralion and Labour, New York, 1913. —Lenin13. 20:46Briefwechsel von Marx und Engels, Bd. II, S. 290; 1V, 433—Karl Kautsky, Sozialismus und Kolonialpolitik, Berlin, 1907, S. 79; this pamphletwas written by Kautsky in those infinitely distant days when he was still a Marxist. —Lenin14. 23:21Russian social-chauvinism in its overt form, represented by the Potresovs, Chkenkelis, Maslovs, etc., and its covert form (Chkeidze, Skobelev, Axelrod, Martov, etc.) also emerged from the Russian variety of opportunism, namely, liquidationism. —Lenin
This week’s reading is Imperialism, the Highest Stage of Capitalism, part 6by Vladimir Ilyich LeninAvailable online here: https://www.marxists.org/archive/lenin/works/1916/imp-hsc/imperialism.pdf[Part 1]I. Concentration of Production and Monopolies[Part 2]II. Banks and Their New Role[Part 3]III. Finance Capital and the Financial Oligarchy[Part 4]IV. Export of CapitalV. Division of the World Among Capitalist Associations[Part 5]VI. Division of the World Among the Great Powers[Part 6 – This Week]VII. Imperialism as a Special Stage of Capitalism[Part 7]VIII. Parasitism and Decay of Capitalism[Part 8]IX. Critique of Imperialism[Part 9]X. The Place of Imperialism in HistoryFigures:1 – 18:55“Breakdown of the area, population, transport, trade and industry of each of the five principle economic areas in 1890 and 1913.”2 – 22:24“000s of kilometres of railways for Europe, the US, all colonies, independent and semi-independent states of Asia and America in 1890 and 1913,”3 – 23:55“000s of kilometres of railways for the US, the British Empire, Russia, Germany and France in 1890 and 1913.”Footnotes:1. 08:08Die Neue Zeit, 1914, 2 (B. 32), S. 909, Sept. 11, 1914; cf. 1915, 2, S. 107 et seq. —Lenin2. 11:13Hobson, Imperialism, London, 1902, p. 324. —Lenin3. 15:29Die Neue Zeit, 1914, 2 (B. 32), S. 921, Sept. 11, 1914. Cf. 1915, 2, S. 107 et seq. —Lenin4. 15:51Ibid., 1915, 1, S. 144, April 30, 1915. —Lenin5. 17:57R. Calwer, Einfü hrung in die Weltwirtschaft, Berlin, 1906. —Lenin6. 22:09Statistisches Jahrbuch für das deutsche Reich, 1915; Archiv für Eisenbahnwesen, 1892. Minor details for the distribution of railways among the colonies of the various countries in 1890 had to be estimated approximately. —Lenin7. 25:31Cf. also Edgar Crammond, “The Economic Relations of the British and German Empires” in The Journal of the Royal Statistical Society, July 1914, p. 777 et seq. —Lenin
A routine surgery leads to a puzzling reaction. Is more surgery required, or is it something else? Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
A common skin condition affects much more than a patient’s skin, and misinformation only exacerbates the stigma. This episode is brought to you by Novartis Pharmaceuticals Corporation. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
A dermatologist is paged to examine a rare condition. But something doesn’t add up. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
While skin findings can sometimes help with a diagnosis, they can also distract from other undiagnosed symptoms. This episode is brought to you by Novartis Pharmaceuticals Corporation. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
What do you do when faced with a set of symptoms that has two contradictory courses of treatment? Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
Unconscious bias can run so deep that patients and doctors alike can miss a potentially fatal diagnosis. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
A patient presents with fever, swollen digits, and skin "the color of a red delicious apple." She’s been scratching so hard that she’s bleeding through her shirt. What’s going on? This episode is brought to you by Novartis Pharmaceuticals Corporation. Head to Figure1.com/ddx, where you can find full show notes, photos, and speaker bios.
As DDx gets ready to launch season two, we're re-releasing our first season. A young man’s near-death experience results in a very puzzling diagnosis on the season finale of DDx. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.
As DDx gets ready to launch season two, we're re-releasing our first season. A patient with an acute subdural hematoma presents with no sign of head trauma. The search for an answer almost overlooks an obvious question. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.
As DDx gets ready to launch season two, we're re-releasing our first season. A patient says she feels fine. A quick-thinking doctor arrives at a dire and uncommon diagnosis. Then it happens again. And again. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.
As DDx gets ready to launch season two, we're re-releasing our first season. Chronic vomiting, a flushed complexion, and acute agitation: can cannabis be the cause? A growing consensus among doctors suggests cannabinoid hyperemesis syndrome is real and on the rise. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.
As DDx gets ready to launch season two, we're re-releasing our first season. A young woman is almost misdiagnosed — perhaps fatally — when she presents at an E.R. with nausea, vomiting, and myalgia. For related photos, medical cases and links to pertinent research, visit Figure1.com/ddx.
心脏骤停患者的福音: ——建设多科室合作的体外肺膜氧合(ED ECMO)项目可显著提高患者神经有利性生存机率 Despite advances inthe medical and surgical management of cardiovascular disease, greater than350,000 patients experience out-of-hospital cardiac arrest in the United Statesannually, with only a 12% neurologically favorable survival rate. Of these patients,23% have an initial shockable rhythm of ventricular fibrillation/pulselessventricular tachycardia (VF/VT), a marker of high probability of acute coronaryischemia (80%) as the precipitating factor. However, few patients (22%) willexperience return of spontaneous circulation and sufficient hemodynamicstability to undergo cardiac catheterization and revascularization. Previous case series and observationalstudies have demonstrated the successful application of intra-arrestextracorporeal life support, including to out-of-hospital cardiac arrestvictims, with a neurologically favorable survival rate of up to 53%. Forpatients with refractory cardiac arrest, strategies are needed to bridge themfrom out-of-hospital cardiac arrest to the catheterization laboratory andrevascularization. To address this gap, we expanded our ICU and perioperativeextracorporeal membrane oxygenation (ECMO) program to the emergency department(ED) to reach this cohort of patients to improve survival. 尽管人类在心血管疾病的医学和外科治疗上取得了进展,但美国每年仍有超过350000名患者经历了院外心脏骤停,且对神经系统预后有利的存活率只有12%。其中23%的患者具有室颤或者无脉性室性心动过速(VF/VT)的初始可电击心律,这有80%的机率诱发急性冠状动脉缺血,因此可作为其发病的标志。 然而,很少有患者(22%)会经历自主循环恢复以及拥有足够的血液动力学稳定性来进行心脏导管术和血运重建。过往病例分析和观察性研究已经证明内骤停后成功应用体外生命支持的患者,包括院外心脏骤停患者,可以将对神经系统预后有利生存率提高到53%。 对于难治性心脏骤停患者,需要采取的策略是将他们从院外心脏骤停与导管室以及血运重建连接起来。为了缩小这一差距,该研究团队提倡将ICU和围术期应用体外膜肺氧合(ECMO)的项目扩展到急诊科(ED),以期提高患者的生存率。 A primary goal of this program was thedevelopment of a multidisciplinary system to coordinate patient care acrossmultiple silos within our medical system, ranging from emergency medicalservices (EMS), emergency department (ED), cardiac catheterization laboratory,cardiothoracic surgery, and ICU. The author strongly believes thatmultidisciplinary support is essential for good outcomes, and the team observedthat their multidisciplinary program resulted in a high rate of successfulinitiation of ECMO during cardiac arrest in the ED. This article primallyintroduces the research team's experience of design and implementation of acomprehensive and multidisciplinary program of ED ECMO as a template forinstitutions interested in building their own ED ECMO programs. 该项目的主要目标是开发一个多科室系统,用以协调医疗系统内多个科室的患者护理,包括紧急医疗服务(EMS),急诊科(ED),心导管室,心胸外科和重症监护室(ICU)。 作者认为多学科支持对能否取得良好的治疗效果至关重要,并且发现他们开展的多科室合作项目能提高急诊科对心脏骤停患者实施ECMO的成功率。本文主要介绍作者及其团队开展综合性且多科室合作的ED ECMO流程,以此作为其他机构有意建立ED ECMO项目的实施模板。 The process about ED ECMO program carried outin the University of Utah is showed in the Figure1. The program has evaluationand activation levels with associated page groups. The “EVAL” page is initiatedby the ED charge nurse in conjunction with the ED attending physician; theyreceive base calls from EMS and identify any patients who meet the inclusioncriteria. The EVAL page goes out before patient arrival and includes the cardiothoracicsurgeon on call, the in-house cardiovascular ICU intensivist, theinterventional cardiologist, the cardiovascular ICU charge nurse or ECMO chargenurse, the house supervisor, and the ED echocardiography group. Meanwhile, thepreparation for ED resuscitation room should be completed. 图1展示了作者及其团队在犹他大学开展的ED ECMO项目的流程。该项目具有评估和激活水平的相关页面。“EVAL”页面由ED护士长与ED主治医师共同管理;他们接受来自EMS的调用,并确定符合标准的患者。 EVAL页面在患者到来之前将被发送给待命的心胸外科医生,心血管重症监护室专科医生,心内科医生,心血管重症监护室护士长或者ECMO护士长,医院主管以及ED心脏超声组。同时,应完成ED复苏室的准备工作。 For the process to move from evaluation toactivation, confirmation of the availability of a cardiovascular ICU chargenurse or ECMO charge nurse (both bed and staffing availability),a catheterization laboratory bythe interventional cardiologist, and a cardiothoracic surgeon for initialcannulation should be made. All 3 individuals must agree on the appropriatenessof the patient for ECMO. Once determination of candidate appropriateness ismade, the second-tier activation process activates the catheterizationlaboratory and anesthesia. Then the ECMO for patients start to be performed. 流程由评估阶段进入激活阶段,心血管重症监护室护士长或者ECMO护士长以及床位与人力资源的可用性需要得到确认,导管室的可用性由心脏病介入治疗专家确认,以及负责患者初始穿刺的心胸外科医生可用性需要得到确认。以上3个人必须就患者是否适合实施ECMO达成一致。 一旦确定候选人符合要求,第二层激活程序激活导管室和麻醉室。然后对患者实施ECMO治疗。 Once flow is adequate, vasopressors andinotropes are adjusted and the patient is transported to the catheterizationlaboratory for angiography, assessment of left ventricular function withdecompression (as needed), and establishment of distal limb perfusion. 一旦患者血流量充足,调整血管加压剂和强心剂的使用量,并将患者转移到导管室进行血管造影,通过减压(根据需要)评估左心室功能,并建立远端肢体灌注。 On arrival in the cardiovascular ICU,patients are managed at the bedside by an ECMO-trained charge nurse, withdirection from the ICU intensivist and cardiothoracic surgeon. We attempt towean ECMO during 3 to 7 days, or as rapidly as possible, to achieve an“ECMO-free” assessment of patients' postarrest cardiac and neurologic function.Neurology and neurocritical care consultants provide neuroprognostication,which, for patients not waking up spontaneously. 患者转到心血管重症监护室后,由接受培训的ECMO护士长在重症监护室特护医生和心胸外科医生指导下进行临床护理。我们尽可能快地在3至7天内停止ECMO治疗,以实现对患者心脏和神经功能的“无ECMO”评估。对于不自发醒来的患者,神经病学和神经临床护理顾问提供神经损伤的评估。 The value of an ED ECMO program lies in theability to temporally bridge the patient with adequate organ perfusion to atherapeutic intervention, such as percutaneous coronary intervention. Without aclear therapeutic goal and interventions to achieve it, the application of EDECMO adds only cost and prolongation of the end of life. Conversely, theappropriate measured application of ED ECMO to select victims ofout-of-hospital cardiac arrest in conjunction with practiced efforts to reversethe inciting cause of arrest may offer one of greatest possible increases insurvival of any bundled medical therapy. ED ECMO项目的价值在于能够通过适当的器官灌注暂时性地将患者桥接到干预性治疗,如冠脉介入治疗。如果没有明确的治疗目标和干预措施,ED ECMO的应用只是增加了成本和推迟患者死亡的期限。相反,采用合适的标准选择院外心脏骤停患者进行 ED ECMO 治疗,再辅以熟练的技巧可以逆转造成心脏骤停的病因,从而有可能得到医药配合治疗下最大的生存率提高。 Annals of EmergencyMedicine: Development and Implementation of a Comprehensive, MultidisciplinaryEmergency Department Extracorporeal Membrane Oxygenation Program. 想收听更多医学前沿咨询,欢迎下载医阶APP,不仅有顶尖医师的临床分享,还有行业大咖的病例解析。
It seems like all we hear about today is disruption, disruption, disruption. Everybody is disrupting something -- from Transportation to Hospitality -- all anyone wants to do is blow everything up. So what is the difference between Disruption and Innovation? Well, Disruptors are innovators, but not all innovators are disruptors. Disruption and Innovation are often different sides of the same coin. Today we explore how companies are approaching innovation and disruption in the Healthcare industry. We talk with Joshua Landry of Figure1 and Sasha Bhatia, the Director of Women’s College Hospital Institute for Health System Solutions and Virtual Care in Toronto. Learn more about your ad choices. Visit megaphone.fm/adchoices
On this episode of The Backbone, I chat with Trisha about: - Her path into health and technology after starting her career at PwC, and moving to CAMH - the Centre for Addiction and Mental Health before jumping into tech and at her current role as Finance Manager at Figure1. - Figure1 and what it's all about. - The most important metrics to track for the largest crowd-sourced medical platform and how to correlate non-financial metrics into financial outcomes. - The challenges of balancing ad-load and monetizing through sponsored content. - The importance of the finance function at a technology company. We close things off with a quickfire round: - Your go to online resource for all things startup finance related - Your favourite productivity hack - Tech jargon that makes you cringe - The best advise you've received - One thing you don't leave the office before finishing --- Send in a voice message: https://anchor.fm/backbone/message
A 19-year-old with sickle cell disease is well-known to ER doctors as a "frequent flyer". Every time they see her it's due to chronic pain related to her disease. Except for the one time it isn't. For related photos, medical cases and links to research on cognitive bias, visit Figure1.com/DDx
It seems like all we hear about today is disruption, disruption, disruption. Everybody is disrupting something -- from Transportation to Hospitality -- all anyone wants to do is blow everything up. So what is the difference between Disruption and Innovation? Well, Disruptors are innovators, but not all innovators are disruptors. Disruption and Innovation are often different sides of the same coin. Today we explore how companies are approaching innovation and disruption in the Healthcare industry. We talk with Joshua Landry of Figure1 and Sasha Bhatia, the Director of Women’s College Hospital Institute for Health System Solutions and Virtual Care in Toronto. Learn more about your ad choices. Visit megaphone.fm/adchoices
In part two of the series, Josh Landy, discusses why he co-founded the social photo sharing platform for medicine, Figure1, which offers a visually-engaging and privacy-compliant educational experience for med school and beyond. You should definitely use it on the wards, in preparing for the USMLE or COMLEX, to share your own cases and to participate in the Figure 1 community by commenting and viewing other medical cases. Leave a review of the show on iTunes for your chance to win a Figure1 "Swag Bag." Just send a screenshot to info@insidetheboards.com to enter this episode's contest. And check out the show notes page at https://www.insidetheboards.com/episode021 for more great content. Music courtesy of Tom Dutton, Forgive Durden, "Life is Looking Up."
In part one of the series, Figure1 founder, Josh Landy discusses medical education in Canada and offers a preview of why he founded the social photo sharing platform for medicine, Figure1. Figure1 offers a visually-engaging and privacy-compliant educational experience. And it's all free. Leave a review of the show on iTunes for your chance to win a Figure1 "Swag Bag." Just send the screenshot to info@insidetheboards.com to enter this episode's contest. And check out the show notes page at insidetheboards.com/episode021 for more great content. Music courtesy of Tom Dutton, Forgive Durden, "Life is Looking Up."
A great podcast with the Chief Medical Officer at Figure1.