In a single academic medical center study, implementation of a tele-ICU intervention was associated with reduced adjusted odds of mortality and reduced hospital length of stay, as well as with changes in best practice adherence and lower rates of preventable complications.
Abstract-Digital fingerprinting is a method for protecting digital data in which fingerprints that are embedded in multimedia are capable of identifying unauthorized use of digital content. A powerful attack that can be employed to reduce this tracing capability is collusion, where several users combine their copies of the same content to attenuate/remove the original fingerprints. In this paper, we study the collusion resistance of a fingerprinting system employing Gaussian distributed fingerprints and orthogonal modulation. We introduce the maximum detector and the thresholding detector for colluder identification. We then analyze the collusion resistance of a system to the averaging collusion attack for the performance criteria represented by the probability of a false negative and the probability of a false positive. Lower and upper bounds for the maximum number of colluders max are derived. We then show that the detectors are robust to different collusion attacks. We further study different sets of performance criteria, and our results indicate that attacks based on a few dozen independent copies can confound such a fingerprinting system. We also propose a likelihood-based approach to estimate the number of colluders. Finally, we demonstrate the performance for detecting colluders through experiments using real images.
Sudden unexpected death in epilepsy (SUDEP) is a devastating epilepsy complication. Seizure-induced respiratory arrest (S-IRA) occurs in many witnessed SUDEP patients and animal models as an initiating event leading to death. Thus, understanding the mechanisms underlying S-IRA will advance the development of preventive strategies against SUDEP. Serotonin (5-HT) is an important modulator for many vital functions, including respiration and arousal, and a deficiency of 5-HT signaling is strongly implicated in S-IRA in animal models, including the DBA/1 mouse. However, the brain structures that contribute to S-IRA remain elusive. We hypothesized that the dorsal raphe (DR), which sends 5-HT projections to the forebrain, is implicated in S-IRA. The present study used optogenetics in the DBA/1 mouse model of SUDEP to selectively activate 5-HT neurons in the DR. Photostimulation of DR 5-HT neurons significantly and reversibly reduced the incidence of S-IRA evoked by acoustic stimulation. Activation of 5-HT neurons in the DR suppressed tonic seizures in most DBA/1 mice without altering the seizure latency and duration of wild running and clonic seizures evoked by acoustic stimulation. This suppressant effect of photostimulation on S-IRA is independent of seizure models, as optogenetic stimulation of DR also reduced S-IRA induced by pentylenetetrazole, a proconvulsant widely used to model human generalized seizures. The S-IRA-suppressing effect of photostimulation was increased by 5-hydroxytryptophan, a chemical precursor for 5-HT synthesis, and was reversed by ondansetron, a specific 5-HT receptor antagonist, indicating that reduction of S-IRA by photostimulation of the DR is specifically mediated by enhanced 5-HT neurotransmission. Our findings suggest that deficits in 5-HT neurotransmission in the DR are implicated in S-IRA in DBA/1 mice, and that targeted intervention in the DR is potentially useful for prevention of SUDEP.
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