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We examined whether combining biomarkers measurements and brain images early after the return of spontaneous circulation improves prognostic performance compared with the use of either biomarkers or brain images for patients with cardiac arrest following target temperature management (TTM). This retrospective observational study involved comatose out-of-hospital cardiac arrest survivors. We analyzed neuron-specific enolase levels in serum (NSE) or cerebrospinal fluid (CSF), grey-to-white matter ratio by brain computed tomography, presence of high signal intensity (HSI) in diffusion-weighted imaging (DWI), and voxel-based apparent diffusion coefficient (ADC). Of the 58 patients, 33 (56.9%) had poor neurologic outcomes. CSF NSE levels showed better prognostic performance (area under the curve (AUC) 0.873, 95% confidence interval (CI) 0.749–0.950) than serum NSE levels (AUC 0.792, 95% CI 0.644–0.888). HSI in DWI showed the best prognostic performance (AUC 0.833, 95% CI 0.711–0.919). Combining CSF NSE levels and HSI in DWI had better prognostic performance (AUC 0.925, 95% CI 0.813–0.981) than each individual method, followed by the combination of serum NSE levels and HSI on DWI and that of CSF NSE levels and the percentage of voxels of ADC (AUC 0.901, 95% CI 0.792–0.965; AUC 0.849, 95% CI 0.717–0.935, respectively). Combining CSF/serum NSE levels and HSI in DWI before TTM improved the prognostic performance compared to either each individual method or other combinations.

Recently, there has been considerable interest in micro gyroscopes made of silicon chips. It can be applied to many micro-electro-mechanical systems (MEMS): devices for stabilization, general rate control, directional pointing, autopilot systems, and missile control. The mechanical design of the gyroscope is carried out using axiomatic design, followed by the application of the Taguchi robust design method to determine the dimensions of the parts so as to accommodate the dimensional variations during fabrication. Functional requirements are defined twofold. One is the natural frequencies should have fixed values, and the other is the system should be robust to large tolerances. According to the Independence Axiom, design parameters are classified into a few groups. Then, the detailed design process is performed according to the sequence indicated by the design matrix. The dimensions of the structure are determined to have constant values for the difference of frequencies regardless of the tolerances. It is noted that the Taguchi concept is utilized as a unit process of the entire axiomatic approach.