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The following are specific diseases, conditions, and clinical syndromes commonly managed by a neurointensivist:
A. Cerebrovascular Diseases
1. Infarction and ischemia
• Massive hemispheric infarction
• Basilar artery occlusion and stenosis
• Carotid artery occlusion and stenosis
• Crescendo TIAs
• Occlusive vasculopathies (Moya-Moya, sickle cell)
• Spinal cord infarction
2. Intracerebral hemorrhage
• Supratentorial
• Cerebellar
• Brainstem
• Intraventricular
3. Subarachnoid hemorrhage - aneurysmal and other Vascular malformations
• Arteriovenous malformations
• AV fistulas
• Cavernous malformations
• Developmental venous anomalies
4. Dural sinus thrombosis
5. Carotid-cavernous fistulae
6. Cervical and cerebral arterial dissections
1. Traumatic brain injury
• "Diffuse axonal injury"
• Epidural hematoma
• Subdural hematoma
• Skull fracture
• Contusions and lacerations
• Penetrating craniocerebral injuries
• Traumatic subarachnoid hemorrhage
2. Spinal cord injury
• Traumatic injury (transection, contusion, concussion)
• Vertebral fracture and ligamentous instability
C. Disorders, Diseases, Seizures, and Epilepsy
1 . Seizures and epilepsy
• Status epilepticus (SE) Convulsive
Non-convulsive (partial-complex and "subtle" secondarily generalized SE) Myoclonic
2. Neuromuscular diseases
• Myasthenia gravis
• Guillain-Barre syndrome
• Rhabdomyolysis and toxic myopathies
• Critical illness myopathy and neuropathy
3. Infections
• Encephalitis (viral, bacterial, parasitic)
• Meningitis (viral, bacterial, parasitic)
• Brain and spinal epidural abscess
4. Toxic-metabolic disorders
• Neuroleptic malignant syndrome/malignant hyperthermia
• Serotonin syndrome
• Drug overdose and withdrawal (e.g., barbiturates, narcotics, alcohol, cocaine, acetaminophen).
• Temperature related injuries (hyperthermia, hypothermia)
5. Inflammatory and demyelinating diseases
• Multiple sclerosis (Marburg variant, transverse myelitis)
• Neurosarcoidosis
• Acute disseminated encephalomyelitis (ADEM)
• CNS vasculitis
• Chemical or sterile meningitis (i.e. posterior fossa syndrome, NSAID induced)
• Central pontine myelinolysis
• Others
6. Neuroendocrine disorders
• Pituitary apoplexy
• Diabetes insipidus (including triple phase response)
• Panhypopituitarism
• Thyroid storm and coma
• Myxedema coma
• Addisonian crisis
D. Neuro-oncology
1 . Brain tumors and metastases
2. Spinal cord tumors and metastases
3. Carcinomatous meningitis
4. Paraneoplastic syndromes
1. Eclampsia, including HELLP Syndrome
2. Hypertensive encephalopathy
3. Hepatic encephalopathy
4. Uremic encephalopathy
5. Hypoxic-ischemic and anoxic encephalopathy
F.Clinical syndromes
2. Herniation syndromes with monitoring & ICP
3. Elevated intracranial pressure and Intracranial hypotension/hypovolemia
4. Hydrocephalus detection & treatment
5. Cord compression
6. Death by neurologic criteria, end of life issues, and organ donation
7. Vegetative state
8. Dysautonomia (cardiovascular instability, central fever, hyperventilation)
9. Reversible posterior leukoencephalopathy
10. Psychiatric emergencies (psychosis)
G. Perioperative Neurosurgical Care
II. General Critical Care: Pathology, Pathophysiology, and Therapy
A. Cardiovascular Physiology, Pathology, Pathophysiology, and Therapy
1. Shock (hypotension) and its complications (vasodilatory and cardiogenic)
2. Myocardial infarction and unstable coronary syndromes
3. Neurogenic cardiac disturbances (ECG changes, stunned myocardium)
4. Cardiac rhythm and conduction disturbances; use of antiarrhythmic medications; indications for and types of pacemakers
5. Pulmonary embolism
6. Pulmonary edema: cardiogenic versus noncardiogenic (including neurogenic)
7. Acute aortic and peripheral vascular disorders (dissection, pseudoaneurysm)
8. Recognition, evaluation and management of hypertensive emergencies and urgencies
9. Calculation of derived cardiovascular parameters, including systemic and pulmonary vascular resistance, alveolararterial gradients, oxygen transport and consumption
B.Respiratory Physiology, Pathology, Pathophysiology and Therapy
1.Acute respiratory failure
• Hypoxemic respiratory failure (including ARDS)
• Hypercapnic respiratory failure
• Neuromuscular respiratory failure
2. Aspiration
3. Bronchopulmonary infections
4. Upper airway obstruction
5. COPD and status asthmaticus, including bronchodilator therapy
6. Neurogenic breathing patterns (central hyperventilation, Cheyne-Stokes respirations)
7. Mechanical ventilation
• Positive pressure ventilation (BIPAP)
• PEEP, CPAP, inverse ratio ventilation, pressure support ventilation, pressure control, and non- invasive ventilation
• Negative pressure ventilation
• Barotrauma, airway pressures (including permissive hypercapnia)
• Criteria for weaning and weaning techniques
8. Pleural Diseases
• Empyema
• Massive effusion
• Pneumothorax
9. Pulmonary hemorrhage and massive hemoptysis
10. Chest X-ray interpretation
11. End tidal C02 monitoring
12. Sleep apnea
13. Control of breathing
C. Renal Physiology,Pathology, Pathophysiology and Therapy
1.Renal regulation of fluid and water balance and electrolytes
2.Renal failure: Prerenal, renal, and postrenal
3.Derangements secondary to alterations in osmolality and electrolytes
4. Acid-base disorders and their management
5.Principles of renal replacement therapy
6. Evaluation of oliguria and polyuria
7.Drug dosing in renal failure
8. Management of rhabdomyolysis
9. Neurogenic disorders of sodium and water regulation (cerebral salt wasting and SIADH).
D. Metabolic and Endocrine Effects of Critical Illness
1. Enteral and parenteral nutrition
2. Endocrinology
• Disorders of thyroid function (thyroid storm, myxedema coma, sick euthyroid syndrome)
• Adrenal crisis
• Diabetes mellitus
Ketotic and hyperglycemic hyperosmolar coma Hypoglycemia
3. Disorders of calcium and magnesium balance
4. Systemic Inflammatory Response Syndrome (SIRS)
5. Fever, thermoregulation, and cooling techniques
E.Infectious Disease Physiology, Pathology, Pathophysiology and Therapy
1. Antibiotics
• Antibacterial agents
• Antifungal agents
• Antituberculosis agents
• Antiviral agents
• Antiparasitic agents
2. Infection control for special care units
• Development of antibiotic resistance
• Universal precautions
• Isolation and reverse isolation
3. Tetanus and botulism
4. Hospital acquired and opportunistic infections in the critically ill
5. Acquired Immune Deficiency Syndrome (AIDS)
6. Evaluation of fever in the ICU patient
7. Central fever
8. Interpretation of antibiotic concentrations, sensitivities
F.Physiology, Pathology, Pathophysiology and therapy of Acute Hematologic Disorders
1 . Acute defects in hemostasis
• Thrombocytopenia, thrombocytopathy
• Disseminated intravascular coagulation
• Acute hemorrhage (GI hemorrhage, retroperitoneal hematoma)
• Iatrogenic coagulopathies (warfarin and heparin induced)
2. Anticoagulation and fibrinolytic therapy
3. Principles of blood component therapy (blood, platelets, FFP)
4. Hemostatic therapy (vitamin K, aminocaproic acid, protamine, factor VIla)
5. Prophylaxis against thromboembolic disease
6. Prothrombotic states
G. Physiology, Pathology, Pathophysiology and Therapy of Acute Gastrointestinal (GI) and Genitourinary (GU)
1. Upper and lower gastrointestinal bleeding
2. Acute and fulminant hepatic failure (including drug dosing)
3. Ileus and toxic megacolon
4. Acute perforations of the gastrointestinal tract
5. Acute vascular disorders of the intestine, including mesenteric infarction
6. Acute intestinal obstruction, volvulus
7. Pancreatitis
8. Obstructive uropathy, acute urinary retention
9. Urinary tract bleeding
H. Immunology and Transplantation
1. Principles of transplantation (brain death, organ donation, procurement, maintenance of organ donors, implantation)
2. Immunosuppression, especially the neurotoxicity of these agents
I. General Trauma and Burns
1. Initial approach to the management of multisystem trauma
2. Skeletal trauma including the spine and pelvis
3. Chest and abdominal trauma - blunt and penetrating
4. Burns and electrical injury
J. Monitoring
1. Neuromonitoring
2. Prognostic, disease severity and therapeutic intervention scores
3. Principles of electrocardiographic monitoring
4. Invasive hemodynamic monitoring
5. Noninvasive hemodynamic monitoring
6. Respiratory monitoring (airway pressure, intrathoracic pressure, tidal volume, pulse oximetry, dead space, compliance, resistance, capnography)
7. Metabolic monitoring (oxygen consumption, carbon dioxide production, respiratory quotient)
8. Use of computers in critical care units for multimodality monitoring
K. Administrative and Management Principles and Techniques
1. Organization and staffing of critical care units
2. Collaborative practice principles, including multidisciplinary rounds and management
3. Emergency medical systems in prehospital care
4. Performance improvement, principles and practices
5. Principles of triage and resource allocation, bed management
6. Medical economics: health care reimbursement, budget development
L. Ethical and Legal Aspects of Critical Care Medicine
1. Death and dying
2. Forgoing life-sustaining treatment and orders not to resuscitate
3. Rights of patients, the right to refuse treatment
4. Living wills, advance directives; durable power of attorney
5. Terminal extubation and palliative care
6. Rationing and cost containment
7. Emotional management of patients, families and caregivers
8. Futility of care and the family in denial
M. Principles of Research in Critical Care
1. Study design
2. Biostatistics
3. Grant funding and protocol writing
4. Manuscript preparation
5. Presentation preparation and skills
6. Institutional Review Boards and HIPAA
Ill. Procedural Skills
A. General Neuro-Critical Care
1 . Central venous catheter placement; dialysis catheter placement
2. Pulmonary artery catheterization
3. Management of mechanical ventilation, including CPAP/BiPAP ventilation
4. Administration of vasoactive medications (hemodynamic augmentation and hypertension lysis)
5. Maintenance airway and ventilation in nonintubated, unconscious patients
6. Interpretation and performance of bedside pulmonary function tests
7. Direct laryngoscopy
8. Endotracheal intubation
9. Shunt and ventricular drain tap for CSF sampling
10. Performance and interpretation of transcranial Doppler
11. Administration of analgosedative medications, including conscious sedation and barbiturate anesthesia
12. Interpretation of continuous EEG monitoring
13. Interpretation and management of ICP and CPP data
14. Jugular venous bulb catheterization
15. Interpretation of Sjv02 and Pbt02 data
16. Management of external ventricular drains
I 7. Management of plasmapheresis and IVIG
18. Administration of intravenous and intraventricular thrombolysis
19. Interpretation of CT and MR standard neuroimaging and perfusion studies and biplane contrast neuraxial angiography
20. Perioperative and postoperative clinical evaluation of neurosurgical and interventional neuroradiology patients
21. Performance of lumbar puncture and interpretation of cerebrospinal fluid results
22. Induction and maintenance of therapeutic coma and hypothermia

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How the armed forces can get more out of artificial intelligence | NCC PDF Dumps and Real test Questions

The country wide safety commission on artificial Intelligence (NSCAI) has been busy in exact months, accurately. The stakes are excessive in the event you seem to be at the function artificial intelligence will play at nearly every stage of countrywide safety within the years ahead. To underestimate the have an effect on of AI on their nation’s security and protection is to accomplish that at wonderful risk. The biggest possibility would be to forget the recruitment, retention and working towards of elite human warfighters who will drive the a hit deployment of AI.

Like many in the fields of operations research, analytics, and information science, we've been intently following the work and suggestions of the NSCAIΒ  with a eager and specific eye as veterans. we've served as each officers within the operational forces (Navy helicopters, military air defense artillery and Navy floor war respectively) and as analysts. absolutely everyone participated in the armed forces services’ development and execution of analysis to e-book countrywide defense method as well.

Now they look at from outside the working analytical levels of executive and strongly assert the significance that each one sectors of society have interaction with the arrival age of AI.

The military, most of all, ought to remain proficient and develop into the masters of AI as a substitute of training to be its servants. to accomplish this, there has to be adequate proficient talent in uniform to take into account how operation and conception of latest and future systems work, and how they fail. Many AI techniques found in commerce are developed, deployed and developed incrementally as extra adventure is gained. in the protection assemble, these methods will actually be tested for the first time beneath fire. These carrier contributors may have an magnificent quantity of leverage as to the effect – success or failure – of future wars. The influence of a single AI knowledgeable sooner or later might also eclipse even that of the combatant commander.

who're the β€˜actual warriors’?

the arriving revolution in choice centric conflict requires an intensive re-examination of real warrior ethos. The military functions are cultural agencies, and there is, as one could expect, resistance to the thought that so-called β€˜techno nerds’ share status with jet pilots and infantrymen. the earlier they get previous this, the better off – and more relaxed – they can be. devoid of cultural acceptance, the proper talent will continue to disappear in spite of economic and different incentives.

at present, there is unbounded help in the branch of defense for β€œall things AI.”  satirically, there's little assist for concentrated strategies to entice and maintain required skill. with out developing promoting paths to senior degrees (generally flag/regular rank), the profession paths within the current system will in the end fail.

despite the fact the services have the technical mechanisms presently in place to create uniformed warfighters in records analytics and AI, they see a gentle decrease in the variety of operationally experienced officers sent to those courses. decreased creation has elevated the demand on these people in the service, and their marketability in the civilian sector. there is a need to make defense force and civil profession fields more porous in the experience that AI consultants need to be in a position to move in and out of government and a digital provider academy might assist with that.

check in for the Air force times daily news Roundup

do not miss the exact Air drive studies, delivered each afternoon



Three offsets and two profession paths

It might be helpful, when thinking about manpower for AI, to believe the ways that β€˜offset recommendations’ have changed the branch of protection as a whole. since the relationship between executive and industry, the first offset is inherently governmental, with non-govt trade playing a very small function, if any. The 2nd offset was govt-led, with business following carefully behind. The third offset is diverse in that industry is, at worst, coequal with executive, and in many areas seemingly ahead. This change ought to practice no longer simply to the technologies themselves, however also the individuals involved in constructing and operationalizing them. for this reason, to have valuable AI leadership, uniformed members could need to spend time each in and out of uniform.

Create analytic flags

The uniformed capabilities are very a whole lot just like the relaxation of society in that success follows success. In academia, this is measured through promotions – positional or rank based mostly – and publications. In company, success is measured via each technical and non-technical promotions and earnings.

in the military, success is also measured by way of promotions, certainly to flag rank (regular or admiral).Β  Admittedly, each of the provider analytic agencies have flag officers and/or senior civilians who're answerable for them and act nominally as the recommend; besides the fact that children, it is uncommon – however now not unprecedented – that the recommend for evaluation is themselves an analyst. The advent of analytic flags who're each the product and proponent of their neighborhood will reveal both the viability of the career and provide appropriate-degree mentorship for the group as an entire. this may create individuals who are the de facto leaders of their group with the horsepower to shepherd it.

Some steps within the correct route

In early 2019, the army activated the AI task force, making an attempt to follow the contemporary strategies from NSCAI, to deliver a bunch of biological, knowledgeable degree developers and in the reduction of reliance on contractors.

The Navy’s personal effort at this came within the variety of the Operations evaluation area of expertise profession softwareΒ  which begun in 2011 and comfortably ended in 2019.

The U.S. Air drive recently moved their operations analysis evaluation strong point code from the acquisition and monetary management field to a newly created 15A area of expertise code positioning officers to supply direct guide to operations and senior operational commanders.

What else must be finished

These are solid steps, but to reach AI’s full talents, organizational changes to capture, cost and boost the twenty first century warfighter should be made. That warfighter should take into account the underlying mathematics at the back of the decision algorithms, their strengths, limitations and assumptions; and if fundamental, be in a position to adjust these algorithms to satisfy rising challenges. Likewise, they ought to be capable of attack adversary AI techniques and guard their personal from misdirection. As they movement ahead into the robotics age of struggle, warfighting techniques requiring people will develop into now not most effective much less significant however will also pose a chance to the operational commander when employed. for this reason, the minds of the twenty first century warfighter deserve to be nurtured, trained and advanced.

Jeff Kline is a professor of apply of military Operations analysis at the Naval Postgraduate faculty and the director of the Naval conflict experiences Institute. A 26-yr veteran of the U.S. Navy’s floor war community, he commanded two ships and served in numerous senior operational positions. he is additionally a member of INFORMS, the greatest change association of Operations research and Analytics gurus.

Scott Nestler is the educational director for the MS in business Analytics software in the Mendoza faculty of enterprise. earlier than joining the institution of Notre Dame in 2015, he turned into a U.S. military officer within the Air protection Artillery and served as an operations research & systems analyst. He up to now served as the chair of the INFORMS Analytics Certification Board.

Harrison Schramm is the president-select of the Analytics Society of INFORMS and a primary research scientist at group W. earlier than joining trade, he was a helicopter pilot and operations analysis knowledgeable in the U.S. Navy.

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