Purpose
To validate our previously designed transcatheter arterial embolization (TAE) technique for bilateral iliac arteries in unstable pelvic fractures, which is designed to also prevent gluteal necrosis and avoid vasopressors.
Methods
We retrospectively analyzed the data of patients with pelvic fractures who underwent our new TAE procedure to determine the incidence of subsequent gluteal necrosis. We also compared certain variables between patients who underwent TAE before 2005 using a different technique and developed gluteal necrosis and patients who underwent TAE in 2005 and onward using our technique. Gluteal necrosis was confirmed by a radiologist based on imaging findings.
Results
Seventy patients with pelvic fractures who underwent our TAE technique met the inclusion criteria (bilateral iliac arterial embolization and no embolic agent other than a gelatin sponge). Patients’ median age was 47.5 years, 33 were male, and 92.9% (65/70) had unstable fractures. Sixty-eight patients had severe multiple trauma. No patients developed gluteal necrosis following our TAE procedure and the overall survival rate was 82.9% (58/70). We found no statistically significant difference in procedure time between the previous and new technique, although the new procedure tended to be shorter. Furthermore, overall survival did not significantly differ between the groups. Multiple regression analysis revealed that TAE procedure time and external pelvic fracture fixation were independently related to gluteal necrosis.
Conclusions
Our non-selective bilateral iliac arterial embolization procedure involves arresting shock quickly, resulting in no post-procedure gluteal necrosis. The procedure involves cutting the gelatin sponge rather than “pumping” and avoids the use of vasopressors.
English is the only language available for global communication and is used by approximately 1.5 billions of speakers. It is also known to have a large diversity of pronunciation due to the influence of speakers' mother tongue, called accents. Our project aims at creating a global and individual-basis map of English pronunciations to be used in teaching and learning World Englishes (WE) as well as research studies of WE [1,2]. Creating the map mathematically requires a distance matrix in terms of pronunciation differences among all the speakers considered, and technically requires a method of predicting the pronunciation distance between any pair of the speakers only by using their speech samples. In our previous study [3], we combined invariant pronunciation structure analysis [4,5,6,7] and Support Vector Regression (SVR) to predict the inter-speaker pronunciation distances. In this paper, several techniques are introduced and examined whether they can increase accuracy and robustness of prediction. Experiments show that the correlation between IPA-based reference distances and the predicted distances is increased from 0.805 to 0.903, which is over the correlation of 0.829 that is obtained by using the phoneme-based ground truth distances.
English is the only language available for international communication and is used by approximately 1.5 billions of speakers. It is also known to have a large diversity of pronunciation partly due to the influence of the speakers' mother tongue, called accents. Our project aims at creating a global and individual-basis map of English pronunciations to be used in teaching and learning World Englishes (WE) as well as research studies of WE [1], [2]. Creating the map mathematically requires a distance matrix in terms of pronunciation differences among all the speakers considered, and technically requires a method of predicting the pronunciation distance between any pair of the speakers. Our previous but very recent study [3] combined invariant pronunciation structure analysis [4], [5], [6], [7] and Support Vector Regression (SVR) effectively to predict the interspeaker pronunciation distances. In [3], very high correlation of 0.903 was observed between reference IPA-based pronunciation distances and the distances predicted by our proposed method. In this paper, after explaining our proposed method, some new results of analytical investigation of the method are described.
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