Back And Lower Extremity Functional Scale: Fill & Download for Free

Yes. And I'll answer like I was presenting the case during staffing.A 51-year old White male presented to the ER with a six hour history of mid-sternal chest pain. He described it as a crushing pressure, non-radiating, constant, an eight on a scale of 1 to 10, and nothing he did made it better or worse.His past medical history was significant only for peptic ulcers which were treated with ranitidine. His past surgical history was negative. Current medications included ranitidine and acetaminophen prn (as needed) for pain. The APAP provided no relief of his chest pain.Family history was non-contributory. There was no history of sudden death in any close relative that he could remember. His father passed away at 76 from complications arising from a CVA (stroke), and his mother was still alive at 79. She had hypertension, glaucoma, anxiety, and dry macular degeneration but was otherwise in good health.A physical exam showed a well-dressed, well-nourished, middle-aged White male, in some distress secondary to pain. Gait was normal and there were no gross neurological abnormalities. Skin was pale and diaphoretic. Sclera white, non-icteric (no jaundice), EOM-I (extraocular muscles) intact. Neck was supple, non-tender, and with a FROM (full range of motion). Lungs were CTA (clear to auscultation). Heart had a regular rate and rhythm, without murmurs or rubs. Abdomen was obese, non-tender, bowel sounds normoactive in all four quadrants, and non-tender to palpation. There was no HSM (hepatosplenomegaly, enlarged liver or spleen), or involuntary guarding. Calves were non-tender and there was no lower extremity edema. Genitourinary exam was deferred.Based on his age, presentation, and PE findings, I was leaning heavily to an acute myocardial infarction (AMI) as the cause. So I ordered an EKG, chest x-ray, and labs that included a cardiac panel. All came back negative. What next?I called the local internist and he suggested that I get a head CT. Why? He has chest pain, not a headache. The intern reassured me that in his experience, it was necessary. (Please be aware that some carriers will not cover this procedure if it comes back negative). So I did, but admitted him to the Cardiac Care Unit in the meantime because I was still sure it was a heart attack.A couple of hours later, the results of the CT came back (those were in the days when we had mobile CT units). The scan showed a stroke in the thalamus, a structure in the forebrain which, along with many other functions, transmits sensory information to the cerebral cortex. In other words, the thalamic stroke made the patient feel like the problem was in his chest. I spoke with the doc on call for the hospital and told him the news. Since the patient was now his, he switched tactics. Thankfully none of my interventions worsened the cause. But then again, except for the oxygen I started him on, none helped, either.

First of all VLSI field can never be saturated at least for the next 10 years. Those who are telling this they are unaware of the innovations right now happening in the industry R&D and worldwide top universities. Its true that we have reached a limit with MOSFETs and FINFETs for scaling but right now we have a roadmap ready for 5nm technology node. So devices based on 5nm node will be available in 2021.Now i would like to tell you what is the need of scaling1.)Through scaling we reduce the size of the transistors so basically we can put more number of transistors on a given area through this we achieve more functionality.2.) We get a benefit of performance and powerSo basically scaling helps us to achieve better power performance and area on the expense of high leakage current and design complexity. This leakage current is also a serious issue because even if your transistor is in off mode but still some current flows through it that means power dissipation will occur (VIleak) known as leakage power. Also Imagine previously you had 100 transistors now you have twice of them so you need more routing resource which could lead to routing congestion (routing means interconnection between logic).Now we have more transistors so we have more number of timing paths so STA( Static timing analysis) becomes complex. These are just basic examples though lot of other things also happen when we go down to lower Nodes. Basically design becomes extremely difficult to implement and leakage power increases as we go down to lower nodes.Now companies like intel, samsung, qualcomm, tsmc, mediatek etc they were aware of these situations some few years back and they started working on these issues they worked on gate all around transistor (GAA) and they are still working on it through this they are optimistic that they could possibly go below 5nm. These companies and academic institutes are also working on new devices like graphene transistor which is more efficient than finfet and mosfet. There are lot of other things also happening at the architectural level to improve performance and powerSummary is companies are ready and prepared to face the challenges of design complexity and they are doing innovations to bring new device. So VLSI field can never be saturated at least for the next 10 years

To classify data we use a probability measure and determine if it belongs to a particular class or not. We are not always 100% sure if it is 0 or 1 (so a step function is ruled out). This means we need a function that could convert any given value to a value between 0 to 1. One of the function that does this is sigmoid function.There are several advantages of using a sigmoid function -1. The nature of this function can clip any value to have an upper bound of 1 and lower bound of 0.2. It is centered at the value of 0.5. So any value above 0.5 can be classified as 1 and below 0.5 can be classified as 0 ( note that this threshold can change depending on data/business use case)3. Given that it has an exponential in its function formula, it makes it easy to compute the derivative of the function ( derivatives are computed to find the gradient descent)However it has few drawbacks as well -As it is a non-zero centered ( as mentioned above, it is centered at 0.5), it causes few issues while scaling, normalizing or combining the output of this function ( note that we usually desire to have a normalized data centered at 0, for eg: ‘z’ scale, ‘t’ scale Gaussian distributions )The gradient of this function quickly flattens out to zero value on either sides. This causes the gradient signal to get weakened out at extremes and hence difficult to back propagate to the early layers in a MLP / neural network.In a simple classification task like logistic regression, usually the sigmoid function does a great job. However when we want to use to output of sigmoid function to feed forward to further layers, there are functions (like ReLU, leaking ReLU or tanh for example) that do a better job at gradient descent and back propagation.