Casino Destroyer System
Early schemes to provide defibrillators in public places reported dramatic results. In the first year after their introduction at O'Hare airport, Chicago, several airline passengers who sustained a cardiac arrest were successfully resuscitated after defibrillation by staff at the airport. In Las Vegas, security staff at casinos have been trained to use AEDs with dramatic result 56 out of 105 patients (53 ) with VF survived to be discharged from hospital. The closed circuit TV surveillance in use at the casinos enabled rapid identification of potential patients, and 74 of those defibrillated within three minutes of collapsing survived.
Most victims of SCA demonstrate ventricular fibrillation (VF) at some point in their arrest.3-5 Several phases of VF have been described-7 and resuscitation is most successful if defibrillation is performed in about the first 5 minutes after collapse. Because the interval between call to the emergency medical services (EMS) system and arrival of EMS personnel at the victim's side is typically longer than 5 minutes-8 achieving high survival rates depends on a public trained in CPR and on well-organized public access defibrillation programs.9-10 The best results of lay rescuer CPR and automated external defibrillation programs have occurred in controlled environments- with trained- motivated personnel- a planned and practiced response- and short response times. Examples of such environments are airports-9 airlines-11 casinos-12 and hospitals (see Part 4 Adult Basic Life Support ). Significant improvement in survival from out-of-hospital VF SCA also has been reported in well-organized...
Randomization means assigning treatment via a chance device. It does not mean give the first patient the active treatment, the second the control, and so forth. A weakness with this latter approach which you may have experienced yourself on the occasional visit to Las Vegas, Atlantic City, or Monte Carlo, is that sometimes red comes up seven times in a row or you experience an equally long streak with the dice.
The sharp rise in premiums for medical malpractice liability insurance over the past several years has led many professional associations to lobby Congress and state legislatures for caps on noneconomic damages, as well as for other changes in the tort liability system. Proponents of such changes point to the loss of access to care in the only level 1 trauma center in Las Vegas in 2002 the difficulty of providing on-call surgical care to emergency rooms in Jacksonville, Florida, and in Mississippi in 2003 and the loss of neurosurgical services in the northern panhandle of West Virginia in 2002. Concerned about continued increases, the reform advocates cite the reduced rates of increase in premiums reported in states that have imposed caps on noneconomic losses (e.g., California, Colorado, and Montana).
A gambler is given N coins with which to play a slot machine having two arms. (A conventional slot machine is colloquially known as a one-armed bandit. ) The arms are labeled A and A2, and they have mean payoff (per trial) rates and with respective variances and A22. The payoff processes from the two arms are each stationary and independent of one another, which means that the mean payoff rates do not change over time. The gambler does not know these payoff rates or their variances she can estimate them only by playing coins on the different arms and observing the payoff obtained on each. She Holland's analytic solution to the Two-Armed Bandit problem states that, as more and more information is gained through sampling, the optimal strategy is to exponentially increase the probability of sampling the better-seeming arm relative to the probability of sampling the worseseeming arm. To apply this to schema sampling in a GA, the 3L schemas in an L-bit search...
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