Penicillin vs. erythromycin in the treatment of diphtheria

PURPOSE: To review the University of Florida experience in treating ependymomas, analyze prognostic factors, and provide treatment recommendations. METHODS AND MATERIALS: Forty-one patients with ependymoma and no metastases outside the central nervous system received postoperative radiotherapy with curative intent between 1966 and 1989. Ten patients had supratentorial lesions, 22 had infratentorial lesions, and 9 had spinal cord lesions. All patients had surgery (stereotactic biopsy, subtotal resection, or gross total resection). Most patients with high-grade lesions received radiotherapy to the craniospinal axis. Low-grade intracranial lesions received more limited treatment. Spinal cord lesions were treated using either partial spine or whole spine fields. RESULTS: Of 32 intracranial tumors, 21 recurred, all at the primary site; no spinal cord tumors recurred. Overall 10-year survival rates were 51% (absolute) and 46% (relapse-free); by tumor site: spinal cord, 100%; infratentorial, 45%; supratentorial, 20% (p = 0.002). On multivariate analysis, tumor site was the only factor that influenced absolute survival (p = 0.0004); other factors evaluated included grade, gender, age, duration of symptoms, resection extent, primary tumor dose, treatment field extent, surgery-to-radiotherapy interval, and days under radiotherapy treatment. CONCLUSIONS: Patients with supratentorial or infratentorial tumors receive irradiation, regardless of grade. Craniospinal-axis fields are used when spinal seeding is radiographically or pathologically evident. Spinal cord tumors are treated using localized fields to the primary site if not completely resected. Failure to control disease at the primary site remains the main impediment to cure.     

Patient education for discharge after coronary bypass surgery in the 1990s: are patients adequately prepared?

Short hospitalizations for patients undergoing coronary artery bypass grafting (CABG) require continuous nursing evaluation of patients' discharge education. Six institutions collaborated in surveying 300 postoperative patients with CABG to identify learning priorities and patients' perceptions of the effectiveness of discharge education. Data analysis from the self-administered questionnaire demonstrated consistent patient priorities across institutions. Differences in teaching methods and content did not affect perceived preparedness or importance scores. Regional experience demonstrates that variable teaching efforts meet patients' priorities and provide high overall patient preparedness for discharge. Patients with the shortest hospitalizations had higher preparedness scores.     

Trypanosoma cruzi genotypes associated with domestic Triatoma sordida in Bolivia

Triatoma sordida is the second species of Triatominae considered of epidemiological significance in Bolivia. Associated with Triatoma infestans in various regions, it is as yet the only triatomine species established in human dwellings in localities of Velasco province, Department of Santa Cruz. This domestication is considered as primary. Flagellate parasites were detected in 16.2% of domiciliary T. sordida and the kDNA-PCR confirmed the presence of Trypanosoma cruzi. Frequencies of T. cruzi clonets 20 and 39, common clonets in Bolivian domestic cycle (T. infestans), were established by their direct detection in feces using PCR and hybridization. These clonets present low frequencies in T. sordida and synanthropic mammals. Forty-six stocks were isolated and analysed by multilocus enzyme electrophoresis (MLEE). The MLEE showed a higher clonal diversity than in T. infestans domestic cycle and the genotypes were clustered in the two principal lineages of T. cruzi. Within each lineage, a broad variability was observed. Mixture of genotypes was mostly observed in mammals. The large diversity of T. cruzi in this cycle should be related to its sylvatic origin. Moreover, the current limited sample of stocks suggests a lineage association with specific hosts.     

High-output congestive heart failure following transjugular intrahepatic portal-systemic shunting

A hyperdynamic circulatory state with elevated cardiac output, decreased peripheral vascular resistance, and sodium retention occurs in patients with portal cirrhosis. Surgical portal-systemic shunts and transjugular intrahepatic portal-systemic shunts (TIPS) have been shown to worsen the high-output state in these patients. However, clinical evidence of high-output congestive heart failure has been reported only rarely to complicate cirrhosis. We describe a patient who developed high-output congestive heart failure with markedly elevated filling pressures after TIPS and had complete resolution of heart failure after liver transplantation.     

Stock trading strategy creation using GP on GPU

This paper investigates the speed improvements available when using a graphics processing unit (GPU) for evaluation of individuals in a genetic programming (GP) environment. An existing GP system is modified to enable parallel evaluation of individuals on a GPU device. Several issues related to implementing GP on GPU are discussed, including how to perform tree-based GP on a device without recursion support, as well as the effect that proper memory layout can have on speed increases when using CUDA-enabled nVidia GPU devices. The specific GP implementation is designed to evolve stock trading strategies using technical analysis indicators. The second goal of this research is to investigate the possible improvement in performance when training individuals on a larger number of stocks and training days. This increased training size (nearly 100,000 training points) is enabled due to the speedups realized by GPU evaluation. Several different scenarios were used to test various speed optimizations of GP evaluation on the GPU device, with a peak speedup factor of over 600 (when compared to sequential evaluation on a 2.4 GHz CPU). Also, it is found that increasing the number of stocks and the length of the training period can result in higher out-of-training testing profitability.     

Fourth International Conference on Durability of Building Materials and Components

RILEM Bulletin

Fourth International Conference on Durability of Building Materials and Components     

Analytical electron microscopy of Al2O3 implanted with iron ions

Single crystals of -Al₂O₃ were implanted with iron ions at room temperature to fluences ranging from 4×10¹⁶ Fe cm^–2 to 1×10¹⁷ Fe cm^–2. The microstructure and composition in the implanted region were examined using analytical electron microscopy techniques. Special emphasis was placed on monitoring the microstructural changes which take place during post-implantation annealing. Clusters of metallic -Fe were identified in the specimen after implantation to a dose of 1×10¹⁷ Fe cm^–2. Analytical electron microscopy of implanted specimens annealed in oxygen revealed the redistribution of the implanted iron and the formation of surface precipitates of -Fe₂O₃, subsurface precipitates of various forms of spinel, and, in some cases, subsurface precipitates of iron, depending on the annealing temperature. Examination of implanted specimens annealed under reducing conditions revealed the presence of precipitates of -Fe.     

Practical observations on the methodology for determining 3-methyl-l-histidine using fluorescamine derivatives

The method for the detection and possible quantification of the unusual amino acid 3-methyl-l-histidine has been refined and elucidated. This is an essential prerequisite for the determination of its value as a robust unequivocal index of lean meat protein.     

On the layer removal analysis of residual stress

The layer removal analysis of residual stress distribution is examined for mouldings which contain depth-varying Young's modulus. The approach is to compute the stress distribution which would be derived from the layer removal procedure if the assumption is made that the Young's modulus is uniform, and to compare it with the actual stress distribution. For this analysis a parabolic stress distribution is assumed to be present, and computed distributions are obtained for two cases, (i) in which the modulus varies linearly from the surface to the centre of the moulding and (ii) in which the modulus has a constant value near to the surface (skin) then changes suddenly to another constant value in the interior (core). The general features of the computed profiles are compared with experimental layer removal analyses conducted on injection-moulded specimens and the extent to which non-uniform modulus influences the results of such studies is discussed.     

Utility,probabilistic constraints,mean and variance of discounted rewards in Markov decision processes

Summary This paper deals with discounted Markov decision processes, Markov with respect to a finite statespaceI, where for eachiI, and each decision epocht, there is a finite action space K(i, t). The paper is concerned with problems which are formulated in terms of the discounted rewards in several ways. In order to ensure that optimal, or near optimal, policies are obtained, the state spaceI is extended to augmented state-spaces A(n), or A(), including the accumulated discounted rewards. Specimen problems are formulated and some computational aspects examined.

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Zusammenfassung Es werden diskontierte Markovsche Entscheidungsprozesse behandelt mit endlichem Zustandsraum I, wobei die Mengen der zulässigen Entscheidungen K(i, t) vom Zustandi I und vom Zeitpunktt abhängen können. Es werden verschiedene Zielfunktionen betrachtet, die jeweils als Funktion des diskontierten Gesamtgewinns (nicht dessen Erwartungswerts) formuliert werden. Um optimale oder fast-optimale Politiken zu erhalten ohne die gesamte Vorgeschichte zu registrieren, wird der Zustandsraum um die akkumulierten diskontierten Auszahlungen erweitert. Eine Auswahl solcher Probleme wird exemplarisch diskutiert einschließlich einiger Aspekte der numerischen Behandlung.