Infective endocarditis complicated with rapidly progressive glomerulonephritis: a case report

Despite a general national decline in criminal activities in the 1990s, juvenile criminal offenses continue to increase, (including violent, property, and delinquency acts). In addition increased numbers of children are being held in juvenile jails. It is all but impossible for pediatric health providers to think that "their patients" and "their practices" are immune from the epidemic of crime that affects and is caused by "just kids."     

Rerouting of the intratemporal facial nerve: an analysis of the literature

Anterior rerouting of the intratemporal facial nerve in the infratemporal fossa approach is employed to access to the jugular bulb, hypotympanum, and lateral skull base, whereas posterior rerouting of the facial nerve, as employed in the transcochlear craniotomy, is most frequently used for surgery of the posterior fossa, cerebellopontine angle, prepontine region, and petrous apex. Facial nerve rerouting may lead to facial paresis or paralysis. This review of the literature is intended to define the physiologic "cost" of these procedures, so that the neurotologic surgeon can determine if the morbidity incurred in these techniques is worth the resultant exposure. Inconsistencies in reporting facial function places into question the validity of some of the cumulative data reported. Postoperatively, grades I-II facial nerve function was seen in 91% of patients undergoing short anterior rerouting, 74% of patients undergoing long anterior rerouting, and 26% of patients undergoing posterior complete rerouting. Although facial nerve rerouting allows unhindered exposure to previously inaccessible regions, it is achieved at the cost of facial nerve function. Facial nerve dysfunction increases with the length of facial nerve rerouted.     

Measuring science: an exploration

This paper examines the available United States data on academic research and development (R&D) expenditures and the number of papers published and the number of citations to these papers as possible measures of "output" of this enterprise. We look at these numbers for science and engineering as a whole, for five selected major fields, and at the individual university field level. The published data in Science and Engineering Indicators imply sharply diminishing returns to academic R&D using published papers as an "output" measure. These data are quite problematic. Using a newer set of data on papers and citations, based on an "expanding" set of journals and the newly released Bureau of Economic Analysis R&D deflators, changes the picture drastically, eliminating the appearance of diminishing returns but raising the question of why the input prices of academic R&D are rising so much faster than either the gross domestic product deflator or the implicit R&D deflator in industry. A production function analysis of such data at the individual field level follows. It indicates significant diminishing returns to "own" R&D, with the R&D coefficients hovering around 0.5 for estimates with paper numbers as the dependent variable and around 0.6 if total citations are used as the dependent variable. When we substitute scientists and engineers in place of R&D as the right-hand side variables, the coefficient on papers rises from 0.5 to 0.8, and the coefficient on citations rises from 0.6 to 0.9, indicating systematic measurement problems with R&D as the sole input into the production of scientific output. But allowing for individual university field effects drives these numbers down significantly below unity. Because in the aggregate both paper numbers and citations are growing as fast or faster than R&D, this finding can be interpreted as leaving a major, yet unmeasured, role for the contribution of spillovers from other fields, other universities, and other countries.     

User sensitive research in e-learning: exploring the role of individual user characteristics

The increasing need for active and accessible learning in the inclusive knowledge society drives the demand for e-learning that engages users much more effectively than ever before. In this context, it is crucial to conduct research that embraces innovation in user sensitive design, or else influential individual user differences may be overlooked. The objective of this paper is to explore the creation of successful e-learning systems that are able to increase users’ learning performance and enhance their personal learning experiences. The paper reports two converging and complimentary approaches, namely case studies and experimentation. First, case studies are used to explore the extent to which effective e-learning systems comply with eight specific factors. Of the eight, accessibility, individual differences and student modeling turn out to be the weakest points in current practice. Second, an empirical study investigates the influences of user individual user differences on users’ learning outcomes in an e-learning environment. The experiment found that individual differences in motivation to learn and expectations about e-learning significantly impacted users’ learning achievements. Third, based on these studies, improvements in research methodology are identified towards greater consideration of user sensitive research issues, thus enabling us to outline improved experimental procedures. Further experiment results should provide us with better insights into the arguments needed to carefully assess benefits of developing and involving a user model in an e-learning application. Consequently, evaluation and justification could now encompass both system performance as well as user performance.     

Label-free Growth Receptor-2 Detection and Dissociation Constant Assessment in Diluted Human Serum Using a Longitudinal Extension Mode of a Piezoelectric Microcantilever Sensor

We have investigated real-time, label-free, in-situ detection of human epidermal growth factor receptor 2 (Her2) in diluted serum using the first longitudinal extension mode of a lead zirconate-lead titanate (PZT)/glass piezoelectric microcantilever sensor (PEMS) with H3 single-chain variable fragment (scFv) immobilized on the 3-mercaptopropyltrimethoxysilane (MPS) insulation layer of the PEMS surface. We showed that with the longitudinal extension mode, the PZT/glass PEMS consisting of a 1 mm long and 127 μm thick PZT layer bonded with a 75 μm thick glass layer with a 1.8 mm long glass tip could detect Her2 at a concentration of 6-60 ng/ml (or 0.06-0.6 nM) in diluted human serum, about 100 times lower than the concentration limit obtained using the lower-frequency flexural mode of a similar PZT/glass PEMS. We further showed that with the longitudinal mode, the PZT/glass PEMS determined the equilibrium H3-Her2 dissociation constant K(d) to be 3.3±0.3 × 10(-8) M consistent with the value, 3.2±0.28 ×10(-8) M deduced by the surface plasmon resonance method (BIAcore).     

Simulated environments with animated agents: effects on visual attention,emotion, performance,and perception

This research assessed how emotive animated agents in a simulation‐based training affect the performance outcomes and perceptions of the individuals interacting in real time with the training application. A total of 56 participants consented to complete the study. The material for this investigation included a nursing simulation in which participants interacted with three animated agents. The results of this investigation indicated that both experienced and novice participants focused more visual attention time on the body of the animated agent than the other defined areas of interest in the simulated environment. The results also indicated that novice participants conveyed more neutral facial expressions during the interaction with the animated agents than experience participants. The results of the simulation performance scores indicated that novice participants achieved higher simulation performance scores on the simulation task than experienced participants. Lastly, the results of the agent persona instrument showed that experienced and novice participants perceived the animated agents as facilitators of learning, credible, human‐like and engaging.     

State-Space Synthesis of Virtual Auditory Space

Binaural displays for immersive listening must model realistic acoustic environments, multiple sound sources, and accommodate source and head motion. Many displays accomplish this by convolving collections of spatially distributed point sources with head-related transfer functions (HRTFs). The computational load of such a system scales linearly with the number of HRTFs modeled by the display. Realistic scenes often require a large number of HRTFs, and this framework is computationally burdensome. We propose a method that significantly eases this load by formulating the HRTF filter array as a state-space system. Three state-space architectures are explored. The performance of the most general architecture is found to suffer due to the interaural time delay (ITD). This problem may be circumvented with two alternative architectures, although the ideal choice depends on the specific display application. For each architecture, two order-reduction techniques are explored. Both techniques are based on the Hankel operator; one is ad hoc and simple to implement whereas the other is optimal in the Hankel norm. The two methods yield similar auditory performance, although the optimal method may be desirable for HRTF approximation.     

Convergent Smoothing and Segmentation of Noisy Range Data in Multiscale Space

With few exceptions, most of the existing noise reduction and data segmentation algorithms are only suited to image data. Therefore, an adaptive smoothing algorithm, with model-based masks, within a scale space framework is proposed for range data in this paper. This algorithm smoothes range data that conform to predefined, geometric models, while leaving other data points unaffected. The convergence of the algorithm in yielding dominant features is shown based on its compliance with the anisotropic diffusion concept. The weights of the smoothing masks are adaptively calculated according to the Mahalanobis distances between range data and model-based predictions. These behave as the diffusion coefficient in the anisotropic diffusion equation, thus satisfying the requirements of the causality criterion that no new features are introduced from fine to coarse scales. The computational complexity of this algorithm is examined and compared to that of the well-known RANSAC feature extraction algorithm. Unlike RANSAC, it has the advantage that the computational complexity is less affected by increasing the order of the model, and is independent of the number of model outliers. The proposed algorithm can be used to smooth range data in multiscale space by increasing the number of smoothing iterations. Robust, robot-occlusion-invariant features are then easily extracted from the smoothed data by least squares fitting algorithms.     

Radiopharmacology of inhaled 133Xe in skeletal sites containing deposits of Gaucher cells

Gaucher's disease is a lysosomal storage disease in which cells of the reticuloendothelial system accumulate the lipid glucocerebroside. It is characterized by slowly progressive visceral and osseous involvement. One of the latter manifestations includes lipid infiltration of bone marrow. We monitored the rate of inhaled 133Xe uptake and wash-out over diseased and normal metaphyseal and epiphyseal areas of the knee. Twenty-two patients (15 adults, 7 children) with various degrees of previously diagnosed Gaucher's disease were positioned supine under a gamma-camera interfaced to a computer system. All patients rebreathed 133Xe gas from a closed system for 10 min followed by 14 min of wash-out. Digitized images of the lung, liver, spleen, bony sites and soft tissue were obtained at 1 min intervals during the wash-in and wash-out phases. Counts for each ROI were normalized per 100 pixels and plotted as a function (time). Maximum uptake was also calculated by relating the counts/ROI/100 pixels to the 10 min integrated lung count during equilibrium (the administered "dose"). There was essentially no 133Xe uptake in liver and spleen involved with Gaucher's disease. Monophasic uptake and biphasic wash-out curves were observed in the limited investigative population. Skeletal Gaucher deposits released the 133Xe at a greater rate relative to soft tissue.