The dose-dependent effects of oral premedication with midazolam

OBJECTIVE: The aim of this study was to examine the psychological effects, well-being and side effects after various doses of oral midazolam medication. METHODS: After informed consent has been obtained and following the approval by the institutional ethical committee, 80 adult patients in the ASA physical status I and II were randomly assigned to one of five different premedication groups: 3.75, 7.5, 11.25, 15 mg midazolam, and placebo. The medication was given in a double-blind fashion 60 min before induction of general anaesthesia for various surgical procedures. At 3 definite stages (before premedication, 30 and 60 min after premedication), blood pressure, heart rate, transcutaneous oxygen saturation and respiratory rate were measured. Sedation and well-being were graded according to a 5-point scale, and the subjective anxiety level was assessed according a visual analogue scale (range 0-100 mm). Anterograde and retrograde amnesia were measured by recall of auditive and visual stimuli. Finally, patients were asked whether in case of future surgery they would prefer the same or a different medication. RESULTS: Demographic data were similar in all groups. There was no significant difference in respiratory rate, oxygen saturation, blood pressure or heart rate. Alertness declined only after 60 min in the groups treated with 7.5 mg and more midazolam. During the entire measurement period, anxiolysis was not different from placebo in any of the midazolam groups. In comparison to placebo, all midazolam groups showed a statistically significant and dose dependent anterograde amnesia for visual stimuli. Subjective well-being scores showed no differences between the groups. Only few side effects were seen following doses of 7.5 mg and higher, including ptosis, strabismus, diplopia, speech disorders, disorientation and vertigo. The majority of patients in all groups indicated a wish for the same medication in case of future anaesthesia for surgical interventions. CONCLUSIONS: Midazolam administered orally prior to surgical procedures showed marked interindividual variability. Sedation and amnesia were dose-dependent and were evaluated by the patients as acceptable. Anxiolysis was not significantly different from placebo. A dose of 7.5 mg midazolam showed the best relation between desirable and undesirable effects. Adequate attention given to the patient by the anaesthesiologist prior to surgery seems to be as important and beneficial as oral medication with midazolam.     

Improved parallel approximation of a class of integer programming problems

We present a method to derandomizeRNC algorithms, converting them toNC algorithms. Using it, we show how to approximate a class of NP-hard integer programming problems inNC, to within factors better than the current-bestNC algorithms (of Berger and Rompel and Motwaniet al.); in some cases, the approximation factors are as good as the best-known sequential algorithms, due to Raghavan. This class includes problems such as global wire-routing in VLSI gate arrays and a generalization of telephone network planning in SONET rings. Also for a subfamily of the “packing” integer programs, we provide the firstNC approximation algorithms; this includes problems such as maximum matchings in hypergraphs, and generalizations. The key to the utility of our method is that it involves sums ofsuperpolynomially many terms, which can however be computed inNC; this superpolynomiality is the bottleneck for some earlier approaches, due to Berger and Rompel and Motwaniet al. A preliminary version of this work appeared inProc. International Colloquim on Automata, Languages and Programming, 1996, pages 562–573. Work done in parts at DIMACS (supported in part by NSF-STC91-19999 and by support from the N.J. Commission on Science and Technology), at the Institute for Advanced Study, Princeton (supported in part by Grant 93-6-6 of the Alfred P. Sloan Foundation), and at the National University of Singapore.     

Adaptations for Wear Resistance and Damage Resilience: Micromechanics of Spider Cuticular “Tools”

In the absence of minerals as stiffening agents, insects and spiders often use metal‐ion cross‐linking of protein matrices in their fully organic load‐bearing “tools.” In this comparative study, the hierarchical fiber architecture, elemental distribution, and the micromechanical properties of the manganese‐ and calcium‐rich cuticle of the claws of the spider Cupiennius salei, and the Zn‐rich cuticle of the cheliceral fangs of the same animal are analyzed. By correlating experimental results to finite element analysis, functional microstructural and compositional adaptations are inferred leading to remarkable damage resilience and abrasion tolerance, respectively. The results further reveal that the incorporation of both zinc and manganese/calcium correlates well with increased biomaterial's stiffness and hardness. However, the abrasion‐resistance of the claw material cross‐linked by incorporation of Mn/Ca‐ions surpasses that of many other non‐mineralized biological counterparts and is comparable to that of the fang with more than triple Zn content. These biomaterial‐adaptation paradigms for enhanced wear‐resistance may serve as novel design principles for advanced, high‐performance, functional surfaces, and graded materials.     

A Hebrew verb–complement dictionary

We present a verb–complement dictionary of Modern Hebrew, automatically extracted from text corpora. Carefully examining a large set of examples, we defined ten types of verb complements that cover the vast majority of the occurrences of verb complements in the corpora. We explored several collocation measures as indicators of the strength of the association between the verb and its complement. We then used these measures to automatically extract verb complements from corpora. The result is a wide-coverage, accurate dictionary that lists not only the likely complements for each verb, but also the likelihood of each complement. We evaluated the quality of the extracted dictionary both intrinsically and extrinsically. Intrinsically, we showed high precision and recall on randomly (but systematically) selected verbs. Extrinsically, we showed that using the extracted information is beneficial for two applications, prepositional phrase attachment disambiguation and Arabic-to-Hebrew machine translation.     

Practical Thermal Multi–Scale Analysis for Composite Materials–Mechanical-Orientated Approach

This paper describes a thermal multi-scale formulation for composite materials based on a mechanical homogenization approach. The presented formulation evaluates the effective macroscopic thermal conductivity of the composite materials and also the microscopic heat flux field by scaling down to the micro-scale level. The effective thermal conductivity of the composite materials was calculated by applying the homogenization theory over the unit cell. The uniqueness of the presented multi-scale analysis related to the elastic problems solved at the microscopic scale (unit cell). This method has the advantage of applying periodic boundary conditions and uniform macroscopic temperature gradient over the unit cell. The proposed thermal multi-scale analysis was verified and its efficiency was demonstrated on large scale problem.     

Defining the relationship between fetal Doppler indices,abdominal circumference and growth rate in severe fetal growth restriction using functional linear discriminant analysis

The relationship between Doppler measurements, size and growth rate in fetal growth restriction has not been defined. We used functional linear discriminant analysis (FLDA) to investigate these parameters taking account of the difficulties inherent in exploring relationships between repeated observations from a small number of cases. In 40 fetuses with severe growth restriction, serial abdominal circumference (AC), umbilical, middle cerebral artery (MCA) and ductus venosus Doppler pulsatility index measurements were recorded. In 11 singleton fetuses with normal growth, umbilical artery pulsatility index only was measured. Data were expressed as z-scores in relation to gestation and analysed longitudinally using FLDA. In severe growth restriction, the Spearman correlation coefficients between umbilical artery pulsatility index and AC z-score, MCA pulsatility index and AC z-score and ductus venosus pulsatility index z-score and AC z-score were, respectively: −0.36, p = 4.4 × 10⁻⁷; 0.70, p = 1.1 × 10⁻¹⁷ and −0.50, p = 8.1 × 10⁻⁴. No relationship was seen between Doppler parameters and growth rate. There was no relationship between umbilical artery pulsatility index and AC nor growth rate in normally grown fetuses. In severe fetal growth restriction, Doppler changes are related to absolute fetal AC size, not growth rate.     

Digital library information-technology infrastructures

This paper charts a research agenda on systems-oriented issues in digital libraries. It focuses on the most central and generic system issues, including system architecture, user-level functionality, and the overall operational environment. With respect to user-level functionality, in particular, it abstracts the overall information lifecycle in digital libraries to five major stages and identifies key research problems that require solution in each stage. Finally, it recommends an explicit set of activities that would help achieve the research goals outlined and identifies several dimensions along which progress of the digital library field can be evaluated.