Portugal's contribution to navigation and discovery of the New World

Even before the birth of Prince Henry the Navigator (1394) Portugal had displayed a maritime calling due to its 500-mile shore line and numerous natural bays. Inspired by the riches of India he saw during the Portuguese exploration along the coast of West Africa, Prince Henry set out methodically to collect information by bringing together Jews and Moors with geographical knowledge to found his School of Navigation. From 1415 until his death in 1460 he attracted to his school the foremost contemporary scholars in mathematics, astronomy, and cartography along with experts in knowledge of the compass, astrolabe, water currents, and the winds. This concentration of talent yielded the invention of the caravel, the most important navigational advancement of the time, crucial for long voyages across the high seas. Although the rest of Europe busied itself in political and religious wars, for 70 years (1415-1492) Portugal alone pursued the discovery of the Atlantic. "No nation in the 15th century exhibited so great a spirit of maritime enterprise as the Portuguese."     

Treatment of acute lymphoblastic leukemia. 30 years' experience at St. Jude Children's Research Hospital

BACKGROUND: Therapy for childhood lymphoblastic leukemia has evolved during the past three decades, but key questions about what are the least toxic, most effective forms of treatment remain unanswered because of the lack of comprehensive follow-up information. METHODS: To assess long-term outcome in the series of clinical trials conducted at St. Jude Hospital, we compared the results of treatment typical of four eras: exploratory combination chemotherapy (era 1, 1962 to 1966; 91 patients), regimens for the control of meningeal leukemia (era 2, 1967 to 1979; 825 patients), limited intensification of therapy (era 3, 1979 to 1983; 428 patients), and extended intensification of therapy (era 4, 1984 to 1988; 358 patients). ("Intensification" refers to strategies of systemic chemotherapy that are more aggressive than conventional ones.) The major end points were survival and event-free survival; we also calculated the relative risk of treatment failure and the rate of relapse or death after treatment ended (post-treatment failure rate). RESULTS: The probability of event-free survival improved significantly in each successive era (P < 0.001 by the log-rank test), reaching 71 percent in era 4. There was a decrease of approximately 50 percent in the risk of treatment failure from one era to the next in each subgroup of patients defined according to different combinations of the leukocyte count, race, age, and sex. Leukemia appeared to be eradicated in patients who remained in complete remission for three years or more after treatment in era 4. The incidence of death due to nonleukemic causes remained 4 to 6 percent despite the trend toward more intensive treatment. An estimated 765 patients (45 percent) are long-term survivors; most of them (80 percent) have no health problems related to leukemia or its treatment. CONCLUSIONS: The development and successful application of preventive therapy for meningeal leukemia, followed by the intensification of systemic chemotherapy, has progressively improved the rate of cure of childhood lymphoblastic leukemia, with relatively few adverse sequelae.     

Reliability of seizure classification using a semistructured interview

Methods for standardized classification of epileptic seizures are important for both clinical practice and epidemiologic research. In this study, we developed a strategy for standardized classification using a semistructured telephone interview and operational diagnostic criteria. We interviewed 1,957 adults with epilepsy ascertained from voluntary organizations. To confirm and expand the seizure history, we also interviewed a first-degree relative for 67% of subjects and obtained medical records for 59%. Three lay reviewers used all available information to classify seizures. To assess reliability, each reviewer classified a sample of subjects assigned to the others. In addition, an expert physician classified a sample of subjects assigned to two of the reviewers. Agreement was "moderate-substantial" for generalized-onset seizures, both for the comparisons between pairs of lay reviewers and for the neurologist versus lay reviewers. Agreement was "substantial-almost perfect" for partial-onset seizures, both for pairs of lay reviewers and for the neurologist versus lay reviewers. These results suggest that seizures can be reliably classified by lay reviewers, using operational criteria applied to symptoms ascertained in a semistructured telephone interview.     

Computer simulation of the precordial QRS complex: effects of simulated changes in ventricular wall thickness and volume

Over a 4-year period 40,923 operations and 44,716 surgical admissions were monitored for both community and hospital onset infections. One thousand eight hundred sixty-five patients had 1966 surgical wound infections and 2056 remote infections including 1652 hospital onset and 404 community onset infections. One thousand one hudnred forty-four patients with multiple infections averaged 40 days in the hospital contrasted with 24 days for 721 patients with a single wound infection. The total excess cost of hospitalization for these patients was $951,150. A statistically significant reduction occurred for urinary tract infections, lower respiratory infections and clean and contaminated surgical wound infections. It is suggested that these are all inter-related and a significant reduction in surgical wound infections can be achieved through control of infections at remote sites, particularly those associated with medical devices. The coagulase positive staphylococcus is still the most important single bacterial species in the primary etiology of surgical wound infections. When the gastrointestinal tract is entered or "supra" infecting organisms appear, gram negative bacteria and mixed gram negative and gram positive infections are dominant. Reduction in remote site infections occurring in surgical patients is necessary to reduce the incidence of surgical wound infections, suggest preventive and control measures, and document the effectiveness of such measures.     

Oligodendrogliomas. Part II: A new grading system based on morphological and imaging criteria

Myocardial perfusion scintigraphy is a noninvasive diagnostic method for the evaluation of patients with suspected or proven coronary artery disease (CAD). We utilized case-based reasoning (CBR) methods to develop the computer-based image interpretation system SCINA which automatically derives from a scintigraphic image data set an assessment concerning the presence of CAD. We compiled a case library of 100 patients who underwent both perfusion scintigraphy and coronary angiography to document or exclude the presence of CAD. The angiographic diagnosis of the retrieved nearest neighbor match of a scintigraphic input case was selected as the CBR diagnosis. We examined the effects of input data granularity, case indexing, similarity metric, and adaptation on the diagnostic accuracy of the CBR application SCINA. For the final prototype, sensitivity and specificity for detection of coronary heart disease were 98% and 70% suggesting that CBR systems may achieve a diagnostic accuracy that appears feasible for clinical use.     

Conditional and Marginal Mutual Information in Gaussian and Hyperbolic Decay Time Series

We consider the amount of available information about an arbitrary future state of a Gaussian stochastic process. We derive an infinite series for the marginal mutual information in terms of the autocorrelation function. We derive an infinite series for the newly available information for prediction, the conditional mutual information, in terms of the moving average parameters, and directly characterize predictability in terms of sensitivity to random shocks. We apply our results to long memory, or more generally, hyperbolic decay models, and give information‐theoretic characterizations of the transition from persistence to anti‐persistence, stationary long memory to nonstationarity, and a stationary regime where the mutual information is not summable.     

Combustion Properties of Amino‐Substituted Guanidinium 4,4′,5,5′‐Tetranitro‐2,2′‐biimidazolate(N4BIM) Salts

This paper describes the combustion properties of the amino‐substituted guanidinium 4,4′,5,5′‐tetranitro‐2,2′‐biimidazolate (N4BIM) series, including the bis‐mono, di and triaminoguanidinium salts. These salts are of interest as propellant ingredient additives, and in particular, the bis‐triaminoguanidinium salt of N4BIM displays excellent burn rate and combustion behavior. Our combustion studies have shown that TAGN4‐BIM displays a fast burning rate and has the lowest pressure dependence exponent yet measured for a triaminoguanidinium salt.     

Imide‐containing ladder polyphenylsilsesquioxanes with high thermal stability and thermoplastic properties

This work reports for the first time the synthesis of ladder polyphenylsilsesquioxanes containing imide building blocks as parts of the main parallel chains. The ladder structure of the synthesized polymers was documented by means of small angle X‐ray scattering (SAXS) measurements. The obtained ladder polymers exhibit stability with respect to decomposition up to temperatures as high as 460°C; additionally, they have melting points far below their decomposition temperatures, which make them interesting candidate materials for thermoplastic processing. © 2013 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014 , 131, 40085.     

Ultrastructural and immunohistochemical study of the effect of sodium alendronate in the progression of experimental periodontitis in rats

The aim of the present research was to investigate the ultrastructural aspects and the immunoexpression of receptor activator of NFκB ligand (RANKL) and osteoprotegerin (OPG) on experimental periodontal disease of alendronate (ALN)‐treated rats. Male Wistar rats received daily injections of 2.5 mg/kg body weight of ALN during 7 days previously and 7, 14, and 21 days after the insertion of a 4.0 silk suture into the gingival sulcus around the right upper second molar. Specimens were fixed in 0.1% glutaraldehyde + 4% formaldehyde under microwave irradiation, decalcified in 4.13% EDTA and paraffin embedded for TRAP histochemistry and immunohistochemistry for RANKL and OPG, or embedded in Spurr epoxy resin for TEM analysis. ALN reduced the activity of osteoclasts and significantly decreased the resorption of the alveolar crest. In the control group the alveolar crest appeared resorbed by TRAP‐positive osteoclasts, which presented ultrastructural features of activated cells. The immunoexpression of RANKL was not inhibited by the drug; however, the expression of OPG was increased in the treated animals. The alveolar crest of ALN‐treated specimens at 21 days showed signs of osteonecrosis, like empty osteocyte lacunae, the exposed bone regions and bacterial infection. The results showed that ALN treatment in individuals with periodontal disease represents a risk of osteonecrosis because of the reduced activity of osteoclasts resultant of the increased immunoexpression of OPG. Microsc. Res. Tech. 77:902–909, 2014. © 2014 Wiley Periodicals, Inc.