Awakening of intensive care patients after prolonged continuous sedation

OBJECTIVE: To investigate the relevance of the Symptom Checklist 90-R Obsessive-Compulsive subscale to cognition in individuals with brain tumor. DESIGN: A prospective study of patients assessed with a neuropsychological test battery. SETTING: A university medical center. PATIENTS: Nineteen adults with biopsy-confirmed diagnoses of malignant brain tumors were assessed prior to aggressive chemotherapy. MAIN OUTCOME MEASURES: Included in the assessment were the Mattis Dementia Rating Scale, California Verbal Learning Test, Trail Making Test B, Symptom Checklist 90-R, Mood Assessment Scale, Beck Anxiety Inventory, and Chronic Illness Problem Inventory. RESULTS: The SCL 90-R Obsessive-Compulsive subscale was not related to objective measures of attention, verbal memory, or age. It was related significantly to symptoms of depression (r = .81, P < .005), anxiety (r = .66, P < .005), and subjective complaints of memory problems (r = .75, P < .005). Multivariate analyses indicated that reported symptoms of depression contributed 66% of the variance in predicting SCL 90-R Obsessive-Compulsive Scores, whereas symptoms of anxiety contributed an additional 6% (P < .0001). CONCLUSIONS: Our data suggest that the SCL 90-R is best viewed as an indicator of unidimensional emotional distress and somatic effects of structural brain injury.     

Mechanical wear behavior of nanocrystalline and multilayer diamond coatings on temporomandibular joint implants

We used microwave plasma chemical vapor deposition to deposit nanocrystalline and multilayer (nanocrystalline/microcrystalline/nanocrystalline) diamond thin films on Ti-6AI-4V substrates imitating the condyle and fossa components of the temporomandibular joint. We tested the condyle/fossa pairs for wear in a mandibular movement simulator for an equivalent of two years of clinical use. Analysis of the wear surfaces by optical microscopy, scanning electron microscopy (SEM), and Raman spectroscopy showed that damage in both the films was minimal, no loss of film occurred and the wear performance was superior for the multilayer film. Comparisons with an uncoated condyle/fossa pair showed that the coated temporomandibular joint pairs had improved wear performance.     

Controlled modification and direct characterization of multimode-fiber refractive-index profiles

A combination of controlled annealing and characterization by scanning probe microscopy (SPM) is used to demonstrate that the refractive-index proffle of a commercially available silica-based optical fiber can be accurately reconfigured for use as an evanescent field sensor. The process relies on the controlled relocation of the silica glass dopants across the fiber cross section through heat treatment and the accurate measurement of the resulting dopant redistribution with SPM and differential etching techniques. The effect of variable annealing along a length of fiber is to produce a mode transformer to couple light from a laser source into the sensing region of the fiber.     

Mechanistic insights into the development of optical chloride sensors based on the [9]mercuracarborand-3 ionophore

Fluorescent sensing microspheres based on perhaps the most selective and practically useful chloride ionophore known, the recently reported [9]mercuracarborand-3 (MC-3), have been prepared and optimized for physiological measurements. In initial work, this ionophore was shown to yield functional optical sensing films in combination with an electrically neutral chromoionophore, ETH 5418. Unfortunately, however, these optodes suffered from unacceptably high levels of sodium interference under physiological conditions. To better understand the sensing mechanism, optical and potentiometric binding experiments were used to characterize the stoichiometry and the complex formation constants for this ionophore. It was found that the preferred stoichiometry is 1:2, rather than 1:1 as assumed earlier. The 1:2 complex is extremely stable (logbeta2 = 13.4), but a relatively strong 1:1 complex also exists (log K1 = 9.9). These characteristics were used to fabricate chloride optodes that make use of the stepwise ion-ionophore decomplexation equilibrium, by adding a calculated amount of lipophilic anion exchanger to the polymer film. Such optodes showed dramatically reduced sodium interference while maintaining the excellent selectivity of the traditional formulation. The optimized composition also shifted the measuring range to physiological conditions, making them useful for the assessment of chloride in undiluted and 10-fold-diluted blood at pH 7.4. After necessary alterations of the particle preparation procedure and sensor formulation, the new insights were used to fabricate mass-produced optical sensing microspheres with characteristics essentially identical to those of the optode sensing films.     

Ion-pairing ability,chemical stability,and selectivity behavior of halogenated dodecacarborane cation exchangers in neutral carrier-based ion-selective electrodes

Recently, it has been discovered that carba-closo-dodecaborates can be used as cation exchangers in neutral carrier-based ion-selective chemical sensors. Because of their inherent chemical stability and versatile functionalization chemistries, they offer many advantages that may potentially be exploited for ion analyses that require nontraditional sample conditions, including strongly acidic media. In this work, trimethylammonium salts of undecachlorinated (UCC), undecabrominated (UBC), hexabrominated (HBC), and undecaiodinated (UIC) carborane anions were prepared and evaluated for their potential use in solvent polymeric membrane-based sensors. Computational methods including Natural population analysis and electrostatic mapping were used to predict the ion-exchanging ability of each lipophilic anion. In addition, the sandwich membrane technique was used to evaluate the ion-pairing ability of each carborane anion in situ (i.e., within bis(2-ethylhexyl) sebacate (DOS)- and 2-nitrophenyl octyl ether (o-NPOE)-plasticized ISE membranes). The results of the computational and potentiometric studies found that binding affinity of the anions followed the generalized trend HBC > UCC > UBC > UIC. PVC-DOS bulk optode thin films containing the chromoionophore ETH 5315 and a respective anion were used to determine the chemical stability/lipophilicity of the carboranes and tetrakis[3,5-bis(trifluoromethyl)phenyl] borate (TFPB) in acidic media (0.2 M HOAc) under flowing conditions. The studies found that in terms of stability/lipophilicity UIC > UBC > TFPB approximately UCC > HBC. Electrodes containing a Pb(2+)-selective ionophore, tert-butylcalix[4]arene-tetrakis(N,N-dimethylthioacetamide)(lead IV), were used to evaluate the functionality of each cation exchanger. An evaluation of response characteristics such as slope and selectivity found that UIC and UBC were quite comparable to the behavior of TFPB. Interestingly, both UIC and UBC showed a marked selectivity improvement over cadmium, with log K(pot)(pb),(Cd) values of -7.19 and -7.29, respectively, with TFPB giving a value of -5.89. Demonstrating excellent stability and suitable electrostatic properties, the carboranes, UIC in particular, are a very promising alternative to the tetraphenylborates and should find widespread application in the field of chemical sensors.     

The Commercialization of Information Infrastructure as Technological Mediation: The Internet Access Market

The study interprets the geographic diffusion of Internet Service Providers (ISPs) and the expansion of ISPs product lines in terms of the market for technological mediation. A firm involved in technology mediation takes advantage of gaps between general technological opportunities and particular user needs in specific places at particular times. If the economic opportunities are fleeting, then so too is the business. If the economic opportunities are renewed frequently, then the business can grow and adapt to take advantage of them. The concept of technological mediation helps us understand business behavior accompanying the commercialization of internet access technology.     

Solving shortest paths efficiently on nearly acyclic directed graphs

Shortest path problems can be solved very efficiently when a directed graph is nearly acyclic. Earlier results defined a graph decomposition, now called the 1-dominator set, which consists of a unique collection of acyclic structures with each single acyclic structure dominated by a single associated trigger vertex. In this framework, a specialised shortest path algorithm only spends delete-min operations on trigger vertices, thereby making the computation of shortest paths through non-trigger vertices easier. A previously presented algorithm computed the 1-dominator set in O(mn) worst-case time, which allowed it to be integrated as part of an O(mn+nrlogr) time all-pairs algorithm. Here m and n respectively denote the number of edges and vertices in the graph, while r denotes the number of trigger vertices. A new algorithm presented in this paper computes the 1-dominator set in just O(m) time. This can be integrated as part of the O(m+rlogr) time spent solving single-source, improving on the value of r obtained by the earlier tree-decomposition single-source algorithm. In addition, a new bidirectional form of 1-dominator set is presented, which further improves the value of r by defining acyclic structures in both directions over edges in the graph. The bidirectional 1-dominator set can similarly be computed in O(m) time and included as part of the O(m+rlogr) time spent computing single-source. This paper also presents a new all-pairs algorithm under the more general framework where r is defined as the size of any predetermined feedback vertex set of the graph, improving the previous all-pairs time complexity from O(mn+nr²) to O(mn+r³).     

Laboratory and self-report assessments of impulsive behavior in adolescent daily smokers and nonsmokers.

This research compared adolescent daily smokers (n = 25) and nonsmokers (n = 26) on different measures of impulsivity. Assessments included question-based measures of delay (DDQ) and probability (PDQ) discounting, a measure of behavioral disinhibition (go-stop task), and a self-report measure of impulsivity (Barratt Impulsiveness Scale-Adolescent). Adolescent smokers were more impulsive on the DDQ and Barratt Impulsiveness Scale--Adolescent but not on the PDQ or the go-stop task. However, there was a significant interaction between smoking status and gender on the go-stop task, with male smokers performing less impulsively on this measure than male nonsmokers--an effect not observed with the female adolescents. These findings indicate that adolescents who smoke cigarettes are more impulsive with respect to some, but not all, types of impulsivity than are adolescents who do not smoke. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antimicrobial coatings produced by “tethering” biocides to the coating matrix: A comprehensive review

Covalently attached, non-leaching biocidal-moieties are being explored as an environmentally friendly option for replacing antimicrobial coatings that release biocides. This review highlights studies on antimicrobial surface treatments and coatings in which the antimicrobial agent is covalently bound (i.e. tethered) to the surface or coating matrix. In addition, test methods for measuring antimicrobial surface activity are reviewed, and a discussion of advantages and disadvantages of the various methods is provided.     

Multi-stage modeling using fuzzy multi-criteria feature selection to improve survival prediction of ICU septic shock patients

In many binary medical classification problems, the cost of misclassifying one category is higher than the other, and in these applications it is desirable to employ a classifier with selective sensitivity or specificity. This work explores the utility of a fuzzy multi–criteria function for performance evaluation during knowledge–based medical classification and prediction. The method presented here uses fuzzy optimization to combine the sensitivity, specificity, and accuracy of classification as goals in a single objective function. This approach is used to assign flexible goals, which can be used to maximize the outcome in terms of each one of the goals. The proposed approach significantly increases the sensitivity and the specificity while maintaining or increasing accuracy. The versatility of the method is further exploited in a multi-model approach, using individual structures of multi-objective optimization of sensitivity and specificity separately, and then combining their outcomes through a decision-making module. Among various medical benefits derived from applying this technique, the divergent feature sets selected by high sensitivity and specificity models lend insight into factors more integrally connected to what causes risk of death for patients.