Evaluation of the Short Parkinson's Evaluation Scale: a new friendly scale for the evaluation of Parkinson's disease in clinical drug trials

The extensive use of the Unified Parkinson's Disease Rating Scale (UPDRS) has revealed low interrater reliability in some items and redundancy in others. In view of these shortcomings, we have structured a new scale that includes a zero-to three-point scale for each item in the evaluation of PD. The mental axis includes memory, thought disorders, and depression. Activities of daily living (ADL) includes eight items: speech, eating, feeding, dressing, hygiene, handwriting, walking, and turning in bed. The motor examination includes eight items: speech, tremor, rest and posture, rigidity, finger tapping, arising from chair, gait, and postural stability. Complications of therapy were also included: dyskinesias, dystonia, motor fluctuations, and freezing episodes, collected by history. In addition, a global scoring for motor fluctuations that should complement the Hoehn and Yahr Scale was incorporated. In this report, we present a statistical analysis of the ADL, motor evaluation, and complications of therapy sections. Concerning the interrater reliability mean, Kendall's W values were >0.9 for most of the items in the Short Parkinson's Evaluation Scale (SPES). Kendall's W <0.8 (motor evaluation) was found for two items of the SPES and nine items of the UPDRS. The mean interrater reliability for both scales across all seven centers (seven Kendall's W for seven centers) (Mann-Whitney test) showed no statistical differences between the scales. Spearman's correlations between items of both scales were significant. Factor analysis of the SPES and UPDRS data revealed a four-factor solution that explained approximately 60% of the data. All participating centers found the SPES easier to apply and quicker to complete, when compared with the UPDRS. The results obtained strongly favor the introduction of SPES for clinical practice.     

Distribution and Fate of Escherichia coli in Lake Michigan Following Contamination with Urban Stormwater and Combined Sewer Overflows

Escherichia coli distribution and persistence in nearshore Lake Michigan were assessed following heavy rains and sanitary sewer overflow (SSO) and combined sewer overflow (CSO) events over a 5-year period, including an 18-day period following 25.4 cm of rainfall in which intensive studies were conducted following multiple CSO and SSO events. E. coli levels in the Milwaukee estuary and harbor following SSO and CSO events ranged from 10⁴ to nearly 10⁵ CFU/100 mL, which were significantly higher (p ≤ 0.05) than levels following rainfall alone. Sites outside of the breakwall but within the contamination plume (e.g., within 2 km of the harbor) were an order of magnitude lower. Locations 2–5 km from the harbor ranged from below detection limits, of < 1 to 5 CFU/100 mL. E. coli levels corrected for dilution based on specific conductivity measurements were lower than what would be expected for loss due to dilution alone, suggesting a combination of die-off and dilution, were responsible for the rapid disappearance of these organisms outside of the harbor. E. coli and fecal coliforms measured concurrently demonstrated that fecal coliforms could be recovered longer than E. coli in the open waters of the lake. E. coli isolated directly from sewage treatment plant influent were found to have a marked increase in antibiotic resistance traits for ten antibiotics commonly used in the human population compared with isolates from two animal sources of fecal pollution. However, E. coli obtained from sewage impacted water (n = 2,513) and from stormwater impacted water (n = 1,465) collected the previous year when there were no sewage overflows, were found to have no significant difference (p < 0.05) in the frequency of resistance when comparing the two conditions. E. coli survival characteristics and population dynamics are most likely influenced by multiple factors in complex systems such as the watershed/estuarine/lake environments of the Great Lakes.     

Experimental results on adiabatic coupling into SOI photonic Crystal coupled-cavity waveguides

The experimental implementation of an adiabatic coupling technique for efficient coupling between photonic crystal single-line defect waveguides and coupled-cavity waveguides is reported. The samples were fabricated in a silicon-on-insulator substrate using 248-nm-deep ultraviolet lithography. Experimental results are compared with three-dimensional (3-D) finite-difference time-domain simulations. Furthermore, the discrepancies between two-dimensional and 3-D simulation results are analyzed.     

Small bowel transplantation: current progress and clinical application

Total parenteral nutrition (TPN) is used routinely to maintain patients with the Short Bowel Syndrome (SBS). Until recently, TPN has been the only available therapeutic modality for patients with SBS. Currently, it is the treatment of choice for such individuals and occasionally, when the loss of bowel is extensive, it may be the only way of maintaining life. Unfortunately, TPN is expensive and markedly restrains an individual's lifestyle. Despite the overall success of TPN, the numerous risks associated with its use and the many complications of having an intravenous indwelling for years have served as the stimulus for alternative treatments such as small bowel transplantation (SBT). The first attempts at small bowel transplantation in clinical medicine were by Detterling almost 25 years ago. Patient death or graft loss in these early attempts was caused by the failure to control graft rejection and/or the inability to prevent Graft Versus Host Disease (GVHD). A stimulus for renewed clinical interest in SBT was provided by Starzl et al in 1988 with a report of prolonged graft survival without graft rejection or GVHD in a patient who was the recipient of a multivisceral graft consisting of the entire small bowel and other abdominal organs. Since 1964, 78 Small Bowel transplants have been performed in humans. Several variations of the multivisceral procedure in which the liver and the small bowel constitute the major components of the graft were adopted. The longest survival has been in a child who is still alive with a working graft for more than two years, as reported by Goulet from Paris in 1989. The introduction in SBT of the new immunosuppressive agent FK 506 had provided results which are superior to those achieved with Cyclosporine A (CsA). This latter observation prompted the Pittsburgh group to initiate a large series of isolated and composite intestinal grafts. The remarkable results have demonstrated the clinical utility of intestinal transplantation. This paper will try to summarize the history of the small bowel transplantation until the end of the year 1992, with the current progress in use today.     

Is Relevance Relevant? Market,Science, and War: Discourses of Search Engine Quality

In the face of rising controversy about search engine results—that they are too restrictive, too comprehensive, lacking in certain areas, over-represented in others—this article presents the results of in-depth interviews with search engine producers, examining their conceptions of search engine quality and the implications of those conceptions. Structuration theory suggests that the cultural schemas that frame these discourses of quality will be central in mobilizing resources for technological development. The evidence presented here suggests that resources in search engine development are overwhelmingly allocated on the basis of market factors or scientific/technological concerns. Fairness and representativeness, core elements of the journalists' definition of quality media content, are not key determiners of search engine quality in the minds of search engine producers. Rather, alternative standards of quality, such as customer satisfaction and relevance, mean that tactics to silence or promote certain websites or site owners (such as blacklisting, whitelisting, and index "cleaning") are seen as unproblematic.     

From dust till drawn

We present a system for drawing pastel media in real-time as an effective alternative to most existing digital solutions that basically allow for drawing arbitrary strokes in a particular style. Our approach is focused on the simulation of the natural material itself and on its interaction with the drawing surface and the drawing tool. Upon free-form drawing, a bidirectional transfer of pigment takes place. In one direction, the paper surface is dusted with new pigment particles broken off the tip (i.e., the end of the drawing tool). A large part of these particles will be deposited or blended together with previously deposited ones whereas the remainder does not contribute to the drawing and is blown off. On the other hand, a certain amount of previously deposited pigment is scraped off and picked up again soiling the tip. This is noticeable in the next strokes to be drawn. Furthermore, both the tip and the paper surface are subject to weathering depending on the exerted pressure and friction of the drawing tool, and the bumpiness of the paper. As a result, the paper surface becomes slightly damaged, limiting the deposition of new pigment. The tip, on the other hand, becomes blunt making new strokes wider. From a stylistic point of view, similarly to traditional drawings our results convey the artists’ characteristics (e.g., the way of wielding the brush, skillfulness, feeling for the medium). Therefore, we believe that our system allows an artist to create realistically looking pastel images without losing his/her personal touch.     

Six Synthesis Methods for Reversible Logic

The (2 ^w )! reversible transformations on w wires, i.e. reversible logic circuits with w inputs and w outputs, together with the action of cascading, form a group, isomorphic to the symmetric group S ₂ ^w . Therefore, we investigate the group S _n as well as one of its subgroups isomorphic to S _n/2 × S _n/2. We then consider the left cosets, the right cosets, and the double cosets generated by the subgroup. Each element of a coset can function as the representative of the coset. The coset can then be considered as the set of all group elements that differ from the representative by merely multiplying (either to the left or to the right or to both sides) by an arbitrary element of the subgroup. Different choices of the coset space and different choices of the coset representatives lead to six different syntheses for implementing an arbitrary reversible logic operation into hardware. Evaluation of all six methods, by means of three different cost functions (gate cost, switch cost, and quantum cost), leads to a best choice.