Pharmacologic profile of survivors of acute myocardial infarction at United States academic hospitals

Optimal drug therapy for patients with acute myocardial infarction (AMI) is well described in the medical literature. However, data on the actual pharmacologic management of patients surviving AMI at academic hospitals is unavailable. The purpose of this study was to document treatment profiles in 500 patients surviving AMI at 12 academic hospitals in the United States. These profiles were compared with established guidelines and were evaluated for trends. Overall, thrombolytics (streptokinase > or = tissue-type plasminogen activator) were administered in 29% of the patients, with a greater proportion of patients receiving beta-blockers than calcium channel antagonists in the initial 72 hours (61% vs 40%; p < 0.005) and at discharge (51% vs 35%; p < 0.005). Further, women were less likely than men to receive thrombolytic therapy (odds ratio [OR] = 0.61; confidence interval [CI], 0.54 to 0.69) or beta-blocker therapy within the first 72 hours (OR = 0.61; CI, 0.55 to 0.67) or at hospital discharge (OR = 0.53; CI, 0.48 to 0.58). Overall, improvements could still be made in the number of patients who receive thrombolytic and acute and chronic beta-blocker therapies after AMI, particularly in women. Changes in treatment profiles may be a reflection of the publication of large clinical trials.     

795 nm and 1064 nm dual pump thulium-doped tellurite fibre for S-band amplification

Gain measurement in thulium-doped tellurite fibre is demonstrated with a maximum internal gain of 7 dB at 1480 nm. An improvement in gain by a factor of 2 is achieved using a 795 nm and 1064 nm dual pump scheme. Gain in tellurite fibres extends to longer wavelength than in fluorides, showing improved overlap with the C-band EDFA.     

An elementary proof of Sylvester’s double sums for subresultants

In 1853 Sylvester stated and proved an elegant formula that expresses the polynomial subresultants in terms of the roots of the input polynomials. Sylvester’s formula was also recently proved by Lascoux and Pragacz using multi-Schur functions and divided differences. In this paper, we provide an elementary proof that uses only basic properties of matrix multiplication and Vandermonde determinants.     

Parallel Computation of High-Dimensional Robust Correlation and Covariance Matrices

The computation of covariance and correlation matrices are critical to many data mining applications and processes. Unfortunately the classical covariance and correlation matrices are very sensitive to outliers. Robust methods, such as Quadrant Correlation (QC) and the Maronna method, have been proposed. However, existing algorithms for QC only give acceptable performance when the dimensionality of the matrix is in the hundreds; and the Maronna method is rarely used in practice because of its high computational cost. In this paper we develop parallel algorithms for both QC and the Maronna method. We evaluate these parallel algorithms using a real data set of the gene expression of over 6000 genes, giving rise to a matrix of over 18 million entries. In our experimental evaluation, we explore scalability in dimensionality and in the number of processors, and the trade-offs between accuracy and computational efficiency. We also compare the parallel behaviours of the two methods. From a statistical standpoint, the Maronna method is more robust than QC. From a computational standpoint, while QC requires less computation, interestingly the Maronna method is much more parallelizable than QC. After a thorough experimentation, we conclude that for many data mining applications, both QC and Maronna are viable options. Less robust, but faster, QC is the recommended choice for small parallel platforms. On the other hand, the Maronna method is the recommended choice when a high degree of robustness is required, or when the parallel platform features a large number of processors (e.g., 32).     

Double blind, randomised, placebo controlled study of oral vancomycin in prevention of necrotising enterocolitis in preterm, very low birthweight infants

AIMS: To evaluate the effectiveness of oral vancomycin in the prophylaxis of necrotising enterocolitis in preterm, very low birthweight infants. METHODS: A prospective, double blind, randomised, placebo controlled study in a tertiary referral centre of a university teaching hospital was conducted on 140 very low birthweight infants consecutively admitted to the neonatal unit. The babies were randomly allocated to receive oral vancomycin (15 mg/kg every 8 hours for 7 days) or an equivalent volume of placebo solution. Prophylaxis was started 24 hours before the start of oral feeds. All suspected cases of necrotising enterocolitis were investigated with a full sepsis screen and serial abdominal radiographs. Necrotising enterocolitis was diagnosed and staged according to modified Bell's criteria. RESULTS: Nine of 71 infants receiving oral vancomycin and 19 of 69 infants receiving the placebo solution developed necrotising enterocolitis (p = 0.035). Infants with necrotising enterocolitis were associated with a significant increase in mortality (p = 0.026) and longer duration of hospital stay (p = 0.002). CONCLUSIONS: Prophylactic oral vancomycin conferred protection against necrotising enterocolitis in preterm, very low birthweight infants and was associated with a 50% reduction in the incidence. However, widespread implementation of this preventive measure is not recommended, as it would only be effective in necrotising enterocolitis caused by Gram positive organisms and could increase the danger of the emergence of vancomycin resistant or dependent organisms. Its use should be restricted to a high prevalence nursery for a short and well defined period in a selected group of high risk patients.     

Severe progressive deformities after limb lengthening in type-II fibular hemimelia

Until recently the accepted treatment of choice for severe type-II fibular hemimelia has been Syme's or Boyd's amputation. The alternative of distraction lengthening using the Ilizarov technique is now available. We report three patients (four limbs) with type-II fibular hemimelia who were treated by the Ilizarov technique and followed up for two to six years. Severe progressive procurvatum and valgus deformity of the tibia and valgus deformity and lateral subluxation of the ankle were found in all four limbs. Multiple additional soft-tissue and bony surgery was necessary. In view of these problems we feel that reappraisal of the indications for lengthening in type-II fibular hemimelia is necessary.     

Prevalence and role of anticardiolipin antibodies in Crohn disease

OBJECTIVES: Anticardiolipin antibodies belong to the group of antiphospholid antibodies, and may be seen in association with endothelial damage and recurrent vascular thrombosis. The aim of our study was to determine in patients with Crohn's disease the frequency of anticardiolipin antibodies, and to correlate their presence with clinical activity and treatment of the disease. METHODS: One hundred and thirty-eight sera from patients with Crohn's disease and 118 from age-matched controls were tested for IgG anticardiolipin antibodies. In the Crohn's disease group, we determined whether the patients had a past history of vascular thrombosis, a clinically active intestinal disease, or a current immunosuppressive therapy (steroids or azathioprine). RESULTS: Anticardiolipin antibodies were found significantly more often in patients with Crohn's disease than in controls: 11.0% versus 2.5%, P < 0.02. Three patients with Crohn's disease had a past history of vascular thrombosis, but none of them had anticardiolipin antibodies. The presence of anticardiolipin antibodies was not correlated with the fact that patients had a clinically active disease (P = 0.77), or a current immunosuppressive therapy at the time of the serological test (P = 0.95). CONCLUSIONS: There is a significantly high prevalence of patients with anticardiolipin antibodies during Crohn's disease. The positivity of the test does not seem to be correlated to the existence of a past history of vascular thrombosis, nor to the clinical activity of the disease.     

Cardiac dysrrhthmia in systemic disease

This is an ECG of a 6-year-old girl. She presented to us for management of epilepsy. Magnetic resonance imaging (MRI) of the brain showed multiple lesions consistent with cortical and subcortical tubers. There were also achromic spots on her skin and echocardiography demonstrated a rhabdomyoma near the right ventricular outflow tract. A diagnosis of tuberous sclerosis, an autosomal-dominantly inherited condition, was made. What is abnormal about the ECG?     

High-performance simulations of turbulent boundary layer flow using Intel Xeon Phi many-core processors

The Journal of Supercomputing - Direct numerical simulations (DNS) of turbulent flows have increasing importance because they not only provide fundamental understanding of turbulent flows but also...     

Adaptive load balancing algorithm for multiple homing mobile nodes

In places where mobile users can access multiple wireless networks simultaneously, a multipath scheduling algorithm can benefit the performance of wireless networks and improve the experience of mobile users. However, existing literature shows that it may not be the case, especially for TCP flows. According to early investigations, there are mainly two reasons that result in bad performance of TCP flows in wireless networks. One is the occurrence of out-of-order packets due to different delays in multiple paths. The other is the packet loss which is resulted from the limited bandwidth of wireless networks. To better exploit multipath scheduling for TCP flows, this paper presents a new scheduling algorithm named Adaptive Load Balancing Algorithm (ALBAM) to split traffic across multiple wireless links within the ISP infrastructure. Targeting at solving the two adverse impacts on TCP flows, ALBAM develops two techniques. Firstly, ALBAM takes advantage of the bursty nature of TCP flows and performs scheduling at the flowlet granularity where the packet interval is large enough to compensate for the different path delays. Secondly, ALBAM develops a Packet Number Estimation Algorithm (PNEA) to predict the buffer usage in each path. With PNEA, ALBAM can prevent buffer overflow and schedule the TCP flow to a less congested path before it suffers packet loss. Simulations show that ALBAM can provide better performance to TCP connections than its other counterparts.