Distributed associative memory for use in scene analysis

A distributed associative memory system which is ideal for scene analysis is described. Recall of associated patterns using incomplete originals is made possible by the use of a distributed storage mechanism and a novel recall procedure. The memory is shown to store associations between patterns more efficiently than a conventional file store. The paper describes the memory structure, the recall process and its storage abilities, as well as an example of its implementation in hardware.     

External tools for collaborative medication scheduling

Medication adherence—taking medication as prescribed—is critical for successful self-care, especially among older adults. Adherence depends on developing and implementing plans for taking medications. Age-related cognitive declines that affect adherence may be mitigated using external tools that support patient-provider collaboration needed to develop these adherence plans. We tested the effectiveness of structured collaborative medication tools to support better medication planning and adherence practices. Evidence for benefits of collaborative tools has been mixed in terms of their usefulness for medication-scheduling tasks, perhaps because the tools have not been explicitly designed to support patient-provider collaboration. A total of 144 community-dwelling older adults participated in pairs and performed the role of a patient or provider in a simulated patient-provider medication-scheduling task. Each pair worked with a structured (MedTable^? and e-MedTable) or unstructured (Medcard) scheduling tool and completed four problems (2 simple and 2 complex). Performance was measured using the following: problem-solving (medication schedule) accuracy, problem-solving time, solution (schedule) optimality, tool usability, collaborative effectiveness, and subjective workload involved in creating the medication schedules. Participants using structured tools produced more accurate and optimal schedules. They also rated subjective workload as lower and thought that the structured tools were easier to use, reduced subjective workload associated with creating the schedules. There was also suggestive evidence that participants using the structured tools rated more highly the quality of their collaboration. Structured medication-scheduling tools have the potential to improve medication adherence among older adults because they support collaborative planning and reduce the cognitive load involved in creating these adherence plans.     

Circumventing mental health stigma by embracing the warrior culture: Lessons learned from the Defender's Edge program.

Despite considerable efforts on the part of the Department of Defense, Department of Veterans Affairs, and the wider mental health community, mental health stigma continues to be a significant barrier to seeking help by service members, highlighting the need for newer modes of thought. A significant factor contributing to this stigma is the fundamental difference between traditional mental health approaches and the warrior culture. As a mental health prevention initiative, the Defender's Edge (DEFED) program was specifically developed to fit within the United States Air Force Security Forces (SF) charged with ground combat operations while deployed to Iraq. DEFED adopted a strengths-based philosophy and integrated a psychologist into the SF culture. Evaluative feedback from 192 program participants is presented, demonstrating high programmatic acceptability and feasibility suggestive of success in circumventing mental health stigma. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Time to clinical stability in patients hospitalized with community-acquired pneumonia: implications for practice guidelines

CONTEXT: Many groups have developed guidelines to shorten hospital length of stay in pneumonia in order to decrease costs, but the length of time until a patient hospitalized with pneumonia becomes clinically stable has not been established. OBJECTIVE: To describe the time to resolution of abnormalities in vital signs, ability to eat, and mental status in patients with community-acquired pneumonia and assess clinical outcomes after achieving stability. DESIGN: Prospective, multicenter, observational cohort study. SETTING: Three university and 1 community teaching hospital in Boston, Mass, Pittsburgh, Pa, and Halifax, Nova Scotia. PATIENTS: Six hundred eighty-six adults hospitalized with community-acquired pneumonia. MAIN OUTCOME MEASURES: Time to resolution of vital signs, ability to eat, mental status, hospital length of stay, and admission to an intensive care, coronary care, or telemetry unit. RESULTS: The median time to stability was 2 days for heart rate (< or =100 beats/min) and systolic blood pressure (> or =90 mm Hg), and 3 days for respiratory rate (< or =24 breaths/min), oxygen saturation (> or =90%), and temperature (< or =37.2 degrees C [99 degrees F]). The median time to overall clinical stability was 3 days for the most lenient definition of stability and 7 days for the most conservative definition. Patients with more severe cases of pneumonia at presentation took longer to reach stability. Once stability was achieved, clinical deterioration requiring intensive care, coronary care, or telemetry monitoring occurred in 1% of cases or fewer. Between 65% to 86% of patients stayed in the hospital more than 1 day after reaching stability, and fewer than 29% to 46% were converted to oral antibiotics within 1 day of stability, depending on the definition of stability. CONCLUSIONS: Our estimates of time to stability in pneumonia and explicit criteria for defining stability can provide an evidence-based estimate of optimal length of stay, and outline a clinically sensible approach to improving the efficiency of inpatient management.     

Sound localization in the median sagittal plane by listeners with presbyacusis

In Experiment 1, a group of listeners with substantial hearing loss due to presbyacusis and a group of listeners with normal hearing were given three localization tests: a frontal plane test in which they judged whether sounds came from the left, overhead, or the right; a sagittal plane test in which they judged whether sounds came from directly in front, overhead, or behind; and an elevation test in which they judged the vertical position of sounds coming from in front. The two groups performed similarly on the frontal plane test, which chiefly depended upon their ability to use binaural localization cues. They performed differently on the sagittal plane and elevation tests, for which the predominant localization cues were spectral. The listeners with presbyacusis were substantially less accurate than those with normal hearing in both of these instances. They had particular difficulty judging source elevation, rarely scoring much above chance. Follow-up testing of a group of subjects in the early stages of presbyacusis showed localization performance that was intermediate to the other two groups, but far more like that of the normal-hearing listeners. In Experiment 2, additional tests were run with the following conditions designed to encourage improved performance by listeners with presbyacusic hearing loss: (1) filtering of stimuli to preclude masking of more informative high-frequency components by low frequencies; (2) simplification of the elevation test and greater spatial separation of its loudspeaker sources; and (3) use of hearing aids. Conditions 1 and 2 had no appreciable effect on performance; condition 3 significantly improved presbyacusic listeners' ability to localize in the sagittal plane, particularly when sounds came from the front.     

Adenovirus-mediated p53 gene transfer in patients with advanced recurrent head and neck squamous cell carcinoma

PURPOSE: Standard therapies of head and neck squamous cell carcinoma (HNSCC) often cause profound morbidity and have not significantly improved survival over the last 30 years. Preclinical studies showed that adenoviral vector delivery of the wild-type p53 gene reduced tumor growth in mouse xenograft models. Our purpose was to ascertain the safety and therapeutic potential of adenoviral (Ad)-p53 in advanced HNSCC. PATIENTS AND METHODS: Patients with incurable recurrent local or regionally metastatic HNSCC received multiple intratumoral injections of Ad-p53, either with or without tumor resection. Patients were monitored for adverse events and antiadenoviral antibodies, tumors were monitored for response and p53 expression, and body fluids were analyzed for Ad-p53. RESULTS: Tumors of 33 patients were injected with doses of up to 1 x 10(11) plaque-forming units (pfu). No dose-limiting toxicity or serious adverse events were noted. p53 expression was detected in tumor biopsies despite antibody responses after Ad-p53 injections. Clinical efficacy could be evaluated in 17 patients with nonresectable tumors: two patients showed objective tumor regressions of greater than 50%, six patients showed stable disease for up to 3.5 months, and nine patients showed progressive disease. One resectable patient was considered a complete pathologic response. Ad-p53 was detected in blood and urine in a dose-dependent fashion, and in sputum. CONCLUSION: Patients were safely injected intratumorally with Ad-p53. Objective antitumor activity was detected in several patients. The infectious Ad-p53 in body fluids was asymptomatic, and suggests that systemic or regional treatment may be tolerable. These results suggest the further investigation of Ad-p53 as a therapeutic agent for patients with HNSCC.     

Apoptotic induction in transformed follicular lymphoma cells by Bcl-2 downregulation

The roles of Bcl-2 protein and the protein ratio of Bcl-2/Bax in regulating cell growth in various lymphoma cell lines were examined. A dose-dependent decrease in Bcl-2 protein expression was observed in the different lymphomas incubated with lipid-incorporated bcl-2 antisense oligonucleotides (L-bcl-2). Growth inhibition was observed in a transformed follicular lymphoma (FL) cell line, which has the t(14;18) translocation and Bcl-2 protein overexpression. One of the mechanisms by which L-bcl-2 growth inhibition is mediated in these transformed FL cells might be through apoptotic induction, because the treated cells had an increased apoptotic index and showed the typical DNA fragmentation. These studies indicate that Bcl-2 protein is critical in the growth regulation of transformed FL cells. L-bcl-2 did not induce growth inhibition in lymphoma cells not expressing Bcl-2 or Bax protein. Thus, the protein ratio of Bcl-2/Bax may also be important in regulating the growth of these lymphomas.     

Outbreak of Salmonella serotype Hartford infections associated with unpasteurized orange juice

CONTEXT: Acidic foods such as orange juice have been thought to be unlikely vehicles of foodborne illness. OBJECTIVE: To investigate an outbreak of Salmonella enterica serotype Hartford (Salmonella Hartford) infections among persons visiting a theme park in Orlando, Fla, in 1995. DESIGN: Review of surveillance data, matched case-control study, laboratory investigation, and environmental studies. SETTING: General community. PARTICIPANTS: The surveillance case definition was Salmonella Hartford or Salmonella serogroup C1 infection in a resident of or a visitor to Orlando in May or June 1995. In the case-control study, case patients were limited to theme park hotel visitors and controls were matched to case patients by age group and hotel check-in date. MAIN OUTCOME MEASURES: Risk factors for infection and source of implicated food. RESULTS: Sixty-two case patients from 21 states were identified. Both Salmonella Hartford and Salmonella enterica serotype Gaminara (Salmonella Gaminara) were isolated from stool samples of 1 ill person. Thirty-two case patients and 83 controls were enrolled in the case-control study. Ninety-seven percent of case patients had drunk orange juice in the theme park vs 54% of controls (matched odds ratio, undefined; 95% confidence interval, 5.2 to undefined). The orange juice was unpasteurized and locally produced. Salmonella Gaminara was isolated from 10 of 12 containers of orange juice produced during May and July, indicating ongoing contamination of juice probably because of inadequately sanitized processing equipment. CONCLUSIONS: Unpasteurized orange juice caused an outbreak of salmonellosis in a large Florida theme park. All orange juice was recalled and the processing plant closed. Pasteurization or other equally effective risk-management strategies should be used in the production of all juices.     

The orphan granzymes of humans and mice

The granzyme/perforin pathway is a central pathway for lymphocyte-mediated killing in both the innate and adaptive immune systems. This pathway is important in a variety of host defenses, including viral clearance and tumor cell killing, and its dysregulation results in several human and rodent diseases. To date, the majority of reports in this field have concentrated on the functions of granzymes A and B. Recent reports, however, suggest that the non-A/non-B 'orphan' granzymes found in both humans and mice are potentially significant. Although the functions of these orphan granzymes have yet to be fully established, initial data suggests their importance in both immune and nonimmune cells.     

Anatomical basis of a congenital hearing impairment: basilar papilla dysplasia in the Belgian Waterslager canary

We studied the role of proteases in apoptosis using a cell-free system prepared from a human leukemia cell line. HL60 cells are p53 null and extremely sensitive to a variety of apoptotic stimuli including DNA damage induced by the topoisomerase I inhibitor, camptothecin. We measured DNA fragmentation induced in isolated nuclei by cytosolic extracts using a filter elution assay. Cytosol from camptothecin-treated HL60 cells induced internucleosomal DNA fragmentation in nuclei from untreated cells. This fragmentation was suppressed by serine protease inhibitors. Serine proteases (trypsin, endoproteinase Glu-C, chymotrypsin A, and proteinase K) and papain by themselves induced DNA fragmentation in naive nuclei. This effect was enhanced in the presence of cytosol from untreated cells. Cysteine protease inhibitors (E-64, leupeptin, Ac-YVAD-CHO [ICE inhibitor]) did not affect camptothecin-induced DNA fragmentation. The apopain/Yama inhibitor, Ac-DEVD-CHO, and the proteasome inhibitor, MG-132, were also inactive both in the cell-free system and in whole cells. Interleukin-1 beta converting enzyme (ICE) or human immunodeficiency virus protease failed to induce DNA fragmentation in naive nuclei. Together, these results suggest that DNA damage activates serine protease(s) which in turn activate(s) nuclear endonuclease(s) during apoptosis in HL60 cells.