Risk stratification using the Society of Thoracic Surgeons Program

In an era of progressive cost containment and public scrutiny, the wisdom of aggressive surgical therapy for high-risk candidates has been questioned. At our center in the previous 24 months, 728 patients with coronary artery disease were entered into The Society of Thoracic Surgeons national database, and the hospital outcomes plus length of stay were analyzed. Patients were separated according to the predicted mortality based on the groupings in The Society of Thoracic Surgeons database: 0 to 5% (453 patients); 5% to 10% (126 patients); 10% to 20% (96 patients); 20% to 30% (17 patients); and 30% and greater (36 patients). There was a close correlation with the predicted rates of mortality. Importantly, the preoperative risk stratification demonstrated a strong correlation with the significant morbidity and excessive length of stay in the highest-risk groups (predicted risk of 20% to > or = 30%). The incidences of the most common complications in the group with the highest predicted risk (> or = 30%) were 28%, renal failure; 33%, ventilator dependence; and 17%, cardiac arrest. In addition, at short-term follow-up (6 to 8 months), a 24.3% mortality was identified in patients with a predicted mortality that exceeded 20%. These data quantify the risks and morbidities associated with the care of seriously ill patients with coronary artery disease and demonstrate the need for professional and public discussions focusing on the association of a high preoperative risk status and the consumption of resources.     

Penicillin vs. erythromycin in the treatment of diphtheria

PURPOSE: To review the University of Florida experience in treating ependymomas, analyze prognostic factors, and provide treatment recommendations. METHODS AND MATERIALS: Forty-one patients with ependymoma and no metastases outside the central nervous system received postoperative radiotherapy with curative intent between 1966 and 1989. Ten patients had supratentorial lesions, 22 had infratentorial lesions, and 9 had spinal cord lesions. All patients had surgery (stereotactic biopsy, subtotal resection, or gross total resection). Most patients with high-grade lesions received radiotherapy to the craniospinal axis. Low-grade intracranial lesions received more limited treatment. Spinal cord lesions were treated using either partial spine or whole spine fields. RESULTS: Of 32 intracranial tumors, 21 recurred, all at the primary site; no spinal cord tumors recurred. Overall 10-year survival rates were 51% (absolute) and 46% (relapse-free); by tumor site: spinal cord, 100%; infratentorial, 45%; supratentorial, 20% (p = 0.002). On multivariate analysis, tumor site was the only factor that influenced absolute survival (p = 0.0004); other factors evaluated included grade, gender, age, duration of symptoms, resection extent, primary tumor dose, treatment field extent, surgery-to-radiotherapy interval, and days under radiotherapy treatment. CONCLUSIONS: Patients with supratentorial or infratentorial tumors receive irradiation, regardless of grade. Craniospinal-axis fields are used when spinal seeding is radiographically or pathologically evident. Spinal cord tumors are treated using localized fields to the primary site if not completely resected. Failure to control disease at the primary site remains the main impediment to cure.     

Inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program of the National Cancer Institute, 1975-1992

BACKGROUND: Little is known about the cause of inflammatory breast carcinoma (IBC), the most aggressive form of breast cancer. To the authors' knowledge, no studies have investigated whether IBC risk factors are different from those for breast carcinoma overall, and there has been only one report of IBC incidence and survival patterns. METHODS: The authors used data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute for the period 1975-1992 to calculate age-adjusted incidence and survival rates for 913 white and 121 African American women with IBC involving dermal invasion of lymphatic ducts and 166,375 white and 13,674 African American women with other types of breast carcinoma (non-IBC). RESULTS: Between 1975-1977 and 1990-1992, IBC incidence doubled, increasing among whites from 0.3 to 0.7 cases per 100,000 person-years and among African Americans from 0.6 to 1.1 cases. However, rates for African Americans varied due to the small numbers of IBC cases. The twofold increase in IBC incidence was higher than that observed for non-IBC during the same period (27% for African Americans and 25% for whites). IBC patients were significantly younger at diagnosis than non-IBC patients; and among both IBC and non-IBC patients, African Americans were younger than whites. Overall survival was significantly worse for IBC patients than for non-IBC patients and for African Americans than for whites. Among whites, 3-year survival improved more for IBC patients than for non-IBC patients between 1975-1979 and 1988-1992, increasing from 32% to 42% for IBC patients (P=0.0001) and from 80% to 85% for non-IBC patients (P=0.0001). CONCLUSIONS: The disparities observed in incidence trends and age at diagnosis, particularly according to race, highlight the need for further investigation of the differences between IBC and non-IBC incidence.     

Temperature Dependence of the Phototransport Properties in C60 films

Solid C₆₀ is a semiconductor with very special properties which are sensitive to its preparation conditions. Very little is known about the forbidden gap states and about the recombination centers in this material. An attempt is made in this paper to deduce information on the latter from the temperature dependences of the photoconductivity and the corresponding light intensity exponent that were measured on C₆₀ films. This attempt combines a comparison of the experimental results with numerical simulation of a simple model. It is concluded that oxygen centers play a major role in the electronic structure of solid C₆₀ These centers are acceptor-like, they act as compensators to the shallow donors and they result in recombination centers which lie 0.3 eV below the conduction band edge. It is further concluded that the oxygen suppresses the well-known phase transition that occurs around 260°C by prohibiting the expansion of the lattice upon the increase of temperature.     

Multitask learning for health condition identification and remaining useful life prediction: deep convolutional neural network approach

Predicting remaining useful life (RUL) is crucial for system maintenance. Condition monitoring makes not only degradation data available for RUL estimation but also categorized health status data for health state identification. However, RUL prediction has been treated as an independent process in most cases even though potential relevance exists with health status detection process. In this paper, we propose a convolution neural network based multi-task learning method to reflect the relatedness of RUL estimation with health status detection process. The proposed method applied to the C-MAPSS dataset for aero-engine unit prognostics supported superior performances to existing baseline models.

     

基于演化算法的奇偶校验器自动设计*

基于演化算法技术,提出一种新的设计思想,实现奇偶校验器的电路自动设计.实验证明,多目标演化算法具有较少的运算量和较高的效率,能自动设计出使用逻辑门数更少、延时更小的奇偶校验器.     

金属磁记忆检测技术概况及初步应用

介绍金属磁记忆检测技术的背景、发展、现状、目的和意义，用两个应用实例初步评价了磁记忆检测技术的有效性，提出了磁记忆技术发展的近期和远期目标，展望了应用前景。     

Structural and transport effects of doping perfluorosulfonic acid polymers with the heteropoly acids, H3PW12O40 or H4SiW12O40

A perfluorosulfonic acid (PFSA) polymer with pendant side chain -O(CF₂)₄SO₃H was doped with the heteropoly acids (HPAs), H₃PW₁₂O₄₀ and H₄SiW₁₂O₄₀. Infrared spectroscopy revealed a strong interaction between the HPA and the PFSA ionomer. Modes associated with the peripheral bonds of the HPA were shifted to lower wave numbers when doped into PFSA membranes. Small-angle X-ray scattering (SAXS) measurements showed the presence of large crystallites of HPA in the membrane with d spacings of ca. 10 Å, close to the lattice spacing observed in bulk HPA crystals. Under wet conditions the HPA was more dispersed and constrained the size of the sulfonic acid clusters to 20 Å at a 5 wt% HPA doping level, the same as in the vacuum treated ionomer samples. Under conditions of minimum hydration the HPA decreased the E_a for the self-diffusion of water from 27 to 15 kJ mol⁻¹. The reverse trend was seen under 100% RH conditions. Proton conductivity measurements showed improved proton conductivity of the HPA doped PFSAs at a constant dew point of 80 °C for all temperatures up to 120 °C and at all relative hummidities up to 80%. The activation energy for proton conduction generally was lower than for the undoped materials at RH ≤80%. Significantly the E_a was 1/2 that of the undoped material at RHs of 40 and 60%. A practical proton conductivity of 113 mS cm⁻¹ was observed at 100 °C and 80% RH.     

Temperature-dependent diffusion coefficient of soluble substances during ethanol extraction of clove

The temperature dependence of the diffusion coefficient of ethanol-soluble substances from ground cloves (particle size 250 μm) during extraction was estimated by fitting batch extraction data at several temperatures (27.8, 40, 50, and 60°C) to a previously developed mass transfer model. The model was based on spherical geometry of particles. Nonlinear regression analysis was used to develop an equation that describes the diffusivity as a function of temperature. The temperature dependence ofD _A was of the Arrhenius type.     

Resistivity and thermal reproducibility of carbon black and metallic powder filled silicone rubber heaters

Flexible heaters were prepared by extruding platinum‐catalyzed silicone rubber composites with conductive carbon black (CB) and metallic fillers. The conductor resistivity of the extruded heaters decreased in order of conductive titanium dioxide (TiO₂) > aluminum powder ≈ zinc powder > copper powder. Thermoelectric switching phenomena were investigated for the silicone rubber/CB/metallic powder systems. The positive temperature coefficient effect was dependent mainly on the CB content rather than on the content of the metallic powders. Resistivity and thermal reproducibility of the extruded heaters were also investigated by periodically applying AC voltage of 110 V. The heaters containing copper and TiO₂ powders exhibited excellent electrical reproducibility. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci 95: 1122–1128, 2005