Prevention of bacterial endocarditis: recommendations by the American Heart Association

OBJECTIVE: To update recommendations issued by the American Heart Association last published in 1990 for the prevention of bacterial endocarditis in individuals at risk for this disease. PARTICIPANTS: An ad hoc writing group appointed by the American Heart Association for their expertise in endocarditis and treatment with liaison members representing the American Dental Association, the infectious Diseases Society of America, the American Academy of Pediatrics and the American Society for Gastrointestinal Endoscopy. EVIDENCE: The recommendations in this article reflect analyses of relevant literature regarding procedure-related endocarditis, in vitro susceptibility data of pathogens causing endocarditis, results of prophylactic studies in animal models of endocarditis and retrospective analyses of human endocarditis cases in terms of antibiotic prophylaxis usage patterns and apparent prophylaxis failures. MEDLINE database searches from 1936 through 1996 were done using root words endocarditis, bacteremia and antibiotic prophylaxis. Recommendations in this document fall into evidence level III of the U.S. Preventive Services Task Force categories of evidence. CONSENSUS PROCESS: The recommendations were formulated by the writing group after specific therapeutic regimens were discussed. The consensus statement was subsequently reviewed by outside experts not affiliated with the writing group and by the Science Advisory and Coordinating Committee of the American Heart Association. These guidelines are meant to aid practitioners but are not intended as the standard of care or as a substitute for clinical judgment. CONCLUSIONS: Major changes in the updated recommendations include the following: (1) emphasis that most cases of endocarditis are not attributable to an invasive procedure; (2) cardiac conditions are stratified into high-, moderate- and negligible-risk categories based on potential outcome if endocarditis develops; (3) procedures that may cause bacteremia and for which prophylaxis is recommended are more clearly specified; (4) an algorithm was developed to more clearly define when prophylaxis is recommended for patients with mitral valve prolapse; (5) for oral or dental procedures the initial amoxicillin dose is reduced to 2 g, a follow-up antibiotic dose is no longer recommended, erythromycin is no longer recommended for penicillin-allergic individuals, but clindamycin and other alternatives are offered.     

Fast mode decision algorithm for H.264/SVC enhancement layer

Scalable video coding (SVC) has been standardized to extend the capabilities of the H.264 advanced video coding (AVC). The SVC can compress several video sequences of various resolutions as a single bit-stream. In the SVC enhancement layer, for Joint Scalable Video Model (JSVM) software implementation, an exhaustive mode decision process based on the base layer mode predictions is performed to obtain the best mode for each macroblock (MB). This technique may achieve a higher coding efficiency; however, it induces a significant computational complexity in the encoding engine. In order to speedup the SVC encoder, a fast mode decision algorithm was proposed in this paper. In other words, our aim was to decrease the number of candidate modes to reduce the computational complexity and maintain the same level of coding efficiency, this approach used the spatial and temporal correlation between MB situated at the enhancement layer and its co-located MB at the base layer. Our statistical analyses were made using several HD sequences with different motion characteristics. Experimental results show a significant improvement in terms of time encoding which is a major constraint for any real-time implementation. However, this gain is accompanied with an acceptable loss in video quality and a tolerable bit rate increase for most media supports. In fact, our proposed algorithm permits a major improvement that can reach up to 64.9 % in terms of computational effort. This gain will induce an average loss yield to 10.5 or 13.87 % that is comparable to the 13.12 % of the He Li’s algorithm with an acceptable loss in terms of subjective video quality.     

Digital image steganalysis based on the reciprocal singular value curve

Embedding secret messages in steganographic approaches is similar to adding some weak noises to the original media. One of the traditional ways for image steganalysis is computing a feature sets using noise residuals. From another perspective, the disturbance of natural image statistics can be explored to extract the feature vector for steganalysis. In fact, the alteration of natural scene statistics can be investigated to reveal the presence of secret messages embedded in images. Hence, the feature vectors can be constructed using such changes. In the proposed scheme, the alteration of singular value curve is used to construct the steganalysis feature vector. Two spatial and JPEG based feature vectors are extracted in the proposed statistical exploitation. The experimental results illustrate the acceptable performance of the proposed feature vectors for both universal and JPEG based steganalysis methods.

     

Equilibrium and non‐equilibrium gas–liquid two phase flow in long and short pipelines following a rupture

The two‐phase flow following the blowdown of pipeline carrying flashing liquid is numerically investigated by using thermodynamic equilibrium and non‐equilibrium models. Model equations are solved numerically by the finite volume method. The values of fluxes at cell boundaries are obtained by AUSM+‐up. To obtain proper values for the coefficients of dissipation, both single phase liquid and two phase shock tube problems are investigated. The transient release from the pressurized pipeline is studied for two cases of long and short pipes. Comparison of the predictions against experimental data reveals non‐equilibrium model performs a little better than equilibrium model in the prediction of temporal variations of pressure and void fraction of the long pipe. However, equilibrium model totally overestimates pressure and void fraction of the short pipe. The relative error of equilibrium model in the prediction of pressure variation with time exceeds 50% and it is 20% for non‐equilibrium model. © 2017 American Institute of Chemical Engineers AIChE J, 63: 3214–3223, 2017     

Maize-nutrient response information applied across Sub-Saharan Africa

The profit potential for a given investment in fertilizer use can be estimated using representative crop nutrient response functions. Where response data is scarce, determination of representative response functions can be strengthened by using results from homologous crop growing conditions. Maize (Zea mays L.) nutrient response functions were selected from the Optimization of Fertilizer Recommendations in Africa (OFRA) database of 5500 georeferenced response functions determined from field research conducted in Sub-Saharan Africa. Three methods for defining inference domains for selection of response functions were compared. Use of the OFRA Inference Tool (OFRA-IT; http://agronomy.unl.edu/OFRA) resulted in greater specificity of maize N, P, and K response functions with higher R² values indicating superiority compared with using the Harvest Choice Agroecological Zones (HC-AEZ) and the recommendation domains of the Global Yield Gap Atlas project (GYGA-RD). The OFRA-IT queries three soil properties in addition to climate-related properties while the latter two options use climate properties only. The OFRA-IT was generally insensitive to changes in criteria ranges of 20–25% used in queries suggesting value in using wider criteria ranges compared with the default for information scarce crop nutrient response functions.     

DMSO Chemically Alters Cell Membranes to Slow Exocytosis and Increase the Fraction of Partial Transmitter Released

Dimethyl sulfoxide (DMSO) is frequently used as a solvent in biological studies and as a vehicle for drug therapy; but the side effects of DMSO, especially on the cell environment, are not well understood, and controls with DMSO are not neutral at higher concentrations. Herein, electrochemical measurement techniques are applied to show that DMSO increases exocytotic neurotransmitter release, while leaving vesicular contents unchanged. In addition, the kinetics of release from DMSO‐treated cells are faster than that of untreated ones. The results suggest that DMSO has a significant influence on the chemistry of the cell membrane, leading to alteration of exocytosis. A speculative chemical mechanism of the effect on the fusion pore during exocytosis is presented.     

Scalar mixing measurements in batch operated stirred tanks

An LIF technique was used to obtain unobtrusive measurements of scalar concentration as a function of time and mixing times in a fully baffled batch operated mixing vessel agitated by five forms of impeller (Rushton, ‘bucket’, six bladed 45°-and 60°-pitched blade, hyperboloid). The mixing time was comparable to the time required for the dye/scalar to be transported from the top of the vessel to the bottom part plus the time required for a further two rotations of the bulk flow in the circumferential direction. At constant power input the mixing times for similar impellers were similar, although different for different types.     

Introduction of a chaotic dough mixer, part A: mathematical modeling and numerical simulation

The motivation of this work is to propose a special dough mixer with chaotic advection to take advantage of high performance mixing in chaotic mixers and to develop typical dough mixers. In order to prevent common difficulties encountered due to the dynamic mesh, a mathematical model was employed based on neglecting the transient term of the momentum equation using conceptual features from creeping flow. Then, the numerical simulation was performed using the bird Carreau dough model of Dhanasekharan. The mathematical model was further developed to complete the numerical procedure in order to find the required material point trajectories for assessing the presence of chaotic advection in the proposed mixer. In this approach, Lyapunov exponents were also calculated which quantify the exponential divergence of the initially close state-space trajectories and identify chaotic behavior of the system as well. The results indicated that the flow field was a combination of both chaotic and non-chaotic zones.