The "first generation" of endovascular stent-grafts for patients with aneurysms of the descending thoracic aorta

OBJECTIVE: Our goal was to determine whether endovascular stent-grafting is feasible and effective for patients with aneurysms of the descending thoracic aorta. METHODS: Starting in July 1992, we conducted a prospective, uncontrolled clinical trial in 103 patients (mean age 69 years [range 34-89 years]) who underwent endovascular treatment of aneurysms of the descending thoracic aorta using a custom-fabricated, self-expanding stent-graft device. Follow-up was 100% complete and averaged 22 months. Sixty-two patients (60%) were judged not to be reasonable candidates for a conventional "open" surgical procedure. RESULTS: Complete thrombosis of the aneurysm was ultimately achieved in 86 (83%) patients. The early mortality rate was 9% +/- 3% (+/- 70% CL). Multivariable analysis revealed that myocardial infarction or stroke was linked with a higher likelihood of early death (P = .001). Early serious complications included paraplegia in 3% +/- 2% and stroke in 7% +/- 3%. Actuarial survival estimates at 1 year and 2 years were 81% +/- 4% and 73% +/- 5% (+/- 1 SE), respectively; being judged not to be a surgical candidate portended a higher probability of death (P = .003). According to the intent-to-treat principle, "treatment failure" (including all late sudden unexplained deaths) occurred in 38 patients; 53% +/- 10% of patients were free from treatment failure at 3.7 years. Stent-graft related complications occurred commonly and were linked with several anatomic, technical, and patient-related risk factors. CONCLUSIONS: This 5-year clinical trial involving use of a "first generation" device indicates that endovascular stent-grafting of descending thoracic aortic aneurysms is feasible with acceptable medium-term results. More refined, commercially developed devices available today offer less traumatic and more precise stent-graft deployment; these major technical advantages, coupled with important lessons we have learned over time and better patient selection, should be associated with more salutary clinical results in the future.     

Temporal processing of the pitch of complex tones

The effect of tone duration on fundamental frequency (F0) discrimination is greater for complexes containing unresolved harmonics than for those containing resolved harmonics [Plack and Carlyon, J. Acoust. Soc. Am. 98, 1355-1364 (1995)]. Three experiments explored this effect further. The first experiment measured sensitivity (as d') to fundamental frequency (F0) differences for two complexes, both with an F0 of 250 Hz. The first complex was low-pass filtered at 1875 Hz to create a resolved complex and the second was bandpass filtered between 5500 and 7500 Hz to create an unresolved complex. The harmonics for the resolved complex were selected so that no two harmonics were the same between the two observation intervals. Performance for both complexes was measured for tone durations of 20, 40, 80, and 160 ms. For the unresolved complex, the effect of duration was greater than that for the resolved complex and greater than the predictions of a "multiple-looks" model assuming either peripheral (before sampling) or central (after combining samples) sources of variance. The second experiment replicated these results using an F0 of 62.5 Hz with the cutoff frequencies of the bandpass filters divided by four, confirming that the effect is related to resolvability and not to spectral region. In the final experiment, F0 discrimination for pairs of complexes separated by a temporal gap was measured relative to that for one complex. Performance for the resolved and unresolved complexes was similar: Very little effect of gap duration was observed and the results were consistent with the predictions of the peripheral-variance multiple-looks model. Taken together, the results suggest that the pitch mechanism for resolved harmonics uses a relatively short sampling window of around 20 ms, while the mechanism for unresolved harmonics may use a more complex strategy for optimizing the combination of information over time, perhaps involving a flexible integration time.     

Trick or treat?: uneven understanding of mind and emotion and executive dysfunction in "hard-to-manage" preschoolers

It is widely recognised that impaired social relations are characteristic of school-aged children with behavioural disorders, and predict a poor long-term outcome (Parker & Asher, 1987). However, little is known about the early antecedents of social impairment in behaviourally disturbed children. The aim of the present study was to explore three areas of potential dysfunction in younger children: theory of mind, emotion understanding, and executive function. Forty preschoolers, rated by their parents on the Strengths and Difficulties Questionnaire (Goodman, 1994) as "hard to manage" (H2M) were compared with a control group on a set of: (1) theory of mind tasks (including an emotion prediction task involving either a nice or a nasty surprise); (2) emotion understanding stories (that required affective perspective-taking skills as well as situational understanding); and (3) simple executive function tasks (adapted for preschoolers, and tapping inhibitory control, attentional set-shifting, and working memory). Small but significant group differences were found in all three cognitive domains. In particular, hard-to-manage preschoolers showed poor understanding of emotion and executive control, poor prediction or recall of a false belief, and better understanding of the belief-dependency of emotion in the context of a trick than a treat. Moreover, executive function was associated with performance on the theory of mind tasks for the hard-to-manage group alone, suggesting both direct and indirect links between executive dysfunction and disruptive behaviour.     

Differences in detection of alcohol use in a prenatal population (on a Northern Plains Indian Reservation) using various methods of ascertainment

Although Fetal Alcohol Syndrome (FAS) rates have been reported to be higher in American Indian populations, no screening tool has been validated for alcohol use in American Indian women. The objectives of this study were to compare the detection of prenatal alcohol use by a self-administered questionnaire to detection by clinical interview; and to ascertain whether the screening tool would increase detection of pregnant women who are abusing alcohol. The hospital records of the women were reviewed for any history of alcohol-related illnesses or injuries to compare with results obtained from the questionnaire. Seventy women attending their first prenatal clinic visit on a reservation were screened for alcohol use. There was a wide range in detection of prenatal alcohol use (20%-71% of the sample detected) depending on the method used. There was a large variation in sensitivities (7%-93%) of the individual questions in identifying patients detected as "high risk" by the clinicians. The T-ACE screening questions significantly increased detection of alcohol use compared to detection by the clinicians (p = 0.04 Fisher's exact test). Due to the large variation between different methods of detection, it is recommended that screening tools that increase detection of alcohol use should be combined with methods of higher specificity such as using questions about quantity and frequency of alcohol intake, medical chart review and clinical interview. We also found that various interpretations of the screening questions by the patients highlighted the need to tailor the wording of individual questions to the particular patient population.     

Use of subjective and nonsubjective methodologies to evaluate lens radiation damage in exposed populations--an overview

The general epidemiological acceptability of prevalence, or incidence, for assessing risk of radiation cataract development has dictated an almost exclusive dependence on cataract onset as a measure of cataractogenicity for given doses of radiation. The advent of instrumentation capable of acquiring images amenable to quantitative analyses offers the possibility of exploiting "relative opacification" as an added, if not exclusive, parameter. This development is particularly important in efforts to assess populations such as that in the Altai, which are temporally far removed from their exposure and among whom there exists a large subset with extant cataracts. The new technologies, Scheimpflug and retroillumination imaging, combined with the application of the appropriate analytical algorithms can not only provide quantitative and nonsubjective assessment of lens transparency, but also serve as a means to immortalize the state of the pathology at the time of acquisition. Highly relevant to the assessment of an aging exposed population is the use of lens epithelial fragments as potential dosimeters. The material is routinely available as a result of cataract extraction procedures and is amenable to the application of a modified micronucleus (MN) assay. The MN assay in the lens has tremendous advantages over its use in other tissues for a number of reasons, not least of which is that lens MNs are extremely long-lived. Given the relative ease of application and its potential as a radiation bioindicator, the lens MN assay should be considered in any follow-up of populations exposed to ionizing radiation.     

Automated diagnosis of feature model configurations

Software product-lines (SPLs) are software platforms that can be readily reconfigured for different project requirements. A key part of an SPL is a model that captures the rules for reconfiguring the software. SPLs commonly use feature models to capture SPL configuration rules. Each SPL configuration is represented as a selection of features from the feature model. Invalid SPL configurations can be created due to feature conflicts introduced via staged or parallel configuration or changes to the constraints in a feature model. When invalid configurations are created, a method is needed to automate the diagnosis of the errors and repair the feature selections.This paper provides two contributions to research on automated configuration of SPLs. First, it shows how configurations and feature models can be transformed into constraint satisfaction problems to automatically diagnose errors and repair invalid feature selections. Second, it presents empirical results from diagnosing configuration errors in feature models ranging in size from 100 to 5,000 features. The results of our experiments show that our CSP-based diagnostic technique can scale up to models with thousands of features.     

The Malta cistern mapping project: Underwater robot mapping and localization within ancient tunnel systems

This paper documents the development of an underwater robot system enabled with several mapping and localization techniques applied to a particular archaeological expedition. The goal of the expedition was to explore and map ancient cisterns located on the islands of Malta and Gozo. The cisterns of interest acted as water storage systems for fortresses, private homes, and churches. Such cisterns often consisted of several connected chambers, still containing water. A sonar‐equipped remotely operated vehicle (ROV) was deployed into these cisterns to obtain both video footage and sonar range measurements. Six different mapping and localization techniques were employed, including (1) sonar image mosaics using stationary sonar scans, (2) sonar image mosaics using stationary sonar scans with Smart Tether position data, (3) simultaneous localization and mapping (SLAM) while the vehicle was in motion, (4) SLAM using stationary sonar scans, (5) localization using previously created maps, and (6) SLAM while the vehicle was in motion with Smart Tether position data. Top‐down‐view maps of 22 different cisterns were successfully constructed. It is estimated that the cisterns were built as far back as 300 B.C., and few records of their size, shape, and connectivity existed before the expedition. © 2010 Wiley Periodicals, Inc.     

An application of the technology acceptance model to the level of Internet usage by older adults

In this cross-sectional study, the principles of a technology acceptance model were used to identify variables related to the level of Internet usage by older adults. Community-dwelling older adults aged 60–88 years completed a postal questionnaire survey that elicited responses on the use of the Internet. Out of a sample of 592 older adults (236 males and 356 females), 50.7% used the Internet. A multiple linear regression analysis was carried out on the Internet users sample using the self-reported number of hours of Internet usage per week as the dependent variable. The results indicated that attitude toward using the Internet and good health status were statistically significant predictors of the level of Internet usage. A second multiple regression analysis using Internet activity as the dependent variable showed that attitude, usefulness, good health, and gender (males) were significant predictor variables.     

Indoor robot gardening: design and implementation

This paper describes the architecture and implementation of a distributed autonomous gardening system with applications in urban/indoor precision agriculture. The garden is a mesh network of robots and plants. The gardening robots are mobile manipulators with an eye-in-hand camera. They are capable of locating plants in the garden, watering them, and locating and grasping fruit. The plants are potted cherry tomatoes enhanced with sensors and computation to monitor their well-being (e.g. soil humidity, state of fruits) and with networking to communicate servicing requests to the robots. By embedding sensing, computation, and communication into the pots, task allocation in the system is de-centrally coordinated, which makes the system scalable and robust against the failure of a centralized agent. We describe the architecture of this system and present experimental results for navigation, object recognition, and manipulation as well as challenges that lie ahead toward autonomous precision agriculture with multi-robot teams.