Predicting neurologic deterioration in patients with cerebellar hematomas

BACKGROUND: Patients with cerebellar hematomas may appear stable but may worsen suddenly. Whether certain clinical or CT scan findings predict worsening is not known. METHODS: We reviewed clinical and neuroimaging data in 72 patients with cerebellar hematomas at the Mayo Clinic from 1973 through 1993 to identify predictive features for neurologic deterioration. Patients presenting in coma and patients with vascular malformations or malignancies were excluded. Data were analyzed using chi-square or Fisher's exact test, with calculation of odds ratios with 95% confidence intervals. Multivariate logistic regression analysis was performed on appropriate variables. RESULTS: Thirty-three patients (46%) deteriorated, with a decrease in level of consciousness, new brainstem signs, or worsened motor response on the Glasgow Coma Scale. Clinical and neuroradiologic predictors for neurologic deterioration at p < 0.05 were admission systolic blood pressure greater than 200 mm Hg, pinpoint pupils and abnormal corneal or oculocephalic reflexes, hemorrhage extending into the vermis, hematoma size more than 3 cm in diameter, brainstem distortion, intraventricular hemorrhage, upward herniation, and acute hydrocephalus. Multivariate analysis demonstrated that hemorrhage located in the vermis (p = 0.03) and acute hydrocephalus (p = 0.0006) on admission CT scanning independently predicted deterioration. CONCLUSION: Patients with a cerebellar vermian hematoma or acute hydrocephalus are at high risk for neurologic deterioration. These patients should be carefully monitored and are more likely to require consideration for neurosurgical intervention.     

Induced magnetic fields as evidence for subsurface oceans in Europa and Callisto

The Galileo spacecraft has been orbiting Jupiter since 7 December 1995, and encounters one of the four galilean satellites-Io, Europa, Ganymede and Callisto-on each orbit. Initial results from the spacecraft's magnetometer have indicated that neither Europa nor Callisto have an appreciable internal magnetic field, in contrast to Ganymede and possibly Io. Here we report perturbations of the external magnetic fields (associated with Jupiter's inner magnetosphere) in the vicinity of both Europa and Callisto. We interpret these perturbations as arising from induced magnetic fields, generated by the moons in response to the periodically varying plasma environment. Electromagnetic induction requires eddy currents to flow within the moons, and our calculations show that the most probable explanation is that there are layers of significant electrical conductivity just beneath the surfaces of both moons. We argue that these conducting layers may best be explained by the presence of salty liquid-water oceans, for which there is already indirect geological evidence in the case of Europa.     

Hemi- and Homozygous Loss-of-Function Mutations in DSG2 (Desmoglein-2) Cause Recessive Arrhythmogenic Cardiomyopathy with an Early Onset

About 50% of patients with arrhythmogenic cardiomyopathy (ACM) carry a pathogenic or likely pathogenic mutation in the desmosomal genes. However, there is a significant number of patients without positive familial anamnesis. Therefore, the molecular reasons for ACM in these patients are frequently unknown and a genetic contribution might be underestimated. Here, we used a next-generation sequencing (NGS) approach and in addition single nucleotide polymor-phism (SNP) arrays for the genetic analysis of two independent index patients without familial medical history. Of note, this genetic strategy revealed a homozygous splice site mutation (DSG2–c.378+1G>T) in the first patient and a nonsense mutation (DSG2–p.L772X) in combination with a large deletion in DSG2 in the second one. In conclusion, a recessive inheritance pattern is likely for both cases, which might contribute to the hidden medical history in both families. This is the first report about these novel loss-of-function mutations in DSG2 that have not been previously identi-fied. Therefore, we suggest performing deep genetic analyses using NGS in combination with SNP arrays also for ACM index patients without obvious familial medical history. In the future, this finding might has relevance for the genetic counseling of similar cases.     

Possible effects of site isolation in antimony oxide-modified vanadia/titania catalysts for selective oxidation of o-xylene

Titania-supported vanadia catalysts were modified by addition of antimony oxide for application in o-xylene selective oxidation to phthalic anhydride. It was shown that active and selective catalysts can be prepared by ball-milling mixtures of powders of TiO₂, V₂O₅and Sb₂O₃followed by calcination. X-ray photoelectron spectroscopy proves the formation of highly dispersed overlayers of vanadium oxide and antimony oxide, in which V⁵⁺is partially reduced to lower oxidation states and Sb³⁺is partially oxidized to Sb⁵⁺. Antimony oxide segregated into the outermost surface layers. It is therefore inferred that the presence of the antimony oxide modifier spatially separates V–O species and leads to site isolation which may be responsible for the positive effect of the modifier for the catalyst's selectivity.     

A New Research Infrastructure for Investigating Flow Hydraulics and Process Equipment at Critical Fluid Properties

An optimized equipment design for natural gas processing and liquefaction plants becomes increasingly difficult with changing process conditions: Particularly low values of surface tension create rising challenges on the design of phase separators and column internals. The TERESA test rig at HZDR was designed to allow the investigation of multiphase thermohydraulics and phase separator performance under critical fluid properties in industrial dimensions. A versatile pipe test section is available in DN200 and equipment internals may be tested in a sectional DN300/DN500 test separator. The applied test fluid shows a high vapor-liquid density difference between 1470 and 940 kg m⁻³, viscosity as low as 0.12 mm²s⁻¹, and surface tension down to 1.3 mN m⁻¹. Volumetric liquid and vapor flow rates may be varied up to 9 and 530 m³h⁻¹ in the test rig, respectively.     

Toward Self‐Motivated,Cognitive, Continually Planning Agents

We present a flexible initial framework for defining self‐motivated, self‐aware agents in simulated worlds, planning continuously so as to maximize long‐term rewards. While such agents employ reasoned exploration of feasible sequences of actions and corresponding states, they also behave opportunistically and recover from failure, thanks to their continual plan updates and quest for rewards. Our framework allows for both specific and general (quantified) knowledge and for epistemic predicates such as knowing‐that and knowing‐whether. Because realistic agents have only partial knowledge of their world, the reasoning of the proposed agents uses a weakened closed‐world assumption; this has consequences for epistemic reasoning, in particular introspection. The planning operators allow for quantitative, gradual change and side effects such as the passage of time, changes in distances and rewards, and language production, using a uniform procedural attachment method. Question answering (involving introspection) and experimental runs are shown for our particular agent ME in a simple world, demonstrating the value of continual deliberate, reward‐driven planning. Though the primary merit of agents definable in our framework is that they combine all of the aforementioned features, they can also be configured as single or multiple goal‐seeking agents and as such perform comparably with some recent experimental agents.     

On the evaluation of unsupervised outlier detection: measures,datasets, and an empirical study

The evaluation of unsupervised outlier detection algorithms is a constant challenge in data mining research. Little is known regarding the strengths and weaknesses of different standard outlier detection models, and the impact of parameter choices for these algorithms. The scarcity of appropriate benchmark datasets with ground truth annotation is a significant impediment to the evaluation of outlier methods. Even when labeled datasets are available, their suitability for the outlier detection task is typically unknown. Furthermore, the biases of commonly-used evaluation measures are not fully understood. It is thus difficult to ascertain the extent to which newly-proposed outlier detection methods improve over established methods. In this paper, we perform an extensive experimental study on the performance of a representative set of standard k nearest neighborhood-based methods for unsupervised outlier detection, across a wide variety of datasets prepared for this purpose. Based on the overall performance of the outlier detection methods, we provide a characterization of the datasets themselves, and discuss their suitability as outlier detection benchmark sets. We also examine the most commonly-used measures for comparing the performance of different methods, and suggest adaptations that are more suitable for the evaluation of outlier detection results.     

MALDI-TOF MS: an upcoming tool for rapid detection of antibiotic resistance in microorganisms

MALDI-TOF MS profiling for microorganism detection has already been demonstrated in the 1990s, but has evolved to the first-line identification method in many laboratories just during the past five years. While this application of MALDI-TOF MS has proven its broad applicability, accuracy, robustness, and cost-effectiveness it is of particular interest to expand the capabilities of the mass spectrometric platform. Resistance detection is the most desirable further application of MALDI-TOF MS in microbiology, but maybe also the most challenging. Different approaches have been published regarding diverse antibiotic drugs and distinct microorganism classes. The current review shall give an overview about the developments of the recent years and their potential to get transformed in clinical useful assays in the future.