Public release of cardiac surgery outcomes data in New York: what do New York state cardiologists think of it?

BACKGROUND AND OBJECTIVE: Since 1990, risk-adjusted outcomes for patients undergoing coronary artery bypass graft surgery in New York state have been released to the public. The purpose of this study was to assess the extent to which referring cardiologists share these data with patients and use these data to make referrals. METHODS: A survey questionnaire was sent to all cardiologists in New York in the New York State Chapter of the American College of Cardiology. RESULTS: Four hundred fifty cardiologists responded to the survey. Most (94%) found the report "easy to read." A majority (67%) found the report to be "very accurate" or "somewhat accurate" in capturing differences in the performance of cardiac surgeons, whereas 33% found it to be "not at all accurate." Twenty-two percent reported that they "routinely discuss the reports with their patients," and 38% responded that the information has affected their referrals to surgeons "very much" or "somewhat." CONCLUSIONS: A majority of cardiologists has not generally changed their well-established referral patterns as a result of the New York coronary artery bypass graft surgery reports. However, there has been a modest impact on referrals resulting from the distribution of these reports. The findings also suggest that increased dialogue between clinicians and policy makers regarding the format and structure of public releases would be a valuable undertaking.     

Intramuscular clindamycin for therapy of infective endocarditis. Report of 23 cases and review of the literature

Twenty-three patients with infective endocarditis received intramuscular clindamycin (Cleocin) for treatment. Thirteen had acute Staphylococcus (S.) aureus endocarditis but none had involvement of the aortic valve. Eleven of these 13 infections were heroin-related and involved the tricuspid valve.Twenty-one patients were successfully treated. Two patients with heroin-related S. aureus infection failed to respond to intramuscularly administered clindamycin, but responded to retreatment with methicillin. There have been 34 reported cases of endocarditis treated with clindamycin. Although 80 percent of all cases due to staphylococci responded favorably, almost all were heroin-related tricuspid valve infections. In addition 91 percent of cases due to aerobic streptococci responded but, surpisingly, treatment failed in three of four cases of anaerobic endocarditis. Although clindamycin can be useful in streptococcal endocarditis and in some cases of heroin-related S. aureus tricuspid endocarditis, caution should be exercised in its use. It is "less" bactericidal than the penicillins or cephalosporins, and organisms have become resistant during treatment. Furthermore, patients with anaerobic endocarditis have not responded well, and data are not available to recommend administration of clindamycin for acute S. aureus infections engrafted on the aortic or mitral valve.     

In vitro perfusion studies of the human placenta. IV. Some characteristics of the glucose transport system in the human placenta

Cross infection has become a serious risk to hospitalized patients. Potential sources of infection by anaesthetic apparatus and equipment and the danger arising from disregard of proper asepsis are discussed. Prophylactic and hygienic measures to minimize these hazards are reviewed. Since patients receiving intensive therapy are particularly are risk very high hygienic standards are a "must" in these units. The need for thoroughly and regularly checking all equipment for contamination is emphasized.     

Adenomatous tumors of the middle ear and mastoid

Three cases of middle ear and mastoid neoplasms are reported as "adenomatous tumors" since in their search of the literature the authors did not find any previously described lesions with a similar histologic appearance and benign biologic behavior. Microscopically, all three tumors are similarly composed of solid cords and nests of closely-packed small cells having an epithelial appearance. Two distinct cell types are present: cuboidal cells, arranged in a rudimentary gland-like pattern, and angular cells forming irregular nests with no distinct pattern. All three tumors developed in patients in their 20's, over a period of months with minimal symptoms; yet in all of the lesions the tympanic membrane was intact at the time of initial examination. None of the neoplasms was diagnosed preoperatively, and, once removed, all three tumors were pathologic enigmas and therapeutic problems in view of the initial and subsequent consultant pathologic opinions; nevertheless, total local excision with preservation of the tympanic membrane would appear to be safe treatment in these cases. The term "adenomatous tumor" is applied to these three neoplasms because: 1. a true glandular epithelial origin warranting the term adenoma or adenocarcinoma cannot be proven; and 2. the biologic behavior and prognosis is not necessarily reflected by the histologic appearance. A more specific term reflecting the origin and behavior of these tumors does not appear possible without the study of further cases.     

Nonray‐tracing determination of the 3D refractive index profile of polymeric fibres using single‐frame computed tomography and digital holographic interferometric technique

In this paper, we present a nonray‐tracing technique for evaluating the three dimensional distribution of the refractive index values inside polymeric fibres. This technique, named ‘single‐frame computed‐tomography (SFCT)’, is applied to digital holography. A comparative study between the calculated optical phase values using ordinary tomography and SFCT is carried out, and a negligible deviation is detected. The proposed technique is used to determine the three‐dimensional refractive index profile of isotactic Polypropylene fibres, IPP. The variation of the optical properties is measured before, during and after the formation of the necking phenomenon. In addition, SFCT technique is applied to the online determination of the change of the optical properties of IPP fibres. Holograms are given for illustration.     

Anti-inflammatory and antioxidant potential capacities of AD-MSCs and BM-MSCs in suppressing pancreatic β-cells auto-immunity and apoptosis in rats with T1DM induced model

Since Type 1 diabetes (T1DM) occurs when β-cells mass is reduced to less than 20% of the normal level due to autoimmune destruction of cells resulting in the inability to secrete insulin, preservation or replenishment of the functional β-cells mass has become a major therapeutic focus for this diabetic type treatment. Thus, this 4-week work plan was designed to determine which mesenchymal stem cells (MSCs) type is more appropriate to alleviate pancreatic hazards resulting from diabetes induction; via tracking a comparative study between MSCs derived from adipose tissue (AD-MSCs) and from bone marrow (BM-MSCs) in management of T1DM considering their immunomodulatory, anti-apoptotic and antioxidative roles. Rats were divided randomly into 4 groups; control, STZ-diabetic (D), D+AD-MSCs, and D+BM-MSCs groups. Both stem cells types in this study were allogenic. Herein, both oxidative stress and antioxidant markers were evaluated using colorimetric analysis, while inflammatory, immune and apoptotic markers were assessed through flow cytometric analysis. Results showed that diabetic rats treated with either AD-MSCs or BM-MSCs exhibited marked pancreatic antioxidant and anti-inflammatory activities that were able to initiate pancreatic immunomodulation and reducing β-cells apoptotic death, thus, help to restore their normal insulin secretion and hypoglycemic abilities. However, AD-MSCs injection was shown to be superior as a pancreatic regenerative tool in overcoming diabetes; owing to their marked antioxidant, anti-inflammatory, immunomodulatory, and anti-apoptotic characteristics over BM-MSCs treatment.     

弱交流磁场下裸铜表面结晶特性研究

本文研究了环境温度恒定为25℃、相对湿度为49%、体积为0. 01 m L的液滴在-20℃裸铜底板的冻结实验,发现在附加交流磁场强度分别为2. 0×10^-3、2. 5×10^-3、3. 0×10^-3、3. 5×10^-3、4. 0×10^-3、4. 5×10^-3、5. 0×10^-3、5. 5×10^-3、6. 0×10^-3T的作用下,液滴结晶过冷度增大,最大过冷度提高了2. 08℃;但附加磁场会减小成核驱动力;相比无磁场情况下,液滴冷凝时间减少,凝结粒径相比无磁场下较小。通过对在相同温湿度下自然对流条件的冷铜底板结霜可视化研究发现,由于附加磁场使极性水分子有序的在底板排列,较无磁场下液滴结晶过程熵增更小,在宏观上呈现液滴有序排列。此外,实验发现在0～6×10^-3T的磁场强度范围,随着磁场强度的增大,平板单位面积结霜量减小,单位面积结霜量与交流磁场强度有较高的相关性,得到了拟合关...     

Data Augmentation and Random Multi-Model Deep Learning for Data Classification

In the machine learning (ML) paradigm, data augmentation serves as a regularization approach for creating ML models. The increase in the diversification of training samples increases the generalization capabilities, which enhances the prediction performance of classifiers when tested on unseen examples. Deep learning (DL) models have a lot of parameters, and they frequently overfit. Effectively, to avoid overfitting, data plays a major role to augment the latest improvements in DL. Nevertheless, reliable data collection is a major limiting factor. Frequently, this problem is undertaken by combining augmentation of data, transfer learning, dropout, and methods of normalization in batches. In this paper, we introduce the application of data augmentation in the field of image classification using Random Multi-model Deep Learning (RMDL) which uses the association approaches of multiDL to yield random models for classification. We present a methodology for using Generative Adversarial Networks (GANs) to generate images for data augmenting. Through experiments, we discover that samples generated by GANs when fed into RMDL improve both accuracy and model efficiency. Experimenting across both MNIST and CIAFAR-10 datasets show that, error rate with proposed approach has been decreased with different random models.