Sources and determinants of social support for caregivers of persons with AIDS

Endocrine studies of captive strepsirrhine primates suggest that physical environment and social factors mediate inter-individual variations in testicular function and serum testosterone (sT) in males. While these studies have made major contributions to our understanding of the individual proximate mechanisms influencing androgen activity in male strepsirrhines, none have investigated how these mechanisms work coincidentally in free-ranging populations. In this study we used fecal steroid analysis to examine androgen-behavior interactions associated with reproduction in free-ranging male Propithecus verreauxi. Behavioral and hormone data were collected from two social groups during the 1990-91 and 1991-92 breeding seasons at Beza Mahafaly, Madagascar. Solid phase and radioimmunoassay techniques were used to quantify testosterone (T) in 105 desiccated fecal samples collected weekly from seven males. Results suggest that 1) solid phase extraction and radioimmunoassay techniques were reliable and accurate methods for quantifying T in sifaka feces; 2) fecal T (fT) elevations spanned a minimum of 4 months, peak levels occurring 1 month prior to the January onset of the breeding season; 3) fecal T concentrations were influenced by developmental factors and, among mature males, social factors associated with rank, intergroup aggression, and group instability.     

Comparison of gastric mucosal pH and clinical judgement in critically ill patients

OBJECTIVES: To compare gastric tonometry (pHi) with estimates of pHi in ill injured patients, and to correlate pHi with haemodynamic variables. DESIGN: Prospective, non-interventional study. SETTING: ICU of Level I trauma centre, USA. MAIN OUTCOME MEASURES: 154 gastric tonometry measurements were compared with physicians' estimates of adequacy of resuscitation. Resuscitation was categorised as inadequate (pHi < 7.35) or adequate (pHi> or = 7.35). Measured and estimated pHi were also compared with oxygen delivery, oxygen consumption, cardiac index, mixed venous O2 saturation, and critical illness scores. RESULTS: Estimated pHi was often higher than measured pHi in the judgement of all four surgical intensive care physicians. Measured pHi correlated positively with mixed venous O2 tension (r = 0.21). There were significant negative correlations between measured pHi and both oxygen delivery (r = -0.25) and oxygen consumption (r = 0.28). Estimated pHi correlated positively with mean arterial pressure (r = 0.21) and hospital day (r = 0.26); it correlated negatively with pulmonary arterial elastance (r = -0.35). CONCLUSION: Experienced intensive care physicians tended to overestimate visceral perfusion, which suggests that gastric tonometry adds useful information over and above routine haemodynamic indices. Arterial blood pressure and mixed venous oxygen saturation correlated better with measured pHi than with other indices of perfusion.     

Acute erythroleukemia: evaluation of 48 cases with reference to classification, cell proliferation, cytogenetics, and prognosis

We evaluated 48 archival cases of acute erythroleukemia and divided them into 3 groups: M6a, corresponding to the traditional French-American-British M6 category; M6b, which is pure erythroleukemia; and M6c, in which myeloblasts and pronormoblasts each account for more than 30% of cells by the French-American-British exclusion criteria. No significant differences were noted among the subtypes for ratio of males to females; age; or exposure to toxins, alcohol, or both. However, compared with the patients in the M6a group, patients in the M6b and M6c groups demonstrated a statistically significant increase in cytogenetic aberrations, proliferation markers (proliferating cell nuclear antigen and Ki67), and ringed (type III) sideroblasts. Marked survival differences were noted between the M6a (30.1 +/- 29.5 months) and M6b (3.15 +/- 4.2 months) groups, with patients in the M6c group demonstrating an intermediate prognosis (10.5 +/- 12.7 months). Chemotherapeutic regimens induced remission in all treated patients in the M6a and M6c groups but did not appear to affect the M6b group. However, the patients in the M6c group remained in remission for a significantly shorter period of time than did patients in the M6a group. Overall, survival appeared to depend on the ratio of pronormoblasts to myeloblasts at diagnosis and demonstrated a rapid decline with increasing pronormoblast and decreasing myeloblast counts. We must, therefore, devise chemotherapeutic regimens that target both blastic components of this disease.     

The association of intra-abdominal infection and abdominal wound dehiscence

Concurrent infection is a risk factor for abdominal wound dehiscence. We reviewed our experience with fascial dehiscence to determine the incidence and to identify prognostic factors for associated intra-abdominal infection. Over a 7-year period, 107 patients with abdominal wound dehiscence were identified. Seventeen were managed nonoperatively, and 90 underwent exploratory laparotomy, 43 of whom had no intra-abdominal pathology and 47 of whom had intra-abdominal infections. Demographic factors, comorbid diseases, and potential indicators of systemic infection did not distinguish patients with intra-abdominal infection from those without. Patients with an intra-abdominal infection were more likely to have undergone an emergency operation (74% vs 48%; P < 0.02), an operation on the colon (55% vs 25%; P < 0.005), or an operation with a higher wound classification (P < 0.02). Mortality was higher in patients with intra-abdominal infection than in those without (44% vs 20%; P < 0.02). Wound dehiscence after emergent operations, and operations with a higher wound classification, especially those involving the colon, should raise concern for intra-abdominal infection. Thorough abdominal exploration should be performed at the time of dehiscence repair. Before nonoperative management is chosen, intra-abdominal infection should be excluded.     

Fingerprinting diamonds using ion implantation

It is possible to ion implant patterns in diamond crystals at fluences below that which would impart visible damage and then to reveal those patterns by electrostatic charging and dusting. The charge distribution — and therefore the dust attachement — is related to the difference in electrical conductivity between the implanted region and the rest of the crystal. The technique may have applicability for fingerprinting or personalizing diamond gemstones.Retired.     

AutoRELAX: automatically RELAXing a goal model to address uncertainty

Dynamically adaptive systems (DAS) must cope with system and environmental conditions that may not have been fully understood or anticipated during development. RELAX is a fuzzy logic-based specification language for identifying and assessing sources of environmental uncertainty, thereby making DAS requirements more tolerant of unanticipated conditions. This paper presents AutoRELAX, an approach that automatically generates RELAXed goal models to address environmental uncertainty. Specifically, AutoRELAX identifies goals to RELAX, which RELAX operators to apply, and the shape of the fuzzy logic function that establishes the goal satisfaction criteria. AutoRELAX generates different solutions by making tradeoffs between minimizing the number of RELAXed goals and maximizing delivered functionality by reducing the number of adaptations triggered by minor and adverse environmental conditions. In a recent extension, AutoRELAX uses a stepwise adaptation of weights to balance these two competing concerns and thereby further improve the utility of AutoRELAX. We apply it to two industry-based applications involving network management and a robotic controller, respectively.     

Optimum composition of blast furnace slag as deduced from liquidus data for the quaternary system CaO-MgO-Al<Subscript>2</Subscript>O<Subscript>3</Subscript>-SiO<Subscript>2</Subscript>

On the basis of liquidus measurements in the system CaO-MgO-Al₂O₃-SiO₂ and previously published data, diagrams have been constructed at 5 pct Al₂O₃ intervals from 5 to 35 pct Al₂O₃. Liquidus temperatures and primary phase fields are shown. The optimum composition of a blast furnace slag for a given alumina content is indicated. At the optimum point, ordinary slags will be entirely liquid and will have maximum desulphurization potential and minimum viscosity. The relation of optimum composition of slags to the “plateau region” of the liquidus surface, and the application of these data on synthetic quaternary slags to actual slag compositions are discussed. Index of refraction of glasses is given as well as composition, temperature, and phase data for each mixture.     

On the determination of thermal phenomena during drilling—Part II. Comparison of experimental and analytical twist drill temperature distributions

The analytical models, developed in Part I of this paper, for estimating the temperature distributions along the cutting edge and on the clearance face of a twist drill are evaluated using an experimental technique that measures average drill flank temperatures. While the transient model tends to overestimate the values of the average flank temperatures, especially during drilling to a one diameter hole depth, the temperatures predicted from the steady state model agree reasonably well with the experimental results. The difference between the analytical and experimental results varied with the physical and thermal properties of the powder metallurgy work materials used in this experiment. The analytical drill temperature distribution models are also compared with others found in the literature.     

Management of early-stage epithelial ovarian cancer

"Early" epithelial ovarian carcinoma encompasses a spectrum of patients with diseases that have markedly different survivals, ranging from indolent lesions truly confined to the ovary to high-grade lesions that have a significant chance of occult metastasis at the time of diagnosis. The basic principles of management rest on an adequate primary surgical procedure that removes all gross disease and accurately assesses the sites at risk for metastasis with a comprehensive staging laparotomy. After a comprehensive staging laparotomy, patients can be stratified into low-risk and high-risk groups. Those with low-risk disease have such a low risk of recurrence that the toxicity of adjuvant therapy is not warranted. Although patients with high-risk disease have a high enough of a risk of recurrence to justify consideration of adjuvant therapy, their ultimate prognosis may be determined more by an accurate determination of the stage of disease rather than by currently available, marginally effective or ineffective therapy. Patients who are thought to have early stage disease on the basis of inadequate staging procedures either should undergo a restaging laparotomy or receive therapy for the possibility of occult advanced disease.