Infective endocarditis complicated with rapidly progressive glomerulonephritis: a case report

Despite a general national decline in criminal activities in the 1990s, juvenile criminal offenses continue to increase, (including violent, property, and delinquency acts). In addition increased numbers of children are being held in juvenile jails. It is all but impossible for pediatric health providers to think that "their patients" and "their practices" are immune from the epidemic of crime that affects and is caused by "just kids."     

Accuracy and efficacy of chest radiography in the intensive care unit

264 patients with cancer of larynx, 21 female and 234 male, had a testosterone and sex hormone binding globulin (SHBG) before the treatment in serum estimated. Because of dependence of levels of hormones the group of patients was divided into three following groups: "lower than standard", "standard", "higher than standard". The correlation between these groups and sex, age, localization of tumor, organs' advances, stage of morphological malignancy and type of cancer was reported. Anomalous values of testosterone were in male group more frequently reported. Anomalous values of SHBG were similar in male and female groups, but in the female group there was a significant majority of "lower than standard" values reported. The majority of abnormal values of testosterone and SHBG was described in groups of age higher than 50 years. There were no differences in testosterone and SHBG levels in different localization of tumors in larynx. In advanced stage T3 and T4 there were more frequent lower mean values of testosterone levels and higher values of SHBG levels in comparison to T2 stages. In tumors in G1 and G2 stages of histological malignancy higher levels of SHBG and higher mean levels of testosterone. The tumors in stage G3 the hormone levels were lowers were observed. The levels of SHBG in groups of carcinoma planoepitheliale keratodes were in 66% higher than in a group of carcinoma planoepitheliale akeratodes but in both groups the levels of testosterone were nearing the same. In group of patients with larynx cancer the negative correlation between the levels of testosterone and SHBG was not observed. Higher SHBG levels were not always accompanied by lower testosterone levels.     

Video-assisted lateral intertransverse process arthrodesis. Validation of a new minimally invasive lumbar spinal fusion technique in the rabbit and nonhuman primate (rhesus) models

STUDY DESIGN: Cadaveric anatomic and in vivo survival animal studies were performed to develop a new arthrodesis technique for the lumbar spine. OBJECTIVES: To examine the feasibility, efficacy, and safety of a minimally invasive lumbar intertransverse process arthrodesis technique using an osteoinductive growth factor (rhBMP-2) delivered in a collagen sponge carrier. The technique was first developed using a rabbit model and modified for the nonhuman primate (rhesus monkey), a larger animal with the most similar bone biology to humans. SUMMARY OF BACKGROUND DATA: The morbidity of conventional posterolateral lumbar intertransverse process arthrodesis includes graft donor site morbidity; paraspinal muscle devascularization, denervation, and scarring and nonunion in up to 36% of patients. Minimally invasive anterior lumbar interbody arthrodesis techniques have been developed, but these often require a metal implant and carry risks to major vessels and development of retrograde ejaculation. A minimally invasive technique for posterolateral intertransverse process arthrodesis has not been described previously. METHODS: In Part 1, we examined seven New Zealand white rabbits and five rhesus monkeys at necropsy and during nonsurvival surgeries to determine the best access routes and to develop special instruments for video-assisted lateral intertransverse process arthrodesis. In Part 2, 38 New Zealand white rabbits underwent L4-L5 intertransverse process arthrodesis: the "OPEN" group (n = 16) underwent a standard open muscle-splitting approach using rhBMP-2 (bone morphogenetic protein) and collagen as a bone graft substitute; the "video-assisted control" group (n = 6) underwent video-assisted lateral intertransverse process arthrodesis with the collagen implant only (no growth factor); and the "video-assisted-BMP" group (n = 16) underwent video-assisted lateral intertransverse process arthrodesis with rhBMP-2 and collagen as the graft material. In Part 3, rhesus monkeys (n = 4) underwent video-assisted lateral intertransverse process arthrodesis using rhBMP-2 and collagen after laminectomy of L4-L5. RESULTS: In Part 1, we identified expedient, minimally invasive routes to the intertransverse process interval appropriate for each species: an intermuscular approach for the rabbit and a lateral, extramuscular approach for the rhesus monkey. In Part 2, all rabbits in the OPEN and video-assisted-BMP groups achieved solid intertransverse process lumbar fusions when assessed at 10 weeks. There were no neurologic impairments nor any difference between the two groups in the frequency of postoperative infection or other complications. None of the animals in the video-assisted control group showed evidence of fusion. In Part 3, exposure, decortication and grafting with rh-BMP-2 and collagen was accomplished successfully in all four monkeys through the video-assisted minimally invasive approach without complications. CONCLUSION: Video-assisted lateral intertransverse process arthrodesis is a feasible, effective, and safe method of lumbar spinal fusion in the rabbit and rhesus monkey. Use of this arthrodesis procedure will minimize the morbidity of paraspinal muscle denervation and devascularization seen with open intertransverse process fusion techniques, and the use of an osteoinductive growth factor will eliminate the problem of graft donor site morbidity and possibly increase the chances for successful fusion.     

Performance analysis of available bandwidth estimation tools for grid networks

Modern large-scale grid computing systems for processing advanced science and engineering applications rely on geographically distributed clusters. In such highly distributed environments, estimating the available bandwidth between clusters is a key issue for efficient task scheduling. We analyze the performance of two well known available bandwidth estimation tools, pathload and abget, with the aim of using them in grid environments. Differently than previous investigations (Jain et al., ; Shriram et al., in Passive and active network measurement: 6th international workshop, PAM 2005. Springer, Berlin, 2005), our experiments consider a series of relevant metrics such as accuracy of the estimation, convergence time, degree of intrusion in the grid links, and ability to handle multiple simultaneous estimations. No previous work has analyzed the use of available bandwidth tools for the derivation of efficient grid scheduling.     

Reducing the Health and Digital Divides: A Model for Using Community‐Based Participatory Research Approach to E‐Health Interventions in Low‐Income Hispanic Communities

Low‐income Hispanics are the most digitally underserved population in the U.S. This article examines the potential of community‐based participatory research approach to e‐health to decrease the disparities in access to technology and health information in low‐income Hispanic communities. To demonstrate this framework, we describe the process of designing a community‐based e‐health intervention to increase knowledge and parental self‐efficacy in coping with young children's mental health problems including mental health service utilization. Our model incorporates utilizing promotoras de salud (lay community health educators) and community media principles to create the content of e‐health interventions and train community members in using the technology. This case study illustrates the processes involved in using this approach, barriers for participatory e‐health interventions in bridging the Digital Divide, and lessons learned.     

The influence of epiphylls on remote sensing of humid forests

Epiphylls - lichens, fungi, liverworts, etc. infesting leaf surfaces - are found throughout humid forests of the world. It is well understood that epiphylls inhibit light interception by host plants, but their effect on remote sensing of colonized forests has not been examined. Incorporating leaf-level spectra from Terra Firme (primary forest) and Amazonian Caatinga (woodlands/forest growing on nutrient-deficient sandy soils), we used the GeoSAIL model to propagate leaf-level measurements to the canopy level and determine their effect on commonly used vegetation indices. In Caatinga, moderate infestations (50% leaf area epiphyll cover), lowered simulated Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) values by 6.1% and 20.4%, respectively, largely due to near infrared dampening. Heavy infestation (100% cover) simulations exhibited decreases 1.5-2 times greater than those of moderate infestations. For Terra Firme, which are generally less affected by epiphylls, moderate (20% leaf area) and heavy infestations (40%) lowered EVI by 4.4% (S.D. 0.8%) and 8.1% (S.D. 1.5%), respectively. Near infrared and green reflectance were most affected at the canopy level, showing mean decreases of 10.6% (S.D. 2.25%) and 9.5% (S.D. 3.49%), respectively, in heavy Terra Firme infestations. Time series of Moderate Resolution Imaging Spectrometer (MODIS) data corroborated the modeling results, suggesting a degree of coupling between epiphyll cover and the EVI and NDVI. These results suggest that, without explicit consideration of the presence of epiphylls, remote sensing-based methodologies may underestimate leaf area index, biomass and productivity in humid forests.     

Fitness functions in evolutionary robotics: A survey and analysis

This paper surveys fitness functions used in the field of evolutionary robotics (ER). Evolutionary robotics is a field of research that applies artificial evolution to generate control systems for autonomous robots. During evolution, robots attempt to perform a given task in a given environment. The controllers in the better performing robots are selected, altered and propagated to perform the task again in an iterative process that mimics some aspects of natural evolution. A key component of this process–one might argue, the key component–is the measurement of fitness in the evolving controllers. ER is one of a host of machine learning methods that rely on interaction with, and feedback from, a complex dynamic environment to drive synthesis of controllers for autonomous agents. These methods have the potential to lead to the development of robots that can adapt to uncharacterized environments and which may be able to perform tasks that human designers do not completely understand. In order to achieve this, issues regarding fitness evaluation must be addressed. In this paper we survey current ER research and focus on work that involved real robots. The surveyed research is organized according to the degree of a priori knowledge used to formulate the various fitness functions employed during evolution. The underlying motivation for this is to identify methods that allow the development of the greatest degree of novel control, while requiring the minimum amount of a priori task knowledge from the designer.