Enzyme structure with two catalytic sites for double-sieve selection of substrate

High-fidelity transfers of genetic information in the central dogma can be achieved by a reaction called editing. The crystal structure of an enzyme with editing activity in translation is presented here at 2.5 angstroms resolution. The enzyme, isoleucyl-transfer RNA synthetase, activates not only the cognate substrate L-isoleucine but also the minimally distinct L-valine in the first, aminoacylation step. Then, in a second, "editing" step, the synthetase itself rapidly hydrolyzes only the valylated products. For this two-step substrate selection, a "double-sieve" mechanism has already been proposed. The present crystal structures of the synthetase in complexes with L-isoleucine and L-valine demonstrate that the first sieve is on the aminoacylation domain containing the Rossmann fold, whereas the second, editing sieve exists on a globular beta-barrel domain that protrudes from the aminoacylation domain.     

US-guided core breast biopsy: use and cost-effectiveness

OBJECTIVES: We sought to determine, using serial echocardiography, the hydrodynamic mechanisms involved in the occurrence of hemolysis after mitral valve repair. BACKGROUND: Recently, fluid dynamic simulation models have identified distinct patterns of mitral regurgitant flow disturbances in patients with mitral prosthetic hemolysis that were associated with high shear stress and may therefore produce clinical hemolysis. Rapid acceleration, fragmentation, and collision jets were associated with high shear stress and hemolysis whereas slow deceleration and free jets were not. METHODS: We reviewed serial echocardiographic studies of 13 consecutive patients with hemolytic anemia after mitral valve repair who were referred for mitral reoperation between January 1985 and December 1996 (group 1). Thirteen patients undergoing reoperation for mitral regurgitation after mitral valve repair but without hemolysis served as controls (group 2). RESULTS: The mitral regurgitant jet was central in origin in 12 group 1 patients and 9 group 2 patients (Fisher exact test, p= 0.3). The other patients had para-ring regurgitation. Group 1 patients had collision (n=11), rapid acceleration (n=2) or fragmentation (n=1) jets whereas group 2 patients had slow deceleration (n=11) or free jets (n=2) (Fisher exact test, p < 0.0001). One patient with hemolysis had both collision and rapid acceleration jets. The "culprit" jet could be identified on the postbypass transesophageal echocardiography (TEE) study in only 1 patient at the time of initial mitral repair. Twelve group 1 patients underwent reoperation, with subsequent resolution of hemolysis in all patients. At reoperation, the initial repair was found to be intact in 8 (67%) patients. CONCLUSION: Distinct patterns of flow disturbance associated with high shear stress were identified by color Doppler imaging in patients with hemolysis after mitral valve repair. The majority (92%) of these color flow disturbances were not present during intraoperative postbypass TEE study after initial mitral repair and subsequently developed in the early postoperative period.     

Pediatric pain management in an adult critical care unit

Many children every year will be treated in "adult" critical care units because of the limited pediatric trauma centers currently available. Assessment is an integral part of all pain management. Ideally, self-report is the gold standard for assessing pain; however, some children may not have the ability to use these tools. Nonverbal children may be assessed with behavioral tools such as the CHEOPS or FLACC. In children as young as 3 years old, the self-report tool called an OUCHER can be administered to assess their pain. Easy to apply nonpharmacological approaches are discussed with recommendations for nurses to incorporate into their daily care.     

Differences between completers and early dropouts from 2 HIV intervention trials: a health belief approach to understanding prevention program attrition

OBJECTIVES: The purpose of this study was to identify factors predicting program attrition among participants in human immunodeficiency virus (HIV) risk reduction trials. METHODS: Participants were gay/bisexual men and severely mentally ill adults recruited to take part in HIV risk reduction small-group interventions. Program completers were compared with participants who were assessed at baseline but then failed to attend any sessions. The health belief model provided a framework for selection of possible predictors of program attrition. RESULTS: Younger age was associated with early dropout in both samples. Other predictors among gay/bisexual men included involvement in an exclusive sexual relationship, minority ethnicity, injection drug use, and higher perceived severity of AIDS. Severely mentally ill dropouts were less knowledgeable about safer sex methods and more likely to hold positive outcome expectancies for condom use. CONCLUSIONS: Evaluation of intervention effectiveness among vulnerable population segments is threatened if there is selective attrition. Better methods are needed to attract and maintain participation in HIV prevention programs. Alternatively, wider application of "intention to treat" analysis of intervention outcomes is recommended to minimize selection bias due to program dropout.     

Free-living inferential modeling of blood glucose level using only noninvasive inputs

The goal of this work is to present a causation modeling methodology with the ability to accurately infer blood glucose levels using a large set of highly correlated noninvasive input variables over an extended period of time. These models can provide insight to improve glucose monitoring, and glucose regulation through advanced model-based control technologies. The efficacy of this approach is demonstrated using real data from a type 2 diabetic (T2D) subject collected under free-living conditions over a period of 25 consecutive days. The model was identified and tested using eleven variables that included three food variables as well as several activity and stress variables. The model was trained using 20 days of data and validated using 5 days of data. This gave a fitted correlation coefficient of 0.70 and an average absolute error (AAE) (i.e., the average of the absolute values for the measured glucose concentration minus modeled glucose concentration) of 13.3 mg/dL for the validation data. This AAE result was significantly better than the subject’s personal glucose meter AAE of 15.3 mg/dL for replicated measurements.     

Robot-Assisted Bridge Inspection

The Center for Robot-Assisted Search and Rescue (CRASAR®) deployed a customized AEOS man-portable unmanned surface vehicle and two commercially available underwater vehicles (the autonomous YSI EcoMapper and the tethered VideoRay) for inspection of the Rollover Pass bridge in the Bolivar peninsula of Texas in the aftermath of Hurricane Ike. A preliminary domain analysis with the vehicles identified key tasks in subsurface bridge inspection (mapping of the debris field and inspecting the bridge footings for scour), control challenges (navigation under loss of GPS, underwater obstacle avoidance, and stable positioning in high currents without GPS), possible improvements to human-robot interaction (having additional display units so that mission specialists can view and operate on imagery independently of the operator control unit, incorporating 2-way audio to allow operator and field personnel to communicate while launching or recovering the vehicle, and increased state sensing for reliability), and discussed the cooperative use of surface, underwater, and aerial vehicles. The article posits seven milestones in the development of a fully functional UMV for bridge inspection: standardize mission payloads, add health monitoring, improve teleoperation through better human-robot interaction, add 3D obstacle avoidance, improve station-keeping, handle large data sets, and support cooperative sensing.     

<Emphasis Type="Italic">A Midsummer Night’s Dream</Emphasis> (with flying robots)

Seven flying robot “fairies” joined human actors in the Texas A&;M production of William Shakespeare’s A Midsummer Night’s Dream. The production was a collaboration between the departments of Computer Science and Engineering, Electrical and Computer Engineering, and Theater Arts. The collaboration was motivated by two assertions. First, that the performing arts have principles for creating believable agents that will transfer to robots. Second, the theater is a natural testbed for evaluating the response of untrained human groups (both actors and the audience) to robots interacting with humans in shared spaces, i.e., were believable agents created? The production used two types of unmanned aerial vehicles, an AirRobot 100-b quadrotor platform about the size of a large pizza pan, and six E-flite Blade MCX palm-sized toy helicopters. The robots were used as alter egos for fairies in the play; the robots did not replace any actors, instead they were paired with them. The insertion of robots into the production was not widely advertised so the audience was the typical theatergoing demographic, not one consisting of people solely interested technology. The use of radio-controlled unmanned aerial vehicles provides insights into what types of autonomy are needed to create appropriate affective interactions with untrained human groups. The observations from the four weeks of practice and eight performances contribute (1) a taxonomy and methods for creating affect exchanges between robots and untrained human groups, (2) the importance of improvisation within robot theater, (3) insights into how untrained human groups form expectations about robots, and (4) awareness of the importance of safety and reliability as a design constraint for public engagement with robot platforms. The taxonomy captures that apparent affect can be created without explicit affective behaviors by the robot, but requires talented actors to convey the situation or express reactions. The audience’s response to robot crashes was a function of whether they had the opportunity to observe how the actors reacted to robot crashes on stage, suggesting that pre-existing expectations must be taken into account in the design of autonomy. Furthermore, it appears that the public expect robots to be more reliable (an expectation of consumer product hardening) and safe (an expectation from product liability) than the current capabilities and this may be a major challenge or even legal barrier for introducing robots into shared public spaces. These contributions are expected to inform design strategies for increasing public engagement with robot platforms through affect, and shows the value of arts-based approaches to public encounters with robots both for generating design strategies and for evaluation.     

Using cross-layer metrics to improve the performance of end-to-end handover mechanisms

Network centric handover solutions for all IP wireless networks usually require modifications to network infrastructure which can stifle any potential rollout. This has led researchers to begin looking at alternative approaches. Endpoint centric handover solutions do not require network infrastructure modification, thereby alleviating a large barrier to deployment. Current endpoint centric solutions capable of meeting the delay requirements of Voice over Internet Protocol (VoIP) fail to consider the Quality of Service (QoS) that will be achieved after handoff. The main contribution of this paper is to demonstrate that QoS aware handover mechanisms which do not require network support are possible. This work proposes a Stream Control Transmission Protocol (SCTP) based handover solution for VoIP called Endpoint Centric Handover (ECHO). ECHO incorporates cross-layer metrics and the ITU-T E-Model for voice quality assessment to accurately estimate the QoS of candidate handover networks, thus facilitating a more intelligent handoff decision. An experimental testbed was developed to analyse the performance of the ECHO scheme. Results are presented showing both the accuracy of ECHO at estimating the QoS and that the addition of the QoS capabilities significantly improves the handover decisions that are made.     

Cytochemical localization of acetylcholine receptors at the neuromuscular junction by means of horseradish peroxidase-labeled alpha-bungarotoxin

The cytochemical localization of acetylcholine (ACh) receptors at the neuromuscular junction was investigated with a procedure utilizing alpha-bungarotoxin (alpha-BtX) labeled directly with horseradish peroxidase (HRP). Following incubation of tissues in the conjugate and reaction for peroxidase, activity was observed on the junctional folds of the motor endplate. A uniform layer of reaction product approximately 15 nm thick occurred over the apical portions of the junctional folds. Membranes at the bases of the synaptic cleft showed only small amounts of reaction product. Non-junctional regions of the muscle fiber were unreactive. Activity was also observed in the membrane of the axon facing the muscle surface, often including the axolemma overlying the "active zones" of the nerve terminal. Such presynaptic activity was still evident on nerve terminals disjuncted from the synapse by enzymatic treatment prior to incubation in the conjugate. This localization indicates the possible presence of presynaptic ACh receptors within the axolemma. In muscle denervated for 7-12 days, motor endplates were reactive and parajunctional sarcolemma showed slight activity, but most extrajunctional regions contained no obvious accumulations of reaction product. Activity at all sites was prevented by preincubation of tissues in native alpha-BTX prior to incubation in the conjugate and reaction for HRP. This procedure represents a simple and convenient method for the high resolution localization of ACh receptors.