Pulmonary infiltrates in neutropenic patients with acute leukemia during chemotherapy: outcome and prognostic factors

STUDY OBJECTIVE: To determine predictors of mortality from pulmonary infiltrates in neutropenic patients with acute leukemia during chemotherapy, and the significance of those factors related to the underlying malignancy and its therapy as well as of those related to the severity of the illness associated with pulmonary infiltrates. DESIGN: A historical cohort study. SETTING: A university teaching hospital and tertiary referral center. PATIENTS AND METHODS: Overall, 53 patients with neutropenia during chemotherapy and with first episodes of pulmonary infiltrates during a 4-year period were studied. Prognostic analysis included 38 variables. Multivariate analyses were performed by logistic regression. RESULTS: The survival rate from pneumonia was 57% (30/53). The following eight parameters were significantly associated with death in univariate analysis: comorbidity present; development of "late" pulmonary infiltrates (> or = 14 days after hospital admission); heart rate > or = 100 beats/min; a ratio heart rate/systolic blood pressure (HR/SBP) > or = 1.2; urea nitrogen > 7 mmol/L; radiographic score > or = 3; neutropenia < 1.0x10(9)/L at the treatment end point; and failed complete remission. In a multivariate model including only parameters available at diagnosis of pulmonary infiltrates, the presence of a ratio HR/SBP > or = 1.2 and of a radiographic score > or = 3 remained independently associated with death. In a second model also including the evolutionary parameter neutropenia < or = 1.0x10(9)/L at the treatment end point, both parameters remained significant together with neutropenia <1.0x 10(9)/L at the treatment end point. The presence of a ratio HR/SBP > or = 1.2 was a strong marker of early death. CONCLUSION: Both therapy- and malignancy-associated neutropenia as well as the severity of illness associated with pulmonary infiltrates are independent prognostic factors. Patients with a ratio HR/SBP > or = 1.2 at diagnosis of pulmonary infiltrates suffer from potentially reversible acute illness, are at risk for early death and, therefore, may be appropriate candidates for treatment in an ICU.     

Radiometric calibration of the telescope and ultraviolet spectrometer SUMER on SOHO

The prelaunch spectral-sensitivity calibration of the solar spectrometer SUMER (Solar Ultraviolet Measurements of Emitted Radiation) is described. SUMER is part of the payload of the Solar and Heliospheric Observatory (SOHO), which begins its scientific mission in 1996. The instrument consists of a telescope and a spectrometer capable of taking spatially and spectrally highly resolved images of the Sun in a spectral range from 50 to 161 nm. The pointing capabilities, the dynamic range, and the sensitivity of the instrument allow measurements both on the solar disk and above the limb as great as two solar radii. To determine plasma temperatures and densities in the solar atmosphere, the instrument needs an absolute spectral-sensitivity calibration. Here we describe the prelaunch calibration of the full instrument, which utilizes a radiometric transfer-standard source. The transfer standard was based on a high-current hollow-cathode discharge source. It had been calibrated in the laboratory for vacuum UV radiometry of the Physikalisch-Technische Bundesanstalt by use of the calculable spectral photon flux of the Berlin electron storage ring for synchrotron radiation (BESSY)-a primary radiometric source standard.     

On-line laser-photometric monitoring of aerosol deposition in ventilated rabbit lungs

A photometric technique was developed for on-line measurement of aerosol deposition in isolated, ventilated, and perfused rabbit lungs. A jet nebulizer was used for aerosolization of saline (hygroscopic particles) and di(2-ethylhexyl) sebacate (nonhygroscopic particles). Aerosol concentration (laser photometer, constructed for measurements in rabbit lungs) and flow rate (commercial pneumotachograph) were continuously monitored at the inlet of the tracheal cannula. Computer-assisted data processing allowed the breath-by-breath calculation of inhaled and exhaled aerosol mass, thus providing the deposition fraction. With the use of hygroscopic particles, however, this approach was hampered by the humidity-induced particle growth in the airways, leading to an overestimation of the aerosol concentration in exhaled air. This effect was corrected by an algorithm using a "particle growth factor" derived breath by breath from the photometer signal. To test the reliability of this approach, saline particles carrying technetium-99m label were aerosolized into rabbit lungs with the use of various ventilator settings, and the aerosol deposition was assessed in parallel by photometry and by radioactivity detection over the lung and over a trap in the exhaled-air circuit. Superimposable curves of cumulative aerosol deposition, with changes in kinetics dependent on the ventilator mode, were obtained. For a given ventilator setting, absolute values of the deposition fraction were 0.32 +/- 0.04 (radiotracer quantification) and 0.36 +/- 0.04 (photometry; means +/- SD; n = 4). We conclude that the presented laser-photometric technique allows reliable on-line monitoring of the deposition of both nonhygroscopic and hygroscopic aerosol particles in ventilated lungs.     

Report of the Second Workshop on the Usage of NetFlow/IPFIX in Network Management

Following the success of the First Workshop on the Usage of NetFlow/IPFIX (Pras et al. in J Netw Syst Manag 17(4), 2009) in 2008, the European EMANICS Network of Excellence organized a second workshop in October 2009, held at Jacobs University Bremen. This report summarizes the workshop and presents its main conclusions.     

Computing delay resistant railway timetables

In the past, much research has been dedicated to compute optimum railway timetables. A typical objective has been the minimization of passenger waiting times. But only the planned nominal waiting times have been addressed, whereas delays as they occur in daily operations have been neglected. Delays have been rather treated mainly in an online context and solved as a separate optimization problem, called delay management.We provide the first computational study which aims at computing delay resistant periodic timetables. In particular we assess the delay resistance of a timetable by evaluating it subject to several delay scenarios to which optimum delay management will be applied.We arrive at computing delay resistant timetables by selecting a new objective function which we design to be somehow in the middle of the traditional simple timetabling objective and the sophisticated delay management objective. This is a slight extension of the concept of “light robustness” (LR) as it has been proposed by Fischetti and Monaci [2006. Robust optimization through branch-and-price. In: Proceedings of AIRO]. Moreover, in our application we are able to provide accurate interpretations for the ingredients of LR. We apply this new technique to real-world data of a part of the German railway network of Deutsche Bahn AG. Our computational results suggest that a significant decrease of passenger delays can be obtained at a relatively small price of robustness, i.e. by increasing the nominal travel times of the passengers.     

Design and implementation of the Node Identity Internetworking Architecture

The Internet Protocol (IP) has been proven very flexible, being able to accommodate all kinds of link technologies and supporting a broad range of applications. The basic principles of the original Internet architecture include end-to-end addressing, global routeability and a single namespace of IP addresses that unintentionally serves both as locators and host identifiers. The commercial success and widespread use of the Internet have lead to new requirements, which include Internetworking over business boundaries, mobility and multi-homing in an untrusted environment. Our approach to satisfy these new requirements is to introduce a new Internetworking layer, the node identity layer. Such a layer runs on top of the different versions of IP, but could also run directly on top of other kinds of network technologies, such as MPLS and 2G/3G PDP contexts. This approach enables connectivity across different communication technologies, supports mobility, multi-homing, and security from ground up. This paper describes the Node Identity Architecture in detail and discusses the experiences from implementing and running a prototype.     

Adaptive Finite Element Simulation of the Time-dependent Simplified <Emphasis Type="Italic">P</Emphasis><Subscript><Emphasis Type="Italic">N</Emphasis></Subscript> Equations

The steady-state simplified P _N approximation to the radiative transfer equation has been successfully applied to many problems involving radiation. Recently, time-dependent simplified P _N equations have been derived by an asymptotic analysis similar to the asymptotic derivation of the steady-state SP _N equations (Frank et al. in J. Comput. Phys. 226:2289–2305, 2007). In this paper, we present computational results for the time-dependent SP _N equations in two dimensions, obtained by using an adaptive finite element approach. Several numerical comparisons with other existing models are shown.     

Water diffusion in polymer nano-films measured with microcantilevers

We present a method to measure the absorption of water molecules from the liquid and the vapour phase into polymer nano-films and the diffusion inside these films. Film thickness can be down to 45 nm. To demonstrate the possibilities of this method we use polymer films that are deposited on the upper side of a silicon cantilever by plasma polymerization of norbornene. When a microdrop of water is deposited onto the initially straight cantilever, the drop causes the cantilever to bend while it evaporates. Evaporation of such small water drops usually takes less than a second. An upwards bending is due to capillary forces and a downwards bending is due to the diffusion of water into the polymer film – and the consequent volume expansion (swelling) of the film. The magnitude of the capillary forces and the extent of swelling continuously change during drop evaporation. When drop evaporation is over the cantilever returns to its initial straight position. We simulate the time dependent bending with a numerical model that qualitatively agrees with the experiment. From the time dependence of cantilever bending we are able to determine the diffusion coefficient of water in the thin polymer film.     

Compressed Multiresolution Hierarchies for High‐Quality Precomputed Shadows

The quality of shadow mapping is traditionally limited by texture resolution. We present a novel lossless compression scheme for high‐resolution shadow maps based on precomputed multiresolution hierarchies. Traditional multiresolution trees can compactly represent homogeneous regions of shadow maps at coarser levels, but require many nodes for fine details. By conservatively adapting the depth map, we can significantly reduce the tree complexity. Our proposed method offers high compression rates, avoids quantization errors, exploits coherency along all data dimensions, and is well‐suited for GPU architectures. Our approach can be applied for coherent shadow maps as well, enabling several applications, including high‐quality soft shadows and dynamic lights moving on fixed‐trajectories.