Transjugular intrahepatic portosystemic shunts (TIPS) in children

The transjugular intrahepatic portosystemic shunt procedure is an accepted treatment for adults with complications of portal hypertension. We performed a retrospective review of all pediatric TIPS placements performed at the University of California, San Francisco between 1990 and 1996. Twelve procedures were attempted in nine children, with a mean age (+/- SD) of 9.4 +/- 3.9 years (range, 5 to 15 years) and a mean weight of 31 +/- 18 kg (range, 16 to 70 kg). The indications for TIPS placement were portal hypertension complicated by chronic variceal hemorrhage not controlled with sclerotherapy (n = 7) and hypersplenism with thrombocytopenia (n = 2). TIPS placement was successfully completed initially in seven of nine (78%) patients. Unfavorable vascular anatomy was the cause of failure in two cases. The seven patients who underwent successful TIPS placement were followed up for an average of 136 days (range, 1 to 800 days); two still have patent shunts, three underwent liver transplantation, one had a splenorenal shunt after stenosis, and one died of underlying liver disease. Variceal bleeding was controlled in four of five patients who successfully underwent TIPS placement. Shunt occlusion occurred in four patients; patency was restored by transjugular shunt revision in three, and a splenorenal shunt was performed in one.     

Surface tension as a controlled variable in mechanical dishwashing

Using a continuous, in-line, nondestructive technique based on the maximum bubble pressure method, the surface tension of the wash water in a mechanical dishwashing machine has been monitored. This technique has enabled surface tension to be used as a controlled variable, providing feedback to regulate the amount of surfactant added. Assuming the mechanical force of the water spray is adequate to remove bound soil from the dish surface, the food soil may be titrated against surfactant, providing an indirect indication as to when the dishes are clean. This technique also could be applied to a recirculated wash solution for in-place cleaning.     

Analysis of optical coherence multiplexing networks for satellite communication

Free-space optical communication between satellites networked together can enable a high data rate between the satellites. Coherence multiplexing (CM) is an attractive technique for satellite networking due to its ability to cope with the asynchronous nature of communication traffic and the dynamic changes taking place in the satellite constellation. The use of optical radiation for intersatellite links creates very narrow beam divergence angles. Due to the narrow beam divergence angle, the vibration of the pointing system, the movement of the satellite, and the large distance between them the pointing from one satellite to another is a complicated task. The vibration of the pointing system is caused by two stochastic fundamental mechanisms: 1) tracking noises created by the electrooptic tracker and 2) vibrations created by internal satellite mechanical mechanisms and external environments. We derive mathematical models of signal, noise, the approximate signal-to-noise ratio, and the approximate bit-error rates of optical communication satellite networks as functions of the system's parameters, the number of satellites, and the vibration amplitude for frequency-shift keying coherence multiplexing (FSK-CM). Based on these models, we can calculate the negative impact of both the number of satellites and the optical terminal vibration on the system's performance.     

Patients requiring sedation

Recent advances in the pharmacology of sedative drugs have expanded their use in the intensive care unit. Indications and endpoints for sedation, however, often are defined poorly and are difficult to assess. Nevertheless, the complications of sedative drug administration are real. New indications for sedation have been proposed in recent years, including enforcing sleep/wake cycles, manipulating cellular metabolism, and preventing myocardial ischemia. The evidence supporting the efficacy of these new indications is not yet complete.     

Teachers' brief nonverbal behaviors in defined instructional situations can predict students' evaluations.

Can a few seconds of high school teachers' nonverbal (NV) behavior predict students' ratings of these teachers (SRT)? Yes, but NV-SRT relations varied among various instructional situations. NV behaviors while administering the class and using the board were unrelated to SRT. Positive judgments of NV behavior while disciplining the class and interacting with students were positively related to SRT. NV behaviors in frontal teaching were negatively related to SRT. The most negative NV-SRT relations were found for teachers' differential NV behavior toward high- versus low-achieving students. Teacher differentiality and SRT have rarely been investigated in high school. The structure of SRT seems to differ between high school and college, and students' anger about teachers' differentiality strongly predicted their evaluations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mechanical behaviour of SiC fibre-reinforced titanium/titanium aluminide hybrid composites

The viability of developing an SiC fibre-reinforced titanium/titanium aluminide hybrid matrix composite was explored. The hybrid composites are expected to be used at temperatures beyond those attainable in conventional titanium matrix composites while improving the damage tolerance of the titanium aluminide matrix composites. The room-temperature mechanical characteristics studied were tensile strength, fracture toughness, low-cycle fatigue life and fatigue crack growth rate. The mechanisms of damage initiation and propagation under various loading conditions were also characterized. The directions for developing a satisfactory composite with hybrid titanium/titanium aluminide matrix are also addressed.     

The feasibility of smoking bans on psychiatric units

Cryptococcal meningitis has a high mortality rate of central nervous infection. The patients usually die of the disease itself, or complications from increased intracranial pressure. Early diagnosis and treatment, including surgical drainage, will improve the results. In this series, twenty-one patients with high intracranial pressure (ICP > 300 mmH2 O) are presented. Fourteen received implantation of Ommaya reservoir to aspirate cerebrospinal fluid (CSF) for relief of symptoms of ICP. Meanwhile 4 of these 14 patients also received intraventricular injection of amphotericin B because of poor response to systemic drugs. Another seven patient received systemic drug therapy only. Survival during therapy occurred in 11 of 14 patients in the surgical group, compared with only 1 of 7 patients treated by drug therapy alone (P = 0.019). In the 14 patients who received implantation of an Ommaya reservoir, there was one complication of CSF leakage when the reservoir ruptured because of repeated aspiration. For patients with cryptococcal meningitis with high ICP, early implantation of an Ommaya reservoir will improve the survival rate.     

Assessing pre- and post-deformation in the southern Arava Valley segment of the Dead Sea Transform, Israel by differential interferometry

Differential radar interferometry, using archived ERS data over the region of the Dead Sea Transform, allows to detect ground movement (subsidence or uplift) in playas within the southern Arava Valley segment of the Dead Sea Rift. These measurements are consistent with a mean displacement rate of about 0.4 cm/month, in the direction of the radar beam, during the 8-month period preceding the Nuweiba earthquake of 22 November 1995. In the 3 years following the earthquake, the measured rate was smaller by a factor of 10. These movements are not related to salt diapirs or water pumping activities in the area. The exact location, along faults, suggests a possible correlation with pre-seismic and post-seismic fault deformation.A simple fault model consistent with the observed phenomena associates the observed subsidence/uplift to right and left stepping en-echelon fault patterns related to inter-seismic tensional accumulation along the faults. Further observations are necessary on this site and similar fault areas to corroborate the correlation between seismic activity and the observed phenomena. Monitoring of these sites should continue with differential Global positioning system (GPS) measurements and radar interferometric analysis using Envisat and Radarsat as well as archived data (including J-ERS).     

Reduced speed of sound in tibial bone of haemodialysed patients: association with serum PTH level

BACKGROUND: In end-stage renal disease, average bone mineral density has been reported to be normal or only modestly reduced, more so in the cortical bone. The purpose of the present study was to explore the potential use of quantitative ultrasound, a method reflecting both quantitative and qualitative properties of bone, in assessing bone status in patients on maintenance haemodialysis. METHODS: We studied 71 patients (age 17-81 years, time on dialysis 0-18 years). The speed of sound waves (tSOS; m/s) propagating along the cortical bone has been determined at the tibial shaft. tSOS results were expressed as Z scores, i.e. units of standard deviations from age- and sex-matched normal mean values, and correlated with relevant clinical and biochemical variables. RESULTS: SOS Z score averaged -2. 0 (range -6.8 to 0.6; P<0.001) and was negative in 93% of the patients. Significant inverse correlations were found between SOS Z score and both time on dialysis (r=-0.52; P<0.0001) and serum PTH (r=-0.39; P=0.0002). Markedly reduced SOS Z score, below -2, was found in 80% of the patients whose PTH levels exceeded 34 pmol/l (five times the upper normal limit), compared with 43% of the patients whose PTH levels were below 34 pmol/l(P=0.04). Compared to patients without bone pain (n=51), subjects with bone pain (n=20) had somewhat lower SOS Z scores -2.5+/-2.0 versus -1.8+/-1.4; P=0. 08), but this could be accounted for by longer time on dialysis. CONCLUSIONS: tSOS is substantially reduced in the majority of haemodialysed patients and is related to time on dialysis and serum PTH level. The clinical value of this novel method needs further exploration.