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Selected AbstractsImproved aetiological diagnosis of ischaemic stroke in a Vascular Medicine Unit , the significance of transesophageal echocardiogramINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2008A. Martignoni Summary Background:, The TOAST study estimates that 34% of ischaemic strokes are of undetermined aetiology. Improvements in the diagnosis of the pathogenetic mechanism of ischaemic stroke would translate into a better care, in analogy to other fields of vascular and internal medicine. Objective:, To measure the reduction of undetermined aetiology strokes performing a set of additional diagnostic tests. Design:, Consecutive case series with historical controls. Setting:, Internal Medicine Ward with a stroke area (SA) admitting most stroke patients of a large hospital in Italy. Subjects:, A total of 179 ischaemic stroke patients admitted to SA in 2004,2005 compared with 105 ischaemic stroke patients admitted to the whole department in 2001. Intervention:, To perform more diagnostic tests, including transesophageal echocardiography (TEE), in the greatest possible number of ischaemic stroke inpatients admitted in SA of the Internal Medicine Department, in the years 2004,2005. Results:, More diagnostic tests were performed during the study period than in 2001, especially TEE (56% of patients in 2004,2005 vs. 3% of patients in 2001). We observed a significant reduction of undetermined aetiology from 38% in 2001 to 16% in 2004,2005 (p < 0.0001), largely for an increased identification of cases of cardio-embolic mechanism (from 18% to 40%, p = 0.0002). In the years 2004,2005 the fraction of patients on anticoagulant treatment at discharge was 21% vs. 12% in 2001 (p = 0.041). Conclusion:, Performing more tests, particularly TEE, brought improvements in the aetiological diagnosis of stroke, increasing cardio-embolism diagnosis and anticoagulant treatment. [source] An artificial neural network satisfiability testerINTERNATIONAL JOURNAL OF INTELLIGENT SYSTEMS, Issue 12 2001Tatiana Tambouratzis An artificial neural network tester for the satisfiability problem of propositional calculus is presented. Satisfiability is treated as a constraint satisfaction optimization problem and, contrary to most of the existing satisfiability testers, the expressions are converted into disjunctive normal form before testing. The artificial neural network is based on the principles of harmony theory. Its basic characteristics are the simulated annealing procedure and the harmony function; the latter constitutes a measure of the satisfiability of the expression under the current truth assignment to its variables. The tester is such that: (a) the satisfiability of any expression is determined; (b) a truth assignment to the variables of the expression is output which renders true the greatest possible number of clauses; (c) all the truth assignments which render true the maximum number of clauses can be produced. © 2001 John Wiley & Sons, Inc. [source] All (k;g)-cages are k -edge-connectedJOURNAL OF GRAPH THEORY, Issue 3 2005Yuqing Lin Abstract A (k;g)-cage is a k -regular graph with girth g and with the least possible number of vertices. In this paper, we prove that (k;g)-cages are k -edge-connected if g is even. Earlier, Wang, Xu, and Wang proved that (k;g)-cages are k -edge-connected if g is odd. Combining our results, we conclude that the (k;g)-cages are k -edge-connected. © 2005 Wiley Periodicals, Inc. J Graph Theory 48: 219,227, 2005 [source] The use of three different solid dispersion formulations,melt extrusion, film-coated beads, and a glass thermoplastic system,to improve the bioavailability of a novel microsomal triglyceride transfer protein inhibitorJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 5 2004Geert Verreck Abstract A bioavailable formulation for a water-insoluble microsomal triglyceride transfer protein inhibitor, R103757, was developed using solid dispersion technology. The need for an advanced formulation was tested in the dog by assessing the oral bioavailability of three generic concepts: a tablet (crystalline drug), a capsule (film-coated beads), and an oral solution. These screening studies steered further development in the direction of a solid dispersion. Three solid dispersion platforms were assessed: melt extrusion, film-coated beads, and a glass thermoplastic system. Thermal and spectrophotometric analysis revealed that no crystalline drug was present in any of the formulations. The dissolution profiles of the three dispersion systems showed that release was improved compared with the unmanipulated drug. In addition, stability studies confirmed the physical and chemical integrity of the formulation. A human clinical trial was performed to assess the pharmacokinetics of the three amorphous dispersions. Plasma levels were obtained after single oral administration in both the fasting and fed state. The study indicated that all three approaches improved the bioavailability of R103757 with the glass thermoplastic system providing the best performance. These studies point to the potential usefulness of solid dispersion approaches and expand the possible number of ways to implement these methodologies. © 2004 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 93:1217,1228, 2004 [source] Motor unit number estimation using reversible jump Markov chain Monte Carlo methodsJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES C (APPLIED STATISTICS), Issue 3 2007P. G. Ridall Summary., We present an application of reversible jump Markov chain Monte Carlo sampling from the field of neurophysiology where we seek to estimate the number of motor units within a single muscle. Such an estimate is needed for monitoring the progression of neuromuscular diseases such as amyotrophic lateral sclerosis. Our data consist of action potentials that were recorded from the surface of a muscle in response to stimuli of different intensities applied to the nerve supplying the muscle. During the gradual increase in intensity of the stimulus from the threshold to supramaximal, all motor units are progressively excited. However, at any given submaximal intensity of stimulus, the number of units that are excited is variable, because of random fluctuations in axonal excitability. Furthermore, the individual motor unit action potentials exhibit variability. To account for these biological properties, Ridall and co-workers developed a model of motor unit activation that is capable of describing the response where the number of motor units, N, is fixed. The purpose of this paper is to extend that model so that the possible number of motor units, N, is a stochastic variable. We illustrate the elements of our model, show that the results are reproducible and show that our model can measure the decline in motor unit numbers during the course of amyotrophic lateral sclerosis. Our method holds promise of being useful in the study of neurogenic diseases. [source] Phaseless antenna characterization by prolate function expansion of the aperture fieldMICROWAVE AND OPTICAL TECHNOLOGY LETTERS, Issue 10 2006A. Capozzoli Abstract To be of actual interest for practical applications, phaseless antenna characterization must be reliable and accurate. This inverse problem suffers from the ill-posedeness, and its solution is very sensitive to the adopted formulation that should be able to incorporate all the available information. An "effective" representation of the unknowns is able to reduce the overall number of parameters to be sought for and therefore to have significant beneficial effects on both accuracy and reliability. This aim is attained by means of a prolate spheroidal wave function expansion of the aperture field, which allows accounting for the finite dimensions of the antenna aperture with the least possible number of parameters. Numerical and experimental results point out the accuracy and reliability of the proposed algorithm, also in comparison with other available methods. © 2006 Wiley Periodicals, Inc. Microwave Opt Technol Lett 48: 2060,2064, 2006; Published online in Wiley Inter-Science (www.interscience.wiley.com). DOI 10.1002/mop.21852 [source] Approximating the smallest k -edge connected spanning subgraph by LP-roundingNETWORKS: AN INTERNATIONAL JOURNAL, Issue 4 2009Harold N. Gabow Abstract The smallest k-ECSS problem is, given a graph along with an integer k, find a spanning subgraph that is k -edge connected and contains the fewest possible number of edges. We examine a natural approximation algorithm based on rounding an LP solution. A tight bound on the approximation ratio is 1 + 3/k for undirected graphs with k > 1 odd, 1 + 2/k for undirected graphs with k even, and 1 + 2/k for directed graphs with k arbitrary. Using iterated rounding improves the first upper bound to 1 + 2/k. On the hardness side we show that for some absolute constant c > 0, for any integer k , 2 (k , 1), a polynomial-time algorithm approximating the smallest k -ECSS on undirected (directed) multigraphs to within ratio 1 + c/k would imply P = NP. © 2008 Wiley Periodicals, Inc. NETWORKS, 2009 [source] All (k;g)-cages are edge-superconnectedNETWORKS: AN INTERNATIONAL JOURNAL, Issue 2 2006Yuqing Lin Abstract A (k;g)-cage is a k -regular graph with girth g and with the least possible number of vertices. In this article we prove that (k;g)-cages are edge-superconnected if g is even. Earlier, Marcote and Balbuena proved that (k;g)-cages are edge-superconnected if g is odd [Networks 43 (2004), 54,59]. Combining our results, we conclude that all (k;g)-cages are edge-superconnected. © 2006 Wiley Periodicals, Inc. NETWORKS, Vol. 47(2), 102,110 2006 [source] Minimum linear gossip graphs and maximal linear (,, k)-gossip graphs ,NETWORKS: AN INTERNATIONAL JOURNAL, Issue 3 2001Pierre Fraigniaud Abstract Gossiping is an information dissemination problem in which each node of a communication network has a unique piece of information that must be transmitted to all other nodes using two-way communications between pairs of nodes along the communication links of the network. In this paper, we study gossiping using a linear-cost model of communication which includes a start-up time and a propagation time which is proportional to the amount of information transmitted. A minimum linear gossip graph is a graph (modeling a network), with the minimum possible number of links, in which gossiping can be completed in minimum time under the linear-cost model. For networks with an even number of nodes, we prove that the structure of minimum linear gossip graphs is independent of the relative values of the start-up and unit propagation times. We prove that this is not true when the number of nodes is odd. We present four infinite families of minimum linear gossip graphs. We also present minimum linear gossip graphs for all even numbers of nodes n , 32 except n = 22. A linear (,, k)- gossip graph is a graph with maximum degree , in which gossiping can be completed in k rounds with minimum propagation time. We present three infinite families of maximal linear (,, k)- gossip graphs, that is, linear (,, k)-gossip graphs with a maximum number of nodes. We show that not all minimum broadcast graphs are maximal linear (,, k)-gossip graphs. © 2001 John Wiley & Sons, Inc. [source] Latest news and product developmentsPRESCRIBER, Issue 6 2007Article first published online: 8 JUN 200 Initial macrolide better for pneumonia? An observational study has suggested that initial treatment with a macrolide antibiotic (such as erythromycin) may be more effective than a fluoroquinolone (like ciprofloxacin) or tetracycline as initial treatment for community acquired pneumonia and bacteraemia (Chest 2007;131:466-73). The US review of 2209 hospital episodes found that macrolide therapy was associated with a 40 per cent lower risk of death during hospital stay or within 30 days and of hospital readmission within 30 days of discharge. By contrast, no such benefit was apparent with fluoroquinolones or tetracycline. Two-year safety data for inhaled insulin Compared with sc insulin, inhaled insulin (Exubera) is associated with a small early decrease in lung function in the first three months of therapy but no further difference for up to two years (Diabetes Care 2007;30: 579-85). The comparative trial found that FEV1 declined at a mean rate of 0.051 litres per year with inhaled insulin and 0.034 litres per year with sc insulin, but there was no significant difference in the rates of decline after three months. Inhaled insulin was associated with a higher incidence of cough (37.6 vs 13.1 per cent) but a lower incidence of severe hypoglycaemic events (2.8 vs 4.1 events per 100 subject- months) and mean weight gain was 1.25kg less. Fracture risk warning with rosiglitazone GlaxoSmithKline has warned US prescribers that rosiglitazone may be associated with an increased risk of fractures. The company says information for prescribers in Europe will follow shortly. The warning comes from the ADOPT study (N Engl J Med 2006;355:2427-43), which found a significantly higher incidence of fractures of the humerus, hand and foot among women taking rosiglitazone (9.3 per cent) than with metformin (5.1 per cent) or glibenclamide (3.5 per cent). There was no difference in fracture incidence among men. The company recommends that fracture risk should be considered for women taking or about to take rosiglitazone. Oral treatment for grass pollen allergy A new treatment for allergic rhinitis due to grass pollen allergy has been introduced by ALK-Abelló. Grazax is a sublingual tablet containing a stan-dardised dose of allergen from the pollen of timothy grass. Treatment should be initiated by a specialist four months before the onset of the allergy season and continued throughout the season. Adverse effects include oral and ear pruritus, nasopharyngitis and mouth oedema. A month's treatment at the recommended dose of one tablet daily costs Ł67.50. Frequent analgesics linked with hypertension Men who take analgesics regularly have an increased frequency of hypertension, a US study has shown (Arch Intern Med 2007;167:394-9). The US Health Professionals Follow-Up study evaluated the use of NSAIDs, paracetamol and aspirin in 16 031 men with normal blood pressure and followed them up for four years. Compared with those who did not report analgesic use, the risk of hypertension was increased by 38 per cent for NSAID use, 34 per cent for paracetamol and 26 per cent for aspirin, all for for six or seven days a week. Similar risks were found when anal- gesic use was determined according to the number of tablets taken. The authors acknowledge the increased risk is modest, but point out that the implications may nonetheless be important because analgesics are widely used. Multiples do most pharmacist MURs Uptake of medicines use reviews (MURs) by pharmacists was modest in 2005 and most reviews were carried out by pharmacy chains rather than independent contractors, a new study has shown (Pharm J 2007;278:218-23). The survey of PCTs and SHAs in England and Wales found that, although 38 per cent of community pharmacies claimed payments for the service, 84 per cent of MURs were carried out by pharmacy chains. Uptake was low, amounting to only 7 per cent of the maximum possible number of MURs. Patients see information needs differently There is a mismatch in the perceptions of patients and health professionals about the purpose of written information about medicines, a systematic review has concluded (Health Technol Assess 2007;11:1-178). Some health professionals believe the main purpose of information is to promote compliance, whereas patients want information to help them make decisions about their treatment, including not taking it. In particular, patients want information on adverse effects, but health professionals have reservations about providing it. Aspirin for all women over 65? All women over 65 should take low-dose aspirin if the benefits are likely to outweigh the risk of adverse effects, according to new guidelines from the American Heart Association on preventing cardiovascular disease in women (published online 19 Feb 2007;doi: 10.1161/circulationaha.107.181546). The guidelines have moved away from the long-established Framingham model of risk assessment to categorising three levels of risk: high (heart disease or other relevant disease present), at risk (at least one risk factor) and optimal (healthy lifestyle, no risk factors). Low-dose aspirin is recommended for all women at high risk, for women aged 65 or over when reducing the risk of MI or ischaemic stroke outweighs the risk of adverse effects, and for younger women when reducing the risk of ischaemic stroke outweighs that of toxicity. Combination inhaler therapy Combining an inhaled long-acting bronchodilator with a steroid reduces COPD exacerbations but not all-cause mortality, a three-year trial has shown (N Engl J Med 2007;356:775-89). However, inhaled steroids appear to increase the risk of pneumonia. The TORCH trial randomised 6112 patients (FEV1<60 per cent predicted) to treatment with salmeterol 50µg plus fluticasone 500µg (Seretide) twice daily, salmeterol (Serevent) or fluticasone (Flixotide) as monotherapy, or placebo. All-cause mortality rates were 12.6, 13.5, 16.0 and 15.2 per cent respectively; the risk of death was 17 per cent lower with combined therapy, but the difference did not reach statistical significance. The combination reduced the incidence of exacerbations by 25 per cent and improved health status and FEV1. Use of fluticasone was not associated with more ocular or bone disorders, but there was an increased incidence of pneumonia among users (19.6 per cent with combined therapy and 18.3 per cent with fluticasone vs 12.3 per cent with placebo). Seretide is currently licensed in the UK for use in patients with FEV1 <50 per cent predicted. Tamoxifen long- term benefits Women with breast cancer who take tamoxifen for five to eight years continue to have a lower risk of recurrence for 10-20 years, long-term follow-up of two blinded trials has shown (J Nat Cancer Inst 2007; 99:258-60, 272-90). The frequency of adverse effects was markedly reduced when treatment ended, changing the balance of risk and benefit. Copyright © 2007 Wiley Interface Ltd [source] Effect of load distribution in path protection of MPLSINTERNATIONAL JOURNAL OF COMMUNICATION SYSTEMS, Issue 4 2003Sook-Yeon Kim Abstract We analyse and compare a protection mechanism based on load distribution with a typical protection mechanism in an multiprotocol label switching (MPLS) network. The protection mechanism based on load distribution is modelled as a fully shared mechanism (FSM) and the typical protection mechanism is a partially shared mechanism (PSM). By comparing the FSM and the PSM, we numerically analyse the effect of load distribution in path protection of MPLS. The comparison is based on numerical equations representing the relationship between service reliability and resource utilization. From the equations, we show that both the FSM and the PSM have a tradeoff between service reliability and resource utilization. In addition, we provide solutions for the FSM and the PSM to determine the amount of bandwidth occupied according to the requested service reliability. The comparison of the FSM and the PSM shows that the PSM cannot provide greater service reliability than the FSM under the same utilization. In addition, the PSM is not capable of accommodating greater resource utilization than the FSM for the same level of service reliability. However, an appropriate choice of the number of protection paths allows the PSM to provide the same level of service reliability as the FSM. The choice is the maximum among the possible numbers of protection paths of the PSM. In short, the typical protection mechanism is as good as the FSM in terms of service reliability and resource utilization even though the FSM is an attractive alternative to the typical protection mechanism. Copyright © 2003 John Wiley & Sons, Ltd. [source] | ||||||||||||||||