Ambulatory blood pressure monitoring in the elderly hypertensive patient.

In this retrospective analysis, we assessed the usefulness of ambulatory blood pressure monitoring in the evaluation of elderly hypertensive patients. Thirty-eight untreated and 31 treated hypertensives aged 70 years or more had a systolic blood pressure greater than or equal to 160 mmHg and/or a diastolic blood pressure greater than or equal to 95 mmHg in the clinic. All 69 patients underwent blood pressure monitoring during their customary daily activities using a portable semi-automatic blood pressure recorder (Remier M2000). The mean of all blood pressures obtained with this device was taken as the ambulatory recorded blood pressure. Recorded blood pressures were greater than or equal to 160 mmHg systolic and greater than or equal to 90 mmHg diastolic in 17 untreated and 17 treated patients. In these patients, the introduction of antihypertensive therapy, or its modification, markedly reduced blood pressure during a 4-8 month follow-up. A further 21 untreated and 14 treated patients had recorded blood pressures of less than 160/90 mmHg. The treatment status of these patients was left unchanged for 4-8 months of follow-up. Nevertheless, office blood pressure in these groups, with no change in treatment, decreased significantly during the observation period. At the last visit to the outpatient clinic, there was no significant difference in blood pressure between the four subgroups of patients. Thus, ambulatory blood pressure monitoring appears to be useful in the elderly hypertensive patient in detecting those patients whose blood pressure is elevated only in the clinic. Blood pressure profiles obtained outside the clinic may therefore be useful in making therapeutic decisions in the aged hypertensive.

Diagnosis of periprosthetic hip infection : review

Since its introduction, total hip arthroplasty has become one of the most successful orthopedic operations ever. However, periprosthetic infection, now reported with the prevalence of around 1-2% is the most challenging complication. It is associated with disasterous physiological, psychological and financial effects. Therefore, early firm diagnosis is essential to avoid further patient morbidity and mortality as well as overwhelming financial medical service costs. This article reviews our current understanding of periprosthetic infection with particular focus on the clinical usefulness of various tests which are used to help make the diagnosis.

Relevancia valorativa del resultado global y sus componentes frente al resultado neto

Este trabajo tiene como objeto verificar si el resultado global presenta mayor relevancia valorativa respecto al resultado tradicional, y si es así cuáles son los componentes del resultado global que explican las diferencias. El estudio muestra que el resultado global es una variable relevante tanto para explicar el valor intrínseco de la empresa como para explicar su rentabilidad. Sin embargo, sólo al explicar la rentabilidad el resultado global y su incremento aumentan la relevancia valorativa del resultado neto y su incremento. De los componentes analizados del resultado global, tan sólo los resultados por diferencias de conversión de la moneda extranjera a la moneda de presentación añaden poder explicativo adicional al del resultado neto, aunque sólo en los modelos de rentabilidad. Ni los resultados por valoración de instrumentos financieros a valor razonable con cambios en patrimonio ni los resultados por coberturas de flujos de efectivo aportan un mayor poder explicativo al del resultado neto.

Diagnostic immunologique du cancer

Two different types of immunological reaction are of assistance in the diagnosis of cancer: The first is detection of a weak immunological response of the patient toward his own tumor cells. Unfortunately the currently available techniques for the demonstration of humoral or cellular immunological reaction against autologous tumor cells are not reproducible enough to be recommended as routine clinical tests. Secondly, it is possible to use antisera, obtained by immunization of animals with human tumor extracts, for the detection of substances released into the blood by the tumor cells. The two major antigens associated with human cancer that can be measured in the blood by very sensitive immunological methods are the alphafetoprotein (AFP) and the carcinoembryonic antigen (CEA). It is very important for the physician to be fully alive to the usefulness and limitations of such tests in order to interpret them correctly. Clinical situations in which the measurement of AFP and CEA can provide useful information are reviewed.

PixFRET, an ImageJ plug-in for FRET calculation that can accommodate variations in spectral bleed-throughs.

Fluorescence resonance energy transfer (FRET) allows the user to investigate interactions between fluorescent partners. One crucial issue when calculating sensitized emission FRET is the correction for spectral bleed-throughs (SBTs), which requires to calculate the ratios between the intensities in the FRET and in the donor or acceptor settings, when only the donor or acceptor are present. Theoretically, SBT ratios should be constant. However, experimentally, these ratios can vary as a function of fluorophore intensity, and assuming constant values may hinder precise FRET calculation. One possible cause for such a variation is the use of a microscope set-up with different photomultipliers for the donor and FRET channels, a set-up allowing higher speed acquisitions on very dynamic fluorescent molecules in living cells. Herein, we show that the bias introduced by the differential response of the two PMTs can be circumvented by a simple modeling of the SBT ratios as a function of fluorophore intensity. Another important issue when performing FRET is the localization of FRET within the cell or a population of cells. We hence developed a freely available ImageJ plug-in, called PixFRET, that allows a simple and rapid determination of SBT parameters and the display of normalized FRET images. The usefulness of this modeling and of the plug-in are exemplified by the study of FRET in a system where two interacting nuclear receptors labeled with ECFP and EYFP are coexpressed in living cells.

French summaries of product characteristics: content in relation to therapeutic monitoring of psychotropic drugs.

The prescription information (summary of product characteristics, SPC) is compiled by the pharmaceutical industry as required by the national regulatory authorities. They vary in their content about the properties of drugs and about the usefulness of therapeutic drug monitoring (TDM) in the blood of patients. Based on a previous study carried out in Germany, the degree of agreement of French SPC for 59 psychotropic drugs with the existing medico-scientific evidence in the area of TDM was examined using a recently developed instrument. A summary score of SPC content (SPCC) related to TDM (SPCC(TDM)) has been calculated and compared with the level of recommendation of TDM of the AGNP-TDM expert group consensus guidelines for TDM in psychiatry [AGNP: Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (Association for neuropsychopharmacology and pharmacopsychiatry)]. Among the antidepressants, antipsychotics, tranquillizers/hypnotic agents and mood stabilizers, the highest SPCC(TDM) scores in the French SPC were reached for imipramine (16), haloperidol (6), clonazepam (8) and lithium (23), respectively. Results were similar to those obtained from the analysis of German SPC, and considerable disagreement was found between the information on TDM in SPC and existing medico-scientific evidence, albeit less in the case of mood stabilizers. Taking into account the recommendations of the AGNP-TDM expert group guidelines, there is a deficit in the French SPC concerning TDM-relevant information. An amelioration of this situation could help to improve the clinical practice of TDM of psychotropic drugs, as the SPC is a widely used tool.

Post-mortem β-hydroxybutyrate determination in synovial fluid.

β-hydroxybutyrate concentrations were determined in blood and synovial fluid in a series of medico-legal cases including hypothermia fatalities, individuals found dead in a cold environment and non-hypothermia cases with various, non-traumatic causes of death. Hypothermia was considered to be the cause of death according to circumstantial elements indicating exposure to cold, autopsy findings, biochemical investigation results and exclusion of other causes of death. The intention of this study was to characterize β-hydroxybutyrate distribution in synovial fluid and assess its usefulness for the postmortem diagnosis of antemortem abnormalities in blood β-hydroxybutyrate levels. Unenhanced CT scans, autopsies, histology, neuropathology, toxicology, and biochemistry were systematically performed. Within the limited number of subjects included in the study, the results indicate that abnormalities in antemortem β-hydroxybutyrate blood levels, as may be observed in hypothermia fatalities, are reflected in postmortem synovial fluid values. These preliminary findings notwithstanding, synovial fluid analysis to determine β-hydroxybutyrate is unlikely to be generally applied due to the more invasive collection technique it requires and could be limited to special cases in which biological fluids systematically collected upon autopsy are unavailable.

Retrieving Cloud Characteristics from Ground-Based Daytime Color All-Sky Images

A discussion is presented of daytime sky imaging and techniques that may be applied to the analysis of full-color sky images to infer cloud macrophysical properties. Descriptions of two different types of skyimaging systems developed by the authors are presented, one of which has been developed into a commercially available instrument. Retrievals of fractional sky cover from automated processing methods are compared to human retrievals, both from direct observations and visual analyses of sky images. Although some uncertainty exists in fractional sky cover retrievals from sky images, this uncertainty is no greater than that attached to human observations for the commercially available sky-imager retrievals. Thus, the application of automatic digital image processing techniques on sky images is a useful method to complement, or even replace, traditional human observations of sky cover and, potentially, cloud type. Additionally, the possibilities for inferring other cloud parameters such as cloud brokenness and solar obstruction further enhance the usefulness of sky imagers

An Evaluation of the Second Generation Consolidation Monitoring Device, HR-1013, 1984

The objective was to evaluate the usefulness, accuracy, precision, and reproducibility of the second generation CMD for PC concrete under production conditions.

Development of Concepts for Pavement Management, MLR-79-04, 1979

Sufficient evidence was not discovered in this brief search to alter the general opinion that the Serviceability (Present Serviceability Index-PSI) - Performance Concepts developed by the AASHO Road Test provides the optimum engineering basis for pavement management. Use of these concepts in Iowa has the additional advantage in that we have a reasonable quantity of historical data over a period of time on the change in pavement condition as measured by PSI's. Some additional benefits would be the ability to better assess our needs with respect to those being recommended to Congress by AASHTO Committees. These concepts have been the basis used for developing policies on dimensions and weight of vehicles and highway needs which the AASHTO Transport Committees have recommended to the United States House Committee on Ways and Means. The first recommendation based on these concepts was made in the mid 1960's. Iowa's participation in the evaluation for this recommendation was under the direction of our present Director of Transportation, Mr. Raymond Kassel. PSI Indexes had to be derived from subjective surface ratings at that time. The most recent recommendation to Congress was made in November of 1977. Based on the rationale expressed above, a pilot study of the major part of the rural interstate system was conducted. The Objective of the study was to measure pavement performance through the use of the Present Serviceability Index (PSI) - Pavement Performance concepts as developed by the AASHO Road Test and to explore the usefulness of this type of data as a pavement management tool. Projects in the vicinity of the major urban centers were not included in this study due to the extra time that would be required to isolate accurate traffic data in these areas. Projects consisting of asphalt surface courses on crushed stone base sections were not included.

Evaluation of Hot Mix Asphalt Moisture Sensitivity Using the Nottingham Asphalt Test Equipment, TR-555, 2010

Pavements are subjected to different stresses during their design lives. A properly designed pavement will perform adequately during its design life, and the distresses will not exceed the allowable limits; however, there are several factors that can lead to premature pavement failure. One such factor is moisture sensitivity. AASHTO T 283 is the standard test used in the moisture susceptibility evaluation of asphalt mixtures, but the results of the test are not very representative of the expected behavior of asphalt mixtures. The dynamic modulus test measures a fundamental property of the mixture. The results of the dynamic modulus test can be used directly in the Mechanistic-Empirical Pavement Design Guide (MEPDG) and are considered a very good representation of the expected field performance of the mixture. Further research is still needed to study how the dynamic modulus results are affected by moisture. The flow number test was studied in previous research as a candidate test for moisture-susceptibility evaluation, but the results of that research were not favorable. This research has four main objectives. The first objective of this research is to evaluate the usefulness of the dynamic modulus and flow number tests in moisture-susceptibility evaluation. The second objective is to compare the results to those achieved using the AASHTO T 283 test. The third objective is to study the effect of different methods of sample conditioning and testing conditions. The fourth objective of the research is to study the variability in the test results.

Frequent cytolytic T-cell responses to peptide MAGE-A10(254-262) in melanoma.

MAGE genes encode tumor-specific shared antigens that are among the most interesting candidates for cancer vaccines. Despite extensive studies, however, CD8+ T-cell responses to MAGE-derived epitopes have been detected only occasionally in cancer patients, even after vaccination. In contrast with these findings, we report here that HLA-A2 melanoma patients respond frequently to the recently identified peptide MAGE-A10(254-262). Indeed, as assessed by staining with fluorescent HLA-A2/peptide MAGE-A10(254-262) tetramers, CD8+ T cells directed against this peptide were readily detectable in a large proportion of HLA-A2+ melanoma patients. These results provide new insight into the immunogenicity of MAGE antigens and underline the potential usefulness of MAGE-A10 peptide-based cancer vaccines.

Graphical probabilistic analysis of the combination of items of evidence

Unlike the evaluation of single items of scientific evidence, the formal study and analysis of the jointevaluation of several distinct items of forensic evidence has to date received some punctual, ratherthan systematic, attention. Questions about the (i) relationships among a set of (usually unobservable)propositions and a set of (observable) items of scientific evidence, (ii) the joint probative valueof a collection of distinct items of evidence as well as (iii) the contribution of each individual itemwithin a given group of pieces of evidence still represent fundamental areas of research. To somedegree, this is remarkable since both, forensic science theory and practice, yet many daily inferencetasks, require the consideration of multiple items if not masses of evidence. A recurrent and particularcomplication that arises in such settings is that the application of probability theory, i.e. the referencemethod for reasoning under uncertainty, becomes increasingly demanding. The present paper takesthis as a starting point and discusses graphical probability models, i.e. Bayesian networks, as frameworkwithin which the joint evaluation of scientific evidence can be approached in some viable way.Based on a review of existing main contributions in this area, the article here aims at presentinginstances of real case studies from the author's institution in order to point out the usefulness andcapacities of Bayesian networks for the probabilistic assessment of the probative value of multipleand interrelated items of evidence. A main emphasis is placed on underlying general patterns of inference,their representation as well as their graphical probabilistic analysis. Attention is also drawnto inferential interactions, such as redundancy, synergy and directional change. These distinguish thejoint evaluation of evidence from assessments of isolated items of evidence. Together, these topicspresent aspects of interest to both, domain experts and recipients of expert information, because theyhave bearing on how multiple items of evidence are meaningfully and appropriately set into context.

Monte Carlo simulation of a clearance box monitor used for nuclear power plant decommissioning.

When decommissioning a nuclear facility it is important to be able to estimate activity levels of potentially radioactive samples and compare with clearance values defined by regulatory authorities. This paper presents a method of calibrating a clearance box monitor based on practical experimental measurements and Monte Carlo simulations. Adjusting the simulation for experimental data obtained using a simple point source permits the computation of absolute calibration factors for more complex geometries with an accuracy of a bit more than 20%. The uncertainty of the calibration factor can be improved to about 10% when the simulation is used relatively, in direct comparison with a measurement performed in the same geometry but with another nuclide. The simulation can also be used to validate the experimental calibration procedure when the sample is supposed to be homogeneous but the calibration factor is derived from a plate phantom. For more realistic geometries, like a small gravel dumpster, Monte Carlo simulation shows that the calibration factor obtained with a larger homogeneous phantom is correct within about 20%, if sample density is taken as the influencing parameter. Finally, simulation can be used to estimate the effect of a contamination hotspot. The research supporting this paper shows that activity could be largely underestimated in the event of a centrally-located hotspot and overestimated for a peripherally-located hotspot if the sample is assumed to be homogeneously contaminated. This demonstrates the usefulness of being able to complement experimental methods with Monte Carlo simulations in order to estimate calibration factors that cannot be directly measured because of a lack of available material or specific geometries.

XML y web semántica : estudio del impacto de las aplicaciones comerciales basadas en tecnologías de web semántica

Much has been written about the Semantic Web, on the theory, its possible applications, how to implement it, how to make it effective and commercially attractive ... However, this work aims to be more specific. It is attempted to address a detailed analysis of the technologies that use concepts and tools of the Semantic Web, verifying their actual usefulness, quantifying as far as possible the impact and trying to extrapolate data about its future.It will be an analysis of what the Semantic Web is, how it is defined, which languages are the most appropriate for their development, the commercial applications that can be developed with Semantic Web technology, the applications that are currently running with this technology what kind of deployment of the Semantic Web currently exists, the real use of the Semantic Web technology...