Valve surgery in active infective endocarditis: a simple score to predict in-hospital prognosis

Aims Surgery for infective endocarditis (IE) is associated with high mortality. Our objectives were to describe the experience with surgical treatment for IE in Spain, and to identify predictors of in-hospital mortality. Methods Prospective cohort of 1000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Results Surgery was performed in 437 patients (43.7%). Patients treated with surgery were younger and predominantly male. They presented fewer comorbid conditions and more often had negative blood cultures and heart failure. In-hospital mortality after surgery was lower than in the medical therapy group (24.3 vs 30.7%, p = 0.02). In patients treated with surgery, endocarditis involved a native valve in 267 patients (61.1%), a prosthetic valve in 122 (27.9%), and a pacemaker lead with no clear further valve involvement in 48 (11.0%). The most common aetiologies were Staphylococcus (186, 42.6%), Streptococcus (97, 22.2%), and Enterococcus (49, 11.2%). The main indications for surgery were heart failure and severe valve regurgitation. A risk score for in-hospital mortality was developed using 7 prognostic variables with a similar predictive value (OR between 1.7 and 2.3): PALSUSE: prosthetic valve, age ≥ 70, large intracardiac destruction, Staphylococcus spp, urgent surgery, sex [female], EuroSCORE ≥ 10. In-hospital mortality ranged from 0% in patients with a PALSUSE score of 0 to 45.4% in patients with PALSUSE score > 3. Conclusions The prognosis of IE surgery is highly variable. The PALSUSE score could help to identify patients with higher in-hospital mortality.

Application of Inductive Logic Programming to Structure-Based Drug Design

Enot, D. and King, R. D. (2003) Application of Inductive Logic Programming to Structure-Based Drug Design. 7th European Conference on Principles and Practice of Knowledge Discovery in Databases (PKDD '03). Springer LNAI 2838 p156-167

Error-driven active learning in growing radial basis function networks for early robot learning

Q. Meng and M.H. Lee, 'Error-driven active learning in growing radial basis function networks for early robot learning', 2006 IEEE International Conference on Robotics and Automation (IEEE ICRA 2006), 2984-90, Orlando, Florida, USA.

Active paraplegics are protected against exercise-induced oxidative damage through the induction of antioxidant enzymes

Exercise improves functional capacity in spinal cord injury (SCI). However, exhaustive exercise, especially when sporadic, is linked to the production of reactive oxygen species that may have a detrimental effect on SCI. We aimed to study the effect of a single bout of exhaustive exercise on systemic oxidative stress parameters and on the expression of antioxidant enzymes in individuals with paraplegia. The study was conducted in the Physical Therapy department and the Physical Education and Sports department of the University of Valencia. Sixteen paraplegic subjects were submitted to a graded exercise test (GET) until volitional exhaustion. They were divided into active or non-active groups. Blood samples were drawn immediately, 1 and 2 h after the GET. We determined plasma malondialdehyde (MDA) and protein carbonylation as markers of oxidative damage. Antioxidant gene expression (catalase and glutathione peroxidase-GPx) was determined in peripheral blood mononuclear cells. We found a significant increase in plasma MDA and protein carbonyls immediately after the GET (P<0.05). This increment correlated significantly with the lactate levels. Active paraplegics showed lower levels of exercise-induced oxidative damage (P<0.05) and higher exercise-induced catalase (P<0.01) and GPx (P<0.05) gene expression after the GET. These results suggest that exercise training may be useful in SCI patients to develop systemic antioxidant defenses that may protect them against exercise-induced oxidative damage.

Active Blobs

A new region-based approach to nonrigid motion tracking is described. Shape is defined in terms of a deformable triangular mesh that captures object shape plus a color texture map that captures object appearance. Photometric variations are also modeled. Nonrigid shape registration and motion tracking are achieved by posing the problem as an energy-based, robust minimization procedure. The approach provides robustness to occlusions, wrinkles, shadows, and specular highlights. The formulation is tailored to take advantage of texture mapping hardware available in many workstations, PC's, and game consoles. This enables nonrigid tracking at speeds approaching video rate.

PeriScope: An Active Internet Probing and Measurement API

Growing interest in inference and prediction of network characteristics is justified by its importance for a variety of network-aware applications. One widely adopted strategy to characterize network conditions relies on active, end-to-end probing of the network. Active end-to-end probing techniques differ in (1) the structural composition of the probes they use (e.g., number and size of packets, the destination of various packets, the protocols used, etc.), (2) the entity making the measurements (e.g. sender vs. receiver), and (3) the techniques used to combine measurements in order to infer specific metrics of interest. In this paper, we present Periscope: a Linux API that enables the definition of new probing structures and inference techniques from user space through a flexible interface. PeriScope requires no support from clients beyond the ability to respond to ICMP ECHO REQUESTs and is designed to minimize user/kernel crossings and to ensure various constraints (e.g., back-to-back packet transmissions, fine-grained timing measurements) We show how to use Periscope for two different probing purposes, namely the measurement of shared packet losses between pairs of endpoints and for the measurement of subpath bandwidth. Results from Internet experiments for both of these goals are also presented.

Active Hidden Models for Tracking with Kernel Projections

We introduce Active Hidden Models (AHM) that utilize kernel methods traditionally associated with classification. We use AHMs to track deformable objects in video sequences by leveraging kernel projections. We introduce the "subset projection" method which improves the efficiency of our tracking approach by a factor of ten. We successfully tested our method on facial tracking with extreme head movements (including full 180-degree head rotation), facial expressions, and deformable objects. Given a kernel and a set of training observations, we derive unbiased estimates of the accuracy of the AHM tracker. Kernels are generally used in classification methods to make training data linearly separable. We prove that the optimal (minimum variance) tracking kernels are those that make the training observations linearly dependent.

Active Voodoo Dolls: A Vision Based Input Device for Nonrigid Control

A vision based technique for non-rigid control is presented that can be used for animation and video game applications. The user grasps a soft, squishable object in front of a camera that can be moved and deformed in order to specify motion. Active Blobs, a non-rigid tracking technique is used to recover the position, rotation and non-rigid deformations of the object. The resulting transformations can be applied to a texture mapped mesh, thus allowing the user to control it interactively. Our use of texture mapping hardware allows us to make the system responsive enough for interactive animation and video game character control.

An Active Pattern Recognition Architecture for Mobile Robots

An active, attentionally-modulated recognition architecture is proposed for object recognition and scene analysis. The proposed architecture forms part of navigation and trajectory planning modules for mobile robots. Key characteristics of the system include movement planning and execution based on environmental factors and internal goal definitions. Real-time implementation of the system is based on space-variant representation of the visual field, as well as an optimal visual processing scheme utilizing separate and parallel channels for the extraction of boundaries and stimulus qualities. A spatial and temporal grouping module (VWM) allows for scene scanning, multi-object segmentation, and featural/object priming. VWM is used to modulate a tn~ectory formation module capable of redirecting the focus of spatial attention. Finally, an object recognition module based on adaptive resonance theory is interfaced through VWM to the visual processing module. The system is capable of using information from different modalities to disambiguate sensory input.

'La Violence et la mauvaise foi': Context and rhetoric in Pierre Bayle's Ce que c'est que la France toute Catholique

My thesis presents an examination of Ce que c'est que la France toute Catholique (1686) by Pierre Bayle, a prominent figure in the Republic of Letters and the Huguenot Refuge in the seventeenth century. This pamphlet was the first occasional text that Bayle published following the Revocation of the Edict of Nantes in which the religious toleration afforded to the Huguenot minority in France was repealed, a pivotal moment in the history of early modern France. In my thesis, I analyse the specific context within which Bayle wrote this pamphlet as a means of addressing a number of issues, including the legitimacy of forced conversions, the impact of the religious controversy upon exchanges in the Republic of Letters, the nature of religious zeal and finally the alliance of Church and state discourses in the early modern period. An examination of this context provides a basis from which to re-interpret the rhetorical strategies at work within the pamphlet, and also to come to an increased understanding of how, why and to what end he wrote it. In turn this allowed me to examine the relationship between this often overlooked pamphlet and the more extensively studied Commentaire Philosophique, in which Bayle argued in favour of religious toleration. Ultimately, understanding the relationship between these two texts proves essential in order to characterise his response to the Revocation of the Edict of Nantes and to understand the place of the pamphlet within his oeuvre. Furthermore, an analysis of the pamphlet and the Commentaire Philosophique provide a lens through which to elucidate both Bayle's intellectual development at this early stage in his career, and also the wider context of the rise of toleration theory and the evolution of modes of civility within the Republic of Letters on the eve of the Enlightenment.

Generation and characterisation of biologically active milk-derived protein and peptide fractions

In recent years, extensive research has been carried out on the health benefits of milk proteins and peptides. Biologically active peptides are defined as specific protein fragments which have a positive impact on the physiological functions of the body; such peptides are produced naturally in vivo, but can also be generated by physical and/or chemical processes, enzymatic hydrolysis and/or microbial fermentation. The aims of this thesis were to investigate not only the traditional methods used for the generation of bioactive peptides, but also novel processes such as heat treatment, and the role of indigenous milk proteases, e.g., in mastitic milk, in the production of such peptides. In addition, colostrum was characterised as a source of bioactive proteins and peptides. Firstly, a comprehensive study was carried out on the composition and physical properties of colostrum throughout the early-lactation period. Marked differences in the physico-chemical properties of colostrum compared with milk were observed. Various fractions of colostrum were also tested for their effect on the secretion of pro- and anti-inflammatory cytokines from a macrophage cell line and bone marrow dendritic cells, as well as insulin secretion from a pancreatic beta cell line. A significant reduction in the secretion of the pro-inflammatory cytokines, TNF-α, IL-6, IL-1β and IL-12, a significant increase in the secretion of the anti-inflammatory cytokine, IL-10, as well as a significant increase in insulin secretion were observed for various colostrum fractions. Another study examined the early proteomic changes in the milk of 8 cows in response to infusion with the endotoxin lipopolysaccharide (LPS) at quarter level in a model mastitic system; marked differences in the protein and peptide profile of milk from LPS challenged cows were observed, and a pH 4.6-soluble fraction of this milk was found to cause a substantial induction in the secretion of IL-10 from a murine macrophage cell line. Heat-induced hydrolysis of sodium caseinate was investigated from the dual viewpoints of protein breakdown and peptide formation, and, a peptide fraction produced in this manner was found to cause a significant increase in the secretion of the anti-inflammatory cytokine, IL-10, from a murine macrophage cell line. The effects of sodium caseinate hydrolysed by chymosin on the gut-derived satiety hormone glucagon-like peptide-1 (GLP-1) were investigated; the resulting casein-derived peptides displayed good in vitro and in vivo secretion of GLP-1. Overall, the studies described in this thesis expand on current knowledge and provide good evidence for the use of novel methods for the isolation, generation and characterisation of bioactive proteins and/or peptides.

Optimised crystal morphologies for active pharmaceutical ingredients and related studies

The majority of active pharmaceutical ingredients (APIs) are crystalline solids in their pure forms. Crystalline solids have definable morphologies, i.e. shape and size. Crystal morphology is determined by both the internal structure of the crystals and external factors during growth from solution. The morphology of a crystal batch can affect key processes during manufacturing. Companies generally accept whatever morphology the manufacturing process provides and deal with any subsequent problems by costly trouble‒shooting. Rational design of optimised morphologies for crystalline pharmaceutical solids would be a very significant technical and commercial advance. Chapter one introduces the concept of crystal nucleation and growth. The phenomenon of polymorphism alongside the causes and impact is discussed. A summary of the scope of instrumentation used in the investigation of crystal polymorphism and morphology, including crystal size distribution (CSD), is also included. Chapter two examines the research carried out during an exploration of the optimum crystallisation parameters of phenacetin. Following a morphological study, the impact this induces on particle density and flow properties is examined. The impact of impurities on the crystallisation properties of phenacetin is investigated. Significantly, the location of impurities within individual crystals is also studied. The third chapter describes an industrial collaboration looking at the resolution and polymorphic study of trometamol and lysine salts of ketoprofen and 2‒phenylpropionic acid (2‒PPA). Chapter four incorporates a solid state study on three separate compounds: 2‒chloro‒4‒nitroaniline, 4‒hydroxy‒N‒phenylbenzenesulfonamide and N‒acetyl‒D‒glucosamine‒6‒O‒sulfate. 2‒Chloro‒4‒nitroaniline and 4‒hydroxy‒N‒phenylbenzenesulfonamide both produced interesting, extreme morphologies which warranted further investigation as part of a collaborative study. Following a summarisation of results in chapter five, chapter six contains the full experimental details, incorporating spectral and other analytical data for all compounds synthesised during the course of the research.

Mature results of a randomized phase II multicenter study of exemestane versus tamoxifen as first-line hormone therapy for postmenopausal women with metastatic breast cancer.

BACKGROUND: Women with hormone-responsive metastatic breast cancer (MBC) may respond to or have stable disease with a number of hormone therapies. We explored the efficacy and safety of the steroidal aromatase inactivator exemestane as first-line hormonal therapy in MBC in postmenopausal women. PATIENTS AND METHODS: Patients with measurable disease were eligible if they had received no prior hormone therapy for metastatic disease and had hormone receptor positive disease or hormone receptor unknown disease with a long disease-free interval from adjuvant therapy. They were randomized to tamoxifen 20 mg/day or exemestane 25 mg/day in this open-label study. RESULTS: Blinded independently reviewed response rates for exemestane and tamoxifen were 41% and 17%, respectively. Fifty-seven per cent of exemestane- and 42% of tamoxifen-treated patients experienced clinical benefit, defined as complete or partial response, or disease stabilization lasting at least 6 months. There was a low incidence of severe flushing, sweating, nausea and edema in women who received exemestane. One exemestane-treated patient had a pulmonary embolism with grade 4 dyspnea. CONCLUSIONS: Exemestane is well tolerated and active in the first-line treatment of hormone-responsive MBC. An ongoing EORTC phase III trial is comparing the efficacy, measuring time-to-disease progression, of exemestane and tamoxifen.