Refining the risk-benefit equation for thrombolysis: How to identity the low risk patient before administering thrombolytic therapy

In view of the relative risk of intracranial haemorrhage and major bleeding with thrombolytic therapy, it is important ro identify as early as possible the low risk patient who may not have a net clinical benefit from thrombolysis in the setting of acute myocardial infarction. An analysis of 5434 hospital-treated patients with myocardial infarction in the Perth MONICA study showed that age below 60 and absence of previous infarction or diabetes, shock, pulmonary oedema, cardiac arrest and Q-wave or left bundle branch block on the initial ECG identified a large group of patients with a 28 day mortality of only 1%, and one year mortality of only 2%. Identification of baseline risk in this way helps refine the risk-benefit equation for thrombolytic therapy, and may help avoid unnecessary use of thrombolysis in those unlikely to benefit.

Tidal effects on sea water intrusion in unconfined aquifers

A variable-density groundwater model is used to analyse the effects of tidal fluctuations on sea-water intrusion in an unconfined aquifer. It is shown that the tidal activity forces the sea-water to intrude further inland and it also creates a thicker interface than would occur without tidal effects. Moreover, the configuration of the interface is radically changed when the tidal fluctuations are included. This is because of the dramatic changes in the flow pattern and velocity of the groundwater near the shoreline. For aquifer depths much larger than tidal amplitudes, the tidal fluctuation does not have much effect on how far the sea-water intrudes into the aquifer; nevertheless, a significant change in the configuration of concentration contours because of the effect of tidal fluctuations is observed. This change is more noticeable at the top of the aquifer, near the water table, than at the bottom of the aquifer, and is caused by the infiltration of salt water into the top of the aquifer at higher tidal levels. A flatter beach slope, therefore, intensifies this phenomenon. The interface configurations do not change noticeably over the course of a tidal cycle. Neglecting tidal fluctuation effects results in an inaccurate evaluation of the water table elevation at the land end of the aquifer, although no distinguishable difference is seen between the water tables near the shoreline. Where the landward boundary condition is a constant head, the effects of tidal fluctuations on sea-water intrusion are more pronounced than for cases where the landward boundary condition is a specified flux. Also it is shown that the effects of tidal fluctuations are more significant for a sloping beach than for a vertical shoreline and the salt water intrudes further inland for the sloping case. (C) 1999 Elsevier Science B.V. All rights reserved.

Tailored advice on exercise - Does it make a difference?

Objectives: A controlled trial to compare the effectiveness of verbal advice from a family physician (FP) combined with either standard or tailored written information on physical activity in increasing the levels of physical activity in sedentary patients. Design: Sedentary patients (n = 763) were recruited through ten family practices and allocated to a control group or one of two intervention groups, Brief advice on physical activity was given by the FP during the consultation and either a standard or tailored pamphlet was mailed to the home address of patients assigned to the intervention groups within two days of their visit to the FP. Results: The response to follow-up, via a postal survey at one, six, and twelve months after the index consultation was 70%, 60%, and 57%, respectively. Treating all nonresponders as sedentary, the results revealed that although more tailored subjects reported some physical activity at each follow-up compared with the standard group, these differences were not significant, Furthermore, there was no significant difference in movement across the stages of readiness to exercise at follow-up between subjects in the tailored group who received material targeting their current stage (precontemplation or contemplation) and the standard group who received generic material that addressed both stages. Conclusion: These findings do not concur with the results from previous research in the areas of nutrition and smoking cessation where additional benefits were seen with a tailored intervention. Future research on the application of the principles of tailoring to the promotion of physical activity should focus on identifying which, if any, physical, social, psychological or environmental variables should be addressed to produce improved outcomes over and above the effects of well designed generic materials. (C) 1999 American Journal of Preventive Medicine.

A wavelet visible difference predictor

In this paper, we describe a model of the human visual system (HVS) based on the wavelet transform. This model is largely based on a previously proposed model, but has a number of modifications that make it more amenable to potential integration into a wavelet based image compression scheme. These modifications include the use of a separable wavelet transform instead of the cortex transform, the application of a wavelet contrast sensitivity function (CSP), and a simplified definition of subband contrast that allows us to predict noise visibility directly from wavelet coefficients. Initially, we outline the luminance, frequency, and masking sensitivities of the HVS and discuss how these can be incorporated into the wavelet transform. We then outline a number of limitations of the wavelet transform as a model of the HVS, namely the lack of translational invariance and poor orientation sensitivity. In order to investigate the efficacy of this wavelet based model, a wavelet visible difference predictor (WVDP) is described. The WVDP is then used to predict visible differences between an original and compressed (or noisy) image. Results are presented to emphasize the limitations of commonly used measures of image quality and to demonstrate the performance of the WVDP, The paper concludes with suggestions on bow the WVDP can be used to determine a visually optimal quantization strategy for wavelet coefficients and produce a quantitative measure of image quality.

A pore-size-dependent equation of state for multilayer adsorption in cylindrical mesopores

The chemical potential of adsorbed film inside cylindrical mesopores is dependent on the attractive interactions between the adsorbed molecules and adsorbent, the curvature of gas/adsorbed phase interface, and surface tension. A state equation of the adsorbed film is proposed to take into account the above factors. Nitrogen adsorption on model adsorbents, MCM-41, which exhibit uniform cylindrical channels, are used to verify the theoretical analysis. The proposed theory is capable of describing the important features of adsorption processes in cylindrical mesopores. According to this theory, at a given relative pressure, the smaller the pore radius is, the thicker the adsorbed film will be. The thickening of adsorbed films in the pores as the vapor pressure increases inevitably causes an increase in the interface curvature, which consequently leads to capillary condensation. Besides, this study confirmed that the interface tension depends substantially on the interface curvature in small mesopores. A quantitative relationship between the condensation pressure and the pore radius can be derived from the state equation and used to predict the pore radius from a condensation pressure, or vice versa.

Extended integrability regime for the supersymmetric U model

An extension of the supersymmetric U model for correlated electrons is given and integrability is established by demonstrating that the model can he constructed through the quantum inverse scattering method using an R-matrix without the difference property. Some general symmetry properties of the model are discussed and from the Bethe ansatz solution an expression for the energies is presented.

Groundwater waves in a coastal aquifer: A new governing equation including vertical effects and capillarity

Groundwater waves, that is, water table fluctuations, are a natural phenomenon in coastal aquifers. They represent an important part of the interaction between the ocean and aquifer and affect the mass exchange between them. This paper presents a new groundwater wave equation. Because it includes the effects of vertical flows and capillarity, the new equation is applicable to both intermediate-depth aquifers and high-frequency waves. Compared with the wave equation derived by Nielsen ed al. [1997], the present equation provides a closer representation of groundwater waves. In particular, it predicts high-frequency water table fluctuations as observed in the field. A validation of the new equation has been carried out by comparing the analytical solutions to it with predictions from direct simulations using the numerical model SUTRA. The effects of various physical parameters and their relative importance are also discussed.

A two-dimensional analytical solution of groundwater responses to tidal loading in an estuary and ocean

Previous studies on tidal dynamics of coastal aquifers have focussed on the inland propagation of oceanic tides in the cross-shore direction, a configuration that is essentially one-dimensional. Aquifers at natural coasts can also be influenced by tidal waves in nearby estuaries, resulting in a more complex behaviour of head fluctuations in the aquifers. We present an analytical solution to the two-dimensional depth-averaged groundwater flow equation for a semi-infinite aquifer subject to oscillating head conditions at the boundaries. The solution describes the tidal dynamics of a coastal aquifer that is adjacent to a cross-shore estuary. Both the effects of oceanic and estuarine tides on the aquifer are included in the solution. The analytical prediction of the head fluctuations is verified by comparison with numerical solutions computed using a standard finite-difference method. An essential feature of the present analytical solution is the interaction between the cross- and along-shore tidal waves in the aquifer area near the estuary's entry. As the distance from the estuary or coastline increases, the wave interaction is weakened and the aquifer response is reduced, respectively, to the one-dimensional solution for oceanic tides or the solution of Sun (Sun H. A two-dimensional analytical solution of groundwater response to tidal loading in an estuary, Water Resour Res 1997;33:1429-35) for two-dimensional non-interacting tidal waves. (C) 2000 Elsevier Science Ltd. All rights reserved.

Asymptotic solutions to the Gross-Pitaevskii gain equation: Growth of a Bose-Einstein condensate

We give an asymptotic analytic solution for the generic atom-laser system with gain in a D-dimensional trap, and show that this has a non-Thomas-Fermi behavior. The effect is due to Bose-enhanced condensate growth, which creates a local-density maximum and a corresponding outward momentum component. In addition, the solution predicts amplified center-of-mass oscillations, leading to enhanced center-of-mass temperature.

Finite-difference time-domain-based studies of MRI pulsed field gradient-induced eddy currents inside the human body

In modern magnetic resonance imaging (MRI), patients are exposed to strong, rapidly switching magnetic gradient fields that, in extreme cases, may be able to elicit nerve stimulation. This paper presents theoretical investigations into the spatial distribution of induced current inside human tissues caused by pulsed z-gradient fields. A variety of gradient waveforms have been studied. The simulations are based on a new, high-definition, finite-difference time-domain method and a realistic inhomogeneous 10-mm resolution human body model with appropriate tissue parameters. it was found that the eddy current densities are affected not only by the pulse sequences but by many parameters such as the position of the body inside the gradient set, the local biological material properties and the geometry of the body. The discussion contains a comparison of these results with previous results found in the literature. This study and the new methods presented herein will help to further investigate the biological effects caused by the switched gradient fields in a MRI scan. (C) 2002 Wiley Periodicals, Inc.

Estimation of crystalline phase present in the glucose crystal-solution mixture by water activity measurement

The amount of crystalline fraction present in monohydrate glucose crystal-solution mixture up to 110% crystal in relation to solution (crystal:solution=110:100) was determined by water activity measurement. It was found that the water activity had a strong linear correlation (R-2=0.994) with the amount of glucose present above saturation. Difference in the water activities of the crystal-solution mixture (a(w1)) and the supersaturated solution (a(w2)) by re-dissolving the crystalline fraction allowed calculation of the amount of crystalline phase present (DeltaG) in the mixture by an equation DeltaG=846.97(a(w1)-a(w2)). Other methods such as Raoult's, Norrish and Money-Born equations were also tested for the prediction of water activity of supersaturated glucose solution. (C) 2003 Swiss Society of Food Science and Technology. Published by Elsevier Science Ltd. All rights reserved.

Increased rates of ENT surgery among young children: Have clinical guidelines made a difference?

Objectives: To examine the association between introduction of paediatric ear, nose and throat (ENT) surgery guidelines and population procedure rates. To determine changes in children's risk of undergoing ENT surgery. Methods: Trend analysis of incidence of myringotomy, tonsillectomy and adenoidectomy among New South Wales (NSW) children aged 0-14 between 1981 and mid 1999. Poisson regression models were used to estimate annual rates of change pre and postguidelines introduction and age/gender specific rates, and lifetable methods to determine risk of undergoing an ENT procedure by age 15. Results: ENT surgery rates increased by 21% over the study period. Children's risk of surgery increased from 17.9% in 1981 to 20.2% in 1998/99. Guideline introduction was associated with moderate short-term decreases in rates. For tonsillectomy, rates decreased between 1981 and 1983, but then rose continually until the introduction of myringotomy guidelines in 1993, when they fell, only to recommence rising until the end of the study period. For myringotomy, rates rose annually from 1981 to 1992/93 and fell in the 3 years following guideline introduction, after which they rose again. Increases were almost exclusively restricted to children aged 0-4 and correspond with increased use of formal childcare. The prevalence of myringotomy by the age of 5 years rose from 5.6% of children born in 1988/89 to 6.4% of those born in 1994/95, and the prevalence of tonsillectomy from 2.4% to 2.7%. Conclusions: The risk of young Australian children undergoing ENT surgery increased significantly over the last two decades despite the introduction of guidelines and no evidence of an increase in otitis media, one condition prompting surgery. Surgery increased most among the very young. We hypothesize this is related to increasing use of childcare.