Evaluation of propofol for repeated prolonged deep sedation in children undergoing proton radiation therapy

Background The aim of this study is to evaluate the safety and sufficiency of a fixed dose rate propofol infusion for repeated prolonged deep sedation in children for proton radiation therapy (PRT). Methods With ERB approval, we recorded anaesthesia monitoring data in children undergoing repeated prolonged propofol sedation for PRT. Sedation was introduced with a single bolus of i.v. midazolam 0.1 mg kg−1 followed by repeated small boluses of propofol until sufficient depth of sedation was obtained. Sedation was maintained with fixed dose rate propofol infusion of 10 mg kg−1 h−1 in all patients up to the end of the radiation procedure. Patient characteristics, number and duration of sedation, propofol induction dose, necessity to alter propofol infusion rate, and heart rate, mean arterial pressure, respiratory rate were noted at the end of the radiation procedure before cessation of the propofol infusion. Data are mean (sd) or range (median) as appropriate. Results Eighteen children aged from 1.4 to 4.2 yr (2.6 yr) had 27.6 (sd 2.0) (497 in total) radiation procedures within 44.1 (4.0) days lasting 55.7 (8.8) min. Propofol bolus dose for induction, monitoring, and positioning was 3.7 (1.0) mg kg−1. Propofol bolus requirements were quite stable over the successive weeks of treatment and variability was larger between individuals than over time. In none of the children did propofol infusion rate need to be changed from the pre-set 10 mg kg−1 h−1 flow rate because of haemodynamic state, respiratory conditions or inadequate anaesthesia. Conclusions Repeated prolonged deep sedation over several weeks in very young children using a fixed rate propofol infusion was safe and adequate for all patient

Very Light Rail (VLR) technology - a new, simple, safe, cost-effective environmental solution to meet future transportation needs

An increasing number of papers, government programs, and studies, are directed toward the economics of lighter weight vehicles in mass transit. The objectives of these activities are generally directed toward the increased energy efficiency of the fighter vehicles or the benefits to the infrastructure-less wear, repair, or construction cost, or both. Some systems studies of potential magnetic levitation concepts have minimized the size of the vehicles in order to increase the operational flexibility of the system. CyberTran was designed and developed from the ground up as a small vehicle transportation system with the primary objectives of (1) reducing the capital and operating costs of high speed rail and transit systems and (2) maximizes rider appeal and safety. The potential for significant savings in capital cost with a small vehicle rail system like CyberTran has been evaluated. This paper discusses the operational benefits which can be realized with a rail system based on small, light weight, and computer controlled vehicles. CyberTran was developed at the Idaho National Engineering Laboratory, a U.S. Department of Energy Research and Development Laboratory in Southeastern Idaho

Wound Infection Rates After Invasive Procedures in HIV-1 Seropositive Versus HIV-1 Seronegative Hemophiliacs

One-hundred and two patients with hemophilia A, hemophilia B, or acquired antibody to factor VIII who had undergone invasive procedures were cross referenced with patients participating in an ongoing prospective natural history study of HIV-1 infection in hemophiliacs. Matching revealed that HIV-1 status was known for 83 patients (83%) who had undergone 169 procedures between July 1979 and April 1988. Invasive procedures were classified as clean in 108 patients (63.9%), clean-contaminated in 45 (26.6%), contaminated in 2 (1.2%), and infected in 14 (8.3%). Wound infection rates by HIV-1 status were as follows (95% confidence intervals): HIV+ 1.4% (0% to 5%), HIV- 0% (0% to 9%), and procedure before testing HIV+ 1.5% (0% to 6%). There were no significant differences between the wound infection rates of HIV-positive and HIV-negative hemophiliacs nor in the wound infection rate among all three subgroups of patients (p greater than 0.5, Fisher's Exact Test). We conclude that surgery in HIV-1-infected patients who have not progressed to AIDS does not entail an increased risk of postoperative wound infections

Tools for the identification of bioactives impacting the metabolic syndrome: Screening of a botanical extract library using subcutaneous and visceral human adipose-derived stem cell-based assays

Plant extracts continue to represent an untapped source of renewable therapeutic compounds for the treatment and prevention of illnesses including chronic metabolic disorders. With the increase in worldwide obesity and its related morbidities, the need for identifying safe and effective treatments is also rising. As such, use of primary human adipose-derived stem cells represents a physiologically relevant cell system to screen for bioactive agents in the prevention and treatment of obesity and its related complications. By using these cells in a primary screen, the risk and cost of identifying artifacts due to interspecies variation and immortalized cell lines is eliminated. We demonstrate that these cells can be formatted into 384-well high throughput screens to rapidly identify botanical extracts that affect lipogenesis and lipolysis. Additionally, counterscreening with human primary stem cells from distinct adipose depots can be routinely performed to identify tissue specific responses. In our study, over 500 botanical extracts were screened and 16 (2.7%) were found to affect lipogenesis and 4 (0.7%) affected lipolysis. © 2012 Elsevier Inc

Jamming Bandits - A Novel Learning Method for Optimal Jamming

Can an intelligent jammer learn and adapt to unknown environments in an electronic warfare-type scenario? In this paper, we answer this question in the positive, by developing a cognitive jammer that adaptively and optimally disrupts the communication between a victim transmitter-receiver pair. We formalize the problem using a multiarmed bandit framework where the jammer can choose various physical layer parameters such as the signaling scheme, power level and the on-off/pulsing duration in an attempt to obtain power efficient jamming strategies. We first present online learning algorithms to maximize the jamming efficacy against static transmitter-receiver pairs and prove that these algorithms converge to the optimal (in terms of the error rate inflicted at the victim and the energy used) jamming strategy. Even more importantly, we prove that the rate of convergence to the optimal jamming strategy is sublinear, i.e., the learning is fast in comparison to existing reinforcement learning algorithms, which is particularly important in dynamically changing wireless environments. Also, we characterize the performance of the proposed bandit-based learning algorithm against multiple static and adaptive transmitter-receiver pairs. © 2015 IEEE

Feed-Forward Inhibition of Androgen Receptor Activity by Glucocorticoid Action in Human Adipocytes

SummaryWe compared transcriptomes of terminally differentiated mouse 3T3-L1 and human adipocytes to identify cell-specific differences. Gene expression and high content analysis (HCA) data identified the androgen receptor (AR) as both expressed and functional, exclusively during early human adipocyte differentiation. The AR agonist dihydrotestosterone (DHT) inhibited human adipocyte maturation by downregulation of adipocyte marker genes, but not in 3T3-L1. It is interesting that AR induction corresponded with dexamethasone activation of the glucocorticoid receptor (GR); however, when exposed to the differentiation cocktail required for adipocyte maturation, AR adopted an antagonist conformation and was transcriptionally repressed. To further explore effectors within the cocktail, we applied an image-based support vector machine (SVM) classification scheme to show that adipocyte differentiation components inhibit AR action. The results demonstrate human adipocyte differentiation, via GR activation, upregulates AR but also inhibits AR transcriptional activity

Channel estimation method with improved performance for the UMTS-TDD mode

Channel estimation is an essential building block for UTRA-TDD high performance receivers. Once the performance of the channel estimator algorithm proposed by 3GPP is highly dependent on the time spreading between consecutive multi-path components, a Successive Multi-path channel Estimation Technique (SMET) that improves the time resolution is proposed in this paper. A SMET based maximum likelihood approach for vectorial channel estimation, to include the estimation of the direction-of-arrival, is also proposed. This algorithm solves efficiently the complex problem of DOA estimation of multiple users in a multi path propagation environment even when the number of required DOA's exceeds the number of antenna array elements. Another property of the proposed algorithm is its ability to resolve signals from different users arriving from the same direction. This is due to processing in both time and space dimensions. The performance of these algorithms is assessed by resorting to simulations in multi-path environments using the UMTS-TDD specifications, and also by comparing the rms estimation errors against the Crámer-Rao Bound. The effect of imperfect channel estimation on the performance of RAKE and Hard-Decision Parallel Interference Canceller receivers is also analysed. The results show that a good performance can be achieved with SMET, from low to high values of Eb/n0

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV