Disease recurrence and rejection following liver transplantation for autoimmune chronic active liver disease

Autoimmune chronic active liver disease (ACALD), a major indication for liver transplantation, is associated strongly with antigenic determinants HLA-B8 and DR3. A retrospective analysis of 43 patients who underwent OLTx for putative ACALD and who, as well as their tissue organ donors, were typed, was performed. Disease recurrence and graft rejection episodes were determined by chart review and histopathological review of all material available. Disease recurrence was histologically documented in 11 (25.6%) of these 43 cases. Graft rejection episodes occurred in 24 (66.8%). All recurrences were in recipients of HLA-DR3-negative grafts. Nine of the recurrences were in HLA-DR3-poeitive recipients (odds ratio: 6.14, P<0.03). Two of 11 cases of disease recurrence were in recipients who were HLA-DR3-negative. Nine of these 11 had received HLA-DR3-negative grafts. Rejection occurred in 13 HLA-B8-positive recipients, 12 of whom received HLA-B8-negative grafts. Eleven HLA-B8-negative recipients experienced at least one rejection episode and 9 of these had received HLA-B8-negative grafts. Based upon these data we conclude: 1) that recurrence of putative ACALD is more likely to occur in HLA-DR3-positive recipients of HLA-DR3-negative grafts; (2) that recurrences were not seen in recipients of HLA-DR3-positive grafts; (3) that BXA-B8 status does not affect disease recurrence; and (4) that neither the HLA-B8 nor the DR3 status of the graft or recipient has an effect on the observed frequency of rejection. ©1992 by Williams & Wilkins

Conditional Lower Bounds for Space/Time Tradeoffs

In recent years much effort has been concentrated towards achieving polynomial time lower bounds on algorithms for solving various well-known problems. A useful technique for showing such lower bounds is to prove them conditionally based on well-studied hardness assumptions such as 3SUM, APSP, SETH, etc. This line of research helps to obtain a better understanding of the complexity inside P. A related question asks to prove conditional space lower bounds on data structures that are constructed to solve certain algorithmic tasks after an initial preprocessing stage. This question received little attention in previous research even though it has potential strong impact. In this paper we address this question and show that surprisingly many of the well-studied hard problems that are known to have conditional polynomial time lower bounds are also hard when concerning space. This hardness is shown as a tradeoff between the space consumed by the data structure and the time needed to answer queries. The tradeoff may be either smooth or admit one or more singularity points. We reveal interesting connections between different space hardness conjectures and present matching upper bounds. We also apply these hardness conjectures to both static and dynamic problems and prove their conditional space hardness. We believe that this novel framework of polynomial space conjectures can play an important role in expressing polynomial space lower bounds of many important algorithmic problems. Moreover, it seems that it can also help in achieving a better understanding of the hardness of their corresponding problems in terms of time

A high-wavenumber boundary-element method for an acoustic scattering problem

In this paper we show stability and convergence for a novel Galerkin boundary element method approach to the impedance boundary value problem for the Helmholtz equation in a half-plane with piecewise constant boundary data. This problem models, for example, outdoor sound propagation over inhomogeneous flat terrain. To achieve a good approximation with a relatively low number of degrees of freedom we employ a graded mesh with smaller elements adjacent to discontinuities in impedance, and a special set of basis functions for the Galerkin method so that, on each element, the approximation space consists of polynomials (of degree $\nu$) multiplied by traces of plane waves on the boundary. In the case where the impedance is constant outside an interval $[a,b]$, which only requires the discretization of $[a,b]$, we show theoretically and experimentally that the $L_2$ error in computing the acoustic field on $[a,b]$ is ${\cal O}(\log^{\nu+3/2}|k(b-a)| M^{-(\nu+1)})$, where $M$ is the number of degrees of freedom and $k$ is the wavenumber. This indicates that the proposed method is especially commendable for large intervals or a high wavenumber. In a final section we sketch how the same methodology extends to more general scattering problems

A Galerkin boundary element method for high frequency scattering by convex polygons

In this paper we consider the problem of time-harmonic acoustic scattering in two dimensions by convex polygons. Standard boundary or finite element methods for acoustic scattering problems have a computational cost that grows at least linearly as a function of the frequency of the incident wave. Here we present a novel Galerkin boundary element method, which uses an approximation space consisting of the products of plane waves with piecewise polynomials supported on a graded mesh, with smaller elements closer to the corners of the polygon. We prove that the best approximation from the approximation space requires a number of degrees of freedom to achieve a prescribed level of accuracy that grows only logarithmically as a function of the frequency. Numerical results demonstrate the same logarithmic dependence on the frequency for the Galerkin method solution. Our boundary element method is a discretization of a well-known second kind combined-layer-potential integral equation. We provide a proof that this equation and its adjoint are well-posed and equivalent to the boundary value problem in a Sobolev space setting for general Lipschitz domains

Accuracy of Emergency Medical Services Dispatcher and Crew Diagnosis of Stroke in Clinical Practice.

BACKGROUND: Accurate recognition of stroke symptoms by Emergency Medical Services (EMS) is necessary for timely care of acute stroke patients. We assessed the accuracy of stroke diagnosis by EMS in clinical practice in a major US city. METHODS AND RESULTS: Philadelphia Fire Department data were merged with data from a single comprehensive stroke center to identify patients diagnosed with stroke or TIA from 9/2009 to 10/2012. Sensitivity and positive predictive value (PPV) were calculated. Multivariable logistic regression identified variables associated with correct EMS diagnosis. There were 709 total cases, with 400 having a discharge diagnosis of stroke or TIA. EMS crew sensitivity was 57.5% and PPV was 69.1%. EMS crew identified 80.2% of strokes with National Institutes of Health Stroke Scale (NIHSS) ≥5 and symptom durationmodel, correct EMS crew diagnosis was positively associated with NIHSS (NIHSS 5-9, OR 2.62, 95% CI 1.41-4.89; NIHSS ≥10, OR 4.56, 95% CI 2.29-9.09) and weakness (OR 2.28, 95% CI 1.35-3.85), and negatively associated with symptom duration \u3e270 min (OR 0.41, 95% CI 0.25-0.68). EMS dispatchers identified 90 stroke cases that the EMS crew missed. EMS dispatcher or crew identified stroke with sensitivity of 80% and PPV of 50.9%, and EMS dispatcher or crew identified 90.5% of patients with NIHSS ≥5 and symptom duration \u3c6 \u3eh. CONCLUSION: Prehospital diagnosis of stroke has limited sensitivity, resulting in a high proportion of missed stroke cases. Dispatchers identified many strokes that EMS crews did not. Incorporating EMS dispatcher impression into regional protocols may maximize the effectiveness of hospital destination selection and pre-notification

Distributed Edge Connectivity in Sublinear Time

We present the first sublinear-time algorithm for a distributed message-passing network sto compute its edge connectivity $\lambda$ exactly in the CONGEST model, as long as there are no parallel edges. Our algorithm takes $\tilde O(n^{1-1/353}D^{1/353}+n^{1-1/706})$ time to compute $\lambda$ and a cut of cardinality $\lambda$ with high probability, where $n$ and $D$ are the number of nodes and the diameter of the network, respectively, and $\tilde O$ hides polylogarithmic factors. This running time is sublinear in $n$ (i.e. $\tilde O(n^{1-\epsilon})$) whenever $D$ is. Previous sublinear-time distributed algorithms can solve this problem either (i) exactly only when $\lambda=O(n^{1/8-\epsilon})$ [Thurimella PODC'95; Pritchard, Thurimella, ACM Trans. Algorithms'11; Nanongkai, Su, DISC'14] or (ii) approximately [Ghaffari, Kuhn, DISC'13; Nanongkai, Su, DISC'14]. To achieve this we develop and combine several new techniques. First, we design the first distributed algorithm that can compute a $k$-edge connectivity certificate for any $k=O(n^{1-\epsilon})$ in time $\tilde O(\sqrt{nk}+D)$. Second, we show that by combining the recent distributed expander decomposition technique of [Chang, Pettie, Zhang, SODA'19] with techniques from the sequential deterministic edge connectivity algorithm of [Kawarabayashi, Thorup, STOC'15], we can decompose the network into a sublinear number of clusters with small average diameter and without any mincut separating a cluster (except the `trivial' ones). Finally, by extending the tree packing technique from [Karger STOC'96], we can find the minimum cut in time proportional to the number of components. As a byproduct of this technique, we obtain an $\tilde O(n)$-time algorithm for computing exact minimum cut for weighted graphs.Comment: Accepted at 51st ACM Symposium on Theory of Computing (STOC 2019

catena-Poly[[[bis­(methanol-κO)lead(II)]-μ-N′-[1-(pyridin-2-yl-κN)ethyl­idene]isonicotinohydrazidato-κ3 N′,O:N 1] perchlorate]

The PbII atom in the polymeric title compound, {[Pb(C13H11N4O)(CH3OH)2]ClO4}n, is coordinated by an N′-[1-(pyridin-2-yl-κN)ethyl­idene]isonicotinohydrazidate ligand via O,N,N′-donors and simultaneously bridged by a neighbouring ligand via the isonicotinoyl N atom; two additional sites are occupied by methanol O atoms. The resultant supra­molecular chain is a zigzag along the c axis. The PbII atom is seven-coordinated within an N3O3 donor set and a lone pair of electrons, which defines a Ψ-pentagonal–bipyramidal coordination geometry with the pyridine N and lone pair in axial positions. The supra­molecular chains are linked into the two-dimensional array via inter­molecular Pb⋯N [3.020 (4) Å] inter­actions. Layers stack along the a axis, being connected by O—H⋯O hydrogen bonds formed between the coordinated methanol mol­ecules and perchlorate anions