Purpose
Patient decision aids (PtDAs) have been reported to have a positive influence on patients making a health care decision in trials. Nevertheless, post-trial implementation is poor. The aim of ...this study is to explore patient, clinician, and organizational success factors for implementing a PtDA designed for breast cancer patients, facing a decision on their radiation treatment.
Methods
We performed a process evaluation within a multi-center pre- and post-implementation trial. The PtDA was incorporated as much as possible in the logistics of 13 participating centers. Tracking data were collected on PtDA use. Process characteristics were recorded by both clinicians and patients. A logistic regression method was applied to investigate which process characteristics were significantly related to the probability that patients logged in to the PtDA.
Results
189 patients received the PtDA of whom140 (77%) used the PtDA. If patients received the link via the surgery department they were more likely to use the PtDA (OR 9.77 (1.28–74.51)), compared to patients that received the link via the radiation oncology department. If the report of the multidisciplinary team stated that radiation treatment “had to be discussed with the patient”, patients were more likely to use the PtDA (OR 2.29 (1.12–4.71)). Educational level was not related to the probability of PtDA use.
Conclusions
We accomplished a high level of PtDA use. Patients were more likely to use the PtDA if they received the link via the surgery department and if “to be discussed with the patient” was written in the multidisciplinary team report.
Systemic infection is associated with long-term cognitive deficits and functional decline. In this study we hypothesized that severe systemic inflammation leads to a neuroinflammatory response that ...is characterized by microglial activation, and that these effects might be more pronounced in patients using medication with anticholinergic side-effects.
Based on the results of a pilot study in 8 patients, we assessed the number of MHC-II and CD-68 positive cells by immunohistochemistry and compared the number of microglia in specific brain regions of 16 well-characterized patients with septic shock and 15 controls.
In the pilot study, patients with sepsis tended to have higher density of MHC-II and CD-68 positive microglia in the basal ganglia (putamen, caudate nucleus and globus pallidus) and of MHC-II positive microglia in the hippocampus. In the validation study, patients with sepsis had a significantly higher number of CD-68 positive cells in hippocampus (1.5 fold;
= 0.012), putamen (2.2 fold;
= 0.008) and cerebellum (2.5 fold;
= 0.011) than control patients. The density of MHC-II positive microglia was similar between sepsis and control groups. There was no consistent correlation between microglia counts and anti-cholinergic activity drugs score.
In patients who die during septic shock, severe systemic inflammation is accompanied by localized and strong upregulation of CD-68 positive microglia, but not of MHC-II positive microglia. We identified regional differences in the brain with increased microglial activation in putamen, hippocampus and cerebellum.
Summary
We describe a segmentation algorithm that is able to identify defects (cracks, holes and breakages) in particle systems. This information is used to segment image data into individual ...particles, where each particle and its defects are identified accordingly. We apply the method to particle systems that appear in Li‐ion battery electrodes. First, the algorithm is validated using simulated data from a stochastic 3D microstructure model, where we have full information about defects. This allows us to quantify the accuracy of the segmentation result. Then we show that the algorithm can successfully be applied to tomographic image data from real battery anodes and cathodes, which are composed of particle systems with very different morpohological properties. Finally, we show how the results of the segmentation algorithm can be used for structural analysis.
Data obfuscation with network coding Hessler, A.; Kakumaru, T.; Perrey, H. ...
Computer communications,
2012, 2012-1-00, 20120101, Letnik:
35, Številka:
1
Journal Article
Recenzirano
Network coding techniques such as fountain codes are a promising way to disseminate large bulks of data in a multicast manner over an unreliable medium. In this work we investigate how to conceal ...such an encoded data stream on its way to numerous receivers with a
minimum investment. Compared to conventional ‘encrypt – encode/decode – decrypt’ approaches, our solution is preferable for two reasons: First, it causes less CPU investment for encryption and decryption proportional to the ratio of the payload length to the signaling data length. Second, besides obfuscating the payload data from an eavesdropper, we hide the coding information from an eavesdropper. We evaluate the approach with respect to its application to various data types like MPEG-2 video streams and Java bytecode.
Wired equivalent security is difficult to provide in ad hoc networks due to high dynamics, wireless link vulnerability, and the requirement of complete decentralization. Especially mutual ...authentication among nodes in a self-organized mode of ad hoc network, where a single definition of trust is hard to build, is very difficult. This leads to several loopholes in previously established security architectures and intrusion detection systems if employed to ad hoc networks. Also, typical to ad hoc routing major security lacks are unfair participation of nodes in the system, and frequent attacks to the routing protocols by ad hoc nodes that do not want to forward foreign packets but use other nodes to forward their own packets. Contrary to detection-based approaches to tackle this situation, we propose a motivation-based approach, which does not require mutual authentication. We enable this by providing (a) a realistic architecture of ad hoc access network to an Internet Service Provider, (b) a workable business model for charging in this architecture and (c) a necessary security protocol to implement the charging scheme. For the latter we give a formal validation.
The safety of a non-adjuvanted inactivated fungal vaccine for the treatment of dermatophytosis in cats was investigated in two studies: a controlled laboratory study, and a placebo-controlled ...double-blind field study with a cross-over design in Europe. In the laboratory study, two groups of 10 cats each were administered an intramuscular twofold overdose, followed by five single 1 ml doses, of either vaccine or control product at 14-day intervals. In the field study, cats were treated with three intramuscular injections of 1 ml vaccine administered at 14-day intervals, as recommended by the manufacturer. A total of 89 cats were enrolled in the field study and divided into two groups to receive either vaccine or placebo for the first three treatments, followed by the opposite product for the final three treatments. The cats enrolled in the two studies were 12 weeks of age or older, as recommended by the manufacturer. All the cats were monitored closely for possible injection site reactions, systemic reactions (including changes in rectal body temperature) and adverse events. The results from both studies showed no significant differences between the vaccinated cats and the control or placebo-treated cats with regard to local or systemic reactions. A few mild to moderate local reactions were noted, but these were evenly distributed between the vaccinated and placebo-treated cats and resolved within a few days. No severe or serious adverse events related to the vaccinations were observed.
End-to-end encryption for wireless sensor networks is a challenging problem. To save the overall energy resources of the network, it is agreed that sensed data need to be consolidated and aggregated ...on their way to the final destination. We present an approach that (1) conceals sensed data end-to-end, by (2) still providing efficient in-network data aggregation. The aggregating intermediate nodes are not required to operate on the sensed plaintext data. We apply a particular class of encryption transformation and exemplarily discuss the approach on the basis of two aggregation functions. We use actual implementation to show that the approach is feasible and flexible and frequently even more energy efficient than hop-by-hop encryption.
Microglial activation after systemic infection has been suggested to mediate sepsis-associated delirium. A systematic review of animal studies suggested distinct differences between microglial ...activation after systemic challenge with live bacteria and lipopolysaccharide (LPS). Here, we describe a mouse model of microglial activation after systemic challenge with live
(
) and compare results with systemic challenge with LPS.
Sixty mice were intraperitoneally injected with
(1 × 10
colony-forming units) and sacrificed at 12, 20, 48, and 72 h after inoculation. For 48 and 72 h time points, mice were treated with ceftriaxone. Thirty mice were intraperitoneally injected with LPS (5 mg/kg) and sacrificed 3 and 48 h after inoculation; 48 control mice were intraperitoneally injected with isotonic saline. Microglial response was monitored by immunohistochemical staining with Iba-1 antibody and flow cytometry; and inflammatory response by mRNA expression of pro- and anti-inflammatory mediators.
Mice infected with live
showed microglial activation 72 h post-inoculation, with increased cell number in cortex (
= 0.0002), hippocampus (
= 0.003), and thalamus (
= 0.0001), but not in the caudate nucleus/putamen (
= 0.33), as compared to controls. At 72 h, flow cytometry of microglia from
infected mice showed increased cell size (
= 0.03) and CD45 expression (
= 0.03), but no increase in CD11b expression, and no differences in brain mRNA expression of inflammatory mediators as compared to controls. In mice with systemic LPS stimulation, microglial cells were morphologically activated at the 48 h time point with increased cell numbers in cortex (
= 0.002), hippocampus (
= 0.0003), thalamus (
= 0.007), and caudate nucleus/putamen (
< 0.0001), as compared to controls. At 48 h, flow cytometry of microglia from LPS stimulated mice showed increased cell size (
= 0.03), CD45 (
= 0.03), and CD11b (
= 0.04) expression. Brain mRNA expression of TNF-α (
= 0.02), IL-1β (
= 0.02), and MCP-1 (
= 0.03) were increased as compared to controls.
Systemic challenge with live
causes a neuro-inflammatory response, but this response occurs at a later time point and is less vigorous as compared to LPS stimulation.The
model mimics the clinical situation of infection associated delirium more closely than stimulation with supra-natural LPS.
Antibiotics are of limited value against Staphylococcus aureus due to development of resistant strains, scar tissue formation, and blockage of ducts due to inflammation. Though macrophages are the ...predominant cell type in the mammary gland, they are primarily scavenger cells and are not effective against bacteria entering the gland. Neutrophil phagocytosis is the bovine's primary defense against S. aureus mastitis. Attempts to develop vaccines that enhance neutrophil phagocytosis by stimulating production of opsonizing antibodies to S. aureus have met with limited success because of the low immunogenicity of the exopolysaccharide capsule surrounding S. aureus. Staphylococcus aureus can also adhere to and penetrate epithelial tissue. This study was conducted to determine whether lysates of S. aureus encapsulated in biodegradable microspheres would increase the production of opsonizing antibodies to capsule and block adherence. Four groups of four cows each were injected with 1 ml of the respective treatment in the area of the supramammary lymph node and 1 ml in the hip muscle. The treatments were: lysate in NaCl, lysate in Freund's incomplete adjuvant (FICA), lysate in microspheres in NaCl, and lysate in microspheres in FICA. Antigen in microspheres produced a similar antibody response to antigen emulsified in FICA, but to a lesser magnitude. Antigen in microspheres produced antibodies that were more opsonic for neutrophils at 20 and 52 wk postimmunization and inhibited S. aureus adherence to mammary epithelium. Ability to control antigen release and presentation, and the benefit of a single injection for long-term immunity using microspheres warrants additional studies.
Annatto preparations are used to impart distinctive flavor and color to foods and are a primary colorant in dairy foods such as cheese and butter. There are several reports indicating that certain ...fractions of the annatto plant have biological activities against microorganisms of significance in food fermentation, food preservation, and human health. However, little is reported describing the nature of the antimicrobial compound(s) or their potential presence in commercial annatto colorant preparations. This study was conducted to determine whether commonly available annatto extracts are capable of influencing the outgrowth of selected lactic acid, spoilage, and pathogenic microorganisms. Disk diffusion and tube macrodilution techniques were used to determine the MICs and MBCs of double-strength water-soluble annatto extracts. Standard antibiotic disks were used as controls for the disk diffusion assay. The results demonstrate that annatto has an inhibitory effect on Bacillus cereus, Clostridium perfringens, and Staphylococcus aureus, with MICs of 0.08, 0.31, and 0.16% (vol/vol) and diameters of inhibition of 9 to 10, 12 to 13, and 15 to 16 mm, respectively. A concentration of 0.63% (vol/vol) inhibited the growth of Streptococcus thermophilus, Lactobacillus casei subsp. casei, Lactococcus lactis, and Paenibacillus polymyxa. The MICs for Listeria monocytogenes and Enterococcus durans were 1.25 and 2.5% (vol/vol), respectively. No activity was detected against Lactobacillus plantarum, Bifidobacterium bifidum, yeasts, or selected gram-negative bacteria.
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