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We consider an M/M/1 queue with a removable server that dynamically chooses its service rate from a set of finitely many rates. If the server is off, the system must warm up for a random, exponentially distributed amount of time, before it can begin processing jobs. We show under the average cost criterion, that work conserving policies are optimal. We then demonstrate the optimal policy can be characterized by a threshold for turning on the server and the optimal service rate increases monotonically with the number in system. Finally, we present some numerical experiments to provide insights into the practicality of having both a removable server and service rate control.
OBJECTIVES/SPECIFIC AIMS: Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea and an increasingly common infection in children in both hospital and community settings. Between 20% and 30% of pediatric patients will have a recurrence of symptoms in the days to weeks following an initial infection. Multiple recurrences have been successfully treated with fecal microbiota transplantation (FMT), though the body of evidence in pediatric patients is limited primarily to case reports and case series. The goal of our study was to better understand practices, success, and safety of FMT in children as well as identify risk factors associated with a failed FMT in our pediatric patients. METHODS/STUDY POPULATION: This multicenter retrospective analysis included 373 patients who underwent FMT for CDI between January 1, 2006 and January 1, 2017 from 18 pediatric centers. Demographics, baseline characteristics, FMT practices, C. difficile outcomes, and post-FMT complications were collected through chart abstraction. Successful FMT was defined as no recurrence of CDI within 60 days after FMT. Of the 373 patients in the cohort, 342 had known outcome data at two months post-FMT and were included in the primary analysis evaluating risk factors for recurrence post-FMT. An additional six patients who underwent FMT for refractory CDI were excluded from the primary analysis. Unadjusted analysis was performed using Wilcoxon rank-sum test, Pearson χ2 test, or Fisher exact test where appropriate. Stepwise logistic regression was utilized to determine independent predictors of success. RESULTS/ANTICIPATED RESULTS: The median age of included patients was 10 years (IQR; 3.0, 15.0) and 50% of patients were female. The majority of the cohort was White (89.0%). Comorbidities included 120 patients with inflammatory bowel disease (IBD) and 14 patients who had undergone a solid organ or stem cell transplantation. Of the 336 patients with known outcomes at two months, 272 (81%) had a successful outcome. In the 64 (19%) patients that did have a recurrence, 35 underwent repeat FMT which was successful in 20 of the 35 (57%). The overall success rate of FMT in preventing further episodes of CDI in the cohort with known outcome data was 87%. Unadjusted predictors of a primary FMT response are summarized. Based on stepwise logistic regression modeling, the use of fresh stool, FMT delivery via colonoscopy, the lack of a feeding tube, and a lower number of CDI episodes before undergoing FMT were independently associated with a successful outcome. There were 20 adverse events in the cohort assessed to be related to FMT, 6 of which were felt to be severe. There were no deaths assessed to be related to FMT in the cohort. DISCUSSION/SIGNIFICANCE OF IMPACT: The overall success of FMT in pediatric patients with recurrent or severe CDI is 81% after a single FMT. Children without a feeding tube, who receive an early FMT, FMT with fresh stool, or FMT via colonoscopy are less likely to have a recurrence of CDI in the 2 months following FMT. This is the first large study of FMT for CDI in a pediatric cohort. These findings, if confirmed by additional prospective studies, will support alterations in the practice of FMT in children.
The development of magnetic resonance (MR) imaging systems has been extended for the entire radiotherapy process. However, MR images provide voxel values that are not directly related to electron densities, thus MR images cannot be used directly for dose calculation. The aim of this study is to investigate the feasibility of dose calculations to be performed on MR images and evaluate the necessity of re-planning.
A prostate cancer patient was imaged using both MR and computed tomography (CT). The multilevel threshold (MLT) algorithm was used to categorise voxel values in the MR images into three segments (air, water and bone) with homogeneous Hounsfield units (HU). An intensity-modulated radiation therapy plan was generated from CT images of the patient. The plan was then copied to the segmented MR datasets and the doses were recalculated using pencil beam (PB) and collapsed cone (CC) algorithms and Monte Carlo (MC) modelling.
γ Evaluation showed that the percentage of points in regions of interest with γ<1 (3%/3 mm) were more than 94% in the segmented MR. Compared with the planning CT plan, the segmented MR plan resulted in a dose difference of –0·3, 0·8 and –1·3% when using PB, CC and MC algorithms, respectively.
The segmentation and conversion of MR images into HU data using the MLT algorithm, used in this feasibility study, can be used for dose calculation. This method can be used as a dosimetric assessment tool and can be easily implemented in the clinic.
We consider the problem of routing and admission control in a loss system featuring two classes of arriving jobs (high-priority and low-priority jobs) and two types of servers, in which decision-making for high-priority jobs is forced, and rewards influence the desirability of each of the four possible routing decisions. We seek a policy that maximizes expected long-run reward, under both the discounted reward and long-run average reward criteria, and formulate the problem as a Markov decision process. When the reward structure favors high-priority jobs, we demonstrate that there exists an optimal monotone switching curve policy with slope of at least −1. When the reward structure favors low-priority jobs, we demonstrate that the value function, in general, lacks structure, which complicates the search for structure in optimal policies. However, we identify conditions under which optimal policies can be characterized in greater detail. We also examine the performance of heuristic policies in a brief numerical study.
The redshifted 21cm line of neutral hydrogen (Hi), potentially observable at low radio frequencies (~50–200 MHz), should be a powerful probe of the physical conditions of the inter-galactic medium during Cosmic Dawn and the Epoch of Reionisation (EoR). The sky-averaged Hi signal is expected to be extremely weak (~100 mK) in comparison to the foreground of up to 104 K at the lowest frequencies of interest. The detection of such a weak signal requires an extremely stable, well characterised system and a good understanding of the foregrounds. Development of a nearly perfectly (~mK accuracy) calibrated total power radiometer system is essential for this type of experiment. We present the BIGHORNS (Broadband Instrument for Global HydrOgen ReioNisation Signal) experiment which was designed and built to detect the sky-averaged Hi signal from the EoR at low radio frequencies. The BIGHORNS system is a mobile total power radiometer, which can be deployed in any remote location in order to collect radio frequency interference (RFI) free data. The system was deployed in remote, radio quiet locations in Western Australia and low RFI sky data have been collected. We present a description of the system, its characteristics, details of data analysis, and calibration. We have identified multiple challenges to achieving the required measurement precision, which triggered two major improvements for the future system.
In late February and early March 2002, an archaeological watching brief at Lynford Quarry, Mundford, Norfolk revealed a palaeochannel with a dark organic fill containing in situ mammoth remains and associated Mousterian stone tools and debitage buried under 2–3 m of bedded sands and gravels. Well-preserved in situ Middle Palaeolithic open air sites are very unusal in Europe and exceedingly rare within a British context. As such, the site was identified as being of national and international importance, and was subsequently excavated by the Norfolk Archaeological Unit with funding provided by English Heritage through the Aggregates Levy Sustainability Fund.
This report presents some of the initial results of the excavation. It sets out how the site was excavated, outlines the stratigraphic sequence for the site, and presents some provisional findings of the excavation based on the results of the assessment work carried out by project specialists and Norfolk Archaeological Unit staff.
Barium ferrite thin films with excellent perpendicular c-axis orientation were successfully fabricated on Si substrate without any buffer layer. To compensate for possible barium deficiency due to the inter-diffusion between films and substrate, a barium-rich target was used. For a 900 Å-thick film, the perpendicular remanent squareness is about 0.9, while the in-plane remanent squareness is about 0.3. The saturation magnetization (Ms) is about 220 emu/cc, while the coercivity is around 3500 Oe. X-ray diffraction (XRD) results show the (001) perpendicular c-axis texture in the films. It was also found that the rapid thermal annealing conditions greatly affect the magnetic properties of barium ferrite films. With a certain flow rate of oxygen gas in the rapid thermal annealer (RTA), barium ferrite films generally crystallize with good perpendicular c-axis texture. Without oxygen gas, the hexagonal barium ferrite phase fails to develop; instead spinel Fe 30 4 phase forms. The reason for the collapsing of hexagonal barium ferrite texture is thought to be an oxygen deficiency in the barium ferrite films due to the reduction of oxygen in the films during the high temperature annealing.
A survey study of solvent effects on the linear and nonlinear absorption properties of C60 has been done. The nonlinear absorption measurements are done at 694 nm with a Q-switched Nd:YAG pumped dye laser. In conjunction with this study a three level rate equation system has been solved analytically and the model results used to extract effective excited state cross sections. A difference and a ratio are calculated from the effective excited state cross section and the ground state cross section. The analysis demonstrates that it is this difference and the initial transmission which determine the critical fluence for the onset of nonlinear absorption. The saturation behavior is determined by the ratio of the cross sections and the initial transmission. Based on these findings C60 is shown to have some of the highest reported nonlinear absorption properties at 694 nm. The effective excited state cross sections at 694 nm are reported for the solutions and correlations to the solvent types demonstrated.
This paper describes the development of high quality solid state optical components which have been made by the incorporation of the reverse saturable dye chloro aluminium phthalocyanine (CAP) into polymeric host material.
In particular, the effect of using different host materials with CAP is investigated in terms of key parameters such as solubility, integrity of the dye molecules in the polymer host, hardness of the resulting polymer, ease of polishing to the production of a good optical finish, induced stress, and non-linear absorption performance.
Results are presented highlighting the above considerations, and problems encountered in material preparation will be described together with details on how, by careful choice of guest/host combination, good optical quality samples can be produced.
To develop optical power limiting thin films prepared from water-soluble materials, we have prepared chromophore-doped gelatin thin films. Thin films of gelatin were prepared by spin coating followed by annealing. We also prepared thin films doped with the water-soluble chromophore copper phthalocyanine sodium tetrasulfonate. The films were characterized by film profilometry and optical absorption spectroscopy. Optical power limiting measurements of these films, as well as comparisons with aqueous solution and gels were performed.
After the January 12, 2010, earthquake in Haiti, Project Medishare and the University of Miami organized, built, and staffed a 200-bed field hospital (the University of Miami Hospital in Haiti [UMHH] ) on the outskirts of Port-au-Prince. We describe the operational challenges of providing a safe environment at the UMHH. Furthermore, we compared how these issues were addressed at this ad hoc hospital with how they were addressed at the field hospital of the Israel Defense Force, a fully deployable hospital with an organization fine-tuned as a result of prior disaster situations, also in Haiti.