Cardiac markers: a clear cause for point-of-care testing

Point-of-care testing (POCT) in patients with ischemic heart disease is driven by the time-critical need for fast, specific, and accurate results to initiate therapy instantly. According to current guidelines, the results of the cardiac marker testing should be available to the physician within 30 min (“vein-to-brain” time) to initiate therapy within 60–90 min (“door-to-needle” time) after the patient has arrived at the emergency room or intensive care unit. This article reviews the current efforts to meet this goal (1) by implementing POCT of established biochemical markers such as cardiac troponins, creatine kinase MB, and myoglobin, in accelerated diagnosis and management workflow schemes, (2) by improving current POCT methods to obtain more accurate, more specific, and even faster tests through the integration of optical and electrochemical sensor technology, and (3) by identifying new markers for the very early and sensitive detection of myocardial ischemia and necrosis. Furthermore, the specific requirements for cardiac POCT in regard to analytical performance, comparability, and diagnostic sensitivity/specificity are discussed. For the future, the integration of new immunooptical and electrochemical chip technology might speed up diagnosis even further. However, every new development will have to meet the stringent method validation criteria set for corresponding central laboratory testing.     

Manifold Reconstruction in Arbitrary Dimensions Using Witness Complexes

It is a well-established fact that the witness complex is closely related to the restricted Delaunay triangulation in low dimensions. Specifically, it has been proved that the witness complex coincides with the restricted Delaunay triangulation on curves, and is still a subset of it on surfaces, under mild sampling conditions. In this paper, we prove that these results do not extend to higher-dimensional manifolds, even under strong sampling conditions such as uniform point density. On the positive side, we show how the sets of witnesses and landmarks can be enriched, so that the nice relations that exist between restricted Delaunay triangulation and witness complex hold on higher-dimensional manifolds as well. We derive from our structural results an algorithm that reconstructs manifolds of any arbitrary dimension or co-dimension at different scales. The algorithm combines a farthest-point refinement scheme with a vertex pumping strategy. It is very simple conceptually, and it does not require the input point sample to be sparse. Its running time is bounded by c(d)n ², where n is the size of the input point cloud, and c(d) is a constant depending solely (yet exponentially) on the dimension d of the ambient space. Although this running time makes our reconstruction algorithm rather theoretical, recent work has shown that a variant of our approach can be made tractable in arbitrary dimensions, by building upon the results of this paper. This work was done while S.Y. Oudot was a post-doctoral fellow at Stanford University. His email there is no longer valid.     

K6‐minors in triangulations and complete quadrangulations

In this paper, we shall prove that a projective‐planar (resp., toroidal) triangulation G has K₆ as a minor if and only if G has no quadrangulation isomorphic to K₄ (resp., K₅ ) as a subgraph. As an application of the theorems, we can prove that Hadwiger's conjecture is true for projective‐planar and toroidal triangulations. © 2009 Wiley Periodicals, Inc. J Graph Theory 60: 302‐312, 2009     

高质量点集的快速局部网格生成算法

高效及高质量的局部网格生成算法是基于节点有限元并行方法设计的关键。泡泡布点算法能够在复杂区域上不经过人工干预生成高质量的节点集,本文提出了基于该方法所生成的节点集的快速局部网格生成算法。该算法充分利用泡泡布点方法提供的节点集及节点邻接链表信息,避免了桶数据结构的建立以及节点的局部搜索过程,只需应用Delaunay三角剖分的外接圆准则从中心节点的邻接链表中去除极少数的非卫星点,可快速地生成局部网格,比现有的局部网格生成算法更为快捷。算例结果表明,该算法高效可靠,生成网格与Delaunay三角剖分网格一致。     

Monitoring the brain metabolites of children with acute encephalopathy caused by the H1N1 virus responsible for the 2009 influenza pandemic: a quantitative in vivo H MR spectroscopy study

Background and Purpose

Influenza viral infection, which results in central nervous system dysfunction, is a major cause of acute encephalopathy (AE). The purpose of this study was to investigate the changes in the concentrations of brain metabolites in children with AE using single-voxel magnetic resonance spectroscopy (MRS) and to provide diagnostic information about the relationship between the symptoms of AE and metabolite concentrations.

Materials and Methods

The subjects were 10 children (mean age: 6.2 years; range: 1–13) with AE caused by the novel influenza A virus responsible for the 2009 influenza pandemic. The serial MRS data (TE/TR=30/5000 ms, 3 T) acquired from the basal ganglia (BG) and centrum semiovale (CS) of each patient were categorized into three periods: (1) initial neurological symptom presentation and the start of treatment (n= 10), (2) short-term follow-up (n= 9) and (3) long-term follow-up (n= 3). As controls, the magnetic resonance (MR) spectra of eight age-matched children were also investigated.

Results

In both regions, the concentrations of the major metabolites (N-acetylaspartate, creatine, choline, myo-inositol, glutamate/glutamine complex and glutamate) only showed minor fluctuations between the three periods. On the other hand, higher levels of taurine (Tau) were observed in the BG during the second period (P=.005), and increased levels of glucose were observed in the CS during the first (P=.005) and second (P=.036) periods.

Conclusions

Serial monitoring of brain metabolite changes was carried out with a clinical MR system. The concentrations of major metabolites only displayed very minor fluctuations in response to mild H1N1-related AE. However, a higher Tau concentration was found to be associated with neurological symptoms. Further studies are required to improve our understanding of the detailed activity of Tau in AE.     

Beta‐decomposition for the volume and area of the union of three‐dimensional balls and their offsets

Given a set of spherical balls, called atoms, in three‐dimensional space, its mass properties such as the volume and the boundary area of the union of the atoms are important for many disciplines, particularly for computational chemistry/biology and structural molecular biology. Despite many previous studies, this seemingly easy problem of computing mass properties has not been well‐solved. If the mass properties of the union of the offset of the atoms are to be computed as well, the problem gets even harder. In this article, we propose algorithms that compute the mass properties of both the union of atoms and their offsets both correctly and efficiently. The proposed algorithms employ an approach, called the Beta‐decomposition, based on the recent theory of the beta‐complex. Given the beta‐complex of an atom set, these algorithms decompose the target mass property into a set of primitives using the simplexes of the beta‐complex. Then, the molecular mass property is computed by appropriately summing up the mass property corresponding to each simplex. The time complexity of the proposed algorithm is O(m) in the worst case where m is the number of simplexes in the beta‐complex that can be efficiently computed from the Voronoi diagram of the atoms. It is known in ?³ that m = O(n) on average for biomolecules and m = O(n²) in the worst case for general spheres where n is the number of atoms. The theory is first introduced in ?² and extended to ?³. The proposed algorithms were implemented into the software BetaMass and thoroughly tested using molecular structures available in the Protein Data Bank. BetaMass is freely available at the Voronoi Diagram Research Center web site. © 2012 Wiley Periodicals, Inc.     

A Point-of-Care Immunotest for Bedside Determination of Heart-Type Fatty Acid-Binding Protein

Heart-type fatty acid-binding protein (H-FABP) is a small cytosolic protein abundant in heart muscle cells. It offers great potential as a sensitive biomarker for early diagnosis of acute myocardial infarction (AMI).

Ninety-one patients presented to the Emergency Department suspected of AMI with a median symptom onset of 6 h (IQR 3–20 h), of which 75 (82.4%) had AMI. The diagnostic performance of a point-of-care immunotest for H-FABP was compared with those of cardiac troponin T (cTnT), creatinine kinase MB (CK-MB), and myoglobin. The H-FABP immunotest was found to have a significant better sensitivity than the other markers and a better specificity than myoglobin and CK-MB. The H-FABP Immunotest gave the greatest area under the receiver operating characteristic (ROC) curve (0.864) for those admitted within 6 h after the onset of symptoms; whereas, cTnT gave the greatest area under the ROC curve (0.936) for those admitted 6–24 h. The H-FABP was also found to be the most efficient marker to diagnose patients suspected of AMI without ST-elevation and with a negative cTnT.

Early detection of H-FABP using the point-of-care immunotest in patients suspected of AMI may allow more accurate targeting of appropriate therapy and considerable cost savings than the current diagnostic tests.     

用激光三角法重构混凝土断裂面三维轮廓与断裂能分析

采用基于激光三角法的测试方法对混凝土断面表面轮廓进行了三维重构,初步的断面分析结果表明,相对于传统断面分析方法,本试验方法实现了断面的无损、快速和准确的测量分析,在测量到的断面基础上,给出了本试验所得到的混凝土材料断裂能与分维的关系。     

任意平面区域三角形网格的全自动生成算法

本文基于波前法提出了一种对任意平面区域生成三角形网格自动生成算法。算法具有区域适应性强,边界网格质量高,自动化程度高的优点。算法还包括了网格的拓扑优化,光滑及加密处理。此外,初边值条件的自动给定大大减少了数值计算中数据输入和避免了边界搜索计算。大量算例显示了算法的可靠性和适用性。     

一类三角剖分下样条空间S_3~1(Δ)维数

首次提出了一种判别样条空间S13(Δ)维数不依赖剖分几何性质的协调条件·　依此 ,在一类较一般的三角剖分下 ,获得了S13(Δ)的维数·