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Assessment of right ventricular size and function is an important part of the clinical cardiac evaluation; however, these quantitative measures are challenging by echocardiography. Automated software could be useful in place of manual measurements and qualitative assessment. This study evaluates a semi-automated software by comparing automated to manual measures in normal children.
Neonates to adolescents with normal echocardiograms were prospectively enrolled. Measurements were performed using manual techniques and semi-automated software (EchoInsight®, Epsilon Imaging, Ann Arbor, Michigan, United States of America). Right ventricular measurements included end-diastolic and end-systolic area, fractional area change, chamber dimensions, and tricuspid annular plane systolic excursion. Agreement between manual and semi-automated measures was compared.
Echocardiograms for 233 patients were included in the analysis. Intra- and inter-observer reliabilities for semi-automated measures were good with intraclass correlation coefficients all over 0.9 and 0.85, respectively. There was very strong correlation between manual and semi-automated methods for areas and dimensions (r = 0.93–0.99) and low bias (1.4–10.8%). For functional measures, tricuspid annular plane systolic excursion measures correlated well (r = 0.84), but fractional area change did not (r = 0.50). Both demonstrated significant bias (33.5–43.0%). The semi-automated method consistently underestimated fractional area change with a mean of 26.6% versus a manual mean of 36.1%.
The semi-automated software is capable of generating quantitative right ventricular measures in children with good reliability. The software demonstrates very good correlation and low bias when compared to manual methods for right ventricular areas and dimensions. There is a significant difference between manual and semi-automated techniques for the functional measures.
Outside Switzerland, the Schauspielhaus Zürich (Zürich Playhouse) is best known among theatre historians for the role it played in supporting and advancing the career of German playwright Bertolt Brecht during and just after World War II. We learn, from our studies of Brecht, that while he was living in exile in Finland and the United States his plays Mother Courage and Her Children, The Good Person of Szechwan, and Galileo all received their first productions in Zürich, and that when he returned to Europe from exile the city was also his initial destination. Brecht was not the only exiled playwright to find a producing home at the Schauspielhaus; the theatre has additionally long been recognized, particularly among German and Swiss theatre historians, for the important role it played in producing the work of many other exiled German and Austrian playwrights during World War II. Some American theatre historians have also made note of the quality of the work produced at the Schauspielhaus: for example, Oscar Brockett mentions the Zürich theatre in passing as “one of the best in Europe during the Nazi regime because so many refugees settled in Switzerland.” But what remains underrecognized among historians outside Switzerland is the pivotal role that both the Schauspielhaus and its dramaturg (and later artistic director) Kurt Hirschfeld played in keeping an international repertoire on life support in Europe when most of the Continent was under Nazi occupation (Fig. 1). A look at the list of wartime and postwar productions at the Schauspielhaus reveals a veritable who's who of the modern Western dramatic canon: productions of works by playwrights like Karel Čapek, Thornton Wilder, Jean Giraudoux, Jean-Paul Sartre, Paul Claudel, Federico García Lorca, T. S. Eliot, Arthur Miller, Tennessee Williams, Luigi Pirandello, and many, many—in fact, many dozens—of others.
Economic reforms and political changes often take place simultaneously. The outcomes of reforms in transitional countries depend on the sequence of these changes. Kornai developed his transition framework based on Central and Eastern Europe, and extended it to Asian nations. This article builds on Kornai's model and the institutional dialogue of economic development to construct and apply a model of transformation for Latin America. The aim is to better explain the relationship between institutional transformation and developmental outcomes over time. Our analysis utilises historical information and the views of current political leaders in Argentina. The analysis performed reflects on institutional performance, and evaluates the applicability of the proposed Latin American transition framework in practice. Based on the empirical evidence presented, we argue that economic transition is a path-dependent phenomenon, and that our model explaining the interaction of economic and political changes provides an explanation for the performance of institutional transformation in Argentina.
Birdwatching has become a global pastime and a driving force for conservation. Because of China’s economic and environmental importance, the emergence of birdwatching as a mass participation leisure activity in China over the past three decades is of global interest. We documented this emergence by conducting an extensive literature search and two online questionnaires which we used to describe the history, geographic distribution, demographics, activities, motivations, and environmental concerns of Chinese birdwatchers. The emergence happened because of (1) the transfer of ornithological knowledge to birdwatchers, (2) the increasing political tolerance to pursue pastimes, (3) the increasing leisure time, affordability of optical equipment, and urbanisation of China’s society, (4) increased internet use, and (5) interactions of birdwatchers with the media and foreign birdwatchers. Of the 576 respondents to our questionnaires, two-thirds were male, about half were younger than 35 years of age, approximately 90% were university-educated, and many also had an above-average income and originated mostly from the more urbanised coastal or near-coastal provinces. Our respondents were thus part of China’s economic and educational elite who largely birdwatch for enjoyment, but also because of the knowledge gained about the birds’ ecology. Many birdwatchers have become concerned about the deteriorating state of the environment and are frustrated about the lack of government action. Within the political constraints set by the government, many birdwatchers support environmental conservation through various activities, which have yielded some conservation successes. However, birdwatching societies remain constrained by the same legislative and administrative restraints which limit the actions of other environmental non-governmental organizations, thus hindering the effective discourse between China’s government and its emerging but still strictly controlled and regulated civil society.
Repetitive deep transcranial magnetic stimulation (dTMS) is efficacious for treatment resistant major depressive disorder (TRD) with the H1 coil by stimulating the prefrontal cortex, left more than right, at high frequency. Theoretically, the efficacy of dTMS could be optimized by simultaneously stimulating the right and left lateral prefrontal cortices (PFC) with different frequencies. This study tested the efficacy of a novel dual-channel dTMS stimulator with dual dTMS coils, in patients with TRD.
This study recruited forty-seven outpatients diagnosed with TRD, age 18-65, Hamilton Depression Rating Scale (HDRS-21) score ≥25. Each patient received 20 open label treatment sessions, five days a week for 4 consecutive weeks. Treatments were administered with the dual-channel stimulator (Brainsway Multiway dTMS device) using two channels: a. 10 Hz over the left PFC. b. 1 Hz over the right PFC. Primary and secondary efficacy outcome measures were the change in HDRS-21 score and response/remission rates at week 5, respectively.
The HDRS-21 score decreased from an average of 25.94 to 14.69 (P<0.001). Thirty-six patients completed four weeks of treatment. Of them, seventeen (47%) responded (HDRS-21 score decrease of ≥ 50% from their initial score) and eight (22%) remitted (HDRS-21 score of < 10 at the end of the study).
This open study shows promising results for multichannel simultaneous dTMS treatment of TRD using the Brainsway Multiway Device. Further randomized controlled studies are necessary to aid the high number of patients with TRD.
Healthcare-associated norovirus outbreaks increase later but have a more pronounced seasonality than nonhealthcare norovirus outbreaks. Healthcare-associated norovirus outbreaks had higher correlation with Google Trends activity than nonhealthcare outbreaks (R2=0.68 vs 0.39). Google Trends data may have the potential to supplement existing norovirus surveillance due to its real-time availability.
Intercalated and unmodified TiS2 nanomaterials were synthesized and characterized by UV-Visible-NIR spectroscopy, Powder X-Ray Diffraction, and X-Ray Photoelectron and Ultraviolet Photoelectron Spectroscopy. Photoelectron spectroscopy measurements indicated that CoS and Cu2S appeared to be intercalated between sheets of partially or fully oxidized TiS2, which could be solution processed on conductive oxide substrates. The materials were then applied toward water oxidation and evaluated by cyclic voltammetry, chronoamperometry, and impedance measurements. While unmodified TiS2 was not observed to perform well as an electrocatalyst with overpotentials >3 V in 1 M NaOH electrolyte, CoS intercalation was found to lower the overpotential by ∼1.8–1.44 V at 10 mA/cm2. Conversely, Cu2S intercalation resulted in only a modest increase in performance (>2.3 V overpotential). Impedance measurements indicated that intercalation increased the series resistance in the as-prepared samples but decreased the series resistance in oxidized samples.
I survey recent theoretical work on the structure of the magnetospheres of rotation-powered pulsars, within the observational constraints set by their observed spindown, their ability to power synchrotron nebulae and their ability to produce beamed collective radio emission, while putting only a small fraction of their energy into incoherent X- and gamma radiation. I find no single theory has yet given a consistent description of the magnetosphere, but I conclude that models based on a dense outflow of pairs from the polar caps, permeated by a lower density flow of heavy ions, are the most promising avenue for future research.
The shock termination of a relativistic magnetohydrodynamic wind from a pulsar is the most interesting and viable model for the excitation of the synchrotron sources observed in plerionic supernova remnants. We have studied the structure of relativistic magnetosonic shock waves in plasmas composed purely of electrons and positrons, as well as those whose composition includes heavy ions as a minority constituent by number. We find that relativistic shocks in symmetric pair plasmas create fully thermalized distributions of particles and fields downstream. Therefore, such shocks are not good candidates for the mechanism which converts rotational energy lost from a pulsar into the nonthermal synchrotron emission observed in plerions. However, when the upstream wind contains heavy ions which are a minority constituent by number density, but carry the bulk of the energy density, much of the energy of the shock goes into a downstream, nonthermal power-law distribution of positrons with energy distribution N(E)dE ∝ E–s. In a specific model presented in some detail, s = 3. These characteristics are close to those assumed for the pairs in macroscopic MHD wind models of plerion excitation. The essential mechanism is collective synchrotron emission of left-handed extraordinary modes by the ions in the shock front at high harmonics of the ion-cyclotron frequency, with the downstream positrons preferentially absorbing almost all of this radiation, mostly at their fundamental (relativistic) cyclotron frequencies. Possible applications to the models of plerions and to constraints on theories of energy loss from pulsars are briefly outlined.
Since its development, the Qualidem has had items that were considered unsuited for people with very severe dementia. This study attempted to investigate the applicability of all Qualidem items in people with all stages of dementia severity.
Four data sets that contained Qualidem observations on people with dementia were combined. Dementia severity was categorized based on the Global Deterioration Scale (GDS), with a dichotomization of very severe dementia (GDS 7) and others (GDS 1–6). Unidimensional latent-trait models (Mokken scaling) were estimated to fit the Qualidem responses in the overall sample and the dichotomized groups. Scalability was assessed using coefficients of homogeneity (Loevinger's H), while reliability was assessed with Cronbach's α and ρ.
Combining the four databases resulted in 4,354 Qualidem measurements. The scalability of all scales was considered acceptable in the overall sample, as well is in the subgroups (all H > 0.3). Additionally, the reliability was good–excellent in the scales: “positive affect,” “positive self-image,” “care relationship,” and “negative affect.” Reliability was questionable–acceptable for “feeling at home,” “social relations,” “social isolation,” and “restless tense behavior.” Reliability was poor for “having something to do.”
Statistical considerations allow using all Qualidem items in all dementia stages. Future research should determine balance of statistical- versus conceptual-based reasoning in this academic debate.
Is Aboriginal† nutrition a priority for local government? A policy analysis
The present study aimed to explore how Australian local governments prioritise the health and well-being of Aboriginal populations and the extent to which nutrition is addressed by local government health policy.
In the state of Victoria, Australia, all seventy-nine local governments’ public health policy documents were retrieved. Inclusion of Aboriginal health and nutrition in policy documents was analysed using quantitative content analysis. Representation of Aboriginal nutrition ‘problems’ and ‘solutions’ was examined using qualitative framing analysis. The socio-ecological framework was used to classify the types of Aboriginal nutrition issues and strategies within policy documents.
Local governments’ public health policy documents (n 79).
A small proportion (14 %, n 11) of local governments addressed Aboriginal health and well-being in terms of nutrition. Where strategies aimed at nutrition existed, they mostly focused on individual factors rather than the broader macroenvironment.
A limited number of Victorian local governments address nutrition as a health issue for their Aboriginal populations in policy documents. Nutrition needs to be addressed as a community and social responsibility rather than merely an individual ‘behaviour’. Partnerships are required to ensure Aboriginal people lead government policy development.
This abstract should be read in conjunction with the papers by Arons and by Klein and Arons in these proceedings. In the context of the accretion models described there, one can find an analytic solution for the flow down the polar field lines if a number of simplifying assumptions are made. These are (1) steady flow in the co–rotating frame; (2) radiation pressure large compared to gas pressure; (3) pure scattering for the Rosseland opacity, with the magnetic corrections set equal to constants instead of using the actual functions of temperature; (4) diffusion flux of radiative energy proportional to the gradient of the energy density alone, instead of the correct sum of terms proportional to the photon energy density and the number density gradients; and (5) below a radiative shock, subsonic flow in approximate hydrostatic equilibrium. We assumed dipole geometry, and also assume the mass flux is independent of distance from the magnetic axis. The essential trick is to use (1), (2) and (5) to write the advective contribution to the radiation transfer equation as Mg/area = rate at which gravity does work on a fluid element, and use (3) and (4) to write the nonlinear diffusion flux as the ratio of gradients in the energy density. Then the multidimensional diffusion equation can be cast in a separable, linear form by using the logarithmic radial gradient of the energy density as the basic variable (see also Kirk, J., 1985, Astron. and Astrophys., 142, 430). The result is exponential stratification of the energy density, velocity and mass density along B with scale height R*[L(EDeff)/4Lco-p]; the effective Eddington luminosity is discussed by Arons, these proceedings. This result can be understood as the result of almost exact balance between upward diffusion and downward advection of photons in the optically thick medium. The same fluid quantities are stratified in a Gaussian manner across B, with angular half width at half maximum Δθ = [L(EDeff)/Lcap](r/R*)3/2. These distributions agree well with more sophisticated computational results, during times when the flow is steady. When used as a basis for calculations of the radiative entropy, the calculated emergent spectra are not dissimilar to the spectra of high luminosity, accretion powered pulsars.
Some basic concepts of accretion onto the polar caps of magnetized neutron stars are reviewed. Preliminary results of new, multidimensional, time–dependent calculations of polar cap flow are outlined, and are used to suggest the possible observability of fluctuations in the X–ray intensity of accretion powered pulsars on time scales of 10–100 msec. The possible relevance of such fluctuations to Quasi–Periodic oscillations is suggested. Basic concepts of the interaction between a disk and the magnetosphere of a neutron star are also discussed. Some recent work on the disk–magnetosphere interaction is outlined, leading to the suggestion that a neutron star can lose angular momentum by driving some or all of the mass in the disk off as a centrifugally driven wind. The relevance of such mass loss to the orbital evolution of the binary is pointed out.
We summarize the discussion of the current status and future prospects of space and astrophysical plasma research prepared by the Panel on Space and Astrophysical plasmas, a part of the study on Physics administered by the National Research Council of the National Academy of Sciences. The Study on Physics is chaired by W. Brinkman of Bell Laboratories and will be completed in 1984.
We present results of the first self-consistent, time-dependent, 2-D calculations of the accretion of plasma onto polar caps of high luminosity (L*>1036erg-s−1) magnetized neutron stars. We follow the temporal and spatial evolution of three fluids, electrons, ions and photons in a superstrong (B=3×1012 Gauss) dipole magnetic field where radiation pressure dominates plasma pressure by solving coupled 2-D equations of radiation hydrodynamics. We have included several physical processes in the radiation-plasma coupling in superstrong magnetic fields (Klein, et al., 1984, Santa Cruz Workshop on High Energy Transients, and Arons, this conference). We solve the resulting system of coupled 2-D PDEs on a Cray XMP-48 by applying implicit finite-difference techniques with iterative operator splitting methods. We present results for two models of 5×1037 erg-s and 1.5×1038 erg-s−1 super-Eddington luminosity on one polar cap, each having initial mass flux independent of co-latitude of a field lines footprint. We find (a) Radiation develops a broad transverse fan beam that emerges from an annulus 0.2–0.5km above the polar cap. (b) The beam profile is determined by advective trapping of radiation in optically thick (τ11,τ⊥ ≈103) flow. Here the time for diffusion of radiation up through the accretion column is ≫ the time for downward advection. (c) There is a three fluid nonequilibrium with Ti≫Tγ≥Te. (d) Maximum photon temperature of ≈ 10–20 keV in the fan beam is in the observed range. (e) Cyclotron emission ≫ bremsstrahlung as a source of photons. (f) At early times (≪lms) radiation pressure strongly decelerates flow to 10−3 of freefall in central regions of accretion column resulting in a density mound, but plasma freefalls down the sides of the column. (g) Analytical models have reasonable agreement with numerical calculations; velocity and energy density roughly Gaussian transversally and exponential vertically, until the onset of “photon bubbles” after several dynamical times (∼lms). (h) Multiple “photon bubbles” rising subsonically in the accretion column form in the high luminosity model. We believe the photon bubbles to be a possible consequence of overstable convection in super-Eddington flows. These photon bubbles could be observable as 10–100μs fluctuations in the emergent flux and, thus, be an important diagnostic for inhomogeneous structure of the column.