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In order to optimise care of the adult patients with complex congenital heart disease, there is a need to develop recommendations for interventions. This document is the work of representatives of the three relevant societies and provides recommendations for institutions and operators performing cardiac interventions in these patients.
Recent developments in reactive potentials for the simulation of complex bonding and complex chemistry are reviewed. In particular, the reactive force field and charged optimized many-body methods are two paradigms that enable atoms to autonomously determine their charge state and the nature of their local bonding environments. The capabilities of these methods are illustrated by examples involving ionic-covalent systems, a metal-covalent system, a high-k dielectric gate stack, and the interaction of water with an oxide. Prospects for future development and applications are also discussed.
Abnormal somatosensory processing may contribute to motor impairments observed in Parkinson's disease (PD). Dopaminergic medications have been shown to alter somatosensory processing such that tactile perception is improved. In PD, it remains unclear whether the temporal sequencing of tactile stimuli is altered and if dopaminergic medications alter this perception.
Somatosensory tactile perception was investigated using temporal order judgment in patients with Parkinson's disease on and off dopaminergic medications and in aged-matched healthy controls. Measures of temporal order judgment were acquired using computer controlled stimulation to digits 2 and 3 on the right hand and subjects were required to determine which stimuli occurred first. Two experimental tasks were compared, temporal order judgment without and with synchronization whereby digits 2 and 3 were vibrated synchronously in advance of the temporal order judgment sequence of stimuli.
Temporal order judgment in PD patients off and on medications were similar to controls. Temporal order judgment preceded by synchronous vibration impaired tactile acuity in controls and in PD off medications to similar degrees, but this perceptual impairment by synchronous vibration was not present in PD patients on medications.
These findings suggest that dopamine in PD reduces cortico-cortical connectivity within SI and this leads to changes in tactile sensitivity.
Calcium phosphates form a vast family of biominerals, which have attracted much attention in fields like biology, medicine, and materials science, to name a few. Solid state Nuclear Magnetic Resonance (NMR) is one of the few techniques capable of providing information about their structure at the atomic level. Here, examples of recent advances of solid state NMR techniques are given to demonstrate their suitability to characterize in detail synthetic and biological calcium phosphates. Examples of high-resolution 31P, 1H (and 17O), solid state NMR experiments of a 17O-enriched monocalcium phosphate monohydrate-monetite mixture and of a mouse tooth are presented. In both cases, the advantage of performing fast Magic Angle Spinning NMR experiments at high magnetic fields is emphasized, notably because it allows very small volumes of sample to be analyzed.
The Far-Infrared Radio Correlation (FRC) is the tightest and most universal correlation known among global parameters of galaxies. Here we present the results of our investigation of the 70 μm FRC of starforming galaxies in the Extended Chandra Deep Field South (ECDFS) out to z > 2. In order to quantify the evolution of the FRC we used both survival analysis and stacking techniques, which gave similar results. We also calculated the FRC using total infrared luminosity and rest-frame radio luminosity, qTIR, and find that qTIR is constant (within 0.22) over the redshift range 0 - 2. We see no evidence for evolution in the FRC at 70 μm, which is surprising given the many factors that are expected to change this ratio at high redshifts.
We carried out a population-based study of dystrophin mutations in patients followed by members of the Canadian Paediatric Neuromuscular Group (CPNG) over a ten-year period.
We aimed to describe the changes in diagnostic testing for dystrophinopathy and to determine the frequency of dystrophin mutations from 2000 to 2009.
De-identified data containing the clinical phenotypes, diagnostic methods, and mutational reports from dystrophinopathy patients followed by CPNG centres from January 2000 to December 2009 were analyzed using descriptive statistics.
773 patients had a confirmed diagnosis of dystrophinopathy based on genetic testing (97%), muscle biopsy (2%), or family history (1%). 573 (74%) had complete deletion/duplication analysis of all 79 exons or whole gene sequencing, resulting in 366 (64%) deletions, 64 (11%) duplications, and 143 (25%) point mutations. The percentage of patients who were diagnosed using currently accepted genetic testing methods varied across Canada, with a mean of 63% (SD 23). 246 (43%) mutations involved exons 45 to 53. The top ten deletions (n=147, 26%) were exons 45-47, 45-48, 45, 45-50, 45-55, 51, 45-49, 45-52, 49-50, and 46-47. 169 (29%) mutations involved exons 2 to 20. The most common duplications (n=29, 5.1%) were exons 2, 2-7, 2-17, 3-7, 8-11, 10, 10-11, and 12.
This is the most comprehensive report of dystrophin mutations in Canada. Consensus guidelines regarding the diagnostic approach to dystrophinopathy will hopefully reduce the geographical variation in mutation detection rates in the coming decade.
To support formal reasoning in mathematical and software engineering applications, it is desirable to have a generic prover that can be instantiated with a range of logics. This allows the prover to be applied to a wider variety of reasoning tasks than a fixed-logic prover. This paper describes the design principles and the architecture of the latest version of the Ergo proof engine, Ergo 6. Ergo 6 is a generic interactive theorem prover, similar to Isabelle, but with better support for proving schematic theorems with user-defined constraints, and with a different approach to handling variable scoping. A major theme of the paper is that Prolog implementation technology can be generalized to obtain efficient implementations of generic proof engines. This is demonstrated via a Qu-Prolog implementation of Ergo 6.
A cluster of patients with respiratory cultures positive for Pseudomonas aeruginosa with a unique antibiogram was observed during June and July 2007 at a 1,000-bed urban teaching hospital in Atlanta, Georgia. These P. aeruginosa isolates were recovered from bronchoscopically obtained specimens.
A cross-sectional study was performed to assess whether the cluster was associated with exposure to a particular bronchoscope (B1); cultures from specimens from the bronchoscopes and the environment were obtained, and the P. aeruginosa isolate type was determined using pulsed-field gel electrophoresis (PFGE). Records of patients exposed to B1 during the cluster period were reviewed.
Twelve patients with a culture positive for P. aeruginosa with the unique susceptibility pattern were identified in June-July 2007. No cases were documented from March 1 through May 31, 2007. Culture specimens obtained from B1 after high-level disinfection revealed P. aeruginosa, prompting removal of B1 from service on July 23, 2007. No cases occurred after that date. Eleven (55%) of 20 patients who were exposed to Bl during the cluster period had a culture positive for P. aeruginosa, compared with 1 (2%) of 53 patients who were exposed to other bronchoscopes (P < .001). PFGE patterns for P. aeruginosa isolates obtained from case patients and from B1 were identical. An engineering evaluation of B1 documented several internal damages. Two (10.5%) of 19 patients exposed to Bl during the cluster period may have developed P. aeruginosa infection following exposure to B1.
An outbreak or pseudo-outbreak of P. aeruginosa infection occurred in association with use of a damaged bronchoscope. Periodic engineering maintenance may be needed to prevent bronchoscope contamination that is resistant to high-level disinfection.
We clarify here certain aspects of the magnetic field (H) – temperature (T) phase diagram of YbMnO3, a hexagonal Rare-Earth manganite oxide in which two multiferroic ordered states – ferroelectricity and antiferromagnetism coexist at low temperature. Single crystals of YbMnO3 were carefully grown from a Floating Zone (FZ) at low speed, then oriented and studied at variable temperature and magnetic field. Magnetization and heat capacity measurement show features corresponding to the antiferromagnetic (AFM) ordering of Mn3+, and the rare earth Yb3+. We find that the ordering temperature of Mn3+ is independent of applied magnetic field up to 5T. However, contrary to previous reports in flux-grown crystals, we do not observe a complete suppression of Yb3+ order above 0.1T. Instead, we find that Yb3+ remains at least up to 1 T, suggesting a revision of our current understanding of the ordering mechanism of the Mn-Yb and Yb –Yb sub-lattices in this hexagonal structure.
TbMnO3 is a multiferroic magnetoelectric material known to simultaneously exhibit antiferromagnetism below 40K and ferroelectricity below 28K in the same crystalline phase . Following interesting results of Cu substitution in LaMn1-yCuyO3 [2, 3], we report a study of TbMn1-x CuxO3 (0 < x < 0.15). We describe here our results of crystal structure refinement, together with measurements of magnetic and dielectric properties in the temperature range 2 - 320 K, and magnetic field 0 - 9 T. We find no major changes in structure or symmetry upon substitution of Cu up to x = 0.15 in TbMn1-x CuxO3. Unlike LaMn1-yCuyO3, which exhibits ferromagnetism with very low values of y, we observe antiferromagnetism at x = 0.15. Our study of dielectric properties as a function of temperature suggests increased lossy behavior upon substitution of Cu at the Mn site. In our temperature dependent studies of tan δ at 1 kHz, we observe a well-defined step-like feature near 120K in both pure and substituted samples, possibly ascribable to a change in carrier mobility, or a dielectric-relaxation process mediated by ordered oxygen vacancies [4, 5], which we will continue to study.
Doping of thin body Si becomes very essential topic due to increasing interest of forming source/drain regions in fully depleted planar silicon-on-isolator (SOI) devices or vertical Fin field-effect-transistors (FinFETs). To diminish the role of the short-channel-control-effect (SCE) the Si layers thicknesses target the 10 nm range. In this paper many aspects of thin Si body doping are discussed: dopant retention, implantation-related amorphization, thin body recrystallization, sheet resistance (Rs) and carrier mobility in crystalline or amorphized material, impact of the annealing ambient on Rs for various SOI thicknesses. The complexity of 3D geometry for vertical Fin and the vicinity of the extended surface have an impact on doping strategies that are significantly different than for planar bulk devices.
FinFET is one of the leading candidates to replace the classical planar MOSFET for future CMOS technologies due to the double-gate configuration of the device leading to an intrinsically superior short channel effect (SCE) control. A major challenge for FinFETs is the increase in parasitic source-drain resistance (Rsd) as the fin width is scaled. As fins must be narrow in order to control SCEs, Rsd reduction is critical. This work will deal with the challenges faced in the use of ion implantation for the low-ohmic source-drain contacts. Firstly a new technique to characterize fin sidewall doping concentration will be introduced. We will have a closer look at the Rsd dependency upon fin width for different fin implant conditions and investigate how the implant conditions affect FinFET device performance. It will be shown that the cause of the device degradation upon fin width scaling is related to the fundamental issues of silicon crystal integrity in thin-body Si after amorphizing implant and recrystallization during source-drain activation.
While the physical correlates of knee osteoarthritis are well documented, less well documented are aspects of psychological functioning that may affect overall health and functional status. This paper describes the findings of a cross-sectional analysis that examined the strength of the relationship between selected psychological factors and the walking ability of adults with knee joint osteoarthritis. The variables assessed were pain, depression, levels of self-efficacy for pain and other-symptoms management, walking endurance, walking speed, and perceived exertion when walking. The sample, including 57 persons with unilateral and 43 persons with bilateral radiographic and symptomatic knee osteoarthritis, mean age, 69.9 ± 1 years, underwent standard assessment procedures on a single test occasion using several validated questionnaires and a series of walking tests on level ground. Bivariate and multiple regression analyses revealed that (a) higher pain and other-symptoms self-efficacy scores were associated with lower levels of pain (r = −0.29, −0.20.), perceived exertion during a walking task (r = −0.29, −0.31), and depression scores (r = −0.46, −0.54) (p < 0.001); (b) subjects with higher levels of self-efficacy for managing symptoms other than pain also recorded faster and fast speed walking velocities than those with lower self-efficacy scores (r = 0.30, 0.31) (p < 0.001); (c) self-efficacy for pain was the strongest predictor of pain intensity, and self-efficacy for symptom management was the strongest predictor of perceived exertion during walking, depression, and pain self-efficacy. Although no cause–effect relationship can be deduced from a cross-sectional analysis, these data imply that efforts to heighten self-efficacy for pain and other-symptoms management may influence the affective status, function, and effort-related perceptions of people with knee osteoarthritis quite significantly.
Collegiate-based emergency medical systems (CBEMS) are a unique model for the delivery of prehospital care. The National Collegiate Emergency Medical Services Foundation (NCEMSF) was founded to serve as a resource for CBEMS groups. The purpose of this investigation is to describe the current state of CBEMS organizations.
The NCEMSF maintains a Web-based, data collection system to gather data on CBEMS organizations. Collegiate-based emergency medical services are defined as emergency medical services in a university or college campus setting. The abstracted data from the NCEMSF registry were analyzed using descriptive statistics.
The NCEMSF registry contained data on 175 groups, and 145 groups were identified as providing CBEMS. The levels of service provided by the groups were: (1) first responder, 8.3%; (2) basic life support (BLS) 66.2%; (3) intermediate life support (ILS) 4.8%; (4) advanced life support (ALS), 9.7%; and (5) combination BLS/ALS, 8.3%. Transport capabilities were provided by 31.7% of the CBEMS. The average response time was estimated at 2.6 minutes (95% confidence interval (CI), 2.35–2.91 minutes). Early defibrillation using a automated external defibrillator (AED) or ALS was available by 75.9% (95% CI, 68.8–83.0) of CBEMS. Service to the community beyond the campus was provided by 21.3% of CBEMS groups. Forty-eight percent of the services operate 24 hours/day, seven days/week. The average call volume per year was 568 responses (95% CI, 315–820), and the groups averaged 29 (95% CI, 25–34) members. During the past five years, an average of 4.3 new CBEMS groups were formed per year. Eleven of the CBEMS are based at international schools.
I know we've come a long way. We're changing day to day. But tell me … where do the children play? – Yusuf Islam
(formerly Cat Stevens)
How can designers and planners better engage children and youth and include their ideas in urban design? This chapter focuses on the culture of childhood today and the limits it places on meaningful children's participation in design and planning. We examine some of the ideas children themselves have about city form and suggest a more proactive process for city design. It is our hope that through more meaningful participation, critical aspects of childhood can be renewed, including children's access and reshaping of the built environment (Gaster, 1991; Perez and Hart, 1980).
We have previously developed a historical and critical review of children's participation in city planning and design over the last forty years (Francis and Lorenzo, 2002). We suggested that participatory efforts with children can be viewed in at least seven distinct approaches or ‘realms’ – advocacy, romantic, needs, learning, rights, institutionalization, and proactive (see Table 13.1). The proactive realm is seen as the most integrative and effective way to involve children and youth in design and planning. At the same time, this approach can also help create places that better satisfy the needs of all citizens including children. It can, we believe, activate a process of childhood renewal rendering local environments, and entire cities, accessible, comprehensible and friendly to children of all ages.