Transesophageal echocardiographic predictors for maintenance of sinus rhythm after electrical cardioversion of atrial fibrillation

The aim of this study was to assess the value of transesophageal echocardiography (TEE) in patients with atrial fibrillation in predicting restoration and maintenance of sinus rhythm after electrical cardioversion. TEE was performed in 62 patients with atrial fibrillation before their first elective cardioversion. Clinical variables evaluated were: age, gender, duration, and etiology of atrial fibrillation. TEE variables included: left atrial (LA) length, width, and size, LA annulus size, as well as presence of LA spontaneous contrast, thrombus and mitral regurgitation, LA appendage size and flow, and left ventricular function. Based on initial outcome of cardioversion, patients were grouped into patients who remained in atrial fibrillation and in whom sinus rhythm was restored. The latter group of patients was followed for 1 year, and grouped into patients who reverted to atrial fibrillation and in whom sinus rhythm was maintained. Successful cardioversion was achieved in 50 of 62 patients (81%). None of the clinical or TEE variables were related to initial outcome. At 1-year follow-up, 29 of 50 patients (58%) who underwent successful cardioversion continued to have sinus rhythm. The following variables were related to maintenance of sinus rhythm: duration of atrial fibrillation (6.7 +/- 7.3 vs 2.0 +/- 2.4 months; p < 0.005); LA length (6.2 +/- 0.7 vs. 5.5 +/- 1.0 cm; p < 0.008); width (5.1 +/- 0.5 vs. 4.5 +/- 0.7 cm; p < 0.002); size (26.4 +/- 5.0 vs 19.8 +/- 6.5 cm2; p < 0.0005); annulus size (4.0 +/- 0.2 vs 3.7 +/- 0.3 cm; p < 0.0005); presence of LA spontaneous contrast (13 [62%] vs 4 [14%]; p < 0.002), and LA appendage flow (19 +/- 8 vs 36 +/- 15 cm/s; p < 0.0005). In multivariate logistic regression analysis, LA annulus size, but especially LA appendage flow, were significantly associated with maintenance of sinus rhythm. Thus, in TEE-guided electrical cardioversion of atrial fibrillation, variables often used to assess thromboembolic risk may also be used to predict 1-year outcome of cardioversion.     

A hierarchical view on modeling the reliability of a DSRC link for ETC applications

For electronic payments, the communication link has to be reliable. Dedicated short-range communication (DSRC) is a proposed solution for the automatic debiting of vehicles in an electronic toll collection (ETC) system without disturbing the traffic flow. The requirements on the reliability of such a system are high, which implies that only large-scale simulations with a lot of detail are effective for analyzing occasional errors. In this paper, a hierarchical approach is worked out that allows such simulations of the communication link, with a 80% reduction of the computational effort compared to simulation with full detail.     

Strongly Typed Rewriting For Coupled Software Transformation

Coupled transformations occur in software evolution when multiple artifacts must be modified in such a way that they remain consistent with each other. An important example involves the coupled transformation of a data type, its instances, and the programs that consume or produce it. Previously, we have provided a formal treatment of transformation of the first two: data types and instances. The treatment involved the construction of type-safe, type-changing strategic rewrite systems. In this paper, we extend our treatment to the transformation of corresponding data processing programs.The key insight underlying the extension is that both data migration functions and data processors can be represented type-safely by a generalized abstract data type (GADT). These representations are then subjected to program calculation rules, harnessed in type-safe, type-preserving strategic rewrite systems. For ease of calculation, we use point-free representations and corresponding calculation rules.Thus, coupled transformations are carried out in two steps. First, a type-changing rewrite system is applied to a source type to obtain a target type together with (representations of) migration functions between source and target. Then, a type-preserving rewrite system is applied to the composition of a migration function and a data processor on the source (or target) type to obtain a data processor on the target (or source) type. All rewrites are type-safe.     

Burnout Prevention Through Personal Growth.

This study evaluated the effects of a burnout prevention program based on insights from transpersonal psychology, notably psychosynthesis. It examined the effects of the program on burnout, happiness, spirituality, emotional intelligence, and relative deprivation with respect to one's career. Thirty-eight individuals, mostly with a background in engineering, participated in a 10-day program over 3 months. A comparison group of similar age and work experience was recruited of colleagues from the same firms and departments. Both groups filled out questionnaires at 3 time points: before the start of the program, immediately after the program (3 months later), and 9 months later. Results showed that a psychosynthesis-based prevention program might be an effective instrument in reducing burnout and enhancing happiness, emotional intelligence, and feelings of spirituality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of self-overlap reveals trade-offs in plankton swimming trajectories

Movement is a fundamental behaviour of organisms that not only brings about beneficial encounters with resources and mates, but also at the same time exposes the organism to dangerous encounters with predators. The movement patterns adopted by organisms should reflect a balance between these contrasting processes. This trade-off can be hypothesized as being evident in the behaviour of plankton, which inhabit a dilute three-dimensional environment with few refuges or orienting landmarks. We present an analysis of the swimming path geometries based on a volumetric Monte Carlo sampling approach, which is particularly adept at revealing such trade-offs by measuring the self-overlap of the trajectories. Application of this method to experimentally measured trajectories reveals that swimming patterns in copepods are shaped to efficiently explore volumes at small scales, while achieving a large overlap at larger scales. Regularities in the observed trajectories make the transition between these two regimes always sharper than in randomized trajectories or as predicted by random walk theory. Thus, real trajectories present a stronger separation between exploration for food and exposure to predators. The specific scale and features of this transition depend on species, gender and local environmental conditions, pointing at adaptation to state and stage-dependent evolutionary trade-offs.     

Technological learning in bioenergy systems

The main goal of this article is to determine whether cost reductions in different bioenergy systems can be quantified using the experience curve approach, and how specific issues (arising from the complexity of biomass energy systems) can be addressed. This is pursued by case studies on biofuelled combined heat and power (CHP) plants in Sweden, global development of fluidized bed boilers and Danish biogas plants. As secondary goal, the aim is to identify learning mechanisms behind technology development and cost reduction for the biomass energy systems investigated. The case studies reveal large difficulties to devise empirical experience curves for investment costs of biomass-fuelled power plants. To some extent, this is due to lack of (detailed) data. The main reason, however, are varying plant costs due to differences in scale, fuel type, plant layout, region etc. For fluidized bed boiler plants built on a global level, progress ratios (PRs) for the price of entire plants lies approximately between 90–93% (which is typical for large plant-like technologies). The costs for the boiler section alone was found to decline much faster. The experience curve approach delivers better results, when the production costs of the final energy carrier are analyzed. Electricity from biofuelled CHP-plants yields PRs of 91–92%, i.e. an 8–9% reduction of electricity production costs with each cumulative doubling of electricity production. The experience curve for biogas production displays a PR of 85% from 1984 to the beginning of 1990, and then levels to approximately 100% until 2002. For technologies developed on a local level (e.g. biogas plants), learning-by-using and learning-by-interacting are important learning mechanism, while for CHP plants utilizing fluidized bed boilers, upscaling is probably one of the main mechanisms behind cost reductions.     

Discrete fracture in high performance fibre reinforced concrete materials

In this paper a simple, but effective methodology to simulate opening mode fracture in high performance fibre reinforced concrete is presented. The main contribution of the paper is a technique to extrapolate the load displacement curves of three point bending experiments on fibre reinforced concrete. The extrapolation allows the full work of fracture to be determined, from which the fracture energy may be obtained. The fracture energy is used in the definition of a cohesive softening function with crack tip singularity. The softening relation is implemented in an embedded discontinuity method, which is employed for the numerical simulation of three point bending experiments. The experimental work includes a size effect study on three point bending specimens. The numerical simulation provides a satisfactory prediction of the flexural behaviour and the size effect observed in the experiments.     

Gentrification and South African Cities: Towards a research agenda

Whereas South Africa’s cities have generally been understood as a “unique” urban form, many theoretical perspectives and urban processes – such as gentrification – which are often reserved for consideration in cities of advanced capitalist societies, are also of relevance there. In fact, important contributions to these theoretical perspectives can be made by drawing upon the South African urban experiences, while also providing a basis whereby local scholarship can be integrated into international urban debates.