Condorcet-compatible election methods are examined and compared. The Ranked Pairs method proves significantly better than Beatpath; that both are clone-free, and have other desirable properties, ...makes them much better than any alternative.
P-selectin - a biomarker of platelet and endothelial cell activation is elevated in patients with non-valvular atrial fibrillation (NVAF). However, the association between sP-selectin level and ...thromboembolic complications in NVAF patients remains controversial. We tested the hypothesis that plasma soluble P-selectin (sPSL) level correlates with the measures of left atrial blood stasis in NVAF.
Plasma sPSL concentration was measured using solid-phase ELISA in 103 NVAF patients (age 63 ± 14 years; 26% women) and 48 normal sinus rhythm controls (NSR; age 64 ± 14 years; 41% women) who were not on aspirin. Within the group of NVAF cases, 27 had no spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography, 31had mild SEC, 15 moderate, 20 severe, and 10 patients had left atrial appendage thrombus (LAAT).
The median soluble sPSL level was higher in NVAF cases compared to NSR controls (interquartile range) 26 (20−32) ng/mL vs 22 (15–29) ng/mL, p = 0.0045. Only NVAF patients with CHA2DS2-VASc score ≥ 1 had higher sPSL level compared to NSR controls. Patients with severe SEC had significantly higher sPSL levels 32 (24–38) ng/mL compared to all other NVAF patients (p = 0.0042) and to NSR controls (p < 0.0001). Also NVAF patients with LAAT had higher sPSL level compared to NSR controls.
There is a direct correlation between p-selectin level and severe blood stasis in the left atrium. Only NVAF patients with CHA2DS2-VASc score ≥ 1 or with LAAT had higher sPSL level compared to NSR controls.
•P-selectin (sPSL) is higher in patients with atrial fibrillation (AF).•Severe spontaneous echocardiographic contrast is associated with higher sPSL.•Patients with left atrial appendage thrombus have higher sPSL.•There is a direct correlation between sPSL and severe blood stasis in left atrium.
An improved measurement of the electron electric dipole moment (EDM) appears feasible using ground-state alkali atoms in an atomic fountain in which a strong electric field, which couples to a ...conceivable EDM, is applied perpendicular to the fountain axis. In a practical fountain, the ratio of the atomic tensor Stark shift to the Zeeman shift is a factor μ∼100 . We expand the complete time-evolution operator in inverse powers of this ratio; complete results are presented for atoms of total spin F=3 , 4, and 5. For a specific set of entangled hyperfine sublevels (coherent states), potential systematic errors enter only as even powers of 1/μ , making the expansion rapidly convergent. The remaining EDM-mimicking effects are further suppressed in a proposed double-differential setup, where the final state is interrogated in a differential laser configuration, and the direction of the strong electric field also is inverted. Estimates of the signal available at existing accelerator facilities indicate that the proposed apparatus offers the potential for a drastic improvement in EDM limits over existing measurements, and for constraining the parameter space of supersymmetric (SUSY) extensions of the Standard Model.
Charlie Munger Griffin, Tren
2015., 20150915, 2015
eBook
Charlie Munger, Berkshire Hathaway's visionary vice chairman and Warren Buffett's indispensable financial partner, has outperformed market indexes again and again, and he believes any investor can do ...the same. His notion of "elementary, worldly wisdom"--a set of interdisciplinary mental models involving economics, business, psychology, ethics, and management--allows him to keep his emotions out of his investments and avoid the common pitfalls of bad judgment.
Munger's system has steered his investments for forty years and has guided generations of successful investors. This book presents the essential steps of Munger's investing strategy, condensed here for the first time from interviews, speeches, writings, and shareholder letters, and paired with commentary from fund managers, value investors, and business-case historians. Derived from Ben Graham's value-investing system, Munger's approach is straightforward enough that ordinary investors can apply it to their portfolios. This book is not simply about investing. It is about cultivating mental models for your whole life, but especially for your investments.
Previous studies of atrial flutter have found linear block at the crista terminalis; this was thought to predispose the patient to the arrhythmia. More recent observations, however, have demonstrated ...crista conduction. We sought to characterize the posterior boundary of atrial flutter.
Patients with counterclockwise flutter (n=20), clockwise flutter (n=3), or both (n=5) were studied using two 20-pole catheters. Biplane fluoroscopy determined catheter positions. During counterclockwise flutter, craniocaudal activation occurred along the entire lateral and posterior right atrial walls. Septal activation proceeded caudocranially. In all patients, a line of block was seen in the posteromedial (sinus venosa) right atrium; this was manifested by the presence of double potentials where the upward and downward activations collided. Anatomic location was confirmed by intracardiac echocardiography in 9 patients. In patients with clockwise flutter, the line of block and double potentials were seen in the same location during counterclockwise flutter, but the activation sequence around the line of block was reversed. Pacing near the site of double potentials during sinus rhythm excluded a fixed line of block, and premature atrial complexes demonstrated functional block with manifest double potentials. In 2 patients, posterior ectopy organized to subsequently initiate isthmus-dependent atrial flutter.
(1) A functional line of block is seen at the posteromedial (sinus venosa region) right atrium during counterclockwise and clockwise atrial flutter. (2) All lateral wall right atrial activation can be uniform during flutter, without linear block or double potentials in the region of the crista terminalis. (3) Activation at the site of posteromedial right atrial functional block can organize to subsequently initiate isthmus-dependent atrial flutter.
IMRT for breast. A planning study Fogliata, A.; Nicolini, G.; Alber, M. ...
Radiotherapy and oncology,
September 2005, 2005-Sep, 2005-9-00, Letnik:
76, Številka:
3
Journal Article
Recenzirano
To evaluate the performance of ten different treatment-planning systems when intensity modulated (IMRT) plans are designed for breast treatments that include the irradiation of the internal mammary ...chain.
A dataset of five patients (CT images and volumes of interest) was distributed to design IMRT plans on the ten systems. To minimise biases, the same geometry and clinical planning aims were imposed on the individual plans. Results were analysed in terms of dose distributions and dose volume histograms.
For target coverage, the volume receiving more than 95% of the prescribed dose ranged from 77% (OTP) to 91% (Eclipse and Pinnacle), the volume receiving more than 107% ranged from 3.3% (Hyperion) to 23.2% (OTP). The mean dose to ipsilateral lung ranged from 13Gy (Eclipse) to 18Gy (OTP). The volume of the contralateral breast receiving more than 10Gy ranged from 3% (Pinnacle) to 26% (Precise). The volume of heart receiving more than 20Gy ranged from 7% (Eclipse) to 47% (Precise), the maximum significant dose to heart ranged from ∼27Gy (XiO) to ∼49Gy (Precise). The maximum significant dose to healthy tissue ranged from ∼51Gy (Eclipse) to ∼62Gy (OTP). It was also possible to show that the treatment geometry proposed here enables to minimise contralateral breast irradiation while keeping minimal ipsilateral lung (or heart) involvement and satisfactory target coverage.
Virtually all natural history studies of Wolff-Parkinson-White (WPW) syndrome have been case series and, as such, have been constrained by referral biases, skewed age and sex distributions, or brief ...follow-up periods. The purpose of our study was to examine the natural history, the development of arrhythmias, and the incidence of sudden death in an entire cohort of pediatric and adult WPW patients from a community-based local population.
We identified 113 residents of Olmsted County, Minnesota, during the period 1953-1989 using the centralized records-linkage system provided by the Mayo Clinic and the Rochester Epidemiology Program Project. Medical records and ECGs were reviewed to confirm the diagnosis and to establish pathway location by ECG criteria. Follow-up, via record review and telephone interview, was complete in 95% of subjects through 1990. The incidence of newly diagnosed cases was approximately four per 100,000 per year. Preexcitation was not present on the initial ECG of 22% of the cohort. Approximately 50% of the population was asymptomatic at diagnosis, with 30% subsequently having symptoms related to arrhythmia at follow-up. Two sudden cardiac deaths (SCD) occurred over 1,338 patient-years of follow-up, yielding an overall SCD rate of 0.0015 (95% confidence interval, 0.0002-0.0054) per patient-year. No SCD occurred in patients asymptomatic at diagnosis.
The incidence of sudden death in a local community-based population is low and suggests that electrophysiological testing should not be performed routinely in asymptomatic patients with WPW syndrome. Nevertheless, young, asymptomatic patients, particularly those < 40 years old, should return for medical follow-up should symptoms develop.
In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternative therapeutic ...approach. The effect of this procedure on long-term survival is unknown.
We studied all patients who underwent ablation of the atrioventricular node and implantation of a permanent pacemaker at the Mayo Clinic between 1990 and 1998. Observed survival was compared with the survival rates in two control populations: age- and sex-matched members of the Minnesota population between 1970 and 1990 and consecutive patients with atrial fibrillation who received drug therapy in 1993.
A total of 350 patients (mean +/-SD age, 68+/-11 years) were studied. During a mean of 36+/-26 months of follow-up, 78 patients died. The observed survival rate was significantly lower than the expected survival rate based on the general Minnesota population (P<0.001). Previous myocardial infarction (P<0.001), a history of congestive heart failure (P=0.02), and treatment with cardiac drugs after ablation (P=0.03) were independent predictors of death. Observed survival among patients without these three risk factors was similar to expected survival (P=0.43). None of the 26 patients with lone atrial fibrillation died during follow-up (37+/-27 months). The observed survival rate among patients who underwent ablation was similar to that among 229 controls with atrial fibrillation (mean age, 67+/-12 years) who received drug therapy (P=0.44).
In the absence of underlying heart disease, survival among patients with atrial fibrillation after ablation of the atrioventricular node is similar to expected survival in the general population. Long-term survival is similar for patients with atrial fibrillation, whether they receive ablation or drug therapy. Control of the ventricular rate by ablation of the atrioventricular node and permanent pacing does not adversely affect long-term survival.
Magnetic fields from statistical fluctuations in currents in conducting materials broaden atomic linewidths by the Zeeman effect. The constraints imposed by this broadening on the design of ...experiments that measure the electric dipole moment of the electron are analyzed. Contrary to the predictions of Lamoreaux S. K. Lamoreaux, Phys. Rev. A 60, 1717 (1999), the standard material for high-permeability magnetic shields proves to be as significant a source of broadening as is an ordinary metal. A scheme that would replace this standard material with ferrite is proposed.
To determine the importance of competition control and annual fertilization on leaf gas exchange, light-saturated net photosynthesis (Asat), stomatal conductance (g(s)), and internal CO2 ...concentration (Ci) were measured multiple times in different-aged loblolly pine (Pinus taeda L.) stands growing at a Piedmont (BF Grant) and Coastal Plain (Waycross) location in Georgia, U.S.A. At both locations, competition control decreased Asat and g(s) (Asat from 4.53 to 4.12 µmol·m-2·s-1, g(s) from 0.058 to 0.050 mol·m-2·s-1 at BF Grant; Asat from 4.22 to 4.01 µmol·m-2·s-1, gs from 0.054 to 0.049 mol·m-2·s-1 at Waycross). Overall, fertilization did not have a positive impact on Asat, even though fertilization significantly increased foliar nitrogen concentration. At BF Grant, fertilization significantly decreased gs from 0.057 to 0.051 mol·m-2·s-1 and Ci from 217 to 205 µmol·mol-1. In addition, the decrease in Ci associated with fertilization became larger with stand age. At Waycross, fertilization decreased Ci from 211 to 203 µmol·mol-1 and the interaction between fertilization and stand age was significant for gs and Ci. These results indicate that silivcultural practices that increase resource availability and stand growth did not enhance leaf gas exchange.
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