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The world's financial markets have exploded with new products and new techniques such as derivatives and securitizations, giving rise to huge new markets. The author reviews recent developments in insurance-linked securities (ILS), financial products that link insurance and reinsurance with these new markets. Pricing and availability problems after Hurricane Katrina have led to newer types of products making their way into these markets. While catastrophe bonds still make up a significant portion of ILS, the risk of not recovering reinsurance receivables, for instance, can now be transferred to the financial markets via credit derivatives. Catastrophe risk can also be packaged as a credit derivative. New participants, like hedge funds and specialized mutual funds, have also caused a revival of exchange-traded ILS. Trading in catastrophe futures and weather derivatives is thriving. Sidecars were revived. Contingent capital is readily available. New perils, combined with others, are being covered. Insurance and reinsurance companies can no longer treat these instruments as a matter of relative pricing between traditional products and ILS. After Katrina, access to multiple sources of capital has become an essential strategic objective.The Geneva Papers (2007) 32, 319–331. doi:10.1057/palgrave.gpp.2510134 [ABSTRACT FROM AUTHOR]

Summary: We report two brothers with an unknown form of early-onset familiar dystonia. Characteristic clinical features are (1) childhood-onset; (2) extrapyramidal motor symptoms; (3) dysarthria; and (4) mental retardation. Additional findings include loss of D2-receptors in both basal ganglia and hypoplasia of the cerebellar vermis with dilatation of the fourth ventricle and cisterna magna. There seems to be a progressive and non-progressive form of this clinical entity. Dystonic symptoms of the progressive form that occurred in one of the brothers were alleviated dramatically by bilateral internal globus pallidus (Gpi) stimulation, and the improvement has lasted now for 5 years. [Copyright &y& Elsevier]

alpha-Synuclein is the major constituent of Lewy bodies and Lewy neurites in Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Relatively little is known about the exact mechanism of alpha-synuclein deposition and fibrillization in these alpha-synucleinopathies. In order to better understand the pathogenesis of alpha-synucleinopathies it is important to identify molecules that regulate the fibrillization of alpha-synuclein. Since it has been demonstrated that heparan sulfate proteoglycans (HSPGs) and glycosaminoglycans (GAGs) promote the conversion of non-fibrillar amyloid beta-protein (Abeta) into neurotoxic fibrillar Abeta in Alzheimer's disease, they might also be involved in alpha-synuclein aggregation. It was the aim of our study to examine the distribution pattern of these macromolecules in PD brains and the possible association with Lewy bodies and Lewy neurites. Although HSPGs clearly colocalized with senile plaques, we were unable to identify HSPGs or GAGs in Lewy bodies and Lewy neurites and therefore concluded that it is likely that alpha-synuclein fibrillization and stabilization occurs independently of the presence of HSPGs or GAGs. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the influence of prehospital administration of aspirin and heparin on the initial patency of the infarct-related artery (IRA) in patients with acute myocardial infarction (MI).Background: Prehospital diagnosis of acute MI facilitates early pharmacologic intervention on the way to the catheterization laboratory for primary angioplasty.Methods: We studied the angiographic data and 30-day clinical outcome of 1,702 patients treated with primary angioplasty; 860 received aspirin and heparin before transportation to our hospital and 842 received aspirin and heparin in our hospital.Results: The Thrombolysis In Myocardial Infarction (TIMI) 2 or 3 flow in the IRA was higher in the prehospital treated group (31% vs. 20%, relative risk 0.65, 95% confidence interval 0.55 to 0.78, p < 0.001). Patients with TIMI 2 or 3 flow on the initial angiogram had a higher angioplasty success rate (94% vs. 89%, p < 0.001), a smaller enzymatic infarct size, a higher left ventricular ejection fraction and a lower 30-day mortality (1.6% vs. 3.4%, p = 0.04).Conclusions: Prehospital administration of aspirin and heparin results in a higher initial patency of the IRA in patients with acute MI. [ABSTRACT FROM AUTHOR]

A key question in decision-making is how people integrate amounts and probabilities to form preferences between risky alternatives. Here we rely on the general principle of integration-to-boundary to develop several biologically plausible process models of risky-choice, which account for both choices and response-times. These models allowed us to contrast two influential competing theories: i) within-alternative evaluations, based on multiplicative interaction between amounts and probabilities, ii) within-attribute comparisons across alternatives. To constrain the preference formation process, we monitored eye-fixations during decisions between pairs of simple lotteries, designed to systematically span the decision-space. The behavioral results indicate that the participants' eye-scanning patterns were associated with risk-preferences and expected-value maximization. Crucially, model comparisons showed that within-alternative process models decisively outperformed within-attribute ones, in accounting for choices and response-times. These findings elucidate the psychological processes underlying preference formation when making risky-choices, and suggest that compensatory, within-alternative integration is an adaptive mechanism employed in human decision-making.

Introduction Self-management interventions show promising results on symptom outcomes and self-management behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients’ symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses.Methods and analysis This pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness—Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients’ accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses’ fidelity of providing the intervention as intended, and patients’ safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis.Ethics and dissemination The Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017–00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences.Trial registration number NCT03649984; Pre-results.

This paper describes a new ultrasonic measuring device called “W-Box”. It was developed based on the requirements of the DFG Forschergruppe (research unit) CoDA for a portable device for monitoring of concrete specimens, models and actual structures using embedded ultrasonic transducers as well as temperature and humidity sensors. The W-Box can send ultrasonic pulses with a variable frequency of 50–100 kHz to one selectable transducer and records signals from up to 75 multiplexed channels with a sample rate of 1 MHz and a resolution of 14 bits. In addition, it measures temperature and humidity with high accuracy, adjustable amplification, restarts automatically after a power failure and can be fully controlled remotely. The measured data are automatically stored locally on-site data quality checks and transferred to remote servers. The comparison of the W-Box with a laboratory setup using commercial devices proves that it is equally reliable and precise, at much lower cost. The W-Box also shows that their measurement capacities, with the used embedded ultrasonic transducers, can reach above 6 m in concrete.

In the field of orthopedic surgery, distraction osteogenesis (DO) is well known for limb lengthening procedures or secondary corrective surgery in the fracture treatment of the extremities. The principle of gradual expansion of bone and surrounding soft tissues as originally described by G.A. Ilizarov is also applicable to the craniofacial skeleton when growth deficiency is present, and the patients affected by craniofacial or dentofacial anomalies may require distraction procedures. The surgical management is comparable. After osteotomy and the mounting of a specific craniomaxillofacial distraction device, active distraction is started after a latency phase of several days, with a distraction rate of up to 1 mm/day until the desired amount of distraction has been achieved. Subsequently, distractors are locked to provide appropriate stability within the distraction zone for callus mineralization during the consolidation phase of 3–6 months, which is followed by a further remodeling of the bony regenerate. After 14 years of clinical application, the role and significance of craniomaxillofacial DO are discussed after reviewing the files of all patients who were treated by craniomaxillofacial distraction procedures.

The mechanisms controlling differentiation in adult cardiac precursor cells (CPCs) are still largely unknown. In this study, CPCs isolated from the human heart were found to produce predominantly smooth muscle cells but could be redirected to the cardiomyocyte fate by transient activation followed by inhibition of NOTCH signaling. NOTCH inhibition repressed MIR-143/145 expression, and blocked smooth muscle differentiation. Expression of the microRNAs is under control of CARMEN, a long noncoding RNA associated with an enhancer located in the MIR-143/145 locus and target of NOTCH signaling. The CARMEN/MIR-145/143 axis represents, therefore, a promising target to favor production of cardiomyocytes in cell replacement therapies.

Due to the high sensitivity of coda waves to the smallest structural alterations such as strain, humidity or temperature changes, ultrasonic waves are a valid means to examine entire structures employing networks of ultrasonic transducers. In order to substantiate this ex ante assessment, the viability of measuring ultrasonic waves as a valid point of reference and inference for structural changes is to be further scrutinized in this work. In order to investigate the influence of mechanical strain on ultrasonic signals, a four-point bending test was carried out on a reinforced concrete beam at Ruhr University Bochum. Thus, measurements collected from a network of selected transducer pairings arranged across the central, shear-free segment of the test specimen, were correlated to their respective strain fields. Detected ultrasonic signals were evaluated employing Coda Wave Interferometry. Such analysis comprised the initial non-cracked state as well as later stages with incremental crack depth and quantity. It was to ascertain that the test specimen can in fact be qualitatively compartmentalized into areas of compression and tension identified via Relative Velocity Changes presented in Attribute Maps. However, since results did not entail a zero crossing, i.e., neither positive nor negative values were to be calculated, only relative changes in this work displayed staggered over the height of the object under test, are discussed. Under the given methodological premises, additional information is currently required to make quantitative assertions regarding this correlation of ultrasonic and strain results. This holds true for the comparability of the ultrasonic and strain results for both non-cracked and even the cracked state.

Metallic Zn alloys have recently gained interest as potential candidates for developing platforms of bioresorbable vascular stents (BVS). Previous studies revealed that Mg alloys used for BVS can degrade too early, whereas PLLA materials may fail to provide effective scaffolding properties. Here we report on results of a new bioresorbable, metallic stent made from a Zn-Ag alloy studied in a porcine animal model of thrombosis and restenosis. While the tensile strength (MPa) of Zn-3Ag was higher than that of PLLA and resembled Mg's (WE43), fracture elongation (%) of Zn-3Ag was much greater (18-fold) than the PLLA's or Mg alloy's (WE43). Zn-3Ag exposed to HAoSMC culture medium for 30 days revealed degradation elements consisting of Zn, O, N, C, P, and Na at a 6 nm surface depth. Platelet adhesion rates and blood biocompatibility did not differ between Zn-3Ag, PLLA, Mg (WE43), and non-resorbable Nitinol (NiTi) stent materials. Balloon-expandable Zn-3Ag alloy BVS implanted into iliofemoral arteries of 15 juvenile domestic pigs were easily visible fluoroscopically at implantation, and their bioresorption was readily detectable via X-ray over time. Histologically, arteries with Zn-3Ag BVS were completely endothelialized, covered with neointima, and were patent at 1, 3, and 6 months follow-up with no signs of stent thrombosis. Zn-3Ag alloy appears to be a promising material platform for the fabrication of a new generation of bioresorbable vascular stents.

The enlargement of the cracks outside the permitted dimension is one of the main causes for the reduction of service life of Reinforced Concrete (RC) structures. Cracks can develop due to many causes such as dynamic or static load. When tensile stress exceeds the tensile strength of RC, cracks appear. Traditional techniques have limitations in early stage damage detection and localisation, especially on large-scale structures. The ultrasonic Coda Wave Interferometry (CWI) method using diffuse waves is one of the most promising methods to detect subtle changes in heterogeneous materials, such as concrete. In this paper, the assessment of the CWI method applied for multiple cracks opening detection on two specimens based on four-point bending test is presented. Both beams were monitored using a limited number of embedded Ultrasonic (US) transducers as well as other transducers and techniques (e.g., Digital Image Correlation (DIC), LVDT sensors, strain gauges, and Fiber Optics Sensor (FOS)). Results show that strain change and crack formation are successfully and efficiently detected by CWI method even earlier than by the other techniques. The CWI technique using embedded US transducers is undoubtedly a feasible, efficient, and promising method for long-term monitoring on real infrastructure.

This paper addresses key factors that impact the financial success of international mergers and acquisitions, with particular focus on the integration implementation process. Drawing upon their research and consulting experience, the authors develop a practical framework for assisting human resource and other senior managers to effectively manage this process. Discussion of the strategy underlying a merger or acquisition, its particular organizational change requirements, and interventions for managing such changes are discussed. [ABSTRACT FROM AUTHOR]

Recently developed new transducers for ultrasonic transmission, which can be embedded right into concrete, are now used for non-destructive permanent monitoring of concrete. They can be installed during construction or thereafter. Large volumes of concrete can be monitored for changes of material properties by a limited number of transducers. The transducer design, the main properties as well as installation procedures are presented. It is shown that compressional waves with a central frequency of 62 kHz are mainly generated around the transducer’s axis. The transducer can be used as a transmitter or receiver. Application examples demonstrate that the transducers can be used to monitor concrete conditions parameters (stress, temperature, …) as well as damages in an early state or the detection of acoustic events (e.g., crack opening). Besides application in civil engineering our setups can also be used for model studies in geosciences.

The standard architecture of neocortex is a network with excitation and inhibition in closely maintained balance. These networks respond fast and with high precision to their inputs and they allow selective amplification of patterned signals. The stability of such networks is known to depend on balancing the strengths of positive and negative feedback. We here show that a second condition is required for stability which depends on the relative strengths and time courses of fast (AMPA) and slow (NMDA) currents in the excitatory projections. This condition also determines the response time of the network. We show that networks which respond quickly to an input are necessarily close to an oscillatory instability which resonates in the delta range. This instability explains the existence of neocortical delta oscillations and the emergence of absence epilepsy. Although cortical delta oscillations are a network-level phenomenon, we show that in non-pathological networks, individual neurons receive sufficient information to keep the network in the fast-response regime without sliding into the instability.

The authors wish to make the following corrections to this paper [...]

The assessment of Coda Wave Interferometry (CWI) and Distributed Fiber Optics Sensing (DFOS) techniques for the detection of damages in a laboratory size reinforced concrete beam is presented in this paper. The sensitivity of these two novel techniques to micro cracks is discussed and compared to standard traditional sensors. Moreover, the capacity of a DFOS technique to localize cracks and quantify crack openings is also assessed. The results show that the implementation of CWI and DFOS techniques allow the detection of early subtle changes in reinforced concrete structures until crack formation. With their ability to quantify the crack opening, following early detection and localization, DFOS techniques can achieve more effective monitoring of reinforced concrete structures. Contrary to discrete sensors, CWI and DFOS techniques cover larger areas and thus provide more efficient infrastructures asset management and maintenance operations throughout the lifetime of the structure.

Ultrasonic transmission measurements have been used for decades to monitor concrete elements, mostly on a laboratory scale. Recently, coda wave interferometry (CWI), a technique adapted from seismology, was introduced to civil engineering experiments. It can be used to reveal subtle changes in concrete laboratory samples and even large structural elements without having a transducer directly at the place where the change is taking place. Here, several load tests until failure on large posttensioned concrete beams have been monitored using networks of embedded transducers. To detect subtle effects at the beginning of the experiments and cope with severe changes due to cracking close to failure, the coda wave interferometry procedures had to be modified to an adapted step-wise approach. Using this methodology, we were able to monitor stress distribution and localize large cracks by a relatively simple technique. Implementation of this approach on selected real structures might help to make decisions in infrastructure asset management.

Purpose The Vestibular/Ocular Motor Screening (VOMS) tool for concussion evaluates symptom provocation (in a fixed order) across the following neuromotor tasks: smooth pursuits (SP), saccades-horizontal (Sac-H), saccades-vertical (Sac-V), near point of convergence (NPC), vestibular-ocular reflex-horizontal (VOR-H), vestibular-ocular reflex-vertical (VOR-V), and visual motion sensitivity (VMS). The current study evaluates the incremental validity of each VOMS component in consecutive order. Methods Retrospective record review of 193 subjects (49% male) aged 10–22 years old diagnosed with concussion (sport and non-sport injuries) and demonstrated an abnormal VOMS (defined by symptom provocation >2 or NPC >5cm) at initial evaluation in a specialty concussion clinic. Hierarchical regression was performed with VOMS total score (range: 0-320) as the dependent variable and each VOMS component as predictors in seven consecutive steps. Results The model was significant (p<.001) at each step; the final model including all seven VOMS components in order (SP, Sac-H, Sac-V, NPC, VOR-H, VOR-V, and VMS) was significant, F(7,185)= 6.87, p<.001 and accounted for 20.6% of the variance in total VOMS score. The only significant predictors in the final model included: SP (p=.01), NPC (p=.04), and VOR-H (p=.04). Conclusion Provocation of symptoms on SP, NPC, and VOR-H are the best predictors of total VOMS score. NPC and VOR-H symptom provocation provide unique value to vestibular screening beyond symptom provocation on SP and after completion of all other VOMS components. This information may be clinically useful when vestibular screening must be expedited (e.g. highly symptomatic patient, sideline assessment). [ABSTRACT FROM AUTHOR]

OBJECTIVE: 1014 EEGs of children in the 3-months to 12-years age group were obtained during sleep with the purpose of assessing the frequency and amplitude gradient (FAG) its absence thought to be an indicator of neurological disorder. METHOD: FAG findings were divided into present/absent. The neurological findings were classified according to the presence (abnormal neurological finding-ANF) or absence (normal neurological finding-NNF) of neurological disorder. The association and significance between FAG and neurological findings was determined by prevalence ration (PR) and chi-square test (chi2). RESULTS: FAG showed a characteristic distributions of voltage output during non-REM sleep, stage II, in the 3-months to 5-years age group with NNF. The PR and the chi2 test demonstrated a strong association between FAG absent and ANF. CONCLUSION: FAG is an age-dependent EEG sleep parameter and absence of FAG in the 3-months to 5-years age group is highly suggestive of neurological disorder.OBJETIVO: Estudaram-se 1014 EEG de crianças na faixa etária de 3 meses a 12 anos de idade obtidos em sono com o objetivo de avaliar o gradiente de freqüência-amplitude (GFA) ausente como possível indicador de comprometimento neurológico. MÉTODO: O GFA foi caracterizado: 1 - presente; 2 - ausente. O padrão neurológico foi classificado segundo a presença ou ausência de comprometimento neurológico em padrão neurológico anormal (PNA) e normal (PNN), respectivamente. RESULTADOS: O GFA mostrou-se um parâmetro EEG próprio da criança em sono na faixa etária dos 3 meses aos 5 anos de idade e com PNN. O teste do qui quadrado e a razão de prevalência mostraram relação altamente significativa para o GFA ausente, e o PNA. CONCLUSÃO: O GFA é um parâmetro EEG do sono idade-dependente e sua ausência na faixa etária dos 3 meses aos cinco anos é altamente sugestivo de comprometimento neurológico.