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A letter to the editor is presented in response to the article "Counterpoint: efficacy of extracorporeal membrane oxygenation in 2009 influenza," by A. H. Morris and colleagues that was published in the October 2010 issue, and a response by A. H. Morris and colleagues to the letter.

The authors presents a rebuttal to the response by Pauline Park and colleagues concerning their study on the use of extracorporeal membrane oxygenation (ECMO) in treating the 2009 influenza AH1N1. The authors assert that Park and colleagues should have considered rigorous clinical trials on extracorporeal life support which failed to produce proofs of the efficacy of ECMO in influenza-associated respiratory failure. They however applaud the call by Park for a reassessment of ECMO.

The article reports on the discovery of the Australopithecus sediba in Malapa, South Africa. The hominin fossils were discovered and announced by Lee and Matthew Berger. However, it notes that these skeletons remained incomplete. Morover, Berger and his team have placed these fossilized hominin skeletons in Australopithecine species.

The article presents the author's views on the study "Genes, Tribes, and African History," by Scott MacEachern, which has been published within the issue. MacEachern discussed various issues related to human genetics. The author stresses the efforts made by biological anthropologists to explain the relations between biological and ethnic groupings. He appreciates the research work done by MacEachern. However, he also points out some problems in the study.

In liberal market Anglophone nations, where private rental housing is typically lightly regulated, little is known about the household-level drivers of recent private rental sector growth. In Australia, where long-term private renting (10 years plus) has doubled since the 1990s, growing numbers are thus exposed to risks of landlord- initiated moves and unpredictable rent rises for lengthy periods. Our research suggests that although long-term renting mainly reflects adaptation to increasingly unafordable home ownership, lifestyle choices are also significant--at least in Australia's major cities where renting in a 'desirable' area may be preferred to owning elsewhere. While many tenants appear sanguine about their housing security, this is highly problematic for lower income residents lacking other choices, many of whom appear likely to remain lifelong renters. The paper contributes an additional perspective to debates about the interplay between changing housing market dynamics, lifestyles and housing choices/constraints. [ABSTRACT FROM AUTHOR]

There is mounting evidence of increased international student financial and work precarity over the last decade in Australia. Yet, there has been a little scholarly analysis of which students are most affected by precarity and its sources. Drawing on two surveys of international students in Australia's two largest cities, conducted before and during the pandemic, we investigate the financial and work vulnerabilities of international students. We demonstrate that vulnerability is related to characteristics which describe particular cohorts of students: being from low-income countries, working class families, seeking a low-level qualification, enrolled in a non-university institution, and being without a scholarship. The concepts of "noncitizenship" and "work precarity" are used to explain how the mechanisms of each characteristic heighten vulnerability, thereby contributing to a broader evidence-base about the causality of international student precarity. [ABSTRACT FROM AUTHOR]

Fine-grained low permeability sedimentary rocks, such as shale and mudrock, have drawn attention as unconventional hydrocarbon reservoirs. Fracturing – both natural and induced – is extremely important for increasing permeability in otherwise low-permeability rock. We analyze natural extension fracture networks within a complete measured outcrop section of the Ernst Member of the Boquillas Formation in Big Bend National Park, west Texas. Results of bed-center, dip-parallel scanline surveys demonstrate nearly identical fracture strikes and slight variation in dip between mudrock, chalk, and limestone beds. Fracture spacing tends to increase proportional to bed thickness in limestone and chalk beds; however, dramatic differences in fracture spacing are observed in mudrock. A direct relationship is observed between fracture spacing/thickness ratio and rock competence. Vertical fracture penetrations measured from the middle of chalk and limestone beds generally extend to and often beyond bed boundaries into the vertically adjacent mudrock beds. In contrast, fractures in the mudrock beds rarely penetrate beyond the bed boundaries into the adjacent carbonate beds. Consequently, natural bed-perpendicular fracture connectivity through the mechanically layered sequence generally is poor. Fracture connectivity strongly influences permeability architecture, and fracture prediction should consider thin bed-scale control on fracture heights and the strong lithologic control on fracture spacing. [ABSTRACT FROM AUTHOR]

Cerebrovascular dysfunction is a critical component of Alzheimer's disease (AD) pathogenesis. Oligomeric amyloid-β42 (oAβ42) is considered a major contributor to AD progression. However, data are limited on the role of oAβ42 in brain endothelial cell vessel degeneration/angiogenesis, including the interaction with angiogenic mediators. Thus, the current study determined the effect of oAβ42 on angiogenesis in vitro, utilizing single brain endothelial cell cultures and triple cultures mimicking the microvascular unit (MVU: brain endothelial cells, astrocytes, and pericytes). oAβ42 dose-dependently reduced angiogenesis and induced vessel disruption. Critically, epidermal growth factor prevented oAβ42-induced deficits, implicating angiogenic pathways as potential therapeutics for AD. [ABSTRACT FROM AUTHOR]

Cerebrovascular (CV) dysfunction is emerging as a critical component of Alzheimer's disease (AD), including altered CV coverage. Angiogenic growth factors (AGFs) are key for controlling CV coverage, especially during disease pathology. Therefore, evaluating the effects of AGFs in vivo can provide important information on the role of CV coverage in AD. We recently demonstrated that epidermal growth factor (EGF) prevents amyloid-beta (Aβ)-induced damage to brain endothelial cells in vitro. Here, our goal was to assess the protective effects of EGF on cognition, CV coverage and Aβ levels using an AD-Tg model that incorporates CV relevant AD risk factors. APOE4 is the greatest genetic risk factor for sporadic AD especially in women and is associated with CV dysfunction. EFAD mice express human APOE3 (E3FAD) or APOE4 (E4FAD), overproduce human Aβ42 and are a well characterized model of APOE pathology. Thus, initially the role of APOE and sex in cognitive and CV dysfunction was assessed in EFAD mice in order to identify a group for EGF treatment. At 8 months E4FAD female mice were cognitively impaired, had low CV coverage, high microbleeds and low plasma EGF levels. Therefore, E4FAD female mice were selected for an EGF prevention paradigm (300 μg/kg/wk, 6 to 8.5 months). EGF prevented cognitive decline and was associated with lower microbleeds and higher CV coverage, but not changes in Aβ levels. Collectively, these data suggest that EGF can prevent Aβ-induced damage to the CV. Developing therapeutic strategies based on AGFs may be particularly efficacious for APOE4-induced AD risk. [ABSTRACT FROM AUTHOR]

The author discusses the increase of body mass index (BMI) in South Africa which has suggested a rise in wealth and risk for obesity. He states that perception for the threat of obesity has been varied among ethnic or racial groups. The author notes that the presence of excess body weight is effectively identified by the calculation of BMI.

A response by Roy Brower, Alan Morris and Neil MacIntyre to a letter to the editor about their article "Higher Versus Lower Positive End-Expiratory Pressures in Patients With the Acute Respiratory Distress Syndrome," published in the July 22, 2004 issue is presented.

The Dutch East India Company (VOC) intended the Cape of Good Hope to be a refreshment stop for ships travelling between the Netherlands and its eastern colonies. The indigenous Khoisan, however, did not constitute an adequate workforce, therefore the VOC imported slaves from East Africa, Madagascar and Asia to expand the workforce. Cape Town became a cosmopolitan settlement with different categories of people, amongst them a non-European underclass that consisted of slaves, exiles, convicts and free-blacks. This study integrated new strontium isotope data with carbon and nitrogen isotope results from an 18th-19th century burial ground at Cobern Street, Cape Town, to identify non-European forced migrants to the Cape. The aim of the study was to elucidate individual mobility patterns, the age at which the forced migration took place and, if possible, geographical provenance. Using three proxies, 87Sr/86Sr, δ13Cdentine and the presence of dental modifications, a majority (54.5%) of the individuals were found to be born non-locally. In addition, the 87Sr/86Sr data suggested that the non-locally born men came from more diverse geographic origins than the migrant women. Possible provenances were suggested for two individuals. These results contribute to an improved understanding of the dynamics of slave trading in the Indian Ocean world. [ABSTRACT FROM AUTHOR]

Reviews the resource pack `AIDS Education Resource and HIV Simulation Game, 2nd edition,' by Graham Thomas.

Reviews the resource pack `HIV/AIDS: Telling the Children,' available from Daniels Publishing (Cambridge, England).

Interpretation of newly acquired modern broadband seismic reflection data and structural restoration of three regional, WNW-ESE oriented cross-sections across the Orphan Basin, Flemish Pass and Flemish Cap provide new insights into rift evolution and structural style in the area. Our results show that regional extension in the Orphan Basin and Flemish Pass area largely occurred between 170 Ma and 135 Ma, and later extension (135 Ma onwards) in the study area was accommodated east of Flemish Cap. Seismic stratigraphic mapping provides evidence for significant thicknesses of Jurassic strata throughout the Orphan Basin and Flemish Pass area, and structural interpretations highlight the importance of crustal-scale extensional detachment faults in controlling the geometry and position of Jurassic sub-basins at a range of scales. Stacked detachment surfaces and coincident extreme crustal attenuation (to ca. 3.1 km) are observed in eastern parts of the Orphan Basin in an area defined in this study as the Orphan Trough. Rifting style in the central, northern, and eastern parts of the Orphan Basin is dominated by low-angle detachment faulting with maximum extension perpendicular to the incipient rift axis. In contrast, structural geometries in the southwestern part of the basin are suggestive of transtensional deformation, and interplay of normal and strike-slip faulting. Results from map-based interpretation show that strike-slip faults within this transtensional zone are associated with displacement transfer between half-grabens of opposing polarity, rather than regional strike-slip displacement. These structures are interpreted as contemporaneous and kinematically linked to displacement along low-angle detachment surfaces elsewhere and are not attributed to distinct episodes of oblique extension. • Regional structural characterization of the Orphan Basin - Flemish Pass – Flemish Cap region. • Kinematic restoration and crustal area balancing of three laterally compatible, regional cross sections. • A single phase of protracted rifting from ca. 170 Ma to 135 Ma is interpreted in the Orphan Basin and Flemish Pass region. • Hyperextension, crustal-scale detachment surfaces and crustal attenuation associated with rift development. • Transtensional deformation in the southern part of the Orphan Basin compatible with rift-related extension. [ABSTRACT FROM AUTHOR]

Abstract: Understanding stress states and rock mass deformation deep underground is critical to a range of endeavors including oil and gas exploration and production, geothermal reservoir characterization and management, and subsurface disposal of CO2. Geomechanical modeling can predict the onset of failure and the type and abundance of deformation features along with the orientations and magnitudes of stresses. This approach enables development of forward models that incorporate realistic mechanical stratigraphy (e.g., including competence contrasts, bed thicknesses, and bedding planes), include faults and bedding-slip surfaces as frictional sliding interfaces, reproduce the overall geometry of the fold structures of interest, and allow tracking of stress and strain through the deformation history. Use of inelastic constitutive relationships (e.g., elastic–plastic behavior) allows permanent strains to develop in response to the applied loads. This ability to capture permanent deformation is superior to linear elastic models, which are often used for numerical convenience, but are incapable of modeling permanent deformation or predicting permanent deformation processes such as faulting, fracturing, and pore collapse. Finite element modeling results compared with field examples of a natural contractional fault-related fold show that well-designed geomechanical modeling can match overall fold geometries and be applied to stress, fracture, and subseismic fault prediction in geologic structures. Geomechanical modeling of this type allows stress and strain histories to be obtained throughout the model domain. [Copyright &y& Elsevier]

Abstract: The occurrence of hybrid failure – the transition from tensile to shear failure – has been controversial. Production of hybrid failure in laboratory experiments in recent years has strengthened the case for hybrid failure, but field recognition has remained elusive. In this paper, we present data from a small-displacement fault in the Hidden Valley fault zone at Canyon Lake Gorge, Texas, which is refracted through mechanically layered carbonates and exhibits surface characteristics expected for hybrid failure on steep fault segments. We discuss field criteria for identifying hybrid fractures and the deformation conditions under which hybrid failure is to be expected. Documented field examples of hybrid fractures are rare, yet presence of hybrid fractures can be useful indicators of stress conditions at the time of failure. Specifically, hybrid fractures are likely indicators of tensile minimum effective stress and low differential stress at failure. [Copyright &y& Elsevier]

Purpose: Although pediatric intensivists claim to embrace lung protective ventilation for acute lung injury (ALI), ventilator management is variable. We describe ventilator changes clinicians made for children with hypoxemic respiratory failure, and evaluate the potential acceptability of a pediatric ventilation protocol. Methods: This was a retrospective cohort study performed in a tertiary care pediatric intensive care unit (PICU). The study period was from January 2000 to July 2007. We included mechanically ventilated children with PaO/FiO (P/F) ratio less than 300. We assessed variability in ventilator management by evaluating actual changes to ventilator settings after an arterial blood gas (ABG). We evaluated the potential acceptability of a pediatric mechanical ventilation protocol we adapted from National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI) Acute Respiratory Distress Syndrome (ARDS) Network protocols by comparing actual practice changes in ventilator settings to changes that would have been recommended by the protocol. Results: A total of 2,719 ABGs from 402 patients were associated with 6,017 ventilator settings. Clinicians infrequently decreased FiO, even when the PaO was high (>68 mmHg). The protocol would have recommended more positive end expiratory pressure (PEEP) than was used in actual practice 42% of the time in the mid PaO range (55-68 mmHg) and 67% of the time in the low PaO range (<55 mmHg). Clinicians often made no change to either peak inspiratory pressure (PIP) or ventilator rate (VR) when the protocol would have recommended a change, even when the pH was greater than 7.45 with PIP at least 35 cmHO. Conclusions: There may be lost opportunities to minimize potentially injurious ventilator settings for children with ALI. A reproducible pediatric mechanical ventilation protocol could prompt clinicians to make ventilator changes that are consistent with lung protective ventilation. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented in response to the article "New Knowledge and the University," by Martin Hall, including one where the sender compared his work with Hall, another which argues savage science, public accountability and the missing debate in South African universities, and one which describes Hall as an activist in writing his research.

The authors reflect on research regarding the Pulmonary and Renal Support in Acute Respiratory Distress Syndrome (PARSA). Topics discussed include the extracorporeal rescue therapy feasilbility for Acute Respiratory Distress Syndrome (ARDS), the incorporation of membrane oxygenator into a renal replacement therapy (RRT), and the extracorporeal carbon dioxide removal.

Abstract: Purpose: Implementation of evidence-based techniques, such as explicit computerized protocols, has achieved limited success among clinicians. In this study, we describe the development and validation of an instrument for assessing clinicians’ perceptions about use of explicit computerized protocols. Methods: Qualitative assessment of semi-structured interviews with clinicians gave rise to a cognitive model evaluating the factors that motivate clinicians to use explicit computerized protocols. Using these constructs we developed a 35-item instrument which was administered to 240 clinicians (132 nurses, 53 physicians and 55 respiratory therapists), in three health-care institutions. Results: Factor analysis identified nine factors that accounted for 66% of the total variance cumulatively. Factors identified were: Beliefs regarding Self-Efficacy, Environmental Support, Role Relevance, Work Importance, Beliefs regarding Control, Attitude towards Information Quality, Social Pressure, Culture, and Behavioral Intention. The strongest predictor was Beliefs regarding Self-Efficacy, which accounted for 26% of the total variance of intention to use explicit computerized protocols. Results supported the reliability and construct validity of the instrument. Conclusions: Clinicians’ perceptions play a critical role in determining their intention to use explicit computerized protocols in routine clinical practice. Behavioral theories will help us understand factors predicting clinicians’ intention to use explicit computerized protocols and recognize the implications of these factors in the design and implementation of these protocols. [Copyright &y& Elsevier]

A baseball injury to an instrumented human cadaver maxillae was simulated with a regulation (142 g) baseball traveling at 14 m s−1. Measurements of strain were obtained with three-axis strain gauge rosettes located at the medial palate and both canine fossae. A three-dimensional finite element (FE) model of a dentate human maxilla was constructed from computed tomography scans of the skull of an adolescent. This three-dimensional mathematical model of the maxilla was deemed geometrically accurate by convergence testing when the model's degrees of freedom approximated 74 000. The simulated load case involved a transient dynamic impact to the medial maxilla with boundary conditions imposed at skeletal buttresses of the model. The model was calibrated through direct comparison with the displacements and principal strains gathered from experimental and epidemiological data. The comparison of experimental and calculated principal strains as a result of the simulated impacts revealed a 1.7–11.4% difference. [ABSTRACT FROM AUTHOR]

The article presents a study which discusses the use of performance profiling in the measurement overhead of parallel message passing program execution. It offers four important outcomes including message passing interface (MPI) profiling support, schemes to local delays, tuning and analysis utilities (TAU) overhead compensation prototype and the transmission of delay information with messages. It was observed that the most parallel performance measurement tools ignore the overhead incurred by their use. It is concluded that the performance uncertainty principle implies accuracy of performance data and is inversely correlated with the degree of performance instrumentation.

The modern requirement for low weight/high strength aircraft structures is placing an every increasing emphasise on the direct use of optimisation methods in the overall design process. In certain cases, such as that of the Blended Wing-Body (BWB) aircraft, the design cannot be successfully completed without the application of optimisation methods. This type of complex design has inevitably led to the growth in the size of the optimisation problem with large numbers of design variables and constraints being required in a design with strong interactions between the various structural components. Treating the problem in the conventional manner with all components considered simultaneously leads to excessive computer run times. In order to control this growth in problem size a multi-level approach has to be used in order to break down the problem into several sub-problems taking into account the structural coupling effects. Such an approach enables the use of parallel computer processing leading to a significant reduction of the computer run time and decreases the design cycle time. [Copyright &y& Elsevier]

Objective: To study morbidity and mortality in ARDS patients from 1987 to 1999. Design: Review of a prospectively collected database of ARDS patients. Setting: Large, community hospital located in Salt Lake City, UT. Patients: ARDS patients identified for the years 1987 to 1999. We prospectively identified ARDS patients at LDS Hospital in Salt Lake City, UT, using PaO[sub 2]/fraction of inspired oxygen ratio (P/F) criteria, the presence of bilateral chest radiograph infiltrates, and the absence of left atrial hypertension. Measurements: We assigned a primary risk factor for ARDS and identified the presence of organ failure before and after ARDS. We compared two temporal groups (ie, 1987 to 1990 vs 1994 to 1999) and used two criteria of arterial hypoxemia (P/F: patients from 1994 to 1999, ≤ 105 and ≤ 173; patients from 1987 to 1990, ≤ 0.2) At 1,500 m (the altitude of Salt Lake City), a PaO[sub 2] of ≤ 173 corresponds to an alveolar-arterial oxygen pressure difference of ≤ 200 at sea level. We used death at hospital discharge as an end point. Main results: We identified 516 ARDS patients with a P/F of ≤ 105 (1987 to 1990, 256 patients; 1994 to 1999, 260 patients). Patients who had ARDS between 1994 and 1999 with a P/F of ≤ 105 had a lower mortality rate than patients between 1987 and 1990 with a P/F of ≤ 105 (44% vs 54%, respectively; p < .05). There were 288 patients with a P/F range of 106 to 173 during 1994 to 1999. Patients from 1994 to 1999 with a P/F of ≤ 173 had a lower mortality rate compared to patients from 1987 to 1990 (35% vs 54%, respectively; p < .01). Patients from 1994 to 1999 (for both P/F groups) had statistically fewer total nonpulmonary organ failures (ie, more patients had zero organ failures or single organ failures) and fewer specific organ failures (ie, sepsis, cardiovascular failures, and CNS failures). There were statistically fewer eases of cardiovascular failure, sepsis, and in both periods (ie, prior to ARDS and after the onset of ARDS) for 1994-to-1999 patients with a P/F of ≤ 105 compared to 1987-to-1990 patients with a P/F of ≤ 105. Conclusions: Mortality from ARDS has decreased and is associated with decreased organ failure prior to and during the course of ARDS. [ABSTRACT FROM AUTHOR]

This article describes an innovative program, the Comprehensive Assessment and Response Training System (CARTS), designed to address the clinical needs of a selected population of adolescents with severe emotional disturbances who were made wards of Illinois Department of Children and Family Services (DCFS) for severe abuse and neglect. A collaborative effort between DCFS and the University of Illinois at Chicago, Department of Psychiatry, the CARTS Program provides crisis intervention, intensive evaluation and treatment planning services, technical assistance and consultation to residential facilities, and consultation to DCFS. [ABSTRACT FROM AUTHOR]

What constitutes poor quality housing is culturally defined and varies greatly between cities and countries across the globe. While self-help settlement has become common in many cities in recent years and a certain number of poor households rent rooms in central areas, a significant proportion of poor families occupy a different form of accommodation; they occupy shacks or formal rooms in the backyards of other households. The article compares the South African situation with the pattern found in most other third world countries. During the early apartheid period, when the government was still committed to providing houses for urban Africans, migrants who qualified for urban status found accommodation in hostels or official council housing. Backyard accommodation was the only option during the 1970s and early 1980s because the state was still able to prevent land invasions. Backyard accommodation is unevenly distributed around Soweto, South Africa with the vast majority being located in the backyards of the stands of council houses. In part, this high concentration reflects the dominance of council housing in Soweto, which occupies 74% of all stands and makes up 84% of all format structures.

The Orphan Basin and Flemish Pass region on the Newfoundland continental margin is a frontier area in terms of oil and gas exploration and remains poorly understood in terms of structural evolution and rift development. The area has few exploration wells and, until recently, sparse seismic data coverage. Existing gravity inversion and seismic refraction data from the area suggest that stretched continental crust in the Orphan Basin is highly attenuated (locally to < 5 km) but previously published structural restorations have been unable to fully restore the continental crust below the Orphan Basin to pre-deformed thicknesses (30–32 km). Here we perform a structural restoration of a regional, WNW-ESE oriented cross-section to investigate crustal structure, rifting style, and structural evolution of the Orphan Basin and Flemish Pass region. Interpretation is constrained by modern regional depth converted broadband 2D and 3D seismic reflection data, well data, and published gravity inversion results. Present-day crustal thicknesses are used as constraints for crustal area balancing and estimation of crustal thinning across the basin. We find that low-angle extensional detachments are widespread in the area, with offsets on individual structures of up to 42 km. Zones of attenuated continental crust are coincident with the presence of low-angle detachment surfaces displaying isostatic uplift of detachment footwalls. Comparison of total extension derived from crustal area balancing vs. structural restoration suggests approximately 39% of extension across the cross-section is unresolvable in seismic data. We attribute this to (i) ductile deformation prior to brittle faulting, (ii) subseismic-scale faulting, (iii) uncertainties in detachment breakaway positions, and (iv) unresolvable later offset of detachment surfaces. Widespread and relatively evenly distributed extension across the Orphan Basin and Flemish Pass region from Middle-Late Jurassic to Early Cretaceous influences sediment distribution across the region. Calibrated regional seismic mapping of the Orphan Basin suggests that significant thicknesses of Jurassic strata exist throughout the area, including in the northwestern part of the study area, where Kimmeridgian and Tithonian strata reach combined thicknesses of up to 4.9 km. • sSignificantthicknesses of Jurassic strataidentified throughout the Orphan Basin and Flemish Pass. • kinematic restoration and crustal area balancing used to constrain timing and amount of extension across the study area. • Structure dominated by low-angle extensional detachments with offsets on individual structures of up to 42 km. • Attenuated continental crust is coincident with low-angle detachment surfaces and isostatic uplift of detachment footwalls. [ABSTRACT FROM AUTHOR]

This paper examines the role of local government in the provision of housing across advanced economies in the contemporary economy and historically, while seeking to locate the Australian experience in a broader international perspective. The paper finds that ongoing challenges have given rise to policy innovation and new programmatic perspective. These developments have reflected non-systematic, and often disruptive, change rather than the continuation of predictable trends. The paper argues such evolution will continue and will be more likely to deliver benefits to the local government sector and housing affordability if acknowledged and enabled by more senior tiers of government. 本文探讨了在当代经济和历史上的发达经济体中，地方政府在提供住房方面的作用，同时试图从更广阔的国际视角来定位澳大利亚的经验. 报告发现，持续的挑战带来了政策创新和新的规划视角. 这些发展反映了非系统的、往往是破坏性的变化，而不是可预测的趋势的继续. 该论文认为，这种演变将继续下去，如果得到更高层政府的承认和支持，将更有可能为地方政府部门和住房负担能力带来好处. [ABSTRACT FROM AUTHOR]

Left atrial (LA) volumes are related to success of atrial fibrillation (AF) ablation, but the relation to other functional and structural parameters is less well understood. Our goal was to detect potential functional and structural predictors of arrhythmia recurrence after ablation using cardiac magnetic resonance imaging (CMRi) and to non-invasively assess the relation between LA functional and structural remodeling pre- and post-ablation. A total of 55 patients (38 male, age 67 ± 10 years) underwent CMRi prior to and then within 24-h and 3-months after ablation. LA volumes (LAV) and function (as assessed by ejection fraction and peak longitudinal atrial strain (PLAS)) were measured by feature-tracking CMRi, and LA fibrosis/scarring was quantified using late‑gadolinium enhancement (LGE) imaging. Atrial function was lower acutely in patients with recurrence versus those with non-recurrence: [R vs NR: EF Total 27.8 ± 10.3% vs 38.1 ± 11% p = 0.002; EF Active 10.5 ± 8% vs 19.1 ± 12% p = 0.007; EF Passive 19.4 ± 8 vs 25.8 ± 10 p = 0.021; PLAS 13 ± 5.9% vs 20.2 ± 7% p = 0.004]. With univariate analysis, baseline minimum volume (MinLAV, MinLAVi), several baseline functional parameters (EF Total , EF Passive , EF Active , PLAS), and LA-LGE were predictors of recurrence [all p < 0.05]. Acute function (EF Total , EF Passive , EF Active , PLAS) also predicted recurrence (p < 0.01). Lower pre-ablation EF Total , EF Passive , and PLAS correlated with higher amount of pre-ablation LA-LGE (p < 0.05). In a multivariate model including MinLAV, EF Active and LA-LGE (all at baseline), LA-LGE was the only independent predictor of recurrence (p = 0.0322). Pre-ablation function inversely correlated with LA-LGE and was related to success of AF ablation. Multi-parametric and longitudinal assessment of LA function and structure could be helpful in selection of optimal treatment strategies for AF patients by predicting outcomes. • This longitudinal CMRi study reports left atrial (LA) function and structure pre-ablation, acutely (< 24-h) and at follow-up • Lower LA strain (measured in sinus rhythm) correlated with higher fibrosis • Besides baseline LA function and fibrosis, acute functional impairment also associated with AF recurrence • Acute functional impairment was more severe in patients with high baseline LA fibrosis • Poor functional recovery was detected in patients with poor baseline function regardless of the amount of ablation scar [ABSTRACT FROM AUTHOR]

Background: Left atrial (LA) fibrosis is thought to be a substrate for atrial fibrillation (AF) and can be quantified by late gadolinium enhancement magnetic resonance imaging (LGE‐MRI). Fibrosis formation in LA is a dynamic process and may either progress or regress following AF ablation. We examined the impact of postablation progression in LA fibrosis on AF recurrence. Methods: LA enhancement in LGE‐MRI was quantified in 127 consecutive patients who underwent first time AF ablation. Serial LGE‐MRIs were done prior to AF ablation, 3 months postablation and at least 12 months after second LGE‐MRI. Transient postablation lesion (TL) was defined as atrial enhancement caused by ablation lesions that was detected on the first (3 month) but not on the second postablation LGE‐MRI. New fibrosis (NF) was defined as atrial enhancement detected on the most recent LGE‐MRI, at least 15 months after the ablation procedure. AF recurrence and its correlation with TL and NF was assessed in all patients during the follow‐up period. Results: An increase of 1% NF increased the chance of postablation AF recurrence by 3% (hazard ratio [HR] 1.03, 95% CI 1‐1.06, P =.05). TL had no significant impact on recurrence (P =.057). After adjusting for cardiovascular risk factors, HR increased as NF became greater. Greater volume of NF (≥21%) corresponded with lower arrhythmia‐free survival (37% vs 62%, P =.01). Conclusion: NF formation postablation of AF is a novel marker of long‐term procedural outcome. Extensive NF is associated with significantly higher risk of atrial arrhythmia recurrence. [ABSTRACT FROM AUTHOR]

Background: In addition to hyperglycemia, hypoglycemia, and glycemic variability, reduced time in targeted blood glucose range (TIR) is associated with increased risk of death in critically ill patients. This relation between TIR and mortality may be confounded by diabetic status and antecedent glycemic control.Methods: This study retrospectively analyzed critically ill patients managed with the same IV insulin protocol at multiple centers. The percentage of TIR between 70 and 139 mg/dL was calculated. Patients with diabetic ketoacidosis, patients who had < 10 blood glucose readings, and patients with repeat admissions were excluded. The highest recorded glycosylated hemoglobin value in the preceding 3 months or up to 1 month following admission were used as a surrogate for the patient's preexisting glucose control. Stratified regression analyses were performed for 30-day mortality, with covariates of age, sex, TIR ≥ 80%, Acute Physiology Score, and Charlson Comorbidity Index.Results: A total of 9,028 patients, 53.2% of whom had diabetes, were studied. Median TIR was 84.1% for nondiabetic patients and 64.5% for patients with diabetes. Mortality was lower in those with TIR > 80% compared with those with TIR ≤ 80% (12.4% vs 19.2%; P < .001). TIR > 80% was independently associated with reduced mortality in nondiabetic patients (OR, 0.52; P < .001), patients with diabetes (OR, 0.69; P = .001), and patients with well-controlled disease (OR, 0.50; P < .001) but not in patients with poorly controlled disease (OR, 0.86; P = .40).Conclusions: TIR was independently associated with mortality in critically ill patients, particularly those with good antecedent glucose control. [ABSTRACT FROM AUTHOR]

The partial photoionization cross sections and asymmetry parameters of S atoms have been measured using constant-ionic-state (CIS) spectroscopy in the photon energy range 10.0–30.0 eV. The ionizations investigated in these CIS experiments are the (3p)-1 ionizations S+(4S)←S(3P), S+(2D)←S(3P), and S+(2P)←S(3P). For the first time Rydberg series which converge to the fourth ionization limit have been observed and assignments of these series have been proposed. These correspond to excitations to Rydberg states that are parts of series which converge to the fourth ionization limit, S+(4P)←S(3P) (3s)-1, and autoionize to the lower S+(4S), S+(2D), or S+(2P) states. For each series observed in the CIS spectra photoelectron angular distribution studies, combined with other evidence, has allowed the angular momentum character of the free electron on autoionization to be determined. [ABSTRACT FROM AUTHOR]

Studies the photoionization of the OH and OD radicals in the gas phase in the photon energy region 13.0-17.0 eV using constant ionic state and photoelectron spectroscopy with synchrotron radiation. Photoelectron spectra recorded at the synchrotron source; Rydberg states of OH below the first ionization limit which have been characterized.