Transesophageal echocardiography in cryptogenic stroke and patent foramen ovale: analysis of putative high-risk features from the risk of paradoxical embolism database

BACKGROUND Patent foramen ovale (PFO) is associated with cryptogenic stroke (CS), although the pathogenicity of a discovered PFO in the setting of CS is typically unclear. Transesophageal echocardiography features such as PFO size, associated hypermobile septum, and presence of a right-to-left shunt at rest have all been proposed as markers of risk. The association of these transesophageal echocardiography features with other markers of pathogenicity has not been examined. METHODS AND RESULTS We used a recently derived score based on clinical and neuroimaging features to stratify patients with PFO and CS by the probability that their stroke is PFO-attributable. We examined whether high-risk transesophageal echocardiography features are seen more frequently in patients more likely to have had a PFO-attributable stroke (n=637) compared with those less likely to have a PFO-attributable stroke (n=657). Large physiologic shunt size was not more frequently seen among those with probable PFO-attributable strokes (odds ratio [OR], 0.92; P=0.53). The presence of neither a hypermobile septum nor a right-to-left shunt at rest was detected more often in those with a probable PFO-attributable stroke (OR, 0.80; P=0.45; OR, 1.15; P=0.11, respectively). CONCLUSIONS We found no evidence that the proposed transesophageal echocardiography risk markers of large PFO size, hypermobile septum, and presence of right-to-left shunt at rest are associated with clinical features suggesting that a CS is PFO-attributable. Additional tools to describe PFOs may be useful in helping to determine whether an observed PFO is incidental or pathogenically related to CS.

Towards an Emergent Semantic Web

In his in uential article about the evolution of the Web, Berners-Lee [1] envisions a Semantic Web in which humans and computers alike are capable of understanding and processing information. This vision is yet to materialize. The main obstacle for the Semantic Web vision is that in today's Web meaning is rooted most often not in formal semantics, but in natural language and, in the sense of semiology, emerges not before interpretation and processing. Yet, an automated form of interpretation and processing can be tackled by precisiating raw natural language. To do that, Web agents extract fuzzy grassroots ontologies through induction from existing Web content. Inductive fuzzy grassroots ontologies thus constitute organically evolved knowledge bases that resemble automated gradual thesauri, which allow precisiating natural language [2]. The Web agents' underlying dynamic, self-organizing, and best-effort induction, enable a sub-syntactical bottom up learning of semiotic associations. Thus, knowledge is induced from the users' natural use of language in mutual Web interactions, and stored in a gradual, thesauri-like lexical-world knowledge database as a top-level ontology, eventually allowing a form of computing with words [3]. Since when computing with words the objects of computation are words, phrases and propositions drawn from natural languages, it proves to be a practical notion to yield emergent semantics for the Semantic Web. In the end, an improved understanding by computers on the one hand should upgrade human- computer interaction on the Web, and, on the other hand allow an initial version of human- intelligence amplification through the Web.

BPM software and process modelling languages in practice

IT has turned out to be a key factor for the purposes of gaining maturity in Business Process Management (BPM). This book presents a worldwide investigation that was conducted among companies from the ‘Forbes Global 2000’ list to explore the current usage of software throughout the BPM life cycle and to identify the companies’ requirements concerning process modelling. The responses from 130 companies indicate that, at the present time, it is mainly software for process description and analysis that is required, while process execution is supported by general software such as databases, ERP systems and office tools. The resulting complex system landscapes give rise to distinct requirements for BPM software, while the process modelling requirements can be equally satisfied by the most common languages (BPMN, UML, EPC).

Delivery of health care at the end of life in cancer patients of four swiss cantons a retrospective database study (SAKK 89/09)

Background The use of cancer related therapy in cancer patients at the end-of-life has increased over time in many countries. Given a lack of published Swiss data, the objective of this study was to describe delivery of health care during the last month before death of cancer patients. Methods Claims data were used to assess health care utilization of cancer patients (identified by cancer registry data of four participating cantons), deceased between 2006-2008. Primary endpoints were hospitalization rate and delivery of cancer related therapies during the last 30 days before death. Multivariate logistic regression assessed the explanatory value of patient and geographic characteristics. Results 3809 identified cancer patients were included. Hospitalization rate (mean 68.5%, 95%CI 67.0-69.9) and percentage of patients receiving anti-cancer drug therapies (ACDT, mean 14.5%, 95%CI 13.4-15.6) and radiotherapy (mean 7.7%, 95%CI 6.7-8.4) decreased with age. Canton of residence and insurance type status most significantly influenced the odds for hospitalization or receiving ACDT. Conclusions The intensity of cancer specific care showed substantial variation by age, cancer type, place of residence and insurance type status. This may be partially driven by cultural differences within Switzerland and the cantonal organization of the Swiss health care system.

Advances in Kartvelian Morphology and Syntax. Contributions to the festival of languages Bremen, 17 Sep to 7 Oct, 2009

Within the scope of Festival of Languages took place in 2009 the Conference Advances in Kartvelian Morphology and Syntax. Selected presentations are presented in this publication. The authors discuss topics such as anaphora in Svan, intonation in Georgien, pragmatics of subordinating clauses in Georgian, but also research on modern developments as SMS-communication in Georgian language area etc. DEUTSCH: Im Rahmen des Festivals der Sprachen fand im Jahre 2009 an der Universität Bremen die Tagung Advances in Kartvelian Morphology and Syntax statt. Ausgewählte Vorträge werden mit dieser Publikation vorgestellt. Die Autoren behandeln unter anderem Themen wie Ana-pher im Svanischen, Intonation im Georgischen, Pragmatik von Nebensätzen des Georgi-schen, aber auch Forschungen über moderne Entwicklungen wie die SMS-Kommunikation im georgischsprachigen Sprachraum usw. CONTENTS: NINO AMIRIDZE, TAMAR RESECK & MANANA TOPADZE GÄUMANN: Preface; KEVIN TUITE: The Kartvelian suffixal intransitive; MANANA KOBAIDZE: Towards the morphological and syntactical classification of Georgian verbs; RENÉ LACROIX: Origin of Sets I–II suffixes in South Caucasian through reanalysis; STAVROS SKOPETEAS & CAROLINE FÉRY: Prosodic cues for exhaustive interpretations: a production study on Georgian intonation; WINFRIED BOEDER: Anaphora in Svan; YASUHIRO KOJIMA : The position of rom and the pragmatics of subordinate clauses in Georgian; NATIA AMAGHLOBELI : Morphological aspects of Georgian SMS language.

Word Formation in South American Languages

This volume focuses on word formation processes in smaller and so far underrepresented indigenous languages of South America. The data for the analyses have been mainly collected in the field by the authors. The several language families described here, among them Arawakan, Takanan, and Guaycuruan, as well as language isolates, such as Yurakaré and Cholón, reflect the linguistic diversity of South America. Equally diverse are the topics addressed, relating to word formation processes like reduplication, nominal and verbal compounding, clitic compounding, and incorporation. The traditional notions of the processes are discussed critically with respect to their implementation in minor indigenous languages. The book is therefore not only of interest to readers with an Amerindian background but also to typologists and historical linguists, and it is a supplement to more theory-driven approaches to language and linguistics.

Treatment of iron deficiency with intravenous ferric carboxymaltose in general practice: a retrospective database study.

BACKGROUND Iron deficiency is a frequent problem in general practice. Oral supplementation may in some cases not be well tolerated or not be efficient. Intravenous ferric carboxymaltose may be an alternative for iron supplementation in general practice. The aim of the present study was to analyze the indications for and the efficacy of intravenous ferric carboxymaltose in a primary care center. METHODS We retropectively analyzed electronic data from 173 patients given intravenous ferric carboxymaltose between 2011 and 2013 in primary care center with 18 GPs in Bern, Switzerland. RESULTS Of all patients, 34% were treated intravenously due to an inappropriate increase in ferritin levels after oral therapy, 24% had side effects from oral treatment, 10% were treated intravenously due to the patients explicit wish, and in 39% of all cases, no obvious reason of intravenous instead of oral treatment could be found. Intravenous ferric carboxymaltose led to a significant increase in hemoglobin and serum ferritin levels. Side effects of intravenous treatment were found in 2% of all cases. CONCLUSION We conclude that treatment with intravenous ferric carboxymaltose is an efficient alternative for patients with iron deficiency in general practice, when oral products are not well tolarated or effective. As treatment with iron carboxymaltose is more expensive and potentially dangerous due to side effects, the indication should be placed with (more) care.