Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia: 12-month results from the IN.PACT DEEP randomized trial.

BACKGROUND Drug-eluting balloons (DEB) may reduce infrapopliteal restenosis and reintervention rates versus percutaneous transluminal angioplasty (PTA) and improve wound healing/limb preservation. OBJECTIVES The goal of this clinical trial was to assess the efficacy and safety of IN.PACT Amphirion drug-eluting balloons (IA-DEB) compared to PTA for infrapopliteal arterial revascularization in patients with critical limb ischemia (CLI). METHODS Within a prospective, multicenter, randomized, controlled trial with independent clinical event adjudication and angiographic and wound core laboratories 358 CLI patients were randomized 2:1 to IA-DEB or PTA. The 2 coprimary efficacy endpoints through 12 months were clinically driven target lesion revascularization (CD-TLR) and late lumen loss (LLL). The primary safety endpoint through 6 months was a composite of all-cause mortality, major amputation, and CD-TLR. RESULTS Clinical characteristics were similar between the 2 groups. Significant baseline differences between the IA-DEB and PTA arms included mean lesion length (10.2 cm vs. 12.9 cm; p = 0.002), impaired inflow (40.7% vs. 28.8%; p = 0.035), and previous target limb revascularization (32.2% vs. 21.8%; p = 0.047). Primary efficacy results of IA-DEB versus PTA were CD-TLR of 9.2% versus 13.1% (p = 0.291) and LLL of 0.61 ± 0.78 mm versus 0.62 ± 0.78 mm (p = 0.950). Primary safety endpoints were 17.7% versus 15.8% (p = 0.021) and met the noninferiority hypothesis. A safety signal driven by major amputations through 12 months was observed in the IA-DEB arm versus the PTA arm (8.8% vs. 3.6%; p = 0.080). CONCLUSIONS In patients with CLI, IA-DEB had comparable efficacy to PTA. While primary safety was met, there was a trend towards an increased major amputation rate through 12 months compared to PTA. (Study of IN.PACT Amphirion™ Drug Eluting Balloon vs. Standard PTA for the Treatment of Below the Knee Critical Limb Ischemia [INPACT-DEEP]; NCT00941733).

Von Fuzzy-Sets zu Computing-with-Words

Dieser Artikel bietet einen Überblick über die Entwicklung und Zusammenhänge der einzelnen Elemente der Fuzzy-Logik, wovon Fuzzy-Set-Theorie die Grundlage bildet. Die Grundproblematik besteht in der Handhabung von linguistischen Informationen, die häufig durch Ungenauigkeit gekennzeichnet sind. Die verschiedenen technischen Anwendungen von Fuzzy-Logik bieten eine Möglichkeit, intelligentere Computersysteme zu konstruieren, die mit unpräzisen Informationen umgehen können. Solche Systeme sind Indizien für die Entstehung einer neuen Ära des Cognitive-Computing, di in diesemArtikel ebenfalls zur Sprache kommt. Für das bessere Verständnis wird der Artikel mit einem Beispiel aus der Meteorologie (d. h. Schnee in Adelboden) begleitet.

Consciousness and choking in visually-guided actions

Choking under pressure describes the phenomenon of people performing well below their expected standard under circumstances where optimal performance is crucial. One of the prevailing explanations for choking is that pressure increases the conscious attention to the underlying processes of the performer's task execution, thereby disrupting what would normally be a relatively automatic process. However, research on choking has focused mainly on the influence of pressure on motor performance, typically overlooking how it might alter the way that vision is controlled when performing these motor actions. In this article we ask whether the visual component of expert motor-skill execution is susceptible to choking much like the motor component is thought to be. To do so, we draw heavily on empirical findings from studies of sporting expertise, in particular focussing on the role of gaze in three types of visually-guided actions: interceptive actions, aiming tasks, and anticipatory skill. For each of these skills we evaluate the nature of the expert advantage, discuss the role of consciousness in their control, examine the potential impact of pressure on task performance, and consider interventions designed to reduce the likelihood of choking when performing these tasks

Cognitive Cities: An Application for Nairobi. Text Message Participation of Slum Inhabitants to Improve Sanitary Facilities

Population growth is always increasing, and thus the concept of smart and cognitive cities is becoming more important. Developed countries are aware of and working towards needed changes in city management. However, emerging countries require the optimization of their own city management. This chapter illustrates, based on a use case, how a city in an emerging country can quickly progress using the concept of smart and cognitive cities. Nairobi, the capital of Kenya, is chosen for the test case. More than half of the population of Nairobi lives in slums with poor sanitation, and many slum inhabitants often share a single toilet, so the proper functioning and reliable maintenance of toilets are crucial. For this purpose, an approach for processing text messages based on cognitive computing (using soft computing methods) is introduced. Slum inhabitants can inform the responsible center via text messages in cases when toilets are not functioning properly. Through cognitive computer systems, the responsible center can fix the problem in a quick and efficient way by sending repair workers to the area. Focusing on the slum of Kibera, an easy-to-handle approach for slum inhabitants is presented, which can make the city more efficient, sustainable and resilient (i.e., cognitive).

Synchronizing Mind Maps with Fuzzy Cognitive Maps for Decision-Finding in Cognitive Cities

Synchronizing mind maps with fuzzy cognitive maps can help to handle complex problems with many involved stakeholders by taking advantage of human creativity. The proposed approach has the capacity to instantiate cognitive cities by including cognitive computing. A use case in the context of decision-finding (concerning a transportation system) is presented to illustrate the approach.

Longitudinal extension of myelomalacia by intramedullary and subdural hemorrhage in a canine model of spinal cord injury

BACKGROUND CONTEXT In canine intervertebral disc (IVD) extrusion, a spontaneous animal model of spinal cord injury, hemorrhage is a consistent finding. In rodent models, hemorrhage might be involved in secondary tissue destruction by biochemical mechanisms. PURPOSE This study aimed to investigate a causal association between the extents of intramedullary, subdural and epidural hemorrhage and the severity of spinal cord damage following IVD extrusion in dogs. STUDY DESIGN/SETTING A retrospective study using histologic spinal cord sections from 83 dogs euthanized following IVD extrusion was carried out. METHODS The degree of hemorrhage (intramedullary, subdural, epidural), the degree of spinal cord damage in the epicenter (white and gray matter), and the longitudinal extent of myelomalacia were graded. Associations between the extent of hemorrhage and the degree of spinal cord damage were evaluated statistically. RESULTS Intramedullary and subdural hemorrhages were significantly associated with the degree of white (p<.001/ p=.004) and gray (both p<.001) matter damage, and with the longitudinal extension of myelomalacia (p<.001/p=.005). Intriguingly, accumulation of hemorrhagic cord debris inside or dorsal to a distended and ruptured central canal in segments distant to the epicenter of the lesion was observed exhibiting a wave-like pattern on longitudinal assessment. The occurrence of this debris accumulation was associated with high degrees of tissue destruction (all p<.001). CONCLUSIONS Tissue liquefaction and increased intramedullary pressure associated with hemorrhage are involved in the progression of spinal cord destruction in a canine model of spinal cord injury and ascending or descending myelomalacia. Functional and dynamic studies are needed to investigate this concept further.

Standard model cross-over on the lattice

With the physical Higgs mass the standard model symmetry restoration phase transition is a smooth cross-over. We study the thermodynamics of the cross-over using numerical lattice Monte Carlo simulations of an effective SU(2)×U(1) gauge+Higgs theory, significantly improving on previously published results. We measure the Higgs field expectation value, thermodynamic quantities like pressure, energy density, speed of sound and heat capacity, and screening masses associated with the Higgs and Z fields. While the cross-over is smooth, it is very well defined with a width of only ∼5  GeV. We measure the cross-over temperature from the maximum of the susceptibility of the Higgs condensate, with the result Tc=159.5±1.5  GeV. Outside of the narrow cross-over region the perturbative results agree well with nonperturbative ones.

Personal Digital Assistant 2.0 - A Software Prototype for Cognitive Cities

This paper presents a software prototype of a personal digital assistant 2.0. Based on soft computing methods and cognitive computing this mobile application prototype improves calendar and mobility management in cognitive cities. Applying fuzzy cognitive maps and evolutionary algorithms, the prototype represents a next step towards the realization of cognitive cities (i.e., smart cities enhanced with cognition). A user scenario and a test version of the prototype are included for didactical reasons.

The Five Senses in Medieval and Early Modern England

Edited by Annette Kern-Stähler, Beatrix Busse, and Wietse de Boer The essays collected in The Five Senses in Medieval and Early Modern England examine the interrelationships between sense perception and secular and Christian cultures in England from the medieval into the early modern periods. They address canonical texts and writers in the fields of poetry, drama, homiletics, martyrology and early scientific writing, and they espouse methods associated with the fields of corpus linguistics, disability studies, translation studies, art history and archaeology, as well as approaches derived from traditional literary studies. Together, these papers constitute a major contribution to the growing field of sensorial research that will be of interest to historians of perception and cognition as well as to historians with more generalist interests in medieval and early modern England.

Impact of Taylor-Aris diffusivity on analyte and system zone dispersion in CZE assessed by computer simulation and experimental validation.

Application of pressure-driven laminar flow has an impact on zone and boundary dispersion in open tubular CE. The GENTRANS dynamic simulator for electrophoresis was extended with Taylor-Aris diffusivity which accounts for dispersion due to the parabolic flow profile associated with pressure-driven flow. Effective diffusivity of analyte and system zones as functions of the capillary diameter and the amount of flow in comparison to molecular diffusion alone were studied for configurations with concomitant action of imposed hydrodynamic flow and electroosmosis. For selected examples under realistic experimental conditions, simulation data are compared with those monitored experimentally using modular CE setups featuring both capacitively coupled contactless conductivity and UV absorbance detection along a 50 μm id fused-silica capillary of 90 cm total length. The data presented indicate that inclusion of flow profile based Taylor-Aris diffusivity provides realistic simulation data for analyte and system peaks, particularly those monitored in CE with conductivity detection.

Enhanced Knowledge Management by Synchronizing Mind Maps and Fuzzy Cognitive Maps

This paper presents a conceptual approach to enhance knowledge management by synchronizing mind maps and fuzzy cognitive maps. The use of mind maps allows taking advantage of human creativity, while the application of fuzzy cognitive maps enables to store information expressed in natural language. By applying cognitive computing, it makes possible to gather and extract relevant information out of a data pool. Therefore, this approach is supposed to give a framework that enhances knowledge management. To demonstrate the potential of this framework, a use case concerning the development of a smart city app is presented.