Development of a fully quantitative approach to the interpretation of stress echocardiography using radial and longitudinal myocardial velocities

Background: Tissue Doppler may be used to quantify regional left ventricular function but is limited by segmental variation of longitudinal velocity from base to apex and free to septal walls. We sought to overcome this by developing a composite of longitudinal and radial velocities. Methods and Results. We examined 82 unselected patients undergoing a standard dobutamine echocardiogram. Longitudinal velocity was obtained in the basal and mid segments of each wall using tissue Doppler in the apical views. Radial velocities were derived in the same segments using an automated border detection system and centerline method with regional chords grouped according to segment location and temporally averaged. In 25 patients at low probability of coronary disease, the pattern of regional variation in longitudinal velocity (higher in the septum) was the opposite of radial velocity (higher in the free wall) and the combination was homogenous. In 57 patients undergoing angiography, velocity in abnormal segments was less than normal segments using longitudinal (6.0 +/- 3.6 vs 9.0 +/- 2.2 cm/s, P = .01) and radial velocity (6.0 +/- 4.0 vs 8.0 +/- 3.9 cm/s, P = .02). However, the composite velocity permitted better separation of abnormal and normal segments (13.3 +/- 5.6 vs 17.5 +/- 4.2 cm/s, P = .001). There was no significant difference between the accuracy of this quantitative approach and expert visual wall motion analysis (81% vs 84%, P = .56). Conclusion: Regional variation of uni-dimensional myocardial velocities necessitates site-specific normal ranges, probably because of different fiber directions. Combined analysis of longitudinal and radial velocities allows the derivation of a composite velocity, which is homogenous in all segments and may allow better separation of normal and abnormal myocardium.

A conspiracy theory for clefts : the syntax and interpretation of cleft constructions

O objetivo final deste estudo é contribuir para a discussão sobre qual a medida em que conceitos semânticos e discursivos estão sintaticamente codificados. Mais especificamente, investiga-se se existe alguma correlação consistente entre alguns aspetos interpretativos e sintáticos de quatro construções clivadas do Português Europeu, e como se deve dar conta teoricamente destas potenciais correlações. As clivadas consideradas são as clivadas canónicas, as pseudoclivadas, as clivadas de é que e as clivadas de SER. Sintaticamente podemos distinguir dois tipos: clivadas bioracionais (canónicas e pseudoclivadas) e clivadas mono-oracionais (clivadas de é que e de SER). Todas as estruturas têm um constituinte clivado focalizado que pode constituir tanto um foco informacional como um foco contrastivo, e uma oração clivada que introduz uma pressuposição existencial. Adicionalmente, o constituinte clivado identifica exaustivamente uma posição vazia na oração clivada. Adota-se a semântica alternativa para o foco (Rooth 1985), segundo a qual o foco entoacional contribui uniformemente um conjunto de alternativas na Forma Lógica. Regras pragmáticas operando neste conjunto dão origem a duas implicaturas que podem ser suspensas: pressuposição existencial e exaustividade. Dado que as clivadas de é que e as de SER têm a mesma interpretação que orações não-clivadas, conclui-se que a sua estrutura sintática particular não contribui para estas propriedades interpretativas. Em contrapartida, as clivadas bioracionais, que são orações copulativas especificacionais, têm uma presuposição existencial e uma interpretação exaustiva que não pode ser suspensa, tal como as orações especificacionais não-clivadas. Argumenta-se que isto se deve ao facto de o constituinte clivado identificar uma variável introduzida por uma descrição definida. Demonstra-se que a oração clivada, uma relativa em posição de complemento de um determinador definido nas clivadas canónicas e uma relativa livre nas pseudoclivadas, tem a mesma denotação que um DP definido, e portanto tem uma pressuposição existencial inerente. A interpretação exaustiva deve-se à relação identificacional entre o constituinte clivado e a descrição definida. Além disso, defende-se que em Português Europeu um traço de foco não desencadeia movimento-A’ para um FocP especializado. Os constituintes focalizados movem-se antes por razões independentes do foco. Isto é confirmado pelo facto de apenas o constituinte clivado das clivadas de é que ter propriedades de movimento A’, os outros parecem estar in situ. Propõe-se que o constituinte clivado das clivadas de é que é um tópico com um traço de foco que se move para um TopP. Esta análise dá conta da existência de restrições discursivas semelhantes para tópicos não focalizados e para o constituinte clivado das clivadas de é que. O traço quantificacional de foco arrastado pela topicalização dá origem a efeitos de intervenção, causando a não-recursividade do foco na periferia esquerda e a sua incompatibilidade com movimento de outros constituintes com traços quantificacionais. A análise prediz as restrições de encaixe observadas para as clivadas de é que. Finalmente, desenvolve-se uma análise sintática das clivadas de SER que aproxima estas estruturas das estruturas com partículas de foco. Propõe-se que a cópula é um operador sensível ao foco que é merged juntamente com o constituinte clivado. As restrições distribucionais da cópula devem-se a requisitos selecionais de núcleos.

Context-dependent interpretation of the prognostic value of BRAF and KRAS mutations in colorectal cancer.

BACKGROUND: The mutation status of the BRAF and KRAS genes has been proposed as prognostic biomarker in colorectal cancer. Of them, only the BRAF V600E mutation has been validated independently as prognostic for overall survival and survival after relapse, while the prognostic value of KRAS mutation is still unclear. We investigated the prognostic value of BRAF and KRAS mutations in various contexts defined by stratifications of the patient population. METHODS: We retrospectively analyzed a cohort of patients with stage II and III colorectal cancer from the PETACC-3 clinical trial (N = 1,423), by assessing the prognostic value of the BRAF and KRAS mutations in subpopulations defined by all possible combinations of the following clinico-pathological variables: T stage, N stage, tumor site, tumor grade and microsatellite instability status. In each such subpopulation, the prognostic value was assessed by log rank test for three endpoints: overall survival, relapse-free survival, and survival after relapse. The significance level was set to 0.01 for Bonferroni-adjusted p-values, and a second threshold for a trend towards statistical significance was set at 0.05 for unadjusted p-values. The significance of the interactions was tested by Wald test, with significance level of 0.05. RESULTS: In stage II-III colorectal cancer, BRAF mutation was confirmed a marker of poor survival only in subpopulations involving microsatellite stable and left-sided tumors, with higher effects than in the whole population. There was no evidence for prognostic value in microsatellite instable or right-sided tumor groups. We found that BRAF was also prognostic for relapse-free survival in some subpopulations. We found no evidence that KRAS mutations had prognostic value, although a trend was observed in some stratifications. We also show evidence of heterogeneity in survival of patients with BRAF V600E mutation. CONCLUSIONS: The BRAF mutation represents an additional risk factor only in some subpopulations of colorectal cancers, in others having limited prognostic value. However, in the subpopulations where it is prognostic, it represents a marker of much higher risk than previously considered. KRAS mutation status does not seem to represent a strong prognostic variable.

Aortic vessel wall magnetic resonance imaging at 3.0 Tesla: a reproducibility study of respiratory navigator gated free-breathing 3D black blood magnetic resonance imaging.

The purpose of this study was to evaluate a free-breathing three-dimensional (3D) dual inversion-recovery (DIR) segmented k-space gradient-echo (turbo field echo [TFE]) imaging sequence at 3T for the quantification of aortic vessel wall dimensions. The effect of respiratory motion suppression on image quality was tested. Furthermore, the reproducibility of the aortic vessel wall measurements was investigated. Seven healthy subjects underwent 3D DIR TFE imaging of the aortic vessel wall with and without respiratory navigator. Subsequently, this sequence with respiratory navigator was performed twice in 10 healthy subjects to test its reproducibility. The signal-to-noise (SNR), contrast-to-noise ratio (CNR), vessel wall sharpness, and vessel wall volume (VWV) were assessed. Data were compared using the paired t-test, and the reproducibility of VWV measurements was evaluated using intraclass correlation coefficients (ICCs). SNR, CNR, and vessel wall sharpness were superior in scans performed with respiratory navigator compared to scans performed without. The ICCs concerning intraobserver, interobserver, and interscan reproducibility were excellent (0.99, 0.94, and 0.95, respectively). In conclusion, respiratory motion suppression substantially improves image quality of 3D DIR TFE imaging of the aortic vessel wall at 3T. Furthermore, this optimized technique with respiratory motion suppression enables assessment of aortic vessel wall dimensions with high reproducibility.

Free and total GMP (glycomacropeptide) contents of milk during bovine lactation

Individual milk samples taken every two weeks from parturition to the end of lactation from 34 animals of three different herds and breeds were analyzed for free-GMP. A milk pool of each herd was analyzed for free and total GMP (released from k-casein by the action of rennin) and the data were correlated with sanitary conditions of animal and udder, phase of lactation and milk production. Most udder problems were concentrated near parturition, with few and spaced occurrences of clinical mastitis. The Californian Mastitis Test (CMT) results showed oscillations compatible with the phases of lactation period and environmental conditions. The widest variations in free-GMP occurred as a function of lactation period and as a consequence of clinical or subclinical mastitis. Higher levels were observed at the beginning of lactation (5.87mg L-1 of sialic acid), becoming normal with mean values of about 3.30mg L-1 at the end of the second month, and increasing again during the final third of lactation. On average, the same trends were observed for total GMP released by commercial rennet, beginning with slightly high values (35.59mg L-1), becoming normal by the sixth month with values close to 27.15mg L-1, and rising gradually up to the end of lactation, with 58.35mg L-1 of sialic acid. These results prove to be useful for the correct interpretation of tests applied to milk selection with respect to proteolytic status or even to restrain frauds by the addition of whey to milk.

Nietzsche's will-to-power ontology : an interpretation of Beyond Good and Evil

Abstract: Nietzsche's Will-to-Power Ontology: An Interpretation of Beyond Good and Evil § 36 By: Mark Minuk Will-to-power is the central component of Nietzsche's philosophy, and passage 36 of Beyond Good and Evil is essential to coming to an understanding of it. 1 argue for and defend the thesis that will-to-power constitutes Nietzsche's ontology, and offer a new understanding of what that means. Nietzsche's ontology can be talked about as though it were a traditional substance ontology (i.e., a world made up of forces; a duality of conflicting forces described as 'towards which' and 'away from which'). However, 1 argue that what defines this ontology is an understanding of valuation as ontologically fundamental—^the basis of interpretation, and from which a substance ontology emerges. In the second chapter, I explain Nietzsche's ontology, as reflected in this passage, through a discussion of Heidegger's two ontological categories in Being and Time (readiness-to-hand, and present-at-hand). In a nutshell, it means that the world of our desires and passions (the most basic of which is for power) is ontologically more fundamental than the material world, or any other interpretation, which is to say, the material world emerges out of a world of our desires and passions. In the first chapter, I address the problematic form of the passage reflected in the first sentence. The passage is in a hypothetical style makes no claim to positive knowledge or truth, and, superficially, looks like Schopenhaurian position for the metaphysics of the will, which Nietzsche rejects. 1 argue that the hypothetical form of the passage is a matter of style, namely, the style of a free-spirit for whom the question of truth is reframed as a question of values. In the third and final chapter, 1 address the charge that Nietzsche's interpretation is a conscious anthropomorphic projection. 1 suggest that the charge rests on a distinction (between nature and man) that Nietzsche rejects. I also address the problem of the causality of the will for Nietzsche, by suggesting that an alternative, perspectival form of causality is possible.

The voters of Colombia are free?

A fundamental principle of democracy is citizenship freedom. We suggest that a fair electoral contest is possible if a relationship between free will, electoral preferences and respect to the public institutions (constitutionalism) (section 1) exists. We focus on three illiberal practices that perturb the voter's decision: political clientelism and political markets (sections 2 to 4), media influence (which feeds on the voter's limited rationality and limited information) (section 5), and the suppression of opposition options (section 6). Later (section 8), we provide a brief balance and, additionally, we show how in Colombia the political system has missed opportunities to expand the voters' freedom. Our interpretation of the electoral process in Colombia is an appeal, supported on theoretical arguments and empirical evidence, to doubt about the voters' freedom. Also we make a call for more etudies.

Cats about town: is predation by free-ranging pet cats Felis catus likely to affect urban bird populations?

Even though they are fed daily by their owners, free-ranging pet cats Felis catus may kill wild birds and, given their high densities (typically > 200 cats/km(2)), it has been postulated that cat predation could be a significant negative factor affecting the dynamics of urban bird populations. In this study, we: (1) used questionnaire surveys in 10 sites within the city of Bristol, UK, to estimate cat density; (2) estimated the number of birds killed annually in five sites by asking cat owners to record prey animals returned home; and then (3) compared the number of birds killed with breeding density and productivity to estimate the potential impact of cat predation. In addition, we (4) compared the condition of those birds killed by cats versus those killed in collisions, e.g. window strikes. Mean (+/- sd) cat density was 348 +/- 86 cats/km(2) (n = 10 sites); considering the eight species most commonly taken by cats, the mean ratios of adult birds/cats and juvenile birds/cats across the five sites were 1.17 +/- 0.23 and 3.07 +/- 0.74, respectively. Approximately 60% of the cats studied for up to 1 year at each site never returned any prey home; despite this, the estimated number of birds killed was large relative to their breeding density and productivity in many sites. Across species, cat-killed birds were in significantly poorer condition than those killed following collisions; this is consistent with the notion that cat predation represents a compensatory rather than additive form of mortality. Interpretation of these results is, however, complicated by patterns of body mass regulation in passerines. The predation rates estimated in this study would suggest that cats were likely to have been a major cause of mortality for some species of birds. The effect of cat predation in urban landscapes therefore warrants further investigation. The potential limitations of the current study are discussed, along with suggestions for resolving them.

Glycogen phosphorylase inhibitors: a free energy perturbation analysis of glucopyranose spirohydantoin analogues

GP catalyzes the phosphorylation of glycogen to Glc-1-P. Because of its fundamental role in the metabolism of glycogen, GP has been the target for a systematic structure-assisted design of inhibitory compounds, which could be of value in the therapeutic treatment of type 2 diabetes mellitus. The most potent catalytic-site inhibitor of GP identified to date is spirohydantoin of glucopyranose (hydan). In this work, we employ MD free energy simulations to calculate the relative binding affinities for GP of hydan and two spirohydantoin analogues, methyl-hydan and n-hydan, in which a hydrogen atom is replaced by a methyl- or amino group, respectively. The results are compared with the experimental relative affinities of these ligands, estimated by kinetic measurements of the ligand inhibition constants. The calculated binding affinity for methyl-hydan (relative to hydan) is 3.75 +/- 1.4 kcal/mol, in excellent agreement with the experimental value (3.6 +/- 0.2 kcal/mol). For n-hydan, the calculated value is 1.0 +/- 1.1 kcal/mol, somewhat smaller than the experimental result (2.3 +/- 0.1 kcal/mol). A free energy decomposition analysis shows that hydan makes optimum interactions with protein residues and specific water molecules in the catalytic site. In the other two ligands, structural perturbations of the active site by the additional methyl- or amino group reduce the corresponding binding affinities. The computed binding free energies are sensitive to the preference of a specific water molecule for two well-defined positions in the catalytic site. The behavior of this water is analyzed in detail, and the free energy profile for the translocation of the water between the two positions is evaluated. The results provide insights into the role of water molecules in modulating ligand binding affinities. A comparison of the interactions between a set of ligands and their surrounding groups in X-ray structures is often used in the interpretation of binding free energy differences and in guiding the design of new ligands. For the systems in this work, such an approach fails to estimate the order of relative binding strengths, in contrast to the rigorous free energy treatment.

Implications of non-cylindrical flux ropes for magnetic cloud reconstruction techniques and the interpretation of double flux rope events

Magnetic clouds (MCs) are a subset of interplanetary coronal mass ejections (ICMEs) which exhibit signatures consistent with a magnetic flux rope structure. Techniques for reconstructing flux rope orientation from single-point in situ observations typically assume the flux rope is locally cylindrical, e.g., minimum variance analysis (MVA) and force-free flux rope (FFFR) fitting. In this study, we outline a non-cylindrical magnetic flux rope model, in which the flux rope radius and axial curvature can both vary along the length of the axis. This model is not necessarily intended to represent the global structure of MCs, but it can be used to quantify the error in MC reconstruction resulting from the cylindrical approximation. When the local flux rope axis is approximately perpendicular to the heliocentric radial direction, which is also the effective spacecraft trajectory through a magnetic cloud, the error in using cylindrical reconstruction methods is relatively small (≈ 10∘). However, as the local axis orientation becomes increasingly aligned with the radial direction, the spacecraft trajectory may pass close to the axis at two separate locations. This results in a magnetic field time series which deviates significantly from encounters with a force-free flux rope, and consequently the error in the axis orientation derived from cylindrical reconstructions can be as much as 90∘. Such two-axis encounters can result in an apparent ‘double flux rope’ signature in the magnetic field time series, sometimes observed in spacecraft data. Analysing each axis encounter independently produces reasonably accurate axis orientations with MVA, but larger errors with FFFR fitting.

Choice-induced preference change in the free-choice paradigm: a critical methodological review

Choices not only reflect our preference, but they also affect our behavior. The phenomenon of choice-induced preference change has been of interest to cognitive dissonance researchers in social psychology, and more recently, it has attracted the attention of researchers in economics and neuroscience. Preference modulation after the mere act of making a choice has been repeatedly demonstrated over the last 50 years by an experimental paradigm called the “free-choice paradigm.” However, Chen and Risen (2010) pointed out a serious methodological flaw in this paradigm, arguing that evidence for choice-induced preference change is still insufficient. Despite the flaw, studies using the traditional free-choice paradigm continue to be published without addressing the criticism. Here, aiming to draw more attention to this issue, we briefly explain the methodological problem, and then describe simple simulation studies that illustrate how the free-choice paradigm produces a systematic pattern of preference change consistent with cognitive dissonance, even without any change in true preference. Our stimulation also shows how a different level of noise in each phase of the free-choice paradigm independently contributes to the magnitude of artificial preference change. Furthermore, we review ways of addressing the critique and provide a meta-analysis to show the effect size of choice-induced preference change after addressing the critique. Finally, we review and discuss, based on the results of the stimulation studies, how the criticism affects our interpretation of past findings generated from the free-choice paradigm. We conclude that the use of the conventional free-choice paradigm should be avoided in future research and the validity of past findings from studies using this paradigm should be empirically re-established. (PsycINFO Database Record (c) 2013 APA, all rights reserved)(journal abstract)

The “pain matrix” in pain-free individuals

Human functional imaging provides a correlative picture of brain activity during pain. A particular set of central nervous system structures (eg, the anterior cingulate cortex, thalamus, and insula) consistently respond to transient nociceptive stimuli causing pain. Activation of this so-called pain matrix or pain signature has been related to perceived pain intensity, both within and between individuals,1,2 and is now considered a candidate biomarker for pain in medicolegal settings and a tool for drug discovery. The pain-specific interpretation of such functional magnetic resonance imaging (fMRI) responses, although logically flawed,3,4 remains pervasive. For example, a 2015 review states that “the most likely interpretation of activity in the pain matrix seems to be pain.”4 Demonstrating the nonspecificity of the pain matrix requires ruling out the presence of pain when highly salient sensory stimuli are presented. In this study, we administered noxious mechanical stimuli to individuals with congenital insensitivity to pain and sampled their brain activity with fMRI. Loss-of-function SCN9A mutations in these individuals abolishes sensory neuron sodium channel Nav1.7 activity, resulting in pain insensitivity through an impaired peripheral drive that leaves tactile percepts fully intact.5 This allows complete experimental disambiguation of sensory responses and painful sensations

Affine processes, arbitrage-Free Term structures of legendre polynomials,and option pricing

Multivariate Affine term structure models have been increasingly used for pricing derivatives in fixed income markets. In these models, uncertainty of the term structure is driven by a state vector, while the short rate is an affine function of this vector. The model is characterized by a specific form for the stochastic differential equation (SDE) for the evolution of the state vector. This SDE presents restrictions on its drift term which rule out arbitrages in the market. In this paper we solve the following inverse problem: Suppose the term structure of interest rates is modeled by a linear combination of Legendre polynomials with random coefficients. Is there any SDE for these coefficients which rules out arbitrages? This problem is of particular empirical interest because the Legendre model is an example of factor model with clear interpretation for each factor, in which regards movements of the term structure. Moreover, the Affine structure of the Legendre model implies knowledge of its conditional characteristic function. From the econometric perspective, we propose arbitrage-free Legendre models to describe the evolution of the term structure. From the pricing perspective, we follow Duffie et al. (2000) in exploring Legendre conditional characteristic functions to obtain a computational tractable method to price fixed income derivatives. Closing the article, the empirical section presents precise evidence on the reward of implementing arbitrage-free parametric term structure models: The ability of obtaining a good approximation for the state vector by simply using cross sectional data.

Free and total GMP (glycomacropeptide) contents of milk during bovine lactation

Amostras quinzenais, desde o parto até o final do período de lactação, obtidas de 34 vacas de três diferentes raças e propriedades, foram analisadas quanto à presença de GMP livre. Um pool das amostras quinzenais de cada rebanho foi analisada tanto para o conteúdo de GMP livre quanto para o GMP total (liberado da k-caseína pela ação da renina), correlacionando-os com as condições sanitárias do animal e do úbere, à fase da lactação e à produção de leite. A maioria dos problemas sanitários concentrou-se próximo ao parto, com poucas e espaçadas ocorrências de mastites clínicas. Os resultados do teste de CMT mostraram reações compatíveis às fases da lactação. Para o GMP livre as maiores variações ocorreram em função do período de lactação e em conseqüência de mastites clínicas e subclínicas. Valores elevados foram observados no início da lactação (5,87mg de ácido siálico/L de leite), normalizando para valores próximos de 3,30mg/L já ao final do segundo mês e voltando a elevar-se no terço final da lactação. em média, as mesmas tendências foram observadas para o teor de GMP total liberado pela ação de coalho comercial, iniciando com valores ligeiramente elevados (35,59mg/L), tornando-se normal e assim se mantendo até o sexto mês com valores próximos a 27,15mg/L, e novamente elevando-se gradualmente até o final da lactação, com 58,35mg de ácido siálico/L de leite. Esses resultados mostram-se úteis para a correta interpretação de métodos aplicados à seleção do leite, seja em relação ao status proteolítico da matéria-prima ou mesmo para coibição de fraudes por adição de soro ao leite.

The acid-base impact of free water removal from, and addition to, plasma

Water, compared with plasma at a pH of 7.4, is a weak acid. The addition of free water to a patient should have an acidifying effect (dilutional acidosis) and the removal of it, an alkalinizing effect (concentrational alkalosis). The specific effects of free water loss or gain in a relatively complex fluid such as plasma has, to the authors' knowledge, not been reported. This information would be useful in the interpretation of the effect of changes in free water in patients. Plasma samples from goats were either evaporated in a tonometer to 80% of baseline volume or hydrated by the addition of distilled water to 120% of baseline volume. The pH and partial pressure of carbon dioxide, sodium, potassium, ionized calcium, chloride, lactate, phosphorous, albumin, and total protein concentrations were measured. Actual base excess (ABE), standard bicarbonate, anion gap, strong ion difference, strong ion gap, unmeasured anions, and the effects of sodium, chloride, phosphate, and albumin changes on ABE were calculated. Most parameters changed 20% in proportion to the magnitude of dehydration or hydration. Bicarbonate concentration, however, increased only 11% in the evaporation trial and decreased only -2% in the dehydration trial. The evaporation trial was associated with a mild, but significant, metabolic alkalotic effect (ABE increased 3.2 mM/L), whereas the hydration trial was associated with a slight, insignificant metabolic acidotic effect (ABE decreased only 0.6 mM/L). The calculated free water ABE effect (change in sodium concentration) was offset by opposite changes in calculated chloride, lactate, phosphate, and albumin ABE effects.