Validity of an arterial pressure waveform analysis device: does the puncture site play a role in the agreement with intermittent pulmonary artery catheter thermodilution measurements?

OBJECTIVE: The measurement of cardiac output is a key element in the assessment of cardiac function. Recently, a pulse contour analysis-based device without need for calibration became available (FloTrac/Vigileo, Edwards Lifescience, Irvine, CA). This study was conducted to determine if there is an impact of the arterial catheter site and to investigate the accuracy of this system when compared with the pulmonary artery catheter using the bolus thermodilution technique (PAC). DESIGN: Prospective study. SETTING: The operating room of 1 university hospital. PARTICIPANTS: Twenty patients undergoing cardiac surgery. INTERVENTIONS: CO was determined in parallel by the use of the Flotrac/Vigileo systems in the radial and femoral position (CO_rad and CO_fem) and by PAC as the reference method. Data triplets were recorded at defined time points. The primary endpoint was the comparison of CO_rad and CO_fem, and the secondary endpoint was the comparison with the PAC. MEASUREMENTS AND MAIN RESULTS: Seventy-eight simultaneous data recordings were obtained. The Bland-Altman analysis for CO_fem and CO_rad showed a bias of 0.46 L/min, precision was 0.85 L/min, and the percentage error was 34%. The Bland-Altman analysis for CO_rad and PAC showed a bias of -0.35 L/min, the precision was 1.88 L/min, and the percentage error was 76%. The Bland-Altman analysis for CO_fem and PAC showed a bias of 0.11 L/min, the precision was 1.8 L/min, and the percentage error was 69%. CONCLUSION: The FloTrac/Vigileo system was shown to not produce exactly the same CO data when used in radial and femoral arteries, even though the percentage error was close to the clinically acceptable range. Thus, the impact of the introduction site of the arterial catheter is not negligible. The agreement with thermodilution was low.

Key elements for, and indicators of, a successful transition: an international Delphi study.

PURPOSE: The purpose of this study was to reach an international consensus to determine what key elements should be part of a transition program and what indicators could be used to assess its success. METHODS: For this purpose, a Delphi study including an international panel of 37 experts was carried out. The study consisted of three rounds, with response rates ranging from 86.5% to 95%. At each round, experts were asked to assess key elements (defined as the most important elements for the task) and indicators (defined as quantifiable characteristics). At each round, panelists were contacted via e-mail explaining them the tasks to be done and giving them the Web link where to complete the questionnaire. At Round 3, each key element and indicator was assessed as essential, very important, important, accessory, or unnecessary. A 70% agreement was used as cutoff. RESULTS: At Round 3, more than 70% of panelists agreed on six key elements being essential, with one of them (Assuring a good coordination between pediatric and adult professionals) reaching an almost complete consensus (97%). Additionally, 11 more obtained more than 70% agreement when combined with the Very important category. Among indicators, only one (Patient not lost to follow-up) was considered almost unanimously (91%) as essential by the panelists and seven others also reached consensus when the Very important category was included. CONCLUSIONS: Using these results as a framework to develop guidelines at local, national, and international levels would allow better assessing and comparing transition programs.

Colombia y el transpacific partnership agreement

Colombia, a partir de 1990, inicia un plan de gobierno enfocado en la apertura económica, con estrategias que propugnaban por un cambio en el modelo económico a través de políticas como la reducción de aranceles a las importaciones y otra serie de medidas proteccionistas, flexibilización laboral, la reducción del papel del Estado para darle protagonismo al sector privado y procesos de privatización de empresas públicas En este entorno internacional se ha adquirido conciencia de que, en un mundo globalizado y cada vez más interdependiente, no puede haber espacio para “aventuras solitarias de Estados soberanos”, lo que justifica la proliferación de organizaciones multilaterales en América Latina y el Caribe en la última década. Recientemente Colombia ha mostrado su interés en entrar a formar parte de un bloque económico de gran relevancia a nivel internacional: el "Transpacific Partnership Agreement" (TPP); tratado integrado por: Canadá, Estados Unidos, México, Perú, Chile, Japón, Vietnam, Malasia, Singapur, Brunei, Australia y Nueva Zelanda, representando el 35% del PIB mundial y el 11% de la población. El presente trabajo pretende presentar una visión objetiva del TPP, generando el espacio para la libre interpretación de sus beneficios o perjuicios. Para ello, se analiza el estado actual del TPP con sus principales indicadores, su desempeño en los últimos años y las relaciones diplomáticas y los flujos comerciales entre Colombia y los países miembros del mismo.

Comparative analysis by protocol and key of seed storage behaviour of sixty Vietnamese tree species

Seed storage behaviour of 5 1 native and 9 introduced tree species in Vietnam was investigated using a brief protocol developed to aid biodiversity conservation in circumstances where little is known about the seeds. Of the 60 species, 34 appeared to show orthodox (Acacia auriculaeformis, Adenanthera pavonina, Afzelia xylocarpa, Bauhinia purpurea, Callistemon lanceolatus, Cananga odorata, Canarium nigrum, Cassia fistula, Cassia javanica, Cassia splendida, Chukrasia tabularis, Dalbergia bariaensis, Dialium cochinchinensis, Diospyros mollis, Diospyros mun, Dracuntomelon duperreanum, Erythrophleum fordii, Khaya senegalensis, Lagerstroemia speciosa, Leucaena leucocephala, Livistona cochinchinensis, Markhamia stipulata, Melaleuca cajuputi, Millettia ichthyotona, Peltophorum pterocarpum, Peltophorum tonkinensis, Pinus khasya, Pinus massoniana, Pinus merkusii, Pterocarpus macrocarpus, Sindora siamensis, Sophora tonkinense, Sterculia foetida, Swietenia macrophylla), 13 recalcitrant (Avicennia alba, Beilschmiedia roxburghiana, Caryota mitis, Dimocarpus sp., Diospyros malabarica, Dipterocarpus chartaceus, Dypsis pinnatifrons, Hopea odorata, Lithocarpus gigantophylla, Machilus odoratissimus, Melanorrhoea laccifera, Melanorrhea usitata, Syzygium cinereum) and 13 intermediate (Anisoptera cochinchinensis, Aphanamixis polystachya, Averrhoa carambola, Carissa carandas, Chrysopylum cainito, Cinnamomum camphora, Citrofortunella microcarpa, Citrus grandis var. grandis, Elaeis guineensis, Hydnocarpus anthelmintica, Madhuca floribunda, Manilkara achras, Mimusops elengi) seed storage behaviour. A double-criteria key to estimate likely seed storage behaviour showed good agreement with the above: the key can reduce the workload of seed storage behaviour identification considerably.

Motivation, rationale and key results from the GERBILS Saharan dust measurement campaign

The Geostationary Earth Radiation Budget Intercomparison of Longwave and Shortwave radiation (GERBILS) was an observational field experiment over North Africa during June 2007. The campaign involved 10 flights by the FAAM BAe-146 research aircraft over southwestern parts of the Sahara Desert and coastal stretches of the Atlantic Ocean. Objectives of the GERBILS campaign included characterisation of mineral dust geographic distribution and physical and optical properties, assessment of the impact upon radiation, validation of satellite remote sensing retrievals, and validation of numerical weather prediction model forecasts of aerosol optical depths (AODs) and size distributions. We provide the motivation behind GERBILS and the experimental design and report the progress made in each of the objectives. We show that mineral dust in the region is relatively non-absorbing (mean single scattering albedo at 550 nm of 0.97) owing to the relatively small fraction of iron oxides present (1–3%), and that detailed spectral radiances are most accurately modelled using irregularly shaped particles. Satellite retrievals over bright desert surfaces are challenging owing to the lack of spectral contrast between the dust and the underlying surface. However, new techniques have been developed which are shown to be in relatively good agreement with AERONET estimates of AOD and with each other. This encouraging result enables relatively robust validation of numerical models which treat the production, transport, and deposition of mineral dust. The dust models themselves are able to represent large-scale synoptically driven dust events to a reasonable degree, but some deficiencies remain both in the Sahara and over the Sahelian region, where cold pool outflow from convective cells associated with the intertropical convergence zone can lead to significant dust production.

Identifying key knowledge needs for evidence-based conservation of wild insect pollinators: a collaborative cross-sectoral exercise

In response to evidence of insect pollinator declines, organisations in many sectors, including the food and farming industry, are investing in pollinator conservation. They are keen to ensure that their efforts use the best available science. We convened a group of 32 ‘conservation practitioners’ with an active interest in pollinators and 16 insect pollinator scientists. The conservation practitioners include representatives from UK industry (including retail), environmental non-government organisations and nature conservation agencies. We collaboratively developed a long list of 246 knowledge needs relating to conservation of wild insect pollinators in the UK. We refined and selected the most important knowledge needs, through a three-stage process of voting and scoring, including discussions of each need at a workshop. We present the top 35 knowledge needs as scored by conservation practitioners or scientists. We find general agreement in priorities identified by these two groups. The priority knowledge needs will structure ongoing work to make science accessible to practitioners, and help to guide future science policy and funding. Understanding the economic benefits of crop pollination, basic pollinator ecology and impacts of pesticides on wild pollinators emerge strongly as priorities, as well as a need to monitor floral resources in the landscape.

Analysis of two-party salary negotiations: factos impeding a mutually-beneficial joint agreement

Business professionals were surveyed to explore both factors associated with negotiation propensity, as well as the strategies used by employees and employers in salary negotiations. The objective is to examine the factors that impede both pasties in reaching a mutually-beneficial joint agreement in salary negotiations. In order to achieve this objective, a review of the negotiations literature was conducted including both. Descriptive literature - present research finding and scientific theory which characterizes negotiation and examines the forces that determine it's course and outcome - as well as a review of the prescriptive literature - in order to develop practical advice given a description of hw negotiators behave. Research result show that, although there is general tendency for employers to leave room in the first offer for negotiation, employees rarely ask for more and generally accept the first offer. The sub-optimal outcome was partially a result of the employees' preferred strategies for negotiation salary: a soft approach focusing on compromised and maintaining the relationship. An analysis of the results combined with the literature explore, demonstrates that both parties exhibited a fixed-pie perspective, focusing on salary as the key issue, which impeded the search for integrative settlements and, mutually beneficial trade-offs.

Ex-post evaluation of the employment effects of a preferential trade agreement: methodological issues, illustrated with a reference to Chile

Includes bibliography

Experimental results on gravity driven fully condensing flows in vertical tubes, their agreement with theory, and their differences with shear driven flows' boundary-condition sensitivities

This doctoral thesis presents the experimental results along with a suitable synthesis with computational/theoretical results towards development of a reliable heat transfer correlation for a specific annular condensation flow regime inside a vertical tube. For fully condensing flows of pure vapor (FC-72) inside a vertical cylindrical tube of 6.6 mm diameter and 0.7 m length, the experimental measurements are shown to yield values of average heat transfer co-efficient, and approximate length of full condensation. The experimental conditions cover: mass flux G over a range of 2.9 kg/m2-s ≤ G ≤ 87.7 kg/m2-s, temperature difference ∆T (saturation temperature at the inlet pressure minus the mean condensing surface temperature) of 5 ºC to 45 ºC, and cases for which the length of full condensation xFC is in the range of 0 < xFC < 0.7 m. The range of flow conditions over which there is good agreement (within 15%) with the theory and its modeling assumptions has been identified. Additionally, the ranges of flow conditions for which there are significant discrepancies (between 15 -30% and greater than 30%) with theory have also been identified. The paper also refers to a brief set of key experimental results with regard to sensitivity of the flow to time-varying or quasi-steady (i.e. steady in the mean) impositions of pressure at both the inlet and the outlet. The experimental results support the updated theoretical/computational results that gravity dominated condensing flows do not allow such elliptic impositions.

Chow–Liu trees are sufficient predictive models for reproducing key features of functional networks of periictal EEG time-series

Seizure freedom in patients suffering from pharmacoresistant epilepsies is still not achieved in 20–30% of all cases. Hence, current therapies need to be improved, based on a more complete understanding of ictogenesis. In this respect, the analysis of functional networks derived from intracranial electroencephalographic (iEEG) data has recently become a standard tool. Functional networks however are purely descriptive models and thus are conceptually unable to predict fundamental features of iEEG time-series, e.g., in the context of therapeutical brain stimulation. In this paper we present some first steps towards overcoming the limitations of functional network analysis, by showing that its results are implied by a simple predictive model of time-sliced iEEG time-series. More specifically, we learn distinct graphical models (so called Chow–Liu (CL) trees) as models for the spatial dependencies between iEEG signals. Bayesian inference is then applied to the CL trees, allowing for an analytic derivation/prediction of functional networks, based on thresholding of the absolute value Pearson correlation coefficient (CC) matrix. Using various measures, the thus obtained networks are then compared to those which were derived in the classical way from the empirical CC-matrix. In the high threshold limit we find (a) an excellent agreement between the two networks and (b) key features of periictal networks as they have previously been reported in the literature. Apart from functional networks, both matrices are also compared element-wise, showing that the CL approach leads to a sparse representation, by setting small correlations to values close to zero while preserving the larger ones. Overall, this paper shows the validity of CL-trees as simple, spatially predictive models for periictal iEEG data. Moreover, we suggest straightforward generalizations of the CL-approach for modeling also the temporal features of iEEG signals.

Ordered water molecules as key allosteric mediators in a cooperative dimeric hemoglobin

One of the most remarkable structural aspects of Scapharca dimeric hemoglobin is the disruption of a very well-ordered water cluster at the subunit interface upon ligand binding. We have explored the role of these crystallographically observed water molecules by site-directed mutagenesis and osmotic stress techniques. The isosteric mutation of Thr-72 → Val in the interface increases oxygen affinity more than 40-fold with a surprising enhancement of cooperativity. The only significant structural effect of this mutation is to destabilize two ordered water molecules in the deoxy interface. Wild-type Scapharca hemoglobin is strongly sensitive to osmotic conditions. Upon addition of glycerol, striking changes in Raman spectrum of the deoxy form are observed that indicate a transition toward the liganded form. Increased osmotic pressure, which lowers the oxygen affinity in human hemoglobin, raises the oxygen affinity of Scapharca hemoglobin regardless of whether the solute is glycerol, glucose, or sucrose. Analysis of these results provides an estimate of six water molecules lost upon oxygen binding to the dimer, in good agreement with eight predicted from crystal structures. These experiments suggest that the observed cluster of interfacial water molecules plays a crucial role in communication between subunits.

The Role of Market Mechanisms in a Post-2020 Climate Change Agreement. CEPS Special Report No. 87/May 2014

This special report is intended to serve as a background briefing document for the European Climate Platform seminar on Carbon Markets in the 2015 Agreement: Role and Architecture, but also raises issues of more enduring relevance in the wider debate about market mechanisms and the next climate change agreement. The paper looks at the relationship between the carbon market and a new climate change agreement, to be finalised in Paris in 2015. It tries to answer two key questions: does the carbon market have a role to play in a post-2020 agreement, and what is the role of a post-2020 agreement in the creation and operation of a carbon market? Introduction. The world has changed in many ways since 1997 when the Kyoto Protocol was adopted, along some critical axes, both from an economic and emissions points of view. Moreover, and this cannot be quantified, the appetite for global governance, especially for an agreement with such far-reaching implications as a climate change agreement, has diminished considerably. This paper looks at the relationship between the carbon market and a new climate change agreement, to be finalised in Paris in 2015. It tries to answer two key questions: does the carbon market have a role to play in a post-2020 agreement, and what is the role of a post-2020 agreement in the creation and operation of a carbon market?

Low key but not low impact: the results of the EU's 'transition' summit. EPC Post-Summit Analysis, 27 October 2014

The European Council Summit of 23-24 October 2014 may have been relatively low key, but many important decisions were made which could encourage historical changes. In this post-summit analysis, Janis A. Emmanouilidis examines the agreement reached on a new climate and energy policy framework for 2020-2030 which despite falling short of the European Commission’s original proposals, it nevertheless delivers a positive message to international community ahead of the global climate negotiations next year. He also highlights the significance of the request from euro-zone leaders for a new report on ‘better economic governance’ by December. More broadly, he uses this moment of transition in the EU’s leadership to analyse the current state and future direction of the Union, and underlines the need to provide a coherent and holistic response to the damage caused by the crisis and the challenges facing the Union, on the basis of an ambitious but pragmatic ‘package deal’ – a new pact between EU governments, and between the Union and its citizens – to heal the divisions of recent years and restore public faith in the benefits of EU membership.

The prospects for the EU-Ukraine free trade agreement. OSW Commentary No. 94, 2012-10-15

The European Union and Ukraine initialled the Deep and Comprehensive Free Trade Area Agreement (DCFTA) on 19 July 2012. The scope of the agreement which the EU and Ukraine reached following their negotiations is much more extensive than that of a typical free trade agreement. It envisages not only the lifting of tariff and extra-tariff barriers but also, more importantly, Kyiv adopting EU legal solutions and standards in this area. Whether the agreement will be signed and implemented is still an open question and depends on the existing political conditions. On the one hand, the repression imposed by the government in Kyiv on its political opponents (including the detention of the former prime minister, Yulia Tymoshenko) has provoked criticism from the EU, which refuses to sign the agreement if the government in Kyiv continues to violate democratic principles. The manner in which Ukraine’s parliamentary elections are conducted this October will be the key test. On the other hand, Russia is increasingly active in its efforts to involve Ukraine in the integration projects it has initiated (the Customs Union and the Eurasian Economic Community). It should be noted that Moscow has effective instruments to exert its will, such as the dependence of the Ukrainian economy on supplies of Russian oil and gas and on exports to the Russian market. Besides, Moscow also has political instruments at its disposal. It is impossible to participate in integration projects both with the EU and with Russia. Therefore, Kyiv will have to make a strategic decision and choose the direction of its economic integration. Unless Ukraine takes concrete action to implement its agreements with the EU, primarily including the free trade agreement, its economic dependence on Russia will grow, and it will be more likely to join the Russian integration projects.

A Plurilateral Agenda for Services? Assessing the case for a Trade in Services Agreement (TISA)

This paper explores a number of procedural and substantive considerations arising from ongoing attempts to craft a plurilateral Trade in Services Agreement (TISA) among the so-called “Really Good Friends of Services” coalition of WTO Members. The paper suggests that considerable scope exists to move forward a multilateral negotiating agenda on services that both the digital revolution and a continued surge of preferential rule-making has rendered increasingly obsolete. As the most significant attempt to date to craft a GATS Article V-compatible PTA in services, TISA offers considerable promise. The paper, however, cautions that the case for embedding TISA into the architecture of WTO rules alongside the General Agreement on Trade in Services or in its place is weak on both procedural and substantive grounds to the extent that the ongoing talks take place behind doors that remain closed even to the WTO Secretariat, let alone to many of the world’s leading developing country suppliers of services, and involve potentially significant departures from GATS rules liable to complicate any hoped for multilateral migratory journey. Key words: WTO, GATS, trade in services, plurilateral agreements, critical mass negotiations, preferential trade liberalization.