Prevalence of Acute Coronary Syndrome in Patients Suspected for Pulmonary Embolism or Acute Aortic Syndrome: Rationale for the Triple Rule-out Concept.

BACKGROUND: The aims of the study were to evaluate the prevalence of acute coronary syndrome (ACS) among patients presenting with atypical chest pain who are evaluated for acute aortic syndrome (AAS) or pulmonary embolism (PE) with computed tomoangiography (CTA) and discuss the rationale for the use of triple rule-out (TRO) protocol for triaging these patients. METHODS: This study is a retrospective analysis of patients presenting with atypical chest pain and evaluated with thoracic (CTA), for suspicion of AAS/PE. Two physicians reviewed patient files for demographic characteristics, initial CT and final clinical diagnosis. Patients were classified according to CTA finding into AAS, PE and other diagnoses and according to final clinical diagnosis into AAS, PE, ACS and other diagnoses. RESULTS: Four hundred and sixty-seven patients were evaluated: 396 (84.8%) patients for clinical suspicion of PE and 71 (15.2%) patients for suspicion of AAS. The prevalence of ACS and AAS was low among the PE patients: 5.5% and 0.5% respectively (P = 0.0001), while the prevalence of ACS and PE was 18.3% and 5.6% among AAS patients (P = 0.14 and P = 0.34 respectively). CONCLUSION: The prevalence of ACS and AAS among patients suspected clinically of having PE is limited while the prevalence of ACS and PE among patients suspected clinically of having AAS is significant. Accordingly patients suspected for PE could be evaluated with dedicated PE CTA while those suspected for AAS should still be triaged using TRO protocol.

Studying the non-thermal lobes of IRAS 16547-4247 through a multi-wavelength approach

In recent years, massive protostars have turned out to be a possible population of high-energy emitters. Among the best candidates is IRAS 16547-4247, a protostar that presents a powerful outflow with clear signatures of interaction with its environment. This source has been revealed to be a potential high-energy source because it displays non-thermal radio emission of synchrotron origin, which is evidence of relativistic particles. To improve our understanding of IRAS 16547-4247 as a high-energy source, we analyzed XMM-Newton archival data and found that IRAS 16547-4247 is a hard X-ray source. We discuss these results in the context of a refined one-zone model and previous radio observations. From our study we find that it may be difficult to explain the X-ray emission as non-thermal radiation coming from the interaction region, but it might be produced by thermal Bremsstrahlung (plus photo-electric absorption) by a fast shock at the jet end. In the high-energy range, the source might be detectable by the present generation of Cherenkov telescopes, and may eventually be detected by Fermi in the GeV range.

Australiassa muistitietotutkimus on "must" : Old Stories, New Ways

Ajankohtaista

Singling out individual inventors from patent data

An increasing number of studies in recent years have sought to identify individual inventors from patent data. A variety of heuristics have been proposed for using the names and other information disclosed in patent documents to establish who is who in patents. This paper contributes to this literature by describing a methodology for identifying inventors using patents applied to the European Patent Office, EPO hereafter. As in much of this literature, we basically follow a threestep procedure : 1- the parsing stage, aimed at reducing the noise in the inventor’s name and other fields of the patent; 2- the matching stage, where name matching algorithms are used to group similar names; and 3- the filtering stage, where additional information and various scoring schemes are used to filter out these similarlynamed inventors. The paper presents the results obtained by using the algorithms with the set of European inventors applying to the EPO over a long period of time.

Elaborated Literary Violence: Genre and Ideology of the Two Stories I Sam 22,6-23 and II Sam 21,1-14

The present article focuses on two stories dealing with acts of big blood shed. I Sam 22,6-23 relates the massacre of the priests of Nob; II Sam 21,1-14 is about the execution of seven descendents of Saul, as atonement for Saul's attempt to exterminate the Gibeonites. Most researchers consider both stories or at least certain parts of them old.1 For both stories few verses are regarded as secondary. In this paper I try to reassess the analysis of these stories and will point to indices favoring a late date of origin for both of them. They concern the language in use, intertextual connections and particular motifs. A further indication consists in the fact that the reported events of the stories lack significant resonance in the corpus of the Hebrew Bible. There are only two texts, I Sam 2,33 and Ps 52,2, which allude or refer to I Sam 22,6-23.With regard to the importance of the related events and acts this silence in the Biblical context is astonishing. Interestingly, also in the Book of Chronicles one does not find any allusions to these stories. This raises the question whether the latter were composed after the formation of the book of Chronicles.

Inférence de source de traces d'essence retrouvées dans des débris d'incendie: Evaluation de la contribution de la chromatographie en phase gazeuse couplée à la spectrométrie de masse à rapport isotopique

Lorsque de l'essence est employée pour allumer et/ou propager un incendie, l'inférence de la source de l'essence peut permettre d'établir un lien entre le sinistre et une source potentielle. Cette inférence de la source constitue une alternative intéressante pour fournir des éléments de preuve dans ce type d'événements où les preuves matérielles laissées par l'auteur sont rares. Le but principal de cette recherche était le développement d'une méthode d'analyse de spécimens d'essence par GC-IRMS, méthode pas routinière et peu étudiée en science forensique, puis l'évaluation de son potentiel à inférer la source de traces d'essence en comparaison aux performances de la GC-MS. Un appareillage permettant d'analyser simultanément les échantillons par MS et par IRMS a été utilisé dans cette recherche. Une méthode d'analyse a été développée, optimisée et validée pour cet appareillage. Par la suite, des prélèvements d'essence provenant d'un échantillonnage conséquent et représentatif du marché de la région lausannoise ont été analysés. Finalement, les données obtenues ont été traitées et interprétées à l'aide de méthodes chimiométriques. Les analyses effectuées ont permis de montrer que la méthodologie mise en place, aussi bien pour la composante MS que pour l'IRMS, permet de différencier des échantillons d'essence non altérée provenant de différentes stations-service. Il a également pu être démontré qu'à chaque nouveau remplissage des cuves d'une station-service, la composition de l'essence distribuée par cette station est quasi unique. La GC-MS permet une meilleure différenciation d'échantillons prélevés dans différentes stations, alors que la GC-IRMS est plus performante lorsqu'il s'agit de comparer des échantillons collectés après chacun des remplissages d'une cuve. Ainsi, ces résultats indiquent que les deux composantes de la méthode peuvent être complémentaires pour l'analyse d'échantillons d'essence non altérée. Les résultats obtenus ont également permis de montrer que l'évaporation des échantillons d'essence ne compromet pas la possibilité de grouper des échantillons de même source par GC-MS. Il est toutefois nécessaire d'effectuer une sélection des variables afin d'éliminer celles qui sont influencées par le phénomène d'évaporation. Par contre, les analyses effectuées ont montré que l'évaporation des échantillons d'essence a une forte influence sur la composition isotopique des échantillons. Cette influence est telle qu'il n'est pas possible, même en effectuant une sélection des variables, de grouper correctement des échantillons évaporés par GC-IRMS. Par conséquent, seule la composante MS de la méthodologie mise en place permet d'inférer la source d'échantillons d'essence évaporée. _________________________________________________________________________________________________ When gasoline is used to start and / or propagate an arson, source inference of gasoline can allow to establish a link between the fire and a potential source. This source inference is an interesting alternative to provide evidence in this type of events where physical evidence left by the author are rare. The main purpose of this research was to develop a GC-IRMS method for the analysis of gasoline samples, a non-routine method and little investigated in forensic science, and to evaluate its potential to infer the source of gasoline traces compared to the GC-MS performances. An instrument allowing to analyze simultaneously samples by MS and IRMS was used in this research. An analytical method was developed, optimized and validated for this instrument. Thereafter, gasoline samples from a large sampling and representative of the Lausanne area market were analyzed. Finally, the obtained data were processed and interpreted using chemometric methods. The analyses have shown that the methodology, both for MS and for IRMS, allow to differentiate unweathered gasoline samples from different service stations. It has also been demonstrated that each new filling of the tanks of a station generates an almost unique composition of gasoline. GC-MS achieves a better differentiation of samples coming from different stations, while GC-IRMS is more efficient to distinguish samples collected after each filling of a tank. Thus, these results indicate that the two components of the method can be complementary to the analysis of unweathered gasoline samples. The results have also shown that the evaporation of gasoline samples does not compromise the possibility to group samples coming from the same source by GC-MS. It is however necessary to make a selection of variables in order to eliminate those which are influenced by the evaporation. On the other hand, the carried out analyses have shown that the evaporation of gasoline samples has such a strong influence on the isotopic composition of the samples that it is not possible, even by performing a selection of variables, to properly group evaporated samples by GC-IRMS. Therefore, only the MS allows to infer the source of evaporated gasoline samples.

Aetiologies of pulseless electrical activity in out-of-hospital cardiac arrests:A retrospective study and analysis of specific causes

Background: Pulseless electrical activity (PEA) cardiac arrest is defined as a cardiac arrest (CA) presenting with a residual organized electrical activity on the electrocardiogram. In the last decades, the incidence of PEA has regularly increased, compared to other types of CA like ventricular fibrillation or pulseless ventricular tachycardia. PEA is frequently induced by reversible conditions. The "4 (or 5) H" & "4 (or 5) T" are proposed as a mnemonic to asses for Hypoxia, Hypovolemia, Hypo- /Hyperkalaemia, Hypothermia, Thrombosis (cardiac or pulmonary), cardiac Tamponade, Toxins, and Tension pneumothorax. Other pathologies (intracranial haemorrhage, severe sepsis, myocardial contraction dysfunction) have been identified as potential causes for PEA, but their respective probability and frequencies are unclear and they are not yet included into the resuscitation guidelines. The aim of this study was to analyse the aetiologies of PEA out-of-hospital CA, in order to evaluate the relative frequencies of each cause and therefore to improve the management of patients suffering a PEA cardiac arrest. Method: This retrospective study was based on data routinely and prospectively collected for each PEMS intervention. All adult patients treated from January 1st 2002 to December 2012 31st by the PEMS for out-of-hospital cardiac arrest, with PEA as the first recorded rhythm, and admitted to the emergency department (ED) of the Lausanne University Hospital were included. The aetiologies of PEA cardiac arrest were classified into subgroups, based on the classical H&T's classification, supplemented by four other subgroups analysis: trauma, intra-cranial haemorrhage (ICH), non-ischemic cardiomyopathy (NIC) and undetermined cause. Results: 1866 OHCA were treated by the PEMS. PEA was the first recorded rhythm in 240 adult patients (13.8 %). After exclusion of 96 patients, 144 patients with a PEA cardiac arrest admitted to the ED were included in the analysis. The mean age was 63.8 ± 20.0 years, 58.3% were men and the survival rate at 48 hours was 29%. 32 different causes of OHCA PEA were established for 119 patients. For 25 patients (17.4 %), we were unable to attribute a specific cause for the PEA cardiac arrest. Hypoxia (23.6 %), acute coronary syndrome (12.5%) and trauma (12.5 %) were the three most frequent causes. Pulmonary embolism, Hypovolemia, Intoxication and Hyperkaliemia occurs in less than 10% of the cases (7.6 %, 5.6 %, 3.5%, respectively 2.1 %). Non ischemic cardiomyopathy and intra-cranial haemorrhage occur in 8.3 % and 6.9 %, respectively. Conclusions: According to our results, intra-cranial haemorrhage and non-ischemic cardiomyopathy represent noticeable causes of PEA in OHCA, with a prevalence equalling or exceeding the frequency of classical 4 H's and 4 T's aetiologies. These two pathologies are potentially accessible to simple diagnostic procedures (native CT-scan or echocardiography) and should be included into the 4 H's and 4 T's mnemonic.

Creating a research network for a successful e-portfolio design and implementation

The presence of e-portfolios in educational centres, companies and administrations has emergedstrongly during the last years by creating very different practices coming from different objectives and purposes. This situation has led researchers and practitioners to design and implement e-portfolios with little reference to previous knowledge of them; consequently, developments are disparate with many of the processes and dimensions used both in development and use being unnecessary complex. In order to minimize the inconveniences, unify these developmental processes and improve the resultsof implementation and use of e-portfolios, it seemed necessary to create a network of researchers, teachers and trainers coming from different universities and institutions of different kinds who are interested in the investigation and the practice of e-portfolios in Spain. Therefore, The Network on e-portfoliowas created in 2006, funded by the Spanish Ministry of Education and led by the UniversitatOberta de Catalunya. Besides the goals associatedwith the creation of this network and which wewanted to share with other European researchers and experts of other continents, we will also present in this paper some data concerned with the first study carried out on the use of e-portfolios in our country that shows where we are and which trends are the most important for the near future.

La història de la llengua contemporània davant les escriptures populars de l'exili

The studies that have been carried out about the history of contemporary Catalan have used, generally, sources coming from literary, intellectual and politician fields. Often, sources from common people have been omitted. However, they are documents which provide a very important proof to notice not only the Catalan vitality but also the level of the application of the current rules. This article proposes to highlight ordinary writings as an object of study that will allow us analyze several aspects related to the history of language and sociolinguistics. The study focuses on the ordinary writings that emerged in the Republican exile in 1939, a capital period in the production of such documents

The experience of identity transformation process for people living with tetraplegia and paraplegia = El proceso de reconstrucción de la identidad de las personas afectadas de una paraplejia o tetraplejia

A spinal cord injury (SCI) is perceived as a source of biographical disruption, not only at a physical level but also in terms of people’s life stories, their motivation and their self-esteem. The aim of this study is to explore the factors that people with spinal cord injuries perceive as contributing to rebuilding their sense of self. Two focus groups were established from the SCIcommunity, one of which was made up of 14 people with paraplegia and the other of 9 people with tetraplegia. In addition, four individual interviews were conducted with the participants. The results of content analysis show that the two most prominent factors in the process of identity renegotiation are the partial transformation of the subject’s identity followed by a coming to terms with that new identity. To rebuild self-worth, the importance of finding a balance between change and continuity was identified. Renegotiation of identity after a spinal cord injury is a complex phenomenon that greatly influences the SCI individual’s quality of life perceptions. Reaching a balance between the changes experienced due to the injury and finding a sense of continuity can be either facilitated or obstructed by the economic, political, legal, architectural, and social context

Tietoliikenteen tulevaisuuden näkymiä - Etelä-Karjala 2018

Tekniikan kehitys menee vauhdilla eteenpäin ja uusi verkkotekniikoita syntyy koko ajan. Haasteita tuottavat sopivien verkkotekniikoiden löytäminen käyttöön tietylle alueelle ja joissakin tapauksissa joudutaan tyytymään kompromissiratkaisuihin. Lyhyen kantaman langattomat kommunikaatioteknologiat soveltuvat esimerkiksi haja-asutusalueille ja saaristoon, mikäli perinteisen kuidun vetäminen niille alueille ei ole mahdollista. Tässä työssä tuodaan esille niitä langallisia ja langattomia tekniikoita, jotka ovat tällä hetkellä tai tulevaisuudessa merkityksellisiä Etelä-Karjalan kannalta. Osa tekniikoista voi jäädä kokonaan pois käytöstä kymmenen vuoden sisällä tai ne voivat yhdistyä ja muuttaa muotoaan. Työn tuloksena syntyneen kartoituksen perusteella saadaan visio siitä, miltä Etelä-Karjalan tilanne näyttää vuonna 2018. Nyt on jo tiedossa Soneran puhelinlankaverkon alasajo lähivuosina ja kuidun vetäminen viemäriin viemäröintitöiden yhteydessä. Tulevaisuuden kaistankäyttötarpeet ja erilaisten palvelujen lisääntyminen edesauttavat viihdepalveluiden tarjonnan monipuolistumista. Open Access ja triple-play ovat tulevaisuuden termejä. Viihteen lisäksi myös muilla eri osa-alueilla kuten työelämässä, sairaaloissa ja kouluissa on tarvetta laajakaistaisille monipalveluille.

Validation of plant dynamic model by online and laboratory measurements – a tool to predict online COD loads out of production of mechanical printing papers

COD discharges out of processes have increased in line with elevating brightness demands for mechanical pulp and papers. The share of lignin-like substances in COD discharges is on average 75%. In this thesis, a plant dynamic model was created and validated as a means to predict COD loading and discharges out of a mill. The assays were carried out in one paper mill integrate producing mechanical printing papers. The objective in the modeling of plant dynamics was to predict day averages of COD load and discharges out of mills. This means that online data, like 1) the level of large storage towers of pulp and white water 2) pulp dosages, 3) production rates and 4) internal white water flows and discharges were used to create transients into the balances of solids and white water, referred to as “plant dynamics”. A conversion coefficient was verified between TOC and COD. The conversion coefficient was used for predicting the flows from TOC to COD to the waste water treatment plant. The COD load was modeled with similar uncertainty as in reference TOC sampling. The water balance of waste water treatment was validated by the reference concentration of COD. The difference of COD predictions against references was within the same deviation of TOC-predictions. The modeled yield losses and retention values of TOC in pulping and bleaching processes and the modeled fixing of colloidal TOC to solids between the pulping plant and the aeration basin in the waste water treatment plant were similar to references presented in literature. The valid water balances of the waste water treatment plant and the reduction model of lignin-like substances produced a valid prediction of COD discharges out of the mill. A 30% increase in the release of lignin-like substances in the form of production problems was observed in pulping and bleaching processes. The same increase was observed in COD discharges out of waste water treatment. In the prediction of annual COD discharge, it was noticed that the reduction of lignin has a wide deviation from year to year and from one mill to another. This made it difficult to compare the parameters of COD discharges validated in plant dynamic simulation with another mill producing mechanical printing papers. However, a trend of moving from unbleached towards high-brightness TMP in COD discharges was valid.