CT coronary angiography versus conventional invasive coronary angiography - the view of the referring physician

PURPOSE Assessment of experience gained by local referring physicians with the procedure of coronary computed tomographic angiography (CCTA) in the everyday clinical routine. MATERIALS AND METHODS A 25-item questionnaire was sent to 179 physicians, who together had referred a total of 1986 patients for CCTA. They were asked about their experience to date with CCTA, the indications for coronary imaging, and their practice in referring patients for noninvasive CCTA or invasive catheter angiography. RESULTS 53 questionnaires (30 %) were assessable, corresponding to more than 72 % of the patients referred. Of the referring physicians who responded, 94 % saw a concrete advantage of CCTA in the treatment of patients, whereby 87 % were 'satisfied' or 'very satisfied' with the reporting. For excluding coronary heart disease (CHD) where there was a low pre-test probability of disease, the physicians considered CCTA to be superior to conventional coronary diagnosis (4.2 on a scale of 1 - 5) and vice versa for acute coronary syndrome (1.6 of 5). The main reasons for unsuitability of CCTA for CT diagnosis were claustrophobia and the absence of a sinus rhythm. The level of exposure to radiation in CCTA was estimated correctly by only 42 % of the referring physicians. 90 % of the physicians reported that their patients evaluated their coronary CT overall as 'positive' or 'neutral', while 87 % of the physicians whose patients had undergone both procedures reported that the patients had experienced CCTA as the less disagreeable of the two. CONCLUSION CCTA is accepted by the referring physicians as an alternative imaging procedure for the exclusion of CHD and received a predominantly positive assessment from both the referring physicians and the patients.

Charakterstudie gewidmet meinem Objekt Herrn Dr. S. Spitzer, z. Zt. Oberrabbiner zu Hamburg

vom Verf. d. "Klageworte" etc.

Partiality, Agent-Relative Reasons, and the Individuals View

The paper offers a critical discussion of Simon Keller’s individuals view concerning the grounds of special obligations. It is argued that the view offers a misleading account of agent-relative reasons, which leads to problems with the arguments Keller offers for his view – the Kantian, consequentialist, particularistic argument. Furthermore, it argues that Keller’s argument from phenomenology suffers from not distinguishing between reasons for partiality and reasons from partiality. At best, it can be applied to reasons from partiality – reasons that agents have in virtue of standing in a relationship of partiality with some other person. Thus, the argument does not support the individuals view, as it is compatible with the other approaches Keller discusses. The paper suggests a modified relationship view to ground reasons of partiality.

Measurement of the mass difference between top and anti-top quarks in pp collisions at View the MathML √s=7 TeV using the ATLAS detector

A measurement of the mass difference between top and anti-top quarks is presented. In a 4.7 fb−14.7 fb−1 data sample of proton–proton collisions at View the MathML sources=7 TeV recorded with the ATLAS detector at the LHC, events consistent with View the MathML sourcett¯ production and decay into a single charged lepton final state are reconstructed. For each event, the mass difference between the top and anti-top quark candidate is calculated. A two b -tag requirement is used in order to reduce the background contribution. A maximum likelihood fit to these per-event mass differences yields View the MathML sourceΔm≡mt−mt¯=0.67±0.61(stat)±0.41(syst) GeV, consistent with CPT invariance.

A view from the Royal Exchange

Karikierende Darstellung von N. M. Rothschild

The Emergence of Formal Control Specificity in Information Systems Outsourcing: A Process-View

Information systems (IS) outsourcing projects often fail to achieve initial goals. To avoid project failure, managers need to design formal controls that meet the specific contextual demands of the project. However, the dynamic and uncertain nature of IS outsourcing projects makes it difficult to design such specific formal controls at the outset of a project. It is hence crucial to translate high-level project goals into specific formal controls during the course of a project. This study seeks to understand the underlying patterns of such translation processes. Based on a comparative case study of four outsourced software development projects, we inductively develop a process model that consists of three unique patterns. The process model shows that the performance implications of emergent controls with higher specificity depend on differences in the translation process. Specific formal controls have positive implications for goal achievement if only the stakeholder context is adapted, while they are negative for goal achievement if in the translation process tasks are unintendedly adapted. In the latter case projects incrementally drift away from their initial direction. Our findings help to better understand control dynamics in IS outsourcing projects. We contribute to a process theoretic understanding of IS outsourcing governance and we derive implications for control theory and the IS project escalation literature.

Scheduled versus Pro Re Nata Dosing in the VIEW Trials

PURPOSE To analyze visual acuity (VA) outcomes before and after preplanned treatment regimen change in the VIEW studies at week 52 (W52). DESIGN Multiple post hoc analyses for retrospectively defined subgroups in 2 multicenter, multinational, double-masked trials. PARTICIPANTS Two thousand four hundred fifty-seven neovascular age-related macular degeneration (AMD) patients. METHODS Patients were randomized to treatment with 0.5 mg ranibizumab given monthly, a 0.5-mg or 2-mg intravitreal aflibercept injection given monthly, or 2 mg intravitreal aflibercept given every other month, after 3 initial monthly doses, up to W52. From W52 through W96, patients received their original dosing assignment using a capped pro re nata (PRN) regimen, with defined retreatment criteria based on VA and morphologic signs of disease activity and mandatory dosing at least every 12 weeks. MAIN OUTCOME MEASURES Best-corrected VA (BCVA) and optical coherence tomography assessments were mandatory at all visits from baseline to W96. Outcomes were changes in BCVA and central retinal thickness. Outcomes were evaluated in all patients who completed 2 years of the VIEW studies using the last observation carried forward method for missing data at interim visits. RESULTS After W52, approximately 20% of patients lost 5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or more across all treatment arms with PRN treatment. Patients who met the retreatment criterion of loss of 5 ETDRS letters or more in the first quarter of the PRN dosing phase did not recover; mean final VA loss across the 4 study arms was -4.4 to -5.8 letters. Outcomes of these patients up to W52 were indistinguishable from those of the overall population. There were no differences between groups in serious ocular adverse events or Anti-Platelet Trialists' Collaboration arterial thromboembolic events through W96. CONCLUSIONS These analyses suggest that there are subgroups of patients for whom VA outcomes in the second year of the VIEW studies were less stable than in the first year and for whom W52 seems to be an important inflection point. Although alternate reasons specific to the nature of the underlying AMD cannot be fully excluded, the switch in treatment regimen at W52 is a plausible explanation.

Achievements and Challenges 20 Years after Beijing: A View from Switzerland

Despite being one of the world’s wealthiest countries and most modern economies, in Switzerland gender equality remains an elusive challenge. Paid maternity leave, legal abortion and an increase in women’s educational attainment are some of the milestones achieved since 1995, when the country was one of 189 states to adopt the Beijing Declaration and Platform for Action at the Fourth World Conference on Women. But while legal gender equality may be nearly achieved, much remains to be done to achieve gender equality in practice. Rigid gender stereotypes, wage discrimination, women’s heavy care burden, segregation in the workplace, violence against women, under-representation of women in political and economic decision making, and structural obstacles to reconciling family duties with employment still stand in the way of gender equality. In order to realize gender equality, government, employers, politicians and civil society all need to take concrete and coordinated actions. These range from changes in the educational sector, in the labour market and in the social security system to an active foreign policy that promotes women’s human rights.

Electrochemical CO2 Reduction - A Critical View on Fundamentals, Materials and Applications

The electrochemical reduction of CO2 has been extensively studied over the past decades. Nevertheless, this topic has been tackled so far only by using a very fundamental approach and mostly by trying to improve kinetics and selectivities toward specific products in half-cell configurations and liquid-based electrolytes. The main drawback of this approach is that, due to the low solubility of CO2 in water, the maximum CO2 reduction current which could be drawn falls in the range of 0.01–0.02 A cm–2. This is at least an order of magnitude lower current density than the requirement to make CO2-electrolysis a technically and economically feasible option for transformation of CO2 into chemical feedstock or fuel thereby closing the CO2 cycle. This work attempts to give a short overview on the status of electrochemical CO2 reduction with respect to challenges at the electrolysis cell as well as at the catalyst level. We will critically discuss possible pathways to increase both operating current density and conversion efficiency in order to close the gap with established energy conversion technologies.