Quantitative multi-slice computed tomography assessment of the mitral valvular complex for transcatheter mitral valve interventions part 1: systematic measurement methodology and inter-observer variability

AIMS Transcatheter mitral valve replacement (TMVR) is an emerging technology with the potential to treat patients with severe mitral regurgitation at excessive risk for surgical mitral valve surgery. Multimodal imaging of the mitral valvular complex and surrounding structures will be an important component for patient selection for TMVR. Our aim was to describe and evaluate a systematic multi-slice computed tomography (MSCT) image analysis methodology that provides measurements relevant for transcatheter mitral valve replacement. METHODS AND RESULTS A systematic step-by-step measurement methodology is described for structures of the mitral valvular complex including: the mitral valve annulus, left ventricle, left atrium, papillary muscles and left ventricular outflow tract. To evaluate reproducibility, two observers applied this methodology to a retrospective series of 49 cardiac MSCT scans in patients with heart failure and significant mitral regurgitation. For each of 25 geometrical metrics, we evaluated inter-observer difference and intra-class correlation. The inter-observer difference was below 10% and the intra-class correlation was above 0.81 for measurements of critical importance in the sizing of TMVR devices: the mitral valve annulus diameters, area, perimeter, the inter-trigone distance, and the aorto-mitral angle. CONCLUSIONS MSCT can provide measurements that are important for patient selection and sizing of TMVR devices. These measurements have excellent inter-observer reproducibility in patients with functional mitral regurgitation.

Beyond Racial Precedents: Loving v. Virginia as an Appropriate Legal Model and Strategy for Same-Sex Marriage Litigation

This thesis explores how LGBT marriage activists and lawyers have employed a racial interpretation of due process and equal protection in recent same-sex marriage litigation. Special attention is paid to the Supreme Court's opinion in Loving v. Virginia, the landmark case that declared anti-miscegenation laws unconstitutional. By exploring the use of racial precedent in same-sex marriage litigation and its treatment in state court cases, this thesis critiques the racial interpretation of due process and equal protection that became the basis for LGBT marriage briefs and litigation, and attempts to answer the question of whether a racial interpretation of due process and equal protection is an appropriate model for same-sex marriage litigation both constitutionally and strategically. The existing scholarly literature fails to explore how this issue has been treated in case briefs, which are very important elements in any legal proceeding. I will argue that through an analysis of recent state court briefs in Massachusetts and Connecticut, Loving acts as logical precedent for the legalization of same-sex marriage. I also find, more significantly, that although this racial interpretation of due process and equal protection represented by Loving can be seen as an appropriate model for same-sex marriage litigation constitutionally, questions remain about its strategic effectiveness, as LGBT lawyers have moved away from race in some arguments in these briefs. Indeed, a racial interpretation of Due Process and Equal Protection doctrine imposes certain limits on same-sex marriage litigation, of which we are warned by some Critical Race theorists, Latino Critical Legal theorists, and other scholars. In order to fully incorporate a discussion of race into the argument for legalizing same-sex marriage, the dangers posed by the black/white binary of race relations must first be overcome.

Minding the 3 R's: Response, Remediation and Restoration

Working with CT DEP, the NOAA Office of Damage Assessment, Remediation and Restoration uses funds recovered from polluters to conduct restoration projects. Here in Connecticut, projects include the Jordan Brook Fishway in Waterford, the Remington Gun Club site at Lordship Point in Stratford, and more.

Einzelbemerkungen zur Lieferung 3 - 6 der Holzmannschen Mischna-Ausgabe [Rezension]

Viktor Aptowitzer

Einzelbemerkungen zur Lieferung 3 - 6 der Holtzmannschen Mischna-Ausgabe [Rezension] : (Fortsetzung von Jahrg. 1918, S. 70-75)

Viktor Aptowitzer

Ms.Ff.F.Stoltze 3. 6 - Brief von ... von Baumbach-Lenderscheid an Friedrich Stoltze

"Schwarz-Weiß & Braun", "Gedichte in Frankfurter Mundart"

Fragm. lat. I 3 - Glossarium latinum

Trägerband: Ms. Praed. 123; Vorbesitzer: Konrad Textoris; Dominikanerkloster Frankfurt am Main

Lohengrin (I. 3.)

Signatur des Originals: S 36/F07559

Tannhäuser (I. 3.)

Signatur des Originals: S 36/F07571

Der Struwwelpeter oder Lustige Geschichten und drollige Bilder : für Kinder von 3 - 6 Jahren

von Heinrich Hoffmann

(Table 3) Concentration of Au, Pd, and Pt in the interstitial waters of ODP Leg 125 samples

Palladium, platinum, and gold were analyzed for 20 interstitial water samples from Leg 125. No Pd or Pt was detected in fluids from serpentinite muds from Conical Seamount in the Mariana forearc, indicating that low-temperature seawater-peridotite interaction does not mobilize these elements into the serpentinizing fluids to levels above 0.10 parts per billion (ppb) in solution. However, Au may be mobilized in high pH solutions. In contrast, fluids from vitric-rich clays on the flanks of the Torishima Seamount in the Izu-Bonin forearc have Pd values of between 4.0 and 11.8 nmol/L, Pt values between 2.3 and 5.0 nmol/L and Au values between 126.9 and 1116.9 pmol/L. The precious metals are mobilized, and possibly adsorbed onto clay mineral surfaces, during diagenesis and burial of the volcanic-rich clays. Desorption during squeezing of the sediments may produce the enhanced precious metal concentrations in the analyzed fluids. The metals are mobilized in the fluids probably as neutral hydroxide, bisulfide, and ammonia complexes. Pt/Pd ratios are between 0.42 and 2.33, which is much lower than many of the potential sources for Pt and Pd but is consistent with the greater solubility of Pd compared with Pt in most natural low-temperature fluids.