Pulmonary valve stenosis due to undifferentiated pleomorphic sarcoma

Pulmonary artery sarcomas are uncommon intracardiac tumours with poor prognosis. We report the case of a 69-year-old woman in good health presenting with rapidly progressive dyspnoea and an unfamiliar systolic murmur. Echocardiography revealed pulmonary valve stenosis due to an obstructing mobile mass. Imaging studies confirmed the presence of a contrast-enhancing lesion adherent to the valve, extending into the pulmonary trunk and right ventricular outflow tract, and suggestive of malignancy. Endovascular biopsy was attempted with no success. Surgical resection with autologous graft valve replacement and pulmonary artery reconstruction was performed. Postoperative histological examination confirmed the diagnosis of an undifferentiated pleomorphic sarcoma. Pulmonary artery sarcoma should be considered as a rare differential diagnosis in patients presenting with dyspnoea and a crescendo-decrescendo systolic murmur increasing with inspiration. Echocardiography is a useful first diagnostic approach but multi-imaging assessment is almost always necessary for definite diagnosis. Our case provides insights into the challenges met by cardiologists, radiologists and cardiac surgeons in the management of such cases.

Treaty shopping in international investment law

Is "treaty shopping" in international investment law "legitimate nationality planning" or "treaty abuse"? This is the question investment arbitral tribunals have been increasingly faced with over past years. This PhD thesis will examine in a systematic and comprehensive manner investment arbitral decisions that have attempted to draw this line. It will show that while some legal approaches taken by arbitral tribunals have started to consolidate, others remain unsettled, contributing to the picture of an overall inconsistent jurisprudence. The thesis will also make proposals de lege ferenda on how States could reform their international investment agreements in order to make them less susceptible to the practice of treaty shopping.

Parent-adolescent relationship in youths with a chronic condition.

BACKGROUND: Suffering from a chronic disease or disability (CDD) during adolescence can be a burden for both the adolescents and their parents. The aim of the present study is to assess how living with a CDD during adolescence, the quality of parent-adolescent relationship (PAR) and the adolescent's psychosocial development interact with each other. METHODS: Using the Swiss Multicenter Adolescent Survey on Health 2002 (SMASH02) database, we compared adolescents aged 16-20 years with a CDD (n = 760) with their healthy peers (n = 6493) on sociodemographics, adolescents' general and psychosocial health, interparental relationship and PAR. RESULTS: Bivariate analyses showed that adolescents with a CDD had a poorer psychosocial health and a more difficult relationship with their parents. The log-linear model indirectly linked CDD and poor PAR through four variables: two of the adolescents' psychosocial health variables (suicide attempt and sensation seeking), the need for help regarding difficulties with parents and a highly educated mother that acted as a protective factor, allowing for a better parent-adolescent with a CDD relationship. CONCLUSION: It is essential for health professionals taking care of adolescents with a CDD to distinguish between issues in relation with the CDD from other psychosocial difficulties, in order to help these adolescents and their parents deal with them appropriately and thus maintain a healthy PAR.

Validation of a brief form of the Perceived Neighborhood Social Cohesion questionnaire.

The aim of this study was the validation of a brief form of the Perceived Neighborhood Social Cohesion questionnaire using data from 5065 men from the "Cohort Study on Substance-Use Risk Factors." A 9-item scale covering three factors was proposed. Excellent indices of internal consistency were measured (α = .93). The confirmatory factor analyses resulted in acceptable fit indices supporting measurement invariance across French and German forms. Significant correlations were found between the brief form of the Perceived Neighborhood Social Cohesion questionnaire, and satisfaction and self-reported health, providing evidence of the concurrent validity of the scale. Perceived neighborhood social cohesion, and depression and suicide attempts were negatively associated, sustaining the protective effect of perceived social cohesion.

Digital evidence, 'absence' of data and ambiguous patterns of reasoning

In this paper we discuss the use of digital data by the Swiss Federal Criminal Court in a recent case of attempted homicide. We use this case to examine drawbacks for the defense when the presentation of scientific evidence is partial, especially when the only perspective mentioned is that of the prosecution. We tackle this discussion at two distinct levels. First, we pursue an essentially non-technical presentation of the topic by drawing parallels between the court's summing up of the case and flawed patterns of reasoning commonly seen in other forensic disciplines, such as DNA and particle traces (e.g., gunshot residues). Then, we propose a formal analysis of the case, using elements of probability and graphical probability models, to justify our main claim that the partial presentation of digital evidence poses a risk to the administration of justice in that it keeps vital information from the defense. We will argue that such practice constitutes a violation of general principles of forensic interpretation as established by forensic science literature and current recommendations by forensic science interest groups (e.g., the European Network of Forensic Science Institutes). Finally, we posit that argument construction and analysis using formal methods can help replace digital evidence appropriately into context and thus support a sound evaluation of the evidence.

La adaptación a la jubilación y sus fases: afectación de los niveles de satisfacción y duración del proceso adaptativo

This research attempted to describe, according to the model of Atchley (1975), the experience of the adaptive phases, the changes of life satisfaction levels and the duration of the process and its phases. A total of 30 retired people were interviewed in depth, representated their Life Chart Methodology-retrospective (LCM-r) on the life satisfaction levels and responded to the Life Satisfaction Index. The results show that even though the retirees did not all experience exactly the same adjustment processes, most of the stages were found. It is also noteworthy that during the adustment process large fluctuations were observed in the level of satisfaction experienced by the participants, but once they had adjusted to retirement their degree of satisfaction returned to levels similar to those reported before retirement. Substantial differences were also found with regards to the duration of the adjustment process, which fluctuated from six months to more than a year

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Sleep problems among detainees are common. Appropriate evaluation and treatment remain challenging in correctional settings. However, this is not primarily a problem of resources; rather, it is, to a great extent, an issue of adequate training. Correctional health professionals need appropriate education regarding insomnia evaluation and management. Guidelines should be based on the principle of equivalence of care and should take into account all evidence from research in the community and in correctional settings. Educational material from outside prisons exists and should be made available to detainees and health professionals (Falloon et al., 2011; Sateia & Nowell, 2004). Priority should be given to changes in prison conditions and to nonpharmacological treatment. There is no evidence-based justification to replace BZD prescriptions with antipsychotics or antidepressants. In correctional settings, prescriptions of antipsychotics and antidepressants for sleep problems can increase risk due to polypharmacy and higher suicide risks. Correctional physicians should monitor and document the evaluation and treatment practice concerning insomnia complaints to improve safe, evidence-based treatment.

Chemistry and light - part 2: light and energy

The conversion of solar energy into more useful forms of energy, such as chemical fuels or electricity, is one of the central problems facing modern science. Progress in photochemistry and chemical synthesis has led to a point where light energy conversion by means of artificial molecular devices can be rationally attempted. In this article, a general approach towards this challenging goal is presented.

Review of Rewriting Terror: The 9/11 Terrorists in American Fiction (Juanjo Bermúdez de Castro, 2012)

In the wake of the terrorist attacks of September 11, 2001, many authors of fiction, filmmakers, journalists, public figures and scholars have attempted to narrate, recreate, explain, reflect on, and theorize about the event and its aftermath.

Hexaclorobenzè a Sidney : estudi de bioremediació i percepció social

El magatzem de residus de l'empresa Orica de Sidney, Austràlia, és el magatzem d'hexaclorobenzè (HCB) més gran del món. El HCB és un dels compostos més tòxics i persistents que es coneixen, i està inclòs a la llista de la Convenció d'Estocolm sobre contaminants orgànics persistents (POPs). Durant molts anys, Orica ha intentat exportar els seus residus a diversos països d'Europa. Però un tractament alternatiu com la bioremediació podria ser una solució més segura, econòmica i ambientalment responsable.

Manuaalisen kokoonpanon tuottavuuden kehittäminen vaihdetehtaan projektimaisessa piensarjatuotannossa

Vaihdetehtaan tilauskannan lisääntyminen sekä jo ennestään maksimikapasiteetilla käyvä tuotanto ovat aiheuttaneet vaihdetehtaalle kapasiteetin lisäämisen tarpeen. Tuotannon kasvattamiseen pyritään laiteinvestointien avulla, joiden oletetaan lisäävän tehtaan osavalmistuksen kapasiteettia 50 prosentilla. Vuotuisten tuotantomäärien kasvaminen asettaa paineita vaihdetehtaan kokoonpanosoluun, jonka tulisi kyetä vastaamaan tuotantomäärien kasvuun. Tämän diplomityön tarkoituksena on kartoittaa kokoonpanosolun potentiaaliset kehityskohteet, joiden pohjalta luodaan systemaattinen toimintamalli kokoonpanosolun tuottavuuden kehittämiseksi. Työn keskeisimpinä tavoitteina ovat materiaalivirran- ja välivarastoinninhallinnan kehittäminen sekä tuotteiden kokoonpanon läpimenoajan lyhentäminen. Työn tuloksena on tarkoitus luoda toteutuskelpoinen kehityssuunnitelma, joka sisältää suunnitelmat kokoonpanotyön vaiheistuksesta, kokoonpanosolun layoutista sekä suunnitelman välivarastoinnin kehittämisestä. Lisäksi kehitystyöhön liittyvät olennaisesti kokoonpanosoluun suoritettavat investoinnit ja niiden kannattavuuden arviointi sekä tuottavuuden seurantaan liittyvän mittariston laadinta.

Economía urbana y calidad de vida. Una revisión del estado del conocimiento en España

Quality of life is increasingly becoming a concept researched empirically and theoretically in the field of economics. In urban economics in particular, this increasing interest stems mainly from the fact that quality of life affects urban competitiveness and urban growth: research shows that when households and businesses decide where to locate, quality of life considerations can play a very important role. The purpose of the present paper is to examine the way economic literature and urban economic literature in particular, have adopted quality of life considerations in the economic thinking. Moreover, it presents the ways various studies have attempted to capture the multidimensional nature of the concept, and quantify it for the purposes of empirical research. Additionally we focus on the state of the art in Spain. Looking at the experiences in the last years we see very important possibilities of developing new studies in the field.

Knapsack sets for cryptography

The basic goal of this study is to extend old and propose new ways to generate knapsack sets suitable for use in public key cryptography. The knapsack problem and its cryptographic use are reviewed in the introductory chapter. Terminology is based on common cryptographic vocabulary. For example, solving the knapsack problem (which is here a subset sum problem) is termed decipherment. Chapter 1 also reviews the most famous knapsack cryptosystem, the Merkle Hellman system. It is based on a superincreasing knapsack and uses modular multiplication as a trapdoor transformation. The insecurity caused by these two properties exemplifies the two general categories of attacks against knapsack systems. These categories provide the motivation for Chapters 2 and 4. Chapter 2 discusses the density of a knapsack and the dangers of having a low density. Chapter 3 interrupts for a while the more abstract treatment by showing examples of small injective knapsacks and extrapolating conjectures on some characteristics of knapsacks of larger size, especially their density and number. The most common trapdoor technique, modular multiplication, is likely to cause insecurity, but as argued in Chapter 4, it is difficult to find any other simple trapdoor techniques. This discussion also provides a basis for the introduction of various categories of non injectivity in Chapter 5. Besides general ideas of non injectivity of knapsack systems, Chapter 5 introduces and evaluates several ways to construct such systems, most notably the "exceptional blocks" in superincreasing knapsacks and the usage of "too small" a modulus in the modular multiplication as a trapdoor technique. The author believes that non injectivity is the most promising direction for development of knapsack cryptosystema. Chapter 6 modifies two well known knapsack schemes, the Merkle Hellman multiplicative trapdoor knapsack and the Graham Shamir knapsack. The main interest is in aspects other than non injectivity, although that is also exploited. In the end of the chapter, constructions proposed by Desmedt et. al. are presented to serve as a comparison for the developments of the subsequent three chapters. Chapter 7 provides a general framework for the iterative construction of injective knapsacks from smaller knapsacks, together with a simple example, the "three elements" system. In Chapters 8 and 9 the general framework is put into practice in two different ways. Modularly injective small knapsacks are used in Chapter 9 to construct a large knapsack, which is called the congruential knapsack. The addends of a subset sum can be found by decrementing the sum iteratively by using each of the small knapsacks and their moduli in turn. The construction is also generalized to the non injective case, which can lead to especially good results in the density, without complicating the deciphering process too much. Chapter 9 presents three related ways to realize the general framework of Chapter 7. The main idea is to join iteratively small knapsacks, each element of which would satisfy the superincreasing condition. As a whole, none of these systems need become superincreasing, though the development of density is not better than that. The new knapsack systems are injective but they can be deciphered with the same searching method as the non injective knapsacks with the "exceptional blocks" in Chapter 5. The final Chapter 10 first reviews the Chor Rivest knapsack system, which has withstood all cryptanalytic attacks. A couple of modifications to the use of this system are presented in order to further increase the security or make the construction easier. The latter goal is attempted by reducing the size of the Chor Rivest knapsack embedded in the modified system. '

Predictors of psychiatric hospitalization during 6 months of maintenance treatment with olanzapine long-acting injection: post hoc analysis of a randomized, double-blind study.

BACKGROUND: Hospitalization is a costly and distressing event associated with relapse during schizophrenia treatment. No information is available on the predictors of psychiatric hospitalization during maintenance treatment with olanzapine long-acting injection (olanzapine-LAI) or how the risk of hospitalization differs between olanzapine-LAI and oral olanzapine. This study aimed to identify the predictors of psychiatric hospitalization during maintenance treatment with olanzapine-LAI and assessed four parameters: hospitalization prevalence, incidence rate, duration, and the time to first hospitalization. Olanzapine-LAI was also compared with a sub-therapeutic dose of olanzapine-LAI and with oral olanzapine. METHODS: This was a post hoc exploratory analysis of data from a randomized, double-blind study comparing the safety and efficacy of olanzapine-LAI (pooled active depot groups: 405 mg/4 weeks, 300 mg/2 weeks, and 150 mg/2 weeks) with oral olanzapine and sub-therapeutic olanzapine-LAI (45 mg/4 weeks) during 6 months' maintenance treatment of clinically stable schizophrenia outpatients (n=1064). The four psychiatric hospitalization parameters were analyzed for each treatment group. Within the olanzapine-LAI group, patients with and without hospitalization were compared on baseline characteristics. Logistic regression and Cox's proportional hazards models were used to identify the best predictors of hospitalization. Comparisons between the treatment groups employed descriptive statistics, the Kaplan-Meier estimator and Cox's proportional hazards models. RESULTS: Psychiatric hospitalization was best predicted by suicide threats in the 12 months before baseline and by prior hospitalization. Compared with sub-therapeutic olanzapine-LAI, olanzapine-LAI was associated with a significantly lower hospitalization rate (5.2% versus 11.1%, p < 0.01), a lower mean number of hospitalizations (0.1 versus 0.2, p = 0.01), a shorter mean duration of hospitalization (1.5 days versus 2.9 days, p < 0.01), and a similar median time to first hospitalization (35 versus 60 days, p = 0.48). Olanzapine-LAI did not differ significantly from oral olanzapine on the studied hospitalization parameters. CONCLUSIONS: In clinically stable schizophrenia outpatients receiving olanzapine-LAI maintenance treatment, psychiatric hospitalization was best predicted by a history of suicide threats and prior psychiatric hospitalization. Olanzapine-LAI was associated with a significantly lower incidence of psychiatric hospitalization and shorter duration of hospitalization compared with sub-therapeutic olanzapine-LAI. Olanzapine-LAI did not differ significantly from oral olanzapine on hospitalization parameters.

El suïcidi a Catalunya : una mirada teòrica i estadística

Endinsar-se en l’estudi de les tipologies i les estadístiques de suïcidis implica posarsobre la taula una problemàtica que durant els últims anys ha estat tabú fora delsarticles científics, ja que es tenia por que parlar d’aquest tema en mitjans decomunicació podria fomentar l’aparició de més suïcidis.Aquest article pretén realitzar una mirada estadística i comparativa del suïcidi aCatalunya els darrers dos anys i a la província de Girona els darrers 10 anys. Laintenció es desvetllar certs interrogants que, per manca d’informació, no estant al’abast de molta gent, com podrien ser: Quin gènere es suïcida més, homes o dones?A quina edat o franja d’edat hi ha més suïcidis? Aquestes dades són percentualmentiguals a tot arreu?Amb aquesta finalitat, i per intentar donar resposta a aquestes qüestions realitzaremun visió objectiva, comparativa i concreta dels resultats obtinguts, tenint present queés tan sols una fotografia determinada d’una població