Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection

Acute type A aortic dissection is a lethal condition requiring emergency surgery. It has diverse presentations, and the diagnosis can be missed or delayed. Once diagnosed, decisions with regard to initial management, transfer, appropriateness of surgery, timing of operation, and intervention for malperfusion complications are necessary. The goals of surgery are to save life by prevention of pericardial tamponade or intra-pericardial aortic rupture, to resect the primary entry tear, to correct or prevent any malperfusion and aortic valve regurgitation, and if possible to prevent late dissection-related complications in the proximal and downstream aorta. No randomized trials of treatment or techniques have ever been performed, and novel therapies-particularly with regard to extent of surgery-are being devised and implemented, but their role needs to be defined. Overall, except in highly specialized centers, surgical outcomes might be static, and there is abundant room for improvement. By highlighting difficulties and controversies in diagnosis, patient selection, and surgical therapy, our over-arching goal should be to enfranchise more patients for treatment and improve surgical outcomes.

Performance of the Halex in Logitudinal Studies of Older Adults

Goal: The Halex is an indicator of health status that combines self-rated health and activity limitations, which has been used by NCHS to predict future years of healthy life. The scores for each health state were developed based on strong assumptions, notably that a person in excellent health with ADL disabilities is as healthy as a person in poor health with no disabilities. Our goal was to examine the performance of the Halex as a longitudinal measure of health for older adults, and to improve the scoring if necessary. Methods: We used data from the Cardiovascular Health Study (CHS) to compare the relationship of baseline health to health 2 years later. Subject ages ranged from 65 to 103 (mean age 75). A total of 40,827 transitions were available for analysis. We examined whether Halex scores at time 0 were related monotonically to scores two years later, and iterated the original scores to improve the fit over time. Findings: The original Halex scores were not consistent over time. Persons in excellent health with ADL limitations were much healthier 2 years later than people in poor health with no limitations, even though they had been assumed to have identical health. People with ADL limitations had higher scores than predicted. The assumptions made in creating the Halex were not upheld in the data. Conclusions: The new iterated scores are specific to older adults, are appropriate for longitudinal data, and are relatively assumption-free. We recommend the use of these new scores for longitudinal studies of older adults that use the Halex health states.

Expected performance of the ATLAS experiment - detector, trigger and physics

A detailed study is presented of the expected performance of the ATLAS detector. The reconstruction of tracks, leptons, photons, missing energy and jets is investigated, together with the performance of b-tagging and the trigger. The physics potential for a variety of interesting physics processes, within the Standard Model and beyond, is examined. The study comprises a series of notes based on simulations of the detector and physics processes, with particular emphasis given to the data expected from the first years of operation of the LHC at CERN.

Root Foraging Increases Performance of the Clonal Plant Potentilla reptans in Heterogeneous Nutrient Environments

Background Plastic root-foraging responses have been widely recognized as an important strategy for plants to explore heterogeneously distributed resources. However, the benefits and costs of root foraging have received little attention. Methodology/Principal Findings In a greenhouse experiment, we grew pairs of connected ramets of 22 genotypes of the stoloniferous plant Potentilla reptans in paired pots, between which the contrast in nutrient availability was set as null, medium and high, but with the total nutrient amount kept the same. We calculated root-foraging intensity of each individual ramet pair as the difference in root mass between paired ramets divided by the total root mass. For each genotype, we then calculated root-foraging ability as the slope of the regression of root-foraging intensity against patch contrast. For all genotypes, root-foraging intensity increased with patch contrast and the total biomass and number of offspring ramets were lowest at high patch contrast. Among genotypes, root-foraging intensity was positively related to production of offspring ramets and biomass in the high patch-contrast treatment, which indicates an evolutionary benefit of root foraging in heterogeneous environments. However, we found no significant evidence that the ability of plastic foraging imposes costs under homogeneous conditions (i.e. when foraging is not needed). Conclusions/Significance Our results show that plants of P. reptans adjust their root-foraging intensity according to patch contrast. Moreover, the results show that the root foraging has an evolutionary advantage in heterogeneous environments, while costs of having the ability of plastic root foraging were absent or very small.

Executive compensation and the performance of the firm

A sample of large industrial corporations is examined to determine whether there is a relationship between the levels of compensation received by the senior executives of those firms and the firms' economic performances. We find consistent evidence of such a relationship, with differences across firms in the total compensation of their three highest-paid officers being positively related to differences in both the common stock returns and operating profitability of the firms. The implication is that compensation packages are designed to reduce agency costs.

Performance of the Hamamatsu R11410 photomultiplier tube in cryogenic xenon environments

The Hamamatsu R11410 photomultiplier, a tube of 3" diameter and with a very low intrinsic radioactivity, is an interesting light sensor candidate for future experiments using liquid xenon (LXe) as target for direct dark matter searches. We have performed several experiments with the R11410 with the goal of testing its performance in environments similar to a dark matter detector setup. In particular, we examined its long-term behavior and stability in LXe and its response in various electric field configurations.

Understanding the performance of the FLake model over two African Great Lakes

The ability of the one-dimensional lake model FLake to represent the mixolimnion temperatures for tropical conditions was tested for three locations in East Africa: Lake Kivu and Lake Tanganyika's northern and southern basins. Meteorological observations from surrounding automatic weather stations were corrected and used to drive FLake, whereas a comprehensive set of water temperature profiles served to evaluate the model at each site. Careful forcing data correction and model configuration made it possible to reproduce the observed mixed layer seasonality at Lake Kivu and Lake Tanganyika (northern and southern basins), with correct representation of both the mixed layer depth and water temperatures. At Lake Kivu, mixolimnion temperatures predicted by FLake were found to be sensitive both to minimal variations in the external parameters and to small changes in the meteorological driving data, in particular wind velocity. In each case, small modifications may lead to a regime switch, from the correctly represented seasonal mixed layer deepening to either completely mixed or permanently stratified conditions from similar to 10 m downwards. In contrast, model temperatures were found to be robust close to the surface, with acceptable predictions of near-surface water temperatures even when the seasonal mixing regime is not reproduced. FLake can thus be a suitable tool to parameterise tropical lake water surface temperatures within atmospheric prediction models. Finally, FLake was used to attribute the seasonal mixing cycle at Lake Kivu to variations in the near-surface meteorological conditions. It was found that the annual mixing down to 60m during the main dry season is primarily due to enhanced lake evaporation and secondarily to the decreased incoming long wave radiation, both causing a significant heat loss from the lake surface and associated mixolimnion cooling.