Interatrial block and atrial arrhythmias in centenarians: Prevalence, associations, and clinical implications

Data are lacking on the characteristics of atrial activity in centenarians, including interatrial block (IAB). The aim of this study was to describe the prevalence of IAB and auricular arrhythmias in subjects older than 100 years and to elucidate their clinical implications. We studied 80 centenarians (mean age 101.4 ± 1.5 years; 21 men) with follow-ups of 6–34 months. Of these 80 centenarians, 71 subjects (88.8%) underwent echocardiography. The control group comprised 269 septuagenarians. A total of 23 subjects (28.8%) had normal P wave, 16 (20%) had partial IAB, 21 (26%) had advanced IAB, and 20 (25.0%) had atrial fibrillation/flutter. The IAB groups exhibited premature atrial beats more frequently than did the normal P wave group (35.1% vs 17.4%; P < .001); also, other measurements in the IAB groups frequently fell between values observed in the normal P wave and the atrial fibrillation/flutter groups. These measurements included sex preponderance, mental status and dementia, perceived health status, significant mitral regurgitation, and mortality. The IAB group had a higher previous stroke rate (24.3%) than did other groups. Compared with septuagenarians, centenarians less frequently presented a normal P wave (28.8% vs 53.5%) and more frequently presented advanced IAB (26.3% vs 8.2%), atrial fibrillation/flutter (25.0% vs 10.0%), and premature atrial beats (28.3 vs 7.0%) (P < .01). Relatively few centenarians (<30%) had a normal P wave, and nearly half had IAB. Our data suggested that IAB, particularly advanced IAB, is a pre–atrial fibrillation condition associated with premature atrial beats. Atrial arrhythmias and IAB occurred more frequently in centenarians than in septuagenarians.

SOUTH CAROLINA COMMUNITY BLOCK GRANTS FOR EDUCATION PILOT PROGRAMS

The South Carolina General Assembly created the South Carolina Community Block Grant for Education Pilot Program by Proviso 1.94 in the 2014-15 General Appropriation Act. The intent of the proviso is to encourage public school districts and district entrepreneurial public educators to undertake state-of-the-art initiatives to improve student learning and to share the results with the state’s public education community. Although community partnerships were the focus of the grant, school districts were the lead agencies on the grant were directed by proviso to provide reports, summaries and items for the evaluation component of the grant. Through this proviso, one million dollars was allocated for the block grants with direct allocations to school districts. One hundred percent of the funds were allocated to school districts. No grant award was to exceed $250,000 annually unless the grants committee found that exceptional circumstances warranted exceeding this amount.

South Carolina Community Block Grants for Education Pilot Programs: Year 1 Report

The South Carolina General Assembly created the South Carolina Community Block Grant for Education Pilot Program by Proviso 1.94 in the 2014-15 General Appropriation Act. The purpose of the proviso was to encourage and sustain partnerships between a community and its public school district for the implementation of innovative, state-of-the-art education initiatives and models to improve learning. Any public school, including a charter school, was eligible to submit a grant application. The proviso asserts that the success of the grant program is best served when there is vigorous community support, which is integral to the development and implementation on innovative initiatives for young people. Through this proviso, one million dollars was allocated for the block grants with direct allocations to school districts. Grants awarded were to be implemented for a period of one year beginning July 1, 2015 until June 30, 2016.

Heaven's Sense: a novel / At hand-grips with ruin: the psychology of writer's block

There is a significant attitude of scepticism when it comes to belief in the existence of writer's block as a valid psychological phenomenon, alongside what might be described as the "Tortured Artist Personality". It is contended here that both writer's block and the "Tortured Artist Personality" do exist in a minority of professional and aspiring fiction writers, and furthermore that these phenomena are forms of personality behaviour that have already been well-catalogued by the academic fields of psychiatry, psychology and psychotherapy: specifically, writer's block is a form of unconscious maladaptive procrastination - expressed through avoidance coping or escape coping behaviour - which in turn arises from the fully-accepted personality trait of perfectionism. Aspects of perfectionism, together with various sub-scale traits and mediators, are also the key components in at least one form of "Tortured Artist Personality". This paper lays out the extensive evidence for these assertions, using existing research in the fields of psychology, psychiatry, psychotherapy and neuroscience.

Superposition relations of microfabrics in the northern hanging-wall block

This study reports alternation of D2 extension-related and D3 contraction-related microfabrics in the northern hanging wall block of a gneiss dome-like structure recognized in the Évora Massif (Ossa-Morena Zone). In the Arraiolos – Santo Antonio de Alcorrego traverse high- to low-grade mylonites are dominant. Microfabrics related to D2 ductile deformation and M2 high-amphibolite to greenschist facies characterize an extensional shear zone with telescoping metamorphic isograds. D2 microstructures indicate shear sense with top-to-SE. Superposition of D3 contraction developed under greenschist facies (M3) producing folding of D2 microfabrics, mylonitization of granites along strike-slip shear zones and retrogression of M2 mineral assemblages.

Economic and Environmental Optimization of Ornamental Stone Block Cutting with a 3D Algorithm

This thesis focuses on finding the optimum block cutting dimensions in terms of the environmental and economic factors by using a 3D algorithm for a limestone quarry in Foggia, Italy. The environmental concerns of quarrying operations are mainly: energy consumption, material waste, and pollution. The main economic concerns are the block recovery, the selling prices, and the production costs. Fractures adversely affect the block recovery ratio. With a fracture model, block production can be optimized. In this research, the waste volume produced by quarrying was minimised to increase the recovery ratio and ensure economic benefits. SlabCutOpt is a software developed at DICAM–University of Bologna for block cutting optimization which tests different cutting angles on the x-y-z planes to offer up alternative cutting methods. The program tests several block sizes and outputs the optimal result for each entry. By using SlabCutOpt, ten different block dimensions were analysed, the results indicated the maximum number of non-intersecting blocks for each dimension. After analysing the outputs, the block named number 1 with the dimensions ‘1mx1mx1m’ had the highest recovery ratio as 43% and the total Relative Money Value (RMV) with a value of 22829. Dimension number 1, also had the lowest waste volume, with a value of 3953.25 m3, for the total bench. For cutting the total bench volume of 6932.25m3, the diamond wire cutter had the lowest dust emission values for the block with the dimension ‘2mx2mx2m’, with a value of 24m3. When compared with the Eco-Label standards, block dimensions having surface area values lower than 15m2, were found to fit the natural resource waste criteria of the label, as the threshold required 25% of minimum recovery [1]. Due to the relativity of production costs, together with the Eco-Label threshold, the research recommends the selection of the blocks with a surface area value between 6m2 and 14m2.

Rethinking the block. The 1970s European discourses on the city and the IBA Berlin 1979-87

The dissertation explores the relationship between projects for urban blocks and the discourses on the city between the late 1960s and the 1980s, with a particular focus on the blocks of the Internationale Bauausstellung (IBA) Berlin 1979-87. The main research questions center on whether and how the block changed in connection with the emerging ideas of the city during this period and whether these changes had, in turn, effects on the whole city. Thus far, despite extensive research on the theories and the ideas of the city between the 1960s and 1980s, there is a lack of studies that interweave this research with insights into the block. To fill this gap, this dissertation examines how the block was thematized in the 1970s discourses on the city. It highlights projects for blocks designed between the late 1960s and the 70s in various European cities, particularly West Berlin. Then, it focuses on the blocks of the IBA Berlin 1979-87, examining them through theory, history, and drawings. The study of the examples reveals three distinctive aspects of all blocks considered in the dissertation: the overcoming of small private plots, the individualization of the buildings, and the accessibility of the courtyards from public streets. These aspects reflect the changing understandings of the city and of the urban spaces in the 1970s and 1980s, which resulted in new compositional logics of the block. When examined with critical distance, the blocks of the 1970s and 80s offer a lesson in architectural and urban composition which is still current. - The author has made every effort to contact the owners of the copyrights of the material in the dissertation. The author is available to the right holders with whom it was not possible to communicate as well as for any omissions or inaccuracies in quoting the sources.

Structural steel design with BIM technology - interventions on a three buildings block in Deruta (PG)

The aim of this thesis is to use the developments, advantages and applications of "Building Information Modelling" (BIM) with emphasis on the discipline of structural design for steel building located in Perugia. BIM was mainly considered as a new way of planning, constructing and operating buildings or infrastructures. It has been found to offer greater opportunities for increased efficiency, optimization of resources and generally better management throughout the life cycle of a facility. BIM increases the digitalization of processes and offers integrated and collaborative technologies for design, construction and operation. To understand BIM and its benefits, one must consider all phases of a project. Higher initial design costs often lead to lower construction and operation costs. Creating data-rich digital models helps to better predict and coordinate the construction phases and operation of a building. One of the main limitations identified in the implementation of BIM is the lack of knowledge and qualified professionals. Certain disciplines such as structural and mechanical design depend on whether the main contractor, owner, general contractor or architect need to use or apply BIM to their projects. The existence of a supporting or mandatory BIM guideline may then eventually lead to its adoption. To test the potential of the BIM adoption in the steel design process, some models were developed taking advantage of a largely diffuse authoring software (Autodesk Revit), to produce construction drawings and also material schedule that were needed in order to estimate quantities and features of a real steel building. Once the model has been built the whole process has been analyzed and then compared with the traditional design process of steel structure. Many relevant aspect in term of clearness and also in time spent were shown and lead to final conclusions about the benefits from BIM methodology.

Cognitive And Behavioral Heterogeneity In Genetic Syndromes.

this study aimed to investigate the cognitive and behavioral profiles, as well as the psychiatric symptoms and disorders in children with three different genetic syndromes with similar sociocultural and socioeconomic backgrounds. thirty-four children aged 6 to 16 years, with Williams-Beuren syndrome (n=10), Prader-Willi syndrome (n=11), and Fragile X syndrome (n=13) from the outpatient clinics of Child Psychiatry and Medical Genetics Department were cognitively assessed through the Wechsler Intelligence Scale for Children (WISC-III). Afterwards, a full-scale intelligence quotient (IQ), verbal IQ, performance IQ, standard subtest scores, as well as frequency of psychiatric symptoms and disorders were compared among the three syndromes. significant differences were found among the syndromes concerning verbal IQ and verbal and performance subtests. Post-hoc analysis demonstrated that vocabulary and comprehension subtest scores were significantly higher in Williams-Beuren syndrome in comparison with Prader-Willi and Fragile X syndromes, and block design and object assembly scores were significantly higher in Prader-Willi syndrome compared with Williams-Beuren and Fragile X syndromes. Additionally, there were significant differences between the syndromes concerning behavioral features and psychiatric symptoms. The Prader-Willi syndrome group presented a higher frequency of hyperphagia and self-injurious behaviors. The Fragile X syndrome group showed a higher frequency of social interaction deficits; such difference nearly reached statistical significance. the three genetic syndromes exhibited distinctive cognitive, behavioral, and psychiatric patterns.

Elevated Micronucleus Frequency In Patients With Type 2 Diabetes, Dyslipidemia And Periodontitis.

The over-production of reactive oxygen species (ROS) can cause oxidative damage to a large number of molecules, including DNA, and has been associated with the pathogenesis of several disorders, such as diabetes mellitus (DM), dyslipidemia and periodontitis (PD). We hypothesise that the presence of these diseases could proportionally increase the DNA damage. The aim of this study was to assess the micronucleus frequency (MNF), as a biomarker for DNA damage, in individuals with type 2 DM, dyslipidemia and PD. One hundred and fifty patients were divided into five groups based upon diabetic, dyslipidemic and periodontal status (Group 1 - poor controlled DM with dyslipidemia and PD; Group 2 - well-controlled DM with dyslipidemia and PD; Group 3 - without DM with dyslipidemia and PD; Group 4 - without DM, without dyslipidemia and with PD; and Group 5 - without DM, dyslipidemia and PD). Blood analyses were carried out for fasting plasma glucose, HbA1c and lipid profile. Periodontal examinations were performed, and venous blood was collected and processed for micronucleus (MN) assay. The frequency of micronuclei was evaluated by cell culture cytokinesis-block MN assay. The general characteristics of each group were described by the mean and standard deviation and the data were submitted to the Mann-Whitney, Kruskal-Wallis, Multiple Logistic Regression and Spearman tests. The Groups 1, 2 and 3 were similarly dyslipidemic presenting increased levels of total cholesterol, low density lipoprotein cholesterol and triglycerides. Periodontal tissue destruction and local inflammation were significantly more severe in diabetics, particularly in Group 1. Frequency of bi-nucleated cells with MN and MNF, as well as nucleoplasmic bridges, were significantly higher for poor controlled diabetics with dyslipidemia and PD in comparison with those systemically healthy, even after adjusting for age, and considering Bonferroni's correction. Elevated frequency of micronuclei was found in patients affected by type 2 diabetes, dyslipidemia and PD. This result suggests that these three pathologies occurring simultaneously promote an additional role to produce DNA impairment. In addition, the micronuclei assay was useful as a biomarker for DNA damage in individuals with chronic degenerative diseases.

Association Of Lipophilic Opioids And Hyperbaric Bupivacaine In Spinal Anesthesia For Elective Cesarean Section. Randomized Controlled Study.

To evaluate the efficacy and side-effects of fentanyl and sufentanil combined with hyperbaric spinal bupivacaine in elective cesarean section. A prospective, randomized, double-blind study with 64 term parturients, distributed into 2 groups according to the opioid combined with hyperbaric bupivacaine 0.5% (10mg): GF - fentanyl (25 µg) and GS - sufentanil (5.0 µg). The latency and maximum sensory block level; degree and duration of motor block; duration and quality of analgesia; maternal-fetal repercussions were evaluated. This was an intention-to-treat analysis with a 5% significance level. The latency period, maximum sensory block level, motor block degree and perioperative analgesia were similar in both groups. Motor block and analgesia had a longer duration in the sufentanil group. Maternal adverse effects and neonatal repercussions were similar. The incidence of hypotension was higher in the fentanyl group. In both groups, there was a predominance of patients who were awake and either calm or sleepy. The addition of fentanyl and sufentanil to hyperbaric subarachnoid bupivacaine was shown to be effective for the performance of cesarean section, and safe for the mother and fetus. Analgesia was more prolonged with sufentanil.