Therapy of acute massive pulmonary embolism associated with Klippel-Trenaunay syndrome.

Acute massive pulmonary embolism (PE) is a life-threatening event. Before the era of cardiopulmonary bypass, acute pulmonary embolectomy had been historically attempted in patients with severe hemodynamic compromise. The Klippel-Trenaunay syndrome (KTS) represents a significant life-long risk for major thromboembolic events. We present two young patients with Klippel-Trenaunay syndrome who survived surgical embolectomy after massive PE and cardiopulmonary resuscitation, with good postoperative recovery. Even though the role of surgical embolectomy in massive PE is not clearly defined, with current technology it can be life saving and can lead to a complete recovery, especially in young patients as described in this study.

Successful Surgical Pulmonary Embolectomy for Massive Perinatal Embolism after Emergency Cesarean Section.

Pregnant women are exposed to an increased risk for developing pulmonary embolism (PE), a main cause for maternal mortality. Surgical pulmonary embolectomy is one important therapeutic and potential life-saving armamentarium, considering pregnancy as a relative contraindication for thrombolysis. We present a case of a 36-year-old woman with massive bilateral PE after emergent caesarean delivery, requiring reanimation by external heart massage. The onset of massive intrauterine bleeding contraindicated thrombolysis and emergency surgical pulmonary embolectomy, followed by a hysterectomy, were preformed successfully. Acute surgical pulmonary embolectomy may be an option in critically diseased high-risk patients, requiring a multiteam approach, and should be part of the therapeutic armamentarium of the attending cardiac surgeon.

Modularité massive ou construction sociale? : une analyse de l'approche psychoévolutionniste de Cosmides et Tooby.

Ce mémoire se veut un examen épistémologique de la thèse psychoévolutionniste de Leda Cosmides et John Tooby, principalement en ce qui concerne la modularité massive. Nous avons tâché de voir si la modularité massive permet de rendre compte des processus mentaux complexes en nous penchant plus particulièrement sur le cas des émotions. Nous explorons d'abord la thèse de Cosmides et Tooby en la distinguant d'avec d'autres conceptions comme l'écologie béhaviorale et en expliquant le rôle particulier que jouent les émotions au sein de la théorie. Nous analysons ensuite la thèse de la modularité massive et les différents arguments théoriques ou empiriques qui l'appuient, et évaluons finalement des critiques de la modularité émises par certains philosophes, dont David Buller.

Actions of resiliencia opposite to the housing policies in the city of Buenos Aires, Argentina: the social organizations, the institutions, and the massive evictions

The current housing problems in the city of Buenos Aires revolves around two phenomena, the precariousness and the evictions, in a context that is conceived like housing emergency. In response to this situation, some institutional organisms and certain social organizations with territorial roots in the south of the city, began to take forward actions of resilience opposing to the massive evictions, which take place as consequence of the real-estate pressure, and were concerning to the hotels, pensions, tenancies, and usurped houses of this zone of the city. It will be analyzed the actions of resilience displayed by them in their individual and collective dimensions and their relation to housing policies.

Los Massive Open On line Courses (MOOCs) como extensi??n universitaria

Resumen basado en el de la publicaci??n

Massive Science with VO and Grids

There is a growing need for massive computational resources for the analysis of new astronomical datasets. To tackle this problem, we present here our first steps towards marrying two new and emerging technologies; the Virtual Observatory (e.g, AstroGrid) and the computa- tional grid (e.g. TeraGrid, COSMOS etc.). We discuss the construction of VOTechBroker, which is a modular software tool designed to abstract the tasks of submission and management of a large number of compu- tational jobs to a distributed computer system. The broker will also interact with the AstroGrid workflow and MySpace environments. We discuss our planned usages of the VOTechBroker in computing a huge number of n–point correlation functions from the SDSS data and mas- sive model-fitting of millions of CMBfast models to WMAP data. We also discuss other applications including the determination of the XMM Cluster Survey selection function and the construction of new WMAP maps.

Teaching programming to beginners in a massive open online course

The University of Reading’s first Massive Open Online Course (MOOC) “Begin Programming: Build your first mobile game” (#FLMobiGame) was offered in Autumn 2013 on the FutureLearn platform. This course used a simple Android game framework to present basic programming concepts to complete beginners. The course attracted wide interest from all age groups. The course presented opportunities and challenges to both participants and educators. While some participants had difficulties accessing content some others had trouble grasping the concepts and applying them in a real program. Managing forums was cumbersome with the limited facilities supported by the Beta-platform. A healthy community was formed around the course with the support of social media. The case study reported here is part of an ongoing research programme exploring participants’ MOOC engagement and experience using a grounded, ethnographical approach.

Massive Open Online Courses on health and medicine: review

Background: Massive Open Online Courses (MOOCs) have become immensely popular in a short span of time. However, there is very little research exploring MOOCs in the discipline of Health and Medicine. This paper is aimed to fill this void by providing a review of Health and Medicine related MOOCs. Objective: Provide a review of Health and Medicine related MOOCs offered by various MOOC platforms within the year 2013. Analyze and compare the various offerings, their target audience, typical length of a course and credentials offered. Discuss opportunities and challenges presented by MOOCs in the discipline of Health and Medicine. Methods: Health and Medicine related MOOCs were gathered using several methods to ensure the richness and completeness of data. Identified MOOC platform websites were used to gather the lists of offerings. In parallel, these MOOC platforms were contacted to access official data on their offerings. Two MOOC aggregator sites (Class Central and MOOC List) were also consulted to gather data on MOOC offerings. Eligibility criteria were defined to concentrate on the courses that were offered in 2013 and primarily on the subject ‘Health and Medicine’. All language translations in this paper were achieved using Google Translate. Results: The search identified 225 courses out of which 98 were eligible for the review (n = 98). 58% (57) of the MOOCs considered were offered on the Coursera platform and 94% (92) of all the MOOCs were offered in English. 90 MOOCs were offered by universities and the John Hopkins University offered the largest number of MOOCs (12). Only three MOOCs were offered by developing countries (China, West Indies, and Saudi Arabia). The duration of MOOCs varied from three weeks to 20 weeks with an average length of 6.7 weeks. On average MOOCs expected a participant to work on the material for 4.2 hours a week. Verified Certificates were offered by 14 MOOCs while three others offered other professional recognition. Conclusions: The review presents evidence to suggest that MOOCs can be used as a way to provide continuous medical education. It also shows the potential of MOOCs as a means of increasing health literacy among the public.

Massive Open Online Courses

Massive Open Online Courses (MOOCs) are a new addition to the open educational provision. They are offered mainly by prestigious universities on various commercial and non-commercial MOOC platforms allowing anyone who is interested to experience the world class teaching practiced in these universities. MOOCs have attracted wide interest from around the world. However, learner demographics in MOOCs suggest that some demographic groups are underrepresented. At present MOOCs seem to be better serving the continuous professional development sector.

Massive Open Online Courses and sustainability

Massive Open Online Courses (MOOCs) have become very popular among learners millions of users from around the world registered with leading platforms. There are hundreds of universities (and other organizations) offering MOOCs. However, sustainability of MOOCs is a pressing concern as MOOCs incur up front creation costs, maintenance costs to keep content relevant and on-going support costs to provide facilitation while a course is being run. At present, charging a fee for certification (for example Coursera Signature Track and FutureLearn Statement of Completion) seems a popular business model. In this paper, the authors discuss other possible business models and their pros and cons. Some business models discussed here are: Freemium model – providing content freely but charging for premium services such as course support, tutoring and proctored exams. Sponsorships – courses can be created in collaboration with industry where industry sponsorships are used to cover the costs of course production and offering. For example Teaching Computing course was offered by the University of East Anglia on the FutureLearn platform with the sponsorship from British Telecom while the UK Government sponsored the course Introduction to Cyber Security offered by the Open University on FutureLearn. Initiatives and Grants – The government, EU commission or corporations could commission the creation of courses through grants and initiatives according to the skills gap identified for the economy. For example, the UK Government’s National Cyber Security Programme has supported a course on Cyber Security. Similar initiatives could also provide funding to support relevant course development and offering. Donations – Free software, Wikipedia and early OER initiatives such as the MIT OpenCourseware accept donations from the public and this could well be used as a business model where learners could contribute (if they wish) to the maintenance and facilitation of a course. Merchandise – selling merchandise could also bring revenue to MOOCs. As many participants do not seek formal recognition (European Commission, 2014) for their completion of a MOOC, merchandise that presents their achievement in a playful way could well be attractive for them. Sale of supplementary material –supplementary course material in the form of an online or physical book or similar could be sold with the revenue being reinvested in the course delivery. Selective advertising – courses could have advertisements relevant to learners Data sharing – though a controversial topic, sharing learner data with relevant employers or similar could be another revenue model for MOOCs. Follow on events – the courses could lead to follow on summer schools, courses or other real-life or online events that are paid-for in which case a percentage of the revenue could be passed on to the MOOC for its upkeep. Though these models are all possible ways of generating revenue for MOOCs, some are more controversial and sensitive than others. Nevertheless unless appropriate business models are identified the sustainability of MOOCs would be problematic.

Elderly learners and Massive Open Online Courses: a review

Background: Massive open online courses (MOOCs) have become commonplace in the e-learning landscape. Thousands of elderly learners are participating in courses offered by various institutions on a multitude of platforms in many different languages. However, there is very little research into understanding elderly learners in MOOCs. Objective: We aim to show that a considerable proportion of elderly learners are participating in MOOCs and that there is a lack of research in this area. We hope this assertion of the wide gap in research on elderly learners in MOOCs will pave the way for more research in this area. Methods: Pre-course survey data for 10 University of Reading courses on the FutureLearn platform were analyzed to show the level of participation of elderly learners in MOOCs. Two MOOC aggregator sites (Class Central and MOOC List) were consulted to gather data on MOOC offerings that include topics relating to aging. In parallel, a selected set of MOOC platform catalogues, along with a recently published review on health and medicine-related MOOCs, were searched to find courses relating to aging. A systematic literature search was then employed to identify research articles on elderly learners in MOOCs. Results: The 10 courses reviewed had a considerable proportion of elderly learners participating in them. For the over-66 age group, this varied from 0.5% (on the course “Managing people”) to 16.3% (on the course “Our changing climate”), while for the over-56 age group it ranged from 3.0% (on “A beginners guide to writing in English”) to 39.5% (on “Heart health”). Only six MOOCs were found to include topics related to aging: three were on the Coursera platform, two on the FutureLearn platform, and one on the Open2Study platform. Just three scholarly articles relating to MOOCs and elderly learners were retrieved from the literature search. Conclusions: This review presents evidence to suggest that elderly learners are already participating in MOOCs. Despite this, there has been very little research into their engagement with MOOCs. Similarly, there has been little research into exploiting the scope of MOOCs for delivering topics that would be of interest to elderly learners. We believe there is potential to use MOOCs as a way of tackling the issue of loneliness among older adults by engaging them as either resource personnel or learners.

Dynamic portrait of the planetary 2/1 mean-motion resonance - I. Systems with a more massive outer planet

We analyse the global structure of the phase space of the planar planetary 2/1 mean-motion resonance in cases where the outer planet is more massive than its inner companion. Inside the resonant domain, we show the existence of two families of periodic orbits, one associated to the librational motion of resonant angle (sigma-family) and the other related to the circulatory motion of the difference in longitudes of pericentre (Delta pi-family). The well-known apsidal corotation resonances (ACR) appear as intersections between both families. A complex web of secondary resonances is also detected for low eccentricities, whose strengths and positions are dependent on the individual masses and spatial scale of the system. The construction of dynamical maps for various values of the total angular momentum shows the evolution of the families of stable motion with the eccentricities, identifying possible configurations suitable for exoplanetary systems. For low-moderate eccentricities, several different stable modes exist outside the ACR. For larger eccentricities, however, all stable solutions are associated to oscillations around the stationary solutions. Finally, we present a possible link between these stable families and the process of resonance capture, identifying the most probable routes from the secular region to the resonant domain, and discussing how the final resonant configuration may be affected by the extension of the chaotic layer around the resonance region.

Imprints of fast-rotating massive stars in the Galactic Bulge

The first stars that formed after the Big Bang were probably massive(1), and they provided the Universe with the first elements heavier than helium (`metals`), which were incorporated into low-mass stars that have survived to the present(2,3). Eight stars in the oldest globular cluster in the Galaxy, NGC 6522, were found to have surface abundances consistent with the gas from which they formed being enriched by massive stars(4) (that is, with higher alpha-element/Fe and Eu/Fe ratios than those of the Sun). However, the same stars have anomalously high abundances of Ba and La with respect to Fe(4), which usually arises through nucleosynthesis in low-mass stars(5) (via the slow-neutron-capture process, or s-process). Recent theory suggests that metal-poor fast-rotating massive stars are able to boost the s-process yields by up to four orders of magnitude(6), which might provide a solution to this contradiction. Here we report a reanalysis of the earlier spectra, which reveals that Y and Sr are also over-abundant with respect to Fe, showing a large scatter similar to that observed in extremely metal-poor stars(7), whereas C abundances are not enhanced. This pattern is best explained as originating in metal-poor fast-rotating massive stars, which might point to a common property of the first stellar generations and even of the `first stars`.

ON THE NATURE OF THE PROTOTYPE LUMINOUS BLUE VARIABLE AG CARINAE. II. WITNESSING A MASSIVE STAR EVOLVING CLOSE TO THE EDDINGTON AND BISTABILITY LIMITS

We show that the significantly different effective temperatures (T(eff)) achieved by the luminous blue variable AG Carinae during the consecutive visual minima of 1985-1990 (T(eff) similar or equal to 22,800 K) and 2000-2001 (T(eff) similar or equal to 17,000 K) place the star on different sides of the bistability limit, which occurs in line-driven stellar winds around T(eff) similar to 21,000 K. Decisive evidence is provided by huge changes in the optical depth of the Lyman continuum in the inner wind as T(eff) changes during the S Dor cycle. These changes cause different Fe ionization structures in the inner wind. The bistability mechanism is also related to the different wind parameters during visual minima: the wind terminal velocity was 2-3 times higher and the mass-loss rate roughly two times smaller in 1985-1990 than in 2000-2003. We obtain a projected rotational velocity of 220 +/- 50 km s(-1) during 1985-1990 which, combined with the high luminosity (L(star) = 1.5 x 10(6) L(circle dot)), puts AG Car extremely close to the Eddington limit modified by rotation (Omega Gamma limit): for an inclination angle of 90 degrees, Gamma(Omega) greater than or similar to 1.0 for M(circle dot) less than or similar to 60. Based on evolutionary models and mass budget, we obtain an initial mass of similar to 100 M(circle dot) and a current mass of similar to 60-70 M(circle dot) for AG Car. Therefore, AG Car is close to, if not at, the Omega Gamma limit during visual minimum. Assuming M = 70 M(circle dot), we find that Gamma(Omega) decreases from 0.93 to 0.72 as AG Car expands toward visual maximum, suggesting that the star is not above the Eddington limit during maximum phases.