Late migration of percutaneous bio-absorbable devices--a word of caution.

BACKGROUND: Closures of atrial septal defects or a patent foramen ovale (PFO) are increasingly performed percutaneously. The experience of late migration of a new bio-absorbable device is presented here, followed by conceptual discussion. METHODS: Six months post PFO closure with a BioSTAR® device a patient presented with chest pain. Echocardiography showed a hyperechogenic structure perforating the aortic wall. RESULTS: Surgical exploration showed a perforation of the ascending aorta by one metallic, non absorbable arm. This is the second case of late (>6 months) dislocation of the residual framework of the occluder. CONCLUSIONS: The overall incidence of perforation of cardiac structures due to secondary dislocation is low. However this complication exists and should kept in mind in symptomatic patients with new onset of chest pain, after percutaneous procedures. The concept of biodegradation, with residual, non absorbable metal braiding, should be reviewed, analyzing in particular long term results and incidence of secondary dislocation.

Caution on the storage of waters and aqueous solutions in plastic containers for hydrogen and oxygen stable isotope analysis

RATIONALE The choice of containers for storage of aqueous samples between their collection, transport and water hydrogen (2H) and oxygen (18O) stable isotope analysis is a topic of concern for a wide range of fields in environmental, geological, biomedical, food, and forensic sciences. The transport and separation of water molecules during water vapor or liquid uptake by sorption or solution and the diffusive transport of water molecules through organic polymer material by permeation or pervaporation may entail an isotopic fractionation. An experiment was conducted to evaluate the extent of such fractionation. METHODS Sixteen bottle-like containers of eleven different organic polymers, including low and high density polyethylene (LDPE and HDPE), polypropylene (PP), polycarbonate (PC), polyethylene terephthalate (PET), and perfluoroalkoxy-Teflon (PFA), of different wall thickness and size were completely filled with the same mineral water and stored for 659?days under the same conditions of temperature and humidity. Particular care was exercised to keep the bottles tightly closed and prevent loss of water vapor through the seals. RESULTS Changes of up to +5 parts per thousand for d2H values and +2.0 parts per thousand for d18O values were measured for water after more than 1?year of storage within a plastic container, with the magnitude of change depending mainly on the type of organic polymer, wall thickness, and container size. The most important variations were measured for the PET and PC bottles. Waters stored in glass bottles with Polyseal (TM) cone-lined PP screw caps and thick-walled HDPE or PFA containers with linerless screw caps having an integrally molded inner sealing ring preserved their original d2H and d18O values. The carbon, hydrogen, and oxygen stable isotope compositions of the organic polymeric materials were also determined. CONCLUSIONS The results of this study clearly show that for precise and accurate measurements of the water stable isotope composition in aqueous solutions, rigorous sampling and storage procedures are needed both for laboratory standards and for unknown samples. Copyright (c) 2012 John Wiley & Sons, Ltd.

Caution, children crossing: Heterogeneity of victim's cost of care and negligence rule

The paper deals with a bilateral accident situation in which victims haveheterogeneous costs of care. With perfect information,efficient care bythe injurer raises with the victim's cost. When the injurer cannot observeat all the victim's type, and this fact can be verified by Courts, first-bestcannot be implemented with the use of a negligence rule based on thefirst-best levels of care. Second-best leads the injurer to intermediate care,and the two types of victims to choose the best response to it. This second-bestsolution can be easily implemented by a negligence rule with second-best as duecare. We explore imperfect observation of the victim's type, characterizing theoptimal solution and examining the different legal alternatives when Courts cannotverify the injurers' statements. Counterintuitively, we show that there is nodifference at all between the use by Courts of a rule of complete trust and arule of complete distrust towards the injurers' statements. We then relate thefindings of the model to existing rules and doctrines in Common Law and Civil Lawlegal systems.

Consumer Advisory Bulletin, Credit Cards on Student Incomes: Proceed With Caution – and Shop With Care, Fall 2007

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: Credit Cards on Student Incomes: Proceed With Caution – and Shop With Care.

Consumer Advisory Bulletin, Caution: Watch What You Sign, October 2003

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: Caution: Watch What You Sign

Caution and necessity

In this paper I examine Crispin Wright's modal anti-realism as based on the availability of a certain attitude of Caution towards judgements of necessity. I think that Wright's account should be attractive in several ways for modal theorists with an anti-realist bend. However, the attitude of Caution to which it appeals has attracted some controversy. Wright himself has later come to doubt whether Caution is ultimately coherent. Here I first address Wright's worries concerning the coherence of Caution and show that they are unfounded. But then I argue that although the attitude of Caution is coherent, it cannot provide a suitable basis for a non-eliminativist account of necessity. I offer two different objections against Caution. (1) I argue that Wright's appeal to Caution, if successful, would show not only that modal judgement is non-objective but also that it is dispensable. Thus, I claim that appeal to Caution would seem to serve more as a threat against a non-eliminativist account of necessity, rather than as a potential adequate basis for it. However, (2) I argue that Wright's appeal to Caution is unsuccessful, for there is no genuine Caution: Caution is a mere verbal attitude.

Idealized SST anomaly regional climate model experiments: a note of caution

To date, a number of studies have focused on the influence of sea surface temperature (SST) on global and regional rainfall variability, with the majority of these focusing on certain ocean basins e.g. the Pacific, North Atlantic and Indian Ocean. In contrast, relatively less work has been done on the influence of the central South Atlantic, particularly in relation to rainfall over southern Africa. Previous work by the authors, using reanalysis data and general circulation model (GCM) experiments, has suggested that cold SST anomalies in the central southern Atlantic Ocean are linked to an increase in rainfall extremes across southern Africa. In this paper we present results from idealised regional climate model (RCM) experiments forced with both positive and negative SST anomalies in the southern Atlantic Ocean. These experiments reveal an unexpected response of rainfall over southern Africa. In particular it was found that SST anomalies of opposite sign can cause similar rainfall responses in the model experiments, with isolated increases in rainfall over central southern Africa as well as a large region of drying over the Mozambique Channel. The purpose of this paper is to highlight this finding and explore explanations for the behaviour of the climate model. It is suggested that the observed changes in rainfall might result from the redistribution of energy (associated with upper level changes to Rossby waves) or, of more concern, model error, and therefore the paper concludes that the results of idealised regional climate models forced with SST anomalies should be viewed cautiously.

A word of caution on calculating market-based minimum capital risk requirements

This paper demonstrates that the use of GARCH-type models for the calculation of minimum capital risk requirements (MCRRs) may lead to the production of inaccurate and therefore inefficient capital requirements. We show that this inaccuracy stems from the fact that GARCH models typically overstate the degree of persistence in return volatility. A simple modification to the model is found to improve the accuracy of MCRR estimates in both back- and out-of-sample tests. Given that internal risk management models are currently in widespread usage in some parts of the world (most notably the USA), and will soon be permitted for EC banks and investment firms, we believe that our paper should serve as a valuable caution to risk management practitioners who are using, or intend to use this popular class of models.