Which available transapical transcatheter valve fits into degenerated aortic bioprostheses?

The transapical transcatheter aortic valve implantation (TA-TAVI) in degenerated aortic bioprosthesis is an emerging therapy for surgically non-amenable patients. However, the presence of different types of aortic bioprostheses (stented and stentless), available in different sizes (19-27 mm), can be at the origin of important mismatches between the malfunctioning, degenerated aortic valves and the inner stent-valves implanted through transapical accesses (23 and 26 mm Edwards Sapien transcatheter stent-valves). We report an emergency TA-TAVI treatment of a severely regurgitant degenerated 23 mm Mitroflow aortic bioprosthesis (Sorin Group, Milano, Italy) implanted seven years earlier in an 80-year-old lady, and we reviewed the current available literature about transapical 'valve-in-valve' procedures to analyze the hemodynamic results and the ideal 'prosthesis-to-prosthesis' match.

Physician behavioral adaptability: A model to outstrip a "one size fits all" approach

Objective: Based on a literature review, we propose a model of physician behavioral adaptability (PBA) with the goal of inspiring new research. PBA means that the physician adapts his or her behavior according to patients' different preferences. The PBA model shows how physicians infer patients' preferences and adapt their interaction behavior from one patient to the other. We claim that patients will benefit from better outcomes if their physicians show behavioral adaptability rather than a "one size fits all" approach. Method: This literature review is based on a literature search of the PsycINFO1 and MEDLINE1 databases. Results: The literature review and first results stemming from the authors' research support the validity and viability of parts of the PBA model. There is evidence suggesting that physicians are able to show behavioral flexibility when interacting with their different patients, that a match between patients' preferences and physician behavior is related to better consultation outcomes, and that physician behavioral adaptability is related to better consultation outcomes. Practice implications: Training of physicians' behavioral flexibility and their ability to infer patients' preferences can facilitate physician behavioral adaptability and positive patient outcomes.

One size fits all: the increasing standardisation of English teachers' work in England

English teachers in England have experienced a lengthy period of external constraint, increasingly controlling their practice. This constraint was originated in the 1989 National curriculum. Although in its first version it was in harmony with practice, its numerous revisions have moved it a long way from teachers’ own values and beliefs. This move is illustrated through research into the teaching of literature, which is seen by English teachers as often arid and driven by examinations alone. This period has been increasingly dominated by high-stakes testing, school league tables and frequent school inspections. Another powerful element has been the introduction of Standards for teachers at every career level from student teachers to the Advanced Skills Teachers. Research demonstrates that this introduction of Standards has had some beneficial effects. However, research also shows that the government decision to replace all these, hierarchically structured standards, with a single standard is seen by many teachers as a retrograde step. Evidence from Advanced Skills Teachers of English shows that the government’s additional proposal to bring in a Master Teacher standard is equally problematic. The decline of the National Association for the Teaching of English, the key subject association for English teachers, is discussed in relation to this increasingly negative and constraining environment, concluding that many English teachers are choosing a form of local resistance which, while understandable, weakens the credibility of the profession and erodes the influence of its key voice, NATE.

Reliability of orbital fits for resonant extrasolar planetary systems: the case of HD82943

We perform a statistical study of the process of orbital determination of the HD82943 extrasolar planetary system, using the current observational data set of N = 165 radial velocity (RV) measurements. Our aim is to analyse the dispersion of possible orbital fits leading to residuals compatible with the best solution, and to discuss the sensitivity of the results with respect to both the data set and the error distribution around the best fit. Although some orbital parameters (e.g. semimajor axis) appear well constrained, we show that the best fits for the HD82943 system are not robust, and at present it is not possible to estimate reliable solutions for these bodies. Finally, we discuss the possibility of a third planet, with a mass of 0.35M(Jup) and an orbital period of 900 d. Stability analysis and simulations of planetary migration indicate that such a hypothetical three-planet system could be locked in a double 2/1 mean-motion resonance, similar to the so-called Laplace resonance of the three inner Galilean satellites of Jupiter.

DETECTABILITY AND ERROR ESTIMATION IN ORBITAL FITS OF RESONANT EXTRASOLAR PLANETS

We estimate the conditions for detectability of two planets in a 2/1 mean-motion resonance from radial velocity data, as a function of their masses, number of observations and the signal-to-noise ratio. Even for a data set of the order of 100 observations and standard deviations of the order of a few meters per second, we find that Jovian-size resonant planets are difficult to detect if the masses of the planets differ by a factor larger than similar to 4. This is consistent with the present population of real exosystems in the 2/1 commensurability, most of which have resonant pairs with similar minimum masses, and could indicate that many other resonant systems exist, but are currently beyond the detectability limit. Furthermore, we analyze the error distribution in masses and orbital elements of orbital fits from synthetic data sets for resonant planets in the 2/1 commensurability. For various mass ratios and number of data points we find that the eccentricity of the outer planet is systematically overestimated, although the inner planet`s eccentricity suffers a much smaller effect. If the initial conditions correspond to small-amplitude oscillations around stable apsidal corotation resonances, the amplitudes estimated from the orbital fits are biased toward larger amplitudes, in accordance to results found in real resonant extrasolar systems.

Arbitragem regulatória X one size fits all: a discricionariedade na regulação bancária internacional entre Cila e Caríbdis

As peculiaridades da atividade bancária - normalmente vista como fundamental à persecução do desenvolvimento, bem como bastante influenciada pelo direito - estimularam a emergência de um regime internacional de regulação da categoria. Tal advento se deu na esteira dos trabalhos realizados por organizações internacionais, como o Comitê da Basileia (BCBS) e o Comitê de Estabilidade Financeira (FSB), e em virtude da percepção de estarmos em um mundo no qual os mercados estão muito interligados, mas permanecem nacionalmente regulados. À parte da discussão do mérito e efetividade dos padrões regulatórios propostos por essas organizações, em um contexto no qual uma série de países busca implementá-los, interessa ao presente trabalho perscrutar os elementos que definem o grau adequado de discricionariedade de implementação conferida na formulação desses. A análise de tal problema sugere a existência de dois extremos a se evitar: a arbitragem regulatória e o one size fits all. Evitar a arbitragem regulatória é uma preocupação da literatura de regulação bancária que se traduz em conter uma variação muito acentuada entre os regimes regulatórios de diferentes jurisdições. Isso enseja três vetores favoráveis a um menor grau de discricionariedade, representado por desígnios de maior coordenação, maior competitividade e de evitar uma race to the bottom regulatória entre os países. Já evitar o one size fits all é uma preocupação recorrente da literatura de direito e desenvolvimento que sugere a necessidade de se atentar para as peculiaridades locais na formulação de políticas regulatórias. Por sua vez, isso enseja outros três vetores, dessa vez em direção a um maior grau de discricionariedade. Sendo esses representados por preocupações com a eficiência das medidas adotadas, com a garantia de um espaço de manobra que respeite a autodeterminação dos países - ao menos minorando eventuais déficits democráticos da estipulação de padrões internacionais - e com a viabilidade prática do experimentalismo. A fim de analisar esse problema e levando em conta esses extremos, propõe-se uma estratégia bipartida: a construção de um enquadramento teórico e a verificação de uma hipótese de pesquisa, segundo a qual um caso específico de regulação bancária pode demonstrar como esses elementos interagem na definição do grau de discricionariedade. Assim, em um primeiro momento - após a necessária contextualização e descrição metodológica - é construído um framework teórico do problema à luz da literatura da regulação bancária e do instrumental utilizado pelas discussões acerca do impacto do direito no desenvolvimento. Discussões essas que há anos têm abordado a formulação de padrões internacionais e a sua implementação em contextos nacionais diversos. Também nesse primeiro momento e como parte da construção dos alicerces teóricos, procede-se a um excurso que busca verificar a hipótese da confiança no sistema bancário ser uma espécie de baldio (common), bem como suas possíveis consequências. Partindo desse enquadramento, elege-se o segmento de regulação bancária relativo aos garantidores de depósito para uma análise de caso. Tal análise - realizada com subsídios provenientes de pesquisa bibliográfica e empírica - busca demonstrar com que grau de discricionariedade e de que forma se deu a formulação e implementação de padrões internacionais nesse segmento. Ao fim, analisa-se como os vetores determinantes do grau de discricionariedade interagem no caso dos garantidores de depósitos, bem como as sugestões possivelmente inferíveis dessa verificação para os demais segmentos da regulação bancária.

Variational fits to the lattice energy of heavy-light mesons

We perform variational calculations of heavy-light meson masses using a fitted formula to a lattice two-quark potential. We examine the light quark mass dependence of the meson mass using the Schrodinger equation and the Dirac equation. For the Dirac equation, a saddle-point variational principle is employed, since the Dirac Hamiltonian is not bound from below.