Asymptomatic cardiac rhabdomyoma in neonates : is surgery indicated?

Neonatal Tuberose sclerosis complex may be associated with symptomatic cardiac rhabdomyomas. Cardiac rhabdomyomas are the most common cardiac tumours. The symptoms include haemodynamic instability and life threatening arrhythmias usually requiring early surgical intervention. This article reports a case of a 32 week gestation newborn diagnosed with a right ventricular outflow tract mass and subsequently diagnosed with tuberose sclerosis that needed early surgical intervention.peer-reviewe

A thin ring model for the OH megamaser in IIIZw35

We present a model for the OH megamaser emission in the starburst galaxy IIIZw35. The observed diffuse and compact OH maser components in this source are explained by a single phase of unsaturated clumpy gas distributed in a thin ring structure and amplifying background continuum. We emphasize the importance of clumpiness in the OH masing medium, an effect that has not been fully appreciated previously. The model explains why multiple bright spots are seen only at the ring tangents while smoother emission is found elsewhere. Both the observed velocity gradients and the line to continuum ratios around the ring enquire a geometry where most of the seed photons come from a continuum emission which lies outside the OH ring. To explain both the OH and continuum brightness, free-free absorbing gas is required along the ring axis to partially absorb the far side of the ring. It is proposed that the required geometry arises from an inwardly propagating ring of starburst activity

The Holevo-Schumacher-Westmoreland Channel Capacity for a Class of Qudit Unital Channels

The Holevo-Schumacher-Westmoreland (HSW) classical (entanglement-unassisted) channel capacity for a class of qudit unital channels is shown to be C = log2(d) - Smin, where d is the dimension of the qudit, and Smin is the minimum possible von Neumann entropy at the channel output. The HSW channel capacity for tensor products of this class of unital qudit channels is shown to obey the same formula.Comment: 21 Pages. No Figure

Non-ischaemic cardiomyopathy, sudden death and implantable defibrillators: a review and meta-analysis

Objective: The recent Danish Study to Assess the Efficacy of ICDs in Patients with Non-ischemic Systolic Heart Failure on Mortality (DANISH) trial suggested that implantable cardioverter defibrillators (ICDs) do not reduce overall mortality in patients with non-ischaemic cardiomyopathy (NICM), despite reducing sudden cardiac death. We performed an updated meta-analysis to examine the impact of ICD therapy on mortality in NICM patients. Methods: A systematic search for studies that examined the effect of ICDs on outcomes in NICM was performed. Our analysis compared patients randomised to an ICD with those randomised to no ICD, and examined the endpoint of overall mortality. Results: Six primary prevention trials and two secondary prevention trials were identified that met the pre-specified search criteria. Using a fixed-effects model, analysis of primary prevention trials revealed a reduction in overall mortality with ICD therapy (RR 0.76, 95% CI 0.65 to 0.91). Conclusions: Although our updated meta-analysis demonstrates a survival benefit of ICD therapy, the effect is substantively weakened by the inclusion of the DANISH trial—which is both the largest and most recent of the analysed trials—indicating that the residual pooled benefit of ICDs may reflect the risk of sudden death in older trials which included patients treated sub-optimally by contemporary standards. As such, these data must be interpreted cautiously. The results of the DANISH trial emphasise that there is no ‘one size fits all’ indication for primary prevention ICDs in NICM patients, and clinicians must consider age and comorbidity on an individual basis when determining whether a defibrillator is appropriate

The Impact of School Quality on Earnings and Educational Returns

The expansion of education has been widely adopted as a key element in the development strategies of low-income countries. While there is substantial evidence on the benefits of greater educational attainment for subsequent labor market earnings, empirical evidence on the role played by school quality is scarce. This paper combines household survey data with unique data on school quality, from Honduras, to study the importance of school quality as a determinant of earnings. Our objective measures of school quality capture teacher training, school infrastructure and school crowding. The results diaplay strong positive effects of school quality on earnings and on educational returns. These effects persist across a variety of model specifications

High-temperature superconductivity from realistic Coulomb and Frohlich interactions

In recent years ample experimental evidence has shown that charge carriers in high-temperature superconductors are strongly correlated but also coupled with lattice vibrations (phonons), signalling that the true origin of high-Tc superconductivity can only be found in a proper combination of Coulomb and electron-phonon interactions. On this basis, we propose and study a model for high-Tc superconductivity which accounts for realistic Coulomb repulsion, strong electron-phonon (Frohlich) interaction and residual on-site (Hubbard ~U ) correlations without any ad-hoc assumptions on their relative strength and interaction range. In the framework of this model, which exhibits a phase transition to a superconducting state with a critical temperature Tc well in excess of 100K, we emphasize the role of ~U as the driving parameter for a BEC/BCS crossover. Our model lays a microscopic foundation for the polaron-bipolaron theory of superconductivity. We argue that the high-Tc phenomenon originates in competing Coulomb and Frohlich interactions beyond the conventional BCS description

Who benefits from a defibrillator—balancing the risk of sudden versus non-sudden death

Purpose of Review: Treatment with a defibrillator can reduce the risk of sudden death by terminating ventricular arrhythmias. The identification of patient groups in whom this function reduces overall mortality is challenging. In this review, we summarise the evidence for who benefits from a defibrillator. Recent Findings: Recent evidence suggests that contemporary pharmacologic and non-defibrillator device therapies are altering the potential risks and benefits of a defibrillator. Summary: Who benefits from a defibrillator is determined by both the risk of sudden death and the competing risk of other, non-sudden causes of death. The balance of these risks is changing, which calls into question whether historic evidence for the use of defibrillators remains robust in the modern era

Coherent States and Modified de Broglie-Bohm Complex Quantum Trajectories

This paper examines the nature of classical correspondence in the case of coherent states at the level of quantum trajectories. We first show that for a harmonic oscillator, the coherent state complex quantum trajectories and the complex classical trajectories are identical to each other. This congruence in the complex plane, not restricted to high quantum numbers alone, illustrates that the harmonic oscillator in a coherent state executes classical motion. The quantum trajectories are those conceived in a modified de Broglie-Bohm scheme and we note that identical classical and quantum trajectories for coherent states are obtained only in the present approach. The study is extended to Gazeau-Klauder and SUSY quantum mechanics-based coherent states of a particle in an infinite potential well and that in a symmetric Poschl-Teller (PT) potential by solving for the trajectories numerically. For the coherent state of the infinite potential well, almost identical classical and quantum trajectories are obtained whereas for the PT potential, though classical trajectories are not regained, a periodic motion results as t --> \infty.Comment: More example

ILRI in Asia: an assessment of priorities for Asian livestock research and development

The purpose of this discussion paper is, firstly, to promote debate amongst potential clients of ILRI's research in South and South-East Asia on what ILRI could do in these regions, in collaboration with the NARS, which will assist the development of the livestock industries and, secondly, to provide advice to the ILRI Board and management on the rational for ILRI involvement in the regions, the nature of that involvement, and the mechanisms and process by which ILRI might maximise the benefits from its investment into research and development, particularly in these regions. The paper looks initially at the economic trends in selected countries in both regions and assesses the likely impact of this on dietary preferences and priorities. Having established the potential demands in the regions for the major livestock products (meat, milk, draft-power, eggs and, to a lesser extent, leather, wool and hair) in the next decade or so, the ways in which deficits in supply can be met from existing systems are assessed. The major constraints to improved production are identified and the role that technologically based research can play in alleviating these constraints is examined. The discussion paper then canvasses options for ILRI's participation, facilitation and leadership in some areas of priority research for the region and some possible mechanisms by which ILRI might achieve such objectives are detailed

Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis

Objective: Heart failure is a prothrombotic state, and it has been hypothesised that thrombosis and embolism cause non-fatal and fatal events in heart failure and reduced ejection fraction (HFrEF). We sought to determine the effect of anticoagulant therapy on clinical outcomes in patients with HFrEF who are in sinus rhythm. Methods: We conducted an updated systematic review and meta-analysis to examine the effect of anticoagulation therapy in patients with HFrEF in sinus rhythm. Our analysis compared patients randomised to anticoagulant therapy with those randomised to antiplatelet therapy, placebo or control, and examined the endpoints of all-cause mortality, (re)hospitalisation for worsening heart failure, non-fatal myocardial infarction, non-fatal stroke of any aetiology and major haemorrhage. Results: Five trials were identified that met the prespecified search criteria. Compared with control therapy, anticoagulant treatment did not reduce all-cause mortality (risk ratio [RR] 0.99, 95% CI 0.90 to 1.08), (re)hospitalisation for heart failure (RR 0.97, 95% CI 0.82 to 1.13) or non-fatal myocardial infarction (RR 0.92, 95% CI 0.75 to 1.13). Anticoagulation did reduce the rate of non-fatal stroke (RR 0.63, 95% CI 0.49 to 0.81, p=0.001), but this was offset by an increase in the incidence of major haemorrhage (RR 1.88, 95% CI 1.49 to 2.38, p=0.001). Conclusions: Our meta-analysis provides evidence to oppose the hypothesis that thrombosis or embolism plays an important role in the morbidity and mortality associated with HFrEF, with the exception of stroke-related morbidity