ECMELLA as a bridge to heart transplantation in refractory ventricular fibrillation: A case report.

Extracorporeal membrane oxygenation (ECMO) is an effective cardiorespiratory support technique in refractory cardiac arrest (CA). In patients under veno-arterial ECMO, the use of an Impella device, a microaxial pump inserted percutaneously, is a valuable strategy through a left ventricular unloading approach. ECMELLA, a combination of ECMO with Impella, seems to be a promising method to support end-organ perfusion while unloading the left ventricle. The present case report describes the clinical course of a patient with ischemic and dilated cardiomyopathy who presented with refractory ventricular fibrillation (VF) leading to CA in the late postmyocardial infarction (MI) period, and who was successfully treated with ECMO and IMPELLA as a bridge to heart transplantation. In the case of CA on VF refractory to conventional resuscitation maneuvers, early extracorporeal cardiopulmonary resuscitation (ECPR) associated with an Impella seems to be the best strategy. It provides organ perfusion, left ventricular unloading, and ability for neurological evaluation and VF catheter ablation before allowing heart transplantation. It is the treatment of choice in cases of end-stage ischaemic cardiomyopathy and recurrent malignant arrhythmias

A simple accurate method to predict time of ponding under variable intensity rainfall

The prediction of the time to ponding following commencement of rainfall is fundamental to hydrologic prediction of flood, erosion, and infiltration. Most of the studies to date have focused on prediction of ponding resulting from simple rainfall patterns. This approach was suitable to rainfall reported as average values over intervals of up to a day but does not take advantage of knowledge of the complex patterns of actual rainfall now commonly recorded electronically. A straightforward approach to include the instantaneous rainfall record in the prediction of ponding time and excess rainfall using only the infiltration capacity curve is presented. This method is tested against a numerical solution of the Richards equation on the basis of an actual rainfall record. The predicted time to ponding showed mean error ≤7% for a broad range of soils, with and without surface sealing. In contrast, the standard predictions had average errors of 87%, and worst-case errors exceeding a factor of 10. In addition to errors intrinsic in the modeling framework itself, errors that arise from averaging actual rainfall records over reporting intervals were evaluated. Averaging actual rainfall records observed in Israel over periods of as little as 5 min significantly reduced predicted runoff (75% for the sealed sandy loam and 46% for the silty clay loam), while hourly averaging gave complete lack of prediction of ponding in some of the cases.Keywords: Infiltration, Variable rainfall, Pondering, Runof

Combined paclitaxel and gemcitabine as first-line treatment in metastatic non-small cell lung cancer: a multicentre phase II study

The efficacy and toxicity of combined paclitaxel and gemcitabine was evaluated in 54 chemotherapy-naive patients with metastatic non-small cell lung cancer (NSCLC). Gemcitabine i.v. 1000 mg/m2was administered on days 1 and 8 and paclitaxel 200 mg/m2as a continuous 3-hour infusion on day 1. Treatment was repeated every 21 days. Patients had a median age of 53 years. ECOG performance status was 0 or 1 in 48 patients. 41 patients (75.9%) had initial stage IV disease; histology was mainly adenocarcinoma (46.3%). 2 patients (4.3%) achieved a complete response and 15 (31.9%) achieved a partial response giving an overall response rate of 36.2% (95% CI: 22.4–49.9%); 19 patients (40.4%) had stable disease and 10 (21.3%) had progressive disease. The median survival time was 51 weeks (95% CI: 46.5–59.3), with a 1-year survival probability of 0.48 (95% CI: 0.34–0.63). Grade 3/4 neutropenia and febrile neutropenia occurred in 15.2% and 2.2% of courses, respectively. Grade 3/4 thrombocytopenia was rare (1.8% of courses). Peripheral neurotoxicity developed in 25 patients (47.2%), mostly grade 1/2. Arthalgia/myalgia was observed in 30 patients (56.6%), generally grade 1 or 2. Grade 3 abnormal levels of serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate transaminase (SGOT) occurred in 5 patients (9.4%) and 1 patient (1.9%), respectively. Combined paclitaxel and gemcitabine is an active and well-tolerated regimen for the treatment of advanced NSCLC, and warrants further investigation in comparative, randomized trials. © 2001 Cancer Research Campaign http://www.bjcancer.co

On the Diurnal Soil Water Content Dynamics during Evaporation using Dielectric Methods

The water content dynamics in the upper soil surface during evaporation is a key element in land–atmosphere exchanges. Previous experimental studies have suggested that the soil water content increases at the depth of 5 to 15 cm below the soil surface during evaporation, while the layer in the immediate vicinity of the soil surface is drying. In this study, the dynamics of water content profiles exposed to solar radiative forcing was monitored at a high temporal resolution using dielectric methods both in the presence and absence of evaporation. A 4-d comparison of reported moisture content in coarse sand in covered and uncovered buckets using a commercial dielectric-based probe (70 MHz ECH2O-5TE, Decagon Devices, Pullman, WA) and the standard 1-GHz time domain reflectometry method. Both sensors reported a positive correlation between temperature and water content in the 5- to 10-cm depth, most pronounced in the morning during heating and in the afternoon during cooling. Such positive correlation might have a physical origin induced by evaporation at the surface and redistribution due to liquid water fluxes resulting from the temperature-gradient dynamics within the sand profile at those depths. Our experimental data suggest that the combined effect of surface evaporation and temperature-gradient dynamics should be considered to analyze experimental soil water profiles. Additional effects related to the frequency of operation and to protocols for temperature compensation of the dielectric sensors may also affect the probes response during large temperature changes

Evaporation from three water bodies of different sizes and climates: Measurements and scaling analysis

Evaporation from small reservoirs, wetlands, and lakes continues to be a theoretical and practical problem in surface hydrology and micrometeorology because atmospheric flows above such systems can rarely be approximated as stationary and planar-homogeneous with no mean subsidence (hereafter referred to as idealized flow state). Here, the turbulence statistics of temperature(T)and water vapor (q)most pertinent to lake evaporation measurementsover three water bodies differing in climate, thermal inertia and degree of advective conditions are explored. The three systems included Lac Le´man in Switzerland (high thermal inertia, near homogeneous conditions with no appreciable advection due to long upwind fetch), Eshkol reservoir in Israel (intermediate thermal inertia, frequent strong advective conditions) and Tilopozo wetland in Chile (low thermal inertia, frequent but moderate advection). The data analysis focused on how similarity constants for the flux-variance approach, CT/Cq, and relative transport efficiencies RwT/Rwq, are perturbed from unity with increased advection or the active role of temperature. When advection is small and thermal inertia is large, CT/Cq 1)primarily due to the active role of temperature, which is consistent with a large number of studies conducted over bare soil and vegetated surfaces. However, when advection is significantly large, then CT/Cq >1 (orRwT/Rwq < 1). When advection is moderate and thermal inertia is low, then CT/Cq �1. This latter equality, while consistent with Monin–Obukhov similarity theory (MOST), is due to the fact that advection tends to increase CT/Cq above unity while the active role of temperature tends to decrease CT/Cq below unity. A simplified scaling analysis derived from the scalar variance budget equation, explained qualitatively how advection could per¬turb MOST scaling (assumed to represent the idealized flow state)

Evaporation from a small water reservoir: Direct measurements and estimates

Summary Knowing the rate of evaporation from surface water resources such as chan¬nels and reservoirs is essential for precise management of the water balance. However, evaporation is difficult to measure experimentally over water surfaces and several tech¬niques and models have been suggested and used in the past for its determination. In this research, evaporation from a small water reservoir in northern Israel was measured and estimated using several experimental techniques and models during the rainless summer. Evaporation was measured with an eddy covariance (EC) system consisting of a three-dimensional sonic anemometer and a Krypton hygrometer. Measurements of net radia¬tion, air temperature and humidity, and water temperature enabled estimation of other energy balance components. Several models and energy balance closure were evaluated. In addition, evaporation from a class-A pan was measured at the site. EC evaporation measurements for 21 days averaged 5.48 mm day�1. Best model predictions were obtained with two combined flux-gradient and energy balance models (Penman–Mon¬teith–Unsworth and Penman–Brutsaert), which with the water heat flux term, gave sim¬ilar daily average evaporation rates, that were up to 3% smaller than the corresponding EC values. The ratio between daily pan and EC evaporation varied from 0.96 to 1.94. The bulk mass transfer coefficient was estimated using a model based on measurements of water surface temperature, evaporation rate and absolute humidity at 0.9 and 2.9 m above the water surface, and using two theoretical approaches. The bulk transfer coefficient

Evaporation from a shallow water table: Diurnal dynamics of water and heat at the surface of drying sand

Accurate estimates of water losses by evaporation from shallow water tables are important for hydrological, agricultural, and climatic purposes. An experiment was conducted in a weighing lysimeter to characterize the diurnal dynamics of evaporation under natural conditions. Sampling revealed a completely dry surface sand layer after 5 days of evaporation. Its thickness was <1 cm early in the morning, increasing to reach 4-5 cm in the evening. This evidence points out fundamental limitations of the approaches that assume hydraulic connectivity from the water table up to the surface, as well as those that suppose monotonic drying when unsteady conditions prevail. The computed vapor phase diffusion rates from the apparent drying front based on Fick's law failed to reproduce the measured cumulative evaporation during the sampling day. We propose that two processes rule natural evaporation resulting from daily fluctuations of climatic variables: (i) evaporation of water, stored during nighttime due to redistribution and vapor condensation, directly into the atmosphere from the soil surface during the early morning hours, that could be simulated using a mass transfer approach and (ii) subsurface evaporation limited by Fickian diffusion, afterward. For the conditions prevailing during the sampling day, the amount of water stored at the vicinity of the soil surface was 0.3 mm and was depleted before 11:00. Combining evaporation from the surface before 11:00 and subsurface evaporation limited by Fickian diffusion after that time, the agreement between the estimated and measured cumulative evaporation was significantly improved.Keywords: Transport, Vapor, Enhancement, Models, Hydraulic conductivity, Temperature depencence, In field soils, Porous media, Diffusion, Movemen

Artificial Intelligence for Sustainable Development: Synthesis Report, Mobile Learning Week 2019

(First paragraph) 2019’s Mobile Learning Week (MLW), UNESCO’s flagship event for information and communication technology (ICT) in education, focused on the theme ‘Artificial Intelligence for Sustainable Development’. Held over five days in Paris, it comprised a sequence of high-profile events (a global conference, a policy forum and workshops, a symposium and strategy labs), and involved more than 1,500 participants from 140 countries (including Ministers of Education and ICT, other representatives from Member States, the private sector, academia and international organizations)

Novel NDUFA12 variants are associated with isolated complex I defect and variable clinical manifestation

Isolated biochemical deficiency of mitochondrial complex I is the most frequent signature among mitochondrial diseases and is associated with a wide variety of clinical symptoms. Leigh syndrome represents the most frequent neuroradiological finding in patients with complex I defect and more than 80 monogenic causes have been involved in the disease. In this report, we describe seven patients from four unrelated families harboring novel NDUFA12 variants, with six of them presenting with Leigh syndrome. Molecular genetic characterization was performed using next-generation sequencing combined with the Sanger method. Biochemical and protein studies were achieved by enzymatic activities, blue native gel electrophoresis, and western blot analysis. All patients displayed novel homozygous mutations in the NDUFA12 gene, leading to the virtual absence of the corresponding protein. Surprisingly, despite the fact that in none of the analyzed patients, NDUFA12 protein was detected, they present a different onset and clinical course of the disease. Our report expands the array of genetic alterations in NDUFA12 and underlines phenotype variability associated with NDUFA12 defect