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

Residential density classification for sustainable housing development using a machine learning approach

Using Machine Learning (ML) algorithms for classification of the existing residential neighbourhoods and their spatial characteristics (e.g. density) so as to provide plausible scenarios for designing future sustainable housing is a novel application. Here we develop a methodology using a Random Forests algorithm (in combination with GIS spatial data processing) to detect and classify the residential neighbourhoods and their spatial characteristics within the region between Oxford and Cambridge, that is, the 'Oxford-Cambridge Arc'. The classification model is based on four pre-defined urban classes, that is, Centre, Urban, Suburban, and Rural for the entire region. The resolution is a grid of 500 m × 500 m. The features for classification include (1) dwelling geometric attributes (e.g. garden size, building footprint area, building perimeter), (2) street networks (e.g. street length, street density, street connectivity), (3) dwelling density (number of housing units per hectare), (4) building residential types (detached, semi-detached, terraced, and flats), and (5) characteristics of the surrounding neighbourhoods. The classification results, with overall average accuracy of 80% (accuracy per class: Centre: 38%, Urban 91%, Suburban 83%, and Rural 77%), for the Arc region show that the most important variables were three characteristics of the surrounding area: residential footprint area, dwelling density, and number of private gardens. The results of the classification are used to establish a baseline for the current status of the residential neighbourhoods in the Arc region. The results bring data-driven decision-making processes to the level of local authority and policy makers in order to support sustainable housing development at the regional scale

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

The Importance of Time Congruity in the Organisation.

In 1991 Kaufman, Lane, and Lindquist proposed that time congruity in terms of an individual's time preferences and the time use methods of an organisation would lead to satisfactory performance and enhancement of quality of work and general life. The research reported here presents a study which uses commensurate person and job measures of time personality in an organisational setting to assess the effects of time congruity on one aspect of work life, job-related affective well-being. Results show that time personality and time congruity were found to have direct effects on well-being and the influence of time congruity was found to be mediated through time personality, thus contributing to the person–job (P–J) fit literature which suggests that direct effects are often more important than indirect effects. The study also provides some practical examples of ways to address some of the previously cited methodological issues in P–J fit research

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)

Volumetric Enhancing Tumor Burden at CT to Predict Survival Outcomes in Patients with Neuroendocrine Liver Metastases after Intra-arterial Treatment

Purpose: To investigate whether liver enhancing tumor burden (LETB) assessed at contrast-enhanced CT indicates early response and helps predict survival outcomes in patients with multifocal neuroendocrine liver metastases (NELM) after intra-arterial treatment.Materials and Methods: This retrospective study included patients with NELM who underwent intra-arterial treatment with transarterial embolization (TAE) or chemoembolization (TACE) between April 2006 and December 2018. Tumor response in treated NELM was evaluated by using the Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST). LETB was mea-sured as attenuation 2 SDs greater than that of a region of interest in the nontumoral liver parenchyma. Overall survival (OS); time to unTA(C)Eable progression, defined as the time from the initial treatment until the time when intra-arterial treatments were considered technically unfeasible, either not recommended by the multidisciplinary tumor board or until death; and hepatic and whole-body progression-free survival (PFS) were evaluated using multivariable Cox proportional hazards analyses, the Kaplan-Meier method, and log-rank test.Results: The study included 119 patients (mean age, 60 years +/- 11 [SD]; 61 men) who underwent 161 treatments. A median LETB change of -25.8% best discriminated OS (83 months in responders vs 51 months in nonresponders; P = .02) and whole-body PFS (18 vs 8 months, respectively; P < .001). A -10% LETB change best discriminated time to unTA(C)Eable progression (32 months in re-sponders vs 12 months in nonresponders; P < .001) and hepatic PFS (18 vs 8 months, respectively; P < .001). LETB change remained independently associated with improved OS (hazard ratio [HR], 0.56), time to unTA(C)Eable progression (HR, 0.44), hepatic PFS (HR, 0.42), and whole-body PFS (HR, 0.47) on multivariable analysis. Neither RECIST nor mRECIST helped predict patient outcome. Conclusion: Response according to LETB change helped predict survival outcomes in patients with NELM after intra-arterial treat-ments, with better discrimination than RECIST and mRECIST

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