Interventional fetal balloon valvuloplasty for congenital heart disease—current shortcomings and possible perspectives

Fetal cardiac interventions are new and relatively unknown investigational options for modifying congenital heart disease in utero. Techniques for safer access to the fetus must be improved, and selection criteria for patients for whom these procedures are potentially beneficial must be developed. Currently, antenatal cardiac intervention attempts are being made to either prevent or reverse hydrops in fetuses with cardiac valve disease or outflow tract obstruction or to recruit hypoplastic ventricles. Most important are early detection and referral of these fetuses, thereby enabling timely procedures with improved outcomes. However, performing successful fetal cardiac interventions requires multidisciplinary collaboration between obstetricians, pediatric cardiologists, pediatric cardiac surgeons, and anesthesiologists, as each discipline provides specific skills for these critically ill babie

Prospective navigator-echo-based real-time triggering of fetal head movement for the reduction of artifacts

The purpose of this study was to evaluate the neuroimaging quality and accuracy of prospective real-time navigator-echo acquisition correction versus untriggered intrauterine magnetic resonance imaging (MRI) techniques. Twenty women in whom fetal motion artifacts compromised the neuroimaging quality of fetal MRI taken during the 28.7 ± 4week of pregnancy below diagnostic levels were additionally investigated using a navigator-triggered half-Fourier acquired single-shot turbo-spin echo (HASTE) sequence. Imaging quality was evaluated by two blinded readers applying a rating scale from 1 (not diagnostic) to 5 (excellent). Diagnostic criteria included depiction of the germinal matrix, grey and white matter, CSF, brain stem and cerebellum. Signal-difference-to-noise ratios (SDNRs) in the white matter and germinal zone were quantitatively evaluated. Imaging quality improved in 18/20 patients using the navigator echo technique (2.4 ± 0.58 vs. 3.65 ± 0.73 SD, p < 0.01 for all evaluation criteria). In 2/20 patients fetal movement severely impaired image quality in conventional and navigated HASTE. Navigator-echo imaging revealed additional structural brain abnormalities and confirmed diagnosis in 8/20 patients. The accuracy improved from 50% to 90%. Average SDNR increased from 0.7 ± 7.27 to 19.83 ± 15.71 (p < 0.01). Navigator-echo-based real-time triggering of fetal head movement is a reliable technique that can deliver diagnostic fetal MR image quality despite vigorous fetal movemen

Synthesis of 2D anatase TiO₂ with highly reactive facets by fluorine-free topochemical conversion of 1T-TiS₂ nanosheets

Two-dimensional (2D) anatase titanium dioxide (TiO(2)) is expected to exhibit different properties as compared to anatase nanocrystallites, due to its highly reactive exposed facets. However, access to 2D anatase TiO(2) is limited by the non-layered nature of the bulk crystal, which does not allow use of top-down chemical exfoliation. Large efforts have been dedicated to the growth of 2D anatase TiO(2) with high reactive facets by bottom-up approaches, which relies on the use of harmful chemical reagents. Here, we demonstrate a novel fluorine-free strategy based on topochemical conversion of 2D 1T-TiS(2) for the production of single crystalline 2D anatase TiO(2), exposing the {001} facet on the top and bottom and {100} at the sides of the nanosheet. The exposure of these faces, with no additional defects or doping, gives rise to a significant activity enhancement in the hydrogen evolution reaction, as compared to commercially available Degussa P25 TiO(2) nanoparticles. Because of the strong potential of TiO(2) in many energy-based applications, our topochemical approach offers a low cost, green and mass scalable route for production of highly crystalline anatase TiO(2) with well controlled and highly reactive exposed facets

Foreign policy beliefs and support for Stephen Harper and the Conservative Party

Similar to other recent Canadian elections, foreign policy did not feature prominently in the 2011 federal election campaign. In fact, many doubt Canadian public opinion on international affairs is linked to the actions taken by recent Governments. In this paper, we examine Canadian public opinion toward a range of foreign policy issues and argue that the survey questions measure two latent dimensions —militarism and internationalism. Our survey evidence indicates the existence of an “issue public” which is prepared to endorse military action and is skeptical of human rights and overseas aid programs, and this group is far more supportive of Prime Minister Harper and the Conservative Party than other Canadians. The absence of an elite discussion, either among politicians or between media elites, about the direction of Canadian foreign policy does not prevent the Canadian voter from thinking coherently about questions pertaining to this issue domain and employing these beliefs to support or oppose political parties and their leaders

Mirror therapy: A potential intervention for pain management.

The consequences of chronic pain and associated disabilities to the patient and to the health care system are well known. Medication is often the first treatment of choice for chronic pain, although side effects and high costs restrict long-term use. Inexpensive, safe and easy to self-administer non-pharmacological therapies, such as mirror therapy, are recommended as adjuncts to pain treatment. The purpose of this review is to describe the principles of use of mirror therapy so it can be incorporated into a health care delivery. The physiological rationale of mirror therapy for the management of pain and the evidence of clinical efficacy based on recent systematic reviews are also discussed. Mirror therapy, whereby a mirror is placed in a position so that the patient can view a reflection of a body part, has been used to treat phantom limb pain, complex regional pain syndrome, neuropathy and low back pain. Research evidence suggests that a course of treatment (four weeks) of mirror therapy may reduce chronic pain. Contraindications and side effects are few. The mechanism of action of mirror therapy remains uncertain, with reintegration of motor and sensory systems, restored body image and control over fear-avoidance likely to influence outcome. The evidence for clinical efficacy of mirror therapy is encouraging, but not yet definitive. Nevertheless, mirror therapy is inexpensive, safe and easy for the patient to self-administer

Ideological Labels in America

This paper extends Ellis and Stimson’s (Ideology in America. New York: Cambridge UniversityPress, 2012) study of the operational-symbolic paradox using issue-level measures of ideological incongruence based on respondent positions and symbolic labels for these positions across 14 issues. Like Ellis and Stimson, we find that substantial numbers—over 30 %—of Americans experience conflicted conservatism. Our issue-level data reveal, furthermore, that conflicted conservatism is most common on the issues of education and welfare spending. In addition, we also find that 20 % of Americans exhibit conflicted liberalism. We then replicate Ellis and Stimson’s finding that conflicted conservatism is associated with low sophistication and religiosity, but also find that it is associated with being socialized in a post-1960s generation and using Fox News as a main news source. Finally, we show the important role played by identities, with both conflicted conservatism and conflicted liberalism linked with partisan and ideological identities, and conflicted liberalism additionally associated with ethnic identities

Thermodynamic Formulations of Excess and Absolute Values of Adsorption on Solid Surfaces: A Comparison of One- and Two-Phase Approaches

The generally used methods of thermodynamic adsorption analysis are summarized in two basic concepts: the two-phase approach (which is an adequate picture of volume phase thermodynamics in adsorption) and the one-phase approach (which uses excess values for the thermodynamic description of adsorption). Differential and integral molar values of adsorption Δ a X̄ and Δ a X in the two-phase approach are not identical with the corresponding excess values Δ a X̄ s and Δ a X s in the one-phase approach. Especially at high temperatures and high pressures they may be entirely different. It is shown that the experimental methods most usually in adsorption thermodynamics (as adsorption volumetry and gravimetry) give excess data which are to be used in the one-phase approach but which can be transformed to the two-phase approach. Using statistical thermodynamic calculations the difference between these basic concepts is shown over a wide temperature range for the first virial coefficient, the internal energy and the heat capacity of adsorption

Development of a solar radiation and BIPV design tool as energyplus plugin for google sketchup

IBPSA 2009 - International Building Performance Simulation Association 20091989-199

Solar heat gain coefficient measurement of semi-transparent photovoltaic modules with indoor calorimetric hot box and solar simulator

10.1016/j.enbuild.2012.06.005Energy and Buildings5374-84ENEB