Spectral-phase interferometry for direct electric-field reconstruction applied to seeded extreme-ultraviolet free-electron lasers

We present a setup for complete characterization of femtosecond pulses generated by seeded free-electron lasers (FEL's) in the extreme-ultraviolet spectral region. Two delayed and spectrally shifted replicas are produced and used for spectral phase interferometry for direct electric field reconstruction (SPIDER). We show that it can be achieved by a simple arrangement of the seed laser. Temporal shape and phase obtained in FEL simulations are well retrieved by the SPIDER reconstruction, allowing to foresee the implementation of this diagnostic on existing and future sources. This will be a significant step towards an experimental investigation and control of FEL spectral phase

Percutaneous mitral valve repair: the beginning of the end or the end of the beginning?

The new percutaneous mitral valve repair techniques are at an early stage. Preliminary series show that they are feasible; however, they need to be further evaluated in comparison with contemporary treatment to accurately assess their efficiency. Potential applications may benefit high-risk patients after thorough evaluation

Automatic classification of registered clinical trials towards the Global Burden of Diseases taxonomy of diseases and injuries

Includes details on the implementation of MetaMap and IntraMap, prioritization rules, the test set of clinical trials and the classification of the external test set according to the 171 GBD categories. Dataset S1: Expert-based enrichment database for the classification according to the 28 GBD categories. Manual classification of 503 UMLS concepts that could not be mapped to any of the 28 GBD categories. Dataset S2: Expert-based enrichment database for the classification according to the 171 GBD categories. Manual classification of 655 UMLS concepts that could not be mapped to any of the 171 GBD categories, among which 108 could be projected to candidate GBD categories. Table S1: Excluded residual GBD categories for the grouping of the GBD cause list in 171 GBD categories. A grouping of 193 GBD categories was defined during the GBD 2010 study to inform policy makers about the main health problems per country. From these 193 GBD categories, we excluded the 22 residual categories listed in the Table. We developed a classifier for the remaining 171 GBD categories. Among these residual categories, the unique excluded categories in the grouping of 28 GBD categories were “Other infectious diseases” and “Other endocrine, nutritional, blood, and immune disorders”. Table S2: Per-category evaluation of performance of the classifier for the 171 GBD categories plus the “No GBD” category. Number of trials per GBD category from the test set of 2,763 clinical trials. Sensitivities, specificities (in %) and likelihood ratios for each of the 171 GBD categories plus the “No GBD” category for the classifier using the Word Sense Disambiguation server, the expert-based enrichment database and the priority to the health condition field. Table S3: Performance of the 8 versions of the classifier for the 171 GBD categories. Exact-matching and weighted averaged sensitivities and specificities for 8 versions of the classifier for the 171 GBD categories. Exact-matching corresponds to the proportion (in %) of trials for which the automatic GBD classification is correct. Exact-matching was estimated over all trials (N = 2,763), trials concerning a unique GBD category (N = 2,092), trials concerning 2 or more GBD categories (N = 187), and trials not relevant for the GBD (N = 484). The weighted averaged sensitivity and specificity corresponds to the weighted average across GBD categories of the sensitivities and specificities for each GBD category plus the “No GBD” category (in %). The 8 versions correspond to the combinations of the use or not of the Word Sense Disambiguation server during the text annotation, the expert-based enrichment database, and the priority to the health condition field as a prioritization rule. Table S4: Per-category evaluation of the performance of the baseline for the 28 GBD categories plus the “No GBD” category. Number of trials per GBD category from the test set of 2,763 clinical trials. Sensitivities and specificities (in %) of the 28 GBD categories plus the “No GBD” category for the classification of clinical trial records towards GBD categories without using the UMLS knowledge source but based on the recognition in free text of the names of diseases defining in each GBD category only. For the baseline a clinical trial records was classified with a GBD category if at least one of the 291 disease names from the GBD cause list defining that GBD category appeared verbatim in the condition field, the public or scientific titles, separately, or in at least one of these three text fields. (DOCX 84 kb

Norm entrepreneurs promote local values and practices in pursuit of just and sustainable forest governance.

This paper explores the dissonance between conceptions of justice among forest-adjacent communities and their representation in global forest policies, a persistent barrier to delivering just sustainability. We empirically track justice claims of rural villagers upwards through specific intermediaries or ‘justice brokers’: civil society, state, or private sector actors operating at local to international levels, who navigate different institutions to advance various social and ecological interests. We draw on interviews with 16 intermediaries in each of Nepal and Uganda and find that recognition of local values and practices such as customary tenure systems are key justice concerns of forest-adjacent communities in each country. However, intermediaries perceive a low likelihood of advancing those claims through national or international climate and forest policy debates, such as REDD+ (Reducing Emissions from Deforestation and forest Degradation), in large part because deliberations on justice are subordinated to concerns such as carbon accounting and arrangements for distributing monetary benefits. This suggests these policy processes must be modified to offer potential for transformational pathways. Intermediaries who pursued recognition justice issues developed innovative tactics in alternative forums. These ‘norm entrepreneurs’ adopted a suite of complementary strategies to attain influence, including: (1) formation of associations at the grassroots level; (2) media and advocacy campaigns through national coalitions to reach powerful international donors, and; (3) drawing on international support networks for advice, training and to influence national government. In both Uganda and Nepal these strategies were evidenced to enhance recognition for local values and practices

Impact of Degree of Commissural Opening After Percutaneous Mitral Commissurotomy on Long-Term Outcome

ObjectivesWe sought to evaluate the prognostic value of the degree of commissural opening (CO) on outcome.BackgroundCommissural opening is the main mechanism by which the mitral valve area (MVA) increases after percutaneous mitral commissurotomy (PMC) but its impact on long-term outcome has never been evaluated.MethodsOf 1,024 consecutive patients with severe MS who underwent PMC, degree of CO was prospectively evaluated in 875 patients (age 48 ± 13 years, female 83%, New York Heart Association (NYHA) functional class III/IV 75%) with good immediate PMC results (MVA ≥1.5 cm2 and no mitral regurgitation >2/4). These 875 patients were divided into 3 groups: both commissures only partially opened or not split (Group 1, n = 189), 1 commissure completely split (Group 2; n = 459), and both commissures completely split (Group 3; n = 227). During a follow-up of 55 ± 28 months, following clinical end points were collected: death, cardiovascular death, need for mitral valve surgery or repeat dilation, and NYHA functional class.ResultsBefore PMC, patients in Group 1 were older, more often in NYHA functional class III/IV, but MVA and mean gradient were not different (p ≥ 0.50). Immediately after PMC, there were significant differences between groups with regard to mean gradient (Group 1, 5.1 ± 2.1 mm Hg; Group 2, 4.5 ± 1.7 mm Hg; Group 3, 4.0 ± 1.6 mm Hg; p < 0.0001) and MVA (Group 1, 1.8 ± 0.2 cm2; Group 2, 1.9 ± 0.2 cm2; Group 3, 2.1 ± 0.3 cm2; p < 0.0001). The 10-year rate of good functional results (survival without need for mitral surgery or repeat dilation and NYHA functional class I or II at last follow-up) was significantly higher in Group 3 (76 ± 5%) than in Groups 1 and 2 (39 ± 8% and 57 ± 11%, respectively; p < 0.0001). In multivariable analysis, either the degree of CO or the MVA was an independent predictor of good late functional results (p < 0.05).ConclusionsComplete CO is associated with larger MVA, smaller gradients, and functional improvement. The degree of CO provides important prognostic information and thus should be systematically evaluated during and after PMC and considered as a complementary measure of the procedural success in addition to the MVA, not always easy to assess

Percutaneous mitral annuloplasty through the coronary sinus: An anatomic point of view

ObjectiveWe assessed the anatomic relationships among the mitral annulus, coronary sinus, and circumflex artery in human cadaver hearts.MethodsPercutaneous posterior mitral annuloplasty has been proposed to treat functional mitral regurgitation on the basis of the proximity of the coronary sinus to the mitral annulus. However, concern remains about the ability to perform a trigone-to-trigone posterior annuloplasty and the potential for compromise of the circumflex coronary artery. Ten hearts were studied after injection of expansible foam into the coronary sinus and circumflex artery. The mitral annulus perimeter, posterior intertrigonal (T1–T2) and intercommissural (C1–C2) distance, and coronary sinus projection on the native annulus (S1–S2) were measured. The spatial geometry of the coronary sinus was correlated with the circumflex artery route and the distance with the native mitral annulus.ResultsThe projection of coronary sinus annuloplasty achieves at best a commissure-to-commissure annuloplasty 14.5 (6–24) mm behind each trigone: T1–T2: 74 (56–114) mm, C1–C2: 62.2 (48–80) mm, S1–S2: 59.5 (40–80) mm. The coronary sinus was distant from the native annulus (8–14 mm at the coronary sinus ostium, 13.7–20.4 mm at the middle of the coronary sinus, 6.9–14 mm at the level of the great coronary vein). The circumflex artery was located between the coronary sinus and the mitral annulus in 45.5% of cases.ConclusionsThis anatomic study highlights the 3-dimensional structure of the coronary sinus and its distance from the native mitral annulus and fibrous trigones. Human anatomic studies are mandatory for the further development of percutaneous mitral repair technology