Quality of Life in Patients with Implantable Cardioverter Defibrillators

Background: The implantable cardioverter defibrillator (ICD) is a life saving device for individuals with life threatening ventricular arrhythmias. There is no doubt that it is a cost effective therapy in various congenital and acquired arrhythmogenic disorders. Nevertheless, shock delivery may be painful and frightening which causes psychological distress and deterioration of perceived quality of life. Methods: A systematic meta-analysis on studies reporting quality of life in patients implanted with ICDs was done using professional databases. Related articles and references of the relevant articles were also searched for suitable studies. Results: Thirty studies with a total of 3412 patients on implantable defibrillators were identified. Five of them were large randomised studies with a total of 1680 patients, while 25 were non-randomised studies. Medical Outcome Study 36-item Short Form health survey (SF - 36) was the most common instrument used for assessment of quality of life. Only one of the 5 major randomised trial reported worsening of quality of life after implantation of a defibrillator. In the subgroup of patients receiving shocks, three out of the five trials reported worsening of quality of life. Summary: Most of the randomised studies showed either neutral or better quality of life in patients on implantable defibrillators. In the subset of patients receiving shocks, worsening of quality of life was found in most randomised studies. Therefore, activation of antitachycardia pacing should be performed in every ICD-patient in order to miminze painful shocks and consequent deterioration of quality of life

Model for Estimating the Probability of Crop Production for Ginkgo biloba L.

Mature female Maidenhair trees (Ginkgo biloba L.)have been observed to produce seed dispersal units in some years and none in other years. A temperature and/or photoperiod flowering threshold is suggested. Daily temperatures and daylengths at five Ginkgo sites in continental U.S. for January-April 1964-1974 were evaluated. A computer program was designed to estimate daily photothermal equivalent (PTE = temperature and photoperiod), and the magnitude and duration of the PTE in relation to a series of photothermal constants. Use of the data from production and nonproduction years provided a mathematical model for prediction of dispersal unit production. The model was tested with environmental data for additional sites recorded in the botanical literature

Capacity and Complexity of HMM Duration Modeling Techniques

The ability of a standard hidden Markov model (HMM) or expanded state HMM (ESHMM) to accurately model duration distributions of phonemes is compared with specific duration-focused approaches such as semi-Markov models or variable transition probabilities. It is demonstrated that either a three-state ESHMM or a standard HMM with an increased number of states is capable of closely matching both Gamma distributions and duration distributions of phonemes from the TIMIT corpus, as measured by Bhattacharyya distance to the true distributions. Standard HMMs are easily implemented with off-the-shelf tools, whereas duration models require substantial algorithmic development and have higher computational costs when implemented, suggesting that a simple adjustment to HMM topologies is perhaps a more efficient solution to the problem of duration than more complex approaches

Irish Sea Coastal Stakeholder Engagement in NW England consultation, participation, strategic purpose and rhetoric. Do you reap just what you sow?

The creation of a holistic more inclusive approach to marine management could be positively influenced by the development of well structured and sincere Stakeholder Engagement and Public Participation (SEPP) processes. However poorly designed frameworks and processes lacking sincerity may engender skepticism, mistrust and create barriers in the attainment of a thriving and diverse coastal economy During 2009 a public participation and stakeholder engagement policy has been used by government agencies, Defra and the Department of Energy and Climate Change to gauge public opinion within the marine and coastal environment of the Irish Sea. This concerns the development of Irish Sea Conservation Zones and the UK’s Nuclear Newbuild programme. Both issues have complex dynamics regarding their environmental, economic, societal and sustainability aspects. This paper studies two contrasting styles of SEPP deployed during this critical ‘first contact’ stage by a participatory observation approach and assesses how this phase may affect the development of the engagement process and how this may affect a project’s outcome

A Majorization-Minimization Approach to Design of Power Transmission Networks

We propose an optimization approach to design cost-effective electrical power transmission networks. That is, we aim to select both the network structure and the line conductances (line sizes) so as to optimize the trade-off between network efficiency (low power dissipation within the transmission network) and the cost to build the network. We begin with a convex optimization method based on the paper ``Minimizing Effective Resistance of a Graph'' [Ghosh, Boyd \& Saberi]. We show that this (DC) resistive network method can be adapted to the context of AC power flow. However, that does not address the combinatorial aspect of selecting network structure. We approach this problem as selecting a subgraph within an over-complete network, posed as minimizing the (convex) network power dissipation plus a non-convex cost on line conductances that encourages sparse networks where many line conductances are set to zero. We develop a heuristic approach to solve this non-convex optimization problem using: (1) a continuation method to interpolate from the smooth, convex problem to the (non-smooth, non-convex) combinatorial problem, (2) the majorization-minimization algorithm to perform the necessary intermediate smooth but non-convex optimization steps. Ultimately, this involves solving a sequence of convex optimization problems in which we iteratively reweight a linear cost on line conductances to fit the actual non-convex cost. Several examples are presented which suggest that the overall method is a good heuristic for network design. We also consider how to obtain sparse networks that are still robust against failures of lines and/or generators.Comment: 8 pages, 3 figures. To appear in Proc. 49th IEEE Conference on Decision and Control (CDC '10