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Background and Aims: Expert endoscopists previously reported ERCP outcomes for the first commercialized single-use duodenoscope. We aimed to document usability of this device by endoscopists with different levels of ERCP experience. Methods: Fourteen “expert” (>2000 lifetime ERCPs) and 5 “less-expert” endoscopists performed consecutive ERCPs in patients without altered pancreaticobiliary anatomy. Outcomes included ERCP completion for the intended indication, rate of crossover to another endoscope, device performance ratings, and serious adverse events. Results: Two hundred ERCPs including 81 (40.5%) with high complexity (American Society for Gastrointestinal Endoscopy grades 3-4) were performed. Crossover rate (11.3% vs 2.5%, P =.131), ERCP completion rate (regardless of crossovers) (96.3% vs 97.5%, P =.999), median ERCP completion time (25.0 vs 28.5 minutes, P =.130), mean cannulation attempts (2.8 vs 2.8, P =.954), and median overall satisfaction with the single-use duodenoscope (8.0 vs 8.0 [range, 1.0-10.0], P =.840) were similar for expert versus less-expert endoscopists, respectively. The same metrics were similar by procedural complexity except for shorter median completion time for grades 1 to 2 versus grades 3 to 4 (P Conclusions: In consecutive ERCPs including high complexity procedures, endoscopists with varying ERCP experience had good procedural success and reported high device performance ratings. (Clinical trial registration number: NCT04223830.)

This paper presents a measurement and simulation studies on the near magnetic field radiated by an integrated inductor with magnetic material. It presents the probe influence on the measured magnetic field and the importance of the probe position. These studies are performed in simulation using HFSS software and in measurement using scan near field bench. A very good agreement between measurement and simulation is shown.

In this article, the simulation results, the technological steps of manufacturing, and the characterization results at low and medium frequencies (20 MHz to a few hundred MHz) of integrated inductors with two magnetic layers are presented. Simulation realized with the high-frequency structure simulator (HFSS) software allows the impact of the vertical and horizontal air gaps on the inductance value for inductors with two magnetic layers to be determined. Inductors with two magnetic layers are manufactured with magnetic thicknesses varying from 100 to $500~\mu \text{m}$ . The interest of this new manufacturing process is compatible with most ferrite. The measurement results show good agreement with the simulation results. By minimizing the vertical air gap, the inductance value increases with a ratio equal to the relative permeability of the magnetic material when field lines are totally canalized into the magnetic layers. The extracted resistance evolution of the inductor on the frequency is explained by taking into account the skin and proximity effects for the conductor losses and the iron losses for the magnetic material.

Our objectives were to describe and compare the uterine bacterial composition of postpartum Holstein cows diagnosed as healthy (n = 8), subclinical endometritis (SCE; n = 8), or clinical endometritis (CE; n = 5) in the fifth week postpartum. We did metagenomic analyses of 16S rRNA gene sequences from endometrial cytobrush samples at 10, 21, and 35 days in milk (DIM), and endometrial bacterial culture at 35 DIM. Uterine bacterial composition in healthy, SCE, and CE was stable at 10, 21, and 35 DIM. Alpha and beta diversities showed a different uterine microbiome from CE compared to healthy or SCE, but no differences were found between healthy and SCE cows. At the phylum level, the relative abundance of Bacteroidetes and Fusobacteria, and at genera level, of Trueperella was greater in CE than healthy or SCE cows. Trueperella pyogenes was the predominant bacteria cultured in cows with CE, and a wide variety of bacterial growth was found in healthy and SCE cows. Bacteria that grew in culture were represented within the most abundant bacterial genera based on metagenomic sequencing. The uterine microbiota was similar between SCE and healthy, but the microbiome in cows with CE had a loss of bacterial diversity.

The hybrids are new varieties that are resistant to the cryptogamic diseases of vines, and they may be a good solution to the reduction of pesticide use. However, these new varieties have appeared recently and only few studies have been conducted to check the quality of the wine that they produce. In this study, wines originated from hybrids were chemically characterized (polyphenols, tannins, anthocyanins, and color analysis). Results show that their oenological parameters were close to those of the Vitis vinifera wines. The wines made from Vinifera (100%), with Vidoc, and all the resistant Bouquets studied are malvidin-3 glucoside dominant, and all the others hybrids varieties are cyanidin dominant. Furthermore, the hybrid wines had a higher concentration in condensed tannins and a lower one in molecular tannins compared with the Vitis vinifera wines, except for the Vidoc wines. As far as the anthocyanin content is concerned, the samples contained anthocyanin diglucosides, with the malvidin-3,5-diglucoside (malvin) the most abundant one. Also, their concentration in molecular anthocyanins were higher than the concentration in normal wines. The Vidoc wines do not contain any malvin. For the other wines, malvin co-eluted with cyanidin-3-O-glucoside and in this case, the cyanidin’s concentration was impressively higher than the Vidoc wines. The current OIV method gives different results for malvidol diglucoside compared to the use of an HPLC chromatography method (HPLC-DAD-QQQ). The current OIV method does not appear reliable in comparison with the HPLC method for detecting malvin. Finally, the hybrid wines had a darker blue/purplish color than the Vitis vinifera wines.

Background Single-use flexible bronchoscopes eliminate cross contamination from reusable bronchoscopes and are cost-effective in a number of clinical settings. The present bench study aimed to compare the performance of a new single-use bronchoscope (Boston Scientific EXALT Model B) to a marketed single-use comparator (Ambu aScope 4), each in slim, regular and large diameters. Methods Three bronchoscopy tasks were performed: water suction and visualization, “mucus” mass (synthetic mucoid mixture) suctioned in 30 s, and “mucus” plug (thicker mucoid mixture) suction. Suction ability, task completion times, and subjective ratings of visualization and overall performance on a scale of one to 10 (best) were compared. All bronchoscopy tasks were completed by 15 physicians representing diversity in specialization including pulmonary, interventional pulmonary, critical care, anesthesia, and thoracic surgery. Each physician utilized the six bronchoscope versions with block randomization by bronchoscope and task. Results Aspirated mean mass of “mucus” using EXALT Model B Regular was comparable to that for an aScope 4 Large (41.8 ± 8.3 g vs. 41.5 ± 5.7 g respectively, p = 0.914). In comparisons of scopes with the same outer diameter, the aspirated mean mass by weight of water and “mucus” was significantly greater for EXALT Model B than for aScope 4 (p p-value range 0.001−0.029). Conclusion A new single-use bronchoscope provided strong suction capability and visualization compared to same-diameter marketed single-use comparators in a bench model simulation.

The southeastern United States has wide-scale potential to achieve high productivity from elite eastern cottonwood and hybrid poplar varietals to produce renewable bioenergy and bioproducts. In order to determine how environmental drivers impact water use and growth so that individuals can maintain growth during drought periods, varietals that use water efficiently, and/or tolerate water stress conditions, are needed to make planting recommendations across a variety of sites. Additionally, inoculation with nitrogen-fixing endophytic bacteria may improve water stress tolerance. The goals of this research were (1) to determine water use strategies using measurements of diurnal sapflow and differences in leaf retention for three eastern cottonwood (Populus deltoides, ST66, S7C8, and 110412) and three hybrid poplar (two P. deltoides × Populus maximowiczii, 6329 and 8019, and one Populus trichocarpa × P. deltoides, 5077) varietals on contrasting field sites, (2) determine the physiological impact of endophyte inoculation, and (3) determine which physiological parameters were most highly correlated with aboveground biomass. We found that whole-tree water use efficiency (WUE) was similar across varietals at 5.2 g biomass per kg water used and that water use scaled with tree size. We found that water use strategies in terms of scaled stomatal sensitivity to vapor pressure deficit converged across varietals under stressful soil water conditions at both sites, but that varietals 8019 and 110412 tended to exhibit the highest plasticity in stomatal sensitivity exhibiting the largest range in scaled stomatal sensitivity under different soil moisture conditions. Endophyte inoculation increased growth and stomatal sensitivity at the nitrogen-limited site. Leaf area, whole-tree WUE, and plasticity in stomatal sensitivity were correlated with aboveground biomass production across sites and varietals. Overall, these data can be used to model hydrologic impacts of large-scale Populus biofuel production as well as recommend varietals with efficient water use and stomatal sensitivity under a range of soil and atmospheric moisture stress factors.

Nowadays, the characterization of planar integrated components is a challenge. The objective is to characterize these devices on a broadband frequency (from a few Hz to a few GHz). Currently, these integrated devices cannot be characterized at low frequencies (less than 1 MHz). This paper presents a new method and techniques for measuring integrated devices where their operating frequencies are up to 100 MHz. Indeed, by using an impedance-meter in the frequency band of 40 Hz to 110 MHz, integrated magnetic transformers have been characterized. In order to validate this method, a comparison made by a vector network analyzer has been made on the frequency band overlap (2 MHz to 110 MHz). This new method consists in measuring the impedance and admittance matrices of the device in order to determine the electronic properties of the component. The results obtained using two measurement instruments present a good correlation on the frequency band overlap. The measurement uncertainties are equal to 2% for the impedance-meter and 1% with the vector network analyzer. This comparison validates the good performance of the techniques and methods developed for characterizing integrated components.

This study evaluated the effects of treatment with meloxicam (a non-steroidal anti-inflammatory drug), parity, and blood progesterone concentration on the dynamics of the uterine microbiome of clinically healthy postpartum dairy cows. Seven primiparous and 9 multiparous postpartum Holstein cows received meloxicam (0.5 mg/kg SC, n = 7 cows) once daily for 4 days (10 to 13 days in milk (DIM)) or were untreated (n = 9 cows). Endometrial cytology samples were collected by cytobrush at 10, 21, and 35 DIM, from which the metagenomic analysis was done using 16S rRNA gene sequence analysis. A radioimmunoassay was used to measure progesterone concentration in blood serum samples at 35 DIM and cows were classified as > 1 ng/mL (n = 10) or ≤ 1 ng/mL (n = 6). Alpha diversity for bacterial genera (Chao1, Shannon-Weiner, and Camargo’s evenness indices) were not affected by DIM, meloxicam treatment, parity, or progesterone category (P > 0.2). For beta diversity (genera level), principal coordinate analysis (Bray-Curtis) showed differences in microbiome between parity groups (P = 0.01).There was lower overall abundance of Anaerococcus, Bifidobacterium, Corynebacterium, Lactobacillus, Paracoccus, Staphylococcus, and Streptococcus and higher abundance of Bacillus, Fusobacterium, and Novosphingobium in primiparous than multiparous cows (P < 0.05); these patterns were consistent across sampling days. Bray-Curtis dissimilarity did not differ by DIM at sampling, meloxicam treatment, or progesterone category at 35 DIM (P > 0.5). In conclusion, uterine bacterial composition was not different at 10, 21, or 35 DIM, and meloxicam treatment or progesterone category did not affect uterine microbiota in clinically healthy postpartum dairy cows. Primiparous cows presented a different composition of uterine bacteria than multiparous cows. The differences in microbiome associated with parity might be attributable to changes that occur consequent to the first calving, but this hypothesis should be investigated further.

In order to miniaturize components, planar technology has become essential. For frequency characterization of integrated quadrupole devices, only network vector analyzers can be used, but these instruments cannot be employed for frequencies below a few MHz. At these frequencies, only the impedance-meter allows devices to be measured. But, this instrument only measures dipole devices. Thus, the objective of this paper is to present a characterization method using an impedance-meter in order to characterize integrated quadrupole devices. The implemented method allows all elements of an electrical model of integrated component to be extracted with low uncertainties (less than 3%) over the entire study band.

Magnetic material is the key component in lot of electromagnetically-based optical to microwave applications. In the case of radio-frequencies/microwave applications, passive components are developed using planar design to facilitate their fabrication while 3D geometries are the best shapes to improve components properties. But nowadays, 3D printing technologies are coming up in industries and 3D design of passive components grows in interest. But 3D shaping of magnetic material remains a problem which has to be solved before considering industrial implementation. In this work, we demonstrate the possibility of 3D shaping ferrite magnetic powder using Selective laser melting/sintering in ambient air. A ferrimagnetic powder of Yttrium Iron Garnet (YIG) was used to form a 10-layers stack of magnetic material. A simple method for small surface (10x10mm2) deposition of powder was developed by dispersing the YIG powder into ethanol. A drop is then deposited on top of a substrate. Ethanol evaporates and an homogeneous layer is obtained. A 1064nm-nanosecond laser combined to a scanning lens is used to irradiate the powder layer and induce melting/sintering of the powder at ambient temperature and in ambient air. Chemical and structural changes induced by the laser process were studied using Raman spectroscopy. Results show that a part of the YIG was decomposed into a weakly magnetic phase of Fe3O4. Vibrating Sample Magnetometry was then used to compare the magnetic behavior of the YIG multilayer and the YIG powder. The multilayer always exhibit a magnetic behavior whatever the substrate is: YIG powder, YIG bulk or Al bulk.

Toxin-antitoxin (TA) systems are broadly distributed modules whose biological roles remain mostly unknown. The mqsRA system is a noncanonical TA system in which the toxin and antitoxins genes are organized in operon but with the particularity that the toxin gene precedes that of the antitoxin. This system was shown to regulate global processes such as resistance to bile salts, motility, and biofilm formation. In addition, the MqsA antitoxin was shown to be a master regulator that represses the transcription of the csgD, cspD, and rpoS global regulator genes, thereby displaying a pleiotropic regulatory role. Here, we identified two promoters located in the toxin sequence driving the constitutive expression of mqsA, allowing thereby excess production of the MqsA antitoxin compared to the MqsR toxin. Our results show that both antitoxin-specific and operon promoters are not regulated by stresses such as amino acid starvation, oxidative shock, or bile salts. Moreover, we show that the MqsA antitoxin is not a global regulator as suggested, since the expression of csgD, cspD and rpoS is similar in wild-type and ΔmqsRA mutant strains. Moreover, these two strains behave similarly in terms of biofilm formation and sensitivity to oxidative stress or bile salts.IMPORTANCE There is growing controversy regarding the role of chromosomal toxin-antitoxin systems in bacterial physiology. mqsRA is a peculiar toxin-antitoxin system, as the gene encoding the toxin precedes that of the antitoxin. This system was previously shown to play a role in stress response and biofilm formation. In this work, we identified two promoters specifically driving the constitutive expression of the antitoxin, thereby decoupling the expression of antitoxin from the toxin. We also showed that mqsRA contributes neither to the regulation of biofilm formation nor to the sensitivity to oxidative stress and bile salts. Finally, we were unable to confirm that the MqsA antitoxin is a global regulator. Altogether, our data are ruling out the involvement of the mqsRA system in Escherichia coli regulatory networks., info:eu-repo/semantics/published

There is growing controversy regarding the role of chromosomal toxin-antitoxin systems in bacterial physiology. mqsRA is a peculiar toxin-antitoxin system, as the gene encoding the toxin precedes that of the antitoxin. This system was previously shown to play a role in stress response and biofilm formation. In this work, we identified two promoters specifically driving the constitutive expression of the antitoxin, thereby decoupling the expression of antitoxin from the toxin. We also showed that mqsRA contributes neither to the regulation of biofilm formation nor to the sensitivity to oxidative stress and bile salts. Finally, we were unable to confirm that the MqsA antitoxin is a global regulator. Altogether, our data are ruling out the involvement of the mqsRA system in Escherichia coli regulatory networks., Toxin-antitoxin (TA) systems are broadly distributed modules whose biological roles remain mostly unknown. The mqsRA system is a noncanonical TA system in which the toxin and antitoxins genes are organized in operon but with the particularity that the toxin gene precedes that of the antitoxin. This system was shown to regulate global processes such as resistance to bile salts, motility, and biofilm formation. In addition, the MqsA antitoxin was shown to be a master regulator that represses the transcription of the csgD, cspD, and rpoS global regulator genes, thereby displaying a pleiotropic regulatory role. Here, we identified two promoters located in the toxin sequence driving the constitutive expression of mqsA, allowing thereby excess production of the MqsA antitoxin compared to the MqsR toxin. Our results show that both antitoxin-specific and operon promoters are not regulated by stresses such as amino acid starvation, oxidative shock, or bile salts. Moreover, we show that the MqsA antitoxin is not a global regulator as suggested, since the expression of csgD, cspD and rpoS is similar in wild-type and ΔmqsRA mutant strains. Moreover, these two strains behave similarly in terms of biofilm formation and sensitivity to oxidative stress or bile salts.

OBJECTIVE To measure prospectively apparent diffusion coefficient (ADC) values between 28 and 32 weeks of gestation in different cerebral territories of fetuses with estimated fetal weight (EFW) ≤ 5th centile, and analyze their association with adverse perinatal outcome. METHODS This was a prospective study involving six tertiary-level perinatal centers. In the period 22 November 2016 to 11 September 2017, we included singleton, small-for-gestational-age (SGA) fetuses with EFW ≤ 5th percentile, between 28 and 32 weeks of gestation, regardless of the umbilical artery Doppler and maternal uterine artery Doppler findings. A fetal magnetic resonance imaging (MRI) examination with diffusion-weighted sequences (DWI) was performed within 14 days following inclusion and before 32 weeks. ADC values were calculated in the frontal and occipital white matter, basal ganglia and cerebellar hemispheres. An ultrasound examination was performed within 1 week prior to the MRI examination. The primary outcome was a composite measure of adverse perinatal outcome, defined as any of the following: perinatal death; admission to neonatal intensive care unit with mechanical ventilation > 48 h; necrotizing enterocolitis; Grade III-IV intraventricular hemorrhage; periventricular leukomalacia. A univariate comparison of median ADC values in all cerebral territories between fetuses with and those without adverse perinatal outcome was performed. The association between ADC values and adverse perinatal outcome was then analyzed using multilevel logistic regression models to adjust for other common prognostic factors for growth-restricted fetuses. RESULTS MRI was performed in 64 patients, of whom five were excluded owing to fetal movement artifacts on DWI and two were excluded for termination of pregnancy with no link to fetal growth restriction (FGR). One intrauterine death occurred secondary to severe FGR. Among the 56 liveborn neonates, delivered at a mean ± SD gestational age of 33.6 ± 3.0 weeks, with a mean birth weight of 1441 ± 566 g, four neonatal deaths occurred. In addition, two neonates required prolonged mechanical ventilation, one of whom also developed necrotizing enterocolitis. Overall, therefore, seven out of 57 (12.3%) cases had an adverse perinatal outcome (95% CI, 3.8-20.8%). The ADC values in the frontal region were significantly lower in the group with adverse perinatal outcome vs those in the group with favorable outcome (mean values of both hemispheres, 1.68 vs 1.78 × 10-3 mm2 /s; P = 0.04). No significant difference in ADC values was observed between the two groups in any other cerebral territory. A cut-off value of 1.70 × 10-3 mm2 /s was associated with a sensitivity of 57% (95% CI, 18-90%), a specificity of 78% (95% CI, 63-88%), a positive predictive value of 27% (95% CI, 8-55%) and a negative predictive value of 93% (95% CI, 80-98%) for the prediction of adverse perinatal outcome. A mean frontal ADC value

BACKGROUND: Although induction of labor (IOL) of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains given that this intervention historically has been thought to incur greater resource utilization. OBJECTIVE: To determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum. STUDY DESIGN: This is a planned secondary analysis of a multi-center randomized trial in which low-risk nulliparous women were assigned to IOL at 39 weeks or expectant management. We assessed resource utilization post-randomization in three time periods: antepartum (AP), delivery admission, and discharge through 8 weeks postpartum (PP). RESULTS: Of 6096 women with data available, those in the IOL group (n = 3059) were significantly less likely in the AP period after randomization to have at least one ambulatory visit for routine prenatal care (32.4% vs. 68.4%), unanticipated care (0.5% vs. 2.6%), or urgent care (16.2% vs. 44.3%), or at least one antepartum hospitalization (0.8% vs. 2.2%, p0.05 for all). CONCLUSIONS: Women randomized to IOL had longer durations in labor and delivery, but significantly fewer AP visits, tests, and treatments, and shorter maternal and neonatal hospital durations post-delivery. These results demonstrate that the health outcome advantages associated with IOL are gained without incurring uniformly greater health care resource use. TRIAL REGISTRATION: ClinicalTrials.gov number NCT01990612

We investigate the role of relative tRNA availabilities in limiting the rate of amino acid incorporation during the translation stage of protein synthesis. Although an extensive literature focuses on maximizing the incorporation rate, the physical importance of having only finite amounts of information to control tRNA abundances has not been similarly addressed. This project quantifies the existing tradeoff between the protein synthesis rate and available information by maximizing the system's entropy, and defines the minimum information required to achieve a given mean synthesis rate. The resulting model predicts the distribution of likely sets of tRNA abundances required to produce the essential proteins of a given cell type for an initial set of codon frequencies. Numerical methods and Monte Carlo simulations then characterize and manipulate the selectivity of the model's solution space for tRNA abundance sets of E. coli under several experimental settings, demonstrating the feasibility of achieving the predicted minimum incorporation time. At the localization limit, we show that the optimal solutions involve largely mid-range concentrations but are distinctly nonuniform, with individual tRNAs varying by the importance of the corresponding cognate codon. The findings demonstrate the types of analyses possible with the model, but more accurate data about tRNA abundances under various conditions could usefully fine-tune the parameters. The model provides a plausible mechanism by which, given a set of weighted codon frequencies, one can predict the optimal tRNA availability and directly determine the cell's state at a given point on the information tradeoff continuum.

Summary Objective There is a need to identify reliable biomarkers that can predict knee osteoarthritis (OA) progression. We investigated a panel of adipokines and some related inflammatory factors alone and their ratios for their associative value at assessing cartilage volume loss over time and symptoms in obese [High body mass index (BMI)] and non-obese (Low BMI) OA subjects. Design Human OA serum was from the Osteoarthritis Initiative Progression subcohort. Baseline levels of adiponectin (high and low molecular weight forms), adipsin, chemerin, leptin, visfatin, C-reactive protein (CRP), interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) were evaluated with specific assays. Cartilage volume was assessed at baseline and 48 months by quantitative magnetic resonance imaging (MRI), and symptoms using baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Data were analysed by linear regression with confounding factors at baseline, followed by multiple comparison adjustment. Results The levels of the nine biomarkers and their ratios (36) were studied. Among High BMI subjects, only the ratio adipsin/MCP-1 was associated with cartilage volume loss over time in the lateral compartment [β, −2.95; 95% confidence interval (CI), −4.42, −1.49; P = 0.010], whereas MCP-1 was associated with WOMAC pain (−1.74; −2.75, −0.73; P = 0.030) and the ratio CRP/MCP-1 with WOMAC pain (0.76; 0.37, 1.14; P = 0.023), function (2.43; 1.20, 3.67; P = 0.020) and total (3.29; 1.58, 5.00; P = 0.027). No associations were found for biomarkers or ratios in Low BMI OA. Conclusion In this study, the ratio adipsin/MCP-1 was found to be associated with the knee structural changes and that of CRP/MCP-1 with symptoms in obese OA subjects. Our data further underline the relevance of ratios as biomarkers to a stronger association to OA progression and symptoms.

Patient navigation is increasingly employed to guide patients through cancer treatment. We assessed the elements of navigation that promoted patients’ involvement in treatment among patients with breast and colorectal cancer that participated in a navigation study. We conducted qualitative analysis of 28 audiotaped and transcribed semi-structured interviews of navigated and unnavigated cancer patients. Themes included feeling emotionally and cognitively overwhelmed and desire for a strong patient-navigator partnership. Both participants who were navigated and those who were not felt that navigation did or could help address their emotional, informational, and communicational needs. The benefits of logistical support were cited less often. Findings underscore the salience of personal relationships between patients and navigators in meeting patients’ emotional and informational needs.

Objectives This study sought to determine if the risk of mortality associated with inappropriate implantable cardioverter-defibrillator (ICD) shocks is due to the underlying arrhythmia or the shock itself. Background Shocks delivered from ICDs are associated with an increased risk of mortality. It is unknown if all patients who experience inappropriate ICD shocks have an increased risk of death. Methods We evaluated survival outcomes in patients with an ICD and a cardiac resynchronization therapy defibrillator enrolled in the LATITUDE remote monitoring system (Boston Scientific Corp., Natick, Massachusetts) through January 1, 2010. First shock episode rhythms from 3,809 patients who acutely survived the initial shock were adjudicated by 7 electrophysiologists. Patients with a shock were matched to patients without a shock (n = 3,630) by age at implant, implant year, sex, and device type. Results The mean age of the study group was 64 ± 13 years, and 78% were male. Compared with no shock, there was an increased rate of mortality in those who received their first shock for monomorphic ventricular tachycardia (hazard ratio [HR]: 1.65, p Conclusions Compared with no shock, those who received their first shock for ventricular rhythms and atrial fibrillation had an increased risk of death. There was no significant difference in survival after inappropriate shocks for sinus tachycardia or noise/artifact/oversensing. In this study, the adverse prognosis after first shock appears to be more related to the underlying arrhythmia than to an adverse effect from the shock itself.

Open-pollinated progeny tests of American sycamore (Platanus occidentalis L.), which included 55 open-pollinated families selected from several prior Westva - co progeny tests and seed orchards and six control-pollinated families were established in 2002 and 2003. The half-sibling families were planted at two sites in western Kentucky and southeastern Missouri. The six full-sibling families, generated from selections based on exhibition of parental disease resistance and susceptibility to a variety of diseases, were also planted near Stoneville, MS at the US Forest Service Center for Bottomland Hardwoods Research. All full-sibling families planted at the Stoneville site were inoculated in the fall 2002 with the leaf-scorch-causing bacterium, Xylella fastidiosa. Diameter and height data for trees of both half- and full-sibling families were recorded at ages three, five, seven, and nine at the various sites. Bacterial leaf scorch disease presence was also recorded as symptomatic or asymptomatic/ mildly symptomatic. Average family heritability across ages was 0.58, 0.50, and 0.55 for height, diameter, and volume, respectively, indicating that increased growth traits can be gained from family selection. In conjunction with derived age-age correlations, selection based on age-five data results in the greatest gain per unit time for age nine gains for half-sibling families. Breeding for bacterial leaf scorch resistance can also be successfully undertaken if proper selection and breeding of two resistant parents are undertaken which can result in a 4.5 fold decrease in the probability in symptoms of offspring by age nine. Results indicate a large potential for increased growth and disease resistance in American sycamore through traditional breeding.

Patient navigation (PN) programs are being widely implemented to reduce disparities in cancer care for racial/ethnic minorities and the poor. However, few systematic studies cogently describe the processes of PN. We qualitatively analyzed 21 transcripts of semistructured exit interviews with three navigators about their experiences with patients who completed a randomized trial of PN. We iteratively discussed codes/categories, reflective remarks, and ways to focus/organize data and developed rules for summarizing data. We followed a three-stage analysis model: reduction, display, and conclusion drawing/verification. We used ATLAS.ti_5.2 for text segmentation, coding, and retrieval. Four categories of factors affecting cancer care outcomes emerged: patients, navigators, navigation processes, and external factors. These categories formed a preliminary conceptual framework describing ways in which PN processes influenced outcomes. Relationships between processes and outcomes were influenced by patient, navigator, and external factors. The process of PN has at its core relationship-building and instrumental assistance. An enhanced understanding of the process of PN derived from our analyses will facilitate improvement in navigators' training and rational design of new PN programs to reduce disparities in cancer-related care.

It is generally accepted that year-to-year variability in moisture conditions and drought are linked with increased wildfire occurrence. However, quantifying the sensitivity of wildfire to surface moisture state at seasonal lead-times has been challenging due to the absence of a long soil moisture record with the appropriate coverage and spatial resolution for continental-scale analysis. Here we apply model simulations of surface soil moisture that numerically assimilate observations from NASA's Gravity Recovery and Climate Experiment (GRACE) mission with the US Forest Service's historical Fire-Occurrence Database over the contiguous United States. We quantify the relationships between pre-fire-season soil moisture and subsequent-year wildfire occurrence by land-cover type and produce annual probable wildfire occurrence and burned area maps at 0.25-degree resolution. Cross-validated results generally indicate a higher occurrence of smaller fires when months preceding fire season are wet, while larger fires are more frequent when soils are dry. This result is consistent with the concept of increased fuel accumulation under wet conditions in the pre-season. These results demonstrate the fundamental strength of the relationship between soil moisture and fire activity at long lead-times and are indicative of that relationship's utility for the future development of national-scale predictive capability.

In 1987, an open-pollinated test of cherrybark oak (Quercus pagodae Raf.) was established on a loess site in Carlisle County, Kentucky. The test contained 37 half-sib families representing eight provenances from Louisiana, Mississippi, Tennessee, and Virginia. Height measurements were taken at ages one, three, five, ten, and fifteen, and diameter at ages five, ten, and fifteen. Significant differences existed among provenances and among families within provenances. Seed sources from the west-central Mississippi area performed better for both diameter and height, yet no overall geographic trend was apparent. The top three families were all from the Warren Co., Mississippi source while two of the top three diameter families were from Washington Co., MS and the third was from Warren Co., Mississippi. Survival among the eight provenances was constant from age one to ten. A drop in survival was shown between ages 10 and 15, probably a result of inter-tree competition. Height and diameter growth between ages five and 10 was nearly double that prior to age five and between ages 10 and 15. Family heritabilities for height and diameter were calculated for each measurement year. Family heritabilities for diameter ranged from 0.55 to 0.70 while height ranged from 0.50 to 0.70. Strong age-age correlations for height, diameter, and volume were found indicating good trait predictability from early measurements. Genetic gain equations were used to identify the optimum selection age and trait for maximizing age 15 volume. Early selection of families within provenances should yield gains in height, diameter, and volume.

International audience; The wine industry needs to know the yield of each vine field precisely to optimize quality management and limit the costs of harvest operations. Yield estimation is usually based on random vine sampling. The resulting estimations are often not precise enough because of the high variability within vineyard fields. The aim of the work was to study the relevance of using NDVI-based sampling strategies to improve estimation of mean field yield. The study was conducted in 9 non-irrigated vine fields located in southern France. For each field, NDVI was derived from multi-spectral airborne images. The variables which define the yield: (berry weight at harvest (BWh), bunch number per vine (BuN) and berry number per bunch (BN)) were measured on a regular grid. This data-base allowed for five different sampling schemes to be tested. These sampling methods were mainly based on a stratification of NDVI values, they differed in the way as to whether NDVI was used as ancillary information to design a sampling strategy for BuN, BN, BW or for all yield variables together. Results showed a significant linear relationship between NDVI and BW, indicating the interest of using NDVI information to optimize sampling for this parameter. However this result is mitigated by the low incidence of BW in the yield variance (4 %) within the field. Other yield components, BuN and BN explain a higher percentage of yield variance (60% and 11 % respectively) but did not show any clear relationship with NDVI. A large difference was observed between fields, which justifies testing the optimized sampling methods on all of them and for all yield variables. On average, sampling methods based on NDVI systematically improved vine field yield estimates by at least 5-7 % compared to the random method. Depending on the fields, error improvement ranged from -2 % to 15 %. Based on these results, the practical recommendation is to consider a two-step sampling method where BuN is randomly sampled and BW is sampled according to the NDVI values.

Eastern cottonwood ( Populus deltoides Marsh.) is grown in plantations by MeadWestvaco for use at its Wickliffe Kentucky Fine Papers Mill 1 . Genetic and productivity research over the past two decades have led to significant increases in biomass yield while reducing production costs. Initially, genetic research identified fast growing clones for sites along the Mississippi River alluvial floodplain near Wickliffe, Kentucky. Clone recommendations are refined continuously through testing, and we add new clones to the program to broaden the genetic base. Breeding and selection allow us to combine traits important to the paper making process in select clones. In 1996, a fiber farm was established, and additional genetic testing was needed to develop clones for this radically different production system. Biotechnological advances such as the use of genetic markers and transformation have proven their value for cottonwood, but regulatory approval is needed to commercialize this technology. Over the past five years, our plantation productivity research has reduced fiber production costs by defining optimal management regimes for alluvial and fiber farm sites. As research identifies the best herbicides, rates, and application times, chemical weed control use is increasing and gradually substituted for mechanical cultivation. Studies on planting dates and cutting length showed that successful plantations can be established in July to avoid spring floods, and long cuttings grow faster than shorter ones. Water, nutrient, and spacing studies indicated that initial fiber farm management regimes could be improved substantially. In addition, research on cottonwood leaf beetle showed that damage was minimized during the critical plantation establishment phase using an insecticide that is new to forestry.

An examination of the efficiency of the marketing distribution channel and organizational structure for insurance companies is presented from a framework that views the insurer as a financial intermediary rather than as a "production entity" which produces "value added" through loss payments. Within this financial intermediary approach, solvency can be a primary concern for regulators of insurance companies, claims-paying ability can be a primary concern for policyholders, and return on investment can be a primary concern for investors. These three variables (solvency, financial return, and claims-paying ability) are considered as outputs of the insurance firm. The financial intermediary approach acknowledges that interests potentially conflict, and the strategic decision makers for the firm must balance one concern versus another when managing the insurance company. Accordingly, we investigate the efficiency of insurance companies using data envelopment analysis (DEA) having as insurer output an appropriately selected (for the firm under investigation) combination of solvency, claims-paying ability, and return on investment as outputs. These efficiency evaluations are further examined to study stock versus mutual form of organizational structure and agency versus direct marketing arrangements, which are examined separately and in combination. Comparisons with the "value-added" or "production" approach to insurer efficiency are presented. A new DEA approach and interpretation is also presented. INTRODUCTION This article uses the nonparametric properties of data envelopment analysis (DEA) coupled with distribution-free rank-order statistics to study the relative efficiency of the different organizational structures used by U.S. property and liability insurance companies (cross classified by their marketing distribution systems). Additionally, this article extends the interpretation of DEA toward a goal-directing technique with the goals as outputs rather than simply having a "product" as an output. This provides another focus and interpretation for DEA analysis in the insurance literature. We also use a form of DEA (the Range-Adjusted Measure, or RAM, model), new to the insurance literature, which is able to provide ordinal level efficiency scoring that allows for subsequent nonparametric statistical analysis such as regression, rank statistical analysis, etc. to be performed incorporating efficiency score as an explanatory variable in subsequent analysis. (1) We dichotomize our results by organizational form into mutual versus stock companies to examine whether these two organizational structures might have differential managerial strategic focus in terms of goals, and have different efficiency and slack variables when using solvency propensity, return on investment, and claims-paying ability as output goals. One might expect potential differences in efficiency between stock and mutual insurers due to the different incentive structures inherent in the two types of organizational forms; in stock companies return on shareholder investment dominates incentives, whereas solvency and claims-paying ability considerations can dominate considerations of mutual insurance company decision makers. Possible efficiency differences between mutual and stock types of organization are intrinsically intertwined with the use of the agency versus direct sales type of marketing distribution systems (2) and these dichotomies are also correlated to emphasis in commercial versus personal lines of insurance. Finally, the differences that can occur by using different DEA formulations (production approach considering losses as the output versus the financial intermediary approach of this article) are explored and discussed. THE RAM DEA MODEL (3) There is a theoretical problem in using DEA efficiency numbers from the standard CCR or BCC models for subsequent statistical analysis because, while DEA evaluates the efficiency of each firm, the comparison set for each firm may be different producing potentially nonmetric level data. …

Substantial progress continues to be made in a variety of biological fields toward increasing plantation productivity. Productivity in a wide variety of forest ecosystems is controlled by environmental variables, cultural treatments, the genotypes deployed, and the interactions thatmay exist among these various factors. Effective and efficient increases in productivity require a thorough understanding of these complex interactions. A thorough understanding of the biological limits to productivity and the development of effective genetic resources and cultural regimesto overcome some of these limitations is only one facet that forest managers must currently address. New management strategies for future plantations inherently carry new challenges and limitations that must prove to be substantially more profitable and ecologically sound than current technologies.To operate in the social context we currently face, industrial forest lands will continue to represent a range of management intensities with differing primary management objectives. On many of our most intensively managed forest lands, clonal plantation forestry is becoming the future. Thenext step in this progression may be the use of genetically modified trees. The form that intensive forest management will take in the future in the United States is subject to factors beyond the development of improved cultural regimes or new genotypes that may be deployed. Government restrictionsmay greatly impede or halt new technologies. Beyond controls imposed by formal regulations, negative public sentiment has been seen in the form of boycotts of retail markets thus pressuring the industry to use more costly management strategies. Research that is not directly related to stand productivity but rather possible impacts of increasing stand productivity to the environment and other ecological processes will draw even greater attention. South. J. Appl. For. 29(2):105–109.

Solvency is a primary concern for regulators of insurance companies, claims paying ability is a primary concern for policyholders, and return on investment is a primary concern for investors. These interests potentially conflict, and the decision-makers for the firm must trade off one concern versus another. Here we examine the efficiency of insurance companies via data envelopment analysis using solvency, claims paying ability, and return on investment as outputs and using a financial intermediary model for the insurance company. The effect of solvency on efficiency is then examined. These efficiency evaluations are further examined to study stock versus mutual form of organizational structure and agency versus direct marketing arrangements, which are examined separately and in combination.

Current debates in the insurance and public policy literatures over health care financing and cost control measures continue to focus on managed care and HMOs. The lower utilization rates found in HMOs (compared to tradi- tional fee-for-service indemnity plans) have generally been attributed to the organization's incentive to eliminate all unnecessary medical services. As a consequence HMOs are often considered to be a more efficient arrangement for delivering health care. However, it is important to make a distinction between utilization and efficiency (the ratio of outcomes to resources). Few studies have investigated the effect that HMO arrangements would have on the actual efficiency of health care delivery. Because greater control over provider autonomy appears to be a recurrent theme in the literature on re- form, it is important to investigate the effects these restrictions have already had within the HMO market. In this article, the efficiencies of two major classes of HMO arrangements are compared using "game-theoretic" data envelopment analysis (DEA) models. While other studies confirm that abso- lute costs to insurance firms and sponsoring companies are lowered using HMOs, our empirical findings suggest that, within this framework, efficiency generally becomes worse when provider autonomy is restricted. This should give new fuel to the insurance companies providing fee-for-service (FFS) indemnification plans in their marketplace contentions.

There are relatively few publications on the methodology of one-arm meta-analyses, especially when the outcome is binary and has low probability of occurring. We will discuss a few of the important assumptions underlying one-arm meta-analyses, including publication bias, fixed effect versus random-effects models, and raw event incidence rate transformations required when the event frequency is low. Finally, we will provide a real-life example taken from the endoscopic colonic stenting literature to illustrate the consequences of failure to thoroughly investigate these assumptions. In this example, we find arcsine transformation provides more appropriate results than logit transformation.

In steel ladles (steel industry) or in coal-fired power plants (energy production), the refractory linings anchored to the steel structure (casing) are subjected to significant thermal loadings which lead to cracking (owing to the difference between the thermal expansion coefficients). A first approach allows us to analyse the problem at a local scale: a smeared crack model permits the computation of the damage which is observed in an experimental test. But since a structure contains thousand of anchors, it is not possible to compute it with this model. An approach was therefore developed with a two-layered shell equivalent to the anchored lining and the casing. This model is identified with an inverse method and uses results from the first approach, validated by a bending test performed on a refractory lining specimen. The damage computing of a structure shows that it is very important to take the expansion joints into account.

The wall of refractorized vessels are composites, made of metallic casing often containing tubes and a refractory material for the protection against the high temperature environment. The objective of the present paper is to model a two layer shell with a thermomechanical behavior equivalent to those of the 3D lining and that render possible the finite element analysis of the complete vessel. A smeared crack model is used for the damage analysis of the refractory material. The equivalent shell is made up of an exterior orthotropic layer and an interior isotropic damageable layer. The set of thermal and mechanical parameters of the equivalent shell is obtained by an inverse method in conjunction with finite element analyses of the 3D panel subjected to an appropriate set of loadings. Some validation analyses show that the identified parameters lead to shell behavior, which is in good agreement with those of the 3D wall. In the case of a simplified cyclone, it is shown that the equivalent shell permits to compute the thermomechanical behavior of a complete refractorized vessel and especially to follow the damaged zones of the refractory.

We present an optical study of silica gel matrix doped with maghemite /spl gamma/-Fe/sub 2/O/sub 3/ nanoparticles originating from a ferrofluid. This work is a preliminary study for building adjusted birefringent components suitable for ellipsometry. Silica gel matrix is obtained as sol-gel synthesis. Results show that pure and doped samples solidified out of a magnetic field are quasi-isotropic, whereas samples solidified in the presence of a magnetic field exhibit a very large permanent linear birefringence comparable to that produced by the ferrofluid under the same magnetic field.

This paper presents a method for extracting a catalogue of galaxy candidates from the Digitized Sky Survey (DSS). The method is based on a functional analysis applied on each individual plate. The standard deviation of pixel optical densities versus the inverse of surface area leads to a diagram in which extended and star-like objects are well separated. This diagram is used for a preliminary recognition. Then, a filtering process is applied using a Neural Network method associated with a training sample built with well identified objects. The main catalogue gives coordinates, total magnitude, isophotal diameter, axis ratio, position angle for galaxy candidates. The method favors the detection of normal galaxies. This creates a bias against compact high surface brightness galaxies.

In interventional magnetic resonance imaging (MRI), the systems designed to help the surgeon during biopsy must provide accurate knowledge of the positions of the target and also the entry point of the needle on the skin of the patient. In some cases, this needle entry point can be outside the B(0) homogeneity area, where the distortions may be larger than a few millimeters. In that case, major correction for geometric deformation must be performed. Moreover, the use of markers to highlight the needle entry point is inaccurate. The aim of this study was to establish a three-dimensional coordinate correction according to the position of the entry point of the needle. We also describe a 2-degree of freedom electromechanical device that is used to determine the needle entry point on the patient's skin with a laser spot.