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Flooding risk identification is a task always treated within a very narrow scope between the life-cycle of a passenger ship. Therefore, different approaches and methods are available for design, operational or onboard applications. Furthermore, the models employed and proposed solutions use simplified methods based on empirical or probabilistic concepts. One of the aims of the EC-founded project FLARE was to promote the use of first principle methods throughout the whole vessel life-cycle, from the design phase up to the onboard risk management. To this end, this work presents the challenges and potential applicability of a real-time flooding risk evaluation methodology for ship-to-ship collisions, based on first-principles calculations. The possibility to perform direct calculations for survivability allows us to define a multi-level approach to flooding risk, separating Level-1 predictions, purely based on semi-empirical models and databases, from Level-2 predictions based on the concept of Potential Loss of Life (PLL). Here, besides a description of the multi-level risk assessment based on PLL, the different tasks of design and operational phases are addressed. Such issues are then linked to the real-time flooding risk evaluation for onboard applications, potentially working for different hazard types but conceptualised for the case of ship-to-ship collisions. The developed method applied to an arbitrary set of models, shows that the approach and tools employed for creating the framework are suitable for a real-time calculation of flooding risk.

The formation and evolutionary processes of galaxy bulges are still unclear, and the presence of young stars in the bulge of the Milky Way is largely debated. We recently demonstrated that Terzan 5, in the Galactic bulge, is a complex stellar system hosting stars with very different ages and a striking chemical similarity to the field population. This indicates that its progenitor was likely one of the giant structures that are thought to generate bulges through coalescence. Here we show that another globular cluster-like system in the bulge (Liller 1) hosts two distinct stellar populations with remarkably different ages: only 1-3 Gyr for the youngest, 12 Gyr for the oldest, which is impressively similar to the old component of Terzan 5. This discovery classifies Liller 1 and Terzan 5 as sites of recent star formation in the Galactic bulge and provides clear observational proof that the hierarchical assembly of primordial massive structures contributed to the formation of the Milky Way spheroid., Comment: 29 pages, 10 figures, typo in author affiliation fixed, published in Nature Astronomy

The incorporation of azobenzene chromophores into polymer systems gives rise to a number of unique effects under UV and visible light irradiation. The light-driven isomerization of the azobenzene element acts as a light-to-mechanical energy converter, translating the nanoscopic structural movement of the isomerization azobenzene into macroscopic topographic film modulation in the form of surface relief. This review focuses on the study of reversible changes in shape in various systems incorporating azobenzene, including large-scale superficial photo-patterned glassy materials, light-driven reshaping of tridimensional superficial azo-textures and contractions of stimuli-responsive liquid crystalline networks (LCNs). Further, promising applications of azo systems are investigated as smart biointerfaces able to mimic time-varying biological systems.

Background: Acute treatment of atrial fibrillation often requires concomitant intravenous (IV) continuous infusions of unfractionated heparin and diltiazem. Concomitantly infusing these medications through the same IV line minimizes multiple IV sites. Diltiazem and heparin visual compatibility have been previously investigated but with limited drug dwell times and differing drug concentrations leading to inconsistent published results. Objective: To investigate the physical compatibility of diltiazem hydrochloride at concentrations of 5 and 1 mg/mL combined with an equal volume of heparin sodium 100 units/mL. Methods: Using a 0.22-µm filter, 15 mL of heparin sodium were placed into a polyvinyl chloride infusion bag followed by 15 mL of either diltiazem hydrochloride 5 or 1 mg/mL. Admixtures were prepared in triplicate. Each admixture was investigated for visual precipitation, spectrophotometric absorbance, and pH change at baseline and 1, 5, 8, and 24 hours after mixing. Physical incompatibility was determined by visual observation, increased spectrophotometric absorbance, and demonstrative pH changes. Results: Each diltiazem 5 mg/mL admixture exhibited a slight haze and enhanced absorbance readings indicating turbidity while none revealed a demonstrative pH change. None of the diltiazem 1 mg/mL assessments revealed visual precipitation or suggested turbidity. Only one pH reading at 5 hours revealed a demonstrative change from baseline. Conclusions: Our findings indicate that infusing diltiazem hydrochloride 5 mg/mL with heparin sodium 100 units/mL in the same IV line cannot be advocated. In contrast, our findings suggest that heparin sodium 100 units/mL infused with diltiazem hydrochloride 1 mg/mL is physically compatible but chemical stability was not assessed.

Aims. In this paper we analyze the chemical evolution of the main body of the SMC, adding six additional clusters to previously published samples, based on homogeneously determined and accurate metallicities. Methods. We derived radial velocities and Ca II Triplet (CaT) metallicity of more than 150 red giants stars in six SMC star clusters and their surrounding fields, with the instrument GMOS on GEMINI-S. The mean cluster radial velocity and metallicity were obtained with mean errors of 2.2 km s−1 and 0.03 dex, while the mean field metallicities have a mean error of 0.13 dex. We add this information to that available for another 51 clusters and 30 fields with CaT metallicities on the same scale. Using this expanded sample we analyze the chemical properties of the SMC main body, defined as the inner 3.4° in semimajor axis. Results. We found a high probability that the metallicity distribution of the main body clusters is bimodal with a metal-rich and a metal-poor cluster group, having mean metallicities with a dispersion of μ = −0.80, σ = 0.06 and μ = −1.15, σ = 0.10 dex, respectively. On the other hand, main body field stars show a unimodal metallicity distribution peaking at [Fe/H] ∼ −1 and dispersion of 0.3. Neither metal-rich nor metal-poor clusters present a metallicity gradient. However, the full main body cluster sample and field stars have a negative metallicity gradient consistent with each other, but the one corresponding to clusters has a large error due to the large metallicity dispersion present in the clusters studied in that region. Metal-rich clusters present a clear age–metallicity relation, while metal-poor clusters present no chemical enrichment throughout the life of the galaxy. Conclusions. We present observational evidence that the chemical enrichment is complex in the SMC main body. Two cluster groups with potential different origins could be coexisting in the main body. More data with precise and homogeneous metallicities and distances are needed and dynamical simulations are required to understand the possible different origins for the two cluster groups.

Context. Globular clusters (GCs) are excellent tracers of the formation and early evolution of the Milky Way. The bulge GCs (BGCs) are particularly important because they can reveal vital information about the oldest in situ component of the Milky Way. Aims. Our aim is to derive the mean metallicities and radial velocities for 13 GCs that lie toward the bulge and are generally associated with this component. This region is observationally challenging because of high extinction and stellar density, which hampers optical studies of these and similar BGCs, making most previous determinations of these parameters quite uncertain. Methods. We used near-infrared low-resolution spectroscopy with the FORS2 instrument on the VLT to measure the wavelengths and equivalent widths of the CaII triplet (CaT) lines for a number of stars per cluster. We derived radial velocities, ascertained membership, and applied known calibrations to determine metallicities for cluster members, for a mean of 11 members per cluster. Unfortunately, one of our targets, VVV-GC002, which is the closest GC to the Galactic center, turned out not to have any members in our sample. Results. We derive mean cluster RV values to 3 km s−1, and mean metallicities to 0.05 dex. We find general good agreement with previous determinations for both metallicity and velocity. On average, our metallicities are 0.07 dex more metal-rich than those of Harris (2010, arXiv:1012.3224), with a standard deviation of the difference of 0.25 dex. Our sample has metallicities between −0.21 and −1.64, and the values are distributed between the traditional metal-rich BGC peak near [Fe/H] −0.5 and a more metal-poor peak around [Fe/H] −1.1, which has recently been identified. These latter are candidates for the oldest GCs in the Galaxy, if blue horizontal branches are present, and include BH 261, NGC 6401, NGC 6540, NGC 6642, and Terzan 9. Finally, Terzan 10 is even more metal-poor. However, dynamically, Terzan 10 is likely an intruder from the halo, possibly associated with the Gaia-Enceladus or Kraken accretion events. Terzan 10 is also confirmed as an Oosterhoff type II GC based on our results. Conclusions. The CaT technique is an excellent method for deriving mean metallicities and velocities for heavily obscured GCs. Our sample provides reliable mean values for these two key properties via spectroscopy of a significant number of members per cluster for this important yet previously poorly studied sample of BGCs. We emphasize that the more metal-poor GCs are excellent candidates for being ancient relics of bulge formation. The lone halo intruder in our sample, Terzan 10, is conspicuous for also having by far the lowest metallicity, and casts doubt on the possibility of any bona fide BGCs at metallicities below about −1.5.

We have investigated the stellar and interstellar content of the distant star formation region IRAS 17591-2228 (WISE HII region GAL 007.47+0.06). It is associated to a water maser, whose parallax distance is d=20.4^{+2.8} {-2.2} kpc, supported by independent measurements of proper motion and radial velocity. It is projected in the same direction as an extremely red (J-Ks ~ 6 mag) group of stars, and a shell of mid-infrared emission. We qualify the group of stars as a cluster candidate, VVV CL177. Its radius spans between 0.45' and 1' and contains at least two young stellar objects with an extreme extinction near Av ~ 40 mag. Yet more analysis will be required to determine is it is a real single cluster associated with the water maser. The 13CO emissions at the radial velocity of the maser corresponds to the mid-infrared emission., 10 pages, 5 figures, accepted for publication in ApJ

The incorporation of azobenzene chromophores into polymer systems gives rise to a number of unique effects under UV and visible light irradiation. The light-driven isomerization of the azobenzene element acts as a light-to-mechanical energy converter, translating the nanoscopic structural movement of the isomerization azobenzene into macroscopic topographic film modulation in the form of surface relief. This review focuses on the study of reversible changes in shape in various systems incorporating azobenzene, including large-scale superficial photo-patterned glassy materials, light-driven reshaping of tridimensional superficial azo-textures and contractions of stimuli-responsive liquid crystalline networks (LCNs). Further, promising applications of azo systems are investigated as smart biointerfaces able to mimic time-varying biological systems.

In the offshore industry, the thruster layout for dynamic positioning (DP) is not optimal to reach the maximum station-keeping capability. It is possible to optimise the position of the thrusters since early design stage applying a genetic algorithm-based optimisation procedure. The enhancements due to an optimal thruster configuration can be reported in the standard capability plot format as commonly done in the offshore industry. However, besides standard capability plots, additional calculations can be performed by explicitly considering the vessel’s geographic operational areas. By adopting this novel approach, it is possible to associate to vessel’s DP capability an operability index which is specific for the considered sea area and is in analogy of that adopted for ship motion criteria. In this way, the improvements of the optimised thruster configuration can be represented in terms of the increment of DP operability index in a selected sea area, instead of the capability plot area increase for standard conditions. The procedure is here applied to a reference Pipe-lay vessel, where the thruster layout has been optimised. The improvements are reported through both conventional capability plot and newly proposed DP operability index for the North Sea area.

Context. Milky Way globular clusters (GCs) are difficult to identify at low Galactic latitudes because of high differential extinction and heavy star crowding. The new deep near-infrared (IR) images and photometry from the VISTA Variables in the Via Láctea Extended Survey (VVVX) allow us to chart previously unexplored regions. Aims. Our long term aim is to complete the census of Milky Way GCs. The immediate goals are to estimate the astrophysical parameters for the newly discovered GC candidates, measuring their reddenings, extinctions, distances, total luminosities, proper motions, sizes, metallicities, and ages. Methods. We used the near-IR VVVX survey database, in combination with the optical photometry and proper motions (PMs) from Gaia Data Release 2 (DR2), and with the Two Micron All Sky Survey photometry to search for and characterise new GCs within the southern Galactic plane (|b| < 5°). Results. We report the detection of a heretofore unknown Galactic GC at RA = 14:09:00.0; Dec =-65:37:12 (J2000) corresponding to l = 310.828 deg; and b =-3.944 deg in galactic coordinates. We calculate a reddening of E(J-Ks) = (0.3 ± 0.03) mag and an extinction of AKs = (0.15 ± 0.01) mag for this new GC. Its distance modulus and corresponding distance were measured as (m-M) = (15.93 ± 0.03) mag and D = (15.5 ± 1.0) kpc, respectively. We also estimate the metallicity and age by comparison with known GCs and by fitting PARSEC and Dartmouth isochrones, finding [Fe/H] = (-0.70 ± 0.2) dex and t = (11.0 ± 1.0) Gyr. The mean GC PMs from Gaia DR2 are μα∗ = (-4.68 ± 0.47) mas yr-1 and μδ = (-1.34 ± 0.45) mas yr-1. The total luminosity of our cluster is estimated to be MKs = (-7.76 ± 0.5) mag. The core and tidal radii from the radial density profile are rc ∼ 2.1′ (4.6 pc) and rt = 6.5′ (14.6 pc) at the cluster distance. Conclusions. We have found a new low luminosity, old and metal-rich GC, situated in the far side of the Galactic disk at RG = 11.2 kpc from the Galactic centre and at z = 1.0 kpc below the plane. Interestingly, the location, metallicity, and age of this GC are coincident with the Monoceros ring structure. Fil: Garro, E. R.. Universidad Andrés Bello; Chile Fil: Minniti, D.. Universidad Andrés Bello; Chile. Vatican Observatory; Italia Fil: Gómez, M.. Universidad Andrés Bello; Chile Fil: García Alonso, José. Universidad de Antofagasta; Chile. Millennium Institute of Astrophysics; Chile Fil: Barbá, Rodolfo. Universidad de La Serena; Chile Fil: Barbuy, B.. Universidade de Sao Paulo; Brasil Fil: Clariá, Juan José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; Argentina Fil: Chené, A. N.. Observatorio Gemini; Chile Fil: Dias, Bruno. Universidad de Tarapaca. Instituto de Alta Investigacion.; Chile Fil: Hempel, M.. Universidad Andrés Bello; Chile Fil: Ivanov, V. D.. European Southern Observatory; Alemania Fil: Lucas, P. W.. University of Hertfordshire; Reino Unido Fil: Majaess, D.. Mount Saint Vincent University; Canadá. Saint Mary's University. School of Environmental Studies; Canadá Fil: Mauro, F.. Universidad Católica del Norte; Chile Fil: Moni Bidin, C.. Universidad Católica del Norte; Chile Fil: Palma, Tali. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; Argentina Fil: Pullen, J. B.. Universidad Andrés Bello; Chile Fil: Saito, R. K.. Universidade Federal de Santa Catarina; Brasil Fil: Smith, L.. University of Cambridge; Reino Unido Fil: Surot, F.. Instituto de Astrofísica de Canarias; España Fil: Ramírez Alegría, S.. Universidad de Antofagasta; Chile Fil: Rejkuba, M.. University of Hertfordshire; Reino Unido Fil: Ripepi, V.. Osservatorio Astronomico Di Capodimonte; Italia Fil: Fernández Trincado, J.. Universidad de Atacama.; Chile

The pharmacology, pharmacokinetics, efficacy and safety of ivabradine are reviewed. Ivabradine is an oral medication that directly and selectively inhibits the hyperpolarization-activated cyclic-nucleotide gated funny (If) current in the sinoatrial node resulting in heart rate reduction. It has a plasma elimination half-life of 6 hours and is administered twice daily. Ivabradine is extensively metabolized by cytochrome P450 3A4, and its metabolism is affected by inducers and inhibitors of the 3A4 enzyme. Studies in patients with heart failure indicate that ivabradine improves surrogate markers such as exercise tolerance. The results of (1) phase III trial demonstrated ivabradine significantly reduced heart failure hospitalizations but had no effect on mortality. Ivabradine has been extensively evaluated for coronary artery disease wherein (2) large trials was shown to have no mortality benefit. Ivabradine has been associated with improved symptoms in stable chronic angina pectoris. Ivabradine has been evaluated for other cardiovascular conditions including tachycardias of various natures, arrhythmia prevention postcardiac surgery, in acute coronary syndrome, and for heart rate control during coronary computed tomography angiogram. The most common adverse events reported in clinical trials were bradycardia, new-onset atrial fibrillation, and phosphenes. Ivabradine, a novel cardiac medication, has been studied in numerous cardiac conditions. It is only currently approved in the United States to reduce hospitalizations for systolic heart failure. The role of this medication in other conditions has not been fully elucidated.

Continuous i.v. milrinone infusions are used to treat patients with acute decompensated heart failure.[1][1] It is conceivable that patients receiving i.v. milrinone may also be treated for infection, making it necessary to administer milrinone and i.v. antibiotics through the same i.v. line.

In this article, we present a detailed chemical analysis of seven red giant members of NGC 6553 using high-resolution spectroscopy from VLT FLAMES. We obtained the stellar parameters (Teff, Log(g), vt, [Fe/H]) of these stars from the spectra, and we measured the chemical abundance for 20 elements, including light elements, iron-peak elements, alpha-elements and neutron-capture elements. The metallicities in our sample stars are consistent with a homogeneous distribution. We found a mean of [Fe/H]=-0.14+/-0.07 dex, in agreement with other studies. Using the alpha-elements Mg, Si, Ca and Ti we obtain the mean of [alpha/Fe]=0.11+/-0.05. We found a vertical relation between Na and O, characterized by a significant spread in Na and an almost non-existent spread in O. In fact, Na and Al are the only two light elements with a large intrinsic spread, which demonstrates the presence of Multiple Populations (MPs). An intrinsic spread in Mg is not detected in this study. The alpha, iron-peak and neutron capture elements show good agreement with the trend of the bulge field stars, indicating similar origin and evolution, in concordance with our previous studies for two other bulge GCs (NGC 6440 and NGC 6528)., 12 pages, 11 figures, 4 tables. Accepted for publication in MNRAS

The analysis of time records, coming from seakeeping experiments in irregular waves, is used to determine the occurrence of extreme events. The common procedure used for data analysis is to assume that the statistics of record's peaks is following two or three parameters Weibull distribution. For particularly severe sea states, it can happen that the peaks assume a multi-modal distribution and the use of a Weibull distribution may lead to errors in the extreme value estimate. It is than possible to use multi-modal distributions, or to change the peaks extraction technique, adopting a certain threshold. Here, the determination of extreme values probability distribution parameters by genetic algorithm is applied to improve the methodology of extreme sea state prediction. A data analysis procedure is here proposed and tested on a time record coming from seakeeping model-scale experiments and on a set of wave heights record, in comparison with standard Weibull approach.

Context. Bulge globular clusters (BGCs) are exceptional tracers of the formation and chemodynamical evolution of this oldest Galactic component. However, until now, observational difficulties have prevented us from taking full advantage of these powerful Galactic archeological tools. Aims. CAPOS, the bulge Cluster APOgee Survey, addresses this key topic by observing a large number of BGCs, most of which have only been poorly studied previously. Even their most basic parameters, such as metallicity, [{\alpha}/Fe], and radial velocity, are generally very uncertain. We aim to obtain accurate mean values for these parameters, as well as abundances for a number of other elements, and explore multiple populations. In this first paper, we describe the CAPOS project and present initial results for seven BGCs. Methods. CAPOS uses the APOGEE-2S spectrograph observing in the H band to penetrate obscuring dust toward the bulge. For this initial paper, we use abundances derived from ASPCAP, the APOGEE pipeline. Results. We derive mean [Fe/H] values of $-$0.85$\pm$0.04 (Terzan 2), $-$1.40$\pm$0.05 (Terzan 4), $-$1.20$\pm$0.10 (HP 1), $-$1.40$\pm$0.07 (Terzan 9), $-$1.07$\pm$0.09 (Djorg 2), $-$1.06$\pm$0.06 (NGC 6540), and $-$1.11$\pm$0.04 (NGC 6642) from three to ten stars per cluster. We determine mean abundances for eleven other elements plus the mean [$\alpha$/Fe] and radial velocity. CAPOS clusters significantly increase the sample of well-studied Main Bulge globular clusters (GCs) and also extend them to lower metallicity. We reinforce the finding that Main Bulge and Main Disk GCs, formed in situ, have [Si/Fe] abundances slightly higher than their accreted counterparts at the same metallicity. We investigate multiple populations and find our clusters generally follow the light-element (anti)correlation trends of previous studies of GCs of similar metallicity. We finally explore the abundances ..., Comment: 27 pages, 10 figures, 5 tables. Abridged abstract. Accepted for publication in Astronomy & Astrophysics (A&A)

The Bulge Globular Clusters (GCs) are key tracers of this central ancient component of our Galaxy. It is essential to understand their formation and evolution to study that of the bulge, as well as their relationship with the other Galactic GC systems (halo and disk GCs). Our main goals are to obtain detailed abundances for a sample of seven red giant members of NGC 6528 in order to characterize its chemical composition and study the relationship of this GC with the bulge, and with other bulge, halo and disk GCs. Moreover, we analyze this cluster$'$s behavior associated with the Multiple Populations (MPs) phenomenon. We obtained the stellar parameters and chemical abundances of light elements (Na, Al), iron-peak elements (V, Cr, Mn, Fe, Co, Ni, Cu), {\alpha}-elements (O, Mg, Si, Ca, Ti) and heavy elements (Zr, Ba, Eu) in seven red giant members of NGC 6528 using high resolution spectroscopy from FLAMES-UVES. We obtained in six stars of our sample a mean iron content of [Fe/H]=-0.14+/-0.03 dex, in good agreement with other studies. We found no significant internal iron spread. We detected one candidate variable star, which was excluded from the mean in iron content, we derived a metallicity in this star of [Fe/H]=-0.55+/-0.04 dex. Moreover, we found no extended O-Na anticorrelation but instead only an intrinsic Na spread. In addition, NGC 6528 does not exhibit a Mg-Al anticorrelation, and no significant spread in either Mg or Al. The {\alpha} and iron-peak elements show good agreement with the bulge field star trend. The heavy elements are slightly dominated by the r-process. The chemical analysis suggests an origin and evolution similar to that of typical old Bulge field stars. Finally, we find remarkable agreement in the chemical patterns of NGC 6528 and another bulge GC, NGC 6553, suggesting a similar origin and evolution., Comment: Accepted for publication in A&A. 12 pages, 13 figures, 4 tables

In this paper we review the operational definition of the so-called main sequence knee (MS-knee), a feature in the color-magnitude diagram (CMD) occurring at the low-mass end of the MS. The magnitude of this feature is predicted to be independent of age at fixed chemical composition. For this reason, its difference in magnitude with respect to the MS turn-off (MS-TO) point has been suggested as a possible diagnostic to estimate absolute globular cluster (GC) ages. We first demonstrate that the operational definition of the MS-knee currently adopted in the literature refers to the inflection point of the MS (that we here more appropriately named MS-saddle), a feature that is well distinct from the knee and that cannot be used as its proxy. The MS-knee is only visible in near-infrared CMDs, while the MS-saddle can be also detected in optical-NIR CMDs. By using different sets of isochrones we then demonstrate that the absolute magni- tude of the MS-knee varies by a few tenths of a dex from one model to another, thus showing that at the moment stellar models may not capture the full systematic error in the method. We also demonstrate that while the absolute magnitude of the MS-saddle is almost coincident in different models, it has a systematic dependence on the adopted color combinations which is not predicted by stellar models. Hence, it cannot be used as a reliable reference for absolute age determination. Moreover, when statistical and systematic uncertainties are properly taken into ac- count, the difference in magnitude between the MS-TO and the MS-saddle does not provide absolute ages with better accuracy than other methods like the MS-fitting., 31 pages, 12 figures, 4 tables. Accepted for publication in The Astrophysical Journal

Levetiracetam is an anticonvulsant for partial, myoclonic, and primary generalized tonic-clonic seizures.[1][1] Levetiracetam is often administered intravenously in the intensive care setting and may require simultaneous i.v. administration with cardiovascular agents. Evidence defining compatibility

This paper describes the software architecture and the implementation of a fully operational testbed that demonstrates the benefits of flexible, dynamic resource allocation with virtualized LTE-A nodes. The testbed embodies and specializes the general software architecture devised within the Flex5Gware EU project, and focuses on two intelligent programs: the first one is a Global Scheduler, that coordinates radio resource allocation among interfering nodes; the second one is a Global Power Manager, which switches on/off nodes based on their expected and measured load over a period of minutes. The software framework is written using open-source software, and includes fast, scalable optimization algorithms at both components. Moreover, it supports virtualized BaseBand Units, implemented using OpenAir-Interface, that can run on physical and virtual machines. We present the results obtained via on-field measurements, that demonstrate the feasibility and benefits of our approach.

The visual landscape is a part of the total landscape related to the aesthetics of the observed environment and the personal preferences of the observer. The visual landscape must be considered in landscape management and planning processes, in impact assessments and other activities such as biodiversity conservation and implementation of best practices in forestry. There are criteria that can be applied to avoid impacts and contribute to the conservation at the landscape scale for a given forest type. Mature and virgin boreal forests have characteristics that make them very important for the landscape quality, and they are necessary elements to preserve biodiversity. These forests are the type of forest that is most often destroyed and even today, their area in the boreal biome is shrinking due to clear cuts and forest fires. Preserving and managing these forests in a sustainable way is urgent as they are key elements in the landscape of boreal areas. Fortunately, there is knowledge and previous experiences that make it possible to create and manage complex forest environments from simplified forest structures, and that are economically profitable and present attributes of old-growth forest.

Over the last decade, the classical definition of Globular Clusters (GCs) as simple stellar populations was revolutionized due to the discovery of "Multiple Populations" (MPs). However, our knowledge of this phenomenon and its characteristics is still lacking greatly observationally, and there is currently no scenario that adequately explains its origin. It is therefore important to study as many GCs as possible to characterize whether or not they have MPs, and determine their detailed behavior to enlighten formation scenarios, using a wide range of techniques. The Washington photometric system has proved to be useful to find MPs thanks mainly to the UV-sensitivity and high efficiency of the C filter. We search for MPs in the Galactic GC NGC 7099 (M30), the second GC being searched for MPs using this system. We obtained photometric data using the Swope 1m telescope at Las Campanas Observatory, as well as the 4m SOAR facility. Our reduction procedure included addstar experiments to properly assess photometric errors. We find a clear signal of MPs based on an intrinsically wide color spread on the RGB, in particular due to a relatively small fraction of stars significantly bluer than the main RGB locus. These stars should correspond to so-called first generation stars, which we estimate to be roughly 15\% of the total. However, we find these first-generation stars to be more spatially concentrated than their second generation counterparts, which is the opposite to the general trend found in other clusters. We briefly discuss possible explanations for this phenomenon., Comment: 11 pages, 8 figures, 2 tables

Using Coordinated Scheduling (CS), eNodeBs in a cellular network dynamically agree on which Resource Blocks (not) to use, so as to reduce the interference, especially for cell-edge users. This paper describes a software framework that allows dynamic CS to occur among a relatively large number of nodes, as part of a more general framework of network management devised within the Flex5Gware project. The benefits of dynamic CS, in terms of spectrum efficiency and resource saving, are illustrated by means of simulation and with live measurements on a prototype implementation using virtualized eNodeBs.

Pulmonary arterial hypertension is a devastating disease. Before the 1990s, when pharmacologic treatment was finally approved, only supportive therapy was available, consisting of anticoagulation, digoxin, diuretics, and supplemental oxygen. Calcium channel blocker therapy was also an option, but only a small percentage of patients respond to it. However, starting with epoprostenol in 1996, the number of drugs approved to treat pulmonary arterial hypertension increased. Three distinct classes of drugs were developed based on the pathophysiology of the disease: the prostanoids, endothelin-1 receptor antagonists, and phosphodiesterase type 5 inhibitors. The prostanoids are administered either parenterally or by inhalation to replace the lack of prostacyclin within the pulmonary arterial vasculature. The endothelin-1 receptor antagonists were the first class of oral drugs to be developed, but drug interactions and adverse effects are prominent with this class. The phosphodiesterase type 5 inhibitors increase the second messenger cyclic guanosine monophosphate (GMP) that is induced by nitric oxide stimulation. All of the drugs within these three classes are distinct in and of themselves, and their clinical use requires in-depth knowledge of pulmonary arterial hypertension and its pathophysiology. Because these drugs have different mechanisms of action, combination therapy has shown promise in patients with severe disease, although data are still lacking. This article should serve as a practical guide for clinicians who encounter patients with pulmonary arterial hypertension and the drugs used for the treatment of this devastating disease.

Purpose: To evaluate and discuss the role of specific types of abdominal surgery (SURG) before radical radiation therapy as a risk factor for late rectal toxicity in prostate cancer patients. Methods: Results concerning questionnaire-based scored late bleeding and faecal incontinence in 718 patients with a complete follow-up of 36 months were analysed, focusing on the impact of specific pre-radiotherapy abdominal/pelvic surgery procedures. Patients were accrued in the prospective study AIROPROS 0102. Different types of surgery (rectum-sigma resection, kidney resection, cholecystectomy or appendectomy) were considered as covariates together with a number of different parameters previously found to be predictive of late toxicity and including clinical as well as dosimetric parameters. Univariate (UVA) and multivariate (MVA) logistic analyses were carried out. Results: In total 69/718 patients were previously submitted to one or more surgical procedures, mostly cholecystectomy (n = 21) and appendectomy (n = 27). Actuarial incidences of G2–G3 and G3 bleeding were 52 (7.2%) and 24 (3.3%) respectively; 19 (2.6%) chronic incontinence events were registered. Results: Cholecystectomy was found to be highly correlated with late rectal bleeding at UVA: OR = 4.3 and p = 0.006 for G2–G3 and OR = 5.4 and p = 0.01 for G3. Considering MVA (including dosimetric and clinical factors), G2–G3 bleeding was significantly correlated to cholecystectomy (OR = 6.5, p = 0.002), V75Gy (OR = 1.074, p = 0.003) and secondarily with appendectomy (OR = 2.7, p = 0.10), presence of acute radioinduced rectal bleeding (OR = 1.70, p = 0.21) and androgen deprivation (OR = 0.67, p = 0.25). Results: Appendectomy (OR = 5.9, p = 0.004) and cholecystectomy (OR = 5.5, p = 0.016) were very strong predictors of G3 bleeding with V75Gy playing a less significant role (OR = 1.037, p = 0.26). Conversely, no specific surgery was correlated with actuarial or chronic incontinence. Conclusions: This analysis highlights previous SURG as the best predictor of late rectal bleeding. Among the different types of abdominal surgery, cholecystectomy and appendectomy play the major role, especially for severe late bleeding.

BACKGROUND: Limited data are available regarding adverse bleeding events associated with antithrombotic agents incorrectly dosed based on renal function in patients receiving percutaneous coronary intervention (PCI). OBJECTIVE: To compare the incidence of bleeding during their hospital stay in patients with reduced renal function receiving incorrect doses of bivalirudin or eptifibatide to the incidence of correct doses, based on manufacturer recommendations; secondary objectives were to determine the incidence of correct dosing based on manufacturer recommendations and the incidence of TIMI (Thrombolysis in Myocardial Infarction) major bleeding. METHODS: A chart review over a 32-month period showed that patients with reduced renal function who received either eptifibatide or bivalirudin during PCI were evaluated for correct dosing based on manufacturer recommendations, bleeding incidence according to the TIMI criteria, and extent of bleeding according to the TIMI and GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) criteria. RESULTS: One hundred ninety patients met inclusion criteria, 56 who received eptifibatide and 134 who received bivalirudin. Eptifibatide was dosed incorrectly in 64% of the patients. Patients receiving incorrectly dosed compared to correctly dosed eptifibatide experienced significantly more bleeding (64% vs 35%, respectively, p = 0.04), a greater extent of bleeding based on the TIMI and GUSTO criteria (p = 0.03 and p = 0.009, respectively), and had more TIMI major bleeding (19% vs 5%, respectively). Bivalirudin was dosed incorrectly in 28% of the patients. Patients receiving incorrectly dosed compared to correctly dosed bivalirudin experienced a significantly greater extent of bleeding based on the GUSTO criteria (p = 0.01). There was no significant difference between the incidence of bleeding (37% vs 21%, respectively; p = 0.06), extent of bleeding based on the TIMI criteria (p = 0.058), or incidence of TIMI major bleeding (5% vs 3%). CONCLUSIONS: Patients receiving incorrectly dosed eptifibatide and bivalirudin are susceptible to adverse bleeding events. The occurrence of incorrect dosing offers an opportunity for pharmacist-driven institutional improvement.

Valproate sodium injection is an anticonvulsant used intravenously when oral valproic acid formulations cannot be used to treat complex partial or absence seizures.[1][1] It is very likely that valproate sodium injection will need to be infused simultaneously with other i.v. medications into the

Many technologies have life cycles that are shorter than the life cycle of the product they are in. Life cycle mismatches caused by the obsolescence of technology (and particularly the obsolescence of electronic parts) results in high sustainment costs for long field life systems, e.g., avionics and military systems. This paper demonstrates the use of data mining based algorithms to augment commercial obsolescence risk databases thus improving their predictive capabilities. The method is a combination of life cycle curve forecasting and the determination of electronic part vendor-specific windows of obsolescence using data mining of historical last-order or last-ship dates. The extended methodology not only enables more accurate obsolescence forecasts but can also generate forecasts for user-specified confidence levels. The methodology has been demonstrated on both individual parts and modules.

Objective To develop pharmacist practice standards, pharmacy preceptor standards, and objectives for students completing advanced practice community pharmacy rotations. Setting Ohio. Practice Description Pharmacy schools and community pharmacies that serve as advanced practice rotation sites. Practice Innovation Developed standards for preceptors and objectives for student experiences. Interventions Focus groups that included both community pharmacists and pharmacy faculty collaborated on defining key standards for advanced community pharmacy rotations. Main Outcome Measure Not applicable. Results Three main documents were produced in this initiative, and these are provided as appendices to this article. Professional and patient care guidelines for preceptors define minimum standards for these role models. Expectations of pharmacists as preceptors provide insights for managing this student–teacher relationship, which is fundamentally different from the more common employer–employee and coworker relationships found in pharmacies of all types. Objectives for student experiences during advanced practice community pharmacy rotations present core expectations in clinical, dispensing, patient education, wellness, and drug information areas. Conclusion Through this collaboration, Ohio colleges of pharmacy developed a partnership with practitioners in community settings that should enhance the Ohio experiential educational program for student pharmacists. Use of the established guidelines will help educators and practitioners achieve their shared vision for advanced practice community pharmacy rotations and promote high-quality patient care.

A 23-year-old male presented from a nursing home with hypotension, tachycardia, diaphoresis and electrocardiographic evidence of right ventricular strain that was confirmed by echocardiography. His differential diagnosis included sepsis and pulmonary embolism. A high-resolution computed tomography scan demonstrated no pulmonary emboli but did demonstrate multiple bilateral pulmonary nodules. Upon questioning he admitted to injecting a long-acting narcotic that had been manually macerated, dissolved in saline, and injected through an indwelling intravenous line. Lung biopsy findings were consistent with cellulose-induced perivascular granulomatosis. Cellulose granulomatosis can be seen in patients who inject medications designed for oral use and should be considered in patients who present with acute pulmonary hypertension.

This article reviews recent trials that have compared aspirin to anticoagulation in post-myocardial infarction (MI) patients. Warfarin dosed to international normalized ratios (INRs) between 2.8 and 4.2 was superior to placebo in reducing morbidity and mortality; however, post-MI patients are generally receiving aspirin. When aspirin therapy was compared to warfarin plus aspirin, no clinical benefit occurred when warfarin was dosed to achieve INRs less than 2.0. In contrast, warfarin reduced morbidity and mortality compared to aspirin when it was dosed as monotherapy to achieve INRs between 3.0 and 4.0 or used with aspirin 75 to 80 mg daily and dosed to INRs between 2.0 and 2.5. With respect to mortality alone, warfarin was superior to aspirin only when it was used as monotherapy and compared to aspirin 80 mg daily. No difference in mortality was observed when warfarin monotherapy was compared to aspirin 160 mg daily.

OBJECTIVE: To review the evidence for statin secondary prevention of coronary artery disease in patients with near-optimal or optimal low-density lipoprotein cholesterol (LDL-C). DATA SOURCES: A MEDLINE search (1966-October 2003) was conducted using the search terms HMG-CoA reductase inhibitor, statins, coronary disease, post-myocardial infarction, and average cholesterol. DATA SYNTHESIS: Secondary prevention trials enrolling subjects with near-optimal (CONCLUSIONS: Statin secondary prevention of coronary artery disease in patients near goal LDL-C is controversial, but recent trial results show promise.

OBJECTIVE To determine whether rate control is a viable initial treatment approach in persistent atrial fibrillation (AF) through the evaluation of recently completed trials comparing rate and rhythm control. DATA SOURCES Biomedical literature was obtained through MEDLINE (1966—December 2003) and the Iowa database. STUDY SELECTION AND DATA EXTRACTION Articles identified from the biomedical literature search were reviewed and included if deemed relevant. DATA SYNTHESIS Currently available data suggest that rate control is not inferior to rhythm control in patients with persistent AF with respect to mortality. Rate control also reduces hospitalizations and the occurrence of proarrhythmias. No significant difference was observed between treatments with respect to thromboembolism and strokes. CONCLUSIONS Due to the increased incidence of hospitalizations and antiarrhythmic adverse effects associated with rhythm control, rate control is a reasonable first-line strategy in the treatment of recurrent AF, especially in elderly patients who are asymptomatic or mildly symptomatic. Further studies are needed to clearly define the role of rate control in younger patients.

Full list of authors: Tang, B.; Geisler, D.; Friel, E.; Villanova, S.; Smiljanic, R.; Casey, A. R.; Randich, S.; Magrini, L.; San Roman, I.; Muñoz, C.; Cohen, R. E.; Mauro, F.; Bragaglia, A.; Donati, P.; Tautvaišien*error*ė, G.; Drazdauskas, A.; Ženovienė, R.; Snaith, O.; Sousa, S.; Adibekyan, V. Costado, M. T.; Blanco-Cuaresma, S.; Jiménez-Esteban, F.; Carraro, G.; Zwitter, T.; François, P.; Jofrè, P.; Sordo, R.; Gilmore, G.; Flaccomio, E.; Koposov, S.; Korn, A. J.; Lanzafame, A. C.; Pancino, E.; Bayo, A.; Damiani, F.; Franciosini, E.; Hourihane, A.; Lardo, C.; Lewis, J.; Monaco, L.; Morbidelli, L.; Prisinzano, L.; Sacco, G.; Worley, C. C.; Zaggia, S., Milky Way open clusters are very diverse in terms of age, chemical composition, and kinematic properties. Intermediate-age and old open clusters are less common, and it is even harder to find them inside the solar Galactocentric radius, due to the high mortality rate and strong extinction inside this region. NGC 6802 is one of the inner disk open clusters (IOCs) observed by the Gaia-ESO survey (GES). This cluster is an important target for calibrating the abundances derived in the survey due to the kinematic and chemical homogeneity of the members in open clusters. Using the measurements from Gaia-ESO internal data release 4 (iDR4), we identify 95 main-sequence dwarfs as cluster members from the GIRAFFE target list, and eight giants as cluster members from the UVES target list. The dwarf cluster members have a median radial velocity of 13.6 ± 1.9 km s, while the giant cluster members have a median radial velocity of 12.0 ± 0.9 km s and a median [Fe/H] of 0.10 ± 0.02 dex. The color-magnitude diagram of these cluster members suggests an age of 0.9 ± 0.1 Gyr, with (m-M) = 11.4 and E(B-V) = 0.86. We perform the first detailed chemical abundance analysis of NGC 6802, including 27 elemental species. To gain a more general picture about IOCs, the measurements of NGC 6802 are compared with those of other IOCs previously studied by GES, that is, NGC 4815, Trumpler 20, NGC 6705, and Berkeley 81. NGC 6802 shows similar C, N, Na, and Al abundances as other IOCs. These elements are compared with nucleosynthetic models as a function of cluster turn-off mass. The α, iron-peak, and neutron-capture elements are also explored in a self-consistent way. © ESO, 2017., Based on data products from observations made with ESO Telescopes at the La Silla Paranal Observatory under programme ID 188.B-3002. These data products have been processed by the Cambridge Astronomy Survey Unit (CASU) at the Institute of Astronomy, University of Cambridge, and by the FLAMES/UVES reduction team at INAF/Osservatorio Astrofisico di Arcetri. These data have been obtained from the Gaia-ESO Survey Data Archive, prepared and hosted by the Wide Field Astronomy Unit, Institute for Astronomy, University of Edinburgh, which is funded by the UK Science and Technology Facilities Council. This work was partly supported by the European Union FP7 programme through ERC grant number 320360 and by the Leverhulme Trust through grant RPG-2012-541. We acknowledge the support from INAF and Ministero dell' Istruzione, dell' Universita e della Ricerca (MIUR) in the form of the grant "Premiale VLT 2012". The results presented here benefit from discussions held during the Gaia-ESO workshops and conferences supported by the ESF (European Science Foundation) through the GREAT Research Network Programme. We thank the anonymous referee for insightful comments. D.G., S.V., and B.T. gratefully acknowledges support from the Chilean BASAL Centro de Excelencia en Astrofisica y Tecnologias Afines (CATA) grant PFB-06/2007. C.M. acknowledges support from CONICYT-PCHA/Doctorado Nacional/2014-21141057. R.E.C. acknowledges funding from Gemini-CONICYT for Project 32140007. F.M. gratefully acknowledges the support provided by Fondecyt for project 314017. This work was partly supported (A.R.C.) by the European Union FP7 programme through grant number 320360. This work was partly supported (A.D., G.T., R.Z.) by the grant from the Research Council of Lithuania (MIP082/2015). S.G.S. acknowledges the support from FCT through Investigador FCT contract of reference IF/00028/2014 and the support from FCT through the project PTDC/FIS-AST/7073/2014. C.L. gratefully acknowledges financial support from the European Research Council (ERC-CoG-646928, Multi-Pop, PI: N. Bastian). V.A. acknowledges the support from the FCT (Portugal) in the form of the grant SFRH/BPD/70574/2010, the support by FCT through national funds (Refs. PTDC/FIS-AST/7073/2014 and PTDC/FIS-AST/1526/2014) and by FEDER through COMPETE2020 (Refs. POCI-01-0145-FEDER-016880 and POCI-01-0145-FEDER-016886).

OBJECTIVE: To review literature relating to significant changes in drug therapy recommendations in the 1999 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for treating patients with acute myocardial infarction (AMI). DATA SOURCES: 1999 ACC/AHA AMI guidelines, English-language clinical trials, reviews, and editorials researching the role of drug therapy and primary angioplasty for AMI that were referenced in the guidelines were included. Additional data published in 2000 or unpublished were also included if relevant to interpretation of the guidelines. STUDY SELECTION: The articles selected influence AMI treatment recommendations. DATA SYNTHESIS: Many clinicians and health systems use the ACC/AHA AMI guidelines to develop treatment plans for AMI patients. This review highlights important changes in AMI drug therapy recommendations by reviewing the results of recent clinical trials. Insights into evolving drug therapy strategies that may impact future guideline development are also described. CONCLUSIONS: Several changes in drug therapy recommendations were included in the 1999 AMI ACC/AHA guidelines. There is emphasis on administering fibrin-specific thrombolytics secondary to enhanced efficacy. Selection between fibrin-specific agents is unclear at this time. Low response rates to thrombolytics have been noted in the elderly, women, patients with heart failure, and those showing left bundle-branch block on the electrocardiogram. These patient groups should be targeted for improved utilization programs. The use of glycoprotein (GP) IIb/IIIa receptor inhibitors in non-ST—segment elevation MI was emphasized. Small trials combining reduced doses of thrombolytics with GP IIb/IIIa receptor inhibitors have shown promise by increasing reperfusion rates without increasing bleeding risk, but firm conclusions cannot be made until the results of larger trials are known. Primary percutaneous coronary intervention (PCI) trials suggest lower mortality rates for primary PCI when compared with thrombolysis alone. However, primary PCI, including coronary angioplasty, is only available at approximately 13% of US hospitals, making thrombolysis the preferred strategy for most patients. Clopidogrel has supplanted ticlopidine as the recommended antiplatelet agent for patients with aspirin allergy or intolerance following reports of a better safety profile. The recommended dose of unfractionated heparin is lower than previously recommended, necessitating a separate nomogram for patients with acute coronary syndromes. Routine use of warfarin, either alone or in combination with aspirin, is not supported by clinical trials; however, warfarin remains a choice for antithrombotic therapy in patients intolerant to aspirin. β -Adrenergic receptor blockers continue to be recommended, and emphasis is placed on improving rates of early administration (during hospitalization), even in patients with moderate left ventricular dysfunction. New recommendations for drug treatment of post-AMI patients with low high-density lipoprotein cholesterol and/or elevated triglycerides are included, with either niacin or gemfibrozil recommended as an option. Supplementary antioxidants are not recommended for either primary or secondary prevention of AMI, with new data demonstrating lack of efficacy for vitamin E in primary prevention. Estrogen replacement therapy or hormonal replacement therapy should not be initiated solely for prevention of cardiovascular disease, but can be continued in cardiovascular patients already taking long-term therapy for other reasons. Bupropion has been added as a new treatment option for smoking cessation. As drug therapy continues to evolve in treating AMI, more frequent updates of therapy guidelines will be necessary.

This paper presents a new design for a three-dimensional cell for the TLM method, and its application in the resonator analysis. The new proposed cell is based on ‘π-type’ transmission line, and it uses incident and reflected currents. A condensed scattering matrix is developed. The computational results are compared with the analytical results and with TLM-SCN (symmetrical condensed node) computational results. Copyright © 2001 John Wiley & Sons, Ltd.

Increased interest in combining drugs with different targets has emerged over recent years. Our study aims at evaluating the effectiveness of combined gemcitabine/paclitaxel treatment taking into consideration doses, schedules, and toxicity. A spontaneous mammary carcinoma was transplanted into the right-hind foot of C3D2F1 mice. Paclitaxel (in doses from 20 to 80 mg/kg b.w.) and gemcitabine (in doses from 30 to 480 mg/kg b.w.) were administered i.p. in single or fractionated treatments. Toxicity and tumor growth delay (TGD) were the endpoints. TGDs for different gemcitabine doses in single administration (120, 240, and 360 mg/kg) overlapped (TGD ≃ 2.5 days). Toxicity was very high in daily administration. Results with gemcitabine alone showed the efficacy of treatments every 3 days. TGDs in fractionated treatments of 60 and 120 mg/kg x 4 were of ≃ 16 days. Also in this case, tumor growth curves overlapped pointing out the uselessness of the high drug doses. For combined treatments, we used only fractionated protocols, administering gemcitabine every 3 days. Paclitaxel was administered alone in one or two fractions and with different sequences in respect to gemcitabine administration. With 120 mg/kg of gemcitabine all the protocols showed an increased unacceptable toxicity. The best result was obtained administering paclitaxel 40 mg/kg on days 1 and 15 and gemcitabine 60 mg/kg on days 3, 6, 9, and 12 (TGD = 38.2 days). The light toxicity and the high efficacy obtained with this protocol indicate the possible use of gemcitabine/paclitaxel treatment in clinical practice.

OBJECTIVE: To review published reports on the pharmacology and clinical use of dofetilide in the management of cardiac dysrhythmias. DATA SOURCES: A MEDLINE search (January 1966–June 1999) was performed using dofetilide and UK-68,798 as key words. English-language articles were identified, and the references of these articles were used to further identify pertinent articles. STUDY SELECTION: All acquired studies and reviews discussing the pharmacology, pharmacokinetics, chemistry, and clinical efficacy of dofetilide were reviewed. DATA EXTRACTION: Articles were selected based on quality of review of the pharmacology and clinical use of dofetilide. Given the paucity of data on the clinical pharmacology and use of dofetilide, most articles obtained were used, including abstracts when full reports were not available. DATA SYNTHESIS: Dofetilide is a relatively specific class III antiarrhythmic agent. It increases action potential duration and effective refractory period without impacting conduction velocity. These actions of dofetilide are explained by its ability to inhibit the rapid component of the delayed, outward-rectifying potassium current, thus blocking the efflux of potassium during repolarization. Introductory investigations suggest that dofetilide may be of use in treating and preventing atrial dysrhythmias such as atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia. Dofetilide may also have a role in preventing ventricular tachycardia from occurring. Some data also suggest that dofetilide may improve the morbidity of heart failure patients. Currently, the most troublesome adverse effect of dofetilide is its propensity to induce ventricular proarrhythmias, especially torsade de pointes. CONCLUSIONS: Based on the data currently available, dofetilide should have a role in the pharmacotherapy of cardiac dysrhythmias, especially those of atrial origin. More data on its efficacy and tolerability are needed, however, to fully delineate dofetilide's role amid currently available antiarrhythmic agents.

OBJECTIVE: To review the pathophysiology, diagnosis, and pharmacotherapy of syncope, with emphasis placed on neurocardiogenic syncope. DATA SOURCES: A MEDLINE search (1980–1995) using the term syncope and cross-referencing selected articles. STUDY SELECTION: Articles selected were those considered to assist in providing the reader with a basic introduction to the pathophysiology, diagnosis, and pharmacotherapy of syncope, with emphasis placed on neurocardiogenic syncope. DATA SYNTHESIS: Syncope is a common disorder with many different etiologies. The patient's history and physical examination are extremely important in making the diagnosis. The recent availability of head-upright tilt testing and electrophysiologic studies of the myocardium have helped define the etiology in many patients in whom an etiology would not have been found in the past. When the cause of syncope has been diagnosed, the appropriate therapy to prevent future attacks will be defined in many instances. One form of syncope, known as neurocardiogenic syncope, can be difficult to treat. Recent trials have suggested the use of beta-blockers, fludrocortisone, disopyramide, or selective serotonin reuptake inhibitors may be helpful in some patients.