Extracorporeal membrane oxygenation (ECMO) is an accepted treatment modality for life support refractory to conventional efforts in neonates with complex congenital heart lesions. Cannulation for ECMO can be accomplished by venovenous (VV) access where patients receive primarily respiratory support or venoarterial (VA) access which provides complete cardiopulmonary support. VV ECMO delivered by a single-vessel cannulation with a dual-chamber venous cannula allows for respiratory support while the patient remains dependent upon intrinsic cardiac function to support hemodynamics. We present a case of support of a newborn with single ventricle physiology and intraparenchymal near-atresia of the pulmonary veins using VV ECMO.
We report two neonates with distal ductal origin of the left pulmonary artery who also had rare vascular rings comprised of a left aortic arch and right arterial duct with a midline/rightward descending aorta. To the best of our knowledge, this association has not previously been described, although other abnormalities of the left pulmonary artery in the setting of vascular rings have been reported. We review the embryology, utility of imaging, and clinical course.
We present the use of a low-resistance membrane oxygenator (Quadrox D, Maquet) in series with a pulsatile right ventricular assist device (Berlin Heart EXCOR, Berlin Heart) in a patient with biventricular support who required high-frequency oscillatory ventilation (HFOV), due to refractory acute respiratory distress syndrome associated with Cytomegalovirus pneumonia. The high mean airway pressure associated with the use of HFOV resulted in a significant negative impact on left ventricular assist device (LVAD) filling that led to a combined respiratory and metabolic acidosis and the need for vasopressor support. Oxygenator placement enabled transition to conventional ventilation and the discontinuation of vasopressor support. This case demonstrates the feasibility and safety of the use of this lung support system in patients requiring ventricular assist device (VAD) support.
The aim of this study was to use the life cycle assessment tool to assess, from an environmental point of view, the different possible municipal solid waste (MSW) management scenarios for the island of Mauritius. The scenarios include landfilling with energy recovery (S1), incineration with energy recovery (S2), composting, incineration and landfilling (S3) and finally composting, recycling, incineration and landfilling (S4). The MSW generated in 2010 was selected as the functional unit. Foreground data were collected through surveys and literature. Background data were obtained from ecoinvent data in SimaPro 8 libraries. The scenarios were compared both through the CML-IA baseline–midpoint method and the ReCiPe end-point method. From the midpoint method, the results obtained indicates that landfilling (S1) has the greatest impact in all the analyzed impact categories except ozone layer depletion and human toxicity, while incineration (S2) has the least impact on almost all the analyzed damage categories except in global warming potential and human toxicity. The collection and transportation of waste has a significant impact on the environment. From the end-point method, S4 reduces the damage impact categories on Human Health, Ecosystems and Resources due to the recycling process. S3 is not favorable due to the impact caused by the composting process. However, it is also very important to emphasize that for incineration, the best available technology with energy recovery shall be considered. It is recommended that S2 and S4 are considered for strategic planning.
Municipal solid waste generation is huge in growing cities of developing nations such as India, owing to the rapid industrial and population growth. In addition to various methods for treatment and disposal of municipal solid waste (landfills, composting, bio-methanation, incineration and pyrolysis), aerobic/anaerobic bioreactor landfills are gaining popularity for economical and effective disposal of municipal solid waste. However, efficiency of municipal solid waste bioreactor landfills primarily depends on the municipal solid waste decomposition rate, which can be accelerated through monitoring moisture content and temperature by using the frequency domain reflectometry probe and thermocouples, respectively. The present study demonstrates that these landfill physical properties of the heterogeneous municipal solid waste mass can be monitored using these instruments, which facilitates proper scheduling of the leachate recirculation for accelerating the decomposition rate of municipal solid waste.
Vegetables waste is generally utilized through a bioconversion process or disposed of at municipal landfills, dumping sites or dumped on open land, emitting a foul odor and causing health hazards. The presents study deals with an alternative way to utilize solid vegetable waste through a thermochemical route such as briquetting and gasification for its energy recovery and subsequent power generation. Briquettes of 50 mm diameter were produced from four different types of vegetable waste. The bulk density of briquettes produced was increased 10 to 15 times higher than the density of the dried vegetable waste in loose form. The lower heating value (LHV) of the briquettes ranged from 10.26 MJ kg–1 to 16.60 MJ kg–1 depending on the type of vegetable waste. The gasification of the briquettes was carried out in an open core downdraft gasifier, which resulted in syngas with a calorific value of 4.71 MJ Nm–3 at the gasification temperature between 889°C and 1011°C. A spark ignition, internal combustion engine was run on syngas and could generate a maximum load up to 10 kWe. The cold gas efficiency and the hot gas efficiency of the gasifier were measured at 74.11% and 79.87%, respectively. Energy recovery from the organic vegetable waste was possible through a thermochemical conversion route such as briquetting and subsequent gasification and recovery of the fuel for small-scale power generation.
Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee. The purpose of this study was to compare outcomes following infrageniculate lower extremity open bypass (LEB) versus peripheral vascular intervention (PVI) in patients with critical limb ischemia. Using data from the 2008–2014 Vascular Quality Initiative, 1-year primary patency, major amputation, and mortality were compared among all patients undergoing LEB versus PVI at or below the knee for rest pain or tissue loss. Overall, 2566 patients were included (LEB=500, PVI=2066). One-year primary patency was significantly worse following LEB (73% vs 81%; p<0.001). One-year major amputation (14% vs 12%; p=0.18) and mortality (4% vs 6%; p=0.15) were similar regardless of revascularization approach. Multivariable analysis adjusting for baseline differences between groups confirmed inferior primary patency following LEB versus PVI (HR 0.74; 95% CI, 0.60–0.90; p=0.004), but no significant differences in 1-year major amputation (HR 1.06; 95% CI, 0.80–1.40; p=0.67) or mortality (HR 0.71; 95% CI, 0.44–1.14; p=0.16). Based on these data, we conclude that endovascular revascularization is a viable treatment approach for critical limb ischemia resulting from infrageniculate arterial occlusive disease.
Treatment of non-thrombotic iliac vein lesions is an active area of research. Intravascular ultrasound allows its localization. We chose intravascular ultrasound to clarify the exact anatomical location of non-thrombotic iliac vein lesions and correlate it with clinical findings.
Over seven months, we performed ilio-femoral intravascular ultrasound studies on 217 patients, in 141 women and 76 men. The average age ± standard deviation was 68 ± 14 years. We used intravascular ultrasound intraoperatively to measure the ilio-femoral veins and compared it with adjacent non-stenotic ilio-femoral veins. If more than 50% area or diameter reduction was found, it was treated with appropriate balloon and stent.
We identified 244 lesions, 124 in left lower extremity and 120 in the right lower extremity. The most common site was the proximal common iliac vein 38.7% (22.5% females and 16.12% males) in left lower extremity and middle external iliac vein 29.16% (18.33% females and 10.83% males) in right lower extremity. The least common site was the distal external iliac vein in 3.2% (all 3.2% females) and the distal external iliac vein 7.5% (5% females and 2.5% males) in right lower extremity. Clinical correlation was noted between laterality and location of the NIVL lesion (p < 0.0001).
This analysis gives an insight into understanding the exact anatomical locations of the non-thrombotic iliac vein lesions helping clinicians and researchers guide their treatment and research.
To compare the long-term safety and clinical efficacy of endovascular treatment for TASC-II type C/D femoropopliteal lesion compared with TASC-II type A/B femoropopliteal lesion in Korea.
A total of 179 limbs [TASC-II A/B femoropopliteal lesion (group I, n = 105 limbs) and TASC-II C/D (group II, n = 74 limbs)] were retrospectively analyzed from patients who underwent angioplasty with or without primary stent implantation between February 2008 and November 2012 at two medical centers in South Korea. The major adverse limb event was defined as a composite of target lesion revascularization, symptom relapse with abnormal ankle brachial index, and major amputation.
Immediate procedural success rates were not significantly different (96.2% vs. 95.7%, p = 0.450). Although major adverse limb event, mainly driven by symptom relapse with abnormal ankle brachial index, were significantly higher in group II (p = 0.013), the incidence of major amputation was very low and similar in both groups.
Even though there were higher incidences of overall procedural complication and major adverse limb event, the technical success rate of endovascular treatment for TASC-II C/D femoropopliteal lesion was comparable to endovascular treatment for TASC-II A/B FPL without an increase in major procedural complications or serious clinical events during follow-up.
Recent accounts of sexual commerce have drawn attention to the proliferation of online and sexual consumption. Yet the mediated exchange of sexual images and content folds into the spaces of the city in a variety of complex ways. Drawing on a variety of social science perspectives, this paper provides an introductory overview of a collection of papers exploring the changing contours of sexual consumption in the city and the distribution of sexual commerce across – and between – private, domestic and public, commercial spaces. Exploring the ways in which diverse LGBT and heterosexual identities are differently marketised, commodified and consumed, this introduction argues that over the last decade, contradictory moments of sexual emancipation and repression have changed where (and how) sexual consumption is visible in the city, shaping rights to the city in complex ways which need to be more thoroughly acknowledged in ‘mainstream’ urban studies.
Gay men have been implicated in neoliberal urban development strategies (e.g. the creative city) as a ‘canary’ population that forecasts growth. Paradoxically, both neoliberal re-development of North American inner-cities and the ways in which gay men become neoliberalised as individuals contribute to the dissolution of urban gay communities. In contrast to discourses of homonormativity, which suggest that gay men’s declining attachments to gay communities stem from new equalities and consequent desires to assimilate into the mainstream, this article argues that gay men in DC have internalised neoliberal discourses that call for career development, home ownership and social hypermobilities. The narratives of 24 gay-identified men living in DC indicate that the social and spatial dissolution of the gay community is linked with individual aspirations that are increasingly difficult to achieve. These aspirations include career advancement in a transient local economy, property ownership in an out-of-reach market, and the attainment of social status based on an ability to move through multiple neighbourhoods and venues with ease. As might be expected, African American and working class men are often left beyond the fray of these new neoliberal ideals.
Gentrification has often been linked to the spatial displacement of the marginalised, including prostitutes. However, in Germany, the legal spaces of prostitution are to a certain extent defensible, and gentrification processes often cover larger parts of inner cities, leaving little room for displacement. Using the example of prostitution in Frankfurt, this paper analyses how police make sense of and shape the shifting geographies of gentrification. It shows how spatial displacement is partially subsumed by two additional police strategies: intensifying attempts to discursively appease protesting citizens, and flexibilising the containment of prostitution in the inner city (e.g. by keeping street scenes on the move and lobbying for temporary brothel licenses).
The massive increases in women’s labour participation and the return of families with children to the city are often overlooked in understanding contemporary views on urban planning, despite decades of feminist urban theory. This article proposes to understand what is termed the ‘urban gender revolution’ through looking closely at the celebration of Jane Jacobs as the planning hero of the day. Zooming in on the city of Amsterdam, this article offers a case study of the popularity of Jane Jacobs to investigate the production of space for post-Fordist gender notions – genderfication – and to ask the question what new forms of exclusions are the result of this perhaps less sexist city (when compared to the modernist patriarchal ideal that Jacobs rallied against). In addition, it posits that the genderfication-project may help to overcome inequalities along gender lines; it underlines those along class lines.
This article considers the function of friendship as a form of urban relation for young people living in working class areas of Australia’s multicultural capital cities. These neighbourhoods are characterised by very high diversity, significant socioeconomic disadvantage and large youth populations, and over the last five years many have received the largest influx of refugees and migrants of any Australian municipality. Against this backdrop, this article investigates the ways that sociality is produced amongst young people of many backgrounds who must constantly negotiate interethnic propinquity in their daily lives. It explores how young people create ways of being together beyond and beneath the imperatives of formal social cohesion initiatives to participate in harmonious community-making. It argues that everyday forms of convivial co-habitation are produced and regulated through friendship relations and networks that embed mix in daily life, and these can serve to recognise and manage, rather than eliminate, intensity, conflict and ambivalence. It suggests that such practices of sociality complicate mainstream policy endeavours, and can offer some important and hopeful ways to expand theorisation of social relations in the multicultural city.
Planners and policy makers are increasingly promoting biking and public transit as viable means of transportation. The integration of bicycling and transit has been acknowledged as a strategy to increase the mode share of bicycling and the efficiency of public transit by solving the first- and last-mile problem. However, the economic outcomes of jointly promoting neighbourhood bikeability and transit accessibility are still poorly understood. This study aims to assess the property value impact of neighbourhood bikeability, transit accessibility, and their synergistic effect by analysing the single-family and condominium property sale transactions during 2010–2012 in Austin, Texas, USA. Our Cliff-Ord spatial hedonic modelling approach, which is also known as the general spatial model (or SAC), controls for the spatial dependent effects in the sale price and the error terms simultaneously. In order to quantify neighbourhood bikeability and transit accessibility, we use Bike Score and Transit Score as publicly available indices. We have assessed how residents’ willingness to pay (WTP) for bikeability and transit accessibility depend on various socio-demographic and built-environment factors, and whether the WTP is influenced by the bicycle-transit synergy. The results from this research show that jointly enhancing bikeability and transit accessibility can generate positive synergistic effects on property values. The effects would behoove policy makers to pursue the coordination of bicycle master plans with regional transit plans and to consider strategies of spatially-joint bicycle and transit investment.
The arts have long played a role in debates around gentrification and displacement, yet their roles and impacts as change agents are not clear-cut. According to the standard account, artists facilitate gentrification and ultimately engender the displacement of lower income households, but more recent research complicates the accepted narrative. This article seeks to untangle the relationship between the arts, gentrification and displacement through a statistical study of neighbourhood-level arts industry activity within large US regions. The findings indicate that the standard arts-led gentrification narrative is too generalised or simply no longer applicable to contemporary arts-gentrification processes. Rather, the arts have multiple, even conflicting relationships with gentrification and displacement that depend on context and type of art. These results have important implications for how we study the role of the arts in neighbourhood change and for how governments approach the arts and creative industries in urban policy.
This article offers an explanation for the wide spatial variations in choice of insolvency route by personal debtors across local authorities in England and Wales. It is argued that formal bankruptcy has a more negative impact on social capital through stigma effects than the alternative of Individual Voluntary Arrangements. Consequently, spatial variations in choices are related to variations in social capital. The hypotheses derived from this approach are tested through the use of spatial econometric models utilising data from England and Wales. The results provide support for a positive link between variables related to social capital (age, mobility and home ownership) and choice of IVAs. It is argued that avoidance of stigma costs provides an explanation for the apparent paradox of the significant growth of IVAs despite their high cost to debtors compared to bankruptcy. Whilst there is only limited support for impacts directly related to the urban-rural environment, significant spatial interdependencies in choices across neighbouring areas are also uncovered.
The high property price syndrome in Hong Kong has led to heightened concern about the role of landed capital in property development. Recently, the hegemony of the real estate industry has become a buzzword in local literature, but unfortunately there is neither adequate theoretical articulation nor informed understanding of the concept of hegemony. There is widespread misunderstanding of hegemony, equating it to domination by property tycoons. The local literature has overlooked the government-business collusion in constructing the common sense of society so as to dominate others. Through an empirical investigation of the redevelopment of ‘Government/Institution or Community’ (G/IC) land in Hong Kong, this article attempts to offer an alternative explanation to the land question of G/IC redevelopment by highlighting that the everyday life of the silent majority and of professionals has in fact perpetuated the hegemony of the real estate industry in Hong Kong. It is argued that the government, property developers, professionals, charitable organisations and the general public have altogether participated, in different ways and to different extents, in the capital accumulation projects of leading developer conglomerates in Hong Kong. A land (re)development regime has thus contributed to the property boom in Hong Kong.
This paper is an empirical analysis of employment centres in the Los Angeles region from 1997 to 2014. Most extant work on employment centres focuses on identification methodology or their dynamics during a period of industrial restructuring from 1980 to 2000. We analyse employment centres using point-based, rather than census tract-based employment data and a non-parametric identification method with a single concept of proximity. We focus on changes across five key industries: knowledge-intensive business services (KIBS), retail, creative, industrial and high-tech, emphasising changes in centre composition as well as their boundaries. Results show far greater change across centres than previous longitudinal studies. Only 43% of the land area that is in an employment centre is part of one in both 1997 and 2014. Using a persistence score, centres range from stable to highly fluctuating, but emerging, persisting and dying centres are found in core and fringe areas alike. KIBS are most associated with stable centres, while high tech employment is attracted toward emerging areas and retail exists throughout. Emerging centres are more likely to have greater accessibility, while industrial employment becomes far more concentrated in centres by 2014.
The effects of atmospheric pressure plasma treatment and the tightness factor on the low-stress mechanical properties of weft-knitted wool fabrics were evaluated using the Kawabata Evaluation System for Fabric (KES-F). The statistical analysis showed that the plasma treatment and the tightness factor had significant effects on the fabric low-stress mechanical properties (p-value < 0.05). Plasma-treated fabrics showed significantly higher bending and shear rigidity and hysteresis, compression energy, thickness, compressibility, surface friction and lower compression resilience and geometrical roughness values compared with untreated fabrics. An increase in the fabric tightness factor significantly increased fabric thickness, bending and shear rigidity and hysteresis, and decreased tensile extensibility and geometrical roughness. The relationship between primary handle attributes evaluated by Wool HandleMeter and KES-F mechanical properties was also investigated. The results confirmed a highly linear correlation between these two sets of data, where rough/smooth and hard/soft attributes evaluated by the Wool HandleMeter had the highest correlation with bending rigidity, shear properties and bending hysteresis, as measured by the KES-F.
Sixty-six commonly used suitings were selected as the experimental samples of the current study. The Kawabata Evaluation System was used to measure the mechanical properties of the samples. Each sample fabric was made into a shoulder-back as a part of a men’s suit. In order to study the appropriateness of the samples for making good shaped men’s suits, which is known as fabric formability, sensory evaluation methods have been applied to obtain panelists’ assessments on the shape of the shoulder-backs. During data analysis, principal component analysis was initially adopted to reduce the complexity of the system by extracting a small number of important mechanical properties. Then, a fuzzy neural network was developed to model the underlying relations between the samples’ formability and their mechanical properties. Finally, a number of testing samples were used to verify the effectiveness of the proposed predictive model.
This article contains the first detailed historical study of one of the new high-frequency trading (HFT) firms that have transformed many of the world’s financial markets. The study, of Automated Trading Desk (ATD), one of the earliest and most important such firms, focuses on how ATD’s algorithms predicted share price changes. The article argues that political-economic struggles are integral to the existence of some of the ‘pockets’ of predictable structure in the otherwise random movements of prices, to the availability of the data that allow algorithms to identify these pockets, and to the capacity of algorithms to use these predictions to trade profitably. The article also examines the role of HFT algorithms such as ATD’s in the epochal, fiercely contested shift in US share trading from ‘fixed-role’ markets towards ‘all-to-all’ markets.
Ball screw drives are commonly used to provide linear motion in machine tools. And stiffness is one of the most important performance indexes. However, stiffness of nuts with different preloads is difficult to be calculated precisely because of complex structures. In order to improve the calculating accuracy, a new model is proposed with the consideration of geometry errors of grooves and balls based on the existing theoretical model. The influence of geometry errors on axial deformation of double-nut is analyzed and modeled. Meanwhile, a preload-adjustable ball screw drive is constructed on the basis of a modified double-nut mechanism. A novel loading mechanism is designed to apply axial load on the working table and test the force in real time. Two laser displacement sensors are adopted to test axial deformation of the double-nut. The axial stiffness of the double-nut is analyzed based on the axial load and the axial deformation. Stiffness simulations of the new improved model, the theoretical model, and the empirical model are also analyzed. The contrastive analysis shows that the experimental results agree much better with the axial stiffness calculated by the new improved model. This study provides a more accurate model to calculate the stiffness of the double-nut with preloads for preloaded ball screw drives.
Analyse venous haemodynamics in healthy primigravidae during pregnancy and in the postpartum.
Cohort with primigravidae evaluated in the three trimesters of pregnancy and postpartum. Duplex evaluated venous diameters and reflux; air plethysmography evaluated venous filling index, ejection fraction, residual volume fraction and outflow fraction in both limbs.
During pregnancy, diameters increased in bilateral common femoral and right infravalvar great saphenous, but returned to first trimester values after delivery. Reflux developed in one woman (5%) in the second trimester and in two more women (15%) in the third trimester. No reflux was detected in postpartum. Bilateral venous filling index was higher during pregnancy. Bilateral ejection fraction and residual volume fraction did not change. Bilateral outflow fraction increased progressively. The right limb outflow fraction in left lateral decubitus was similar. All changes returned to first trimester values after delivery.
Healthy primigravidae presented changes in lower limbs’ veins during pregnancy: diameters in bilateral common femoral and infravalvar great saphenous veins increased; new reflux was developed in 15% of women, but there was no venous hypertension. Calf muscular pump function did not change. All changes returned to first trimester values after delivery.
Here I discuss the philosophical contributions to Analytical Sociology and Social Mechanisms, a collection of essays edited by Pierre Demeulenaere. I begin by introducing the idea of a social mechanism and showing that it has already had an impact within empirical analytical sociology. I then discuss some examples of the philosophical work offered in Demeulenaere’s collection in support of this analytical "movement" in the social sciences. I argue that some of these examples demonstrate thin scholarship and only a veneer of philosophical argument, but that Jon Elster’s contribution fuses impressively philosophical analysis and social science. I conclude by suggesting that analytical sociologists should focus on producing sociological explanations not philosophical theories.
Available evidence has suggested that strong primary care (PC) systems are associated with better outcomes. This study aims to investigate whether PC strength is specifically related to the prevalence of patients’ financially driven postponement of general practitioner (GP) care. Therefore, data from a cross-sectional multicountry study in 33 countries among GPs and their patients were analyzed using multilevel logistic regression modelling. According to the results, the variation between countries in the levels of patients’ postponement of seeking GP care for financial reasons was large. More than one third of these cross-country differences could be explained by characteristics of the health care system and the GP practices. In particular, PC systems with good accessibility and those systems that offer comprehensive care were associated with lower levels of financially driven delay. Consequently, we can conclude that well-organized PC systems can compensate for the negative influence of individual characteristics (socioeconomic position) on the care-seeking behaviors of patients.