To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
We sought to evaluate the risk and image quality from cardiovascular CT in patients across all stages of single-ventricle palliation, and to define accuracy by comparing findings with intervention and surgery.
Consecutive CT scans performed in patients with single-ventricle heart disease were retrospectively reviewed at a single institution. Diagnosis, sedation needs, estimated radiation dose, and adverse events were recorded. Anatomical findings, image quality (1–4, 1=optimal), and discrepancy compared with interventional findings were determined. Results are described as medians with their 25th and 75th percentiles.
From January, 2010 to August, 2015, 132 CT scans were performed in single-ventricle patients of whom 20 were neonates, 52 were post-Norwood, 15 were post-Glenn, and 45 were post-Fontan. No sedation was used in 76 patients, 47 were under minimal or moderate sedation, and nine were under general anaesthesia. The median image quality score was 1.2. The procedural dose–length product was 24 mGy-cm, and unadjusted and adjusted radiation doses were 0.34 (0.2, 1.8) and 0.82 (0.55, 1.88) mSv, respectively. There was one adverse event. No major and two minor discrepancies were noted at the time of 79 surgical and 10 catheter-based interventions.
Cardiovascular CT can be performed with a low radiation exposure in patients with single-ventricle heart disease. Its accuracy compared with that of interventional findings is excellent. CT is an effective advanced imaging modality when a non-invasive pathway is desired, particularly if cardiac MRI poses a high risk or is contraindicated.
Climatic change is expected to result in changes in species' distributions. However, current networks of protected areas, designed to conserve biodiversity, have been designated and designed on the basis of a paradigm of long-term stability of species' geographical distributions. As a result, these networks may not be effective in conserving biodiversity in a world with rapidly changing climatic conditions. We investigate this using as a model system the 1679 bird species breeding in sub-Saharan Africa and the network of 803 Important Bird Areas (IBAs) designated in the region by Bird Life International. Using climatic envelope models fitted to species' present distributions and the current climate, species' present and potential future occurrences in IBAs were simulated. The results show that the current network has the potential to maintain most species throughout the present century. However, they also indicate that this outcome depends upon substantial potential species turnover in many IBAs. This is only likely if the connectivity of the current network is enhanced substantially in key areas, and will also depend upon sympathetic management of the wider landscape, so as to enhance its permeability, and appropriate management of individual sites, taking into account their role in the overall network.
It is now generally accepted that anthropogenic activities have resulted in global climatic changes over the past century (Trenberth et al.,2007); they may even have done so over several millennia (Ruddiman, 2003).
Email your librarian or administrator to recommend adding this to your organisation's collection.