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Stenting of ostial pulmonary artery stenosis presents several unique challenges. These include difficulty in defining anatomy and need for precise stent placement in order to avoid missing the ostial stenosis or jailing either the contralateral branch pulmonary artery or the ipsilateral upper lobe branch.
A retrospective review of outcomes was conducted in 1.5 or 2-ventricle patients who underwent stent placement for ostial branch pulmonary artery stenosis. Specific catheterisation lab techniques were reviewed.
Forty-seven branch pulmonary arteries underwent stent placement for ostial stenosis in 43 patients. The median age and weight were 3.7 (0.3–18.1) years and 14.2 (5.6–70.0) kg, respectively. Three (2–8) angiographic projections were needed to profile the ostial stenosis. Open-cell stents were used in 23 and stents were modified in 5 cases. Following stent implantation, the minimum diameter improved from 3.6 (0.8–10.5) to 8.1 (4.2–16.5) mm (p < 0.001). The gradient improved from 21 (0–66) to 4 (0–27) mmHg (p < 0.001). Stent malposition occurred in eight (17%) of the stents placed. Five migrated distally causing suboptimal ostial coverage necessitating placement of a second stent in four. Three migrated proximally and partially jailed the contralateral pulmonary artery. Intentional jailing of the upper lobe branch occurred in four additional cases. At a follow-up of 2.4 (0.3–4.9) years, 15 stents underwent further dilation and 1 had a second stent placed within the exiting stent.
Ostial branch pulmonary artery stenosis may require additional angiography to accurately define the ostial stenosis. Treatment with stents is effective but carries high rates of stent malposition.
Sketching is a natural and intuitive communication tool used for expressing concepts or ideas which are difficult to communicate through text or speech alone. Sketching is therefore used for a variety of purposes, from the expression of ideas on two-dimensional (2D) physical media, to object creation, manipulation, or deformation in three-dimensional (3D) immersive environments. This variety in sketching activities brings about a range of technologies which, while having similar scope, namely that of recording and interpreting the sketch gesture to effect some interaction, adopt different interpretation approaches according to the environment in which the sketch is drawn. In fields such as product design, sketches are drawn at various stages of the design process, and therefore, designers would benefit from sketch interpretation technologies which support these differing interactions. However, research typically focuses on one aspect of sketch interpretation and modeling such that literature on available technologies is fragmented and dispersed. In this paper, we bring together the relevant literature describing technologies which can support the product design industry, namely technologies which support the interpretation of sketches drawn on 2D media, sketch-based search interactions, as well as sketch gestures drawn in 3D media. This paper, therefore, gives a holistic view of the algorithmic support that can be provided in the design process. In so doing, we highlight the research gaps and future research directions required to provide full sketch-based interaction support.
Alterations of the gut microbiome have been associated with obesity and metabolic disorders. The gut microbiota can be influenced by the intake of dietary fibres with prebiotic properties, such as inulin-type fructans. This study tested the hypothesis that obese individuals subjected for 12 weeks to a inulin-enriched versus inulin-poor diet have differential faecal fermentation patterns. The fermentation of cellulose and inulin hydrolysates, of six different inulin-rich and inulin-poor vegetables of both groups was analysed in vitro on faecal inocula. The results showed that the microbiota from obese patients who received fructan-rich diet for three weeks produce more gas and total short-chain fatty acid (SCFA) compared to the microbiota taken of the same individuals before the treatment. Obese individuals fed with a low-fructan diet produce less gas and less SCFA compared to the treated group. This study highlighted profound changes in microbiota fermentation capacity obtained by prebiotic intervention in obese individuals, which favors the production of specific bioactive metabolites.
How do international observers decide whether to criticize or condone electoral fraud in a country? We argue that this decision depends on the identity of the victims of electoral fraud. A monitoring organization is more likely to overlook fraud committed against groups that are deemed dangerous by its sponsor. Based on this insight, we hypothesize that in the post-Cold War era election monitors are more tolerant of fraud against Islamic challengers, especially when Islamic movements are perceived as a threat to political stability. In support of our hypothesis, we find that outside monitors are more likely to endorse an election in countries with an Islamic opposition party and an ongoing Islamist terrorist campaign. Furthermore, we find that the effect is driven by Western monitoring organizations and becomes stronger after the September 11 attacks. Our findings provide a simple yet powerful insight: the calculus of outside observers depends not only on who they wish to see in power, but also who they want to keep from power.
Southern crabgrass [Digitaria ciliaris (Retz.) Koeler] is an annual grass weed that commonly infests turfgrass, roadsides, wastelands, and cropping systems throughout the southeastern United States. Two biotypes of D. ciliaris (R1 and R2) with known resistance to cyclohexanediones (DIMs) and aryloxyphenoxypropionates (FOPs) previously collected from sod production fields in Georgia were compared with a separate susceptible biotype (S) collected from Alabama for the responses to pinoxaden and to explore the possible mechanisms of resistance. Increasing rates of pinoxaden (0.1 to 23.5 kg ha−1) were evaluated for control of R1, R2, and S. The resistant biotypes, R1 and R2, were resistant to pinoxaden relative to S. The S biotype was completely controlled at rates of 11.8 and 23.5 kg ha−1, resulting in no aboveground biomass at 14 d after treatment. Pinoxaden rates at which tiller length and aboveground biomass would be reduced 50% (I50) and 90% (I90) for R1, R2, and S ranged from 7.2 to 13.2 kg ha−1, 6.9 to 8.6 kg ha−1, and 0.7 to 2.1 kg ha−1, respectively, for tiller length, and 7.7 to 10.2 kg ha−1, 7.2 to 7.9 kg ha−1, and 1.6 to 2.3 kg ha−1, respectively, for aboveground biomass. Prior selection pressure from DIM and FOP herbicides could result in the evolution of D. ciliaris cross-resistance to pinoxaden herbicides. Amplification of the carboxyl-transferase domain of the plastidic ACCase by standard PCR identified a point mutation resulting in an Ile-1781-Leu amino acid substitution only for the resistant biotype, R1. Further cloning of PCR product surrounding the 1781 region yielded two distinct ACCase gene sequences, Ile-1781 and Leu-1781. The amino acid substitution, Ile-1781-Leu in both resistant biotypes (R1 and R2), however, was revealed by next-generation sequencing of RNA using Illumina platform. A point mutation in the Ile-1781 codon leading to herbicide insensitivity in the ACCase enzyme has been previously reported in other grass species. Our research confirms that the Ile-1781-Leu substitution is present in pinoxaden-resistant D. ciliaris.
The National Project on Achievement in Twins (NatPAT) began in 2017 as part of the third funding cycle of the Florida Learning Disabilities Research Center, a program project grant funded by the Eunice Kennedy Shriver National Institute of Child Health and Development. NatPAT will have a nationally representative sample of elementary school-aged twins in the United States. The overall goal of the project is to uncover salient factors, including genetic and environmental influences, which contribute to the co-development of reading and math performance during the critical developmental period of elementary school. Here we present the specific aims, methods and materials, and future directions of the project.
Fine fescues (Festuca spp.) are cool-season grasses used in low-maintenance turf areas. Mesotrione is a PRE and early-POST herbicide used during establishment of most cool-season turfgrasses, excluding fine fescues. Currently, efforts are being made to breed for increased tolerance to mesotrione in fine fescues to enhance weed control during establishment. This study was conducted to evaluate the association of foliar and root uptake of [14C]mesotrione with the tolerance of three lines each of Chewings fescue [Festuca rubra ssp. commutata Gaudin; syn. F. rubra ssp. fallax (Thuill.) Nyman], hard fescue [Festuca trachyphylla (Hack.) Hack.], and strong creeping red fescue (Festuca rubra L. ssp. rubra) lines. From a rate-titration experiment, the hierarchical rank of species for mesotrione tolerance from highest to lowest was: hard > Chewings > strong creeping red fescue. The hierarchical rank of species for foliar uptake from highest to lowest was: Chewings > strong creeping red > hard fescue. Translocation of foliar-absorbed 14C was not associated with differential tolerance levels of the three species. Root absorption was comparable among species, but differences between lines were detected within the species. The most susceptible lines of Chewings and strong creeping red fescue exhibited greater root uptake than lines with greater tolerance. Hard fescue translocated the least amount of root-absorbed radioactivity to shoots, while Chewings and strong creeping red fescues were comparable.
Proximal environments could facilitate smoking cessation among low-income smokers by making cessation appealing to strive for and tenable.
We sought to examine how home smoking rules and proximal environmental factors such as other household members' and peers' smoking behaviors and attitudes related to low-income smokers' past quit attempts, readiness, and self-efficacy to quit.
This analysis used data from Offering Proactive Treatment Intervention (OPT-IN) (randomized control trial of proactive tobacco cessation outreach) baseline survey, which was completed by 2,406 participants in 2011/12. We tested the associations between predictors (home smoking rules and proximal environmental factors) and outcomes (past-year quit attempts, readiness to quit, and quitting self-efficacy).
Smokers who lived in homes with more restrictive household smoking rules, and/or reported having ‘important others’ who would be supportive of their quitting, were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting.
Adjustments to proximal environments, including strengthening household smoking rules, might encourage cessation even if other household members are smokers.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Experiments were initiated to characterize a waterhemp population (CHR) discovered in a central Illinois corn field after it was not controlled by the 4-hydroxyphenylpyruvate dioxygenase (HPPD) inhibitor topramezone. Field experiments conducted during 2014–2015 indicated that acetolactate synthase (ALS)-, protoporphyrinogen oxidase (PPO)-, photosystem II (PSII)-, and HPPD-inhibiting herbicides and the synthetic auxin 2,4-D did not control the CHR population. Laboratory experiments confirmed target site–based resistance mechanisms to ALS- and PPO-inhibiting herbicides. Herbicide doses required to reduce dry biomass 50% (GR50) were determined in greenhouse dose–response experiments, and indicated 16-fold resistance to the HPPD inhibitor mesotrione, 9.5-fold resistance to the synthetic auxin 2,4-D, and 252-fold resistance to the PSII inhibitor atrazine. Complementary results from field, laboratory, and greenhouse investigations indicate that the CHR population has evolved resistance to herbicides from five sites of action (SOAs): ALS-, PPO-, PSII-, and HPPD-inhibiting herbicides and 2,4-D. Herbicide use history for the field in which CHR was discovered indicates no previous use of 2,4-D.
Here, we report that a marine sandworm Nereis virens jaw protein, Nvjp1, nucleates hemozoin with similar activity as the native parasite hemozoin protein, HisRPII. X-ray diffraction and scanning electron microscopy confirm the identity of the hemozoin produced from Nvjp1-containing reactions. Finally, we observed that nAl assembled with hemozoin from Nvjp1 reactions has a substantially higher energetic output when compared to analogous thermite from the synthetic standard or HisRPII-nucleated hemozoin. Our results demonstrate that a marine sandworm protein can nucleate malaria pigment and set the stage for engineering recombinant hemozoin production for nanoenergetic applications.
This study examined the interplay between a polygenic composite and cortisol activity as moderators of the mediational pathway among family adversity, youth negative emotional reactivity to family conflict, and their psychological problems. The longitudinal design contained three annual measurement occasions with 279 adolescents (Mean age = 13.0 years) and their parents. Latent difference score analyses indicated that observational ratings of adversity in interparental and parent–child interactions at Wave 1 predicted increases in a multimethod, multi-informant assessment of youth negative emotional reactivity to family conflict from Waves 1 to 2. Changes in youth negative emotional reactivity, in turn, predicted increases in a multi-informant (i.e., parents, adolescent, and teacher) assessment of psychological problems from Waves 1 to 3. Consistent with differential susceptibility theory, the association between family adversity and negative emotional reactivity was stronger for adolescents who carried more sensitivity alleles in a polygenic composite consisting of 5-HTTLPR, DRD4 VNTR, and BDNF polymorphisms. Analyses of adolescent cortisol in the period surrounding a family disagreement task at Wave 1 revealed that overall cortisol output, rather than cortisol reactivity, served as an endophenotype of the polygenic composite. Overall cortisol output was specifically associated with polygenic plasticity and moderated the association between family adversity and youth negative emotional reactivity in the same for better or for worse manner as the genetic composite. Finally, moderator-mediated-moderation analyses indicated that the moderating role of the polygenic plasticity composite was mediated by the moderating role of adolescent cortisol output in the association between family adversity and their emotional reactivity.
Despite established clinical associations among major depression (MD), alcohol dependence (AD), and alcohol consumption (AC), the nature of the causal relationship between them is not completely understood. We leveraged genome-wide data from the Psychiatric Genomics Consortium (PGC) and UK Biobank to test for the presence of shared genetic mechanisms and causal relationships among MD, AD, and AC.
Linkage disequilibrium score regression and Mendelian randomization (MR) were performed using genome-wide data from the PGC (MD: 135 458 cases and 344 901 controls; AD: 10 206 cases and 28 480 controls) and UK Biobank (AC-frequency: 438 308 individuals; AC-quantity: 307 098 individuals).
Positive genetic correlation was observed between MD and AD (rgMD−AD = + 0.47, P = 6.6 × 10−10). AC-quantity showed positive genetic correlation with both AD (rgAD−AC quantity = + 0.75, P = 1.8 × 10−14) and MD (rgMD−AC quantity = + 0.14, P = 2.9 × 10−7), while there was negative correlation of AC-frequency with MD (rgMD−AC frequency = −0.17, P = 1.5 × 10−10) and a non-significant result with AD. MR analyses confirmed the presence of pleiotropy among these four traits. However, the MD-AD results reflect a mediated-pleiotropy mechanism (i.e. causal relationship) with an effect of MD on AD (beta = 0.28, P = 1.29 × 10−6). There was no evidence for reverse causation.
This study supports a causal role for genetic liability of MD on AD based on genetic datasets including thousands of individuals. Understanding mechanisms underlying MD-AD comorbidity addresses important public health concerns and has the potential to facilitate prevention and intervention efforts.
Recommending nitrofurantoin to treat uncomplicated cystitis was associated with increased nitrofurantoin use from 3.53 to 4.01 prescriptions per 1,000 outpatient visits, but nitrofurantoin resistance in E. coli isolates remained stable at 2%. Concomitant levofloxacin resistance was a significant risk for nitrofurantoin resistance in E. coli isolates (odds ratio [OR], 2.72; 95% confidence interval [CI], 1.04–7.17).
Herbicide resistance within key driver weeds, such as common waterhemp [Amaranthus tuberculatus (Moq.) Sauer var. rudis (Sauer) Costea and Tardif ], constrains available management options for crop production. Routine surveillance for herbicide resistance provides a mechanism to monitor the development and spread of resistant populations over time. Furthermore, the identification and quantification of resistance mechanisms at the population level can provide information that helps growers develop effective management plans. Populations of Amaranthus spp., including A. tuberculatus, redroot pigweed (Amaranthus retroflexus L.), and Palmer amaranth (Amaranthus palmeri S. Watson), were collected from 51 fields in Ohio during the 2016 growing season. Twenty-four A. tuberculatus populations were screened for resistance to the herbicides lactofen, atrazine, and glyphosate. Phenotypically resistant plants were further investigated to determine the frequency of known resistance mechanisms. Resistance to lactofen was infrequently observed throughout the populations, with 8 of 22 populations exhibiting resistant plants. Within those eight resistant populations, the ΔG210 resistance mechanism was observed in 17 of 30 phenotypically resistant plants, and the remainder lacked all known resistance mechanisms. Resistance to atrazine was observed in 12 of 15 populations; however, a target-site resistance mechanism was not observed in these populations. Resistance to glyphosate was observed in all populations. Gene amplification was the predominant glyphosate-resistance mechanism (147 of 322 plants) in the evaluated populations. The Pro-106-Ser mutation was identified in 24 plants, half of which also possessed gene amplification. In this study, molecular screening generally underestimated the phenotypically observed resistance. Continued mechanism discovery and marker development is required for improved detection of herbicide resistance through molecular assays.
A number of biological reference materials (RM) have been prepared in our laboratory specifically for validating analytical methods for the determination of Pb in biological matrices (e.g. blood, urine, liver, and bone). The RM's were developed using animal (goats and cows) that are routinely dosed with lead acetate to produce proficiency test samples for blood lead (and erythrocyte protoporphyrin). In cases where an animal becomes injured or infirm, the veterinarian in charge may recommend that the animal be euthanized. In such cases, samples of bone, brain, liver, and other tissues containing lead are removed at autopsy.
Currently, we have collected bone samples from nine goats and one cow that were dosed with lead over periods ranging from 1 to 10 years, During the autopsy, the epiphyses (bone joints) are separated from each long bone. Skin, muscle, and other adhering tissues are dissected or scraped from each bone. Bone marrow is also removed. All bare bones are currently stored at -70°C until analyses for Pb are conducted.
The only certified reference materials for bone Pb are those available from the National Institute for Standards and Technology (NIST), Gaithersburg, MD. Standard Reference Material (SRM) 1486 Bone Meal has a certified Pb concentration of only 1.335 μg/g. This is close to normal for humans, but is too low to be of practical use for in vivo X-Ray Fluorescence (XRF) equipment, SRM 1400 Bone Ash has a certified Pb concentration of 9.07 μg/g. Neither SRM is optimal for validating in vivo XRF equipment, but they are both very useful in validating other analytical methods for bone Pb such as Graphite Furnace Atomic Absorption Spectrometry (GFAAS).
We have developed an accurate, precise, and sensitive method for determining Pb in bone using GFAAS with Zeeman background correction. Using this method, we have analyzed the animal bones for Pb. Bone samples were divided into smaller pieces using a diamond-disc saw, freeze dried, and homogenized in a tantalum ball mill. Samples of bone powder were digested in nitric acid using a closed vessel microwave digestion system. Lead was determined using aqueous Pb standards in a chemical modifier optimized for the bone matrix. The method was validated using NIST SRM Bone Meal and Bone Ash. The detection limit is 0.6 μg/g based on 3 SD. Results for Pb in our animal bone range from approximately 5 to 50 μg/g dry weight. The results indicate that the intact bare bones would be excellent candidates for interlaboratory studies of in vivo XRF measurements of bone Pb. They are stable, well-characterized, easily transported between sites, and cover the clinically relevant range of bone lead concentrations likely to be encountered in the field. It is proposed that these materials be circulated as part of an interlaboratory comparison to interested centers using in vivo XRF After the XRF analyses, the bone samples will be analyzed for Pb by GFAAS for comparison purposes.
In 1995, Robert Ambrogi, former columnist for Legal Technology News, wrote about the Internet's potential to revolutionize the accessibility and delivery of legal information. Almost 25 years later, Ambrogi now describes his initial optimism as a “pipe dream.” Perhaps one of the greatest problems facing the legal industry today is the sheer inaccessibility of legal information. Not only does this inaccessibility prevent millions of Americans from obtaining reliable legal information, but it also prevents many attorneys from adequately providing legal services to their clients. Whether locked behind government paywalls or corporate cash registers, legal information is simply not efficiently and affordably attainable through traditional means.