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An internationally approved and globally used classification scheme for the diagnosis of CHD has long been sought. The International Paediatric and Congenital Cardiac Code (IPCCC), which was produced and has been maintained by the International Society for Nomenclature of Paediatric and Congenital Heart Disease (the International Nomenclature Society), is used widely, but has spawned many “short list” versions that differ in content depending on the user. Thus, efforts to have a uniform identification of patients with CHD using a single up-to-date and coordinated nomenclature system continue to be thwarted, even if a common nomenclature has been used as a basis for composing various “short lists”. In an attempt to solve this problem, the International Nomenclature Society has linked its efforts with those of the World Health Organization to obtain a globally accepted nomenclature tree for CHD within the 11th iteration of the International Classification of Diseases (ICD-11). The International Nomenclature Society has submitted a hierarchical nomenclature tree for CHD to the World Health Organization that is expected to serve increasingly as the “short list” for all communities interested in coding for congenital cardiology. This article reviews the history of the International Classification of Diseases and of the IPCCC, and outlines the process used in developing the ICD-11 congenital cardiac disease diagnostic list and the definitions for each term on the list. An overview of the content of the congenital heart anomaly section of the Foundation Component of ICD-11, published herein in its entirety, is also included. Future plans for the International Nomenclature Society include linking again with the World Health Organization to tackle procedural nomenclature as it relates to cardiac malformations. By doing so, the Society will continue its role in standardising nomenclature for CHD across the globe, thereby promoting research and better outcomes for fetuses, children, and adults with congenital heart anomalies.
The University of Georgia (USA) is partnering with the University of Padova (Italy) for a dual Master’s degree program in sustainable agriculture, promoting collaboration on some of the biggest challenges facing agriculture today. This innovative program which was launched during 2016 provides students with outstanding training and a unique opportunity to learn about the challenges, opportunities, and leading edges of precision agriculture on another continent – an experience which will serve graduates well when they enter the job market in an increasingly global economy. This paper presents the goals of the program, the curriculum, and describes the opportunities available to prospective students. In addition it describes the process of developing the dual degree which can be used as guide by others wishing to develop similar programs.
A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7–27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29–23·4) and 5·65 (95% CI 1·09–29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control.
A history of self-injurious thoughts and behaviors (SITBs) is consistently cited as one of the strongest predictors of future suicidal behavior. However, stark discrepancies in the literature raise questions about the true magnitude of these associations. The objective of this study is to examine the magnitude and clinical utility of the associations between SITBs and subsequent suicide ideation, attempts, and death.
We searched PubMed, PsycInfo, and Google Scholar for papers published through December 2014. Inclusion required that studies include at least one longitudinal analysis predicting suicide ideation, attempts, or death using any SITB variable. We identified 2179 longitudinal studies; 172 met inclusion criteria.
The most common outcome was suicide attempt (47.80%), followed by death (40.50%) and ideation (11.60%). Median follow-up was 52 months (mean = 82.52, s.d. = 102.29). Overall prediction was weak, with weighted mean odds ratios (ORs) of 2.07 [95% confidence interval (CI) 1.76–2.43] for ideation, 2.14 (95% CI 2.00–2.30) for attempts, and 1.54 (95% CI 1.39–1.71) for death. Adjusting for publication bias further reduced estimates. Diagnostic accuracy analyses indicated acceptable specificity (86–87%) and poor sensitivity (10–26%), with areas under the curve marginally above chance (0.60–0.62). Most risk factors generated OR estimates of <2.0 and no risk factor exceeded 4.5. Effects were consistent regardless of sample severity, sample age groups, or follow-up length.
Prior SITBs confer risk for later suicidal thoughts and behaviors. However, they only provide a marginal improvement in diagnostic accuracy above chance. Addressing gaps in study design, assessment, and underlying mechanisms may prove useful in improving prediction and prevention of suicidal thoughts and behaviors.
In the United States alone, ∼14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve. The International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was held on February 4 and 5, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children’s Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children’s Hospital Andrews/Daicoff Cardiovascular Program, the International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary “think-tank”. The purpose of this manuscript is to summarise the lessons from the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children’s Heart Institute, to describe the “state of the art” of the treatment of paediatric cardiac failure, and to discuss future directions for research in the domain of paediatric cardiac failure.
Aligned multi-walled carbon nanotubes were grown on carbon fiber surface in order to provide a way to tailor the thermal, electrical and mechanical properties of the fiber-resin interface of a polymer composite. As the deposition temperature of the nanotubes is very high, an elevated exposure time can lead to degradation of the carbon fiber. To overcome this obstacle we have developed a deposition technique where the fiber is exposed to an atmosphere of growth for just one minute, and different concentrations of precursor solution were used.
The contamination of water by a large variety of molecules is a major environmental issue that will require the use of efficient and versatile materials to purify hydrological systems from source to point-of-use. The present study describes the aqueous-phase adsorption of heavy metal ions and multiple organic compounds at environmentally relevant concentrations onto graphene-single-walled carbon nanotube free-standing hybrid papers. Optical absorption spectroscopy results clearly showed that the hybrid nanocomposites exhibit superior adsorption properties compared to activated carbon, the most widely used adsorbent to date.
Insight into dynamic electrochemical processes can be obtained with in situ electrochemical-scanning/transmission electron microscopy (ec-S/TEM), a technique that utilizes microfluidic electrochemical cells to characterize electrochemical processes with S/TEM imaging, diffraction, or spectroscopy. The microfluidic electrochemical cell is composed of microfabricated devices with glassy carbon and platinum microband electrodes in a three-electrode cell configuration. To establish the validity of this method for quantitative in situ electrochemistry research, cyclic voltammetry (CV), choronoamperometry (CA), and electrochemical impedance spectroscopy (EIS) were performed using a standard one electron transfer redox couple [Fe(CN)6]3−/4−-based electrolyte. Established relationships of the electrode geometry and microfluidic conditions were fitted with CV and chronoamperometic measurements of analyte diffusion coefficients and were found to agree with well-accepted values that are on the order of 10−5 cm2/s. Influence of the electron beam on electrochemical measurements was found to be negligible during CV scans where the current profile varied only within a few nA with the electron beam on and off, which is well within the hysteresis between multiple CV scans. The combination of experimental results provides a validation that quantitative electrochemistry experiments can be performed with these small-scale microfluidic electrochemical cells provided that accurate geometrical electrode configurations, diffusion boundary layers, and microfluidic conditions are accounted for.
SMYB1 is a Schistosoma mansoni protein highly similar to members of the Y-box binding protein family. Similar to other homologues, SMYB1 is able to bind double- and single-stranded DNA, as well as RNA molecules. The characterization of proteins involved in the regulation of gene expression in S. mansoni is of great importance for the understanding of molecular events that control morphological and physiological changes in this parasite. Here we demonstrate that SMYB1 is located in the cytoplasm of cells from different life-cycle stages of S. mansoni, suggesting that this protein is probably acting in mRNA metabolism in the cytoplasm and corroborating previous findings from our group that showed its ability to bind RNA. Protein–protein interactions are important events in all biological processes, since most proteins execute their functions through large supramolecular structures. Yeast two-hybrid screenings using SMYB1 as bait identified a partner in S. mansoni similar to the SmD3 protein of Drosophila melanogaster (SmRNP), which is important in the assembly of small nuclear ribonucleoprotein complexes. Also, pull-down assays were conducted using immobilized GST-SMYB1 proteins and confirmed the SMYB1-SmRNP interaction. The interaction of SMYB1 with a protein involved in mRNA processing suggests that it may act in processes such as turnover, transport and stabilization of RNA molecules.
Ground ivy and khakiweed are troublesome broadleaf weeds of warm-season turfgrass. Field studies were conducted in Tennessee (TN) and Texas (TX) from 2008 to 2010 to evaluate the efficacy of sulfentrazone plus metsulfuron and carfentrazone plus metsulfuron tank mixtures compared with metsulfuron alone for control of ground ivy and khakiweed. In TN, sulfentrazone plus metsulfuron and carfentrazone plus metsulfuron provided accelerated control of ground ivy compared with metsulfuron alone. Over a 2-yr period, ground ivy control with metsulfuron at 10, 21, and 42 g ai ha−1 ranged from 0 to 5% 7 d after treatment (DAT) and 12 to 60% 14 DAT. Ground ivy control with mixtures of sulfentrazone plus metsulfuron ranged from 40 to 72% 7 DAT and 87 to 100% 14 DAT. Similarly, carfentrazone plus metsulfuron controlled ground ivy 5 to 32% 7 DAT and 23 to 93% 14 DAT. In TX, carfentrazone plus metsulfuron and sulfentrazone plus metsulfuron controlled khakiweed greater than metsulfuron alone 7 and 14 DAT as well. Few differences in ground ivy and khakiweed control were detected 56 DAT because metsulfuron applied alone at 21 g ai ha−1 controlled both weeds > 77%, similar to each mixture. These data indicate that when applied in mixtures, sulfentrazone and carfentrazone accelerate ground ivy and khakiweed control with metsulfuron but do not affect long-term efficacy.
Three types of HIV-associated neurocognitive disorders (HAND) exist that are distinguished by presence and severity of impairment in cognitive and everyday functioning. Although well-validated neurocognitive measures exist, determining impairment in everyday functioning remains a challenge. We aim to determine whether Self-Report measures of everyday functioning are as effective in characterizing HAND as Performance-Based measures. We assessed 674 HIV-infected participants with a comprehensive neurocognitive battery; 233 met criteria for a HAND diagnosis by having at least mild neurocognitive impairment. Functional decline was measured via Self-Report and Performance-Based measures. HAND diagnoses were determined according to published criteria using three approaches to assess functional decline: (1) Self-Report measures only, (2) Performance-Based measures only, and (3) Dual-method combining Self-Report and Performance-Based measures. The Dual-method classified the most symptomatic HAND, compared to either singular method. Singular method classifications were 76% concordant with each other. Participants classified as Performance-Based functionally impaired were more likely to be unemployed and more immunosuppressed, whereas those classified as Self-Report functionally impaired had more depressive symptoms. Multimodal methods of assessing everyday functioning facilitate detection of symptomatic HAND. Singular Performance-Based classifications were associated with objective functional and disease-related factors; reliance on Self-Report classifications may be biased by depressive symptoms. (JINS, 2012, 18, 79–88)
Most medical devices utilized in blood storage and transfusion, as well as in many medical and surgical procedures, are manufactured with polyvinylchloride (PVC) plastic containing the plasticizer di(2-ethylhexyl)phthalate (DEHP). During exposure of blood to the plastic surface, the DEHP is leached into the plasma where it is converted to mono(2-ethylhexyl)phthalate (MEHP) by a plasma enzyme in vivo or ex vivo during storage in plastic containers. The toxic effects of MEHP when infused into rats were investigated. The amount of MEHP infused was based on MEHP levels found in a variety of stored blood products (>6 ug/mL in red cell concentrates) and values actually measured during exchange transfusion (5 ug/mL) and cardiopulmonary bypass surgery (2.7 ug/mL). When the circulating level of MEHP in the rat's blood was >125 ug/mL, a greater than 50% decrease in heart rate and blood pressure was observed. This represents a margin of safety of only 25 fold higher than levels measured in humans during exchange transfusions. Although DEHP and MEHP have low oral toxicity, acute exposure by infusion may have lethal effects.
In a previous publication, preliminary results obtained using secondary ion mass spectrometry to determine selective elemental distributions in cast iron were reported. These results were used to tentatively assign possible roles to the important solutes in controlling the graphite morphology. The current paper is a continuation of this work and presents the most recent results of the SIMS analysis.
Two complementary techniques are used to study the electrical transport properties related to the use of diamonds as materials for ionizing radiation detectors. Transient photoconductivity using soft x-rays is used to probe the first few microns of the material, while ionizing particle-excited conductivity is used to probe the entire bulk of the material (1 millimeter). Both techniques measure the mean drift distance of free carriers, or the collection distance d. In addition, transient photoconductivity is able to extract the lifetimes and mobilities of the excited carriers. The collection distance measured by the two methods are in agreement, suggesting the material is homogeneous. At an applied field of 10 kV/cm, d is 25 to 30 microns, and, up to a field of 25 kV/cm, d has not saturated. The lifetime varies between 100 and 600 ps, and the mobility varies between 1000 and 4000 cm2/V-s, the range due to natural variations from sample to sample. The primary defects limiting the lifetime are believed to be nitrogen impurities and dislocations.