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Systemic venous hypertension and low cardiac output are believed to be important mediators of liver injury after the Fontan procedure. Pulmonary vasodilators have the potential to improve such haemodynamics. The aim of this study was to assess the acute effects of exercise on liver stiffness and venous pressures and to assess the impact of inhaled Treprostinil on this response.
In this prospective, double-blind, placebo-controlled, crossover trial, 14 patients with a Fontan circulation were randomised to inhalation of placebo and Treprostinil. Incremental and constant work rate exercise tests were performed to assess the effect of Treprostinil on exercise tolerance. Venous pressures were measured throughout and liver stiffness at rest and immediately after peak exercise.
Mean age was 27.8 ± 7.9 years and 66% were females. Exercise acutely increased liver stiffness by 30% (mean shear wave speed: 2.38 ± 0.71 versus 2.89 ± 0.51 ms, p = 0.02). Peripheral venous pressures increased acutely during both incremental (12.1 ± 2.4 versus 22.6 ± 8.0 mmHg, p < 0.001) and constant work rate exercise (12.5 ± 2.5 versus 23.4 ± 5.2 mmHg, p < 0.001). Overall, Treprostinil failed to attenuate exercise-induced increases in liver stiffness. Compared with placebo, Treprostinil did not significantly impact venous pressure responses, VO2peak, nor exercise endurance times.
Peripheral venous pressure increased acutely during exercise by an average of 88% above baseline and was not altered by administration of inhaled Treprostinil. Liver stiffness measured immediately post-exercise increased acutely by an average of 30%, with no attenuation following Treprostinil inhalation.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
Neuropsychological testing reveals a pattern of impairment among patients with obsessive-compulsive disorder (OCD) which implicates the orbitofrontal region. Studies of neuropsychological function in OCD differ regarding performance deficits on classical tests of frontal executive function. In some studies, OCD patients did not demonstrate impaired performance on tests of executive function. However, other researchers have documented performance deficits among OCD patients on measures of executive function. Patients with OCD also exhibit performance deficits on tests of visual/spatial memory and verbal memory. Again, in some studies, OCD patients did not demonstrate impaired performance on tests of memory function. How can we account for the conflicting findings? One possibility is that performance deficits on tests of cognitive function are associated with comorbid conditions. In prior work, we observed that OCD patients who did poorly on executive function tasks obtained high scores on a measure of schizotypal personality. A second possibility is that executive function deficits among patients with OCD are associated with comorbid depressive symptoms.
In the present study, a comprehensive neuropsychological test battery was administered to patients with OCD and matched healthy control subjects. We also administered dimensional measures of schizotypal personality and depression to patients with OCD and controls. We conducted analyses of covariance (ANCOVA), with scores on measures of schizotypal personality and depression used as covariates.
OCD patients demonstrated performance deficits on measures of delayed memory, response inhibition, alternation learning, and obtained significantly higher scores on measures of disinhibition, impulsivity, and temporolimbic symptoms; however, OCD patients did not exhibit impaired performance on tests of executive function and verbal fluency, and did not report a significantly greater number of dysexecutive symptoms, when coexistent depressive and schizotypal symptoms were taken into account.
Findings are consistent with the contention that dysfunction of an orbitofrontal-limbic network underlies OCD.
This paper reports on undergraduate health care students’ perception of societal vulnerability to disasters in the context of population aging. Forecast increases in extreme weather events are likely to have a particularly devastating effect on older members of the community.
Undergraduate paramedicine and nursing students were surveyed using the Perceptions of Ageing and Disaster Vulnerability Scale (PADVS) to determine their views on the risks posed to older members of the community by disasters. Data analysis included a comparison of subscales relating to isolation, health system readiness, declining function, and community inclusiveness.
Students reported a moderate level of concern about disaster vulnerability. Students who had previously completed another university degree reported significantly higher levels of concern than those without a prior degree. Australian students reported lower concern about societal vulnerability compared to a previously reported cohort of Japanese students.
Our study suggests current education of future health care students does not promote adequate levels of awareness of the health-related challenges posed by disasters, particularly among older members of the community. Without addressing this gap in education, the risk of negative outcomes for both unprepared first responders and older members of the community is significant. (Disaster Med Public Health Prep. 2019;13:449-455)
The discovery of the radio source Centaurus A and its optical counterpart NGC 5128 were important landmarks in the history of Australian astronomy. NGC 5128 was first observed in August 1826 by James Dunlop during a survey of southern objects at the Parramatta Observatory, west of the settlement at Sydney Cove. The observatory had been founded a few years earlier by Thomas Brisbane, the new governor of the British colony of New South Wales. Just over 120 years later, John Bolton, Gordon Stanley and Bruce Slee discovered the radio source Centaurus A at the Dover Heights field station in Sydney, operated by CSIRO's Radiophysics Laboratory (the forerunner to CSIRO Astronomy and Space Sciences). This paper will describe this early historical work and summarize further studies of Centaurus A by other Radiophysics groups up to 1960.
Nonindigenous invasive weed species can have substantial negative impacts on the quantity and quality of outdoor recreational activities such as fishing, hunting, hiking, wildlife viewing, and water-based recreation. Despite the significance of impacts on recreation, very little research has been performed to estimate the corresponding economic losses at spatial scales such as regions, states, and watersheds. This is true primarily because in most jurisdictions the data necessary to estimate recreational impacts are scarce and incomplete. Because of the challenges involved in measuring recreational losses precisely, we illustrate a method that can provide indications of the ranges in which the true economic losses likely lie. To reflect underlying uncertainty in parameters such as the number of acres infested in a jurisdiction and the rate at which wildlife-related recreation decreases as a function of increasing weed infestation, we developed a range of estimates using lower, medium, and higher scenario combinations of parameter and variable values. Our case study jurisdiction is a western state (Nevada) in which nonindigenous weed infestations on public lands have expanded rapidly in recent years. Under conservative assumptions, the negative economic impacts stemming from the adverse influence of nonindigenous weeds on wildlife-related recreation in Nevada likely range from $6 million to $12 million per year. Using the most conservative findings for annual recreation losses, the predicted discounted stream of negative economic impacts over a future time horizon of 5 yr ranges from about $30 million to $40 million in Nevada, depending on actual future expansion rates of weeds.
Oxides with significant mesopore volume can be produced from gels through ambient pressure drying (APD) if the oxide network within the gel is sufficiently strong. To obtain a strong alumina gel, a commercial alumina powder (100 nm diameter) was combined with different amounts of ethanol, water, and acid. Significant mesoporosity was observed in dried and calcined gels prepared from this precursor and ethanol alone, particularly when “poor wettability” was established in the gel through azeotropic distillation in toluene. When water (or water and nitric acid) was also utilized the pore volume decreased dramatically; this observation may be attributed to the creation of amorphous alumina from the crystalline precursor that is displaced into the interparticle pores, and in which mesopores are poorly preserved during APD.