Migrated Avalon Veno-Venous Extracorporeal Membrane Oxygenation Cannula: How to Adjust Without Interruption of Flow.

The Avalon dual lumen cannula is presently the cannula of choice for veno-venous extracorporeal membrane oxygenation (VV-ECMO) via right internal jugular cannulation. This cannula establishes VV-ECMO with a single cannulation; however, it requires appropriate positioning to gain adequate oxygenation. Malposition of this cannula can cause inadequate ECMO flow, hypoxia, and structural injury. We have experienced two cases of migration: one into the hepatic vein and the other into the right ventricle. The former was repositioned using echocardiographic guidance without using a guidewire. The latter was repositioned using a guidewire from the femoral vein under fluoroscopy, without antegrade wire placement into the Avalon cannula, discontinuation of ECMO, or bleeding

Stratigraphic Variation of the Leonardian (Permian) Avalon Shale and Bone Spring Formation, Southeastern Delaware Basin, Reeves County, West Texas, U.S.A.

Stratigraphic thickness may vary as a member is deposited basinward of the shelf margin. Leonardian (Lower Permian) Avalon Shale and Bone Spring Formation strata of the southeastern region of the Delaware Basin in Reeves County, West Texas provide an example of these stratigraphic thickness variations. Wireline log data of the Avalon Shale and Bone Spring Formation records a mixed carbonate and siliciclastic slope-basinal system. Units of the Avalon Shale were deposited primarily by sediment gravity flows. Members of the Bone Spring Formation were deposited by reciprocal sedimentation caused by relative sea level change. Transgressions and relative sea level highstands deposited carbonate, whereas regressions and relative sea level lowstands deposited siliciclastic rocks. Carbonate sediment gravity flows and suspension settling of sandstone and shale channelized deposition contribute to the development of Avalon Shale and Bone Spring Formation basin strata. This research investigates the change in stratigraphic thickness of the Avalon Shale and Bone Spring Formation from the southeastern to the central region of the Delaware Basin throughout Reeves County in a regional context, utilizing well log data. 26 well logs were analyzed and correlated for this study. Correlations show Avalon Shale and Bone Spring Formation units (in stratigraphically descending order); First BS (Bone Spring) Carbonate, Avalon Shale (within the First BS Carbonate; Leonard Shale (also known as “Upper Avalon” in previous studies), Middle Avalon, and Lower Avalon Shales), First BS Sandstone, Second BS Carbonate, Second BS Sandstone, Third BS Carbonate, and Third BS Sandstone have various thinning and thickening stratigraphic thickness trends from west to east, and from northwest to southeast, throughout the southeastern region of the basin. Future work on the Avalon Shale and Bone Spring Formation in the southeastern Delaware Basin can further integrate core, seismic, and petrographic data to better understand the Avalon Shale and Bone Spring Formation’s depositional processes and patterns that affected variations of thickness throughout the southeastern to central region of the basin

We\u27re All Jock Tamson\u27s Bairns : Scottish Ethnic Identity and Nationalism in America

This paper explores how Scottish-Americans have contributed to Scottish national dialogues by laying roots for future generations in the form of early ethnic organizations as well as religious and social practices, engaging in discussion about what it means to be both white and ethnic, sustaining forms of traditional culture through Scottish Highland Games, and interpreting their personal experiences with ethnic and national identity as a way of negotiating their relationships with Scottish nationalism. The 2014 referendum on Scottish independence offered historical circumstances that were both relevant and exhilarating to explore these topics under. This exploration incorporates both interview and survey data gathered from Scottish-Americans

Prevention, incidence, and survival of cervical cancer in Sweden

Cervical cancer is preventable by screening. In 1967, Sweden introduced a cervical screening program. Screening for high-risk human papillomavirus (hr-HPV), the causative factor of cervical cancer, is more sensitive than cytology and can be performed as a self-sample. Non-attendance to screening is a large risk factor for cervical cancer. Self-samples may improve screening attendance. The aims of this thesis were: To analyze if the cervical screening program in Sweden can be improved by using vaginal self-samples and an HPV mRNA assay, with the main focus on screening non-attendees. To obtain knowledge if cervical cancer incidence and survival has changed since the implementation of the screening program. Study I: Incidence and net survival according to morphology, age, and stage at diagnosis among women diagnosed with invasive cervical cancer between 1960 and 2014 were calculated. The age-standardized incidence of squamous cell carcinoma (SCC) decreased until the year 2000, while the incidence of adenocarcinoma (ADC) increased continuously. Age-standardized 5-year net survival increased. SCC and ADC did not statistically differ in net survival after 2012. Among women >75 years, long-term net survival has decreased since 1960. Study II: The sensitivity and specificity of vaginal and urine self-samples compared to cervical samples analyzed by Aptima HPV mRNA assay were evaluated in a referral population. The sensitivity for detection of high-grade squamous intraepithelial lesions /adenocarcinoma in situ/cancer was 85.5% for the vaginal self-sample, 44.8% for the urinary sample, 100.0% for the cervical sample and 81.7% for cytology. Study III-V: Screening non-attendees or women in the upper age screening limit were sent a vaginal self-sampling kit by mail. In study III, 1,000 women, aged 69-70 years, received a kit. In study IV and V, 6,023 and 19,766 women, aged 30-70 years, received a kit. Returned samples were analyzed for HPV mRNA by Aptima assay. HPV-positive women were invited to follow-up. The response rate of the self-sample was 43.3%, 13.2% and 18.5% for study III, IV and V respectively. The HPV prevalence was 6.2% in study III, and no cases of high-grade dysplasia/cancer were diagnosed. The HPV prevalence was 9.9% and 11.3% in study IV and V respectively. In study IV, the prevalence of cervical cancer was almost seven times higher compared to organized screening, but in study V the prevalence of cancer was not increased. Conclusion: This thesis demonstrated that the incidence of SCC, but not ADC, has decreased since 1960. SCC and ADC did not statistically differ in net survival after 2012. The decreased long-term net survival among women >75 years of age suggests the need for prolonged HPV screening up to 75 years of age. Self-sampling is a promising method since it was accepted among women 69-70 years old, and it increased the attendance to cervical screening by almost one fifth among non-attendees. A vaginal HPV self-sample analyzed by Aptima mRNA assay showed a similar sensitivity as routine cytology and may be used to reach screening non-attendees. Among screening non-attendees and women in the upper age screening limit, around one in 10-20 tested positive for HPV mRNA, with risk of development of cervical dysplasia, although the prevalence of cervical cancer varied between the studies

Roundtable: Exposing Shadow Culture for Transformative Learning

Discussion will be based from the proposed transformative learning framework lesson materials to determine 1) whether a critical event can be expected from material exposure; 2) how long disorientation is likely to ensue based on previous knowledge; and 3) best classroom techniques to manage individuals’ transformative learning needs within group instruction. Instruction materials include historical timelines, extent of exposure around the world, and sketches of prime examples for comparison and are structured as an observation inquiry project for learners to determine the prevalence of astrology as a socially constructed shadow culture influence

Application of a library of near isogenic lines to understand context dependent expression of QTL for grain yield and adaptive traits in bread wheat

(a) Summary of the mixed model analysis performed for the grain number components studied comprising 553 NILs carrying the Avalon or Cadenza alleles in the introgressed region in 2013. (b) Average values for the two groups (carrying the Avalon or Cadenza alleles in the QTL region) based on the chromosome and background in 2013. Significant difference between Avalon and Cadenza alleles are highlighted in bold (spikes/m2 (S), spikelet/spike (s/S) and grains/spikelet (G/S). (PDF 111 kb

A framework for gene mapping in wheat demonstrated using the Yr7 yellow rust resistance gene

We used three approaches to map the yellow rust resistance gene Yr7 and identify associated SNPs in wheat. First, we used a traditional QTL mapping approach using a double haploid (DH) population and mapped Yr7 to a low-recombination region of chromosome 2B. To fine map the QTL, we then used an association mapping panel. Both populations were SNP array genotyped allowing alignment of QTL and genome-wide association scans based on common segregating SNPs. Analysis of the association panel spanning the QTL interval, narrowed the interval down to a single haplotype block. Finally, we used mapping-by-sequencing of resistant and susceptible DH bulks to identify a candidate gene in the interval showing high homology to a previously suggested Yr7 candidate and to populate the Yr7 interval with a higher density of polymorphisms. We highlight the power of combining mapping-by-sequencing, delivering a complete list of gene-based segregating polymorphisms in the interval with the high recombination, low LD precision of the association mapping panel. Our mapping-by-sequencing methodology is applicable to any trait and our results validate the approach in wheat, where with a near complete reference genome sequence, we are able to define a small interval containing the causative gene

Outport adaptations: Social indicators through Newfoundland\u27s Cod crisis

The 1992 moratorium on fishing for Northern Cod marked a symbolic end to the way of life that had sustained Newfoundland\u27s out ports for hundreds of years. It also marked the completion of an ecological regime shift, from an ocean ecosystem dominated by cod and other predatory ground fish, to one in which such fish are comparatively scarce, and lower-trophic-level invertebrates more common. We examine patterns of change seen in large-scale social indicators, which reflect the smaller-scale adaptations of individuals and communities during this ecological shift. Trends in population, migration, age, unemployment and dependency suggest declining conditions in rural Newfoundland over the years of fisheries troubles. The 1992 crisis accelerated previous trends, but did not produce great discontinuities. Some trends date instead to the late-1980s resource-depletion phase that ended the glory years of Newfoundland\u27s ground fish boom. Government interventions meant to soften the economic impact of the 1992 crisis also blunted its social impacts, effectively postponing or distributing these over a number of subsequent years. Out port society is adapting to shifts in the regulatory and global-market environment, as well as changing marine ecology. Adaptive strategies include new investments in invertebrate fisheries, changes in education and migration, and continuing reliance on the informal economy