How to Undertake a Clinically Relevant Systematic Review in a Rapidly Evolving Field: Magnetic Resonance Angiography

Objectives: The aim was to determine which generations of the evolving technology of magnetic resonance angiography (MRA) are currently of clinical relevance in two clinical applications. Our purpose was to plan a systematic review that would be valuable both to purchasers driven by cost-effectiveness and to practicing clinicians. Methods: Information was gathered from a search of major bibliographic databases, from a short questionnaire sent to 500 U.K. vascular radiologists and vascular surgeons, and from local clinical The authors thank A. Jackson and all those who completed a questionnaire. This work was carried out with the financial support of the Secretary of State for Health under the NHS Health Technology Assessment Programme, project 97/13/04. The views and opinions expressed do not necessarily reflect those of the Secretary of State for Health. In part, this work was undertaken by the Leeds Teaching Hospitals NHS Trust, which received funding from the NHS Executive. The views expressed in this publication are those of the authors and not necessarily those of the NHS Executive.experts. We asked which of the MRA techniques were currently used and, assuming availability, what would be their technique of choice. Results: There were 206 published articles that satisfied preliminary inclusion criteria: 69 discussed 2D time of flight (TOF); 47, 3D TOF; and 38, contrast-enhanced techniques. There were 162 questionnaires returned (60 radiologists, 102 surgeons). Of the total respondents, 77/162 (48%) used MRA in the assessment of carotid artery stenosis; 47/77 (61%) used 2D TOF; 32/77 (42%), 3D TOF; and 26/77 (34%), contrast-enhanced techniques. Thirty-five of 162 (22%) respondents used MRA in the assessment of peripheral vascular disease (PVD); 15/35 (43%) used 2D TOF, 4/35 (11%) used 3D TOF, and 22/35 (63%) used contrast-enhanced techniques. For those wishing to use MRA, contrast-enhanced techniques were the method of choice. Conclusions: The TOF methods that represent earlier generations of the technology remain clinically relevant, and will therefore be included in our systematic review. To ensure complete and relevant coverage in reviews of other evolving technologies, it would be advisable to obtain data for guidance in a similar way

Use of magnetic resonance angiography to select candidates with recently symptomatic carotid stenosis for surgery: systematic review

Objective To determine if sufficient evidence exists to support the use of magnetic resonance angiography as a means of selecting patients with recently symptomatic high grade carotid stenosis for surgery. Design Systematic review of published research on the diagnostic performance of magnetic resonance angiography, 1990-9. Main outcome measures Performance characteristics of diagnostic test. Results 126 potentially relevant articles were identified, but many articles failed to examine die performance of magnetic resonance angiography as a diagnostic test at the surgical decision thresholds used in major clinical trials on endarterectomy. 26 articles were included in a meta-analysis that showed a maximal joint sensitivity and specificity of 99% (95% confidence interval 98% to 100%) for identifying 70-99% stenosis and 90% (81% to 99%) for identifying 50-99% stenosis. Only four articles evaluated contrast enhanced magnetic resonance angiography. Conclusions Magnetic resonance angiography is accurate for selecting patients for carotid endarterectomy at the surgical decision thresholds established in the major endarterectomy trials, but the evidence is not very robust because of the heterogeneity of the studies included. Research is to determine the diagnostic performance of the most recent developments in magnetic resonance angiography, including contrast enhanced techniques, as well as to assess the impact of magnetic resonance angiography on surgical decision making and outcomes

Stereochemical criteria for polypeptides and proteins : VI. Non-bonded energy of polyglycine and poly--alanine in the crystalline [beta]-form

This paper describes calculations on the packing energy in the crystal structures of [beta]-forms of polyglycine and poly--alanine. It is shown that the non-bonded interactions between [beta]-chains, in a pleated sheet structure, yields a minimum energy when the interchain spacing is about 4.8 A, which is well-suited for the formation of interchain NH [middle dot][middle dot][middle dot] O hydrogen bonding. The attempts made to deduce the crystal structures of [beta]-forms of polyglycine and poly--alanine are also described.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33067/1/0000453.pd

Galaxy Zoo Green Peas: discovery of a class of compact extremely star-forming galaxies

‘The definitive version is available at www3.interscience.wiley.com '. Copyright Royal Astronomical Society. DOI: 10.1111/j.1365-2966.2009.15383.xWe investigate a class of rapidly growing emission line galaxies, known as 'Green Peas', first noted by volunteers in the Galaxy Zoo project because of their peculiar bright green colour and small size, unresolved in Sloan Digital Sky Survey imaging. Their appearance is due to very strong optical emission lines, namely [O iii]λ5007 Å, with an unusually large equivalent width of up to ∼1000 Å. We discuss a well-defined sample of 251 colour-selected objects, most of which are strongly star forming, although there are some active galactic nuclei interlopers including eight newly discovered narrow-line Seyfert 1 galaxies. The star-forming Peas are low-mass galaxies (M∼ 108.5–1010 M⊙) with high star formation rates (∼10 M⊙ yr−1) , low metallicities (log[O/H]+ 12 ∼ 8.7) and low reddening [ E(B−V) ≤ 0.25 ] and they reside in low-density environments. They have some of the highest specific star formation rates (up to ∼10−8 yr−1 ) seen in the local Universe, yielding doubling times for their stellar mass of hundreds of Myr. The few star-forming Peas with Hubble Space Telescope imaging appear to have several clumps of bright star-forming regions and low surface density features that may indicate recent or ongoing mergers. The Peas are similar in size, mass, luminosity and metallicity to luminous blue compact galaxies. They are also similar to high-redshift ultraviolet-luminous galaxies, e.g. Lyman-break galaxies and Lyα emitters, and therefore provide a local laboratory with which to study the extreme star formation processes that occur in high-redshift galaxies. Studying starbursting galaxies as a function of redshift is essential to understanding the build up of stellar mass in the Universe.Peer reviewe

The stability of the two-bonded collagen triple helix

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33425/1/0000827.pd

Galaxy Zoo: evidence for rapid, recent quenching within a population of AGN host galaxies

We present a population study of the star formation history of 1244 Type 2 active galactic nuclei (AGN) host galaxies, compared to 6107 inactive galaxies. A Bayesian method is used to determine individual galaxy star formation histories, which are then collated to visualize the distribution for quenching and quenched galaxies within each population. We find evidence for some of the Type 2 AGN host galaxies having undergone a rapid drop in their star formation rate within the last 2 Gyr. AGN feedback is therefore important at least for this population of galaxies. This result is not seen for the quenching and quenched inactive galaxies whose star formation histories are dominated by the effects of downsizing at earlier epochs, a secondary effect for the AGN host galaxies. We show that histories of rapid quenching cannot account fully for the quenching of all the star formation in a galaxy's lifetime across the population of quenched AGN host galaxies, and that histories of slower quenching, attributed to secular (non-violent) evolution, are also key in their evolution. This is in agreement with recent results showing that both merger-driven and non-merger processes are contributing to the co-evolution of galaxies and supermassive black holes. The availability of gas in the reservoirs of a galaxy, and its ability to be replenished, appear to be the key drivers behind this co-evolution

WHO global research priorities for antimicrobial resistance in human health

The WHO research agenda for antimicrobial resistance (AMR) in human health has identified 40 research priorities to be addressed by the year 2030. These priorities focus on bacterial and fungal pathogens of crucial importance in addressing AMR, including drug-resistant pathogens causing tuberculosis. These research priorities encompass the entire people-centred journey, covering prevention, diagnosis, and treatment of antimicrobial-resistant infections, in addition to addressing the overarching knowledge gaps in AMR epidemiology, burden and drivers, policies and regulations, and awareness and education. The research priorities were identified through a multistage process, starting with a comprehensive scoping review of knowledge gaps, with expert inputs gathered through a survey and open call. The priority setting involved a rigorous modified Child Health and Nutrition Research Initiative approach, ensuring global representation and applicability of the findings. The ultimate goal of this research agenda is to encourage research and investment in the generation of evidence to better understand AMR dynamics and facilitate policy translation for reducing the burden and consequences of AMR