International registry of congenital porto-systemic shunts: a multi-centre, retrospective and prospective registry of neonates, children and adults with congenital porto-systemic shunts.

BACKGROUND Congenital portosystemic shunts (CPSS) are rare vascular malformations associated with the risk of life-threatening systemic conditions, which remain underdiagnosed and often are identified after considerable diagnostic delay. CPSS are characterized by multiple signs and symptoms, often masquerading as other conditions, progressing over time if the shunt remains patent. Which patients will benefit from shunt closure remains to be clarified, as does the timing and method of closure. In addition, the etiology and pathophysiology of CPSS are both unknowns. This rare disorder needs the strength of numbers to answer these questions, which is the purpose of the international registry of CPSS (IRCPSS). METHOD A retrospective and prospective registry was designed using secuTrial® by the ISO certified Clinical Research Unit. Given that a significant number of cases entered in the registry are retrospective, participants have the opportunity to use a semi-structured minimal or complete data set to facilitate data entry. In addition, the design allows subjects to be entered into the IRCPSS according to clinically relevant events. Emphasis is on longitudinal follow-up of signs and symptoms, which is paramount to garner clinically relevant information to eventually orient patient management. The IRCPSS includes also three specific forms to capture essential radiological, surgical, and cardiopulmonary data as many times as relevant, which are completed by the specialists themselves. Finally, connecting the clinical data registry with a safe image repository, using state-of-the-art pseudonymization software, was another major focus of development. Data quality and stewardship is ensured by a steering committee. All centers participating in the IRCPSS have signed a memorandum of understanding and obtained their own ethical approval. CONCLUSION Through state-of-the-art management of data and imaging, we have developed a practical, user-friendly, international registry to study CPSS in neonates, children, and adults. Via this multicenter and international effort, we will be ready to answer meaningful and urgent questions regarding the management of patients with CPSS, a condition often ridden with significant diagnostic delay contributing to a severe clinical course

International registry of congenital porto-systemic shunts: a multi-centre, retrospective and prospective registry of neonates, children and adults with congenital porto-systemic shunts

BACKGROUND: Congenital portosystemic shunts (CPSS) are rare vascular malformations associated with the risk of life-threatening systemic conditions, which remain underdiagnosed and often are identified after considerable diagnostic delay. CPSS are characterized by multiple signs and symptoms, often masquerading as other conditions, progressing over time if the shunt remains patent. Which patients will benefit from shunt closure remains to be clarified, as does the timing and method of closure. In addition, the etiology and pathophysiology of CPSS are both unknowns. This rare disorder needs the strength of numbers to answer these questions, which is the purpose of the international registry of CPSS (IRCPSS). METHOD: A retrospective and prospective registry was designed using secuTrial® by the ISO certified Clinical Research Unit. Given that a significant number of cases entered in the registry are retrospective, participants have the opportunity to use a semi-structured minimal or complete data set to facilitate data entry. In addition, the design allows subjects to be entered into the IRCPSS according to clinically relevant events. Emphasis is on longitudinal follow-up of signs and symptoms, which is paramount to garner clinically relevant information to eventually orient patient management. The IRCPSS includes also three specific forms to capture essential radiological, surgical, and cardiopulmonary data as many times as relevant, which are completed by the specialists themselves. Finally, connecting the clinical data registry with a safe image repository, using state-of-the-art pseudonymization software, was another major focus of development. Data quality and stewardship is ensured by a steering committee. All centers participating in the IRCPSS have signed a memorandum of understanding and obtained their own ethical approval. CONCLUSION: Through state-of-the-art management of data and imaging, we have developed a practical, user-friendly, international registry to study CPSS in neonates, children, and adults. Via this multicenter and international effort, we will be ready to answer meaningful and urgent questions regarding the management of patients with CPSS, a condition often ridden with significant diagnostic delay contributing to a severe clinical course

Cohort profile: Antiretroviral Therapy Cohort Collaboration (ART-CC).

The advent of effective combination antiretroviral therapy (ART) in 1996 resulted in fewer patients experiencing clinical events, so that some prognostic analyses of individual cohort studies of human immunodeficiency virus-infected individuals had low statistical power. Because of this, the Antiretroviral Therapy Cohort Collaboration (ART-CC) of HIV cohort studies in Europe and North America was established in 2000, with the aim of studying the prognosis for clinical events in acquired immune deficiency syndrome (AIDS) and the mortality of adult patients treated for HIV-1 infection. In 2002, the ART-CC collected data on more than 12,000 patients in 13 cohorts who had begun combination ART between 1995 and 2001. Subsequent updates took place in 2004, 2006, 2008, and 2010. The ART-CC data base now includes data on more than 70,000 patients participating in 19 cohorts who began treatment before the end of 2009. Data are collected on patient demographics (e.g. sex, age, assumed transmission group, race/ethnicity, geographical origin), HIV biomarkers (e.g. CD4 cell count, plasma viral load of HIV-1), ART regimen, dates and types of AIDS events, and dates and causes of death. In recent years, additional data on co-infections such as hepatitis C; risk factors such as smoking, alcohol and drug use; non-HIV biomarkers such as haemoglobin and liver enzymes; and adherence to ART have been collected whenever available. The data remain the property of the contributing cohorts, whose representatives manage the ART-CC via the steering committee of the Collaboration. External collaboration is welcomed. Details of contacts are given on the ART-CC website (www.art-cohort-collaboration.org)

Cross-correlated chemical shift modulation: A signature of slow internal motions in proteins

A novel NMR expt. allows one to characterize slow motion in macromols. The method exploits the fact that motions, such as rotation about dihedral angles, induce correlated fluctuations of the isotropic chem. shifts of the nuclei in the vicinity. The relaxation of two-spin coherences involving Ca and Cb nuclei in proteins provides information about correlated fluctuations of the isotropic chem. shifts of Ca and Cb. The difference between the relaxation rates of double- and zero-quantum coherences C+a C+b and C+a C-b is shown to be affected by cross-correlated chem. shift modulation. In ubiquitin, evidence for slow motion is found in loops or near the ends of b-strands and a-helixes. [on SciFinder (R)

Evaluation of the risk to groundwater after treating logs with cypermethrin

In order to protect conifer logs against attacks from the striped ambrosia beetle (Trypodendron lineatum) during spring in Swiss forests, logs are treated with the insecticide cypermethrin. Rainfall can cause the insecticide to leach into the ground, potentially threatening the groundwater quality. Forest groundwater is widely used for drinking water, which means that any contaminants within it should be avoided. This study assesses the risk of groundwater contamination in field conditions. The two study areas are located on unconsolidated sediments (Censières, or CS) and on karstic rocks (Grand Bochat, or GB). An analytical method was developed to determine the concentration of cypermethrin and its degradation products 3-PBA and DCVA in water samples. Intensive rainfall was simulated in order to mimic a situation that threatens groundwater. The study's results show that, when treated according to the manufacturer's instructions, a certain amount of insecticide was leached during the first rainfall event (2.2g or 4.4% of the applied cypermethrin). This leaching threatens groundwater quality, but can be avoided by decreasing the pesticide amount applied while maintaining a satisfactory protection. The insecticide amount that reached the groundwater was very low and was related to simulated rainfall, not natural rainfall. In Censières, only one groundwater sample presented a cypermethrin concentration (4μg/l). In Grand Bochat, after a simulated rainfall of 36mm, 3.3% of the insecticide (5g) was leached and 0.05% of the total applied insecticide amount (corresponding to 1.5% of the leached insecticide) reached the groundwater under the epikarst layer

Evaluation of the risk to groundwater after treating logs with cypermethrin

In order to protect conifer logs against attacks from the striped ambrosia beetle (Trypodendron lineatum ) during spring in Swiss forests, logs are treated with the insecticide cypermethrin. Rainfall can cause the insecticide to leach into the ground, potentially threatening the groundwater quality. Forest groundwater is widely used for drinking water, which means that any contaminants within it should be avoided. This study assesses the risk of groundwater contamination in field conditions. The two study areas are located on unconsolidated sediments (Censie`res, or CS) and on karstic rocks (Grand Bochat, or GB). An analytical method was developed to determine the concentration of cypermethrin and its degradation products 3-PBA and DCVA in water samples. Intensive rainfall was simulated in order to mimic a situation that threatens groundwater. The study’s results show that, when treated according to the manufacturer’s instructions, a certain amount of insecticide was leached during the first rainfall event (2.2 g or 4.4 % of the applied cypermethrin). This leaching threatens groundwater quality, but can be avoided by decreasing the pesticide amount applied while maintaining a satisfactory protection. The insecticide amount that reached the groundwater was very low and was related to simulated rainfall, not natural rainfall. In Censie`res, only one groundwater sample presented a cypermethrin concentration (4 l g/l). In Grand Bochat, after a simulated rainfall of 36 mm, 3.3 % of the insecticide (5 g) was leached and 0.05 % of the total applied insecticide amount (corresponding to 1.5 % of the leached insecticide) reached the groundwater under the epikarst layer

Der Berner Patienten- und Therapeutenstundenbogen 2000

Theoretischer Hintergrund: Kontinuierliche Qualitätssicherung psychotherapeutischer Behandlung ist Grundlage für die adaptive Indikation und Aufrechterhaltung der Prozessqualität. Dazu werden Messinstrumente gefordert, die zentrale Aspekte des Psychotherapieprozesses möglichst umfassend und dennoch zeitökonomisch aus Therapeuten- und Patientensicht abbilden (Grawe, 1998). Fragestellung: Entspricht der Berner Therapeuten- und Patientenstundenbogen 2000 (TSTB/PSTB) zentralen messtheoretischen Anforderungen? Methode: Anhand von 429 ambulant behandelten Patienten wird die Faktorenstruktur in verschiedenen Settings überprüft sowie Fragen zur Reliabilität und Validität der Bögen beantwortet. Ergebnisse: Die konfirmatorischen Faktoranalysen bestätigen die theoriegeleiteten Skalen der Vorgängerversion über verschiedene Settings und Therapiephasen hinweg (TSTB: Therapiebeziehung, Offenheit, Therapiefortschritte, interaktionelle Schwierigkeit, Problembewältigung, Bezug zur realen Lebenssituation, motivationale Klärung, Ressourcenaktivierung, Problemaktualisierung, Anstrengungsbereitschaft, interaktionelle Perspektive; PSTB: Therapiebeziehung, Selbstwerterfahrungen, Bewältigungserfahrungen, Klärungserfahrungen, Therapiefortschritte, Aufgehobensein, Direktivität/Kontrollerfahrungen, Problemaktualisierung). Die Reliabilitäten der Mehr-Item-Skalen sind mehrheitlich gut. Die mittelstarken Binnenkorrelationen sowie die konvergenten Interkorrelationen zwischen den beiden Beurteilerperspektiven ergeben Hinweise auf die Konstruktvalidität der Stundenbogenskalen. Schlussfolgerungen: Die vorliegenden Stundenbögen bilden ein breites Spektrum psychotherapeutischer Prozesse ab und eignen sich zur Darstellung von individuellen Therapieverläufen sowie zu gruppenstatistischen Vergleichen