Routine Use of Unilateral and Bilateral Radial Arteries for Coronary Artery Bypass Graft Surgery

AbstractObjectives. This study sought to evaluate the routine use of radial artery (RA) grafts in patients undergoing coronary artery revascularization.Background. Previous long-term studies have documented poor patency of saphenous vein grafts compared with internal thoracic artery (ITA) grafts.Methods. We performed a prospective review of 175 of 249 consecutive patients.Results. Fifty-four patients had bilateral RAs harvested. Mean number (±SD) of grafts/patient was 3.27 ± 0.93, with 2.76 ± 0.97 arterial grafts; a mean of 1.53 ± 0.68 grafts were performed with the RA. The operative mortality rate was 1.6%. No deaths were related to RA grafts, and there were no RA harvest site hematomas or infections. Transient dysesthesia 1 day to 4 weeks in duration occurred in the distribution of the lateral antebrachial cutaneous nerve in six extremities (2.6%). Elective cardiac catheterization in 60 patients at 12 weeks postoperatively demonstrated a 95.7% patency rate.Conclusions. Because of potential benefit of long-term patency associated with arterial grafts, minimal morbidity and mortality associated with use of the RA and excellent short-term patency rates, we cautiously recommend use of one or both RAs as additional conduits to be used concomitantly with the ITA for arterial revascularization of the coronary arteries

Record d'altitude pour la couleuvre loup, Lycodon aulicus (L., 1758) sur l'île de La Réunion (Squamata : Colubridae)

Le 22 mai 2013, lors d’une sortie de terrain conduite par les agents du Parc national de La Réunion visant à suivre une population de gecko vert de Bourbon (Phelsuma borbonica Mertens, 1966), une couleuvre loup a été découverte au niveau du site du Maïdo (commune de Saint-Paul), à 2215 mètres d’altitude

Small collections remembered: Sámi material culture and community-based digitization at the Smithsonian Institution

Of the 158 million things housed by the Smithsonian Institution, about 56 objects originate from Sámi communities. By all accounts a small group of objects—even by the standards of the Arctic collections at the Institution—it may be easily overlooked or dismissed as insignificant, based on entrenched ideologies about idealized collections. Presenting a community-based methodology for the engagement of distant museum collections using three-dimensional technologies, this article establishes the latent potential of small collections for Indigenous communities. We demonstrate how a group of 56 objects not only chronicles complex histories of exchange and colonialism, but also provides a manageable conduit for learning and exchange to facilitate the continued restructuring of relationships between museums and descendent stakeholders, from the individual to community level. Small collections, far from incomplete, may not only contain materials significant to descendent groups on their own terms, but provide the grounds to generate new forms of Indigenous initiated, balanced reciprocity

Friends or foes? migrants and sub-state nationalists in Europe

How do sub-state nationalists respond to the growing presence of cultural diversity in their ‘homelands’ resulting from migration? Sub-state nationalists in Europe, in ‘nations without states’ such as Catalonia and Scotland, have been challenging the traditional nation-state model for many decades. While the arguments in favour of autonomy or independence levelled by these movements have become more complex, sub-state nationalist movements remain grounded by their perceived national community that is distinct from the majority nation. Migration to the ‘homeland’ of a sub-state nation, then, presents a conundrum for sub-state elites that we label the ‘legitimation paradox’: too much internal diversity may undermine the claim to cultural distinctiveness. We engage with three common intervening variables thought to influence how sub-state nationalists confront the ‘legitimation paradox’: civic/ethnic nationalism, degree of political autonomy, and party competition. Our overarching argument is that none of these factors have a unidirectional or determinate effect on the sub-state nationalism-immigration nexus, which is why the nuanced case studies that comprise this Special Issue are worthwhile endeavours

Fracturing artefacts into 3D printable puzzles to enhance audience engagement with heritage collections

Three-dimensional (3D) puzzles of heritage artefacts are typically used to engage audiences in the interpretation of archaeological objects in a museum gallery. The reason for this is that a puzzle can be seen as an enjoyable educational activity in the form of a game but also as a complex activity that archaeologists undertake when re-assembling fragments, for instance, of broken pottery. Until now the creation of this type of experiences is mostly a manual process and the artefacts used rarely reflect those in the collection due to the complex nature of the process. The contribution of this article is a novel digital worfklow for the design and fabrication of 3D puzzles that overcomes these limitations. The input to the workflow is an authentic artefact from a heritage collection, which is then digitised using technologies such as 3D scanning and 3D modelling. Thereafter, a puzzle generator system produces the puzzle pieces using a cell fracture algorithm and generates a set of puzzle pieces (female) and a single core piece (male) for fabrication. Finally, the pieces are fabricated using 3D printing technology and post-processed to facilitate the puzzle assembly. To demonstrate the feasibility of the proposed novel workflow, we deployed it to create a puzzle activity of the Saltdean urn, which is exhibited at the Archaeology Gallery of the Brighton Museum and Art Gallery. The workflow is also used with further artefacts to demonstrate its applicability to other shapes. The significance of this research is that it eases the task of creating puzzle-like activities and maintaining them in the long term within a busy public space such as a museum gallery

Epidemiologic and clinical updates on impulse control disorders: a critical review

The article reviews the current knowledge about the impulse control disorders (ICDs) with specific emphasis on epidemiological and pharmacological advances. In addition to the traditional ICDs present in the DSM-IV—pathological gambling, trichotillomania, kleptomania, pyromania and intermittent explosive disorder—a brief description of the new proposed ICDs—compulsive–impulsive (C–I) Internet usage disorder, C–I sexual behaviors, C–I skin picking and C–I shopping—is provided. Specifically, the article summarizes the phenomenology, epidemiology and comorbidity of the ICDs. Particular attention is paid to the relationship between ICDs and obsessive–compulsive disorder (OCD). Finally, current pharmacological options for treating ICDs are presented and discussed

Links between management of a market garden and stormwater losses of sediment, nitrogen and phosphorus

Market gardening is commonly characterised by intensive cultivation, high inputs of both organic and inorganic fertilisers, chemical over/misuse, frequent irrigation, and a low degree of soil cover. While market gardening is readily perceived to be detrimental to waterways, there is remarkably little data to quantify the impacts. Soil and nutrient loss in stormwater runoff varies with soil type, climate and production systems. Therefore local data are needed to determine the impact of market gardening on the Hawkesbury-Nepean. This should lead to a better understanding of how land management influences runoff quantity and quality so that practices can be improved. Objectives of this research were to : quantify sediment, N and P loss and assess the implications for waterways; relate sediment, N and P losses to specific land management practices and assess their impacts on profitability; and, reflect on this research in terms of extension and adoption of better land management. An 8.8 ha property with 6.6 ha of market garden was used as a case study in the Hawkesbury-Nepean Catchment. Soil samples were collected at the beginning and end of the study. Sediment core samples were collected from the drainage channel. A rainfall simulator was used to compare runoff volume from green manure and bare fallow beds. The research produced several recommendations for the extension and adoption of improved land management. In order to reduce sediment, N and P losses in stormwater, the primary focus should be on improving soil and nutrient management, in particular matching fertiliser inputs more closely to nutrient requirements. The secondary focus should be on utilising structural measures, in particular farm dams, to prevent pollutants from entering waterways. The outcome should be decreased costs to the farmer and decreased impacts on waterways. The use of N-fixing green manure to decrease the use of poultry manure should be explored