Characteristics of abdominal vein thrombosis in children and adults

The demographic and clinical characteristics of adults and children with lower extremity deep-vein thrombosis and/or pulmonary embolism (LE DVT/PE) may differ from those with abdominal vein thrombosis (abdominal VT). Abdominal VT can be a presenting sign of an underlying prothrombotic state, and its presence in the setting of known disease might have prognostic implications different from LE DVT/PE. This study describes clinical presentations of abdominal VT compared to LE DVT/PE in adults and children. We analysed prospec-tively-collected data from consecutive consenting patients enrolled in one of seven Centers for Disease Control and Prevention (CDC) funded Thrombosis and Hemostasis Network Centers from August 2003 to April 2011 to compare the demographic and clinical characteristics of adults and children with abdominal VT. Both adults and children with abdominal VT tended to be younger and have a lower body mass index (BMI) than those with LE DVT/PE. Of patients with abdominal V T, children were more likely to have inferior vena cava (IVC) thrombosis than adults. For adults with venous thromboembolism (VTE), relatively more women had abdominal VT than LE DVT/PE, while the proportions with LE DVT/PE and abdominal VT by sex were similar in children. Children with abdominal VT were more likely to have diagnosed inherited thrombophilia, while trauma was more common in children with LE DVT/PE. In conclusion, both children and adults with abdominal VT were younger with a lower BMI than those with LE DVT/ PE. Significant differences exist between children and adults in respect to abdominal VT compared to LE DVT/PE

Advancing an interdisciplinary framework to study seed dispersal ecology

Although dispersal is generally viewed as a crucial determinant for the fitness of any organism, our understanding of its role in the persistence and spread of plant populations remains incomplete. Generalizing and predicting dispersal processes are challenging due to context dependence of seed dispersal, environmental heterogeneity and interdependent processes occurring over multiple spatial and temporal scales. Current population models often use simple phenomenological descriptions of dispersal processes, limiting their ability to examine the role of population persistence and spread, especially under global change. To move seed dispersal ecology forward, we need to evaluate the impact of any single seed dispersal event within the full spatial and temporal context of a plant’s life history and environmental variability that ultimately influences a population’s ability to persist and spread. In this perspective, we provide guidance on integrating empirical and theoretical approaches that account for the context dependency of seed dispersal to improve our ability to generalize and predict the consequences of dispersal, and its anthropogenic alteration, across systems. We synthesize suitable theoretical frameworks for this work and discuss concepts, approaches and available data from diverse subdisciplines to help operationalize concepts, highlight recent breakthroughs across research areas and discuss ongoing challenges and open questions. We address knowledge gaps in the movement ecology of seeds and the integration of dispersal and demography that could benefit from such a synthesis. With an interdisciplinary perspective, we will be able to better understand how global change will impact seed dispersal processes, and potential cascading effects on plant population persistence, spread and biodiversity

Do little embryos make big decisions? How maternal dietary protein restriction can permanently change an embryo's potential, affecting adult health

Periconceptional environment may influence embryo development, ultimately affecting adult health. Here, we review the rodent model of maternal low-protein diet specifically during the preimplantation period (Emb-LPD) with normal nutrition during subsequent gestation and postnatally. This model, studied mainly in the mouse, leads to cardiovascular, metabolic and behavioural disease in adult offspring, with females more susceptible. We evaluate the sequence of events from diet administration that may lead to adult disease. Emb-LPD changes maternal serum and/or uterine fluid metabolite composition, notably with reduced insulin and branched-chain amino acids. This is sensed by blastocysts through reduced mammalian target of rapamycin complex 1 signalling. Embryos respond by permanently changing the pattern of development of their extra-embryonic lineages, trophectoderm and primitive endoderm, to enhance maternal nutrient retrieval during subsequent gestation. These compensatory changes include stimulation in proliferation, endocytosis and cellular motility, and epigenetic mechanisms underlying them are being identified. Collectively, these responses act to protect fetal growth and likely contribute to offspring competitive fitness. However, the resulting growth adversely affects long-term health because perinatal weight positively correlates with adult disease risk. We argue that periconception environmental responses reflect developmental plasticity and 'decisions' made by embryos to optimise their own development, but with lasting consequences

Proposed Standards for Medical Education Submissions to the Journal of General Internal Medicine

To help authors design rigorous studies and prepare clear and informative manuscripts, improve the transparency of editorial decisions, and raise the bar on educational scholarship, the Deputy Editors of the Journal of General Internal Medicine articulate standards for medical education submissions to the Journal. General standards include: (1) quality questions, (2) quality methods to match the questions, (3) insightful interpretation of findings, (4) transparent, unbiased reporting, and (5) attention to human subjects’ protection and ethical research conduct. Additional standards for specific study types are described. We hope these proposed standards will generate discussion that will foster their continued evolution

A View from the Top: International Politics, Norms and the Worldwide Growth of NGOs

This article provides a top-down explanation for the rapid growth of nongovernmental organizations (NGOs) in the postwar period, focusing on two aspects of political globalization. First, I argue that international political opportunities in the form of funding and political access have expanded enormously in the postwar period and provided a structural environment highly conducive to NGO growth. Secondly, I present a norm-based argument and trace the rise of a pro-NGO norm in the 1980s and 1990s among donor states and intergovernmental organizations (IGOs), which has actively promoted the spread of NGOs to non-Western countries. The article ends with a brief discussion of the symbiotic relationship among NGOs, IGOs, and states promoting international cooperation

The impact of women's social position on fertility in developing countries

This paper examines ideas about possible ways in which the extent of women's autonomy, women's economic dependency, and other aspects of their position vis-à-vis men influence fertility in Third World populations. Women's position or “status” seems likely to be related to the supply of children because of its links with age at marriage. Women's position may also affect the demand for children and the costs of fertility regulation, though some connections suggested in the literature are implausible. The paper ends with suggestions for future research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45660/1/11206_2005_Article_BF01124382.pd

Low damage etching and deposition of electronic materials with a novel RF plasma source

Plasmas and ion beams produced from plasma are widely used in the processing, etching and deposition, of semiconductor materials. In spite of this, there are many problems with their use with the more delicate, modern materials, such as the III-Vs, which are damaged by the high energy ions created in the plasma. A novel configuration of a capacitively coupled radio-frequency source was designed and constructed, to overcome these problems. Such a novel source was characterised, and was shown to produce a beam of ions of sufficiently low energy as to avoid causing damage. The source was used to etch GaAs in both Reactive Ion Beam Etching and Chemically Assisted Ion Beam Etching configurations, and Schottky diodes were manufactured on the etched surfaces. Analysis of the characteristics of the diodes showed that a damage free etch had been achieved. The growth of diamond films by Plasma Assisted Chemical Vapour Deposition requires a high plasma density with a low ion energy. To achieve this, commonly microwave plasmas are employed, but there are drawbacks to the use of microwaves, chiefly with regard to "scale-up", and also safety. A development of the novel source used in the early part of this study, led to many of the required plasma characteristics but without the drawbacks. The source was used to grow diamond films, the first successful diamond growth with a capacitive rf source, which were characterised by SEM analysis and Raman spectroscopy

Snoring and carotid artery disease: A new risk factor emerges

OBJECTIVES/HYPOTHESIS: Previous studies have identified a relationship between snoring, carotid intima media thickening, and the presence of atherosclerosis. This study examines the correlation between snoring and carotid artery disease through use of duplex ultrasound identifying greater than 50% internal carotid artery stenosis. STUDY DESIGN: Prospective cohort study. METHODS: Patients presenting to three academic vascular laboratories for carotid duplex examination completed the following surveys: demographic information, assessment of risk factors for carotid stenosis, assessment of history of obstructive sleep apnea, or continuous positive airway pressure use and Snoring Outcomes Survey. Patients were categorized into 2 groups based on the presence or absence of carotid disease. Data were analyzed by univariate contingency tables and logistic regression analysis. RESULTS: Five hundred one patients completed the survey, of whom 243/501 (49%) had evidence of carotid occlusive disease. On univariate analysis, smoking, hypertension, heart disease, hypercholesterolemia, diabetes, and stroke all correlated with greater than 50% carotid stenosis. Multivariate analysis indicated that snorers were significantly more likely to have carotid disease. Three hundred twenty-seven participants were thought to have primary snoring. On univariate analysis, snorers were found to be significantly more likely to have carotid disease. After adjustment for covariates, snoring was not significant for carotid disease. However, multivariate analysis showed snorers to be significantly more likely to have bilateral carotid disease. CONCLUSIONS: This study shows a potential relationship between snoring and bilateral carotid artery stenosis greater than 50%; snorers have risk of carotid stenosis twice that of nonsnorers. Further investigation is warranted to better elucidate this relationship. LEVEL OF EVIDENCE: 2b Laryngoscope, 129:265-268, 2019

Snoring and carotid artery disease: A new risk factor emerges

OBJECTIVES/HYPOTHESIS: Previous studies have identified a relationship between snoring, carotid intima media thickening, and the presence of atherosclerosis. This study examines the correlation between snoring and carotid artery disease through use of duplex ultrasound identifying greater than 50% internal carotid artery stenosis. STUDY DESIGN: Prospective cohort study. METHODS: Patients presenting to three academic vascular laboratories for carotid duplex examination completed the following surveys: demographic information, assessment of risk factors for carotid stenosis, assessment of history of obstructive sleep apnea, or continuous positive airway pressure use and Snoring Outcomes Survey. Patients were categorized into 2 groups based on the presence or absence of carotid disease. Data were analyzed by univariate contingency tables and logistic regression analysis. RESULTS: Five hundred one patients completed the survey, of whom 243/501 (49%) had evidence of carotid occlusive disease. On univariate analysis, smoking, hypertension, heart disease, hypercholesterolemia, diabetes, and stroke all correlated with greater than 50% carotid stenosis. Multivariate analysis indicated that snorers were significantly more likely to have carotid disease. Three hundred twenty-seven participants were thought to have primary snoring. On univariate analysis, snorers were found to be significantly more likely to have carotid disease. After adjustment for covariates, snoring was not significant for carotid disease. However, multivariate analysis showed snorers to be significantly more likely to have bilateral carotid disease. CONCLUSIONS: This study shows a potential relationship between snoring and bilateral carotid artery stenosis greater than 50%; snorers have risk of carotid stenosis twice that of nonsnorers. Further investigation is warranted to better elucidate this relationship. LEVEL OF EVIDENCE: 2b Laryngoscope, 129:265-268, 2019