Subarachnoid Hemorrhage from Posterior Cerebral Artery Aneurysm during Puerperium – Case Report and Review of Literature

Subarachnoid hemorrhages (SAH) due to true aneurysms of the Posterior Cerebral Artery (PCA) during puerperium in young and healthy females are extremely rare. We present the case of a 31-year old, healthy woman that experienced a spontaneous SAH due to a PCA aneurysm, arising from the P3 segment, 9 days post-delivery. The aneurysm was successfully treated via an endovascular approach and the patient recovered well. After 21 days she was discharged from hospital without neurological deficits. The clinical course is described in detail and illustrated with a computed tomography scan (CT) and digital subtraction angiography (DSA) pre – and post-embolization. The literature is reviewed and possible etiologies of the formation and rupture of the aneurysm are discussed

Restorative Justice Impact on Multinational Corporations?: A Response to Andrew Brady Spalding's Article

In response to Andrew Brady Spalding, Restorative Justice for Multinational Corporations, 76 Ohio St. L.J. 357 (2015)

Charakterisierung von microRNA-Profilen im Myokard von Neugeborenen und Kindern mit angeborenen Herzfehlern vor und nach Herz-Lungen-Maschine

Bei Neugeborenen und Kindern, die aufgrund ihres angeborenen Herzfehlers einer kardiochirurgischen Operation unter Einsatz der Herz-Lungen-Maschine bedürfen, birgt der operative Eingriff das Risiko einer erhöhten Mortalität aufgrund eines Myo-kardversagens. Die zugrunde liegenden Pathomechanismen sind bisher weitestge-hend unbekannt. Die erheblichen physiologischen Veränderungen unter Einsatz der Herz-Lungen-Maschine bewirken jedoch eine signifikante Änderung vieler molekula-rer Prozesse im Myokard. MicroRNAs können Veränderungen in diesen molekular-genetischen Prozessen unmittelbar anzeigen. Neueste Studien schreiben microR-NAs eine zunehmende Bedeutung bei der Entstehung kongenitaler und erworbener kardiovaskulärer Erkrankungen zu. Darüber hinaus sind diese nicht kodierenden Sequenzen auch an der myokardialen Adaptation und dem Remodeling beteiligt. Inwieweit die Expression von microRNAs im Myokard von Neugeborenen und Kin-dern mit angeborenen Herzfehlern im Zusammenhang mit diesen Prozessen steht, ist jedoch unbekannt. Daher ist das Ziel dieser Studie, die microRNA-Expression im Myokard von Neugeborenen und Kindern vor und nach kardiochirurgischen Eingrif-fen unter Einsatz der Herz-Lungen-Maschine zu charakterisieren und zu verglei-chen. Diese Studie wird an insgesamt 14 Neugeborenen und Kindern mit angeborenen Herzfehlern am Universitätsklinikum des Saarlandes durchgeführt. Hierzu wird von jedem Studienteilnehmer eine Myokardprobe aus dem rechten Vorhof jeweils vor Anschluss und nach Dekonnektion der Herz-Lungen-Maschine entnommen, aus denen die microRNA-Expression mittels Microarray und RT-qPCR analysiert wird. Außerdem wird eine Signalweg Analyse durchgeführt, um Signalwege und Zielgene der verändert exprimierten microRNAs zu identifizieren. Die Auswertung mittels Microarray ergibt 90 microRNAs im Myokard, die nach Ein-satz der Herz-Lungen-Maschine verändert exprimiert werden. Von diesen 90 microRNAs werden nach Einsatz der Herz-Lungen-Maschine 29 microRNAs ver-mehrt und 61 microRNAs vermindert exprimiert. Diese Ergebnisse können für sie-ben microRNAs (miR-210, miR-423, miR-143, miR-564, miR-770, miR-874, miR-93) mittels RT-qPCR bestätigt werden. Die von uns identifizierten Signalwege werden u.a. mit dem kardiovaskulären System sowie der Differenzierung und Proliferation von Kardiomyozyten assoziiert. Die Ergebnisse unserer Studie stützen also die Vermutung, dass microRNAs, neben den bereits bekannten kardiovaskulären Pathologien, auch Veränderungen auf mo-lekulargenetischer Ebene in Form von Hoch- oder Herunterregulierung anzeigen. Aufgrund der jedoch nur geringen Teilnehmerzahl und der heterogenen Patienten-population sind weitere Studien notwendig, um genauere Aussagen über Auswir-kungen der microRNA-Expressionsänderung im Myokard nach Herz-Lungen-Maschine treffen zu können.Differential expression of microRNAs following cardiopulmonary by-pass in children with congenital heart diseases “Children with congenital heart defects (CHDs) are at high risk for myocardial failure after operative procedures with cardiopulmonary bypass (CPB). Recent studies suggest that microRNAs (miRNA) are involved in the development of CHDs and myocardial failure. Therefore, the aim of this study was to determine alterations in the miRNA profile in heart tissue after cardiac surgery using CPB. In total, 14 tissue samples from right atrium were collected from patients before and after connection of the CPB. SurePrint™ 8 × 60K Human v21 miRNA array and quantitative reverse transcription-polymerase chain reaction (RT-qPCR) were employed to determine the miRNA expression profile from three patients before and after connection of the CPB. Enrichment analyses of altered miRNA expression were predicted using bioin-formatic tools. According to miRNA array, a total of 90 miRNAs were significantly altered including 29 miRNAs with increased and 61 miRNAs with decreased expres-sion after de-connection of CPB (n = 3) compared to before CPB (n = 3). Seven miRNAs had been validated using RT-qPCR in an independent cohort of 11 pa-tients. Enrichment analyses applying the KEGG database displayed the highest cor-relation for signaling pathways, cellular community, cardiovascular disease and cir-culatory system. Our result identified the overall changes of the miRNome in right atrium tissue of patients with CHDs after CPB. The differentially altered miRNAs lay a good founda-tion for further understanding of the molecular function of changed miRNAs in regu-lating CHDs and after CPB in particular.”

A practical approach to monitoring nutrient supplement intake of Australian adults

The adoption, in mid-1995, of the revised food Standard A9, which permits the more liberal addition of nutrients to a range of food products, highlighted the need to obtain information on nutrient intake from supplements to complement the i 995 National Nutrition Survey data on nutrient intake from food. This paper describes the method used to obtain quantitative information on nutrient supplement intake and reports on the prevalence of supplement use in different subgroups of the Australian population. Information on supplement intake was obtained in two Australian Bureau of Statistics Population Survey Monitor surveys in August 1995 and February 1996 using the Therapeutic Goods Administration (TGA) registration numbers to identify individual products. Approximately 18% of men and 29% of women aged 18 years and over reported consuming a nutrient supplement on the day before the survey and these proportions increased to 25% and 35% respectively for consumption during the two weeks before the survey. The prevalence of supplement intake increased with age, education level, socioeconomic status, employment status and with fruit and vegetable intake. The substantial proportion of Australian adults who consume nutrient supplements, and the rapidly changing composition of the Australian food supply in response to changes in food regulation, indicate that there is a need for regular monitoring of nutrient intake from supplements. The use of TGA registration numbers to identify supplements provides a practical way to address this need.<br /

Data-driven optimization of seismicity models using diverse data sets: generation, evaluation and ranking using inlabru

Recent developments in earthquake forecasting models have demonstrated the need for a robust method for identifying which model components are most beneficial to understanding spatial patterns of seismicity. Borrowing from ecology, we use Log‐Gaussian Cox process models to describe the spatially varying intensity of earthquake locations. These models are constructed using elements which may influence earthquake locations, including the underlying fault map and past seismicity models, and a random field to account for any excess spatial variation that cannot be explained by deterministic model components. Comparing the alternative models allows the assessment of the performance of models of varying complexity composed of different components and therefore identifies which elements are most useful for describing the distribution of earthquake locations. We demonstrate the effectiveness of this approach using synthetic data and by making use of the earthquake and fault information available for California, including an application to the 2019 Ridgecrest sequence. We show the flexibility of this modeling approach and how it might be applied in areas where we do not have the same abundance of detailed information. We find results consistent with existing literature on the performance of past seismicity models that slip rates are beneficial for describing the spatial locations of larger magnitude events and that strain rate maps can constrain the spatial limits of seismicity in California. We also demonstrate that maps of distance to the nearest fault can benefit spatial models of seismicity, even those that also include the primary fault geometry used to construct them.K. B. was funded during this work by an EPSRC PhD studentship (Grant 1519006) and during the writing of this paper by NERC‐NSF grant NE/R000794/1 and by the Real‐time Earthquake Risk Reduction for a Resilient Europe "RISE" project, which has received funding from the European Union's Horizon 2020 research and innovation program under grant Agreement 821115

Principles for Responsibility Sharing: Proximity, Culpability, Moral Accountability, and Capability

In this Essay, we explore how responsibility based on culpability, moral accountability, and capability can improve the current regime that rests on responsibility by proximity. In doing so, we draw on the 2017 Model International Mobility Convention (MIMC), a model convention drafted by a commission of independent experts and currently supported as a project of the Carnegie Council for Ethics in International Affairs

An Application of Multi-band Forced Photometry to One Square Degree of SERVS: Accurate Photometric Redshifts and Implications for Future Science

We apply The Tractor image modeling code to improve upon existing multi-band photometry for the Spitzer Extragalactic Representative Volume Survey (SERVS). SERVS consists of post-cryogenic Spitzer observations at 3.6 and 4.5 micron over five well-studied deep fields spanning 18 square degrees. In concert with data from ground-based near-infrared (NIR) and optical surveys, SERVS aims to provide a census of the properties of massive galaxies out to z ~ 5. To accomplish this, we are using The Tractor to perform "forced photometry." This technique employs prior measurements of source positions and surface brightness profiles from a high-resolution fiducial band from the VISTA Deep Extragalactic Observations (VIDEO) survey to model and fit the fluxes at lower-resolution bands. We discuss our implementation of The Tractor over a square degree test region within the XMM-LSS field with deep imaging in 12 NIR/optical bands. Our new multi-band source catalogs offer a number of advantages over traditional position-matched catalogs, including 1) consistent source cross-identification between bands, 2) de-blending of sources that are clearly resolved in the fiducial band but blended in the lower-resolution SERVS data, 3) a higher source detection fraction in each band, 4) a larger number of candidate galaxies in the redshift range 5 < z < 6, and 5) a statistically significant improvement in the photometric redshift accuracy as evidenced by the significant decrease in the fraction of outliers compared to spectroscopic redshifts. Thus, forced photometry using The Tractor offers a means of improving the accuracy of multi-band extragalactic surveys designed for galaxy evolution studies. We will extend our application of this technique to the full SERVS footprint in the future.Comment: accepted to ApJ, 22 pages, 12 figure

Protocol for a systematic review of the impact of resuscitation fluids on the microcirculation after haemorrhagic shock in animal models

BACKGROUND: Modern resuscitation strategies following haemorrhagic shock are influenced by global haemodynamic parameters such as blood pressure and cardiac output. Microcirculatory dysfunction in this context may persist even after restoration of satisfactory global parameters. Additional monitoring of the microcirculatory function may therefore be warranted in order to facilitate goal-directed therapy at a tissue oxygenation level. Although such a phenomenon is recognised in the case of sepsis, clinical evidence regarding the behaviour of the microcirculation following the delivery of resuscitation fluids after haemorrhagic shock is sparse. A summation of the current state of pre-clinical evidence is justified in order to direct avenues for future clinical research. METHODS/DESIGN: Systematic review methodology will be utilised in order to identify relevant studies, assess for bias, and extract data for analysis. Medical databases will be searched to find pre-clinical studies that monitor the microcirculatory function following haemorrhagic shock and subsequent fluid resuscitation. Different fluid types (e.g. blood products, crystalloid, and colloid fluids) will be compared. The search strategy will combine terms for the animal model, resuscitation fluid, and microcirculatory parameters. Randomised and non-randomised experiments, as well as case series, will be eligible for inclusion. Specific quality assessment tools for pre-clinical research will be used depending on study design. A combination of narrative and meta-analysis techniques will be used for the synthesis of data. DISCUSSION: The choice of type, sequence, and quantity of resuscitation fluid following haemorrhagic shock is controversial, and the optimal strategy for restoration of microcirculatory function is yet unknown. A detailed examination of pre-clinical data regarding the microcirculation is timely and will enable a focussed approach to clinical research for the improvement of resuscitation following haemorrhagic shock. SYSTEMATIC REVIEW REGISTRATION: Collaborative Approach to Meta Analysis and Review of Animal Data from Experimental Studies (CAMARADES) ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13643-015-0113-4) contains supplementary material, which is available to authorized users