The Ant mimic, Myrmarachne Plataleoides

Volume: XI

The evaluation of vesicoureteral reflux among children using contrast-enhanced ultrasound : a literature review

Q2Artículo de revisión1Introduction Voiding cystourethrogram (VCUG) with fluoroscopy remains the gold standard for detection and evaluation of vesicoureteral reflux (VUR) among children. However, the ionizing radiation exposure remains a concern for this diagnostic modality. Recent studies have proposed using contrast-enhanced ultrasound as an alternative option for VUR screening and follow-up in children. The aim of the study was to review the literature of comparative studies that assessed the diagnostic accuracy of contrast-enhanced ultrasound compared with VCUG. Methodology A systematic literature search was performed on electronic medical literature databases in July 2017. Literature identification, screening, and assessment of eligibility were performed by five reviewers with a pediatric radiologist. Literature was summarized for the study population, contrast used, and ultrasound mode as well as the timing of comparative reference study being performed. The studies were clustered according to the kind of contrast used. Reported diagnostic accuracy was extracted from individual studies and summarized across the included studies using descriptive statistics of median and interquartile range (IQR). Result A total of 45 comparative studies were identified as eligible for the summary of the literature. Two generations of ultrasound contrast were identified in the available studies (first generation, Levovist and second generation, SonoVue). For the ultrasound studies using the first-generation contrast, the median sensitivity, regardless of the ultrasound mode, was 90.25 (IQR 83.25–97), and the median specificity was 93 (IQR 91.3–95.25). Among studies using the second-generation contrast, the median sensitivity was 86.26 (IQR 81.13–97), and the median specificity was 90.99 (IQR 84–98). No serious adverse events were reported in any of the studies. Conclusion Overall, this review highlights the application of contrast-enhanced ultrasound for its advantage of no exposure to ionizing radiation and diagnostic accuracy relatively comparable to VCUG in the evaluation of VUR. In addition to the functional evaluation of the VUR, it also provides an anatomic evaluation of the kidneys and bladder with ultrasound imaging. However, one should also note that this alternate procedure is highly operator dependent where diagnostic accuracy is excellent when the expertise is available.Revista Internacional - Indexad

Electronic submission and the movement towards a paperless law office in a modern university

The Government’s target of 50% of all under 30 year olds studying at higher education institutions by 2010, coupled with the National Committee Inquiry into Higher Education’ (1997) concluding that further expansion of higher education could not be afforded under the existing funding arrangements, may have serious ramifications for higher education in the UK. Alongside this increase in numbers, students are increasingly seen as educational consumers with increased choice in a demand-led market which universities must recognise. To compete in this academic environment these institutions are having to be ever more consumer aware in the services they offer and are having to increase choice to attract customers from rival enterprises. Information technology is playing an increasing role in the learning experience as noted by institutional commentators such as the Higher Education Funding Council for England, the Joint Information Systems Committee, the Electronic Books ON-screen Interface group and Lord Dearing’s Report. Technology’s use is further evidenced through institutions’ employment of the internet, e-mail and web-based learning to harness the power of this medium. This paper focuses on the concept of commercialism in the university sector and how a movement to a paperless office may be one way in which a university could gain an early competitive advantage over its rivals. The paper takes a student perspective to demonstrate whether students would wish to move towards electronic methods of submission of assessed work and considers the current problems that are encountered in physical submission of documents. This is the first paper in an on-going research project investigating the benefits and viability of a paperless law office, and the results demonstrate both that the students desire more flexibility in submission of university work and that their acceptance may be the easy first step on the road to the paperless law school

Qualidade de silagens de bagaço úmido de laranja e cama de frango e desempenho de novilhos Canchim.

A qualidade de silagens de bagaço de laranja e cama-de-frango com diferentes proporções (80:20; 60:40; 40:60 e 20:80) e de silagem pura de cama-de-frango com diferentes teores de matéria seca, obtidos pela utilização de diferentes proporções de água e cama-de-frango (0:100; 15:85; 30:70 e 45:55) foram avaliadas em silos de laboratório. Uma silagem com 45:55 de cama-de-frango e bagaço de laranja foi utilizada para teste de ganho de peso com animais Canchim. Houve incremento (P<0,05) na porcentagem de MS, PB, pH, FDN, , cinzas, amônia, Ca e P com o aumento da proporções de cama-de-frango em relação ao bagaço de laranja. A silagem com 15:85 apresentou maior teor de PB e menor teor de amônia que as silagens com 30:70 e 45:55. A dieta com silagem de bagaço de laranja e cama-de-frango, cana-de-açúcar e concentrado (44:36:20), na base seca, permitiu consumo adequado para ganho de peso de 1,39 kg por dia

Avaliação de estirpes de rizóbio para a cultura do feijão-caupi em Roraima.

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Alpha-defensin and the Synovasure lateral flow device for the diagnosis of prosthetic joint infection: a systematic review and meta-analysis

AimsThe aim of this review is to evaluate the available literature and to calculate a pooled diagnostic sensitivity and specificity for the different alpha-defensin test systems to diagnose peri-prosthetic infection.Materials and MethodsStudies using alpha-defensin or Synovasure to diagnose periprosthetic joint infection were identified from systematic searches of electronic databases. Study quality was evaluated using the QUADAS tool. Meta-analysis was completed using a bivariate model.ResultsEleven eligible studies were included. Median QUADAS score was 13 [I.Q.R. 13-13] out of 14. Significant conflicts of interest were identified in five studies. Pooled sensitivity for the laboratory alpha-defensin test was 0.95 (95% CI 0.91-0.98) and specificity 0.97 (95% CI 0.95-0.98) for four studies with a threshold level of 5.2mgl-a. Pooled sensitivity for the lateral flow cassette test was 0.85 (95% CI 0.74-0.92) and specificity was 0.90 (95% CI 0.91-0.98). There was a statistically significant difference in sensitivity but not specificity.ConclusionLaboratory based alpha-defensin testing remains a promising tool for diagnosing periprosthetic joint infection. The lateral flow cassette has a significantly lower performance and pooled results are comparable to the leucocyte esterase test. Further studies are essential before the widespread adoption of the lateral flow cassette alpha-defensin test. Take home messageAlpha defensin testing for periprosthetic joint infection has excellent sensitivity and specificity when performed in a laboratory. The pooled sensitivity and specificity is much lower when results are combined for the lateral flow cassette (Synovasure devise

An ionizable supramolecular dendrimer nanosystem for effective siRNA delivery with a favorable safety profile

Gene therapy using small interfering RNA (siRNA) is emerging as a novel therapeutic approach to treat various diseases. However, safe and efficient siRNA delivery still constitutes the major obstacle for clinical implementation of siRNA therapeutics. Here we report an ionizable supramolecular dendrimer vector, formed via self-assembly of a small amphiphilic dendrimer, as an effective siRNA delivery system with a favorable safety profile. By virtue of the ionizable tertiary amine terminals, the supramolecular dendrimer has a low positively charged surface potential and no notable cytotoxicity at physiological pH. Nonetheless, this ionizable feature imparted sufficient surface charge to the supramolecular dendrimer to enable formation of a stable complex with siRNA via electrostatic interactions. The resulting siRNA/dendrimer delivery system had a surface charge that was neither neutral, thus avoiding aggregation, nor too high, thus avoiding cytotoxicity, but was sufficient for favorable cellular uptake and endosomal release of the siRNA. When tested in different cancer cell lines and patient-derived cancer organoids, this dendrimer-mediated siRNA delivery system effectively silenced the oncogenes Myc and Akt2 with a potent antiproliferative effect, outperforming the gold standard vector, Lipofectamine 2000. Therefore, this ionizable supramolecular dendrimer represents a promising vector for siRNA delivery. The concept of supramolecular dendrimer nanovectors via self-assembly is new, yet easy to implement in practice, offering a new perspective for supramolecular chemistry in biomedical applications. [Figure not available: see fulltext.

Seizure first aid training for people with Epilepsy (SAFE) frequently attending emergency departments and their significant others : results of a UK multi-centre randomised controlled pilot trial

Objective To determine the feasibility and optimal design of a randomised controlled trial (RCT) of Seizure First Aid Training For Epilepsy (SAFE). Design Pilot RCT with embedded microcosting. Setting Three English hospital emergency departments (EDs). Participants Patients aged ≥16 with established epilepsy reporting ≥2 ED visits in the prior 12 months and their significant others (SOs). Interventions Patients (and their SOs) were randomly allocated (1:1) to SAFE plus treatment-as-usual (TAU) or TAU alone. SAFE is a 4-hour group course. Main outcome measures Two criteria evaluated a definitive RCT’s feasibility: (1) ≥20% of eligible patients needed to be consented into the pilot trial; (2) routine data on use of ED over the 12 months postrandomisation needed securing for ≥75%. Other measures included eligibility, ease of obtaining routine data, availability of self-report ED data and comparability, SAFE’s effect and intervention cost. Results Of ED attendees with a suspected seizure, 424 (10.6%) patients were eligible; 53 (12.5%) patients and 38 SOs consented. Fifty-one patients (and 37 SOs) were randomised. Routine data on ED use at 12 months were secured for 94.1% patients. Self-report ED data were available for 66.7% patients. Patients reported more visits compared with routine data. Most (76.9%) patients randomised to SAFE received it and no related serious adverse events occurred. ED use at 12 months was lower in the SAFE+TAU arm compared with TAU alone, but not significantly (rate ratio=0.62, 95% CI 0.33 to 1.17). A definitive trial would need ~674 patient participants and ~39 recruitment sites. Obtaining routine data was challenging, taking ~8.5 months. Conclusions In satisfying only one predetermined ‘stop/go’ criterion, a definitive RCT is not feasible. The low consent rate in the pilot trial raises concerns about a definitive trial’s finding’s external validity and means it would be expensive to conduct. Research is required into how to optimise recruitment from the target population

An Overview of the 2014 ALMA Long Baseline Campaign

A major goal of the Atacama Large Millimeter/submillimeter Array (ALMA) is to make accurate images with resolutions of tens of milliarcseconds, which at submillimeter (submm) wavelengths requires baselines up to ~15 km. To develop and test this capability, a Long Baseline Campaign (LBC) was carried out from September to late November 2014, culminating in end-to-end observations, calibrations, and imaging of selected Science Verification (SV) targets. This paper presents an overview of the campaign and its main results, including an investigation of the short-term coherence properties and systematic phase errors over the long baselines at the ALMA site, a summary of the SV targets and observations, and recommendations for science observing strategies at long baselines. Deep ALMA images of the quasar 3C138 at 97 and 241 GHz are also compared to VLA 43 GHz results, demonstrating an agreement at a level of a few percent. As a result of the extensive program of LBC testing, the highly successful SV imaging at long baselines achieved angular resolutions as fine as 19 mas at ~350 GHz. Observing with ALMA on baselines of up to 15 km is now possible, and opens up new parameter space for submm astronomy.Comment: 11 pages, 7 figures, 2 tables; accepted for publication in the Astrophysical Journal Letters; this version with small changes to affiliation