A 7-year follow-up of sacral anterior root stimulation for bladder control in patients with a spinal cord injury: quality of life and users' experiences\ud

Study design: Cross-sectional descriptive study.\ud \ud Objectives: To assess long-term effects and quality of life (QoL) of using sacral anterior root stimulation (SARS) in spinal cord injured patients.\ud \ud Setting: Neurosurgical and Urological Departments of a large teaching hospital and a large rehabilitation centre in the Netherlands.\ud \ud Methods: In all, 42 patients with complete spinal cord injury (SCI) implanted between 1987 and 2000 were included. A questionnaire was constructed to determine complications, technical failures and personal experiences of the patients. The Qualiveen questionnaire was used and the outcome was compared with data obtained from a reference group of 400 SCI patients with neurogenic bladder problems not using the bladder controller. The Qualiveen questionnaire measures disease-specific aspects in four domains with respect to limitations, constraints, fears and feelings and general QoL aspects, suitable for use in SCI patients with urinary disorders.\ud \ud Results: The results of 37 patients are presented. Our results with the bladder controller with respect to medical and technical complications and infection rates are similar to the results presented by others. From users' experiences, the most important advantages reported were a decreased infection rate (68%), improved social life (54%) and continence (54%). Comparison of the obtained results of our patient group with the Qualiveen questionnaire with a reference group not using the bladder controller indicates that the specific impact of urinary disorders in the four domains on QoL is reduced and that general QoL is improved.\ud \ud Conclusion: SARS is effective and safe for neurogenic bladder management in patients with complete SCI. Users' experiences are positive. Furthermore, this therapy seems to reduce the effects of urinary-disorder-specific QoL aspects, and to increase the QoL in general\u

Reverse mathematics, well-quasi-orders, and Noetherian spaces

A quasi-order Q induces two natural quasi-orders on P(Q) P(Q) , but if Q is a well-quasi-order, then these quasi-orders need not necessarily be well-quasi-orders. Nevertheless, Goubault-Larrecq (Proceedings of the 22nd Annual IEEE Symposium 4 on Logic in Computer Science (LICS’07), pp. 453–462, 2007) showed that moving from a well-quasi-order Q to the quasi-orders on P(Q) P(Q) preserves well-quasi-orderedness in a topological sense. Specifically, Goubault-Larrecq proved that the upper topologies of the induced quasi-orders on P(Q) P(Q) are Noetherian, which means that they contain no infinite strictly descending sequences of closed sets. We analyze various theorems of the form “if Q is a well-quasi-order then a certain topology on (a subset of) P(Q) P(Q) is Noetherian” in the style of reverse mathematics, proving that these theorems are equivalent to ACA0 over RCA0. To state these theorems in RCA0 we introduce a new framework for dealing with second-countable topological spaces

Scintigraphic assessment of bone status at one year following hip resurfacing : comparison of two surgical approaches using SPECT-CT scan

Objectives: To study the vascularity and bone metabolism of the femoral head/neck following hip resurfacing arthroplasty, and to use these results to compare the posterior and the trochanteric-flip approaches. Methods: In our previous work, we reported changes to intra-operative blood flow during hip resurfacing arthroplasty comparing two surgical approaches. In this study, we report the vascularity and the metabolic bone function in the proximal femur in these same patients at one year after the surgery. Vascularity and bone function was assessed using scintigraphic techniques. Of the 13 patients who agreed to take part, eight had their arthroplasty through a posterior approach and five through a trochanteric-flip approach. Results: One year after surgery, we found no difference in the vascularity (vascular phase) and metabolic bone function (delayed phase) at the junction of the femoral head/neck between the two groups of patients. Higher radiopharmaceutical uptake was found in the region of the greater trochanter in the trochanteric-flip group, related to the healing osteotomy. Conclusions: Our findings using scintigraphic techniques suggest that the greater intra-operative reduction in blood flow to the junction of the femoral head/neck, which is seen with the posterior approach compared with trochanteric flip, does not result in any difference in vascularity or metabolic bone function one year after surgery

The history of the development of wireless telegraphy and broadcasting in Australia to 1942, with especial reference to the Australian Broadcasting Commission : a political and administrative study

Licences are a crucial aspect of the information publishing process in the web of (linked) data. Recent work on modeling of policies with semantic web languages (RDF, ODRL) gives the opportunity to formally describe licences and reason upon them. However, choosing the right licence is still challenging. Particularly, understanding the number of features - permissions, prohibitions and obligations - constitute a steep learning process for the data provider, who has to check them individ- ually and compare the licences in order to pick the one that better fits her needs. The objective of the work presented in this paper is to reduce the effort required for licence selection. We argue that an ontology of licences, organized by their relevant features, can help providing support to the user. Developing an ontology with a bottom-up approach based on Formal Concept Analysis, we show how the process of licence selection can be simplified significantly and reduced to answering an average of three/five key questions

Islet isolation assessment in man and large animals

Recent progress in islet isolation from the pancreas of large mammals including man, accentuated the need for the development of precise and reproducible techniques to assess islet yield. In this report both quantitative and qualitative criteria for islet isolation assessment were discussed, the main topics being the determination of number, volume, purity, morphologic integrity and in vitro and in vivo function tests of the final islet preparations. It has been recommended that dithizone should be used as a specific stain for immediate detection of islet tissue making it possible to estimate both the total number of islets (dividing them into classes of 50 μ diameter range increments) and the purity of the final preparation. Appropriate morphological assessment should include confirmation of islet identification, assessment of the morphological integrity and of the purity of the islet preparation. The use of fluorometric inclusion and exclusion dyes together have been suggested as a viability assay to simultaneously quantitate the proportion of cells that are intact or damaged. Perifusion of islets with glucose provides a dynamic profile of glucose-mediated insulin release and of the ability of the cells to down regulate insulin secretion after the glycemic challenge is interrupted. Although perifusion data provides a useful guide to islet viability the quantity and kinetics of insulin release do not necessarily predict islet performance after implantation. Therefore, the ultimate test of islet viability is their function after transplantation into a diabetic recipient. For this reason, in vivo models of transplantation of an aliquot of the final islet preparation into diabetic nude (athymic) rodents have been suggested. We hope that these general guidelines will be of assistance to standardize the assessment of islet isolations, making it possible to better interpret and compare procedures from different centers. © 1990 Casa Editrice il Ponte

Multiple volcanic episodes of flood basalts caused by thermochemical mantle plumes

The hypothesis that a single mushroom-like mantle plume head can generate a large igneous province within a few million years has been widely accepted(1). The Siberian Traps at the Permian Triassic boundary(2) and the Deccan Traps at the Cretaceous Tertiary boundary(3) were probably erupted within one million years. These large eruptions have been linked to mass extinctions. But recent geochronological data(4-11) reveal more than one pulse of major eruptions with diverse magma flux within several flood basalts extending over tens of million years. This observation indicates that the processes leading to large igneous provinces are more complicated than the purely thermal, single-stage plume model suggests. Here we present numerical experiments to demonstrate that the entrainment of a dense eclogite-derived material at the base of the mantle by thermal plumes can develop secondary instabilities due to the interaction between thermal and compositional buoyancy forces. The characteristic timescales of the development of the secondary instabilities and the variation of the plume strength are compatible with the observations. Such a process may contribute to multiple episodes of large igneous provinces.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62705/1/nature03697.pd

Clinical Implications of Azole Resistance in Aspergillus fumigatus, the Netherlands, 2007-2009

Contains fulltext : 95722.pdf (publisher's version ) (Open Access)The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp. isolates were screened for itraconazole resistance. In total, 2,062 isolates from 1,385 patients were screened; the prevalence of itraconazole resistance in A. fumigatus in our patient cohort was 5.3% (range 0.8%-9.5%). Patients with a hematologic or oncologic disease were more likely to harbor an azole-resistant isolate than were other patient groups (p<0.05). Most patients (64.0%) from whom a resistant isolate was identified were azole naive, and the case-fatality rate of patients with azole-resistant invasive aspergillosis was 88.0%. Our study found that multiazole resistance in A. fumigatus is widespread in the Netherlands and is associated with a high death rate for patients with invasive aspergillosis

Land manager perspectives on conflict mitigation strategies for urban flying-fox camps

Over the last 20 years, there has been a notable increase in the presence of flying-foxes(Pteropodidae) in urban areas in Australia. Flying-foxes congregate during the day in camps which at times may contain many thousands of individuals. The associated noise, smell, mess and concerns about disease transmission can result in significant conflict with local communities. Managers of flying-fox camps use a range of management approaches to mitigate tensions, but the success or otherwise of these has been largely undocumented. Land managers were surveyed to determine the relative cost and perceived effectiveness of mitigation strategies using semi-structured interviews and an online questionnaire. We found that five actions were commonly used to manage flying-foxes: (1) stakeholder education, (2) the creation of buffers between camps and adjacent residents via vegetation removal or (3) the creation of buffers via deterrents, (4) dispersal of flying-foxes via disturbance, and (5) dispersal of flying-foxes via vegetation removal. Perceptions of effectiveness varied considerably among managers. Overall, the creation of buffers via vegetation removal was considered the most effective action, and stakeholder education was perceived to be the least effective. Dispersal via disturbance was also considered effective at reducing complaints and improving amenity, but not particularly effective overall likely due to the often short-term relief provided to residents before camps were recolonised. It was evident that the actions taken by managers and their perceived effectiveness were influenced by the attitudes of the community. This highlights the importance of considering the human dimensions of human-wildlife conflict in mitigation strategies

A pairwise likelihood augmented Cox estimator for left‐truncated data

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142901/1/biom12746.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142901/2/biom12746-sup-0001-SuppData-S1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142901/3/biom12746_am.pd

A novel CCM2 variant in a family with non-progressive cognitive complaints and cerebral microbleeds

Lobar cerebral microbleeds are most often sporadic and associated with Alzheimer's disease. The aim of our study was to identify the underlying genetic defect in a family with cognitive complaints and multiple lobar microbleeds and a positive family history for early onset Alzheimer's disease. We performed exome sequencing followed by Sanger sequencing for validation purposes on genomic DNA of three siblings with cognitive complaints, reduced amyloid-beta-42 in CSF and multiple cerebral lobar microbleeds. We checked for the occurrence of the variant in a cohort of 363 patients with early onset dementia and/or microbleeds. A novel frameshift variant (c.236_237delAC) generating a premature stop codon in the CCM2 gene shared by all three siblings was identified. Pathogenicity of the variant was supported by the presence of cerebral cavernous malformations in two of the siblings and by the absence of the variant exome variant databases. Two siblings were homozygous for APOE-ϵ4; one heterozygous. The cognitive complaints, reduced amyloid-beta-42 in CSF and microbleeds suggest preclinical Alzheimer's disease, but the stability of the cognitive complaints does not. We hypothesize that the phenotype in this family may be due to a combination of the CCM2 variant and the APOE status. © 2016 The Authors. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics Published by Wiley Periodicals, Inc