Strategies to Incorporate Left Atrial Appendage Occlusion Into Clinical Practice

AbstractThe left atrial appendage (LAA) has been identified as a predominant source of thrombus formation leading to significant thromboembolic events in patients with nonvalvular atrial fibrillation. Medical therapy to eliminate thrombus formation in the LAA has been the standard of care for several decades, but mechanical approaches designed to exclude the LAA from the circulation have recently been developed. The largest body of randomized and nonrandomized data to date has been for the Watchman device (Boston Scientific, Natick, Massachusetts), which was recently approved by the Food and Drug Administration for selected patients in the United States. There are no current guidelines or guidance for institutions and operators looking to become involved in this therapy. This perspective is aimed at exploring these issues and providing necessary information and guidance to these programs and operators to help ensure a successful launch of a LAA occlusion program and optimize patient selection, procedural performance, and outcome

Effectiveness of teaching programme on management of diarrhoea among the mothers of under five children in Kadaperi

EFFECTIVENESS OF TEACHING PROGRAMME ON MANAGEMENT OF DIARRHOEA AMONG THE MOTHERS OF UNDER FIVE CHILDREN IN KADAPERI. OBJECTIVES: to assess the knowledge on management of diarrhoea disease among the mothers of under five children. To evaluate the effectiveness of teaching programme on management of diarrhoea among the mothers of under five children in Pretest and Post test.To associate between the level of knowledge on management of diarrhoea among the mothers of under five children with selected demographic variables. OPERATIONAL DEFINITION EFFECTIVENESS It refers to the extent to which teaching programme was achieved the desired result indented to measure in terms of difference between pretest and post test score. TEACHING PROGRAMME It is systematic and planned teaching programme on management of diarrhea which include definition, causes, transmission, signs and symptoms, management of diarrhoea with help of audio visual aids. DIARRHOEA It is an inflammation of the mucous membrane of stomach and intestine. It results in rapid onset of diarrhea with or without accompanying signs or symptoms such as nausea, vomiting, fever or abdominal pain. MOTHERS OF UNDER FIVE CHILDREN Mother who are having children aged between 0-5 year old. ASSUMPTION:Mother will have inadequate knowledge about management of diarrhoea.Teaching program will enrich mothers knowledge in management of diarrhea. Knowledge regarding management of diarrhoea will help to prevent the incidence of diarrhoea LIMITATIONS:The study can not be generalized.The study is limited to 100 samples. The sample limited to the mothers of under five children. The study is limited at Kadaperi village. PROJECTED OUTCOME The findings of the study may be helpful in knowing the effectiveness of teaching programme regarding management of diarrhea which may help them to reduce the mortality and morbidity of under five children

Correlates of Bio-Psychosocial Factors on Perceived Body Image amongst Adolescents: Implications for Preventive Health Education

The study examined the interrelationships between a variety of measures designed to index the associations among adolescents’ bio-psychosocial factors and body image. Participants were 300 students whose age range between 11 and 26 years (mean =16.80, SD= 4.17) who completed questionnaires. The questionnaire contained measures of demographics, self-esteem, self-efficacy, food habit index, exercise, weight. Data was analyzed using correlation analysis. The results indicated that there was a positive relationship between self-esteem and perceived body image (r = .45, p < .01) and between self-efficacy and body image (r = .22, p < .01. While a negative relationship was found between food habit index and perceived body image (r = -.22, p <.01), food habit and perceived body image (r = -.24, p <. 01) and body weight and perceived body image (r = -.17, p < .01). There was no relationship between exercise and perceived body image (r = .07, p > .05). The implication of these findings for preventive health education were discussed and stakeholders were advised to inculcate the essence of physical activities and balance food eating habit in their programme in order to improve the level of body image satisfaction among adolescents.Keywords: Body image; food habit; self-esteem

Palynomorphs Content and Paleodepositional Environments of Mamu Formation in Okpekpe-1, Imiegba-1 and Imiegba-2, Benin Flank of Anambra Basin, Nigeria

Twenty surface samples were taken from road cuttings along Okpekpe and Imiegba areas located in Benin Flank of Anambra Basin, Nigeria with an aim to establish the biozones, age and paleodepositional environments of the Mamu Formation. Using palynological laboratory standard procedures, the shale surface samples collected from the Mamu Formation in the study area were prepared and analyzed. The recovered marker pollens, spores and dinoflagellate cysts from the study area are Milforadia jardinei, Milforadia sp., Longapertites  marginatus, Longapertites sp., Retidiporites sp., Monocolpites marginatus,Cyathidites minor, Cyathidites spp., Cingulatisporites ornatus, Distaverrusporites simplex, Laevigatosporites spp., Foveotriletes margaritae, Subtilisphaera sp., Andalusiella sp., Paleocystodinium australinium and microforaminiferal wall linings. Four biozones were erected for the shale intervals in the study area, namely: Longapertites sp., Monocolpites marginatus, Cyathidites minor, and Paleocystodinium australinium biozone, respectively, dated to Upper Maastrichtian to Early Paleocene age, which are lateral equivalents to Spinizonocolpites baculatus biozone of the Upper Benue Trough. The presence of the dinoflagellates cysts such as Paleocystodinium australinium, Subtilisphaera sp. and Andalusiella sp., microforaminiferal wall linings, pollens and spores established that the shales were deposited in nearshore to shallow marine environments. The presence of Cingulatisporites ornatus and Distaverrusporites simplex are indicative of marine regression that was followed by fluvial continental influence in anoxic bottom conditions that in turn favored the formation of coal seams in shales in the study area. The paucity of palynomorphs in the study area is inferred to have occurred because of the dry climatic condition that prevailed during the Upper Maastrichtian to Early Paleocene

Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA) is the registered non-governmental organization division of Imaging the World (ITW), a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future

Causative agents of keratomycosis in Ibadan: review of laboratory reports

Introduction: Fungi are responsible for less than 2.0 % of corneal infection around the globe. Trauma to the cornea is the leading cause of fungal keratitis especially with history of corneal trauma with vegetable or organic matter. Because of the dearth of data on the aetiological agents of Keratomycosis in this hospital, this study was aimed at finding the prevalence and fungal etiological agents responsible for this condition Ibadan, Nigeria. Methods: A retrospective review of the laboratory reports of corneal scrapings of patients that presented with signs and symptoms suggestive of Keratomycosis was carried out. The scrapings were subjected to wet preparation with 10.0 % KOH, Gram staining and Giemsa staining to rule out inclusion bodies. The diagnosis of Keratomycosis was made on the basis of the recognizable and characteristic appearance of fungal hyphae and fruiting bodies under microscopy. The media with no obvious growth after 3-4 weeks of incubation were regarded as negative. Results: A total of 48 specimens from patients with suspected diagnosis of Keratomycosis were included in the analysis. The patients consisted of 42 (87.3%) males and 6 (12.5%) females. The ages at diagnosis ranged from 3 to 73 years with a mean of 36.46 years and a median of 35.5 years. The prevalence of Keratomycosis among this group of patients in this hospital was 8.4 %. Candida albicans and Fusarium spp were the fungal isolates in these patients as it occurred in 4.2 % (2/48) of them respectively. Conclusions: Corneal scarring due to trauma or infections is a major cause of monocular blindness, especially in developing countries like Nigeria. Despite the low level of Keratomycosis in this study, high index of suspicion of possible diagnosis should be giving to patients with history of trauma, tissue devitalization with topical steroids and immunocompromised immunity.Keywords: Keratomycosis, Corneal, Fusarium and Candida

The Economic Value of Social and Emotional Learning

There is a growing body of research emphasizing the advantages of teaching students social and emotional (SE) skills in school. Here we examine the economic value of these skills within a benefit-cost analysis (BCA) framework. Our examination has three parts. First, we describe how the current method of BCA must be expanded to adequately evaluate SE skills, and we identify important decisions analysts must make. Second, we review the evidence on the benefits of SE skills, again noting key methodological issues with respect to shadow pricing. Finally, we perform BCA of four selected social and emotional learning (SEL) interventions: 4Rs; Second Step, Life Skills Training; and Responsive Classroom. These analyses illustrate both methodological and empirical challenges in estimating net present values for these interventions. Even with these challenges, we find that the benefits of these interventions substantially outweigh the costs. We highlight promising areas of research for improving the application of BCA to SEL

Phosphatidylinositol 4-kinase IIβ negatively regulates invadopodia formation and suppresses an invasive cellular phenotype

The type II PI 4-kinases enzymes synthesise the lipid phosphatidylinositol 4-phosphate (PI(4)P) which has been detected at the Golgi complex and endosomal compartments, and which recruits clathrin adaptors. Despite common mechanistic similarities between the isoforms, the extent of their redundancy is unclear.We found that depletion of PI4KIIα and PI4KIIβ using siRNA led to actin remodelling. Depletion of PI4KIIβ also induced the formation of invadopodia containing membrane type I matrix metalloproteinase (MT1-MMP).Depletion of PI4KII isoforms also differentially affected TGN pools of PI(4)P and post-TGN traffic. PI4KIIβ depletion caused increased MT1-MMP trafficking to invasive structures at the plasma membrane and was accompanied by reduced colocalisation of MT1-MMP with membranes containing the endosomal markers Rab5 and Rab7, but increased localisation with the exocytic Rab8. Depletion of PI4KIIβ was sufficient to confer an aggressive invasive phenotype on minimally invasive HeLa and MCF-7 cell lines. Mining oncogenomic databases revealed that loss of the PI4K2B allele and underexpression of PI4KIIβ mRNA is associated with human cancers. This finding supports the cell data and suggests that PI4KIIβ may be a clinically significant suppressor of invasion. We propose that PI4KIIβ synthesises a pool of PI(4)P that maintains MT1-MMP traffic in the degradative pathway and suppresses the formation of invadopodia

Themed project case study: Quadruple tanks control with PLCs^†

A themed project based on the control of a quadruple tank rig using PLCs has been successfully carried out as part of the MSc in Advanced Control and Systems Engineering at the University of Manchester. The themed project involves ten students who address a single multivariable control challenge under the supervision of two academics and four PhD students. As every student is required to write their own MSc dissertation, the key point is the possibility of using different control techniques to be implemented on different hardware platforms. </jats:p