Endoscopic submucosal dissection of rectal lesion recurrence at the anastomosis site: when the staples lead the way

info:eu-repo/semantics/publishedVersio

Increase in background stratospheric aerosol observed with lidar at Mauna Loa Observatory and Boulder, Colorado

The stratospheric aerosol layer has been monitored with lidars at Mauna Loa Observatory in Hawaii and Boulder in Colorado since 1975 and 2000, respectively. Following the Pinatubo volcanic eruption in June 1991, the global stratosphere has not been perturbed by a major volcanic eruption providing an unprecedented opportunity to study the background aerosol. Since about 2000, an increase of 4–7% per year in the aerosol backscatter in the altitude range 20–30 km has been detected at both Mauna Loa and Boulder. This increase is superimposed on a seasonal cycle with a winter maximum that is modulated by the quasi‐biennial oscillation (QBO) in tropical winds. Of the three major causes for a stratospheric aerosol increase: volcanic emissions to the stratosphere, increased tropical upwelling, and an increase in anthropogenic sulfur gas emissions in the troposphere, it appears that a large increase in coal burning since 2002, mainly in China, is the likely source of sulfur dioxide that ultimately ends up as the sulfate aerosol responsible for the increased backscatter from the stratospheric aerosol layer. The results are consistent with 0.6–0.8% of tropospheric sulfur entering the stratosphere

Same old song and dance: An exploratory study of portrayal of physical activity in television programmes aimed at young adolescents

Abstract Objective Exposure to health-related behaviours on television has been shown to influence smoking and drinking in young people, but little research has been conducted on the portrayal physical activity. The aim of the current project was to explore the portrayal of physical activity in television programmes aimed specifically at adolescent females. Content analysis of 120 episodes of four popular adolescent television programmes was performed. Information on the type and context of physical activity, motivating factors and characters involved was recorded. Results Physical activity was portrayed 122 times, for a duration of 1 h and 31 min (3.2% of total viewing time). Physical activity was mainly portrayed as part of an informal activity as part of a group activity. Over half (53.2%) of scenes portrayed activity been carried out by teenagers. The types of activities portrayed were mostly of vigorous intensity (76.2%), for recreational purposes (78.7%) such as dancing (54.1%) and running (11.5%), and motivated by enjoyment. This study highlights that physical activity is portrayed infrequently, and often with a skewed representation of type of activity. There may be an opportunity to influence physical activity in young adolescents through the positioning of positive images of an active lifestyle in the media

A tiered-layered-staged model for informed consent in personal genome testing

In recent years, developments in genomics technologies have led to the rise of commercial personal genome testing (PGT): broad genome-wide testing for multiple diseases simultaneously. While some commercial providers require physicians to order a personal genome test, others can be accessed directly. All providers advertise directly to consumers and offer genetic risk information about dozens of diseases in one single purchase. The quantity and the complexity of risk information pose challenges to adequate pre-test and post-test information provision and informed consent. There are currently no guidelines for what should constitute informed consent in PGT or how adequate informed consent can be achieved. In this paper, we propose a tiered-layered-staged model for informed consent. First, the proposed model is tiered as it offers choices between categories of diseases that are associated with distinct ethical, personal or societal issues. Second, the model distinguishes layers of information with a first layer offering minimal, indispensable information that is material to all consumers, and additional layers offering more detailed information made available upon request. Finally, the model stages informed consent as a process by feeding information to consumers in each subsequent stage of the process of undergoing a test, and by accommodating renewed consent for test result updates, resulting from the ongoing development of the science underlying PGT. A tiered-layered-staged model for informed consent with a focus on the consumer perspective can help overcome the ethical problems of information provision and informed consent in direct-to-consumer PGT.European Journal of Human Genetics advance online publication, 21 November 2012; doi:10.1038/ejhg.2012.237

AXY3 encodes a α-xylosidase that impacts the structure and accessibility of the hemicellulose xyloglucan in Arabidopsis plant cell walls

Xyloglucan is the most abundant hemicellulose in the walls of dicots such as Arabidopsis. It is part of the load-bearing structure of a plant cell and its metabolism is thought to play a major role in cell elongation. However, the molecular mechanism by which xyloglucan carries out this and other functions in planta is not well understood. We performed a forward genetic screen utilizing xyloglucan oligosaccharide mass profiling on chemically mutagenized Arabidopsis seedlings to identify mutants with altered xyloglucan structures termed axy-mutants. One of the identified mutants, axy3.1, contains xyloglucan with a higher proportion of non-fucosylated xyloglucan subunits. Mapping revealed that axy3.1 contains a point mutation in XYLOSIDASE1 (XYL1) known to encode for an apoplastic glycoside hydrolase releasing xylosyl residues from xyloglucan oligosaccharides at the non-reducing end. The data support the hypothesis that AXY3/XYL1 is an essential component of the apoplastic xyloglucan degradation machinery and as a result of the lack of function in the various axy3-alleles leads not only to an altered xyloglucan structure but also a xyloglucan that is less tightly associated with other wall components. However, the plant can cope with the excess xyloglucan relatively well as the mutant does not display any visible growth or morphological phenotypes with the notable exception of shorter siliques and reduced fitness. Taken together, these results demonstrate that plant apoplastic hydrolases have a larger impact on wall polymer structure and function than previously thought

Computer-Aided Patient-Specific Coronary Artery Graft Design Improvements Using CFD Coupled Shape Optimizer

This study aims to (i) demonstrate the efficacy of a new surgical planning framework for complex cardiovascular reconstructions, (ii) develop a computational fluid dynamics (CFD) coupled multi-dimensional shape optimization method to aid patient-specific coronary artery by-pass graft (CABG) design and, (iii) compare the hemodynamic efficiency of the sequential CABG, i.e., raising a daughter parallel branch from the parent CABG in patient-specific 3D settings. Hemodynamic efficiency of patient-specific complete revascularization scenarios for right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCX) bypasses were investigated in comparison to the stenosis condition. Multivariate 2D constraint optimization was applied on the left internal mammary artery (LIMA) graft, which was parameterized based on actual surgical settings extracted from 2D CT slices. The objective function was set to minimize the local variation of wall shear stress (WSS) and other hemodynamic indices (energy dissipation, flow deviation angle, average WSS, and vorticity) that correlate with performance of the graft and risk of re-stenosis at the anastomosis zone. Once the optimized 2D graft shape was obtained, it was translated to 3D using an in-house “sketch-based” interactive anatomical editing tool. The final graft design was evaluated using an experimentally validated second-order non-Newtonian CFD solver incorporating resistance based outlet boundary conditions. 3D patient-specific simulations for the healthy coronary anatomy produced realistic coronary flows. All revascularization techniques restored coronary perfusions to the healthy baseline. Multi-scale evaluation of the optimized LIMA graft enabled significant wall shear stress gradient (WSSG) relief (~34%). In comparison to original LIMA graft, sequential graft also lowered the WSSG by 15% proximal to LAD and diagonal bifurcation. The proposed sketch-based surgical planning paradigm evaluated the selected coronary bypass surgery procedures based on acute hemodynamic readjustments of aorta-CA flow. This methodology may provide a rational to aid surgical decision making in time-critical, patient-specific CA bypass operations before in vivo execution

Parma consensus statement on metabolic disruptors

A multidisciplinary group of experts gathered in Parma Italy for a workshop hosted by the University of Parma, May 16–18, 2014 to address concerns about the potential relationship between environmental metabolic disrupting chemicals, obesity and related metabolic disorders. The objectives of the workshop were to: 1. Review findings related to the role of environmental chemicals, referred to as “metabolic disruptors”, in obesity and metabolic syndrome with special attention to recent discoveries from animal model and epidemiology studies; 2. Identify conclusions that could be drawn with confidence from existing animal and human data; 3. Develop predictions based on current data; and 4. Identify critical knowledge gaps and areas of uncertainty. The consensus statements are intended to aid in expanding understanding of the role of metabolic disruptors in the obesity and metabolic disease epidemics, to move the field forward by assessing the current state of the science and to identify research needs on the role of environmental chemical exposures in these diseases. We propose broadening the definition of obesogens to that of metabolic disruptors, to encompass chemicals that play a role in altered susceptibility to obesity, diabetes and related metabolic disorders including metabolic syndrome

Early identification of first-year students at risk of dropping out of high-school entry medical school: the usefulness of teachers' ratings of class participation

Dropping out from undergraduate medical education is costly for students, medical schools, and society in general. Therefore, the early identification of potential dropout students is important. The contribution of personal features to dropout rates has merited exploration. However, there is a paucity of research on aspects of student experience that may lead to dropping out. In this study, underpinned by theoretical models of student commitment, involvement, and engagement, we explored the hypothesis of using inferior participation as an indicator of a higher probability of dropping out in year 1. Class participation was calculated as an aggregate score based on teachers' daily observations in class. The study used a longitudinal dataset of six cohorts of high-school entry students (N = 709, 67% females) in one medical school with an annual intake of 120 students. The findings confirmed the initial hypothesis and showed that lower scores of class participation in year 1 added predictive ability to pre-entry characteristics (Pseudo-R2 raised from 0.22 to 0.28). Even though the inclusion of course failure in year 1 resulted in higher explanatory power than participation in class (Pseudo-R2 raised from 0.28 to 0.63), ratings of class participation may be advantageous to anticipate dropout identification, as those can be collected prior to course failure. The implications for practice are that teachers' ratings of class participation can play a role in indicating medical students who may eventually drop out. We conclude that the scores of class participation can contribute to flagging systems for the early detection of student dropouts.(undefined)info:eu-repo/semantics/acceptedVersio

Contamination, risk, and source apportionment of potentially toxic microelements in river sediments and soil after extreme flooding in the Kolubara River catchment in Western Serbia

Climate change is contributing to an increase in extreme weather events. This results in a higher river flooding risk, causing a series of environmental disturbances, including potential contamination of agricultural soil. In Serbia, the catastrophic floods of 2014 affected six river basins, including the Kolubara River Basin, as one of the larger sub-catchments of the large regional Sava River Basin, which is characterized by large areas under agricultural cultures, various geological substrates, and different types of industrial pollution. The main aim of this study was to establish the sources of potentially toxic elements in soil and flood sediments and the effect of the flood on their concentrations. Field sampling was performed immediately after water had receded from the flooded area in May 2014. In total, 36 soil samples and 28 flood sediment samples were collected. After acid digestion (HNO3), concentrations of the most frequent potentially toxic elements (PTE) in agricultural production (As, Cd, Cr, Cu, Ni, Pb, Zn) and Co which are closely related to the geological characteristics of river catchments, were analyzed. The origin, source, and interrelations of microelements, as well as BACKGROUND: values of the PTE of the river catchment, the pollution index (Pi), enrichment factor (Ef), and geological index (Igeo), were determined, using statistical methods such as Pearson correlations, principal component analysis (PCA), and multiple linear regression (MLRA). The content of the hot acid-extractable forms of the elements, PCA, and MLRA revealed a heavy geological influence on microelement content, especially on Ni, Cr, and Co, while an anthropogenic influence was observed for Cu, Zn, and Cd content. This mixed impact was primarily related to mines and their impact on As and Pb content. The pseudo-total concentrations of all the analyzed elements did not prove to be a danger in the catchment area, except for Cu in some samples, indicating point-source pollution, and Ni, whose pseudo-total content could be a limiting factor in agricultural production. For the Ef, the Ni content in 59% soil and 68% flood sediment samples is classified into influence classes. The similar pseudo-total contents of the elements studied in soil samples and flood sediment and their origin indicate that the long-term soil formation process is subject to periodic flooding in the Kolubara River Basin without any significant changes taking place. This implies that floods are not an endangering factor in terms of the contamination of soil by potentially toxic elements in the explored area