Pentalogy of Cantrell : the first Maltese case with successful outcome

Pentalogy of Cantrell is a rare disorder which was first described by Cantrell and his colleagues in 1958. It is comprised of congenital heart disease and midline defects. Surgical treatment is possible with internalisation of the heart, repair of associated intracardiac anomalies and repair of the thoraco-abdominal defect. In this article the authors describe the first Maltese case, with a successful outcome.peer-reviewe

Internal Migration and Regional Population Dynamics in Europe: Czech Case Study

Report prepared for the Council of Europe (Directorate of Social and Economic Affairs, Population and Migration Division) and for European Commission (Directorate General V, Employment, Industrial Relations and Social Affairs, Unit E1, Analysis and Research on the Social Situation) Czech Republic has experienced, over the last decade, quite a balanced population system with low growth. This has changed recently and from 1994 we noted a decrease in population partially offset by international migration, for the time being mainly temporary labour circular movements. The decreasing trend may well continue due to future replacement in the reproductive ages of large female cohorts with much smaller cohorts, currently aged 0-15 years. Ales and Simek (1996) expect by the year 2020 a population decrease of at least 471 thousand (high variant). International migration will probably reduce to some extent the effect of negative natural increase. In terms of population dynamics the most important feature we have observed is slow but clear deconcentration of population from large cities to suburban areas. The main gains are observed in medium size towns and smaller communities at the expense of large cities and rural areas. However, the migration factor plays a lesser role than in the past. Net migration is low and migration effectiveness is very limited. The relationship between migration and other variables (population density, level of urbanisation) is rather weak. Unemployment has limited negative impacts on migration flows. No doubt, this may change when the serious restructuring of industry starts and unemployment increases - an almost certain scenario given the Czech Republic's willingness to join the European Union. The main enigma of the Czech migration system is its future dynamics. So far migration has been low, but with the development of the economy, including the housing market, improvement of telecommunication and increasing wealth of the society one may expect that migration trends would contribute much more to the regional population dynamics. The large units for which migration data were available in the Czech Republic reduce the number of inter-unit migrations, increase the number of intra-unit migrations, and in effect blur the picture of mobility, which anyway is quite low. Another factor, which made the analysis somewhat difficult is the mixture of signals sent to the economy by the Czech government. This mixture has confused professional economists, not to speak of ordinary people

Comparing Internal Migration between Countries: Who Collects What?

This paper derives from a program of research which aims to develop a robust framework for cross-national comparisons of internal migration. Stage one examined the obstacles to such comparisons and made proposals for a battery of 15 migration indicators covering four broad dimensions of population mobility which were then tested using British and Australian data. Wider implementation requires assembly of databases for countries around the world. Stage two takes the first steps towards this goal by establishing a worldwide inventory of contemporary practice with respect to collection of internal migration data, based on published sources and a comprehensive survey of national statistical agencies. Information collected includes the source and type of data, migration intervals and zonal system. This paper summarises the conclusions from Stage 1, reports results from the Stage 2 inventory and sets out proposals for a collaborative network to implement the cross-national indicators worldwid

A fast genetically encoded fluorescent sensor for faithful in vivo acetylcholine detection in mice, fish, worms and flies

Here we design and optimize a genetically encoded fluorescent indicator, iAChSnFR, for the ubiquitous neurotransmitter acetylcholine, based on a bacterial periplasmic binding protein. iAChSnFR shows large fluorescence changes, rapid rise and decay kinetics, and insensitivity to most cholinergic drugs. iAChSnFR revealed large transients in a variety of slice and in vivo preparations in mouse, fish, fly and worm. iAChSnFR will be useful for the study of acetylcholine in all organisms

The role of insulin in blood glucose abnormalities in canine babesiosis

Abnormal carbohydrate metabolism is a commonly encountered feature of malaria in people, and similar derangements have been detected in veterinary patients with canine babesiosis. Glucose, the major metabolic fuel source, is a key resource in critically ill patients as they mount an immunological response to infection and inflammation. The ability of the individual to effectively mobilise, distribute and utilise glucose is a major determinant of morbidity and mortality. Hypoglycaemia has been identified as a life threatening metabolic complication in almost 20% of severely ill dogs suffering from babesiosis due to Babesia rossi infection. Insulin and glucagon are the primary hormones involved in glucose homeostasis. Insulin lowers blood glucose concentration by facilitating cellular uptake and utilisation of glucose. Hyperinsulinaemia as a result of inappropriate insulin secretion may precipitate hypoglycaemia, and has been identif ed as a cause of hypoglycaemia in human and murine malaria. A similar phenomenon may exist in canine babesiosis. This prospective, cross-sectional, observational study, including 94 dogs with naturally acquired virulent babesiosis, sought to investigate and characterise the relationship between blood glucose concentrations and insulin concentrations in cases of canine babesiosis. Pre-treatment jugular blood samples were collected for simultaneous determination of plasma glucose and insulin concentrations. Animals were retrospectively divided into three groups: hypoglycaemic (plasma glucose concentration 5.5 mmol/L; n=16). The median plasma insulin concentrations (IQR in parentheses) for the hypoglycaemic, normoglycaemic and hyperglycaemic groups were 10.7 pmol/L (10.7-18.8 pmol/L), 10.7 pmol/L (10.7-29.53 pmol/L; i.e below the detection limit of the assay), and 21.7 pmol/L (10.7-45.74 pmol/L), respectively. Statistical analysis revealed no significant difference in insulin concentration between the three groups. These results suggest that insulin secretion was appropriately suppressed in these dogs. Only two dogs had elevated insulin concentrations, one of which was hypoglycaemic. The median time since last meal (available for 87 dogs) was 24 hours (IQR 2-4 days), constituting a significant period of illness-induced starvation. We conclude that hyperinsulinaemia is not a cause of hypoglycaemia in virulent canine babesiosis. It is speculated that prolonged fasting due to disease-induced anorexia, in addition to increased glucose consumption, depletion of hepatic glycogen stores, and hepatic dysfunction with impaired gluconeogenesis, may play important roles in the pathophysiology of hypoglycaemia in canine babesiosis.Dissertation (MMedVet)--University of Pretoria, 2010.Companion Animal Clinical Studiesunrestricte

Are socioeconomic inequalities in mortality decreasing or increasing within some British regions? An observational study, 1990-98

Background: This paper evaluates claims in a recent study that inequalities in small area mortality rates have lessened. We examine the effect of differently estimated populations on time trends in age-specific mortality rates for Yorkshire and the Humber and East of England. Methods: Populations were estimated for wards using four methods that introduce increasing amounts of information. Age-specific mortality rates for age-groups 45-54, 55-64, 65-74 and 75-84 for both sexes were calculated for population-weighted deprivation quintiles. Inequality was tracked using ratios of rates in the most deprived quintile divided by those in the least. Results: When constant 1991 populations are used, rate ratios decrease for all age-sex groups, indicating shrinking inequality. When a method adjusting small area populations to official district estimates is used, both decreases and increases are observed in the mortality rate ratios. These results differ from Trent region findings of decreases in inequality. When small area populations are cohort-survived and adjusted to district populations, most differences in rate ratios indicate increasing inequality. When a method is used that includes information on migration and special populations, then seven out of eight age-sex groups exhibit increasing inequality. Conclusions: A judgement about trends in mortality inequality is highly dependent upon the denominator population used. Simpler estimation methods result in convergence of rate ratios, whereas more sophisticated methods result in increasing inequalities in most age-sex groups

Systematic review of educational interventions for looked-after children and young people: recommendations for intervention development and evaluation

Looked-after children and young people (LACYP) are educationally disadvantaged compared to the general population. A systematic review was conducted of randomised controlled trials evaluating interventions aimed at LACYP aged ≤18 years. Restrictions were not placed on delivery setting or delivery agent. Intervention outcomes were: academic skills; academic achievement and grade completion; special education status; homework completion; school attendance, suspension, and drop-out; number of school placements; teacher-student relationships; school behaviour; and academic attitudes. Fifteen studies reporting on 12 interventions met the inclusion criteria. Nine interventions demonstrated tentative impacts. However, evidence of effectiveness could not be ascertained due to variable methodological quality, as appraised by the Cochrane risk of bias tool. Theoretical and methodological recommendations are provided to enhance the development and evaluation of educational interventions

Magnetic resonance volume flow and jet velocity mapping in aortic coarctation

AbstractObjectives. Nuclear magnetic resonance (MRI) velocity mapping was used to characterize flow waveforms and to measure volume flow in the ascending and descending thoracic aorta in patients with aortic coarctation and in healthy volunteers. We present the method and discuss the relation between these measurements and aortic narrowing assessed by MRI. Finally, we compare coarctation jet velocity measured by MRI velocity mapping with that obtained from continuous wave Doppler echocardiography.Background. The development of a noninvasive imaging method for morphologic visuslization of aortic coarctation and for measurement of its impact on blood flow is highly desirable in the preoperative and postoperative management of patients.Methods. Magnetic resonance imaging phase-shift velocity mapping was used to measure ascending and descending aortic volume flow in 39 patients with aortic coarctation and in 12 healthy volunteers. Magnetic resonance imaging was also used for anatomic and peak jet velocity measurements. The latter were compared with those available from continuous wave Doppler study in 40% of the patients.Results. Whereas ascending aortic volume flow measurement did not show significant differences between the patient and healthy control groups, volume flow curves in the descending aorta did show significant differences between the two groups. Peak volume flow (mean ± SD) was 10.6 ± 5.3 liters/min in patients and 19.6 ± 4.7 liters/min in control subjects (p < 0.001). Time-averaged flow was 2.5 ± 0.9 liters/min in patients and 3.9 ±1.1 liters/min in control subjects (p < 0.05). The descending/ ascending aorta flow ratio was 0.47 ± 0.19 in patients and 0.64 ±0.08 in control subjects (p < 0.05). These variables correlate well with the degree of aortic narrowing. Peak coarctation jet velocity measured by MRI velocity mapping is comparable to that obtained from continuous wave Doppler study (r = 0.95).Conclusions. We established normal ranges for volume flow in the descending aorta and demonstrated abnormalities in patients with aortic coarctation. These abnormalities are likely to be related to resistance to flow imposed by the coarctation and could represent an additional index for monitoring patients before and after intervention

Diagnosing student errors in e-Assessment questions

© The Author 2015. We demonstrate how the re-marker and reporter facility of the DEWIS e-Assessment system facilitates the capture, analysis and reporting of student errors using two case studies: logarithms and indices for first-year computing students at the University of the West of England, and Sturm-Liouville problems for second-year mathematics students at Leeds University. The differences in approach needed for error capture for commonly used numerical or algebraic answer inputs are discussed and shown to facilitate efficient capture and reporting of student errors. Not only does such information provide away to tailor question feedback to address these errors for use by future students, but can be made available to current students by re-marking their answers using the newly identified errors and hencemaking the improved feedback available to them too