Implementation of an ST-Segment Elevation Myocardial Infraction Bypass Protocol in the Northern United Arab Emirates

Objective: The aim was to evaluate the translation of an ST-segment elevation myocardial infraction (STEMI) bypass protocol to the outcomes of patients with acute coronary syndrome in the Emirate of Ras al-Khaimah in the United Arab Emirates (UAE). Methods: A prospective cohort study was conducted, which included all patients who had a prehospital 12-lead electrocardiogram (ECG) performed by ambulance crews. Analysis of those who were identified as having STEMI and who subsequently underwent percutaneous coronary intervention (PCI) was performed. Results: A total of 152 patients had a 12-lead ECG performed during the pilot study period (February 24, 2016-August 31, 2016) with 118 included for analysis. Mean patient age was 52 years. There were 87 male (74%) and 31 female (26%) patients. Twenty-nine patients suffered a STEMI, and data were available for 11 who underwent PCI. There was no mortality, and no major adverse cardiac events were reported. The median door-to-balloon (D2B) time was 73 min (range 48-124), and 81% of patients had a D2B time \u3c90 min. Discharge data were available for six patients: All were discharged home with no impediments to rehabilitation. Conclusion: This pilot study has demonstrated agreement with the existing literature surrounding prehospital ECG and PCI activation in an unstudied STEMI population and in a novel clinical setting. It has demonstrated a D2B time of \u3c90 min in over 80% of STEMI patients, and a faster mean D2B time than self-presentations (mean 77 min vs. 113 min), with no associated mortality or major adverse cardiac events

Potential Interactions Between Diatoms and Bacteria are Shaped by Trace Element Gradients in the Southern Ocean

The growth of diatoms in the Southern Ocean, especially the region surrounding the West Antarctic Peninsula, is frequently constrained by low dissolved iron and other trace metal concentrations. This challenge may be overcome by mutualisms between diatoms and co-occurring associated bacteria, in which diatoms produce organic carbon as a substrate for bacterial growth, and bacteria produce siderophores, metal-binding ligands that can supply diatoms with metals upon uptake as well as other useful secondary compounds for diatom growth like vitamins. To examine the relationships between diatoms and bacteria in the plankton (diatom) size class (\u3e 3 mu m), we sampled both bacterial and diatom community composition with accompanying environmental metadata across a naturally occurring concentration gradient of macronutrients, trace metals and siderophores at 21 stations near the West Antarctic Peninsula (WAP). Offshore Drake Passage stations had low dissolved iron (0.33 ± 0.15 nM), while the stations closer to the continental margin had higher dissolved iron (5.05 ± 1.83 nM). A similar geographic pattern was observed for macronutrients and most other trace metals measured, but there was not a clear inshore-offshore gradient in siderophore concentrations. The diatom and bacteria assemblages, determined using 18S and 16S rDNA sequencing respectively, were similar by location sampled, and variance in both assemblages was driven in part by concentrations of soluble reactive phosphorous, dissolved manganese, and dissolved copper, which were all higher near the continent. Some of the most common diatom sequence types observed were Thalassiosira and Fragilariopsis, and bacteria in the plankton size fraction were most commonly Bacteroidetes and Gammaproteobacteria. Network analysis showed positive associations between diatoms and bacteria, indicating possible in situ mutualisms through strategies such as siderophore and vitamin biosynthesis and exchange. This work furthers the understanding of how naturally occurring gradients of metals and nutrients influence diatom-bacteria interactions. Our data suggest that distinct groups of diatoms and associated bacteria are interacting under different trace metal regimes in the WAP, and that diatoms with different bacterial partners may have different modes of biologically supplied trace metals

Interactions of Bioactive Trace Metals in Shipboard Southern Ocean Incubation Experiments

In the Southern Ocean, it is well‐known that iron (Fe) limits phytoplankton growth. Yet, other trace metals can also affect phytoplankton physiology. This study investigated feedbacks between phytoplankton growth and dissolved Fe, manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), and cadmium (Cd) concentrations in Southern Ocean shipboard incubations. Three experiments were conducted in September–October 2016 near the West Antarctic Peninsula: Incubations 1 and 3 offshore in the Antarctic Circumpolar Current, and Incubation 2 inshore in Bransfield Strait. Additions of Fe and/or vitamin B12 to inshore and offshore waters were employed and allowed assessment of metal (M) uptake relative to soluble reactive phosphorus (P) across a wide range of initial conditions. Offshore, treatments of \u3e1 nmol L−1 added Fe were Fe‐replete, whereas inshore waters were already Fe‐replete. Results suggest Mn was a secondary limiting nutrient inshore and offshore. No Fe‐vitamin B12 colimitation was observed. Overall, M:P uptake in the incubations was closely related to initial dissolved M:P for Fe, Mn, Co, Ni, and Cd, and for Cu inshore. Final concentrations of Fe and Zn were similar across light treatments of the experiments despite very different phytoplankton responses, and we observed evidence for Co/Cd/Zn substitution and for recycling of biogenic metals as inventories plateaued. In dark bottles, the absence of Mn oxidation may have allowed more efficient recycling of Fe and other trace metals. Our results provide insight into factors governing trace metal uptake, with implications for phytoplankton community composition locally and preformed micronutrient bioavailability in Southern Ocean water masses

Effects of CO\u3csub\u3e2\u3c/sub\u3e on Growth Rate, C:N:P, and Fatty Acid Composition of Seven Marine Phytoplankton Species

Carbon dioxide (CO2) is the primary substrate for photosynthesis by the phytoplankton that form the base of the marine food web and mediate biogeochemical cycling of C and nutrient elements. Specific growth rate and elemental composition (C:N:P) were characterized for 7 cosmopolitan coastal and oceanic phytoplankton species (5 diatoms and 2 chlorophytes) using low density, nutrient-replete, semi-continuous culture experiments in which CO2 was manipulated to 4 levels ranging from post-bloom/glacial maxima (ppm) to geological maxima levels (\u3e2900 ppm). Specific growth rates at high CO2 were from 19 to 60% higher than in low CO2 treatments in 4 species and 44% lower in 1 species; there was no significant change in 2 species. Higher CO2 availability also resulted in elevated C:P and N:P molar ratios in Thalassiosira pseudonana (~60 to 90% higher), lower C:P and N:P molar ratios in 3 species (~20 to 50% lower), and no change in 3 species. Carbonate system-driven changes in growth rate did not necessarily result in changes in elemental composition, or vice versa. In a subset of 4 species for which fatty acid composition was examined, elevated CO2 did not affect the contribution of polyunsaturated fatty acids to total fatty acids significantly. These species show relatively little sensitivity between present day CO2 and predicted ocean acidification scenarios (year 2100). The results, however, demonstrate that CO2 availability at environmentally and geologically relevant scales can result in large changes in phytoplankton physiology, with potentially large feedbacks to ocean biogeochemical cycles and ecosystem structure

Involvement in teaching improves learning in medical students: a randomized cross-over study

<p>Abstract</p> <p>Background</p> <p>Peer-assisted learning has many purported benefits including preparing students as educators, improving communication skills and reducing faculty teaching burden. But comparatively little is known about the effects of teaching on learning outcomes of peer educators in medical education.</p> <p>Methods</p> <p>One hundred and thirty-five first year medical students were randomly allocated to 11 small groups for the Gastroenterology/Hematology Course at the University of Calgary. For each of 22 sessions, two students were randomly selected from each group to be peer educators. Students were surveyed to estimate time spent preparing as peer educator versus group member. Students completed an end-of-course 94 question multiple choice exam. A paired t-test was used to compare performance on clinical presentations for which students were peer educators to those for which they were not.</p> <p>Results</p> <p>Preparation time increased from a mean (SD) of 36 (33) minutes baseline to 99 (60) minutes when peer educators (Cohen's <it>d </it>= 1.3; p < 0.001). The mean score (SD) for clinical presentations in which students were peer educators was 80.7% (11.8) compared to77.6% (6.9) for those which they were not (<it>d </it>= 0.33; <it>p </it>< 0.01).</p> <p>Conclusion</p> <p>Our results suggest that involvement in teaching small group sessions improves medical students' knowledge acquisition and retention.</p

Synthesis of iron-doped TiO2 nanoparticles by ball-milling process : the influence of process parameters on the structural, optical, magnetic, and photocatalytic properties

Titanium dioxide (TiO2) absorbs only a small fraction of incoming sunlight in the visible region thus limiting its photocatalytic efficiency and concomitant photocatalytic ability. The large-scale application of TiO2 nanoparticles has been limited due to the need of using an ultraviolet excitation source to achieve high photocatalytic activity. The inclusion of foreign chemical elements in the TiO2 lattice can tune its band gap resulting in an absorption edge red-shifted to lower energies enhancing the photocatalytic performance in the visible region of the electromagnetic spectrum. In this research work, TiO2 nanoparticles were doped with iron powder in a planetary ball-milling system using stainless steel balls. The correlation between milling rotation speeds with structural and morphologic characteristics, optical and magnetic properties, and photocatalytic abilities of bare and Fedoped TiO2 powders was studied and discussed.This work was partially financed by FCT-Fundacao para a Ciencia e Tecnologia-under the project PTDC/FIS/120412/2010: "Nanobased concepts for Innovative & Eco-sustainable constructive material's surfaces.

Estimating population size, density and dynamics of Pre-Pottery Neolithic villages in the central and southern Levant: an analysis of Beidha, southern Jordan

The Pre-Pottery Neolithic (PPN) of the central and southern Levant played an integral role in the Neolithic Demographic Transition (NDT) from mobile hunter-gatherer to village-based, agro-pastoralist societies. An understanding of population dynamics is essential for reconstructing the trajectories of these early village societies. However, few investigations have produced absolute estimates of population parameters for these villages and those which have base estimates on a limited methodological framework. This research examines the methodological and theoretical basis for existing estimates, and explores a range of methodologies in order to derive more empirically-robust demographic data. Results reveal that commonly utilized methodologies and population density coefficients employed for estimating PPN village populations require re-evaluation. This article presents the application of methodologies to the PPNB site of Beidha in southern Jordan

Crime, media and the will-to-representation: Reconsidering relationships in the new media age

This paper considers the ways in which the rise of new media might challenge commonplace criminological assumptions about the crime–media interface. Established debates around crime and media have long been based upon a fairly clear demarcation between production and consumption, between object and audience – the media generates and transmits representations of crime, and audiences engage with them. However, one of the most noticeable changes occurring in the wake of the development of new media is the proliferation of self-organised production by ‘ordinary people’ – everything ranging from self-authored web pages and ‘blogs’, to self-produced video created using hand-held camcorders, camera-phones and ‘webcams’. Today we see the spectacle of people them, send them and upload them to the Internet. This kind of ‘will to representation’ may be seen in itself as a new kind of causal inducement to law- and rule-breaking behaviour. It may be that, in the new media age, the terms of criminological questioning need to be sometimes reversed: instead of asking whether ‘media’ instigates crime or fear of crime, we must ask how the very possibility of bound up with the genesis of criminal behaviour.performing acts of crime and deviance in order to recordmediating oneself to an audience through self-representation might be bound up with the genesis of criminal behaviour