External Iliac Artery Stenting: High Incidence of Concomitant Revascularization Procedures

Objectives: To review immediate results, patency rates, hemodynamic success, and incidence of concomitant procedures with external iliac artery stenting (EIAS). Methods: Demographic features, category and clinical grade, Trans-Atlantic Inter-Society Consensus II classification lesion type, pre- and postprocedure ankle–brachial indices, and primary patency were compared between group 1 (EIAS without distal revascularization) and group 2 (EIAS with concomitant distal revascularization).Results: No mortality and a 100% immediate technical success rate was recorded in group 1 (n = 12) and group 2 (n = 24). Eleven patients (30.6%) also had stenting of the adjacent common iliac artery. Two thirds of group 2 patients required concomitant femoral or distal revascularization. Conclusions: No difference in stent patency rates was found between patients in group 1 versus group 2. Patients requiring EIAS tend to have more diffuse arterial disease necessitating complicated open reconstruction and/or distal revascularization, as well as more proximal iliac stenting

Ideal models and the reality: from Cofradia to Mayordomia in the Valles Centrales of Oaxaca, Mexico

The Civil-Religious hierarchy, or fiesta complex, which is found in indigenous communities in Mesoamerica and the Andean countries, has been central to anthropological studies in the area lavish expenditure of the religious cargo holders, the mayordomos, on fiesta celebrations, which has attracted most theories, as, ethnocentrically and materialistically, it is held to be both irrational and because, as the administrative complex of the villages, it is the pivot of village life. However, it is the lavish expenditure of the religious cargo holders, the mayordomos, on fiesta celebrations, which has attracted most theories, as, ethnocentrically and materialistically, it is held to be both irrational and uneconomic. However both views, I would argue, ignore the religious motivation of those who serve the saints. It is not uncommon for theorists to make backward projections into the colonial era in an attempt to account for the fiesta system as it exists now, and one model that has had some influence is the extractive one of Marvin Harris, which contends that, its ritual system having been proved to be almost wholly 16th century in origin, the complex was imposed by the Church in the early colonial era in order to draw off resources from the Indians - a role which has been sustained ever since. This neo - Marxist contention is both supremely materialistic and simplistic. However, it is the fact that this and other historical projections seemed to lack rigorous research and analysis, which led me to undertake a diachronic study of the colonial forerunners of the mayordomías, the cofradías, and the reason for their erection. I also wished to ascertain how far the civil-religious hierarchies of the colonial era resembled the ideal model of the modern complex; that is, a series of ranked civil and religious cargos held by all at the lowest level, and then undertaken alternatively, with heavy expenditure in time and economic resources, by those with sufficient economic means. Further to this, I wished to explore the transformation from colonial cofradía to modern mayordomía. Thus, the thesis divides into three parts, and, although anthropological in concept, is based principally upon historical research, and so is an ethno-historical study. The area chosen for this research was the Valles Centrales de Oaxaca, in the State and See of Oaxaca, which was a Dominican province from 1529 and whose doctrinas were not fully secularised until the 1760s. Unfortunately, the Dominican archive as such no longer exists, having been largely destroyed, although a part has been widely dispersed. In view of this, I have had recourse to the Dominican histories of the colonial era, which are based both upon their archives and the personal experiences of the authors, as well as the 16th century chronicles of the Franciscans - a rich source for descriptions of the earliest cofradías, their processions, and the reasons for their erection. These I have used in marshalling my arguments vis-á-vis the introduction of the cofradías, whilst detailed analysis of the role of the later cofradías and cargo holders has been based upon specific parochial archives in the Valleys. I shall introduce this thesis with a description of mayordomía in the Valleys today. I shall then discuss the civil, religious and social structures of the valley before and at the time of the Spanish Conquest in an attempt to isolate those aspects of fiesta celebrations, which are preCortesian in origin. This I shall base largely upon archaeological evidence. I shall then demonstrate that cofradía was a tool for attracting and maintaining religious converts by its several functions of ensuring a sumptuous cult, proselytising the faithful, and giving them succour. I shall isolate certain cofradías, which had the specific function of proselytisation, which I shall designate "cofradías proselitistas", and consider the austere and exemplary lives of those who introduced them. However, I shall also show that the Conquest and its aftermath was the occasion of much trauma for the indigenous peoples, in a way which was not always, perhaps, fully appreciated even by those who had their best interests at heart. Next I shall discuss the economic dilemma of the 16th century Church, which, lacking substantial tithes, could not increase the small ratio of priests to converts, nor properly train sufficient secular priests to secularise the parishes. I shall consider the post-Tridentine attempts to do this, and also to ensure that the seculars had reasonable stipends so that the scandal of their dependence upon their parishioners for sustenance, and their neglect of their duties for commercial concerns could be avoided. I shall also demonstrate that this economic crisis placed an economic burden upon the Indians, which Church legislation endeavoured to lessen, and that, whilst the existence of the cofradías increased the income of the priests through payments for Masses, and church furnishings, the Church enacted laws which limited excessive expenditure on these, as well as others preventing the erection of cofradías with illthought out statutes, and the exploitation of the people by unscrupulous priests. Thus, I am arguing that the Church was aware of the failings of those most in contact with the Indians, and, at least, endeavoured to mitigate them. Although much of this material is specific to Oaxaca, it is, of necessity, set in the wider context of the Church in New Spain. The second part of the thesis, based principally upon archival material from the Archivo General del Estado de Oaxaca, the Archivo General de la Nación in Mexico City, and the Archivos Parroquiales de Zaachila, in the Valley of Zimatlán, and Etla, in the Valle of Etla, is concerned with the hierarchies at village level. In this I shall discuss the traumatic background against which the 17th and 18th inhabitants of the Valleys lived, particularly as a result of the pro-secularisation policies of the Church and suggest that the conflict between the Bishops of Oaxaca and the Dominicans was a major cause of the Zapotecs retaining much of their prehispanic religious costumbres (traditions) and beliefs. I shall then consider the roles of the various officers in both the civil and religious hierarchies in the Indian towns, and demonstrate that only members of the nobility were eligible for such cargos. I shall suggest the possibility that the cargo of mayordomo of a cofradía was sufficiently prestigious for some men merely to serve this. I shall also demonstrate, from the Zaachilan material, that there was apparently no hierarchy of saints to serve, and that the ideal model of an achievement ladder of alternatively served prestigious civil and religious cargos did not exist in the colonial era. Further to this, I shall consider other variables which negate the ideal model: specifically the existence of female "mayordomos" throughout the colonial period and the early post-Independence decades; mayordomos who served the same saint for two, and even as many as six or more consecutive years; and the intervention of the priest in cofradía affairs. An analysis of the Libros de Cofradía will show how the mayordomos managed or mismanaged the Bienes de Cofradía, whilst the Libros de Cordillera of the 18th century Bishops of Oaxaca will show how they attempted to influence and change every sphere of Zapotec life. The Libros de Cofradía are the official record of the mayordomos' stewardship of the cofradías, but the Libros de Cordillera of the 18th century and 19th Bishops of Oaxaca give some idea of the celebration of fiesta, and the strictures upon it. They and the Libros de Cofradía suggest that whilst the colonial mayordomos might have incurred high expenses in financing the unofficial activities integral to fiesta celebrations, which are pre-Hispanic survivals, the existence of a lavish cult in a secularised doctrina, such as Etla, resulted in their being drawn into heavy debts in their attempts to sustain this by their management of the Bienes de Cofradía. The books also demonstrate that the ecclesiastical and Liberal post-Independence strictures upon cofradía echoed those of the colonial Church. But it appears that the Liberal policies at the time of La Reforma, during the presidency of the Sierra Zapotec Benito Juárez, were responsible for the transformation of the role of the mayordomo from that of steward of a cofradía's wealth, to the arduous one of financial responsibility for the equally religious mayordomía celebrations. In the third and concluding part of the thesis, I shall speculate upon the evolving nature of fiesta celebrations in the Valleys of Oaxaca from the preCortesian era and argue that the mayordomos continued to celebrate them as a complex of syncretic religious activities and, under threat from the Bishops for so doing, determinedly included the prehispanic survivals they so abhorred in order to reinforce and uphold pueblo and Zapotec identity

Optical structure and function of the white filamentary hair covering the edelweiss bracts

The optical properties of the inflorescence of the high-altitude ''Leontopodium nivale'' subsp. ''alpinum'' (edelweiss) is investigated, in relation with its submicrometer structure, as determined by scanning electron microscopy. The filaments forming the hair layer have been found to exhibit an internal structure which may be one of the few examples of a photonic structure found in a plant. Measurements of light transmission through a self-supported layer of hair pads taken from the bracts supports the idea that the wooly layer covering the plant absorbs near-ultraviolet radiation before it reaches the cellular tissue. Calculations based on a photonic-crystal model provides insight on the way radiation can be absorbed by the filamentary threads.Comment: 9 pages, 13 figures. Published pape

A Collaborative Model for Implementing State Common Core School Standards

In this early part of the 21st century, education leaders are increasingly challenged to improve P-12 teaching and learning to increase student achievement and to prepare all students for college and career success. Education reforms such as the adoption of the Common Core Standards within existing policies and practices of state department, district and school bureaucracies requires the repurposing and refocusing of existing resources and structures. This article describes the efforts in one state to employ collaboration to meet the requirements of legislated mandates for implementation of the Common Core Standards in English language arts and mathematics and the implications of the legislated mandates for postsecondary education. Three education entities (a university, schools, and a state agency) collaborated to design and implement professional development to inform K-12 teachers, state agency personnel, and university faculty about legislated mandates for K-12 education (e.g., state implementation of the Common Core Standards for college- and career-readiness, increase in high school graduation rates, etc.). As the state was the first to adopt the Common Core Standards and the first to assess K-12 student learning in this education reform context, this early adopter model of professional development will be useful and informative for others embarking on such efforts

Low-level lithium in drinking water and subsequent risk of dementia:Cohort study

Background: Lithium, a mood stabilizer, is known to exhibit neuroprotective effects in animal models and may have anti-dementia effects. Aims: We used data from Scottish Mental Survey 1932, a population-based cohort study, to investigate the association between lithium in drinking water and dementia rate in humans. Method: Lithium levels in drinking water from 285 sampling sites across Scotland dating from 2014 were obtained from the sole public water provider (Scottish Water). Dementia and non dementia cases were identified from cohort data by electronic health records until 2012, and linked to postcode. Results: The mean lithium level at all sampling sites was 1.45 μg /L (SD 1.83, range 0.5-18.2) and was 1.26 (SD 0.63, range 0.55-9.19) for sites matched to participant data. Of 37,597 study members, 3,605 developed dementia until June 2012. . Lithium levels were positively associated with the risk of dementia in women (highest in second quartile, HR 1.17, 95%CI 1.04-1.32), but there was no relationship in men (highest in second quartile, HR 0.95, 95% CI 0.81-1.12). The pattern of association was explored further by decile, and in females there was an association between lithium level and increased dementia risk compared to the lowest decile (0.55-0.68 μg/L) in all deciles except the highest, corresponding with lithium levels 0.68-2.1 μg/L. Conclusions: Lithium levels in drinking water are very low across Scotland which limited detection of potential effect. Our results do not support an association between extremely low levels of lithium and later dementia risk.. We found a trend to increased risk in females at lithium levels below but not above 2.1 μg/L

The Immunosuppressive Properties of the HIV Vpr Protein Are Linked to a Single Highly Conserved Residue, R90

BACKGROUND: A hallmark of AIDS progression is a switch of cytokines from Th1 to Th2 in the plasma of patients. IL-12, a critical Th1 cytokine secreted by antigen presenting cells (APCs) is suppressed by Vpr, implicating it as an important virulence factor. We hypothesize that Vpr protein packaged in the virion may be required for disabling APCs of the first infected mucosal tissues. Consistent with this idea are reports that defects in the C-terminus of Vpr are associated with long-term non-progression. PRINCIPAL FINDINGS: Vpr RNA amplified from various sources was electroporated into monocyte-derived DC and IL-12 levels in supernatants were analyzed. The analysis of previously reported C-terminal Vpr mutations demonstrate that they do not alleviate the block of IL-12 secretion. However, a novel single conservative amino acid substitution, R90K, reverses the IL-12 suppression. Analysis of 1226 Vpr protein sequences demonstrated arginine (R) present at position 90 in 98.8%, with other substitutions at low frequency. Furthermore, none of sequences report lysine (K) in position 90. Vpr clones harboring the reported substitutions in position 90 were studied for their ability to suppress IL-12. Our data demonstrates that none of tested substitutions other than K relieve IL-12 suppression. This suggests a natural selection for sequences which suppress IL-12 secretion by DC and against mutations which relieve such suppression. Further analyses demonstrated that the R90K, as well as deletion of the C-terminus, directs the Vpr protein for rapid degradation. CONCLUSION: This study supports Vpr as an HIV virulence factor during HIV infection and for the first time provides a link between evolutionary conservation of Vpr and its ability to suppress IL-12 secretion by DC. DC activated in the presence of Vpr would be defective in the production of IL-12, thus contributing to the prevailing Th2 cytokine profile associated with progressive HIV disease. These findings should be considered in the design of future immunotherapies that incorporate Vpr as an antigen