Anomalous origin of the right coronary artery from the left anterior descending artery: Review of the literature

Coronary artery anomalies that take place during fetal development are determined in approximately 1.3% of coronary angiograms. The right coronary artery originating from the left coronary system is an extremely rare variation of the single coronary artery anomaly in which the prognosis is usually benign provided that the anomalous vessel dose not pass between the aorta and the pulmonary artery. Anomalous right coronary artery anomaly has been rarely associated with other congenital cardiovascular anomalies such as transposition of the great vessels and tetralogy of Fallot. To date, a few attempts at classification have been made for coronary artery anomalies, but none of them seems comprehensive or practical for clinicians. The clinical significance of coronary anomalies is usually determined by underlying anatomic features of the wrong coronary origin and/or coronary atherosclerosis. Although coronary angiography is an important diagnostic method, new non-invasive methods such as coronary computed tomography angiography and cardiac magnetic resonance imaging have important roles to play in characterizing this coronary anomaly. It should be noted that the management strategy of these patients may vary based on clinical presentation, anatomical details and additional findings. (Cardiol J 2012; 19, 2: 122–129

Evaluación de las prácticas tradicionales de lactancia materna, alimentación complementaria y aumento de la leche materna en madres con lactantes de 0 a 24 meses: Un estudio transversal

Introduction: To evaluate the traditional practices of breastfeeding, complementary feeding, and increasing breast milk in mothers with 0-24 month-old infants. Material and methods: The study sample includes 215 mothers with 0-24 month-old infants. The mothers’ socio-demographic characteristics, knowledge and behaviors regarding breast milk, complementary feeding, and traditional practices for increasing breast milk were questioned. Results: 60.0% of the infants were exclusively breastfed in the first six months. There was a significant difference between the mothers’ educational levels and the frequency of breastfeeding (p<0.001). A significant difference was observed between the educational level of the mothers and the first complementary food given to the infants (p=0.046). The rate of mothers who breastfed less frequently after introducing to complementary feeding was significantly lower in the group with a low level of education compared to the group with a high level of education (p=0.040). The rate of receiving training from a healthcare professional specialized in breastfeeding before and after birth was significantly higher in the group with a high level of education (41.1% and 52.8%, respectively) than the group with a low level of education (17.3% and 15.4%) (p=0.002 and p<0.001, respectively). The rate of those who knew that breast milk alone was sufficient for feeding the infant in the first six months was significantly higher in the group with a high level of education (96.3%) than the group with a low level of education (86.5%) (p=0.017). Percentage of mothers with a high educational level who consume herbal tea (17.8%) is higher than those with low educational level (4.0%). There is a statistically significant difference between the educational status of mothers and traditional practices to increase breast milk (p<0.001). Conclusions: Mothers had imperfect knowledge regarding breastfeeding and complementary feeding. They should be educated by healthcare professionals to eliminate deficiencies and correct their current practices.Introducción: Evaluar las prácticas tradicionales de lactancia materna, alimentación complementaria y aumento de la leche materna en madres con bebés de 0-24 meses. Material y métodos: La muestra del estudio incluye 215 madres con bebés de 0-24 meses. Se utilizó un cuestionario sobre las características sociodemográficas, los conocimientos y comportamientos de las madres con respecto a la leche materna, la alimentación complementaria y las prácticas tradicionales para aumentar la leche materna. Resultados: el 60,0% de los lactantes fueron amamantados exclusivamente en los primeros seis meses. Hubo una diferencia significativa entre los niveles educativos de las madres y la frecuencia de la lactancia materna (p<0,001). Se observó una diferencia significativa entre el nivel educativo de las madres y el primer alimento complementario dado a los lactantes (p=0,046). La tasa de madres que amamantaron con menor frecuencia después de la introducción a la alimentación complementaria fue significativamente menor en el grupo con bajo nivel educativo en comparación con el grupo con alto nivel educativo (p=0,040). La tasa de formación de un profesional sanitario especializado en lactancia materna antes y después del parto fue significativamente mayor en el grupo con alto nivel educativo (41,1% y 52,8%, respectivamente) que en el grupo con bajo nivel educativo (17,3% y 15,4%) (p=0,002 y p<0,001, respectivamente). La tasa de quienes sabían que la leche materna sola era suficiente para alimentar al lactante en los primeros seis meses fue significativamente mayor en el grupo con un alto nivel de educación (96,3%) que en el grupo con un bajo nivel de educación (86,5%) (p=0,017). El porcentaje de madres con alto nivel educativo que consumen té de hierbas (17,8%) es superior al de madres con bajo nivel educativo (4,0%). Existe una diferencia estadísticamente significativa entre el nivel educativo de las madres y las prácticas tradicionales para aumentar la leche materna (p<0,001). Conclusiones: las madres tenían conocimientos imperfectos sobre la lactancia materna y la alimentación complementaria. Deben ser educados por profesionales de la salud para eliminar las deficiencias y corregir sus prácticas actuales

Association of heart rate recovery with microalbuminuria in non-obstructive coronary artery disease

Background: Non-obstructive coronary artery disease (CAD) is associated with significantly increased risk for myocardial infarction. Heart rate recovery (HRR), a measure of autonomic function, is a strong predictor of all-cause mortality. Microalbuminuria, a marker of early arterial disease, is an independent risk factor for cardiovascular disease and mortality. We aimed to investigate HRR and determine its relationship with microalbuminuria in patients with non-obstructive CAD.Methods: We prospectively studied 565 patients who underwent elective coronary angiography. All participants underwent urinary analysis and then an exercise test. Microalbuminuria was defined as an urinary albumin-to-creatinine ratio (UACR) of 30 -299 mg/g. The HRR was abnormal if 12 beats/min, n = 439).Results: Patients with microalbuminuria had lower HRR and patients with lower HRR had higher UACR. While UACR was negatively correlated with HRR in patients with microalbuminuria (r = -0.424; P < 0.001) and in patients with lower HRR (r = -0.192; P = 0.042), there was no correlation of UACR with HRR in neither patients with normoalbuminuria nor patients with higher HRR, respectively. In the all study population, there was a significant inverse association between UACR and HRR (r = -0.445, P < 0.001), and UACR independently predicted the presence of lower HRR (P < 0.001).Conclusions: Our findings showed that there was a significant inverse association between UACR and HRR in patients especially with microalbuminuria, and that albuminuria might predict cardiac autonomic imbalance evaluated by HRR in patients with non-obstructive CAD

Effet de resaturation sur le comportement mécanique de mortier

Le présent travail s'intéresse à l'effet de resaturation sur le comportement mécanique d'un mortier normal mature. Aussi, des essais de compression uniaxiale et triaxiale déviatorique ont-ils été réalisés en fonction de l'état de saturation (saturé, séché à 60°C jusqu'à poids constant, resaturé à différents degrés). Il a été observé que les résistances à la compression uniaxiale et triaxiale déviatorique diminuent avec la resaturation après une première augmentation due au séchage. Les éprouvettes resaturées sous vide ont une résistance plus faible que les éprouvettes saturées à cause de la microfissuration induite par séchage notamment, mais cette chute est moins prononcée dans le cas de la compression déviatorique du fait de la présence d'un confinement. Une diminution du module d'Young, venant s'ajouter à celle due au séchage, a également été constatée après resaturation sous vide mais uniquement en compression uniaxiale. Par ailleurs, la contrainte de limite élastique dépend du degré de resaturation. L'ensemble des résultats obtenus montre ainsi la nécessité de prendre en compte les effets de séchage et de resaturation dans l'évaluation de la durabilité des matériaux à matrice cimentaire

Comportement mécanique d'une pâte de ciment pétrolier sous température : Effet de la dégradation chimique

Cette étude présente l'influence d'une dégradation chimique sur le comportement thermo-hydro-mécanique (THM) d'une pâte de ciment pétrolier servant de barrière d'étanchéité dans les puits pétroliers. Afin de caractériser l'évolution du comportement THM avec la dégradation, des essais de compression triaxiale cyclique à différentes pressions de confinement avec une pression interstitielle constante sont réalisés sur le matériau à l'état sain et complètement dégradé par le nitrate d'ammonium, sous température de 90 °C. Les résultats obtenus montrent d'importantes évolutions. Le matériau sain présente une très faible phase élastique et une forte phase plastique évoluant avec le confinement. La résistance à la rupture diminue drastiquement après la dégradation chimique conduisant à une augmentation de la porosité. Le coefficient élastique chute également et évolue peu au cours de l'essai. Par ailleurs, un passage clair d'un comportement fragile à un comportement ductile est constaté avec la dégradation, notamment pour des faibles confinements

A Grhl2-dependent gene network controls trophoblast branching morphogenesis

Healthy placental development is essential for reproductive success; failure of the feto-maternal interface results in pre-eclampsia and intrauterine growth retardation. We found that grainyhead-like 2 (GRHL2), a CP2-type transcription factor, is highly expressed in chorionic trophoblast cells, including basal chorionic trophoblast (BCT) cells located at the chorioallantoic interface in murine placentas. Placentas from Grhl2-deficient mouse embryos displayed defects in BCT cell polarity and basement membrane integrity at the chorioallantoic interface, as well as a severe disruption of labyrinth branching morphogenesis. Selective Grhl2 inactivation only in epiblast-derived cells rescued all placental defects but phenocopied intraembryonic defects observed in global Grhl2 deficiency, implying the importance of Grhl2 activity in trophectoderm-derived cells. ChIP-seq identified 5282 GRHL2 binding sites in placental tissue. By integrating these data with placental gene expression profiles, we identified direct and indirect Grhl2 targets and found a marked enrichment of GRHL2 binding adjacent to genes downregulated in Grhl2(-/-) placentas, which encoded known regulators of placental development and epithelial morphogenesis. These genes included that encoding the serine protease inhibitor Kunitz type 1 (Spint1), which regulates BCT cell integrity and labyrinth formation. In human placenta, we found that human orthologs of murine GRHL2 and its targets displayed co-regulation and were expressed in trophoblast cells in a similar domain as in mouse placenta. Our data indicate that a conserved Grhl2-coordinated gene network controls trophoblast branching morphogenesis, thereby facilitating development of the site of feto-maternal exchange. This might have implications for syndromes related to placental dysfunction

The effects of moisture and micro-structural modifications in drying mortars on vibration-based NDT methods

In this paper, we investigate the utility of vibration-based NDT tests to detect the subtle microstructural modifications and cracking damage in Portland cement mortars subjected to oven drying treatment. Both linear (resonant mode frequency and damping) and nonlinear (nonlinear hysteretic behavior) vibration test data are reported, collected from samples having a range of water to cement ratios and at two different aggregate contents. All test data are affected by the drying treatments, but it appears that the resonant mode frequency response is dominated by the reduction in internal moisture content with drying and changing aggregate cement ratio of the mixture. On the other hand, the linear mode damping, and more so the nonlinear hysteretic parameter, are more influenced by the microstructural modification and cracking damage caused by drying. In particular it appears that the nonlinear hysteretic parameter is very sensitive to internal damage and microstructural modifications caused by oven drying, but not notably sensitive to pore moisture content, and water to cement and aggregate to cement ratios. (C) 2015 Elsevier Ltd. All rights reserved.The authors want to acknowledge the financial support of the Ministerio de Economia y Competitividad (MINECO), Spain, and FEDER funding (Ondacem Project: BIA 2010-19933). J.N. Eiras wants to acknowledge the financial support provided by Ministerio de Economia y Competitividad (MINECO), Spain, grant BES-2011-044624 and grants EEBB I-13-06609, and EEBB-I-14-08993 for supporting extended visits to the University of Illinois.Eiras Fernández, JN.; Popovics, JS.; Borrachero Rosado, MV.; Monzó Balbuena, JM.; Paya Bernabeu, JJ. (2015). The effects of moisture and micro-structural modifications in drying mortars on vibration-based NDT methods. Construction and Building Materials. 94:565-571. https://doi.org/10.1016/j.conbuildmat.2015.07.078S5655719

Cultural Meanings of Utterance Repetitions

The use and different forms of repetititions in interpersonal interactions have been evaluated in several languages (Rieger 2003; Svennevig, 2004; Fujimura-Wilson, 2007; Huang, 2010) as well as in Turkish (Iekdemir 2007). The aim of this study is to examine the repetitions in more detail especially focusing on determining the functions of repetitions in conversations in Turkish. The data consisted of records of conversations among friends and the repetitions were analyzed in terms of the structural characteristics and interactional functions of repetition. The results revealed that the preference for other-repetitions were more frequent than self-repetitions. Self-repetitions were used mainly for repair in conversations. The functions of other-repetitions were acknowledgement, agreement, disagreement, rejection, request for clarification/confirmation and humor The results of the study have been discussed with respect to the relationships between use of linguistic forms and cultural characteristics

Repetitions in Turkish: talk among friends

"Wiederholungen sind Ressourcen zum Aufrechterhalten von Intersubjektivität und zur gemeinsamen Sinn(re)konstruktion in Gesprächen. In der hier vorgestellten Studie ist es darum gegangen, Wiederholungen spezifischer zu untersuchen mit Blick auf die Art der Wiederholungen (Selbst - Andere/r) in Gesprächen von Türkisch sprechenden Freund/innen. Nach einem Vergleich mit einem anderen Datenbestand zu Familiengesprächen ist ein zentrales Ergebnis, dass Nutzung und Funktion von Wiederholungen wesentlich abhängen von der Qualität und der Art der Beziehung zwischen den Gesprächsteilnehmenden." (Autorenreferat)"Repetitions are resources for maintaining intersubjectivity and collaborative meaning-making in talk. The aim of this study was to investigate repetitions in more detail in terms of types of repetitions (self-other) to determine the functions of repetitions in conversations involving friends speaking in Turkish. After a comparison with another collection of conversations among family members, it was proposed that the use and functions of repetitions in conversations were influenced and modified by the quality and type of relationship among the participants." (author's abstract

Construction of Gender in Adolescents' Dyadic Conversations

In this study, interactional strategies and tools utilized in recordings of adolescents' conversations about gender stereotypes were analyzed by using conversation analysis. The participants divided into same-gender (10 woman-woman and 10 man-man) and mixed-gender dyads (10 woman-man) with an age range of 11-14, were asked to talk about 6 picture cards each with a question regarding a gender stereotype. Analysis of recorded conversations revealed that interruptions were used by all gender groups however differ-ently in accordance with the previous studies about performance of gender in talk. The frequency of verbal interruptions were similar in same-gender dyads. In mixed-gender dyads, however, interruptions were done mostly by men. The implications of these results will be discussed in terms of literature on gender construction in verbal interactions