A review of congenital heart block

Congenital heart block is a rare disorder. It has an incidence of about 1 in 22,000 live births. It may be associated with high mortality and morbidity. This should generate a high index of suspicion for early diagnosis and aggressive therapy when appropriate. The congenital heart block associated with neonatal lupus is considered a form of passively acquired autoimmune disease in which maternal autoantibodies to the intracellular ribonucleoproteins Ro (SS-A) and La (SS-B), cross the placenta and injure the previously normal fetal heart. Women with serum titers of anti-Ro antibody carry a 3% risk of having a child with neonatal lupus syndrome. Recurrence rates are about 18%. We believe that serial echocardiograms should be acquired so that early diagnosis is made and aggressive therapy administered, if signs of conduction system disease such as PR interval prolongation by Doppler are found, so as to optimize the outcome. Establishment of guidelines for therapy have been set empirically, should signs of congenital heart block develop. Those patients whose congenital heart block is associated with structural heart disease have a higher morbidity and mortality, which is determined more by the underlying structural congenital heart disease than it is by the need for a pacemaker per se.peer-reviewe

Fabrication of biodegradable poly(lactic acid) particles in flow focusing glass capillary devices

Fabrication of biodegradable poly(lactic acid) particles in flow focusing glass capillary device

Emulsion templating of poly(lactic acid) particles: droplet formation behavior

Monodisperse poly(dl-lactic acid) (PLA) particles of diameters between 11 and 121 ?m were fabricated in flow focusing glass microcapillary devices by evaporation of dichloromethane (DCM) from emulsion droplets at room temperature. The dispersed phase was 5% (w/w) PLA in DCM containing 0.1−2 mM Nile red and the continuous phase was 5% (w/w) poly(vinyl alcohol) in reverse osmosis water. Particle diameter was 2.7 times smaller than the diameter of the emulsion droplet template indicating very low particle porosity. Monodisperse droplets have only been produced under dripping regime using a wide range of dispersed phase flow rates (0.002−7.2 cm3h-1), continuous phase flow rates (0.3−30 cm3h-1) and orifice diameters (50−237 ?m). In the dripping regime, the ratio of droplet diameter to orifice diameter was inversely proportional to the 0.39 power of the ratio of the continuous phase flow rate to dispersed phase flow rate. Highly uniform droplets with a coefficient of variation (CV) below 2 % and a ratio of the droplet diameter to orifice diameter of 0.5−1 were obtained at flow rate ratios of 4−25. Under jetting regime, polydisperse droplets (CV > 6 %) were formed by detachment from relatively long jets (between 4 and 10 times longer than droplet diameter) and a ratio of the droplet size to orifice size was 2−5

Fabrication of monodisperse poly(dl- lactic acid) microparticles using drop microfluidics

Monodisperse poly(dl-lactic acid) particles with a diameter between 11 and 121 μm were fabricated by drop microfluidics/solvent evaporation method using flow focusing glass capillary device. In the dripping regime, the ratio of droplet diameter to orifice diameter was in the range of 0.37−1.34 and was inversely proportional to the 0.39 power of the ratio of the continuous phase flow rate to dispersed phase flow rate

Fabrication of biodegradable poly(lactic acid) particles in flow-focusing glass capillary devices

Monodisperse poly(dl-lactic acid) (PLA) particles with a diameter in the range from 12 to 100 9m were fabricated in flow focusing glass capillary devices by evaporation of dichloromethane (DCM) from emulsions at room temperature. The dispersed phase was 5% (w/w) PLA in DCM containing a small amount of Nile red and the continuous phase was 5% (w/w) poly(vinyl alcohol) in reverse osmosis water. Particle diameter was 2.7 times smaller than the size of the emulsion droplet template indicating that the particle porosity was very low. SEM images revealed that the majority of particle pores are in the sub-micron region but in some instances these pores can reach 3 9m in diameter. Droplet diameter was influenced by the flow rates of the two phases and the entry diameter of the collection capillary tube; droplet diameters decreased with increasing values of the flow rate ratio of the dispersed to continuous phase to reach constant minimum values at 40-60 % orifice diameter. At flow rate ratios less than 5, jetting can occur, giving rise to large droplets formed by detachment from relatively long jets (~10 times longer than droplet diameter)

Child Poverty Monitor: Technical Report 2017

The Child Poverty Monitor and this Technical Report provide data on a set of indicators that assess aspects of child poverty in New Zealand and their implications for child wellbeing. In it are data on income and non-income measures of poverty, including measures that reflect increasing levels of severity. Other data include indicators related to health, living conditions, education, and a selection of economic measures used to assess how well we are doing as a nation that are relevant to the wellbeing of children and their families. The Child Poverty Monitor is a partnership comprising the Office of the Children’s Commissioner, the University of Otago’s New Zealand Child and Youth Epidemiology Service (NZCYES) and the J R McKenzie Trust. The purpose is to compile and share robust information on child poverty measures that are publicly available and easily accessible. Only by having the essential measures on child poverty in New Zealand compiled, published and disseminated annually can we tell how well we are progressing in effectively reducing child poverty in our nation

The correlation between reading and mathematics ability at age twelve has a substantial genetic component

Dissecting how genetic and environmental influences impact on learning is helpful for maximizing numeracy and literacy. Here we show, using twin and genome-wide analysis, that there is a substantial genetic component to children’s ability in reading and mathematics, and estimate that around one half of the observed correlation in these traits is due to shared genetic effects (so-called Generalist Genes). Thus, our results highlight the potential role of the learning environment in contributing to differences in a child’s cognitive abilities at age twelve

Microencapsulated islet allografts in diabetic NOD mice and nonhuman primates

OBJECTIVE: Our goal was to assess the efficacy of encapsulated allogeneic islets transplanted in diabetic NOD mice and streptozotocin (STZ)-diabetic nonhuman primates (NHPs).MATERIALS AND METHODS: Murine or NHP islets were microencapsulated and transplanted in non-immunosuppressed mice or NHPs given clinically-acceptable immunosuppressive regimens, respectively. Two NHPs were treated with autologous mesenchymal stem cells (MSCs) and peri-transplant oxygen therapy. Different transplant sites (intraperitoneal [i.p.], omental pouch, omental surface, and bursa omentalis) were tested in separate NHPs. Graft function was monitored by exogenous insulin requirements, fasting blood glucose levels, glucose tolerance tests, percent hemoglobin A1c (% HbA1c), and C-peptide levels. In vitro assessment of grafts included histology, immunohistochemistry, and viability staining; host immune responses were characterized by flow cytometry and cytokine/chemokine multiplex ELISAS.RESULTS: Microencapsulated islet allografts functioned long-term i.p. in diabetic NOD mice without immunosuppression, but for a relatively short time in immunosuppressed NHPs. In the NHPs, encapsulated allo-islets initially reduced hyperglycemia, decreased exogenous insulin requirements, elevated C-peptide levels, and lowered % HbA1c in plasma, but graft function diminished with time, regardless of transplant site. At necropsy, microcapsules were intact and non-fibrotic, but many islets exhibited volume loss, central necrosis and endogenous markers of hypoxia. Animals receiving supplemental oxygen and autologous MSCs showed improved graft function for a longer post-transplant period. In diabetic NHPs and mice, cell-free microcapsules did not elicit a fibrotic response.CONCLUSIONS: The evidence suggested that hypoxia was a major factor for damage to encapsulated islets in vivo. To achieve long-term function, new approaches must be developed to increase the oxygen supply to microencapsulated islets and/or identify donor insulin-secreting cells which can tolerate hypoxia.</p

GEDI launches a new era of biomass inference from space

Accurate estimation of aboveground forest biomass stocks is required to assess the impacts of land use changes such as deforestation and subsequent regrowth on concentrations of atmospheric CO2. The Global Ecosystem Dynamics Investigation (GEDI) is a lidar mission launched by NASA to the International Space Station in 2018. GEDI was specifically designed to retrieve vegetation structure within a novel, theoretical sampling design that explicitly quantifies biomass and its uncertainty across a variety of spatial scales. In this paper we provide the estimates of pan-tropical and temperate biomass derived from two years of GEDI observations. We present estimates of mean biomass densities at 1 km resolution, as well as estimates aggregated to the national level for every country GEDI observes, and at the sub-national level for the United States. For all estimates we provide the standard error of the mean biomass. These data serve as a baseline for current biomass stocks and their future changes, and the mission's integrated use of formal statistical inference points the way towards the possibility of a new generation of powerful monitoring tools from space