Double chambered right ventricle with severe calcification of the tricuspid valve in an elderly woman: a case report

<p>Abstract</p> <p>Introduction</p> <p>Double chambered right ventricle is a rare congenital cardiac anomaly in which the right ventricle is divided into two chambers by an anomalous muscle bundle. The diagnosis of this disorder is difficult in adults. Calcification of the tricuspid valve is extremely rare, and very few cases have been reported. Most cases of tricuspid valve calcification had a congenital disorder with high pressure in the right ventricle.</p> <p>Case presentation</p> <p>We report a rare case of a 71-year-old Japanese woman who presented with chest discomfort, and was found to have a double chambered right ventricle with severe calcification of the tricuspid valve. This abnormality was found by echocardiography, and the diagnosis was confirmed by multislice cardiac computerized tomography, cardiac magnetic resonance imaging, and cardiac catheterization. Our patient rejected surgical repair, and medical therapy with carvedilol was effective to reduce her symptoms.</p> <p>Conclusion</p> <p>Calcification of the tricuspid valve is extremely rare, and considered to be due to high pressure in the right ventricle. To the best of our knowledge, there are no other reported cases of this combination of double chambered right ventricle and calcification of the tricuspid valve.</p

Proteomic and Physiological Responses of Kineococcus radiotolerans to Copper

Copper is a highly reactive, toxic metal; consequently, transport of this metal within the cell is tightly regulated. Intriguingly, the actinobacterium Kineococcus radiotolerans has been shown to not only accumulate soluble copper to high levels within the cytoplasm, but the phenotype also correlated with enhanced cell growth during chronic exposure to ionizing radiation. This study offers a first glimpse into the physiological and proteomic responses of K. radiotolerans to copper at increasing concentration and distinct growth phases. Aerobic growth rates and biomass yields were similar over a range of Cu(II) concentrations (0–1.5 mM) in complex medium. Copper uptake coincided with active cell growth and intracellular accumulation was positively correlated with Cu(II) concentration in the growth medium (R2 = 0.7). Approximately 40% of protein coding ORFs on the K. radiotolerans genome were differentially expressed in response to the copper treatments imposed. Copper accumulation coincided with increased abundance of proteins involved in oxidative stress and defense, DNA stabilization and repair, and protein turnover. Interestingly, the specific activity of superoxide dismutase was repressed by low to moderate concentrations of copper during exponential growth, and activity was unresponsive to perturbation with paraquot. The biochemical response pathways invoked by sub-lethal copper concentrations are exceptionally complex; though integral cellular functions are preserved, in part, through the coordination of defense enzymes, chaperones, antioxidants and protective osmolytes that likely help maintain cellular redox. This study extends our understanding of the ecology and physiology of this unique actinobacterium that could potentially inspire new biotechnologies in metal recovery and sequestration, and environmental restoration

Disseminating research findings: what should researchers do? A systematic scoping review of conceptual frameworks

Background: Addressing deficiencies in the dissemination and transfer of research-based knowledge into routine clinical practice is high on the policy agenda both in the UK and internationally. However, there is lack of clarity between funding agencies as to what represents dissemination. Moreover, the expectations and guidance provided to researchers vary from one agency to another. Against this background, we performed a systematic scoping to identify and describe any conceptual/organising frameworks that could be used by researchers to guide their dissemination activity.Methods: We searched twelve electronic databases (including MEDLINE, EMBASE, CINAHL, and PsycINFO), the reference lists of included studies and of individual funding agency websites to identify potential studies for inclusion. To be included, papers had to present an explicit framework or plan either designed for use by researchers or that could be used to guide dissemination activity. Papers which mentioned dissemination (but did not provide any detail) in the context of a wider knowledge translation framework, were excluded. References were screened independently by at least two reviewers; disagreements were resolved by discussion. For each included paper, the source, the date of publication, a description of the main elements of the framework, and whether there was any implicit/explicit reference to theory were extracted. A narrative synthesis was undertaken.Results: Thirty-three frameworks met our inclusion criteria, 20 of which were designed to be used by researchers to guide their dissemination activities. Twenty-eight included frameworks were underpinned at least in part by one or more of three different theoretical approaches, namely persuasive communication, diffusion of innovations theory, and social marketing.Conclusions: There are currently a number of theoretically-informed frameworks available to researchers that can be used to help guide their dissemination planning and activity. Given the current emphasis on enhancing the uptake of knowledge about the effects of interventions into routine practice, funders could consider encouraging researchers to adopt a theoretically-informed approach to their research dissemination

Toward a Comprehensive Approach to the Collection and Analysis of Pica Substances, with Emphasis on Geophagic Materials

Pica, the craving and subsequent consumption of non-food substances such as earth, charcoal, and raw starch, has been an enigma for more than 2000 years. Currently, there are little available data for testing major hypotheses about pica because of methodological limitations and lack of attention to the problem.In this paper we critically review procedures and guidelines for interviews and sample collection that are appropriate for a wide variety of pica substances. In addition, we outline methodologies for the physical, mineralogical, and chemical characterization of these substances, with particular focus on geophagic soils and clays. Many of these methods are standard procedures in anthropological, soil, or nutritional sciences, but have rarely or never been applied to the study of pica.Physical properties of geophagic materials including color, particle size distribution, consistency and dispersion/flocculation (coagulation) should be assessed by appropriate methods. Quantitative mineralogical analyses by X-ray diffraction should be made on bulk material as well as on separated clay fractions, and the various clay minerals should be characterized by a variety of supplementary tests. Concentrations of minerals should be determined using X-ray fluorescence for non-food substances and inductively coupled plasma-atomic emission spectroscopy for food-like substances. pH, salt content, cation exchange capacity, organic carbon content and labile forms of iron oxide should also be determined. Finally, analyses relating to biological interactions are recommended, including determination of the bioavailability of nutrients and other bioactive components from pica substances, as well as their detoxification capacities and parasitological profiles.This is the first review of appropriate methodologies for the study of human pica. The comprehensive and multi-disciplinary approach to the collection and analysis of pica substances detailed here is a necessary preliminary step to understanding the nutritional enigma of non-food consumption

The Decision to Outsource: A Case Study of the Complex Interplay Between Strategic Wisdom and Behavioural Reality

The last two decades have seen an unprecedented growth in the use of outsourcing interventions in diverse organisational contexts. This phenomenon can be viewed as a means of unbundling the vertically integrated activities of organisations in response to existing strategic wisdoms that focus upon value-creating activities as a means of enhancing an organisation's sustainable competitive advantage. This paper explores the delicate balance between these more conventional strategic motives and the more complex, emergent and interconnected behavioural impacts and considerations in the context of a decision to outsource the meter reading activities of a well-established, publicly listed Australian energy company. By drawing upon the idiosyncratic experiences reported by particular groups of individuals involved in, or affected by, an outsourcing decision, the authors note some important lessons that may inform the pursuit of such decisions in the future.In recent years the outsourcing phenomenon has fundamentally altered the processing and delivery of a wide range of -goods and services by organisations in public, private and not-for-profit sectors (Auguste et al. 2002; Osterman 1998; Industry Commission 1996; Domberger &amp; Hall 1995). Despite the stellar rise of outsourcing as a mainstream management tool, outsourcing's proponents seem unable to successfully distance themselves from ongoing questioning of the rationale for, and fallout resulting from, its adoption (Jennings 2002: Doig et a1. 2001; Humphry 2000: Hunter &amp; Gates 1998; Commonwealth Ombudsman 1996; Rees &amp; Rodley 1995).Much of the debate and research relating to outsourcing has been informed by the principles of transaction cost economics (Williamson 1979; Williamson 1975; Coase 1937) whereby the make-or-buy decision is crystallised by simply comparing the costs of managing transactions (using the market) with production costs (producing internally). In short, the transaction cost approach suggests that markets are most efficient for all transactions, except those that involve assets of a highly specialised nature used frequently as these represent a set of circumstances open to opportunistic behaviour by the market.However, the hard lessons learned with the passage of time have shown (the informed observer) that managers who limit their sourcing decisions to cost comparisons alone are likely to run the risk of seeing their organisation wither and die: rigorous cost analysis is a part, albeit an important part, of a plethora of other strategic considerations that combine to move an organisation toward its long-term goals and objectives (Fill &amp; Viser 2000; Rule 1999; Meredith 1998; Domberger 1998; Hunter &amp; Gates 1998: Hodge 1996: Kochan et al. 1994). Indeed, this strategic context forms the cornerstone from which this paper proceeds to explore the appropriateness and meaningfulness of the strategic literature's conception of outsourcing decisions for the realities of a complex and dynamic operating environment

Discovering strategic lessons for 'surfing' the outsourcing wave and avoiding the 'wipe-outs'

The last two decades have seen an unprecedented growth in the use of outsourcing interventions in diverseorganisational contexts, as a means of 'unbundling' the vertically integrated activities of organisationsdriven by evolving strategic 'wisdoms' that focus upon value-creating activities that underpin sustainablecompetitive advantage. This paper explores the delicate balance between more conventional strategicmotives and the more complex, emergent and interconnected behavioural impacts and considerations inthe context of an outsourcing decision in a specific case study organisation. By drawing upon theidiosyncratic experiences reported by particular groups of individuals involved in, or affected by, anoutsourcing decision, we note some important lessons that may inform the pursuit of such decisions in thefuture

Thermal Parameters Analysis During Directional Solidification Of Al-Cu Eutectic Alloys

Al-Cu eutectic alloy samples (Al-33.2wt.%Cu) were solidified directionally upward under conditions which produce the columnar-to-equiaxed transition (CET) phenomenon. The position of the CET was located in each sample and the distance from the bottom of the ingot was measured. During solidification the distribution of temperatures were measured by means of thermocouples located strategically. From the measured temperatures the following parameters were obtained; local temperature gradient, cooling rate of the liquid and solid and growth rate. Three different velocities of heat extraction were employed and the temperature gradient reaches values of 2.1 ºC/cm, 0.1 °C/cm and -4.3ºC/cm, respectively. The results are presented and discussed comparing with the results obtained in the case of CET in dendritic Al-Cu alloysFil: Kociubczyk, Alex Iván. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Nordeste. Instituto de Materiales de Misiones; ArgentinaFil: Cabello, Federico. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Schvezov, Carlos Enrique. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Nordeste. Instituto de Materiales de Misiones; ArgentinaFil: Gregorutti, Ricardo Walter. Universidad Nacional de La Plata; ArgentinaFil: Ares, Alicia Esther. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnológico Nordeste. Instituto de Materiales de Misiones; Argentin