21,694 research outputs found

    Transient ischemic attack in the twenty first century: is it still a useful construct?

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    Some argue that the term transient ischemic attack (TIA) has become obsolete in the current age of advanced modern technology. Let us look back and analyze the term, its support and detraction, and its potential continued usefulness. The best way to begin is a review of the history of the term

    No Delayed Ruptures on Long-Term Follow-Up of a Case Series of Persistently Filling Saccular Internal Carotid Artery Aneurysms After Flow Diversion With the Pipeline Embolization Device.

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    BACKGROUND AND OBJECTIVES: Flow diversion of intracranial aneurysms results in high occlusion rates. However, 10% to 20% remain persistently filling at 1 year. Often, these are retreated, but benefits of retreatment are not well established. A better understanding of the long-term rupture risk of persistently filling aneurysms after flow diversion is needed. METHODS: Our institutional database of 974 flow diversion cases was queried for persistently filling saccular aneurysms of the clinoidal, ophthalmic, and communicating segments of the internal carotid artery treated with the pipeline embolization device (PED, Medtronic). Persistent filling was defined as continued flow into the aneurysm on 1 year catheter angiogram. The clinical record was queried for retreatments and delayed ruptures. Clinical follow-up was required for at least 2 years. RESULTS: Ninety-four persistent aneurysms were identified. The average untreated aneurysm size was 5.6 mm. A branch vessel originated separately in 55% of cases from the body of the aneurysm in 10.6% of cases and from the neck in 34% of cases. Eighteen percent of aneurysms demonstrated \u3e95% filling at 1 year, and 61% were filling 5% to 95% of their original size. The mean follow-up time was 4.9 years, including 41 cases with \u3e5 years. No retreatment was undertaken in 91.5% of aneurysms. There were no cases of delayed subarachnoid hemorrhage. CONCLUSION: Among saccular internal carotid artery aneurysms treated with PED that demonstrated persistent aneurysm filling at 1 year, there were no instances of delayed rupture on long-term follow-up. These data suggest that observation may be appropriate for continued aneurysm filling at least in the first several years after PED placement

    Adipose tissue and skeletal muscle wasting precede clinical diagnosis of pancreatic cancer

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    Abstract Patients with pancreatic cancer commonly develop weight loss and muscle wasting. Whether adipose tissue and skeletal muscle losses begin before diagnosis and the potential utility of such losses for earlier cancer detection are not well understood. We quantify skeletal muscle and adipose tissue areas from computed tomography (CT) imaging obtained 2 months to 5 years before cancer diagnosis in 714 pancreatic cancer cases and 1748 matched controls. Adipose tissue loss is identified up to 6 months, and skeletal muscle wasting is identified up to 18 months before the clinical diagnosis of pancreatic cancer and is not present in the matched control population. Tissue losses are of similar magnitude in cases diagnosed with localized compared with metastatic disease and are not correlated with at-diagnosis circulating levels of CA19-9. Skeletal muscle wasting occurs in the 1–2 years before pancreatic cancer diagnosis and may signal an upcoming diagnosis of pancreatic cancer

    Distillation of 56^{56}Fe in Ultramassive O-Ne White Dwarfs

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    When white dwarfs freeze the plasma mixtures inside them undergo separation processes which can produce radical changes in the composition profile of the star. The abundance of neutron rich elements, such as 22^{22}Ne or 56^{56}Fe, determines whether or not the first crystals are more or less dense than the surrounding fluid and thus whether they sink or float. These processes have now been studied for C-O-Ne and C-O-Fe mixtures, finding that distillation and precipitation processes are possible in white dwarfs. In this work, we calculate the phase diagram of more complicated O-Ne-Fe mixtures and make predictions for the internal structure of the separated white dwarf. There are two possible outcomes determined by a complicated interplay between the Ne abundance, the 22^{22}Ne fraction, and the 56^{56}Fe abundance. Either Fe distills to form an inner core because the first O-Ne solids are buoyant, or an O-Ne inner core forms and Fe accumulates in the liquid until Fe distillation begins and forms a Fe shell. In the case of an Fe shell, a Rayleigh-Taylor instability may arise and overturn the core. In either case, Fe distillation may only produce a cooling delay of order 0.1 Gyr as these processes occur early at high white dwarf luminosities. Fe inner cores and shells may be detectable through asteroseismology and could enhance the yield of neutron rich elements such as 55^{55}Mn and 58^{58}Ni in supernovae.Comment: 8 pages, 3 figures, accepted for publication in Ap

    Speaking Swahili, Being Swahili? Some Reflections on a Shifting Field Over The Past Half Century

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    This paper is an epistemological and reflexive account of half a century of research on the Waswahili through the medium of Kiswahili. The first section asks who ‘we’ (scholars) think ‘they’ (subjects of research) are, showing how claims to Swahili identity vary according to historical, geographical and political contexts. It also points out the dangers of orientalism and exoticism and advocates the acknowledgement of the potential for local people to be fellow intellectuals. The second section discusses who ‘they’ (subjects of research) consider themselves to be and how the claiming of Swahili identity has shifted, again according to historical and geographical contexts. In the third section there is a consideration of who ‘they’ think ‘we’ scholars are, since the success of research depends a great deal on how local people perceive us, including by race, gender and education. Importantly, such success also depends on a number of credentials including fluent Kiswahili, knowledge of Islam and familiarity through multiple visits. The final section discusses who we researchers think we ourselves are, the purpose of our research and for whom we write about it. This raises questions around the ethics of research – taking and giving back data and acknowledging that the creation of knowledge is very much a joint venture between locals and researchers

    : Humanimalité: lecture écocritique d'"Alrededor de la jaula" d'Haroldo Conti

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    International audienceAlrededor de la jaula (1966) de Haroldo Conti, es una novela breve que propone una visión desencantada de una sociedad argentina marcada por las injusticias socioeconómicas. La acción de la novela, que se desarrolla en una Buenos Aires en plena mutación, se sitúa particularmente en el jardín zoológico de Palermo, espacio que ha sido estudiado como metáfora de la situación que viven las clases populares y que abordaremos desde una perspectiva ecocrítica, interesándonos en el modelo de relación hombre-animal que propone este texto visionario en muchos aspectos.Alrededor de la jaula (1966) de Haroldo Conti est un court roman qui donne une vision désenchantée d’une société argentine marquée par des inégalités socio-économiques fortes. Le roman, qui a pour toile de fond une Buenos Aires en pleine mutation, se passe en grande partie au jardin zoologique de Palermo. Cet espace, qui a été analysé comme métaphore de la situation d’oppression vécue par les classes populaires est abordé dans ce travail à partir d’une perspective éco-critique qui met en avant les rapports – à maints égards visionnaires- entre hommes et animaux proposés par le romancier

    Feasibility and Acceptability of Facilitated Advance Care Planning in Outpatient Clinics: A Qualitative Study of Patient and Caregivers Experiences

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    Guidelines recommend advance care planning (ACP) for people with advanced illness; however, evidence supporting ACP as a component of outpatient care is lacking. We sought to establish the feasibility and acceptability of a facilitated ACP intervention for people attending tertiary outpatient clinics. Data from 20 semi-structured interviews with patient (M = 79.3 ± 7.7, 60% male) and caregiver (M = 68.1 ± 11.0, 60% female) participants recruited as part of a pragmatic, randomized controlled trial (RCT) were analyzed using qualitative descriptive methodology. Patients were randomized to intervention (e.g., facilitated support) or control (e.g., standard care). Intervention patients expressed high satisfaction, reporting the facilitated ACP session was clear, straightforward, and suited to their needs. Intervention caregivers did not report any significant concerns with the facilitated ACP process. Control participants reported greater difficulty completing ACP compared to intervention participants. Embedding facilitated ACP into tertiary outpatient care appears feasible and acceptable for people with advanced illnesses

    Effects of NEKL depletion on Golgi compartments.

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    (A) Representative confocal images of Phyp7::AMAN-2::mNeonGreen expression in the indicated backgrounds. (B, C) Mean intensity of Phyp7::AMAN-2::mNeonGreen expression (B) and the mean number of Phyp7::AMAN-2::mNeonGreen-positive vesicles (C) for individual worms were plotted in the graphs. (D) Representative confocal images of Phyp7::AMAN-2::mNeonGreen co-expressed with a functional multi-copy NEKL-3::mCherry reporter. Error bars represent the 95% confidence intervals. p-Values were obtained by comparing means using an unpaired t-test: ****p 0.05). Raw data are available in S1 File. (TIFF)</p
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