Abildtruphegelund4336
Legacy mining impacts at Lake Charles and non-mining related environmental changes in the post-1950 sediments at both lakes have thus combined to structure assemblage compositions of primary consumers. At both lakes, assemblages of pelagic-dominated Cladocera differed (p ≤ 0.05) during the mining period compared to periods before and after mining. Taxon richness differed (p ≤ 0.01) only between the pre- and post-mining periods at mining-impacted Lake Charles and reflects long-term declines of substrate-dwelling littoral taxa. Geochemical and biological recovery have not completely occurred at Lake Charles despite the mine district's closure ~80 years ago. Our findings demonstrate that impacts of ore processing and amalgamation from historical gold mining, combined with recent watershed stressors, continue to affect sedimentary arsenic geochemistry and intermediate trophic levels of nearby, downstream aquatic habitats.Melioidosis is an endemic disease in Southeast Asia and Oceania caused by the gram-negative bacillus Burkholderia pseudomallei. We studied 15 adult patients from Colombia with microbiologically diagnosed pulmonary melioidosis. We reviewed 15 chest X-rays and 10 chest computed tomography (CT) studies. Of the 15 patients, 87% met the criteria for acute infection and 13% met the criteria for chronic infection. The most common findings on chest X-rays were consolidation (86%), nodules (26%), and cavitation (20%). On CT studies, consolidation and nodules were observed in 90% of cases; the areas of consolidation were predominantly located in the basal and central zones in 60%. Areas of cavitation were observed in 50%, pleural effusion in 60%, and mediastinal lymph nodes in 30%. In patients with acute pulmonary melioidosis (n=8), the findings observed were nodules (100%), mixed pattern with nodules and consolidation (87%), pleural effusion (88%), and mediastinal lymph nodes (25%). The two patients with chronic pulmonary melioidosis both had cavitation. Acute lung infection with B. Pseudomallei has radiologic manifestations similar to those of pneumonia due to other causes. Phycocyanobilin price In areas where the disease is endemic, it is essential to include acute melioidosis in the differential diagnosis of pulmonary nodules and chronic melioidosis in the differential diagnosis of cavitated chronic lung lesions.More than 30 years have passed since Mehler et al. (1988) proposed that newborns can discriminate between languages that belong to different rhythm classes stress-, syllable- or mora-timed. Thereupon they developed the hypothesis that infants are sensitive to differences in vowel and consonant interval durations as acoustic correlates of rhythm classes. It remains unknown exactly which durational computations infants use when perceiving speech for the purposes of distinguishing languages. Here, a meta-analysis of studies on infants' language discrimination skills over the first year of life was conducted, aiming to quantify how language discrimination skills change with age and are modulated by rhythm classes or durational metrics. A systematic literature search identified 42 studies that tested infants' (birth to 12 months) discrimination or preference of two language varieties, by presenting infants with auditory or audio-visual continuous speech. Quantitative data synthesis was conducted using multivariateonalise rhythm in language in the extent to which it accounts for infants' language discrimination abilities.
Targeting the modifiable risk factors for coronary artery disease (CAD) has substantial impact at the community level. However, it is not uncommon for individuals to present with atherosclerosis related events without identified risk factors. We examined sex differences in the association of risk factors and atherosclerotic burden assessed by CT coronary angiography (CTCA).
We analysed clinical and imaging data in 1002 individuals in the BioHEART cohort.
45% were female, 35% had no CAD identified. Median coronary calcium score was 9.9 Agatston units (IQR 0-146), and median Gensini Score was 3.5 (IQR 0-11.5). 26% had a calcified plaque predominant phenotype, and 18% had a non-calcified plaque predominant phenotype. There were no sex differences in the prevalence of risk factors. However, there were notable sex differences in the adjusted associations of risk factors with CAD. Age and hypercholesterolaemia (OR 1.56, 95% CI 1.03-2.36, p=0.04 in males, and OR 1.75, 95% CI 1.09-2.78, p =0.02 in females) were associated with the presence of CAD in both genders (p<0.05). Diabetes and smoking were associated with presence of CAD, calcified CAD, and non-calcified plaque in males (p <0.05) but not females. In women, none of the standard modifiable risk factors were associated with the amount of plaque present when adjusted for age, BMI, and family history of premature CAD.
CTCA provides an important opportunity for improving the stratification of cohorts to assess underlying biology and risk. We demonstrate sex-specific differences in associations of risk factors with atherosclerosis burden.
CTCA provides an important opportunity for improving the stratification of cohorts to assess underlying biology and risk. We demonstrate sex-specific differences in associations of risk factors with atherosclerosis burden.
Western literature lacks large-scale population studies comparing the influence of academic and high-volume (HV) versus low-volume (LV) cancer centers on gastric cancer oncologic outcomes.
The National Cancer Database from 2004 to 2016 was used.
22871 patients were studied. Patients with stage III signet-ring cell gastric carcinoma (SRGC) received neoadjuvant treatment (NAT) more frequently at academic and HV comprehensive cancer centers (OR 4.27 and 2.42; p<0.0001 and 0.009) compared to community centers. Patients with stage III non-SRGC (NSRGC) had a 2.4 times higher odds of receiving NAT at academic centers. The R1 resection rate for NSRGC was lower at academic centers (OR 0.67; p=0.0018). Lymph node harvest ≥15 nodes was 1.6 and 1.9 times higher at academic centers for NSRGC and SRGC, respectively. Patients treated at academic centers had a significantly improved overall survival (OS).
Treatment at academic centers is associated with significant improvements in oncologic metrics and OS.
Treatment at academic centers is associated with significant improvements in oncologic metrics and OS.
To evaluate whether physicians' choice of ovarian stimulation protocol is associated with laboratory outcomes.
Retrospective cohort study.
Single academic center.
The subjects were 4,458 patients who completed more than one invitro fertilization ovarian stimulation cycle within 1 year. On second stimulation, 49% repeated the same protocol and 51% underwent a different one.
Estradiol priming antagonist, antagonist +/- oral contraceptive pill priming, long luteal protocol, Lupron (Lupron [AbbVie Inc, North Chicago, IL]) stop protocol, and flare were compared. Logistic or linear regression with cluster robust standard errors to account for covariates and paired data was used.
Oocytes collected (OC), fertilization rate, blastocyst progression (BP), usable embryos (UE), and euploid rate (ER).
First stimulation outcomes were comparable across all protocols for FR, BP, UE, and ER but were different for OC, after adjustment for covariates. For OC, the effect of switching protocols differed according to nsideration should be made before switching stimulation protocols for the purpose of improving laboratory outcomes.
Point-of-care ultrasonography can estimate gastric contents and volume to assess the risk of pulmonary aspiration; however, its use in infants has not been well validated. We aimed to develop a predictive model for estimating gastric fluid volume using ultrasonography in infants.
This prospective observational study enrolled 200 infants (≤12 months) undergoing general anaesthesia. After anaesthetic induction, while preserving spontaneous respiration, we measured gastric antral cross-sectional area using ultrasonography in both the supine and right lateral decubitus positions. We then suctioned the gastric content and measured its volume. The primary outcome was development of a gastric fluid volume prediction model with multiple regression analysis. Agreement between the predicted volume and the suctioned volume was evaluated using a Bland-Altman plot.
Overall, 192 infants were included in the final analysis. Pearson correlation analysis showed that the gastric antral cross-sectional area in the supine (P<0.001; correlation coefficient 0.667) and right lateral decubitus (P<0.001; correlation coefficient 0.845) positions and qualitative antral grade (P<0.001; correlation coefficient 0.581) correlated with suctioned volume. We developed a predictive model predicted volume (ml)=-3.7+6.5× (right lateral decubitus cross-sectional area [cm
])-3.9 (supine cross-sectional area [cm
])+1.7× grade (P<0.01). When comparing the predicted volume and suctioned volume, the mean bias was 0.01mlkg
and the limit of agreement was -0.58 to 0.62mlkg
.
Gastric fluid volume can be estimated using a predictive model based on ultrasonography data in infants.
NCT03155776.
NCT03155776.
Tricuspid atresia with normally related great vessels (TA) is considered the optimal substrate for the Fontan pathway. The factors associated with death or transplantation after cavopulmonary shunt (CPS) are underappreciated. We aimed to determine factors associated with CPS-Fontan interstage death/transplantation versus transition to Fontan in TA.
A total of 417 infants younger than 3months of age with TA were enrolled (January 1999 to February 2020) from 40 institutions into the Congenital Heart Surgeons' Society TA cohort. Parametric competing risk methodology was used to determine factors associated with the competing end points of death/transplantation without Fontan completion, and transition to Fontan.
CPS was performed in 382 patients with TA; of those, 5% died or underwent transplantation without transition to Fontan and 91% transitioned to Fontan by 5years after CPS. Prenatal diagnosis (hazard ratio [HR], 0.74; P<.001) and pulmonary artery band (PAB) at CPS (HR, 0.50; P<.001) were negati circulation.
It has been hypothesized that the survival benefit of coronary artery bypass (CABG) compared with percutaneous interventions (PCI) may be associated with the reduction in spontaneous myocardial infarction (SMI) achieved by surgery. This, however, has not been formally investigated. The present meta-analysis aims to evaluate the association between the difference in SMI and in survival in PCI versus CABG randomized controlled trials (RCTs).
A systematic search was performed to identify all RCTs comparing PCI with CABG for the treatment of coronary artery disease and reporting SMI outcomes. Generic inverse variance method was used to pool outcomes as natural logarithms of the incident rate ratios across studies. Subgroup analysis and interaction test were used to compare the difference of the primary outcome among trials that did and did not report a significant reduction in SMI- in the patients treated by CABG. Primary outcome was all-cause mortality; secondary outcome was SMI.
Twenty RCTs were included in the meta-analysis.
