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Some faculty ask their students to characterize “unknown” biological sequence(s) to assess a student's skills in bioinformatics analysis and/or foster student engagement. Unfortunately, ...the ever expanding set of easily accessible, well characterized biological databases and student social media makes maintaining a set of “unknown” sequences challenging and tedious. In response, we have created FauxSeqEvolver(FaSE) to automate the electronic creation of biologically credible sequences whose genuine novelty will afford each student the full benefit of characterizing a unique and un‐annotated sequence. Faculty can customize the sequences FaSE creates by inputting one or more seed sequence(s) (which students shall hopefully uncover later as candidate homologs…), and by defining the timeline for evolutionary divergence and degree and nature of selective pressure. The software, which is implemented in BioPython and C++, iteratively mutates seed sequence(s) to simulate biomolecular evolutionary events. Upon completion, the software outputs include: 1) novel faux biological sequence(s) appropriate to challenge students to do their own novel bioinformatics characterization, and 2) a concise record of each sequence's unique attributes for the instructor's use in assessing the student's forthcoming characterization work. The author welcomes discussions with faculty who might desire to use FaSE or suggest ways to further enhance its utility.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Development of endovascular abdominal aortic aneurysms repair (EVAR), now in its 4th decade, has involved at least 16 different devices, not counting major modifications of some, only 4 of which have ...emerged from clinical trials and gained US Food and Drug Administration approval. The main impetus behind EVAR has been its potential for significantly reducing procedural mortality and morbidity, but it was also expected to speed recovery and reduce costs through decreased use of hospital resources. At the outset, EVAR was touted as a better alternative to OPEN in high-risk patients with large abdominal aortic aneurysms, and to “watchful waiting” (periodic ultrasound surveillance) for those with small abdominal aortic aneurysms. This new technology has evoked a mixed response with enthusiasts and detractors debating its pros and cons. Bias and conflict of interest exist on both sides. This review will attempt to present a balanced review of the development and current status of this controversial competition between EVAR and OPEN, comparing them in terms of the following key considerations: mortality and morbidity, complications, failure modes and durability, and costs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Improving our knowledge of the number of incarcerated youth with disabilities can assist educators, other professionals, and policymakers to develop more effective services for youth. This article ...reports the findings of a national survey conducted to determine the number of youth identified as having disabilities in the juvenile corrections systems in the United States. The data show that, when compared to the national average, there is an overrepresentation of students identified as having disabilities, especially emotional disturbance, in those systems.
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DOBA, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Middle-lobe predominant bronchiectasis affecting the right middle-lobe and/or lingula (RMLP) is classically described in asthenic, elderly females with skeletal abnormalities or associated ...nontuberculous mycobacterial (NTM) infection.
We aimed to evaluate the frequency and clinical characteristics of patients with an RMLP phenotype in a cohort of newly diagnosed bronchiectasis patients and determine associations with disease severity.
A retrospective observational cross-sectional cohort study of consecutive bronchiectasis patients in our institution was performed. Data were collected on baseline variables, microbiology status, lung function, and radiology according to the modified Bhalla score. Disease severity was assessed using bronchiectasis severity index (BSI) and FACED severity scores.
Of 81 patients (mean age SD 62.6 12.4, females 55 67.9%, BMI 26.9 5.7%), 20 (24.7%) had RMLP disease. These patients were significantly younger, female, and with lower BMIs than patients with the classical bronchiectasis phenotype (p = 0.03, 0.01, and p <0.01, respectively). Fewer symptoms of cough and daily sputum (p = 0.01 and <0.01), prior exacerbation frequency (p = 0.03), and higher baseline forced expiratory volume (p = 0.04) were noted. A higher incidence of NTM at diagnosis was demonstrated (p = 0.01). BSI and FACED severity scores in RMLP patients were significantly lower than their counterparts (both p < 0.001).
The RMLP phenotype is associated with younger patients than classically described in the literature. An increased rate of NTM infection in this phenotype was noted, particularly in females, but much lower than previously described. Lung function and disease severity scores in this patient group are relatively normal, suggesting a milder phenotype in patients with this form of the disease.
Although relatively rare, congenital arteriovenous fistulas and other vascular anomalies present a diagnostic challenge to the clinician. The same noninvasive tests that are used for diagnosing ...arterial occlusive disease in the extremities will also detect arteriovenous fistulas. These tests include segmental limb pressure measurements, segmental plethysmography, and arterial waveform analysis. Additionally, magnetic resonance imaging can be used to determine the extent of these vascular anomalies and the involvement of muscle skin and bone, all of which have a direct bearing on resectability. This article will examine these diagnostic modalities and explain how they can be used in this setting.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Vena caval filters (VCFs) were developed and initially used for therapeutic indications, primarily to prevent recurrence of pulmonary embolism (PE) or its occurrence in selected cases of deep venous ...thrombosis (DVT), where risk of PE was very high and anticoagulant therapy (AC Rx) was deemed ineffective, contraindicated by concurrent disease, or had to be discontinued because of complications. Prophylactic indications—where there was no DVT or PE but the risk of them was considered very high and AC Rx was contraindicated or considered ineffective—were invoked relatively infrequently at first, but when percutaneous placement became routine in the late 1980s, this indication increased steadily. The categories of patients considered at high-enough risk of venous thromboembolism (VTE), albeit temporary, to justify VCF have also expanded steadily, most with little objective basis for choosing VCFs over other methods of prophylaxis. In many of these prophylactic categories, eg, patients undergoing surgery associated with a high risk of VTE, the risk is for a limited period only, until the patient is ambulatory or AC Rx can be instituted. In addition, there are potential disadvantages to leaving a permanent filter in, especially in younger patients with an extended longevity outlook and no ongoing risk of VTE. This was brought out in the PREPIC trial. This realization has, in turn, spurred interest in developing temporary or retrievable filters for short-term prophylactic use. No design has yet proven entirely satisfactory for this purpose, but the practice of placing such filters for prophylactic indications has steadily grown, using available devices. This article critically reviews these trends, suggests directions for future developments, and recommends necessary studies on which to base the practice of prophylactic VCF use.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
37.
The changing face of phishing Rutherford, Robert
Computer fraud & security,
11/2018, Volume:
2018, Issue:
11
Journal Article
Peer reviewed
Using cyber attacks to steal sensitive information from businesses is nothing new. In fact, building and updating defences against data breaches is a standard requirement for IT departments around ...the world. However, as the methods of cyber criminals grow more sophisticated and persistent, the number of businesses being targeted is on the rise, with three quarters of organisations hit by phishing attacks in 2017.1
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Total lymphoid irradiation (TLI) has been used to control renal and cardiac allograft rejection. Data evaluating TLI in bronchiolitis obliterans syndrome (BOS), the physiological manifestation of ...chronic lung allograft rejection, is very limited. We present our single center experience of the safety and efficacy of TLI in controlling progressive BOS in a retrospective study.
Over 12 years, 37 lung recipients (16 M:21 F) who had undergone 13 single; 12 bilateral and 12 heart‐lung transplants were treated with TLI for progressive BOS. Grades at time TLI given were BOS 1 (n = 7) BOS 2 (n = 14) BOS 3 (n = 16). Twenty‐seven (73%) completed >8/10 fractions, 10 (27%) failed to complete TLI. Two died from advanced BOS during treatment, 8 stopped early (range 3–7 fractions) due to marrow suppression (6) or infection (2). In the 27 recipients who completed >8/10 fractions, decline in FEV1 was 122.7 mls/month pre‐TLI and 25.1 mls/month post‐TLI, p = 0.0004, mean (95% CI) change in rate of decline was 97.5 (48.2–146.7) mls/month. TLI significantly reduces the rate of decline in graft function associated with BOS. TLI is well tolerated and associated with few serious complications and is an appropriate immunosuppressive approach in progressive BOS.
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BFBNIB, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The recent endovascular aneurysm repair (EVAR) 1 and 2 and Dutch Randomized Endovascular Aneurysm Management (DREAM) trials addressed management of abdominal aortic aneurysms (AAAs) larger than 5.5 ...cm in diameter. The DREAM and EVAR 1 trials randomized patients appropriate for open repair between endovascular repair (EVAR) and open repair (OR), and the EVAR 2 trial randomized patients unfit for OR between EVAR and conservative nonoperative management (No Rx). The EVAR 1 trial showed a 3% lower initial mortality for EVAR, with a persistent reduction in aneurysm-related death at 4 years. Improvement in overall late survival was not demonstrated. Similarly, the DREAM trial observed an initial mortality advantage for EVAR, but overall 1-year survival was equivalent in both groups. Both trials found significantly higher complication and intervention rates and higher hospital costs with EVAR, and by 1 year a quality of life (QOL) benefit was not evident. The EVAR 2 trial did not demonstrate a survival advantage of EVAR with respect to nonoperative management, while noting that EVAR was associated with greater likelihood of treatment complications, subsequent interventions, and threefold higher costs. Both EVAR trials were limited by long delays between randomization and treatment. Moreover, 27% of patients in EVAR 2 crossed over from nonoperative to endovascular repair, and these patients had a lower procedure mortality from EVAR than those originally assigned to it (2%
v 9%). These 47 cases, and the exclusion of 14 patients dying while waiting for EVAR, appears to confer a survival advantage to those receiving EVAR over those receiving no treatment in a post-hoc analysis, but per-protocol analysis of the EVAR 2 trial data performed by the EVAR investigators did not show a significant difference in either all-cause or aneurysm-related mortality. Thus, outcomes of the EVAR 2 trial have not settled the choice between EVAR and no treatment in this scenario to everyone’s satisfaction. In patients with large AAAs who are fit for OR, EVAR offers an initial mortality advantage over OR, with a persistent reduction in AAA-related death at 4 years. However, EVAR offers no overall survival benefit, is more costly, and requires more interventions and indefinite surveillance with only a brief QOL benefit. It may or may not offer a mortality benefit over nonoperative management in patients with large AAAs who are unfit for open repair, but the statistical significance of this comparison is inconclusive.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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