Abstract
In the past 20 years, peripheral artery disease (PAD) has been increasingly recognized as a significant cause of morbidity and mortality in the United States. PAD has traditionally been ...identified as a male-dominant disease; however, recent population trends and studies in PAD suggest that women are affected at least as often as men. Women comprise a larger population of the elderly than men, as well as an increasing proportion of patients with PAD. Much of the existing research on PAD has focused on whole populations, and gender-specific data on PAD is sparse. This review focuses on gender-specific differences in presentation, management, and outcomes of PAD intervention that are important considerations for the interventional radiologist.
Interview and questionnaire studies have identified barriers and challenges to preventing surgical site infections (SSIs) by focusing on compliance with recommendations and care bundles using ...interviews, questionnaires and expert panels. This study proposes a more comprehensive investigation by using observations of clinical practice plus interviews which will enable a wider focus.
To comprehensively identify the factors which affect SSI prevention using cardiac surgery as an exemplar.
The study consisted of 130 h of observed clinical practice followed by individual semi-structured interviews with 16 surgeons, anaesthetists, theatre staff, and nurses at four cardiac centres in England. Data were analysed thematically.
The factors were complex and existed at the level of the intervention, the individual, the team, the organization, and even the wider society. Factors included: the attributes of the intervention; the relationship between evidence, personal beliefs, and perceived risk; power and hierarchy; leadership and culture; resources; infrastructure; supplies; organization and planning; patient engagement and power; hospital administration; workforce shortages; COVID-19 pandemic; ‘Brexit’; and the war in Ukraine.
This is one of the first studies to provide a comprehensive overview of the factors affecting SSI prevention. The factors are complex and need to be fully understood when trying to reduce SSIs. A strong evidence base was insufficient to ensure implementation of an intervention.
The Wind Imaging Interferometer (WINDII) was launched on the NASA's Upper Atmosphere Research Satellite on 12 September 1991 and operated until 2003. Its role in the mission was to measure vector ...winds in the Earth's atmosphere from 80 to 110 km, but its measurements extended to nearly 300 km. The approach employed was to measure Doppler shifts from a suite of visible region airglow lines emitted over this altitude range. These included atomic oxygen O(1S) and O(1D) lines, as well as lines in the OH Meinel (8,3) and O2 Atmospheric (0,0) bands. The instrument employed was a Doppler Michelson Interferometer that measured the Doppler shift as a phase shift of the cosinusoidal interferogram generated by single airglow lines. An extensive validation program was conducted after launch to confirm the accuracy of the measurements. The dominant wind field, the first one observed by WINDII, was that of the migrating diurnal tide at the equator. The overall most notable WINDII contribution followed from this: determining the influence of dynamics on the transport of atmospheric species. Currently, nonmigrating tides are being studied in the thermosphere at both equatorial and high latitudes. Other aspects investigated included solar and geomagnetic influences, temperatures from atmospheric‐scale heights, nitric oxide concentrations, and the occurrence of polar mesospheric clouds. The results of these observations are reviewed from a perspective of 20 years. A future perspective is then projected, involving more recently developed concepts. It is intended that this description will be helpful for those planning future missions.
Key Points
Doppler Michelson interferometers excel in atmospheric space wind measurements
Upper atmosphere winds dramatically influence atomic oxygen concentrations
The thermosphere has enormous scope for future atmospheric dynamics measurements
In patients with advanced idiopathic pulmonary fibrosis, treatment with sildenafil was compared with placebo. In the sildenafil group, there was a nonsignificant trend toward improvement and some ...benefit in other physiological measures and symptom scores.
Idiopathic pulmonary fibrosis is a chronic, progressive lung disease of unknown cause that is characterized by the histopathologic pattern of usual interstitial pneumonia.
1
Progression to end-stage respiratory insufficiency and death within 5 years after the onset of symptoms is characteristic.
2
,
3
To date, no pharmacologic therapies have definitively been shown to improve survival or quality of life in patients with this disease.
Patients with severe idiopathic pulmonary fibrosis have abnormalities of the pulmonary vasculature leading to decreased levels of resting and exercise-induced production of nitric oxide. Since nitric oxide is a potent pulmonary vasodilator, reduced levels are associated with pulmonary . . .
Herbal medicinal products are widely used, vary greatly in content and quality, and are actively tested in randomized, controlled trials (RCTs). The authors' objective was to develop recommendations ...for reporting RCTs of herbal medicine interventions, based on the need to elaborate on the 22-item CONSORT (Consolidated Standards of Reporting Trials) checklist. Telephone calls were made and a consensus meeting was held with 16 participants in Toronto, Canada, to develop these recommendations. The group agreed on context-specific elaborations of 9 CONSORT checklist items for RCTs of herbal medicines. Item 4, concerning the herbal medicine intervention, required the most extensive elaboration. These recommendations have been developed to improve the reporting of RCTs using herbal medicine interventions.
Abstract
We present new discoveries and results from long-term timing of 72 pulsars discovered in the Pulsar Arecibo
L
-band Feed Array (PALFA) survey, including precise determination of astrometric ...and spin parameters, and flux density and scatter broadening measurements at 1.4 GHz. Notable discoveries include two young pulsars (characteristic ages ∼30 kyr) with no apparent supernova remnant associations, three mode-changing, 12 nulling and two intermittent pulsars. We detected eight glitches in five pulsars. Among them is PSR J1939+2609, an apparently old pulsar (characteristic age ∼1 Gy), and PSR J1954+2529, which likely belongs to a newly emerging class of binary pulsars. The latter is the only pulsar among the 72 that is clearly not isolated: a nonrecycled neutron star with a 931 ms spin period in an eccentric (
e
= 0.114) wide (
P
b
= 82.7 days) orbit with a companion of undetermined nature having a minimum mass of ∼0.6
M
⊙
. Since operations at Arecibo ceased in 2020 August, we give a final tally of PALFA sky coverage, and compare its 207 pulsar discoveries to the known population. On average, they are 50% more distant than other Galactic plane radio pulsars; PALFA millisecond pulsars (MSPs) have twice the dispersion measure per unit spin period than the known population of MSP in the plane. The four intermittent pulsars discovered by PALFA more than double the population of such objects, which should help to improve our understanding of pulsar magnetosphere physics. The statistics for these, rotating radio transients, and nulling pulsars suggest that there are many more of these objects in the Galaxy than was previously thought.
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease with an estimated prevalence of 1 in 5000 that is characterized by the presence of vascular malformations (VMs). These ...result in chronic bleeding, acute hemorrhage, and complications from shunting through VMs. The goal of the Second International HHT Guidelines process was to develop evidence-based consensus guidelines for the management and prevention of HHT-related symptoms and complications.
The guidelines were developed using the AGREE II (Appraisal of Guidelines for Research and Evaluation II) framework and GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The guidelines expert panel included expert physicians (clinical and genetic) in HHT from 15 countries, guidelines methodologists, health care workers, health care administrators, patient advocacy representatives, and persons with HHT. During the preconference process, the expert panel generated clinically relevant questions in 6 priority topic areas. A systematic literature search was done in June 2019, and articles meeting a priori criteria were included to generate evidence tables, which were used as the basis for recommendation development. The expert panel subsequently convened during a guidelines conference to conduct a structured consensus process, during which recommendations reaching at least 80% consensus were discussed and approved.
The expert panel generated and approved 6 new recommendations for each of the following 6 priority topic areas: epistaxis, gastrointestinal bleeding, anemia and iron deficiency, liver VMs, pediatric care, and pregnancy and delivery (36 total). The recommendations highlight new evidence in existing topics from the first International HHT Guidelines and provide guidance in 3 new areas: anemia, pediatrics, and pregnancy and delivery. These recommendations should facilitate implementation of key components of HHT care into clinical practice.
Members of the
family have highly similar structures, and yet there are important differences among them in host, transmission, and capsid stabilities. Viruses in the
family have single-stranded RNA ...(ssRNA) genomes with T=3 icosahedral protein shells with a maximum diameter of ∼340 Å. Each capsid protein is comprised of three domains: R (RNA binding), S (shell), and P (protruding). Between the R domain and S domain is the "arm" region that studies have shown to play a critical role in assembly. To better understand how the details of structural differences and similarities influence the
viral life cycles, the structures of cucumber leaf spot virus (CLSV; genus
) and red clover necrotic mosaic virus (RCNMV; genus
) were determined to resolutions of 3.2 Å and 2.9 Å, respectively, with cryo-electron microscopy and image reconstruction methods. While the shell domains had homologous structures, the stabilizing interactions at the icosahedral 3-fold axes and the R domains differed greatly. The heterogeneity in the R domains among the members of the
family is likely correlated with differences in the sizes and characteristics of the corresponding genomes. We propose that the changes in the R domain/RNA interactions evolved different arm domain interactions at the β-annuli. For example, RCNMV has the largest genome and it appears to have created the necessary space in the capsid by evolving the shortest R domain. The resulting loss in RNA/R domain interactions may have been compensated for by increased intersubunit β-strand interactions at the icosahedral 3-fold axes. Therefore, the R and arm domains may have coevolved to package different genomes within the conserved and rigid shell.
Members of the
family have nearly identical shells, and yet they package genomes that range from 4.6 kb (monopartite) to 5.3 kb (bipartite) in size. To understand how this genome flexibility occurs within a rigidly conserved shell, we determined the high-resolution cryo-electron microscopy (cryo-EM) structures of cucumber leaf spot virus and red clover necrotic mosaic virus. In response to genomic size differences, it appears that the ssRNA binding (R) domain of the capsid diverged evolutionarily in order to recognize the different genomes. The next region, the "arm," seems to have also coevolved with the R domain to allow particle assembly via interactions at the icosahedral 3-fold axes. In addition, there are differences at the icosahedral 3-fold axes with regard to metal binding that are likely important for transmission and the viral life cycle.
We present a new version of the standardized Northern Hemisphere “modern” dinoflagellate cyst (“dinocyst”) database, which includes abundances of 71 taxa at 1968 sites across the Northern Hemisphere, ...cross-referenced with 17 environmental parameters extracted mostly from the 2013 World Ocean Atlas. Several taxa with tropical to warm temperate affinities were added to the previous database version. Dinocyst concentrations in the surface sediments reach 106 cysts g−1, with maximum values along the continental margins and minimum values offshore in distal open ocean settings. Assemblages are characterized by the co-occurrence of phototrophic (n = 41) and heterotrophic taxa (n = 30), with maximum proportions of heterotrophic taxa in high productivity regions, notably at the sea-ice edge and in upwelling regions. The main pattern of assemblage distributions includes north–south and nearshore–offshore gradients, with maximum diversity of species along the continental margins and towards the south, in warm temperate and tropical areas. Canonical correspondence analyses performed on heterotrophic and phototrophic taxa independently yield consistent results, hence suggesting similar, but not identical, ecological affinities for both taxonomic groups. For both groups, sea-surface temperature and sea-ice are the most determining parameters, but the phototrophic taxa seem more sensitive to onshore–offshore gradients marked by salinity changes. Productivity-related parameters also determine dinocyst distribution, especially primary productivity in the fall and winter, with a stronger relationship for the combined dataset of phototrophic and heterotrophic taxa.
•Exhaustive dinocyst assemblage data (71 taxa) from 1968 samples are presented.•Relationship with 17 environmental parameters are explored.•Dinocyst assemblages are closely related to salinity, temperature, sea-ice cover and productivity.•The database permits to disentangle salinity from temperature.
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