In 1974, artificial reef researchers organized the first International Conference on the subject of ‘Reefs’. The conference was held 20–22 March 1974 in Houston, Texas, USA ‘…to provide an ...international forum for the exchange of information, experiences and thoughts among persons involved with or interested in any aspect of artificial reef research, construction or use’ (Proceedings of the International Conference on Artificial Reefs, Houston, 1974, Texas A & M University Sea Grant College, College Station, TX). Nearly forty years have passed since that initial meeting and, while there have been many other conferences held on the subject of artificial reefs (see Bortone 2011a for a partial review), the need for these fora continues. Over the years, there have been changes in approaches, technology, political climate, and financial conditions with regard to artificial reef research. Stone et al. () and Bortone () presented summaries of the previous CARAHs. The purpose here is to emphasize the milestones with regard to technology, direction, emphasis, scope and accomplishment of the efforts of the international artificial reef research community. It is through this perspective that one should gain an appreciation of the overall contribution that CARAHs have made toward refinement and progression to resolve many of the issues we face today in modern aquatic resource management. The continuing level of involvement occurs in the absence of a formal society, standing organizing committee, or scientific tribunal to oversee its progress. The fact that these conferences have occurred with such frequency, orderly direction, and high standards is attributable to the professionalism and diligence of all involved.
Objectives
The aim of the present study was to investigate the clinical effectiveness over 12 weeks of Vertise Flow
™
, a self-adhering composite, in dental hypersensitivity (DH).
Material and ...methods
The study was conducted as a split-mouth randomized clinical trial. Vertise Flow™ was compared to the following: (1) Universal Dentine Sealant, (2) Clearfil Protect Bond, and (3) Flor-Opal® Varnish. A total of 46 patients with 116 hypersensitive teeth were studied. Pain experience was generated by a cold stimulus and assessed using the visual analog scale (VAS) of pain. The response was recorded before the application of the materials (pre-1), immediately after (post-1), at 1- (post-2), 2- (post-3), and 12-week controls (post-4). Statistical differences in VAS were performed using the Kruskal–Wallis analysis at the different time-points (
P
< 0.05), adjusting statistical significances for multiple comparisons (Bonferroni correction).
Results
All the materials showed any statistically significant differences at the baseline. After the application of each material, a VAS decrease was demonstrated at every post-control. VF showed significant hypersensitivity reduction in post-1. Statistically significant relief was also observed in post-2 while no significant differences were detected in post-3 and post-4.
Conclusions
After 12-week controls, there was no statistically significant hypersensitivity reduction using VF in respect to the other materials. On the other hand, any significant differences were detected in the decrease of the VAS irrespective of the desensitizing agent employed at the 12-week controls.
Clinical relevance
The significant increase in VAS scores within the 12-weeks of environment suggested there is instability of VF when used as desensitizing agent.
Increased apoptosis of cardiac progenitor cells (CPCs) has been proposed as a mechanism of myocardial damage and dysfunction. Glucagon-like peptide-1 (GLP-1) has been shown to improve heart recovery ...and function after ischemia and to promote cell survival. The protective effects of GLP-1 on oxidative stress-induced apoptosis were investigated in human CPCs isolated from human heart biopsies. Mesenchymal-type cells were isolated from human heart biopsies, exhibited the marker profile of CPCs, differentiated toward the myocardiocyte, adipocyte, chondrocyte, and osteocyte lineages under appropriate culture conditions, and expressed functional GLP-1 receptors. CPCs were incubated with GLP-1 with or without hydrogen peroxide (H2O2). Phospho- and total proteins were detected by immunoblotting and immunofluorescence analysis. Gene expression was evaluated by quantitative RT-PCR. The role of the canonical GLP-1 receptor was assessed by using the receptor antagonist exendin(9–39) and receptor-specific silencer small interfering RNAs. Cell apoptosis was quantified by an ELISA assay and by flow cytometry-detected Annexin V. Exposure of CPCs to H2O2 induced a 2-fold increase in cell apoptosis, mediated by activation of the c-Jun N-terminal protein kinase (JNK) pathway. Preincubation of CPCs with GLP-1 avoided H2O2-triggered JNK phosphorylation and nuclear localization, and protected CPCs from apoptosis. The GLP-1 effects were markedly reduced by coincubation with the receptor antagonist exendin(9–39), small interfering RNA-mediated silencing of the GLP-1 receptor, and pretreatment with the protein kinase A inhibitor H89. In conclusion, activation of GLP-1 receptors prevents oxidative stress-mediated apoptosis in human CPCs by interfering with JNK activation and may represent an important mechanism for the cardioprotective effects of GLP-1.
Hereditary Haemorrhagic Teleangiectasia (HHT) is a vascular disorder of angiogenesis transmitted in an autosomal dominant pattern, characterised by heterogeneity in clinical manifestations. One of ...the most important organ involved is lung, including pulmonary arteriovenous malformations (PAVM). PAVM occur in 20 to 30% of the HHT population and recently are considered a marker of disease. PAVM are direct artery-to-vein connections with low pressure and without an interveining capillary bed. PAVM are classified as simple (supplied by one feeding artery) or complex (receiving blood supply from two or more feeding artery). According to the international reports, treatment it's recommendable for all PAVM with feeding vessels 3mm or larger, in order to reduce the risk of cerebral ischaemia and neurologic manifestations frequently attributed to paradoxical embolisation. Transcatheter embolotherapy of PAVM is a form of treatment based on occlusion of the feeding artery to a PAVM by using platinum coils or detachable balloons. The technique of coil embolisation involves the exact localisation of PAVM by pulmonary angiography followed by superselective percutaneous caheterisation of feeding artery obtained by using a dedicated 7F guiding catheter, which coaxially allocates a 5F hydrophilic catheter advanced in order to perform both superselective angiography of feeding artery and embolisation itself. Inside the 5F catheter the platinum coils are advanced using a .035'' guide-wire and released until an optimal occlusion of feeding artery is achieved. At the end of the procedure angiographic control is performed in order to verify the occlusion of feeding artery. The use of platinum coils is preferable over detachable balloons when feeding artery are greater than 7 mm in diameter and have irregular anatomical configuration. On the other hand, the principal advantage of using detachable balloons is that the balloon itself can be deflated and repositioned if necessary. Transcatheter embolotherapy is technically safe and clinically effective and may represent the primary choice of treatment in HHT patients. On the other hand the most common complications of this treatment (pleurisy and air embolism) can be prevented by using some tips during the embolisation procedure like "anchor technique," "scaffold technique" and "balloon assisted technique." Cerebral arteriovenous malformations (CAVM) are present in 10-20% of patients with HHT and multiple in 50% of cases. Cortical surface is the most frequent localisation. Angiography is needed to diagnose all CAVM and to clarify the angioarchitecture of the lesion. In HHT CAVM are usually either micro-AVM, with a nidus not bigger than 1 cm, or small AVM, with a nidus between 1 and 3 cm. Quite frequently there are lesions characterised by arteriovenous fistulas. In the three patterns of CAVM usually found in HHT, small AVM are the most risky for bleeding although the risk is lower than that associated with sporadic ones. It is estimated from 0.38 to 0.69% per year in spite of the general incidence of bleeding in sporadic CAVM that ranges from 2 to 4% per year. In HHT patients, at present, the precise indications and timing of treatment are not established. Trend is to treat small AVM and AVF and to follow-up micro-AVM with MRI and angiography. As for sporadic CAVM, treatment of small AVM is usually referred to stereotactic radiosurgery. Endovascular embolisation is proposable if the lesion is easily reachable by microcatheterism and the position of the microcatheter is safe. Glue is used for embolisation and the technique is briefly discussed.
Although hurricane disturbance is a natural occurrence in mangrove forests, the effect of widespread human alterations on the resiliency of estuarine habitats is unknown. The resiliency of mangrove ...forests in southwest Florida to the 2004 hurricane season was evaluated by determining the immediate response of mangroves to a catastrophic hurricane in areas with restricted and unrestricted tidal connections. The landfall of Hurricane Charley, a category 4 storm, left pronounced disturbances to mangrove forests on southwest Florida barrier islands. A significant and negative relationship between canopy loss and distance from the eyewall was observed. While a species-specific response to the hurricane was expected, no significant differences were found among species in the size of severely impacted trees. In the region farthest from the eyewall, increases in canopy density indicated that refoliation and recovery occurred relatively quickly. There were no increases or decreases in canopy density in regions closer to the eyewall where there were complete losses of crown structures. In pre-hurricane surveys, plots located in areas of management concern (i.e., restricted connection) had significantly lower stem diameter at breast height and higher stem densities than plots with unrestricted connection. These differences partially dictated the severity of effect from the hurricane. There were also significantly lower red mangrove (Rhizophora mangle) seedling densities in plots with restricted connections. These observations suggest that delays in forest recovery are possible in severely impacted areas if either the delivery of propagules or the production of seedlings is reduced by habitat fragmentation.
Objective: Assessment of endovascular stent-graft treatment for diseases of the descending thoracic aorta as a valid and effective alternative to surgery. Methods: From March 1999 to August 2000, a ...total of 16 patients underwent deployment of endovascular stent-grafts in the descending thoracic aorta. Patients were divided into three groups according to the type of lesion. Group A (n=8) included five patients with atherosclerotic aneurysm and three with chronic post-traumatic pseudoaneurysm. Patients with acute post-traumatic pseudoaneurysm (n=3) and type B aortic dissection (n=5) were included in Groups B and C, respectively. All patients underwent 5-mm chest spiral angio-computerized tomography (CT) scan and angiography as preoperative assessment. The deployed stent-graft systems were Talent™-Medtronic and Excluder®-Gore. Results: A total of 20 stent-grafts were placed. Two patients required deployment of two grafts, while three grafts were juxtaposed in a third patient in order to treat larger lesions. There was no mortality related to the procedure, although one patient (6.2%) died because of multiorgan failure 24 h post-operatively. The placement of the graft was successful in all cases except one affected with type B dissection and characterized by a very large intimal flap, which was eventually fenestrated by graft guidewire. Therefore, an optimal sealing of the grafts was achieved in 15 patients. However, in one patient the descending aorta had to be surgically replaced because of the calcified pseudoaneurysm still compressing the trachea and left bronchus. Two patients required a left carotid-subclavian by-pass in order to achieve a sufficient neck for the proximal placement of the graft. No spinal cord injuries were observed. At the follow-up, performed with chest spiral angio-CT scan within 72 h and scheduled at 6 and 12 months and once a year, no stent-graft related complications have been detected. Conclusions: Endoluminal stent-graft treatment may represent a valid option in well-selected cases of descending thoracic aorta diseases. A longer follow-up in a larger series of patients is desirable to confirm these initial positive results.
Abstract Background The most appropriate ablation strategy for persistent atrial fibrillation (PeAF) has not yet been determined. However, ethanol infusion of the vein of Marshall (VOM) combined with ...a linear set of ablation lesions (namely the Marshall-PLAN) has yielded encouraging results (1). Purpose Our study aimed at analyzing the relationship between low voltage areas (LVA) and arrhythmias recurrences in a PsAF population treated with the Marshall-PLAN. Methods we conducted a retrospective study on consecutive patients undergoing first catheter ablation (CA) for PsAF between 2021 and 2022 at our center. Pulmonary vein isolation (PVI), mitral isthmus ablation (VOM ethanol infusion, endocardial ablation and epicardial ablation in the great cardiac vein), left atrial (LA) roofline and cavo-tricuspid isthmus ablation were carried out in all the patients. Bidirectional block was validated for all the linear lesions as well as for PVI. Pre-ablation LA electroanatomic maps were built with CARTOv3 system and the PentaRay mapping catheter (minimum 3000 points). LVA were identified as areas >1cm2 (containing ≥3 neighboring points with ≤10mm distance) with bipolar voltage <0.5mV in SR and <0.24 mV in AF (2). All patients were followed for at least 12 months. Results Overall, 93 patients (69±7years, 30% female) with PsAF were included. Their left-ventricle ejection fraction and left atrial volume indexed for body surface area (LAVI) were 57% and 92±20 ml/m2. LA maps demonstrated at least one LVA in 70 subjects (75.3%). The mean relative surface of LA in which a LVA was evidenced was 8±14%. LVA were found within the anterior LA wall in 49 patients (53%), in the posterior wall in 33 patients (35.5%), in the inferior wall in 22 patients (24%), in the lateral wall in 14 patients (15.1%) and in the pulmonary vein region in 44 patients (47.3%). After 19±6 months of follow-up, 28 (30%) patients had AF recurrence. At Cox regression analysis (including LVA burden and LAVI dimensions), LVA localized within the anterior LA wall were predictive of arrhythmia recurrences (hazard ratio HR 2.0 95% CI, 1.1–4.7, P=0.04). Kaplan-Meier estimates of survival free from recurrences at 20 months were 51% and 88% in patients with and without LVAs in the anterior LA wall (Log-rank 0.006). Conclusions The Marshall-PLAN led to a global AF-free survival of 70% after 19±6 months in our cohort of patients with PsAF. Importantly however, the data show that the subset of patients with LVA in the anterior LA wall (i.e., the LA region not targeted by the pre-specified ablation set here evaluated) have a 55%-only AF-free survival while that of patients without LVA in the anterior LA wall was of 88%. As a result, our study supports the relevance of atrial substrate assessment and the possibility of CA strategy optimization in the subset of patients with PsAF and LVA in the anterior LA wall (3).
Environmentally induced intersexuality among natural populations of poeciliids was first described by Howell et al. (1980). In two paper mill effluent-receiving streams, the Fenholloway River, Taylor ...Co. and Elevenmile Creek, Escambia Co., Florida, the anal-fins of females of the mosquitofish Gambusia holbrooki) were modified into gonopodium-like structures typical of developing males. Where present, females of two other poeciliids, the least killifish (Heterandria formosa) and the sailfin molly (Poecilia latipinna) also bore similarly modified anal-fins. Masculinization (arrhenoidy) in response to paper mill effluent was subsequently reproduced in controlled exposures using mosquitofish females (Drysdale and Bortone 1989). Although a number of mechanisms of endocrine-disruption, focusing on the presence in effluent of chemicals with steroidal properties have been proposed (Howell et al. 1980; Davis and Bortone 1992) the complex nature of paper mill effluents has made the task of identifying masculinizing chemicals difficult. In controlled exposures, female mosquitofish exposed to the plant sterol, beta -Sitosterol, a major byproduct of wood-pulp delignification, in the presence of Mycobacterium smegmatis became masculinized (Howell and Denton 1989). McLatchy and Van Der Kraak (1995) provided evidence that exposure to beta -Sitosterol reduced gonadal steroid synthesis in goldfish. Mycobacterium smegmatis and plant sterols (including beta -Sitosterol) are present in waters unimpacted by paper mill effluents, albeit at much lower concentrations.
Red Snapper Lutjanus campechanus populations support (or have supported) important commercial and recreational fisheries in Gulf of Mexico and southeastern U.S. Atlantic Ocean waters. Stock ...assessment results and related regulatory actions are contentious in both regions. We assessed the relative availability of information to support Red Snapper assessment and management between the two regions by performing a literature review and comparing the number of region-specific, Red Snapper–focused peer-reviewed publications. One hundred and ten publications (over the period 1982–2013) were identified in this search, with 94% focused on Gulf of Mexico waters. We then assessed the available information on juvenile (≤150 mm total length) Red Snapper. Twenty-eight peer-reviewed publications focused entirely or partially on juvenile Red Snapper in Gulf of Mexico waters. None documented the occurrence of juvenile Red Snapper in southeastern U.S. Atlantic Ocean waters. For the Gulf of Mexico, more than 50,000 records of juvenile Red Snapper were identified in a single trawl survey database. For southeastern U.S. Atlantic Ocean waters, a comprehensive search of fishery-independent survey databases (totaling >75,000 individual gear deployments and occurring across the range of habitats, depths, and seasons in which juvenile Red Snapper were collected in the Gulf of Mexico trawl survey) and institutional collections identified only 132 records of juvenile Red Snapper. These results highlight the need for additional information on Red Snapper in southeastern U.S. Atlantic Ocean waters and on the connectivity between Gulf of Mexico and southeastern U.S. Atlantic Ocean Red Snapper populations to support Red Snapper population assessment and fishery management.
Background: Besides standard left ventricular (LV) stimulation via the coronary sinus, a transseptal approach allows left ventricular endocardial stimulation. We report our long‐term observations ...with biventricular stimulation, using a strictly endocardial system for patients presenting with severe congestive heart failure.
Methods: Six patients with nonischemic cardiomyopathy (mean age = 60 ± 9.6 years, women) in New York Heart Association (NYHA) functional class III (n = 5) or IV, despite optimal drug therapy, and a mean LV ejection fraction of 24 ± 3%, underwent implantation of biventricular stimulation systems between April 1998 and March 1999. All presented with left bundle branch block and an increased LV end‐diastolic diameter (mean = 66 ± 5 mm). In all patients, a bipolar pacing lead was implanted in the lateral LV wall using a direct transseptal approach. After implantation, all patients received oral anticoagulation.
Results: QRS duration decreased from 184 ± 22 ms to 108 ± 11 ms. NYHA functional class decreased to II in all patients within 1 month. Over a 85 ± 5 month follow‐up, two patients underwent cardiac transplantation, 2 and 4 years after device implantation, respectively; two patients died of end‐stage heart failure 4 years after system implantation; and two patients were alive in functional class II. One patient, who experienced syncope due to fast ventricular, underwent implantation of an ICD. One transient ischemic attack occurred in a patient whose anticoagulation was temporarily interrupted.
Conclusions: Long‐term endocardial biventricular stimulation via a transseptal approach was safe and effective in this small population. This approach needs to be further compared with conventional epicardial pacing via the coronary sinus
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