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When Salpingectomy Is Not Salpingectomy-Ipsilateral Recurrence of Tubal Pregnancy
Get PDFCopyright © 2009 Simona Fischer and Marc J. N. C. Keirse. This is an open access article distributed under the
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Theoretically, total salpingectomy eliminates the risk of an ipsilateral tubal pregnancy. However, total salpingectomy is difficult to achieve using endoloops alone. We describe a situation where this resulted in an ipsilateral recurrence of tubal pregnancy which required emergency intervention and removal of the tubal remnants
Hardware Architectures for the Orthogonal and Biorthogonal Wavelet Transform
Get PDFCopyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.In this note, optimal hardware architectures for the orthogonal and biorthogonal wavelet transforms are presented. The approach used here is not the standard lifting method, but takes advantage of the symmetries inherent in the coefficients of the transforms and the decimation/interpolation operators. The design is based on a highly optimized datapath, which seamlessly integrates both orthogonal and biorthogonal transforms, data extension at the edges and the forward and inverse transforms. The datapath design could be further optimized for speed or low power. The datapath is controlled by a small fast control unit which is hard programmed according to the wavelet or wavelets required by the application. Example circuits are given, including one for the Daubechies 9-7 wavelet which requires only 2.5 multipliers for each input data value, when the equivalent for lifting is 3
The microbiome in chronic kidney disease patients undergoing hemodialysis and peritoneal dialysis
Get PDF© 2018 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license:http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 12 month embargo from date of publication (February 2018) in accordance with the publisher’s archiving policyChronic kidney disease (CKD) is associated with an imbalanced human microbiome due not only to CKD-associated factors such as uremia, increased inflammation and immunosuppression, but also to pharmacological therapies and dietary restrictions. End-stage renal disease patients require renal replacement therapies commonly in the form of hemodialysis (HD) or peritoneal dialysis (PD). HD implies the existence of a vascular access, such as an arteriovenous fistula/graft or a venous catheter, whereas PD implies a long-term peritoneal catheter and the constant inflow of peritoneal dialysate. Also, dietary adaptations are mandatory in both therapies. This revision explores the impact of HD or PD therapies on human microbiome.
HD and PD appear to be associated with different changes in the gut microbiome, for example a decrease in Proteobacteria relative abundance in HD patients and increase in PD patients. Both therapies may also have an impact on the human microbiome beyond the gut, leading to increased relative abundance of specific bacteria in the blood microbiome of HD patients and increased relative abundance of other bacteria in the peritoneal microbiome of PD patients. HD and PD catheter biofilms may also play an important role in the changes observed in these microbiomes.
A more interdisciplinary approach is needed to further clarify the role of microbial groups other than bacteria in all body habitats to allow the complete understanding of the impact of HD or PD on the microbiome of CKD patients. Moreover, strategies that promote a healthy balance of the human microbiome on these patients should be explored
Revisiting analytical solutions for steady interface flow in subsea aquifers: Aquitard salinity effects
Get PDF© 2018 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 24 month embargo from date of publication (Jan 2018) in accordance with the publisher’s archiving policy.Existing analytical solutions for the distribution of fresh groundwater in subsea aquifers presume that the overlying offshore aquitard, represented implicitly, contains seawater. Here, we consider the case where offshore fresh groundwater is the result of freshwater discharge from onshore aquifers, and neglect paleo-freshwater sources. A recent numerical modeling investigation, involving explicit simulation of the offshore aquitard, demonstrates that offshore aquitards more likely contain freshwater in areas of upward freshwater leakage to the sea. We integrate this finding into the existing analytical solutions by providing an alternative formulation for steady interface flow in subsea aquifers, whereby the salinity in the offshore aquitard can be chosen. The new solution, taking the aquitard salinity as that of freshwater, provides a closer match to numerical modeling results in which the aquitard is represented explicitly
microRNAs: Key regulators of chemotherapy response and metastatic potential via complex control of target pathways in esophageal adenocarcinoma
Get PDF© 2018 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 12 month embargo from date of publication (April 2018) in accordance with the publisher’s archiving policy.Introduction: Incidence of esophageal adenocarcinoma (EAC) increased significantly over the last decades. Lack of response to chemotherapy is a major problem in the treatment of this disease. This study aims to assess the biological relevance of characteristic microRNA profiles of chemotherapy resistant EAC cells with regards to response to chemotherapy and biological behavior.
Methods: We selected 3 microRNAs from characteristic microRNA profiles of resistant EAC (miR-27b-3p, miR-200b-3p, and miR-148a-3p). Expression of microRNAs was modified in 6 EAC cell lines. Effects on chemotherapy, adhesion, migration, apoptosis and cell cycle were assessed using standard assays. Target analyses were performed using Western Blot and Luciferase techniques.
Results: MiR-27b-3p significantly sensitized cells to 5FU and Cisplatin in 83% respectively in 33% of cell lines, miR-148a-3p in 67% respectively 33% of cases. MiR-200b-3p increased sensitivity only towards 5FU in 50% of cases. Co-transfections with miR-27b-3p/miR-148a-3p showed an additive effect on response to chemotherapy in 50% of cases. Upregulation of miR-148a-3p reduced protein expression levels of DNMT-1, MSK-1, Bcl-2 and Bim, and miR-27b upregulation led to downregulation of Sp1 and PPARy proteins implicating a potential negative post-transcriptional control via the respective microRNAs. Finally, we were able to confirm Bcl-2 for the first time as direct target of miR-148a-3p in EAC.
Conclusion: This study demonstrates that specific microRNA profiles of chemotherapy resistant EAC in fact determine their response to chemotherapy and biological behavior. Our data further show that microRNA-mediated regulation of chemotherapy resistance is complex, and several microRNAs seem to “co-operate” at various steps within a broad number of pathways what fits very well to our recently proposed understanding of microRNA-mediated regulation as function of cellular functional complexes. These data highlight the promising potential of microRNAs to predict or monitor treatment response to chemotherapy in EAC, and to potentially modulate tumor biology in a therapeutic approach
Developing “My Asthma Diary”: a process exemplar of a patient-driven arts-based knowledge translation tool
Get PDF© The Author(s). 2018 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Abstract
Background
Although it is well established that family-centered education is critical to managing childhood asthma, the information needs of parents of children with asthma are not being met through current educational approaches. Patient-driven educational materials that leverage the power of the storytelling and the arts show promise in communicating health information and assisting in illness self-management. However, such arts-based knowledge translation approaches are in their infancy, and little is known about how to develop such tools for parents. This paper reports on the development of “My Asthma Diary” – an innovative knowledge translation tool based on rigorous research evidence and tailored to parents’ asthma-related information needs.
Methods
We used a multi-stage process to develop four eBook prototypes of “My Asthma Diary.” We conducted formative research on parents’ information needs and identified high quality research evidence on childhood asthma, and used these data to inform the development of the asthma eBooks. We established interdisciplinary consulting teams with health researchers, practitioners, and artists to help iteratively create the knowledge translation tools.
Results
We describe the iterative, transdisciplinary process of developing asthma eBooks which incorporates: (I) parents’ preferences and information needs on childhood asthma, (II) quality evidence on childhood asthma and its management, and (III) the engaging and informative powers of storytelling and visual art as methods to communicate complex health information to parents. We identified four dominant methodological and procedural challenges encountered during this process: (I) working within an inter-disciplinary team, (II) quantity and ordering of information, (III) creating a composite narrative, and (IV) balancing actual and ideal management scenarios.
Conclusions
We describe a replicable and rigorous multi-staged approach to developing a patient-driven, creative knowledge translation tool, which can be adapted for use with different populations and contexts. We identified specific procedural and methodological challenges that others conducting comparable work should consider, particularly as creative, patient-driven knowledge translation strategies continue to emerge across health disciplines
Context matters for primary health care access: a multi-method comparative study of contextual influences on health service access arrangements across models of primary health care
Get PDF© The Author(s). 2018 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Abstract
Background
Equitable access to primary health care (PHC) is an important component of integrated chronic disease management. Whilst context is known to influence access to PHC, it is poorly researched. The aim of this study was to determine the contextual influences associated with access arrangements in four Australian models of integrated PHC.
Methods
A multi-method comparative case study design. Purposive sampling identified four models of PHC across six sites in two Australian states. Complexity theory informed the choice of contextual factors that influenced access arrangements, which were analysed across five dimensions: availability and accommodation, affordability, acceptability, appropriateness and approachability. Semi-structured interviews, document/website analysis and non-participant observation were used to collect data from clinicians, administrative staff and other key stakeholders. Within and cross-case thematic analysis identified interactions between context and access across sites.
Results
Overall, financial viability, objectives of the PHC model and relationships with the local hospital network (LHN) underpinned access arrangements. Local supply of general practitioners and financial viability were strong influences on availability of after-hours services. Influences on affordability were difficult to determine because all models had nil/low out-of-pocket costs for general practitioner services. The biggest influence on acceptability was the goal/objectives of the PHC model. Appropriateness and to a lesser degree affordability arrangements were influenced by the relationship with the LHN. The provision of regular outreach services was strongly influenced by perceived population need, referral networks and model objectives.
Conclusions
These findings provide valuable insights for policy makers charged with improving access arrangements in PHC services. A financially sustainable service underpins attempts to improve access that meets the needs of the service population. Smaller services may lack infrastructure and capacity, suggesting there may be a minimum size for enhancing access. Access arrangements may be facilitated by aligning the objectives between PHC, LHN and other stakeholder models. While some access arrangements are relatively easy to modify, improving resource intensive (e.g. acceptability) access arrangements for vulnerable and/or chronic disease populations will require federal and state policy levers with input from primary health networks and LHNs
Radiological findings in ancient Egyptian canopic jars: comparing three standard clinical imaging modalities (x-rays, CT and MRI)
Get PDF© The Author(s) 2018 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract
Background
The aim of our study was to evaluate the potential and the limitations of standard clinical imaging modalities for the examination of ancient Egyptian canopic jars and the mummified visceral organs (putatively) contained within them.
Methods
A series of four ancient Egyptian canopic jars was imaged comparing the three standard clinical imaging modalities: x-rays, computed tomography (CT) and magnetic resonance imaging (MRI). Additionally, imaging-data-based volumetric calculations were performed for quantitative assessment of the jar contents.
Results
The image contrast of the x-ray images was limited by the thickness and high density of the calcite mineral constituting the examined jars. CT scans showed few artefacts and revealed hyperdense structures of organ-specific morphology, surrounded by a hypodense homogeneous material. The image quality of MRI scans was limited by the low amount of water present in the desiccated jar contents. Nevertheless, areas of pronounced signal intensity coincided well with hyperdense structures previously identified on CT scans. CT-based volumetric calculations revealed holding capacities of the jars of 626–1319 cm3 and content volumes of 206–1035 cm3.
Conclusions
CT is the modality of choice for non-invasive examination of ancient Egyptian canopic jars. However, despite its limitations, x-ray imaging will often remain the only practicable method for on-site investigations. Overall, the presented radiological findings are more compatible with contained small organ fragments rather than entire mummified organs, as originally expected, with consequent implications for envisioned future sampling for chemical and genetic analysis
In-pipe fibre optic pressure sensor array for hydraulic transient measurement with application to leak detection
Get PDF© 2018 Elsevier BV. This manuscript version is made available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 24 month embargo from date of publication (May 2018) in accordance with the publisher’s archiving policy.Controlled hydraulic transient pressure waves can be used to actively assess the condition of
pressurised pipelines (e.g. leak detection). One practical challenge to the application of the
technique to buried water pipelines is in the pressure measurement – fast-response pressure
transducers are costly and the deployment is limited to one sensor per access point (e.g. at air
valves or fire hydrants). The measurement from a single sensor is always the superposition of
the waves travelling upstream and downstream along a pipe. It is often difficult to determine
the direction of the propagating waves, unless there are suitable locations nearby where
additional measurements can be made. The research reported here develops a fibre optic
pressure sensor array for in-pipe transient pressure measurement. The sensor array consists of
five Fibre Bragg Gratings (FBGs), each formed into a custom designed pressure transducer.
The cable containing the array has a diameter of approximately 4 mm, making it easy to insert into a pipeline through a single access point for distributed transient pressure measurement. The usefulness of the fibre optic pressure sensors for transient-based pipeline leak detection is validated through laboratory experiments. The measurement from each
individual fibre optic sensor is generally consistent with conventional piezo-resistive pressure
transducers over a wide frequency range. The sensor array configuration enables the
determination of the directional information of waves, therefore enhancing the ability of
pipeline defect detection and localisation
Towards a reliable repeated-measures beads task for assessing the jumping to conclusions bias
Get PDF© 2017 Elsevier BV. This manuscript version is made available under the CC-BY-NC-ND 4.0 license:
http://creativecommons.org/licenses/by-nc-nd/4.0/
This author accepted manuscript is made available following 12 month embargo from date of publication (April 2018) in accordance with the publisher’s archiving policyThe jumping to conclusions bias (JTC), in which some people gather less information than
others before making a decision, has been linked to delusions in psychosis. JTC is usually
identified via the beads task, in which a sequence of beads (the “target” sequence) is used to
measure the amount of evidence participants require before making a decision. Yet, despite
its common use, the reliability of the task has never been properly investigated. We
investigated its reliability, and tested an alternate version which used distractor sequences to
obfuscate the target sequence. Healthy participants (N = 212) were randomised into two
groups. One group completed ten trials using the target sequence, while the other completed
ten trials of the target sequence and three distractor sequences. Our data indicated the
standard task may not be reliable over repeated measures, but that by including distractor
sequences, the task becomes more believable, repeatable, and reliable. Additionally,
excluding first-trial data (a “silent” practice trial) also improves repeatability. These
improvements to the task are relevant to single trial studies, and will be especially useful to
repeated-measures longitudinal, experimental, and treatment studies. Such repeated-measures
studies are important for investigating the causal link between JTC and delusions