31 research outputs found
Ectopic Beats: How Many Count?
No full textPremature atrial and ventricular contractions, or ectopic beats, are frequently detected on routine electrocardiogram monitoring. They are often considered to be benign with no pathological significance; however, the literature suggests that higher ectopic burdens may have clinical importance. This paper reviews the current literature and provides the treating physician with an understanding of when ectopic beats should be deemed significant and when treatment may be appropriate
Chemical derivatization for the enhancement of sensitivity in electron capture negative ion chemical ionization mass spectrometry
No full textThe sensitivity enhancement which can be achieved by the use of electron capture negative ion chemical ionization (ECNICI) in mass spectrometry (MS) is well documented. While some halogenated or highly conjugated molecules have inherent electron affinity, most compounds must first be derivatized to impart the ability to capture electrons.The two primary goals of this work were (1) develop suitable reagents for alcohols which produce structure specific anions in ECNICI/MS and (2) if possible, carry out the derivatization of biologically relevant compounds directly in biological fluids.With these two main objectives in mind, several novel reagents were synthesized and their reactivity and mass spectral properties studied. The reagents included pentafluorophenyl boronic acid (FPBA), anthraquinone-2-carbonyl chloride (ACCl), and pentafluorobenzyl chloroformate (PFBCF). Studies of electrophillic isocyanates were also conducted.Pentafluorophenyl boronic acid exhibited excellent reactivity, specificity and the derivatives had good chromatographic properties. Unfortunately, the ECNICI signal enhancement of the derivatives was not sufficient and the equilibrium of the derivatization did not allow for quantitation at the pg to fg level.Anthraquinone-2-carbonyl chloride (ACCl) was synthesized and used for the derivatization of alcohols with subsequent analysis by particle beam LC/MS. ACCl proved to be a useful reagent, where good transport properties of the derivatives, combined with the electron affinity of the anthraquinone, allowed for detection limits in the low pg.The use of pentafluorobenzyl chloroformate for the derivatization of alcohols, amines and carboxylic acids was investigated. Aqueous PFBCF derivatization was applied to amino acid standards, whole blood, plasma and protein hydrolysates. The ECNICI mass spectra of the derivatives are dominated by the (M-181) \sp- ion and the derivatization is accomplished in seconds, in one step at room temperature. Detection limits are in the low femtomole range.PFBCF derivatization of alcohols, under anhydrous conditions, resulted in carbonate esters which yielded molar responses 2-6 times larger than those of the analogous pentafluorobenzoate esters.Finally, the addition of a Hewlett-Packard particle beam LC/MS interface to a Finnigan TSQ-70 mass spectrometer is described. The optimization of particle path and analyte ionization is reported.Source: Dissertation Abstracts International, Volume: 58-02, Section: B, page: 6740.Advisors: James E. Girard.Ph.D. American University 1995.Englis
A New Form of Authoritarianism? Rethinking Military Politics in Post-1999 Nigeria
No full textDespite the vast research that has been done on the Nigerian military, virtually all of these studies have failed to critically examine the accepted role of the military in the democratising phase. This is important because the relationship between the political elite and the military in post-military authoritarian states guarantees either democratic consolidation, or its reversal. In Nigeria, despite an appearance of significant progress in subordinating the military institution to democratic civilian authority, the military remains a crucial political actor in the polity. It appears that the military has yet to accept the core democratic principles of civilian oversight of the institution. This thesis, therefore, explores whether a new form of military authoritarianism is emerging in Nigeria, with the aim of understanding Nigeria’s military behaviour in a transitional phase, from prolonged military authoritarianism to democratisation. To examine this military behaviour, Alfred Stepan’s concept of military prerogatives that was used to understand the military’s behaviour in a transitional phase in Latin America is applied to Nigeria.
A crucial understanding of authoritarianism in Nigeria is initially discussed in this study using mainly document analysis strategy to examine whether multi-ethnic states, such as Nigeria, tend to have authoritarian systems. Six hypotheses form the core analysis of this thesis: first, that the military has retained significant military prerogatives; second, that retired military officers are gaining influential political and economic positions; third, autonomous military involvement in human rights abuses since 1999; and fourth, that civilian government oversight remains weak, and facilitates military authoritarianism. These hypotheses are primarily analysed using the elite interview technique. During the first half of 2011, the author conducted field research where serving and retired military officers were interviewed. The fifth hypothesis is that the military has intervened in politics post-1999. The examination of this hypothesis relies primarily on key security-related media reports (mostly newspaper editorials) on the military after 1999. The examination of the final hypothesis, that increases in military expenditures might facilitate a new form of military authoritarianism, relies primarily on descriptive statistical analysis. In addition, this study collated relevant historical materials that relate to the military, utilising national archival collections.
The empirical findings of this research did not identify a new form of military authoritarianism in Nigeria. The study, however, argues that the unrestricted institutional framework accorded the military has contributed significantly to authoritarian practices in the post-military era in Nigeria. This study discovered that there were similarities between the Brazilian and Nigerian militaries in regard to their military spending during their period in power. Both countries had lower defence budgets. Just as in Brazil, it appears that part of the reason the Nigerian military decided to relinquish power in 1999 had to do with its desire to gain a higher budget, something that was precluded in a military government struggling to retain a sense of legitimacy. The military needed a higher budget to modernise and re-professionalise its institution after more than a decade in power. This feature, which the Nigerian military shares with the Brazilian military, appears to justify the application to Nigeria of Alfred Stepan’s concept of military prerogatives.
Highlighting reported psychological issues of co-survivors post-delivery of CPR in Out-of-Hospital Cardiac Arrest; a qualitative study
No full textOut of hospital cardiac arrest (OHCA) is a major healthcare concern affecting up to half a million people per year worldwide. In England, up to 80% of OHCA’s occur in a person’s own place of residence, with approximately half of all cases witnessed by a bystander, and bystander initiated cardiopulmonary resuscitation (CPR) is attempted in 78% of witnessed cases. There is growing recognition that witnessing an OHCA and assisting in CPR is a highly traumatic event and that so-called ‘co-survivors’ (those involved in the resuscitation attempt) are likely to have unmet needs. Currently, there is no nationally agreed commissioned model for the follow-up of OHCA survivors or co-survivors despite calls from one major national society to standardise practices</p
Liver-Targeting of Interferon-Alpha with Tissue-Specific Domain Antibodies
No full textPMCID: PMC3581439This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Early fetal echocardiography: Ready for prime time?
No full textThe objective of this study was to examine the performance of early fetal echocardiography as a screening tool for major cardiac defects in a high-risk population. Fetal echocardiograms performed at 12 to 16 weeks were reviewed. Cases that did not undergo a follow-up echocardiogram at 18 to 22 weeks were excluded. Results of the early and follow-up echocardiograms were compared. Over a 4-year period, 119 early fetal echocardiograms were recorded. Of those, 81 (68percent) had follow-up fetal echocardiograms. Results of the early echocardiogram were normal in 77 of 81 (95.1percent) cases. Of these, the follow-up was normal in 75 of these 77 cases; in the remaining 2, the follow-up raised suspicion for a ventricular septal defect (VSD) in one and persistent left superior vena cava in the other. On the other hand, the early echocardiogram was abnormal in 4 (4.9percent) cases: (1) atrioventricular canal defect, with the follow-up demonstrating a VSD; (2) hypoplastic right ventricle and transposition of the great arteries, confirmed on follow-up; (3) VSD and coarctation of the aorta, confirmed on follow-up. In the fourth case, the early echocardiogram suspected a VSD and right-left disproportion, yet the follow-up was normal. In conclusion, early fetal echocardiography appears to be a reasonable screening tool for major cardiac defects. © 2012 by Thieme Medical Publishers, Inc.ALLAN LD, 1988, CLIN OBSTET GYNECOL, V31, P61, DOI 10.1097-00003081-198803000-00009; Bahado-Singh RO, 2005, AM J OBSTET GYNECOL, V192, P1357, DOI 10.1016-j.ajog.2004.12.086; Becker R, 2006, ULTRASOUND OBST GYN, V27, P613, DOI 10.1002-uog.2709; Bonnet D, 1999, CIRCULATION, V99, P916; Buskens E, 1997, AM J PUBLIC HEALTH, V87, P962, DOI 10.2105-AJPH.87.6.962; Carvalho JS, 2004, HEART, V90, P921, DOI 10.1136-hrt.2003.015065; CHANG AC, 1991, J THORAC CARDIOV SUR, V102, P841; Cheitlin MD, 1997, CIRCULATION, V95, P1686; Gabriel CC, 2002, PRENATAL DIAG, V22, P586, DOI 10.1002-pd.372; CRAWFORD DC, 1988, AM J OBSTET GYNECOL, V159, P352; DAVIS GK, 1990, BRIT J OBSTET GYNAEC, V97, P27, DOI 10.1111-j.1471-0528.1990.tb01712.x; GEMBRUCH U, 1993, ULTRASOUND OBST GYN, V3, P310, DOI 10.1046-j.1469-0705.1993.03050310.x; Haak MC, 2002, ULTRASOUND OBST GYN, V20, P9, DOI 10.1046-j.1469-0705.2002.00735.x; Hoffman JIE, 2002, J AM COLL CARDIOL, V39, P1890, DOI 10.1016-S0735-1097(02)01886-7; Huggon IC, 2002, ULTRASOUND OBST GYN, V20, P22, DOI 10.1046-j.1469-0705.2002.00733.x; Hyett J, 1996, ULTRASOUND OBST GYN, V7, P245, DOI 10.1046-j.1469-0705.1996.07040245.x; Hyett JA, 1997, ULTRASOUND OBST GYN, V10, P242, DOI 10.1046-j.1469-0705.1997.10040242.x; Johnson B, 2007, AM J PERINAT, V24, P449, DOI 10.1055-s-2007-986681; Malone Fergal D, 2005, Obstet Gynecol, V106, P288, DOI 10.1097-01.AOG.0000173318.54978.1f; Mavrides E, 2001, ULTRASOUND OBST GYN, V17, P106, DOI 10.1046-j.1469-0705.2001.00342.x; McAuliffe FM, 2005, AM J OBSTET GYNECOL, V193, P1253, DOI 10.1016-j.ajog.2005.05.086; Michailidis GD, 2001, ULTRASOUND OBST GYN, V17, P102, DOI 10.1046-j.1469-0705.2001.00341.x; Montana E, 1996, J AM COLL CARDIOL, V28, P1805; Rasiah SV, 2006, ULTRASOUND OBST GYN, V28, P110, DOI 10.1002-uog.2803; Schwarzler P, 1999, BRIT J OBSTET GYNAEC, V106, P1029, DOI 10.1111-j.1471-0528.1999.tb08109.x; Sharland G, 2004, PRENATAL DIAG, V24, P1123, DOI 10.1002-pd.1069; SHARLAND GK, 1991, ARCH DIS CHILD, V66, P284; Simpson LL, 2007, OBSTET GYNECOL, V109, P376, DOI 10.1097-01.AOG.0000250473.99575.72; Small M, 2004, PEDIATR CARDIOL, V25, P210, DOI 10.1007-s00246-003-0587-z; Smrcek JM, 2006, J ULTRAS MED, V25, P187; Smrcek JM, 2006, J ULTRAS MED, V25, P183; Smrcek JM, 2006, J ULTRAS MED, V25, P173; SMYTHE JF, 1992, AM J CARDIOL, V69, P1471, DOI 10.1016-0002-9149(92)90903-C; Souka AP, 2004, ULTRASOUND OBST GYN, V24, P730, DOI 10.1002-uog.1775; VERGANI P, 1992, AM J OBSTET GYNECOL, V167, P1000; Vimpelli T, 2006, PRENATAL DIAG, V26, P475, DOI 10.1002-pd.1442; Vogel M, 2009, CARDIOL YOUNG, V19, P441, DOI 10.1017-S1047951109990655; Weiner Z, 2002, J ULTRAS MED, V21, P23; Zosmer N, 1999, BRIT J OBSTET GYNAEC, V106, P829, DOI 10.1111-j.1471-0528.1999.tb08405.x12
The Archaeology of Pewter Vessels in England 1200-1700: A Study of Form and Usage
No full textThe first aim is to study the main types of pewter vessels surviving for the period, and to show how they were suited to their domestic purpose, especially the serving of food, and as eating and drinking implements.
The second aim is to attempt to further investigate the alloy ‘trifle’ by having a sample of typical objects analysed by ICP-OES (Inductively Coupled Plasma Optical Emission Spectrometry). This alloy was introduced by the Pewterers’ Company (WCP) by the 16th century for the purpose of providing an extended range of wares in a more durable metal than ‘lay’ metal, but less expensive than ‘fine’ metal, as specified by the Company.
The third aim is to explore the occupations of the differing types of ‘potter’ who worked within the Company during the second half of the 17th century. The growth of this separate capitalist group of middle men ‘potters’ or retailers of ceramics and glassware has not previously been noted. The differing levels of wealth and work of other, mainstream, Pewterers is explored by comparison.
The majority of the finds came from anaerobic marine rather than traditional land sites and consisted chiefly of medieval to 17th century tablewares – dishes, saucers, plates, porringers, salts, beakers and other smaller drinking vessels, together with a few larger flagons. Such smaller drinking vessels were frequently listed as ‘trifles’ from the early 17th century in the Company records.
Individuals described as potters were sometimes identified amongst the Company’s membership. It was decided to try to determine their actual occupations by further examining the Court Minutes and wills and inventories of likely individuals.
It was found that the various dishes, saucers and platters were component parts of the ‘garnish’ the chief serving vessels used between the 14th to 18th century to serve food to the middling sort of people, and that this played a central role not only as utilitarian wares but as objects of decoration and status as well. The Pewterers’ Company members were highly innovative and also produced the country’s first plate (apart from in silver) by the mid-16th century and which remained in use unaltered until the 1670s. Linear dimensions were correlated with the more usual sizes by weight for the first time from the remains of the garnish on the Mary Rose, lost 1545.
Analysis of a sample of the smaller drinking vessels by Sheffield Assay Office detected an alloy of some 4-6% lead and this was likely to qualify as trifle alloy.
While some individuals did indeed make drinking wares, it was discovered that the term potter usually applied to retailers of glassware and ceramics – a new occupational label. A number of such individuals within the Pewterers’ Company played formative roles in setting up a new Glass Sellers Company in 1664. The business activities of this group – typical of individualist ventures during the 17th century – had not previously been noted by historians of the Company and indicated the Pewterers’ heterogeneous and commercial make up from this time
Expedited conveyance of out-of-hospital-cardiac arrest patients with STEMI and shockable rhythms to cardiac arrest centres : a feasibility pilot study of the British Cardiovascular Intervention Society conveyance algorithm
No full textBACKGROUND AND AIMS: Guidelines suggest non-traumatic out-of-hospital cardiac arrest (OHCA) be conveyed to cardiac arrest centres (CAC). We hypothesised that (a) a pre-hospital conveyance algorithm based on initial presenting rhythm following OHCA is feasible and (b) that would demonstrate survival advantage.METHODS: This observational pilot study included all consecutive patients with OHCA from suspected cardiac aetiology from the county of Essex, United Kingdom from April 2022-April 2023. For the first 6 months, OHCA patients had conveyance as standard of care. For the next 6 months, consecutive OHCA patients with STEMI or initial shockable rhythm were directly conveyed to the CAC, initial non-shockable rhythm without STEMI continued to be taken to the nearest Emergency Department (BCIS protocol). Primary outcome was death from any cause at 30 days. Secondary outcome was survival with favourable neurological outcome.RESULTS: Of 330 patients (mean age 67.5 ± 13.1, 66% male), 162 patients were in the standard care group and 168 in the BCIS conveyance group. Algorithm implementation was associated with numerically lower all cause 30-day mortality [(81% vs 73%, RR 1.10 (95% CI 0.98-1.24) p = 0.10] and numerically higher 30-day survival with favourable neurological outcome [15% vs 19%, RR 1.05 (0.95-1.15), p = 0.38]. Post hoc analysis showed that the BCIS conveyance algorithm was associated with lower 30 day mortality in those with an initial shockable rhythm [(61% vs 41%, RR 1.5 (95% CI 1.05-2.13) p = 0.02 and in those with a MIRACLE 2 score ≤ 5 [(63%% vs 38%, RR 0.59 (95% CI 0.61-0.86) p = 0.005]. CONCLUSIONS: The BCIS algorithm is feasible and did not impact overall mortality, but there is signal that direct conveyance of OHCA patients with an initial shockable rhythm and low MIRACLE 2 score, to a dedicated CAC may improve survival. </p
Assessing the impact of prolonged averaging of coronary continuous thermodilution traces
No full textContinuous Thermodilution is a novel method of quantifying coronary flow (Q) in mL/min. To account for variability of Q within the cardiac cycle, the trace is smoothened with a 2 s moving average filter. This can sometimes be ineffective due to significant heart rate variability, ventricular extrasystoles, and deep inspiration, resulting in a fluctuating temperature trace and ambiguity in the location of the “steady state”. This study aims to assess whether a longer moving average filter would smoothen any fluctuations within the continuous thermodilution traces resulting in improved interpretability and reproducibility on a test–retest basis. Patients with ANOCA underwent repeat continuous thermodilution measurements. Analysis of traces were performed at averages of 10, 15, and 20 s to determine the maximum acceptable average. The maximum acceptable average was subsequently applied as a moving average filter and the traces were re-analysed to assess the practical consequences of a longer moving average. Reproducibility was then assessed and compared to a 2 s moving average. Of the averages tested, only 10 s met the criteria for acceptance. When the data was reanalysed with a 10 s moving average filter, there was no significant improvement in reproducibility, however, it resulted in a 12% diagnostic mismatch. Applying a longer moving average filter to continuous thermodilution data does not improve reproducibility. Furthermore, it results in a loss of fidelity on the traces, and a 12% diagnostic mismatch. Overall, current practice should be maintained.</p
Author Correction: Landscape of somatic mutations in 560 breast cancer whole-genome sequences.
No full textIn the Methods section of this Article, 'greater than' should have been 'less than' in the sentence 'Putative regions of clustered rearrangements were identified as having an average inter-rearrangement distance that was at least 10 times greater than the whole-genome average for the individual sample. '. The Article has not been corrected.SCOPUS: er.jinfo:eu-repo/semantics/publishe
