Search

In a 1-day old filly with a loud heart murmur, transthoracic echocardiography revealed right ventricular hypertrophy associated with severe pulmonary valvular stenosis and a transvalvular pressure gradient (between right ventricle and pulmonary artery) of 125 mmHg. Computed tomographic angiography confirmed the finding, with no evidence of other relevant concurrent abnormalities. Balloon valvuloplasty was performed using a single balloon technique. The foal recovered well from anaesthesia. Following the procedure, the right ventricle-pulmonary artery transvalvular gradient decreased to 38 mmHg. At follow up examinations after 1 month, 1 year and 2 years, the filly showed normal exercise capacity and echocardiography confirmed the persistent substantial improvement in the transvalvular outflow gradient. [ABSTRACT FROM AUTHOR]

Since the initial reports surfaced of a novel coronavirus causing illness and loss of life in Wuhan, China, COVID-19 has rapidly spread across the globe, infecting millions and leaving hundreds and thousands dead. As hospitals cope with the influx of patients with COVID-19, new challenges have arisen as health-care systems care for patients with COVID-19 while still providing essential emergency care for patients with acute strokes and acute myocardial infarction. Adding to this complex scenario are new reports that patients with COVID-19 are at increased risk of thromboembolic complications including strokes. In this article, we detail our experience caring for acute stroke patients and provide some insight into neurointerventional workflow modifications that have helped us adapt to the COVID-19 era. • COVID-19 continues its relentless march through the United States and the globe, presenting unique challenges for health-care providers as they treat other emergent conditions while minimizing the risk of COVID-19 exposure and infection. • Acute stroke is especially challenging during the COVID-19 because of time constraints required for effective mechanical thrombectomy to improve neurologic outcomes and survival in patients whose COVID infection status is unknown. • The institutional protocol for mechanical thrombectomy described in this article may help inform models at other centers as they prepare for their respective COVID peaks. [ABSTRACT FROM AUTHOR]

All human tissues present with unique mechanical properties critical to their function. This is achieved in part through the specific architecture of the extracellular matrix (ECM) fibres within each tissue. An example of this is seen in the walls of the vasculature where each layer presents with a unique ECM orientation critical to its functions. Current adopted vascular grafts to bypass a stenosed/damaged vessel fail to recapitulate this unique mechanical behaviour, particularly in the case of small diameter vessels (<6 mm), leading to failure. Therefore, in this study, melt-electrowriting (MEW) was adopted to produce a range of fibrous scaffolds to mimic the extracellular matrix (ECM) architecture of the tunica media of the vasculature, in an attempt to match the mechanical and biological behaviour of the native porcine tissue. Initially, the range of collagen architectures within the native vessel was determined, and subsequently replicated using MEW (winding angles (WA) 45°, 26.5°, 18.4°, 11.3°). These scaffolds recapitulated the anisotropic, non-linear mechanical behaviour of native carotid blood vessels. Moreover, these grafts facilitated human mesenchymal stem cell (hMSC) infiltration, differentiation, and ECM deposition that was independent of WA. The bioinspired MEW fibre architecture promoted cell alignment and preferential neo-tissue orientation in a manner similar to that seen in native tissue, particularly for WA 18.4° and 11.3°, which is a mandatory requirement for long-term survival of the regenerated tissue post-scaffold degradation. Lastly, the WA 18.4° was translated to a tubular graft and was shown to mirror the mechanical behaviour of small diameter vessels within physiological strain. Taken together, this study demonstrates the capacity to use MEW to fabricate bioinspired scaffolds to mimic the tunica media of vessels and recapitulate vascular mechanics which could act as a framework for small diameter graft development to guide tissue regeneration and orientation. [ABSTRACT FROM AUTHOR]

TN-301 is a highly selective, orally available histone deacetylase 6 (HDAC6) inhibitor being developed for the potential treatment of heart failure with preserved ejection fraction (HFpEF). Studies in preclinical models show reversal of HFpEF disease by selective HDAC6 inhibition. This First-in-Human (FiH) Phase 1 clinical trial evaluates the safety and biological activity of TN-301 at a broad range of single doses and multiple daily doses over 2 weeks in healthy adult participants. Multiple preclinical models of HFpEF suggest that selective HDAC6 inhibition has direct and systemic effects on multiple pathways linked to HFpEF pathogenesis, including mitochondrial dysfunction, fibrosis and inflammation, while avoiding undesirable effects of non-selective HDAC inhibitors. This FiH study is designed to identify a dose range for further development and to demonstrate potential clinical utility through use of relevant biomarkers. The double-blinded, randomized clinical trial plans to enroll 72 participants in 6 single-ascending dose (SAD) and 3 multiple-ascending dose (MAD) cohorts, each comprised of 8 participants (6 active, 2 placebo). MAD cohorts are dosed once daily for 14 consecutive days. Endpoints include safety, tolerability, pharmacokinetic (PK) and pharmacodynamic (PD) assessments. A key PD biomarker of HDAC6 inhibition is the level of acetylated tubulin in PMBCs. Comprehensive synthesis of unblinded safety, tolerability, PK, and PD results, including additional planned cohorts, are anticipated by the time of presentation. As of the submission of this abstract, 48 participants have been randomized into the SAD stage and received TN-301 or placebo per protocol at oral doses from 1-700mg. An additional 16 participants have been treated in 2 MAD cohorts at 25mg and 100mg. Among these participants, there were no SAEs, DLTs or premature withdrawals due to tolerability. Interim analysis showed a slightly more than dose-proportional PK profile with a half-life consistent with once-daily dosing. Plasma concentrations were attained that corresponded with those observed in mouse models that demonstrated robust PD affects and reversal of HFpEF phenotype. Target engagement was demonstrated at doses > 5mg and was sustained above baseline throughout the dosing interval in the MAD cohorts at steady state. Initial data from this FiH clinical trial of TN-301 in healthy adult participants demonstrated clear evidence of target engagement. To date, TN-301 has been generally well tolerated with PK consistent with once-daily dosing. TN-301 represents a promising new therapeutic candidate for the potential treatment of HFpEF and other indications. [ABSTRACT FROM AUTHOR]

HFpEF is a form of heart failure characterized by diastolic dysfunction and associated with high morbidity, mortality and significant unmet need. Previously, we have demonstrated that selective inhibition of histone deacetylase 6 (HDAC6) has positive effects on diastolic dysfunction and left ventricular thickness of the heart, as well as overall improvements in systemic inflammation and metabolism, in a mouse model of HFpEF using a high-fat diet (HFD) and L-NAME. Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor approved by the FDA for HFpEF patients, works as expected in this model, confirming the potential clinical translatability of results seen with HDAC6 inhibitors. In head-to-head studies, the beneficial effects of HDAC6 inhibition have been shown to be comparable to empagliflozin, while demonstrating a distinct mechanism of action in gene expression analysis. TN-301, a highly selective HDAC6 inhibitor has been advanced into clinical development for the potential treatment of HFpEF. In this study, we sought to investigate the additive or synergistic effects of combining HDAC6 and SGLT2 inhibition to improve cardiac function in a two-hit mouse model of HFpEF. Low doses of TYA-018 (a highly selective HDAC6 inhibitor) and empagliflozin were co-administered in our HFpEF model. We then assessed functional measures and cardiac gene expression in hearts from treated and control HFpEF mice. In our mouse model of HFpEF, pharmacological inhibition of TYA-018 results in extensive cardiac functional and structural improvements, including diastolic dysfunction and LV mass. Co-administration of TYA-018 and empagliflozin resulted in additive cardiac functional and structural measures vs. the single agents. Of note, multiple measures of diastolic dysfunction (e.g., E/e') were returned to baseline values by combination treatment in HFpEF mice similar to those in WT mice. Gene expression analysis is being conducted using RNA-seq to elucidate the potential mechanisms underlying the efficacy of HDAC6 and SGLT2 inhibition by characterizing the pathway-level modulation by combination treatment compared to each therapy alone. Results of gene expression analysis comparing single-agent and combination activity are planned for inclusion at the time of presentation. These studies demonstrate an additive benefit on diastolic dysfunction and elucidate key molecular mechanisms supporting the rationale for the potential use of HDAC6 inhibition as a single agent or in combination with SGLT2 inhibition for the treatment of HFpEF. [ABSTRACT FROM AUTHOR]

Abstract Numerous hypotheses have been put forward to account for population outbreaks of crown-of-thorns starfishes (CoTS, Acanthaster spp.), which place specific importance on either pre- or post-settlement mechanisms. The purpose of this review is to specifically assess the contributions of pre- versus post-settlement processes in the population dynamics of CoTS. Given the immense reproductive potential of CoTS (>100 million eggs per female), persistent high densities would appear inevitable unless there were significant constraints on larval development, settlement success, and/or early post-settlement growth and survival. In terms of population constraints, pre- and post-settlement processes are both important and have additive effects to suppress densities of juvenile and adult CoTS within reef ecosystems. It is difficult, however, to assess the relative contributions of pre- versus post-settlement processes to population outbreaks, especially given limited data on settlement rates, as well as early post-settlement growth and mortality. Prioritising this research is important to resolve potential effects of anthropogenic activities (e.g., fishing) and habitat degradation on changing population dynamics of CoTS, and will also improve management effectiveness. [ABSTRACT FROM AUTHOR]

The architecture within which cells reside is key to mediating their specific functions within the body. In this study, we use melt electrospinning writing (MEW) to fabricate cell micro-environments with various fibrous architectures to study their effect on human stem cell behaviour. We designed, built and optimised a MEW apparatus and used it to fabricate four different platform designs of 10.4 ± 2 μm fibre diameter, with angles between fibres on adjacent layers of 90°, 45°, 10° and R (random). Mechanical characterisation was conducted via tensile testing, and human skeletal stem cells (hSSCs) were seeded to scaffolds to study the effect of architecture on cell morphology and mechanosensing (nuclear YAP). Cell morphology was significantly altered between groups, with cells on 90° scaffolds having a lower aspect ratio, greater spreading, greater cytoskeletal tension and nuclear YAP expression. Long term cell culture studies were then conducted to determine the differentiation potential of scaffolds in terms of alkaline phosphatase activity, collagen and mineral production. Across these studies, an increased cell spreading in 3-dimensions is seen with decreasing alignment of architecture correlated with enhanced osteogenesis. This study therefore highlights the critical role of fibrous architecture in regulating stem cell behaviour with implications for tissue engineering and disease progression. Statement of Significance This is the first study which has investigated the effect of controlled fibrous architectures fabricated via melt electrospinning writing on stem cell behaviour and differentiation. After optimising the fabrication process and characterising scaffolds via SEM and mechanical testing, skeletal stem cells were seeded onto fibrous scaffolds with various micro-architectures. These architectures drove cell shape changes resulting in architecture dependent nuclear YAP localisation, suggesting altered mechanosensing at early time points. In agreement with these early markers, long term cell culture studies revealed for the first time that a 90° fibrous architecture is optimal for the osteogenic differentiation of skeletal stem cells. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients.Materials and Methods: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first. Secondary endpoints were incidence of acute proximal deep venous thrombosis (DVT), catheter-related thrombosis, catheter-related bloodstream infections, major bleeding events, and clinically significant thrombus (occupying > 25% of volume of filter) detected by cavography before retrieval.Results: The device was placed in 163 critically ill patients with contraindications to anticoagulation; 151 (93%) were critically ill trauma patients, 129 (85%) had head or spine trauma, and 102 (79%) had intracranial bleeding. The primary efficacy endpoint was achieved for all 163 (100%) patients (95% confidence interval [CI], 97.8%-100%, P < .01). Diagnosis of new or worsening acute proximal DVT was time dependent with 11 (7%) occurring during the first 7 days. There were no (0%) catheter-related bloodstream infections. There were 5 (3.1%) major bleeding events. Significant thrombus in the IVC filter occurred in 14 (8.6%) patients. Prophylactic anticoagulation was not initiated for a mean of 5.5 days ± 4.3 after ICU admission.Conclusions: This novel device prevented clinically significant and fatal PE among critically ill trauma patients with low risk of complications. [ABSTRACT FROM AUTHOR]

Objective The effect of a common polymorphism in the Growth Hormone (GH) receptor (d3-GHR) gene on growth, metabolism and body composition was examined in short children born small for gestational age (SGA) on GH treatment. Design In 96 prepubertal, short SGA children treated with high-dose GH (67 μg/kg/day) in the NESGAS study, insulin sensitivity (IS), insulin secretion and disposition index (DI) were determined during the first year of treatment. Body composition was analysed by DXA. The d3-GHR locus was determined by simple multiplex PCR. Results At baseline, children in the d3-GHR group (d3/fl (n = 37), d3/d3 (n = 7)) had significantly lower IS (median (25–75 percentile)) (223.3% (154.4–304.8)) vs. (269.7% (185.1–356.7)) (p = 0.03) and higher concentrations of glucose (mean (SD)) (4.4 mmol/L (0.6) vs. 4.2 mmol/L (0.7)) (p = 0.03), C-peptide (232.1 pmol/L (168.8–304.1) vs. 185.1 pmol/L (137.7–253.9)) (p = 0.04) and insulin (19.2 pmol/L (11.8–32.2)) vs. (13.7 pmol/L (9.3–20.8)) (p = 0.04) compared to children homozygous for the full length allele (fl/fl-GHR (n = 52)). There were no differences in DI or insulin secretion. Postnatal, spontaneous growth was significantly greater in the d3-GHR group compared to the fl/fl-GHR group (p = 0.02). There were no significant differences in growth response, body composition or metabolism after one year of GH therapy. Conclusion Short SGA children carrying the d3-GHR polymorphism had increased spontaneous growth, lower IS and a compensatory increase in glucose, C-peptide and insulin before GH therapy compared to children homozygous for the full-length allele. [ABSTRACT FROM AUTHOR]

Identification of falls while performing normal activities of daily living (ADL) is important to ensure personal safety and well-being. However, falling is a short term activity that occurs rarely and infrequently. This poses a challenge for traditional supervised classification algorithms, because there may be very little training data for falls (or none at all) to build generalizable models for falls. This paper proposes an approach for the identification of falls using a wearable device in the absence of training data for falls but with plentiful data for normal ADL. We propose three ‘X-Factor’ Hidden Markov Model (XHMMs) approaches. The XHMMs have ‘inflated’ output covariances (observation models). To estimate the inflated covariances, we propose a novel cross validation method to remove ‘outliers’ from the normal ADL that serves as proxies for the unseen falls and allow learning the XHMMs using only normal activities. We tested the proposed XHMM approaches on two activity recognition datasets and show high detection rates for falls in the absence of fall-specific training data. We show that the traditional method of choosing threshold based on maximum of negative of log-likelihood to identify unseen falls is ill-posed for this problem. We also show that supervised classification methods perform poorly when very limited fall data is available during the training phase. [ABSTRACT FROM AUTHOR]

Climate-induced coral bleaching represents the foremost threat to coral assemblages globally, however bleaching susceptibility varies among and within coral taxa. We compared bleaching susceptibility among 10 coral morpho-taxa and two colony size classes relative to reef-scale bleaching severity at 33 reefs across the Great Barrier Reef and Coral Sea Marine Parks in February–March 2020. Colony size and bleaching severity caused the hierarchy of bleaching susceptibility among taxa to change considerably. Notably, massive Porites shifted from being among the least likely taxa to exhibit bleaching, to among the most susceptible as overall bleaching severity increased. Juvenile corals (≤5 cm diameter) were generally more resistant to bleaching, except for Montipora and Pocillopora colonies, which were more likely to bleach than adults (>5 cm). These findings suggest that colony size and reef-scale bleaching severity are important determinants of bleaching susceptibility among taxa and provide insights into possible shifts in the structure of coral assemblages caused by bleaching events. • The bleaching likelihood for 10 coral taxa in two colony size classes, at five bleaching severity levels was investigated. • Moderate levels of bleaching severity produced the most pronounced differential susceptibilities among taxa. • Massive Porites shifted to become one of the most susceptible taxa as bleaching severity increased. • Coral colony size influenced bleaching susceptibility but this was dependent on taxonomic identity and bleaching severity. • Juvenile Montipora and Pocillopora were more likely to bleach than adult congeners, contrary to other taxa modelled. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery (ERAS) programmes utilise a multi-modal and multidisciplinary approach to surgical care. The aim of ERAS is to reduce the surgical stress response, maintain physiological function and metabolic homeostasis and expedite patients' recovery to their baseline status. With its success in colorectal practice, ERAS is increasingly adopted in other surgical specialities. A good ERAS programme involves integrated pre-operative, intra-operative and post-operative evidence-based practice. Successful ERAS programme translates to a standardized patient care pathway, improved clinical outcomes and shorter hospital stay, all of which will help facilitate the increasing demand on healthcare and bed pressure. Its principles and many components are transferable to other surgical specialities including acute surgical services and medical specialities to improve patient care and recovery and will soon become the standard of care for the majority of hospital inpatients. [ABSTRACT FROM AUTHOR]

Background Decreases in the rates of traditional autopsy (TA) negatively impact traumatology, especially in the areas of quality improvement and medical education. To help enhance the understanding of trauma-related mortality, a number of initiatives in imaging autopsy (IA) were conceived, including the postmortem computed tomography (“CATopsy”) project at our institution. Though IA is a promising concept, few studies directly correlate TA and IA findings quantitatively. Here, we set out to increase our understanding of the similarities and differences between key findings on TA and IA in a prospective fashion with blinding of pathologist and radiologist evaluations. Methods A prospective study of TA versus IA was conducted at an Academic Level I Trauma Center (June 2001–May 2010). All decedents underwent a postmortem, whole-body, noncontrast computed tomography that was interpreted by an independent, blinded, board-certified radiologist. A blinded, board-certified pathologist then performed a TA. Autopsy results were grouped into predefined categories of pathologic findings. Categorized findings from TA and IA were compared by determining the degree of agreement (kappa). The χ 2 test was used to detect quantitative differences in “potentially fatal” findings (eg, aortic trauma, splenic injury, intracranial bleeding, etc) between TA and IA. Results Twenty-five trauma victims (19 blunt; 9 female; median age 33 years) had a total of 435 unique findings on either IA or TA grouped into 34 categories. The agreement between IA and TA was worse than what chance would predict (kappa = −0.58). The greatest agreement was seen in injuries involving axial skeleton and intracranial/cranio-facial trauma. Most discrepancies were seen in soft tissue, ectopic air, and “incidental” categories. Findings determined to be “potentially fatal” were seen on both TA/IA in 48/435 (11%) instances with 79 (18%) on TA only and 53 (12%) on IA only. TA identified more “potentially fatal” solid organ and heart/great vessel injuries, while IA revealed more spine injuries, “potentially fatal” procedure-related findings, and the presence of ectopic air/fluid. Conclusion This limited study does not support substitution of noncontrast, computed tomography–based IA for TA. Our quantitative analyses suggest that TA and IA evaluations may be complementary and synergistic when performed concurrently. There are potential benefits to using IA in trauma process/quality improvement and in educational settings. Further research should focus on the value (and limitations) of the information provided by IA in the absence of TA. [ABSTRACT FROM AUTHOR]

Parrotfishes (f. Labridae) are a unique and ubiquitous group of herbivorous reef fishes. We compared the distribution and ecosystem function (grazing and erosion) of parrotfishes across 75 reefs in Arabia. Our results revealed marked regional differences in the abundance, and taxonomic and functional composition of parrotfishes between the Red Sea, Arabian Sea, and Arabian Gulf. High densities and diversity of parrotfishes, and high rates of grazing (210% year − 1 ) and erosion (1.57 kg m − 2 year − 1 ) characterised Red Sea reefs. Despite Arabian Sea and Red Sea reefs having broadly comparable abundances of parrotfishes, estimates of grazing (150% year − 1 ) and erosion (0.43 kg m − 2 year − 1 ) were markedly lower in the Arabian Sea. Parrotfishes were extremely rare within the southern Arabian Gulf, and as such rates of grazing and erosion were negligible. This regional variation in abundance and functional composition of parrotfishes appears to be related to local environmental conditions. [ABSTRACT FROM AUTHOR]

Determining how coral ecosystems are structured within extreme environments may provide insights into how coral reefs are impacted by future climate change. Benthic community structure was examined within the Persian Gulf, and adjacent Musandam and northern Oman regions across a 3-year period (2008–2011) in which all regions were exposed to major disturbances. Although there was evidence of temporal switching in coral composition within regions, communities predominantly reflected local environmental conditions and the disturbance history of each region. Gulf reefs showed little change in coral composition, being dominated by stress-tolerant Faviidae and Poritidae across the 3 years. In comparison, Musandam and Oman coral communities were comprised of stress-sensitive Acroporidae and Pocilloporidae; Oman communities showed substantial declines in such taxa and increased cover of stress-tolerant communities. Our results suggest that coral communities may persist within an increasingly disturbed future environment, albeit in a much more structurally simple configuration. [ABSTRACT FROM AUTHOR]

Echinometra mathaei is a common echinoid on tropical reefs and where abundant plays an important role in the control of algal communities. Despite high prevalence of E. mathaei on southern Persian/Arabian Gulf reefs, their abundance and distribution is poorly known. Spatial and temporal patterns in population abundance were examined at 12 sites between breakwater and natural reef habitats in Dubai (UAE) every 3 months from 2008 to 2010. Within the breakwater habitat, densities were greatest at shallow wave-exposed sites, and reduced with both decreasing wave-exposure and increasing depth. Interestingly, E. mathaei were significantly more abundant on exposed breakwaters than natural reef sites, presumably due to differences in habitat structure and benthic cover. Population abundances differed seasonally, with peak abundances during summer (July–September) and lower abundances in winter (December–February). Seasonal fluctuations are likely the result of peak annual recruitment pulses coupled with increased fish predation from summer to winter. [ABSTRACT FROM AUTHOR]

Data support for GES assessment under the MSFD will require subregion-scale Joint Monitoring Programmes (JMPs). These JMPs must be cost-efficient and produce the necessary evidence-base to support management decisions. This review summarises the outputs of a 2.5-day multidisciplinary workshop where scientists and programme managers developed monitoring scenarios as examples of how current sampling activities could be extended and combined into framework JMPs. The objective was to explore opportunities for improved i) integration of monitoring, ii) international collaboration and iii) multi-disciplinary use of platforms. The workshop identified opportunities to upgrade current monitoring programmes, to include additional sampling activities, and to support integration of resources and activities. We found that developing JMPs using this bottom-up approach has potential benefits but requires commitment and expert coordination. Coordination needs include definition of data requirements, common sampling methodologies and data exchange. [ABSTRACT FROM AUTHOR]

Objectives Low levels of physical activity and poor dietary habits are common in people with serious mental illness and contribute to the poorer overall health and early mortality observed in this population. This paper examines the relationships between health behaviour knowledge and self-reported health behaviours in people with serious mental illness. Methods We examined the health behaviour knowledge, level of physical activity, consumption of fruits and vegetables and attitudes towards saturated fat intake in 21 community-based mental health consumers in a regional city in Queensland, Australia. Relationships between dichotomous variables of health behaviour knowledge, physical activity levels, daily fruit and vegetable intake, and attitude towards saturated fat intake were examined using Phi coefficients and point biserial relationships respectively. Results The mean score for health behaviour knowledge was 10.2 out of a possible maximum score of 14 points. No statistically significant relationships were observed between the dichotomous variables of health behaviour knowledge and level of physical activity, consumption of fruits and vegetables or attitudes towards saturated fat intake. A weak statistically significant relationship was observed between raw health knowledge score and the number of daily serves of vegetable. Conclusions The lack of significant relationships between health behaviour knowledge and self-reported health behaviours is supported by health behaviour theory which proposes that knowledge alone is insufficient to elicit behaviour. In this regard, people with serious mental illness may not be dissimilar to the general population. [ABSTRACT FROM AUTHOR]

Highlights: [•] Diversity-disturbance response depends on environmental changes. [•] Attraction of fine sediment species due to sediment refinement caused by the impact. [•] Local increase of biodiversity in impacted area. [•] Shift towards heterogenic, dynamic transitional assemblages. [ABSTRACT FROM AUTHOR]

Highlights: [•] Coral reef habitats are in decline, with reductions in coral cover and structure. [•] Most fishes (regardless of their size) are less abundant on degraded reefs. [•] Highly specialised fishes are most vulnerable to habitat degradation. [•] Response diversity and functional redundancy are likely to have been overestimated. [•] Fisheries productivity will decline with ongoing degradation of reef habitats. [ABSTRACT FROM AUTHOR]

People with serious mental illness experience disparities in primary health care. One solution is a specialist nursing position responsible for the coordination of the primary care of people with serious mental illness. However the views of nurses regarding this proposed role are only beginning to emerge. This study reports the readability, factorability, internal consistency and responses from a questionnaire regarding the views of nurses working in a mental health setting regarding the proposed role. The questionnaire was determined to have adequate readability, and internal consistency. Nurses are positive towards the development of the role however the cost-effectiveness should be considered. [ABSTRACT FROM AUTHOR]

The Western Australia Country Health Service (WACHS) is the largest geographical health service in Australia, covering 2.5 million square Kilometres. The population is diverse, highly dispersed and has widely varying health needs. In 2020-21, there was over 4,200 births across 18 birth sites in country WA, many of which are staffed by just one midwife during a shift. For mothers in country WA, this often means there is no local access to maternity care providers and a need to travel long distances away from home to access maternity care. The Midwifery and Obstetrics Emergency Telehealth Service (MOETS) was introduced in February 2022 through the existing WACHS Command Centre to deliver expert midwifery and specialist obstetric advice via state-of-the-art bedside technology in real-time to support frontline clinicians, including Emergency Departments (ED) and maternity services. The MOETS offers: • specialist midwifery and obstetric support at the bedside for unplanned maternity and gynaecological presentations at non-maternity hospitals (Eds); • consultation and expert opinion through the introduction of new technologies to remotely review cardiotocographs (CTGs) at maternity sites; • a friendly expert available via phone /bedside screen 24/7 to provide collegiate advice, support, reassurance and opinions to give assurance and confidence to both country clinicians and country families; and • logistical support for maternity and neonatal transfers; to enable local clinicians to continue provide clinical care. MOETS aims to not only improve the country clinician experience, many of whom work in isolation, and also those who are recently qualified, new starters or agency /locums but to also improve the outcomes and experience for mothers, partners and newborns whilst keeping care closer to home and community. The new MOETS will be formally evaluated to assess the staff experience and patient satisfaction, the improved equity of access, staff recruitment /retention and clinical outcomes, including transfer rates. [ABSTRACT FROM AUTHOR]

Percutaneous vascular embolization is one of the major applications of interventional radiology. A wide variety of embolization agents are currently available for clinical use. The interventional radiologist needs to be up to date with the newer and different types of embolic agents available along with their biopharmaceutical characteristics, strengths, and weaknesses that have been reviewed. For the purpose of this review, we have classified embolization agents into mechanical occlusion devices, particulate agents, and liquid agents, with some degree of overlap between some of the agents. [Copyright &y& Elsevier]

Right heart chamber enlargement can be caused by a diverse and heterogeneous group of conditions with highly varied clinical symptoms and signs. An appreciation of the pathophysiology, causes, and imaging features of right heart enlargement is paramount in recognizing and potentially ameliorating the development of right heart dysfunction or adverse cardiac events. Chest x-ray and transthoracic echocardiography have traditionally been, and still are, the mainstay in initial evaluation of right heart dilatation; however, recent advances in both multidetector computed tomography and cardiovascular magnetic resonance imaging now permit a comprehensive assessment of the causes and consequences of right heart dilatation. [Copyright &y& Elsevier]

Abstract: The functional composition of reef fish assemblages is highly conserved across large biogeographic areas, but it is unknown whether assembly rules hold at biogeographical and environmental extremes for coral reefs. This study examined the functional composition of butterflyfishes in the Persian Gulf, Musandam Peninsula, and Gulf of Oman. Only five species of butterflyfishes were recorded during this study, and mostly just in the Gulf of Oman. Unlike most locations in the Indo–Pacific where butterflyfish assemblages are dominated by obligate corallivores, the only obligate corallivore recorded, Chaetodon melapterus, was rare or absent at all locations. The most common and widespread species was Chaetodon nigropunctatus, which is shown to be a facultative corallivore. The diversity of butterflyfishes in the Persian Gulf is likely to have been constrained by its’ biogeographical history and isolation, but functional composition appears to be further affected by limited abundance of prey corals and harsh environmental conditions. [Copyright &y& Elsevier]

Abstract: The Three Gorges occupy 193km of the middle reaches of the Yangtze River between Fengjie in Chongqing and Yichang in Hubei Province, China. Due to steep valley-side slopes and long-term river incision, landslides are a major hazard in the Three Gorges region. In this study, we employ the SBAS InSAR technique to process Envisat SAR images collected between 2003 and 2010. Our time series results enable identification of two distinct landslides with deformation rates of up to 10–15mm/yr in Badong County, and field evidence is used to verify the positions of these failures. With both descending and ascending observations, two-dimensional velocity fields in north and up directions are recovered to better understand the landslide movements. Obvious correlation between seasonal landslide movements and water level changes is observed, which not only provides strong support of our InSAR time series results, but also indicates the impacts of water level changes to landslide activities. [Copyright &y& Elsevier]

Cardiovascular magnetic resonance imaging (CMRI) is the reference noninvasive imaging technique for assessment and characterization of a suspected cardiac or juxta-cardiac mass. The multiplanar assessment of anatomy, tissue composition, and functional impact afforded by CMRI allows for early differentiation between a nonneoplastic mass and a tumor mass, be it benign or malignant. Malignant cardiac tumors have a poor prognosis; however, early detection and characterization confer some survival advantage, enabling early instigation of chemotherapy and/or consideration of a surgical debulking procedure. Cardiac metastases are far more common than primary tumors and are an important consideration in patients with disseminated disease. Angiosarcoma accounts for the majority of primary malignant lesions. Less common primary malignant cardiac tumors include sarcomas with myofibroblastic differentiation, lymphoma, rhabdomyosarcoma, pericardial mesothelioma, and pericardial synovial sarcoma. A number of benign masses and normal anatomical variants can cause confusion to the inexperienced observer and must be recognized to avoid unnecessary intervention. These include intracardiac thrombus, bronchogenic and pericardial cysts, and anatomical structures, such as the Crista terminalis and moderator band. [ABSTRACT FROM AUTHOR]

Cardiovascular magnetic resonance imaging (CMRI) is the reference noninvasive technique for assessment and characterization of a suspected cardiac or juxta-cardiac mass. The multiplanar assessment of anatomy, tissue composition, and functional impact afforded by CMRI allows for early differentiation between a nonneoplastic mass and a tumor mass, be it benign or malignant. CMRI has superior tissue contrast resolution compared with competing noninvasive imaging modalities (echocardiography and multidetector computed tomography). A number of different imaging sequences are employed for a comprehensive CMRI assessment. Black-blood prepared sequences are mainly used for tissue characterization and assessment of lesion enhancement characteristics. Bright blood prepared sequences provide functional information, such as lesion mobility and impact on adjacent valves and chambers. Atrial myxoma is the most common primary benign cardiac tumor and can present with obstructive or embolic phenomena. Fibroelastomas are smaller lesions that do not alter hemodynamic function but can cause symptoms secondary to systemic embolization. Less common benign cardiac tumors include lipoma, fibroma, hemangioma, paraganglioma, and cystic tumor of the atrioventricular nodal region. [ABSTRACT FROM AUTHOR]

Abstract: Activity recognition in intelligent environments could play a key role for supporting people in their activities of daily life. Partially observable Markov decision process (POMDP) models have been used successfully, for example, to assist people with dementia when carrying out small multistep tasks such as hand washing. POMDP models are a powerful, yet flexible framework for modeling assistance that can deal with uncertainty and utility in a theoretically well-justified manner. Unfortunately, POMDPs usually require a very labor-intensive, manual set-up procedure. This paper describes a knowledge-driven method for automatically generating POMDP activity recognition and context-sensitive prompting systems for complex tasks. It starts with a psychologically justified description of the task and the particular environment in which it is to be carried out that can be generated from empirical data. This is then combined with a specification of the available sensors and effectors to build a working prompting system. The method is illustrated by building a system that prompts through the task of making a cup of tea in a real-world kitchen. The case is made that, with further development and tool support, the method could feasibly be used in a clinical or industrial setting. [Copyright &y& Elsevier]

Echocardiography is the first-line imaging modality for assessment of structural heart disease but magnetic resonance imaging and multi-detector computed tomography are being increasingly used for cardiac morphologic assessment. Aneurysms and diverticulae of the cardiac chambers and related structures represent a diverse group of conditions with varying etiologies and clinical manifestations. This article reviews the magnetic resonance imaging and multi-detector computed tomography features of these lesions with consideration of the emerging role that cross-sectional imaging has to play in their evaluation. Radiologists should be familiar with the salient imaging appearances of these conditions to facilitate optimal patient management. [ABSTRACT FROM AUTHOR]

Abstract: The Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD) are the European umbrella regulations for water systems. It is a challenge for the scientific community to translate the principles of these directives into realistic and accurate approaches. The aim of this paper, conducted by the Benthos Ecology Working Group of ICES, is to describe how the principles have been translated, which were the challenges and best way forward. We have tackled the following principles: the ecosystem-based approach, the development of benthic indicators, the definition of ‘pristine’ or sustainable conditions, the detection of pressures and the development of monitoring programs. We concluded that testing and integrating the different approaches was facilitated during the WFD process, which led to further insights and improvements, which the MSFD can rely upon. Expert involvement in the entire implementation process proved to be of vital importance. [ABSTRACT FROM AUTHOR]

This study introduces a templating approach using a cellulosic suspension to create a porous SiO 2 –CaO–P 2 O 5 –Na 2 O bioactive glass material. Sol-gel approach was used as the synthesis method. Carbon nanofibers in suspension form was used as the templating material. The amount of CNF used in the experiment ranged from 5% to 25% by volume. The morphology, porosity, crystallinity of the combeite phase, mechanical and chemical properties of the BG samples were examined. The findings show that the templating method had no effect on the formation of the required functional elements, such as Si, Ca, Na and P. The porosity of the BG materials improves by 15% after templating compared to the neat sample. The formed pores were assumed to be homogenous based on the uniform adsorption and desorption BET profiles. The crystallization mechanisms during the sintering process were affected by the templating approach, indicating the need for a specific amount of template to be used in the preparation step. Both the sintering temperatures and the CNF content affected the formation of the combeite phase. The BG samples had excellent mechanical properties and are suitable for use in cancellous bone applications. As a result, this study shows a novel method for synthesizing porous bioactive glass materials via the sol-gel method and a CNF suspension as a template. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports on the effects of porosity and its distribution on the fatigue strength of bone cement. Hand-mixed (HM) and vacuum-mixed (VM) bone cement samples were fatigue tested to failure. The point of failure commonly coincided with large single pores (in the VM materials) and multiple pores in clusters (in the HM material). The effect of pores was analysed using the Theory of Critical Distances (TCD), a theory previously developed to explain the effect of notches and other stress concentrations on fatigue and fracture. Clusters of pores were analysed by developing a criterion to decide whether local cracking would act to link pores together, forming a single stress concentration of more complex shape. This approach enabled us to predict the high-cycle fatigue strength of samples containing clusters of pores, with good accuracy (errors less than 13%). We then used the analysis to develop general rules for the effect of pore size and proximity on fatigue strength. For example, we showed that a single pore of 2mm diameter or more would cause a significant decrease in the fatigue strength (compared to that of pore-free material); however, two pores of only 1mm diameter in close proximity would be equally damaging. This demonstrates the importance not only of pore size but also of pore density and distribution. However, pores do have beneficial effects such as improved drug dispersion, bone ingrowth and crack tip blunting. Therefore, given the findings from this study, a possible step forward in the development of surgical bone cements may involve a compromise in which relatively small pores are evenly distributed throughout the material. [Copyright &y& Elsevier]

Abstract: Thoracic computed tomography (CT) is a commonly requested radiological investigation. Anaesthetists should have an understanding of how CT is performed, be aware of appropriate clinical indications and have an approach to interpretation. In this article, we provide an overview of CT technique, highlight relevant cross-sectional thoracic anatomy and provide examples of clinically important pathology. A CT scanner uses X-rays to generate cross-sectional slices through the body. Images are displayed on a monitor screen and interpreted using different ‘windows’ to enhance contrast between structures of similar attenuation. There are many indications for thoracic CT, including staging of lung cancer, investigation of interstitial lung disease and assessment of chest trauma. The scan protocol is tailored according to the clinical question and may involve administration of iodinated intravenous contrast agent. [Copyright &y& Elsevier]

Wide applications of polymeric membranes are limited by their low selectivity, solution fluxes and fouling issues. Graphene oxide (GO)-based nanocomposite could be used to enhance the membrane performance owing to their large surface area, good chemical and mechanical properties. The alteration of membrane performance for water and wastewater treatment by the GO-based nanocomposites, however, are not detailed by the modified membrane characteristics. Thus, this study aims to evaluate the membrane performance modified by GO-based composites based on the alteration in membrane characteristics. Data from contact angle measurement, Field Emission Scanning Electron Microscopy, Transmission electron microscopy, Fourier-transform infrared spectroscopy and Raman spectroscopy are employed in explaining the membrane performance such as solution flux, flux recovery, fouling tendency, retention capability and selectivity. GO-based nanocomposite membranes have revealed better fouling resistance, higher solute selectivity and solution flux than the unmodified membranes in water treatment. The embedment of GO-based nanofillers in ultrafiltration and nanofiltration polymeric membranes can significantly alter the membrane morphology, surface wettability and functional groups. In brief, GO-based nanocomposites are proven to be effective nanomaterials for water and wastewater treatment in the near future. [Display omitted] • Graphene oxide (GO)-based nanocomposites led to better membrane fouling resistance. • Chitosan-Ag-GO nanocomposites can enhance the biofouling resistance of membranes. • Reversible fouling effect has dominated the total fouling ratio of GO/PES membrane. • GO-modified membrane showed high rejection towards organic and inorganic compounds. • GO and GO composites can improve the membrane surface hydrophilicity. [ABSTRACT FROM AUTHOR]

Variation in water quality can directly affect the composition of benthic assemblages on coral reefs. Yet, few studies have directly quantified nutrient and suspended particulate matter (SPM) to examine their potential impacts on benthic community structure, especially around high oceanic islands. We assessed the spatio-temporal variation of nutrients and SPM across six sites in American Samoa over a 12-month period and used exploratory path analysis to relate dissolved inorganic nutrients, land use, and natural and anthropogenic drivers to benthic assemblages on adjacent shallow reefs. Multivariate analyses showed clear gradients in nutrient concentrations, sediment accumulation and composition, and benthic structure across watersheds. Instream nutrients and land uses positively influenced reef flat nutrient concentrations, while benthic assemblages were best predicted by wave exposure, runoff, stream phosphate and dissolved inorganic nitrogen loads. Identifying locality-specific drivers of water quality and benthic condition can support targeted management in American Samoa and in other high islands. [ABSTRACT FROM AUTHOR]

Abstract: We present a case of complete left pericardial defect which was evaluated with retrospectively gated dual source CT. Imaging findings included right heart chamber dilatation, extreme levoposition and excessive cardiac mobility which was demonstrated by repeat imaging in the left lateral decubitus position. Cardiac CT is an excellent means of evaluating pericardial disease owing to its high spatial resolution. Decubitus imaging helps confidently distinguish partial from complete forms of pericardial defect. [Copyright &y& Elsevier]

Abstract: We present a case of inflammatory myofibroblastic tumor that was evaluated with retrospectively gated dual-source cardiac CT. Imaging features included a broad-based attachment, lobulated contour, and patchy areas of contrast medium enhancement that persisted on delayed imaging. Inflammatory myofibroblastic tumor is an extremely rare slow-growing but locally invasive neoplasm. Cardiac CT has an emerging role in the evaluation of cardiac masses, permitting detailed assessment of lesion extent and relationships. Delayed-enhancement imaging can help with tissue characterization. [Copyright &y& Elsevier]

In this paper we outline the stakeholder-led approaches in the development of biological data products to support effective conservation, management and policy development. The requirements of a broad range of stakeholders and iterative, structured processes framed the development of tools, models and maps that support the FAIR (Findable, Accessible, Interoperable, Reusable) data principles. By structuring the resultant data products around the emerging biological Essential Ocean Variables, and through the engagement with a broad range of end-users, the EMODnet (European Marine Observation and Data Network) Biology project has delivered a suite of demonstration data products. These products are presented in the European Atlas of Marine Life, an online resource demonstrating the value of open marine biodiversity data and help to answer fundamental and policy-driven questions related to managing the natural and anthropogenic impacts in European waters. [ABSTRACT FROM AUTHOR]