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Little data are available concerning the methods used in the long-term follow-up of Fontan patients. We analyzed the association between serum N-terminal pro-brain natriuretic peptide levels, conventional echocardiography findings, exercise parameters, and dyssynchrony measurements in patients who underwent Fontan surgery.
Methods:
This study included 28 patients who underwent Fontan surgery (mean age 12.8 ± 4.36 years) and 27 healthy controls (mean age 12.5 ± 3.76 years). Echocardiography examinations and exercise tests were performed in both groups. The systemic ventricle was examined via echocardiography, dyssynchrony measurement was performed, the systemic ventricular myocardial performance index was calculated, and serum N-terminal pro-brain natriuretic peptide levels were measured for all subjects.
Results:
Lower cardiac output, stroke volume, maximal work, chronotropic index, maximal oxygen uptake, and higher N-terminal pro-brain natriuretic peptide levels were observed in the Fontan group than in the control group (p < 0.05). A negative correlation was found between physical exercise parameters and N-terminal pro-brain natriuretic peptide levels and dyssynchrony measurements.
Conclusion:
Measurements of exercise capacity, serum N-terminal pro-brain natriuretic peptide levels, and dyssynchrony measurement were more valuable than conventional methods for assessing patients’ clinical and functional status. Dyssynchrony measurements provided better information about ventricular status than did conventional echocardiography studies. While patients’ systolic function determined by conventional echocardiography was normal, dyssynchrony measurements showed the opposite result. The negative relationship between serum N-terminal pro-brain natriuretic peptide levels, dyssynchrony measurements, and exercise capacity suggests that these parameters should be investigated further in Fontan patients.
Clay minerals are effective adsorbents used for the remediation of toxic heavy metals from wastewater due to their large surface areas and great cation-exchange capacities. In this study, the removal of lead ions from aqueous solutions via adsorption was investigated using raw and iron-modified Turkish sepiolite. The aim of this study was to examine the effects of modification and environmental conditions on the sorptive properties of sepiolite samples. Initially, the raw sepiolite (Sep) and magnetic sepiolite/Fe2O3 composite (MagSep) prepared using the co-precipitation method were characterized via mineralogical and petrographical means and the physicochemical properties were determined. Then, the batch adsorption of lead (Pb2+) ions on the sepiolite samples was examined under various conditions (solution pH, adsorbent dosage, contact time, initial Pb2+ ion concentration, temperature, shaking rate). The adsorption capacity of MagSep was found to be greater than that of Sep under all experimental conditions. The results showed that the adsorption process followed a pseudo-second-order kinetic model, and the Langmuir isotherm best correlated with the experimental data. The maximum adsorption capacities were found to be 60.6 and 90.1 mg g–1 for Sep and MagSep, respectively. The characterization of the Pb-adsorbed sepiolite samples showed that lead formed covalent bonds with the sepiolite samples and attached to the sepiolite surface mainly through ion exchange. MagSep can be used efficiently in the field of wastewater treatment for the removal of Pb2+ ions as it does not release any toxic pollutants and can be separated easily with the use of a magnetic field.
In this study, stable and radioactive lead removal from aqueous solution by adsorption using bentonite, zeolite and perlite minerals obtained from various locations in Türkiye was studied in batch experiments. The adsorbents were first characterized using X-ray diffraction (XRD), X-ray fluorescence (XRF), Fourier-transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS), and then the physicochemical properties were determined. The effects of various factors that influence adsorption, such as solution pH, adsorbent dosage, contact time, initial Pb2+ ion concentration, temperature and shaking rate, were studied. The adsorption of Pb2+ was modelled using the Langmuir, Freundlich and Dubinin–Radushkevich isotherms. The adsorption capacities of the minerals for Pb2+ followed the order: bentonite > zeolite > perlite, and the maximum adsorption capacities were 131.6, 36.1 and 21.5 mg g–1, respectively. The adsorption data fit well with the Langmuir isotherm. The bonding of lead ions on the adsorbents was confirmed by XRF and FTIR analyses after the adsorption process. The adsorption of Pb2+ ions on the adsorbents was spontaneous and endothermic. The adsorption process took place by cation exchange in addition to electrostatic interaction. Furthermore, radioactive 210Pb2+ adsorption on bentonite, zeolite and perlite was studied, with the analyte being analysed using a liquid scintillation counter. It was seen that in addition to Pb(II) ions, these minerals also adsorbed the radioactive decay products of 210Pb, which were 210Po and 210Bi. The removal percentages of 210Pb were 95%, 38% and 30% and those of 210Po were 75%, 60% and 74% for bentonite, zeolite and perlite, respectively.
The study aimed to assess the associations between newborn thyroid-stimulating hormone (TSH) concentration, a marker of iodine nutrition in early life, and childhood neurodevelopment and growth using data collected from two pregnancy studies, one in a borderline iodine-deficient setting (DHA to Optimize Mother Infant Outcome (DOMInO) Study) and one in an iodine-sufficient setting (Pregnancy Iodine and Neurodevelopment in Kids (PINK) Study). TSH data were obtained from routine newborn screening. Neurodevelopment was assessed at 18 months using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III). Weight, height and head circumference were measured at 18 months. In total, 1467 children were included in the analysis. Comparing the highest with the lowest TSH quartile, the mean differences (MD) in the Bayley-III scores ranged from −2·0 (95 % CI −4·7, 0·7) to −2·2 (95 % CI −5·8, 1·3) points in DOMInO and 1·0 (95 % CI −1·6, 3·6) to 2·0 (95 % CI −0·4, 4·4) points in PINK in the cognitive, language and motor scales; the MD in the anthropometric z scores ranged from −0·01 (95 % CI −0·5, 0·5) to −0·5 (95 % CI −0·9, −0·1) in both studies. A 1 mIU/l increase in TSH was associated with −0·3 (95 % CI −0·9, 0·2) point and 0·2 (95 % CI −0·3, 0·7) point changes in the mean cognitive score in the DOMInO and PINK, respectively. A null association between TSH and growth was also observed in both studies. Longitudinal studies that utilise newborn TSH data and examine neurodevelopmental outcomes at later ages are warranted, as neurodevelopmental assessments in older children are more predictive of later achievement.
The 9th meeting of the African Society of Human Genetics, in partnership with the Senegalese Cancer Research and Study Group and the Human Heredity and Health in Africa (H3Africa) Consortium, was held in Dakar, Senegal. The theme was Strengthening Human Genetics Research in Africa. The 210 delegates came from 21 African countries and from France, Switzerland, UK, UAE, Canada and the USA. The goal was to highlight genetic and genomic science across the African continent with the ultimate goal of improving the health of Africans and those across the globe, and to promote the careers of young African scientists in the field. A session on the sustainability of genomic research in Africa brought to light innovative and practical approaches to supporting research in resource-limited settings and the importance of promoting genetics in academic, research funding, governmental and private sectors. This meeting led to the formation of the Senegalese Society for Human Genetics.
A highly degraded wetland in the Senegal delta, the Ndiael has been the subject of multiple ecological restoration attempts. One of the options for restoration is a seasonal inundation of the Ndiael. This would strengthen the ecosystem services, benefit and empower the rural communities, and enhance biodiversity. As of 2010, local efforts contributed to a small increase in the inundated area. Subsequent joint actions with a newly established regional water authority will allow for artificial inundations at a larger scale. A local team has mapped the baseline ecological situation and formulated key aspects for the future management plan. In spite of the lack of water, the reserve harbours considerable biodiversity, but there are clear threats. Most significantly, tensions exist between a recently established agro-business, small-holders and the restoration of the ecosystem. If these tensions can be managed in an integrative and equitable way, learning from experiences in the nearby Djoudj and Diawling national parks, a third stronghold for waterfowl may result, as well as enhanced availability of forage for livestock, fish and habitat for wild fauna.
Using CHIRP subbottom profiling across the Chukchi shelf, offshore NW Alaska, we observed a large incised valley that measures tens of kilometers in width. The valley appears to have been repeatedly excavated during sea level lowering; however, the two most recent incisions appear to have been downcut during the last sea level rise, suggesting an increase in the volume of discharge. Modern drainage from the northwestern Alaskan margin is dominated by small, low-discharge rivers that do not appear to be large enough to have carved the offshore drainage. The renewed downcutting and incision during the deglaciation and consequent base level rise implies there must have been an additional source of discharge. Paleoprecipitation during deglaciation is predicted to be at least 10% less than modern precipitation and thus cannot account for the higher discharge to the shelf. Glacial meltwater is the most likely source for the increased discharge.
The Republic of Senegal Disaster Preparedness and Response Exercise was held from June 2-6, 2014, in Dakar, Senegal. The goal was to assist in familiarizing roles and responsibilities within 3 existing plans and to update the National Disaster Management Strategic Work Plan.
Methods
There were 60 participants in the exercise, which was driven by a series of evolving disaster scenarios. During the separate Disaster Management Strategic Work Plan review, participants refined a list of projects, including specific tasks to provide a “road map” for completing each project, project timelines, and estimated resource requirements. Project staff administered a survey to conference participants.
Results
A total of 86% of respondents had improved knowledge of Senegal disaster plans as a result of the exercise. A total of 89% of respondents had a better understanding of their ministry’s role in disaster response, and 92% had a better understanding of the role of the military during a pandemic. Participants also generated ideas for disaster management system improvement in Senegal through a formal “gap analysis.”
Conclusions
Participants were in strong agreement that the exercise helped them to better understand the contents of their disaster response plans, build relationships across ministerial lines, and effectively enhance future disaster response efforts. (Disaster Med Public Health Preparedness. 2017;11:183–189)
This study was conducted to determine the additive effects of exogenous growth factors during in vitro oocyte maturation (IVM) and the sequential culture of nuclear transfer (NT) embryos. Oocyte maturation and culture of reconstructed embryos derived from bovine granulosa cells were performed in culture medium supplemented with either epidermal growth factor (EGF) alone or a combination of EGF with insulin-like growth factor-I (IGF-I). The maturation rates of oocytes matured in the presence of EGF or the EGF + IGF-I combination were significantly higher than those of oocytes matured in the presence of only fetal calf serum (FCS) (P < 0.05). The developing NT embryos showed no significant differences in fusion, cleavage or blastocyst rates among the culture groups (P > 0.05). IGF-I alone or in combination with EGF in sequential embryo culture medium significantly increased the ratio of inner cell mass (ICM) to total blastocyst cells (P < 0.05). Our results showed that the addition of growth factors to IVM and sequential culture media of cloned bovine embryos increased the ICM without changing the total cell number. These unknown and uncontrolled effects of growth factors can alter the allocation of ICM and trophectoderm cells (TE) in NT embryos. A decrease in TE cell numbers could be a reason for developmental abnormalities in embryos in the cloning system.
When the reformers began to use the Scripture as a critical norm to flush out biases and problems in the development of the church, the Catholic Church was prompted to reflect on the question of its own position on the authority of the Bible. The understanding of Scripture and tradition became especially apparent at the First Vatican Council of 1869/70. This Council formulated two decrees, one on the Catholic Faith and the other on the Pope. Karl Rahner formulated the idea of sacred writers before anyone had even thought of Second Vatican Council in 1958. The Council had committed itself to a reform process that would put Scripture back into the centre of the church's life and mission. Liberation theology was a significant development which arose in the wake of the Second Vatican Council.
Mentoring Mums, a community-based pilot program, exemplifies a model of volunteer home visiting to vulnerable and socially isolated new mothers and their at-risk infants. An evaluation of the program found that positive changes for both mothers and their babies had been achieved, providing the rationale for exploration of elements that made the mentoring role effective. This article undertakes this exploration through the research question: What do mothers, mentors and workers contribute to the conceptualisation of the mentor role with vulnerable mothers and their infants? The article argues that the program's effectiveness resided in a mentor role that shared primary values of befriending and neighbourliness, rather than in mentors enacting a quasi-professional role. Conceptualisation of the mentor role is based in theory and practice, seeing mentors as straddling the formal world of service intervention and the informal world of kith and kin. It presents ‘befriending’ as part of building substitute networks around very isolated new mothers. The very significant problems experienced by these vulnerable mothers made necessary parallel involvement of a professional volunteer coordinator and ongoing case management. Mentoring did not replace professional involvement, but rather was distinguished as providing something different, but much needed for vulnerable new mothers and their babies.
Stroke usually occurs in the latter years of life, is sudden and all too often unexpected and unforgiving. When non-fatal, stroke, the second leading cause of disability after dementia, is nearly always disabling (World Health Organization (WHO), 2011). Due to common ensuing physical and cognitive impairments, many stroke survivors are unable to care for themselves in the following weeks, months, and possibly years (Lutz et al., 2011). Thus, the caregiver role is instant and often long-term with no or very little time to adapt to the many, varied and immediate challenges.
There is a lack of research data about children with disabilities across the range of child and family welfare services. The study reported in this paper explored the extent and nature of disabilities in children in a variety of programmes within OzChild, an Australian welfare agency. Caseworkers and teachers working with children at the beginning of 2012 considered all children receiving services from their programmes. Of these 475 children, 200 were identified as having a disability. This article presents data on these 200 children and recommendations for improving outcomes for them. A major finding was that disability added further layers of complexity to already complex child–carer/family situations presenting to under-resourced practitioners and programmes. There was an extensive variety of disabilities across all programme areas, and varying proportions across programmes ranging from 29 per cent in kinship care and family services to 44 per cent of children in foster care. Data were suggestive of problems with some diagnoses, and the need for further research in these areas. The need to address questions of causation of environmentally based disability through preventative programmes, and a more targeted approach to families with multiple and complex needs were indicated. Lack of respite care was jeopardising some placements of children with severe disability. Lack of educational achievement and participation in social, cultural and recreational activities were identified, as were inequities in funding across different programme areas – all of which resulted in some children with disabilities continuing to be substantially disadvantaged. These data led to the generation of recommendations for changes to practice, programme and policy to improve outcomes for children.
Previous intervention research has shown that group education sessions for carers are effective but not always feasible due to the demands of the caregiving role and the difficulty in getting carers to attend. This project was a consumer-led research initiative to develop and evaluate a multimedia resource (DVD) providing information and support for carers of people receiving palliative care.
Method:
Eight carers were recruited from a community palliative care service to form a steering committee for the project. In collaboration with two researchers, the committee discussed the topics that would be included in the resource, developed an interview guide, participated in the filmed interviews, and developed the evaluation program. The steering committee participated in a focus group as part of the evaluation to elicit their experiences of the project. An evaluation was conducted that included the following: questionnaires for 29 carers and 17 palliative care health professionals; follow-up telephone interviews with carers; a focus group with health professionals; and a focus group with the Carer Steering Committee.
Results:
The carers and health professionals reported that the DVD was informative (93 and 94%, respectively), realistic (96 and 88%), supportive (93 and 88%), and helpful (83 and 100%). All health professionals and carers reported that they would recommend the resource to carers. Carers on the steering committee reported substantial benefits that involved the opportunity to help others and to openly discuss and reflect on their experiences.
Significance of Results:
This is an important resource that can be utilized to support family carers and introduce palliative care. Currently, 1500 copies have been distributed to palliative care services and professionals nationwide and is available online at centreforpallcare.org/index.php/resources/carer_dvd/. Development of this DVD represents a strong collaboration between carers and researchers to produce a resource that is informative, supportive, and meaningful.
Health care professionals (HCPs) caring for people with primary malignant glioma (PMG) and their carers see many of the profound challenges facing this group, yet their perspectives are not documented. This study aimed to understand and document the unique perspective of HCPs in relation to the supportive and palliative care needs of patients with PMG and their carers, with a view to developing a model of care.
Methods:
Qualitative study involving semi-structured focus groups and interviews with 35 medical, nursing and allied health staff actively engaged in providing care for this patient group. Purposive and theoretical sampling from two major metropolitan hospitals and one community palliative care service in Australia was utilised to seek perspectives from a variety of disciplines and health care settings. Thematic analysis was conducted by three independent researchers, using a constant comparative method influenced by grounded theory.
Results:
Key themes relating to the needs of people with PMG which were apparent from the HCPs included: The difference in the illness course of glioma compared to other cancers; Limitations of current medical care; Challenges in balancing hope with reality of the illness; and Recommendations to improve care, including recognising the role of family and moving from a model where services are offered in response to demonstrated needs.
Significance of the results:
Current models of care based upon the classic cancer trajectory are unresponsive to the needs of people with PMG. Care may be enhanced by moving towards a proactive approach, extending the goals of care beyond medical needs and broadening the focus of care to include family needs.
ZnO nanorods arrays were prepared on soda lime glass substrate by pulsed laser deposition method. Hexagonal rod-like ZnO rods were obtained under different conditions. Well-defined ZnO nanorods arrays were selected among different samples having various morphologies and sizes already studied by X-ray diffraction (XRD) and atomic force microscopy (AFM). Here, we report on the contact angle measurement (CAM) of one of these samples. A systematic change of the surface wettability is observed in W-doped ZnO nanostructures. The water contact angle (WCA) of a 1 wt.% of WO3 target content was found to be the transition doping level from hydrophilic surface to a hydrophobic surface. We attributed the transition in surface wettability of the film with the doping to incorporation increase of tungsten into the film. Such characteristic surface wettability can play a key role in the adhesion of various layers on W-ZnO nanorods arrays for optoelectronic device applications.
The aim of the present study was to test whether the dietary non-essential/conditionally essential amino acid composition has an effect on growth and protein utilisation and on δ13C of individual amino acids in rainbow trout (Oncorhynchus mykiss). Trout were reared on six purified diets containing only synthetic amino acids in place of protein. Diet 1 mimicked the amino acid composition of fishmeal, in diet 2, cysteine (Cys), glycine (Gly), proline (Pro) and tyrosine (Tyr) were isonitrogenously replaced by their precursor amino acids serine (Ser), glutamic acid (Glu) and phenylalanine (Phe), and in diet 3, alanine (Ala), asparagine and aspartate, Cys, Gly, Pro, Ser and Tyr were isonitrogenously replaced by Glu. Diets 4, 5 and 6 resembled diets 1, 2 and 3 except that Glu contained 0·1 % 13C-enriched Glu. A control group was reared on a fishmeal-based diet. A total of forty-two trout (4·7 (sd 0·57) g) were fed one of the diets at a level of 3·5 % body mass for 10 weeks in a flow-through system. Dietary non-essential amino acid composition significantly influenced protein gain (P < 0·025) and δ13C of Ala, arginine (Arg), Gly, histidine (His), Phe and Tyr. Non-enriched Glu was predominantly found in trout fed 13C-enriched Glu, which is consistent with the fact that Glu has been shown to be used extensively in the gut as an energy source but is less consistent with the enrichment of Pro in fish fed diet 6 compared with fish fed diet 3. Further research is required to better understand the mechanisms that lead to the alteration of amino acid δ13C between diet and body tissues.