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Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology
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- Lona Mody, Ibukunoluwa C. Akinboyo, Hilary M. Babcock, Werner E. Bischoff, Vincent Chi-Chung Cheng, Kathleen Chiotos, Kimberly C. Claeys, K. C. Coffey, Daniel J. Diekema, Curtis J. Donskey, Katherine D. Ellingson, Heather M. Gilmartin, Shruti K. Gohil, Anthony D. Harris, Sara C. Keller, Eili Y. Klein, Sarah L. Krein, Jennie H Kwon, Adam S. Lauring, Daniel J. Livorsi, Eric T. Lofgren, Katreena Merrill, Aaron M. Milstone, Elizabeth A. Monsees, Daniel J. Morgan, Luci P. Perri, Christopher D. Pfeiffer, Clare Rock, Sanjay Saint, Emily Sickbert-Bennett, Felicia Skelton, Katie J. Suda, Thomas R. Talbot, Valerie M. Vaughn, David J. Weber, Timothy L. Wiemken, Mohamed H. Yassin, Matthew J. Ziegler, Deverick J. Anderson
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 2 / February 2022
- Published online by Cambridge University Press:
- 25 January 2021, pp. 156-166
- Print publication:
- February 2022
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This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
Electron Ptychography Using Fast Binary 4D STEM Data
- Colum M. O'Leary, Emanuela Liberti, Sean M. Collins, Duncan N. Johnstone, Mathias Rothmann, Jingwei Hou, Christopher S. Allen, Judy S. Kim, Thomas D. Bennett, Paul A. Midgley, Angus I. Kirkland, Peter D. Nellist
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- Journal:
- Microscopy and Microanalysis / Volume 25 / Issue S2 / August 2019
- Published online by Cambridge University Press:
- 05 August 2019, pp. 1662-1663
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- August 2019
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New smallest specimen of the pterosaur Pteranodon and ontogenetic niches in pterosaurs
- S. Christopher Bennett
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- Journal of Paleontology / Volume 92 / Issue 2 / March 2018
- Published online by Cambridge University Press:
- 19 September 2017, pp. 254-271
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A new juvenile specimen of Pteranodon from the Smoky Hill Chalk Member of the Niobrara Formation of western Kansas had an estimated wingspan in life of 1.76 m, ~45% smaller than the smallest previously known specimens, but does not differ in morphology from larger specimens. Its presence indicates that juveniles were capable of flying long distances, so it falsifies the interpretation of Pteranodon as growing rapidly to adult size under parental care before flying. Instead juveniles were precocial, growing more slowly to adult size while flying and feeding independently for several years before going to sea. Because juveniles are otherwise unknown in the Smoky Hill Chalk Member, they must have occupied different environments and ecological niches than adults; thus Pteranodon exhibited ontogenetic niches. Evidence is presented that most other pterosaurs (e.g., Rhamphorhynchus, Pterodactylus, Anhanguera) also exhibited various ontogenetic niches, which, along with their large body size, suggests that pterosaur taxonomic diversity was rather low, like that of crocodilians.
On the taxonomic status of Cycnorhamphus and Gallodactylus (Pterosauria: Pterodactyloidea)
- S. Christopher Bennett
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- Journal:
- Journal of Paleontology / Volume 70 / Issue 2 / March 1996
- Published online by Cambridge University Press:
- 20 May 2016, pp. 335-338
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One of the rarest pterosaurs from the Upper Jurassic Solnhofen Limestone of southern Germany is Pterodactylus suevicus. Only two specimens are known: the holotype, consisting of a virtually complete skeleton described by Quenstedt (1855); and a second specimen, consisting of only postcranial elements described by Wagner (1858) and lost during World War II (Wellnhofer, 1970). Seeley (1870) noted that P. suevicus differed from P. antiquus, the type species of Pterodactylus, in a number of significant points. Therefore, he placed P. suevicus in a new genus, Cycnorhamphus. Seeley (1870:111) gave the following diagnosis of Cycnorhamphus:
“Nares very small, looking upward from a swan-like beak. The middle hole of the skull very large and elongated and lateral. Neck long. Wing-metacarpal long. Four joints in wing-finger. Ilium widening in front. Epipubic bones meeting mesially. The type is Pterodactylus suevicus (Quenstedt).”
The character “nares very small” was the result of a misinterpretation of depressions on the premaxillae that probably resulted from crushing, and “middle hole of the skull” referred to the confluent naris and antorbital fenestra, which Seeley apparently considered the antorbital fenestra alone.
A statistical study of Rhamphorhynchus from the Solnhofen Limestone of Germany: Year-classes of a single large species
- S. Christopher Bennett
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- Journal:
- Journal of Paleontology / Volume 69 / Issue 3 / May 1995
- Published online by Cambridge University Press:
- 20 May 2016, pp. 569-580
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A statistical and morphological study of the pterosaur Rhamphorhynchus from the Solnhofen Limestone of Germany shows that specimens fall into discrete size-classes that are year-classes resulting from seasonal mortality or preservation of specimens. Taxonomic characters used in the past to separate species of Rhamphorhynchus are all related to size and ontogeny, and all specimens belong to a single species, R. muensteri. Thus, the collections of Rhamphorhynchus provide an unequaled record of the growth and development of a Jurassic rhamphorhynchoid pterosaur. Rhamphorhynchus did not have rapid determinate growth; the growth rate was comparable to that of extant crocodilians, and growth continued over the course of at least three years after individuals began to fly.
Posture, Locomotion, and Paleoecology of Pterosaurs. Sankar Chatterjee and R. J. Templin. 2004. The Geological Society of America, Special Paper 376, Boulder, Colorado, 64 + iv p. ISBN 0-8137-2376-0; - Evolution and Palaeobiology of Pterosaurs. 2003. Eric Buffetaut and Jean-Michel Mazin, eds. Geological Society, London, Special Publications 217, London, 347 p. ISBN 1-8623-9143-2.
- S. Christopher Bennett
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- Journal of Paleontology / Volume 79 / Issue 3 / May 2005
- Published online by Cambridge University Press:
- 20 May 2016, pp. 625-627
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A pteranodontid pterosaur from the Early Cretaceous of Peru, with comments on the relationships of Cretaceous pterosaurs
- S. Christopher Bennett
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- Journal of Paleontology / Volume 63 / Issue 5 / September 1989
- Published online by Cambridge University Press:
- 19 May 2016, pp. 669-677
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The first occurrence of a pterosaur fossil from the Early Cretaceous of Peru is reported. The specimen consists of a nearly complete right humerus of a pteranodontid pterosaur preserved in three dimensions, presumably in a concretion. The Pteranodontidae is rediagnosed, and included genera and materials are listed. The Nyctosauridae and Dsungaripteridae are also diagnosed on the basis of postcranial characters, and the relationships of those three taxa plus the Azhdarchidae are discussed. The species Santanadactylus spixi Wellnhofer (1985) is reassigned to the Dsungaripteridae.
Aerodynamics and thermoregulatory function of the dorsal sail of Edaphosaurus
- S. Christopher Bennett
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- Journal:
- Paleobiology / Volume 22 / Issue 4 / Fall 1996
- Published online by Cambridge University Press:
- 08 April 2016, pp. 496-506
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Dorsal sails supported by hyperelongate neural spines of dorsal vertebrae were evolved by various tetrapods, but most work on their function has centered on the pelycosaur Dimetrodon, in which the sail has generally been interpreted as a thermoregulatory structure that would permit rapid warming in the morning and cooling during the hot midday. The pelycosaur Edaphosaurus differed from other sailed tetrapods in that the neural spines supporting the sail had laterally directed tubercles or cross-bars. Past interpretations of Edaphosaurus suggested that the cross-bars were embedded in a thick fat-storage structure or extended from a thin sail to enhance its utility for intraspecific display. However, wind tunnel modeling of air flow over a thin sail with laterally projecting cross-bars supports a thermoregulatory interpretation of the sail of Edaphosaurus. The cross-bars would produce a turbulent flow, which would increase the effectiveness of convective cooling. Measurements of heat flow in an instrumented model show that cross-bars increase heat loss from the sail. The cross-bars may have enabled Edaphosaurus to thermoregulate effectively with a smaller and lower dorsal sail than would have been required without them.
New interpretation of the wings of the pterosaur Rhamphorhynchus muensteri based on the Zittel and Marsh specimens
- S. Christopher Bennett
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- Journal:
- Journal of Paleontology / Volume 89 / Issue 5 / September 2015
- Published online by Cambridge University Press:
- 21 March 2016, pp. 845-869
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The Zittel wing of Rhamphorhynchus muensteri is reinterpreted as preserving negative impressions of closely spaced broad flat actinofibrils that were replaced by calcite but were prepared away by the specimen’s finder. The Marsh specimen preserves positive impressions of the dorsal and ventral surfaces of the wing, which show that the skin was smooth with fine wrinkles and that actinofibrils were not on the wing surface. Based on comparisons of those specimens, the dactylopatagium consisted of dorsal and ventral skins of epidermis and dermis surrounding a common hypodermis core, and keratinous actinofibrils developed in place within the dorsal epidermis adjacent to a layer of linear collagen fibers in the dorsal dermis. The actinofibrils and linear collagen fibers together formed the main functional structure of the dactylopatagium. That structure made the dactylopatagium somewhat stiff and essentially inextensible so that it folded up along discrete fold lines that probably were genetically determined. A pneumatic retrophalangeal wedge behind the antebrachium through at least wing phalanx 3 streamlined the transition between the thick wing spar and thin patagium.
A NOTE ON THE BUSH TAX CUTS: DID THEY SUCCEED IN STIMULATING BUSINESS INVESTMENT?
- Ky-hyang Yuhn, Christopher S. Bennett
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- Macroeconomic Dynamics / Volume 20 / Issue 6 / September 2016
- Published online by Cambridge University Press:
- 07 March 2016, pp. 1623-1639
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Traditional regression models have reported conflicting results on the effectiveness of tax incentives in stimulating business investment. This study investigates the effects of the Bush tax cuts on U.S. investment using intervention analysis in conjunction with regression analysis that controls for relevant variables. Although intervention analysis has the advantage of allowing the behavior of investment to be influenced only by the time path of exogenous shocks such as tax reforms, control variables can test for the robustness of the results. We have found that the two tax reforms enacted in 2001 and 2003 had little impact on marginal investment incentives. The intervention analysis results are further reinforced by the evidence provided by alternative regression models that control for a host of variables. The failure of the tax reforms to stimulate investment spending may be attributable to several factors, such as a global savings glut, cheap global money, inappropriate designs for tax incentives, and budget deficits.
The ontogeny of Pteranodon and other pterosaurs
- S. Christopher Bennett
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- Journal:
- Paleobiology / Volume 19 / Issue 1 / Winter 1993
- Published online by Cambridge University Press:
- 08 February 2016, pp. 92-106
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Immature specimens of the Late Cretaceous pterosaur Pteranodon were identified using three size-independent criteria: (1) fusion of various cranial and postcranial elements; (2) degree of epiphyseal ossification; and (3) bone grain or degree of ossification of limb-bone shafts. Immature individuals make up 15% of available specimens of Pteranodon and do not differ significantly in size from mature individuals. This and the extensive fusion of the mature skeleton suggest that Pteranodon had determinate growth. The bone of limb-bone shafts of immature individuals is fibro-lamellar bone, which suggests that they grew rapidly to adult size. The size-independent criteria can also be used to identify immature and mature individuals of other pterosaur taxa, and other large pterodactyloids also probably exhibited rapid determinate growth.
Contributors
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- By Brittany L. Anderson-Montoya, Heather R. Bailey, Carryl L. Baldwin, Daphne Bavelier, Jameson D. Beach, Jeffrey S. Bedwell, Kevin B. Bennett, Richard A. Block, Deborah A. Boehm-Davis, Corey J. Bohil, David B. Boles, Avinoam Borowsky, Jessica Bramlett, Allison A. Brennan, J. Christopher Brill, Matthew S. Cain, Meredith Carroll, Roberto Champney, Kait Clark, Nancy J. Cooke, Lori M. Curtindale, Clare Davies, Patricia R. DeLucia, Andrew E. Deptula, Michael B. Dillard, Colin D. Drury, Christopher Edman, James T. Enns, Sara Irina Fabrikant, Victor S. Finomore, Arthur D. Fisk, John M. Flach, Matthew E. Funke, Andre Garcia, Adam Gazzaley, Douglas J. Gillan, Rebecca A. Grier, Simen Hagen, Kelly Hale, Diane F. Halpern, Peter A. Hancock, Deborah L. Harm, Mary Hegarty, Laurie M. Heller, Nicole D. Helton, William S. Helton, Robert R. Hoffman, Jerred Holt, Xiaogang Hu, Richard J. Jagacinski, Keith S. Jones, Astrid M. L. Kappers, Simon Kemp, Robert C. Kennedy, Robert S. Kennedy, Alan Kingstone, Ioana Koglbauer, Norman E. Lane, Robert D. Latzman, Cynthia Laurie-Rose, Patricia Lee, Richard Lowe, Valerie Lugo, Poornima Madhavan, Leonard S. Mark, Gerald Matthews, Jyoti Mishra, Stephen R. Mitroff, Tracy L. Mitzner, Alexander M. Morison, Taylor Murphy, Takamichi Nakamoto, John G. Neuhoff, Karl M. Newell, Tal Oron-Gilad, Raja Parasuraman, Tiffany A. Pempek, Robert W. Proctor, Katie A. Ragsdale, Anil K. Raj, Millard F. Reschke, Evan F. Risko, Matthew Rizzo, Wendy A. Rogers, Jesse Q. Sargent, Mark W. Scerbo, Natasha B. Schwartz, F. Jacob Seagull, Cory-Ann Smarr, L. James Smart, Kay Stanney, James Staszewski, Clayton L. Stephenson, Mary E. Stuart, Breanna E. Studenka, Joel Suss, Leedjia Svec, James L. Szalma, James Tanaka, James Thompson, Wouter M. Bergmann Tiest, Lauren A. Vassiliades, Michael A. Vidulich, Paul Ward, Joel S. Warm, David A. Washburn, Christopher D. Wickens, Scott J. Wood, David D. Woods, Motonori Yamaguchi, Lin Ye, Jeffrey M. Zacks
- Edited by Robert R. Hoffman, Peter A. Hancock, University of Central Florida, Mark W. Scerbo, Old Dominion University, Virginia, Raja Parasuraman, George Mason University, Virginia, James L. Szalma, University of Central Florida
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- Book:
- The Cambridge Handbook of Applied Perception Research
- Published online:
- 05 July 2015
- Print publication:
- 26 January 2015, pp xi-xiv
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- By Ioannis P. Androulakis, Djillali Annane, Gérard Audibert, Lisa L. Barnes, Paolo Bartolomeo, Walter S. Bartynski, David A. Bennett, Nicolas Bruder, Nathan E. Brummel, Steve E. Calvano, Alain Cariou, F. Chretien, Jan Claassen, Colm Cunningham, Souhayl Dahmani, Robert Dantzer, Dimitry S. Davydow, Sanjay V. Desai, E. Wesley Ely, Frédéric Faugeras, Karen J. Ferguson, Brandon Foreman, Sadanand M. Gaikwad, Rebecca F. Gottesman, Maura A. Grega, Richard D. Griffiths, Marion Griton, Stefan D. Gurney, Hebah M. Hefzy, Michael T. Heneka, Dustin M. Hipp, Ramona O. Hopkins, Christopher G. Hughes, James C. Jackson, Christina Jones, Peter W. Kaplan, Keith W. Kelley, Raymond C. Koehler, Matthew A. Koenig, Jan Pieter Konsman, Felix Kork, John P. Kress, Stephen F. Lowry, Alawi Luetz, David Luis, Alasdair M. J. MacLullich, Guy M. McKhann, Jean Mantz, Panteleimon D. Mavroudis, Mervyn Maze, Bruno Mégarbane, Lionel Naccache, Dale M. Needham, Pratik P. Pandharipande, Jean-Francois Payen, V. Hugh Perry, Margaret Pisani, C. Rauturier, Benjamin Rohaut, Jennifer Ryan, Robert D. Sanders, Jeremy D. Scheff, Frederic Sedel, Ola A. Selnes, Tarek Sharshar, Martin Siegemund, Yoanna Skrobik, Jamie W. Sleigh, Romain Sonneville, Claudia D. Spies, Luzius A. Steiner, Robert D. Stevens, Raoul Sutter, Fabio Silvio Taccone, Richard E. Temes, Willem A. van Gool, Christel C. Vanbesien, F. Verdonk, Odile Viltart, Julia Wendon, Catherine N. Widmann, Robert S. Wilson
- Edited by Robert D. Stevens, Tarek Sharshar, E. Wesley Ely, Vanderbilt University, Tennessee
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- Brain Disorders in Critical Illness
- Published online:
- 05 October 2013
- Print publication:
- 19 September 2013, pp viii-xii
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“Design of Poly(ethylene glycol)-Polycaprolactone Diblock Micelles with RGD Targeting Ligands and Embedded Iron Oxide Nanoparticles for Thermally-activated Release”
- Christopher S. Brazel, James B. Bennett, Amanda L. Glover, Jacqueline A. Nikles, Maaike Everts, Joel N. Glasgow, David E. Nikles
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1416 / 2012
- Published online by Cambridge University Press:
- 07 March 2012, mrsf11-1416-jj05-31
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- 2012
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A thermally-activated micelle consisting of a crystallizable poly(caprolactone), PCL, core and a poly(ethylene glycol), PEG, corona was developed to contain magnetic nanoparticles and anti-cancer agent doxorubicin as well as display a targeting RGD peptide. This system has the potential to target cancer cells, deliver combination hyperthermia and chemotherapy, and offer magnetic resonance imaging contrast. The micelles self-assemble in aqueous solutions and form a crystalline core with a melting transition ranging from 40 to 50 °C, depending on the length of the PCL blocks, with dynamic light scattering showing micelle sizes typically ranging from 20 to 100 nm, depending on block lengths and added drug or nanoparticles. The micelles become unstable as they are heated above their melting point, creating a thermally-activated drug release mechanism. By adding magnetite (Fe3O4) nanoparticles into the PCL core, the micelles can be heated using an externally applied AC magnetic field to induce hyperthermia in combination with the thermally-activated drug release. The polymers and magnetic nanoparticles (MNPs) were synthesized and characterized in our laboratories. The melting transitions of the PCL micelle cores were investigated using microcalorimetry. The heating of nanoparticles and magnetomicelles was conducted using a custom-built hyperthermia coil capable of generating fields of several hundred Oersteds at frequencies ranging from 50 to 450 kHz. Heating of MNPs was maximized at high field intensities. RGD peptides were attached to the PEG corona using maleimide chemistry, and the ability of the RGD-derivatized micelles to target integrin-expressing cells was investigated using fluorescent dye PKH26 to identify the localization of micelles in cultured human kidney (293) cells in vitro. The crystallizable (and meltable) cores in these micelles were designed to overcome drug leakage common in liposome systems and release the drug on demand after a period of time for localization to integrin receptors.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. 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Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Is the “Perfect Fontan” operation routinely achievable in the modern era?*
- James K. Kirklin, Robert N. Brown, Ayesha S. Bryant, David C. Naftel, Edward V. Colvin, F. Bennett Pearce, Robb L. Romp, Walter H. Johnson, Jr, Yung R. Lau, William S. McMahon, Christopher J. Knott-Craig, Albert D. Pacifico
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- Cardiology in the Young / Volume 18 / Issue 3 / June 2008
- Published online by Cambridge University Press:
- 01 June 2008, pp. 328-336
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Objective
In 1990, Fontan, Kirklin, and colleagues published equations for survival after the so-called “Perfect Fontan” operation. After 1988, we evolved a protocol using an internal or external polytetraflouroethylene tube of 16 to 19 millimetres diameter placed from the inferior caval vein to either the right or left pulmonary artery along with a bidirectional cava-pulmonary connection. The objective of this study was to test the hypothesis that a “perfect” outcome is routinely achievable in the current era when using a standardized surgical procedure.
MethodsBetween 1 January, 1988, and 12 December, 2005, 112 patients underwent the Fontan procedure using an internal or external polytetraflouroethylene tube plus a bidirectional cava-pulmonary connection, the latter usually having been constructed as a previous procedure. This constituted 45% of our overall experience in constructing the Fontan circulation between 1988 and 1996, and 96% of the experience between 1996 and 2005. Among all surviving patients, the median follow-up was 7.3 years. We calculated the expected survival for an optimal candidate, given from the initial equations, and compared this to our entire experience in constructing the Fontan circulation.
ResultsAn internal tube was utilized in 61 patients, 97% of whom were operated prior to 1998, and an external tube in 51 patients, the latter accounting for 95% of all operations since 1999. At 1, 5, 10 and 15 years, survival of the entire cohort receiving polytetraflouroethylene tubes is superimposable on the curve calculated for a “perfect” outcome. Freedom from replacement or revision of the tube was 97% at 10 years.
ConclusionUsing a standardized operative procedure, combining a bidirectional cavopulmonary connection with a polytetraflouroethylene tube placed from the inferior caval vein to the pulmonary arteries for nearly all patients with functionally univentricular hearts, early and late survival within the “perfect” outcome as predicted by the initial equations of Fontan and Kirklin is routinely achievable in the current era. The need for late revision or replacement of the tube is rare.