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Semantic Representation of Affected person Triage Files Gathered throughout Crisis Sectors.
ngs. © 2020 The American Geriatrics Society.Recently, ADAMTS19 was identified as a novel causative gene for heart valve disease (HVD), affecting mainly the aortic and pulmonary valves. Exome sequencing and data repository (CentoMD) analyses were performed to identify patients with ADAMTS19 variants (two families). A third family was recognized based on cardiac phenotypic similarities and SNP array homozygosity. Three novel loss of function (LoF) variants were identified in six patients from three families. Clinically, all patients presented anomalies of the aortic/pulmonary valves, which included thickening of valve leaflets, stenosis and insufficiency. Three patients had (recurrent) subaortic membrane, suggesting that ADAMTS19 is the first gene identified related to discrete subaortic stenosis. One case presented a bi-commissural pulmonary valve. All patients displayed some degree of atrioventricular valve insufficiency. Other cardiac anomalies included atrial/ventricular septal defects, persistent ductus arteriosus, and mild dilated ascending aorta. Our findings confirm that biallelic LoF variants in ADAMTS19 are causative of a specific and recognizable cardiac phenotype. We recommend considering ADAMTS19 genetic testing in all patients with multiple semilunar valve abnormalities, particularly in the presence of subaortic membrane. ADAMTS19 screening in patients with semilunar valve abnormalities is needed to estimate the frequency of the HVD related phenotype, which might be not so rare. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Much of the scholarship concerning African American culture is premised on the notion that it is a legacy of African origins but there has been essentially no attempt to document that relationship empirically. This paper briefly reviews existing evidence for cultural continuity in the Diaspora and then compares the responses of Black and Coloured South African and African Americans on measures of culture emic to African American populations. The observed patterns of psychometric performance, participants' responses, and the predictive utility of the measures employed were consistent with the thesis that despite inevitable variation, these three groups of the African Diaspora share similar orientations on the cultural themes assessed. This research hopes to initiate empirical work on the continuity thesis as it applies to connecting African American culture with a legacy of Africa and as related more broadly to the study of global Diasporas. © 2020 International Union of Psychological Science.Rates of climatic niche evolution vary widely across the tree of life and are strongly associated with rates of diversification among clades. However, why the climatic niche evolves more rapidly in some clades than others remains unclear. Variation in life history traits often plays a key role in determining the environmental conditions under which species can survive, and therefore, could impact the rate at which lineages can expand in available climatic niche space. Here, we explore the relationships among life-history variation, climatic niche breadth, and rates of climatic niche evolution. selleck chemicals We reconstruct a phylogeny for the genus Desmognathus, an adaptive radiation of salamanders distributed across eastern North America, based on nuclear and mitochondrial genes. Using this phylogeny, we estimate rates of climatic niche evolution for species with long, short, and no aquatic larval stage. Rates of climatic niche evolution are unrelated to the mean climatic niche breadth of species with different life histories. Instead, we find that the evolution of a short larval period promotes greater exploration of climatic space, leading to increased rates of climatic niche evolution across species having this trait. We propose that morphological and physiological differences associated with variation in larval stage length underlie the heterogeneous ability of lineages to explore climatic niche space. Rapid rates of climatic niche evolution among species with short larval periods were an important dimension of the clade's adaptive radiation and likely contributed to the rapid rate of lineage accumulation following the evolution of an aquatic life history in this clade. Our results show how variation in a key life-history trait can constrain or promote divergence of the climatic niche, leading to variation in rates of climatic niche evolution among species. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.BACKGROUND Acute obstructive colorectal cancer requires prompt decompression commonly by emergency surgery(ES). However, self-expanding metal stents(SEMS) have been increasingly used as a bridge-to-surgery (BTS) strategy. MATERIALS AND METHODS In a 8-year period, consecutive patients with acute left-sided colonic obstruction, due to locally advanced colorectal cancer, underwent ES or SEMS implantation. We evaluated technical/clinical success of SEMS, adverse events, overall(OS) and disease-free survival(DFS) of the two therapeutic options. RESULTS Forty-five patients underwent ES (n=23) or SEMS (n=22). The two groups were comparable for sex, age, ASA score and cancer site/stage. Technical and clinical successes of SEMS were 100% and 72.7% respectively. Clinical success correlated with neutrophil-lymphocyte ratio (NLR) at baseline (OR=0.65, 95%CI 0.43-0.98, p=0.04). SEMS allowed primary anastomosis in the 45.5% of cases (0% in ES). SEMS implantation allowed a higher rate of surgery carried out by a laparoscopic approach 36.4% vs 13.0% in ES. Performance of a definitive stoma and complications were similar. Median OS (34 in SEMS; 45 in ES, p=0.33) and DFS (36 in SEMS; 35 in ES, p=0.35), did not differ between the two groups. At univariate analysis, DFS was positively associated to primary anastomosis (HR=2.44, 95%CI 1.4-16.6, p=0.04) and laparoscopic surgery (HR=8.33, 95%CI 1.08-50, p=0.04), and inversely to a NLR>3.6 (HR=0.59, 95%CI 0.16-0.92, p=0.03). At multivariate analysis, no feature retained an independent predictive power. CONCLUSION SEMS is an effective and safe procedure, equivalent to emergency surgery in terms of complications, OS and DFS, providing the chance of a primary anastomosis in the majority of patients. This article is protected by copyright. All rights reserved.OBJECTIVE To investigate the relationship between the frequency of sleep bruxism and report of morning headaches, and associations with depression and/or anxiety. BACKGROUND The association between sleep bruxism and headaches in the morning, and between these factors and affective disorders, has been examined in several investigations. Although headache is cited by the International Classification of Sleep Disorders as a symptom associated with sleep bruxism, only a small number of studies have investigated the association between the frequencies of headaches in the morning and bruxism. METHODS This was a cross-sectional observational study conducted between August 2017 and May 2018 in the municipality of Curitiba, Brazil. It comprised individuals of both sexes, ages between 18 and 65 years, with no restriction of race, skin color, or social group (n = 149). Structured questionnaires were used to survey demographic characteristics, sleep bruxism, depression, and anxiety. Self-reports and clinical examinations were used together to diagnose probable sleep bruxism and assess the frequency of this condition. The presence or absence of morning headaches and their frequency were evaluated using a self-report question. It was applied to people with anxiety and/or depression and to free controls of the general population by a trained dentist. RESULTS A significant relationship (P ˂ .001 - Chi-square test) was found between the frequency of sleep bruxism and morning headaches. Symptoms of depression and anxiety were associated with the presence of headache (P ˂ .001 - One way ANOVA), but not with the frequency of sleep bruxism. CONCLUSION The present study confirms the hypothesis of a direct relationship between the frequency of sleep bruxism and the frequency of morning headaches. It also confirmed a linear association between mean depression scores, mean anxiety scores, and morning headaches. © 2020 American Headache Society.OBJECTIVES To summarise the clinical presentation and outcomes in a series of miniature schnauzers diagnosed with histiocytic sarcoma. MATERIALS AND METHODS Retrospective review of medical records of miniature schnauzers diagnosed with histiocytic sarcoma between 2008 and 2019 at two referral centres in the UK. Signalment, clinical signs at initial presentation, imaging results and clinico- and histopathological findings, treatment type and outcome were recorded. Progression-free survival and overall survival time were calculated. RESULTS Thirty dogs were included. Twenty-four of 29 dogs undergoing imaging of the thorax had lung and/or mediastinal involvement. The median overall survival time for dogs that were not euthanased within 3 days of diagnosis was 117 days (range 10 to 790). Three dogs underwent surgery; 13 received treatment with lomustine as a sole therapy - with partial responses documented on imaging in five of six dogs and 11 of 13 showing clinical improvement. CLINICAL SIGNIFICANCE Histiocytic sarcoma should be considered as a differential diagnosis for miniature schnauzers with pulmonary masses. Although responses to treatment were common, they were usually short-lived because of the aggressive nature of the disease. © 2020 The Authors. Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.BACKGROUND We investigated the impact of an elevated plasma volume status (PVS) in patients undergoing TAVI on early clinical safety and mortality, and assessed the prognostic utility of PVS for outcome prediction. MATERIALS AND METHODS We retrospectively calculated the PVS in 652 patients undergoing TAVI between 2009 and 2018 at two centers. They were then categorized into two groups depending on their preoperative PVS (PVS ≤-4; n= 257 vs. PVS >-4; n=379). Relative PVS was derived by subtracting calculated ideal (iPVS = c × weight) from actual plasma volume (aPVS = (1-hematocrit) × (a +( b × weight in kg)). RESULTS The need for renal replacement therapy (1 (0.4%) vs. 17 (4.5%); p=0.001), re-operation for non-cardiac reasons (9 (3.5%) vs. 32 (8.4%); p= 0.003), re-operation for bleeding (9 (3.5%) vs. 27 (7.1%); p= 0.037) and major bleeding (14 (5.4%) vs. 37 (9.8%); p=0.033) were significantly higher in patients with a PVS >-4%. The composite 30-day early safety endpoint (234 (91.1%) vs. 314 (82.8%); p=0.002) confirms that an increased preoperative PVS is associated with a worse overall outcome after TAVI. CONCLUSIONS An elevated PVS (≤-4) as a marker for congestion is associated with significantly worse outcome after TAVI and therefore should be incorporated in preprocedural risk stratification. This article is protected by copyright. All rights reserved.Ants are a widespread group of ecologically important insects. Therefore, ants that are important predators of other ants are likely to play key roles by changing the abundance and impacts of their prey. Familiar arthropod predators, like army ants, are known for their overwhelming raids on invertebrate prey but are limited to mostly tropical systems. Thief ants (Genus Solenopsis Westwood) are a cosmopolitan group of mostly subterranean ants found in a wide variety of ecosystem types. They are known for their extremely small sizes and their specialized predation where they stealthily tunnel into the nests of other larger ant species to capture and consume only immature ants (larvae and pupae). Predation of ant colonies by other ants, and specialized predatory behaviors of presumed top ant predators (e.g., army ants) are well known. However long-term predation effects, such as across several seasons, are still poorly understood because of a lack of experimental studies. Here we report results of a ~1.5-year press field experiment where thief ants were reduced in natural ant communities.
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