Five-year follow-up after catheter ablation of persistent atrial fibrillation using the stepwise approach and prognostic factors for success

BACKGROUND In the meantime, catheter ablation is widely used for the treatment of persistent atrial fibrillation (AF). There is a paucity of data about long-term outcomes. This study evaluates (1) 5-year single and multiple procedure success and (2) prognostic factors for arrhythmia recurrences after catheter ablation of persistent AF using the stepwise approach aiming at AF termination. METHODS AND RESULTS A total of 549 patients with persistent AF underwent de novo catheter ablation using the stepwise approach (2007-2009). A total of 493 patients were included (Holter ECGs ≥ every 6 months). Mean follow-up was 59 ± 16 months with 2.1 ± 1.1 procedures per patient. Single and multiple procedure success rates were 20.1% and 55.9%, respectively (80% off antiarrhythmic drug). Antiarrhythmic drug-free multiple procedure success was 46%. Long-term recurrences (n=171) were paroxysmal AF in 48 patients (28%) and persistent AF/atrial tachycardia in 123 patients (72%). Multivariable recurrent event analysis revealed the following factors favoring arrhythmia recurrence: failure to terminate AF during index procedure (hazard ratio [HR], 1.279; 95% confidence interval [CI], 1.093-1.497; P = 0.002), number of procedures (HR, 1.154; 95% CI, 1.051-1.267; P = 0.003), female sex (HR, 1.263; 95% CI, 1.027-1.553; P = 0.027), and the presence of structural heart disease (HR, 1.236; 95% CI, 1.003-1.524; P = 0.047). AF termination was correlated with a higher rate of consecutive procedures because of atrial tachycardia recurrences (P = 0.003; HR, 1.71; 95% CI, 1.20-2.43). CONCLUSIONS Catheter ablation of persistent AF using the stepwise approach provides limited long-term freedom of arrhythmias often requiring multiple procedures. AF termination, the number of procedures, sex, and the presence of structural heart disease correlate with outcome success. AF termination is associated with consecutive atrial tachycardia procedures.

A retrospective analysis of factors influencing the success of autotransplanted posterior teeth

BACKGROUND Survival and success rates of tooth transplantations even after long follow-up periods have been shown to be very high. Nevertheless, it is important to analyse factors potentially influencing these rates. The aim of this study was to assess the influence on success of potential factors. METHODS The research was based on a retrospective analysis of clinical and radiological data from a sample of 59 subjects (75 transplanted teeth). The follow-up period varied from 0.44 to 12.28 years (mean 3.95 years). Success rates were calculated and depicted with Kaplan-Meier plots. Log-rank tests were used to analyse the effect of root development stage, apex width, the use of enamel matrix proteins or the surgeon on success of transplantations. RESULTS Results for success of premolar transplantations were comparable with already published data, while molars performed worse than shown in other studies. The surgeon performing the transplantation (p = 0.001) and tooth type (p ≤ 0.001) were significantly associated with transplantation success. Use of enamel matrix proteins (p = 0.10), root development stage (p = 0.13), the recipient area (p = 0.48) and apex width (p = 0.59) were not significantly associated with success. CONCLUSIONS Molar transplantations were not as successful as premolar transplantations; however, success rates varied greatly depending on the surgeon's experience. The use of enamel matrix proteins as well as root development stage, the recipient area and apex width did not show significant associations with success of tooth transplantations.

Building Resilience in Young Black Males: Determining the Factors that Lead to Success for Black Men in America

It is no secret that Black men have struggled over the years to obtain the same level of high earning financial success as their White counterparts. Black men face an incredible challenge with regard to educational obtainment, career success, and physical health. Black men are often revered as the most dangerous, least educated, and more unhealthy than any other race or gender. This must change. This researcher investigated the lives of eight successful Black men with the hope of determining how they were able to attain their success. The findings of this research suggest that there are several factors that are key contributors in becoming a successful Black man in America. With a greater understanding of how Black men have managed to gain success, despite the obstacles they have faced, it is hopeful that this research will help other Black men reach the level of success that is often desired and seldom realized.

Factors affecting the success of translocations of the black-faced impala in Namibia

This study analysed 21 translocations of the vulnerable black-faced impala (Aepyceros melampus petersi) to 20 Namibian game farms that occurred between 1970 and 2001, seeking characteristics of the translocated populations and the release sites that significantly correlated with the success of the translocations. Characteristics considered were: initial population size; presence of cheetah and leopard; area; habitat type; occurrence within the historical range of the subspecies and occurrence of trophy hunting. Success of translocations was described by whether the population had a positive growth rate. The success rate of translocations of black-faced impala (62%) was higher than shown in other studies of vertebrate translocations. Initial population size was paramount to the success of translocations. Releases of larger populations were more likely to lead to positive population growth rates than were releases of small populations. The presence of cheetah also influenced the success of translocated populations. In the presence of cheetah, small populations translocated to game farms were significantly less likely to be viable than larger populations. Recommendations for the management of this vulnerable antelope include introducing large initial populations, ideally more than 15 animals, rather than attempting to eliminate cheetah following translocations of impala. (C) 2003 Elsevier Ltd. All rights reserved.

Factors affecting female reproductive success and the survival of pouch young in the threatened brush-tailed rock-wallaby, Petrogale penicillata

Knowledge of factors affecting the survival of individuals and their reproductive success is essential for threatened species management, but studies assessing these factors are lacking for many threatened rock-wallaby species. In this study we investigated the factors influencing the breeding performance of females and the survival of pouch young in a wild colony of the threatened brush-tailed rock-wallaby. Individuals were trapped between October 2000 and April 2004. More than 50% of the females in the colony were breeding below their full potential and giving birth to only one offspring per year. Most females within the colony bred in synchrony, with a substantial birth peak evident during autumn. Pouch young born in autumn left the pouch during spring and were weaned during summer and autumn when forage was most abundant. Pouch young born during the autumn birth peak or in winter had a substantially higher probability of surviving through to pouch emergence than those born during spring or summer. This study provides demographic parameters that may be used in population models and for comparison with other populations, particularly those that are small and declining. To optimise reproductive success in reintroduction programs, females in good condition and with small pouch young should be released at the end of the wettest season.

Learner factors leading to success on intensive language courses

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

The relationship between personality and social factors and success as a sales representative, both of a petrol company and an animal food company

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

Factors driving territory size and breeding success in a threatened migratory songbird, the Canada Warbler

Successful conservation of migratory birds demands we understand how habitat factors on the breeding grounds influences breeding success. Multiple factors are known to directly influence breeding success in territorial songbirds. For example, greater food availability and fewer predators can have direct effects on breeding success. However, many of these same habitat factors can also result in higher conspecific density that may ultimately reduce breeding success through density dependence. In this case, there is a negative indirect effect of habitat on breeding success through its effects on conspecific density and territory size. Therefore, a key uncertainty facing land managers is whether important habitat attributes directly influence breeding success or indirectly influence breeding success through territory size. We used radio-telemetry, point-counts, vegetation sampling, predator observations, and insect sampling over two years to provide data on habitat selection of a steeply declining songbird species, the Canada Warbler (Cardellina canadensis). These data were then applied in a hierarchical path modeling framework and an AIC model selection approach to determine the habitat attributes that best predict breeding success. Canada Warblers had smaller territories in areas with high shrub cover, in the presence of red squirrels (Tamiasciurus hudsonicus), at shoreline sites relative to forest-interior sites and as conspecific density increased. Breeding success was lower for birds with smaller territories, which suggests competition for limited food resources, but there was no direct evidence that food availability influenced territory size or breeding success. The negative relationship between shrub cover and territory size in our study may arise because these specific habitat conditions are spatially heterogeneous, whereby individuals pack into patches of preferred breeding habitat scattered throughout the landscape, resulting in reduced territory size and an associated reduction in resource availability per territory. Our results therefore highlight the importance of considering direct and indirect effects for Canada warblers; efforts to increase the amount of breeding habitat may ultimately result in lower breeding success if habitat availability is limited and negative density dependent effects occur.

Toward an Understanding of Faculty Perceptions about Factors that Influence Student Success in Online Education

This paper explores factors that faculty perceive as significant in influencing student success in online education. Technological support, degree of comfort with technology and a student’s personal characteristics were deemed by faculty as critical to success. Understanding these key factors could help to improve student success in online education.

Physiological and behavioural factors influencing foraging success in otariid seals

 This thesis directly validated methods of estimating energetic gain and energetic expenditure in diving seals and sea lions. Results showed that head-mounted accelerometers and dive behaviour can predict foraging behaviour and energetic gain. In contrast, 3-dimensional body movement was unable to reliably predict energetic expenditure of diving pinnipeds.

Factors influencing success in introductory programming courses.

This study looked at the reasons why Vanier College students in computer programming are encountering difficulties in their learning process, Factors such as prior academic background, prior computer experience, mother tongue, and learning styles were examined to see how they play a role in students' success in programming courses. The initial research hypotheses were the following : Computer science students using understanding and integrating succeed better than students using following coding, or problem solving. Students using problem solving succeed better than those who use participating and enculturation. Students who use coding perform better than those who prefer participating ans enculturation. In addition, this study hoped to examine whether there is a gender difference in how students learn programming.||Résumé :||La présente étude a examiné les raisons pour lesquelles les étudiants en informatique du Collège Vanier rencontrent des difficultés dans leurs études en programmation. Les facteurs tel que le niveau des études précédentes, l'expérience en informatique, la langue maternelle e les méthodes d'apprentissage ont été considérés pour voir quel rôle ces facteurs jouent pour promouvoir la réussite dans les cours de programmation.Les hypothèses initiales de recherche ont été formulées comme suit : 1. Les étudiants en informatique utilisant la compréhension et l'intégration réussissent mieux que ceux utilisant «suivre», le codage ou la résolution des problèmes. 2, Les étudiants utilisant la résolution des problèmes réussissent mieux que ceux qui utilisent la participation dans la culture informatique. 3, Les étudiants utilisant le codage réussissent mieux que ceux qui utilisent la participation dans la culture informatique.

The guide to the project management body of knowledge (PMBOK Guide) : applicability and contribution to project success in Australia

The PMBOK Guide is one of the most influential publications concerning the knowledge of the project manangement. Moreover, the pervasion of this guide seems to be set to increase as the basis of accreditation - in conjunction with the increasing global trend toward obtaining project management professional status. However, despite the influence and strengthening profile of this guide, reports continue to be published that detail numerous project failures in a wide range of different industries. The PMBOK Guide comprises mainly declarative (know-what) and procedural (know-how) information. In this sense, the guide is largely normative and provides a very good example of the limitations of this approach as highlighted by proponents of a move to the genuine application of positibe theory in project management.----- The aim of this paper is to determine the applicability of the guide in Australia and to determine the extent to which project success can be attributed to the guide. Project Managers from a variety of organisations were surveyed. This postal survey yielded 48 replies. Descriptive statistics was used to assess the incidence and effectivieness of all the processes in the guide. The results indicate that there were no processes that could be considered as peripheral or as a candidate for elimination from the guide. More specifically, all the processes were identified as either a key routine process or a key selective process and positively related to the level of project success. However, the results also indicated that other major factors pertaining to causal knowledge (know-why) are, at least, equally important determinants of project success. It is concluded that declarative, procedural and causal knowledge are all valuable, and given the preponderance of the first two types of knowledge, there seems to be an urgent need to now ensure an equal quest for causal knowledge. In terms of developing causal knowledge, a good starting point would appear to be both positive theory from production and economics.

Modulation of dermal microvascular endithelial cell responses to growth factors and haemostatic factors in the presence of vitronectin

In order to effect permanent closure in burns patients suffering from full thickness wounds, replacing their skin via split thickness autografting, is essential. Dermal substitutes in conjunction with widely meshed split thickness autografts (+/- cultured keratinocytes) reduce scarring at the donor and recipient sites of burns patients by reducing demand for autologous skin (both surface area and thickness), without compromising dermal delivery at the wound face. Tissue engineered products such as Integra consist of a dermal template which is rapidly remodelled to form a neodermis, at which time the temporary silicone outer layer is removed and replaced with autologous split thickness skin. Whilst provision of a thick tissue engineered dermis at full thickness burn sites reduces scarring, it is hampered by delays in vascularisation which results in clinical failure. The ultimate success of any skin graft product is dependent upon a number of basic factors including adherence, haemostasis and in the case of viable tissue grafts, success is ultimately dependent upon restoration of a normal blood supply, and hence this study. Ultimately, the goal of this research is to improve the therapeutic properties of tissue replacements, through impregnation with growth factors aimed at stimulating migration and proliferation of microvascular endothelial cells into the donor tissue post grafting. For the purpose of my masters, the aim was to evaluate the responsiveness of a dermal microvascular endothelial cell line to growth factors and haemostatic factors, in the presence of the glycoprotein vitronectin. Vitronectin formed the backbone for my hypothesis and research due to its association with both epithelial and, more specifically, endothelial migration and proliferation. Early work using a platform technology referred to as VitroGro (Tissue Therapies Ltd), which is comprised of vitronectin bound BP5/IGF-1, aided keratinocyte proliferation. I hypothesised that this result would translate to another epithelium - endothelium. VitroGro had no effect on endothelial proliferation or migration. Vitronectin increases the presence of Fibroblast Growth Factor (FGF) and Vascular Endothelial Growth Factor (VEGF) receptors, enhancing cell responsiveness to their respective ligands. So, although Human Microvascular Endothelial Cell line 1 (HMEC-1) VEGF receptor expression is generally low, it was hypothesised that exposure to vitronectin would up-regulate this receptor. HMEC-1 migration, but not proliferation, was enhanced by vitronectin bound VEGF, as well as vitronectin bound Epidermal Growth Factor (EGF), both of which could be used to stimulate microvascular endothelial cell migration for the purpose of transplantation. In addition to vitronectin's synergy with various growth factors, it has also been shown to play a role in haemostasis. Vitronectin binds thrombin-antithrombin III (TAT) to form a trimeric complex that takes on many of the attributes of vitronectin, such as heparin affinity, which results in its adherence to endothelium via heparan sulfate proteoglycans (HSP), followed by unaltered transcytosis through the endothelium, and ultimately its removal from the circulation. This has been documented as a mechanism designed to remove thrombin from the circulation. Equally, it could be argued that it is a mechanism for delivering vitronectin to the matrix. My results show that matrix-bound vitronectin dramatically alters the effect that conformationally altered antithrombin three (cATIII) has on proliferation of microvascular endothelial cells. cATIII stimulates HMEC-1 proliferation in the presence of matrix-bound vitronectin, as opposed to inhibiting proliferation in its absence. Binding vitronectin to tissues and organs prior to transplant, in the presence of cATIII, will have a profound effect on microvascular infiltration of the graft, by preventing occlusion of existing vessels whilst stimulating migration and proliferation of endothelium within the tissue.

An examination of factors influencing effective and continuous improvement of Indonesian contractors' quality management systems

This paper presents the results of a pilot study examining the factors that impact most on the effective implementation of, and improvement to, Quality Mangement Sytems (QMSs) amongst Indonesian construction companies. Nine critical factors were identified from an extensive literature review, and a survey was conducted of 23 respondents from three specific groups (Quality Managers, Project Managers, and Site Engineers) undertaking work in the Indonesian infrastructure construction sector. The data has been analyzed initially using simple descriptive techniques. This study reveals that different groups within the sector have different opinions of the factors regardless of the degree of importance of each factor. However, the evaluation of construction project success and the incentive schemes for high performance staff, are the two factors that were considered very important by most of the respondents in all three groups. In terms of their assessment of tools for measuring contractor’s performance, additional QMS guidelines, techniques related to QMS practice provided by the Government, and benchmarking, a clear majority in each group regarded their usefulness as ‘of some importance’.