Periprocedural Hemodynamic Depression Is Associated With a Higher Number of New Ischemic Brain Lesions After Stenting in the International Carotid Stenting Study-MRI Substudy.

BACKGROUND AND PURPOSE: Carotid artery stenting (CAS) is associated with a higher risk of both hemodynamic depression and new ischemic brain lesions on diffusion-weighted imaging than carotid endarterectomy (CEA). We assessed whether the occurrence of hemodynamic depression is associated with these lesions in patients with symptomatic carotid stenosis treated by CAS or CEA in the randomized International Carotid Stenting Study (ICSS)-MRI substudy. METHODS: The number and total volume of new ischemic lesions on diffusion-weighted imaging 1 to 3 days after CAS or CEA was measured in the ICSS-MRI substudy. Hemodynamic depression was defined as periprocedural bradycardia, asystole, or hypotension requiring treatment. The number of new ischemic lesions was the primary outcome measure. We calculated risk ratios and 95% confidence intervals per treatment with Poisson regression comparing the number of lesions in patients with or without hemodynamic depression. RESULTS: A total of 229 patients were included (122 allocated CAS; 107 CEA). After CAS, patients with hemodynamic depression had a mean of 13 new diffusion-weighted imaging lesions, compared with a mean of 4 in those without hemodynamic depression (risk ratio, 3.36; 95% confidence interval, 1.73-6.50). The number of lesions after CEA was too small for reliable analysis. Lesion volumes did not differ between patients with or without hemodynamic depression. CONCLUSIONS: In patients treated by CAS, periprocedural hemodynamic depression is associated with an excess of new ischemic lesions on diffusion-weighted imaging. The findings support the hypothesis that hypoperfusion increases the susceptibility of the brain to embolism. CLINICAL TRIAL REGISTRATION URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25337470.

Uncovering hidden duplicated content in public transcriptomics data.

As part of the development of the database Bgee (a dataBase for Gene Expression Evolution), we annotate and analyse expression data from different types and different sources, notably Affymetrix data from GEO and ArrayExpress, and RNA-Seq data from SRA. During our quality control procedure, we have identified duplicated content in GEO and ArrayExpress, affecting ∼14% of our data: fully or partially duplicated experiments from independent data submissions, Affymetrix chips reused in several experiments, or reused within an experiment. We present here the procedure that we have established to filter such duplicates from Affymetrix data, and our procedure to identify future potential duplicates in RNA-Seq data. Database URL: http://bgee.unil.ch/

Review of Sharon Achinstein and Elizabeth Sauer, eds. Milton and Toleration.

"Review of Sharon Achinstein and Elizabeth Sauer, eds. Milton and Toleration."

Attrition in the Swiss Household Panel

In this paper, we analyze magnitude and possible selectivity of attrition in first wave respondents in the Swiss Household Panel (SHP), from wave two (2000) through wave seven (2005). After comparing attrition of first wave respondents with that of other panel surveys, we proceed to model selectivity of attrition in two steps: we first build separate waveto- wave models, and second a longitudinal all-wave model. The latter model includes wave interaction effects. The first models allow for tracing of selectivity development, i.e. whether an initial selectivity might compensate or cumulates over time, the second to assessing the effects of the covariates in a specific wave, controlling for the base attrition effect. In particular it allows for the analysis of consequences due to discrete fieldwork events. Our results support the findings in the literature: attritors are in general the younger people and the males, foreigners, the socially and politically "excluded", i.e. those who show little social and political interest and participation, those who are mostly dissatisfied with various aspects in their life, and those who live in households with high unit nonresponse, and who exhibit a worse reporting behavior. This pattern is rather cumulative than compensating over panel waves. Excessive attrition in two waves presumably caused by two discrete events in the panel is not particularly selective. Still existing variation in selective attrition is worth to be further explored.

Intracoronary injection of bone marrow-derived mononuclear cells early or late after acute myocardial infarction: effects on global left ventricular function.

BACKGROUND: Intracoronary administration of autologous bone marrow-derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction. The optimal time point of administration of BM-MNC is still uncertain and has rarely been addressed prospectively in randomized clinical trials. METHODS AND RESULTS: In a multicenter study, we randomized 200 patients with large, successfully reperfused ST-segment elevation myocardial infarction in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were administered either early (ie, 5 to 7 days) or late (ie, 3 to 4 weeks) after acute myocardial infarction. Cardiac magnetic resonance imaging was performed at baseline and after 4 months. The primary end point was the change from baseline to 4 months in global LV ejection fraction between the 2 treatment groups and the control group. The absolute change in LV ejection fraction from baseline to 4 months was -0.4±8.8% (mean±SD; P=0.74 versus baseline) in the control group, 1.8±8.4% (P=0.12 versus baseline) in the early group, and 0.8±7.6% (P=0.45 versus baseline) in the late group. The treatment effect of BM-MNC as estimated by ANCOVA was 1.25 (95% confidence interval, -1.83 to 4.32; P=0.42) for the early therapy group and 0.55 (95% confidence interval, -2.61 to 3.71; P=0.73) for the late therapy group. CONCLUSIONS: Among patients with ST-segment elevation myocardial infarction and LV dysfunction after successful reperfusion, intracoronary infusion of BM-MNC at either 5 to 7 days or 3 to 4 weeks after acute myocardial infarction did not improve LV function at 4-month follow-up. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186.

«Où, quand, et comment ?» : Évolution des conduites agressives en football et en hockey sur glace

RésuméCette étude a pour objectif d'observer l'évolution des actes agressifs dans deux sports d'équipes en fonction de facteurs situationnels (périodes de jeu, lieu de la faute, état du score) et du type d'agressions (instrumentales, hostile). 60 matchs professionnels de football et de hockey sur glace ont été filmés puis analysés à l'aide de grilles d'observation différenciant les deux types d'agressions. Les résultats révèlent que dans ces deux sports, les agressions instrumentales sont plus fréquentes dans les zones importantes du terrain (milieu ou défense) ou lorsque le score est serré. En revanche, les agressions hostiles ne varient pas (ou peu) selon ces facteurs. Les résultats sont discutés au regard de la théorie de l'apprentissage social et de l'hypothèse frustration-agression.AbstractThis study aims at examining observed aggression in two team sports as a function of situational triggers (periods, zones of field, games score) and of type of aggression (instrumental, hostile). 60 soccer and ice hockey games were recorded and analyzed using a grid that differentiates the two types of aggression. The results revealed that theses two sports, instrumental aggressions were more frequent in important zones of field (neutral or defensive ones) and in tied score situations. However, no difference was found for hostile aggression according to these factors. The discussion focused on the social learning theory and frustration-aggression hypothesis.

Role of the paclitaxel-eluting stent and tirofiban in patients with ST-elevation myocardial infarction undergoing postfibrinolysis angioplasty: the GRACIA-3 randomized clinical trial.

BACKGROUND A catheter-based approach after fibrinolysis is recommended if fibrinolysis is likely to be successful in patients with acute ST-elevation myocardial infarction. We designed a 2x2 randomized, open-label, multicenter trial to evaluate the efficacy and safety of the paclitaxel-eluting stent and tirofiban administered after fibrinolysis but before catheterization to optimize the results of this reperfusion strategy. METHODS AND RESULTS We randomly assigned 436 patients with acute ST-elevation myocardial infarction to (1) bare-metal stent without tirofiban, (2) bare-metal stent with tirofiban, (3) paclitaxel-eluting stent without tirofiban, and (4) paclitaxel-eluting stent with tirofiban. All patients were initially treated with tenecteplase and enoxaparin. Tirofiban was started 120 minutes after tenecteplase in those patients randomly assigned to tirofiban. Cardiac catheterization was performed within the first 3 to 12 hours after inclusion, and stenting (randomized paclitaxel or bare stent) was applied to the culprit artery. The primary objectives were the rate of in-segment binary restenosis of paclitaxel-eluting stent compared with that of bare-metal stent and the effect of tirofiban on epicardial and myocardial flow before and after mechanical revascularization. At 12 months, in-segment binary restenosis was similar between paclitaxel-eluting stent and bare-metal stent (10.1% versus 11.3%; relative risk, 1.06; 95% confidence interval, 0.74 to 1.52; P=0.89). However, late lumen loss (0.04+/-0.055 mm versus 0.27+/-0.057 mm, P=0.003) was reduced in the paclitaxel-eluting stent group. No evidence was found of any association between the use of tirofiban and any improvement in the epicardial and myocardial perfusion. Major bleeding was observed in 6.1% of patients receiving tirofiban and in 2.7% of patients not receiving it (relative risk, 2.22; 95% confidence interval, 0.86 to 5.73; P=0.14). CONCLUSIONS This trial does not provide evidence to support the use of tirofiban after fibrinolysis to improve epicardial and myocardial perfusion. Compared with bare-metal stent, paclitaxel-eluting stent significantly reduced late loss but appeared not to reduce in-segment binary restenosis. CLINICAL TRIAL REGISTRATION URL: http://clinicaltrials.gov. Unique identifier: NCT00306228.

Laboratory detection of respiratory viruses by automated techniques.

Advances in clinical virology for detecting respiratory viruses have been focused on nucleic acids amplification techniques, which have converted in the reference method for the diagnosis of acute respiratory infections of viral aetiology. Improvements of current commercial molecular assays to reduce hands-on-time rely on two strategies, a stepwise automation (semi-automation) and the complete automation of the whole procedure. Contributions to the former strategy have been the use of automated nucleic acids extractors, multiplex PCR, real-time PCR and/or DNA arrays for detection of amplicons. Commercial fully-automated molecular systems are now available for the detection of respiratory viruses. Some of them could convert in point-of-care methods substituting antigen tests for detection of respiratory syncytial virus and influenza A and B viruses. This article describes laboratory methods for detection of respiratory viruses. A cost-effective and rational diagnostic algorithm is proposed, considering technical aspects of the available assays, infrastructure possibilities of each laboratory and clinic-epidemiologic factors of the infection.

Impactia: autoservicio en el análisis de la producción científica del Sistema Sanitario Público de Andalucía

URL del congreso: http://congresoinnovatics.org/content/presentaciones-innovatics-2013-0

Estrategias analógicas y sentido del humor en el aprendizaje de la competencia social de los profesionales de la educación social

Exploramos, en este artículo, el desarrollo y los resultados iniciales de una metodología innovadora que, usando la metáfora y el sentido del humor, crea un espacio narrativo en un contexto de formación universitaria en competencia social que favorece el proceso de aprendizaje. La experiencia consiste en vincular un escenario metafórico al escenario académico y al futuro escenario profesional. En el artículo se describen los ingredientes de la metáfora utilizada (la fiesta de cumpleaños) y sus vínculos con las competencias trabajadas en la asignatura de Habilidades sociales en la Facultad de Educación Social y Trabajo Social Pere Tarrés (URL). La valoración del profesorado y de los estudiantes la avala como una práctica educativa de éxito cuyos ingredientes pueden ser generalizados a otros contextos formativos.

El ocio terapéutico y educativo en los centros penitenciarios. Aprenentatge i Servei en el Centre Penitenciari de Lledoners

El Aprendizaje y Servicio (APS) es una propuesta educativa que combina procesos de aprendizaje y de servicio a la comunidad en un solo proyecto. El Aprenentatge i Servei en el Centre Penitenciari de Lledoners nace de la voluntad de estudiantes y docentes de la Facultad de Educación Social y Trabajo Social Pere Tarrés (URL) y del Grupo 33, una Plataforma Ciudadana de Sensibilización y Movilización, formada por más de 7.000 personas de todos los sectores de la sociedad civil, que trabaja para conseguir la reinserción real de las personas privadas de libertad. El proyecto pretende hacer frente al actual modelo de prisiones de Cataluña y promover cambios hacia un modelo rehabilitador.

Supporting the reuse of effective CSCL learning designs through social structure representations

Distance and blended collaborative learning settings are usually characterized by different social structures defined in terms of groups' number, dimension, and composition; these structures are variable and can change within the same activity. This variability poses additional complexity to instructional designers, when they are trying to develop successful experiences from existing designs. This complexity is greatly associated with the fact that learning designs do not render explicit how social structures influenced the decisions of the original designer, and thus whether the social structures of the new setting could preclude the effectiveness of the reused design. This article proposes the usage of new representations (social structure representations, SSRs) able to support unskilled designers in reusing existing learning designs, through the explicit characterization of the social structures and constraints embedded either by the original designers or the reusing teachers, according to well-known principles of good collaborative learning practice. The article also describes an evaluation process that involved university professors, as well as the main findings derived from it. This process supported the initial assumptions about the effectiveness of SSRs, with significant evidence from both qualitative and qualitative data.

Autologous keratinocyte suspension in platelet concentrate accelerates and enhances wound healing - a prospective randomized clinical trial on skin graft donor sites: platelet concentrate and keratinocytes on donor sites.

BACKGROUND: Wound healing involves complex mechanisms, which, if properly chaperoned, can enhance patient recovery. The abilities of platelets and keratinocytes may be harnessed in order to stimulate wound healing through the formation of platelet clots, the release of several growth factors and cytokines, and cell proliferation. The aim of the study was to test whether autologous keratinocyte suspensions in platelet concentrate would improve wound healing. The study was conducted at the Lausanne University Hospital, Switzerland in 45 patients, randomized to three different topical treatment groups: standard treatment serving as control, autologous platelet concentrate (PC) and keratinocytes suspended in autologous platelet concentrate (PC + K). Split thickness skin graft donor sites were chosen on the anterolateral thighs of patients undergoing plastic surgery for a variety of defects. Wound healing was assessed by the duration and quality of the healing process. Pain intensity was evaluated at day five. RESULTS: Healing time was reduced from 13.9 ± 0.5 days (mean ± SEM) in the control group to 7.2 ± 0.2 days in the PC group (P < 0.01). An addition of keratinocytes in suspension further reduced the healing time to 5.7 ± 0.2 days. Pain was reduced in both the PC and PC + K groups. Data showed a statistically detectable advantage of using PC + K over PC alone (P < 0.01). CONCLUSION: The results demonstrate the positive contribution of autologous platelets combined with keratinocytes in stimulating wound healing and reducing pain. This strikingly simple approach could have a significant impact on patient care, especially critically burned victims for whom time is of the essence. CLINICAL TRIAL REGISTRY INFORMATION: Protocol Record Identification Number: 132/03Registry URL: http://www.clinicaltrials.gov.

Long-term outcomes of pandemic 2009 influenza A(H1N1)-associated severe ARDS.

BACKGROUND: No data on long-term outcomes of survivors of 2009 influenza A(H1N1) (A[H1N1])-associated ARDS are available. The objective of this study was to compare the 1-year outcomes of survivors of A(H1N1)-associated ARDS, according to use or no use of extracorporeal lung assist (ECLA), using its need as an ARDS severity surrogate. METHODS: Survivors of ARDS (12 with ECLA use vs 25 without, corresponding to 75% and 54% of the eligible patients for each group, respectively) selected from the Réseau Européen de Ventilation Artificielle (REVA) registry had previously been healthy, with only pregnancy and/or moderate obesity (BMI ≤ 35 kg/m²) as known risk factors for A(H1N1) infection. Lung function and morphology, health-related quality of life (HRQoL), and psychologic impairment were evaluated. RESULTS: At 1 year post-ICU discharge for the ECLA and no-ECLA groups, respectively, 50% and 40% reported significant exertion dyspnea, 83% and 64% had returned to work, and 75% and 64% had decreased diffusion capacity across the blood-gas barrier, despite their near-normal and similar lung function test results. For both groups, exercise test results showed diminished but comparable exercise capacities, with similar alveolar-arterial oxygen gradients at peak exercise, and CT scans showed minor abnormal findings. HRQoL assessed by the 36-Item Short-Form Health Survey was poorer for both groups than for a sex- and age-matched general population group, but without between-group differences. ECLA and no-ECLA group patients, respectively, had symptoms of anxiety (50% and 56%) and depression (28% and 28%) and were at risk for posttraumatic stress disorder (41% and 44%). CONCLUSIONS: One year post-ICU discharge, a majority of survivors of A(H1N1)-associated ARDS had minor lung disabilities with diminished diffusion capacities across the blood-gas barrier, and most had psychologic impairment and poorer HRQoL than a sex- and age-matched general population group. ECLA and no-ECLA group patients had comparable outcomes. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01271842; URL: www.clinicaltrials.gov

Mulheres imigrantes em Portugal : memórias, dificuldades de integração e projetos de vida

Nos últimos trinta anos tem sido desenvolvido pouco esforço concertado para incorporar o género nas teorias das migrações internacionais. As teorias das migrações têm-se centrado nas causas das imigrações, não conseguindo encontrar respostas para uma diversidade de questões. As teorias não proporcionam uma real compreensão sobre quem são as mulheres migrantes, sobre as condições em que as mulheres migram e não explicam o predomínio das mulheres em determinados fluxos laborais, em detrimento de outros. Não explicam, ainda, as circunstâncias que encorajam as mulheres a tornarem-se migrantes transnacionais, a entrarem em canais de tráfico ou a procurar asilo. A dificuldade à escala internacional em incorporar o género nos estudos das migrações pontua, naturalmente, os estudos em Portugal e diferentes áreas disciplinares tendem a centrar-se exclusivamente em determinados tipos de migrações, enfatizando diferentes explicações. Este estudo privilegia uma perspectiva psicológica de análise (para além das perspectivas sociológica e económica mais comuns na análise da temática). Nele as mulheres não representam uma das dimensões de análise, constituindo o próprio objecto de estudo.