Project description:Abstract Corrigan’s pulse is characterized by the abrupt distension and quick collapse of carotid arteries in aortic regurgitation, whereas water hammer pulse is the characteristic pulse observed in peripheral arteries.
Project description:In 2019, the employment rate among 25- to 64-year-olds in the UK reached 80 per cent - the highest on record, and considerably higher than the 76 per cent rate recorded shortly before the Great Recession. In this paper, we investigate the growth in employment between the eve of the Great Recession and the eve of COVID-19 across several dimensions. We analyse which sectors, demographic groups and regions accounted for the rise. We also investigate how job 'quality' - in both financial and non-financial terms - has changed. We find that almost all demographic groups and regions saw a rise in employment, especially those with low pre-existing employment rates and those near the bottom of the income distribution. Hourly pay growth was very weak over the period, with the median actually slightly falling. Other indicators of job quality show a more mixed picture: employees seem to have greater appreciation of their work and firm, but perceive less security and flexibility in their job.
Project description:Insulators can block the action of enhancers on promoters and the spreading of repressive chromatin, as well as facilitating specific enhancer-promoter interactions. However, recent studies have called into question whether the activities ascribed to insulators in model transgene assays actually reflect their functions in the genome. The Drosophila even skipped (eve) gene is a Polycomb (Pc) domain with a Pc-group response element (PRE) at one end, flanked by an insulator, an arrangement also seen in other genes. Here, we show that this insulator has three major functions. It blocks the spreading of the eve Pc domain, preventing repression of the adjacent gene, TER94. It prevents activation of TER94 by eve regulatory DNA. It also facilitates normal eve expression. When Homie is deleted in the context of a large transgene that mimics both eve and TER94 regulation, TER94 is repressed. This repression depends on the eve PRE. Ubiquitous TER94 expression is "replaced" by expression in an eve pattern when Homie is deleted, and this effect is reversed when the PRE is also removed. Repression of TER94 is attributable to spreading of the eve Pc domain into the TER94 locus, accompanied by an increase in histone H3 trimethylation at lysine 27. Other PREs can functionally replace the eve PRE, and other insulators can block PRE-dependent repression in this context. The full activity of the eve promoter is also dependent on Homie, and other insulators can promote normal eve enhancer-promoter communication. Our data suggest that this is not due to preventing promoter competition, but is likely the result of the insulator organizing a chromosomal conformation favorable to normal enhancer-promoter interactions. Thus, insulator activities in a native context include enhancer blocking and enhancer-promoter facilitation, as well as preventing the spread of repressive chromatin.
Project description:Hypothenar hammer syndrome is a rare but serious cause of digital ischemia and morbidity. Presented here is a case of a manual laborer who had symptoms of digital ischemia after acute hyperextension injury to the ring finger. Magnetic resonance imaging revealed thrombosed ulnar artery aneurysm. Etiology, presentation, and current treatments are reviewed.
Project description:Extinct species of Malleodectes gen. nov. from Middle to Late Miocene deposits of the Riversleigh World Heritage Area, northwestern Queensland, Australia are enigmatic, highly specialized, probably snail-eating marsupials. Dentally, they closely resemble a bizarre group of living heterodont, wet forest scincid lizards from Australia (Cyclodomorphus) that may well have outcompeted them as snail-eaters when the closed forests of central Australia began to decline. Although there are scincids known from the same Miocene deposits at Riversleigh, these are relatively plesiomorphic, generalized feeders. This appears to be the most striking example known of dental convergence and possible competition between a mammal and a lizard, which in the long run worked out better for the lizards.
Project description:Objectives: Hypothenar hammer syndrome (HHS) is a rare vascular disease caused by blunt trauma of the hypothenar region. The optimal therapeutic strategy remains debatably since no large comparative studies are available yet. We want to evaluate the effectiveness of intra-arterial thrombolysis on angiographic and clinical outcome parameters in patients with HHS by performing a systematic review of the existing literature. Methods: A literature search of PUBMED/MEDLINE and SCIENCE DIRECT databases was performed up to May 2021. Results: In total, 16 manuscripts with 43 patients were included in the systematic review. Intra-arterial thrombolysis led to angiographic improvement in 29 patients (67.4%) and to clinical improvement in 34 patients (79.1%). Deterioration of arterial perfusion or clinical symptoms after thrombolysis were absent. Post-interventional complications were reported in only one patient (2.3%) without any bleeding complication. Logistic regression analyses demonstrated that a combined administration of fibrinolytics and heparin was associated with a significantly improved arterial patency [OR 12.57 (95% CI 2.48-97.8), p = 0.005] without significant amelioration of clinical symptoms [OR 3.20 (95% CI 0.6-18.9), p = 0.172]. The use of rt-PA compared to other fibrinolytics and a prolonged thrombolysis duration of more than 24 h did not show statistically significant effects. Intra-arterial thrombolysis was significantly less effective in patients who had undergone thrombolysis with a delay of more than 30 days regarding clinical improvement [OR 0.07 (95% CI 0.00-0.54), p = 0.024]. Conclusions: Intra-arterial thrombolysis with a combination of fibrinolytics and heparin is an effective and safe therapeutic option in patients with acute HHS.
Project description:The deep tendon reflex exam is an important part of neurological assessment of patients consisting of two components, reflex elicitation and reflex grading. While this exam has traditionally been performed in person, with trained clinicians both eliciting and grading the reflex, this work seeks to enable the exam by novices. The COVID-19 pandemic has motivated greater utilization of telemedicine and other remote healthcare delivery tools. A smart tendon hammer capable of streaming acceleration measurements wirelessly allows differentiation of correct and incorrect tapping locations with 91.5% accuracy to provide feedback to users about the appropriateness of stimulation, enabling reflex elicitation by laypeople, while survey results demonstrate that novices are reasonably able to grade reflex responses. Novice reflex grading demonstrates adequate performance with a mean error of 0.2 points on a five point scale. This work shows that by assisting in the reflex elicitation component of the reflex exam via a smart hammer and feedback application, novices should be able to complete the reflex exam remotely, filling a critical gap in neurological care during the COVID-19 pandemic.