Current Issue : October - December Volume : 2013 Issue Number : 4 Articles : 6 Articles
Background: Attendance rates of cervical screening programs can be increased by offering HPV self-sampling to\r\nnon-attendees. Acceptability, DNA yield, lavage volumes and choice of hrHPV test can influence effectiveness of the\r\nself-sampling procedures and could therefore play a role in recruiting non-attendees. To increase user-friendliness, a\r\nfrequently used lavage sampler was modified. In this study, we compared this second generation lavage device\r\nwith the first generation device within similar birth cohorts.\r\nMethods: Within a large self-sampling cohort-study among non-responders of the Dutch cervical screening\r\nprogram, a subset of 2,644 women received a second generation self-sampling lavage device, while 11,977 women,\r\nmatched for age and ZIP-code, received the first generation model. The second generation device was different in\r\nshape, color, lavage volume, and packaging, in comparison to its first generation model. The Cochranâ��s test was\r\nused to compare both devices for hrHPV positivity rate and response rate. To correct for possible heterogeneity\r\nbetween age and ZIP codes in both groups the Breslow-Day test of homogeneity was used. A T-test was utilized to\r\ncompare DNA yields of the obtained material in both groups.\r\nResults: Median DNA yields were 90.4 �µg/ml (95% CI 83.2-97.5) and 91.1 �µg/ml (95% CI 77.8-104.4, p= 0.726) and\r\nhrHPV positivity rates were 8.2% and 6.9% (p= 0.419) per sample self-collected by the second - and the first\r\ngeneration of the device (p= 0.726), respectively. In addition, response rates were comparable for the two models\r\n(35.4% versus 34.4%, p= 0.654).\r\nConclusions: Replacing the first generation self-sampling device by an ergonomically improved, second generation\r\ndevice resulted in equal DNA yields, comparable hrHPV positivity rates and similar response rates. Therefore, it can\r\nbe concluded that the clinical performance of the first and second generation models are similar. Moreover,\r\nparticipation of non-attendees in cervical cancer screening is probably not predominantly determined by the type\r\nof self-collection device....
Background: HeartMate II (HM II) and HeartWare (HW) Left Ventricular Assist Devices have been successfully used\r\nin end-stage heart failure patients as a bridge to transplantation, recovery, or decision. We set out to compare their\r\neffect in off-loading the left ventricle and its geometry.\r\nMethods: The left ventricular end diastolic (LVEDD) and end systolic (LVESD) diameters were compared between\r\nfirst time HM II (n = 25) and HW implantations (n = 24) before and after the operation at 1, 3, and 6 months. A p\r\nvalue of less than 0.05 was considered as significant.\r\nResults: Post-operative LVEDD and LVESD at 1, 3, and 6 months were significantly reduced in comparison with preoperative\r\nvalues in both HM II and HW groups. No significant difference was found comparing HM II and HW\r\ngroups together before and after the operation.\r\nConclusions: Our study shows that both HM II and HW can significantly reduce the left ventricular systolic and\r\ndiastolic dimensions and off-load the left ventricle. The miniaturized nature of HW does not affect its performance\r\nand it could be as effective as HM II....
Background: Controlled restriction of cellular movement using microfluidics allows one to study individual cells to\r\ngain insight into aspects of their physiology and behaviour. For example, the use of micron-sized growth channels\r\nthat confine individual Escherichia coli has yielded novel insights into cell growth and death. To extend this approach\r\nto other species of bacteria, many of whom have dimensions in the sub-micron range, or to a larger range of growth\r\nconditions, a readily-fabricated device containing sub-micron features is required.\r\nResults: Here we detail the fabrication of a versatile device with growth channels whose widths range from 0.3�µm\r\nto 0.8�µm. The device is fabricated using electron beam lithography, which provides excellent control over the shape\r\nand size of different growth channels and facilitates the rapid-prototyping of new designs. Features are successfully\r\ntransferred first into silicon, and subsequently into the polydimethylsiloxane that forms the basis of the working\r\nmicrofluidic device. We demonstrate that the growth of sub-micron scale bacteria such as Lactococcus lactis or\r\nEscherichia coli cultured in minimal medium can be followed in such a device over several generations.\r\nConclusions: We have presented a detailed protocol based on electron beam fabrication together with specific dry\r\netching procedures for the fabrication of a microfluidic device suited to study submicron-sized bacteria. We have\r\ndemonstrated that both Gram-positive and Gram-negative bacteria can be successfully loaded and imaged over a\r\nnumber of generations in this device. Similar devices could potentially be used to study other submicron-sized\r\norganisms under conditions in which the height and shape of the growth channels are crucial to the experimental\r\ndesign....
Objectives: Low patency rates of saphenous vein grafts remain a major predicament in surgical revascularization.\r\nWe examined a novel expandable external support device designed to mitigate causative factors for early and late\r\ngraft failure.\r\nMethods: For this study, fourteen adult sheep underwent cardiac revascularization using two vein grafts for each;\r\none to the LAD and the other to the obtuse marginal artery. One graft was supported with the device while the\r\nother served as a control. Target vessel was alternated between consecutive cases. The animals underwent\r\nimmediate and late angiography and were then sacrificed for histopathologic evaluation.\r\nResults: Of the fourteen animals studied, three died peri-operatively (unrelated to device implanted), and ten\r\nsurvived the follow-up period. Among surviving animals, three grafts were thrombosed and one was occluded, all\r\nin the control group (p = 0.043). Quantitative angiographic evaluation revealed no difference between groups in\r\nimmediate level of graft uniformity, with a coefficient-of-variance (CV%) of 7.39 in control versus 5.07 in the\r\nsupported grafts, p = 0.082. At 12 weeks, there was a significant non-uniformity in the control grafts versus the\r\nsupported grafts (CV = 22.12 versus 3.01, p < 0.002). In histopathologic evaluation, mean intimal area of the\r\nsupported grafts was significantly lower than in the control grafts (11.2 mm^2 versus 23.1 mm^2 p < 0.02).\r\nConclusions: The expandable SVG external support system was found to be efficacious in reducing SVG�s non-uniform\r\ndilatation and neointimal formation in an animal model early after CABG. This novel technology may have the\r\npotential to improve SVG patency rates after surgical myocardial revascularization....
Background: A hybrid approach to minimally invasive perventricular closure of VSD in infants is safe and effective,\r\nand has been performed under guidance of transesophageal echocardiography (TEE). We applied transthoracic\r\nechocardiographic (TTE) guidance to this hybrid approach, and compare results guided by TTE with those by TEE.\r\nMethods: From January 2011 to January 2012, 71 infants with VSD were enrolled to undergo a minimally invasive\r\ndevice closure. After evaluation of VSD by TTE, either TEE or TTE was used to guide the minimally invasive device\r\nclosure. 30 patients had TEE guidance, and 41 patients had TTE. All patients were followed for 3 months after the\r\noperation.\r\nResults: The TEE group had a success rate of 93.3% (28/30) for device implantation, compared with 92.7% (38/41)\r\nin the TTE group. Two patients in the TEE group turned to surgical closure, one for involvement of the inlet area of\r\nVSD demonstrated by TEE, another for moderate aortic regurgitation after device implantation. Two patients in the\r\nTTE group also transferred to surgical closure, one for residual shunt, another for failure of the floppy wire across\r\nthe defect. In addition, one patient in the TTE group experienced dropout of the occluder one day postoperatively.\r\nAt 3-month follow-up, one patient had mild aortic regurgitation in the TEE group and in two patients in the TTE\r\ngroup. There were no episodes of cardiac block, thromboembolism, or device displacement in either group.\r\nConclusions: TTE-guided VSD closure is feasible in infants, with results similar to those of TEE guidance, although\r\ncaution is advisable....
Background: Mosquitoes that bite people outdoors can sustain malaria transmission even where effective indoor\r\ninterventions such as bednets or indoor residual spraying are already widely used. Outdoor tools may therefore\r\ncomplement current indoor measures and improve control. We developed and evaluated a prototype mosquito\r\ncontrol device, the ââ?¬Ë?Mosquito Landing Boxââ?¬â?¢ (MLB), which is baited with human odours and treated with\r\nmosquitocidal agents. The findings are used to explore technical options and challenges relevant to luring and\r\nkilling outdoor-biting malaria vectors in endemic settings.\r\nMethods: Field experiments were conducted in Tanzania to assess if wild host-seeking mosquitoes 1) visited the\r\nMLBs, 2) stayed long or left shortly after arrival at the device, 3) visited the devices at times when humans were also\r\noutdoors, and 4) could be killed by contaminants applied on the devices. Odours suctioned from volunteer-occupied\r\ntents were also evaluated as a potential low-cost bait, by comparing baited and unbaited MLBs.\r\nResults: There were significantly more Anopheles arabiensis, An. funestus, Culex and Mansonia mosquitoes visiting\r\nbaited MLB than unbaited controls (P=0.028). Increasing sampling frequency from every 120 min to 60 and 30 min\r\nled to an increase in vector catches of up to 3.6 fold (P=0.002), indicating that many mosquitoes visited the device\r\nbut left shortly afterwards. Outdoor host-seeking activity of malaria vectors peaked between 7:30 and 10:30pm, and\r\nbetween 4:30 and 6:00am, matching durations when locals were also outdoors. Maximum mortality of mosquitoes\r\nvisiting MLBs sprayed or painted with formulations of candidate mosquitocidal agent (pirimiphos-methyl) was 51%.\r\nOdours from volunteer occupied tents attracted significantly more mosquitoes to MLBs than controls (P<0.001).\r\nConclusion: While odour-baited devices such as the MLBs clearly have potential against outdoor-biting mosquitoes\r\nin communities where LLINs are used, candidate contaminants must be those that are effective at ultra-low doses\r\neven after short contact periods, since important vector species such as An. arabiensis make only brief visits to such\r\ndevices. Natural human odours suctioned from occupied dwellings could constitute affordable sources of attractants\r\nto supplement odour baits for the devices. The killing agents used should be environmentally safe, long lasting, and\r\nhave different modes of action (other than pyrethroids as used on LLINs), to curb the risk of physiological insecticide\r\nresistance....
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