Whys and Wherefores of Coronary Arterial Positive Remodeling.

Positive remodeling (PR) is an atherosclerotic plaque feature defined as an increase in arterial caliber at the level of an atheroma, in response to increasing plaque burden. The mechanisms that lead to its formation are incompletely understood, but its role in coronary atherosclerosis has major clinical implications. Indeed, plaques with PR have elevated risk of provoking acute cardiac events. Hence, PR figures among the high-risk plaque features that cardiac imaging studies should report. This review aims to provide an overview of the current literature on coronary PR. It outlines the pathophysiology of PR, the different techniques used to assess its presence, and the imaging findings associated to PR, on both noninvasive and invasive studies. This review also summarizes clinical observations, trials, and studies, focused on the impact of PR on clinical outcome.

Effect of EDTA with porous balloon on calcified lesion: An atherosclerotic cadaver study.

BACKGROUND: Ethylene diamine tetra-acetic acid (EDTA) is a chelating agent used to dissolve calcium deposits but evidence in decalcifying atherosclerotic lesions is limited. AIMS: We assessed the feasibility and efficacy of EDTA delivered via porous balloon to target calcified lesions in cadaveric below-the-knee (BTK) arteries. METHODS: Using porcine carotid arteries, EDTA concentration was measured in the arterial wall and outside the artery at the 0-, 0.5-, 4-, and 24-h circulation after the injection through a porous balloon. In cadaver BTK samples, the proximal and distal anterior tibial artery (ATA) and distal posterior tibial artery (PTA) were studied. EDTA-2Na/H2O or EDTA-3Na/H2O were administrated using a porous balloon, then circulated for 6 h for EDTA-3Na/H2O and 24 h for EDTA-2Na/H2O and EDTA-3Na/H2O. Micro-CT imaging of the artery segments before and after the circulation and cross-sectional analyses were performed to evaluate calcium burden. RESULTS: In the porcine carotid study, EDTA was delivered through a porous balloon present in the arterial wall and was retained there for 24 h. In BTK arteries, cross-sectional analyses of micro-CT revealed a significant decrease in the calcium area in the distal ATA segment under 24-h circulation with EDTA-2Na/H2O and in the distal ATA segment under 24-h circulation with EDTA-3Na/H2O. The proximal ATA segment under 6-h circulation with EDTA-3Na/H2O showed no significant change in any parameters of calcium CONCLUSION: EDTA-3Na/H2O or EDTA-2Na/H2O with longer circulation times resulted in greater calcium reduction in atherosclerotic lesion. EDTA may have a potential therapeutic option for the treatment of atherosclerotic calcified lesions.

Effect of body mass and clothing on carrion entomofauna.

Carcass mass largely affects pattern and rate of carrion decomposition. Supposedly, it is similarly important for carrion entomofauna; however, most of its likely effects have not been tested experimentally. Here, simultaneous effects of carcass mass and clothing are analyzed. A factorial block experiment with four levels of carcass mass (small carcasses 5-15 kg, medium carcasses 15.1-30 kg, medium/large carcasses 35-50 kg, large carcasses 55-70 kg) and two levels of carcass clothing (clothed and unclothed) was made in a grassland habitat of Western Poland. Pig carcasses (N = 24) were grouped into spring, early summer, and late summer blocks. Insects were sampled manually and with pitfall traps. Results demonstrate that insect assemblages are more complex, abundant, and long-lasting on larger carcasses, whereas clothing is of minor importance in this respect. Only large or medium/large carcasses were colonized by all guilds of carrion insects, while small or medium carcasses revealed high underrepresentation of late-colonizing insects (e.g., Cleridae or Nitidulidae). This finding indicates that carcasses weighing about 23 kg-a standard in forensic decomposition studies-give an incomplete picture of carrion entomofauna. Residencies of all forensically relevant insects were distinctly prolonged on larger carcasses, indicating that cadaver mass is a factor of great importance in this respect. The pre-appearance interval of most taxa was found to be unrelated to mass or clothing of a carcass. Moreover, current results suggest that rate of larval development is higher on smaller carcasses. In conclusion, this study demonstrates that carcass mass is a factor of crucial importance for carrion entomofauna, whereas the importance of clothing is small.

Community structure variability of Uropodina mites (Acari: Mesostigmata) in nests of the common mole, Talpa europaea, in Central Europe.

Underground nests of Talpa europaea, known as the common mole, are very specific microhabitats, which are also quite often inhabited by various groups of arthropods. Mites from the suborder Uropodina (Acari: Mesostigmata) are only one of them. One could expect that mole nests that are closely located are inhabited by communities of arthropods with similar species composition and structure. However, results of empirical studies clearly show that even nests which are close to each other can be different both in terms of the species composition and abundance of Uropodina communities. So far, little is known about the factors that can cause these differences. The major aim of this study was to identify factors determining species composition, abundance, and community structure of Uropodina communities in mole nests. The study is based on material collected during a long-term investigation conducted in western parts of Poland. The results indicate that the two most important factors influencing species composition and abundance of Uropodina communities in mole nests are nest-building material and depth at which nests are located. Composition of Uropodina communities in nests of moles was also compared with that of other microhabitats (e.g. rotten wood, forest litter, soil) based on data from 4421 samples collected in Poland. Communities of this habitat prove most similar to these of open areas, especially meadows, as well as some forest types.

Flesh flies (Diptera: Sarcophagidae) colonising large carcasses in Central Europe.

Sarcophagidae are an important element of carrion insect community. Unfortunately, results on larval and adult Sarcophagidae from forensic carrion studies are virtually absent mostly due to the taxonomic problems with species identification of females and larvae. The impact of this taxon on decomposition of large carrion has not been reliably evaluated. During several pig carcass studies in Poland, large body of data on adult and larval Sarcophagidae was collected. We determined (1) assemblages of adult flesh flies visiting pig carrion in various habitats, (2) species of flesh flies which breed in pig carcasses, and (3) temporal distribution of flesh fly larvae during decomposition. Due to species identification of complete material, including larvae, females, and males, it was possible for the first time to reliably answer several questions related to the role of Sarcophagidae in decomposition of large carrion and hence define their forensic importance. Fifteen species of flesh flies were found to visit pig carcasses, with higher diversity and abundance in grasslands as compared to forests. Sex ratio biased towards females was observed only for Sarcophaga argyrostoma, S. caerulescens, S. similis and S. carnaria species group. Gravid females and larvae were collected only in the case of S. argyrostoma, S. caerulescens, S. melanura and S. similis. Sarcophaga caerulescens and S. similis bred regularly in carcasses, while S. argyrostoma was recorded only occasionally. First instar larvae of flesh flies were recorded on carrion earlier or concurrently with first instar larvae of blowflies. Third instar larvae of S. caerulescens were usually observed before the appearance of the third instar blowfly larvae. These results contest the view that flesh flies colonise carcasses later than blowflies. Sarcophaga caerulescens is designated as a good candidate for a broad forensic use in Central European cases.

Factors affecting quality of temperature models for the pre-appearance interval of forensically useful insects.

In the case of many forensically important insects an interval preceding appearance of an insect stage on a corpse (called the pre-appearance interval or PAI) is strongly temperature-dependent. Accordingly, it was proposed to estimate PAI from temperature by using temperature models for PAI of particular insect species and temperature data specific for a given case. The quality of temperature models for PAI depends on the protocols for PAI field studies. In this article we analyze effects of sampling frequency and techniques, temperature data, as well as the size of a sample on the quality of PAI models. Models were created by using data from a largely replicated PAI field study, and their performance in estimation was tested with external body of PAI data. It was found that low frequency of insect sampling distinctly deteriorated temperature models for PAI. The effect of sampling techniques was clearly smaller. Temperature data from local weather station gave models of poor quality, however their retrospective correction clearly improved the models. Most importantly, current results demonstrate that sample size in PAI field studies may be substantially reduced, with no model deterioration. Samples consisting of 11-14 carcasses gave models of high quality, as long as the whole range of relevant temperatures was studied. Moreover, it was found that carcasses exposed in forests and carcasses exposed in early spring are particularly important, as they ensure that PAI data is collected at low temperatures. A preliminary best practice model for PAI field studies is given.

Comments on the biology of Sciodrepoides watsoni watsoni (Spence, 1813) with descriptions of larvae and pupa (Coleoptera: Leiodidae: Cholevinae).

The late-instar larva of Sciodrepoides watsoni watsoni is redescribed and the egg, first and second instar and pupa are described for the first time. Immature stages habitus, chaetotaxy, detailed illustrations and details of life cycle are provided. Previous descriptions of larva of S. watsoni are discussed. The structures of larvae of S. watsoni are compared with those of other known larvae of Cholevinae.

Necrophilous Staphylininae (Coleoptera: Staphylinidae) as indicators of season of death and corpse relocation.

Several case studies confirm that habitat and seasonal preferences of necrophilous insects are the source of valuable information about the season of death or corpse relocation. Rove beetles (Staphylinidae) are common predators found on corpses and subfamily Staphylininae includes species of the largest forensic importance. In order to evaluate usefulness of Staphylininae as indicators of season of death or corpse relocation, a pig carrion experiment was made from April to October in open and forest habitats of Central Europe. Forty species of Staphylininae were collected, with hairy rove beetle (Creophilus maxillosus) being the most abundant. Some species exhibited a clear preference towards particular habitats. It was found that Philonthus lepidus was exclusive to open habitats and therefore may be useful as indicator of corpse relocation from open to forest habitats. Philonthus decorus was the only species found exclusively on carcasses in forests. Clear seasonality was present in nine species. Philonthus lepidus, Bisnius nitidulus, Philonthusconcinnus and Gabrius osseticus were spring-early summer species, while Philonthusspinipes and Ocypus olens were late summer-early fall species. Bisnius fimetarius and Staphylinus erythropterus were spring-summer species. Platydracus stercorarius was summer species. These results indicate that some Staphylininae are good candidates for indicators of season of death or corpse relocation.

Poland health system review.

Since the successful transition to a freely elected parliament and a market economy after 1989, Poland is now a stable democracy and is well represented within political and economic organizations in Europe and worldwide. The strongly centralized health system based on the Semashko model was replaced with a decentralized system of mandatory health insurance, complemented with financing from state and territorial self-government budgets. There is a clear separation of health care financing and provision: the National Health Fund (NFZ) the sole payer in the system is in charge of health care financing and contracts with public and non-public health care providers. The Ministry of Health is the key policy-maker and regulator in the system and is supported by a number of advisory bodies, some of them recently established. Health insurance contributions, borne entirely by employees, are collected by intermediary institutions and are pooled by the NFZ and distributed between the 16 regional NFZ branches. In 2009, Poland spent 7.4% of its gross domestic product (GDP) on health. Around 70% of health expenditure came from public sources and over 83.5% of this expenditure can be attributed to the (near) universal health insurance. The relatively high share of private expenditure is mostly represented by out-of-pocket (OOP) payments, mainly in the form of co-payments and informal payments. Voluntary health insurance (VHI) does not play an important role and is largely limited to medical subscription packages offered by employers. Compulsory health insurance covers 98% of the population and guarantees access to a broad range of health services. However, the limited financial resources of the NFZ mean that broad entitlements guaranteed on paper are not always available. Health care financing is overall at most proportional: while financing from health care contributions is proportional and budgetary subsidies to system funding are progressive, high OOP expenditures, particularly in areas such as pharmaceuticals, are highly regressive. The health status of the Polish population has improved substantially, with average life expectancy at birth reaching 80.2 years for women and 71.6 years for men in 2009. However, there is still a vast gap in life expectancy between Poland and the western European Union (EU) countries and between life expectancy overall and the expected number of years without illness or disability. Given its modest financial, human and material health care resources and the corresponding outcomes, the overall financial efficiency of the Polish system is satisfactory. Both allocative and technical efficiency leave room for improvement. Several measures, such as prioritizing primary care and adopting new payment mechanisms such as diagnosis-related groups (DRGs), have been introduced in recent years but need to be expanded to other areas and intensified. Additionally, numerous initiatives to enhance quality control and build the required expertise and evidence base for the system are also in place. These could improve general satisfaction with the system, which is not particularly high. Limited resources, a general aversion to cost-sharing stemming from a long experience with broad public coverage and shortages in health workforce need to be addressed before better outcomes can be achieved by the system. Increased cooperation between various bodies within the health and social care sectors would also contribute in this direction. The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services, and the role of the main actors in health systems; they describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis.