We developed methods to measure juvenile growth rates of the spionid polychaete Polydora cornuta in nature. We transplanted and recovered small vials containing labeled individuals and measured each ...worm's body volume before and after worms spent a week in field sediments. We transplanted labeled individuals to 3 elevations on an intertidal mudflat in Oneonta Slough within the Tijuana River National Estuarine Research Reserve: a high elevation 0.7 m above mean lower low water (MLLW), a mid-elevation 0.4 m above MLLW, and a low elevation 0.1 m above MLLW. To include a range of environmental conditions, we performed two 7 d transplantations in July 2009 and 2 in November 2009. On average, we recovered one-third of the transplanted juveniles. Mean relative growth rates (RGR) declined significantly from 7.7% d super(-1 at the low elevation to 2.4% d) super(-)1at the high elevation. There was a positive correlation between RGR and the time each elevation was submerged, suggesting the decline in RGRs with increasing elevation was due to a reduction in the time available for suspension feeding. RGRs during 1 transplantation (12 to 19 November) were significantly slower than RGRs during the other 3 transplantations, especially at the high and mid elevations. Due to seasonality in the mixed semidiurnal tides, the 12 to 19 November period was the only transplantation that experienced lower low tides during the afternoon. The slower RGRs during this time of exposure to afternoon sunlight and air temperatures suggest physiological stress might have contributed to reduced RGRs during this transplantation.
Eighty-eight children 0.5 to 17 years of age (median, 9 years of age) received an unrelated donor marrow transplant for treatment of chronic myeloid leukemia (CML; n = 16), acute lymphoblastic ...leukemia (ALL) in first or second remission (n = 15) or more advanced stage (n = 28), acute myeloid leukemia (AML; n = 13), or other hematologic diseases (n = 16) between June 1985 and April 1993. All patients were conditioned with cyclophosphamide and total body irradiation and received a combination of methotrexate and cyclosporine as graft-versus-host disease (GVHD) prophylaxis. Fourty-six patients received transplants from HLA-identical donors and 42 patients received transplants from donors who were minor-mismatched at one HLA-A or B or D/DRB1 locus. The Kaplan-Meier estimates of disease-free survival and relapse were 75% and 0% for patients with CML, 47% and 20% for ALL in first or second remission, 10% and 60% for ALL in relapse or third remission, 46% and 46% for AML in first remission (n = 1) or more advanced disease (n = 12), and 29% and 69% for other diseases. HLA disparity was not significantly associated with lower disease-free survival, but the results suggest more relapses in HLA-matched recipients and there was significantly more transplant-related mortality in mismatched recipients (51% v 24%, P = .04). Most deaths were due to infections associated with acuteor chronic GVHD and occurred within the first 2 years after transplantation. Granulocyte engraftment occurred in all evaluable patients. Sixty-three percent of HLA-matched and 57% of HLA-mismatched recipients were discharged home disease-free at a median of 98 and 103 days, respectively, after transplantation (P = not significant NS). The incidence of grades HIV acute GVHD was 83% in HLA-matched and 98% in HLA-mismatched recipients (P = .009). The incidence of chronic GVHD was 60% in HLA-matched and 69% in HLA-mismatched recipients P = NS). One or multiple late adverse events such as cataracts, osteonecrosis of the hip or knee, restrictive or obstructive pulmonary disease, and hypothyroidism have occurred in 11 of 33 (33%) surviving patients. Immunosuppression was discontinued in 58% of surviving patients, including all 12 patients surviving more than 3.2 years, all of whom have a Lansky or Karnofsky score of 100%. These data show that marrow transplantation from fully or partially HLA-matched unrelated donors can be effective therapy for children with hematologic disorders and that pretransplantation disease status and posttransplantation GVHD remain important factors affecting patient outcome.
Inflammatory bowel diseases (IBD) are chronic inflammatory disorders whose etiology remains unknown. Reports have shown that infiltration of leukocytes into intestinal tissue is a pathognomonic ...hallmark for this disease. Leukocyte β2 integrins are heterodimeric adhesion membrane proteins that are exclusively expressed on leukocytes and participate in immune cell adhesion and activation. In this study, we examined the pathophysiological role of the β2 integrins CD18, CD11a, and CD11b in the pathogenesis of dextran sodium sulfte (DSS)-induced experimental colitis. Disease activity was measured by daily assessment of clinical parameters including stool consistency, weight loss, occult blood, and gross rectal bleeding. Histopathological changes including severity of inflammation, surface epithelial/crypt damage, and depth of injury were also determined. The CD18 null and CD11a null mice had significantly lower disease activity and cumulative histopathological scores compared to wild-type mice. Interestingly, CD11b null mice did not show protection against DSS colitis and displayed increased disease activity compared to wild-type mice. Examination of specific leukocyte populations in the distal colon from various mice revealed significant attenuation of neutrophil and macrophage infiltrates in CD18, CD11a, and CD11b null mice. Surprisingly, the CD11b null mice showed a significant increase in plasma cell infiltration in response to DSS suggesting that this molecule may influence plasma cell function during colitis. This study demonstrates that genetic loss of CD18 or CD11a is protective during experimental colitis and that CD11b may serve a regulatory role during development of disease.
Abstract
Background
The ongoing pandemic is having a collateral health effect on delivery of surgical care to millions of patients. Very little is known about pandemic management and effects on other ...services, including delivery of surgery.
Methods
This was a scoping review of all available literature pertaining to COVID-19 and surgery, using electronic databases, society websites, webinars and preprint repositories.
Results
Several perioperative guidelines have been issued within a short time. Many suggestions are contradictory and based on anecdotal data at best. As regions with the highest volume of operations per capita are being hit, an unprecedented number of operations are being cancelled or deferred. No major stakeholder seems to have considered how a pandemic deprives patients with a surgical condition of resources, with patients disproportionally affected owing to the nature of treatment (use of anaesthesia, operating rooms, protective equipment, physical invasion and need for perioperative care). No recommendations exist regarding how to reopen surgical delivery. The postpandemic evaluation and future planning should involve surgical services as an essential part to maintain appropriate surgical care for the population during an outbreak. Surgical delivery, owing to its cross-cutting nature and synergistic effects on health systems at large, needs to be built into the WHO agenda for national health planning.
Conclusion
Patients are being deprived of surgical access, with uncertain loss of function and risk of adverse prognosis as a collateral effect of the pandemic. Surgical services need a contingency plan for maintaining surgical care in an ongoing or postpandemic phase.
Graphical Abstract
Surgical services are adapting to mitigate the surge in patients with COVID-19 in need of critical care support. All non-essential elective surgery has been cancelled, or is pending cancellation, in healthcare systems around the globe, impacting millions of patients. The postpandemic phase will require re-establishment of surgical services, and capacity building to restore normalcy and to appropriately reduce the backlog of cases by priority. A framework for evaluation and a plan to incorporate surgical care into the WHO strategies for national health plans and pandemic mitigation is urgently needed.
Graphical Abstract
Preparing for the next wave
Eleven coupled climate–carbon cycle models used a common protocol to study the coupling between climate change and the carbon cycle. The models were forced by historical emissions and the ...Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A2 anthropogenic emissions of CO₂ for the 1850–2100 time period. For each model, two simulations were performed in order to isolate the impact of climate change on the land and ocean carbon cycle, and therefore the climate feedback on the atmospheric CO₂ concentration growth rate. There was unanimous agreement among the models that future climate change will reduce the efficiency of the earth system to absorb the anthropogenic carbon perturbation. A larger fraction of anthropogenic CO₂ will stay airborne if climate change is accounted for. By the end of the twenty-first century, this additional CO₂ varied between 20 and 200 ppm for the two extreme models, the majority of the models lying between 50 and 100 ppm. The higher CO₂ levels led to an additional climate warming ranging between 0.1° and 1.5°C.
All models simulated a negative sensitivity for both the land and the ocean carbon cycle to future climate. However, there was still a large uncertainty on the magnitude of these sensitivities. Eight models attributed most of the changes to the land, while three attributed it to the ocean. Also, a majority of the models located the reduction of land carbon uptake in the Tropics. However, the attribution of the land sensitivity to changes in net primary productivity versus changes in respiration is still subject to debate; no consensus emerged among the models.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To measure anti-polyribosylribitolphosphate (PRP) antibody and anti-tetanus toxoid (TT) antibody responses in UK infants to explore the effects of (1) immunization with an acellular ...diphtheria/tetanus/pertussis/Haemophilus influenzae type b (DTPHib) combination vaccine, (2) significant preterm delivery, and (3) a fourth dose of conjugated Hib vaccine (PRP-T) in those with a low anti-PRP antibody (<1.0 microg/mL) after primary immunization.
A prospective study was conducted in 4 tertiary neonatal units at a time when 2 types of DTPHib vaccines were used interchangeably in the United Kingdom for primary immunization: acellular (DTPaHib) and whole cell. Timing and type of all vaccine doses were as per standard UK practice. Blood was taken before and after immunization. A total of 166 preterm and 45 term infants completed the study; 97 (15 term) infants who had anti-PRP antibody <1.0 microg/mL were offered a fourth dose of PRP-T; 61 (55 preterm) then had repeat antibody measurements. Anti-PRP and anti-TT antibody after primary immunization relative to gestation and number of whole cell vaccine doses received was measured, as well as anti-PRP antibody after a fourth dose of PRP-T.
A total of 49% of preterm and 33% of term infants had anti-PRP antibody <1.0 microg/mL after full primary immunization. Receipt of 1 or more acellular vaccine doses was associated with lower anti-PRP antibody, a dose response effect being observed. Preterm infants were less likely to have anti-PRP antibody >1.0 microg/mL compared with term infants. A total of 93% of infants who were given a fourth dose had anti-PRP antibody >1.0 microg/mL. Anti-TT antibody responses were satisfactory for all infants but also reduced by each DTPaHib dose received.
Infants who receive DTPaHib, are significantly preterm, or who do not receive a fourth dose of conjugated Hib vaccine may be at increased risk for Hib disease.
Ecologists have long struggled to understand community dynamics. In this groundbreaking book, leading fish ecologists William Matthews and Edie Marsh-Matthews apply long-term studies of stream fish ...communities to several long-standing questions. This critical synthesis reaches to the heart of ecological theory, testing concepts against the four decades of data the authors have collected from numerous warm-water stream fish communities in the central and eastern United States. Stream Fish Community Dynamics draws together the work of a single research team to provide fresh analyses of the short- and long-term dynamics of numerous streams, each with multiple sampling sites. Conducting repeated surveys of fish communities at temporal scales from months to decades, the authors’ research findings will fascinate anyone searching for a deeper understanding of community ecology. The study sites covered by this book range from small, highly variable headwater creeks to large prairie rivers in Oklahoma and from Ozark and Ouachita mountain streams in Arkansas to the upland Roanoke River in Virginia. Its geographically widespread datasets span the midwestern and southwestern United States. The book includes• A comparison of all global and local communities with respect to community composition at the species and family level, emergent community properties, and the relationship between those emergent properties and the environments of the study sites• Analyses of traits of individual species that are important to their distribution or success in harsh environments• A review of evidence for the importance of interactions—including competition and predation—in community dynamics of stream fishes• An assessment of disturbance effects in fish community dynamics• New analysis of the short- and long-term dynamics of variation in stream fish communities, illustrating the applicability and importance of the loose equilibrium concept• New analyses and comparisons of spatiotemporal variation in community dynamics and beta diversity partitioning• An overview of the effects of fish in ecosystems in the central United States The book ends with a summary chapter that places these disparate findings in broader contexts and describes how the loose equilibrium concept—which may be the most appropriate default assumption for dynamics of stream fishes in the changing climate of the future—applies to many kinds of stream fish communities.
Describes the ‘patient delay’ - the time from symptom onset to first medical contact (FMC) - and ‘system delay’ - the time from FMC until reperfusion therapy (primary percutaneous coronary ...intervention (PCI) or fibrinolysis) - in patients who receive acute reperfusion therapy for ST-elevation myocardial infarction (STEMI) in New Zealand. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
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