Purpose
To update the World Society of the Abdominal Compartment Syndrome (WSACS) consensus definitions and management statements relating to intra-abdominal hypertension (IAH) and the abdominal ...compartment syndrome (ACS).
Methods
We conducted systematic or structured reviews to identify relevant studies relating to IAH or ACS. Updated consensus definitions and management statements were then derived using a modified Delphi method and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines, respectively. Quality of evidence was graded from high (A) to very low (D) and management statements from strong RECOMMENDATIONS (desirable effects clearly outweigh potential undesirable ones) to weaker SUGGESTIONS (potential risks and benefits of the intervention are less clear).
Results
In addition to reviewing the consensus definitions proposed in 2006, the WSACS defined the open abdomen, lateralization of the abdominal musculature, polycompartment syndrome, and abdominal compliance, and proposed an open abdomen classification system. RECOMMENDATIONS included intra-abdominal pressure (IAP) measurement, avoidance of sustained IAH, protocolized IAP monitoring and management, decompressive laparotomy for overt ACS, and negative pressure wound therapy and efforts to achieve same-hospital-stay fascial closure among patients with an open abdomen. SUGGESTIONS included use of medical therapies and percutaneous catheter drainage for treatment of IAH/ACS, considering the association between body position and IAP, attempts to avoid a positive fluid balance after initial patient resuscitation, use of enhanced ratios of plasma to red blood cells and prophylactic open abdominal strategies, and avoidance of routine early biologic mesh use among patients with open abdominal wounds. NO RECOMMENDATIONS were possible regarding monitoring of abdominal perfusion pressure or the use of diuretics, renal replacement therapies, albumin, or acute component-parts separation.
Conclusion
Although IAH and ACS are common and frequently associated with poor outcomes, the overall quality of evidence available to guide development of RECOMMENDATIONS was generally low. Appropriately designed intervention trials are urgently needed for patients with IAH and ACS.
Yttrium doping-stabilized γ-Fe
2
O
3
nanoparticles were studied for its potential to serve as a plant fertilizer and, through enzymatic activity, support drought stress management. Levels of both ...hydrogen peroxide and lipid peroxidation, after drought, were reduced when γ-Fe
2
O
3
nanoparticles were delivered by irrigation in a nutrient solution to
Brassica napus
plants grown in soil. Hydrogen peroxide was reduced from 151 to 83 μM g
−1
compared to control, and the malondialdehyde formation was reduced from 36 to 26 mM g
−1
. Growth rate of leaves was enhanced from 33 to 50% growth compared to fully fertilized plants and SPAD-measurements of chlorophyll increased from 47 to 52 suggesting improved agronomic properties by use of γ-Fe
2
O
3
nanoparticles as fertilizer as compared to chelated iron.
Candidate genes have been identified for both reading and language, but most of the heritable variance in these traits remains unexplained. Here, we report a genome‐wide association meta‐analysis of ...two large cohorts: population samples of Australian twins and siblings aged 12–25 years (n = 1177 from 538 families), and a younger cohort of children of the UK Avon Longitudinal Study of Parents and their Children (aged 8 and 9 years; maximum n = 5472). Suggestive association was indicated for reading measures and non‐word repetition (NWR), with the greatest support found for single nucleotide polymorphisms (SNPs) in the pseudogene, ABCC13 (P = 7.34 × 10−8), and the gene, DAZAP1 (P = 1.32 × 10−6). Gene‐based analyses showed significant association (P < 2.8 × 10−6) for reading and spelling with genes CD2L1, CDC2L2 and RCAN3 in two loci on chromosome 1. Some support was found for the same SNPs having effects on both reading skill and NWR, which is compatible with behavior genetic evidence for influences of reading acquisition on phonological‐task performance. The results implicate novel candidates for study in additional cohorts for reading and language abilities.
Genome‐wide association analysis implicates loci involved in reading and language skills in the general population.
The experimental realization of quantum-degenerate Bose gases made of atoms with sizeable magnetic dipole moments has created a new type of fluid, known as a quantum ferrofluid, which combines the ...extraordinary properties of superfluidity and ferrofluidity. A hallmark of superfluids is that they are constrained to rotate through vortices with quantized circulation. In quantum ferrofluids the long-range dipolar interactions add new ingredients by inducing magnetostriction and instabilities, and also affect the structural properties of vortices and vortex lattices. Here we give a review of the theory of vortices in dipolar Bose-Einstein condensates, exploring the interplay of magnetism with vorticity and contrasting this with the established behaviour in non-dipolar condensates. We cover single vortex solutions, including structure, energy and stability, vortex pairs, including interactions and dynamics, and also vortex lattices. Our discussion is founded on the mean-field theory provided by the dipolar Gross-Pitaevskii equation, ranging from analytic treatments based on the Thomas-Fermi (hydrodynamic) and variational approaches to full numerical simulations. Routes for generating vortices in dipolar condensates are discussed, with particular attention paid to rotating condensates, where surface instabilities drive the nucleation of vortices, and lead to the emergence of rich and varied vortex lattice structures. We also present an outlook, including potential extensions to degenerate Fermi gases, quantum Hall physics, toroidal systems and the Berezinskii-Kosterlitz-Thouless transition.
While there have been many calls to improve the quality of instructional physics labs, there exists little research on the effectiveness of lab instruction. This study provides a direct comparison ...between labs that have goals to reinforce physics content to those that emphasize experimentation skills. In this controlled study, all students attended the same lecture and discussion sections, had the same homework and exams, but attended labs that had one of two aims: teaching experimentation or reinforcing content. We compare students’ engagement with experimentation during the lab as well as the impacts on students’ exam performance and attitudes and beliefs about experimental physics. We find no measurable differences between lab conditions on students’ exam performance. Nonetheless, we find measurable and significant improvements in students’ engagement in expertlike experimentation practices and attitudes and beliefs about experimental physics for students in the experimentation labs. The benefits of the experimentation labs are stable across two subsequent semesters of implementation, as measured via standardized assessments. The results provide direct evidence of the extensive benefits of using labs to teach experimentation while directly demonstrating that shifting instructional goals and structure in labs can occur without cost to performance on course exams.
Genetic studies in adults indicate that genes influencing the personality trait of neuroticism account for substantial genetic variance in anxiety and depression and in somatic health. Here, we ...examine for the first time the factors underlying the relationship between neuroticism and anxiety/depressive and somatic symptoms during adolescence.
The Somatic and Psychological Health Report (SPHERE) assessed symptoms of anxiety/depression (PSYCH-14) and somatic distress (SOMA-10) in 2459 adolescent and young adult twins 1168 complete pairs (35.4% monozygotic, 53% female) aged 12-25 years (mean=15.5 ± 2.9). Differences between boys and girls across adolescence were explored for neuroticism, SPHERE-34, and the subscales PSYCH-14 and SOMA-10. Trivariate analyses partitioned sources of covariance in neuroticism, PSYCH-14 and SOMA-10.
Girls scored higher than boys on both neuroticism and SPHERE, with SPHERE scores for girls increasing slightly over time, whereas scores for boys decreased or were unchanged. Neuroticism and SPHERE scores were strongly influenced by genetic factors heritability (h(2)) = 40-52%. A common genetic source influenced neuroticism, PSYCH-14 and SOMA-10 (impacting PSYCH-14 more than SOMA-10). A further genetic source, independent of neuroticism, accounted for covariation specific to PSYCH-14 and SOMA-10. Environmental influences were largely specific to each measure.
In adolescence, genetic risk factors indexed by neuroticism contribute substantially to anxiety/depression and, to a lesser extent, perceived somatic health. Additional genetic covariation between anxiety/depressive and somatic symptoms, independent of neuroticism, had greatest influence on somatic distress, where it was equal in influence to the factor shared with neuroticism.
Purpose
The study aimed to develop a gastrointestinal (GI) dysfunction score predicting 28-day mortality for adult patients needing mechanical ventilation (MV).
Methods
377 adult patients from 40 ...ICUs with expected duration of MV for at least 6 h were prospectively studied. Predefined GI symptoms, intra-abdominal pressures (IAP), feeding details, organ dysfunction and treatment were documented on days 1, 2, 4 and 7.
Results
The number of simultaneous GI symptoms was higher in nonsurvivors on each day. Absent bowel sounds and GI bleeding were the symptoms most significantly associated with mortality. None of the GI symptoms alone was an independent predictor of mortality, but gastrointestinal failure (GIF)—defined as three or more GI symptoms—on day 1 in ICU was independently associated with a threefold increased risk of mortality. During the first week in ICU, GIF occurred in 24 patients (6.4 %) and was associated with higher 28-day mortality (62.5 vs. 28.9 %,
P
= 0.001). Adding the created subscore for GI dysfunction (based on the number of GI symptoms) to SOFA score did not improve mortality prediction (day 1 AUROC 0.706 95 % CI 0.647–0.766 versus 0.703 95 % CI 0.643–0.762 in SOFA score alone).
Conclusions
An increasing number of GI symptoms independently predicts 28 day mortality with moderate accuracy. However, it was not possible to develop a GI dysfunction score, improving the performance of the SOFA score either due to data set limitations, definition problems, or possibly indicating that GI dysfunction is often secondary and not the primary cause of other organ failure.
Although the progression of non‐alcoholic fatty liver disease (NAFLD) from steatosis to steatohepatitis (NASH) and cirrhosis remains poorly understood, a critical role for dysregulated innate ...immunity has emerged. We examined the utility of ALT‐100, a monoclonal antibody (mAb), in reducing NAFLD severity and progression to NASH/hepatic fibrosis. ALT‐100 neutralizes eNAMPT (extracellular nicotinamide phosphoribosyltransferase), a novel damage‐associated molecular pattern protein (DAMP) and Toll‐like receptor 4 (TLR4) ligand. Histologic and biochemical markers were measured in liver tissues and plasma from human NAFLD subjects and NAFLD mice (streptozotocin/high‐fat diet—STZ/HFD, 12 weeks). Human NAFLD subjects (n = 5) exhibited significantly increased NAMPT hepatic expression and significantly elevated plasma levels of eNAMPT, IL‐6, Ang‐2, and IL‐1RA compared to healthy controls, with IL‐6 and Ang‐2 levels significantly increased in NASH non‐survivors. Untreated STZ/HFD‐exposed mice displayed significant increases in NAFLD activity scores, liver triglycerides, NAMPT hepatic expression, plasma cytokine levels (eNAMPT, IL‐6, and TNFα), and histologic evidence of hepatocyte ballooning and hepatic fibrosis. Mice receiving the eNAMPT‐neutralizing ALT‐100 mAb (0.4 mg/kg/week, IP, weeks 9 to 12) exhibited marked attenuation of each index of NASH progression/severity. Thus, activation of the eNAMPT/TLR4 inflammatory pathway contributes to NAFLD severity and NASH/hepatic fibrosis. ALT‐100 is potentially an effective therapeutic approach to address this unmet NAFLD need.
NAMPT expression is significantly elevated in hepatic tissues from NAFLD patients and mice exposed to STZ/HFD‐induced NAFLD. eNAMPT neutralization with the humanized ALT‐100 mAb significantly reduced NAFLD severity and hepatic fibrosis in STZ/HFD mice. Our study supports eNAMPT/TLR4 signaling as a clinically relevant, highly druggable target with an eNAMPT‐neutralizing biologic therapeutic strategy to reduce the progression from steatosis to NASH and the development of hepatic fibrosis.
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