Background: Day surgery is an established practice for elective operative care, and is considered safe and cost‐effective in several procedures and for several patients. At present, day‐surgery ...accounts for approximately 50% of elective surgery in Finland. The aim of this study was to prospectively describe the present situation at Finnish day‐surgery units, focusing on the quality of care.
Methods: Fourteen large‐ to medium‐sized day surgery and short‐stay units were recruited, and all patient cases performed during a 2‐month study period were registered and analyzed. Quality of care was assessed by analyzing the rates and reasons for overnight admission, readmission, reoperation, and cancellations. Satisfaction of care was inquired from day‐ surgery patients during a 2‐week period. Head anesthesiologists were interviewed about functional policies.
Results: Of 7915 reported cases, 84% were day surgery. Typically, several specialties were represented at the units, with orthopedics accounting for nearly 30% of all day‐surgery procedures. Patient selection criteria were in line with the present‐day recommendations, although the proportion of older patients and the ASA physical status 3 patients were still relatively low. The rate of unplanned overnight admissions was 5.9%. Return hospital visits were reported in 3.7% and readmissions in 0.7% of patients 1–28 days post‐operatively. Patient satisfaction was high.
Conclusion: Along with the growing demand for day surgery, Finnish public hospitals have succeeded in providing good‐quality care, and there still seems to be potential to increase the share of day surgery. Easily accessible benchmarking tools are needed for quality control and learning from peers.
Context. Dark nebulae display a surface brightness because dust grains scatter light of the general interstellar radiation field (ISRF). High-galactic-latitudes dark nebulae are seen as bright ...nebulae when surrounded by transparent areas which have less scattered light from the general galactic dust layer. Aims. Photometry of the bright dark nebulae LDN 1780, LDN 1642, and LBN 406 shall be used to derive scattering properties of dust and to investigate the presence of UV fluorescence emission by molecular hydrogen and the extended red emission (ERE). Methods. We used multi-wavelength optical photometry and imaging at ground-based telescopes and archival imaging and spectroscopic UV data from the spaceborn GALEX and SPEAR/FIMS instruments. In the analysis we used Monte Carlo RT and both observational data and synthetic models for the ISRF in the solar neighbourhood. The line-of-sight extinctions through the clouds have been determined using near infrared excesses of background stars and the 200/250 μm far infrared emission by dust as measured using the ISO and Herschel space observatories. Results. The optical surface brightness of the three target clouds can be explained in terms of scattered light. The dust albedo ranges from ~0.58 at 3500 Å to ~0.72 at 7500 Å. The spectral energy distribution of LDN 1780 is explained in terms of optical depth and background scattered light effects instead of the original published suggestion in terms of ERE. The far-ultraviolet surface brightness of LDN 1780 cannot be explained by scattered light only. In LDN 1780, H2 fluorescent emission in the wavelength range 1400–1700 Å has been detected and analysed. Conclusions. Our albedo values are in good agreement with the predictions of the dust model of Weingartner and Draine and with the THEMIS CMM model for evolved core-mantle grains. The distribution of H2 fluorescent emission in LDN 1780 shows a pronounced dichotomy with a strong preference for its southern side where enhanced illumination is impinging from the Sco OB2 association and the O star ζ Oph. A good correlation is found between the H2 fluorescence and a previously mapped 21-cm excess emission. The H2 fluorescence emission in LDN 1780 has been modelled using a PDR code; the resulting values for H2 column density and the total gas density are consistent with the estimates derived from CO observations and optical extinction along the line of sight.
In B cells, antigen processing and peptide-antigen (pAg) presentation is essential to ignite high-affinity antibody responses with the help of cognate T cells. B cells efficiently internalize and ...direct specific antigens for processing and loading onto MHCII. This critical step, which enables pAg presentation, occurs in MHCII compartments (MIICs) which possess the enzymatic machinery for pAg loading on MHCII. The intracellular transport systems that guide antigen and maintain this unique compartment remain enigmatic. Here, we probed the possible functional role of two known endosomal proteins, the Rab family small GTPases Rab7 and Rab9, that are both reported to colocalize with internalized antigen. As compared to Rab9, we found Rab7 to exhibit a higher overlap with antigen and MIIC components. Rab7 also showed a higher association with antigen degradation. The inhibition of Rab7 drastically decreased pAg presentation. Additionally, we detected the strong colocalization of perinuclearly clustered and presumably MIIC-associated antigen with autophagy protein LC3. When we pharmacologically inhibited autophagy, pAg presentation was inhibited. Together, our data promote Rab7 as an important regulator of antigen processing and, considering the previously reported functions of Rab7 in autophagy, this also raises the possibility of the involvement of autophagy-related machinery in this process.
An increasing body of evidence has linked infections to atherosclerosis and thrombosis. Herpesviruses cause atherosclerosis in experimental animals. Herpesviruses can also be detected in ...atherosclerotic lesions in humans. Cytomegalovirus may play a role in arteriosclerosis in transplanted hearts, and this virus, together with tumor suppressor protein p53, can be found in restenosis lesions following angioplasty. Chlamydia pneumoniae and dental infections are associated with coronary heart disease in cross-sectional and longitudinal studies, and preceding respiratory infections are associated with ischemic stroke. Infections may favor formation of atherosclerosis and thrombosis by elevation of blood levels of fibrinogen, leukocytes, clotting factor, and cytokines and by alteration of the metabolism and functions of endothelial cells and monocyte macrophages. Low-grade infections may also be one of the causes of the inflammatory reaction observed in atherosclerotic lesions and acute ischemic symptoms, reflected in elevated levels of C-reactive protein. These observations warrant further studies in this field.
Objective
Musculoskeletal disorders and depression are common among migraineurs. The aim of our study was to evaluate the occurrence of these disorders among working aged migraineurs.
Material and ...Methods
The risk for fibromyalgia, rheumatoid arthritis (RA), osteoarthrosis (OA), sciatic syndrome, and the occurrence of depression was studied among cases who reported about these conditions and migraine in working aged Finnish population in The Health and Social Support Study (HeSSup) based on postal questionnaire in 2012. Group differences were tested by chi‐square test. Odds ratios (ORs with 95% CI) adjusted for age, gender, education level and depression were calculated with logistic regression analysis.
Results
Total of 1505 migraineurs (13%) and 8092 controls were included among the 11 596 responders in 2012. Age and gender adjusted ORs, 2.37 (95% CI 1.81‐3.09) for fibromyalgia, 1.46 (1.10‐1.95) for RA, 1.58 (1.38‐1.80) for OA, and 2.09 (1.84‐2.37) for sciatic syndrome, were significant. At least moderate depression was more common among migraineurs (7.3%) than among controls (3.4%) (P < .001).
Conclusion
Recognition of comorbid musculoskeletal disorders and mood disorders among migraineurs needs targeted outreach in working aged population. The acute and preventive treatments to control for neuronal sensitization in migraine and comorbid pain disorders may benefit of individual treatment plan and tailored use of antidepressants.
Actin-depolymerizing factor (ADF)/cofilins are essential regulators of actin filament turnover. Several ADF/cofilin isoforms are found in multicellular organisms, but their biological differences ...have remained unclear. Herein, we show that three ADF/cofilins exist in mouse and most likely in all other mammalian species. Northern blot and in situ hybridization analyses demonstrate that cofilin-1 is expressed in most cell types of embryos and adult mice. Cofilin-2 is expressed in muscle cells and ADF is restricted to epithelia and endothelia. Although the three mouse ADF/cofilins do not show actin isoform specificity, they all depolymerize platelet actin filaments more efficiently than muscle actin. Furthermore, these ADF/cofilins are biochemically different. The epithelial-specific ADF is the most efficient in turning over actin filaments and promotes a stronger pH-dependent actin filament disassembly than the two other isoforms. The muscle-specific cofilin-2 has a weaker actin filament depolymerization activity and displays a 5-10-fold higher affinity for ATP-actin monomers than cofilin-1 and ADF. In steady-state assays, cofilin-2 also promotes filament assembly rather than disassembly. Taken together, these data suggest that the three biochemically distinct mammalian ADF/cofilin isoforms evolved to fulfill specific requirements for actin filament dynamics in different cell types.
Efficient generation of antibodies by B cells is one of the prerequisites of protective immunity. B cell activation by cognate antigens via B cell receptors (BCRs), or pathogen-associated molecules ...through pattern-recognition receptors, such as Toll-like receptors (TLRs), leads to transcriptional and metabolic changes that ultimately transform B cells into antibody-producing plasma cells or memory cells. BCR signaling and a number of steps downstream of it rely on coordinated action of cellular membranes and the actin cytoskeleton, tightly controlled by concerted action of multiple regulatory proteins, some of them exclusive to B cells. Here, we dissect the role of Missing-In-Metastasis (MIM), or Metastasis suppressor 1 (MTSS1), a cancer-associated membrane and actin cytoskeleton regulating protein, in B cell-mediated immunity by taking advantage of MIM knockout mouse strain. We show undisturbed B cell development and largely normal composition of B cell compartments in the periphery. Interestingly, we found that MIM
B cells are defected in BCR signaling in response to surface-bound antigens but, on the other hand, show increased metabolic activity after stimulation with LPS or CpG.
, MIM knockout animals exhibit impaired IgM antibody responses to immunization with T cell-independent antigen. This study provides the first comprehensive characterization of MIM in B cells, demonstrates its regulatory role for B cell-mediated immunity, as well as proposes new functions for MIM in tuning receptor signaling and cellular metabolism, processes, which may also contribute to the poorly understood functions of MIM in cancer.
In order to fulfil the special requirements of antigen-specific activation and communication with other immune cells, B lymphocytes require finely regulated endosomal vesicle trafficking. How the ...endosomal machinery is regulated in B cells remains largely unexplored. In our previous proximity proteomic screen, we identified the SNARE protein Vti1b as one of the strongest candidates getting accumulated to the sites of early BCR activation. In this report, we follow up on this finding and investigate the localisation and function of Vti1b in B cells. We found that GFP-fused Vti1b was concentrated at the Golgi complex, around the MTOC, as well as in the Rab7
+
lysosomal vesicles in the cell periphery. Upon BCR activation with soluble antigen, Vti1b showed partial localization to the internalized antigen vesicles, especially in the periphery of the cell. Moreover, upon BCR activation using surface-bound antigen, Vti1b polarised to the immunological synapse, colocalising with the Golgi complex, and with lysosomes at actin foci. To test for a functional role of Vti1b in early B cell activation, we used primary B cells isolated from Vit1b-deficient mouse. However, we found no functional defects in BCR signalling, immunological synapse formation, or processing and presentation of the internalized antigen, suggesting that the loss of Vti1b in B cells could be compensated by its close homologue Vti1a or other SNAREs.
Dispersal capacity is a key life‐history trait especially in species inhabiting fragmented landscapes. Evolutionary models predict that, given sufficient heritable variation, dispersal rate responds ...to natural selection imposed by habitat loss and fragmentation. Here, we estimate phenotypic variance components and heritability of flight and resting metabolic rates (RMRs) in an ecological model species, the Glanville fritillary butterfly, in which flight metabolic rate (FMR) is known to correlate strongly with dispersal rate. We modelled a two‐generation pedigree with the animal model to distinguish additive genetic variance from maternal and common environmental effects. The results show that FMR is significantly heritable, with additive genetic variance accounting for about 40% of total phenotypic variance; thus, FMR has the potential to respond to selection on dispersal capacity. Maternal influences on flight metabolism were negligible. Heritability of flight metabolism was context dependent, as in stressful thermal conditions, environmentally induced variation dominated over additive genetic effects. There was no heritability in RMR, which was instead strongly influenced by maternal effects. This study contributes to a mechanistic understanding of the evolution of dispersal‐related traits, a pressing question in view of the challenges posed to many species by changing climate and fragmentation of natural habitats.
Background: Hamstring injuries are common especially in athletes. Partial and complete tears of the proximal origin may cause pain and functional loss. Objective: To evaluate the results of surgical ...treatment for partial proximal hamstring tears. Methods: Between 1994 and 2005, 47 athletes (48 cases, 1 bilateral) with partial proximal hamstring tears were operated on. The cases were retrospectively analysed. Before surgery, 42 of the patients had undergone conservative treatment with unsatisfactory results, whereas in five patients the operation was performed within four weeks of the injury. Results: The mean length of the follow up was 36 months (range 6–72). The result of the operation was rated excellent in 33 cases, good in nine, fair in four, and poor in two. Forty one patients were able to return to their former level of sport after an average of five months (range 1–12). Conclusion: In most cases, excellent or good results can be expected after surgical repair of partial proximal hamstring tears even after conservative treatment has failed.
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