Normothermia is protective during infrarenal aortic surgery

AbstractPurpose: Mild hypothermia has been suggested to be protective against tissue ischemia during aortic operations. However, recent studies have documented detrimental cardiac effects of hypothermia during a variety of operative procedures. The influence of different warming methods and the impact of hypothermia during standard aortic procedures was assessed. Methods: One hundred patients who underwent repair of infrarenal aortic aneurysms or aortoiliac occlusive disease were prospectively randomized into 2 groups, receiving either a circulating water mattress or a forced air warming blanket. Adjuvant warming methods were standardized. The day before surgery, 48-hour Holter monitors were applied and interpreted by a cardiologist blinded to the treatment. Randomization resulted in equivalent groups with regard to patient history, indications for surgery, body mass index, length of surgery, and fluid requirements. Results: Core temperatures were significantly warmer during surgery (36.3°C ± 0.7°C vs 35.4 ± 0.8°C) and after surgery (36.4°C ± 0.7°C vs 35.6°C ± 0.9°C) in patients with forced air warming (P < .001). The circulating water mattress group had significantly more metabolic acidosis perioperatively (P = .03). Postoperative length of stay, cardiac complications, and death rates were not significantly different. Subgroup analysis of 83 aneurysm patients comparing normothermia with hypothermia (temperature less than 36°C) on arrival to the recovery room identified decreased cardiac output (P = .02), thrombocytopenia (P = .02), elevated prothrombin time (P = .04), and inferior Acute Physiology and Chronic Health Evaluation (APACHE) II scores (P < .001) in the hypothermic group. Holter analysis revealed more sinus tachycardia (ST) segment changes and ventricular tachycardia in hypothermic aneurysm patients (P = .05). Conclusion: Patients treated with forced air blankets had significantly less metabolic acidosis and were kept significantly warmer than those treated with circulating water mattresses. Patients with aneurysms that were kept normothermic had a significantly improved clinical profile, with fewer cardiac events on the Holter recordings. We therefore conclude that (1) normothermia is protective for infrarenal aortic surgical patients; and (2) forced air warming blankets provide improved temperature maintenance compared with circulating water mattresses. (J Vasc Surg 1998;28:984-94.

Wie misst man Textqualit\ue4t im digitalen Zeitalter? (MIT.Qualit\ue4t)

Schreibprodukte in sozialen Netzwerken entsprechen nicht immer den normativen Erwartungen, die man an redigierte Texte in der Presse, der Wissenschaft oder der Belletristik herantr\ue4gt. Die Frage, wie sich dies auf unsere Schriftsprache und auf die Entwicklung von Schreibkompetenzen auswirkt, wird in der 6ffentlichkeit kontrovers diskutiert (vgl. D\ufcrscheid/Brommer 2009; Storrer 2014; D\ufcrscheid/Frick 2016). Allerdings gibt es bislang wenig M\uf6glichkeiten, empirisch fundierte Antworten auf diese Frage zu geben. Das liegt einerseits daran, dass es aufw\ue4ndig ist, Korpora mit Lernertexten aus dem schulischen Bereich und Schreibprodukten aus sozialen Medien zu sammeln und f\ufcr die empirische Analyse aufzubereiten. Es liegt aber auch daran, dass eine \u201eeinheitliche Antwort auf die Frage, was eine gute Schreibkompetenz ist, noch immer aussteht\u201c (D\ufcrscheid/Frick 2016, S. 125). Das Projekt \u201eWie misst man Textqualit\ue4t im digitalen Zeitalter?\u201c (MIT.Qualit\ue4t) setzt an dieser L\ufccke an und m\uf6chte in zwei Arbeitsbereichen dazu beitragen, die Voraussetzungen f\ufcr die empirische Untersuchung des Schreibgebrauchs und der Schreibkompetenzen in digitalen Medien zu verbessern

Association between Coffee Consumption and Brain MRI Parameters in the Hamburg City Health Study

Despite associations of regular coffee consumption with fewer neurodegenerative disorders, its association with microstructural brain alterations is unclear. To address this, we examined the association of coffee consumption with brain MRI parameters representing vascular brain damage, neurodegeneration, and microstructural integrity in 2316 participants in the population-based Hamburg City Health Study. Cortical thickness and white matter hyperintensity (WMH) load were measured on FLAIR and T1-weighted images. Microstructural white matter integrity was quantified as peak width of skeletonized mean diffusivity (PSMD) on diffusion-weighted MRI. Daily coffee consumption was assessed in five groups (&lt;1 cup, 1&ndash;2 cups, 3&ndash;4 cups, 5&ndash;6 cups, &gt;6 cups). In multiple linear regressions, we examined the association between brain MRI parameters and coffee consumption (reference group &lt;1 cup). After adjustment for covariates, 3&ndash;4 cups of daily coffee were associated with lower PSMD (p = 0.028) and higher cortical thickness (p = 0.015) compared to &lt;1 cup. Moreover, 1&ndash;2 cups per day was also associated with lower PSMD (p = 0.022). Associations with WMH load or other groups of coffee consumption were not significant (p &gt; 0.05). The findings indicate that regular coffee consumption is positively associated with microstructural white matter integrity and cortical thickness. Further research is necessary to determine longitudinal effects of coffee on brain microstructure

Natural alleles of the abscisic acid catabolism gene ZmAbh4 modulate water use efficiency and carbon isotope discrimination in maize

Altering plant water use efficiency (WUE) is a promising approach for achieving sustainable crop production in changing climate scenarios. Here, we show that WUE can be tuned by alleles of a single gene discovered in elite maize (Zea mays) breeding material. Genetic dissection of a genomic region affecting WUE led to the identification of the gene ZmAbh4 as causative for the effect. CRISPR/Cas9-mediated ZmAbh4 inactivation increased WUE without growth reductions in well-watered conditions. ZmAbh4 encodes an enzyme that hydroxylates the phytohormone abscisic acid (ABA) and initiates its catabolism. Stomatal conductance is regulated by ABA and emerged as a major link between variation in WUE and discrimination against the heavy carbon isotope (Delta C-13) during photosynthesis in the C-4 crop maize. Changes in Delta C-13 persisted in kernel material, which offers an easy-to-screen proxy for WUE. Our results establish a direct physiological and genetic link between WUE and Delta C-13 through a single gene with potential applications in maize breeding. Forward and reverse genetics identified the abscisic acid catabolism gene ZmAbh4 as a major link between variation in water use efficiency and carbon isotope discrimination through the control of stomatal conductance