Defining the appropriate waiting time between multiple-breath nitrogen washout measurements

Research lette

Impairments after curative intent treatment for non-small cell lung cancer: A comparison with age and gender-matched healthy controls

Background: The aim of this study was to compare measures of exercise capacity, health-related quality of life (HRQoL), muscle force, lung function and feelings of anxiety and depression in people after curative intent treatment for NSCLC with age and gender-matched healthy controls. Methods: This cross-sectional study included 23 participants (68 ± 10yr; 16 females), 6–10 weeks after lobectomy for NSCLC or, for those who received adjuvant chemotherapy, 4–8 weeks after their last cycle. The study also included 20 age and gender-matched healthy controls (69 ± 5yr; 13 females). All participants underwent measurements of exercise capacity (cycle-ergometry test [CPET] and 6-min walk test [6MWT]), HRQoL (Short-Form 36 general health survey [SF-36]), handgrip force, quadriceps torque, lung function and feelings of anxiety and depression. Results When compared with data collected in healthy controls, those in the NSCLC group demonstrated impairments in the peak rate of oxygen consumption (15 ± 3 versus 24 ± 7 ml kg−1·min−1; p < 0.001) and maximum work rate (75 ± 25 versus 127 ± 51Watts; p < 0.001) measured during the CPET, and 6-min walk distance (494 ± 77 versus 649 ± 61 m; p < 0.001). Similarly, impairments were demonstrated in all domains of the SF-36 (p < 0.01 for all), isometric handgrip force (28 ± 7 versus 34 ± 10 kg; p = 0.02), and all measures of lung function (p ≤ 0.001 for all). A higher score for depression was also seen (3.0 ± 2.5 versus 1.5 ± 1.6; p = 0.03). There was no difference between the groups in isometric quadriceps torque or feelings of anxiety.Conclusions: After curative intent treatment for NSCLC, compared to healthy controls, impairments were demonstrated in laboratory and field-based measures of exercise capacity, HRQoL, isometric handgrip force and lung function. Although people after curative intent treatment for NSCLC reported greater feelings of depression, these levels were below those considered clinically relevant. These findings suggest that people after curative intent treatment for NSCLC may benefit from rehabilitative strategies to optimise exercise capacity and HRQoL

Challenges in operationalizing the water–energy–food nexus

Concerns about the water–energy–food (WEF) nexus have motivated many discussions regarding new approaches for managing water, energy and food resources. Despite the progress in recent years, there remain many challenges in scientific research on the WEF nexus, while implementation as a management tool is just beginning. The scientific challenges are primarily related to data, information and knowledge gaps in our understanding of the WEF inter-linkages. Our ability to untangle the WEF nexus is also limited by the lack of systematic tools that could address all the trade-offs involved in the nexus. Future research needs to strengthen the pool of information. It is also important to develop integrated software platforms and tools for systematic analysis of the WEF nexus. The experience made in integrated water resources management in the hydrological community, especially in the framework of Panta Rhei, is particularly well suited to take a lead in these advances

Epistemological dimensions of the water–energy–food nexus approach: reply to discussions of “Challenges in operationalizing the water–energy–food nexus”

We thank the authors, Varis and Keskinen, and Nauditt, for their constructive contributions. We endorse their key comments, further referring to recent literature and events, including the UN 2018 High Level Political Forum on sustainable development. Here, we elaborate on the epistemological perspective of the water–energy–food nexus conceptualization, assessment, discourse and operationalization

The outer limiting membrane (OLM) revisited: clinical implications

PURPOSE: The outer limiting membrane (OLM) is considered to play a role in maintaining the structure of the retina through mechanical strength. However, the observation of junction proteins located at the OLM and its barrier permeability properties may suggest that the OLM may be part of the retinal barrier. MATERIAL AND METHODS: Normal and diabetic rat, monkey, and human retinas were used to analyze junction proteins at the OLM. Proteome analyses were performed using immunohistochemistry on sections and flat-mounted retinas and western blotting on protein extracts obtained from laser microdissection of the photoreceptor layers. Semi-thin and ultrastructure analyses were also reported. RESULTS: In the rat retina, in the subapical region zonula occludens-1 (ZO-1), junction adhesion molecule (JAM), an atypical protein kinase C, is present and the OLM shows dense labeling of occludin, JAM, and ZO-1. The presence of occludin has been confirmed using western blot analysis of the microdissected OLM region. In diabetic rats, occludin expression is decreased and glial cells junctions are dissociated. In the monkey retina, occludin, JAM, and ZO-1 are also found in the OLM. Junction proteins have a specific distribution around cone photoreceptors and Müller glia. Ultrastructural analyses suggest that structures like tight junctions may exist between retinal glial Müller cells and photoreceptors. CONCLUSIONS: In the OLM, heterotypic junctions contain proteins from both adherent and tight junctions. Their structure suggests that tight junctions may exist in the OLM. Occludin is present in the OLM of the rat and monkey retina and it is decreased in diabetes. The OLM should be considered as part of the retinal barrier that can be disrupted in pathological conditions contributing to fluid accumulation in the macula