Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Understanding the educational needs of young offenders: A prevalence study of traumatic brain injury and learning disabilities

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordOffenders in custody are often disadvantaged in terms of education. Research shows that providing and improving education in custody can help reduce the possibility of recidivism and high crime rates in young offenders. Among various factors that can impact on youth's ability to engage effectively with education in custody, prevalence rates of neurodisabilities such as learning disabilities and traumatic brain injuries (TBI) remain high. Young offenders with neurodisabilities may present with various developmental, cognitive, intellectual, social functioning, language and communication deficits, that may impact on learner-teacher relationships and learning acquisition. For the purpose of this paper, we focused on learning disabilities and TBI given high prevalence rates for these neurodisabilities reported in the literature. We also report on general intellectual functioning given the association with specific learning disabilities. Despite contextual vulnerabilities, there is a dearth of literature on neurodisabilities and its associated impact on education for young offenders in South Africa. Our study sample included young offenders (n = 25) and controls (n = 56), aged 14–21 years. Measures of alcohol (AUDIT), substance use (MAP), learning disabilities and TBIs (CHAT), general intellectual functioning (WASI-II), and depression (BDI-II) were included for offenders and controls. Results show significant differences in TBI, alcohol use, substance use, and reported possible learning disabilities, with higher scores and rates for these factors, indicating poorer outcomes, in the young offender as compared to the control group. The young offender group also had significantly lower and therefore poorer verbal IQ (VIQ) scores than the control group. The results for VIQ were upheld even when the significant difference in age (young offenders were on average 5 years older) was controlled for. Results of this nature can potentially be used to inform rehabilitative efforts in our local youth centres for offenders in the hope of screening for various developmental and acquired neuro-disabilities so that rehabilitation strategies may be even more targeted for those with special education needs in of an already vulnerable population. Such results may also inform the schooling structures within such centres by providing profiles needs of offenders in custody based on screenings of neurodisabilities.National Research Foundation Thuthuka GrantMedical Research Council (MRC

Data from: Bumble bee nest abundance, foraging distance, and host-plant reproduction: implications for management and conservation

Recent reports of global declines in pollinator species imply an urgent need to assess the abundance of native pollinators and density-dependent benefits for linked plants. In this study, we investigated (1) pollinator nest distributions and estimated colony abundances, (2) the relationship between abundances of foraging workers and the number of nests they represent, (3) pollinator foraging ranges, and (4) the relationship between pollinator abundance and plant reproduction. We examined these questions in an alpine ecosystem in the Colorado Rocky Mountains, focusing on four alpine bumble bee species (Bombus balteatus, B. flavifrons, B. bifarius, and B. sylvicola), and two host plants that differ in their degrees of pollinator specialization (Trifolium dasyphyllum and T. parryi). Using microsatellites, we found that estimated colony abundances among Bombus species ranged from ~18 to 78 colonies/0.01 km2. The long-tongued species B. balteatus was most common, especially high above treeline, but the subalpine species B. bifarius was unexpectedly abundant for this elevation range. Nests detected among sampled foragers of each species were correlated with the number of foragers caught. Foraging ranges were smaller than expected for all Bombus species, ranging from 25 to 110 m. Fruit set for the specialized plant, Trifolium parryi, was positively related to the abundance of its Bombus pollinator. In contrast, fruit set for the generalized plant, T. dasyphyllum, was related to abundance of all Bombus species. Because forager abundance was related to nest abundance of each Bombus species and was an equally effective predictor of plant fecundity, forager inventories are probably suitable for assessing the health of outcrossing plant populations. However, nest abundance, rather than forager abundance, better reflects demographic and genetic health in populations of eusocial pollinators such as bumble bees. Development of models incorporating the parameters we have measured here (nest abundance, forager abundance, and foraging distance) could increase the usefulness of foraging worker inventories in monitoring, managing, and conserving pollinator populations

Iron X-ray fluorescence (XRF) scannings of ODP Holes 165-1001A and 171-1050C

Abstract: Ocean Drilling Program Sites 1001A (Caribbean Sea) and 1050C (western North Atlantic) display obliquity and precession cycles throughout polarity zone C27 of the late Danian stage (earliest Cenozoic time). Sliding-window spectra analysis and direct cycle counting on downhole logs and high-resolution Fe variations at both sites yield the equivalent of 35-36 obliquity cycles. This cycle-tuned duration for polarity chron C27 of 1.45 Ma (applying a modern mean obliquity period of 40.4 ka) is consistent with trends from astronomical tuning of early Danian polarity chron C29 and 40Ar/39Ar age calibration of the Campanian-Maastrichtian magnetic polarity time scale. The cycle-tuned Danian stage (sensu Berggren et al. 1995, in SEPM Special Publications, 54, 129-212) spans 3.65 Ma (65.5-61.85 Ma). Spreading rates on a reference South Atlantic synthetic profile display progressive slowing during the Maastrichtian to Danian stages, then remained relatively constant through late Palaeocene and early Eocene time

Appendix B. Supplemental information on molecular genetic methods used in determining effective colony abundance (Nc) for Pennsylvania Mountain bumble bees.

Supplemental information on molecular genetic methods used in determining effective colony abundance (Nc) for Pennsylvania Mountain bumble bees

Appendix A. Supplementary figures showing geographic location of study sites on Pennsylvania Mountain, Colorado, species composition of Bombus workers sampled at each site, and measurement of distance between study sites.

Supplementary figures showing geographic location of study sites on Pennsylvania Mountain, Colorado, species composition of Bombus workers sampled at each site, and measurement of distance between study sites

Appendix C. Four ANOVA and ANCOVA tables for statistical analyses discussed in Results.

Four ANOVA and ANCOVA tables for statistical analyses discussed in Results