Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial

INTRODUCTION: Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD. METHODS: Intensive care patients with an ICU stay of more than 72 hours were recruited to a randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD. The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months. RESULTS: 352 patients were randomised to the study at 1 month. The incidence of new cases of PTSD was reduced in the intervention group compared to the control patients (5% versus 13%, P = 0.02). CONCLUSIONS: The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD.RACHEL GROUP in addition to the authors: Denmark, Christensen D, Bogø I, Hansen R, Kjerrumgård H, Mathiasen L, Hyldested C, Toft C, Nordsjaelland Hospital; Bagger C, Larsen MB, Frank de Jong L, Odense University Hospital; Ågård AS, Knudsen K, Hinzel T, Århus University Hospital, Skejby; Italy, Scaramuzza A &amp; Bertacchini S, Ferrara; Norway, Schou Landmark J, Salomonsen A, Tøien K, Walther S, Oslo University Hospital Ulleval; Muri AK, Haukeland University Hospital; Portugal, Neutel E, Gomes E, Cardoso T, Ferreira R, Machado C, Santos C, Pinto S, Hospital Santo António - Centro Hospitalar do Porto, Amaro A, Morujão E, Jerónimo A, Rodrigues T, Carvalho F, Silva A, Morais A Hospital Pedro Hispano; Sweden, Löwenmark U, Etemad W, Rosell E, Sahgrenska University Hospital; Carlson U, Wirbrand Holmquist A, Kungälv Hospital; Åkerman E, Ersson A, Malmö University Hospital; UK, Tobin C, Whiston.</p

A Cure for HIV Infection: "Not in My Lifetime" or "Just Around the Corner"?

With the advent and stunning success of combination antiretroviral therapy (ART) to prolong and improve quality of life for persons with HIV infection, HIV research has been afforded the opportunity to pivot towards studies aimed at finding "a cure." The mere idea that cure of HIV might be possible has energized researchers and the community towards achieving this goal. Funding agencies, both governmental and private, have targeted HIV cure as a high priority; many in the field have responded to these initiatives and the cure research agenda is robust. In this "salon" two editors of Pathogens and Immunity, Michael Lederman and Daniel Douek ask whether curing HIV is a realistic, scalable objective. We start with an overview perspective and have asked a number of prominent HIV researchers to add to the discussion

In search of the authentic nation: landscape and national identity in Canada and Switzerland

While the study of nationalism and national identity has flourished in the last decade, little attention has been devoted to the conditions under which natural environments acquire significance in definitions of nationhood. This article examines the identity-forming role of landscape depictions in two polyethnic nation-states: Canada and Switzerland. Two types of geographical national identity are identified. The first – what we call the ‘nationalisation of nature’– portrays zarticular landscapes as expressions of national authenticity. The second pattern – what we refer to as the ‘naturalisation of the nation’– rests upon a notion of geographical determinism that depicts specific landscapes as forces capable of determining national identity. The authors offer two reasons why the second pattern came to prevail in the cases under consideration: (1) the affinity between wild landscape and the Romantic ideal of pure, rugged nature, and (2) a divergence between the nationalist ideal of ethnic homogeneity and the polyethnic composition of the two societies under consideration

Minimal selective concentrations of tetracycline in complex aquatic bacterial biofilms

Selection pressure generated by antibiotics released into the environment could enrich for antibiotic resistance genes and antibiotic resistant bacteria, thereby increasing the risk for transmission to humans and animals. Tetracyclines comprise an antibiotic class of great importance to both human and animal health. Accordingly, residues of tetracycline are commonly detected in aquatic environments. To assess if tetracycline pollution in aquatic environments promotes development of resistance, we determined minimal selective concentrations (MSCs) in biofilms of complex aquatic bacterial communities using both phenotypic and genotypic assays. Tetracycline significantly increased the relative abundance of resistant bacteria at 10 μg/L, while specific tet genes (tetA and tetG) increased significantly at the lowest concentration tested (1 μg/L). Taxonomic composition of the biofilm communities was altered with increasing tetracycline concentrations. Metagenomic analysis revealed a concurrent increase of several tet genes and a range of other genes providing resistance to different classes of antibiotics (e.g. cmlA, floR, sul1, and mphA), indicating potential for co-selection. Consequently, MSCs for the tet genes of ≤ 1 μg/L suggests that current exposure levels in e.g. sewage treatment plants could be sufficient to promote resistance. The methodology used here to assess MSCs could be applied in risk assessment of other antibiotics as well

Longitudinal diffusion changes in prodromal and early HD: Evidence of white-matter tract deterioration

INTRODUCTION: Huntington's disease (HD) is a genetic neurodegenerative disorder that primarily affects striatal neurons. Striatal volume loss is present years before clinical diagnosis; however, white matter degradation may also occur prior to diagnosis. Diffusion-weighted imaging (DWI) can measure microstructural changes associated with degeneration that precede macrostructural changes. DWI derived measures enhance understanding of degeneration in prodromal HD (pre-HD). METHODS: As part of the PREDICT-HD study, N = 191 pre-HD individuals and 70 healthy controls underwent two or more (baseline and 1-5 year follow-up) DWI, with n = 649 total sessions. Images were processed using cutting-edge DWI analysis methods for large multicenter studies. Diffusion tensor imaging (DTI) metrics were computed in selected tracts connecting the primary motor, primary somato-sensory, and premotor areas of the cortex with the subcortical caudate and putamen. Pre-HD participants were divided into three CAG-Age Product (CAP) score groups reflecting clinical diagnosis probability (low, medium, or high probabilities). Baseline and longitudinal group differences were examined using linear mixed models. RESULTS: Cross-sectional and longitudinal differences in DTI measures were present in all three CAP groups compared with controls. The high CAP group was most affected. CONCLUSIONS: This is the largest longitudinal DWI study of pre-HD to date. Findings showed DTI differences, consistent with white matter degeneration, were present up to a decade before predicted HD diagnosis. Our findings indicate a unique role for disrupted connectivity between the premotor area and the putamen, which may be closely tied to the onset of motor symptoms in HD. Hum Brain Mapp 38:1460-1477, 2017. © 2017 Wiley Periodicals, Inc

Observation of enhanced chiral asymmetries in the inner-shell photoionization of uniaxially oriented methyloxirane enantiomers

Most large molecules are chiral in their structure: they exist as two enantiomers, which are mirror images of each other. Whereas the rovibronic sublevels of two enantiomers are almost identical, it turns out that the photoelectric effect is sensitive to the absolute configuration of the ionized enantiomer - an effect termed Photoelectron Circular Dichroism (PECD). Our comprehensive study demonstrates that the origin of PECD can be found in the molecular frame electron emission pattern connecting PECD to other fundamental photophysical effects as the circular dichroism in angular distributions (CDAD). Accordingly, orienting a chiral molecule in space enhances the PECD by a factor of about 10

How Preussag became TUI : kissing too many toads can make you a toad

In the period 1997-2004, Preussag, a diversified German conglomerate of old economy businesses, changed itself into TUI, a company focused almost entirely on tourism and logistics. This paper analyzes how this strategy was executed and how it contributed to Preussag’s underperformance of the stock market. We collect 417 announcements of acquisitions, financial disclosures and other news and disentangle the impact of different parts of the company’s strategy. We find that only the divestitures created value, that the strategy to invest in tourism destroyed value, and that the acquisition premiums Preussag paid were mostly unjustified. Bad luck like the events of September 11, 2001 cannot account for the poor performance of the stock. Poor management resulted from poor governance, combining a state-owned bank as the largest shareholder, board interlocks, and insufficient managerial incentives. The case shows how divestiture programs increase the liquid resources available to management beyond free operating cash flows and casts doubt on the positive governance role of institutional blockholders

On Scottish sawflies, with results of the 14th International Sawfly Workshop, in the southern Highlands, 2010 (Hymenoptera, Symphyta).

Die Ergebnisse der Feldarbeit aus dem 14. Internationalen Sawfly Workshop werden vorgestellt. Dies fand im südlichen schottischen Hochland, überwiegend in Perthshire, statt. Einige Nachweise von Pflanzenwespen aus anderen Teilen von Schottland sind enthalten. Erstnachweise für die Britischen Inseln werden für acht tenthredinide Arten erbracht: Amauronematus mimus, Phyllocolpa alienata, P. erythropyga, P. plicalapponum, P. plicaphylicifolia, P. prussica, Pristiphora thalictri und Tenthredo ignobilis. A. mimus ist auch aus Irland nachgewiesen. Amauronematus stenogaster ist aus der Liste der Symphyta der Britischen Inseln zu entfernen. Erstmalig sind in Schottland eine Cephiden-Art (Hartigia xanthostoma) und zehn Tenthrediniden gefunden worden (Claremontia uncta, Dolerus brevicornis, Empria basalis, Empria parvula, Parna apicalis, Pristiphora decipiens, Pristiphora leucopus, Pristiphora testacea, Tenthredo mandibularis und Tenthredopsis ornata). Merkmale für die Unterscheidung einzelner Arten werden dargestellt. Der Locus typicus von Nematus herbaceae Cameron, 1876 ist geklärt. Geranium pratense ist als Wirtspflanze von Macrophya albipuncta bestätigt. Salix reticulata ist eine Wirtspflanze von Amauronematus mcluckieae. Sedum rosea kann eine Wirtspflanze von Tenthredo ignobilis sein. Allgemeine Schlussfolgerungen: hoher Artenreichtum der Pflanzenwespenfauna von Perthshire im Vergleich zu anderen Regionen in Schottland, darunter mehrere Arten, die auf den Britischen Inseln nur von dort bekannt sind; die Wichtigkeit der Erhaltung der Lebensräume von Felssimsen; große Defizite in unseren Kenntnissen bei vielen Arten, insbesondere zu Wirtspflanzen, Phänologie und Verbreitung; hoher Wert der Malaise-Falle in faunistischen Untersuchungen von Symphyta, weil das Spektrum von erfassten Taxa sich unterscheidet von dem was mit Streifnetz erfasst wird; Zusammensetzung des 'fall-out’ auf Schneeresten deutet darauf hin, dass Pflanzenwespen in einem größeren Ausmaß als bisher angenommen, aktiver Dispersion innerhalb von Landmassen unterliegen.StichwörterBritish Isles, Cephidae, Pamphiliidae, Tenthredinoidea, hosts, phenology, distribution.Results of fieldwork are presented from the 14th International Sawfly Workshop, held in the southern Highlands of Scotland, mostly in Perthshire. Some records of Symphyta from other parts of Scotland are included. First records in the British Isles are given for eight tenthredinid species: Amauronematus mimus, Phyllocolpa alienata, P. erythropyga, P. plicalapponum, P. plicaphylicifolia, P. prussica, Pristiphora thalictri and Tenthredo ignobilis. A. mimus is also recorded from Ireland. Amauronematus stenogaster is removed from the list of British Isles Symphyta. Recorded for the first time in Scotland are one cephid (Hartigia xanthostoma) and ten tenthredinids (Claremontia uncta, Dolerus brevicornis, Empria basalis, Empria parvula, Parna apicalis, Pristiphora decipiens, Pristiphora leucopus, Pristiphora testacea, Tenthredo mandibularis and Tenthredopsis ornata). Characters useful for the distinction of some species are illustrated. The type locality of Nematus herbaceae Cameron, 1876 is clarified. Geranium pratense is confirmed as a host of Macrophya albipuncta. Salix reticulata is a host of Amauronematus mcluckieae [mandatory correction of spelling of species name]. Sedum rosea may be a host of Tenthredo ignobilis. General conclusions: high species richness of Perthshire sawfly fauna compared to other regions of Scotland, including several species only known in British Isles from there; importance to conservation of rock-ledge habitats; large data deficits for many species, particularly on hosts, phenology and distribution; high value of Malaise traps in faunal survey of Symphyta, because spectrum of taxa captured differs from that recorded by hand-netting; as indicated by species and sex composition of ‘fall-out’ on snow patches, adult sawflies undertake active dispersal, within landmasses, to a greater extent than is often assumed.KeywordsBritish Isles, Cephidae, Pamphiliidae, Tenthredinoidea, hosts, phenology, distribution