Metabolic analysis of the interaction between plants and herbivores

Insect herbivores by necessity have to deal with a large arsenal of plant defence metabolites. The levels of defence compounds may be increased by insect damage. These induced plant responses may also affect the metabolism and performance of successive insect herbivores. As the chemical nature of induced responses is largely unknown, global metabolomic analyses are a valuable tool to gain more insight into the metabolites possibly involved in such interactions. This study analyzed the interaction between feral cabbage (Brassica oleracea) and small cabbage white caterpillars (Pieris rapae) and how previous attacks to the plant affect the caterpillar metabolism. Because plants may be induced by shoot and root herbivory, we compared shoot and root induction by treating the plants on either plant part with jasmonic acid. Extracts of the plants and the caterpillars were chemically analysed using Ultra Performance Liquid Chromatography/Time of Flight Mass Spectrometry (UPLCT/MS). The study revealed that the levels of three structurally related coumaroylquinic acids were elevated in plants treated on the shoot. The levels of these compounds in plants and caterpillars were highly correlated: these compounds were defined as the ‘metabolic interface’. The role of these metabolites could only be discovered using simultaneous analysis of the plant and caterpillar metabolomes. We conclude that a metabolomics approach is useful in discovering unexpected bioactive compounds involved in ecological interactions between plants and their herbivores and higher trophic levels.

Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial

Study objective: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality. Design: Randomised prospective clinical trial. Setting. In two ICUs at University Hospital Groningen, the Netherlands. Patients: Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h. Interventions: Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was,compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long. Measurements and results: No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1-75) versus 5 (1-101) days], ICU-stay [median (range) 8 (1-133) versus 7 (1-221) days], ICU mortality (15% versus 17%), and incidence of pulmonary infections (14% versus 13%). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions; decreased saturation: 2.7% versus 2.0% (P=0.010); increased systolic blood pressure 24.5% versus 16.8% (

Patient recollection of airway suctioning in the ICU:routine versus a minimally invasive procedure

Objective: Many patients have an unpleasant recollection of routine endotracheal suctioning after discharge from the Intensive Care Unit (ICU). We hypothesized that through minimally invasive airway suctioning discomfort and stress may be prevented, resulting in less recollection. Design: A prospective randomized clinical trial. Setting: Two ICUs at the University Hospital of Groningen, the Netherlands. Patients and participants: Adult patients with an intubation period exceeding 24 h were included. Interventions: Patients received either routine endotracheal suctioning (RES) or minimally invasive airway suctioning (MIAS) during the duration of intubation. Measurements and results: Within 3 days after ICU discharge all patients were interviewed, regarding recollection and discomfort of suctioning. The level of discomfort was quantified on a visual analogue scale (VAS). We analyzed data from 208 patients (RES: n=113 ,and MIAS: n=95). A significantly lower prevalence of recollection of airway suctioning was found in the MIAS group (20%) compared to the RES group (41%) (P-value =0.001). No significant difference in level of discomfort was found between the RES and the MIAS group (P-value =0.136). Conclusions: Minimally invasive airway suctioning results in a lower prevalence of recollection of airway suction than in RES, but not in discomfort

Outcome after osteosynthesis of hip fractures in nonagenarians

Kevin de Leur,1 Jos P A M Vroemen,1 Dagmar I Vos,1 Leon Elmans,2 Lijckle van der Laan1 1Department of Surgery, 2Orthopedics, Amphia Hospital, Breda, The Netherlands Background: Hip fractures in the elderly population are associated with high morbidity and mortality. However, there is still a lack of information on mortality and loss of independence in extremely elderly people with a hip fracture. Objective: To study functional outcomes and mortality after osteosynthesis of hip fractures in very old patients in our clinic. Patients and methods: Hospital charts of all patients over 90 years old who were operated for a hip fracture between January 2007 and December 2011 were reviewed. Outcome measures were mortality, preoperative and postoperative mobility, and loss of independence. Results: A total of 149 patients were included; 132 (89%) women, median age 93.5±2.45 years. Thirty-six (24%) patients were classified as American Society of Anesthesiologists (ASA) grade 2, 104 (70%) as ASA grade 3, and nine (6%) as ASA grade 4. The Charlson comorbidity index (CCI) score was 2 or less in 115 (77%) patients and 34 (23%) patients scored 3 or more points. Short-term survival was 91% and 77% at 30 days and 3 months, respectively. Long-term survival was 64%, 42%, and 18% at 1, 3, and 5 years after surgery, respectively. Survival was significantly better in patients with lower ASA scores (P=0.005). No significant difference in survival was measured between patients according to CCI score (P=0.13). Fifty-one percent of patients had to be accommodated in an institution with more care following treatment, and 57% were less mobile after osteosynthesis of a hip fracture. Conclusion: Our study shows that short-term mortality rates in very elderly patients with a hip fracture are high and there is no clear predictive value for mortality. ASA classification is the best predictive value for overall mortality. A large proportion of these patients lost their independence after osteosynthesis of a hip fracture. Keywords: hip fracture, osteosynthesis, very elderly people, mortality, loss of independenc

Innis in the <i>Concertgebouw</i>:Media and musical culture in nineteenth-century amsterdam

Is classical musical culture a purely sonic and aural culture, or is there more to this culture than music? Drawing upon Harold Innis’s media theory, this chapter examines classical musical culture as one that is inseparable from media, and in particular the concert hall and print media. Using the example of nineteenth century Amsterdam to explore this claim, this chapter begins by examining how ideas about listening and musical meaning were disseminated through print media as a means to both educate and discipline Amsterdammers to listen attentively and appreciate the inherent beauty and meaning of secular instrumental music. This edifying mission was complemented by the construction of the Concertgebouw in 1888, the first purpose-built concert hall in Amsterdam. The balance between these two media forms (print and architecture), enabled the classical music tradition to take hold in Amsterdam and endure across both time and space