Trophic ecology of blue whiting in the Barents Sea

Blue whiting (Micromesistius poutassou) are distributed throughout the North Atlantic, including the Norwegian and Barents Seas. In recent years, both abundance and distribution of blue whiting in the Barents Sea have increased dramatically. Therefore, to evaluate the trophic impact of this increase, we analysed the diet of the species. In all, 54 prey species or taxa were identified, the main prey being krill. However, the diet varied geographically and ontogenetically: the proportion of fish in the diet was higher in large blue whiting and in the north of the range. Blue whiting overlap geographically with other pelagic species at the edge of their distribution in the Barents Sea, with juvenile herring in the south, with polar cod in the north, and with capelin in the northeast. The overlap in diet between blue whiting and these other pelagic species ranged from 6 to 86% and was greatest with capelin in areas where both species feed on hyperiids and krill. The importance of blue whiting as prey for predatory fish was highest in the areas of greatest abundance, but overall, blue whiting were seemingly unimportant as prey of piscivorous fish in the Barents Sea

Crowding in the emergency department. A threat towards patient safety when presenting time-sensitive conditions?

Fordypningsoppgave i akuttmedisinsk sykepleie - 60 studiepoeng. 2019Introduksjon Akuttmottak er en høyrisikosone for pasientsikkerhet, hovedsakelig på grunn av faren for overbelastning. Pasienter med tidskritiske tilstander/diagnoser er høyt prioritert og blir viet mye ressurser. Formålet med oppgaven er å utforske hvordan overbelastning i akuttmottak påvirker pasientsikkerheten til pasienter med tidskritiske tilstander. Metode Oppgavens utforming er en litteraturstudie der det er gjort systematiske litteratursøk i databasene PubMed, Cinahl, Medline og SveMed+. Syv studier er inkludert, hvorav en systematisk oversikt, fem med kvantitativ metode og en med kvalitativ metode. Resultat Tematisk analyse av resultatene har identifisert signifikante forskjeller vedrørende forsinkelse av behandling, mortalitet og redusert kvalitet i behandlingen av den tidskritiske pasient ved overbelastning i akuttmottak. Hovedtrekkene er at overbelastning kan føre til at standardiserte behandlingsprotokoller ikke blir etterfulgt. Sykepleiere kan miste oversikt og kontroll på pasientene sine og antall feilvurderinger øker. Evnen til å monitorere pasienter blir svekket. Det er stridende resultater vedrørende økning av mortalitet hos tidskritiske pasienter. Multitraumepasienter kan se ut som å bli mest affisert gjennom forsinkelser i transport ut fra akuttmottaket og flere som utvikler koagulopati. Konklusjon Resultatene ved denne litteraturstudien viser at en kan anta at overbelastning i akuttmottak påvirker pasientsikkerheten til tidskritiske pasienter negativt ved å bli utsatt for risiko for skade, med potensielt dødelig utfall. Resultatene kan imidlertid vanskelig generaliseres eller konkluderes med ettersom overføringsverdien til det norske helsevesenet er usikker, samt at de inkluderte studiene bare dekker en liten del av tidskritiske tilstander/diagnoser. Ytterligere forskning vedrørende tidskritiske pasienter som utsettes for overbelastning behøves for i større grad kunne belyse implikasjoner for praksis

Interplanetary Trajectory Design for NASA's Common Probe Study

The Galileo Probe, Pioneer-Venus probes, and SPRITE concept all share a number of common characteristics. They all follow a similar entry and descent sequence, using an aeroshell to protect against entry environments, and parachutes to aid in extrusion and descent speed control of the descent vehicle containing the science instruments. The descent vehicles all contained similar instruments (e.g. mass spectrometers and atmosphere structure sensors), and data was either relayed back to a carrier spacecraft (Galileo Probe, SPRITE) or transmitted direct to Earth (Pioneer-Venus). Based on these similar characteristics, NASA initiated a study to investigate a common probe' that might be designed to perform similar science in a variety of planetary environments. This concept would leverage a common aeroshell design, and descent vehicle designs that could be made as similar as possible (the primary exception being that Venus will require a pressure vessel due to the extreme pressures and temperatures seen in the lower portion of the descent). To support the Common Probe study, GSFC and JPL performed a series of interplanetary trajectory analyses to help develop the mission designs for Venus, Jupiter, Saturn, Uranus, and Neptune. Primary considerations in the trajectory modeling included: a maximum of 12-year time of flight (for outer planet destinations), generation of both steep and shallow entry trajectories to each destination (where steep and shallow resulted in approximately 150 g and 50 g peak deceleration during entry at each location), and consideration of the data relay. Gravity assists and trajectories with low delta-V requirements (typically much less than 500 m/s) were also incorporated into the design process to enable launch on existing vehicles such as the Atlas V

The phenotypic presentation of adult individuals with SLC6A1-related neurodevelopmental disorders

Epilepsy; Intellectual disability; Neurodevelopmental disordersEpilepsia; Discapacidad intelectual; Trastornos del neurodesarrolloEpilèpsia; Discapacitat intel·lectual; Trastorns del neurodesenvolupamentIntroduction: SLC6A1 is one of the most common monogenic causes of epilepsy and is a well-established cause of neurodevelopmental disorders. SLC6A1-neurodevelopmental disorders have a consistent phenotype of mild to severe intellectual disability (ID), epilepsy, language delay and behavioral disorders. This phenotypic description is mainly based on knowledge from the pediatric population. Method: Here, we sought to describe patients with SLC6A1 variants and age above 18 years through the ascertainment of published and unpublished patients. Unpublished patients were ascertained through international collaborations, while previously published patients were collected through a literature search. Results: A total of 15 adult patients with SLC6A1 variants were included. 9/13 patients had moderate to severe ID (data not available in two). Epilepsy was prevalent (11/15) with seizure types such as absence, myoclonic, atonic, and tonic–clonic seizures. Epilepsy was refractory in 7/11, while four patients were seizure free with lamotrigine, valproate, or lamotrigine in combination with valproate. Language development was severely impaired in five patients. Behavioral disorders were reported in and mainly consisted of autism spectrum disorders and aggressive behavior. Schizophrenia was not reported in any of the patients. Discussion: The phenotype displayed in the adult patients presented here resembled that of the pediatric cohort with ID, epilepsy, and behavioral disturbances, indicating that the phenotype of SLC6A1-NDD is consistent over time. Seizures were refractory in >60% of the patients with epilepsy, indicating the lack of targeted treatment in SLC6A1-NDDs. With increased focus on repurposing drugs and on the development of new treatments, hope is that the outlook reflected here will change over time. ID appeared to be more severe in the adult patients, albeit this might reflect a recruitment bias, where only patients seen in specialized centers were included or it might be a feature of the natural history of SLC6A1-NDDs. This issue warrants to be explored in further studies in larger cohorts

Plasma prostaglandin F2α and plasma 13,14-dihydro-15-keto-prostaglandin F2α levels in women during induction of labor with i. v. infusion of prostaglandin F2α in relation to uterine contractions

Peer Reviewe

Diets of the Barents Sea cod (Gadus morhua) from the 1930s to 2018

A new dataset on the diet of Atlantic cod in the Barents Sea from the 1930s to the present day has been compiled to produce one of the largest fish diet datasets available globally. Atlantic cod is one of the most ecologically and commercially important fish species in the North Atlantic. The stock in the Barents Sea is by far the largest, as a result of both successful management and favourable environmental conditions since the early 2000s. As a top predator, cod plays a key role in the Barents Sea ecosystem. The species has a broad diet consisting mainly of crustaceans and teleost fish, and both the amount and type of prey vary in space and time. The data – from Russia, Norway and the United Kingdom – represent quantitative stomach content records from more than 400 000 fish and qualitative data from 2.5 million fish. Many of the data are from joint collaborative surveys between Norway and Russia. The sampling was conducted throughout each year, allowing for seasonal, annual and decadal comparisons to be made. Visual analysis shows cod diets have changed considerably from the start of the dataset in the 1930s to the present day. There was a large proportion of herring in the diets in the 1930s, whereas in more recent decades capelin, invertebrates and other fish dominate. There are also significant interannual asynchronous fluctuations in prey, particularly capelin and euphausiids. Combining these datasets can help us understand how the environment and ecosystems are responding to climatic changes, and what influences the diet and prey switching of cod. Trends in temperature and variability indices can be tested against the occurrence of different prey items, and the effects of fishing pressure on cod and prey stocks on diet composition could be investigated. The dataset will also enable us to improve parametrization of food web models and to forecast how Barents Sea fisheries may respond in the future to management and to climate change. The Russian data are available through joint projects with the Polar Branch of the Russian Federal Research Institute of Fisheries and Oceanography (VNIRO).publishedVersio

The clinical utility of FDG PET/CT among solid organ transplant recipients suspected of malignancy or infection

PURPOSE: Solid organ transplant (SOT) recipients are at high risk of developing infections and malignancies. (18)F-FDG PET/CT may enable timely detection of these diseases and help to ensure early intervention. We aimed to describe the clinical utility of FDG PET/CT in consecutive, diagnostic unresolved SOT recipients transplanted from January 2004 to May 2015. METHODS: Recipients with a post-transplant FDG PET/CT performed as part of diagnostic work-up were included. Detailed chart reviews were done to extract relevant clinical information and determine the final diagnosis related to the FDG PET/CT. Based on á priori defined criteria and the final diagnosis, results from each scan were classified as true or false, and diagnostic values determined. RESULTS: Among the 1,814 recipients in the cohort, 145 had an FDG PET/CT performed; 122 under the indication of diagnostically unresolved symptoms with a suspicion of malignancy or infection. The remaining (N = 23) had an FDG PET/CT to follow-up on a known disease or to stage a known malignancy. The 122 recipients underwent a total of 133 FDG PET/CT scans performed for a suspected malignancy (66 %) or an infection (34 %). Sensitivity, specificity, and positive and negative predictive values of the FDG PET/CT in diagnosing these conditions were 97, 84, 87, and 96 %, respectively. CONCLUSION: FDG PET/CT is an accurate diagnostic tool for the work-up of diagnostic unresolved SOT recipients suspected of malignancy or infection. The high sensitivity and NPV underlines the potential usefulness of PET/CT for excluding malignancy or focal infections in this often complex clinical situation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00259-016-3564-5) contains supplementary material, which is available to authorized users

Use of Advanced Flexible Modeling Approaches for Survival Extrapolation from Early Follow-up Data in two Nivolumab Trials in Advanced NSCLC with Extended Follow-up

Objectives: Immuno-oncology (IO) therapies are often associated with delayed responses that are deep and durable, manifesting as long-term survival benefits in patients with metastatic cancer. Complex hazard functions arising from IO treatments may limit the accuracy of extrapolations from standard parametric models (SPMs). We evaluated the ability of flexible parametric models (FPMs) to improve survival extrapolations using data from 2 trials involving patients with non–small-cell lung cancer (NSCLC). Methods: Our analyses used consecutive database locks (DBLs) at 2-, 3-, and 5-y minimum follow-up from trials evaluating nivolumab versus docetaxel in patients with pretreated metastatic squamous (CheckMate-017) and nonsquamous (CheckMate-057) NSCLC. For each DBL, SPMs, as well as 3 FPMs—landmark response models (LRMs), mixture cure models (MCMs), and Bayesian multiparameter evidence synthesis (B-MPES)—were estimated on nivolumab overall survival (OS). The performance of each parametric model was assessed by comparing milestone restricted mean survival times (RMSTs) and survival probabilities with results obtained from externally validated SPMs. Results: For the 2- and 3-y DBLs of both trials, all models tended to underestimate 5-y OS. Predictions from nonvalidated SPMs fitted to the 2-y DBLs were highly unreliable, whereas extrapolations from FPMs were much more consistent between models fitted to successive DBLs. For CheckMate-017, in which an apparent survival plateau emerges in the 3-y DBL, MCMs fitted to this DBL estimated 5-y OS most accurately (11.6% v. 12.3% observed), and long-term predictions were similar to those from the 5-y validated SPM (20-y RMST: 30.2 v. 30.5 mo). For CheckMate-057, where there is no clear evidence of a survival plateau in the early DBLs, only B-MPES was able to accurately predict 5-y OS (14.1% v. 14.0% observed [3-y DBL]). Conclusions: We demonstrate that the use of FPMs for modeling OS in NSCLC patients from early follow-up data can yield accurate estimates for RMST observed with longer follow-up and provide similar long-term extrapolations to externally validated SPMs based on later data cuts. B-MPES generated reasonable predictions even when fitted to the 2-y DBLs of the studies, whereas MCMs were more reliant on longer-term data to estimate a plateau and therefore performed better from 3 y. Generally, LRM extrapolations were less reliable than those from alternative FPMs and validated SPMs but remained superior to nonvalidated SPMs. Our work demonstrates the potential benefits of using advanced parametric models that incorporate external data sources, such as B-MPES and MCMs, to allow for accurate evaluation of treatment clinical and cost-effectiveness from trial data with limited follow-up. Flexible advanced parametric modeling methods can provide improved survival extrapolations for immuno-oncology cost-effectiveness in health technology assessments from early clinical trial data that better anticipate extended follow-up. Advantages include leveraging additional observable trial data, the systematic integration of external data, and more detailed modeling of underlying processes. Bayesian multiparameter evidence synthesis performed particularly well, with well-matched external data. Mixture cure models also performed well but may require relatively longer follow-up to identify an emergent plateau, depending on the specific setting. Landmark response models offered marginal benefits in this scenario and may require greater numbers in each response group and/or increased follow-up to support improved extrapolation within each subgroup