Are Albumin levels a good predictor of mortality in elderly patients with neck of femur fractures?

Neck of femur fractures are associated with significant morbidity and mortality. The National Hip Fracture database in England suggest an 8.2% 30 day mortality. Suggested mortality predictors include: The Nottingham Hip Score, POSSUM score, Lactate, End Tidal CO2, Total Lymphocyte Count and Albumin. Predictors of short-term mortality may be a useful healthcare tool in these patients. Hypoalbuminaemia is determined as a level less than 35g/dl. No classification for degree of hypoalbuminaemia exists. It’s clinical significance are associated with liver/renal failure, chronic illness and poor nutritional states. We wanted to assess whether there is an association between hypoalbuminaemia and patient survival, if the severity affected outcomes and whether highlighting those patients with hypoalbuminaemia would be a useful prognostic tool

Clear-sky biases in satellite infrared estimates of upper tropospheric humidity and its trends

We use microwave retrievals of upper tropospheric humidity (UTH) to estimate the impact of clear-sky-only sampling by infrared instruments on the distribution, variability and trends in UTH. Our method isolates the impact of the clear-sky-only sampling, without convolving errors from other sources. On daily time scales IR-sampled UTH contains large data gaps in convectively active areas, with only about 20-30 % of the tropics (30 S­ 30 N) being sampled. This results in a dry bias of about -9 %RH in the area-weighted tropical daily UTH time series. On monthly scales, maximum clear-sky bias (CSB) is up to -30 %RH over convectively active areas. The magnitude of CSB shows significant correlations with UTH itself (-0.5) and also with the variability in UTH (-0.6). We also show that IR-sampled UTH time series have higher interannual variability and smaller trends compared to microwave sampling. We argue that a significant part of the smaller trend results from the contrasting influence of diurnal drift in the satellite measurements on the wet and dry regions of the tropics

MRTF specifies a muscle-like contractile module in Porifera

Muscle-based movement is a hallmark of animal biology, but the evolutionary origins of myocytes are unknown. Although believed to lack muscles, sponges (Porifera) are capable of coordinated whole-body contractions that purge debris from internal water canals. This behavior has been observed for decades, but their contractile tissues remain uncharacterized with respect to their ultrastructure, regulation, and development. We examine the sponge Ephydatia muelleri and find tissue-wide organization of a contractile module composed of actin, striated-muscle myosin II, and transgelin, and that contractions are regulated by the release of internal Ca2+ stores upstream of the myosin-light-chain-kinase (MLCK) pathway. The development of this contractile module appears to involve myocardin-related transcription factor (MRTF) as part of an environmentally inducible transcriptional complex that also functions in muscle development, plasticity, and regeneration. As an actin-regulated force-sensor, MRTF-activity offers a mechanism for how the contractile tissues that line water canals can dynamically remodel in response to flow and can re-form normally from stem-cells in the absence of the intrinsic spatial cues typical of animal embryogenesis. We conclude that the contractile module of sponge tissues shares elements of homology with contractile tissues in other animals, including muscles, indicating descent from a common, multifunctional tissue in the animal stem-lineage.publishedVersio

A pragmatic multi-centre randomised controlled trial of fluid loading and level of dependency in high-risk surgical patients undergoing major elective surgery : trial protocol

Peer reviewedPublisher PD

Large deformations in oriented polymer glasses: experimental study and a new glass-melt constitutive model

An experimental study was made of the effects of prior molecular orientation on large tensile deformations of polystyrene in the glassy state. A new hybrid glass-melt constitutive model is proposed for describing and understanding the results, achieved by parallel coupling of the ROLIEPOLY molecularly-based melt model with a model previously proposed for polymer glasses. Monodisperse and polydisperse grades of polystyrene are considered. Comparisons between experimental results and simulations illustrate that the model captures characteristic features of both the melt and glassy states. Polystyrene was stretched in the melt state and quenched to below Tg, and then tensile tested parallel to the orientation direction near the glass transition. The degree of strain-hardening was observed to increase with increasing prior stretch of molecules within their entanglement tubes, as predicted by the constitutive model. This was explored for varying temperature of stretching, degree of stretching, and dwell time before quenching. The model in its current form, however, lacks awareness of processes of subentanglement chain orientation. Therefore, it under-predicts the orientation-direction strain hardening and yield stress increase, when stretching occurs at the lowest temperatures and shortest times, where it is dominated by subentanglement orientation

Long-Distance Migrations by Inconnu (Stenodus leucichthys) in the Mackenzie River Syste

Inconnu (Stenodus leucichthys) stocks of the Mackenzie River drainage exhibit complex life histories. In a single stock, some fish may make occasional or regular movements between freshwater and marine environments while others lead a completely freshwater existence. Many inconnu migrate between the Mackenzie River system and the Beaufort Sea, but during spawning migrations, most are believed to move only as far south as the Rampart Rapids near the community of Fort Good Hope. However, an inconnu tagged in the Liard River in northern British Columbia in 2001 was recaptured near Inuvik (Northwest Territories) in 2002, and a second inconnu tagged in the Liard River in 2002 was recaptured near Tuktoyaktuk (Northwest Territories) in 2003. These two fish exhibited some of the longest freshwater migrations by a species from Canadian waters other than Pacific salmon. Otolith strontium distributions of these two fish confirmed migrations of close to 1800 km between fresh and marine waters and indicated different life histories. Additional inconnu tagged in the Liard River in 2002 were recaptured in or near Great Slave Lake in 2002 and 2003. The movements of all these fish suggest that the management of inconnu stocks will be far more complicated than previously thought: they point out the need for management plans and protection that incorporate large geographic areas.Les stocks d’inconnu (Stenodus leucichthys) du bassin du Mackenzie affichent des cycles biologiques complexes. On trouve, au sein d’un seul stock, des poissons qui feront des allers retours sur une base épisodique ou régulière, entre un milieu d’eau douce et un milieu marin, tandis que d’autres passeront toute leur vie en eau douce. Un grand nombre d’inconnus migrent entre le réseau hydrographique du Mackenzie et la mer de Beaufort, mais on pense que, durant les migrations de frai, la plupart ne se déplacent en direction du sud que jusqu’aux rapides Rampart, près de la communauté de Fort Good Hope. Un inconnu marqué dans la rivière Liard dans le nord de la Colombie-Britannique en 2001 a cependant été recapturé près d’Inuvik (Territoires du Nord-Ouest) en 2002, et un deuxième inconnu marqué dans la Liard en 2002 a été recapturé près de Tuktoyaktuk (Territoires du Nord-Ouest) en 2003. Les migrations de ces deux spécimens comptent parmi les plus longues en eau douce effectuées par une espèce provenant des eaux canadiennes, autre que le saumon du Pacifique. La distribution du strontium otolithique de ces deux poissons a confirmé des migrations de près de 1800 km entre l’eau douce et l’eau de mer et a révélé des cycles biologiques différents. D’autres inconnus marqués dans la Liard en 2002 ont été recapturés en 2002 et 2003 dans le Grand lac des Esclaves ou à proximité. Les déplacements de tous ces poissons suggèrent que la gestion des stocks d’inconnu sera beaucoup plus compliquée que prévu: ils font ressortir le besoin d’élaborer des plans de gestion et une protection qui tiennent compte de vastes aires géographiques

Effects of breaking up sedentary time with "chair squats" on postprandial metabolism

Prolonged sitting induces adverse metabolic changes. We aimed to determine whether breaking up prolonged sedentary time with short periods of repeated sit-to-stand transitions (“chair squats”) every 20 minutes influences postprandial metabolic responses. Fourteen participants (11 men, 3 women), age 37 ± 16 years, BMI 30.5 ± 3.8 kg.m−2 (mean ± SD) each participated in two experimental trials in random order, in which they arrived fasted, then consumed a test breakfast (8 kcal.kg−1 body weight, 37% energy from fat, 49% carbohydrates, 14% protein) and, 3.5 hours later, an identical test lunch. Expired air and blood samples were taken fasted and for 6.5 hours postprandially. In one trial (SIT) participants sat continuously throughout the observation period; in the “Chair squat” trial (SIT/STAND), participants performed “chair squats” (10 × standing and sitting over 30 seconds, every 20 minutes). Compared to SIT, energy expenditure was 409.7 ± 41.6 kJ (16.6 ± 1.7%) higher in SIT/STAND (p < 0.0001). Postprandial insulin concentrations over the post-breakfast period were 10.9 ± 8.4% lower in SIT/STAND than SIT (p = 0.047), but did not differ between trials in the post-lunch period. Glucose and triglyceride concentrations did not differ significantly between trials. These data demonstrate that a simple, unobtrusive intervention to break up sedentary time can induce some favourable metabolic changes

Novel micelle PCR-based method for accurate, sensitive and quantitative microbiota profiling

In the last decade, many researchers have embraced 16S rRNA gene sequencing techniques, which has led to a wealth of publications and documented differences in the composition of microbial communities derived from many different ecosystems. However, comparison between different microbiota studies is currently very difficult due to the lack of a standardized 16S rRNA gene sequencing protocol. Here we report on a novel approach employing micelle PCR (micPCR) in combination with an internal calibrator that allows for standardization of microbiota profiles via their absolute abundances. The addition of an internal calibrator allows the researcher to express the resulting operational taxonomic units (OTUs) as a measure of 16S rRNA gene copies by correcting the number of sequences of each individual OTU in a sample for efficiency differences in the NGS process. Additionally, accurate quantification of OTUs obtained from negative extraction control samples allows for the subtraction of contaminating bacterial DNA derived from the laboratory environment or chemicals/reagents used. Using equimolar synthetic microbial community samples and low biomass clinical samples, we demonstrate that the calibrated micPCR/NGS methodology possess a much higher precision and a lower limit of detection compared with traditional PCR/NGS, resulting in more accurate microbiota profiles suitable for multi-study comparison

Micelle PCR reduces chimera formation in 16S rRNA profiling of complex microbial DNA mixtures

16S rRNA gene profiling has revolutionized the field of microbial ecology. Many researchers in various fields have embraced this technology to investigate bacterial compositions of samples derived from many different ecosystems. However, it is important to acknowledge the current limitations and drawbacks of 16S rRNA gene profiling. Although sample handling, DNA extraction methods and the choice of universal 16S rRNA gene PCR primers are well known factors that could seriously affect the final results of microbiota profiling studies, inevitable amplification artifacts, such as chimera formation and PCR competition, are seldom appreciated. Here we report on a novel micelle based amplification strategy, which overcomes these limitations via the clonal amplification of targeted DNA molecules. Our results show that micelle PCR drastically reduces chimera formation by a factor of 38 (1.5% vs. 56.9%) compared with traditional PCR, resulting in improved microbial diversity estimates. In addition, compartmentalization during micelle PCR prevents PCR competition due to unequal amplification rates of different 16S template molecules, generating robust and accurate 16S microbiota profiles required for comparative studies (e.g. longitudinal surveys)