One dose of preoperative, intravenous, prophylactic antibiotics significantly lowers postoperative infection rate in septoplasty—a study of 772 operations

Publisher Copyright: © 2021 John Wiley & Sons LtdObjectives Postoperative infection is the most common complication after septoplasty. Pre- or postoperative prophylactic antibiotics are commonly used, although no official guidelines exist. Design We retrospectively collected data on postoperative infections from 772 septoplasties performed in 2015, 2016 and 2018, and classified the infections according to surgical site infection (SSI) criteria by the Centers for Disease Control and Prevention (CDC). We evaluated the infections according to antibiotic use (preoperative or postoperative, both, or none) and accounted for patient and surgical confounding factors. We compared the results with three previous studies from our department to find out the trend in the occurrence of postoperative infections and in the use of antibiotics. Results Twenty-nine cases (3.8%) fulfilled CDC infection criteria. Any kind of antibiotic prophylaxis reduced the risk of SSI (p = .018). One dose of intravenous cefuroxime before incision was the most effective preventive measure (p = .045). We found no significant effect of postoperative antibiotics. However, postoperative antibiotics lowered the infection rate to 1.8% compared to 6.1% among those not treated with any antibiotics. The only other factor reducing the risk of SSI was local anaesthesia compared with general anaesthesia. Conclusion Preoperative antibiotic prophylaxis effectively reduced postoperative infection rate after septoplasty.Peer reviewe

Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.Peer reviewe

Using Spatial Validity and Uncertainty Metrics to Determine the Relative Suitability of Alternative Suites of Oceanographic Data for Seabed Biotope Prediction. A Case Study from the Barents Sea, Norway

The use of habitat distribution models (HDMs) has become common in benthic habitat mapping for combining limited seabed observations with full-coverage environmental data to produce classified maps showing predicted habitat distribution for an entire study area. However, relatively few HDMs include oceanographic predictors, or present spatial validity or uncertainty analyses to support the classified predictions. Without reference studies it can be challenging to assess which type of oceanographic model data should be used, or developed, for this purpose. In this study, we compare biotope maps built using predictor variable suites from three different oceanographic models with differing levels of detail on near-bottom conditions. These results are compared with a baseline model without oceanographic predictors. We use associated spatial validity and uncertainty analyses to assess which oceanographic data may be best suited to biotope mapping. Our results show how spatial validity and uncertainty metrics capture differences between HDM outputs which are otherwise not apparent from standard non-spatial accuracy assessments or the classified maps themselves. We conclude that biotope HDMs incorporating high-resolution, preferably bottom-optimised, oceanography data can best minimise spatial uncertainty and maximise spatial validity. Furthermore, our results suggest that incorporating coarser oceanographic data may lead to more uncertainty than omitting such data.publishedVersio

Distinct modes of meltwater drainage and landform development beneath the last Barents Sea ice sheet

The flow of glacial ice is impacted by basal meltwater drainage systems that fluctuate on a continuum from distributed, high-pressure environments to channelized, lower pressure networks. Understanding the long-term development of dominant drainage modes and impacts on ice flow and landform development is a crucial step in predicting palaeo and contemporary ice-mass response to changes in climate. The spatial and temporal scales at which different drainage modes operate are largely unknown, and the geomorphological legacy of subglacial meltwater networks that evolve over a glaciation provide composite records of drainage system development. Here, we use high-resolution bathymetric data from shallow banks in the central Barents Sea to map the geomorphological imprint of meltwater drainage beneath the collapsing marine-based Barents Sea Ice Sheet (BSIS). We observe a succession of distinct meltwater landforms that provide relative timing constraints for subglacial drainage modes, indicating that extensive networks of channelized drainage were in operation during deglaciation. Interlinked basins and channels suggest that meltwater availability and drainage system development was influenced by filling and draining cycles in subglacial lakes. Networks of eskers also indicate near-margin meltwater conduits incised into basal ice during late-stage deglaciation, and we suggest that these systems were supplemented by increased inputs from supraglacial melting. The abundance of meltwater during the late stages of BSIS deglaciation likely contributed to elevated erosion of the sedimentary substrate and the mobilisation of subglacial sediments, providing a sediment source for the relatively abundant eskers found deposited across bank areas. A newly discovered beaded esker system over 67 km long in Hopendjupet constrains a fluctuating, but generally decelerating, pace of ice retreat from ∼1,600 m a−1 to ∼620 m a−1 over central Barents Sea bank areas during a 91-year timespan

Study circles improve the precision in nutritional care in special accommodations

Background: Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. By identifying residents at the risk of undernutrition, appropriate nutritional care can be provided. Objectives: Do study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high BMI? Design: Pre and post intervention study. Setting: Special accommodations (nursing homes) within six municipalities were involved. Participants: In 2005, 1726 (90.4%) out of 1910 residents agreed to participate and in 2007, 1526 (81.8%) out of 1866 residents participated. Intervention: Study circles in one municipality, having a policy document in one municipality and no intervention in four municipalities. Measurements: Risk of undernutrition was defined as involving any of: involuntary weight loss, low BMI, and/or eating difficulties. Overweight was defined as high BMI. Results: In 2005 and 2007, 64% of 1726 and 66% of 1526 residents respectively were at the risk of undernutrition. In 2007 significantly more patients in the study circle municipality were accurately provided protein and energy enriched food compared to in the no intervention municipalities. There was a decrease in the prevalence of low BMI in the study circle municipality and the prevalence of overweight increased in the policy document municipality between 2005 and 2007

Runx1 modulates adult hair follicle stem cell emergence and maintenance from distinct embryonic skin compartments

Runx1 controls timing of adult HSFC and short-term progenitor emergence in the embryonic epithelium and HFSC differentiation and long-term skin integrity in embryonic mesenchyme

High Temperature Triggers Latent Variation among Individuals: Oviposition Rate and Probability for Outbreaks

It is anticipated that extreme population events, such as extinctions and outbreaks, will become more frequent as a consequence of climate change. To evaluate the increased probability of such events, it is crucial to understand the mechanisms involved. Variation between individuals in their response to climatic factors is an important consideration, especially if microevolution is expected to change the composition of populations.Here we present data of a willow leaf beetle species, showing high variation among individuals in oviposition rate at a high temperature (20 °C). It is particularly noteworthy that not all individuals responded to changes in temperature; individuals laying few eggs at 20 °C continued to do so when transferred to 12 °C, whereas individuals that laid many eggs at 20 °C reduced their oviposition and laid the same number of eggs as the others when transferred to 12 °C. When transferred back to 20 °C most individuals reverted to their original oviposition rate. Thus, high variation among individuals was only observed at the higher temperature. Using a simple population model and based on regional climate change scenarios we show that the probability of outbreaks increases if there is a realistic increase in the number of warm summers. The probability of outbreaks also increased with increasing heritability of the ability to respond to increased temperature.If climate becomes warmer and there is latent variation among individuals in their temperature response, the probability for outbreaks may increase. However, the likelihood for microevolution to play a role may be low. This conclusion is based on the fact that it has been difficult to show that microevolution affect the probability for extinctions. Our results highlight the urge for cautiousness when predicting the future concerning probabilities for extreme population events

I have a dream… – En fokusgruppsstudie om ungdomars framtidsdrömmar

Syftet med uppsatsen är att undersöka och jämföra ungdomars framtidsdrömmar utifrån ett klass- och genusperspektiv. Frågeställningar: • Hur tänker och resonerar ungdomarna om sina framtidsdrömmar och sina valmöjligheter utifrån arbete, utbildning, familj och relationer? • Hur ser ungdomarna på sina möjligheter och hinder inför framtiden? • På vilka sätt samstämmer och/eller skiljer sig ungdomarnas framtidsbilder åt utifrån ett klass- och genusperspektiv? Vi har använt oss av en kvalitativ metod med semistrukturerade fokusgruppsintervjuer, utifrån en abduktiv ansats. Resultaten från de fyra fokusgrupperna som vi har genomfört har analyserats utifrån ett klass- och genusperspektiv. Analysen av resultaten har samtidigt genomsyrats av teorier om kulturell friställning och vårt senmoderna samhälle. Resultaten visar att ungdomarna i fokusgrupperna ser ljust på sin framtid och att viljan är det viktigaste redskapet för att förverkliga sina drömmar. De menar att det är viktigt att drömma om sin framtid men ger också en realistisk bild över sina framtidsscenarion. Då vi jämför grupper med olika socioekonomiska bakgrunder blir det tydligt att valmöjligheterna i livet ser olika ut för dessa ungdomar. Ur ett genusperspektiv visar resultatet främst på likheter mellan tjejernas och killarnas åsikter, tankar och framtidsdrömmar snarare än skillnader. En skillnad som dock framkommer handlar om deras syn på familjebildande