Influence of surgical resection no plasma Endoglin (CD105) level in non-small cell lung cancer patients

Background and Aim: Endoglin is a proliferation-associated antigen on endothelial cells and essential for angiogenesis. Soluble endoglin (s‑endoglin), formed by proteolytic cleavage of ectodomain of membrane receptor could be an indicator of tumor‑activated endothelium. The aim of present study was to analyze changes of s‑endoglin level in plasma of lung cancer patients following surgical resection and to estimate the correlation of s‑endoglin with other soluble receptors, sTie2 and sVEGF R1. Patients and Methods: The study group consisted of 37 patients with stage I of non-small cell lung cancer. Plasma concentrations of s‑endoglin, sTie2 and sVEGF R1 were evaluated by ELISA, three times: before surgical resection and on postoperative day 7 and 30. Results: The median of s‑endoglin concentration decreased significantly on postoperative day 7 when compared with preoperative level and next increased on 30th day and it was comparable with that before surgery. s-Endoglin correlated with another soluble receptors, with sTie2 both before surgery (r=0.44) and on postoperative day 7 (r=0.52) and on 30th day (r=0.58), with sVEGF R1 — only on postoperative day 7 (r=0.75). Conclusion: The increased level of serum endoglin in lung cancer patients compared to controls and its changes after surgical treatment suggest potential application of soluble form of endoglin as potential tumor marker

Traditional Eastern European diet and mortality: prospective evidence from the HAPIEE study

PURPOSE: Cardiovascular disease (CVD) and cancer mortality rates in Eastern Europe are among the highest in the world. Although diet is an important risk factor, traditional eating habits in this region have not yet been explored. This analysis assessed the relationship between traditional dietary pattern and mortality from all-causes, CVD and cancer in Eastern European cohorts. METHODS: Data from the Health, Alcohol and Psychosocial factors in Eastern Europe prospective cohort were used, including participants from Russia, Poland and the Czech Republic. Based on food frequency questionnaire data, we constructed an Eastern European diet score (EEDS) from nine food groups which can be considered as traditional in this region. The relationship between categorical (low, moderate, high) and continuous (range 0-18) EEDS and mortality was estimated with Cox-regression. RESULTS: From 18,852 eligible participants, 2234 died during follow-up. In multivariable adjusted models, participants with high adherence to the traditional Eastern European diet had significantly higher risk of all-cause (HR 1.23; 95% CI 1.08-1.42) and CVD (1.34; 1.08-1.66) deaths compared to those with low adherence. The association with cancer mortality was only significant in Poland (high vs. low EEDS: 1.41; 1.00-1.98). From the specific EEDS components, high consumption of lard was significantly positively related to all three mortality outcomes, while preserved fruit and vegetable consumption showed consistent inverse associations. CONCLUSION: Our results suggest that traditional eating habits may contribute to the poor health status, particularly the high CVD mortality rates, of populations in Eastern Europe. Adequate public health nutritional interventions in this region are essential

Carbon sources of Antarctic nematodes as revealed by natural carbon isotope ratios and a pulse-chase experiment

δ13C of nematode communities in 27 sites was analyzed, spanning a large depth range (from 130 to 2,021 m) in five Antarctic regions, and compared to isotopic signatures of sediment organic matter. Sediment organic matter δ13C ranged from −24.4 to −21.9‰ without significant differences between regions, substrate types or depths. Nematode δ13C showed a larger range, from −34.6 to −19.3‰, and was more depleted than sediment organic matter typically by 1‰ and by up to 3‰ in silty substrata. These, and the isotopically heavy meiofauna at some stations, suggest substantial selectivity of some meiofauna for specific components of the sedimenting plankton. However, 13C-depletion in lipids and a potential contribution of chemoautotrophic carbon in the diet of the abundant genus Sabatieria may confound this interpretation. Carbon sources for Antarctic nematodes were also explored by means of an experiment in which the fate of a fresh pulse of labile carbon to the benthos was followed. This organic carbon was remineralized at a rate (11–20 mg C m−2 day−1) comparable to mineralization rates in continental slope sediments. There was no lag between sedimentation and mineralization; uptake by nematodes, however, did show such a lag. Nematodes contributed negligibly to benthic carbon mineralization

Effects of increased salinity on the diatom assemblage in Fonda Lake, Michigan

A salt storage facility has been located adjacent to Fonda Lake since 1953. In February 1981 a core was taken from the profundal sediments of the lake and analyzed to determine the effects of salt perturbation on the diatom community over a 32-year period. Diatom assemblages from different levels were compared using multivariate techniques including cluster analysis and principal component analysis. Shifts in diatom composition related to salinification were revealed most clearly by subdominant taxa. Five distinct groups of diatom taxa were found to correspond with 5 depth intervals. The diatom component of the lake up to 1960 included two groups of taxa which were alkaliphilous and chloride indifferent. A reduction in species diversity beginning in 1960 may indicate a salt effect. By 1968, when diversity reached a minimum, a variety of halophilic taxa (including Diatoma tenue, Navicula gregaria and Synedra fasciculata ) attained their highest relative abundances. At the top of the core, diversity increased slightly and some halophilic taxa decreased in relative abundance, which suggests a possible decrease in salt loading to the lake.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42866/1/10750_2004_Article_BF00011577.pd

Multivariate statistical analysis of net diatom species distributions in the Southwestern Atlantic and Indian Ocean

Vertical net haul diatom assemblages from near South Georgia, and from between Africa and Antarctica, were examined and compared. Variation among South Georgia stations was examined by principal component, cluster and canonical discriminant analyses. Diatom distributions provide evidence for at least two distinct water masses. The region north of the island is characterized by neritic, temperate diatoms and by an assemblage with low species diversity. The region south of the island is characterized by oceanic, antarctic species and relatively high species diversity. The regions are most distinct to the west of the island, intergrading east of the island. Within the north-south division, five station groupings were detected on the basis of distribution of dominant net diatoms. By comparing classical species ecological categorizations to results of principal component analysis, a “neritic-oceanic” factor was identified from net diatom distributions. This factor was common to both areas in spite of the fact that Biscoe and Agulhas collections were from different seasons.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46982/1/300_2004_Article_BF00446041.pd

Sepsis prevalence and outcome on the general wards and emergency departments in Wales: Results of a multi-centre, observational, point prevalence study

Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis). There were 5317 in-patients in the 24-hour study period. Data were returned on 1198 digital data collection forms on patients with NEWS≥3 of which 87 were removed, leaving 1111 for analysis. 146 patients had sepsis and 144 patients had severe sepsis. Combined prevalence of sepsis and severe sepsis was 5.5% amongst all in-patients. Patients with sepsis had significantly higher NEWS scores (3 IQR 3–4 for non-sepsis and 4 IQR 3–6 for sepsis patients, respectively). Common organ dysfunctions in severe sepsis were hypoxia (47%), hypoperfusion (40%) and acute kidney injury (25%). Mortality at 90 days was 31% with a median (IQR) hospital free stay of 78 (36–85) days. Screening for sepsis, referral to Critical Care and completion of Sepsis 6 bundle was low: 26%, 16% and 12% in the sepsis group. Multivariable logistic regression analysis identified higher National Early Warning Score, diabetes, COPD, heart failure, malignancy and current or previous smoking habits as independent variables suggesting the diagnosis of sepsis. We observed that sepsis is more prevalent in the general ward and ED than previously suggested before and that screening and effective treatment for sepsis and severe sepsis is far from being operationalized in this environment, leading to high 90 days mortality

Four consecutive yearly point-prevalence studies in Wales indicate lack of improvement in sepsis care on the wards

The ‘Sepsis Six’ bundle was promoted as a deliverable tool outside of the critical care settings, but there is very little data available on the progress and change of sepsis care outside the critical care environment in the UK. Our aim was to compare the yearly prevalence, outcome and the Sepsis Six bundle compliance in patients at risk of mortality from sepsis in non-intensive care environments. Patients with a National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled into four yearly 24-h point prevalence studies, carried out in fourteen hospitals across Wales from 2016 to 2019. We followed up patients to 30 days between 2016–2019 and to 90 days between 2017 and 2019. Out of the 26,947 patients screened 1651 fulfilled inclusion criteria and were recruited. The full ‘Sepsis Six’ care bundle was completed on 223 (14.0%) occasions, with no significant difference between the years. On 190 (11.5%) occasions none of the bundle elements were completed. There was no significant correlation between bundle element compliance, NEWS or year of study. One hundred and seventy (10.7%) patients were seen by critical care outreach; the ‘Sepsis Six’ bundle was completed significantly more often in this group (54/170, 32.0%) than for patients who were not reviewed by critical care outreach (168/1385, 11.6%; p < 0.0001). Overall survival to 30 days was 81.7% (1349/1651), with a mean survival time of 26.5 days (95% CI 26.1–26.9) with no difference between each year of study. 90-day survival for years 2017–2019 was 74.7% (949/1271), with no difference between the years. In multivariate regression we identified older age, heart failure, recent chemotherapy, higher frailty score and do not attempt cardiopulmonary resuscitation orders as significantly associated with increased 30-day mortality. Our data suggests that despite efforts to increase sepsis awareness within the NHS, there is poor compliance with the sepsis care bundles and no change in the high mortality over the study period. Further research is needed to determine which time-sensitive ward-based interventions can reduce mortality in patients with sepsis and how can these results be embedded to routine clinical practice

The importance of Antarctic krill in biogeochemical cycles

Antarctic krill (Euphausia superba) are swarming, oceanic crustaceans, up to two inches long, and best known as prey for whales and penguins – but they have another important role. With their large size, high biomass and daily vertical migrations they transport and transform essential nutrients, stimulate primary productivity and influence the carbon sink. Antarctic krill are also fished by the Southern Ocean’s largest fishery. Yet how krill fishing impacts nutrient fertilisation and the carbon sink in the Southern Ocean is poorly understood. Our synthesis shows fishery management should consider the influential biogeochemical role of both adult and larval Antarctic krill

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability